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PubMed2026

Dispositional optimism and open-label placebo responses in hair cortisol concentrations and psychological distress-A randomized controlled trial.

Open-label placebo (OLP) treatments show beneficial effects on various health-related outcomes, but studies investigating OLP effects on physiological measures remain scarce. This randomized controlled trial examined the effect of a 4-week OLP intervention on psychological distress and hair cortisol concentrations (HCC) in 202 healthy university students preparing for mandatory oral exams and whether dispositional optimism moderates the OLP effects. Participants were randomly assigned to an OLP or control group. Psychological distress was repeatedly assessed via negative affect, test anxiety, and subjective stress. HCC was measured before and within the intervention. Treatment expectations were additionally examined in interaction with optimism. Results show that OLPs significantly reduced psychological distress and HCC compared to the controls. Optimism moderated the OLP effect on HCC, with less optimistic individuals demonstrating the strongest reduction, independent of expectation. Optimism did not moderate OLP effects in psychological distress. However, the OLP effect on psychological distress depended on the three-way interaction of group, optimism, and expectation. The results suggest that OLPs alleviate the psychophysiological impact of a real-life stressor and indicate that optimism and expectation differently shape psychological and physiological OLP responses. These findings are discussed within the framework of the interactionist perspective.

Humans↗
PubMed2026

Evaluation of oral health-related quality of life following pulp therapy or extraction in paediatric patients: a systematic review.

BACKGROUND: Treatment decision between pulp therapy and extraction for compromised teeth in paediatric patients remains a topic of debate. While both approaches address the associated pain, their long-term impact on children's well-being remains unclear. This systematic review aimed to analyse and compare the impact of pulp therapy and extraction on OHRQoL in paediatric patients. METHODS: This review was conducted in accordance with PRISMA guidelines. A comprehensive search was performed in multiple electronic databases. Methodological quality and risk of bias were evaluated using the RoB 2 tool for randomised controlled trials, ROBINS-I tool for non-randomised trials, and the Newcastle-Ottawa Scale for observational studies. RESULTS: Seven studies comprising a total of 1367 participants met the inclusion criteria. The results indicated that pulp therapy was associated with superior OHRQoL outcomes compared to extraction. Children who underwent pulp therapy reported lower anxiety, better emotional well-being, and higher parental satisfaction. Given the heterogeneity among the studies, a narrative synthesis was performed. CONCLUSION: Pulp therapy may offer better OHRQoL outcomes than extractions in paediatric patients by preserving function, reducing anxiety, and minimising long-term complications. However, these findings should be interpreted cautiously since the available evidence was limited and of low to very low certainty. Further well-designed randomised controlled trials are required.

Children↗
PubMed2026

Attitudes, knowledge, and behavioral control regarding child abuse reporting in middle eastern nursing professionals: A systematic review and meta-analysis.

INTRODUCTION: Child abuse is critically underreported in the Middle East, with up to 90% of cases going unidentified. Nurses play a central role in child protection systems, yet factors influencing their reporting practices in this region have not been comprehensively synthesized. This study aims to review systematically and meta-analyze evidence on Middle Eastern nurses' knowledge, attitudes, and perceived behavioral control regarding child abuse reporting. METHODS: We conducted a systematic review and meta-analysis following PRISMA guidelines. Five databases (PubMed, Scopus, Web of Science, Embase, Cochrane Library) were searched through November 2025. Studies targeting nursing professionals or students in Middle Eastern countries assessing knowledge, attitudes, intention to report, subjective norms, or perceived behavioral control were included. Random-effects meta-analyses were performed with subgroup analyses comparing students and practicing nurses. RESULTS: Fourteen studies comprising 4018 participants across six countries met the inclusion criteria. The pooled knowledge score was 61.64% (95% CI: 50.14-73.14), with nursing students scoring higher than practicing nurses (75.28% vs. 54.79%, p = 0.03). The pooled attitude score was 60.69% (95% CI: 44.82-76.57). Educational interventions significantly improved knowledge (SMD = 1.54, 95% CI: 0.70-2.38, p = 0.0003). The pooled proportion of nurses intending to report suspected abuse was 75% (95% CI: 0.58-0.92). The pooled subjective norm score was 8.02 (95% CI: 7.75-8.29), and the pooled perceived behavioral control score was 24.34 (95% CI: 22.20-26.46). High heterogeneity (I2 > 95%) reflects substantial variability in educational and legal contexts across the region. CONCLUSIONS: Middle Eastern nurses show moderate knowledge and attitudes toward child abuse reporting, with notable gaps among practicing professionals. Educational interventions are effective but should be integrated with systemic reforms, including mandatory reporting legislation and clear protocols.

Humans↗
PubMed2026

"Orphaned bereavement": Toward a public health model for bereavement.

Bereavement is increasingly recognized as a public health concern, yet support systems in many welfare states continue to allocate support according to the circumstances of death rather than the functional needs of bereaved families. Existing bereavement frameworks have substantially advanced understanding of social recognition and public legitimacy but provide more limited guidance for understanding how institutional responsibility for bereaved families is organized. using Israel as a bereavement-saturated case, this study introduces the concept of orphaned bereavement to describe bereavement in which no institution holds clearly defined and continuing responsibility for identifying needs, coordinating support, and ensuring continuity of care. Drawing on 25 semi-structured interviews with five bereaved family members and 20 professionals, analyzed using reflexive thematic analysis, the analysis generated three interrelated themes: institutionalized invisibility and unequal recognition; reorganizing life in the absence of institutional support; and pathways toward a needs-based model of bereavement support. The findings extend existing theories of disenfranchized grief and grievability by introducing institutional responsibility as a complementary lens for understanding bereavement inequality and support a needs-based public health approach in which support is organized according to families' evolving functional needs rather than the circumstances of death.

Journal Article↗
PubMed2026

Symptom assessment and health-related quality of life in children with lower urinary tract dysfunction: A retrospective cross-sectional study.

INTRODUCTION: Lower urinary tract dysfunction (LUTD) significantly impacts children's health-related quality of life (HRQoL), but key determinants of this impairment remain incompletely understood within a patient-centered framework. METHODS: This retrospective cross-sectional study enrolled 272 children with LUTD. Clinical symptoms were assessed using the Dysfunctional Voiding Scoring System (DVSS) and the Overactive Bladder Symptom Score (OABSS), and HRQoL via the Pediatric Quality of Life Inventory (PedsQL&#x2122;) 4.0 Generic Core Scales. RESULTS: The mean total PedsQL score was 83.66 &#xb1; 16.07, with the School Functioning domain being the most impaired (73.75 &#xb1; 20.94). Univariate analysis identified older age (&#x2265;11 years), daytime urinary leakage, overactive bladder (OAB) symptoms, and abnormal DVSS scores as factors associated with reduced HRQoL (all P < 0.05); multivariate regression further confirmed only older age and abnormal DVSS were independent influencing factors (both P < 0.001). A significant negative correlation existed between the total DVSS score and the total PedsQL score (r = -0.390, P < 0.01), indicating that greater symptom severity predicts poorer overall HRQoL. CONCLUSION: This study indicates that in children with LUTD, the severity of voiding dysfunction (quantified by DVSS) is inversely correlated with HRQoL. Voiding dysfunction impairs multiple domains of daily functioning, including physical well-being, emotional adjustment, social interaction, and school performance. Shifting from a symptom-focused to a patient-centered care model and integrating routine HRQoL assessment into standard clinical management can optimize clinical practice for pediatric LUTD.

Humans↗
PubMed2026

Implementation of Mobile Health Intervention Targeting Belongingness and Burdensomeness: An Ecological Momentary Assessment Study of Self-Injurious Thoughts and Behaviors in LGBTQ+ Individuals.

OBJECTIVE: The goal of this paper was to test a mobile health intervention designed to reduce self-injurious thoughts and behaviors in LGBTQ+ individuals. The intervention consisted of brief messages aimed at increasing feelings of belongingness and meaning. METHOD: We recruited LGBTQ+ individuals (N&#x2009;=&#x2009;55) with past-month self-injurious thoughts and/or behaviors. Participants completed 14&#x2009;days of ecological momentary assessment (EMA) of minority stress, thwarted belongingness, perceived burdensomeness, and self-injurious thoughts and behaviors. Then, participants were randomly assigned to receive brief messages designed to instill belongingness and meaning/purpose, or no intervention for 14&#x2009;days. Then, participants completed an additional 14&#x2009;days of EMA. RESULTS: Our results showed that participants in the control condition had significant increases in self-injurious thoughts and planning over time, whereas those in the intervention condition showed no significant change. For self-injurious behavior, thwarted belongingness, and perceived burdensomeness, there were significant decreases in the intervention condition, but no changes in the control condition. CONCLUSIONS: These results provide support for the interpersonal theory of suicide and indicate a potentially scalable mobile health intervention. PUBLIC HEALTH SIGNIFICANCE: This paper found evidence that a brief mobile health intervention reduced suicidal and non-suicidal self-injurious thoughts and behaviors among LGBTQ+ individuals.

Humans↗
PubMed2026

Assessing the public health impact of routinely collected electronic healthcare record data in NICE guidelines: A systematic review of CPRD research.

OBJECTIVES: Evidence used in NICE guidance has traditionally prioritised randomised controlled trials, but increasing availability of electronic health record (EHR) data has expanded opportunities for real-world evidence. The Clinical Practice Research Datalink (CPRD) is a commonly used UK primary care EHR resource, yet the extent to which CPRD studies have informed NICE guidelines in the past decade is unclear. STUDY DESIGN: The systematic review was conducted in accordance with PRISMA guidelines. METHODS: We conducted a systematic review of CPRD studies in PubMed, MEDLINE, and Embase published between 04/16-09/25. For each eligible CPRD study, targeted searches of NICE guidelines were performed to identify explicit citations in NICE guidelines. Two reviewers screened and extracted data independently, resolving disagreements by consensus or third reviewer. Guideline information, number of guidelines over time, type of guidelines, and disease area guidelines (using British National Formulary (BNF) chapters) were described. RESULTS: 7181 records were identified. After de-duplication, 2704 unique CPRD studies were screened against NICE guidelines. Of these, 92 CPRD-based studies met inclusion criteria and were cited across 67 NICE documents. The annual number of NICE guidelines citing CPRD studies increased between 2016 and 2025; 1.5% of identified guidelines published in 2016 and 27.7% in 2025. The guideline citing the most CPRD studies was cancer related. The most common types of guidelines included clinical guidelines (49.3%) and technology appraisals (32.8%). Guidelines made up 12 different BNF categories, most frequently central nervous system related (23.9%; n&#x202f;=&#x202f;16). CONCLUSION: Observational CPRD studies are increasingly referenced in NICE guidelines across multiple disease areas, supporting the growing role of EHR data in national guideline development.

Clinical studies↗
PubMed2026

The application of artificial intelligence in healthcare practice: A mapping review of systematic reviews.

Artificial intelligence (AI) is rapidly transforming healthcare practice, with growing evidence supporting its use in diagnosis, prognosis, treatment planning, and operational decision-making. The proliferation of systematic reviews in recent years underscores the need for an updated synthesis of the literature to inform research, policy, and practice. We searched PubMed, Web of Science, Scopus, IEEE Xplore, and CINAHL for systematic reviews and meta-analyses published between 2019 and February 2026. Eligible reviews focused on AI applications in healthcare practice, were peer-reviewed, and written in English. A total of 368 reviews met the inclusion criteria. Publication volume increased steadily, peaking in 2025. AI research was concentrated in high-density domains, such as radiology, oncology, and critical care. Across reviews, diagnostic imaging, electronic health record (EHR) data, and biomarkers/laboratory results accounted for 68% of training data sources, though newer data types, such as wearable device and sensor data, emerged from 2022 onward. Diagnosis, prognosis, and treatment comprised over 80% of AI applications, with novel uses emerging in recent years, such as AI-assisted clinical documentation (e.g., ambient documentation tools) and patient education. Ethical concerns were reported in 78.5% of reviews, with privacy, model accuracy, data and algorithmic bias, and explainability as recurrent themes. The proportion of reviews reporting ethical concerns increased from 2021 to 2025. AI applications in healthcare are expanding in scope, diversifying in data sources, and evolving toward novel clinical and operational uses. The human-centered AI or augmented intelligence paradigm, integrating computational precision with clinical expertise, holds significant promise but will require parallel advances in governance, regulatory frameworks, and ethical oversight to ensure safe adoption.

Artificial Intelligence↗
PubMed2026

Impact of Physical Environment of Pediatric Inpatient Wards on Children: A Systematic Literature Review.

ObjectiveThe study aimed to examine empirical studies published between 2003 and 2025 to identify elements of physical environments influencing health outcomes and experiences of children and families.BackgroundIn the past 40 years, research has shown that the physical environment influences the health and well-being of patients in the healthcare environment. However, similar research in the context of "pediatric inpatient wards" remains underexplored.MethodsPubMed, Embase, Scopus, and Web of Science were used to identify relevant articles. All extracted articles underwent a three-step screening process using PRISMA. A total of 30 eligible articles were used for the analysis. The protocol is registered at PROSPERO (CRD42023408997).ResultsKey findings reveal positive and negative impacts of identified elements. Positive-effect elements include play spaces, space for parents, natural light, connections with nature, and so on, which promote comfort, healing, and emotional resilience. Conversely, negative-effect elements, such as noise, artificial lighting, uncomfortable temperature, and so on, contribute to stress and disrupted sleep. Mixed effects were observed for elements like art and television, which underscore the complexity of designing environments that address the diverse needs of different age groups and genders.ConclusionsThe review findings highlight significant knowledge gaps. The study also tries to bridge existing gaps between research and practice by systematically identifying environmental elements, offering actionable insights to architects, designers, healthcare providers, and policymakers. Future research must adopt rigorous, culturally inclusive approaches to advance the field of pediatric healthcare design and ensure equitable care across diverse sociocultural contexts.

Humans↗
PubMed2026

Parents' Awareness of Their Adolescents' Sexual Behaviors and Experiences: A Concordance Analysis.

PURPOSE: Adolescence is a developmental period during which sexual exploration is normative. Parental awareness of adolescents' sexual behaviors can be protective during this stage; however, research suggests both parents and adolescents tend to avoid open conversations about these sensitive issues. This study aimed to examine concordance between parent proxy-reports and adolescent self-reports across three domains of adolescents' sexual behaviors and experiences. METHODS: Data were collected from a national sample of 522 parent-adolescent dyads (aged 15-17 years) from the AmeriSpeak panel (data collected May-September 2022). Prevalence-adjusted bias-adjusted kappa (PABAK) statistics were calculated to evaluate agreement. RESULTS: Findings revealed weak-to-moderate concordance regarding adolescents sending and receiving sexual photos (PABAKs = 0.54-0.79), whereas stronger concordance was observed for experiences related to nonconsensual sharing of sexual photos (PABAKs = 0.92-0.94), with high agreement largely driven by low reported prevalence of these experiences. Strong concordance regarding whether adolescents had ever had sex (PABAK = 0.80) was largely driven by both parents and adolescents reporting the adolescent had not had sex. Concordance regarding sexually transmitted infection and pregnancy prevention methods varied, ranging from weak to strong agreement across specific methods (or lack thereof; PABAKs = -0.07-0.79). DISCUSSION: Results highlight significant discrepancies in parents' knowledge about their adolescents' sexual behaviors and experiences. Interventions aimed at enhancing trust and open dialogue between parents and adolescents about sexuality-related topics, as well as ensuring adolescents have a variety of trusted sources to consult for sexual information, can help adolescents make informed sexual health decisions.

Humans↗
PubMed2026

Orofacial Cleft Disparities in American Indian and Alaska Native Populations: A Systematic Review and Meta-Analysis.

ObjectiveTo evaluate the prevalence, access to care, and health outcomes of orofacial clefts (OFCs) among American Indian and Alaska Native (AI/AN) populations through a systematic review and meta-analysis.DesignSystematic review and meta-analysis performed in accordance with PRISMA 2020 guidelines and registered with PROSPERO (CRD420251035364).SettingUS-based population registries, hospital databases, and institutional or community-level retrospective studies involving AI/AN populations.Patients and ParticipantsAI/AN individuals with OFCs compared with non-Hispanic White patients.InterventionsPrimary cleft lip and palate repair, secondary cleft-related procedures, and multidisciplinary cleft care.Main Outcome Measure(s)Prevalence of OFCs, timing of cleft surgery, discharge disposition, access to specialists, and qualitative determinants of disparities.ResultsEighteen studies including more than 1985 AI/AN patients were identified. Meta-analysis of 5 studies estimated a pooled OFC prevalence of 15 per 10&#x2005;000 live births (95% confidence interval: 5-49), with substantial heterogeneity (I2&#x2009;=&#x2009;99.8%). Individual studies reported significantly higher OFC prevalence in AI/AN populations compared to non-Hispanic Whites (odds ratio range: 1.44-2.68). Geographic maldistribution of craniofacial-trained surgeons, increased odds of nonhome discharge, and delayed cleft palate repair were consistently observed barriers. Qualitative analyses highlighted structural inequities, perceived racism, and lack of culturally responsive care as major contributors to disparities.ConclusionsAI/AN populations face a disproportionately high burden of OFCs alongside structural barriers to timely, culturally competent care. Addressing these disparities requires community-engaged, multidisciplinary interventions that improve geographic access and integrate culturally responsive approaches to care.

Humans↗
PubMed2026

Associations Between Health-Related Physical Fitness and Accelerometry-Based Energy Expenditure in Physiotherapy Workers.

BACKGROUND AND PURPOSE: Although it has been assumed that higher physical activity (PA) levels will contribute to better physical fitness (PF) performance, the interplay between these two has yet to be investigated. Moreover, the majority of studies have been presented in children and adolescents, and older adults, while little is known about the correlation in the adult working population of physiotherapists. Therefore, the main purpose of the study was to examine associations between objectively measured PA and health-related PF. METHODS: We recruited 50 physiotherapists (72.6% women) from several public and private settings in the city of Zagreb. The SenseWearArmbandPro3 (SWA), a triaxial accelerometer placed on the nondominant hand for 7 consecutive days, was used to capture total energy expenditure (TEE) and active EE (AEE). Cardiorespiratory fitness included the Harvard step test, and muscular fitness was composed of sit-ups in 60&#xa0;sec and the Handgrip strength. Flexibility was evaluated using the Toe-touch test. RESULTS: TEE and AEE were moderately and positively correlated with the Harvard step test (r&#xa0;=&#xa0;0.65 and 0.62, p&#xa0;<&#xa0;0.001), sit-ups (r&#xa0;=&#xa0;0.70 and 0.59, p&#xa0;<&#xa0;0.001), and the Handgrip strength test (r&#xa0;=&#xa0;0.74 and 0.64, p&#xa0;<&#xa0;0.001). No significant correlation with the Toe-touch test was observed (r&#xa0;=&#xa0;-0.25 and -0.19, p&#xa0;>&#xa0;0.05). When models were adjusted for age, weaker, but significant positive correlations remained. DISCUSSION: The findings suggest that both cardiorespiratory and muscular fitness are positively associated with PA, whereas no statistically significant association with flexibility was detected. Thus, it is not surprising that we obtained moderate to almost strong correlations between TEE and AEE with cardiorespiratory and muscular fitness. CONCLUSIONS: In physiotherapists, TEE and AEE yield moderate correlations with health-related PF, especially for cardiorespiratory and muscular fitness.

Humans↗
PubMed2026

Systematic review of machine learning approaches for predicting sickle cell crisis and mortality risk at the climate-health nexus.

BACKGROUND: Sickle cell anemia (SCA) is a severe genetic blood disorder characterized by recurrent vaso-occlusive crises and increased mortality, with the greatest burden occurring in low- and middle-income countries. Climatic and environmental conditions, including temperature variability, humidity, rainfall, air pollution, and seasonal changes, have been associated with disease exacerbation. However, the extent to which these factors have been incorporated into predictive models remains unclear. This study systematically reviews the application of machine learning (ML) models for predicting SCA crises and mortality in relation to climate and environmental factors. METHODOLOGY: The PRISMA guidelines were used, and 34 peer-reviewed studies published between 2005 and 2026 were analyzed to identify the climate variables, ML approaches employed, and predictive performance. The reviewed studies applied a range of ML techniques, including artificial neural networks, random forests, support vector machines, decision trees, logistic regression, and deep learning models. Temperature, humidity, rainfall, wind speed, air quality indicators, and seasonal patterns were the most frequently examined environmental variables. RESULTS: The findings indicate that most existing models rely predominantly on clinical and demographic data, with limited integration of climate information and inadequate representation of high-burden regions, especially Sub-Saharan Africa. Studies incorporating environmental variables reported improved predictive performance and highlighted the potential of climate-informed early warning systems for SCA management. CONCLUSION: The review recommends development of interdisciplinary, climate-aware ML frameworks, expansion of longitudinal environmental datasets, and increased research in underrepresented regions to support climate-resilient and patient-centered SCA care.

Humans↗
PubMed2026

BIOCARD framework: integrating fecal bile acids, lipids, and metabolites to assess response to a cardiovascular health intervention.

Cardiovascular disease (CVD) remains a leading cause of morbidity and mortality, particularly in under-resourced populations. Although nutritional interventions are important for CVD prevention, their outcomes are commonly evaluated using conventional clinical and behavioral indicators, which may not fully capture early molecular responses. In this study, we developed the BIOCARD framework, an exploratory fecal multi-omics platform integrating bile acids, lipids, and metabolites to evaluate intervention outcomes related to cardiovascular health. Fecal samples were collected from caregiver-child participants enrolled in a 10-week randomized controlled trial comparing a multicomponent garden-based intervention (SHA) with an education-only control group (MSP). Fecal polar metabolites, lipids, and bile acids were analyzed by UHPLC-HRMS-based approaches and integrated with conventional health indicators. Traditional clinical indicators in the present study showed limited sensitivity for detecting intervention-related differences. In contrast, fecal multi-omics analyzes revealed intervention-associated differences in metabolites, lipids, and bile acids, with children showing more apparent molecular variation than parents. Network analysis further revealed associations between selected molecular features and cardiovascular-related indicators, including blood pressure, body fat, skin carotenoids, and Healthy Eating Index scores. Together, these findings suggest that the BIOCARD framework may serve as an exploratory molecular approach to complement traditional outcome measures and improve the evaluation of nutritional interventions for cardiovascular health.

Humans↗
PubMed2026

Workplace Safety Champions: Strengthening safety culture through nurse engagement.

Workplace violence is a growing concern in health care, disproportionately affecting frontline nurses and nursing assistants. Despite high prevalence, underreporting remains a barrier to effective prevention and response. This article describes the development, implementation, and outcomes of a Workplace Safety Champion program designed to increase reporting of violent incidents and strengthen a culture of safety. A multidisciplinary task force developed an evidence-based Workplace Safety Champion course that emphasizes de-escalation strategies, reporting processes, and staff support. Champions were appointed across inpatient and emergency units and integrated into a hospital-wide Workplace Safety Champion Council. Program evaluation used course completion data and posttraining surveys. The organizational goal of having at least one trained champion in 90% of inpatient and emergency units was exceeded, with 98% of units represented (N = 93 champions). More than 85% of learners reported intent to change their response to workplace violence, and 90% endorsed improved knowledge of resources and de-escalation strategies. The Workplace Safety Champion program successfully improved staff awareness, reporting, and engagement in workplace violence prevention. Embedding champions across units can serve as a sustainable strategy to strengthen safety culture and support frontline health care workers.

Humans↗
PubMed2026

Tele-Oncology in the Post-Pandemic Era: Clinical Integration, Access Disparities and Medico-Legal Accountability.

PURPOSE OF THE REVIEW: Tele-health has evolved from a marginal tool confined to rural populations and selected follow-up programs into a structurally integrated component of modern cancer care. Prior to COVID-19, its adoption was constrained by regulatory fragmentation, non-uniform reimbursement, and licensure barriers. This narrative review evaluates the evolutionary integration of tele-health in oncology post-COVID-19, examines digital disparities across patient populations, and addresses the medico-legal implications of this integration, with the objective of providing a comprehensive and clinically actionable framework for the governance of virtual oncology care. RECENT FINDINGS: The pandemic acted as a global catalyst, driving telehealth to over 50% of oncology outpatient encounters in some settings, before stabilising post-pandemic at approximately 10-20% of consultations within hybrid care models. Evidence supports meaningful clinical benefits - improved access to specialist services, reduced travel burden, and sustained continuity of care - with outcomes comparable to in-person care in postoperative follow-up, symptom monitoring, and survivorship. However, persistent disparities in device availability, connectivity, and digital literacy disproportionately affect older, rural, and socioeconomically disadvantaged patients, raising the risk that geographic inequalities are replaced by technological ones. From a medico-legal standpoint, the remote modality does not modify the applicable standard of care, yet restricted physical examination and reliance on patient-reported data introduce risks of diagnostic delay and incomplete clinical assessment, with direct implications for professional liability, data protection under HIPAA and GDPR, cross-border licensure, and multi-party accountability across physicians, institutions, and technology providers. Tele-oncology has become a permanent structural feature of modern cancer care, offering demonstrable benefits in access, continuity, and patient satisfaction. Yet its integration has been uneven, its governance remains fragmented, and its medico-legal landscape is still evolving. Realising the full potential of virtual oncology care - equitably and safely - requires coherent regulatory frameworks, sustained investment in digital infrastructure, and explicit attention to the populations at greatest risk of being left behind.

Humans↗
PubMed2026

Exploring the role of successful exercise-induced body weight loss on cardiometabolic health in individuals with metabolic syndrome.

BACKGROUND AND AIM: High-intensity interval training (HIIT) is known to improve cardiorespiratory fitness (i.e., VO2MAX), a key marker of cardiometabolic health in individuals with metabolic syndrome (MetS). Nonetheless, body weight loss is widely recognized as a crucial factor in reducing insulin resistance and improving metabolic risk factors. Thus, we aimed to determine the importance of body weight loss following exercise training on improving MetS. METHODS AND RESULTS: Two hundred and twenty-eight adults (55.3&#xa0;&#xb1;&#xa0;7.9&#xa0;yr) with overweight/obesity (32.5&#xa0;&#xb1;&#xa0;4.6&#xa0;kg&#xb7;m-2) and MetS were randomized to: a) standard health care non-exercise group (CONTROL group, N=58) or b) standard health care plus 16 weeks of HIIT (EXER group, N=170). MetS (MetS z-score), insulin resistance (HOMA-IR), cardiorespiratory fitness (VO2PEAK), maximal cycling power (WPEAK), and body weight/composition were assessed. After intervention, EXER group participants were divided according to their weight loss response to training: i) those achieving the weight loss predicted from estimated exercise energy expenditure (-BW group, n=78; -3.3&#xa0;&#xb1;&#xa0;2.2&#xa0;kg); ii) those not reaching the expected weight loss (=BW group, n=38; -0.7&#xa0;&#xb1;&#xa0;0.5&#xa0;kg); iii) and those who gained weight (+BW group, n=54; 1.1&#xa0;&#xb1;&#xa0;1.0&#xa0;kg). VO2PEAK significantly improved regardless of body weight loss response (-BW, 0.3&#xa0;&#xb1;&#xa0;0.3; =BW, 0.2&#xa0;&#xb1;&#xa0;0.3; +BW, 0.3&#xa0;&#xb1;&#xa0;0.2&#xa0;L&#xb7;min-1; all p&#xa0;<&#xa0;0.001) compared to CONTROL group (0.0&#xa0;&#xb1;&#xa0;0.3&#xa0;L&#xb7;min-1). However, significant improvements in MetS z-score (-0.31&#xa0;&#xb1;&#xa0;0.41) and HOMA-IR (-0.7&#xa0;&#xb1;&#xa0;1.6) were observed only in the -BW group (both p&#xa0;<&#xa0;0.001). CONCLUSIONS: Exercise recommendations should consider that greater improvements in MetS are observed when interventions are accompanied by successful body weight loss. CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT05120778.

Humans↗