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Preprints posted in the last 30 days, ranked by how well they match F1000Research's content profile, based on 79 papers previously published here. The average preprint has a 0.14% match score for this journal, so anything above that is already an above-average fit.

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Community needs for FAIR pathogen data

van Geest, G.; Thomas-Lopez, D.; Feitzinger, A. A.; Weissgold, L. A.; Halabi, S.; Cuesta, I.; Hjerde, E.; Gurwitz, K. T.; Arora, N.; Neves, A.; Palagi, P. M.; Williams, J. J.

2026-04-15 scientific communication and education 10.64898/2026.04.14.718420 medRxiv
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BackgroundDatasets related to infectious diseases are essential for public health decision-making, yet their reuse remains limited by persistent barriers to data sharing and integration. Achieving data that are Findable, Accessible, Interoperable, and Reusable (FAIR) is widely recognized as essential for accelerating scientific discovery and enabling coordinated responses to emerging threats, but the needs of the global pathogen data community have not been systematically characterized. AimThis study, conducted by the Pathogen Data Network (PDN), aims to identify infrastructural and educational priorities among stakeholders working with infectious disease-related data in order to guide community-responsive support for data sharing and interoperability. MethodsA cross-sectional stakeholder survey was disseminated to a well-defined expert population within PDN networks and via open professional channels. A total of 136 responses from researchers, healthcare professionals, bioinformaticians, and educators were analyzed descriptively to identify prioritized barriers, training needs, and preferred support mechanisms. ResultsRespondents consistently identified structural constraints as the primary impediments to effective data use, including limited funding (74%), data-aggregation challenges (68%), and a shortage of skilled personnel (52%). Respondents identified bioinformatics for infectious disease research (68%) as the highest priority for training, followed by guidance on using the integrated pathogen data and tools portal provided by the PDN, the Pathogens Portal (51%). The Pathogens Portal was also ranked as the most essential PDN resource (72%). Preferred training formats included virtual short courses (68%) and webinars (66%). Notably, while researchers emphasized technical subjects like machine learning, educators prioritized foundational case studies. ConclusionThese findings provide an evidence-based diagnostic of community needs and suggest that barriers to FAIR pathogen data are predominantly systemic rather than purely technological. The survey framework and openly available dataset offer a reusable template for assessing needs in other communities and regions. By aligning training, infrastructure development, and outreach with empirically identified priorities, organizations supporting infectious disease research can strengthen the interoperability and reuse of data and establish a benchmark for future community-driven improvements.

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Adherence to CDC Antimicrobial Stewardship Core Elements and Barriers to stewardship practices among Healthcare Workers at a Tertiary Care Hospital Uttarakhand, India

K, K.; K, M.; Kumari, K.; Meena, K.; Pilania, M.; Kashyap, M.; Mahala, K.; Bhakar, M.; Kataria, N.; Singh, V.; Panda, P. K.; Sharma, M.

2026-03-28 pharmacology and therapeutics 10.64898/2026.03.26.26349469 medRxiv
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Background: Antimicrobial resistance (AMR) is a growing global health concern driven largely by inappropriate antimicrobial use. Antimicrobial stewardship programs (ASPs), guided by the Centers for Disease Control and Prevention (CDC) core elements, are essential for optimizing antimicrobial use. However, adherence to these practices and the barriers faced by healthcare workers remain inadequately explored, particularly in resource-limited settings. Objective To assess adherence to the CDC antimicrobial stewardship checklist and identify barriers affecting stewardship practices among healthcare workers at a tertiary care hospital in Uttarakhand, India. Methods A quantitative cross sectional descriptive study was conducted among 355 healthcare workers, including nursing officers and physicians. Data were collected using a sociodemographic questionnaire, the CDC antimicrobial stewardship checklist, and a self-structured barrier assessment tool (test retest reliability r = 0.78). Descriptive and inferential statistics were applied using SPSS version 23.0, with a significance level set at p < 0.05. Results The overall adherence to the CDC antimicrobial stewardship checklist was 52.3%, indicating moderate compliance. Higher adherence was observed in action-oriented interventions, while lower adherence was noted in domains such as accountability, pharmacy expertise, reporting, and education. Major barriers identified included lack of antimicrobial supply (89.0%), shortage of key personnel (88.5%), delays in laboratory reports (85.1%), lack of training (83.9%), and inadequate administrative support (79.2%). Significant associations were found between perceived barriers and factors such as working area, designation, qualification, and work experience (p < 0.05), whereas age and gender showed no significant association. Conclusion Adherence to antimicrobial stewardship practices was moderate, with notable gaps in organizational and educational components. Multiple systemic, resource-related, and behavioral barriers hinder effective implementation. Targeted interventions focusing on strengthening infrastructure, workforce capacity, training, and administrative support are essential to improve stewardship practices in tertiary care settings. Keywords: Antimicrobial resistance, Antimicrobial stewardship program, Barriers, CDC Checklist

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Patients' Ideas, Concerns, Expectations in Physiotherapy: A Questionnaire Study

Dani, R.; Dave, D.

2026-04-06 rehabilitation medicine and physical therapy 10.64898/2026.04.06.26350229 medRxiv
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Global healthcare is targeting patient-centred care, as it leads to better health outcomes and higher level of patient satisfaction. Patient-centred communication, is an important part of patient-centred care because it focuses on involving patients in their care. Recent surveys both nationally and globally have shown that patients are not involved enough in their own healthcare decisions. This problem is especially common among the elderly with chronic conditions. This study aimed to describe patient-healthcare professional interactions, expectations, and satisfaction in physiotherapy within an understudied context, thereby providing important, specific data on ICE dynamics and satisfaction in the specific setting. Cross-sectional study of participants in scheduled consultations was conducted. Two government physiotherapy centres, seven private physiotherapy centres and two trust centres with physiotherapy facilities in Gujarat, India. 232 patients (from various public and private physiotherapy clinics) participated in the study. Patients' ideas, concerns, expectations (ICE) and satisfaction were explored. Almost 88% of patients reported their thoughts and explanations about their symptoms during the consultation. Most patients described not having any concerns about the diagnosis/treatment, and more than two-third of patients consulting PTs expected explanation for their symptoms. Almost 90% patients were satisfied with the consultation. The study revealed that while most patients conveyed their thoughts during consultations, very few expressed their concerns. Overall, patients were satisfied with their consultations.

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Impact of high-fat Western diet on chronic lymphocytic leukemia disease progression and gut microbiome profile in Eμ-TCL1 mice

Skupa, S. A.; Hernandez, J. B.; Smith, A. L.; Drengler, E. M.; Seth, A. K.; Rai, S. N.; Clayton, J. B.; D'Angelo, C. R.; El-Gamal, D.

2026-04-01 cancer biology 10.64898/2026.03.30.715124 medRxiv
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BackgroundThe composition and function of the gut microbiome have been shown to contribute to both health and disease. One of the most powerful modulators of microbial composition and function is diet. Materials & MethodsUsing the E{micro}-TCL1 murine model of B-cell chronic lymphocytic leukemia (CLL), we assigned male and female mice to a high-fat, high-carbohydrate Western diet (HF) or standard chow (CH) diet. ResultsMice consuming a HF diet had significantly shorter survival than those consuming a CH diet, irrespective of sex, with female mice exhibiting particularly poor outcomes. We also observed a significant increase in splenic involvement by CLL in the HF diet-fed mice at time of sacrifice. Mice receiving the HF diet demonstrated immediate and profound effects on the gut microbiome, marked by reduced alpha diversity and significantly different community composition as measured by beta diversity. Notably, there was a sustained increase in Akkermansia muciniphila and Bacteroidetes thetaiotaomicron in HF diet-fed mice, coupled with a corresponding increase in microbiome functional pathways related to arginine and histidine biosynthesis, chitin degradation, and nucleotide biosynthesis. DiscussionCollectively our data provides evidence of the profound and sustained impact of a high-fat Western diet upon the gut microbiome community and CLL pathogenesis in the E{micro}-TCL1 murine model of CLL.

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Epidemiology and Associated Risk Factors of Diabetic Retinopathy in Patients with Diabetes Mellitus Attending a Tertiary-care Hospital in Hargeisa, Somaliland

Woredekal, A. T.

2026-03-31 ophthalmology 10.64898/2026.03.29.26349614 medRxiv
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Purpose Diabetic retinopathy (DR) is one of the most important complications of diabetes mellitus (DM), representing the leading cause of blindness among working age adults in developed countries. This study was aimed to investigate the epidemiology and risk factors of DR in patients with diabetes mellitus in a hospital setting in Somalia. Methods The study was an observational, descriptive cross-sectional and hospital-based study and data were collected from January 2023 to May 2023. A structured questionnaire was used to collect relevant demographic and clinical data. Both univariate and bivariate tables were used for analysis. Data analysis included frequency distribution, cross-tabulation, co-relation and association, and statistically significant tests between variables (X2, p-value, and CI). Results A total of 384 DM patients were studied and 76% (n=293) of them had type 2 DM. The average duration of diabetes mellitus was 9.7 SD 6.9 years and the mean age was 47.24 SD 19.36 years (range 18 -100 years old). A majority 66% (n=253) were female, about a third of them had normal body mass index (BMI) (n=172, 44.8%) and 170 (44.3%) had concomitant hypertension. About 51% of the patients (n=197) had DR out of which 17% had non-proliferative diabetic retinopathy (NPDR) (n=67) and 26% had Macular oedema (n=98). Age above 40 years (p=0.020), marital status (P=0.010), employment status (P=0.002) and literacy status (P=0.020) were significantly associated with the presence of DR. Patients aged below 40 had 37% lesser risk of having diabetic retinopathy than patients aged above 40 years. Longer duration of diabetes (p=0.001) and the presence of concomitant cardiac illness (p=0.001) were strongly associated with the presence of diabetic retinopathy. Patients with duration of diabetes more than 10 years had approximately 2 times higher chance of developing DR than those with duration less than 10 years. Conclusion: The very high prevalence of DR (51%) among our patients implies the needs for a good health policy to manage DM and DR patients in Somalia. Effective regular eye screening and treatment for all diabetes patients should get priority.

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Long-term impact of Training the Trainers program on Primary Eye Care networks in Malawi using the Arclight Project package

Windle, T.; Maliko, F.; Burgiss-Kasthala, S.; Blaikie, A.

2026-04-02 ophthalmology 10.64898/2026.03.31.26349901 medRxiv
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Background The World Health Organisation (WHO) advocates integrating primary eye care (PEC) within community health systems, supported by task-shifting and frugal technologies. While low-cost tools such as the Arclight device and Wilson anterior segment loupe have demonstrated training and diagnostic value, their long-term impact on community health worker (CHW) roles and professional networks remain poorly understood. Methods We conducted a qualitative follow-up study 3 years after implementation of an Arclight Project enabled cascade training of the trainers (ToT) PEC programme in central Malawi. Ophthalmic Clinical Officers (OCOs) trained using the Arclight training and diagnostic package subsequently cascaded PEC training to Health Surveillance Assistants (HSAs). Semi-structured interviews were undertaken 3 years later with OCOs and HSAs to explore device use, evolving professional roles, training diffusion, and communication patterns. Data were analysed thematically, informed by concepts from social network analysis to examine changes in advice-seeking, mentorship and peer collaboration. Results Frugal eye-care technologies functioned not only as diagnostic tools but as mechanisms of professional repositioning. HSAs equipped with low-cost diagnostic devices became recognised as community eye focal persons, receiving referrals from colleagues and community members. OCOs who delivered training emerged as central hubs for clinical advice and ongoing training, creating strong vertical networks between district and community levels. However, horizontal peer-to-peer networks among HSAs remained weak and largely informal. Communication relied heavily on ad-hoc phone calls and WhatsApp messaging, with limited structured communities of practice. Despite sustained use of devices and retention of key skills, network activity often declined over time without active reinforcement. Conclusions Frugal eye-care technologies act as social as well as clinical interventions, reshaping CHW networks and professional hierarchies. Designing PEC programmes with explicit attention to strengthening and sustaining professional networks, rather than focusing solely on skills transfer, may further enhance alignment with WHO Integrated People-Centred Eye Care and improve long-term programme sustainability and impact.

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Dual Nanoparticle-Driven Therapeutics for Leishmaniasis: A Mathematical Model of Targeted Macrophage and Parasite Elimination

Arumugam, D.; Ghosh, M.

2026-03-30 immunology 10.64898/2026.03.27.714640 medRxiv
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BackgroundTo control leishmaniasis, chemotherapy drugs are currently under development. However, these drugs often exhibit poor efficacy and are associated with toxicity, adverse effects, and drug resistance. At present, no specific drug is available for the treatment of leishmaniasis. Meanwhile, vaccine research is ongoing. Recent studies have analysed some experimental vaccines using mathematical models. AimIn previous work, drug targeting was focused on the entire human body rather than specifically addressing infected macrophages and parasites. In our current approach, we aim to eliminate infected macrophages and parasites through nano-drug design. Specifically, we utilise two types of nanoparticles: iron oxide and citric acid-coated iron oxide. Moving forward, we plan to advance this strategy using mathematical modelling of macrophage-parasite interactions. MethodsWe design PDE-based models of macrophages and parasites, incorporating cytokine dynamics, to support nano-drug development. Drug efficacy is estimated using posterior distributions to analyse phenotypic fluctuations of macrophages and parasites during the design phase. We investigate implicit and semi-implicit treatment schemes, focusing on energy decay properties. To model drug flow during treatment, we introduce a three-phase moving boundary problem. Comparative analyses are conducted to evaluate macrophage and parasite behaviour with and without treatment. Finally, the entire framework is implemented within a virtual lab environment. ResultsThe results show that the nano-drug exhibits better efficacy compared to combined drug doses. We analysed and compared two types of nano-drug particles: iron oxide and citric acid-coated iron oxide. We discuss how the drug effectively targets and eliminates infected macrophages and parasites. ConclusionOur models results and simulations will support researchers conducting further studies in nano-drug design for leishmaniasis. These simulations are performed within a virtual lab environment.

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Challenges in the Computational Reproducibility of Linear Regression Analyses: An Empirical Study

Jones, L. V.; Barnett, A.; Hartel, G.; Vagenas, D.

2026-04-07 health systems and quality improvement 10.64898/2026.04.07.26350286 medRxiv
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Background: Reproducibility concerns in health research have grown, as many published results fail to be independently reproduced. Achieving computational reproducibility, where others can replicate the same results using the same methods, requires transparent reporting of statistical tests, models, and software use. While data-sharing initiatives have improved accessibility, the actual usability of shared data for reproducing research findings remains underexplored. Addressing this gap is crucial for advancing open science and ensuring that shared data meaningfully support reproducibility and enable collaboration, thereby strengthening evidence-based policy and practice. Methods: A random sample of 95 PLOS ONE health research papers from 2019 reporting linear regression was assessed for data-sharing practices and computational reproducibility. Data were accessible for 43 papers. From the randomly selected sample, the first 20 papers with available data were assessed for computational reproducibility. Three regression models per paper were reanalysed. Results: Of the 95 papers, 68 reported having data available, but 25 of these lacked the data required to reproduce the linear regression models. Only eight of 20 papers we analysed were computationally reproducible. A major barrier to reproducing the analyses was the great difficulty in matching the variables described in the paper to those in the data. Papers sometimes failed to be reproduced because the methods were not adequately described, including variable adjustments and data exclusions. Conclusion: More than half (60%) of analysed studies were not computationally reproducible, raising concerns about the credibility of the reported results and highlighting the need for greater transparency and rigour in research reporting. When data are made available, authors should provide a corresponding data dictionary with variable labels that match those used in the paper. Analysis code, model specifications, and any supporting materials detailing the steps required to reproduce the results should be deposited in a publicly accessible repository or included as supplementary files. To increase the reproducibility of statistical results, we propose a Model Location and Specification Table (MLast), which tracks where and what analyses were performed. In conjunction with a data dictionary, MLast enables the mapping of analyses, greatly aiding computational reproducibility.

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Are Nutritional Aspects And Body Composition Associated With The Can Do, Do Do Concept In People With COPD In Latin America? An Observational Study

Borges, P.; Freire, A. P. F.; Pedroso, M. A.; Spolador de Alencar Silva, B.; Lima, F. F.; Uzeloto, J. S.; Gobbo, L. A.; Grigoletto, I.; Cipulo Ramos, E. M.

2026-04-15 rehabilitation medicine and physical therapy 10.64898/2026.04.13.26350788 medRxiv
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IntroductionIndividuals with COPD can be classified according to their levels of physical activity (PA) and physical capacity (PC). The relationship between nutrition and body composition within these classifications remains unclear. ObjectivesTo compare the body composition and food intake of people with COPD and verify the associations. MethodsCross-sectional exploratory analysis study in which body composition and food intake were assessed in individuals with COPD. Classification was based on six-minute walk test (PC) and accelerometry(PA): Quadrant "can do, dont do" (I-preserved PC, low PA); quadrant "can do, do do" (II-preserved PC, preserved PA). Results72 individuals with COPD, 39 in quadrant I and 33 in quadrant II, with mean ages of (69 {+/-} 6) (67 {+/-} 7), respectively. Group I had a higher proportion of males, whereas group II had a higher proportion of females. A positive trend in skeletal muscle mass (p=0.011) (B= 2.883) and a negative trend in basal metabolic rate (p=0.010) (B=-0.092) for group I. ConclusionBrazilians with COPD classified in quadrants I and II showed similar results in terms of body composition and food intake. A positive trend in skeletal muscle mass was observed for the group I. These findings align with the pathophysiological model of COPD, in which the preservation of muscle mass and adequate protein intake support functional capacity and the maintenance of higher physical activity levels.

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The Gut-Vascular Axis in Intracranial Aneurysm Rupture: A Systematic Review and Meta-analysis of Human Microbiome Evidence

Fahim, F.; Hemmati, M.; Heshmaty, S.; Sharvirani, A.; Shahini, A.; Hosseini, A.; Hosseini Marvast, S. M.; Mojtahedzadeh, A.; Konarizadeh, M.; Dorisefat, F.; Maham, N.; Omranisarduiyeh, A.; Oveisi, S.; Fadaei Juibari, F.; Malekipour Kashan, B.; Sharifi, G.; Zali, A.

2026-04-07 neurology 10.64898/2026.04.05.26350207 medRxiv
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Background Intracranial aneurysm rupture is the leading cause of spontaneous subarachnoid hemorrhage and is associated with substantial mortality and long term neurological disability. Emerging evidence suggests that the gut microbiome may influence vascular inflammation and endothelial integrity through immune and metabolic pathways, yet human evidence linking gut microbial alterations to intracranial aneurysm remains fragmented and inconsistent. Objective This systematic review and meta analysis aimed to synthesize available human evidence on the association between gut microbiome alterations and intracranial aneurysm formation or rupture, with a primary focus on microbial dysbiosis and differences in gut microbial alpha diversity. Methods This study was conducted according to PRISMA 2020 guidelines and the protocol was prospectively registered in PROSPERO (CRD420261360785). A comprehensive search of PubMed, Scopus, Web of Science, Embase, and Cochrane CENTRAL was performed from database inception until April 1, 2026, with additional screening of grey literature sources. Observational human studies evaluating gut microbiome characteristics in patients with intracranial aneurysm were included. Mendelian randomization (MR) studies investigating genetically predicted microbial taxa and aneurysm outcomes were also reviewed. Random effects meta analysis using standardized mean differences (SMD) was performed for alpha diversity outcomes. MR taxa reported in at least two independent studies were quantitatively synthesized using inverse variance weighting of log odds ratios. Results The systematic search identified 396 records. After removal of duplicates and eligibility screening, 20 studies met inclusion criteria, including 12 observational clinical studies and 8 Mendelian randomization analyses. Meta analysis of three microbiome sequencing studies demonstrated significantly reduced gut microbial alpha diversity in patients with ruptured intracranial aneurysms compared with controls. Sensitivity analyses confirmed the robustness of pooled estimates. In addition, MR evidence identified several microbial taxa, including Ruminococcus1, Bilophila, Fusicatenibacter, and Porphyromonadaceae, as potentially protective factors against aneurysm related outcomes. Across observational studies, gut dysbiosis was frequently associated with inflammatory pathways and alterations in microbial metabolites implicated in vascular dysfunction. Conclusion Current human evidence suggests a potential association between gut microbiome dysbiosis and intracranial aneurysm pathophysiology, particularly in relation to aneurysm rupture. Reduced microbial diversity and specific microbial taxa may influence vascular inflammation and aneurysm wall stability. However, existing evidence remains limited and heterogeneous. Large prospective cohorts and mechanistic studies are required to clarify causal relationships and evaluate whether microbiome targeted interventions could contribute to aneurysm risk stratification or prevention strategies.

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Assessment of Oxford Nanopore whole genome sequencing for large-scale genomic characterisation of Staphylococcus aureus

Haugan, I.; Flatby, H. M.; Lysvand, H.; Skei, N. V.; Zaragkoulias, K.; Solligard, E.; Ronning, T. G.; Olsen, L. C.; Damas, J. K.; Afset, J. E.; As, C. G.

2026-04-01 genomics 10.64898/2026.03.30.715209 medRxiv
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Whole-genome sequencing (WGS) is increasingly being utilised in microbial diagnostics, surveillance, and research. In this paper we assess the performance of one leading long-read sequencing technology, Oxford Nanopore Technology (ONT), on 836 Staphylococcus aureus bacteraemia isolates. We compare the results to that of a leading short-read sequencing technology, Illumina. All isolates were sequenced using ONT MinION Mk1B and Illumina HiSeq or MiSeq. Libraries were prepared according to manufacturers instructions. Preprocessing and downstream bioinformatic analyses were performed using a combination of in-house pipelines and publicly available software tools. The average base substitution error rate in ONT assemblies was low but varied between sequence types, possibly due to lineage-specific methylation patterns. Multi locus sequence typing was similar between the technologies, while ONT assemblies allowed for better spa typing than Illumina assemblies. The reported detection rate was similar between ONT and Illumina assemblies for most virulence- and AMR-associated genes and variants. For 42 (22.2%) of 189 genes/variants, the two technologies disagreed in gene detection in 5 isolates or more, and in 39 (20.6.%) of these the highest detection rate was found with ONT. Discrepancies were mainly associated with low GC content, multiple repetitive segments, and small plasmids. Polishing of ONT data resulted in minor changes in gene/variant calling. Our study supports the use of ONT WGS for bacterial population genomic studies on a large collection of S. aureus isolates. While assembly of ONT reads may be affected by its own methodological limitations, it was superior to Illumina assemblies in detection of potentially clinically relevant genes and variants at a low read error rate. Understanding the advantages and limitations of WGS technologies is essential before undertaking studies involving such methods on large sets of bacteria. Author summaryIn this paper, we present a practical assessment of one important whole genome sequencing (WGS) method, Oxford Nanopore Technology (ONT), and compare its performance in bacterial population genomics to that of WGS with Illumina technology. Our goal was to investigate the usefulness of ONT in studies aiming to identify clinically relevant bacterial characteristics in large collections of bacteria, such as genotype-phenotype studies. We sequenced a large set of clinical S. aureus isolates from episodes of bloodstream infections using both ONT and Illumina technologies and performed analyses with widely used software and bioinformatic pipelines. We have elucidated inherent strengths and limitations of ONT and Illumina sequencing and report some of the practical consequences of these on bacterial typing and detection of clinically relevant genes. With this study, we present one of the most comprehensive assessments of long-read sequencing technology for the genomic characterisation of clinical bacterial isolates, and the findings provide guidance for researchers considering WGS in large-scale bacterial genomics.

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Association of axial length and changes in aqueous depth with refractive outcomes in Chinese primary angle closure glaucoma patients

Wang, L.; Yang, Y.; Ng, T. K.; Chen, J.; Sun, X.

2026-04-14 ophthalmology 10.64898/2026.04.10.26350671 medRxiv
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Purpose: To identify the ocular biometric parameters associated with refractive outcomes in Chinese Primary angle closure glaucoma (PACG) patients receiving phacoemulsification and intraocular lens (IOL) implantation (PEI) surgery. Methods: 165 Chinese PACG patients receiving PEI and goniosynechialysis (GSL) and 53 cataract patients as controls only receiving PEI surgery were recruited. The prediction accuracy of IOL power calculation was assessed by the prediction error (PE), mean absolute error (MAE), median absolute error (MedAE), and proportions of eyes with a PE within {+/-} 0.25 diopters (D), {+/-} 0.50 D, {+/-} 0.75 D, and {+/-} 1.00 D. The association of different ocular biometric parameters with the PE of IOL calculation were evaluated. Results: The PACG patients had significantly higher absolute of PE as compared to the control subjects, especially the acute PACG patients. The axial length (AL), changes in aqueous depth pre- and post-surgery ({bigtriangleup}AD), and the ratio of {bigtriangleup}AD/AL were significantly associated with the PE in acute PACG patients. The association of {bigtriangleup}AD with the PE of IOL power calculation was found in PACG patients with AL [&ge;] 22 mm. Conclusions: This study revealed the association of AL and {bigtriangleup}AD with the PE of IOL calculation in Chinese PACG patients. Precisely predict the {bigtriangleup}AD is necessary for acute PACG patients, especially for those with AL [&ge;] 22 mm, to improve the refractive outcomes.

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Infodemic Management Challenges and Training Needs Among Frontline Health Educators in Lagos State Nigeria

Erim, A.; Lansana, P.; Badmus, O.; Olanrewaju, M. F.

2026-04-11 health systems and quality improvement 10.64898/2026.04.09.26350557 medRxiv
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Misinformation circulating through digital platforms and community networks increasingly challenges public health communication, particularly in low- and middle-income countries. Frontline health educators play a critical role in addressing misinformation and promoting accurate health information within primary health care systems; however, empirical evidence on their preparedness to manage infodemics remains limited. This study assessed the training needs and response capacity of primary health care health educators in Lagos State, Nigeria. A convergent mixed-methods design was employed across three districts. Quantitative data were collected from 95 health educators using the 30-item Health Educators Infodemic Management Training Needs Assessment Questionnaire (HEIM-TNAQ). Qualitative data were obtained through six focus group discussions involving 56 educators and 25 key informant interviews with supervisors and programme managers. Quantitative data were analysed using descriptive statistics and t-tests, while qualitative data were analysed thematically. Participants demonstrated relatively strong knowledge of health misinformation (mean = 71.5), but only moderate decision-response skills (48.6) and low confidence in addressing misinformation (42.5). Integration of misinformation response into routine practice was also limited (46.3), and no significant differences were observed between respondents with or without prior training. Qualitative findings revealed frequent exposure to vaccine rumours, spiritual explanations for illness, and misinformation circulating through social media and community networks. Strengthening infodemic management within primary health care requires practical training, behavioural communication skills, and institutional mechanisms for systematic rumour monitoring and response.

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Patient characteristics associated with participation in cardiorespiratory exercise during stroke rehabilitation: a multisite observational cohort study

Devasahayam, A. J.; Tang, A.; Zhong, Y.; Espin Garcia, O.; Munce, S.; Sibley, K. M.; Inness, E. L.; Mansfield, A.

2026-04-03 rehabilitation medicine and physical therapy 10.64898/2026.04.01.26349980 medRxiv
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Objectives: Among individuals attending stroke rehabilitation, we aimed to determine the proportion who participated in cardiorespiratory exercise, identify patient characteristics predicting participation, and describe exercise characteristics. Design, setting, and participants: This was an observational cohort study involving all patients admitted to four stroke rehabilitation centres in Ontario, Canada, during March or October 2019, or over 12 months starting in 2021. Main measures: Patient characteristics extracted during chart review included age, sex, marital status, employment status, date of stroke, time post-stroke at admission, length of stay for rehabilitation, past medical history that could affect exercise participation, Functional Independence Measure, Functional Ambulation Category, mobility aid use, Chedoke-McMaster Stroke Assessment, Montreal Cognitive Assessment, National Institutes of Health Stroke Scale, and details describing cardiorespiratory exercise completed. Results: 40.1% of stroke patients participated in cardiorespiratory exercise, with 26.4% having it included in their treatment plan. Diagnosed cardiac disease (OR=0.74), poor left ventricular function (OR=0.09), history of mental health conditions (OR=0.69), lower functional ambulation ability (OR=0.74), and wheelchair use at rehabilitation admission (OR=0.46) were associated with lower odds of participating in cardiorespiratory exercise after stroke (p-values<0.05). Use of a walker or rollator at rehabilitation admission (OR=3.22), having a cardiorespiratory exercise goal (OR=2.13), and longer lengths of stay (OR=1.01) were associated with higher odds of participating in cardiorespiratory exercise after stroke (p-values<0.05). Only 1.5% of patients (N=9/601) who participated in cardiorespiratory exercise completed it with recommended intensity and duration. Conclusion: Improving participation in cardiorespiratory exercise during stroke rehabilitation may require addressing cardiovascular, mental health, and mobility-related barriers.

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Improving walking after lumbar spinal stenosis surgery: co-design and single-arm feasibility trial of the STructured Rehabilitation and InDividualised Exercise and Education (STRIDE) programme

McIlroy, S.; Bearne, L.; McCarter, A.; McPherson, C.; Chaplin, H.; Brighton, L. J.; Weinman, J.; Norton, S.

2026-03-31 rehabilitation medicine and physical therapy 10.64898/2026.03.28.26349602 medRxiv
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Background: Lumbar spinal stenosis (LSS) can cause pain and severe walking limitation. Although surgery aims to improve walking, many patients do not achieve clinically meaningful gains. Rehabilitation can improve outcomes, yet existing programmes lack robust evidence and theoretical underpinning. This study aimed to (1) co-design a theory-informed rehabilitation programme to improve walking after LSS surgery, and (2) evaluate feasibility of conducting a future trial and acceptability of the intervention. Methods: A multi-methods study included intervention co-design followed by a single-arm feasibility study. Co-design used an adapted Experience-Based Co-Design approach with patients, carers, and healthcare professionals (n=39), integrating the Behaviour Change Wheel. This resulted in STructured Rehabilitation and InDividualised Exercise and Education (STRIDE), delivered over 12-week pre- and 12-weeks post-surgery, targeting knowledge, expectations, perceived control, physical capability, and fears. Adults aged [&ge;]50 years awaiting LSS surgery were recruited to a before-after feasibility study. Feasibility outcomes included recruitment and retention. Acceptability was assessed using the Theoretical Framework of Acceptability questionnaire (0-5 (high acceptability)) and focus groups. Clinical outcomes measured at baseline, post-prehabilitation, and post-rehabilitation included 6-minute walk distance (6MWD) and mean daily step count over 7 days. Results: Fifteen of 31 eligible participants were recruited (48%; mean age 70 years), with 80% retained to study end (2 decided against surgery, 1 unable to complete final assessment). Acceptability was high (median 5/5, IQR 0). Participants valued the personalised, supportive approach and reported improved motivation and preparation for surgery, though travel was burdensome. Small pre-operative and moderate-to-large post-operative improvements were observed in 6MWD (+49.9 m and +81.6 m) and daily step count (+868 and +1405 steps/day). Conclusions: This co-designed, physiotherapy-led, behaviour-change rehabilitation programme was acceptable to participants, with encouraging recruitment, retention, and signals of improved walking following LSS surgery. The findings support progression to a future trial.

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AI in Practice: A Multilingual Survey of 2025 BioHackathon Participants

Sriwichai, N.; Feriau, L.; Tongyoo, P.; Noda, Y.; Gyoji, H.; Noisagul, P.; Goto, S.; Steinberg, D.; Wangsanuwat, C.

2026-03-27 scientific communication and education 10.64898/2026.03.25.713611 medRxiv
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This dataset arises from a multilingual survey of AI use among participants and community members in the DBCLS BioHackathon 2025 in Japan. The questionnaire, offered in English, Japanese, and Thai, asked about how often respondents use AI tools, what they use them for, obstacles they encounter, institutional support, satisfaction, and concerns. Additional items captured role, institution type, work country, and other demographics, totaling 105 responses. The dataset includes both raw anonymized responses and a cleaned, standardized English-only version suitable for quantitative analysis, along with the full questionnaire, a data dictionary for cleaned dataset, and a translation lookup table. Free-text answers were screened and redacted to remove URLs, names, and other potentially identifiable information. Together, these materials provide a community-level view of AI practice in genomics, bioinformatics, software development, and related areas, and can support work on AI adoption, policy, and methods for analyzing survey data on AI use in science.

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Paving the way for automated transscleral cyclophotocoagulation: predicting ciliary body arc length from biometric data using a two-sphere eye model

Szabo, A.; Arpadffy-Lovas, T.; Toth-Molnar, E.

2026-03-31 ophthalmology 10.64898/2026.03.29.26349517 medRxiv
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3.1%
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Purpose:To improve determination of the treatment area for the personalization of subliminal transscleral cyclophotocoagulation (SL-TSCPC) procedures in glaucoma treatment, we designed a biometry based model of the human eye to find the estimated cilary body (CB) arc length (ECBAL) and the calculated CB distance (CCBD). Methods: We developed a rotationally symmetric modified two-sphere eye model based on axial length (AL), mean keratometry (mean K), anterior chamber depth (ACD), lens thickness (LT), and white-to-white (WTW). ECBAL and CCBD were calculated for each eye. Fluence was calculated with standardized parameters. Results: Publicly accessible biometric measurements for 24,001 eyes were pooled for analysis. The mean ECBAL was 23.99+-1.8 mm. The correlations of ECBAL with AL and ACD were 0.723 and 0.754 respectively (p < 0.01). The number of eyes with an ECBAL 21.7-22.0 mm was 131 of 24,001 (0.55%). The mean CCBD was 4.21+-0.8 mm. The number of eyes with a CCBD of 3.8 mm was 1,445 of 24,001 (6.02%). Mean fluence was 120.33+-9.0 J/cm2. A mean difference of -8.18+-6.9%, ranging from -22.66% to +29.07% in fluence was observed with treating only the recommended 22 mm versus the ECBAL. Conclusions: This study demonstrated that use of 22.0 mm as the standard treatment arc length may under or overdose laser treatment in many eyes. Precise estimation or exact localization of the CB treatment area is required to accurately calculate fluence. Translational Relevance:The model proves that CB arc length is a variable while current guidelines consider it a constant

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Maternal respiratory syncytial virus (RSV) vaccine perceptions amongst pregnant women and mothers of infants and toddlers in England: a qualitative study

Bell, S. L.; Chantler, T.; Passanante, A.; Pryce, J.; Bisset, K.; Letley, L.; Campbell, H.; Paterson, P.

2026-03-30 public and global health 10.64898/2026.03.27.26349494 medRxiv
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Aim: To explore RSV knowledge and awareness, RSV vaccination perceptions and acceptability, and preferences for maternal vaccine delivery and communication amongst pregnant women and mothers of infants and toddlers in England. Methods: Between July and November 2024, semi-structured qualitative interviews were performed with 30 mothers (youngest child under 2 years), two of whom were pregnant with a subsequent child. The study was conducted as a follow-on to a UK Health Security Agency survey of attitudes towards RSV vaccination amongst pregnant and post-partum women in England. Findings: Although most mothers had heard of RSV, mothers with experience in health roles were more likely to understand the potential severity of RSV in infants. Likelihood of maternal RSV acceptance was reported as high, with most mothers considering RSV vaccination as beneficial in protecting infants. Most mothers preferred a hybrid approach to vaccine communication, with information available online (e.g. through the NHS website), via written sources (e.g. NHS produced leaflet), and through talking with midwives. For convenience, most mothers preferred the option of fitting vaccinations within the antenatal midwifery appointment schedule rather than going to general practice for a separate appointment. Conclusion: To support maternal RSV vaccination decision-making and access, women need vaccine information early in pregnancy; information provision through a range of different sources (i.e. online, paper, in-person); and vaccination delivery in a convenient location (i.e. as part of antenatal appointments).

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Patient Portal Activation Among Neurology Patients in Washington, DC

Streicher, N. S.

2026-04-11 health policy 10.64898/2026.04.08.26350061 medRxiv
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Background and ObjectivesPatient portals have become essential infrastructure for healthcare delivery following the 21st Century Cures Act, yet adoption remains inequitable. Understanding demographic and geographic determinants of portal activation is critical for addressing digital health disparities, particularly among neurology patients who face unique access barriers. We examined the demographic, geographic, and neighborhood-level factors associated with patient portal activation among neurology patients at multiple geographic scales in the Washington, DC metropolitan area. MethodsWe conducted a retrospective cohort study of 72,417 adult neurology patients seen at two academic medical centers sharing an electronic health record in Washington, DC (February 2021-February 2026). We examined portal activation using multivariable logistic regression and geographic analysis at four nested scales: the metropolitan catchment area, DCs eight wards, individual census tracts (via geocoded patient addresses), and individual DC residents. ResultsPortal activation was 64.7% overall. Activation varied by race/ethnicity (Non-Hispanic White 76.1%, Non-Hispanic Black 57.0%, Non-Hispanic Asian 57.6%, Hispanic 55.0%) and geography (DC Ward 2: 82.0% vs. Ward 7: 48.0%). Ward-level educational attainment (r = 0.948), broadband access (r = 0.889), and income (r = 0.811) were strongly correlated with activation. Within individual wards, Non-Hispanic White patients activated at 84-91% while Non-Hispanic Black patients activated at 48-64%, demonstrating that neighborhood resources alone do not explain disparities. DiscussionPatient portal activation is shaped by demographic, socioeconomic, and geographic factors operating at multiple levels. Persistent within-ward racial disparities indicate that geographically targeted interventions must be paired with culturally tailored approaches to achieve digital health equity.

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Declining Pediatric Representation in NIH Artificial Intelligence and Machine Learning Funding, 2020-2024

Phillips, V.; Woodwal, P.

2026-04-11 health policy 10.64898/2026.04.08.26350420 medRxiv
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BackgroundArtificial intelligence and machine learning (AI/ML) are among the fastest-growing domains in NIH research funding, but whether children have shared equitably in this expansion is unknown. We characterized pediatric representation in NIH AI/ML funding from fiscal years (FY) 2020 to 2024. MethodsNIH grant data were obtained from Research Portfolio Online Reporting Tools Expenditures and Results bulk files for FY2020 to FY2024. AI/ML grants were identified using the NIH Research, Condition, and Disease Categorization "Machine Learning and Artificial Intelligence" category, and pediatric grants using the "Pediatric" category. Subprojects were excluded. Grants were deduplicated within each fiscal year by core project number for trend analyses and across all years retaining the most recent fiscal year for cross-sectional totals. Disease areas were identified by keyword searches of titles and abstracts. ResultsAcross FY2020 to FY2024, 5,624 unique NIH AI/ML grants totaling $3,371 million were identified. Of these, 836 grants (14.9%) were classified as pediatric, representing $401 million (11.9%) of total NIH AI/ML funding. Although this share was consistent with the historically reported overall NIH pediatric funding baseline of approximately 10% to 12%, it remained substantially below the US pediatric population share of approximately 22%. The pediatric share of NIH AI/ML funding declined from 12.3% in FY2020 to 10.8% in FY2024, despite growth in absolute pediatric funding. Indexed to FY2020, pediatric AI/ML funding grew approximately 2.6-fold compared with 3.0-fold growth in the total portfolio. Across disease areas, unadjusted adult/general-to-pediatric funding ratios ranged from 2.0-fold in mental health to 9.8-fold in cancer. ConclusionsPediatric representation in NIH AI/ML funding remained low and declined over time as the overall portfolio expanded. These findings suggest that growth in NIH AI/ML investment has not been matched by proportional gains for pediatric research.