Healthcare最新文献

{"title":"Governing Generative AI in Healthcare: A Normative Conceptual Framework for Epistemic Authority, Trust, and the Architecture of Responsibility.","authors":"Fatma Eren Akgün, Metin Akgün","doi":"10.3390/healthcare14081098","DOIUrl":"10.3390/healthcare14081098","url":null,"abstract":"<p><strong>Background/objectives: </strong>Large language models (LLMs) such as ChatGPT are rapidly being integrated into healthcare for tasks ranging from clinical documentation to diagnostic support. Current ethical discussions focus predominantly on bias, privacy, and accuracy, leaving three critical governance questions unresolved: What kind of knowledge does an LLM output represent in clinical reasoning? When is a clinician's or patient's trust in that output justified? Who bears responsibility when an AI-informed decision leads to patient harm? This study proposes the Epistemic Authority-Trust-Responsibility (ETR) Architecture, a normative conceptual framework that addresses these three questions as an integrated governance challenge.</p><p><strong>Methods: </strong>The framework was developed through normative conceptual analysis-a method that constructs governance proposals by synthesising philosophical principles, ethical theories, and empirical evidence. The literature was identified through structured searches of PubMed, PhilPapers, and EUR-Lex (January 2020-March 2026), drawing on the philosophy of medical knowledge, the ethics of trust and testimony, and the moral philosophy of responsibility.</p><p><strong>Results: </strong>The ETR Architecture produces four outputs: (i) a four-tier classification system that distinguishes LLM outputs-from administrative drafts to clinical evidence claims-and matches each tier to appropriate verification requirements; (ii) the concept of the 'epistemic placebo', formally defined as a governance measure that creates a documented appearance of compliance while lacking at least one operative element of genuine oversight; (iii) a model specifying four conditions under which trust in healthcare AI is justified; (iv) four testable hypotheses with associated research designs connecting governance design to trust calibration and patient safety.</p><p><strong>Conclusions: </strong>The 2025-2027 regulatory transition period offers a critical window for shaping how healthcare institutions govern AI. We argue that deploying LLMs without explicitly classifying their outputs and building appropriate oversight risks allows governance norms to be set by technology vendors rather than by evidence-informed, patient-centred policy.</p>","PeriodicalId":12977,"journal":{"name":"Healthcare","volume":"14 8","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13115902/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147814255","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Medical Practitioners' Acceptance and Use of AI-Based Clinical Decision Support Systems in Western China: A Mixed-Methods Study.","authors":"Runping Zhu, Zunbin Huo, Yue Li, Banlinxin Gao, Richard Krever","doi":"10.3390/healthcare14081096","DOIUrl":"10.3390/healthcare14081096","url":null,"abstract":"<p><p><b>Background</b>: Doctors have made increasing use of artificial intelligence-based clinical decision support systems in recent years in eastern China, but far less so in poorer western China, where hospitals with less access to specialized expert services might be expected to make greater use of such aids. <b>Methods</b>: This study of the reasons for lower uptake in the western hospitals focused on a tertiary referral hospital in the capital city of the poorest province in China. Drawing on UTAUT (unified theory of acceptance and use of technology) theoretical literature and previous studies, seven variables most likely to explain the limited adoption of the technology were identified and tested by means of an explanatory sequential mixed-methods study. <b>Results</b>: Initial bivariate tests revealed no significant differences across variables; however, multivariate logistic regression identified social influence as the sole statistically significant predictor of adoption willingness. Follow-up structured interviews revealed a surprisingly low awareness of the technology by medical personnel, with very limited deployment. <b>Conclusions</b>: The failure to adopt AI diagnosis technology is attributable not to the variables usually cited as factors inhibiting technology adoption but rather the failure of hospital and medical faculty administrators to acquire the technology and train doctors and medical students.</p>","PeriodicalId":12977,"journal":{"name":"Healthcare","volume":"14 8","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13115567/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147814445","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Structural Embedding of Oral Health Within Pooled Universal Coverage Mechanisms: Where Are We in 2026?","authors":"Carol Moussa, Marion Mégly, Jeremy Glomet, Maha H Daou, Céline Clement, Frédéric Denis","doi":"10.3390/healthcare14081104","DOIUrl":"10.3390/healthcare14081104","url":null,"abstract":"<p><p>Oral diseases affect an estimated 3.5 billion people globally and remain among the most prevalent noncommunicable conditions. Despite recent global policy commitments under the WHO Global Oral Health Strategy and Action Plan (2023-2030), substantial variation persists in how countries structurally embed oral health within national health systems. A structural classification of all 194 WHO Member States was conducted using WHO 2022 oral health country profiles and official policy documentation. Countries were categorized according to financing architecture and entitlement design into four integration models: Structural UHC Integration, Partial or Targeted Integration, Predominantly Private or Insurance-Driven Systems, and Minimal or Emerging Integration. Regional and global distributions were calculated using RStudio (version 2025.09.0, Posit Software, PBC, Boston, MA, USA). Globally, Partial or Targeted Integration represents the most common configuration (44%), followed by Predominantly Private systems (17%) and Minimal or Emerging Integration (15%), while Structural UHC Integration accounts for approximately 10% of countries. Marked regional heterogeneity was observed, with Structural UHC Integration concentrated in selected regions and Minimal or Emerging models more prevalent in parts of Africa and South-East Asia. Findings suggest that integration is primarily determined by financing architecture and legally defined entitlements rather than national income level alone. Structural embedding of oral health within pooled universal coverage mechanisms appears to be an important structural feature associated with higher levels of integration.</p>","PeriodicalId":12977,"journal":{"name":"Healthcare","volume":"14 8","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13115761/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147814461","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Integrative Review of Family Health Nursing Support for Single-Parent Families: Evidence Gaps and Implications for a Relational Empowerment Model.","authors":"Elisabete da Luz","doi":"10.3390/healthcare14081088","DOIUrl":"10.3390/healthcare14081088","url":null,"abstract":"<p><p><b>Background/Objectives:</b> Single-parent families represent a growing and particularly vulnerable family structure within community and primary health care contexts. These families often experience cumulative burdens related to caregiving overload, socioeconomic constraints, social isolation, and fragmented support networks, which directly affect health and well-being. This integrative review aimed to synthesize and critically analyse direct and conceptually transferable evidence relevant to Family Health Nursing interventions supporting single-parent families in community and primary health care contexts, identify existing knowledge gaps, and inform the development of a relational empowerment model. <b>Methods:</b> An integrative literature review was conducted following PRISMA 2020 guidelines. A comprehensive search was performed across three electronic databases (PubMed, CINAHL, and Scopus) covering publications from 2020 to 2025. Inclusion criteria comprised peer-reviewed empirical studies and reviews addressing nursing or health interventions relevant to single-parent families in community or primary health care contexts. Data were extracted and synthesized thematically, with attention to theoretical frameworks, intervention characteristics, and reported outcomes. <b>Results:</b> Twenty-nine studies met the inclusion criteria. The synthesis revealed four main thematic domains: (1) caregiving burden and psychosocial vulnerability, (2) access to and coordination of community-based resources, (3) nurse-family relational processes, and (4) empowerment-oriented nursing interventions. Theoretical underpinnings frequently included family systems perspectives, the Calgary Family Assessment and Intervention Models, and empowerment-oriented frameworks. <b>Conclusions:</b> Nursing interventions for single-parent families in community health settings should prioritise relational empowerment approaches that acknowledge family diversity, contextual vulnerability, and dynamic caregiving demands. The proposed relational empowerment model offers a practice-informed framework to guide Family Health Nursing interventions, education, and policy development, supporting more responsive and equitable care for single-parent families.</p>","PeriodicalId":12977,"journal":{"name":"Healthcare","volume":"14 8","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13116908/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147814505","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sexual Torture in Palestinian Male Detainees: Epidemiology, Impacts and Outcomes.","authors":"Mahmud Sehwail, Khader Rasras, Wisam Sehwail, Pau Pérez-Sales, Andrea Galan-Santamarina, Raluca Cosmina Budian","doi":"10.3390/healthcare14081105","DOIUrl":"10.3390/healthcare14081105","url":null,"abstract":"<p><p><b>Background</b>: Torture, as a fundamental violation of human rights, is unequivocally condemned by all international organizations. Sexual torture is one of the most severe forms of torture, encompassing forced nudity, various forms of humiliation, and physical abuse, including rape. Despite testimonial evidence indicating the incidental use of sexual torture by Israeli authorities, there is a lack of epidemiological research providing a comprehensive understanding of this issue. This study aims to analyze the prevalence and characteristics of ill treatment and sexual torture among Palestinian male detainees and the subsequent impacts. <b>Methods</b>: This cross-sectional study analyzed a database of 517 former male detainees. The interview protocol included items related to psychological and physical methods of sexual torture, medical impacts, subjective psychological impacts, clinical medical and psychological measures, and psychosocial and community impacts. <b>Results</b>: The findings indicate that the majority of detainees experienced some form of sexual torture, with humiliation being the most common type. The impact of sexual torture are severe, affecting both clinical and social domains. The impacts of sexual torture persist over time and, in some cases, worsen, particularly regarding physical health outcomes. Socially, the consequences extend to the detainees' families and communities. <b>Conclusions</b>: The prevalence of such torture tactics calls for urgent responses from both the authorities and civil society. These findings highlight the need for proactive measures to address and mitigate the impacts of sexual torture, including independent investigations, robust monitoring, secure reporting mechanisms, the prosecution of perpetrators and comprehensive reparation for victims.</p>","PeriodicalId":12977,"journal":{"name":"Healthcare","volume":"14 8","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13116704/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147814453","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of Foot Health and Toe Strength in Older Adults Undergoing Heart Valve Surgery: A Pilot Study.","authors":"Hiromi Moriwaki, Mihoko Ishizawa","doi":"10.3390/healthcare14081090","DOIUrl":"10.3390/healthcare14081090","url":null,"abstract":"<p><p><b>Objectives</b>: We aimed to explore foot condition and toe strength in older adults undergoing heart valve surgery. <b>Materials and Methods</b>: This exploratory pilot study included nine older adults undergoing heart valve surgery. Subjective data on foot-related symptoms, self-care status, nail care, footwear, exercise habits, and fall history were collected. Preoperative foot and nail conditions were assessed using observation and photography. Toe strength was measured preoperatively in all participants and postoperatively in a subset of participants when feasible. Descriptive analyses were primarily conducted, with exploratory group comparisons. <b>Results</b>: Participants frequently reported foot-related symptoms and difficulties with foot self-care prior to hospitalization. Lower toe strength appeared to be related to greater difficulties in foot self-care, whereas higher toe strength was more commonly observed in those reporting regular exercise habits. Postoperative toe strength was reassessed in six participants. In a participant with prolonged intensive care unit (ICU) stay, delayed recovery of toe strength was observed. <b>Conclusions</b>: These preliminary findings suggest that foot condition and toe strength may be relevant to physical function and fall prevention-related factors in older a dults undergoing cardiac surgery. Reduced toe strength may be related to self-care difficulties, and prolonged ICU stay may influence the recovery of toe strength. However, due to the small sample size, these findings should be interpreted as exploratory and hypothesis-generating.</p>","PeriodicalId":12977,"journal":{"name":"Healthcare","volume":"14 8","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13116255/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147814356","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Threaded Antibiotic-Coated Locking Nails in Osteomyelitis-Associated Long-Bone Non-Union: Short-Term Outcomes of a Prospective Cohort.","authors":"Akef Obeidat, Abdal Ahmad, Akhtar Hussain, Saeed Ahmad, Hidayat Ullah, Mahmood Ul Hassan, Muhammad Abrar, Sadia Qazi","doi":"10.3390/healthcare14081091","DOIUrl":"10.3390/healthcare14081091","url":null,"abstract":"<p><p><b>Background</b>: Long-bone non-unions complicated by osteomyelitis remain a major reconstructive and healthcare challenge, particularly in resource-limited settings with a high prevalence of multidrug-resistant (MDR) pathogens. Conventional staged management is associated with a prolonged treatment burden, repeated procedures, and delayed functional recovery. This study evaluated the clinical, radiological, functional, and short-term safety outcomes of a single-stage approach using custom-threaded antibiotic-coated locking nails (TACLNs) in a high-resistance cohort. <b>Methods</b>: This prospective single-center cohort study enrolled 30 adults with osteomyelitis-associated femoral or tibial nonunion at a tertiary hospital in Peshawar, Pakistan. All patients underwent radical debridement and single-stage stabilization with a chest tube mold TACLN loaded with vancomycin and gentamicin, with culture-directed adjunctive antibiotics for resistant organisms. Outcomes were assessed at baseline, Weeks 3 and 6, and Month 6 using inflammatory markers, RUST score, VAS pain, EQ-5D-5L, ASAMI criteria, and return to work or usual activity. No formal sample size calculation was performed, and this study was exploratory in nature. <b>Results</b>: The cohort (mean age 44.9 ± 9.9 years) had a challenging microbiological profile, with 40.0% MDR and 13.3% extensively drug-resistant (XDR) infections. By Month 6, short-term infection control was achieved in 96.7% of patients, with significant reductions in ESR and CRP (both <i>p</i> < 0.001). Radiographic union was achieved in 90.0% of cases at a mean of 18.6 weeks, and the mean RUST score improved from 4.87 to 10.43 at the final follow-up. The VAS pain decreased from 5.23 at week 3 to 0.73 at month 6, EQ-5D-5L improved from 0.39 to 0.84, and 90.0% returned to work or usual activity by month 6. No cement debonding, implant failure, or nephrotoxicity was noted. <b>Conclusions</b>: In this single-arm exploratory cohort, TACLNs were associated with favorable short-term infection control, radiographic union, and functional recovery in osteomyelitis-associated long-bone nonunion, including in an MDR/XDR setting. The independent contribution of the threaded core design cannot be established. Larger multicenter comparative studies with longer follow-ups are needed to confirm the durability and implementation feasibility.</p>","PeriodicalId":12977,"journal":{"name":"Healthcare","volume":"14 8","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13115833/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147814435","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Research on Threshold Optimization and Variability-Based Digital Biomarker Approaches Through MMSE-Lifelog Multimodal Integrated Analysis from a Clinical Screening Perspective.","authors":"Yeeun Park, Jin-Hyoung Jeong","doi":"10.3390/healthcare14081094","DOIUrl":"10.3390/healthcare14081094","url":null,"abstract":"<p><p><b>Background</b>: Early screening of cognitive impairment is essential for timely clinical intervention; however, conventional cognitive tests such as the Mini-Mental State Examination (MMSE) rely on fixed thresholds that may not be optimal in real-world screening settings. <b>Methods</b>: This study developed a threshold-aware multimodal screening framework integrating MMSE item-level scores with wearable-derived sleep and physical activity lifelog data. A dataset of 174 adults was analyzed and categorized into cognitively normal (CN), mild cognitive impairment (MCI), and dementia, with MCI and dementia combined as an impaired group. A CatBoost-based binary classification model was trained using five-fold cross-validation. The optimal decision threshold was determined by maximizing balanced accuracy using out-of-fold predictions. <b>Results</b>: The optimized threshold (0.49) achieved an accuracy of 0.818 and a balanced accuracy of 0.728 on the validation set. The recall values were 0.885 for CN and 0.571 for the impaired group, with an area under the ROC curve of 0.676. Feature importance and stability analyses showed that variability-related sleep and activity features were consistently selected across folds. <b>Conclusions</b>: These findings suggest that threshold optimization combined with multimodal lifelog integration may improve the interpretability of screening decisions. Variability-based lifelog features may provide complementary information alongside MMSE, although their role remains exploratory and requires further validation in larger and longitudinal cohorts.</p>","PeriodicalId":12977,"journal":{"name":"Healthcare","volume":"14 8","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13116629/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147814450","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of CytoSorb Hemoadsorption Therapy on Cost-Effectiveness and Length of Stay in Critical Care Patients: A Preliminary Study from a Swiss High-Volume Center.","authors":"Tobias Hübner, Oliver Schöffski","doi":"10.3390/healthcare14081103","DOIUrl":"10.3390/healthcare14081103","url":null,"abstract":"<p><p><b>Background:</b> Sepsis remains a major global health challenge, associated with high mortality, prolonged intensive care unit (ICU) stays, and disproportionate healthcare costs. CytoSorb hemoadsorption offers a potential adjunct in septic shock, but real-world cost-effectiveness data in Diagnosis-Related Group (DRG)-based systems are limited. This study aimed to evaluate the clinical and economic impact of CytoSorb therapy in ICU patients with septic shock at a high-volume Swiss tertiary care center. <b>Methods:</b> A retrospective observational cohort study (2020-2023) was conducted at Kantonsspital Münsterlingen. Among 246 septic shock patients, 142 received CytoSorb therapy and 104 standard care. Patients were grouped according to treatment exposure. Baseline characteristics as well as ICU course variables, including sepsis origin, Simplified Acute Physiology Score (SAPS) II, and the Nine Equivalents of Nursing Manpower Use Score (NEMS), were compared between groups. Clinical outcomes included ICU/hospital length of stay (LOS) and duration of mechanical ventilation. Economic analysis included DRG-based revenue, direct case-related hospital costs, and net financial results. <b>Results:</b> CytoSorb-treated patients had significantly higher SAPS II scores at baseline. Despite higher initial acuity, this group showed a significantly shorter ICU LOS (median 408.5 vs. 554.5 h; <i>p</i> = 0.001), reduced hospital LOS (23.5 vs. 30.0 days; <i>p</i> = 0.008), and lower nursing workload (>20% NEMS point reduction; <i>p</i> = 0.015). Survivors treated with CytoSorb had significantly shorter ventilation durations (164.0 vs. 336.0 h; <i>p</i> = 0.014). Total hospital costs were not significantly different between groups; however, CytoSorb patients achieved a significantly better net financial result (CHF 17,125 vs. -1930; <i>p</i> = 0.025), particularly in the abdominal and pneumogenic sepsis subgroups. <b>Conclusions:</b> This study provides the first real-world evidence for the cost-effectiveness of CytoSorb hemoadsorption in septic shock, showing reduced ICU length of stay and improved financial outcomes, without increasing treatment costs or nursing workload. These findings challenge the perception of hemoadsorption as a cost driver and highlight its potential to optimize resource use in critical care. Further multicenter studies are needed to inform reimbursement strategies and integration into sepsis treatment protocols.</p>","PeriodicalId":12977,"journal":{"name":"Healthcare","volume":"14 8","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13116302/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147814459","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Higher Dietary Antioxidant Index Is Associated with Better Lipid Profile in Women with Coronary Artery Disease.","authors":"Mariana Moya-García, Wendy Campos-Pérez, Mariana Pérez-Robles, Sissi Godínez-Mora, Sarai Citlalic Rodríguez-Reyes, Liliana Estefanía Ramos-Villalobos, Erika Martínez-López","doi":"10.3390/healthcare14081085","DOIUrl":"10.3390/healthcare14081085","url":null,"abstract":"<p><strong>Background/objectives: </strong>Cardiovascular diseases are the leading cause of mortality worldwide, with coronary artery disease (CAD) being the most prevalent. An atherogenic diet contributes to oxidative stress by promoting lipid peroxidation in lipoproteins and cellular membranes, thereby compromising membrane integrity, which is reflected in lower phase angle (PhA) values. Dietary antioxidants play a crucial role in cellular health and in reducing atherosclerotic risk; therefore, the Dietary Antioxidant Index (DAI) is an important measure, as dietary antioxidants may counteract oxidative damage. This study aimed to assess the association between anthropometric, PhA, and biochemical variables across groups classified according to DAI.</p><p><strong>Methods: </strong>This was an analytical cross-sectional study. A total of 107 subjects, with and without CAD, were included. Oxidized LDL (oxLDL) and oxidized HDL (oxHDL) were determined using the ELISA technique. PhA was measured by bioelectrical impedance analysis, and DAI was calculated using the formula proposed by Wright et al. Results: DAI was positively associated with HDL concentrations in women with CAD, indicating that HDL levels increased by 5.8 mg/dL for each unit increase in DAI (R² = 0.625, <i>p</i> = 0.001). Furthermore, for each unit increase in DAI, the TC/HDL ratio decreased by 0.3 (R² = 0.625, <i>p</i> = 0.006), and the LDL/HDL ratio decreased by 0.2 (R² = 0.506, <i>p</i> = 0.012).</p><p><strong>Conclusions: </strong>A higher DAI is associated with a more favorable lipid profile in women with CAD, particularly with higher HDL concentrations and lower TC/HDL and LDL/HDL ratios.</p>","PeriodicalId":12977,"journal":{"name":"Healthcare","volume":"14 8","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13116080/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147814451","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}