公共卫生研究摘要 (2026-01-08)
共收录 53 篇研究文章
1. Calcitonin Gene-Related Peptide Inhibitors and Cardiovascular Events in Patients With Migraine: A Retrospective, Observational Cohort Study.
期刊: Neurology 发表日期: 2026-Feb-10 链接: PubMed
摘要
Calcitonin gene-related peptide (CGRP) inhibitors have entered widespread use in the United States for treatment of migraine, but data on their cardiovascular risk profile are lacking. The objective of this study was to determine whether exposure to a CGRP inhibitor is associated with cardiovascular events in patients with migraine. A retrospective, observational, cohort study was conducted using computerized claims data from a proprietary, insurance-based registry, MarketScan (by Merative). Beneficiaries with at least one claim related to a migraine diagnosis and continuous coverage for at least 12 months before migraine diagnosis were included. Using a sequential trial framework, the rate of cardiovascular events was computed in those who did and did not initiate a CGRP inhibitor, using both crude estimates and those derived in propensity score overlap-weighted cohorts. Adjusted hazard ratios (HR) and corresponding 95% CI were computed. The principal exposure was initiation of any CGRP inhibitor. The primary end point was a composite of myocardial infarction (MI), cerebral ischemic stroke, revascularization, peripheral arterial disease, or central retinal artery occlusion (CRAO). Secondary end points included each component individually. A falsification end point (humeral fracture) was included. In total, 900,370 beneficiaries (median age 41 [Q1, Q3: 31, 51] years; 77.8% female) were included, of whom 58,679 initiated a CGRP inhibitor and 841,691 did not initiate a CGRP inhibitor during the study period. Beneficiaries initiating a CGRP inhibitor exhibited a greater degree of cardiovascular morbidity at baseline than noninitiators. In the overlap-weighted analysis, there was a higher rate of the primary end point among beneficiaries who initiated a CGRP inhibitor (8.77 events/1,000 person-years vs 6.76 events/1,000 person-years; aHR 1.26 [95% CI 1.10-1.45]). Initiation of a CGRP inhibitor was associated with a significantly higher rate of one secondary end point (ischemic stroke [aHR 1.26 (95% CI 1.07-1.49)]) but not 4 other secondary end points: MI, revascularization, CRAO, and intracranial hemorrhage. In a nationwide cohort study, initiation of a CGRP inhibitor was associated with an increased risk of a composite of cardiovascular events; however, the magnitude of the increased risk was low. This study provides Class II evidence that in patients with migraine, initiation of a CGRP inhibitor was associated with a modestly increased risk of a composite of cardiovascular events.
2. Serogroup Switching in Neisseria meningitidis with Dual Antibiotic Resistance.
期刊: The New England journal of medicine 发表日期: 2026-Jan-08 链接: PubMed
摘要
3. [Prevalence of Hypovitaminosis D in Portugal: A Narrative Review].
期刊: Acta medica portuguesa 发表日期: 2026-Jan-07 链接: PubMed
摘要
25-hydroxyvitamin D is the best biomarker of vitamin D biological activity, and its serum level has been used in studies assessing vitamin D sufficiency. However, the definitions of vitamin D deficiency and insufficiency remain non-consensual. The cutoff point for serum 25-hydroxyvitamin D levels used to define vitamin D sufficiency typically ranges between 50 and 75 nmol/L. Serum levels below 30 nmol/L, indicative of severe vitamin D deficiency, may have potentially adverse effects on skeletal and overall health. Hypovitaminosis D is highly prevalent worldwide, including across Europe. Several cross-sectional studies using random or convenience sampling, conducted at national or local levels, have documented a high prevalence of hypovitaminosis D, including severe cases, in Portugal. These studies were summarized in a narrative review, confirming the magnitude of this public health problem. The causes of hypovitaminosis D include low dietary intake or malabsorption of vitamin D, as well as inadequate sun exposure and insufficient endogenous synthesis, which are influenced by multiple factors. Several strategies have been proposed to address this significant public health issue, including adopting a healthier lifestyle with increased outdoor physical activity, controlling excess weight and obesity, and consuming foods naturally rich in vitamin D. However, given the high prevalence of sedentary lifestyles and obesity in Portugal, combined with inadequate dietary intake of vitamin D, these measures alone may be insufficient. Vitamin D supplementation and food fortification are two additional strategies for correcting hypovitaminosis D. Supplementation targeted at individuals at risk or with confirmed deficiency has not proven effective in significantly reducing the prevalence of severe deficiency in the Portuguese population. Food fortification, whether mandatory or voluntary, may represent a complementary and potentially more effective approach than individualized supplementation in populations with a high prevalence of severe hypovitaminosis D, as is the case in Portugal. A 25-hidroxi-vitamina D é o melhor biomarcador de atividade biológica da vitamina D e o seu doseamento sérico tem sido usado nos estudos que avaliam a sua suficiência. As definições de deficiência e de insuficiência de vitamina D não são ainda consensuais. O ponto de corte dos níveis séricos de 25-hidroxi-vitamina D, usado para a definição de suficiência da vitamina D, poderá encontra-se na faixa de 50 a 75 nmol/L. Níveis séricos inferiores a 30 nmol/L, traduzindo uma deficiência severa de vitamina D, poderão ter efeitos potencialmente adversos na saúde esquelética e geral. A hipovitaminose D tem uma elevada prevalência mundial incluindo na Europa. Vários estudos transversais com amostragem aleatória ou de conveniência, de âmbito nacional ou local têm vindo a documentar a existência de uma elevada prevalência da hipovitaminose D, incluindo de formas severas, em Portugal. Estes estudos foram alvo de uma revisão narrativa que confirma a dimensão deste problema de Saúde Pública. As causas da hipovitaminose D estão relacionadas com um baixo aporte alimentar ou malabsorção da vitamina D e com a insuficiente exposição solar e síntese endógena, condicionadas por múltiplos fatores. Diversas estratégias têm vindo a ser estabelecidas para fazer face a este importante problema de saúde pública, incluindo a adoção de um estilo de vida mais saudável com incremento da atividade e exercício físico no exterior, controlo do excesso de peso e obesidade e da ingestão de alimentos naturalmente ricos em vitamina D. Tendo em conta a elevada prevalência de sedentarismo e de obesidade em Portugal, assim como o insuficiente aporte de vitamina D na dieta, estas medidas poderão ser insuficientes. A suplementação e a fortificação com vitamina D poderão ser duas outras estratégias para a correção da hipovitaminose D. A suplementação dirigida a indivíduos em risco ou com hipovitaminose D confirmada não se tem revelado eficaz para reduzir de forma clara a prevalência de deficiência severa na população portuguesa. A fortificação dos alimentos, obrigatória ou voluntária, poderá ser uma opção complementar e mais eficaz do que a suplementação individualizada em populações com uma elevada prevalência de hipovitaminose D severa, como é o caso de Portugal.
4. A Social Media Campaign to Promote COVID-19 Vaccination: Cost-Effectiveness Analysis.
期刊: JMIR public health and surveillance 发表日期: 2026-Jan-07 链接: PubMed
摘要
Vaccine hesitancy has increased in recent decades internationally, which sets up a critical barrier to the rapid deployment of novel vaccines against infection with SARS-CoV-2. This study used a quasi-experimental design to evaluate the cost-effectiveness of a social media intervention to reduce COVID-19 vaccine hesitancy implemented in Nigeria in 2022. The intervention targeted health care providers and adults from the general population who were users of a specific social media platform. We used published estimates from a quasi-experimental evaluation of the campaign’s effectiveness compared to the status quo across 6 intervention states and 31 comparison states over a 10-month period. We estimated the cost-effectiveness of the campaign in terms of cost (2022 US dollars) per person vaccinated using a decision tree analysis and probabilistic sensitivity analysis. On the basis of the quasi-experimental trial, the campaign led to a crude 6.4-percentage point increase (219/692, 31.6% vs 117/463, 25.3%; P=.045) in vaccination rates and an adjusted 7.8-percentage point increase (95% CI 1.68-14.2; P=.02) controlling for age group, gender, educational level, religion, and occupation among the 20% (1933/9607) of the overall sample who were unvaccinated and in the persuadable middle. Scaled to the overall population, the campaign led to a 1.57-percentage point (95% CI 0.337-2.87; P=.02) increase in the proportion of those vaccinated against COVID-19 among those reached by the social media campaign. The social media campaign resulted in 58.3 million impressions and 1.87 million people reached for a total societal cost of US $1.15 million, or US $0.61 per person reached. This resulted in an incremental cost-effectiveness ratio of US $54.70 (95% uncertainty interval US $20.90-$163) per person vaccinated. A social media-based campaign to address COVID-19 vaccine hesitancy in 6 states in Nigeria resulted in an increase in vaccination rates. The cost-effectiveness of the campaign compared to no campaign is comparable to that of other campaigns promoting COVID-19 vaccine uptake. The cost per person vaccinated due to the social media campaign was 1% to 8% of the estimated cost per life year saved by vaccination against COVID-19 in low- and middle-income countries. Investing in social media campaigns would likely be a cost-effective approach to increase vaccine uptake and save lives.
5. Adoption of an Electronic Decision Support Tool for Capacity Building of Community Health Workers: Mixed Methods Study.
期刊: JMIR formative research 发表日期: 2026-Jan-07 链接: PubMed
摘要
Complimentary subscriptions to UpToDate, a decision support tool, were provided to community health workers (CHWs) in rural and remote primary care sites as part of a government-funded health system research program. A feasibility evaluation conducted after the first year of implementation showed that UpToDate was acceptable among CHWs despite infrastructural barriers. This follow-up study evaluated the longitudinal adoption of UpToDate among CHWs and examined how sociocultural, political, and environmental factors influenced its use. Drawing on the nonadoption, abandonment, scale-up, spread, and sustainability framework, this study aimed to understand not only use patterns but also broader challenges to scale-up, spread, and sustainability in a complex health system. An explanatory mixed methods design was used combining analysis of use and program activity logs; program reports; and focus groups with CHWs, health care professionals, and program implementers. Quantitative analysis of use logs (March 2021 to September 2023) compared adoption over time by using descriptive statistics, CIs, and chi-square tests. Qualitative data came from the reanalysis of previous focus group transcripts and program reports and from a new focus group with program implementers. Reflexive thematic analysis was used to interpret how CHWs and implementers perceived and used the tool, and findings were integrated to explain quantitative trends. Use of UpToDate was modest and declined over time. Monthly active use among CHWs and midwives fell substantially from 3.57% (97/2720 person-months) in 2021 to 1.07% (37/3456) in 2022 and remained low at 1.50% (39/2592) up to 2023, with markedly higher engagement in the rural site than in the remote site. Peaks in use coincided with program activities, whereas prolonged troughs followed typhoons, power outages, and other disruptions. Log data showed that users primarily consulted patient education articles rather than clinician-oriented decision tools. Qualitative analyses revealed that CHWs appropriated UpToDate as a learning aid and source of professional credibility. Structural shocks, heavy workloads, language barriers, and limited device access constrained individual use, and communal practices (shared devices and learning activities) meant that meaningful engagement often went unrecorded in vendor metrics. Our findings show that acceptability does not guarantee sustained use and that adoption cannot be captured fully by log-in counts. UpToDate’s value for CHWs lay in how it was domesticated as a tool for building capacity and professional credibility, not in its intended function as a decision aid used at the point of care. Therefore, evaluations of digital health tools should incorporate indicators of learning and social capital alongside use metrics. Policymakers should recognize that infrastructural fragility and communal adaptation shape digital health uptake. Embedding tools into ongoing training and peer learning structures, providing offline and multilingual support, and investing in resilience planning will be crucial for meaningful scale-up and sustainability.
6. International Guideline Harmonization Group Recommendations for Breast Cancer Surveillance in Childhood, Adolescent, and Young Adult Cancer Survivors After Anthracyclines.
期刊: JCO oncology practice 发表日期: 2026-Jan-07 链接: PubMed
摘要
With new evidence emerging about breast cancer risk following anthracycline chemotherapy, the International Late Effects of Childhood Cancer Guideline Harmonization Group updated the evidence and breast cancer surveillance recommendations for female childhood, adolescent, and young adult (CAYA) cancer survivors. The Grading of Recommendations Assessment, Development, and Evaluation methodology was used to incorporate new knowledge and refine breast cancer surveillance recommendations. The guideline panel updated the systematic literature review and revised recommendations based on new evidence, clinical judgment, and assessments of benefits and harms of surveillance, ensuring adaptability across various health care systems. The literature update revealed new findings on the effects of anthracyclines on breast cancer risk in female CAYA cancer survivors. Moderate-quality evidence shows no significant association between doxorubicin doses <100 mg/m2 and breast cancer risk. High-quality evidence indicates a statistically significant but weak association between breast cancer risk and 100-199 mg/m2 doxorubicin (relative risk, <2) and a moderate breast cancer risk (relative risk, 2-4) for those treated with ≥200 mg/m2 in the absence of radiotherapy exposing breast tissue (chest radiation). Routine breast cancer surveillance after ≥200 mg/m2 doxorubicin in the absence of chest radiation is reasonable from age 30 years onward or ≥8 years from exposure (whichever occurs last). Due to inconclusive evidence, no recommendation could be formulated for routine breast cancer surveillance after daunorubicin, epirubicin, or idarubicin, in the absence of chest radiation. The newly identified evidence on breast cancer risk after anthracyclines supports changes in the 2019 recommendations regarding breast cancer surveillance for survivors treated with ≥200 mg/m2 doxorubicin without chest radiation.
7. Monoclonal neutralizing antibodies elicited by infection with Kaposi sarcoma-associated herpesvirus reveal critical sites of vulnerability on gH/gL.
期刊: PLoS pathogens 发表日期: 2026-Jan-07 链接: PubMed
摘要
Kaposi sarcoma-associated herpesvirus (KSHV) is an oncogenic virus that causes Kaposi sarcoma, primary effusion lymphoma and multicentric Castleman disease. A vaccine that prevents KSHV infection or serves in the treatment of KSHV-related diseases represents a critical unmet need, however, the types of immune responses a vaccine should elicit have not been well defined. The gH/gL glycoprotein complex is an important target of KSHV-neutralizing antibodies, but the epitope specificities targeted by these antibodies remain unknown. Here, we isolated 12 gH/gL-specific monoclonal antibodies (mAbs) from KSHV-infected donors and performed structure/function analyses. These mAbs bind recombinant gH/gL with nanomolar affinities and epitope binning analyses revealed that the mAbs bind to 5 epitope clusters on gH/gL. Seven mAbs were able to neutralize KSHV infection of epithelial cell lines. Two potent neutralizing mAbs mapped to the EphA2 binding site as determined by inhibition of the receptor-ligand interaction and negative stain electron microscopy (nsEM) of the mAb/gH/gL complex. The epitopes of other neutralizing mAbs targeting novel sites of vulnerability were determined by a combination of cryogenic electron microscopy and nsEM. Together, these mAbs help to define the relevant epitope targets for KSHV vaccine design, have utility in understanding the role of antibodies in preventing KSHV infection, enable the development of immunotherapy approaches, and provide valuable tools to understand the molecular details of the KSHV entry process.
8. Exploring the Dynamics of Actors, Structural Factors, and Bricolage in the Implementation and Sustainability of eHealth Solutions: Qualitative Multiple-Case Study.
期刊: Journal of medical Internet research 发表日期: 2026-Jan-07 链接: PubMed
摘要
European health care systems face mounting pressures from an aging population, workforce shortages, and decentralization, challenging the delivery of accessible, high-quality care. eHealth solutions are widely promoted to enhance efficiency and improve the quality of care. Despite a strong policy report, anticipated benefits remain unrealized, as implementation processes often encounter barriers and high failure rates. Research shows that drivers and barriers are dynamic and shaped by actor interactions. Some studies suggest that certain actors, often acting as bricoleurs, play a critical role in overcoming these barriers through adaptive and improvised practices. However, little is known about how these actors enact roles, what features enable bricolage, and how structural conditions influence these practices. The aim of this study is twofold. First, it investigates the roles and features of actors involved in innovation processes, with a particular emphasis on the application of bricolage to overcome barriers and the influence of structural factors on these processes. Second, it aims to contribute both theoretical and empirical insights to deepen the understanding of barrier dynamics within innovation processes. We conducted a multiple-case study comprising 10 semistructured interviews, 11 focus groups with health care professionals, managers, trainers, and policymakers, participant observations of training sessions, and document analysis. An iterative process integrated the dramaturgical approach with the concept of bricolage, guiding the reflexive thematic analyses. Roles were enacted based on available information, context, and assigned functions. Service specialists (eg, superusers) and mediators (eg, unit or project managers) gained backstage insights through shadowing staff, evaluations, and support activities. When mandated and equipped with contextual and technical knowledge, these actors became bricoleurs, addressing unforeseen challenges by creatively mobilizing resources and thereby transforming barriers into promoters. Effective bricolage required proximity to the implementation site, dedicated involvement, and experiential knowledge of health care and technical domains. Key drivers included colocation, supportive management, stable teams, superusers, tailored training, follow-up activities, and informal evaluations. Barriers such as organizational silos, leadership shifts, staffing shortages, high turnover, geographic dispersion, and technology perceived as challenging or surveillance-oriented constrained bricolage and hindered implementation. Actors may become bricoleurs when their assigned roles, contextual knowledge, and backstage access enable them to improvise in response to unforeseen challenges. Through a dramaturgical lens, bricolage is an adaptive performance that sustains frontstage care delivery. Bricoleurs combine proximity, experiential knowledge, and dual expertise to transform barriers into drivers by adjusting the innovation process and fostering interaction. These practices illustrate the mutual shaping of structure and agency: enabling conditions expand the space for bricolage, while barriers narrow it. Understanding this dynamic is essential for advancing theory on innovation processes and for designing implementation strategies that leverage bricolage as a mechanism for transforming barriers into drivers of innovation.
9. Quantifying the impact of switching from Rotarix to Rotavac rotavirus vaccine in Ghana.
期刊: The Journal of infectious diseases 发表日期: 2026-Jan-07 链接: PubMed
摘要
Ghana introduced the Rotarix vaccine in April 2012 and switched to the Rotavac vaccine in January 2020. Evaluating the health impact of this change is essential for national policy and can inform decisions in other countries. We applied a previously validated mathematical model of rotavirus transmission in Navrongo, Ghana, to quantify the health impact of switching from Rotarix to Rotavac among children under two. We first simulated the model from January 2007 to December 2019 using previously estimated model parameters from pre- and post-Rotarix surveillance data. We then refitted the model to data from January 2020 to March 2023 to estimate Rotavac vaccine effectiveness parameters. To assess overall vaccine effectiveness (OVE), we compared model simulations under the two vaccination scenarios (Rotarix and Rotavac) with a counterfactual scenario assuming no vaccination. The model accurately captured both the trend and seasonality of post-vaccination rotavirus cases, with a Spearman correlation of 0.70. Compared to the no-vaccination scenario, the estimated overall vaccine effectiveness (OVE) against moderate-to-severe rotavirus cases was 21.7% (95% prediction interval [PI]: 17.4%-26.1%) in children under 2 years in Navrongo. Annual OVE ranged from 8.4% (PI: 1.0-21.0%) to 63.5% (PI: 39.0-87.0%). Following the switch from Rotarix to Rotavac (2020-2023), we estimated a mean relative OVE of 37.1% (PI: 27.5-46.5%). Our model offers a robust tool to support policymakers in Ghana and similar settings by evaluating current rotavirus vaccine effectiveness, guiding vaccine switching decisions, and informing introduction strategies in countries yet to adopt immunization.
10. Just-in-Time Adaptive Intervention to Promote Walking Behavior and Reduce Stationary Time in Physically Inactive Adults: Protocol for the Walking With JITAIs Study.
期刊: JMIR research protocols 发表日期: 2026-Jan-07 链接: PubMed
摘要
A Just-in-Time Adaptive Intervention (JITAI) recognizes the dynamic nature of individuals’ states and contexts, predicts support needs, and sends tailored support at more opportune, actionable times. This paper outlines the application architecture and protocol for the pilot “Walking With Just-in-Time Adaptive Interventions” (WWJ) study, which uses a JITAI approach to improve walking behavior-duration, speed, and distance-and reduce stationary time, defined as idle sitting or standing. This study targets 20 adults who are physically inactive and leverages the Apple Watch to deliver fully automated tailored intervention notifications to “walk faster,” “walk longer,” or “stand up and move around” based on real-time data and contextual factors, including time-of-day activity patterns, geographic locations (eg, home, work, park, and gymnasium), weather conditions (eg, precipitation, wind speed, and humidity), and receptiveness. The protocol involves a preintervention assessment of demographics, behavior change constructs, anthropometrics, and resting vital signs; a 2-week observation period to establish walking behavior and stationary time baselines; a 2-week just-in-time learning period to evaluate receptiveness to untailored prompts at all applicable times; the 2-week JITAI intervention phase; and a postintervention assessment. Feasibility will be evaluated through protocol fidelity, participant adherence, Apple Watch wear-time compliance, user burden, acceptability ratings, and perceptions of benefits and preferences. The WWJ architecture development began in spring 2021 and concluded in fall 2022. Participant recruitment and enrollment began in fall 2022. A total of 18 participants were recruited. Upon completion of the analyses, the results of this study are expected to be submitted for publication. Distinctively, the WWJ just-in-time learning period aims to train the learner based on user receptiveness within contexts by sending interventions whenever a participant meets the predetermined thresholds regardless of the likelihood that the user will be receptive to the notification to prune out nonopportune or “nonactionable” times. This approach may allow for greater customization during the JITAI period. DERR1-10.2196/79022.
11. Prevalence and cumulative incidence of low back pain: Findings from a 5-year descriptive cohort study in the dena cohort population.
期刊: Journal of back and musculoskeletal rehabilitation 发表日期: 2026-Jan-07 链接: PubMed
摘要
BackgroundLow back pain (LBP) is a major global cause of disability, with its prevalence rising due to aging populations and sedentary lifestyles. This study aimed to estimate the prevalence and cumulative incidence of LBP and identify related risk factors in the Dena cohort population.MethodsThis prospective cohort study included 3630 adults aged 35-70 years from the Dena Cohort Study. Baseline data were used to calculate the prevalence of LBP, and 5-year follow-up data (2019-2020) were used to estimate cumulative incidence. Participants with baseline LBP or incomplete data were excluded from the incidence analysis (final sample size: 2897). Data collection involved standard Persian Cohort questionnaires, physical examinations, and laboratory evaluations. Statistical analyses were performed using SPSS version 27.ResultsThe baseline prevalence of LBP was 19.5%, and the 5-year cumulative incidence was 12.4%. By 2023, the prevalence had reached 29.2%. Among new LBP cases, 67.4% were women and 32.6% were men, with the highest incidence among housewives (55.2%). About 84% of cases were from middle or high socioeconomic groups. Smoking (16.2%), hookah use (32%), and obesity (BMI >30 in 38.2%) were significantly associated with LBP. Other contributing factors included depression (22%), previous surgery (76.3%), and rheumatoid arthritis (6.1%).ConclusionThis study demonstrates the significant burden of LBP among Iranian adults, emphasizing its high prevalence and incidence. Preventive interventions focusing on physical activity, weight management, ergonomic practices, and early detection could help reduce the impact of LBP in the community.
12. Sex-specific global, regional and national burden of dysthymia and major depression disorder in older adults from 1990 to 2021: a systematic analysis of the global burden of disease 2021 study.
期刊: European archives of psychiatry and clinical neuroscience 发表日期: 2026-Jan-07 链接: PubMed
摘要
Dysthymia and major depression disorder impair the wellbeing of older adults, their families, and communities. Understanding its global disease burden and trends in older adults over 60 is fundamental for policy making. Therefore, we obtained data from Global Burden of Diseases Study 2021 in 204 countries and territories from 1990 to 2021. We calculated the age-standardized prevalence, incidence, disability-adjusted life years (DALYs) rates, and estimated annual percentage change by age, sex, and socio-demographic index (SDI) to assess burden and quantify the temporal trends. We then used spearman correlation analysis to examine the relationship between age-standardized rates and SDI, and adopted a Bayesian age-period-cohort model to predict trends to 2030. In 2021, there were over 67.6 million cases of dysthymia and major depression disorder in older adults globally, with an age-standardized prevalence rate of 6203.2 per 100,000 (95% Uncertainty Interval: 5128.4-7464.5). Age-standardized prevalence, incidence, and DALY rates increased in high-income Asia Pacific and East Asia. Disease burden negatively correlated with SDI levels. A heavier burden was observed in older females consistently across all regions and age groups. Disease burden in older adults peaked at age 60-64 and declined with aging in most but low SDI regions, where an increasement preceded the decline. By 2030, the age-standardized prevalence, incidence, and DALY rates are predicted to increase globally, with a higher projected burden in older females. In conclusion, the allocation of health resources should focus on addressing regional disparities, with special attention to vulnerable groups such as older females in economically disadvantaged regions.
13. A systematic review and meta-analysis on diagnostic accuracy of point-of-care C-reactive protein devices for acute respiratory tract infections.
期刊: Infection 发表日期: 2026-Jan-07 链接: PubMed
摘要
Acute respiratory tract infections (ARTIs) are among the most common reasons for antibiotic prescriptions globally, despite the majority being viral and self-limiting. Because clinical signs alone are often insufficient, there is a clear need for rapid diagnostic methods to support evidence-based prescribing. We assessed the effectiveness of point-of-care C-reactive protein (POCT-CRP) testing devices for distinguishing between bacterial and viral ARTIs. Our search of five databases produced 413 studies, of which 29 met criteria, and six were included in the meta-analysis. The devices with adequate performance data were QuikRead CRP, NycoCard Reader II, and FebriDx®. Overall pooled sensitivity 70% (95% CI 52-83%) and specificity 86% (95% CI 80-91%). The FebriDx showed a pooled sensitivity of 84% (95% CI 76-90%) and specificity of 87% (95% CI 82-91%). The QuikRead showed a pooled sensitivity of 35% (95% CI 30-40%) and specificity of 86% (95% CI 82-89%). The NycoCard Reader II showed a pooled sensitivity of 54% (95% CI 21-83%) and specificity of 86% (95% CI 59-96%). Although POCT-CRP testing is useful in distinguishing between bacterial and viral ARTIs and is critical for antibiotic prescription, further evidence, including cost-effectiveness analysis, is needed to determine whether the implementation of POCT-CRP improves value or merely raises healthcare expenses.
14. Impact of Statin Use on Cardiovascular and Hematologic Outcomes Among Patients with Myeloproliferative Neoplasms.
期刊: Blood advances 发表日期: 2026-Jan-07 链接: PubMed
摘要
Myeloproliferative neoplasms (MPNs), including polycythemia vera (PV), essential thrombocythemia (ET), and myelofibrosis (MF), are chronic myeloid neoplasms associated with increased risk of cardiovascular disease (CVD). Statins are a common group of cholesterol-lower medications recommended for the primary and secondary prevention of CVD, including arterial thrombotic events. Emerging evidence suggests that statins may reduce the risk of developing MPNs and their use may be associated with improved survival. However, statins impact on cardiovascular and hematologic outcomes among patients with MPNs remains uncharacterized. We conducted a multicenter retrospective cohort study of patients with MPNs who had at least one transthoracic echocardiogram (TTE) from 2010 to 2024. Inverse-probability treatment weighting (IPTW) competing-risk regression analysis was performed to assess the association between statin use at time of index TTE on major adverse cardiovascular events (MACE), MPN disease progression, and all-cause death. MPN patients were analyzed as a whole and separately by type (ET or PV and MF). A total of 669 patients were included, 43.9% were on statin use, 50.5% were female, 83.9% were White, 78.8% had JAK2 driver mutation, and 72.9% had class I guideline indication for statin therapy. There were 267 (39.9%) PV, 234 (35.0%) ET, and 168 (25.1%) MF patients. After IPTW, statin use was associated with lower risk of MACE (SHR 0.83, 95% CI 0.70 - 0.98) but not MPN disease progression (SHR 0.96, 95% CI 0.72 - 1.29) or all-cause death (HR 1.04, 95% CI 0.87 - 1.24). Among patients with ET or PV, statin use was associated with lower risk of MACE (SHR 0.78, 95% CI 0.64 - 0.95) but not MPN progression (SHR 1.03, 95% CI 0.74 - 1.44) or all-cause death (HR 0.85, 95% CI 0.68 - 1.06). Among patients with MF, there was no difference in MACE, leukemia progression, or all-cause death. Among patients with MPNs who underwent TTE, statin use was associated with lower risk of MACE, particularly among patients with ET or PV. However, there was no association between statin use and all-cause death or MPN disease progression. Statin therapy is underutilized in this patient population. Further studies are needed to explore the utility of statin therapy in patients with MPN and identify patients who would benefit most from statin therapy.
15. Real-World Safety and Effectiveness of Zanubrutinib versus Ibrutinib in CLL: The CLL-ZANU2024 Italian Cohort.
期刊: Blood advances 发表日期: 2026-Jan-07 链接: PubMed
摘要
Bruton tyrosine kinase inhibitors (BTKis) have dramatically changed the therapeutic landscape of chronic lymphocytic leukemia (CLL), with ibrutinib, first-in-class, demonstrating durable efficacy even in high-risk patients. However, off-target adverse events (AEs) have raised concerns, prompting the development of more selective second-generation BTKi, as zanubrutinib, designed to improve tolerability while maintaining efficacy. Despite encouraging results from clinical trials, real-world data comparing zanubrutinib with ibrutinib remain limited. In this multicenter, retrospective study, we analyzed 934 CLL patients treated outside clinical trials, including 393 receiving zanubrutinib and 541 receiving ibrutinib. We evaluated time to treatment discontinuation (TTD) and time to next treatment or death (TTNTD) in both the overall cohort and a propensity score-matched population. Zanubrutinib-treated patients experienced lower 12-month discontinuation rates (overall:12.6% versus 21.4%; matched:12.4% versus 20.2%) and higher 12-month TTNTD rates (overall:91.9% versus 83.0%; matched:93.2% versus 83.4%). Multivariable analyses confirmed zanubrutinib as an independent predictor of longer TTD and TTNTD, while high-risk features, including age, relapsed/refractory disease, Binet stage C, TP53 disruption, ECOG 2-3, and congestive heart failure, were consistently associated with poorer outcomes. AEs leading to discontinuation, particularly atrial fibrillation, bleeding, and infections, were less frequent with zanubrutinib, reflecting its favorable safety profile. These findings provide real-world evidence that zanubrutinib offers more durable disease control and improved persistence compared with ibrutinib, reinforcing its clinical value as a preferred second-generation BTKi. Nevertheless, the relatively short follow-up for zanubrutinib warrants cautious interpretation of long-term outcomes and underscores the need for ongoing observation to fully characterize its durability and safety.
16. Evaluating modes of influenza transmission (EMIT-2): Insights from lack of transmission in a controlled transmission trial with naturally infected donors.
期刊: PLoS pathogens 发表日期: 2026-Jan-07 链接: PubMed
摘要
A previous controlled human influenza transmission trial produced minimal transmission using nasal inoculation of an egg adapted virus. Therefore, we implemented a new trial with naturally infected Donors. We recruited healthy Recipients for four, two-week hotel quarantine cohorts and naturally infected, qRT-PCR confirmed Donors for two cohorts. Five Donors (mean age: 21; 80% female; two H1N1, three H3N2, one for cohort 24b and 4 for 24c, Jan-Feb 2024) exposed Recipients (mean age: 36; 55% female, eight in cohort 24b and 3 in 24c) in a hotel room with limited ventilation but a high air recirculation rate. We collected exhaled breath, ambient and personal bioaerosols, fomite swabs, and sera, and analyzed samples using dPCR and fluorescent focus assays, hemagglutination inhibition (HAI) assay, and enzyme-linked immunosorbent assay (ELISA). Compared with previously studied community-acquired influenza cases, we detected viral RNA (44%) and culturable virus (6%) less frequently and measured fewer viral RNA copies (79 - 8.9 × 103 copies/30-min) in Donors’ exhaled fine aerosols. One of 23 surface swab samples was culture positive. At admission, 8 of 11 Recipients had HAI titers ≤10 but 9 of 11 had stronger binding antibody responses than Donors against vaccine strains corresponding to Donor viruses. No Recipient developed influenza-like illness, PCR-positive respiratory samples, or serological evidence of infection. Potential explanations and insights regarding lack of transmission include importance of cough and seasonal variation in viral aerosol shedding by Donors, of potential cross-reactive immunity in middle-aged Recipients with decades of exposure, and of exposure to concentrated exhaled breath plumes limited by rapid air mixing from environmental controls that distributed aerosols evenly. Future trials over multiple seasons, Donors that cough, younger recipients, and environments that preserve normal exhaled breath plumes will be required to observe transmission from naturally infected Donors under controlled conditions and generate new insights into influenza transmission dynamics.
17. Secondary traumatic stress and its impact on work efficiency and performance among firefighters in Saudi Arabia: A mixed-methods study.
期刊: Work (Reading, Mass.) 发表日期: 2026-Jan-07 链接: PubMed
摘要
BackgroundSecondary traumatic stress (STS) is a significant concern for firefighters due to their repeated exposure to traumatic events. In Saudi Arabia, cultural and organizational dynamics may amplify the risk of STS among firefighters’ work performance. This heightened risk stems from culturally rooted stigma surrounding mental health, a lack of structured psychological support systems, and rigid hierarchical work environments that often discourage emotional expression or help-seeking behavior.ObjectiveThis study aims to investigate the prevalence of STS among Saudi firefighters, its impact on work efficiency and performance, and the moderating effects of personal, social, and organizational factors.MethodsA mixed-methods design was employed. The quantitative component included a cross-sectional survey of 304 male firefighters from different regions of Saudi Arabia, while the qualitative component involved semi-structured interviews with 22 participants Quantitative data were analyzed using descriptive statistics, Fisher’s exact test, and stepwise regression, while qualitative data underwent thematic analysis guided by an inductive approach.ResultsThe results indicate a notable prevalence of psychological distress among Saudi firefighters. Significant associations were found between STS and several variables, including educational level, marital status, region of work, trauma exposure frequency, and the desire to transfer to another role. The study also highlighted the moderating influence of personal, social, and organizational factors on stress outcomes.ConclusionsThese findings underscore the pressing need for targeted mental health interventions and systemic organizational reforms to support firefighters’ well-being and enhance occupational resilience.
18. Kidney Urate Underexcretion Mediates the Relationship between Per- and Polyfluoroalkyl Substances and their Alternatives and Uric Acid Levels: Evidence from a Case-Control Study and an Animal Study.
期刊: Environmental science & technology 发表日期: 2026-Jan-07 链接: PubMed
摘要
Numerous studies have indicated a relationship between per- and polyfluoroalkyl substances (PFASs) with uric acid levels; yet, the underlying mechanism remains unclear. To investigate this, we conducted a case-control study with 990 adults and animal experiments to examine the impact on kidney urate underexcretion. An interquartile range increase in PFASs was negatively associated with the fractional excretion of uric acid (FEUA%), an index for evaluating kidney urate excretion. Specifically, the association for 6:2 Cl-PFESA was β = -0.18 (95% CI -0.35, -0.02). Additionally, changes in FEUA (%) was negatively associated with uric acid levels (β = -13.42, 95% CI: -15.74, -11.09). Mediation analysis revealed that FEUA (%) mediated 14.22-25.63% of the association between PFASs and the uric acid level. Weighted Quantile Sum (WQS) models show that 6:2 Cl-PFESA had the greatest impact on FEUA (%) (weight: 0.585). Animal studies demonstrated a significant decrease in FEUA (%) and changes in uric acid transporters. In the 400 μg/L CI-PFESA exposure group, FEUA (%) decreased by 0.22-fold, while ABCG2 and NPT4 protein levels decreased by 0.622-fold and 0.729-fold, respectively; the levels of OAT10 increased by 1.331-fold compared with controls. Network toxicology and molecular biology analyses suggested that these effects may be mediated through the activation of the TLR4/NF-κB/NLRP3 axis.
19. An Umbrella Review of Systematic Reviews and Meta-Analyses on Occupational Heat Exposure, Health Risks, and Productivity Losses Globally.
期刊: Current environmental health reports 发表日期: 2026-Jan-07 链接: PubMed
摘要
Workplace heat exposure, intensified by climate change, increasingly threatens workers’ health, safety, and productivity, especially in the agriculture, construction, and manufacturing sectors. However, current evidence is fragmented due to varied study designs, and the absence of an integrated, multidisciplinary synthesis. This umbrella review synthesizes findings from current systematic reviews and meta-analyses to appraise the health and productivity outcomes of workplace heat exposure, assess evidence quality, and identify critical research and policy gaps. Fourteen systematic reviews and meta-analyses (published up to 31st March 2025) were included following predefined (PECOS) criteria. Methodological fidelity was analyzed using the AMSTAR checklist, and the strength of evidence was evaluated using the GRADE approach. The fidelity of the included reviews was rated from moderate to high, while the robustness of evidence spanned from low to moderate due to study heterogeneity and observational designs. Consistent evidence links workplace heat exposure to higher risks of heat-related illness, reduced eGFR (AOR = 3.50, 95% CI: 1.30-9.40) resulting renal impairment, cognitive decline, and injuries (1% increase in risk per 1℃ rises in temperature). Emerging findings suggests heat-induced sub-cellular and molecular damage (i.e., increased 8-OHdG, HSP70), reduced sperm quality, indicating cellular dysfunction. Women and relocated workers face greater physiological strain. Productivity losses affect 30-60% of exposed workers, with prior estimates suggesting annual global economic losses of approximately $2.1 trillion. Workplace heat hazards significantly threaten global workforce health and economic resilience. Urgent, coordinated interventions, robust policy measures, and high-quality longitudinal research are required to alleviate these risks.
20. Quantitative human biomonitoring of micro- and nanoplastics: Exposure profiles, mechanistic insights, and health implications.
期刊: Journal of hazardous materials 发表日期: 2026-Jan-05 链接: PubMed
摘要
Micro- and nanoplastic (MnP) pollution has become an escalating environmental and public health concern, supported by increasing human biomonitoring evidence of their presence in the body. We performed a PRISMA-guided quantitative analysis of 70 human-sample studies (2019-2025) spanning multiple organ systems and body fluids. After being standardized by the unit, reported concentrations ranged 0.2-342.55 items/g or 0.43-275.78 μg/g, with relatively higher content in digestive, reproductive, circulatory, and respiratory samples. Polyethylene (PE, n = 84), polypropylene (PP, n = 63), polystyrene (PS, n = 59), polyethylene terephthalate (PET), and polyvinyl chloride (PVC) were predominant, less frequent polymers followed a long-tail distribution. Particle sizes clustered at 10-100 μm, and nanoplastics (<1 μm) were infrequently quantified due to analytical limits, a few studies have reported detections in placental or brain tissues, but these observations remain preliminary and require prudent interpretation. Common digestion protocols included 30 % H2O2 and 10 % KOH. μ-Raman, LDIR, μ-FTIR, and Py-GC/MS produced systematic differences between particle-count and mass-based metrics, underscoring methodological dependence that limits interstudy comparability. Current toxicological evidence and limited epidemiological observations indicate potential associations with oxidative stress, inflammation, immune alterations, and endocrine-related effects, while no causal relationships have been demonstrated in humans. However, prevalence estimates and risk assessments are limited by small sample sizes and uneven age and sex representation. Importantly, this quantitative synthesis of human-sample data integrates multi-matrix MnP concentrations, delineates exposure profiles, identifies critical knowledge gaps, and underscores the need for standardized analytical approaches and longitudinal low-dose studies to support health risk assessment and policy development.
21. Recent advances in biomimetic sensors for the detection of aquatic pathogens and toxins.
期刊: Journal of hazardous materials 发表日期: 2026-Jan-05 链接: PubMed
摘要
This review examines recent advances in biomimetic sensors for detecting pathogens and toxins in aquatic ecosystems, with emphasis on aptamer-based (aptasensor) and molecularly imprinted polymer (MIP)-based platforms. Timely detection of pathogens and toxins in aquatic environments is critical for preventing waterborne disease outbreaks and safeguarding public and ecological health, yet conventional diagnostic methods remain slow, costly, and labor-intensive. Aptasensors and MIP-based sensors offer tunable specificity, rapid response times, and multiplexing capabilities, positioning them as promising alternatives to traditional laboratory assays. Our review highlights recent developments in aptamer discovery, post-SELEX optimization, and non-SELEX computational approaches, as well as emerging imprinting strategies for enhancing MIP selectivity. We also examine innovations in transduction components, particularly the use of nanomaterials and nanocomposites to enhance sensor sensitivity and performance. In addition, we discuss the integration of biosensors with modern communication technologies, such as wireless systems and the Internet of Things, to enable real-time monitoring and remote data transmission. Lastly, we identify technological challenges and propose pathways to advance practical, field-deployable biosensing solutions for aquatic environments.
22. Risk identification and tracing of heavy metals in rice fields: An integrated framework of machine learning, Google Earth Engine, geochemical modeling, and pollution fingerprinting for regional-scale risk assessment.
期刊: Journal of hazardous materials 发表日期: 2026-Jan-05 链接: PubMed
摘要
Heavy metals in rice have raised public concern due to health hazards. To achieve effective risk identification and tracing of heavy metals in rice fields on a regional scale, this study innovatively integrated machine learning, Google Earth Engine (GEE), geochemical modeling, and pollution fingerprint analysis, aiming to improve target field recognition, speciation prediction, and source apportionment in heavy metal risk assessment. GEE coupling random forest (RF) model achieved to accurately identify rice fields (overall accuracy, 0.98), facilitating the zoning for risk assessment. A multi-surface speciation model (MSM) coupled with RF model further identified speciation distribution, bioavailability, and leaching risks of heavy metals in rice fields, and simulated the adsorption-desorption behavior of heavy metals with soil pH changes. Fulvic acid (FA) can improve rice uptake of heavy metals, while dissolved organic matter (DOM) in soils contribute to the leaching potentials of heavy metals, especially Pb and Cu. Positive matrix factorization (PMF)-RF integrating approach identified the sources of heavy metals, which were mainly from soil parent material, fertilizer application, traffic pollution, and industrial exhaust with relative contributions of 27.8 %, 24.5 %, 26.2 %, and 21.5 %, respectively. The integrated framework for risk identification and tracing in this study may inform regional-scale agricultural pollution management.
23. Gold nanostars-based SERS-LFIA for the rapid and sensitive detection of group A rotavirus.
期刊: Spectrochimica acta. Part A, Molecular and biomolecular spectroscopy 发表日期: 2026-Jan-03 链接: PubMed
摘要
Rotavirus (RV) infection is a zoonotic disease that primarily affects infants, young children, and young animals, with clinical manifestations including anorexia, vomiting, diarrhea, and dehydration. RV can be classified into seven groups (A-G), among which group A rotavirus (RVA) is the most prevalent and pathogenic. The high morbidity and mortality associated with RVA infection not only cause substantial economic losses to the livestock industry but also pose a serious threat to human health. Currently, the detection of RVA mainly relies on enzyme-linked immunosorbent assay (ELISA) and polymerase chain reaction (PCR). However, these methods are limited by their complex procedures, long processing times, and high costs, making them unsuitable for rapid on-site diagnosis. In this study, a surface-enhanced Raman scattering-based lateral flow immunochromatographic assay (SERS-LFIA) employing gold nanostars (AuNS) as signal labels was developed for the rapid and sensitive detection of animal-derived RVA. AuNS were synthesized via a gold seed-mediated growth method. Mouse anti-RVA monoclonal antibodies and 5, 5’-Dithiobis (2-nitrobenzoic acid) (DTNB) were conjugated to the surface of AuNS through AuS bonds to prepare SERS immunoprobes, which were then deposited onto the conjugate pad during test strip assembly. The unique star-shaped morphology of AuNS significantly enhanced the analytical signals, achieving a visual limit of detection (LOD) of 1.02 × 103 copies/μL and a Raman signal-based LOD as low as 3.73 × 102 copies/μL. The method exhibited no cross-reactivity with other diarrhea-causing viruses or bacteria and showed an overall concordance rate of 95% (76/80) with RT-PCR when tested using 80 clinical samples. Furthermore, the RVA detection could be completed within 20 min without the need for complex instrumentation. Thus, the dual-signal-mode immunochromatographic assay demonstrates high sensitivity, specificity, and accuracy, making it highly suitable for the rapid on-site detection of RVA.
24. Association between Muslim population, legal status, political system, geography, income category, human development index, and suicide rates in Asian countries: An ecological analysis.
期刊: Asian journal of psychiatry 发表日期: 2026-Jan-02 链接: PubMed
摘要
25. Zebrafish sperm toxicity tests: An emerging in vitro and in vivo model for male reproductive toxicity.
期刊: Journal of hazardous materials 发表日期: 2026-Jan-02 链接: PubMed
摘要
Male reproductive toxicity tests are a standard component of toxicological research, regulatory and safety assessment during drug development and environmental biomonitoring. Zebrafish (Danio rerio) has emerged as a valuable model for studying male reproductive toxicity, particularly through sperm toxicity tests. Thus, this review systematically analyzed the scientific literature concerning the Zebrafish Sperm Toxicity test (ZST), focusing on the effects of environmental chemicals on sperm quality and reproductive health. Results showed that over 80 chemicals have been studied for their adverse effects on zebrafish sperm, including synthetic estrogens, metals, pesticides, and antibiotics. Several endocrine disruptors, such as bisphenol A (BPA) and tributyltin (TBT), impairing sperm count, motility, and morphology by disrupting hormonal regulation and inducing oxidative stress. Methodological approaches were discussed, including sperm collection techniques and storage media, which are critical for experimental reproducibility. Exposure times vary widely, with chronic and long-term exposures being more common in in vivo studies, while in vitro studies typically involve shorter exposure periods. The most frequently adverse effects on zebrafish sperm were reduced sperm count, volume or density, motility, DNA and membrane integrity, and morphological alterations, with endocrine disruption being a primary mechanism of action and toxicity. The review underscores the need for standardized protocols and further research on emerging pollutants, transgenerational effects, and the development of advanced in vitro models to reduce reliance on in vivo experiments. Overall, the zebrafish sperm toxicity test is a suitable tool for assessing the impact of environmental contaminants on reproductive health, helping to protect human and environmental health.
26. Evaluation of residual virulence and protective efficacy for Brucella melitensis vaccine strain M5-90 in mice and guinea pigs.
期刊: Veterinary microbiology 发表日期: 2026-Jan-02 链接: PubMed
摘要
Brucellosis, a globally significant zoonosis caused by Brucella species, leads to severe reproductive complications including abortion and infertility in animals and humans. Vaccination remains a cornerstone strategy for the control of brucellosis transmission. The Brucella melitensis vaccine strain M5‑90 was developed in China during the 1970s-1980s by attenuation from virulent M28 strain. This study systematically evaluated the safety and protective efficacy of M5‑90 in mouse and guinea pigs models. Results indicated that M5‑90 was completely cleared from mice within 15 weeks after subcutaneous inoculation of 10⁸ CFU, exhibiting a 50 % recovery time (RT50) of 9.27 ± 1.26 weeks. Bacterial replication was not dose-dependent. The bacterial burden in M5‑90-infected mice reduced by 1-3 log10 compared with the virulent M28 group at a challenge dose of 10⁶ CFU (P < 0.05). Immunization with 10⁵ CFU conferred significant protection against virulent B. melitensis M28 and B. abortus 544 challenges at 45 and 150 days post-vaccination, respectively (P < 0.05 or P < 0.01). In guinea pigs, the splenic bacterial load of M5‑90 was markedly lower than that in the M28 group (2440 ± 240 vs. 223,000 ± 3800 CFU/g; P < 0.001). A dose of 3 × 10⁸ CFU of M5‑90 provided complete (100 %) and strong (90 %) protection against M28 and 544 challenges, respectively. In summary, Brucella melitensis vaccine strain M5‑90 demonstrates favorable safety and protective efficacy in mice and guinea pigs, supporting its potential as a promising vaccine for brucellosis control.
27. Evaluation of spatial distribution of cancer risk induced by traffic-related ultrafine particles within an urban microenvironment in New Taipei City, Taiwan.
期刊: Journal of hazardous materials 发表日期: 2026-Jan-02 链接: PubMed
摘要
Ultrafine particles (UFPs) pose substantial health risks due to their deep lung penetration and high surface area, yet their spatial distribution and associated cancer risks in urban microenvironments remain poorly quantified. This study applied microscale computational fluid dynamics (CFD) simulations (1.2 × 1.2 km2 domain with about 5 m horizontal resolution near the ground) coupled with a size-resolved convection-diffusion model for 20-100 nm particles to quantify UFP dispersion and excess lifetime cancer risk (ELCR) under seasonal wind regimes. Emissions from four traffic line-source categories (urban roads, elevated expressways, interchanges, and freeways) were simulated under seasonal wind regimes and peak/off-peak traffic to produce spatial maps of lung-deposited surface area (SAUFP) and ELCR. Ground-level urban roads create narrow near-road bands with SAUFP maxima of about 40 μm2/cm3, while elevated corridors generate broader plumes with lower near-ground intensity that still form distinct downwind hotspots. Domain-averaged SAUFP during peak hours ranges from roughly 15 μm2/cm3 in winter to 31 μm2/cm3 in summer. Peak adult ELCR reaches about 2.2 × 10-4 in winter and 3.0 × 10-4 in summer, and 9-year-old children experience the highest risks, up to about 6.5 × 10-4, due to higher inhalation doses and lung deposition efficiencies. Many near-road and intersection locations harbor a high risk of exposure. The source-resolved, size-aware CFD-ELCR framework reveals strong spatial heterogeneity and age-dependent vulnerability that cannot be captured by sparse fixed-site monitoring alone, and it provides a transferable tool to identify traffic-related UFP risk hotspots and support targeted mitigation in dense urban microenvironments.
28. Association between subway iron particulate matter exposure and respiratory disease in New York City.
期刊: PLOS global public health 发表日期: 2026 链接: PubMed
摘要
Particulate matter exposure is linked to increased morbidity and mortality. Iron-rich particulate matter (PM2.5), common in rapid transit systems, is a potential but understudied contributor to respiratory illness. Using electronic health records (EHR) from 452,272 patients in the INSIGHT Clinical Research Network in New York City (2020-2023), we examined whether local iron exposure is associated with asthma, chronic obstructive pulmonary disease (COPD), breathing difficulties, or respiratory inhaler use. Iron exposure was estimated using particulate matter measurements from New York City (NYC) subway stations, linked to each patients residential census block group. To account for potential non-linear relationships, we applied linear probability models and an adjacent block group estimator with paired fixed effects to assess respiratory outcomes across deciles of iron exposure. We found that the relative risk of developing asthma, COPD, or breathing difficulties increased by 6-15% between the lowest two exposure deciles. Beyond this range, there was no significant association between iron exposure and respiratory disease. This suggests that iron exposure from rapid transit is associated with respiratory disease primarily at lower exposure levels, with limited health benefits from marginal reductions in iron exposure at already high exposure levels.
29. Identifying subgroups with differential levels of service response to a digital screening and service navigation program for unmet social care needs.
期刊: PloS one 发表日期: 2026 链接: PubMed
摘要
Digital screening and navigation interventions are increasingly integrated into health systems to identify and support families’ unmet social care needs, yet their effectiveness in improving outcomes remains unclear among priority population communities. We hypothesise that responses to such digital interventions might vary based on sociodemographic and psychosocial characteristics. Data were analysed from 288 participants in a randomised controlled trial evaluating Watch Me Grow-Electronic - a digital screening and service navigation model to identify psychosocial needs, parental wellbeing, and child developmental needs in South Western Sydney (urban site) and Murrumbidgee (regional/rural site), New South Wales, Australia. Latent class analysis was used to identify subgroups of families based on parental and child clinical and sociodemographic factors. A zero-inflated negative binomial regression was conducted to assess changes in unmet needs, stratified by class and intervention group. Three distinct classes were identified. Class 1 (n = 134) included people who were entirely non-culturally and linguistically diverse (CALD) background, in good mental health, with higher education and socioeconomic status (SES), and from the regional/rural site. Class 2 (n = 94) included people who were predominantly non-CALD, of low education and SES, had poor mental health, and from the regional/rural site. Class 3 (n = 56) included people of CALD, high SES and education, and good mental health, who were from the urban site. Compared to the Class 3, participants in Class 2 showed significantly higher needs, indicating that the intervention was not effective in this vulnerable group. Digital navigation tools might support families that experience lower psychosocial adversity but are insufficient for families that experience higher levels of adversity, highlighting the need for tiered approaches to ensure equity.
30. Linking physiological state to movement dynamics in an open ocean predator, the blue shark (Prionace glauca).
期刊: PloS one 发表日期: 2026 链接: PubMed
摘要
The movement behavior of open ocean fishes is challenged by metabolic demands resulting from sustained swimming and the availability of resources in a dynamic, ephemeral environment. Advances in electronic tagging and tracking technologies have permitted unprecedented opportunities to describe the movements of open ocean fishes in these environments, however, our understanding of the mechanistic drivers of individual variation in movement performance is limited. In this study, we tested the hypothesis that movement capacities of open ocean sharks would be related to physiology and body condition. We measured the physiological status (e.g., energy stores and body condition) of blue sharks (Prionace glauca) captured in the open ocean, and then tracked their movements over 45 days. We then explored for relationships between physiological metrics and individual differences in metrics of movement behavior (distance traveled, activity space, behavioral state, and tortuosity) of the tracked blue sharks. Analyses detected consistent positive relationships between individual plasma triglyceride concentrations and body condition (sampled at time of capture) on distance traveled, activity space, behavioral state, and tortuosity - up to 45 days post tagging, with models explaining up to 79% of individual variation in movement. These findings highlight the potential role of metabolic lipid reserves in shaping movement behavior of open ocean, predatory sharks in patchy, ephemeral environments. More broadly, they offer new insight into the factors which may influence individual variation in the timing and scale of movement in oceanic fishes.
31. Molecular Variations in Glycoprotein B of Asian Human Cytomegalovirus: Potential Impact on Virus Entry and Immune Evasion in Ocular Diseases.
期刊: Journal of medical virology 发表日期: 2026-Jan 链接: PubMed
摘要
Human cytomegalovirus (HCMV)-associated ocular diseases have gained increasing attention due to a recent rise in cases diagnosed in Asia. A glycoprotein encoded by the virus UL55 gene, glycoprotein B (gB), is essential for viral entry and a primary target for naturally-produced antibodies and vaccine development. gB is classified into five genotypes (gB1-gB5) based on polymorphisms surrounding the furin cleavage site. This study analyzed the UL55 gene in 62 blood and ocular specimens of Japanese patients with CMV viremia and CMV-associated ocular diseases. Distinct gB genotype distributions were found between sample types (p = 0.008): gB2 was the most prevalent genotype in blood samples (41%, 11/27), while gB3 (43%, 15/35) and gB1 (37%, 13/35) predominated in ocular fluids. Viral loads were significantly higher in gB1 and gB3-positive samples compared with gB2 (p = 0.016). A shared gB1/gB3-specific peptide (aa 190-204; SRVIAGTVFVAYHRD), distinct from that of gB2, exhibited reduced HLA class II binding. In addition, a K518R substitution was identified in 80% of gB1 and gB3 variants in our cohort and other Asian-derived GenBank entries, but only 3% of European origin strains. This substitution was significantly enriched in ocular fluids from patients with CMV ocular infection (71%, 17/24), compared with blood from patients with CMV viremia (32%, 8/25) (p = 0.01). The predicted structural modeling infers that this substitution is located in the core of gB Domain III, and potentially increase the local molecular stability in this region. Evolutionary analyses indicated positive selective pressure at this site, implying the biological significance. These findings infer that genetic variations enriched in ocular fluids and Asian-derived HCMV strains, may contribute to ocular pathogenesis through influencing on viral entry and reduced immune recognition.
32. Predictive Value of Serum Autotaxin for Hepatocellular Carcinoma Recurrence After Curative Radiofrequency Ablation.
期刊: Cancer medicine 发表日期: 2026-Jan 链接: PubMed
摘要
Despite recent treatment advancements, the high recurrence rate of hepatocellular carcinoma (HCC) following curative therapy remains a significant challenge. Autotaxin (ATX) is a key biomarker in chronic liver disease that has a yet unclarified role in predicting HCC recurrence. This study examined whether precurative radiofrequency ablation (RFA) serum ATX level could serve as a predictor of HCC recurrence after treatment. Fifty-six HCC patients (37 [66%] male; median age: 74 years) treated by curative RFA were retrospectively analyzed. Twenty-one patients experienced HCC recurrence during follow-up. ATX demonstrated superior predictive performance for HCC recurrence after RFA, with an area under the receiver operating characteristic curve of 0.729, sensitivity of 0.857, and specificity of 0.629. Kaplan-Meier analysis revealed that patients with high ATX had a significantly higher incidence of HCC recurrence than those with low ATX (p = 0.0006). In univariate analysis, the significant predictors of HCC recurrence included ATX (≥ 1.323 mg/L; hazard ratio [HR]: 6.49; 95% confidence interval [CI]: 1.90-22.13; p = 0.003), fibrosis-4 index (≥ 3.524; HR: 2.75; 95% CI: 1.00-7.55; p = 0.050), and mac-2 binding protein glycosylation isomer (≥ 3.85; HR: 2.12; 95% CI: 1.08-4.19; p = 0.030). According to multivariate Cox proportional hazards analysis with seven different models adjusting for age and various established biomarkers, ATX consistently emerged as the only significant independent predictor of HCC recurrence, with HR values ranging from 6.38 to 10.50 (all p < 0.05). Serum ATX is a promising biomarker for predicting HCC recurrence post-RFA treatment that may outperform conventional markers.
33. Effectiveness of an Exploratory Pragmatic Universal School-Based Resilience Intervention in Improving Adolescent Physical Activity and Fruit and Vegetable Consumption.
期刊: Health promotion journal of Australia : official journal of Australian Association of Health Promotion Professionals 发表日期: 2026-Jan 链接: PubMed
摘要
School resilience focused programs have been identified as a possible method of improving health behaviours; however, few trials have been conducted to determine the effect of such comprehensive programs on adolescent physical activity and healthy eating practices. The aim of this trial was to determine the effect of a school-based resilience intervention on student physical activity levels and fruit and vegetable consumption. A three-year exploratory cluster-randomised controlled trial of students in Australian secondary schools was conducted to determine the effectiveness of a pragmatic universal intervention targeting a range of student resilience protective factors grouped according to the Health Promoting Schools framework, in improving student physical activity and fruit and vegetable consumption. Data regarding physical activity, fruit and vegetable consumption, and resilience protective factors was collected. No significant differences were found at follow-up between intervention and control students for any health risk physical activity: mean difference (MD) -40.7, 95% confidence interval (CI) -94.3,13.0, p = 0.14; fruit serves: MD 0.01, 95% CI -0.20, 0.22, p = 0.95; vegetable serves: MD -0.07, 95% CI -0.24, 0.11, p = 0.44; or resilience protective factor outcomes (individual: MD -0.01, 95% CI -0.07, 0.06, p = 0.87; environmental: MD -0.02, 95% CI -0.09, 0.06, p = 0.67). This resilience intervention was not effective in improving the physical activity, fruit and vegetable consumption, or resilience protective factors of students. SO WHAT?: Further research is warranted to determine the specific resilience protective factors that may be most effective for these outcomes, given the significant policy and practice potential this approach has. Trial Rregistration: ACTRN12611000606987.
34. Acceptance of Lung Cancer Screening and Associated Factors in Hong Kong: A Population-Based Study.
期刊: Cancer medicine 发表日期: 2026-Jan 链接: PubMed
摘要
Low-dose computed tomography (LDCT) enables early detection of lung cancer and reduces mortality, yet public willingness to undergo screening remains suboptimal. This study aimed to assess willingness and its associated factors among high-risk individuals in Hong Kong. A territory-wide cross-sectional survey was conducted among adults aged 54 years or above, and those aged 45-54 years with at least one lung cancer risk factor (e.g., smoking, secondhand smoke exposure, or family history) in Hong Kong. Data were collected via self-administered questionnaires, which included socio-demographic information, risk exposure, awareness and experience of LDCT, and constructs from the Health Belief Model (HBM). Logistic regression was performed to identify factors associated with willingness to undergo LDCT screening. A total of 1100 participants were included in the analysis. Among them, 57.3% expressed willingness to undergo LDCT within the next year. Multivariable logistic regression showed that higher self-efficacy was the strongest factor of willingness, followed by greater perceived benefits and stronger cues to. Additional significant factors included being a current or former smoker, secondhand smoke exposure, age > 65 years, and being responsible for cooking at home. In contrast, unmarried individuals were significantly less likely to be willing to undergo LDCT (aOR = 0.678; 95% CI: 0.486-0.946; p = 0.022). Willingness to undergo LDCT screening was suboptimal among high-risk individuals in Hong Kong. Key facilitators included higher self-efficacy, perceived benefits, and cues to action-central domains of the Health Belief Model. Targeted strategies that strengthen these domains may improve screening uptake.
35. The Personal and Social Determinants with Men's Age During Their First Transition to Fatherhood: A Case Study From Mashhad, Iran.
期刊: American journal of men’s health 发表日期: 2026 链接: PubMed
摘要
Deciding when to become a father for the first time is shaped by personal and social factors, yet little is known about the determinants of men’s age at first childbearing. This study examines the key personal and social predictors with men’s age during their first transition to fatherhood. This descriptive-analytical, cross-sectional study examined 290 men who, with their wife’s first pregnancy, were referred to health centers in Mashhad, Iran for pregnancy care in 2023. Cluster sampling was used. The data-collection tools included the Enrich Marital Satisfaction questionnaire, the Quality of Life questionnaire, the Multidimensional Scale of Perceived Social Support, the Snyder Hope Scale, and demographic characteristics. The outcome variable of interest is the age of the men. Data analysis was done using univariate and multiple linear regression models in SPSS 26, with statistical significance set at p < .05. A total of 290 men who became fathers for the first time participated in the study, with a mean age of 29.73 years and a standard deviation of 6.28 years. Among the variables included in the multiple linear regression analysis, the indicators of marital satisfaction (p = .001), marriage span (p = .001), occupation levels (p < .05), some economic status levels (p < .05), and the person who decides the number of children (p = .008) had a significant effect on men during their first transition to fatherhood. The duration of marriage, marital satisfaction, and economic factors are determinants during men’s first transition to fatherhood. Governments and policymakers should include men in education and fertility planning by providing them with appropriate solutions.
36. Fate, bioaccumulation, and toxic responses of PFOA, PFOS, and GenX in the paddy soil-rice system across the full growth cycle.
期刊: Journal of hazardous materials 发表日期: 2026-Jan-01 链接: PubMed
摘要
Per- and polyfluoroalkyl substances (PFAS) are persistent organic pollutants with exceptional stability and significant ecological risk. However, their distribution and accumulation in soil-crop systems, especially for the replacement compound GenX, remain poorly characterized. Here, rice (Oryza sativa, Nipponbare) was cultivated for five months in paddy soils amended with PFOA, PFOS, and GenX to map fate, bioaccumulation, and toxic responses across the soil-crop system and to derive soil safety thresholds protective of human health. PFAS exposure (10-100 μg/g) altered plant morphology and development and induced dose-linear oxidative stress (SOD, POD, CAT, MDA, H2O2, protein). Compound-specific translocation emerged: short-chain GenX showed greater upward transport and endosperm accumulation, whereas long-chain PFOA/PFOS were more root-retained (endosperm accumulation in total plant: PFOA 8.973-10.440 %, PFOS 9.951-12.800 %, GenX 10.286-20.773 %). Overall toxic potency ranked PFOA ≥ PFOS > GenX. Based on measured plant uptake, we propose provisional exposure safety thresholds for rice cultivation of 3.157 ng/g (PFOA), 2.327 ng/g (PFOS), and 21.220 ng/g (GenX). This growth-cycle assessment provides an integrated evidence base for PFAS ecological risk evaluation and delivers actionable guidance to safeguard food security.
37. Etiological factors of the risk for occupational illness in nursing professionals: An etiology and risk review protocol.
期刊: PloS one 发表日期: 2026 链接: PubMed
摘要
Nursing professionals are inherently exposed to various risk factors, which may be exacerbated depending on the conditions under which care is provided. For instance, many healthcare institutions are considered hazardous environments for admitting patients with diverse diseases and performing procedures that carry potential risks of accidents and occupational diseases with them. To identify the etiological factors associated with the Risk for Occupational Illness Nursing diagnosis in Nursing professionals. An Etiology and Risk Review Protocol was developed following the guidelines outlined in the JBI Manual for Evidence Synthesis and registered in the International Prospective Register of Systematic Reviews under number CRD42024549181. The findings of this review will be publicly disseminated through scientific journals in health sciences, contributing to enhancing the evidence base corresponding to the Risk for Occupational Illness Nursing diagnosis. This will support its inclusion in future NANDA International editions, ensuring that the diagnosis remains current and aligned with the latest scientific literature. It is anticipated that the review will generate evidence addressing stages 3, 4, 7, and 8 of the concept analysis for the Risk for Occupational Illness diagnosis, specifically: Identifying possible uses of the concept; Determining critical defining attributes; Identifying antecedents and consequences; and Defining empirical referents. Occupational stress; Occupational diseases; Etiology; Nursing diagnosis; Nursing professionals.
38. Use of a Tracheal Tube, Flexible Bronchoscope, and a Supraglottic Airway to Remove Foreign Bodies: A Case Report.
期刊: A&A practice 发表日期: 2026-Jan-01 链接: PubMed
摘要
When removing an airway foreign body using a flexible bronchoscope through a supraglottic airway device, the foreign body must be passed through the glottis. However, passing the foreign body through the glottis may be difficult because of a relatively narrow glottic opening. We report 2 cases in which a tracheal tube was used to assist bronchoscopic removal of the foreign body when passage through the glottis was difficult. Both foreign bodies were successfully removed without complications. Our method prevented the foreign bodies from being dropped or crushed and was useful as an adjunct to bronchoscopic removal with supraglottic airway devices.
39. Community-Based Interventions Improve the Quality of Life for Children Living With Disabilities, Zambia.
期刊: Child: care, health and development 发表日期: 2026-Jan 链接: PubMed
摘要
Children living with disabilities in Zambia face many barriers to quality of life. This study evaluated any participation in activities, the number of activities and which activities of a community-based intervention impacted quality of life among children living with disabilities and their families. We used a pre-post evaluation design for 228 families with a child living with disabilities who participated from 2019 to 2021 in Kusamala+, a multifaceted community-based intervention. Participation in five activities (home visits by community caregivers, play therapy, church talks, physiotherapy and registration with the Zambian Association of Persons with Disabilities) (that provided cash transfers for families) was associated with change in the three Beach Center Family Quality of Life domains of emotional, physical and disability-related quality of life. Analysis included descriptive statistics, calculating change in quality of life over time and multinomial linear regression that compared any versus no participation, the number of events and which event was most associated with quality of life change. All three domains increased, with a statistically significant change in physical and disability-related quality of life. Nearly all families participated in at least one activity. The most common activity was the community caregiver home visits (87%), followed by assessment by the Zambian Association of Persons with Disability (68%), physiotherapy (49%), play therapy (41%) and church talks (20%). Regression models indicated that physiotherapy was an important predictor of positive change in all three domains, community caregiver visits and play groups were key for emotional quality of life improvement, and Zambian Association of Persons with Disability registration was important for improvement in physical and disability-related domains. Play groups were also associated with positive change for disability-related quality of life. Community-based interventions that reduce barriers to access and increase social support and physical well-being are key to improving the quality of life for CLWD and their families in low-resource settings.
40. BeeMSAI: A multi-dimensional evaluation strategy for honeybee toxicity in agrochemicals integrating mode of action, structural analysis, and AI-powered prediction.
期刊: Journal of hazardous materials 发表日期: 2025-Dec-31 链接: PubMed
摘要
Honeybees (Apis mellifera) play a crucial role in crop pollination; however, their population is decreasing owing to pesticide exposure. Understanding the mechanisms underlying pesticide toxicity and accurately predicting toxicity to honeybees are essential for developing sustainable agrochemicals and effective ecological risk management strategies. Herein, we developed a multi-dimensional evaluation strategy combining mode of action (MOA), structural analysis, and artificial intelligence (AI)-powered prediction (BeeMSAI) to analyze the toxicity of pesticides to honeybees. First, an MOA-based classification system was established for pesticides, which were divided into 46 MOAs and 9 physiological systems. Second, toxicity classification rules were established for six high-variability structural groups. Six representative structures with a toxicity probability of > 97.8 % were identified through fragment analysis. Third, a series of ternary classification AI models for predicting pesticide toxicity to honeybees was developed through multi-feature fusion. The support vector machine model showed robust predictive performance with an overall accuracy of 81.82 %, with the accuracy for neonicotinoids and new pesticides being 84.21 % and 80.77 %, respectively. Furthermore, an online user-friendly platform was developed to assess agrochemical risks, achieving a recall level approximately 35 % higher than that of existing online platforms. Overall, this study introduces a multi-dimensional strategy for assessing pesticide toxicity to honeybees, providing insights for developing ecologically safe agrochemicals.
41. Beyond macrophages: FIPV tropism includes T and B lymphocytes.
期刊: Veterinary microbiology 发表日期: 2025-Dec-31 链接: PubMed
摘要
If untreated, feline infectious peritonitis (FIP) is a fatal disease that is caused by feline infectious peritonitis virus (FIPV), a virulent biotype of feline coronavirus (FCoV) that disseminates broadly and triggers severe systemic inflammation. While the prevailing model holds that FIPV selectively infects monocytes/macrophages, the full range of susceptible cell types and the mechanisms of immune cell invasion remain poorly defined. Here, we applied single-cell RNA sequencing, multiplex immunofluorescence, and in situ hybridization to mesenteric lymph node aspirates and formalin fixed and paraffin embedded lymph node tissues from cats with naturally occurring effusive FIP. We identified FIPV RNA and nucleocapsid protein in T and B lymphocytes and myeloid cells, and subgenomic viral RNA in T cells, demonstrating cell entry and viral genomic replication across multiple immune compartments. Rare FIPV RNA-positive lymphocytes persisted after antiviral treatment cessation and resolution of clinical signs. These findings revise current models of FIPV pathogenesis and reveal new insights into coronavirus-driven immune dysregulation, viral persistence, and relapse. Our study highlights the utility of FIP as a naturally occurring animal model for exploring adaptive immune cell infection in coronavirus diseases, providing a translational platform for understanding virus-host interactions that drive chronic or relapsing immunopathology.
42. NSP9 is a key virulence determinant in highly pathogenic PRRSV-mediated thymic injury via synergistic activation of apoptotic and metabolic pathways.
期刊: Veterinary microbiology 发表日期: 2025-Dec-31 链接: PubMed
摘要
Highly pathogenic porcine reproductive and respiratory syndrome virus (HP-PRRSV) induces severe thymic atrophy, contributing to immunosuppression in infected piglets. This study investigated the roles of viral nonstructural proteins NSP9 and NSP10 in thymic pathogenesis using chimeric viruses (HC9 and HC10) generated by replacing NSP9/NSP10 of the HP-PRRSV HuN4 strain with those from the classical CH-1a strain. In vitro replication was significantly affected by these swaps, with NSP9 showing a more pronounced effect. In vivo replication kinetics, pathogenicity, and thymus damage were analyzed in piglets inoculated with the HuN4 strain or the chimeric strains. The study found that NSP9 and NSP10 are closely associated with PRRSV replication efficiency and pathogenicity, with NSP9 having a greater impact on thymus atrophy and both NSP9 and NSP10 playing a key role in inducing thymocytes apoptosis. Transcriptomic analysis revealed that HuN4 infection significantly upregulated genes associated with apoptosis, inflammatory responses, and metabolic pathways (e.g., NF-κB, PI3K-Akt, and p53 signaling), while HC9 showed attenuated effects. Flow cytometry confirmed HuN4-induced depletion of CD4+CD8+ thymocytes and dysregulated surface marker expression (CD4). TUNEL assays and apoptosis-related gene profiling further implicated NSP9 in activating both intrinsic and extrinsic apoptotic pathways. Notably, metabolic pathway enrichment suggested crosstalk between apoptosis and energy sensing (e.g., AMPK-mTOR). These findings highlight NSP9 as a critical virulence factor driving thymic atrophy through synergistic immune hyperactivation, apoptotic cascades, and metabolic reprogramming, providing novel insights for PRRSV vaccine design and immunomodulatory strategies.
43. Risk Factors for Suicide Attempts and Psychiatric Hospitalization Among Brazilian Health Care Professionals.
期刊: The Journal of clinical psychiatry 发表日期: 2025-Dec-31 链接: PubMed
摘要
Background: Health care professionals face elevated suicide risk, yet longitudinal studies during occupational crises are lacking. We investigated factors associated with suicide attempts and psychiatric hospitalizations in health care workers seeking emotional support during COVID-19. Methods: We prospectively evaluated 3,087 Brazilian health care professionals enrolled in a digital mental health trial (May-July 2020). Participants were recruited nationwide from May 2020 to December 2021. From this cohort, 2,815 with complete baseline data comprised the intention-to-treat (ITT) sample. Outcomes were assessed at 4, 12, and 24 weeks. Baseline predictors included demographics, Patient Health Questionnaire-9 item 9 (suicidal ideation), Patient-Reported Outcomes Measurement Information System T-scores (depression, anxiety, irritability, sleep), life satisfaction, and burnout. Cox models examined associations; inverse probability weighting addressed attrition. Additive interaction was quantified using relative excess risk due to interaction (RERI). Results: In the total sample, 53 participants (1.59%) attempted suicide. In the ITT sample (86% female, mean age 36.5), 46 (1.63%) attempted suicide (64 events), and 60 (2.22%) required psychiatric hospitalization. Nearly every day ideation (hazard ratio [HR]=39.58, 95% CI, 14.03-111.64, P<.001), severe sleep disturbances (HR=17.39, 95% CI, 2.05-147.46, P=.009), and male sex (HR=2.08, 95% CI, 1.01-4.26, P=.046) independently predicted attempts. The 24-week attempt probability reached 57.1% for individuals with both ideation and sleep problems versus 1.2% with neither, with 40% of the combined risk attributable to synergistic interaction (RERI=11.51). Notably, 28.3% of attempts occurred among individuals denying baseline ideation. For hospitalizations, only nearly every day ideation remained significant (HR=8.11, 95% CI, 3.10-21.18, P<.001). Results remained robust after weighting. Conclusions: Daily suicidal ideation and severe sleep disturbances synergistically elevate suicide risk among health care professionals. Findings support a comprehensive assessment incorporating sleep disturbances and multicomponent interventions targeting both domains simultaneously. Trial Registration: ClinicalTrials.gov identifiers: NCT04635618, NCT04632082.
44. A Ratiometric fluorescent Nanoprobe LRH/CDs/MOF for the detection of Cu(II) and Anthrax biomarker.
期刊: Spectrochimica acta. Part A, Molecular and biomolecular spectroscopy 发表日期: 2025-Dec-30 链接: PubMed
摘要
2,6-Pyridinedicarboxylic acid (DPA), an anthrax biomarker, and excess copper ions (Cu2+) pose significant health risks, necessitating effective detection methods. This work presents a novel dual-emission ratiometric “on-off” fluorescent nanoprobe, LEuH@Cu-CDs@UiO-66, for sensing DPA and Cu2+. It was synthesized by intercalating LEuH and encapsulating copper-doped carbon dots (Cu-CDs) into a zirconium-based UiO-66 framework. The composite maintained the excellent optical properties of its components and exhibited good aqueous stability. Upon 275 nm excitation, it showed three distinct emission peaks at 390 nm (from Cu-CDs), 593 nm, and 617 nm (both from Eu3+). Introducing DPA significantly enhanced the Eu3+ emission peaks at 593 nm and 617 nm via an energy ligand sensitization mechanism, while the Cu-CDs peak at 390 nm remained stable. This allowed for ratiometric detection, with the intensity ratios (F617/F390 and F593/F390) increasing linearly with DPA concentration (0-50 μM), achieving a low detection limit of 31.89 nM. Conversely, adding Cu2+ to the system containing DPA progressively quenched the Eu3+ emission, causing the same intensity ratios to decrease linearly across a wide Cu2+ concentration range (0-1000 μM), facilitating a sensitive “off” response. The material was successfully applied to detect DPA in environmental water samples, demonstrating its practical potential as a versatile “on-off” ratiometric fluorescent nanoprobe for the simultaneous detection of DPA and Cu2+.
45. Microplastic-affected pathogens in drinking water supply systems: Survival mechanisms, ecological impacts and control challenges.
期刊: Water research 发表日期: 2025-Dec-30 链接: PubMed
摘要
Microplastics (MPs), as emerging pollutants, can affect pathogens, primarily opportunistic pathogens (OPs), and influence their behavior in aquatic environments. However, evidences regarding their impacts in drinking water supply systems (DWSSs) remain scarce. Focusing on the safety of DWSSs, this review synthesizes how MPs affect pathogen proliferation, transport, and resistance development under typical DWSS conditions characterized by low nutrients, high flow rates, oxidative stress, and user demand. MPs can distinctly promote the growth and reproduction of pathogens, act as mobile carriers enabling cross-watershed transport, and facilitate direct migration from source water to humans, thereby increasing health risks. Furthermore, MPs enhance pathogen resistance at both individual and community levels, thereby complicating subsequent control efforts. This study further summarizes how MPs compromise existing pathogen control measures in DWSSs and introduce secondary risks, including MP additives and the disinfection by-products from MPs. Finally, a strategy integrating “pretreatment interception” and “secondary risk reduction” is proposed to control MP-affected pathogens in DWSSs. The review provides valuable insights into mitigating pathogen risks associated with MPs in DWSSs, addressing a significant knowledge gap in safeguarding water security.
46. Gut microbiota composition and derived enterotypes are associated with ponderal status in preschool children. Childhood obesity risk assessment longitudinal study (CORALS) cohort.
期刊: Clinical nutrition (Edinburgh, Scotland) 发表日期: 2025-Dec-29 链接: PubMed
摘要
Childhood obesity is a growing public health concern increasingly linked to gut microbiota. We analysed associations between microbiota composition, functionality, and weight status in 1134 children aged 3-6 years from the CORALS cohort. The baseline cross-sectional study stratified participants by weight status (underweight, normal weight, overweight, obesity) and performed shotgun metagenomic sequencing of stool samples. Analyses in R assessed alpha/beta diversity, taxonomic composition, enterotypes, and microbial pathways. Alpha diversity decreased with increasing BMI, particularly in obesity (Shannon adj.P = 0.00301; Simpson adj.P = 0.00158). Beta diversity revealed distinct microbial structures across groups (p = 0.001). Four enterotypes were identified: obesity was associated with Enterotype 3 (Segatella-dominated, p = 0.023), while Enterotype 1 (Alistipes, Akkermansia, Coprococcus) was enriched in underweight/normal weight. Species linked to obesity included higher Phocaeicola dorei (adj.P = 0.003) and Segatella hominis (adj.P = 0.001), and lower Longicatena caecimuris (adj.P = 0.03) and Blautia parvula (adj.P = 0.003). Functional analyses showed downregulation of vitamin and nucleotide biosynthesis pathways and reduced carbohydrate metabolism in overweight/obesity. Gut microbiota composition and functionality are strongly associated with weight status in early childhood, suggesting microbial biomarkers and metabolic pathways relevant to understand early obesity development. gov ID NCT06317883.
47. A reverse J-shaped association between carbohydrate intake and mortality among populations with high carbohydrate diets.
期刊: Clinical nutrition (Edinburgh, Scotland) 发表日期: 2025-Dec-17 链接: PubMed
摘要
Limited evidence exists on the associations of carbohydrate intake, both in quantity and quality, with mortality in high-carbohydrate populations, particularly in relation to the type of fat replacing carbohydrates. We investigated these associations in relation to all-cause, cancer-specific, and cardiovascular disease (CVD) mortality in a large Korean cohort. A total of 113,043 participants aged 40-69 years were included from the Health Examinees-Gem (HEXA-G) cohort of the Korean Genome and Epidemiology Study (KoGES). Dietary intake was assessed using a validated food frequency questionnaire (FFQ). Cox proportional hazards regression models were used to estimate hazard ratios (HRs) and 95 % confidence intervals (CIs) for all-cause, cancer-specific, and CVD mortality. During a mean follow-up of 9.2 years, 2,009 deaths were documented, including 1035 from cancer and 304 from CVD. When considering isocaloric substitution of fat with carbohydrates, a reverse J-shaped association was observed between carbohydrate intake and mortality from all causes and CVD. Compared with 55-<65 % of energy from carbohydrates, the HRs (95 % CIs) for all-cause mortality were 1.50 (1.09-2.06) for <55 %, 0.90 (0.74-1.08) for 65-<70 %, 0.96 (0.78-1.18) for 70-<75 %, 0.96 (0.76-1.21) for 75-<80 %, and 0.94 (0.71-1.24) for ≥80 % (P for trend = 0.16). Similarly, CVD mortality risk was significantly higher among participants with <55 % of energy intake from carbohydrates (HR: 3.04; 95 % CI: 1.44-6.43), compared with those with 55-<65 %. These findings were consistent across fat subtypes when carbohydrates replaced saturated, monounsaturated, or polyunsaturated fatty acids. No significant associations were observed between carbohydrate intake and cancer mortality. Regarding carbohydrate quality, no clear associations were found between dietary glycemic index or glycemic load and all-cause, cancer, and CVD mortality. In a population with a predominantly high-carbohydrate diet, replacing fat with <55 % of energy from carbohydrates was suggestive of increased risks of all-cause and CVD mortality, and these associations were consistent regardless of the type of fat replaced.
48. Afrocentric approaches to primary health care provision with Black populations: a scoping review protocol.
期刊: JBI evidence synthesis 发表日期: 2025-Dec-04 链接: PubMed
摘要
This scoping review aims to identify and map how the global literature describes Afrocentric approaches to primary health care provision for Black populations in both clinical and community settings to support culturally responsive care. Most Black populations have roots in Africa, and there are specific sociocultural characteristics unique to African contexts. For Black populations, an Afrocentric approach to health is valuable because it can challenge anti-Black racism and promote health equity. Therefore, the consideration or acknowledgment of these unique aspects is vital for Black populations. Global literature on Afrocentric approaches to primary health care provision with Black populations will be included. To provide context for this review, we are using our evolving definition of Afrocentric approaches to primary health care provision as follows: culturally meaningful patient engagement processes, clinical practices, and procedures that are grounded in the values, worldviews, and lived experiences of Black peoples of African descent. We will include approaches used for all Black populations. This review will be conducted using the JBI scoping review methodology. We will search 6 academic electronic databases and include qualitative, quantitative, and mixed methods study designs, with no date limitations. The grey literature search will include opinion, policy, and practice documents from specific health organization websites. Two reviewers will independently complete the title and abstract screening, followed by full-text review and data extraction. Articles published in English will be included, with other languages included if English translations are available. English translations will be requested from journal authors. OSF https://osf.io/e2vxq.
49. Biomarkers.
期刊: Alzheimer’s & dementia : the journal of the Alzheimer’s Association 发表日期: 2025-Dec 链接: PubMed
摘要
Cardiovascular risk factors, such diabetes, hypertension, blood pressure, obesity, and smoking, are linked with allostatic-interoception - the continuous monitoring of internal bodily states in anticipation of environmental demands. These risk factors are associated with dementia risk. How these factors affect brain networks vulnerable to neurodegeneration and involved in allostatic-interoception, such as the Allostatic-Interoceptive Network (AIN), is unknown. We investigated the relationship between cardiovascular risk and AIN structure and function in frontotemporal lobar degeneration (FTLD) and Alzheimer’s disease (AD). We recruited 1501 participants (304 with FTLD, 512 with AD, and 685 healthy controls) from the Multi-Partner Consortium to Expand Dementia Research in Latin America (ReDLat)(Figure 1). A cardiovascular risk score was calculated based on: age, sex, diabetes, hypertension, systolic blood pressure, body mass index, and smoking status. Cardiovascular risk was associated with gray matter integrity and functional connectivity in age- and sex-matched patient-control groups focusing on predefined regions of interest within the AIN. Higher cardiovascular risk was associated with reduced structural integrity and functional connectivity within the AIN in both FTLD and AD. In FTLD patients, extensive structural (Figure 2) and functional connectivity disruptions (Figure 3) were observed throughout the AIN. In AD patients, structural reductions in the AIN were prominent (Figure 2), with functional connectivity restricted to the hippocampus, parahippocampal gyrus, and orbitofrontal regions (Figure 3). Cardiovascular risk factors appear to adversely impact the AIN structure and function, with disease-specific patterns of vulnerability. Our results underscore the importance of integrating cardiovascular health into models of neurodegenerative disease and managing cardiovascular health to support brain integrity in dementia. Future work is needed to uncover longitudinal effects of cardiovascular risk in dementia and to determine if cardiovascular risk factors exacerbate neurodegenerative processes.
50. Biomarkers.
期刊: Alzheimer’s & dementia : the journal of the Alzheimer’s Association 发表日期: 2025-Dec 链接: PubMed
摘要
Elevated brain iron deposition is recognized as a characteristic of normal aging and neurodegenerative diseases, particularly Alzheimer’s disease (AD), where it correlated with amyloid-β plaques and neurofibrillary tangles. Our study aimed to investigate the relationship between longitudinal changes in hippocampal iron deposition and episodic memory, and how this relationship is impacted by AD pathology and APOE4 allele carriership. We measured longitudinal changes in brain iron levels using quantitative susceptibility mapping (QSM)-MRI (see Figure 1), in a cohort of old adults at risk of AD (N =143, 102 females, 41 males; mean age = 67.7 ± 5.0 years; longitudinal duration = 2.7 ± 0.4 years). Cognition was assessed using the RBANS. Plasma was collected from all participants at a single time point (Time 2, T2) and p-tau181 measured using in-house single-molecule arrays. We examined the relationship between iron accumulation and memory, the mediating effect of plasma p-tau181. We also investigated how APOE4 status moderates the relationship between iron deposition and plasma p-tau181. Hippocampal iron levels demonstrated a significant increase over time (t(142)=2.45, Cohen’s d=0.21, p = 0.016). Changes in iron levels were significantly negatively correlated with memory performance (β=-0.223, p = 0.009, Figure 2A), and positively associated with plasma p-tau181 (β=0.217, p = 0.011, Figure 2B). Plasma p-tau181 were also negatively associated memory (β=-0.207, p = 0.015, Figure 2C). Furthermore, p-tau181 mediated the relationship between hippocampal iron increases and memory performance, accounted for 16.2% of the total association (β = -0.034, p = 0.045, CI: -0.09 to -0.004, Figure 2D). APOE4 status moderated the impact of increased hippocampal iron on plasma p-tau181 levels (β =0.431, p = 0.021, CI: 0.06 to 0.8, Figure 3). These findings underscore the unique effect of hippocampal iron accumulation on cognition, which is additionally impacted by AD pathology. Further, we find a novel association in APOE4 carriers, wherein increases in iron interact with AD pathology, which highlights the need for early detection and intervention strategies tailored to APOE4 carriers. This work deepens our understanding of the interplay among iron dysregulation, tau pathology, and APOE4, offering a promising avenue for precision-based approaches to AD risk assessment and therapeutic development.
51. Prevalence of Sinus Pathology in Dentistry: Retrospective Observational Pilot Study.
期刊: Stomatologija 发表日期: 2025 链接: PubMed
摘要
Changes in the sinus membrane in the form of thickening or opacification often pose challenges in the differential diagnosis between rhinological and odontogenic causes. Due to their clinical similarities, the development of a radiological diagnosis, with Cone Beam Computed Tomography (CBCT) being the technique of choice, will be crucial for achieving an accurate diagnosis. A descriptive retrospective study was designed, comprising a pilot sample of 20 patients from the Faculty of Dentistry, Complutense University of Madrid, who had previously undergone a maxillary cone beam computed tomography (CBCT). The research applies Di Girolamo’s classification to categorize radiological findings and assesses the relationship between sinus pathology and factors such as age, gender, and odontogenic causes. A total of 20 CBCT scans and health surveys from patients (14 males and 6 females), with mean age of 60 ± 8.14years were studied. Some type of sinus pathology was observed in 30 sinuses (75%) and no pathology in 10 sinuses (25%). Regarding potential etiology, dental pathology was the most prevalent (63.6%), followed by implants (18%) and oroantral communications (9%). There is a high incidence of sinus pathology. Sinus pathology is diagnosed more frequently in men and smokers. The most common types of sinus pathology are thickening of the sinus membrane, followed by opacification of the maxillary sinus.
52. A Statewide Approach to Collaboratively Improve Access to Medical Genetics Services in Wisconsin.
期刊: WMJ : official publication of the State Medical Society of Wisconsin 发表日期: 2025 链接: PubMed
摘要
In the absence of a state-led initiative to monitor and address medical genetics issues affecting Wisconsin, a collaborative approach among stakeholders was implemented to identify and address service needs. Surveys and consensus-building tools were employed to identify priority service-access needs and establish strategies to address these needs. Four statewide medical genetics priorities were identified: (1) improved coordination and collaboration, (2) increased funding for the Newborn Screening Program, (3) Medicaid policy changes regarding inpatient genomic testing and reimbursement for outpatient genetic counseling services, and (4) educational opportunities for nongenetic providers to incorporate genomic medicine into practice. Three workgroups were formed and remain active in advanced efforts in these areas. A stakeholder-driven process supported engagement, shared communication, and collaboration within the Wisconsin medical genetics community. Workgroups facilitated measurable progress, including increased newborn screening funding, advancement of administrative rules, expanded educational opportunities, and ongoing policy advocacy. Survey findings underscore the need for improved statewide communication and continued attention to funding and telehealth policy. This initiative demonstrates an efficient and effective approach to advancing statewide collaboration and policy change in medical genetics. Sustained engagement will be critical to ensure equitable access to genetic services across Wisconsin.
53. Hepatitis C in Wisconsin Jails: Barriers to Testing and Treatment During Incarceration.
期刊: WMJ : official publication of the State Medical Society of Wisconsin 发表日期: 2025 链接: PubMed
摘要
Justice-involved individuals are disproportionately affected by hepatitis C virus (HCV) infection. Wisconsin’s viral hepatitis elimination plan prioritizes this population, yet little is known about jail capacity for testing and treatment. A 10-item survey was emailed to administrators of 71 county jails and 1 Tribal detention facility to assess HCV testing and treatment practices and barriers. Responses were analyzed descriptively. Thirty facilities (41.7%) responded. Ten jails (33.3%) offered HCV testing; 15 (51.7%) provided treatment. Common barriers to testing included lack of contracted services (40%) and staffing constraints (23.3%). Barriers to treatment included financial restrictions (66.7%) and short incarceration periods (33.3%). Limited testing and treatment capacity persists despite Medicaid coverage and effective therapies. Partnerships with local health agencies and policy changes addressing cost and contractual limitations are essential to expand HCV services in Wisconsin jails.