公共卫生研究摘要 (2026-01-07)
共收录 60 篇研究文章
1. Real-World Efficacy and Safety of Neuromyelitis Optica Spectrum Disorder Disease-Modifying Treatments.
期刊: Neurology(R) neuroimmunology & neuroinflammation 发表日期: 2026-Mar 链接: PubMed
摘要
Neuromyelitis optica spectrum disorder (NMOSD) is characterized by inflammatory relapses that result in severe disability, including blindness and paralysis. Relapse prevention with safe and effective treatments is key to reducing long-term disability. We aim to compare the efficacy and safety of rituximab-the most commonly used treatment-with recently approved NMOSD-specific treatments-eculizumab, inebilizumab, satralizumab-and other common off-label NMOSD treatments-mycophenolate mofetil (MMF) and azathioprine. The primary outcomes are relapse-free survival and annualized relapse rate. Secondary outcomes are serious infectious adverse event (SIAE) and treatment-limiting adverse event (TLAE)-free survival. A retrospective cohort study of NMOSD was conducted on patients at the Mass General Brigham hospital network. Patients meeting 2015 NMOSD diagnostic criteria, who were seen between 2000 and 2024 were included. Poisson regression, frequentist negative binomial analysis with inverse probability of treatment weighting, and Cox proportional hazard models were used to assess relapse rates, relapse-free survival, and SIAEs. A total of 176 patients with NMOSD were followed for a median of 9 years (interquartile range: 5-14), contributing 691 relapse assessments. The median age at first attack was 42 years, and 83% were female. Compared with rituximab, relapse risk was significantly lower with C5 inhibitors (HR 0.12, 95% CI 0.07-0.24), inebilizumab (HR 0.22, 95% CI 0.12-0.65), and satralizumab (HR 0.19, 95% CI 0.11-0.42). Annualized relapse rates were the lowest for C5 inhibitors (0, 95% CI 0-0.063) and the highest for azathioprine (0.34, 95% CI 0.18-0.56). A composite outcome of relapse, SIAE, and TLAE favored C5 inhibitors (HR 0.22, 95% CI 0.05-0.67), while azathioprine (HR 2.33, 95% CI 1.08-4.86) and MMF (HR 1.75, 95% CI 1.02-2.95) showed increased risk compared with rituximab. C5 inhibitors had the lowest incidence of serious infections (incidence rate ratio 0.16, 95% CI 0.05-0.42 vs rituximab). Clinicians should consider using NMOSD-approved treatments given their favorable efficacy and safety profiles in the real-world setting. MMF and azathioprine should be avoided. We caution against rituximab as a default first-line given the cumulative risk of relapse, SIAEs, and TLAEs over time. This study provides Class III evidence that, in patients with NMOSD, FDA-approved disease-modifying therapies are associated with lower relapse rates and fewer serious adverse events compared with rituximab.
2. Micro-Nano Plastics and 6-PPD-Q in Cardio-Pulmonary Health: Environmental Sources, Systemic Exposure, and Mechanistic Insights.
期刊: Comprehensive Physiology 发表日期: 2026-Feb 链接: PubMed
摘要
Micro- and nanoplastics (MNPs) and the tire-derived transformation product 6-PPD-Quinone (6-PPD-Q) have emerged as pervasive environmental pollutants with critical implications for cardiopulmonary health and ecosystem integrity. This review identifies tire wear particles (TWPs) as a primary source of both airborne and waterborne MNPs, as well as 6-PPD, which readily oxidizes into the highly toxic 6-PPD-Q. These contaminants have been detected across diverse environmental compartments including air, soil, water, and remote ecosystems highlighting their global distribution and persistence. Human exposure occurs primarily through inhalation, ingestion, and dermal contact. Although mechanistic studies remain limited, available evidence indicates that MNPs and 6-PPD-Q induce oxidative stress, inflammation, mitochondrial dysfunction, apoptosis, and endothelial damage, particularly in pulmonary and cardiovascular tissues. Their detection in human tissues and excreta raises urgent public health concerns. Beyond human health, these toxicants adversely affect soil microbial communities, aquatic organisms, and crop productivity, underscoring their broader ecological footprint within a One Health framework. Regulatory oversight remains limited, especially for nanoplastics and tire-derived compounds, emphasizing the need for standardized detection methods and globally coordinated research and policy initiatives. This review underscores the urgency of implementing comprehensive mitigation strategies, including environmental monitoring, occupational safeguards, and public education, to address the growing threat posed by TWPs, MNPs, and 6-PPD-Q.
3. Reconstructing the early spatial spread of pandemic respiratory viruses in the United States.
期刊: Proceedings of the National Academy of Sciences of the United States of America 发表日期: 2026-Jan-13 链接: PubMed
摘要
Understanding the geographic spread of emerging respiratory viruses is critical for pandemic preparedness, yet the early spatiotemporal dynamics of the 2009 H1N1 pandemic influenza and severe acute respiratory syndrome coronavirus 2 in the United States remain unclear. While mobility and genomic data have revealed important aspects of pandemic spatial spread, several key questions remain: Did the two pandemics follow similar spatial transmission routes? How rapidly did they spread across the United States? What role did stochastic processes play in early spatial transmission? To address these questions, we integrated high-resolution disease data with a robust, data-efficient inference framework combining air travel, commuting flows, and pathogen superspreading potentials to reconstruct their spatial spread across US metropolitan areas. The two pandemics exhibited distinct transmission pathways across locations; however, both pandemics established local circulation in most metropolitan areas within weeks, driven by several shared transmission hubs. Early spatial spread was more strongly associated with air travel than with commuting, though stochastic dynamics introduced substantial uncertainty in transmission routes, creating challenges for timely detection and control. Simulations indicate that broad wastewater surveillance coverage beyond top transmission hubs coupled with effective infection control may slow initial spatial expansion. Our findings highlight the rapid, stochastic spread of pandemic respiratory pathogens and the difficulties of early outbreak containment.
4. Cocreating Principles for Digital Health Equity: Cross-Sectional, Qualitative Study for Participatory Human-Centered Design in Catalonia.
期刊: Journal of medical Internet research 发表日期: 2026-Jan-06 链接: PubMed
摘要
Digital health technologies promise to democratize health care access yet often exacerbate existing inequalities when developed through traditional top-down approaches that prioritize technology implementation and exclude end users from design processes. The COVID-19 pandemic accelerated digital transformation while simultaneously exposing how technology can both bridge and widen gaps in health care access. Understanding how to systematically integrate equity considerations into digital health transformation across entire health systems has become increasingly urgent. This study aims to cocreate actionable design principles for equitable digital health transformation through a large-scale participatory human-centered design (PHCD) process involving diverse stakeholders across Catalonia’s health care ecosystem (northeast Spain), with the aim of establishing guidelines for information systems that support a person-centered, integrated, and longitudinal care delivery model. We conducted a qualitative PHCD research study involving 265 participants representing diverse stakeholder groups: citizens and informal caregivers (n=106), health care professionals (n=83), health care managers and leaders (n=50), and experts representing various domains of digital health innovation (n=26). Through two sequential rounds of participation between June 2024 and April 2025, we used design thinking methodologies and cocreation tools in 24 sessions across Catalan geography and 7 topic-specific expert sessions. Data collection used innovative visual tools, including journey mapping, care model animations, future scenario storyboarding, and facilitated ideation techniques. Analysis followed an inductive-deductive approach combining affinity mapping, thematic synthesis, and participant validation to transform stakeholder proposals into actionable design principles. Participants identified critical barriers to digital health equity, including digital literacy gaps, fragmented information systems, a lack of user involvement in design, and insufficient consideration of vulnerable populations’ needs. The cocreation process yielded 10 fundamental principles: (1) the person and their care circle at the center, (2) health for everyone, everywhere, (3) tools for more compassionate care, (4) a better professional experience, (5) an active role of the population, (6) personalized and proactive care, (7) systematic use of data for decision-making, (8) integrated quality data working for health, (9) an information system that builds trust, and (10) collaboration as a driver of innovation. This study shows how large-scale, rigorously conducted PHCD can uncover and address equity barriers in health information systems. Beyond producing 10 actionable design principles, it highlights how engaging diverse stakeholders can turn complex inequities into practical guidance for equitable digital transformation. The resulting principles provide a framework for creating person-centered systems that are robust, inclusive, and accessible to all, while underscoring the need for enduring partnerships among public institutions, researchers, design experts, and communities as a foundation for sustainable and equitable digital health innovation.
5. Acceptability, Feasibility, and Perceived Effectiveness of Video-Based Patient Records for Supporting Care Delivery to Older Adults With Frailty: Nonrandomized Mixed Methods Pilot Study.
期刊: Journal of medical Internet research 发表日期: 2026-Jan-06 链接: PubMed
摘要
Frailty constitutes a growing challenge for health and social care systems around the world. In England, 35% of adults aged 65 years and older live with frailty, with international estimates indicating that almost half of all hospital inpatients within the same age group are frail. This population often experiences multimorbidity and frequent care transitions. Written documentation and verbal handovers may lack the precision and nuance required to understand an older adult’s presentation and support needs. Video recordings of individual patients, capturing aspects of their functional abilities and condition, may help to enhance multidisciplinary team communication and care continuity, yet little is known about their use in the care of older inpatients with frailty. We aimed to evaluate the acceptability, feasibility of implementation, and perceived effectiveness of video-based patient records (the Isla Health Digital Pathway Platform) for supporting the assessment and care of older inpatients with frailty within the acute hospital setting. A nonrandomized mixed methods pilot study was conducted within 3 acute medicine wards for older adults. The video-based patient records intervention, permitting videos to be embedded securely within the electronic patient record, was implemented over a 3-month period alongside usual care. Patient enrollment and retention figures; qualitative interviews with patients, carers, and clinical staff; and video capture and view metrics were used to address the study objectives. The Theoretical Framework of Acceptability of Healthcare Interventions was applied to the framework analysis of interview data, capturing concepts such as intervention ethicality, burden, and coherence. Patient and public involvement and engagement informed each research stage. Twenty-nine patients were enrolled (56.9%); 1 patient withdrew before receiving the intervention. Modal reasons given by patients for nonparticipation included not wanting to take part in research (n=8) or feeling too unwell (n=2). Staff identified multiple opportunities for capturing patient videos, including documentation of mobility assessments or seizures. The intervention was considered acceptable on the grounds that safeguards were always in place, including secure data storage and upholding of patient dignity. Implementation barriers and facilitators were identified; factors such as difficulties in capturing videos within busy ward environments and scheduling issues were voiced by participants. Video view metrics and data from interviews collectively suggested low rates of engagement with videos by clinical staff once captured. Potential intervention impacts included perceived enhancements to clinical assessment and person-centered care. Our findings suggest that the intervention is largely acceptable to patients, carers, and clinical staff. Conclusions as to intervention feasibility were mixed, with limited engagement with videos suggesting further work is required to promote sufficient uptake among staff. Finally, this research presents promising patient, carer, and clinical opinion as to the potential effectiveness of video-based patient records for improving aspects of patient care.
6. World Health Organization-Recommended Periodic Presumptive Treatment Versus Doxycycline Post-Exposure Prophylaxis for Sexually Transmitted Infection Control Among Men Who Have Sex With Men in Kenya: Protocol for a Randomized Controlled Trial.
期刊: JMIR research protocols 发表日期: 2026-Jan-06 链接: PubMed
摘要
Men who have sex with men (MSM) are at high risk for bacterial sexually transmitted infections (STIs), including gonorrhea, chlamydia, and syphilis, in Kenya. Because nucleic acid amplification testing (NAAT) is not widely accessible, most gonorrhea and chlamydia infections go undiagnosed and are treated only if symptomatic. World Health Organization (WHO)-recommended periodic presumptive treatment (PPT) and doxycycline post-exposure prophylaxis (doxyPEP) are both potential interventions to reduce the burden of bacterial STIs in this population. Neither has been rigorously tested among MSM in Africa. This study aims to evaluate the effectiveness of WHO-recommended PPT versus doxyPEP, compared with standard syndromic treatment, in reducing the prevalence of bacterial STIs, including gonorrhea, chlamydia, and syphilis, among MSM in Kenya. We are conducting an open-label randomized controlled trial with 2900 participants assigned in a 2:2:1 ratio to WHO-recommended PPT given every 3 months, doxyPEP taken 24-72 hours after condomless sex, or standard treatment. Sociodemographic, psychosocial, and behavioral data are collected by audio computer-assisted self-interview. Syphilis testing and treatment are provided as part of standard care. Throat and rectal swabs and urine are collected, pooled, and batch tested for gonorrhea and chlamydia by NAAT; these results are not used to guide treatment. The primary trial outcome is the combined prevalence of laboratory-diagnosed gonorrhea, chlamydia, and early syphilis after baseline; secondary outcomes include the prevalence of each pathogen individually and antimicrobial resistance in Neisseria gonorrhoeae. Primary and secondary outcomes will be compared between each intervention and the common control arm by estimating relative risks over follow-up (months 3-18) using a modified Poisson model fitted with generalized estimating equations. We will also assess implementation outcomes, including acceptability, feasibility, and safety of each intervention compared to standard care among providers and patients using a mixed methods approach. Finally, we will evaluate the potential health and economic impact of scaling up WHO-recommended PPT and doxyPEP compared to standard of care on STI control among MSM and their partners in Kenya using a stochastic, network-based model and cost-effectiveness analysis on trial data. Enrollment commenced on October 29, 2025. As of November 25, 2025, a total of 357 participants (12.3% of target) have been enrolled, including 133 in Kisumu, 122 in Nairobi, and 102 in Mombasa. Full enrollment is expected to take 6 months, with follow-up occurring over 18 months per participant. Results will be published in 2028. Results of this trial will provide critical data needed to inform guidelines to improve STI control among MSM in sub-Saharan Africa and other resource-limited settings where NAAT is not routinely available. Modeled estimates of the health and economic impact of scaling up these two interventions on STI control among MSM and their partners in Kenya will provide critical information to guide policymakers considering adoption of either intervention. ClinicalTrials.gov NCT06468462; https://clinicaltrials.gov/ct2/show/NCT06468462. PRR1-10.2196/81113.
7. Impact of Age on Hospital Outcomes Following Minimally Invasive Posterior Lumbar Interbody Fusion: Retrospective Analysis of the Nationwide Inpatient Sample Database from 2016 to 2020.
期刊: JMIR medical informatics 发表日期: 2026-Jan-06 链接: PubMed
摘要
Minimally invasive posterior lumbar interbody fusion (MIS-PLIF) is commonly performed to treat degenerative lumbar spinal conditions. Patients of advanced age often present with multiple comorbidities and reduced physiological reserves, influencing surgical risks and recovery. The growing aging population has led to a rising demand for care for older adults, posing significant challenges for health care systems worldwide. This study aimed to identify the associations between different age groups and MIS-PLIF outcomes. This study retrospectively analyzed data from the United States Nationwide Inpatient Sample collected between 2016 and 2020. Patients aged ≥60 years who underwent MIS-PLIF were eligible for inclusion in this study. Patients were categorized into age groups (60-69, 70-79, and ≥80 y). Logistic and linear regressions were used to determine the associations between the study variables and outcomes, including in-hospital mortality, complications, nonroutine discharge, and length of stay. A total of 785 patients aged ≥60 (mean age 69.4, SD 0.2) years who underwent MIS-PLIF were included in the analysis, and 18.7% (147/785) experienced at least one complication. After adjustment, compared with patients aged 60 to 69 years, the risk of nonroutine discharge was significantly increased in patients aged 70 to 79 years (adjusted odds ratio 2.33, 95% CI 1.57-3.46; P<.001) and ≥80 years (adjusted odds ratio 4.79, 95% CI 2.64-8.67; P<.001). No significant differences in the risk of complications or length of hospital stay were observed across the age groups. In older patients undergoing MIS-PLIF, advanced age is an independent predictor of nonroutine discharge. Furthermore, our findings suggest that age alone is not an independent risk factor for complications or extended hospital stays among older patients. These findings underscore that MIS-PLIF is a viable option for older patients, for whom extra attention may still be needed for postoperative care. Implementing age-stratified management for older patients undergoing MIS-PLIF may have important clinical policy implications.
8. General Practitioners' Perspectives on Digital Health Applications for Mental Disorders and Their Prescribing Behavior: Mixed Methods Study.
期刊: JMIR mental health 发表日期: 2026-Jan-06 链接: PubMed
摘要
The high number of mental disorders poses challenges for health care systems. In 2020, digital health applications (DHAs) were introduced in Germany as a new form of health care financed by the statutory health insurance. They aim to detect, monitor, treat, or alleviate disease, injury, or disability. DHAs for mental disorders (DHA-MD) intend to improve outpatient care for patients with mental disorders. However, evidence on general practitioners’ (GPs’) perspectives on DHA-MD and their prescribing behavior is limited. This study aimed to analyze GPs’ perspectives on DHA-MD and their prescribing behavior in the care of patients with mental disorders. A mixed methods study was conducted (January-October 2024), including a Germany-wide online survey and qualitative interviews with GPs and medical assistants (MAs). Sampling was conducted in collaboration with German research practice networks, which distributed the study invitation to their affiliated GPs. The questionnaire as well as the interview guides for GPs and MAs was developed by the study team according to the Consolidated Framework for Implementation Research. Descriptive analyses of prescribing behavior and perceived need (measured on an 11-point scale) for DHA-MD were conducted, followed by multivariate regression analyses to identify predictors of prescribing behavior and perceived need for DHA-MD. The interviews with GPs and MAs were analyzed using qualitative content analysis according to Mayring. A sample of 149 GPs participated, and 12 GPs as well as 5 MAs were interviewed. The median prescription frequency of DHA-MD per quarter was 1, whereas the median estimated need was 3. Working in a half digitized and half paper-based practice (odds ratio 5.133, 95% CI 1.695-15.542) as well as working in a completely digitized practice (odds ratio 3.006, 95% CI 1.296-6.969) positively predicted the prescribing behavior. The duration of GPs’ medical practice (b=-0.057; P=.01) negatively predicted the perceived need, while working in a group practice (b=0.980; P=.02) positively predicted the perceived need for DHA-MD. In the interviews, GPs and MAs reported that they valued DHA-MD as a temporary or supplementary option for bridging waiting times for psychotherapy and considered their effectiveness to be highly dependent on indication and patient adherence. Reported barriers of GPs according to DHA-MD included lacking knowledge about DHA-MD, missing effectiveness studies, and difficulties integrating them into existing care processes. GPs are reluctant to prescribe DHA-MD, as the need is considered to be low and their use is primarily seen as a temporary or supplementary treatment option rather than a stand-alone intervention. There are significant reasons for rejection and barriers that hinder prescription in primary care. Addressing these barriers and involving GPs as well as patients in future research are essential for the development of DHA-MD.
9. Hashimoto Thyroiditis and Progression of Papillary Thyroid Cancer: 10-Year Retrospective Cohort Study.
期刊: JMIR cancer 发表日期: 2026-Jan-06 链接: PubMed
摘要
In recent years, the global incidence of thyroid cancer has been increasing. This study aimed to examine the association between Hashimoto thyroiditis (HT) and papillary thyroid cancer (PTC) progression under active surveillance (AS). Our retrospective study was conducted at Peking University Third Hospital and included 203 patients with PTC who underwent AS for ≥6 months before surgery. Patients were first categorized into 2 groups: the HT group (n=90) and the non-HT group (n=113). Cox proportional hazards models were then used to evaluate the association between HT and PTC progression during AS, adjusting for age, sex, baseline tumor size, BMI, pregnancy status, number of tumor foci, and thyroid-stimulating hormone level. Subgroup analyses stratified by the 6 covariates mentioned above were also applied to explore the potential effect modification. No significant difference was observed between the HT and non-HT groups in PTC progression-free survival (hazard ratio [HR] 1.11, 95% CI 0.61-1.99; P=.74), tumor enlargement-free survival (HR 1.02, 95% CI 0.56-1.86; P=.95), or lymph node metastasis-free survival (HR 1.76, 95% CI 0.31-10.12; P=.52). Subgroup analyses revealed a potential interaction between HT and BMI. Among patients who were overweight or obese (BMI >24 kg/m²), HT was significantly associated with an increased risk of disease progression (HR 6.32, 95% CI 1.84-21.69; P=.003), while among patients with BMI ≤24 kg/m2, no association between HT and progression risk was observed (P=.01). We found no evidence of association between HT and PTC progression during AS. However, the relationship between HT and PTC progression may be modified by overweight or obesity status.
10. Attitudes Toward Video Consultations From the Perspective of Physicians and Psychotherapists in German Outpatient Care After the COVID-19 Pandemic: Survey Study.
期刊: Journal of medical Internet research 发表日期: 2026-Jan-06 链接: PubMed
摘要
Although video consultations (VCs) are permitted in German outpatient care and have seen a notable rise during the COVID-19 pandemic, their use still does not seem to have become established in Germany. This survey aims to evaluate the attitudes of physicians and psychotherapists with regard to the use of VC after the COVID-19 pandemic, in particular in the context of types of treatment and suitable medical fields. A standardized questionnaire was sent out to all 34,095 physicians and psychotherapists in 4 German regions. The analysis consisted of both descriptive and inferential statistics. Subgroup analysis included gender, age groups, community size of practice location, VC experience, type and ownership of practice, and area of medical care. Binary logistic regression was conducted to determine whether physicians’ and psychotherapists’ individual factors, organizational factors, or area of medical care were associated with at least monthly VC provision or interest in VC provision. The response rate was 17.9%, including a total of 5930 participants in the analysis. About 40% (2216/5863) of the physicians and psychotherapists surveyed stated that they offer VC at least once a month. In the area of medical care, the odds ratio (OR) of at least monthly VC provision in psychotherapeutic care was about 8.2 (95% CI 7.4-1.64; P<.001) compared to primary care, whereas in specialist care, the odds for monthly VC provision were approximately 50% lower than in primary care (OR 0.5, 95% CI 0.43-0.59; P<.001). Further, female participants have higher odds to provide VC at least once a month (OR 1.163, 95% CI 1.01-1.34; P=.03). The odds for monthly VC provision in older age groups are approximately 60% higher than in the <40 years old age group (OR 0.41, 95% CI 0.32-0.52; P<.001). Around 80% (4347/5442) of the participants expressed interest in VC use. The most common occasions for which treatment by VC was reported to be suitable were discussing test results (1422/1896, 75.0%), taking the patient’s medical history (1195/2147, 55.7%), issuing prescriptions for drugs and remedies (793/1204, 65.9%), and the issuing of incapacity certificates for work (677/1042, 65.0%). There has been an increase in the self-reported uptake of VC among physicians and psychotherapists compared to prepandemic levels, although this remains at a relatively low level in primary and specialist care. A significant proportion of doctors and psychotherapists have expressed an interest in using VC after the pandemic period. However, this self-reported use is not yet reflected in actual usage data, suggesting the need for further investigation into the underlying factors influencing the gap and identifying potential enablers. Further, these self-assessments by service providers on suitable types of treatment and suitable medical fields can inform political decision-making.
11. Development and Validation of a Generative Artificial Intelligence-Based Pipeline for Automated Clinical Data Extraction From Electronic Health Records: Technical Implementation Study.
期刊: JMIR bioinformatics and biotechnology 发表日期: 2026-Jan-06 链接: PubMed
摘要
The manual abstraction of unstructured clinical data is often necessary for granular clinical outcomes research but is time consuming and can be of variable quality. Large language models (LLMs) show promise in medical data extraction yet integrating them into research workflows remains challenging and poorly described. This study aimed to develop and integrate an LLM-based system for automated data extraction from unstructured electronic health record (EHR) text reports within an established clinical outcomes database. We implemented a generative artificial intelligence pipeline (UODBLLM) utilizing a flexible language model interface that supports various LLM implementations, including Health Insurance Portability and Accountability Act-compliant cloud services and local open-source models. We used extensible markup language (XML)-structured prompts and integrated using an open database connectivity interface to generate structured data from clinical documentation in the EHR. We evaluated the UODBLLM’s performance on the completion rate, processing time, and extraction capabilities across multiple clinical data elements, including quantitative measurements, categorical assessments, and anatomical descriptions, using sample magnetic resonance imaging (MRI) reports as test cases. System reliability was tested across multiple batches to assess scalability and consistency. Piloted against MRI reports, UODBLLM processed 1800 clinical documents with a 100% completion rate and an average processing time of 8.90 seconds per report. The token utilization averaged 2692 tokens per report, with an input-to-output ratio of approximately 13:2, resulting in a processing cost of US $0.009 per report. UODBLLM had consistent performance across 18 batches of 100 reports each and completed all processing in 4.45 hours. From each report, UODBLLM extracted 16 structured clinical elements, including prostate volume, prostate-specific antigen values, Prostate Imaging Reporting and Data System scores, clinical staging, and anatomical assessments. All extracted data were automatically validated against predefined schemas and stored in standardized JSON format. We demonstrated the successful integration of an LLM-based extraction system within an existing clinical outcomes database, achieving rapid, comprehensive data extraction at minimal cost. UODBLLM provides a scalable, efficient solution for automating clinical data extraction while maintaining protected health information security. This approach could significantly accelerate research timelines and expand feasible clinical studies, particularly for large-scale database projects.
12. Etiologic Types and Complications of Diabetes Mellitus in Newly Diagnosed Patients at Health Institutions in Bulawayo, Zimbabwe: Protocol for a Cross-Sectional and Prospective Observational Study.
期刊: JMIR research protocols 发表日期: 2026-Jan-06 链接: PubMed
摘要
The prevalence of diabetes mellitus is increasing in sub-Saharan Africa. Data on the prevalence of diabetes in Zimbabwe are scarce, and the etiologic types of diabetes are not well characterized. Classification of diabetes in Zimbabwe relies on clinical criteria at the time of diagnosis, and more detailed phenotype data are lacking. Furthermore, the prevalence of complications at diagnosis of diabetes and the incidence of complications during follow-up are not well documented in Zimbabwe. The primary aim of this study is to characterize the etiological types of diabetes in adult and adolescent patients with newly diagnosed diabetes in Bulawayo, Zimbabwe. The secondary objectives are to determine the prevalence of chronic complications of diabetes among adult and adolescent patients with newly diagnosed diabetes and to determine the incidence and risk factors for the development of diabetes complications after a 2-year follow-up in patients with type 2 diabetes who are free of complications at baseline. This is a cross-sectional and prospective observational study. The cross-sectional (phase 1) study was conducted in patients presenting for the first time to the diabetes service at 2 referral hospitals and 2 diabetes clinics in Bulawayo, Zimbabwe. Data collected from consenting participants included demographic data, social and medical history, and clinical examination. Laboratory tests included serum urea, creatinine and electrolytes, liver function tests, lipids, plasma glucose, glycated hemoglobin, serum C-peptide, spot urine (dipstick, albumin, and creatinine), and β-cell antibodies (antiglutamic acid decarboxylase, anti-islet antigen, anti-insulin antibodies, anti-islet cell antibodies, and antizinc transporter 8 antibodies). All patients had retinal photography, a 12-lead electrocardiograph, and measurement of carotid intima-media thickness and arterial stiffness. Determination of the incidence of diabetes complications will be conducted through a 2-year follow-up (encompassing 6-mo review) of a subgroup of patients with type 2 diabetes and no diabetes complications at the time of enrollment. At each 6-month visit, in addition to all variables collected at baseline, data on diabetes management and drug therapy compliance will be obtained. Data collection commenced in October 2021, with 323 participants recruited. Data analysis for phase 1 is ongoing. The study will be completed in October 2026. The results will describe the spectrum of diabetes and complications found at diagnosis (phase 1) and the incidence and risk factors associated with the development of complications of diabetes (phase 2). The study will provide data on etiologic types of diabetes in patients presenting to health facilities in urban centers in Bulawayo, Zimbabwe. In addition, data on diabetes complications at the time of diagnosis as well as incident complications over 2 years of follow-up will be compared with data from other studies. The data will be used to inform management strategies for patients diagnosed with diabetes in Zimbabwe.
13. Effectiveness and Implementation of Adapted Physical Activity Delivery Strategies for Older Adults Living With HIV in Ivory Coast: Protocol for a Type 2 Hybrid Randomized Controlled Trial.
期刊: JMIR research protocols 发表日期: 2026-Jan-06 链接: PubMed
摘要
With improved access to antiretroviral treatment, HIV infection has become a chronic disease, and the proportion of people living with HIV aged 50 years or older is increasing. However, the long-term evolution of this disease is associated with an increased risk of comorbidities and functional impairments, which negatively impact the social participation and quality of life of people living with HIV. In resource-limited countries, population aging is a new situation, and significant challenges remain unaddressed to respond to this demographic shift. Strong evidence supports the role of physical activity (PA) in improving health and decreasing functional limitations in many chronic conditions, including HIV. However, there is a lack of information on how to effectively implement this type of nondrug intervention in resource-limited contexts. This study aims to examine the effectiveness and implementation of 2 strategies to deliver an adapted PA program to older adults living with HIV. This is a prospective, randomized controlled trial following a type 2 hybrid design, with a dual focus on intervention effectiveness and implementation outcomes. It also includes prior formative research that provides information on the context and guides the implementation. Conducted in Ivory Coast, the study aims to randomize 180 people living with HIV aged 50 years or older, receiving antiretroviral treatment and presenting moderate functional limitations or disabilities into the following three arms: (1) a reference arm receiving a group-based PA program supervised by a coach, (2) an exploratory arm receiving a home-based PA program with remote supervision via phone calls and messaging apps, or (3) a control arm receiving health education sessions. The total follow-up period is planned for 12 months, with an initial 6-month active phase and then a 6-month maintenance phase. The primary effectiveness outcome is the increase in the number of steps in the 6-minute step-up test between baseline and 6 months. The secondary outcomes include changes in performance on other functional tests and improvements in cardiometabolic risk factors. The implementation outcomes include the acceptability, adoption, feasibility, and sustainability of the intervention. This study is funded by ANRS Emerging Infectious Disease, which is also the study sponsor. It received ethical approval from the National Ethical Committee of Ivory Coast (00231 3124/MSHPCMU/CNESVS-km). As of manuscript submission, the baseline formative research has been completed, participants have been randomized, and they have started the PA activity program. Results dissemination will involve civil society and decision-makers through workshops and policy briefs. This study builds on previous research on healthy aging while living with HIV. Its hybrid design allows for a comprehensive evaluation of implementation processes and outcomes alongside effectiveness outcomes. ClinicalTrial.gov NCT06139497; https://clinicaltrials.gov/study/NCT06139497. DERR1-10.2196/84677.
14. Sleep Disturbance and Its Association With Purchasing Behavior of COVID-19 Medicine Among the Public After the Adjustment of Zero-COVID Policy in China: Results From a Web-Based Survey Study.
期刊: Interactive journal of medical research 发表日期: 2026-Jan-06 链接: PubMed
摘要
In December 2022, in light of the weakened pathogenicity of the new variants and other scientific considerations, China optimized its zero-COVID policy. As the situation evolved, the virus spread more widely across the country. This study aims to explore the public’s sleep status and its association with purchasing behavior of COVID-19 medicine after the adjustment of zero-COVID policy in China. A cross-sectional, internet-based survey among residents aged 18-69 years was conducted in Zhejiang province, China, from December 16 to 30, 2022, to collect data on sociodemographic characteristics, COVID-19 drug purchasing behavior, sleep disturbance levels, etc. Chi-square tests, univariate analyses, and multivariate analyses were used to explore the associations among these factors. Out of 38,480 participants, 20,803 (54.1%) reported sleep disruption after China’s COVID-19 response policy adjustment. The degree of impact varied, with 10,964 (52.70%) reporting “slight,” 3105 (14.93%) “moderate,” 3493 (16.79%) “significant,” and 3241 (15.58%) “very significant” impacts. Only 20.90% (782/3742) of those who deemed purchasing unnecessary had sleep disruptions, compared to 45.19% (6214/13,752) of those who acquired medications and 65.79% (13,807/20,986) of those who tried but failed to obtain them. Sleep disturbance levels were significantly associated with sociodemographic factors like age, education levels, occupation, marital status, and presence of family members diagnosed with COVID-19 (P<.05). By age, sleep disturbance proportions differed notably: 36.32% (409/1126) for those under 20 years, 54.81% (19,714/35,970) for the 20 to 60 age group, and 49.13% (680/1384) for individuals over 60 years. For education level, the proportions were 57.44% (517/900, primary school), 54.34% (3928 /7229, junior high school), 54.27% (3808/7017, senior high school), 53.99% (11,974/22,180, junior college/undergraduate), and 49.91% (576/1154, master’s degree), showing a clear downward trend as education level increased. By occupation, farmers had the highest rate (855/1447, 59.09%), followed by business/service industry workers and stay-at-home/unemployed individuals (13,925/24,750, 56.26%) and government staff (4161/7712, 53.95%), while 1242 out of 3049 (40.73%) health workers and 620 out of 1522 (40.74%) students had lower rates. Married participants had a 55.21% (17,143/31,053) sleep disturbance rate, and those with COVID-positive family members had the highest rate (2023/2873, 70.41%). Multivariate logistic regression, adjusting for these sociodemographic factors, showed that compared to those who thought purchasing COVID-19 medications was unnecessary, those who acquired medications were 3.11 times (adjusted odds ratio 3.11, 95% CI 2.85-3.39) more likely, and those who tried but couldn’t get medications were 7.11 times (adjusted odds ratio 7.11, 95% CI 6.53-7.74) more likely to experience sleep disturbance. The adjustment of China’s zero-COVID policy affected the sleep health of the public, which was closely linked to drug-purchasing status, especially among the older people, those with lower education levels, and those with family members diagnosed with COVID-19. It highlights the need to develop and deploy interventions aimed at promoting better sleep health in times of crisis.
15. Innovative Diabetes Therapies and Impact on Peripheral and Autonomic Diabetic Neuropathies: A State-of-the-Art Review.
期刊: Diabetes therapy : research, treatment and education of diabetes and related disorders 发表日期: 2026-Jan-06 链接: PubMed
摘要
As a leading complication of diabetes mellitus, diabetic neuropathy (DN) represents a major public health challenge due to its high prevalence and impact on patients’ quality of life. The most common form, diabetic peripheral neuropathy (DPN), is characterized by progressive sensory loss, neuropathic pain, and autonomic dysfunction, all of which can significantly increase the risk of serious complications, such as foot ulcers and amputations. Traditionally, therapeutic strategies for DN have been largely limited to symptomatic management. However, recent advancements in diabetes therapy have opened promising avenues for disease-modifying interventions. In particular, incretin-based therapies and sodium-glucose co-transporter 2 (SGLT2) inhibitors have attracted increasing interest not only for their glucose-lowering effects, but also for their broader metabolic, renal, and cardiovascular benefits. In this narrative review, we synthesize emerging evidence on the potential role of these innovative therapies in the management of DN. Preclinical models, clinical trials and real-world observational studies strongly support the hypothesis that glucagon-like peptide-1 receptor agonists (GLP-1 RAs) and SGLT2 inhibitors may confer neuroprotective benefits. Beyond these established classes, novel agents such as dual and triple receptor agonists are currently being investigated. Although clinical data on their effects in DN are still limited, the simultaneous activation of multiple metabolic pathways suggests the potential for synergistic neuroprotective effects through enhanced regulation of glucose and lipid metabolism, attenuation of systemic inflammation and oxidative stress, improvement of mitochondrial function and reduction of neuronal damage. Although innovative diabetes therapies are still in early stages of development, they reflect a rapidly evolving landscape in the management of DN in the future.
16. Japanese version of MICRA: introduction of the Shizuoka Cancer Center version.
期刊: Familial cancer 发表日期: 2026-Jan-06 链接: PubMed
摘要
17. Digital Health Communication and Vaccine Confidence in Mexico Using Aggregated Randomized Brand Lift Studies: Secondary Analysis.
期刊: JMIR formative research 发表日期: 2026-Jan-06 链接: PubMed
摘要
Digital vaccination campaigns are increasingly used to address declining vaccine confidence, yet evidence from large-scale, real-world interventions in middle-income countries is limited. Meta’s Brand Lift Studies (BLS), which use randomized test-control exposure, provide Bayesian estimates of attitudinal shifts resulting from digital content. Mexico, with over 88.6 million active internet users, provides a setting to evaluate the impact of targeted campaigns on vaccine attitudes. This study evaluated the impact of 5 digital vaccination campaigns implemented by the Asociación Mexicana de Vacunología (@Vacunologia) on Facebook (Meta Platforms Inc) and Instagram (Meta Platforms Inc) in Mexico between 2021 and 2022 on key attitudinal constructs related to COVID-19 vaccine confidence. This study used a retrospective ecological design. We analyzed aggregated BLS results for 5 campaigns targeting different audiences and vaccination themes. Measured outcomes included standard ad recall, perceived importance, perceived safety, perceived efficacy, and concerns about side effects. Statistical significance within the BLS framework was defined as an incremental lift of ≥2 percentage points with ≥90% posterior probability of replication-a threshold consistent with Meta’s operational Bayesian approach. Exploratory comparisons across campaigns were conducted using 1-way ANOVA, unpaired 2-tailed t tests, and Fisher exact tests. Campaigns reached 84.9 million accounts and generated 179.4 million impressions with a total investment of US $215,600. All campaigns produced statistically significant improvements in at least one attitudinal outcome (Bayesian threshold ≥90%). Standard ad recall increased in 4 campaigns (ANOVA, P<.001), and concerns about side effects decreased in 2 campaigns (t test, P=.049; P=.006). Perceived safety, importance, and efficacy improved in selected audiences, with stronger effects observed among younger users and women (ANOVA, P=.005). No direct behavioral outcomes (eg, vaccination uptake) were measured; therefore, the findings reflect attitudinal rather than behavioral change. However, these constructs are recognized as proximal predictors of vaccine decision-making and constitute health-related outcomes. Large-scale digital vaccination campaigns can meaningfully strengthen attitudinal determinants of vaccine confidence in a middle-income context. These social media advertising campaigns effectively increased standard ad recall and improved perceptions of vaccine importance and safety, particularly among younger audiences and women in urban areas. However, changes in efficacy perceptions and concerns about side effects were limited. The innovation and implications of this study lie in evaluating large-scale, real-world digital vaccine campaigns in Latin America using experimental BLS data. Findings highlight that audience segmentation yields stronger perceptual shifts, suggesting that tailored digital strategies can complement traditional public health communication. While the BLS does not measure behavioral end points, the observed attitudinal improvements represent foundational steps toward influencing vaccine-related behaviors. Future work should link digital attitudinal metrics with vaccination and epidemiological data to assess real-world health impact.
18. Improving access to care for neurological disorders in Sub-Saharan Africa: leading the change after a twenty years lesson from primary care - DREAM.
期刊: Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology 发表日期: 2026-Jan-06 链接: PubMed
摘要
19. Gut microbiome as a predictor for positive youth development transition from childhood to early adolescence: a cohort study.
期刊: Journal of child psychology and psychiatry, and allied disciplines 发表日期: 2026-Jan-06 链接: PubMed
摘要
The gut microbiome is increasingly implicated in childhood mental health and may influence positive youth development (PYD). This study aims to characterize PYD transition patterns from childhood to adolescence and explore the predictive value of the gut microbiome. This cohort study used two waves of data from the Chinese Adolescent Cohort study, including children aged 8-11 years at Wave 1, from Sichuan, Guizhou, and Chongqing provinces. PYD was assessed at both time points, and latent transition analysis identified changes over the 3-year follow-up period. Baseline stool samples were analyzed using 16 s rRNA sequencing. A light gradient boosting machine model was developed to link gut microbiota with PYD transition type in a training set (70%, n = 461), and validated with multinominal logistic analysis within a test set (30%, n = 200). Linear regression models were performed to assess dietary modifications on the gut microbiome. Three PYD transition profiles were identified: downgraded (declining to a lower pattern), promoted (advancing to a higher pattern), and stable development type (remaining in the same pattern). Fifteen microbial genera were identified as predictors of PYD transitions, and children with higher abundance of these taxa were more likely to transition to a stable or promoted profile rather than a downgraded profile (odds ratio ranging from 2.03 to 5.45). This predictive model demonstrated excellent performance, with an area under the curve of 0.91 (95% CI: 0.89, 0.93). The microbiome-PYD transition association was more pronounced in children in earlier stages of puberty. Furthermore, a diet high in fruits, vegetables, and soybeans was positively linked with PYD stable or promoted transition type. The gut microbiome presents predictive value in PYD transition from childhood to adolescence. Targeting these microbial taxa may inform future health promotion programs to optimize child development, particularly during the critical pubertal transition.
20. Nurses' Perspective of Barrier Structure and Promotion Strategies for Digital Health Transformation: An Interpretive Structural Modeling Approach.
期刊: Computers, informatics, nursing : CIN 发表日期: 2026-Jan-06 链接: PubMed
摘要
Potentially complex structures underlie the barriers to digital health transformation. This study aimed to identify the elements of barriers to digital health transformation and clarify the relationships among them using Interpretive Structural Modeling and Cross Impact Matrix-Multiplication Applied to Classification. We identified 11 barriers through a brainstorming session conducted by 3 nursing researchers in Japan. These elements were analyzed via mathematical processing, and a hierarchical structural diagram was constructed. The characteristics of each element were classified using the Cross Impact Matrix-Multiplication Applied to Classification analysis. The results demonstrated consistency with those of previous studies, thus indicating content validity. Furthermore, this study succeeded in systematically organizing the multilayered barriers and visualizing a comprehensive model that even individuals unfamiliar with the cultural context of health care could easily understand. These findings suggest that the organizational culture of nursing plays a fundamental role in the promotion of digital health transformation and emphasize the importance of collaboration among stakeholders at the clinical, developmental, and policy levels. Future strategies for digital health transformation should incorporate more flexible approaches using SWOT analysis and the Decision-Making Trial and Evaluation Laboratory technique.
21. Exhaled Breath Analysis to Stratify Cardiovascular Risk Using Machine Learning Model: A Novel Frontier in Preventive Cardiology.
期刊: Journal of breath research 发表日期: 2026-Jan-06 链接: PubMed
摘要
Despite major progress in diagnosis and treatment, cardiovascular disease (CVD) continues to be the leading cause of death worldwide, responsible for roughly 19.8 million lives lost each year. A key challenge in preventive cardiology is still the early detection of those at elevated risk of serious heart complications. Aims: Assess the ability of the machine learning model to stratify CVD risk using exhaled breath analysis. Materials and methods: A single-center study involved 80 participants with vs. without stress-induced myocardial perfusion defect. All participants underwent a single resting breath sample collection in PTR-TOF-MS-1000, single blood sample intake, and stress computed tomography myocardial perfusion imaging with vasodilation test. Statistical analyses were performed using Statistica 12 (StatSoft, Inc., 2014), IBM SPSS Statistics v29.0.1.1 (IBM Corp., 2024). The threshold for statistical significance was p < 0.05. Machine learning models were developed using Google Colab with Python 3. Results: The gradient-boosting model demonstrated the best performance and was therefore selected for further evaluation. The model showed an AUC of 0.77 [95% CI; 0.4976 - 1.0000] to differentiate participants with low CVD risk, moderate risk 0.55 [95% CI; 0.3345 - 0.7875], and high risk 0.66 [95% CI; 0.3765 - 0.8661]. Conclusion: The gradient boosting machine learning model provides initial evidence that rest exhaled breath analysis can differentiate cardiovascular risk strata through identifiable concentration patterns of specific volatile organic compounds. However, substantial challenges remain regarding model performance and the confounding effects of class imbalance within a limited sample.
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22. Reliability of RSV Antigen Diagnostic Tests in the Presence of Nirsevimab.
期刊: The Pediatric infectious disease journal 发表日期: 2026-Jan-06 链接: PubMed
摘要
Nirsevimab is approved for the prevention of respiratory syncytial virus (RSV) lower respiratory tract disease in neonates and infants. Although nucleic acid detection by polymerase chain reaction is primarily utilized for the clinical diagnosis of RSV, antigen detection is still routinely used and primarily relies on direct interaction with the RSV F protein in patient nasal samples. While expected monoclonal antibody (mAb) levels in nasal samples are typically <1 μg/mL following administration, some mAbs targeting the RSV F protein, such as palivizumab, have been shown to interfere with antigen detection. We assessed whether the presence of nirsevimab in nasal samples may interfere with RSV detection by antigen tests. RSV detection was evaluated in 6 antigen detection tests utilizing contrived samples containing RSV A or B, and nirsevimab at 2 concentrations (1 or 10 µg/mL) chosen to estimate and exceed physiologically relevant concentrations. To better simulate real-world diagnostic specimens, RSV-positive nasal samples were pooled and assessed in the presence of nirsevimab in 2 frequently utilized detection tests. RSV was detected in contrived samples by all diagnostic kits evaluated in the presence of nirsevimab at both concentrations. Furthermore, RSV was detected in all nasal specimen pools by both diagnostic tests and remained detectable in the presence of nirsevimab at both concentrations tested, displaying 100% agreement with nonspiked pools. Nirsevimab did not interfere with RSV detection with any of the antigen tests evaluated, suggesting patients who receive nirsevimab are unlikely to require alternative assays for clinical RSV diagnosis.
23. Co-N4-Coordinated Single-Atom Nanozymes with Dual Bactericidal-Regenerative Functions: Overcoming Tetracycline Resistance through Self-Enhanced Oxidase-Mimicking Catalysis.
期刊: ACS applied materials & interfaces 发表日期: 2026-Jan-06 链接: PubMed
摘要
Antibiotic therapy is the current option for wound healing; however, this strategy will bring about serious antibiotic resistance. Herein, a Co-N-C single-atom nanozyme with oxidase mimicking properties (calculated Km value, 0.224 mM) was synthesized instead of traditional antibiotics in wound healing, which was evaluated using four tetracycline-resistant bacteria as representative indicators. Our experimental system achieved >99% eradication of all tested tetracycline-resistant bacterial strains. Besides, bacterial damage investigation confirmed that Co-N-C exerted its bactericidal effect by releasing ROS. Moreover, Co-N-C-treated wounds achieved complete re-epithelialization with restored skin appendages by day 10, whereas vehicle controls exhibited only partial wound closure (52.4 ± 5.8% area reduction) with persistent fibrinous exudate. Consequently, the investigations conducted in vitro and in vivo showed that Co-N-C SAzyme possesses excellent antibacterial activity as well as the ability to promote wound healing, demonstrating encouraging uses in wound healing and antimicrobial applications. Furthermore, a cycling inhibition assay with Co-N-C, gentamicin, and kanamycin also revealed Co-N-C’s ability to inhibit tetracycline-resistant bacteria and delay resistance development. The overall result indicated that Co-N-C is an effective metal antibacterial agent and has a lot of promise for use in human health and environmental applications.
24. Efficient Degradation of Bisphenol A by a Laccase-Like Copper-Lanthanide Aminoclay Nanozyme.
期刊: Langmuir : the ACS journal of surfaces and colloids 发表日期: 2026-Jan-06 链接: PubMed
摘要
Bisphenol A (BPA) poses significant risks to human health and ecosystems due to its severe adverse effects. Consequently, effective BPA removal from water sources is imperative. While naturally occurring laccase (Lac) can degrade BPA, its widespread use is limited by high costs and instability. Nanozymes, with their superior catalytic activity and robust properties, offer a viable alternative. Herein, we synthesized a novel layered nanozyme by incorporating rare-earth metals (La, Gd, Dy, Er) with copper. The La-based material demonstrated the highest laccase-like activity. Comparative analyses revealed that La-based material with optimized composition exhibits significantly enhanced and more stable enzymatic activity toward BPA than natural laccase under varying conditions. Under optimized degradation parameters, the La-based material achieved nearly 90% BPA degradation within 20 min. This study provides an efficient and scalable strategy for BPA removal, demonstrating strong potential for practical environmental remediation.
25. Environmental Stressors and Adaptive Mechanisms in Long-Term Care Resident Bedrooms: A Canadian Case Study.
期刊: HERD 发表日期: 2026-Jan-06 链接: PubMed
摘要
The aim of this research was to identify the adaptive comfort mechanisms available in resident bedrooms of a newly built long-term care (LTC) home in Ontario, Canada, and examine how these were used to manage environmental stressors. LTC facilities house vulnerable populations susceptible to various stressors. While psychosocial stressors are well-documented, physical stressors caused by the indoor environment also significantly impact resident behavior and satisfaction. This study was nested within a larger mixed-methods postoccupancy evaluation. Methods included building walkthroughs, spot measurements, structured observations, staff and resident interviews, and an analysis of network sensor data extracted from building system reports. Few adaptive mechanisms were available to residents. Those that were-window blinds and adjustable thermostats-were being actively used to mitigate perceived environmental stressors. While light levels in resident bedrooms met minimum requirements, frequent use of blinds and reliance on artificial lighting diminished the benefits of daylight on health and well-being. Temperature trends indicated frequent fluctuation within the acceptable thresholds and greater sensitivity to heat than cold. Personal control mechanisms play a critical role in enhancing resident comfort in LTC facilities. Despite meeting regulatory standards for indoor environment quality, blind and thermostat use revealed additional layers of environmental stressors that need to be addressed along with critical opportunities for further research. Limitations in the accessibility and usability of personal control devices for residents with mobility or cognitive impairments highlight significant areas for improvement in LTC design.
26. A Sensitive and Specific Dual-T-Line Immunochromatographic Assay Based on Rational Hapten Design for On-Site Rapid Detection of Fenazaquin in Food and Environmental Samples.
期刊: Journal of agricultural and food chemistry 发表日期: 2026-Jan-06 链接: PubMed
摘要
Fenazaquin (FEN), a widely used quinazoline acaricide, poses potential risks to public health and ecosystems due to its residue accumulation in food and the environment, thus demanding rapid and reliable detection methods. Herein, novel FEN haptens were rationally designed based on computational chemistry to successfully generate a highly specific and sensitive monoclonal antibody. The antibody exhibited a half-inhibitory concentration of 1.90 ng/mL. A gold nanoparticle-based dual-T-line lateral flow immunochromatographic assay was established for the rapid detection of FEN in lake water, soil, apples, and tea within 20 min. The detection limits were 1.74, 2.29, 4.38, and 2.64 μg/kg, with quantitative ranges of 6.12-450.44, 7.38-404.59, 11.49-309.78, and 8.16-385.02 μg/kg, respectively. Spiked recovery and blind sample tests showed excellent agreement with instrumental analysis. This study provides a rational hapten design strategy and a practical tool for field screening of FEN in food and environmental matrices.
27. IRP1 deficiency alters mitochondrial metabolism and protects against metabolic syndrome pathologies.
期刊: JCI insight 发表日期: 2026-Jan-06 链接: PubMed
摘要
Iron regulatory protein 1 (IRP1) is a post-transcriptional regulator of cellular iron metabolism. In mice, loss of IRP1 causes polycythemia through translational de-repression of hypoxia-inducible factor 2α (HIF2α) mRNA, which increases renal erythropoietin production. Here we show that Irp1-/- mice develop fasting hypoglycemia and are protected against high-fat diet-induced hyperglycemia and hepatic steatosis. Discovery-based proteomics of Irp1-/- livers revealed a mitochondrial dysfunction signature. Seahorse flux analysis in primary hepatocytes and differentiated skeletal muscle myotubes confirmed impaired respiratory capacity, with a shift from oxidative phosphorylation to glycolytic ATP production. This metabolic rewiring was associated with enhanced insulin sensitivity and increased glucose uptake in skeletal muscle. Under metabolic stress, IRP1 deficiency altered the redox balance of mitochondrial iron, resulting in inefficient energy production and accumulation of amino acids and metabolites in skeletal muscle, rendering them unavailable for hepatic gluconeogenesis. These findings identify IRP1 as a critical regulator of systemic energy homeostasis.
28. Integrating chemical and microbial strategies for heavy metal remediation in contaminated soils: opportunities, challenges, and key factors.
期刊: Environmental science and pollution research international 发表日期: 2026-Jan-06 链接: PubMed
摘要
Concerns are increasing about heavy metals in soil that harm human health and the integrity of ecosystems. Traditional treatment methods are insufficient to solve the problem. Therefore, new and sustainable methods should be investigated. Removal of heavy metals from the soil matrix through microbial and chemical treatments is a significant concern these days. Many chemical methods for soil improvement involve the use of lime, phosphate, zeolites, and chelating agents. The application of these amendments also changed the physical and chemical properties of the soil, leading to the formation of stable metal complexes or the precipitation of poorly soluble metals. Although chemical treatment is fast and effective, its long-term impact on the environment is worth considering. Alternatively, bacteria can metabolize the contaminated soil by removing the heavy metals, which is the basic concept of microbial remediation. This method of bioremediation is generally environmentally friendly because it employs natural processes and minimizes the need for external inputs. However, environmental conditions and other soil diseases can affect its performance. A combination of chemical and microbial remediation strategies can provide an integrated approach to remediating heavy metals in soil. The interaction between chemical treatments and microbial methods may offer additional solutions for effectively remediating heavy metal contamination in soil.
29. The usability and effectiveness of the Mobithera application on musculoskeletal pain and physical function in adult caregivers of oncology patients: a single-group pilot study.
期刊: Informatics for health & social care 发表日期: 2026-Jan-06 链接: PubMed
摘要
This pilot study evaluated the effectiveness and usability of the Mobithera application, a mobile health intervention designed to reduce musculoskeletal pain and improve physical function in adult caregivers of oncology patients. Thirty-five caregivers with self-reported neck or lower back pain participated in this study. The intervention involved 10 sessions over two weeks, during which participants performed therapeutic exercises using the Mobithera. Pain levels, lower extremity reaction time, body awareness, and balance were assessed before and after the intervention using to the Visual Analog Scale (VAS), Rapid Foot-Tap Test, Fremantle Awareness Scales, and Tinetti Gait and Balance Test. Usability of the application was evaluated using the System Usability Scale (SUS). The Mobithera significantly reduced both neck and lower back pain among participants. Improvements were also observed in lower extremity reaction time, body awareness, and balance. The findings suggest that the Mobithera is effective in enhancing the physical health and well-being of caregivers. The Mobithera demonstrates significant potential as a supportive tool for caregivers, reducing pain and improving physical function. Further research with larger sample sizes and longer follow-up periods is recommended to confirm these findings and explore the long-term benefits of such interventions in the caregiver population.
30. Navigating biosimilar transitions in IV rituximab therapy: Efficacy and safety insights from a real-world switching study.
期刊: Journal of oncology pharmacy practice : official publication of the International Society of Oncology Pharmacy Practitioners 发表日期: 2026-Jan-06 链接: PubMed
摘要
AimThis study evaluates the efficacy and safety of rituximab biosimilars (BRs) compared to the original rituximab (MAB) administered intravenously, particularly from the aspect of switching and switch directions.Materials and MethodsThis retrospective study included patients treated with BR and/or MAB for hematological diagnoses. For efficacy analyses, patients with DLBCL or FL receiving BR during R-CHOP were compared with two matched-control groups treated only with MAB. Patients completing fewer than two consecutive cycles of BR or MAB were excluded. Study groups were classified as BR-only or switching (S). Switching was defined as replacing rituximab between MAB and BR for at least two consecutive cycles. Switch directions are denoted as OB (MAB to BR), BO (BR to MAB), and M (multiple switches).ResultsToxicity was evaluated in 185 patients. Responses of 69 DLBCL and 33 FL patients were compared with 52 DLBCL and 11 FL patients treated only with MAB. Median follow-up was 20 months. In DLBCL, MAB had significantly higher interim ORR and CR than BR and S (p = 0.04), but not at end-of-treatment (p = 0.081, 0.125). FL responses were similar across groups. Among 1266 rituximab infusions, 32 (2.5%) IRRs occurred, 78% during first-cycle. No difference in IRR or first-cycle reactions was seen between BR and S (p = 0.175, 0.429). IRR rates in S subgroups were 1/37 (OB), 8/35 (BO), and 4/28 (M), with BO direction higher than OB (p = 0.029).ConclusionOur findings confirm that intravenous BRs and MAB are equivalent in efficacy and toxicity, while a direction-specific increase in IRRs occurs when switching from BR to MAB, warranting further prospective studies to clarify clinical significance and guide safer treatment transitions.
31. Associations Between Employment and Health Outcomes: A Systematic Review of Reviews.
期刊: Journal of occupational rehabilitation 发表日期: 2026-Jan-06 链接: PubMed
摘要
The subject of employment as a determinant of health has received considerable attention from researchers. To our knowledge, a comprehensive synthesis of evidence on the health effects of employment has not been completed in almost 20 years. This systematic review aimed to provide an up-to-date summary of the associations between employment status and any measurable domain of health. We searched Ovid MEDLINE, Embase, CINAHL Plus with Full Text, and APA PsycINFO. We included peer-reviewed, full-text systematic reviews or overviews published in English between January 2012 and November 2024. Two reviewers independently screened resultant publications and extracted data from those found eligible for the review. Our search yielded 1862 reviews and meta-analyses, 49 of which were eligible for synthesis. Employment status was associated with several health domains including general health and wellbeing, mental health, alcohol and substance use disorders, cardiovascular health, systemic inflammation, sleep quality, cognitive functioning, and mortality. Being employed was almost universally associated with favourable physical and mental health outcomes, with evidence to suggest re-employment may facilitate improvements in health after a period of unemployment. Socioeconomic status was a notable factor which affected health outcomes for both employed and unemployed people, illustrative of social gradients in health. Insecure or low-quality work demonstrated the potential to override identified health benefits of work. Heterogeneity in the operationalization of employment across publications, and the influence of survivorship bias on health outcomes highlights a task for future research to establish causality in the relationship between employment status and health.
32. Remediation of novel sources linked to an outbreak of Legionnaires' disease in a manufacturing facility.
期刊: Journal of occupational and environmental hygiene 发表日期: 2026-Jan-06 链接: PubMed
摘要
In September 2022, public health officials identified a legionellosis outbreak among workers at a manufacturing facility. Upon recognition of the outbreak, public health officials and company management investigated to identify the source and prevent additional cases. Facility management assembled an inventory of potential water sources and worked with a consultant to conduct sampling. Legionella bacteria were cultured from bulk water samples collected from two water jet cutters and a floor scrubber. All other sampling locations had no Legionella identified by culture. Legionellosis cases were distributed throughout the facility. Floor scrubbers were used to clean up water that spilled from the water jet cutters and to clean the floors adjacent to employee work areas. After multiple cycles of cleaning and disinfection of the water jet cutters and floor scrubbers, repeat sampling revealed no Legionella detected. Company management returned the equipment to service in November 2022 with a maintenance, disinfection, and monitoring plan; no additional cases of legionellosis among employees have been reported. Evidence indicates that water jet cutters provided a conducive environment for Legionella growth, while floor scrubbers may have also contributed to employee exposure. This case study describes a remediation plan and illustrates the importance of identifying all potential Legionella sources and maintaining a comprehensive water management program to protect workers from Legionella and other waterborne pathogens.
33. Authors' Response.
期刊: Journal of the American Dental Association (1939) 发表日期: 2026-Jan-06 链接: PubMed
摘要
34. Acute intravascular hemolysis and acute hepatic injury caused by consuming Paxillus orientalis.
期刊: Clinical toxicology (Philadelphia, Pa.) 发表日期: 2026-Jan-06 链接: PubMed
摘要
35. Increased phosphorylated tau (pTau-181) is associated with neurological post-acute sequelae of coronavirus disease in essential workers: a prospective cohort study before and after COVID-19 onset.
期刊: EBioMedicine 发表日期: 2026-Jan-05 链接: PubMed
摘要
The COVID-19 pandemic led to a spectrum of post-acute sequelae including several neurological complications including cognitive dysfunction labelled Neurological PASC (N-PASC). We hypothesised that N-PASC was associated with changes in neurological biomarkers after COVID-19. N-PASC was established when individuals reported accepted neurological symptoms persisting for ≥3 months arising alongside validated COVID-19. Plasma samples were retrieved from before and after COVID-19 onset among all (n = 227) essential workers who developed COVID-19 with N-PASC and demographically matched with data from 227 controls who either developed COVID-19 without N-PASC (n = 124) or did not develop COVID-19 before follow-up (n = 103). We used single molecular analysis measured pTau-181, GFAP, NfL, Aβ40/42, and total Aβ burden (IAB). Risk factors for N-PASC were examined prior to COVID-19 infection. Multivariable adjusted generalised linear longitudinal modelling with random intercepts was used to examine changes in biomarkers after COVID-19 onset. N-PASC was only associated with higher IAB before COVID-19 onset (area under the receiver-operating curve = 0.77). Longitudinal analyses revealed plasma pTau-181 levels increased by 59.3% (95% C.I. = [45.2, 73.4] P = 0.006) following COVID-19 onset in participants who developed N-PASC that were worst among participants reporting central nervous symptoms persisting ≥1.5 years. Post-COVID-19 decreased GFAP and NfL were associated with peripheral symptoms of N-PASC, but not with increased pTau-181. Having ≥20% increases in pTau-181 were associated with increased Aβ40/42 levels at follow-up, and with central neurological symptoms including lingering brain fog and loss of taste/smell. N-PASC with symptoms consistent with central damage were associated with increased pTau-181 levels. Increases in pTau-181 were associated with increased risk of changes to amyloid biomarkers consistent with Alzheimer’s disease in participants with N-PASC and could therefore inform N-PASC prognostication. This study was supported in part by funding from the Centers for Disease Control and Prevention (CDC/NIOSH CDC-75D30122c15522) and the National Institutes of Health (NIH/NIA AG049953).
36. Estimation of Health Utility Values for Health States in Head and Neck Cancers Using Real-World Data.
期刊: Value in health regional issues 发表日期: 2026-Jan-05 链接: PubMed
摘要
To generate India-specific health state utility values for head and neck cancers (HNCs) using EuroQol 5-Dimension 5-Level (EQ-5D-5L) and EuroQol Visual Analog Scale (EQ-VAS) instruments, enabling context-relevant cost-utility analyses and health technology assessments. A cross-sectional study was conducted at a tertiary HNC center in India from July 2023 to June 2024. Adults with confirmed HNCs across 53 predefined health states were enrolled. A health state is a specific condition of overall well-being, represented by a utility value indicating how preferable it is compared with perfect health or death. Utility scores were derived from the EQ-5D-5L index using the Indian tariff set and the EQ-VAS. Utility variations across treatment phases, tumor subsites, stage, and comorbidity status were also examined. Of 767 recruited patients, 753 were included for analysis across 48 health states, excluding 5 health states with less sample size. The mean EQ-5D-5L utility was 0.84 (SD 0.20), significantly higher than EQ-VAS (mean 0.73, SD 0.18; P < .001). Utilities varied significantly across treatment phases (P < .001). Clinically, patients in active treatment and palliative recurrence had the poorest perceived health, whereas those in remission showed the highest utility, mirroring expected functional recovery patterns. EQ-5D-5L produced consistently higher utility values than EQ-VAS, reflecting differences between population-weighted and self-perceived health assessments. To our knowledge, this is the first Indian data set of real-world health state utility values in HNC. These values provide essential inputs for economic evaluations and health technology assessments in oncology, supporting more accurate, locally relevant healthcare decision making in resource-limited settings.
37. Paediatric cerebrospinal fluid immune profiling distinguishes paediatric-onset multiple sclerosis from other paediatric-onset acute neurological disorders.
期刊: EBioMedicine 发表日期: 2026-Jan-05 链接: PubMed
摘要
The cerebrospinal fluid (CSF) provides a unique glimpse into the central nervous system (CNS) compartment and offers insights into immune processes associated with both healthy immune surveillance as well as inflammatory disorders of the CNS. The latter include demyelinating disorders, such as multiple sclerosis (MS) and myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD), that warrant different therapeutic approaches yet are not always straightforward to distinguish on clinical and imaging grounds alone. We established a comprehensive phenotypic landscape of the paediatric CSF immune compartment across a range of non-inflammatory and inflammatory neurological disorders, with a focus on better elucidating CNS-associated immune mechanisms potentially involved in, and discriminating between, paediatric-onset MS (MS) and other paediatric-onset suspected neuroimmune disorders, including MOGAD. CSF from paediatric patients with non-inflammatory neurological disorders is primarily composed of non-activated CD4+ T cells, with few if any B cells present. CSF from paediatric patients with acquired inflammatory demyelinating disorders is characterised by increased numbers of B cells compared to CSF of both patients with other inflammatory or non-inflammatory conditions. Certain features, including particular increased frequencies of antibody-secreting cells (ASCs) and decreased frequencies of CD14+ myeloid cells, distinguish MS from MOGAD and other acquired demyelinating syndromes. Increased CSF ASC frequencies and decreased CSF CD14+ myeloid cell frequencies help distinguish paediatric-onset MS from paediatric-onset MOGAD and other acquired demyelinating syndromes. Our findings provide insight into CNS-associated immune mechanisms that may be present early in the clinical course of MS. Stated in acknowledgements section of manuscript.
38. Feasibility and safety of a modified volume-based feeding protocol in critically ill children: A pilot study.
期刊: Journal of pediatric gastroenterology and nutrition 发表日期: 2026-Jan-05 链接: PubMed
摘要
Enteral nutrition interruptions (ENIs) are common in critically ill children and may cause underfeeding. Volume-based feeding practices (VBFPs) mitigate ENIs, but their use has not been reported in pediatric critical care. We analyzed whether a modified VBFP (MVBFP), based on compensatory feeding over the subsequent 24 h, is feasible and safe. Prospective longitudinal study of critically ill children aged 1 month-18 years receiving enteral nutrition in whom an MVBFP was applied. Compensatory increased enteral feeding goal rates (CIEFGR) were defined as instances in which the volume lost due to an ENI was replaced gradually over the subsequent 24 h by increasing the infusion rate. Data included demographics, ENI characteristics, volume and rate during compensatory feeding, caloric and protein intake, and gastrointestinal or metabolic adverse effects. We also recorded pre-existing gastrointestinal conditions and formula type. Twenty-eight CIEFGR were recorded in 21 children. The median compensatory period was 24 h (interquartile range [IQR]: 17.5-24), with a median additional volume of 20 mL/kg (IQR: 10.5-33.1), corresponding to increases of 18.8 kcal/kg (IQR: 9.8-27.8) and 0.5 g/kg protein (IQR: 0.23-0.8). The infusion rate rose from 21 to 27 mL/h (IQR: 20-33). Gastrointestinal signs (increased gastric residual volume, abdominal distension, nausea) occurred in 10.7% of episodes, were mild, and required no intervention. No significant metabolic alterations were observed. An MVBFP using compensatory feeding in critically ill children appears feasible and safe, improving caloric and protein delivery without increasing gastrointestinal side effects.
39. Spatiotemporal risk assessment of river water quality for tropical river systems using hydrological dynamics, anthropogenic influences, and ecological health index.
期刊: The Science of the total environment 发表日期: 2026-Jan-05 链接: PubMed
摘要
Sustainable management of River Water Quality (RWQ) in tropical river systems requires an approach that addresses both spatial and temporal risks associated with hydrological dynamics, anthropogenic influences, and ecological health. This study develops an uncertainty-aware spatiotemporal risk assessment approach integrating upstream hydrological dynamics (SWAT), operational variability with Environmental Flow (Eflow), water quality simulations (QUAL2K), and probabilistic Water Quality Index (WQI) calculations. Block-Bootstrap ensembles and Monte Carlo techniques are used to quantify uncertainty propagation and construct confidence intervals within the model chain. The monthly WQI estimates under the different Eflow and pollution control scenarios are used to assess the spatial risk variability of the river system. Temporal risk was assessed with WQI using various probabilistic measures, including mean, variance, loss probability, entropy, mean excess loss, and value at risk. A unified risk ranking was developed by using Borda and Copeland aggregation techniques. Categorised spatial risk maps were created using GIS by integrating Eflows and ecological index. The results revealed significant seasonal variations in water quality, with April, March, and May identified as high-risk months due to increased pollution levels. The monthly WQI-mean in the Monte Carlo analysis (1000 iterations), as per the severity of the risk, April, March, and May months are identified as the riskiest months. Spatial risk mapping revealed distinct high-risk zones and highlighted the necessity of pollution treatment level of 25-50 % to reduce ecological risk under optimal Eflow regimes. This comprehensive framework underscores the need for both flow regulation and pollution management to protect river ecosystems, providing actionable insights for effective river health protection.
40. Time-resolved, label-free electrochemical monitoring of neurotoxicity via differential pulse voltammetry.
期刊: Bioelectrochemistry (Amsterdam, Netherlands) 发表日期: 2026-Jan-02 链接: PubMed
摘要
Neurotoxicity assessment is crucial for ensuring the safety of pharmaceuticals and chemicals while protecting public health by identifying hazardous substances. Here, a simple and innovative electrochemical neurotoxicity assay was presented using a screen-printed carbon electrode (SPCE) integrated petri dish platform. This system serves as a rapid, quantitative, and time-resolved alternative to standard neurotoxicity assays such as the MTT assay (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide) test and is particularly suited for drug development studies. Briefly, the surface of SPCEs were modified with poly-l-lysine (PLL) to enhance both the electrochemical signal and the adherence of human neuroblastoma (SH-SY5Y) cells. Electrochemical measurements were taken in 0.5 mM [Fe(CN)6]3-/4- whose non-toxic effect was confirmed, and a good relationship was observed between electrochemical signal and cell viability. The electrochemical platform was then successfully tested to assess the toxic effects of H2O2 and doxorubicin. These findings demonstrate the platform’s potential for routine electrochemical neurotoxicity evaluation and emphasize the feasibility of using a cell-based analytical system for toxicity screening applications.
41. Gender Identity Milestones and Hormone Utilization in Transgender Men and Women in China.
期刊: JAMA network open 发表日期: 2026-Jan-02 链接: PubMed
摘要
Little is known about how gender identity develops and how it affects gender-affirming hormone therapy (GAHT) utilization among transgender people in China. To investigate gender identity development among Chinese transgender men (TM) and transgender women (TW) and to explore how identity-related factors are associated with GAHT utilization. This cross-sectional study is based on the latest Chinese Transgender Health Survey targeting the transgender population in China conducted from May to December in 2021. Data analysis was completed in December 2024. Participants were recruited online via snowball sampling. The primary outcomes are the timing of gender identity development milestones (first perception of gender incongruence, confirmation, disclosure, and initiating GAHT) and GAHT utilization status. Multivariable binary logistic regression identified factors associated with GAHT-related behaviors and feedback. A total of 4296 transgender people (1462 TM [34.0%] and 2834 TW [66.0%]; median [IQR] age, 21 [18-24] years) were included in the final analysis. The age distribution of first perceived gender incongruence exhibited a bimodal pattern, with peak occurrences at ages 5 to 6 and at 12 years. The median (IQR) ages at gender identity development milestones were all younger for TM than for TW: 6 (4-10) years vs 9 (6-12) years for perception, 14 (11-16) years vs 15 (12-17) years for confirmation, and 16 (14-19) years vs 17 (15-20) years for disclosure, whereas the age of initiating GAHT was older in TM than in TW (median [IQR] age, 19 [17-22] years vs 18 [16-21] years). The demand for GAHT (3759 participants [87.5%]), usage (2247 participants [52.3%]), and the rate of valid prescriptions among hormone users (339 participants [15.1%]) have all increased significantly compared with 2017. Being a TW and without a college education were associated with starting GAHT before age 16 years, while being a TM, having family disclosure of gender identity, and having official prescriptions were associated with positive feedback on GAHT. In this cross-sectional study of Chinese TM and TW, gender identity development differed by gender, with TM recognizing incongruence earlier and TW progressing faster in initiating GAHT. Both groups showed strong demand for GAHT. Despite recent improvements in GAHT service accessibility, challenges persist in medical accessibility. These findings highlight the need for personalized support for transgender youths and underscore the importance of improving formal transgender health care services in China to enhance the well-being of this population.
42. Medicare Spending On Artificial Intelligence: Payment Policy Is Only Part Of The Story.
期刊: Health affairs (Project Hope) 发表日期: 2026-Jan 链接: PubMed
摘要
The rapid growth of clinical artificial intelligence (AI) applications poses a unique challenge to Medicare’s prospective payment systems, with two issues at the forefront. First, the productivity gains from AI may dwarf those of previous non-AI innovations, but they are uncertain and will take time to realize. Second, AI forces the Centers for Medicare and Medicaid Services (CMS) to think very differently about software. For many clinical applications of AI, the software itself is the service. It does not make sense to treat this expense as overhead, but direct reimbursement will likely exceed the true cost of using AI. Finally, although CMS currently pays for only a small fraction of all AI-enabled medical devices approved by the Food and Drug Administration, Medicare may already be spending more on AI as a result of additional AI-generated findings and follow-up care.
43. Impact Of Housing Support Services For Medicaid Enrollees With Serious Mental Illness, Substance Use Disorder.
期刊: Health affairs (Project Hope) 发表日期: 2026-Jan 链接: PubMed
摘要
In 2019, pursuant to a Section 1115 waiver, Florida launched a Statewide Medicaid Managed Care housing assistance pilot to foster housing stability and reduce preventable health care use in adults with serious mental illness (SMI) or substance use disorder (SUD). We conducted a retrospective cohort study to examine the relationship between four housing support services provided in the pilot (transitional housing support, tenancy support, peer support, and crisis management) and health care use and health outcomes among 1,300 pilot enrollees during the period December 2017-June 2024. Transitional housing support services were associated with a 15 percent increase in emergency department (ED) visits. Tenancy support services were associated with 51 percent lower odds of all-cause mortality, and peer support was associated with a 20 percent reduction in ED use. Crisis management was associated with a 45 percent increase in ED visits, a 41 percent increase in outpatient visits, and a 90 percent increase in psychiatric hospitalizations. Findings highlight the value of tailored Medicaid housing interventions for people with SMI or SUD. Medicaid policy should prioritize high-value, data-driven housing interventions and protect them from budget cuts. Embedding such services within managed care contracts and aligning them with broader care coordination strategies offer a viable path for sustainability.
44. Artificial Intelligence Payment Policies: Challenges For CMS And The Medicare Physician Fee Schedule.
期刊: Health affairs (Project Hope) 发表日期: 2026-Jan 链接: PubMed
摘要
The proliferation of artificial intelligence (AI) clinical decision support technologies requires careful consideration of payment policies under the Medicare Physician Fee Schedule. In this Policy Insight, we identify key challenges faced by policy makers and the Centers for Medicare and Medicaid Services (CMS), and we discuss the interplay between the Medicare Physician Fee Schedule and the adoption of AI technologies in care delivery. The resource-based relative value scale methodology, which determines Medicare Physician Fee Schedule rates, was not designed for software-based technologies and requires both comprehensive adaptation and implementation reform. We recommend developing a policy framework for coverage determinations for AI technologies, reforming the resource-based relative value scale, creating clear reimbursement pathways for AI technologies, and implementing cost-effectiveness analysis to ensure that marginal Medicare expenditures yield proportional improvements in health care delivery and outcomes.
45. When Safety-Net Programs Compete: Medicaid, 340B, And The Battle Over Drug Discounts.
期刊: Health affairs (Project Hope) 发表日期: 2026-Jan 链接: PubMed
摘要
The Medicaid Drug Rebate Program and the 340B Drug Pricing Program are generally understood as separate efforts to promote drug affordability-one by directly subsidizing low-income patients through insurance coverage (Medicaid) and the other by indirectly subsidizing safety-net clinics and hospitals (340B). Yet they interact in ways that can unintentionally raise costs for Medicaid. This Policy Insight examines how this interaction occurs, introduces two policy strategies to mitigate the interaction, and summarizes the use of these strategies across states as of 2024. We conclude with recommendations for how policy makers can weigh the costs and benefits of states’ efforts to preserve Medicaid savings against lost revenue for 340B-participating organizations.
46. Aligning AI Payment Policy With Desired Outcomes Rather Than Inputs May Require Customized Pathways.
期刊: Health affairs (Project Hope) 发表日期: 2026-Jan 链接: PubMed
摘要
Artificial intelligence (AI) has the potential to create health care value independent of traditional inputs, such as clinicians’ time, skill, and resources. However, Medicare’s current structuring of reimbursement around human inputs has the potential to miscalculate the value of AI in clinical practice. We examine the tension between input-based prices and outcome-based care by comparing and contrasting payment for AI with the approach for prescription drug pricing. We propose a classification system to distinguish between the types of AI that differ in their implications for clinician time and cost. By aligning AI reimbursement policy with desired outcomes rather than inputs, policy makers can ensure that innovators, clinicians, and patients alike benefit from novel AI technologies.
47. Economic burden of drought using the life satisfaction approach: A case study of slum dwellers in southeast Iran.
期刊: PloS one 发表日期: 2026 链接: PubMed
摘要
Drought is one of the most visible effects of climate change and poses significant challenges for sustainable development. Assessing the costs of drought is essential for effective policymaking, and indirect costs are likely to provide a more comprehensive estimate. This descriptive-analytical study was conducted in 2023 among households in the slum areas of Kerman, a city in southeastern Iran. Given the population’s diversity, a cluster sampling method was employed, and data were collected from 507 households through a questionnaire. The research team estimated the Ordinary Least Squares (OLS) model, the Marginal Rate of Substitution (MRS), and Willingness to Pay (WTP) using the life satisfaction approach. The results indicated that 38.42% of households identified drought as the primary reason for their migration, while 33.27% were formerly smallholder farmers or agricultural workers. Notably, farmers and ranchers reported significantly lower life satisfaction levels. The MRS for these households was -0.570, underscoring the negative impact of drought on their income. Furthermore, based on their income, their willingness to pay for drought mitigation was estimated at $1,968.98 per household, reflecting their economic constraints. Overall, the modeling results from the life satisfaction approach indicate that drought imposes a significant economic burden on households, particularly smallholders and agricultural workers. The forced migration to the slum areas of Kerman, driven by declining agricultural potential viability, has not produced stability but has instead led to ongoing economic instability and reduced life satisfaction.
48. Comment on "Phenotype Overlap and Lung Function in Childhood Asthma: The Interaction Between T2 and Non-T2 Responses".
期刊: Pediatric pulmonology 发表日期: 2026-Jan 链接: PubMed
摘要
49. State Comprehensive Opioid Prescribing Limits Associated With Reduced Opioid-Related Hospitalizations And ED Visits.
期刊: Health affairs (Project Hope) 发表日期: 2026-Jan 链接: PubMed
摘要
Drug overdose deaths involving prescription opioids rose by more than 400 percent from 1999 to 2022, partly driven by overprescribing. Following 2016 Centers for Disease Control and Prevention guidelines, thirty-nine states instituted opioid prescribing limits (OPLs), with twelve adopting comprehensive OPLs combining maximum duration limits and dosage caps. However, the relationship between comprehensive OPLs and health outcomes remains unclear. Using data from the State Inpatient Databases and State Emergency Department Databases with a difference-in-differences design, we evaluated the association between state OPLs and opioid-related inpatient stays and emergency department (ED) visits during the period 2016-21. We found that the states’ adoption of comprehensive OPLs was associated with a 6.2 percent decline in opioid-related hospitalizations and an 11.9 percent decline in opioid-related ED visits per 100,000 population per quarter. Stratified analyses showed that these associations were driven by adults ages 25-44 and people residing in lower income quartiles of ZIP codes. In addition, the reductions were most pronounced in states with comprehensive OPLs that included dosage caps below 90 morphine milligram equivalents per day, whereas states with only duration limits or only dosage caps did not experience similar reductions. Our findings underscore the potential importance of comprehensive OPLs in mitigating opioid-related adverse health events.
50. Impact of improved stove intervention on infant acute respiratory infections: Results from a randomized trial in Northwest Ethiopia.
期刊: PloS one 发表日期: 2026 链接: PubMed
摘要
Globally, millions of young children affected by acute respiratory infections every year, which is the leading cause of death and serious illness among children. Though strategies, including promoting improved stoves, have been implemented to combat this public health challenge, the effectiveness of local improved stoves introduced during pregnancy in reducing household air pollution and related respiratory illnesses remains limited. Following the main trial randomization, 343 infants born to mothers in the study groups were followed for six months, with assessments of acute respiratory infections (ARI) occurring every two months. The stove intervention’s impact was evaluated by comparing the acute respiratory infection incidence rate between the intervention and control groups. Respiratory illnesses were assessed using Integrated Management of Childhood Illness (IMCI) guidelines. The incidence rate ratio (IRR) was estimated using a marginal Poisson model fitted via Generalized Estimating Equations (GEE). During the six-month follow-up period, a total of 43 infants (18 intervention, 25 control) experienced at least one acute respiratory infection (ARI) episode, resulting in a cumulative incidence of 12% (95% CI: 10, 14%). Although the intervention group consistently showed a reduction in ARI incidence rates compared to the control group (a 20% reduction), the adjusted Incidence Rate Ratio (IRR = 0.81; 95%CI: 0.56, 1.16; P = 0.252) was not statistically significant. A non-significant trend toward benefit was noted overall, with the subgroup analyses suggesting promising, non-significant reductions primarily among female infants and infants from larger families. The overall study did not find a statistically significant protective effect of the intervention stoves on ARI incidence. However, the observed non-significant trend suggests a potential protective effect. Further research with larger sample sizes and longer follow-up periods is warranted to confirm this potential benefit. The main trial was registered at the Pan African Clinical Trial Registry website under the code PACTR202111534227089, (https://pactr.samrc.ac.za/ (Identifier) on the registration date of (11/11/2021).
51. Validation of stearoyl-coA desaturase gene TaqMan probe-based SNP for genotyping Tattykeel Australian White MARGRA lamb for health-beneficial omega-3 long-chain fatty acids and intramuscular fat content.
期刊: PloS one 发表日期: 2026 链接: PubMed
摘要
The Tattykeel Australian White (TAW) branded MARGRA lamb is a premium Australian sheep breed developed through decades of careful linebreeding, with the aim of improving the natural levels of health beneficial omega-3 long-chain polyunsaturated fatty acids (n-3 LC-PUFA), micro-marbled intramuscular fat (IMF) content, and low fat melting point (FMP) in the highly priced Longissimus dorsi muscle. These traits are key attributes contributing to the well documented superior meat eating quality of the TAW lamb, hence, fundamental to the TAW breeding program. The focus on Stearoyl-CoA Desaturase (SCD) gene is relevant because it plays an essential part in the biosynthesis of n-3 LC-PUFA and IMF metabolism. Previous studies had identified and established significant associations between the g.23881050T > C single nucleotide polymorphism (SNP) in the SCD gene and meat eating quality traits. Therefore, the aim of this study was to develop a reliable, fast, cost-effective, and accurate TaqMan probe-based Real-Time PCR assay for genotyping the identified SCD SNP in 118 TAW, Poll Dorset, Martin More sheep, and Angus bulls (as a distinguishing species control). By designing allele-specific TaqMan probes targeting the polymorphic locus, the assay accurately identified two genotypes, homozygous CC and heterozygous CT, at an estimated cost of AUD 2.16 and processing time of 49.30 minutes per 96-well sample plate. The genotype frequencies for CC and CT were 0.58 and 0.42 in rams, and 0.57 and 0.43 in ewes, respectively. The major and minor allele frequencies in TAW rams and ewes were 0.21 and 0.79, while in young TAW rams, they were 0.17 and 0.83, respectively. Both Poll Dorset and Martin More sheep exclusively displayed the CC genotype at a minor allele frequency of 1.00. The findings validate the identified SNP g.23881050T > C as a suitable DNA marker for breeding for meat quality traits. and the validated TaqMan probe-based genotyping assay is a simple, reliable, fast, precise and cost-effective tool for genotyping TAW. Therefore, the developed and validated TaqMan probe herein, can facilitate genetic selection within the TAW breeding program, and assist in streamlining efforts to enhance meat eating quality of the breed.
52. Mortality and comorbidities among teaching professionals: A cross-sectional study in Colombia.
期刊: PloS one 发表日期: 2026 链接: PubMed
摘要
Teachers play a critical role in social and economic development, yet evidence on their health outcomes in Latin America remains scarce. In Colombia, teachers are generally classified in occupational risk level 1, a category considered to have minimal hazards. This study aimed to describe and compare mortality and comorbidities among teachers and non-teachers in the same risk category, and to explore differences across educational levels within the teaching profession. We conducted a retrospective cohort study using four linked national administrative databases in 2017. Adults affiliated to the contributory health insurance scheme and classified under occupational risk level 1 were included. Teachers were identified and stratified by educational level. Outcomes included one-year all-cause mortality and prevalence of mental health and hearing disorders. Multivariable logistic regression models adjusted for sociodemographic and clinical covariates were used to estimate associations. A total of 4,256,719 individuals were included, of whom 353,985 (8.3%) were teachers. Teachers were older (mean age 40.1 vs 36.4 years) and more frequently female (69% vs 60%) than non-teachers. The one-year mortality proportion was higher among teachers (0.14%) than non-teachers (0.11%). After adjustment, teaching was associated with a 15% higher risk of mortality (OR: 1.15, 95% CI: 1.03-1.28). No significant associations were found for mental health (OR: 0.98, 95% CI: 0.96-1.01) or hearing disorders (OR: 0.97, 95% CI: 0.92-1.02). Subgroup analyses showed the highest mortality proportions among teachers in technical and technological education. Despite being classified in the lowest occupational risk level, private-sector teachers in Colombia exhibited higher mortality compared with other workers in the same group. Differences in mental health and hearing disorders were not significant. These findings highlight the need to strengthen surveillance, prevention, and protection strategies tailored to teachers, recognizing them as a priority population within occupational health and education policies.
53. Association of tobacco and other substance use with nicotine pouch awareness and use in US adolescents.
期刊: Drug and alcohol dependence 发表日期: 2025-Dec-24 链接: PubMed
摘要
Evidence on the association between tobacco/nicotine and other substance use (TOSU) and adolescent nicotine pouch (NP) awareness and use is lacking but vital for policy and prevention planning. The sample was drawn from the 2023 Monitoring the Future study, a nationally representative survey of U.S. adolescents (8th, 10th, 12th graders). One-third of participants were randomly selected to complete questions on NP awareness and use (lifetime, past 12-month, past 12-month frequency) and past 30-day TOSU measures (yes/no). We estimated risk ratios (RRs) and incident rate ratios (IRRs) to examine the associations between TOSU and NP awareness and use. Overall (n = 6958; 53.4 % female), 35.4 % reported NP awareness, 2.5 % reported lifetime use, and 1.8 % reported past 12-month use. Past 30-day use of tobacco/nicotine products was each positively associated with NP awareness (RRs:1.42-1.70), lifetime (RRs:7.14-20.40), and past 12-month (RRs:5.84-22.44) use, with the strong associations for youth with vs. without smokeless tobacco use. Cannabis, alcohol, and other drug past 30-day use were each associated with NP awareness (RRs:1.49-1.68), lifetime (RRs:3.47-10.49), and past 12-month (RRs:4.70-15.70) use. NP awareness and use prevalence were disproportionately high among adolescents with various forms of TOSU in 2023, especially smokeless tobacco. These findings suggest the importance of monitoring NP use among youth with TOSU while recognizing that awareness may also reflect broader marketing, product availability, or incidental exposure. Policy and prevention efforts should address NP use alongside TOSU with established health risks.
54. HNF4A-AS1 promotes hepatic steatosis in metabolic dysfunction-associated steatotic liver disease by driving HNF4A degradation.
期刊: Drug metabolism and disposition: the biological fate of chemicals 发表日期: 2025-Dec-04 链接: PubMed
摘要
Metabolic dysfunction-associated steatotic liver disease (MASLD) is a significant public health concern. Accumulating evidence suggests that long noncoding RNAs are dysregulated in MASLD. However, the roles and underlying mechanism of long noncoding RNAs in MASLD progression have not been fully elucidated. Here, we investigated the liver-specific functions of hepatocyte nuclear factor 4 α antisense 1 (HNF4A-AS1) and its mouse homolog, HNF4A opposite strand (Hnf4aos), in the pathogenesis of MASLD. HNF4A-AS1 and Hnf4aos were significantly upregulated in MASLD and diet-induced obese mice, respectively. Functionally, liver-specific knockdown of Hnf4aos reduced blood glucose levels and improved insulin sensitivity in the MASLD mouse model. Similarly, HNF4A-AS1 knockdown suppressed lipid droplet formation, intracellular triglyceride accumulation, and total cholesterol production in free fatty acid-induced HepG2 cells. Conversely, HNF4A-AS1 overexpression produced the opposite effects. Mechanistically, HNF4A-AS1 bound to the HNF4A protein and recruited heterogeneous nuclear ribonucleoprotein C (HNRNPC), thereby promoting HNF4A protein degradation. Taken together, our findings highlight the critical role of HNF4A-AS1 in MASLD progression and indicate that repressing HNF4A-AS1/HNF4A axis might be a potential therapeutic strategy for MASLD. SIGNIFICANCE STATEMENT: Long noncoding RNA HNF4A-AS1 and its mouse homolog, Hnf4aos, are upregulated in metabolic dysfunction-associated steatotic liver disease (MASLD) progression. Knockdown of HNF4A-AS1 or Hnf4aos alleviates MASLD progression in vitro or in vivo. HNF4A-AS1 interacts with HNF4A and promotes its protein degradation via HNRNPC, therefore aggravating MASLD progression.
55. Evaluation of Sealant Retention and Caries Prevention on Posterior Teeth of Children - A Comparative Study.
期刊: Indian journal of dental research : official publication of Indian Society for Dental Research 发表日期: 2025-Dec-04 链接: PubMed
摘要
Dental caries continues to be among the most widespread diseases in the world. Pits and fissure sealants play a vital role in preventing dental caries. To compare the retention of four different types of sealants (resin-based sealant, glass ionomer based sealant, resin-modified glass ionomer and polyacid-modified resin-based sealants) in the permanent first and second molars and premolars among children aged 6-14 years old, during the 18-month follow-up period. A double-blind randomized split-mouth trial was conducted among 20 children. Indicated teeth were selected in all the four quadrants. Computer-generated random allocation of either one of four sealants to the tooth was done. Evaluation was done at 6-month intervals for 18 months using modified Simonsen’s criteria. Intergroup comparison of retention of sealants and reapplication percentage was analysed using Pearson’s Chi-square test. A total of 140 teeth were sealed. At 6-month evaluation, resin-based sealants showed significantly maximum retention (90.0%) and least retention by glass ionomer sealants (6.1%). At 18-month follow-up, resin-based sealants (66.7%) showed significantly higher retention followed by polyacid-modified resin (33.3%), resin-modified glass ionomer (6.1%) and glass ionomer sealants (3.0%). The retention rates of resin-based sealants were superior to that of other sealants at the end of 6 months and 18 months.
56. First-line lenvatinib plus pembrolizumab versus chemotherapy for advanced endometrial cancer: 1-Year follow-up after final analysis of the ENGOT-en9/LEAP-001 phase 3 trial.
期刊: International journal of gynecological cancer : official journal of the International Gynecological Cancer Society 发表日期: 2025-Nov-11 链接: PubMed
摘要
The phase 3 ENGOT-en9/LEAP-001 trial (NCT03884101) comparing first-line lenvatinib+pembrolizumab with carboplatin+paclitaxel did not meet pre-specified statistical criteria for overall survival or progression-free survival in participants with advanced/recurrent endometrial cancer. We report results after an additional year of follow-up (overall median 54.5 [range; 46.5-69.0] months). Eligible participants were adult females with stage III to IV or recurrent, histologically confirmed endometrial cancer. Measurable or non-measurable disease per Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1 and radiographically apparent disease per blinded independent central review was required. Participants were randomly allocated 1:1 to lenvatinib+pembrolizumab or chemotherapy (paclitaxel+carboplatin). The primary end points were overall survival and progression-free survival per RECIST version 1.1 by blinded independent central review. Secondary end points included objective response rate per RECIST version 1.1 by blinded independent central review and safety. The median overall survival (95% confidence interval [CI]) was 30.9 (range; 25.4-37.6) months with lenvatinib+pembrolizumab versus 29.4 (range; 26.2-34.8) months with chemotherapy in mismatch repair-proficient endometrial cancer (hazard ratio [HR] 0.99, 95% CI 0.82 to 1.21), 37.9 (range; 32.2-43.0) versus 32.3 (range; 27.2-35.7) months in all-comers (HR 0.91, 95% CI 0.77 to 1.09), and not reached in either treatment group in mismatch repair-deficient endometrial cancer (HR 0.60, 95% CI 0.39 to 0.93]). Corresponding results for progression-free survival were 9.6 (range; 8.2-11.9) versus 10.2 (range; 8.4-10.5) months (HR 1.01, 95% CI 0.83 to 1.22), 12.5 (range; 10.3-15.1) versus 10.2 (range; 8.4-10.4) months (HR 0.92, 95% CI 0.77 to 1.10]), and 31.8 (22.5 to not reached) versus 9.0 (range; 8.2-17.1) months (HR 0.62, 95% CI 0.41-0.93). Objective response rates were 50.6% versus 54.7%, 55.7% versus 55.5%, and 72.0% versus 58.0%, respectively. No new safety signals were identified. The results were consistent with those at the final analysis. The mismatch repair-proficient, all-comer, and mismatch repair-deficient populations continued to demonstrate antitumor activity for lenvatinib+pembrolizumab after an additional year of follow-up. These results should be interpreted with caution due to the exploratory nature of the analysis. ClinicalTrials.gov No. NCT03884101.
57. Factors associated with treatment delay for cervical cancer patients treated with definitive chemoradiation and brachytherapy.
期刊: International journal of gynecological cancer : official journal of the International Gynecological Cancer Society 发表日期: 2025-Nov-01 链接: PubMed
摘要
This study aimed to explore the demographic and clinical factors associated with delayed initiation of treatment for patients with cervical cancer treated with chemoradiation and brachytherapy and determine its impact on oncologic outcomes. Patients with stage IB2 to IVA cervical cancer who were treated with definitive chemoradiation therapy and brachytherapy from 2009 to 2019 were included. Patients who initiated treatment within 8 weeks of diagnosis (early) were compared with those who initiated treatment after 8 weeks (delayed). Time intervals at each stage of care and reasons for delay were evaluated. Logistic regression was performed to identify factors associated with delayed treatment initiation. Cox regression analyzed factors associated with progression-free and overall survival. Of 122 patients, 76 (62%) initiated early treatment, with a median time to treatment of 35 days, and 46 (38%) underwent delayed treatment initiation, with 76 median days to treatment. Patients referred from the public hospital were more likely to experience delayed treatment than those referred from the private hospital (odds ratio 4.31, 95% confidence interval [CI] 1.31 to 14.07). Most delays were due to system factors (85%). Each 10-day increase in time to treatment initiation was associated with worsened overall survival (hazard ratio [HR] 1.07, 95% CI 1.01 to 1.13). Public hospital patients were more likely to experience delays but were less likely to present with advanced stage (29% vs 50%, p = .031) and had improved overall survival compared with patients referred from the private hospital (HR 0.37, 95% CI 0.16 to 0.87). Treatment initiation delays were associated with a decrement in survival. In this cohort, public hospital patients were more likely to have a favorable stage and improved survival than those from the private hospital but also were more likely to experience treatment initiation delays. Referral patterns and delays related to diagnostic workup were the most common factors contributing to delays in care establishment. Improving care coordination may ensure equitable access to timely staging and treatment. Further studies are needed to determine whether treatment initiation delays impact cancer outcomes.
58. Catheter-Related Bloodstream Infections Among Critically Ill Patients With Central Vascular Access Devices: A Cross-Sectional Study in China.
期刊: Journal of infusion nursing : the official publication of the Infusion Nurses Society 发表日期: 链接: PubMed
摘要
The aim of this study is to assess catheter-related bloodstream infections (CRBSIs) in Chinese intensive care units (ICUs), covering prevalence, risk factors, pathogen distribution, and impacts of outcome. A cross-sectional study was conducted in ICUs across 22 tertiary hospitals (2023-2024), with CRBSI diagnoses following Chinese national guidelines. Data were analyzed using R software (version 4.4.2), employing chi-square tests, robust Poisson regression, and Bayesian logistic regression (P < .05). The prevalence of CRBSI was 1.19% (1.53/1000 catheter days, 32 patients, and 36 episodes). Risk factors included no formal education/illiteracy (OR: 1.995-9.604), circulatory diseases (OR: 1.142-5.787), complex/rare diseases (OR: 2.417-13.048), and multiple catheterizations (OR: 4.502-15.093). The subclavian vein was safest (femoral/axillary OR: 4.01-6.86). Gram-negatives predominated (47.22%). Each additional day of catheter dwell days increased CRBSI risk by 4.33% (95% CI: 3.04%-5.20%), and each additional ICU stay raised risk by 4.2% (95% CI: 2.9%-5.1%). CRBSI increased mortality (OR: 8.65), prolonged ICU stay (mean increase of 9.09 days), and additional costs (¥122 539.56 per case, approximately $17 505.65). CRBSI significantly worsens outcomes and costs in Chinese ICUs. Prioritizing subclavian catheterization, infection prevention bundles, and gram-negative antimicrobial stewardship is essential. Further research is needed to validate these interventions across diverse settings.
59. Peripheral Vasopressor Administration in Adults With Sepsis: A Retrospective Study of Guideline Adherence and Complications.
期刊: Journal of infusion nursing : the official publication of the Infusion Nurses Society 发表日期: 链接: PubMed
摘要
Peripheral intravenous catheter (PIVC) vasopressor administration is increasingly used to expedite the treatment of septic shock when central venous access is not immediately available. This shift in practice reflects growing support from national guidelines, which permit short-term peripheral administration of vasopressors in adults. On March 9, 2023, hospitals within 1 health care system implemented guidelines for PIVC vasopressor administration in adult critical care settings, specifically emergency departments and intensive care units. This study examined adherence to these guidelines for PIVC vasopressor use and to identify associated complications. This retrospective descriptive study included 106 adult patients (68 emergency department and 38 intensive care unit patients) diagnosed with sepsis and receiving peripheral vasopressors. The majority of patients received norepinephrine through a short PIVC. Overall, 5 patients (4.7%) experienced complications, 4 with thrombophlebitis and 1 with an extravasation. All 5 patients received norepinephrine at the organization’s policy-specified concentration via short PIVCs. However, only 1 of these patients met the system’s guidelines for minimum PIVC size, quantity, and maximum infusion duration. Overall, only 58% of patients were managed in full compliance with the system’s guidelines. These results support the use of standardized protocols to reduce complications associated with short-term peripheral vasopressor administration.
60. Neuroscience Nursing Interventions and Outcomes in Acute Ischemic Stroke Patients Outside the Intensive Care or Rehabilitation Unit: A Scoping Review.
期刊: The Journal of neuroscience nursing : journal of the American Association of Neuroscience Nurses 发表日期: 链接: PubMed
摘要
BACKGROUND: Neuroscience nurses generate new knowledge through research. Establishing research priorities is essential to support evidence-based nursing practice and direct research agendas. The purpose of this scoping review was to describe the nursing interventions and outcomes of adult 18 years of age or older nonintensive care or rehabilitation hospitalized patients with acute ischemic stroke (AIS) and identify gaps in the evidence. METHODS: Scoping review was followed, which included creation of a structured review protocol, a comprehensive librarian-assisted literature search of studies from 2010 to 2023, and the use of systematic review software. Reviewers performed title, abstract, and full-text review of studies meeting the inclusion criteria. A structured data extraction form was used to record characteristics of included studies, as well as nursing interventions and outcomes for hospitalized patients with AIS. RESULTS: Of the 797 studies identified from the literature search, 35 studies met the inclusion criteria. Nursing interventions included specific activities related to motor functioning (13), patient and family education (7), dysphagia (8), workflow (3), management of hyperglycemia (3) and fever (3), and discharge planning (1). Clinical outcomes included measures of disability (20), mortality (17), neurological deficits (15), adverse events and complications (14), and length of stay (14). Additional less frequently reported outcomes included time (9), patient satisfaction (6), and unplanned emergency department visits and readmissions (1). No studies reported metrics related to return on investment or costs related to nursing interventions. Across all interventions, motor functioning appears to have a positive impact on length of stay, neurological deficits, disability, and timing. CONCLUSION: This review provides a summary of nursing interventions and outcomes for adult hospitalized patients with AIS from a small sample of studies over 20 years. Gaps in the literature are noted to help inform the American Association of Neuroscience Nurses on the need for future research.