Touch, massage, and thermal practices are widely used to promote relaxation, pain relief, and bodily restoration. Yet the mechanisms that make these practices feel pleasurable or restorative are usually explained in separate literatures, including somatosensory neuroscience, pain modulation, autonomic physiology, psychoneuroendocrinology, placebo research, and social psychology. This article proposes the Multilevel Integrative Model of Hedonic Regulation (MIHR) as a conceptual framework for linking these domains. The model synthesizes established findings on tactile and thermal signaling, descending modulation, reward and stress systems, and contextual meaning, while adding a testable account of how pleasure and relief arise when sensory input, bodily state, regulation, and context become aligned for the recipient. The same pressure, stroking velocity, warmth, or cold may feel soothing, neutral, intrusive, or aversive depending on expectation, perceived control, interpersonal trust, cultural familiarity, prior experience, and current bodily state. Relief is central to this account. In massage, sauna, bathing, and contrast exposure, positive affect often comes not only from pleasant stimulation itself, but from the easing of tension, pain, cold, heat, or bodily unease. The MIHR is presented as a testable framework rather than a validated mechanism. Future studies should manipulate sensory and contextual variables together, distinguish anticipation, stimulation, offset, and recovery phases, and combine subjective reports with autonomic, endocrine, and neurobiological measures. The model also separates immediate hedonic pleasure from broader eudaimonic wellbeing, which may emerge when repeated practices support recovery, agency, social connection, and a more secure relation to the body.

Adolescents in Lebanon face socioeconomic and political stressors that undermine socioemotional development and mental health. This study evaluated the Yes to Emotions (YEY) programme, a culturally adapted 11-session intervention to enhance trait Emotional Intelligence (trait EI) and mental health. The sample comprised 712 adolescents (326 girls) aged 14-21 years from public schools allocated to either the YEY intervention (with voluntary diary completion) or a waitlist comparison condition. A mixed-methods design combined self-report and diary data. Results showed higher trait EI, intrapersonal emotional competencies, adaptive coping and reduced maladaptive coping and depressive symptoms. Effect sizes were larger in the diary group, whereas the non-diary group showed more modest gains and often did not differ from the waitlist comparison group. Qualitative findings illustrated the quantitative results, illustrating improvements in emotion regulation, self-esteem, empathy and interpersonal relationships. Findings support EI training and the potential value of emotional diaries in high-adversity contexts.

Previous research has shown neighborhood environmental interventions can improve health and safety for residents. It is unknown whether these interventions impact opioid overdose outcomes.

To evaluate the association of neighborhood environmental interventions with opioid overdose rates.

This quasi-experimental nonrandomized trial used a continuous treatment difference-in-differences design and was conducted in a single neighborhood of Philadelphia, Pennsylvania, between January 1, 2019, and December 31, 2021. The quasi-experimental design used nonrandomized comparator groups to evaluate the associations of neighborhood environmental interventions with opioid overdose rates since randomization was not possible. Data analysis took place between May 2022 and February 2025.

Community trash pickups, vacant lot cleanups, and abandoned house remediation.

Outcomes of interest were nonfatal and fatal opioid overdoses.

Of 1667 individual blocks (median household income, $37 821) included in the study geography, 622 blocks (37.3%) received at least 1 intervention during the study period. Among 59 590 residents in the study area, there were 1179 Asian residents (2.0%), 9951 Black residents (16.7%), 23 261 White residents (39.0%), 5016 residents (8.4%) who identified as 2 or more races, and 19 903 residents (33.4%) who identified as another race; 30 286 residents (50.8%) were Hispanic or Latinx. A total of 763 community trash pickups, 483 abandoned house remediations, and 855 vacant lot cleanups were included in analysis. In aggregate, the interventions were associated with a significant reduction in fatal opioid overdoses (change, -6.6%; 95% CI, -10.5% to -2.4%), with no measurable association for nonfatal opioid overdoses (change, -0.0%; 95% CI, -3.4% to 3.5%). Abandoned house remediation was associated with a significant reduction in both fatal (change, -17.6%; 95% CI, -26.2% to -7.9%) and nonfatal (change, -11.5%; 95% CI, -19.0% to -3.3%) opioid overdoses. Community trash pickup was not associated with rates of fatal or nonfatal overdoses. Vacant lot cleanup was not associated with rates of fatal overdoses but was associated with a significant increase in nonfatal overdoses (change, 11.7%; 95% CI, 4.0% to 20.0%). No significant displacement associations were found in other locations.

In this study of the association of neighborhood environmental interventions with opioid overdose rates, interventions analyzed in aggregate were associated with reduced fatal opioid overdoses outcomes, with no association with nonfatal outcomes. Abandoned house remediation was significantly associated with reduced fatal and nonfatal opioid overdose rates and should be considered along with other essential interventions that provide treatment and harm reduction to individuals with substance use disorder.

Digital health technologies (DHTs) have the potential to improve care delivery and outcomes for patients with noncommunicable diseases. Yet their implementation in rural settings remains uneven, and the factors influencing uptake are not well understood.

This mixed methods systematic review aimed to identify barriers and facilitators influencing the implementation and use of DHTs for remote management of noncommunicable diseases in rural areas.

We searched Medline, Embase, and CINAHL from inception to February 12, 2026, using terms related to digital health, noncommunicable diseases, and rural settings. Following the Joanna Briggs Institute methodology for mixed-method systematic review, we synthesized quantitative and qualitative studies. Barriers and facilitators were categorized using the Consolidated Framework for Implementation Research, and study quality was appraised using the Mixed Methods Appraisal Tool.

From the initial 1491 records, 14 studies met the inclusion criteria, with most conducted in high-income countries (n=11). Key barriers included technical challenges (software instability and hardware issues), poor internet connectivity, financial constraints, and workforce constraints, such as staff shortages and heavy workloads. Key facilitators included user-friendly technology design, strong leadership, effective teamwork, and ongoing communication. Evidence was predominantly qualitative, with only limited quantitative data available.

DHTs show promise for improving access and continuity of care for cardiovascular disease, hypertension, and diabetes in rural settings; however, their impact is constrained by structural inequities, including limited broadband access, workforce shortages, and financial fragility. These findings highlight important implications for research, policy, and practice, including the need for rigorous mixed methods evaluations sensitive to rural contexts, long-term equity-oriented financing mechanisms, and strengthened organizational readiness to support effective DHT uptake.

Identify the perceived importance of front-of-package warning labels in purchase decisions of industrialized food products among Mexican adults with self-reported noncommunicable diseases (NCDs).

Data from the 2021 Mexican National Health and Nutrition Survey labeling and health questionnaires were analyzed. Logistic regression models adjusted for confounding variables and health data were used to estimate the mean predicted probability of considering each warning label (WL) as the most important.

Overall, 80.9% considered at least one WL important. The adjusted mean probabilities of considering each WL as the most important were 35.4% for "Excess sugar" and 9.0% for "Excess trans fat". Among participants with diabetes mellitus 2 (DM2), probabilities were 12.1 percentage points higher for "Excess sugar" and 3.1 percentage points lower for "Excess trans fat" than those without DM2.

WLs are widely considered in purchasing decisions of industrialized food products in Mexico, with perceived importance varying by nutrient and health condition, particularly among adults with DM2. These findings highlight the relevance of WLs as a policy tool to support informed decision-making, promote healthier food environments and comprehensive NCDs prevention and control strategies.

The widespread use of herbal medicines in clinical practice, particularly in Southeast Asia, presents significant challenges for medication safety management, notably regarding interactions between herbs and conventional drugs. Current drug interaction screening tools demonstrate substantial gaps in documenting herb-drug interactions, especially for regionally specific medicinal plants, creating potential risks for patients receiving concurrent therapies.

(1) to identify the prevalence of potential herb-drug and herb-herb interactions and the disclosure rate of HM use in patients with NCDs; and (2) to assess the consistency of interaction information across commonly used drug interaction databases.

An observational study enrolled 658 patients with non-communicable diseases from two Vietnamese tertiary care facilities. Structured interviews captured herbal medicine utilization patterns, disclosure practices, and specific botanical preparations used. Potential herb-drug and herb-herb interactions were systematically evaluated using four databases: Micromedex®, UpToDate Lexicomp Drug Interactions, Medscape Drug Interaction Checker, and Stockley's Herbal Medicines Interactions. Inter-database agreement was assessed using Fleiss' kappa statistics.

48.6% of participants reported active herbal medicines use, with 96% failing to disclose this to their healthcare providers. Potential interactions were identified in 31.3% of herbal medicine users, representing 15.2% of the total cohort. Database concordance was remarkably poor, with only 0.7% of interactions consistently documented across all four resources (Fleiss' κ = -0.0653; p < 0.001). Multiple indigenous medicinal plants commonly used by patients were absent from all evaluated databases.

The substantial prevalence of undisclosed herbal medicine use, alongside inadequate representation in drug interaction databases, represents a critical gap in medication safety infrastructure. These findings demonstrated the necessity for integrating herbal medicine assessment into routine care, enhanced provider training, and expansion of clinical decision support systems to include region-specific botanical data for populations using concurrent traditional and conventional therapies.

This study investigates the potential causal relationship between circulating ketone bodies, specifically beta-hydroxybutyrate (β-OHB), and the risk of myocardial infarction (MI), addressing limitations of confounding and reverse causation inherent in previous observational studies. We employed both univariable Mendelian randomization and multivariable Mendelian randomization (MVMR) analyses using publicly available genome-wide association study summary statistics. Genetic variants robustly associated with serum β-OHB levels (P < 5 × 10-8) served as instrumental variables. Primary analysis used the inverse-variance weighted method, supplemented by sensitivity analyses (MR-Egger, weighted median, weighted mode, MR-Lasso) and tests for pleiotropy/heterogeneity (Cochran's Q, MR-Egger intercept, MR-Pleiotropy RESidual Sum and Outlier, leave-one-out). The MVMR model adjusted for key cardiometabolic confounders: type 2 diabetes, alcohol intake, body mass index, smoking, hypertension, and blood lipids. univariable Mendelian randomization analysis indicated a significant positive association: a one-unit increase in natural log-transformed β-OHB concentration was associated with higher MI risk (IVW odds ratio [OR] = 1.407, 95% confidence interval (CI): 1.1660-1.6980, P = .0003691). Sensitivity analyses (weighted median: OR = 1.260, 95% CI: 1.0022-1.585, P = .0478442; MR-Egger: directionally consistent) supported this finding. MVMR analysis adjusting for confounders yielded divergent results. While conventional IVW showed no significant independent association (OR = 0.9787, 95% CI: 0 0.7410-1.2928, P = .8797), the MR-Lasso method revealed a significant independent positive association between β-OHB and MI risk (OR = 1.2366, 95% CI: 1.0397-1.4707, P = .0163751). This Mendelian randomization study suggests that genetically predicted, chronically elevated levels of β-OHB may confer an increased risk of MI.

Cervical cancer from persistent HPV infection is the leading cause of cancer death among Sub-Saharan African women. We here addressed the existing knowledge gap concerning the prevalence of HPV infection and cervical lesions in asymptomatic women living with HIV (WLWH) in Addis Ababa, Ethiopia. Adult WLWH (N = 334) were recruited at the HIV clinic of the Tikur Anbessa Specialized Hospital, Addis Ababa. Real-time PCR targeting 12 high-risk (HR) and 2 low-risk HPV types on cervical samples and Pap smear testing were performed. Logistic regression was used in IBM SPSS Statistics to identify factors associated with HPV infection and abnormal cytology. HR-HPV infections occurred in 20.6% of participants and the most prevalent HR-HPV genotypes were HPV35 (16.8%) and HPV16 (14.7%). Abnormal cytology was more common among HR-HPV-positive women than HR-HPV-negative women (36.1% vs. 12.6%, p < 0.0001). LSIL and HSIL were detected in 9.9% and 6.6% of HR-HPV-positive women, respectively. Condom use was associated with reduced odds of HPV infection and abnormal cytology. HR-HPV infections dominated by non-HPV16/18 types and abnormal cytology were common among asymptomatic WLWH in Ethiopia underscoring the need for strengthened cervical cancer screening, HPV vaccinations and safe-sex education for this high-risk population.

Trichophyton indotineae is an emerging dermatophyte associated with extensive inflammatory tinea and terbinafine resistance. Routine laboratory methods often fail to distinguish T indotineae from related lineages in the Trichophyton mentagrophytes-interdigitale complex, hindering surveillance and delaying resistance testing. We aimed to define the public internal transcribed spacer (ITS) haplotypes of T indotineae and develop novel molecular assays for accurate identification.

We conducted a marker identification and assay validation study by recurating GenBank ITS records (annotated as T mentagrophytes, T interdigitale, and T indotineae) from database inception to March 10, 2026, and performing haplotype analysis based on a 540 bp ITS region. We excluded records lacking complete coverage of this region or containing degenerate bases or alignment gaps from the primary network. We analysed Trichophyton genomes to identify a T indotineae-specific single-copy marker, OG7443, and developed duplex endpoint PCR and TaqMan real-time PCR assays. These assays were validated using culture isolates and direct skin-scraping specimens across two centres in China and one in the Netherlands.

Of 5584 ITS records retrieved, 4744 were retained for haplotype analysis after curation. The type-associated haplotype H002 comprised 1576 records, and a type-strain-anchored T indotineae cluster comprised 1698 records across 75 haplotypes. Duplex endpoint PCR identified all T indotineae and non-T indotineae isolates (sensitivity 100% [57/57; 95% CI 93·7-100·0]; specificity 100% [105/105; 96·5-100·0]). The TaqMan assay identified all culture isolates and direct skin scrapings, with sensitivity 100% (53/53; 93·3-100·0) and specificity 100% (160/160; 97·7-100·0). Estimated consumable costs were US$0·39 per sample for duplex endpoint PCR and $4·24 for TaqMan PCR.

OG7443 is a species-specific genomic marker for T indotineae that supports two assay formats. These assays could aid surveillance, case recognition, and triage for downstream resistance testing, but direct-specimen performance requires confirmation in larger prospective cohorts.

Noncommunicable Chronic Diseases-National Science and Technology Major Project; Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences; 111 Project; Brazilian Council for Scientific and Technological Development.

Racial and ethnic differences in diabetic cardiomyopathy (DbCM) exist, with black and Hispanic participants showing poorer health status. It remains unclear whether these differences affect the natural progression of the disease. We aimed to evaluate disease progression in individuals with DbCM, as well as racial differences in the response to AT-001.

A total of 625 participants with DbCM were randomised to either placebo or AT-001 and followed for 15 months. The primary outcome was change in peak oxygen uptake (peak VO₂) and secondary outcomes included Kansas City Cardiomyopathy Questionnaire (KCCQ) and Physical Activity Scale for the Elderly scores. Analyses were stratified by race and ethnicity (black, Hispanic, white).

Black and Hispanic participants who received placebo experienced greater declines in peak VO₂ (-0.74 and -1.67 mL/kg/min, respectively) compared with white participants (-0.23 mL/kg/min, p=0.005). AT-001 demonstrated a non-statistically significant trend towards slower declines in peak VO₂ in black and Hispanic participants (-0.31 and -0.62 mL/kg/min, p=0.29, respectively). Black participants who received placebo had the largest declines in most KCCQ scores.

Black and Hispanic participants with DbCM experienced faster disease progression, with black participants showing the most pronounced functional and quality of life declines. The effect of AT-001 on peak VO₂ changes was not statistically significant with similar effects between racial and ethnic groups (NCT04083339).

NCT04083339.