Journal of Public Health Research最新文献

{"title":"Biomedical waste management in independent dental practices: Interrogating regulatory challenges, sociocultural dynamics, and environmental health implications in Indonesia.","authors":"Oktavia Dewi, Herniwanti Herniwanti, Novita Rany, Emy Leonita","doi":"10.1177/22799036261463303","DOIUrl":"10.1177/22799036261463303","url":null,"abstract":"<p><p>Effective medical waste management is a critical intersection of public and environmental health that remains a persistent challenge within independent dental practices. These clinics generate hazardous biomedical waste introducing significant risks if inadequately handled due to constrained regulatory oversight and institutional capacity. This study investigated waste management practices among independent dental clinics in Pekanbaru, Indonesia to elucidate the regulatory hurdles, resource deficits, and social and environmental dynamics governing compliance and operational execution. A descriptive qualitative design was employed using an input, process, and output analytical framework. Data triangulation was achieved through detailed interviews, direct observations, and document analyses involving local health authorities, professional associations, and independent practitioners. The evaluation matrix assessed inputs including policy, human capital, financing, and infrastructure, processes ranging from waste identification to final destruction, and outputs such as regulatory adherence. Findings revealed pronounced deficiencies in policy dissemination, workforce competency, and disposal infrastructure. Although baseline waste identification and segregation were generally executed, critical vulnerabilities emerged during the collection, temporary storage, and final disposal phases. Overall regulatory adherence remained moderate because of suboptimal enforcement, economic constraints, and prevailing cultural norms influencing practitioner behavior. Medical waste management in independent dental practices constitutes a multifaceted challenge dictated by regulatory and organizational determinants. Mitigating these risks necessitates robust policy enforcement, comprehensive professional capacity building, and integrating environmental health metrics into primary care governance to ensure safe and sustainable healthcare delivery.</p>","PeriodicalId":45958,"journal":{"name":"Journal of Public Health Research","volume":"15 2","pages":"22799036261463303"},"PeriodicalIF":2.1,"publicationDate":"2026-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13319819/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148370233","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 occupational exposure to formaldehyde in Keratin hair treatments on lung function among salon workers: A cross-sectional study.","authors":"Mohammad Z Darabseh, Rahaf Badran, Aseel Aburub, Ragad Alkaraki, Tarekq Gharibeh, Ala'a M Shurrab, Anas Nizar, Owis Eilayyan, Bence L Raposa, Pongrác Ács","doi":"10.1177/22799036261441337","DOIUrl":"10.1177/22799036261441337","url":null,"abstract":"<p><strong>Background: </strong>Keratin hair treatments are widely used in salons due to their ability to straighten hair. However, these treatments often contain formaldehyde, a known volatile organic compound (VOC) associated with adverse respiratory effects. Salon workers performing keratin treatments may be at increased risk of respiratory impairment due to occupational exposure to formaldehyde. This study aimed to assess the impact of formaldehyde exposure during keratin hair treatments on lung function among salon workers.</p><p><strong>Design and methods: </strong>This cross-sectional study included 41 female salon workers who regularly perform keratin treatments. Spirometry was conducted to measure FEV1 (forced expiratory volume in the first second), FVC (forced vital capacity), and the FEV1/FVC ratio. Values were compared with predicted norms, and associations with exposure-related variables were analyzed using independent <i>t</i>-tests and Spearman correlation analysis.</p><p><strong>Results: </strong>Participants showed significantly lower mean values for FEV1, FVC, and FEV1/FVC ratios than predicted norms (<i>p</i> < 0.001).</p><p><strong>Conclusion: </strong>These findings underscore the need for improved protective protocols in salons to safeguard workers' respiratory health.</p>","PeriodicalId":45958,"journal":{"name":"Journal of Public Health Research","volume":"15 2","pages":"22799036261441337"},"PeriodicalIF":2.1,"publicationDate":"2026-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13320075/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148370350","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":"Perceived stress, diet, and medication use associated with GERD symptoms in Lebanese adults: A cross-sectional study.","authors":"Iqbal Fahs, Jana Hayek, Seham Kanaan, Faten Hamed, Mariam Dabbous, Jihan Safwan, Mohamad Rahal, Fouad Sakr","doi":"10.1177/22799036261465301","DOIUrl":"10.1177/22799036261465301","url":null,"abstract":"<p><strong>Background: </strong>Gastroesophageal reflux disease (GERD) is a common condition influenced by lifestyle, clinical, and psychosocial factors. This study examined the relationship between GERD symptoms and perceived stress among Lebanese adults, while accounting for key demographic, dietary, and clinical variables.</p><p><strong>Method: </strong>A cross-sectional study was conducted among Lebanese adults between January and September 2024 using an online self-administered questionnaire. GERD symptoms and perceived stress were assessed using the GERDQ and PSS-10 scales. Bivariate analyses followed by multivariable logistic regression were performed to identify factors independently associated with GERD symptoms.</p><p><strong>Results: </strong>A total of 440 participants were included (mean age of 36.4 ± 16.96 years), of whom 28.4% had probable GERD symptoms. Most participants (83.2%) reported moderate stress levels with a mean PSS score of 19.74±5.05. Higher perceived stress was independently associated with increased odds of GERD symptoms (ORa=1.110). Additional correlates included dietary factors (frequent intake of fatty/fried foods, carbonated beverages, and caffeinated drinks), medication-related factors (NSAIDs, bisphosphonates, and iron supplements), former smoking, and a personal or family history of gastrointestinal disease. Being married was associated with lower odds of GERD symptoms.</p><p><strong>Conclusion: </strong>Probable GERD symptoms were independently associated with perceived stress, dietary habits, smoking history, medication use, and gastrointestinal disease history. These findings support a biopsychosocial understanding of GERD symptom burden and provide further evidence that psychosocial factors should be considered when investigating gastrointestinal health in vulnerable populations.</p>","PeriodicalId":45958,"journal":{"name":"Journal of Public Health Research","volume":"15 2","pages":"22799036261465301"},"PeriodicalIF":2.1,"publicationDate":"2026-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13310329/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148346810","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":"System dynamics of preadolescent mental wellbeing: A multi-actor perspective in Amsterdam using systems archetypes.","authors":"Eline M Meuleman, Vincent Busch, Wilma E Waterlander, Nanda E van der Poel, Carry M Renders, Maartje M van Stralen","doi":"10.1177/22799036261455634","DOIUrl":"10.1177/22799036261455634","url":null,"abstract":"<p><strong>Background: </strong>Although research into the system dynamics underlying mental wellbeing has increased over recent years, it often remains rooted in positivist approaches that overlook lived experiences and dynamic system behaviour. This paper examines the system dynamics shaping preadolescent mental wellbeing by incorporating the perspectives of diverse stakeholders and analysing the system's overall behaviour.</p><p><strong>Design and methods: </strong>This qualitative study builds on earlier literature and scientific expert focus group data by incorporating the perspectives of preadolescents, caretakers, and professionals in Amsterdam, which were collected through a cocreated conversational tool and semistructured interviews. These insights informed a causal loop diagram (CLD), which was analysed using systems archetypes.</p><p><strong>Results: </strong>Multi-actor input from preadolescents, caretakers, and professionals expanded a science-based CLD to 62 factors, 50 identified feedback loops, and eleven subsystems. It revealed how social norms, institutional structures, and local contexts interact to shape preadolescent mental wellbeing. Seven systems archetypes were identified - mainly 'Success to the Successful', 'Shifting the Burden', and 'Fixes that Fail' - offering an understanding of recurring patterns that sustain (poor) mental wellbeing, from fragmented poverty support to changing societal norms around smartphone use.</p><p><strong>Conclusions: </strong>These findings underscore that complex public health issues have no quick or simple fixes. Instead, they require multilevel strategies that target various structural drivers while taking into account archetypal patterns. By mapping the system's structure and behaviour, this study hopes to encourage policymakers, educators, and communities to adopt a systems (archetype) lens to understand preadolescent mental wellbeing and act accordingly.</p>","PeriodicalId":45958,"journal":{"name":"Journal of Public Health Research","volume":"15 2","pages":"22799036261455634"},"PeriodicalIF":2.1,"publicationDate":"2026-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13305245/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148346843","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 of neonatal sepsis among neonates admitted to a neonatal intensive care unit in a university hospital in eastern Ethiopia: A cross-sectional study.","authors":"Mesud Abrahim, Lemesa Abdisa, Tesfaye Assebe Yadeta, Dawit Firdisa, Abera Kenay Tura","doi":"10.1177/22799036261462910","DOIUrl":"10.1177/22799036261462910","url":null,"abstract":"<p><strong>Background: </strong>Neonatal sepsis is a leading cause of neonatal mortality, yet data on its prevalence and associated factors remain limited. This study aimed to assess the prevalence of neonatal sepsis and associated factors among neonates admitted to the neonatal intensive care unit of a university hospital in eastern Ethiopia.</p><p><strong>Methods: </strong>An institution-based cross-sectional study was conducted on randomly selected neonates admitted to the NICU of Hiwot Fana Comprehensive Specialized Hospital from January 1, 2016 to December 31, 2019. Sociodemographic and feto-maternal data were collected and analyzed using Epi Data 3.1 and Stata 14. Bivariate and multivariate analyses identified factors associated with neonatal sepsis through binary logistic regression, presenting results as adjusted odds ratios (AORs) with 95% confidence intervals (CIs), with statistical significance set at p < 0.05.</p><p><strong>Results: </strong>Of the 414 neonates included, with a mean age of 3.6 (±2.3 SD) days, 264 (63.7%) were diagnosed with neonatal sepsis. Significant factors associated with neonatal sepsis included; being under seven days old (AOR = 2.18), rural residence (AOR = 1.70), lack of antenatal care (AOR = 0.61), premature rupture of membranes (AOR = 1.66), shorter labor duration (AOR = 0.40), meconium-stained amniotic fluid (AOR = 1.92), birth asphyxia (AOR = 2.25), and neonatal comorbidity (AOR = 1.98).</p><p><strong>Conclusion: </strong>Nearly two-thirds of NICU-admitted neonates had sepsis, with associations such as age, rural residence, and lack of antenatal care, premature rupture of membranes, shorter labor duration, meconium-stained amniotic fluid, birth asphyxia, and neonatal comorbidity highlighting the need for targeted interventions to improve outcomes.</p>","PeriodicalId":45958,"journal":{"name":"Journal of Public Health Research","volume":"15 2","pages":"22799036261462910"},"PeriodicalIF":2.1,"publicationDate":"2026-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13305584/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148346834","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":"Improved prediction of childhood anemia using hybrid ensemble learning and dual-level explainability.","authors":"Ashima Kukkar, Julius Moinget Loibor, Mehmet Akif Cifci, Manash Pratim Barman, Sadiq Hussain, Silvia Gaftandzhieva, Rositsa Doneva","doi":"10.1177/22799036261462908","DOIUrl":"10.1177/22799036261462908","url":null,"abstract":"<p><strong>Purpose: </strong>Millions of children under five, particularly in low- and middle-income countries, suffer from preventable anemia, making early detection critical for improving public health outcomes. This study proposes an interpretable machine learning framework for early prediction of childhood anemia using structured healthcare data.</p><p><strong>Methods: </strong>The proposed approach integrates TabNet, XGBoost, and Multi-Layer Perceptron (MLP) within a stacked ensemble architecture, with logistic regression as a meta-learner. Hyperparameter optimization is performed using GridSearchCV and compared with RandomizedSearchCV, Optuna, Genetic Algorithms (GA), Particle Swarm Optimization (PSO), and Ant Colony Optimization (ACO). SHAP provided global feature importance, and LIME explained individual predictions. The system was trained and tested using the Tanzania Demographic and Health Survey (DHS) dataset.</p><p><strong>Results: </strong>Experimental results on the Tanzania Demographic and Health Survey (TDHS 2022) dataset demonstrate that the proposed ensemble significantly outperforms individual models, achieving an accuracy of 98.5% and high precision, recall, and F1-scores across both classes. Among optimization strategies, GridSearchCV and Optuna provide the most consistent and optimal performance. SHAP-based global analysis identifies key predictors such as child age, wealth index, and breastfeeding status, while LIME offers instance-level explanations, enhancing model transparency and clinical interpretability. Comparative evaluation with baseline models and ablation analysis confirms the effectiveness of the stacked architecture and meta-learning strategy. External validation using NFHS (India) data shows close agreement (±1-2%) with observed anemia prevalence trends, indicating cross-regional generalizability. The study also discusses ethical considerations, fairness implications, and deployment strategies for integration into healthcare systems.</p><p><strong>Conclusions: </strong>The proposed framework is accurate, transparent, and adaptable. It supports early anemia detection and can assist clinical decision-making, especially in under-resourced regions, making it a valuable tool for global public health applications.</p>","PeriodicalId":45958,"journal":{"name":"Journal of Public Health Research","volume":"15 2","pages":"22799036261462908"},"PeriodicalIF":2.1,"publicationDate":"2026-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13305737/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148346782","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":"Oral contraceptive safety in humanitarian settings: A WHO-based assessment among syrian refugee women.","authors":"Samar Karout, Hani M J Khojah, Tareq L Mukattash, Abdalla El-Lakany","doi":"10.1177/22799036261462906","DOIUrl":"10.1177/22799036261462906","url":null,"abstract":"<p><strong>Background: </strong>Women with elevated cardiovascular and systemic risks face major contraindications to combined hormonal contraceptives (CHCs). In humanitarian settings, limited healthcare access may lead to overreliance on CHCs. This study assessed the prevalence and predictors of CHC ineligibility among Syrian refugee women in Lebanon.</p><p><strong>Methods: </strong>A cross-sectional survey was conducted with 105 current CHC users aged 18-50 years, extracted from a larger cohort. Sociodemographic, clinical, and reproductive data were analyzed using the WHO Medical Eligibility Criteria (MEC). Univariate and multivariable logistic regression identified predictors of MEC Category 3-4 ineligibility.</p><p><strong>Results: </strong>Nearly half of the women (44.8%) were classified as MEC Category 3-4, indicating substantial risk. Migraine with aura was the most frequent comorbidity (25.7%), followed by migraine without aura (6.7%) and gallbladder disease (6.7%). In univariate analysis, age ≥ 35 years (UOR = 2.77, p = 0.01), residence in Mount Lebanon (UOR = 4.88, p = 0.001) or North Lebanon (UOR = 4.15, p = 0.001), and specific comorbidities were significantly associated with ineligibility. In multivariable analysis, only migraines with aura remained an independent predictor (AOR = 4.684, p = 0.04), suggesting high-risk clinical indicators are often overlooked during provision.</p><p><strong>Conclusion: </strong>High ineligibility highlights deficiencies in contraceptive screening in humanitarian contexts. Routine MEC-based assessments, and safer alternatives are urgently needed.</p><p><strong>Innovation and limitations: </strong>This study uniquely applies the WHO safety framework to a displaced population, revealing migraine with aura as a major safety barrier. Limitations include a cross-sectional design and reliance on self-reported medical data.</p>","PeriodicalId":45958,"journal":{"name":"Journal of Public Health Research","volume":"15 2","pages":"22799036261462906"},"PeriodicalIF":2.1,"publicationDate":"2026-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13305491/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148346807","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":"Parental perspectives on children's screen use: Exploring impact, challenges, and support needs - A qualitative study.","authors":"Marie Werner, Felicia Delfechresh, Aleksandra Barstowe, Sabina Kapetanovic, Emma Claesdotter-Knutsson","doi":"10.1177/22799036261462200","DOIUrl":"10.1177/22799036261462200","url":null,"abstract":"<p><strong>Background: </strong>Like adults, many children and adolescents spend several hours each day engaged in screen-based activities. This has raised concerns among adults, and the consequences of screen use are the subject of intense research and public debate. Despite growing research interest, there is currently a lack of evidence-based interventions available to families experiencing negative consequences related to their child's screen use. The aim of this study was to explore parents' perceptions of the consequences of their children's screen use, as well as the type of support they seek in response.</p><p><strong>Design and methods: </strong>Through collaboration with schools in a medium-sized Swedish city, eleven participants with children aged 12-17 were recruited. Semi-structured interviews were conducted, transcribed, and analyzed using thematic analysis.</p><p><strong>Results: </strong>The analysis resulted in three main themes: <i>Consequences of children's screen use</i>, <i>A problem for the whole society</i>, and <i>Need of support on family and individual level</i>, along with a total of nine subthemes.</p><p><strong>Conclusion: </strong>Our conclusion is that, according to parents, screen use among children is a complex phenomenon that calls for broad and systemic responses. While consequences for the child are primarily observed at the microsystem level-affecting relationships, health, and development-parents also express expectations for change at higher societal levels. Taken together, our findings underscore the need for multi-level interventions that combine structural measures with accessible, family-oriented support strategies aimed at promoting healthy digital habits in children and adolescents.</p>","PeriodicalId":45958,"journal":{"name":"Journal of Public Health Research","volume":"15 2","pages":"22799036261462200"},"PeriodicalIF":2.1,"publicationDate":"2026-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13291565/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148333482","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":"Appraising spina bifida care in Africa: Challenges, implications, and progress - A perspective review.","authors":"Favour Tope Adebusoye, Tomas Ferreira, Wireko Andrew Awuah, Pearl Ohenewaa Tenkorang, Mohammed Ahmed, Rohan Sampat Mane, Brandon Lucke-Wold, Paul R Krafft, Julie L Chan","doi":"10.1177/22799036261462197","DOIUrl":"10.1177/22799036261462197","url":null,"abstract":"<p><p>Spina bifida (SB) is a neurodevelopmental disorder characterised by the incomplete closure of the embryonic neural tube, resulting in a neural tube defect (NTD) that affects the development of the spine and spinal cord. Both genetic and non-genetic factors contribute to the occurrence of SB, including deficiencies in folic acid and vitamin B12, maternal obesity, smoking, epilepsy, alcohol consumption, drug use, and a history of previous pregnancies affected by SB. Complications associated with SB include meningitis, hydrocephalus, neonatal paralysis, and urinary or faecal incontinence. Considerable advancements have been made in raising awareness, improving diagnostic capabilities, and establishing specialised clinics and multidisciplinary teams (MDTs) dedicated to SB management. However, several gaps persist in its management. These include inadequate awareness and education among healthcare professionals, limited access to healthcare services, a scarcity of surgical workforce and MDTs, social stigma and discrimination, and research and data accessibility gaps. The implications of these management gaps in SB care encompass diminished quality of life, increased morbidity and mortality rates, and economic consequences related to surgical management. To improve SB management outcomes in Africa, strategic interventions should focus on enhancing healthcare infrastructure and resources, strengthening education and awareness programs for SB prevention and support, addressing cultural concerns, improving neonatal surgical care, and enhancing research and guidelines. By addressing these gaps through targeted, equity-focused interventions in healthcare infrastructure, education, cultural adaptation, neonatal surgical care, research, and policy, substantial improvements can be made in SB care and outcomes in Africa, reducing the disproportionate burden of disability in low-resource settings.</p>","PeriodicalId":45958,"journal":{"name":"Journal of Public Health Research","volume":"15 2","pages":"22799036261462197"},"PeriodicalIF":2.1,"publicationDate":"2026-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13273006/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148279218","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":"Asyndromic surveillance of New York City emergency department diagnoses with the tree-temporal scan statistic.","authors":"Sharon K Greene, Alison Levin-Rector, Martin Kulldorff, Ramona Lall","doi":"10.1177/22799036261457753","DOIUrl":"10.1177/22799036261457753","url":null,"abstract":"<p><strong>Objectives: </strong>Illness trends are typically monitored by reportable disease and syndromic surveillance systems, but unanticipated health issues might not be captured. Using diagnosis codes, the New York City Health Department developed a novel data mining process to detect unusual increases in emergency department (ED) visits for any reason.</p><p><strong>Methods: </strong>We applied the tree-temporal scan statistic in TreeScan software to ICD-10-CM diagnosis codes for ED visits. We searched for unusual citywide increases in ED visits or hospital admissions, over any recent time period, and at any part of and level on the ICD-10-CM tree. We conducted proof-of-concept analyses for March 2020 when COVID-19 emerged, then investigated signals detected in daily, automated analyses during April-August 2025.</p><p><strong>Results: </strong>If TreeScan analyses had been in place, then increasing hospital admissions for viral pneumonia (J12) would have triggered a signal on March 13, 2020, two days before widespread COVID-19 community transmission was announced. An extreme heat event in June 2025 triggered a signal for admissions for acute kidney failure (N17), prompting outreach to dialysis networks. A sustained signal for hand, foot, and mouth disease (B08.4) prompted outreach to child care programs. Other signals supported situational awareness, including a seasonal increase for swimmer's ear (H60.33) and burns (T30.0) related to consumer fireworks.</p><p><strong>Conclusions: </strong>TreeScan quickly detected credible increases in various diagnoses without pre-specification, from minor to severe, rare to common, acute to sustained, and foreseen to unforeseen. TreeScan can strengthen surveillance for health issues related to new pathogens, non-notifiable conditions, environmental exposures, and mass gatherings.</p>","PeriodicalId":45958,"journal":{"name":"Journal of Public Health Research","volume":"15 2","pages":"22799036261457753"},"PeriodicalIF":2.1,"publicationDate":"2026-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13273000/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148279215","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}