PurposeTo evaluate the short-term effects of a brief mindfulness-based intervention delivered during hemodialysis on trait mindfulness, cognitive reappraisal, expressive suppression, and kidney disease-related quality of life (QOL) in adults with end-stage renal disease (ESRD).DesignCluster-randomized, parallel-group, pretest-posttest trial.MethodsAdults receiving maintenance hemodialysis (N = 104 analyzed) were randomized by six dialysis day/shift clusters to a mindfulness intervention (n = 52) or wait-list control group (n = 52). The intervention consisted of a 30-min guided mindfulness protocol three times weekly for 5 weeks during dialysis. Outcomes were measured using the Mindful Attention Awareness Scale, Emotion Regulation Questionnaire, and Kidney Disease QOL.ResultsLinear mixed models showed the intervention group achieved significantly higher posttest scores than controls in trait mindfulness (mean difference [MD] = 0.64, p = .004) and cognitive reappraisal (MD = 0.53, p < .001). Regarding health-related QOL domains, significant improvements were found for the physical component summary (MD = 7.35, p < .001), kidney disease effects (MD = 25.82, p = .001), and kidney disease burden (MD = 21.66, p = .001).ConclusionPossible short-term benefits of a dialysis-chair mindfulness intervention for trait mindfulness, cognitive reappraisal, and QOL among adults receiving hemodialysis.

Psychological stress impairs both mental health and physiological function, making it a major occupational health risk for office workers. Although non-pharmacological emotional interventions have gained attention, scientific evidence for structured animal-based video content remains scarce. This study investigated whether structured puppy video viewing improves stress responses and compared outcomes between normal blood pressure (BP) and elevated BP office workers.

Sixty-six participants (36 for normal BP, 30 for elevated BP) took part in a non-randomized pre-post intervention, viewing structured puppy videos for 15 min. Systolic BP (SBP), diastolic BP (DBP) and pulse rate were measured as physiological outcomes; psychological outcomes were assessed with the 20-item State Anxiety subscale of the State-Trait Anxiety Inventory (STAI-S) and with the 30-item the Korean Profile of Mood States-Brief (K-POMS-B), summarized as Total Mood Disturbance (TMD).

In normal BP group, SBP decreased by 3.16 mmHg (p = 0.002), pulse rate by 2.76 bpm (p < 0.001), STAI-S by 6.64 points (p < 0.001), and TMD by 7.92 points (p < 0.001) after viewing the video. In the elevated BP group, there were significant reductions in SBP (Δ6.65 mmHg), DBP (Δ4.93 mmHg), pulse rate (Δ4.12 bpm), and STAI-S (Δ9.43 points) (with all p < 0.001), alongside a TMD reduction of 11.77 points (p < 0.001). When comparing between normal and elevated BP groups, SBP and DBP were decreased more in the elevated BP participants (p < 0.049, and p < 0.001, respectively). Overall, structured puppy video viewing significantly alleviated both physiological and psychological stress.

These findings suggest its potential as a scalable, non-pharmacological approach to support workplace stress management.

Athletes frequently encounter considerable emotional challenges during high-intensity training and competition. Effective emotion regulation is essential not only for athletic performance but also for long-term mental health and career longevity. Although mindfulness interventions have been increasingly applied in sport psychology, their effects on athletes' emotion regulation have not been comprehensively evaluated. This meta-analysis therefore examined the effects of mindfulness interventions on emotion regulation among athletes.

Seven eligible studies involving 273 participants were synthesized to evaluate the effects of mindfulness interventions on athletes' emotion regulation.

Mindfulness interventions produced a statistically significant, moderate effect on athletes' emotion regulation (Hedges' g = 0.81, 95% CI [0.51, 1.11], p < 0.0001). Egger's regression test was not statistically significant (p > 0.05); however, this finding provides limited reassurance because the test has low statistical power when fewer than 10 studies are included.

The overall estimate was based on only seven studies, and the direct comparison between Mindfulness-Acceptance-Commitment training and Psychological Skills Training was based on only three studies. The findings should therefore be considered preliminary and require confirmation in larger, higher-quality randomized controlled trials. Future research should examine diverse athlete populations and intervention conditions to clarify how mindfulness-based and traditional psychological training approaches contribute to athletes' emotion regulation and psychological functioning.

PROSPERO. Registration number: CRD420261340782. https://www.crd.york.ac.uk/PROSPERO/view/CRD42026134078.

Advances in data science and medical artificial intelligence (AI) raise complex philosophical and ethical quandaries about what it means to know a person or a community through data and what kinds of people and societies we are becoming in this era of predictive data science. Drawing on four lightly fictional but reality-informed case studies in mental health, radiology, genomics and environmental public health, we reflect on how AI technologies, largely built on Western biomedical traditions, may conflict with relational, spiritual and Indigenous understandings of health and wellbeing. This may manifest as epistemic friction, algorithmic fatalism and diminished trust in patient-clinician relationships. Besides familiar concerns regarding bias and transparency, this paper advances the discourse on the ethics of medical AI and data science in healthcare by shifting the analysis from epistemology (how AI systems know, classify and predict) to ontology (the study of the nature of being, as reconfigured by data and AI). We argue that AI systems may inflict significant ontological harm by reconfiguring identity, moral agency and imagined futures and advocate for a renewed medical humanism driven by inter- philosophies dialogue, cross-cultural ethics and ecocentric approaches to care. From Bamenda, Cameroon, to Mthatha, South Africa and Toronto, Canada, the future of medical AI must be defined by the moral and philosophical traditions that people already live by. African, Indigenous, Islamic, Buddhist, Confucian and marginalised Western worldviews should not be treated as peripheral critiques, but as constitutive resources for building inclusive, human-centred health technologies. We conclude that bioethics should be recognised as a core infrastructure in global health, on equal footing with data science, medicine, biomedical research and health innovation.

Online social anxiety (OSA), a multidimensional form of social evaluative anxiety in online social contexts, disproportionately affects emerging adults who constitute the largest active group of media users and face heightened psychological sensitivity due to growing pressures and immature sociocognitive regulation during the transition to adulthood. However, its heterogeneity, transitions, and longitudinal associations with mental health outcomes remain underexplored.

This study utilized data from two waves of a three-wave longitudinal survey, with 849 Chinese participants (Mean_age = 21.6 years; 50.4 percent female) assessed at 4-month intervals. Individuals were classified using latent profile analysis and the stability and changes of profiles were assessed via latent transition analysis (LTA). Multinomial logistic regressions were conducted separately at baseline and follow-up to identify correlates of profile membership. Predictors of profile transitions were examined using manual three-step LTA models, and associations between latent transition patterns and follow-up mental health outcomes were examined using BCH-LTA distal outcome analyses controlling for the corresponding baseline symptom level.

Four profiles of OSA were identified: low, privacy-sensitive, moderate-high, and high OSA. Extreme profiles (low/high OSA) showed high stability (80.4 percent and 79.1 percent), while privacy-sensitive OSA exhibited the lowest stability (55.1 percent). Profile memberships were influenced by social-cognitive biases and digital interaction, particularly fear of negative evaluation and online interpersonal trust, whereas profile transitions were mainly associated with anxiety. Transitions toward less severe OSA profiles were generally associated with better subsequent mental health, whereas transitions toward more severe profiles corresponded to poorer outcomes, particularly for offline social anxiety.

OSA was heterogeneous in its manifestation, severity and transitions. Personalized and early interventions targeting profile-specific vulnerabilities are critical to prevent the worsening of OSA and mitigate its psychological burden.

People with serious mental illness (SMI) are a vulnerable population with poor health outcomes who also experience challenges interacting with health providers. This study aimed to explore the perceptions and recommendations of people with SMI for the development of physician assistant (PA) curriculum using the Socio-Ecological Model of Health framework (SEM). No known previous studies have explored the attitudes of people with SMI about their mental illness care to inform curriculum.

People with SMI (n = 7) were recruited from a state chapter of a mental health advocacy organization to explore experiences with health care providers and recommendations for PA education. The focus group lasted 90 minutes and was facilitated by a PA and mental health provider using an interview guide.

Four themes were identified and coded using the SEM framework. These included (1) individual attributes of health, (2) interpersonal relationships contributing to health, (3) community features contributing to health, and (4) educational aspects needed for positive health encounters.

People with SMI noted difficulties in interactions with medical professionals and systems. They perceived that medical providers need more education and skills to engage with people with complex health and mental health conditions. Results of this study may suggest that PA education can be improved by considering the SEM levels of interaction and listening to patients to incorporate feedback into service provision.

The growing burden of non-communicable diseases (NCDs) among people living with HIV (PWH) in low- and middle-income countries (LMICs), threatens gains in life expectancy. Global organizations have called for integrating NCD management into existing HIV care systems, but it is unclear what actions countries are taking to accomplish this goal. To bridge this knowledge gap, we conducted a quantitative content analysis of HIV policy documents from the World Health Organization (WHO), the US President's Emergency Plan for AIDS Relief (PEPFAR) and 22 PEPFAR-sponsored LMICs to analyze mentions of: 1) screening and treatment of selected NCDs (hypertension, diabetes, cervical cancer, and depression) and/or two NCD risk factors (alcohol and tobacco use), and 2) health system-strengthening strategies when mentioned in relation to the selected NCDs and risk factors. We used the WHO's Building Blocks framework to identify these strategies. Screening and treatment for cervical cancer and mental health conditions were reported in the WHO and PEPFAR documents and in the majority of country documents. Strategies to strengthen service delivery (e.g., NCD care coordination across health facilities, establishing guidelines for integrated care) were frequently referenced across WHO, PEPFAR, and country-level documents. Far fewer documents mentioned strategies related to health information technology, medication access, and financing to support care integration. Although the WHO, PEPFAR and country-level documents illustrate a commitment to NCD-HIV health system integration, there was variation in which NCDs were being prioritized. Mentions of screening and treatment of NCD risk factors were rare, suggesting that tobacco and alcohol-related services may be comparatively under-resourced. Integrating NCD and HIV care requires sustained investments that align with local resources and attention to system-level enablers (e.g., improved information systems, stronger medicine supply chains) that support comprehensive care. Future research should focus on identifying the determinants of policy adoption, including factors that either drive or constrain integration of the full spectrum of NCD services within HIV care settings.

BackgroundInterventions aimed at providing oral motor stimulation improve the preparedness for oral feeding and support the earlier attainment of full oral feeding in preterm infants. However, utilizing the Premature Infant Oral Motor Intervention (PIOMI) as a structured method may prolong the time needed to reach complete oral feeding and enhance feeding efficiency regarding weight gain and exclusive breastfeeding, compared to an unstructured approach.ObjectiveThe current study aimed to evaluate the impact of PIOMI on the progression of oral feeding and weight gain in premature infants.MethodsThis study represents a randomized controlled trial that took place in a neonatal intensive care unit in 2024. The intervention group received PIOMI, and the control group did not receive the intervention. The participants of the two groups were compared based on weight gain, mean height, head circumference, and length of hospitalization.ResultsThe findings of this study showed that the mean of studied parameters, such as weight, height, and head circumference of the infants in the intervention group, was higher than that of the control group, and this difference was statistically significant (p < 0.05). Moreover, the mean number of uninterrupted sucking of infants in the intervention group was higher, and it was statistically significant (p < 0.001).DiscussionThe PIOMI intervention enhances the sucking strength and consequently boosts the growth metrics of premature infants.ConclusionIt was concluded that the PIOMI intervention increases the sucking power and, as a result, improves the growth indicators of premature neonates, such as weight, height, and head circumference, which is clinically important. Additionally, it reduces the mean hospitalization time.

The integration of data-driven continuous monitoring into chronic disease management is often presented as a solution for clinical efficiency. However, this technological shift may substantially reshape care relations, power, and intimacy. Prevailing research, focused on technical validation, fails to capture how such systems operate as social forces. A critical, theory-informed examination of these lived transformations is needed. This study goes beyond documenting ethical dilemmas by critically investigating how data-driven surveillance restructures nurse-patient dynamics. We aim to uncover the mechanisms through which data-driven surveillance disciplines both caregivers and recipients, and to identify where and how the irreducible elements of humanistic care persist and resist.

A critical qualitative design was employed, guided by Foucault's concept of governmentality as a sensitising lens. Semi-structured interviews were conducted with 12 registered nurses and 15 patients with hypertension or type 2 diabetes in one Chinese tertiary hospital that had, for six months, implemented real-time automated physiological monitoring. Data were analysed using reflexive thematic analysis with a hybrid (deductive-inductive) approach.

Our analysis reveals three core mechanisms: (1) systematic arbitration (nurses as constant negotiators between automated alerts and situated clinical judgment); (2) datafied self-surveillance, patients internalise the data-driven gaze, policing their own behaviour; (3) a shared convergence around the human boundary, both nurses and patients actively defend empathy, contextual interpretation, and emotional recognition as domains irreducible to data. This boundary is not a passive remnant but an active, shared accomplishment.

Digital surveillance in chronic care does not act as a neutral adjunct. Instead, it operates as a disciplinary technology that asymmetrically disciplines nurses and patients. However, the identified human boundary represents a critical site of resistance and re-humanisation. The future of humane digital health depends on deliberately designing socio-technical systems that strengthen, rather than erode, the relational and interpretive core of clinical practice.

Gestational diabetes mellitus (GDM) is associated with adverse pregnancy outcomes and long-term metabolic and cardiovascular risk. However, oral glucose tolerance testing at 24-28 gestational weeks limits early risk stratification. Gut microbiota-associated metabolites may reflect early metabolic abnormalities, including those relevant to cardiometabolic health, but robust early-pregnancy biomarkers remain limited.

We conducted a multicenter nested case-control and prospective study involving 2,693 pregnant women. Untargeted metabolomics and metagenomics were integrated to identify GDM-associated metabolites and gut microbial alterations. Three consistently dysregulated metabolites, 3-hydroxydecanoic acid, γ-Glu-Leu, and propionic acid, were quantified by targeted LC-MS/MS. Candidate algorithms were compared using repeated 10-fold cross-validation, and a final generalized linear model was externally and prospectively validated.

Women who later developed GDM showed an adverse early-pregnancy metabolic profile, including higher BMI, triglycerides, and platelet count. Untargeted metabolomics identified 14 persistently altered metabolites enriched in energy, oxidative stress, and amino acid metabolism pathways. Metagenomics revealed taxonomic restructuring and coordinated microbiota-metabolite associations. The three-metabolite model achieved AUCs of 0.838 (95% CI, 0.791-0.885) in training, 0.840 (95% CI, 0.769-0.911) in internal validation, 0.955 (95% CI, 0.925-0.985) and 0.917 (95% CI, 0.875-0.958) in two external cohorts, and 0.969 (95% CI, 0.937-1.000) in the prospective cohort.

Early microbiota-associated metabolic dysregulation is detectable before routine GDM diagnosis. This compact three-metabolite panel may support early GDM risk stratification and provides metabolic evidence relevant to broader cardiometabolic risk assessment in pregnancy.