Nursing Research最新文献

{"title":"Correlates of Glycemic Status Among American Indian Adults With Type 2 Diabetes in Rural Southeastern Oklahoma.","authors":"Tarah Nelson, Diana J Wilkie, Yingwei Yao, Richard Segal, Ashley DeVaughan Circles, William T Donahoo, R Turner Goins, Spero M Manson, Anatolia B Legaspi, Lisa Scarton","doi":"10.1097/NNR.0000000000000916","DOIUrl":"10.1097/NNR.0000000000000916","url":null,"abstract":"<p><strong>Background: </strong>Elevated glycosylated hemoglobin (HbA1c) levels have been associated with an increased risk for type 2 diabetes (T2D) complications.</p><p><strong>Objective: </strong>The aim of this study was to examine the electronic health record (EHR) correlates of HbA1c levels among adults with T2D using Tribal health services.</p><p><strong>Methods: </strong>EHR data from one Tribal health center were used for this study. Variables included driving distance to clinics, socioeconomic status, use of primary care and diabetes educators, age, sex, glycemic status, and HbA1c. Descriptive, bivariate, and linear regression analyses were performed.</p><p><strong>Results: </strong>Nearly 40% of the 5,205 patients in the sample had HbA1c levels <7% in 2021. HbA1c in 2020 was a strong predictor of HbA1c in 2021. Older age was weakly associated with lower HbA1c. A lack of primary care visits or diabetes educator visits was associated with lower HbA1c, likely due to patients with lower HbA1c levels having less need for T2D-related primary care or diabetes educator visits.</p><p><strong>Discussion: </strong>This study provided insight into factors associated with HbA1c levels that deserve further exploration, but it is important to note that factors included in social determinant of health frameworks specifically developed for Indigenous communities were not available in the EHR data set. Therefore, future studies are needed that examine Indigenous social determinants of health specific to the local community.</p>","PeriodicalId":49723,"journal":{"name":"Nursing Research","volume":" ","pages":"338-345"},"PeriodicalIF":2.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13390767/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148521344","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":"Scoping Review of Barriers and Facilitators of Cervical Cancer Screening in Appalachia.","authors":"Jill E Sergison, Amy Alspaugh, Sarah Janek, Eleanor L Stevenson, Devon Noonan, Megan Huchko, Leila Ledbetter, Savannah Brinkley, Mitchell R Knisely","doi":"10.1097/NNR.0000000000000923","DOIUrl":"10.1097/NNR.0000000000000923","url":null,"abstract":"<p><strong>Background: </strong>Cervical cancer incidence and mortality in Appalachia exceed national averages, reflecting long-standing inequities in preventive care. Although cervical cancer screening (CCS) effectively reduces morbidity and mortality, participation among Appalachian women remains low. Understanding the multilevel factors that influence screening behavior is critical to inform culturally responsive and sustainable interventions.</p><p><strong>Objectives: </strong>To synthesize existing evidence on barriers to and facilitators of CCS among women residing in Appalachia using Levesque's Access to Care Framework.</p><p><strong>Methods: </strong>A scoping review was conducted in accordance with the JBI Manual for Evidence Synthesis and reported following PRISMA-ScR guidelines. PubMed, CINAHL, and Scopus were searched for studies published between January 2002 and August 2025. Eligible studies reported original empirical data on CCS among women aged 21-64 living in Appalachian counties. Editorials, reviews, gray literature, and studies lacking disaggregated Appalachian data were excluded. Extracted data were categorized into Levesque's five patient-level domains: the abilities to perceive, seek, reach, pay, and engage in care.</p><p><strong>Results: </strong>Of 3,457 records identified, 27 met the inclusion criteria. Studies employed qualitative, quantitative, and mixed methods designs. Barriers included cost, lack of insurance, transportation challenges, medical mistrust, fatalism, low health literacy, and negative prior health care experiences. Facilitators included trusted and consistent patient-provider relationships, clear provider communication, social support, female clinician availability, and access to free or subsidized screening through Title X and the National Breast and Cervical Cancer Control Program services.</p><p><strong>Discussion: </strong>Structural, interpersonal, and psychosocial factors intersect to shape screening behaviors in Appalachia. Findings highlight the importance of trust-building, trauma-informed, and culturally responsive communication, and system-level supports that address cost and access barriers. Expanding Medicaid, strengthening rural provider capacity, and increasing participation in Title X and national cervical cancer programs may reduce disparities and improve screening uptake. Future research should incorporate standardized measures of trust, health literacy, and psychosocial readiness to strengthen intervention design and cross-study comparability.</p>","PeriodicalId":49723,"journal":{"name":"Nursing Research","volume":" ","pages":"395-406"},"PeriodicalIF":2.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148206566","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Genome-Wide Association of Cardiovascular Disease and Lifestyle in Korean Adults With Metabolic Syndrome.","authors":"Haejung Lee, DaeEun Lee, Sukhyun Jun","doi":"10.1097/NNR.0000000000000915","DOIUrl":"10.1097/NNR.0000000000000915","url":null,"abstract":"<p><strong>Background: </strong>Cardiovascular disease (CVD) is a major complication in patients with metabolic syndrome (MetS). The risk of CVD is influenced by genetic, sociodemographic, and lifestyle factors.</p><p><strong>Objectives: </strong>The aims of this study were to identify single-nucleotide polymorphisms (SNPs) associated with CVD risk in patients with MetS and examine the impact of sociodemographic, lifestyle, and genetic factors.</p><p><strong>Methods: </strong>We analyzed baseline data from the Korean Genome and Epidemiology Study-Urban Health Examinee cohort (KoGES-HEXA). MetS was defined as the presence of three or more of the MetS risk factors based on the National Cholesterol Education Program Adult Treatment Panel III. Participants who reported a diagnosis of angina, myocardial infarction, or stroke were classified into the CVD group. PLINK 1.9 was used to identify CVD-related SNPs, and logistic regression analyses to estimate odds ratios for CVD were performed using IBM SPSS Statistics (Version 27.0) and SAS (Version 9.4) software.</p><p><strong>Results: </strong>A genome-wide association study (GWAS) was conducted with 12,047 participants, comprising 839 participants in the CVD group and 11,208 in the non-CVD group. Three SNPs were associated with CVD. Sex, age, income level, drinking, smoking, sleep duration, nutrient intake, and specific SNPs were associated with CVD.</p><p><strong>Discussion: </strong>These findings highlight the identification of suggestive SNPs associated with CVD among individuals with MetS in a non-European population, addressing gaps in genomic research. Associations with alcohol consumption, smoking, and diet may reflect reverse causation or confounding rather than protective effects, and further longitudinal studies are needed to clarify causal relationships.</p>","PeriodicalId":49723,"journal":{"name":"Nursing Research","volume":" ","pages":"369-377"},"PeriodicalIF":2.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147822843","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mediation of Smoking and Cardiometabolic Factors on Diabetic Peripheral Neuropathy.","authors":"Siti Fadlilah, Untung Sujianto, Ratsiri Thato, Mei-Ling Yeh, Hsiu Ting Tsai","doi":"10.1097/NNR.0000000000000943","DOIUrl":"https://doi.org/10.1097/NNR.0000000000000943","url":null,"abstract":"<p><strong>Background: </strong>Diabetic peripheral neuropathy (DPN) is a common complication of type 2 diabetes, yet the combined roles of smoking behavior and cardiometabolic factors in shaping neuropathy risks remain insufficiently understood.</p><p><strong>Objectives: </strong>To examine the associations of smoking behavior and cardiometabolic factors with DPN risk and evaluate their independent, combined, and mediating effects.</p><p><strong>Methods: </strong>This cross-sectional study included 905 adults with type 2 diabetes attending primary care services in Indonesia. DPN risk was assessed using the Michigan Neuropathy Screening Instrument. Tobacco smoking behavior was assessed using a structured questionnaire, while cardiometabolic factors were obtained from clinical examinations and laboratory measurements. Associations were analyzed using multinomial logistic regression, and mediation pathways were examined using partial least squares-structural equation modeling.</p><p><strong>Results: </strong>Both active smoking and secondhand smoke exposure were associated with an increased DPN risk, particularly among active smokers also exposed to secondhand smoke. Cardiometabolic factors, including elevated glycated hemoglobin, high fasting blood glucose, and an abnormal ankle-brachial index, showed independent associations with neuropathy risks. Combined exposure analyses demonstrated a cumulative pattern, with increasing numbers of abnormal risk factors associated with progressively higher odds of neuropathy. A pathway analysis indicated that the association between smoking behaviors and DPN was primarily mediated through metabolic dysfunction and impaired peripheral perfusion, whereas the mediating role of blood pressure was limited.</p><p><strong>Discussion: </strong>These findings support the multifactorial nature of DPN and suggest that behavioral and cardiometabolic factors interact in shaping neuropathy risks. Integrating smoking exposure assessments with glycemic and vascular risk management may strengthen prevention strategies in primary care populations with type 2 diabetes.</p>","PeriodicalId":49723,"journal":{"name":"Nursing Research","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148809270","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Statistical Considerations for Research Reproducibility: Strategies for Building Transparent Analytic Workflows.","authors":"Laura K Kaizer, Zahra Ali, Grace N Bosma, Dawn M Aycock, Matthew J Hayat, Sarah J Schmiege","doi":"10.1097/NNR.0000000000000940","DOIUrl":"https://doi.org/10.1097/NNR.0000000000000940","url":null,"abstract":"<p><strong>Background: </strong>Reproducibility, the ability for independent investigators to obtain consistent results using the same data and analytic procedures, is foundational to scientific integrity, yet remains a challenge across research settings. Common practices such as manual data cleaning, point-and-click analyses, and creating tables by manually copying and pasting values from output to table shells increase the likelihood of error, reduce transparency, and impede efficient collaboration. As data become more complex and expectations for reproducibility from journals, funders, and the scientific community grow, researchers need practical, accessible guidance on implementing reproducible workflows.</p><p><strong>Objectives: </strong>To provide actionable steps to improve the reproducibility of data management, statistical analyses, and reporting, and demonstrate reproducible workflows using both R and IBM SPSS Statistics.</p><p><strong>Methods: </strong>We outline five steps toward reproducibility: (1) project organization and file structure, (2) use of ReadME documentation, (3) clear traceability from raw to analytic data sets, (4) use of syntax for all data cleaning and management, and (5) reproducible generation of tables and reports. A synthetic data set is used to illustrate these principles in both R and SPSS, highlighting how fully syntax-based workflows in R and syntax-supported workflows in SPSS can move researchers toward greater transparency and efficiency.</p><p><strong>Results: </strong>Implementing reproducible workflows reduces error, saves time, and strengthens scientific rigor. Syntax-based approaches create a complete, defensible record of every analytic decision, supporting clearer team communication and easier project hand off. Even small changes, such as maintaining untouched raw data, standardizing folder structures, and documenting decisions in ReadMe files, substantially improve transparency. Across platforms, the guiding principle holds: anything that is done manually can be done with syntax, enabling faster, more accurate, and fully repeatable results.</p><p><strong>Discussion: </strong>Reproducibility is both an ethical and methodological imperative. Incremental improvements can reshape research culture, producing more trustworthy work. Integrating reproducibility into education, mentorship, and team science can help ensure that rigorous, transparent analytic practices become standard in research.</p>","PeriodicalId":49723,"journal":{"name":"Nursing Research","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148800873","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vibe Coding for Statistical Analysis Using Large Language Models.","authors":"Dante Anthony Tolentino, Elizabeth Kohout, Paul Boy, Hafifa Siddiq","doi":"10.1097/NNR.0000000000000942","DOIUrl":"https://doi.org/10.1097/NNR.0000000000000942","url":null,"abstract":"<p><strong>Background: </strong>Large language models have accelerated the adoption of generative artificial intelligence (AI), making AI tools more widely accessible through conversational prompting. One emerging application is vibe coding, in which users use natural-language prompts to generate code and desired outputs rather than manually writing traditional code.</p><p><strong>Objective: </strong>To examine AI-assisted, human-in-the-loop (HITL) vibe coding as a proof of concept for data analysis, describe its components and a proposed workflow with explicit safeguards, and present a case study illustrating its use and potential failure points.</p><p><strong>Methods: </strong>We used a proposed workflow that included framing research questions, operationalizing variables, organizing project folders, documenting decisions, applying retrieval-augmented generation, and using prompt engineering techniques. We used Cursor (v1.5.11) on a limited, clean admissions data set, in which admission status was modeled as a function of the Graduate Record Exam, grade point average, and undergraduate rank. Logistic regression was generated via conversational prompts, implemented in R, and the results were compared with a published reference output on a publicly available website.</p><p><strong>Results: </strong>AI-assisted, HITL vibe coding produced statistical codes that included schema checks, range validations, data cleaning, exploratory analyses, regression modeling, and visualization. There were mixed results of both valid and invalid outputs. Regression coefficients, p values, and model fit statistics matched the outputs posted on the published reference output website. However, an error was identified in the predicted-probability confidence interval output, which was missed during the initial review of outputs.</p><p><strong>Discussion: </strong>While vibe coding has the potential to reduce barriers to data analysis for researchers, this case study demonstrated that it can produce both valid and invalid outputs and that foundational statistical training, knowledge, understanding, and methodological expertise remain paramount when using it. Future studies should address important empirical questions about the use of vibe coding, such as under what conditions it can be safely used in research and what kinds of errors are most commonly generated when using it. AI-assisted HITL vibe coding should be used with caution and only with structured verification and safeguards, transparent reporting, and appropriate statistical and methodological oversight.</p>","PeriodicalId":49723,"journal":{"name":"Nursing Research","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148800892","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence, Sociodemographic Differences, and Comorbidity in Pediatric Obesity.","authors":"Maharaj Singh, Sylvia Peña, Wendy Bauer, Abir Bekhet, Maria Peña, Kristin Haglund, Shanna Doucette Knierim, Marilyn Frenn","doi":"10.1097/NNR.0000000000000941","DOIUrl":"https://doi.org/10.1097/NNR.0000000000000941","url":null,"abstract":"<p><strong>Background: </strong>Pediatric obesity is a major public health concern with important implications for acute care and long-term health outcomes. National estimates of obesity among hospitalized children using recent data are limited.</p><p><strong>Objectives: </strong>To estimate the prevalence of documented obesity among hospitalized children and examine associated sociodemographic differences and comorbidity patterns using the 2021 National Inpatient Sample.</p><p><strong>Methods: </strong>We conducted a cross-sectional analysis of pediatric discharges (ages 2-17 y) in the 2021 National Inpatient Sample. Obesity was defined using the International Classification of Diseases, 10th Revision, Clinical Modification codes. Survey-weighted analyses were used to estimate prevalence and examine comorbidity patterns. Multivariable logistic regression models were used to evaluate sociodemographic correlates of obesity.</p><p><strong>Results: </strong>Among an estimated 961,529 pediatric hospitalizations, 6.29% had a documented obesity diagnosis. Obesity prevalence was higher among Black, Hispanic, and Native American children and increased with decreasing neighborhood income. In adjusted analyses, older age and Medicaid coverage were associated with higher odds of obesity, while females had lower odds than males. Children with obesity had substantially higher prevalence of cardiometabolic, respiratory, and mental health comorbidities compared with nonobese children.</p><p><strong>Discussion: </strong>Pediatric obesity among hospitalized children is associated with significant sociodemographic disparities and a high burden of comorbidities. Hospitalization represents a vital opportunity for identification and linkage to care.</p>","PeriodicalId":49723,"journal":{"name":"Nursing Research","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148800863","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Subjective Cognitive Decline and Fear of Falling Among Community-Dwelling Racially Diverse Older Adults in Low-Income Settings.","authors":"Renata Komalasari, Nikki L Hill, Ladda Thiamwong","doi":"10.1097/NNR.0000000000000938","DOIUrl":"10.1097/NNR.0000000000000938","url":null,"abstract":"<p><strong>Background: </strong>Subjective cognitive decline (SCD) and fear of falling share similar mental health consequences (e.g. increased depression and anxiety), but limited research evaluates their relationships in racially diverse older adults living in low-income settings.</p><p><strong>Objectives: </strong>We examined associations of older adults' SCD and SCD-related functional difficulties with fear of falling and the moderating effects of depressive and anxiety symptoms.</p><p><strong>Methods: </strong>A cross-sectional study, part of a larger clustered randomized controlled trial, was conducted. The sample consisted of racially diverse adults aged 60+ with the ability to stand without assistance, living in residential units and apartments in Central Florida (N=91; 89% female, Mage=73.26, SD ±6.99, 96.7% non-White). The short Fall-Efficacy Scale International assessed fear of falling. SCD was evaluated using a single question regarding confusion or memory loss, followed by a follow-up question that captured SCD-related functional difficulties on a Likert scale. The Patient Health Questionnaire assessed depressive symptoms. The Geriatric Anxiety Inventory-Short Form assessed anxiety. A Poisson regression analysis examined associations among SCD, SCD-related functional difficulties, fear of falling, and interactions with depressive and anxiety symptoms.</p><p><strong>Results: </strong>Depressive symptoms were independently associated with fear of falling, while SCD, SCD-related functional difficulties, and anxiety symptoms were not. Older adults with SCD-related functional difficulties who reported higher anxiety also reported greater fear of falling, whereas those with lower anxiety reported fewer fall-related concerns The interaction of SCD-related functional difficulties with depressive symptoms was not significantly related to fear of falling, but its interaction with anxiety symptoms was. Simple slope analysis showed the association between SCD-related functional difficulties and fear of falling was accentuated with higher anxiety symptoms and attenuated with lower anxiety.</p><p><strong>Discussion: </strong>Among racially diverse older adults, SCD was not independently associated with fear of falling; however, accounting for co-occurring affective symptoms provided a more comprehensive understanding. Although depressive symptoms were associated with fear of falling, it was anxiety that contributed to concerns about falling when older adults experienced functional difficulties due to SCD. Future studies should use larger, more representative samples to evaluate whether older adults' fear of falling and affective well-being changes over time, particularly among those experiencing SCD.</p>","PeriodicalId":49723,"journal":{"name":"Nursing Research","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148723101","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pilot Study of Oral Microbiome and Psychoneurological Symptom Cluster in Breast Cancer.","authors":"Julia Slack, Emily Vogtmann, Sharron Docherty, Tara A Albrecht","doi":"10.1097/NNR.0000000000000939","DOIUrl":"10.1097/NNR.0000000000000939","url":null,"abstract":"<p><strong>Background: </strong>Women with breast cancer experience high symptom burden from a psychoneurological symptom cluster consisting of fatigue, anxiety, depression, sleep disturbances, and pain. Interventions to manage this symptom cluster are limited as its etiology is not well understood. One system that has been linked with this symptom cluster in both healthy and other chronically ill populations but has not been explored in breast cancer is the oral microbiome.</p><p><strong>Objective: </strong>We examined differences in oral microbiome diversity and composition between women with breast cancer who reported high versus low levels of psychoneurological symptoms.</p><p><strong>Methods: </strong>Oral microbial changes based on bacterial diversity and relative abundance were estimated from 16S rRNA gene sequencing data of oral tongue swabs from 22 women with breast cancer prior to mastectomy. The fatigue, anxiety, depression, sleep disturbance, and pain interference subscales of the Patient-Reported Outcomes Measurement Information System 29 scale were used to calculate the symptom groups.</p><p><strong>Results: </strong>Observed amplicon sequence variants were lower in the high-symptom group than in the low-symptom group, but no differences between groups were seen in other alpha diversity metrics (Shannon, Inverse Simpson). No differences in beta diversity were found between the high- and low-symptom groups. For differential abundance, three genera were more abundant in the high-symptom group than the low-symptom group: Aggregatibacter, Lautropia, and Prevotellaceae UCG-001.</p><p><strong>Discussion: </strong>Preliminary associations were identified between the psychoneurological symptom cluster and oral microbiome diversity and composition. Of the differentially abundant genera, Lautropia has been previously linked with anxiety, and Aggregatibacter has been researched due to its pro-inflammatory potential. As inflammation is posited to influence psychoneurological symptom cluster severity, further research on the relationship between the oral microbiome and the psychoneurological symptom cluster, specifically in relation to potential causal mechanisms, is warranted. Enhanced insight into this relationship could inform targeted interventions to improve the symptom experience for women with breast cancer.</p>","PeriodicalId":49723,"journal":{"name":"Nursing Research","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13475779/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148725306","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":"Accelerated Biological Age as an Early Pregnancy Risk Factor for Preeclampsia.","authors":"Cindy M Anderson, John Lesniak, Shannon L Gillespie, Joyce E Ohm, Joshua J Joseph, Nathan P Helsabeck, Shili Lin","doi":"10.1097/NNR.0000000000000937","DOIUrl":"https://doi.org/10.1097/NNR.0000000000000937","url":null,"abstract":"<p><strong>Background: </strong>The inability to predict risk in early pregnancy for preeclampsia represents a major limitation in prenatal care.</p><p><strong>Objectives: </strong>We used machine-learning approaches to identify early pregnancy features that distinguish women who develop preeclampsia from those with normotensive pregnancies, specifically focusing on the influence of maternal biological age.</p><p><strong>Methods: </strong>Data were analyzed from a prospective cohort of pregnant women living in the upper Midwest (Midwest cohort) and from a cohort using publicly available data from the Prenatal Exposures & Preeclampsia Prevention Project (PEPP3). In both data sets, DNA methylation (DNAm) was quantified from blood samples collected in early pregnancy. Biological aging was estimated using established epigenetic clocks including Hannum, Horvath, and PhenoAge. Maternal data across pregnancy were collected via medical record abstraction. Predictors of preeclampsia were identified using LASSO regression and Random Forest. The potential predictive capacity of the selected features was evaluated by building logistic regression models with leave-one-out cross-validation and reporting performance metrics.</p><p><strong>Results: </strong>In the Midwest cohort, accelerated biological aging per Hannum's epigenetic clock as well as higher chronological age and higher gestational weight gain were identified as important predictors of preeclampsia. Interestingly, only Hannum's epigenetic clock showed predictive power for preeclampsia. In the PEPP3 cohort, accelerated biological aging, as measured by Hannum's epigenetic clock, and chronological age were also identified as significant predictors of preeclampsia.</p><p><strong>Discussion: </strong>Among women who developed preeclampsia, accelerated biological aging during early pregnancy may represent a risk biomarker that can be leveraged in clinical care. These findings identify a promising clinical indicator for preeclampsia risk, addressing a critical gap in screening and early diagnosis.</p>","PeriodicalId":49723,"journal":{"name":"Nursing Research","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148702432","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}