SAGE Open Medicine最新文献

{"title":"Invasive versus non-invasive management in non-ST segment elevation myocardial infarction patients with pulmonary hypertension.","authors":"Ze Zhang, Tianshu Gu, Haonan Xu, Yukun Zhang, Sutao Hu, Huaying Fu, Weiding Wang, Xing Liu, Xian Shao, Lin Wang, Yongjian Li, Tong Liu, Kang-Yin Chen","doi":"10.1177/20503121261449544","DOIUrl":"10.1177/20503121261449544","url":null,"abstract":"<p><strong>Background: </strong>Non-ST-segment elevation myocardial infarction (NSTEMI) represents a substantial proportion of acute coronary syndrome and is associated with considerable morbidity and mortality. Pulmonary hypertension (PH) is linked to adverse cardiovascular outcomes and may complicate management decisions in NSTEMI. However, evidence regarding the optimal treatment strategy for NSTEMI patients with PH remains limited. This study evaluated the association between invasive versus conservative management and short- and long-term outcomes in a real-world multicenter cohort.</p><p><strong>Materials and methods: </strong>This retrospective multicenter cohort study used data from the Tianjin Health and Medical Big Data Super Platform. Adult patients hospitalized with NSTEMI and concomitant PH between January 2010 and March 2023 were included. Patients were categorized according to treatment strategy during the index hospitalization (invasive vs. conservative management). The primary outcome was 1-year major adverse cardiovascular events (MACE), defined as cardiac death, recurrent myocardial infarction, ischemic stroke, or repeat revascularization. Propensity scores were estimated using logistic regression. The primary analysis used inverse probability of treatment weighting with doubly robust Cox regression models, with additional sensitivity analyses.</p><p><strong>Results: </strong>Among 985 patients with NSTEMI and PH, 243 (24.7%) received invasive management and 742 (75.3%) conservative treatment. In doubly robust Cox models, invasive management was associated with a lower risk of 1-year MACE (adjusted hazard ratio [aHR] 0.60, 95% CI 0.41-0.88, P = 0.009) and cardiac death (aHR 0.54, 95% CI 0.34-0.87, P = 0.011). However, bleeding risk was higher in the invasive group (aHR 2.86, 95% CI 1.34-6.11, P = 0.007).</p><p><strong>Conclusion: </strong>Invasive management was associated with fewer ischemic events but a higher risk of bleeding in patients with NSTEMI and PH, highlighting the need for individualized treatment strategies.</p>","PeriodicalId":21398,"journal":{"name":"SAGE Open Medicine","volume":"14 ","pages":"20503121261449544"},"PeriodicalIF":2.2,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13292034/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148332592","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identifying individual, community and country-level determinants of poor knowledge of mother-to-child transmission of HIV among women in sub-Saharan Africa: spatial and multilevel analysis.","authors":"Mihret Getnet, Lamrot Yohannes, Nigusu Worku, Adina Yeshambel Belay, Lakew Asmare, Demiss Mulatu Geberu, Asebe Hagos, Melak Jejaw, Misganaw Guadie Tiruneh, Kaleb Assegid Demissie, Yawkal Tsega, Abel Endawkie, Amare Mesfin Workie, Wubshet Debebe Negash","doi":"10.1177/20503121261449371","DOIUrl":"10.1177/20503121261449371","url":null,"abstract":"<p><strong>Background: </strong>Mother-to-child transmission (MTCT) of HIV accounts for over 90% of new HIV infections among children. In 2018, a report from the World Health Organization showed that about 14.8 million children between the ages of 0 and 14 years were HIV-exposed globally, of which 13.2 million reside in sub-Saharan Africa (SSA). This study aimed to determine the spatial variation and identify factors of poor Knowledge of MTCT of HIV among women in SSA.</p><p><strong>Methods: </strong>A cross-sectional study was conducted using secondary data of 318,354 women collected during a Demographic Health Survey (DHS) in SSA countries from the 2006-2024. Spatial cluster detection was conducted using SaTScan version 10.1, spatial mapping was performed in ArcGIS version 10.7, and statistical analyses were carried out using Stata version 17. Multilevel logistic regression was used to identify the associations of health and demographic variables with poor knowledge of MTCT.</p><p><strong>Results: </strong>The spatial analysis revealed that poor knowledge of the MTCT of HIV among women of reproductive age significantly varied across countries. The spatial window analysis identified the primary clusters in Madagascar, the Congo Democratic Republic and parts of Angola. Overall, 46% of women had poor knowledge of MTCT of HIV. In multivariable analysis, age of 15 to 24 years (AOR: 1.11, 95% CI 1.04,1.18), no media exposure (AOR: 1.13, 95% CI 1.08, 1.19), being poorest (AOR: 1.17, 95% CI 1.06, 1.28), not working (AOR: 1.07, 95% CI 1.02, 1.12), never tested for HIV (AOR: 1.38, 95% CI 1.21, 1.57), lack of comprehensive knowledge (AOR: 1.16, 95% CI 1.10, 1.21), low community media exposure (AOR: 1.11, 95% CI 1.03, 1.19), Western Africa region (AOR: 1.27, 95% CI 1.20, 1.40), low income (AOR: 1.97, 95% CI 1.51, 2.56), and lower middle income (AOR: 1.53 95% CI 1.19, 1.95) were associated with poor knowledge of MTCT.</p><p><strong>Conclusion: </strong>Spatial analysis demonstrated that poor knowledge of MTCT of HIV among women was unevenly distributed, with significant regional variation across the SSA countries. This study found that individual, community and country-level variables were significantly associated with poor knowledge of MTCT of HIV. The finding highlights the need for targeted, multilevel HIV education and testing programs that prioritize hotspot areas and address disparities in knowledge of MTCT of HIV across SSA.</p>","PeriodicalId":21398,"journal":{"name":"SAGE Open Medicine","volume":"14 ","pages":"20503121261449371"},"PeriodicalIF":2.2,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13161648/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147933006","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence, severity and multidimensional factors associated with pain among hemodialysis patients: A cross-sectional study in a resource-limited healthcare system.","authors":"Abdallah Alqurnah, Mohammad Alsharouf, Faruq Salah, Taha Salhab, Hatim Hijaz, Ramzi Shawahna","doi":"10.1177/20503121261448294","DOIUrl":"10.1177/20503121261448294","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to determine the prevalence, severity and multidimensional factors associated with pain among hemodialysis (HD) patients in a resource-limited healthcare system.</p><p><strong>Methods: </strong>A multicenter cross-sectional study was conducted across eight hospitals in the West Bank of Palestine, enrolling 361 adult patients on maintenance HD. Pain intensity was measured using the Visual Analog Scale (VAS), pain interference with the Brief Pain Inventory (BPI) and health-related quality of life with the EuroQol 5-Dimension 5-Level (EQ-5D-5L).</p><p><strong>Results: </strong>Pain was reported by 281 patients, corresponding to a prevalence of 77.8%, with more than half (53.8%) experiencing moderate to severe intensity. Gender (OR = 2.29, 95% CI: 1.17-4.50), comorbid chronic diseases (OR = 3.62, 95% CI: 1.59-8.23), and HD vintage (OR = 1.12, 95% CI: 1.04-1.20) were independently associated with presence of pain. Pain severity was higher among females (B = 0.86, p = 0.006) and those with longer HD vintage (B = 0.05, p = 0.047), while smoking was linked to lower scores (B = -0.59, p = 0.006). Pain interference was higher in females (B = 1.23, p < 0.001) and patients with chronic diseases (B = 1.46, p = 0.001). Lower EQ-5D utility values were associated with age (β = -0.19, p = 0.003) and regular exercise (B = -0.14, p = 0.011). Self-assessed health scores declined with age (B = -0.23, p < 0.001) and chronic diseases (B = -4.69, p = 0.041). Pain control effectiveness was negatively associated with employment status (B = -2.53, p = 0.001).</p><p><strong>Conclusion: </strong>Pain is highly prevalent and undertreated among HD patients. The findings underscore the need for multidisciplinary, culturally sensitive strategies integrating pharmacologic, non-pharmacologic, psychosocial and spiritual care to better manage pain and enhance patient quality of life.</p>","PeriodicalId":21398,"journal":{"name":"SAGE Open Medicine","volume":"14 ","pages":"20503121261448294"},"PeriodicalIF":2.2,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13157544/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147875557","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quality of comprehensive emergency obstetric and newborn care services and associated factors among mothers with obstetric emergencies in public hospitals of west shoa zone, central Ethiopia: A cross-sectional study design.","authors":"Tolera Gudissa Damme, Sileshi Garoma Abeya, Dereje Bayissa Demissie","doi":"10.1177/20503121261449066","DOIUrl":"10.1177/20503121261449066","url":null,"abstract":"<p><strong>Introduction: </strong>The obstetric complications remain the leading cause of death in women of reproductive age and their neonates in low and middle-income countries. These deaths are largely preventable through providing quality of care. However, there is limited information about quality of emergency obstetric and newborn care and its associated factors in Ethiopia.</p><p><strong>Objectives: </strong>This study aims to assess quality of comprehensive emergency obstetric and newborn care and factors associated with mother satisfaction in public hospitals of West Shoa Zone.</p><p><strong>Methods and materials: </strong>A facility-based cross-sectional study design was conducted at four public hospitals of West Shoa Zone from September 01, 2023 to February 28, 2024. A facility audit was conducted at 04 selected public hospitals, and 348 mothers were randomly selected to participate in observation of care, mother exit interview and their medical record reviews. Then, the input, process and output components of quality care were computed. Furthermore, linear regression analysis was fitted and variables having p-value of <0.05 in multivariate analysis were considered as statistically significant predictors for mother satisfaction with quality care.</p><p><strong>Results: </strong>The result of the study finding indicates the input, process, and output components of quality care were 81.2%, 78.2%, and 75.9%, respectively. The study also identified mothers' waiting time for receiving care (B =-2.68, 95% CI: -4.66, -0.70) and duration of hospital stays (B =-0.17, 95%CI:-0.34, -0.01) were significantly associated with mother satisfaction with quality of comprehensive emergency obstetric and newborn care services.</p><p><strong>Conclusion and recommendations: </strong>The input, process and output dimensions of quality care were acceptable level in the study area. Mother waiting time and duration of hospital stays were significant predictors of mother satisfaction toward quality of care. Therefore, the health system should strengthen facility infrastructures, availability of essential supplies, and enforcing health care providers' adherence to standards of care.</p>","PeriodicalId":21398,"journal":{"name":"SAGE Open Medicine","volume":"14 ","pages":"20503121261449066"},"PeriodicalIF":2.2,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13157543/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147875565","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"First aid training in conflict zones: An interventional training study and a post-training knowledge assessment.","authors":"Kinan Jafar, Rami Janoud, Ahmed Sheikh Sobeh, Rawan Al-Deeb, Omran Janoud","doi":"10.1177/20503121261449059","DOIUrl":"10.1177/20503121261449059","url":null,"abstract":"<p><strong>Background: </strong>In conflict-affected regions such as Syria, where health systems are severely disrupted, first aid training for laypersons is a critical intervention to reduce preventable mortality. This study aimed to evaluate Post-training theoretical knowledge of Syrian university students regarding the principles of First Aid.</p><p><strong>Methods: </strong>An interventional training study was conducted in Swaida, Syria, in April 2025. University students (n=98 enrolled, n=55 analyzed) participated in a 10-hour, evidence-based course aligned with international guidelines. Post-training knowledge was assessed using a validated 14-question instrument. Data were analyzed using non-parametric tests (Kruskal-Wallis, Mann-Whitney U, Spearman's correlation).</p><p><strong>Results: </strong>Participants demonstrated a high level of post-course knowledge, with a median score of 13 (IQR: 12-13) and 75% scoring above 12 points. No statistically significant differences in scores were found between students from different faculties (p=0.051) or between those with and without prior training (p=0.461). A moderate positive correlation existed between academic year and test score (r=0.425, p<0.01). The most frequent knowledge gaps pertained to the management of shock and poisoning.</p><p><strong>Conclusions: </strong>A structured first aid course is important for theoretical knowledge among students in a conflict setting, demonstrating potential to build equitable, community-level emergency response capacity. These findings support the strategic integration of context-adapted first aid education into public health initiatives in crisis-affected regions to strengthen resilience and mitigate the health consequences of conflict.</p>","PeriodicalId":21398,"journal":{"name":"SAGE Open Medicine","volume":"14 ","pages":"20503121261449059"},"PeriodicalIF":2.2,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13157576/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147875589","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Expressional and prognostic value of cytokine receptor-like factor 3 in liver hepatocellular carcinoma patients via integrated bioinformatics analyses and experiments.","authors":"Xingxing Wang, Zhen Huang, Lili Huang, Yi Wang, Congxiang Huang, Xiaoying Zhang, Xiantu Zhang","doi":"10.1177/20503121261440458","DOIUrl":"10.1177/20503121261440458","url":null,"abstract":"<p><strong>Background: </strong>Liver hepatocellular carcinoma is a highly prevalent and lethal malignancy. The orphan cytokine receptor-like factor 3, although evolutionarily conserved and implicated in hematopoiesis and neuroprotection, remains poorly characterized in liver hepatocellular carcinoma.</p><p><strong>Objective: </strong>To investigate the expression pattern of cytokine receptor-like factor 3 in liver hepatocellular carcinoma and its association with clinicopathological characteristics, prognosis, and potential biological functions through bioinformatics analysis.</p><p><strong>Methods: </strong>Cytokine receptor-like factor 3 mRNA and protein expression in liver hepatocellular carcinoma were evaluated using the cancer genome atlas, human protein atlas, immunohistochemistry, and qPCR. The association of cytokine receptor-like factor 3 expression with prognosis and clinicopathological features was assessed using Kaplan-Meier survival analysis, Cox regression, logistic regression, and receiver operating characteristic curves. Potential functional pathways associated with cytokine receptor-like factor 3 were explored using gene ontology, Kyoto encyclopedia of genes and genomes, gene set enrichment analysis, and ssGSEA.</p><p><strong>Results: </strong>Cytokine receptor-like factor 3 expression was significantly elevated in liver hepatocellular carcinoma tissues and correlated with poorer overall survival, disease-specific survival, and progression-free interval. High cytokine receptor-like factor 3 expression was associated with advanced T stage, pathologic stage, histologic grade, and elevated alpha-fetoprotein levels, and emerged as an independent prognostic factor. Receiver operating characteristic curve analysis suggested a potential diagnostic value for cytokine receptor-like factor 3 in distinguishing liver hepatocellular carcinoma tissues from normal tissues. Enrichment analysis indicated that genes correlated with cytokine receptor-like factor 3 are enriched in pathways such as PI3K/Akt, Wnt, and JAK/STAT, as well as immune-related processes. Notably, cytokine receptor-like factor 3 expression showed a strong positive correlation with Th2 cell infiltration.</p><p><strong>Conclusions: </strong>This study reveals that cytokine receptor-like factor 3 is overexpressed in liver hepatocellular carcinoma and is associated with poor patient prognosis and immune infiltration. These findings suggest that cytokine receptor-like factor 3 may serve as a promising candidate prognostic biomarker and warrants further investigation as a potential immunotherapeutic target in liver hepatocellular carcinoma. The mechanistic hypotheses generated here provide a foundation for subsequent experimental validation.</p>","PeriodicalId":21398,"journal":{"name":"SAGE Open Medicine","volume":"14 ","pages":"20503121261440458"},"PeriodicalIF":2.2,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13157535/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147875576","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of a structured remediation program on academic performance of family medicine residents in difficulty: A training centre experience.","authors":"Malak A Al Shammari","doi":"10.1177/20503121261448293","DOIUrl":"10.1177/20503121261448293","url":null,"abstract":"<p><strong>Background: </strong>Residents in difficulty represent a significant challenge in postgraduate medical education. Early, structured remediation may improve academic and clinical performance, yet regional evidence from family medicine training programs remains limited.</p><p><strong>Objectives: </strong>To evaluate the impact of a structured remediation program on examination performance and clinical assessments of family medicine residents in difficulty, and to explore resident-perceived mechanisms contributing to improvement.</p><p><strong>Methods: </strong>A mixed-methods study was conducted at a single accredited family medicine training center over three academic years (2022-2025). Quantitative analysis included a retrospective review of promotion examination scores and clinical assessment outcomes before and after participation in a standardized remediation program. Qualitative data were obtained through semi-structured interviews with participating residents and analyzed thematically. Wilcoxon signed-rank test, Stuart-Maxwell test, and multivariable linear regression were used to assess performance changes and predictors of post-course outcomes.</p><p><strong>Results: </strong>Thirty-one first-year family medicine residents were included. Mean promotion examination scores improved significantly from 55.1 ± 2.4 pre-course to 79.0 ± 5.1 post-course (p < 0.0001). Clinical assessment outcomes improved from universal borderline or failing status to 100% pass rates (p = 0.0009). Perceived exam difficulty decreased significantly following remediation (p < 0.0001). Multivariable analysis showed that age, gender, and training sector were independently associated with post-course scores. Qualitative analysis identified five key themes underlying improvement: transformation of learning strategies, enhanced clinical exposure, mentorship support, feedback-driven reflection, and professional accountability.</p><p><strong>Conclusion: </strong>A structured remediation program was associated with significant improvements in academic performance, clinical competence, and learner confidence among family medicine residents in difficulty. Early, supportive, and mentorship-driven remediation may represent an important component of postgraduate family medicine training.</p>","PeriodicalId":21398,"journal":{"name":"SAGE Open Medicine","volume":"14 ","pages":"20503121261448293"},"PeriodicalIF":2.2,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13150096/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147869455","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Secreted phosphoprotein 1 is associated with epithelial cell proliferation and PI3K/AKT signalling in sinonasal inverted papilloma.","authors":"Wenrui Tang, Lin Wang, Xudong Yan, Jisheng Zhang, Longgang Yu, Han Chen, Chunge Zheng, Zihui Dong, Qianyou Zheng, Lin Han, Yan Jiang","doi":"10.1177/20503121261445213","DOIUrl":"10.1177/20503121261445213","url":null,"abstract":"<p><strong>Objectives: </strong>Sinonasal inverted papilloma is a locally aggressive epithelial lesion with a relatively high recurrence rate, yet the molecular basis of its proliferative behaviour remains incompletely understood. This study investigated the clinical relevance of secreted phosphoprotein 1 in sinonasal inverted papilloma and its association with epithelial cell proliferation and related signalling pathways.</p><p><strong>Methods: </strong>Differentially expressed genes were identified from the GSE193016 dataset, followed by gene set enrichment analysis. The expression of secreted phosphoprotein 1 and the cell cycle-related molecules cell division cycle 25C and cyclin A2 in clinical specimens was assessed using quantitative PCR, Western blotting, and immunohistochemistry. Associations between secreted phosphoprotein 1 expression and postoperative recurrence were assessed based on follow-up data. In vitro experiments using human nasal epithelial cells were conducted to examine the effects of altered secreted phosphoprotein 1 expression on cell proliferation-associated phenotypes, and pathway inhibition assays were performed to investigate the involvement of the PI3K/AKT signalling pathway.</p><p><strong>Results: </strong>Secreted phosphoprotein 1 expression was significantly upregulated in sinonasal inverted papilloma tissues, with higher levels observed in advanced-stage cases (T3-T4), and was associated with postoperative recurrence. The expression of the cell cycle-related molecules cell division cycle 25C and cyclin A2, positively correlated with secreted phosphoprotein 1 expression and increased with disease progression. In vitro epithelial cell models demonstrated that modulation of secreted phosphoprotein 1 expression was accompanied by corresponding changes in cellular proliferative capacity and cell cycle-related protein expression. Pathway inhibition assays further suggested that PI3K/AKT signalling may be involved in secreted phosphoprotein 1-associated alterations in cell cycle regulation.</p><p><strong>Conclusion: </strong>These findings indicate that secreted phosphoprotein 1 is highly expressed in sinonasal inverted papilloma and may be associated with epithelial cell proliferation and PI3K/AKT signalling. In addition, secreted phosphoprotein 1 expression correlates with disease recurrence, highlighting its potential research value as a biological marker, while the underlying mechanisms warrant further investigation.</p>","PeriodicalId":21398,"journal":{"name":"SAGE Open Medicine","volume":"14 ","pages":"20503121261445213"},"PeriodicalIF":2.2,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13145016/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147842301","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of lifestyle and demographic variables with hepatitis risk: Evidence from machine learning and cross-sectional study.","authors":"Yuhang Tang, Wei Chen","doi":"10.1177/20503121261442016","DOIUrl":"10.1177/20503121261442016","url":null,"abstract":"<p><strong>Background: </strong>Hepatitis remains a major global health concern, leading to significant morbidity and mortality worldwide. Early identification of individuals at high risk is crucial for prevention and management.</p><p><strong>Objective: </strong>This study aims to investigate the clinical or lifestyle variables for early detection of hepatitis risk individuals by integrated machine learning and cross-sectional study.</p><p><strong>Methods: </strong>We analyzed 27,387 participants from the 2023 National Health Interview Survey, randomly divided into training (<i>n</i> = 16,431) and validation (<i>n</i> = 10,956) cohorts. Least absolute shrinkage and selection operator regression was applied to identify candidate predictors, followed by univariate and multivariable logistic regression to determine independent predictors. A nomogram was developed and evaluated using receiver operating characteristic curves, calibration plots, and decision curve analysis. Besides, positive predictive value, negative predictive value, and precision-recall analysis were conducted for evaluation of model efficacy and accuracy.</p><p><strong>Results: </strong>Five independent predictors were identified, including age, sex, hypertension, smoking status, and economic status of which associated with hepatitis prevalence.</p><p><strong>Conclusions: </strong>This study is a cross-sectional, machine learning-based predictive modeling study that aims to identify key demographic and lifestyle factors associated with hepatitis risk and develop a clinically applicable risk prediction tool. Novelty, this study illustrated the association between hepatitis risk and various epidemiologic patterns, including demographic, lifestyle, and health-related factors, which facilitate the precision early-detection of hepatitis risk individuals.</p>","PeriodicalId":21398,"journal":{"name":"SAGE Open Medicine","volume":"14 ","pages":"20503121261442016"},"PeriodicalIF":2.2,"publicationDate":"2026-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13129336/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147820219","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epidemiological characteristics and changing patterns of hospitalizations among middle-aged and elderly patients in Northwest China, 2020-2024: A retrospective cohort study.","authors":"Shaomin Quan, Shuo Li, Shiying Li, Yue Li, Zhigang Fan","doi":"10.1177/20503121261446494","DOIUrl":"10.1177/20503121261446494","url":null,"abstract":"<p><strong>Objective: </strong>To describe hospitalization patterns, major disease spectra, and clinical outcomes among middle-aged and elderly inpatients in Northwest China between 2020 and 2024.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted using electronic medical records from a tertiary hospital. A total of 108,027 admissions were reviewed, and 91,470 were included after excluding cases coded as Z51 (other medical care). Demographic features, length of stay, major diagnoses, and in-hospital mortality were summarized. Annual differences and temporal trends were assessed using appropriate statistical tests.</p><p><strong>Results: </strong>Hospitalizations increased from 16,407 in 2020 to 27,393 in 2024. Patients aged ≥65 years accounted for roughly three-quarters of admissions, with those aged 65-74 years forming the largest subgroup (46.6%). The overall in-hospital mortality was 1.29%, which scaled significantly with age and peaked at 1.77% in 2023 alongside a surge in respiratory admissions. While males consistently accounted for ∼55% of admissions, they exhibited a higher mortality rate than females (1.22% vs. 0.88%) and dominated specific admissions like chronic obstructive pulmonary disease (70.3% male). The median length of stay declined from 9 to 7 days. Chronic non-communicable diseases dominated the inpatient spectrum, with senile cataract, cerebral infarction, angina pectoris, and COPD being the most frequent diagnoses.</p><p><strong>Conclusion: </strong>Non-communicable diseases and age-related conditions remain the primary drivers of hospitalization, but their patterns are highly dynamic. The escalating mortality in the oldest-old and marked post-pandemic respiratory surges highlight the critical role of underlying frailty. Alongside improvements in heart failure management, healthcare systems must prioritize targeted primary prevention, aggressive multimorbidity management, and robust long-term care to address these shifting vulnerabilities.</p>","PeriodicalId":21398,"journal":{"name":"SAGE Open Medicine","volume":"14 ","pages":"20503121261446494"},"PeriodicalIF":2.2,"publicationDate":"2026-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13129271/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147820225","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}