公共卫生研究摘要 (2026-01-10)
共收录 57 篇研究文章
1. Towards best practice recommendations: Perspectives from Australian GPs to inform the use of general practice data for research - A modified Delphi study.
期刊: The European journal of general practice 发表日期: 2026-Dec 链接: PubMed
摘要
General practice medical records offer significant potential for secondary use in research, policy and public health. In Australia, these data remain underused due to concerns around privacy, governance and ethical use. Understanding the perspectives of GPs is essential to developing best practice recommendations for responsible data use. A three-round modified Delphi study was conducted with 22 Australian GPs with experience in research and/or data sharing. Participants rated and commented on 11 recommendations derived from community juries, with consensus defined as ≥75% agreement. Feedback summaries and thematic analysis informed subsequent rounds. Consensus was reached on 10 of 11 recommendations. The panel supported ethical approval, transparency, protection of the doctor-patient relationship and remuneration for practices contributing data. An opt-out approach to consent was endorsed under strict conditions, with clear distinctions made between vulnerable and non-vulnerable populations. The panel also supported the establishment of a governance body and researcher cybersecurity training. However, no consensus was reached on community involvement in research design, despite its growing recognition as best practice by funding bodies. This study highlights the need for a nationally agreed remuneration model for general practices that contribute data, clearer ethical guidance for engaging vulnerable populations and reform of statutory frameworks to support responsible data use. The lack of consensus on community involvement is concerning, especially as initiatives such as the Australian Institute of Health and Welfare (AIHW) and Primary Health Networks (PHN) partnership advance national data standards. Bridging this gap is essential to align professional practice with public expectations and ensure inclusive, ethically robust research. General Practitioners (GPs) support ethical, transparent general practice data use, with Human Research Ethics Committee (HREC) approval, governance, and cybersecurity safeguards. Remuneration and opt-out consent are endorsed, provided strict ethical conditions are met. Community involvement in research design remains contested, revealing a gap between public and practitioner views.
2. Long-term prognosis of cardiometabolic diseases among U.S. workers: The contribution of shift work to mortality.
期刊: American journal of preventive cardiology 发表日期: 2026-Mar 链接: PubMed
摘要
Shift work is a known risk factor for cardiometabolic diseases (CMD), including cardiovascular diseases (CVD) and diabetes. However, limited evidence exists on the long-term prognosis of individuals already diagnosed with CMD, particularly regarding mortality outcomes following continued exposure to shift work. This study aimed to investigate the prospective association between shift work and mortality outcomes, including all-cause, CMD, and CVD mortality, among U.S. workers with CMD. The data of 2010 and 2015 National Health Interview Survey (NHIS) were linked to mortality records from the National Death Index through December 31, 2019. A total of 9,622 workers with CMD were included. Shift work exposure was self-reported usual work schedules and categorized as shift versus regular daytime work. Cox proportional hazards models were performed, with adjustment for baseline demographic information, socioeconomic status, and occupational characteristics. At baseline, 25.7 % (2,470) reported shift work. During follow-up period, 308 deaths in the non-shift work group (100 CMD deaths and 90 CVD deaths) and 129 deaths in the shift work group (50 CMD deaths and 43 CVD deaths) were documented. Shift work was associated with a higher risk of all-cause mortality (HR=1.28, 95 % CI=1.02, 1.62), CMD mortality (HR=1.57, 95 % CI=1.01, 2.42), and CVD mortality (HR=1.61, 95 % CI=1.02, 2.53), adjusting for baseline covariates. Among U.S. workers with CMD, shift work was associated with substantially higher risks of all-cause and cause-specific mortality, highlighting the need to consider occupational exposures in clinical care and workplace policies to support secondary prevention for workers with CMD.
3. Perceived stress precedes declines in Well-being: A prospective study of stress, well-being, hair cortisol, and low-grade inflammation in hospital employees.
期刊: Brain, behavior, & immunity - health 发表日期: 2026-Feb 链接: PubMed
摘要
Chronic low-grade inflammation may help explain the relationship between stress, well-being, and disease, but the pathway and temporal order have not yet been tested prospectively. To understand the pathways between perceived stress, well-being, C-reactive protein, and hair cortisol, we investigated the temporal ordering of these variables in a sample of hospital employees. Random-intercepts cross-lagged panel models were conducted using three 6-monthly waves of data collected from new employees at a German hospital (N = 296, 77.7 % female, M age = 28.59) in a prospective cohort study. Self-reported data on perceived stress and well-being, hair strands for hair cortisol concentration, and capillary blood samples for C-reactive protein were collected for analysis. While our study did not support a causal relationship between changes in stress levels and later changes in either hair cortisol or low-grade inflammation, we provide evidence to suggest that increases in perceived stress led to later decreases in well-being. In contrast, changes in well-being did not predict changes in perceived stress levels. This is the first prospective repeated-measure study to examine the temporal associations between stress, well-being, hair cortisol concentrations, and chronic low-grade inflammation. Our analyses suggest that perceived stress in this sample precedes changes in well-being, highlighting the importance of prevention and early intervention.
4. Orexin Receptor Antagonism Improves Sleep Quality and Mitigates Lipopolysaccharide-Induced Inflammatory Responses in a Mouse Model.
期刊: FASEB journal : official publication of the Federation of American Societies for Experimental Biology 发表日期: 2026-Jan-15 链接: PubMed
摘要
Alterations in the immune system, stemming from sleep/wakefulness disorders, increase the risk of inflammatory pathologies. Orexin, a hypothalamic neuropeptide, regulates sleep and wakefulness. However, the role of orexin in inflammatory responses-whether it is protective or pathological-is still unclear. In this study, our aim was to elucidate the role of orexin in sleep and inflammatory states through the examination of a lipopolysaccharide (LPS)-induced systemic inflammatory model and the effects of daridorexant, a dual orexin receptor antagonist. Intraperitoneal LPS administration significantly decreased rapid eye-movement (REM) sleep and wakefulness while increasing non-REM sleep. Pretreatment with daridorexant enhanced REM sleep recovery in LPS-induced systemic inflammation, evidenced by extended duration and increased episode frequency. Transcriptomic profiling demonstrated a rise in the expression of pro-inflammatory cytokines (Cxcl1, Ccl2, Ccl7, and Tnf) within the hypothalamus of LPS-challenged mice, which was mitigated by daridorexant administration. In addition, daridorexant mitigated LPS-induced acute lung inflammation. These findings suggest that by reducing pro-inflammatory cytokine expression, the inhibition of orexin activity mitigates the lethargy associated with systemic inflammation, while also improving sleep quality. This study explores the potential of orexin receptor antagonists as strategic options for inflammatory pathologies and their associated sleep disorders.
5. Integrated Analysis of Cerebrospinal Fluid-Derived Exosomal miRNA Expression Profiles in a tMCAO Monkey Model During Stroke Progression.
期刊: FASEB journal : official publication of the Federation of American Societies for Experimental Biology 发表日期: 2026-Jan-15 链接: PubMed
摘要
Globally, stroke is a critical condition that can result in enduring disabilities and death. Evidence demonstrates that stroke is linked to a variety of biological processes. Nevertheless, the significance of miRNAs in the progression of stroke remains uncertain. The transient middle cerebral artery occlusion (tMCAO) method was used to construct an ischemic stroke model in rhesus monkeys. Magnetic Resonance Imaging (MRI) scanning was used to determine injury size. Electron microscopy, nanoparticle tracking analysis, and Western blot were employed to detect exosomes. R packages were employed to evaluate and analyze the sequencing data. Venn diagrams and heatmaps were developed to illustrate the differentially expressed miRNAs. The enrichment pathways were identified using Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) analyses. We constructed four tMCAO monkey models and performed miRNA profiling of exosomes isolated from the cerebrospinal fluid before tMCAO (D0), 1 day after tMCAO (D1, the superacute phase), and 7 days after tMCAO (D7, acute phase). A landscape of miRNA profiling of 12 samples was analyzed. We compared the miRNA expressions and identified differentially expressed miRNAs following tMCAO. Twenty-eight miRNAs were dysregulated in D1 compared with D0 and D7, suggesting a crucial role in acute brain injury. GO and KEGG analyses of the 28 miRNA-targeted genes showed the importance of focal adhesion, Notch signaling, Hedgehog signaling pathway, Hippo signaling pathway, and PI3K-AKT signaling pathway. The results show that dysregulated miRNAs contribute to the pathophysiology of the ischemic event. Our study provides novel therapeutic targets for stroke prevention and recovery.
6. Textbook outcome in gastric cancer surgery: a multicenter cohort study and proposal for a new specific index (TOGS).
期刊: Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association 发表日期: 2026-Jan-09 链接: PubMed
摘要
7. Child Malnutrition and Morbidity in Uttar-Pradesh: An Application of Structural Equation Modeling and Geo-Spatial Analysis.
期刊: Maternal and child health journal 发表日期: 2026-Jan-09 链接: PubMed
摘要
Child malnutrition remains a major public health concern in low and middle-income countries, and Uttar Pradesh (UP), India, continues to experience some of the highest levels of stunting, wasting, and underweight among children under five. This study examines the determinants of child malnutrition and its association with morbidity using data from the National Family Health Survey (NFHS-5). Univariate and bivariate analyses, generalized Structural Equation Modeling (GSEM), and spatial analysis (Moran’s I statistics and LISA cluster maps) were applied to assess both individual-level and district-level patterns. The NFHS-5 sample for Uttar Pradesh included 59,232 children under five, providing statistically robust estimates at both state and district levels. GSEM results indicated that maternal height, place of delivery, child age, caste, wealth index, and maternal education were significantly associated with stunting. Wasting was influenced by maternal height, birth order, child age, caste, wealth index, place of residence, and maternal education. Underweight was associated with maternal height, work status, child age, caste, wealth index, and maternal education. Malnutrition had a significant positive association with childhood morbidity (β = 0.032), indicating higher morbidity levels among malnourished children. Spatial analysis revealed clear geographic clustering of stunting, wasting, and underweight across districts, identifying several high-burden hotspots. These findings highlight the need for integrated, geographically targeted interventions addressing socio-economic inequalities, healthcare access, maternal factors, and environmental conditions to improve child nutrition and health outcomes in Uttar Pradesh.
8. Heat spells and birth and peripartum pregnancy complications in Germany: a scoping review.
期刊: Archives of gynecology and obstetrics 发表日期: 2026-Jan-09 链接: PubMed
摘要
Climate change is increasing global temperatures, with mid-latitude regions experiencing significant warming. Pregnant individuals are particularly vulnerable to heat exposure, which has been linked to adverse outcomes, such as preterm birth and low birth weight. However, research in temperate regions like Germany is scarce. This scoping review examines studies on the association between heat exposure and pregnancy complications in Germany. Following the JBI methodology for scoping reviews, a systematic literature search was conducted in eight databases, including PubMed and Scopus. Studies analyzing pregnancy complications in relation to heat events in Germany were included. Studies without systematic temperature data collection or focusing on long-term child development after birth were excluded. Only four studies met the inclusion criteria. Two reported significant associations between heat exposure and preterm birth, though at different pregnancy stages. One study on low birth weight found no clear correlation, while another identified a strong link between high temperatures and pregnancy-related edema. Differences in exposure definitions and outcome measures limited comparability. Despite the heterogeneity in study designs and findings, the results from the small number of studies could indicate that heat exposure may contribute to adverse pregnancy outcomes in Germany, particularly preterm birth. To strengthen the evidence base, future research should focus on standardizing exposure definitions and employing robust methodologies. These findings underscore the need for public health strategies to mitigate the risks associated with rising temperatures for pregnant individuals.
9. Validity of EQ-5D-5L breathing and cognition bolt-ons in non-hospitalized patients after COVID-19.
期刊: Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation 发表日期: 2026-Jan-09 链接: PubMed
摘要
The EQ-5D has been criticized for lacking dimensions for breathing and cognition. In acute COVID-19 and Long COVID, breathing problems and cognitive complaints are common. This study evaluated the inclusion of EQ-5D-5L (bolt-on) items that assess these dimensions. In a follow-up of community-based non-hospitalized patients with COVID-19 in 2020 (n = 450), we used respiratory and cognitive bolt-on items alongside other questionnaires about 30 months later (n = 220). We assessed data quality and construct validity for the bolt-ons, including comparison with concurrently used instruments’ domain and item scores. Bolt-on scores were correlated with pulmonary function tests and tablet-based cognitive tests about 1 year earlier. Finally, we assessed the contribution of the bolt-ons to variability of the EQ VAS. Most patients had none or slight problems with breathing and cognition. The breathing problems bolt-on had an 8% lower ceiling effect, but otherwise a similar response distribution to the mMRC. Cognition bolt-on and four DSQ-SF item scores relating to frequency and severity were similar, except 2-13% higher ceiling effects for the former. The breathing bolt-on had a rank correlation of 0.54 with mMRC scores and higher correlations with Dyspnoea-12 scale scores. EQ-5D-5L dimensions explained 54% of variation in EQ VAS scores; the breathing bolt-on contributed a further 2%, but the cognition bolt-on contributed very little. The results support the validity of the two bolt-ons in follow-up of non-hospitalized patients after COVID-19. Adding items of respiratory and cognitive symptoms may enhance the EQ-5D’s appropriateness in respiratory and cognitive research and clinical practice.
10. Robotic-assisted hip and knee replacement in NHS scotland: trends and efficiency implications (2020-2024).
期刊: Journal of robotic surgery 发表日期: 2026-Jan-09 链接: PubMed
摘要
Robotic-assisted hip and knee replacement has been increasingly adopted in orthopaedic practice, offering potential advantages in surgical precision and workflow consistency. However, its efficiency compared with conventional manual methods in real-world NHS practice remains debated. This retrospective observational study analysed routinely collected data from the Arthroplasty Rehabilitation in Scotland Endeavour (ARISE) programme, including patients undergoing unilateral primary hip or knee replacement between 2020 and 2024. Robotic-assisted status, type of surgery, and operative duration were examined. Uptake of robotic-assisted hip and knee replacement was assessed annually, and comparative analyses evaluated operative times between robotic-assisted and manual procedures. Robotic-assisted hip and knee replacements increased from 101 procedures in 2020 to 1164 in 2024, representing a tenfold rise. Despite this growth, robotic cases accounted for fewer than 10% of all hip and knee replacements, with uptake concentrated in a small number of centres. Median operative durations were similar between robotic-assisted and manual procedures for both hips and knees. However, robotic surgeries demonstrated narrower interquartile ranges and fewer outliers. Knee replacements showed consistently higher adoption than hip replacement across the study period. Robotic-assisted hip and knee replacement has expanded rapidly in NHS Scotland, though access remains uneven across hospitals. Operative efficiency is comparable to conventional methods, but improved consistency may offer service-level benefits such as more predictable theatre scheduling. Wider adoption will require strategic investment in infrastructure, training, and equitable resource distribution to maximise the potential benefits of robotic-assisted technology within the NHS.
11. Home-based transcranial direct current stimulation (tDCS) for bipolar depression: effects on quality of life and functioning-an open-label study.
期刊: Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation 发表日期: 2026-Jan-09 链接: PubMed
摘要
Individuals with bipolar disorder often experience reduced quality of life (QoL). Transcranial direct current stimulation (tDCS) is a promising non-invasive treatment for bipolar depression that is portable, safe, and suitable for use at home. We developed a home-based tDCS protocol with real-time remote supervision and examined its effect on QoL in bipolar depression. In an open-label design, 44 participants (31 women) with bipolar depression of at least a moderate severity received 21 sessions of home-based tDCS (2 mA, 30 min, F3 anode/F4 cathode) over 6 weeks, with a follow-up visit conducted 5 months from baseline. QoL was assessed using the quality of life enjoyment and satisfaction questionnaire (Q-LES-Q) at baseline, week 2, end of treatment, and follow-up session. Baseline and post treatment scores were compared with healthy control participants (28 adults; 17 women). At baseline and at the end of treatment, bipolar participants showed a significantly lower Q-LES-Q score than healthy controls (p < 0.001). Within the bipolar group, there was a significant improvement in total Q-LES-Q scores (p < 0.001) and across multiple domains by week 6 and remained elevated at follow-up. Changes in Q-LES-Q were no longer significant after adjustment for depressive symptoms. A 6-week course of supervised home-based tDCS was associated with significant QoL improvements in bipolar depression, which appeared to be closely linked to reduction in depressive symptoms. Randomized, sham-controlled trials are warranted to clarify the specific contribution of tDCS to improve QoL in bipolar depression.
12. Analysing the impact of complex multimorbidity on health-related quality of life.
期刊: Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation 发表日期: 2026-Jan-09 链接: PubMed
摘要
Multimorbidity, is the co-existence of two or more chronic conditions in an individual, including physical and mental health conditions, non-communicable diseases, and long-term infectious diseases. It is a growing concern for policy makers for several reasons. Firstly, it can have a significant impact on the individual, in terms of their quality of life, psychological well-being and physical function. In addition, it has an impact on the health system, as individuals with multimorbidity tend to require more complex care, involving multiple medical specialties. In this context, this paper provides important estimates of the impact of multimorbidity on health-related quality of life. We find that having multimorbidity leads to a significant decrease in health-related quality of life across five dimensions - mobility, self-care, usual activities, pain/discomfort and anxiety/depression. This means that if we can develop new models of care that delay or prevent the onset and progression of multimorbidity, it is likely to result in significant health benefits for the individual, and by extension, the health system.
13. Assessing quality of life in displaced children on Lesvos using PROMIS: a mixed methods study.
期刊: Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation 发表日期: 2026-Jan-09 链接: PubMed
摘要
Due to the ongoing global refugee crisis, around 400 million children are currently displaced. We investigate domains of quality of life (QoL) in two groups of displaced children; children living with their caregivers in Closed Control Access Centre (CCAC) Mavrovouni and unaccompanied minors (UAMs) in designated shelters on Lesvos, Greece. A mixed-methods study using PROMIS® to quantitatively assess domains of QoL compared to a reference group by using a one-sample Wilcoxon sign-rank test. Associated variables were identified by multivariable linear regression analyses. Open questions were added to UAMs to qualitatively identify elements influencing QoL. A total of 111 children (N = 94) and UAMs (N = 17) participated. Children across all age groups showed significantly worse scores in various domains compared to the reference group. The youngest group (1-4 years) report more Depressive symptoms but better peer relationships, while the 5-18 year groups reported higher levels of anger, anxiety, depressive symptoms, and pain behavior. Adolescents (8-18 years) reported higher scores on meaning and purpose. A longer duration in camp was associated with higher scores on anxiety and depressive symptoms. UAMs mention separation from family as negatively influencing their mental health. They mention future goals, hope and social support as central to their sense of meaning and purpose. Displaced children report high levels of anger, anxiety, pain behavior, and depressive symptoms, a prolonged stay in the camps even worsens these outcomes. This underscores the need for tailored interventions to enhance the overall well-being of this vulnerable population.
14. Preoperative assessment of tumor size by MRI and ultrasound in cervical cancer: a large-scale retrospective comparative study.
期刊: Archives of gynecology and obstetrics 发表日期: 2026-Jan-09 链接: PubMed
摘要
Accurate preoperative evaluation of tumor sizes is essential for guiding optimal treatment planning in cervical cancer. This study aimed to compare the accuracy of preoperative tumor size measurement between magnetic resonance imaging (MRI) and ultrasound. A retrospective study was performed involving 925 patients diagnosed with cervical cancer who underwent primary surgical treatment between January 2020 and June 2025. The accuracy of these two imaging modalities was assessed by comparing their measurements to the maximum tumor diameter determined through postoperative pathological analysis. The Bland-Altman analysis showed that both ultrasound (mean difference: 1.50 mm) and MRI (mean difference: 0.61 mm) overestimated tumor size. In the paired subgroup of 757 patients who underwent both imaging modalities, the agreement rates between imaging and pathology for categorizing tumors into size groups were 65.8% for ultrasound and 67.6% for MRI (p = 0.360). Although MRI showed a significantly smaller mean measurement bias than ultrasound (0.73 mm vs. 1.37 mm; p = 0.012), the proportion of large errors (> 10 mm) was not significantly different. Multivariate analysis indicated that tumors > 40 mm assessed by ultrasound (OR = 2.85) or MRI (OR = 2.72) were significantly associated with increased likelihood of measurement discrepancies > 10 mm. While MRI exhibited a lower measurement error compared to ultrasound, both modalities showed comparable performance in tumor size staging. Furthermore, for tumors exceeding 40 mm in diameter as determined by preoperative imaging, clinicians are advised to integrate clinical examination to enhance the accuracy of staging.
15. A multiobjective optimal control problem for the dynamics of an infectious disease with limited healthcare facilities and vaccination.
期刊: Journal of mathematical biology 发表日期: 2026-Jan-09 链接: PubMed
摘要
Infectious diseases remain a significant threat to global public health, often causing substantial economic burdens. Effective disease management requires an integrated approach involving healthcare facilities, particularly hospital bed capacity, and vaccination campaigns. A four-dimensional mathematical model is investigated to study the dynamics of an emerging infectious disease, considering both vaccination efforts and the limitations of healthcare resources. The model undergoes a series of local bifurcations, including transcritical (both forward and backward), saddle-node, Hopf (supercritical, subcritical, and Bautin), and Bogdanov-Takens bifurcations, revealing the complex dynamics that govern disease transmission and control. To derive optimal control strategies, we apply a multiobjective optimal control approach, transforming the problem into a multiobjective optimization problem and solving it using the ϵ -constraint method. The analysis of Pareto optimal fronts provides valuable insights into the relative effectiveness of varying vaccination and hospitalization strategies under different transmission rates. The numerical results validate the analytical findings and provide comprehensive insight into the best strategies to minimize the infected individuals and associated cost. One such result reveals that the use of saturation-type cost functions offers a cost-efficient approach for managing intervention resources, while more comprehensive cost models may incur higher implementation costs.
16. The Association Between Maternal Adiposity and Breastfeeding Initiation and Duration: Evidence from the Southampton Women's Survey.
期刊: Maternal and child health journal 发表日期: 2026-Jan-09 链接: PubMed
摘要
Most mothers in the UK are not meeting the breastfeeding recommendations set by the World Health Organisation (WHO, Breastfeeding - Recommendations. https://www.who.int/health-topics/breastfeeding#tab=tab_2 , 2023). Maternal obesity has variably been associated with lower initiation and shorter duration of breastfeeding, but few studies have examined the impact of maternal adiposity estimated from skinfold thicknesses. To investigate the relationship between maternal adiposity and breastfeeding initiation and duration. Data from 2,873 mother-offspring pairs in the Southampton Women’s Survey (SWS) mother-offspring cohort study were used to assess the relationship between a mother’s adiposity and breastfeeding initiation and duration. The exposure variables were body mass index (BMI) and body fat percentage, calculated from 4-site skinfold thickness measurements measured prior to conception. The outcome variables were breastfeeding initiation and duration. All analyses were adjusted for confounders identified using a Directed Acyclic Graph. After adjustment for confounders, no associations were found between maternal BMI (RR 0.99 per 5 kg/m2, 95% CI 0.97, 1.01) or body fat percentage (RR 0.99 per 5%, 95% CI 0.97, 1.00) and initiation of breastfeeding. After adjustment for confounders, amongst women who initiated breastfeeding, higher maternal BMI (β -0.09 SDs per 5 kg/m2, 95% CI -0.13, -0.04) and body fat percentage (β -0.10 SDs per 5%, 95% CI -0.16, -0.04) were associated with shorter breastfeeding duration. In this study maternal adiposity had little impact on breastfeeding initiation but higher maternal adiposity was associated with shorter breastfeeding duration. This study suggests that more support should be given to mothers with overweight and obesity to promote longer duration of breastfeeding.
17. A physical and morphometric analysis of intraocular foreign bodies and their clinical correlation.
期刊: Graefe’s archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie 发表日期: 2026-Jan-09 链接: PubMed
摘要
Penetrating injuries with intraocular foreign bodies (IOFB) remain a major cause of ocular morbidity worldwide. This study aimed to determine the physical and morphometric characteristics of IOFBs and investigate the correlation to the injury pattern. Intraocular foreign bodies retrieved between January 2018 and December 2023 were examined for dimension, weight, shape, and magneticity. In order to classify the shape of the IOFB, various indices were calculated. Clinical records, imaging data, and operative reports were retrospectively analyzed to determine the course of the incident, point of entry, and final intraocular position. Fifty-four IOFBs were removed during the study period. Of these, 39 met the inclusion criteria. The majority of IOFBs were metal and magnetic (n = 32; 82%). Three IOFBs consisted of glass, two were made of wood and 2 eyelashes were extracted. The mean length, width and thickness were 4.95 mm, 1.70 mm and 0.86 mm, respectively. The average weight was 20.49 mg (0.2-112 mg; SD: 31 mg). The final intraocular location of foreign bodies was highly variable. With the exception of one case, all wire-shaped foreign bodies entered through the limbal cornea and penetrated into the suprachoroidal space. The variables of roundness, moment of inertia, length, circumference, and secondary moment of the major axis were identified as significant predictors of penetration depth. In order to break through the corneal or scleral rigidity, foreign bodies must have certain physical properties and sufficient kinetic energy upon impact. Specific foreign body shapes can also lead to specific injury patterns. These precise measurement data may be important for future studies in trauma prevention, materials research, or the development of ophthalmic instruments.
18. [Prehospital treatment of severely injured children in Germany : Epidemiology, interventions and structural perspectives].
期刊: Die Anaesthesiologie 发表日期: 2026-Jan-09 链接: PubMed
摘要
Severely injured children account for only a small proportion of emergency medical service (EMS) missions but pose major challenges to the emergency teams due to age-related anatomy and physiology, complex injury patterns and high emotional stress. This narrative review summarizes the current evidence on the epidemiology and prehospital management of pediatric trauma patients in the German EMS system and places these findings in an international context. A PubMed search was carried out using the terms “children”, “trauma” and “prehospital”. Studies reporting the prehospital management of injured children and adolescents were included. Out of 421 records 20 studies were selected and complemented by backward citation searches, with a focus on data from Germany and comparable high-income countries. Pediatric emergencies account for approximately 5% of ground EMS (GEMS) and 6-13% of helicopter EMS (HEMS) missions; severely injured children (e.g. NACA IV-VII) constitute only a small fraction, making pediatric polytrauma a classical low-frequency, high-impact scenario. The proportion of traumatic emergencies increases with age and peaks during adolescence; boys are overrepresented in all cohorts. Falls and traffic incidents dominate, predominantly resulting in blunt trauma with injuries mainly to the head and extremities. Polytrauma is reported in only around 5% of injured children and primarily affects older children and adolescents. Oxygen administration, intravenous access, immobilization and analgesia are frequent measures, whereas intubation, intraosseous access, chest drainage and other invasive procedures are rare. Several studies indicate an association between HEMS or direct admission to a (pediatric) major trauma center and improved survival. Pediatric trauma patients represent a small but high-risk group in whom invasive procedures must be performed under time pressure and emotional stress. The management of complex cases by specialized HEMS teams and clearly designated (pediatric) major trauma centers, the strengthening of paramedic-based care, simulation-based training, standardized prehospital and in-hospital outcome-oriented data collection and the further expansion of regionally coordinated trauma networks are key steps towards improving prehospital care for injured children. HINTERGRUND: Schwer verletzte Kinder machen nur einen kleinen Anteil der Einsätze im Rettungsdienst aus, stellen die Einsatzteams aber aufgrund altersabhängiger Anatomie und Physiologie, komplexer Verletzungsmuster und hoher emotionaler Belastung vor große Herausforderungen. Diese narrative Übersichtsarbeit fasst die Evidenz zu Epidemiologie und präklinischer Versorgung pädiatrischer Traumapatienten im deutschen Rettungsdienst zusammen und ordnet die Befunde in einen internationalen Kontext ein. Es wurde eine PubMed-Suche mit den Begriffen „children“, „trauma“ und „prehospital“ durchgeführt. Eingeschlossen wurden Studien zur präklinischen Versorgung verletzter Kinder und Jugendlicher; von 421 Treffern wurden 20 Arbeiten ausgewählt und durch Rückwärtssuche ergänzt, mit Fokus auf Daten aus Deutschland und vergleichbaren Hochlohnländern. Pädiatrische Notfälle machen etwa 5 % der bodengebundenen und 6–13 % der luftgebundenen Einsätze aus; schwer verletzte Kinder (z. B. NACA IV–VII) stellen nur einen kleinen Bruchteil dar und machen das pädiatrische Polytrauma zu einem klassischen „Low-frequency-high-impact“-Szenario. Der Anteil traumatischer Notfälle steigt mit dem Alter und ist im Jugendalter am höchsten; Jungen sind in allen Kollektiven überrepräsentiert. Stürze und Verkehrsunfälle dominieren, überwiegend als stumpfe Traumata mit vorwiegend Kopf- und Extremitätenverletzungen. Ein Polytrauma wird nur bei rund 5 % der verletzten Kinder beschrieben und betrifft v. a. ältere Kinder und Jugendliche. Sauerstoffgabe, venöse Zugänge, Immobilisation und Analgesie gehören zu den häufigen Maßnahmen, während Intubation, intraossäre Zugänge, Thoraxdrainagen und andere invasive Prozeduren selten bleiben. Mehrere Studien belegen, dass Luftrettung sowie die primäre Aufnahme in ein (pädiatrisches) Traumazentrum mit einer verbesserten Überlebensrate assoziiert sind. Pädiatrische Traumapatienten bilden eine kleine, aber risikobehaftete Patientengruppe, bei der invasive Prozeduren unter Zeitdruck und emotionaler Belastung durchgeführt werden müssen. Die Versorgung komplexer Fälle durch spezialisierte HEMS-Teams und in klar ausgewiesenen (pädiatrischen) Traumazentren, eine gestärkte notfallsanitäterbasierte Versorgung, simulationsbasiertes Training und eine standardisierte prä- und innerklinisches Outcome-orientierte Datenerfassung sowie der weitere Ausbau regional koordinierter Traumanetzwerke sind zentrale Schritte zur Verbesserung der präklinischen Versorgung verletzter Kinder.
19. Impact of robot-assisted cortical bone trajectory (CBT) screw placement on enhanced recovery after surgery (ERAS) in midline lumbar interbody fusion (MIDLIF): a retrospective study.
期刊: Journal of robotic surgery 发表日期: 2026-Jan-09 链接: PubMed
摘要
This study aimed to evaluate the impact of robot-assisted cortical bone trajectory (CBT) screw placement under an enhanced recovery after surgery (ERAS) protocol compared to traditional freehand CBT placement on perioperative outcomes and postoperative recovery in patients undergoing midline lumbar interbody fusion (MIDLIF). In this retrospective study, 81 patients with degenerative lumbar spine disease who underwent single-level L4/5 MIDLIF between January 2020 and June 2025 were analyzed. Patients were divided into two groups: 37 underwent freehand CBT screw placement (control group), and 44 received robot-assisted CBT screw placement within the ERAS protocol (ERAS group). The comparison involved various perioperative metrics, such as drainage volume, blood loss, operative duration, rate of transfusion, use of analgesics, occurrence of postoperative vomiting, length of hospital stay (LOS), and complications. Pain levels and functional outcomes were evaluated with the Visual Analog Scale (VAS) and Oswestry Disability Index (ODI) both before surgery and after one year. The ERAS group experienced significantly less blood loss, reduced drainage volume, decreased analgesic requirements, and a lower incidence of vomiting compared to the control group (P < 0.05). LOS was shorter in the ERAS group (4.27 vs. 5.03 days, P = 0.001). Although the surgical duration was extended in the ERAS group, the complication rates did not differ significantly. Significant enhancements in VAS and ODI scores were observed in both groups one year after surgery (P < 0.001). The integration of robot-assisted CBT screw placement with the ERAS protocol presents considerable benefits for perioperative care and recovery after surgery, while not elevating the risk of complications. This method could prove to be a vital approach for improving surgical results and encouraging the wider implementation of ERAS in spinal operations.
20. Associations of Moderate-to-Vigorous Physical Activity Timing With Type 2 Diabetes Incidence in UK Biobank and Prevalent Glycemic Measures in NHANES.
期刊: Diabetes care 发表日期: 2026-Jan-09 链接: PubMed
摘要
We assessed the association between timing of moderate-to-vigorous physical activity (MVPA) with incident type 2 diabetes (T2D) and glycemic measures. Regression models were used to assess associations between accelerometer-derived MVPA timing and incident T2D in UK Biobank (UKB) (n = 84,528, prospective), prevalent diabetes, and glycemic measures in the National Health and Nutrition Examination Survey (NHANES) (n = 6,998, cross-sectional). In UKB, with early morning (0500-0959) MVPA as reference and before adjustment for total MVPA, “variable-timing” MVPA was associated with the lowest incident T2D risk; while after adjustment, afternoon-evening MVPA (1500-2400) showed the lowest incident T2D risk. In NHANES, afternoon/early evening MVPA was weakly associated with more favorable glycemic measures and lower diabetes prevalence after adjustment for total MVPA. When keeping total MVPA volume constant, clustering MVPA in the afternoon-evening was associated with the strongest reduction in incident T2D risk, fewer prevalent diabetes, and more favorable glycemic measures.
21. Air pollution, meteorological factors, and cardiac remodelling in children: a multi-omics cohort study.
期刊: European heart journal 发表日期: 2026-Jan-09 链接: PubMed
摘要
Exposure to air pollution and several meteorological factors was associated with increased cardiovascular diseases in adults. However, little is known about their effects on cardiovascular structure and function as well as the underlying biomolecular mechanisms in children. A total of 2029 children were enrolled at baseline in the Southwest Health Children Cohort from three provinces (Chongqing, Guizhou, and Sichuan provinces) in China from 2021 to 2025. Exposure to particulate matter smaller than 2.5 µm (PM2.5), temperature (TE), extreme temperature events (ETEs), and relative humidity (RH) were estimated from machine-learning approaches according to residential addresses, and cardiovascular parameters were obtained from high-quality echocardiography images both at baseline and each visit. The results indicated that ambient PM2.5, TE, ETEs, and RH exposure levels were significantly associated with cardiovascular structure and function remodelling from pregnancy to full exposure windows including thickening in carotid intima and decreased ejection fraction. Moreover, the associations were more pronounced in children from low-income families or with elevated blood pressure. In addition, PM2.5 synergistically interacted with ETEs to promote abnormal cardiovascular remodelling in children. Lipidomes including hexosylceramide, phosphoenolpyruvate, and triacylglyceride, and one protein myosin light chain 3 were identified to be important biomarkers linking environmental hazards with abnormal cardiovascular remodelling in children. This study provided new evidence of air pollution and meteorological factors in children’s cardiovascular health, suggesting that environmental improvement strategies are urgently needed to promote cardiovascular health in vulnerable children and adolescents.
22. Living liver donor safety: Preoperative aspects of living liver donation guidelines from the ILTS-iLDLT consensus conference.
期刊: Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society 发表日期: 2026-Jan-09 链接: PubMed
摘要
Living donor liver transplantation (LDLT) is an established therapy with curative intent for pediatric and adult patients with acute liver failure and end stage liver disease. Donor safety remains paramount and commences during preoperative evaluation and assessment. Given the importance of the topic, the International Liver Transplantation Society and International Living Donor Liver Transplantation Group consensus conference on Living Liver Donor Safety was convened in March 2025 (Toronto, Canada). Recommendations were based on the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) system for assessment of recommendations, and Danish model of consensus was followed. This report presents 28 recommendations from the working group focused on addressing clinically relevant questions related to the preoperative aspects of living donor safety including assessment of donor acceptability (age, body mass index and hepatic steatosis; medical conditions and contraindications), medical and surgical workup (liver function and procoagulant work-up; anatomical considerations and safe remnant), and psychosocial evaluation (timing and team; underlying conditions; non-directed, paired, and anonymous directed donors; urgent living donor workups for acute liver failure).
23. [Digital transformation in healthcare to strengthen patient autonomy].
期刊: Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz 发表日期: 2026-Jan-09 链接: PubMed
摘要
Patient autonomy is regarded as a central ethical and health policy principle of modern healthcare delivery. Its practical implementation is gaining increasing importance in light of the rapidly advancing digital transformation of the healthcare system. Digital technologies are changing the conditions under which autonomy can be exercised and safeguarded. They alter access to information and orientation within healthcare settings, thereby influencing individual decision-making processes. Against this backdrop, a purely individualistic concept of autonomy proves insufficient. For the digitalization of healthcare to meaningfully strengthen patient autonomy, it must go beyond technical and organisational implementation and include a conceptual and structural engagement with autonomy. This gives rise to a political and socio-structural design mandate that goes far beyond the introduction of individual applications. A consistent commitment to an expanded understanding of autonomy places substantial demands on the development and integration of digital infrastructures. Digital solutions must function reliably, reflect societal diversity, enable participation and support orientation. Safeguarding informational and participatory self-determination additionally requires an interplay of targeted political governance, coherent regulation, technically robust interoperability and socially responsive structural conditions. The aim of this article is to examine these requirements in detail and to profile them, with regard to a patient-oriented design of digital infrastructures, as an emancipatory mandate for a patient-centered health care system. Patient:innenautonomie gilt als zentrales ethisches und gesundheitspolitisches Leitprinzip moderner Versorgung. Ihre praktische Ausgestaltung gewinnt angesichts der rasch voranschreitenden digitalen Transformation des Gesundheitswesens zunehmend an Bedeutung. Digitale Technologien verändern die Bedingungen, unter denen Autonomie ausgeübt und gesichert werden kann. Sie verändern den Zugang zu Informationen und die Orientierung im Versorgungsgeschehen und haben damit Einfluss auf individuelle Entscheidungsprozesse.Vor dem Hintergrund dieser Entwicklungen erweist sich ein rein individualistisch verstandenes Autonomiekonzept als unzureichend. Soll die Digitalisierung des Gesundheitswesens tatsächlich zur Stärkung der Patient:innenautonomie beitragen, muss über die technische und organisatorische Komponente hinaus Autonomie konzeptionell mitgedacht und strukturell berücksichtigt werden. Daraus ergibt sich ein politisch- und sozialstruktureller Gestaltungsauftrag, der weit über die Einführung einzelner Anwendungen hinausreicht.Die konsequente Berücksichtigung eines erweiterten Autonomieverständnisses stellt hohe Anforderungen an digitale Infrastrukturen und deren systematische Einbettung. Digitale Lösungen müssen verlässlich funktionieren, gesellschaftliche Vielfalt berücksichtigen, Teilhabe ermöglichen und Orientierung fördern. Um informationelle und partizipative Selbstbestimmung abzusichern, ist zudem ein Zusammenspiel zielgerichteter kohärenter Regulierung, politischer Steuerung und sozialsensibler struktureller Bedingungen erforderlich. Ziel des Beitrags ist es, diese Anforderungen differenziert herauszuarbeiten und sie mit Blick auf eine patient:innenorientierte Ausgestaltung digitaler Infrastrukturen als emanzipatorischen Gestaltungsauftrag zu profilieren.
24. Professional values of dentists in the Republic of Korea: Influence of clinical experience and competitive pressure.
期刊: Journal of the American Dental Association (1939) 发表日期: 2026-Jan-09 链接: PubMed
摘要
Dentists’ professional values are shaped by means of both career stage and competitive environments. The authors examined how clinical experience and perceived competitive pressure influence Korean dentists’ professional values and explored their broader applicability. An online cross-sectional, web-based survey was conducted in May 2024 among 28,949 members of the Korean Dental Association, of whom 1,932 completed the questionnaire. Professional values (eg, prestige, service, business expansion, scholarly pursuit, lifestyle, autonomy, and the dentist-patient relationship) were assessed as outcome variables and the following 2 explanatory variables were examined: years of clinical experience and perceived competitive pressure. Data were analyzed using t tests, 1-way analysis of variance, and multivariable linear regression analyses (α = .05). Among respondents, 40.0% had 20 years or more of clinical experience and 57.0% reported experiencing high competitive pressure. Dentists with more experience placed greater importance on prestige, service, and scholarly pursuit, and those with fewer years emphasized lifestyle and business expansion. Competitive pressure had weaker effects; dentists experiencing high competitive pressure valued lifestyle more but service less. Autonomy and the dentist-patient relationship consistently had no significant group differences (P value of autonomy .369 and .597, P value of dentist-patient relationship .075 and .380 for years of clinical experience and competitive pressure, respectively). Multivariable regression confirmed that clinical experience was a stronger and more consistent predictor of professional values than competitive pressure. Dentists’ professional values are dynamic and context-dependent, evolving with career stage while retaining stable core elements of professionalism. Understanding these dynamics requires a life course perspective that accounts for practice environments. Dental workforce planning and continuing education programs should account for generational and practice environment differences, providing targeted support for younger dentists, strengthening professional identity, and ensuring sustainability of the profession.
25. The trials of insurance-based Data to Care-Rx: Low enrollment in the Antiretroviral Improvement among Medicaid enrolleeS (AIMS) study.
期刊: Journal of acquired immune deficiency syndromes (1999) 发表日期: 2026-Jan-09 链接: PubMed
摘要
Approaches to strengthen Data-to-Care (D2C) models are needed. We tested an insurance-based D2C prescription model (D2C-Rx), which used antiretroviral therapy (ART) prescription claims to identify people with HIV who fail to fill ART prescriptions in a timely manner and to provide ART adherence support. The Antiretroviral Improvement among Medicaid EnrolleeS (AIMS) study was the first trial of an insurance-based D2C-Rx program. We describe AIMS study enrollment, focusing on patient-participants in the AIMS program arm. Virginia, USA. AIMS used Virginia Medicaid claims and HIV surveillance data to identify Medicaid enrollees with HIV who were without an ART prescription and their providers; study staff then provided targeted adherence support. The target patient-participant sample size was 1,000. The outcome of interest was HIV viral suppression. The study encountered difficulty recruiting patient-participants. Low enrollment prompted major changes to the protocol, including revisions to study design, eligibility criteria, and recruitment methods. These changes were unsuccessful. The trial was terminated due to low patient-participant enrollment (n=4). Reasons for low patient-participant enrollment may include phone-based recruitment approach; lengthy identity verification and consent procedures; and lack of participant compensation. While we aimed to identify people with HIV without a current ART prescription refill, several participants reported having their medications available; this discrepancy suggests issues with unexpected participant behavior (e.g., stockpiling) or timeliness and accuracy of prescription claims data. Future insurance-based D2C-Rx interventions should account for these challenges, be tailored to context, and be nimble enough to pivot to alternative recruitment methods when needed.
26. The Role of Ryan White HIV/AIDS Program Services in Sustaining Viral Suppression Among People Living with HIV: Insights from South Carolina.
期刊: Journal of acquired immune deficiency syndromes (1999) 发表日期: 2026-Jan-09 链接: PubMed
摘要
The Ryan White HIV/AIDS Program (RW) serves as a critical safety net for low-income and underinsured people living with HIV (PWH). We assessed the relationship between the utilization of comprehensive RW services (core, support, and AIDS Drug Assistance Program [ADAP]) and sustained HIV viral suppression. Despite the expansion of Medicaid under the Affordable Care Act, South Carolina failed to expand its eligibility, leaving many vulnerable PWH without coverage. We utilized a statewide cohort of PWH to identify epidemiologic trends and develop predictive models to improve clinical HIV and public health services. We analyzed data from 8,489 PWH diagnosed in South Carolina (2005-2020) to identify sustained viral suppression (consecutive undetectable viral load tests within a year). We report the descriptive statistics and bivariate associations with sustained viral suppression. Subsequently, using generalized linear mixed modeling, we modeled the relationship between RW service utilization and sustained viral suppression, controlling for key sociodemographic, substance use, mental health, and HIV clinical care variables. Our sample of PWH (n=8,489) was primarily young (18-30 years, 42%), male (75%), black (71%), urban (83%), and 88.3% achieved sustained viral suppression. RW service utilization was more frequent for core (65%) and support services (53%), whereas 3% utilized comprehensive (core, support, and ADAP) services. Our adjusted model revealed that comprehensive utilization significantly increased the odds of sustained viral suppression by 41% (AOR=1.41,95%CI=1.09,1.84). Our findings highlight the importance of structural support and comprehensive low-barrier services for achieving HIV progress in a shifting landscape of healthcare coverage.
27. State Initiatives to Promote Cannabis Industry Entrepreneurship Among Disproportionately Impacted Communities: A Multi-State Analysis.
期刊: Journal of public health management and practice : JPHMP 发表日期: 2026-Jan-09 链接: PubMed
摘要
Given the historic cannabis-related injustices in the US, several states with legalized nonmedical cannabis have initiatives to promote industry participation among disproportionately impacted communities and areas (DICAs). This study assessed these initiatives and relevant outcomes across states. This was a mixed-methods study using publicly available data. Evaluation was attempted among 17 states with non-medical cannabis retail (as of May 2025) and state-level social equity (SE) entrepreneurship initiatives. Data were collected regarding: (1) characteristics of state SE entrepreneurship initiatives, including: (a) licenses available and/or reserved, (b) selection process, (c) eligibility criteria, and (d) training and financial support; and (2) relevant outcomes, including: (a) number of SE applications and SE licenses issued; and (b) percent of: SE applications licensed, total licenses issued to SE entrepreneurs, and total licenses held by each sex, race, and ethnicity. Eleven states reserved a number/percentage of licenses, and certain states reserved specific licenses (n = 2) or specified licenses available (n = 3) for SE entrepreneurs. Each state required majority ownership, and most considered DICA as possible (n = 12) or required criteria (n = 3), required state residency (n = 2) or included other criteria (eg, DICA, farming-related) integrating residency (n = 13), and considered cannabis-related convictions as possible (n = 12) or required criteria (n = 2). Most provided support (training n = 14, financial n = 12, reduced fees n = 10). Percentages ranged for SE applications licensed (Arizona: 2.0% to Massachusetts/Michigan: 100%), licenses issued to SE entrepreneurs (Washington: 2.4% to Maryland: 100%), female-held licenses (Illinois: 22.0% to New Jersey: 44.0%), and minority-held licenses (Vermont: 11.3% to New Jersey: 60.3%). This multistate assessment marks a key step in evaluating SE entrepreneurship initiatives. However, outcomes (eg, licenses issued to SE entrepreneurs or DICA subgroups) were not clearly associated with characteristics of these initiatives, suggesting the need to consider different outcomes or allow greater time for SE initiatives to mature and have an impact.
28. Utility-weighted modified rankin scale scores in patients with ischemic stroke: a multicenter observational study.
期刊: Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation 发表日期: 2026-Jan-09 链接: PubMed
摘要
This study assessed patient-reported health-related quality of life (QOL) in a real-world cohort of patients with ischemic stroke and estimated utility-weighted modified Rankin Scale (UW-mRS) scores. We included 1452 patients with ischemic stroke (median age: 75 [67-83] years; 41.0% female) from a multicenter hospital-based stroke registry in Japan. QOL was evaluated using the EQ-5D-5L with Japanese-specific utility values. Both EQ-5D utility values and mRS scores were assessed after completion of acute treatment. UW-mRS scores were estimated using ordinary least squares (OLS) and Tobit regression models. The mean (SD) EQ-5D utility value was 0.68 (0.27). Higher mRS scores were associated with greater severity and frequency of problems across EQ-5D domains, with a marked decline observed between mRS scores 3 and 4. UW-mRS scores estimated by OLS were: mRS 0: 0.90, mRS 1: 0.85, mRS 2: 0.74, mRS 3: 0.62, mRS 4: 0.41, and mRS 5: 0.28. The Tobit model yielded slightly higher values for mRS 1-3. UW-mRS estimates remained largely consistent across other regression models (fractional logit/probit, beta regression, and two-part models). However, UW-mRS values differed between early (≤ 14 days from onset) and late (> 14 days) assessments and varied considerably when utility values were calculated using tariffs from other countries or with the EQ-5D-3L crosswalk. In this real-world, consecutive cohort of hospitalized Japanese patients with ischemic stroke, utility values were estimated using the EQ-5D-5L, and the UW-mRS was characterized as a practical tool for deriving utility values from mRS scores. Stroke can have a profound impact on individual’s lives, limiting physical abilities and adversely affecting overall well-being. In this study, we asked hospitalized patients with ischemic stroke in routine clinical practice to report their health status using the EQ-5D-5L, a questionnaire that measures health-related quality of life (HRQoL) across five domains: mobility, self-care, usual activities, pain/discomfort, and anxiety/depression. We estimated utility values for these patients and mapped scores on the modified Rankin Scale (mRS), a widely used measure of post-stroke functional status, to EQ-5D utility values. Our findings demonstrate a strong inverse relationship between functional disability and HRQoL, with the steepest decline observed between moderate and severe disability (mRS scores 3 to 4). The utility-weighted mRS (UW-mRS) scores derived from this real-world cohort may provide a practical approach for estimating patient-reported HRQoL from mRS scores commonly used in stroke research. However, UW-mRS values varied depending on the time from stroke onset to assessment, the value sets applied from different countries, and whether EQ-5D-5L results were mapped to the 3L. Therefore, caution is warranted when applying the UW-mRS for mapping across different settings or populations.
29. Six-Color Multiplex Digital PCR Assays for Comprehensive Screening and Identification of Multiple Driver Mutations Associated with Pancreatic Carcinogenesis.
期刊: Clinical chemistry 发表日期: 2026-Jan-09 链接: PubMed
摘要
Digital polymerase chain reaction (dPCR) is widely recognized for its high sensitivity in detecting low-frequency variants; however, conventional 2-color systems have limited multiplex capacity. Expanding this capability is essential for simultaneous detection of multiple driver mutations in cancer-related genes. KRAS and GNAS are key driver genes in the early development of pancreatic cancer and its precursor lesions, and mutations in these genes are often present at low abundance in clinical samples. Two 6-color dPCR assays were developed using a droplet-based platform. PlexScreen-dPCR is a multicolored drop-off assay designed to screen for mutations in KRAS codons 12/13 and 61 and GNAS codon 201, without specifying individual variants. PlexID-dPCR employs variant-specific probes to distinguish among 14 predefined KRAS and GNAS mutations in a single reaction. The assays were validated using synthetic DNA, cell lines, 23 tissue samples, and 12 duodenal fluid samples. Customized primer/probe sets with 6 fluorophores were employed in a 6-color droplet dPCR system, and the limits of detection (LOD) were determined. PlexScreen-dPCR, applied in contrived samples, demonstrated LODs as low as 0.03% to 0.06%, enabling high-sensitivity detection of low-abundance mutations. PlexID-dPCR accurately identified all 14 variants in a single well. Both assays showed complete concordance with conventional methods, exhibiting a strong correlation for variant allele frequency quantification. These 6-color dPCR assays offer scalable solutions for improved throughput detection of KRAS and GNAS mutations. Their compatibility with commercially available platforms and streamlined workflow support their integration into clinical practice. Further optimization can enhance cluster interpretation in high-plex settings and facilitate expansion toward broader genomic targets.
30. Better workplace social capital is associated with greater patient care ownership in medical residents: a nationwide cross-sectional study.
期刊: Postgraduate medical journal 发表日期: 2026-Jan-09 链接: PubMed
摘要
Patient care ownership (PCO) is a critical component of medical professionalism. Although various determinants of PCO among medical residents have been investigated, the impact of workplace social capital (WSC; a social resource concerning employees’ perceptions of trust, reciprocity, and network interactions within the workplace) remains unclear. Here, we aimed to examine the association of WSC and PCO. This nationwide cross-sectional study was conducted using an anonymous online survey from January to February 2025. The participants were residents who participated in the General Medicine In-Training Examination. The primary and secondary outcomes were PCO and its four dimensions (i.e. assertiveness, sense of ownership, diligence, and being the “go-to” person), measured using the Japanese version of the PCO Scale, respectively. We adopted WSC and its two dimensions (i.e. horizontal and vertical trust) as the primary and secondary explanatory variables, assessed using the Japanese medical resident version of the WSC Scale, respectively. A total of 2811 residents were analyzed. On multivariable linear regression analysis, WSC total score was positively associated with PCO total score after adjustment for possible confounders. WSC total score was also positively associated with all PCO dimension scores. Additionally, we observed a positive association between each WSC domain score, PCO total score, and each PCO domain score. Our study revealed a significant and consistent association between WSC and PCO. These findings emphasize the importance of fostering a trusting workplace environment, given that PCO constitutes a pivotal component of professionalism and is likely associated with quality patient care.
31. A photonic crystal sensing array based on a tandem CRISPR/Cas13a system for ultra-sensitive and high-throughput detection of the CVA6 virus.
期刊: The Analyst 发表日期: 2026-Jan-09 链接: PubMed
摘要
Coxsackievirus A6 (CVA6) has emerged as a major cause of hand-foot-mouth disease (HFMD), yet no standardized detection method for it is currently available. Developing a simple, sensitive, and specific CVA6 test is crucial for HFMD control and safeguarding the health of at-risk children. Herein, a photonic crystal (PC) sensing array based on a tandem CRISPR/Cas13a system has been proposed for highly specific and ultra-sensitive analysis of CVA6 RNA, without the need for reverse transcription and amplification procedures. In this strategy, two crRNAs targeting CVA 6 RNA were designed and screened, and the fluorescence signal of the tandem CRISPR/Cas13a system was found to be up to 4.2 times higher than that of the non-tandem CRISPR system. The PC array with periodic nanostructures was prepared through self-deposition and further enhanced the fluorescent signal output from the tandem CRISPR system, owing to the match of the emission wavelength of the fluorescent dyes and the photonic band gap (PBG) of the PC. Benefitting from the synergistic effect of the tandem CRISPR system and PC array, as well as the high trans-cleavage activity of Cas13a protein, this engineered sensing array enables ultra-sensitive detection with a limit of detection (LOD) as low as 24.9 fM for CVA6. Meanwhile, this sensing strategy also achieved high-throughput and rapid analysis with a detection frequency of about 96 samples every 3.4 minutes. Therefore, the proposed strategy offers a simple workflow without reverse transcription or amplification, along with high sensitivity and high throughput, demonstrating strong potential for applications in biometrics and clinical diagnostics.
32. The Evolving Landscape of Colorectal Cancer: Aging Burden and Metabolic Risk Factors in China (1990-2021).
期刊: Journal of gastrointestinal cancer 发表日期: 2026-Jan-09 链接: PubMed
摘要
To analyze the long-term trends, age- and sex-specific patterns, and attributable risk factors of the colorectal cancer (CRC) burden in the Chinese population aged ≥ 60 years from 1990 to 2021, so as to provide a scientific basis for targeted prevention and control in this aging population. Data on the incidence, prevalence, mortality, and disability-adjusted life years (DALYs) of CRC in China from 1990 to 2021 were extracted from the Global Burden of Disease (GBD) 2021 database, along with corresponding age-standardized rates. Temporal trends were analyzed using Joinpoint regression, and risk factors were assessed via population attributable fraction (PAF), with stratified comparisons by age and sex. From 1990 to 2021, the age-standardized incidence rate (ASIR) and age-standardized prevalence rate (ASPR) of CRC in China increased by 65.13% and 141.23%, respectively, while the age-standardized mortality rate (ASMR) and age-standardized DALY rate (ASDR) decreased by 11.94% and 15.08%, respectively. The average annual percentage changes (AAPCs) were as follows: ASIR 1.67%, ASPR 2.95%, ASMR - 0.45%, and ASDR - 0.54%. In 2021, metabolic risk factors (high BMI and high fasting plasma glucose) showed the largest increase in PAF (up 5.4% since 1990) in the 60-74 age group, with high BMI alone accounting for a PAF of 7.7%. The combined PAF for smoking and alcohol use was 19.2% in men versus only 2.0% in women, indicating substantial sex-based disparities in behavioral risks. Dietary factors remained the leading risk category, though their composition shifted: excessive red meat consumption accounted for a PAF of 16.0%, while inadequate calcium intake contributed 7.1%-8.1%, with no marked sex differences. From 1990 to 2021, men aged 60-74 bore the heaviest burden of CRC in China, which was associated with a combination of metabolic factors (high BMI, high blood glucose), behavioral factors (smoking, alcohol use), and dietary factors (excessive red meat intake). This demographic should be prioritized for CRC screening and benefit from integrated interventions such as chronic disease management, smoking and alcohol cessation, and dietary modifications.
33. Effect of consequence-based visual education on oral hygiene outcomes: Randomized controlled clinical trial.
期刊: Journal of the American Dental Association (1939) 发表日期: 2026-Jan-09 链接: PubMed
摘要
Providing effective oral hygiene (OH) instructions is critical for preventive oral health care and oral health maintenance. The authors evaluated the effectiveness of video-based OH instructions alone vs video-based OH instructions supplemented with images highlighting the consequences of poor OH. Healthy adults (aged 18-40 years) were randomly assigned to receive either video-based OH instructions alone (group 1 [G1]) or video-based OH instructions supplemented with consequence-based images (group 2 [G2]). Bleeding on probing (BOP), bleeding index (BI), and plaque score (PS) were recorded at baseline and 4-week follow-up. Between-group, within-group, and sex differences were analyzed using paired and unpaired t tests (P < .05). Fifty-six participants were recruited for this study, with 28 participants in each group. Group differences were observed for PS only, which was 41.8% lower in G2 than in G1 at follow-up (P < .0001). Within-group reductions were -15.3% vs -44.0% for BOP, -27.8% vs -31.6% for BI, and -10.0% vs -53.4% for PS in G1 and G2, respectively. No significant sex-related differences were observed in BOP or BI; however, male and female participants in G2 had significantly lower PS scores than their counterparts in G1 (P = .001 and P = .011, respectively). Although both interventions improved oral health, supplementing video instructions with consequence-based images achieved superior short-term plaque reduction, and the effect was consistent across sexes. Incorporating images of poor OH outcomes into standard video-based education may enhance patient adherence to plaque control and represent a cost-effective tool for clinical practice. This clinical trial was registered at the Australian New Zealand Clinical Trials Registry. The registration number is ACTRN12624000048583.
34. Comparison between modern and Persian medicine bioclimatic comfort indices in temperate climatic regions of Iran.
期刊: International journal of biometeorology 发表日期: 2026-Jan-09 链接: PubMed
摘要
This study investigates bioclimatic comfort conditions in Iran by integrating perspectives from traditional Persian Medicine (PM) with modern climatological methodologies. The primary objective is to develop the Persian Medicine (PMI) as a criterion for evaluating comfort zones across Iran and to compare its results with modern climatological indices, specifically the Terjung Index (TI) and the Standard Effective Temperature Index (SETI). Daily meteorological data from 2003 to 2018 were utilized. To construct the PMI, qualitative variables describing temperate regions were extracted from classical PM texts and implemented Python programming, Excel and ArcGIS 10.8 for spatial analysis. The analysis focuses on May, September, and December, months that exhibited the highest degree of similarity among the comfort zones identified by PMI, TI, and SETI. Results indicate that the spatiotemporal distribution of comfort zones derived from SETI corresponds most closely with those identified by PMI, representing the highest levels of climatic and physiological comfort throughout the year. Overall, the findings demonstrate a strong correspondence between modern climatological comfort indices and PMI-based assessments in temperate regions of Iran. This research highlights the potential of integrating traditional medical- environmental knowledge with modern climate science, providing valuable insights for medical geography, environmental health management, and climate adaptation planning under global warming conditions.
35. Disordered eating in early childhood: DRD2 and COMT gene polymorphisms and behavioral features in family trios.
期刊: Eating and weight disorders : EWD 发表日期: 2026-Jan-09 链接: PubMed
摘要
This study examined the association between dopaminergic genetic variants and environmental factors in young children with disordered eating and their parents. Single nucleotide polymorphisms of DRD2 (rs1800497) and COMT (rs4680) were analyzed in 57 undereating, 51 overeating, and 44 control children, and in their parents. The quality of mother-child interactions during feeding was evaluated by the Italian adaptation of the scale for the assessment of feeding interaction. Child externalizing, internalizing and dysregulation symptoms were assessed with the child behavior checklist, and parental psychological distress with the General Severity Index. Data were analyzed by χ2 tests, ANOVAs, and odds ratios. Children’s undereating was associated with their DRD2 polymorphism; under- and over-eating patterns with DRD2 and COMT polymorphisms, including a gene x gene interaction. Eating behavior was strongly associated with the quality of mother-child interaction but not associated with parent’s genotypes. Finally, parent’s psychological distress correlated with children’s eating behavior but not with genetic variables. Our findings suggest that DRD2 and COMT polymorphisms contribute to early vulnerability to disordered eating, while mother-child relational dynamics act independently of parental genetic factors. Level of evidence III Evidence obtained from well-designed case-control analytic study.
36. Cobalt in the soil-plant system across deficient, beneficial and toxic levels: data analysis and mechanistic interpretations.
期刊: Environmental science. Processes & impacts 发表日期: 2026-Jan-09 链接: PubMed
摘要
Cobalt (Co) is a transition metal essential for human and animal health. Cobalt is classified as a beneficial element for plants, but its precise physiological roles in plant metabolism remain enigmatic. Despite the significant projected 200-500% increase in the industrial application of Co, there is limited literature available on the role of Co in the soil-plant-human continuum compared with other heavy metal(loid)s. Notwithstanding its beneficial roles, Co can negatively affect physiochemical processes in plants both at higher (toxic) and lower (deficient) levels of application. High concentrations of Co cause irreversible changes to plant cells, primarily through the enhanced production of reactive radicals. Similarly, Co deficiency inhibits certain essential plant physiological/biochemical processes. While the optimum levels of Co regulate numerous metabolic and developmental traits of plants. Henceforth, monitoring and understanding the dynamics of Co across deficient, beneficial, and toxic levels is imperative. This review presents a data analysis of the latest literature on Co, including (i) levels and sources in soil, (ii) mobility and phyto-availability, (iii) phytouptake and translocation, (iv) toxic, deficient, and beneficial effects, (v) plant tolerance mechanisms, and (vi) role under environmental stresses. A literature data analysis of 1681 plant observations revealed that plant responses vary significantly for different applied conditions and levels, plant species, and physiological attributes. Overall, the current review provides an updated and critical representation and mechanistic interpretation of the biogeochemical behavior of Co in soil-plant-human systems.
37. Comparative Efficiency of Swab Types for Recovery of Escherichia coli and HF183 from Household Surfaces.
期刊: Journal of applied microbiology 发表日期: 2026-Jan-09 链接: PubMed
摘要
Swabs are used in environmental microbiology studies to assess contamination on surfaces, providing critical information for the water, sanitation, and hygiene (WASH) sector in particular. However, the effects of different swab types and drying times on detection is underexplored. We evaluated the effects of these variables on efficiency of recovery and recapture (absolute recovery) of microbial targets. We tested the performance of polyester, foam, and nylon-flocked swabs for recovery of the sewage-associated Bacteroides marker gene HF183 and the Escherichia coli marker EC23S857 using qPCR, and culture methods to quantify viable E. coli. Surfaces were swabbed while wet, immediately after drying, and 24 hours post-drying. Polyester swabs recaptured significantly more HF183 and E. coli DNA than foam swabs and were on par with nylon-flocked swabs for recapturing culturable E. coli. A significant decrease in the recapture of culturable E. coli was observed from wet to dry conditions, including no detection in 24-hour dry treatments. DNA (HF183 and EC23S857) was much more efficiently recovered than culturable E. coli, e.g. nylon-flocked swabs recovered ∼55% of DNA from wet surfaces, compared to 2.4% recovery for culturable E. coli. Foam swabs generally produced the least precise results among the swab types. Polyester swabs were the most effective for DNA recapture and recovery of culturable E. coli was most strongly affected by drying time.
38. Surgical history and temporal muscle thickness as predictors of successful awake surgery in older patients with glioma.
期刊: Journal of neuro-oncology 发表日期: 2026-Jan-09 链接: PubMed
摘要
39. A biokinetic model to assess radon uptake by the fetus during pregnancy.
期刊: Radiation and environmental biophysics 发表日期: 2026-Jan-09 链接: PubMed
摘要
Epidemiological studies have shown a statistically significant increase in lung cancer risk from prolonged exposure to indoor radon. While current radiation protection efforts address the general population, including workers in radon-prone areas, pregnant individuals represent a vulnerable subgroup that requires specific consideration. Prenatal exposure to ionizing radiation, including radon and its progeny, raises concerns not only for maternal health but also for potential in-utero tissue reactions and/or cancer development in other life stages in the offspring. This study aimed to develop a comprehensive biokinetic model for radon to evaluate fetal uptake following maternal exposure through inhalation. The model was based on the latest ICRP age- and sex-specific biokinetic model for radon, adapted to include pregnancy-specific compartments such as the uterus, placenta, arterial and venous cord blood, and key fetal organs (lungs, brain, kidneys, thyroid, bone surface, liver, and adipose). Transfer rates were calculated using Fick’s law of passive diffusion. Maternal and fetal physiological changes throughout pregnancy, including tissue masses and blood flows, were incorporated. Model simulations show that, despite radon gas being predominantly exhaled after inhalation, a fraction crosses the placenta, reaching fetal tissues-particularly those with higher fat content. Additionally, due to the chemical affinity of radon and fatty tissues, fetal adipose tissue receives a significant proportion of radon, resulting in the highest predicted uptake among fetal tissues. This biokinetic model provides an approach to estimate fetal uptake of radon from maternal exposures, supporting more accurate assessments for radiation protection of pregnant individuals and their developing fetuses.
40. Three-decade trends in risk factor-attributable cancer burden in China: insights from the Global Burden of Disease Study 2023.
期刊: European journal of cancer prevention : the official journal of the European Cancer Prevention Organisation (ECP) 发表日期: 2026-Jan-09 链接: PubMed
摘要
Cancer remains a major public health concern in China, with modifiable risk factors contributing substantially to its burden. However, comprehensive evaluations of long-term, hierarchical risk trends are limited. This study assessed cancer burden attributable to risk factors in China from 1990 to 2023 using data from the Global Burden of Disease Study 2023. Cancer deaths, disability-adjusted life years (DALYs), age-standardized mortality rates, and age-standardized DALY rates (ASDR) attributable to level 1 (behavioral, metabolic, and environmental/occupational) and level 2 risk factors were analyzed to characterize temporal, sex-, and age-specific patterns. Comparative effect sizes between level 1 categories were quantified using prevalence ratios with 95% uncertainty intervals. From 1990 to 2023, cancer deaths attributable to risk factors increased by 74.1%, reaching 1.28 million, while age-standardized mortality rates and ASDR declined by 36.2 and 24.2%, respectively. Behavioral risks consistently imposed the greatest burden, producing 7.65 times more deaths than metabolic risks and 4.29 times more than environmental/occupational risks in 2023. Tobacco remained the leading individual risk factor, whereas high BMI - particularly in males - showed the steepest increase, and alcohol use declined among females. Tracheal, bronchus, and lung cancer had the highest risk-attributable ASDR, and multiple myeloma showed the largest rise since 1990. Cancer burden peaked at ages 70-74 years, with males experiencing substantially higher mortality and DALY rates than females. Despite declining age-standardized rates, the rising absolute burden of risk factor-attributable cancers underscores the need for strengthened tobacco control, obesity prevention, and environmental health interventions.
41. Using a return on investment analysis to estimate the economic impact of potential changes to alcohol control policies in Estonia.
期刊: European journal of public health 发表日期: 2026-Jan-08 链接: PubMed
摘要
Estonia is planning an update of its national alcohol policies where an economic return on investment (ROI) analysis is needed to guide decisions against their monetary returns. Using mostly national data sources, the ROI analysis was based on direct healthcare costs and productivity losses due to premature mortality. The interventions compared comprised availability restrictions and taxation increases. For taxation increases, associated revenue increases to government were included. All analyses used a one-year time horizon and different sensitivity analyses. In 2023, all alcohol-attributable harms in Estonia totalled €510.00 million (1.3% of the Gross Domestic Product of Estonia) with €263.91 million direct costs and €246.08 million indirect costs. The proposed availability reductions are expected to yield a net benefit of €6.33 million, whereas a 15% increase in alcohol excise taxation could lower healthcare costs and productivity losses by €1.77 million in addition to increasing tax revenue by €32.27 million. Moreover, the interventions were estimated to lead to substantial reductions in mortality and hospitalizations. In terms of ROI, the availability interventions would result in €15 gained for each euro invested, and the taxation increase in €477 per euro invested, and without revenue in €25 per euro invested. Positive ROI was also shown in all sensitivity analyses. The proposed alcohol control policies for Estonia would not only reduce mortality and morbidity but also bring sizeable gains for each euro invested. Higher ROI for taxation increase compared to availability restrictions was mainly due to the added tax revenue.
42. Real-world comparative effectiveness of SARS-CoV-2 primary vaccination campaigns against SARS-CoV-2 infections: a federated observational study emulating a target trial in three nations.
期刊: European journal of public health 发表日期: 2026-Jan-07 链接: PubMed
摘要
To assess the impact of large-scale severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination campaigns in real-world settings across regions, we performed a reproducible cross-border comparison of the real-world effectiveness of primary vaccination in preventing SARS-CoV-2 infections across three sites: Aragon (Spain), Brussels and Wallonia (Belgium), and Finland. This observational study emulated a target trial by daily matching primary vaccinated individuals 1:1 to un- or partially vaccinated individuals using propensity scores estimated on a set of relevant confounders from January to September 2021. Matched individuals were followed up until a SARS-CoV-2 infection was contracted or a censoring event occurred. Vaccine effectiveness in preventing infections was estimated by the difference in restricted mean survival time (RMST). Primary vaccination extended the average free-of-infection time by 35.9 [95% confidence interval (CI) (34.9-37.0)], 59.6 [95% CI (59.3-60.0)], and 1.6 [95% CI (1.1-2.0)] days over 365 days in the population cohort of Aragon (Spain), Brussels and Wallonia (Belgium), and Finland, respectively. This federated population-based observational study showed the effectiveness of the SARS-CoV-2 primary vaccination campaign in prolonging the mean time to infection in the Aragon (Spain) and Brussels and Wallonia (Belgium) population cohorts. Only a minor difference over this time frame was found in Finland’s population cohort.
43. A Case-Control Study On Corpus Callosum Volume and Clinical Correlates in Treatment-Resistant and Responsive Schizophrenia Patients: Addressing MRI Analysis within Single-Subject and a Novel Artificial Intelligence Paradigm.
期刊: Current neuropharmacology 发表日期: 2026-Jan-07 链接: PubMed
摘要
The corpus callosum (CC) is critical for inter-hemispheric integration, and its structural abnormalities have been implicated in the neurobiology of schizophrenia (SCZ). Approximately 20-35% of SCZ patients exhibit resistance to antipsychotics and are classified as treatment-resistant schizophrenia (TRS). To date, no studies have specifically analyzed CC morphology in TRS compared to healthy controls (HCs) and treatment-responsive SCZ patients (non-TRS). The study included 75 HCs and 97 SCZ patients (39 TRS and 58 non-TRS, including cannabis users and non-users). Participants underwent cross-sectional assessment using the Neurological Evaluation Scale (NES), the Brief Assessment of Cognition in Schizophrenia, and the Positive and Negative Syndrome Scale (PANSS). CC volume was measured via MRI and analyzed with a novel artificial intelligence program (MRI-AI) for single-subject assessment, with findings confirmed through group-level voxel-based morphometry (VBM). TRS patients exhibited significantly higher total PANSS (p < 0.001) and NES (p < 0.001) scores and performed worse on working memory tasks compared to non-TRS patients. MRI-AI identified CC volume reduction in 55.88% of TRS patients (TRS CC: 3.02 mL vs. non-TRS with cannabis use: 3.69 mL; without cannabis use: 3.28 mL; p = 0.002). VBM confirmed significant CC volume reduction in TRS patients relative to HCs (p = 0.004). Cannabis use in non-TRS patients did not significantly affect CC volume or cognitive performance. TRS is associated with pronounced neurological, cognitive, and clinical dysfunctions. Aberrant CC volume may contribute to TRS pathogenesis and executive function deficits. MRI-AI provides a robust, single-subject approach for characterizing CC abnormalities in schizophrenia, offering potential for personalized clinical assessment.
44. Enzyme-cascade-amplified colorimetric biosensing platform for sub-nanomolar methylmercury in environmental waters.
期刊: RSC advances 发表日期: 2026-Jan-07 链接: PubMed
摘要
We developed an enzyme-cascade-amplified whole-cell biosensor for sub-nanomolar methylmercury (MeHg) detection in environmental waters. By integrating a MerB-based organomercurial lyase with a water-soluble indigoidine reporter system in a decoupled genetic circuit, we achieved a limit of detection (LOD) of 0.04 nM and a linear range of 0.02-1.22 nM. Systematic comparison of intracellular versus surface-displayed MerB strategies revealed that intracellular expression (TOP10/pCon-IND-C-B) provided superior sensitivity. The biosensor demonstrated robust performance across tap water, surface water, and seawater matrices (R 2 > 0.98) with negligible matrix effects, enabling direct colorimetric quantification of culture supernatants. Notably, metabolic burden from pigment synthesis dominated the dose-response profile rather than MeHg cytotoxicity. This biosensor offers a cost-effective alternative for screening MeHg in environmental water, with detection limits that far exceed WHO drinking water guidelines and a potential for high-throughput environmental monitoring.
45. Caffeine Mitigates Adenosine-Mediated Angiogenic Properties of Choroidal Endothelial Cells Through Antagonism of A1 Adenosine Receptor and PI3K-AKT Axis.
期刊: Cells 发表日期: 2026-Jan-05 链接: PubMed
摘要
Aging reduces the tissue regenerative capacity, promotes chronic inflammation, and contributes to neurodegenerative diseases, including age-related macular degeneration (AMD). AMD is a leading cause of vision loss in older adults and manifests as dry (atrophic) or wet (neovascular) disease. Although dry AMD is more prevalent, neovascular AMD (nAMD) causes the most severe vision impairment and remains a major public health burden. Oxidative stress-mediated inflammation and dysfunction of retinal pigment epithelium (RPE) cells and choriocapillaris drive early AMD. Neovascular AMD is marked by pathologic choroidal neovascularization (CNV), driven largely by dysregulated VEGF signaling. Anti-VEGF therapies are the current standard of care for nAMD but require frequent intravitreal injections, carry procedure-related risks, and are ineffective in a substantial subset of patients, underscoring the need for new therapeutic approaches. Caffeine, a widely consumed and well-tolerated adenosine receptor antagonist, has emerging relevance in vascular regulation and inflammatory signaling. Extracellular ATP and its metabolites, including adenosine, accumulate under stress and act through purinergic receptors to influence angioinflammatory processes. We recently showed that systemic caffeine administration suppressed CNV in vivo, an effect partly reproduced by the adenosine receptor A2A antagonist Istradefylline. Here, we investigated the cell-autonomous effects of caffeine on mouse choroidal endothelial cells, focusing on its role as an adenosine receptor antagonist and its potential to inhibit pathological neovascularization.
46. Response to Sansom et al.
期刊: Genetics in medicine : official journal of the American College of Medical Genetics 发表日期: 2026-Jan 链接: PubMed
摘要
47. Epstein-Barr Virus-Associated T/NK-Cell Neoplasms.
期刊: Journal of medical virology 发表日期: 2026-Jan 链接: PubMed
摘要
Epstein-Barr virus (EBV)-associated T- and natural killer (NK)-cell neoplasms encompass a heterogeneous spectrum, ranging from persistent lymphoproliferative disorders (e.g., severe mosquito bite allergy, systemic chronic active EBV disease) to highly aggressive malignancies (e.g., extranodal NK/T-cell lymphoma [ENKTL], aggressive NK-cell leukemia). Genomic and epigenetic studies have revealed shared host genetic alterations-most notably in JAK-STAT signaling, epigenetic regulators, TP53, and DDX3X-supporting a pathogenic and clinicobiological continuum across these disorders. Defective EBV further reshapes viral gene expression programs and contributes to oncogenesis. l-asparaginase-based chemoradiotherapy has improved outcomes in early-stage ENKTL; however, effective treatments for advanced-stage disease and other EBV-associated T/NK-cell neoplasms remain limited. Emerging molecular subclassifications and large-scale prospective cohorts can help clarify disease heterogeneity and accelerate the development of precision therapeutic strategies.
48. Parent and Therapist Perceptions of Early Therapy for Infants With or at Risk of Cerebral Palsy: A Scoping Review.
期刊: Child: care, health and development 发表日期: 2026-Jan 链接: PubMed
摘要
Currently, the early detection of cerebral palsy (CP) or risk of CP is recommended to enable targeted and specific intervention. The provision of early therapy is a complex practice that places high demands on both parents and therapists. More knowledge about the perceptions of parents and therapists is needed to help the implementation of family-centred early therapy interventions that are based on recent evidence in clinical practice. This scoping review aims to identify the extent of literature and summarize the evidence exploring parents’ and therapists’ experiences of early occupational and physical therapy for infants with or at risk of CP. The scoping review was conducted in accordance with the JBI methodology for scoping reviews and reported following the PRISMA Extension for Scoping Reviews checklist. The experiences of parents and therapists were categorized using qualitative content analysis. In total, 16 studies published between 2018 and 2024 were included. Parent-reported experiences were included in 15 studies and therapist-reported experiences in three. The content analysis resulted in five categories reflecting perceptions of valued and challenging aspects of early therapy. Four categories concerned parents’ perceptions: parental commitment, parent-therapist collaboration, parents as training providers and parental education. One category concerned therapists’ perceptions: providing guidance and educating parents. Insight into perceptions of early therapy highlights the importance of professional coordination of intervention, specific training of therapists, managing parents’ feelings of uncertainty and balancing parents’ engagement in their role as treatment providers and the pressure they may experience from the responsibility this role entails. This finding contributes important knowledge for the successful implementation of family-centred and evidence-based early therapy interventions in clinical practice for infants with or at risk of CP. A limited number of studies exploring therapists’ perceptions were identified, which indicates a knowledge gap and a need for further research.
49. Exploring the Muco-Microbiotic Interface as a Hub for Microbial Metabolites and Immune Regulation in Gastroenteric Health and Disease.
期刊: Cells 发表日期: 2025-Dec-25 链接: PubMed
摘要
The mucus layer covering the gastrointestinal tract forms a specialised interface where mucins, microbes, and extracellular vesicles create a dynamic, self-regulating ecosystem. Here, we introduce the concept of the muco-microbiotic layer as an integrated eco-physiological system that maintains mucosal homeostasis through coordinated structural, metabolic, and immune functions. The MuMi layer varies regionally in its biochemical composition, microbial inhabitants, and environmental parameters-from the acidic stomach to the anaerobic colon-thereby generating distinct niches for microbial colonisation and metabolite production. We summarise current evidence on how mucin glycans, mucus-associated microbiota, and vesicle-mediated signalling sustain barrier integrity, nutrient flux, and immune tolerance. Perturbations in any of these components lead to barrier failure, microbial encroachment, and inflammation, contributing to a broad spectrum of disorders, including gastritis, inflammatory bowel disease, colorectal cancer, and metabolic syndrome. Methodological advances such as organoid and mucus-on-chip models, spatial multi-omics, and vesiculomics are now enabling site-specific analyses of this complex system. Conceptually, defining the mucus, microbiota, and vesicular compartments as a single MuMi layer provides a new framework for understanding mucosal physiology and pathophysiology, emphasising the interdependence between structure and function. Integrating this perspective into experimental and clinical research may open new avenues for diagnostics and therapies targeting mucosal health.
50. Therapeutic Antibodies in Hematology: Advances in Malignant and Non-Malignant Disorders.
期刊: Cells 发表日期: 2025-Dec-25 链接: PubMed
摘要
Therapeutic antibodies have revolutionized hematology, offering targeted and effective treatments for both malignant and non-malignant diseases. In hematologic malignancies, anti-CD20, anti-CD19, anti-CD38, and anti-B-cell maturation antigen (BCMA) antibodies have markedly improved survival outcomes, whereas antibody-drug conjugates and bispecific antibodies continue to expand therapeutic possibilities. Besides cancer, complement inhibitors such as eculizumab, ravulizumab, and the recently approved crovalimab have redefined paroxysmal nocturnal hemoglobinuria and atypical hemolytic uremic syndrome management, and the bispecific antibody emicizumab has transformed prophylaxis in hemophilia A. Furthermore, novel antibody formats such as the trifunctional anti-CD38 × CD3 antibody (Tri-31C2) exhibit enhanced anti-myeloma activity compared to chimeric CD38 antibodies, underscoring the future potential of T-cell-redirecting designs. This review summarizes key developments in therapeutic antibodies for hematological disorders, their action mechanisms, and emerging strategies to further optimize their efficacy and safety.
51. Lymphatic Endothelial Cells and Organ-Associated Lymphangiogenesis in Tumor Microenvironment.
期刊: Cells 发表日期: 2025-Dec-23 链接: PubMed
摘要
Lymphatic vessels are a kind of heterogeneous and versatile component of the lymphatic system, with a unique ability to respond to environmental changes in different organs. The heterogeneity and plasticity of lymphatic endothelial cells (LECs) and defective lymphatic architecture are critical for organ-specific lymphatic function. Moreover, lymphatic vessels have a dual effect on tumor microenvironment (TME), and lymphangiogenesis, an active and dynamic player, is a hallmark of cancer progression and treatment resistance. Dysregulation of lymphatic vessels and uncontrolled lymphangiogenesis contribute to the pathogenesis of many diseases, including cancer. Increasing evidence has indicated that lymphangiogenesis provides a critical target for inhibiting lymphatic metastasis, in which immune checkpoint inhibitors, either alone or combined with chemotherapy, may have a therapeutic value. This article reviews the current status of tumor-associated lymphangiogenesis and lymphatic remodeling, as well as the crosstalk among LECs, immune cells and cancer cells, which will help to further understand the role of lymphangiogenesis in cancer progression, metastasis, and therapy.
52. Human Cardiac Organoids: Advances and Prospects from Construction to Preclinical Drug Evaluation.
期刊: Cells 发表日期: 2025-Dec-19 链接: PubMed
摘要
Drug-induced cardiotoxicity (DICT) severely hampers drug development and threatens patient safety. Together with the growing global burden of cardiovascular disease, there is an urgent need to establish more predictive preclinical models. Recently, human pluripotent stem cell-derived cardiac organoids (hCOs) have emerged as a promising three-dimensional in vitro model, achieving significant progress in simulating the complex structure and function of the human heart. However, existing reviews predominantly focus on technical construction or specific applications, lacking an integrated discussion of pathological model construction and their use under evolving regulatory frameworks. This review distinguishes itself by proposing a novel, holistic framework that bridges “construction technology,” “pathological modeling,” and “application evaluation.” We systematically categorize and summarize three major strategies for building hCO-based pathological models: patient-specific, gene-edited, and microenvironment-modulated approaches. Furthermore, we highlight the unique advantages of hCOs in preclinical drug assessment and detail their cutting-edge applications in early DICT warning, metabolism-related safety evaluation, and personalized drug evaluation. Finally, we address current challenges, including maturation and standardization, and outline future directions involving integration with organ-on-a-chip technology and artificial intelligence. This review aims to provide a theoretical foundation and roadmap toward more reliable and human-relevant drug development paradigms.
53. Biomarkers.
期刊: Alzheimer’s & dementia : the journal of the Alzheimer’s Association 发表日期: 2025-Dec 链接: PubMed
摘要
Environmental factors, including pesticides, are increasingly associated with an increased risk of Alzheimer’s disease (AD). Although banned in 1972, DDT remains persistent due to its long half-life, bioaccumulation, and residual dumpsites. However ubiquitous, its metabolite, dichlorodiphenyldichloroethylene (DDE), is considered non-neurotoxic. We previously reported that serum DDE levels were nearly 4x higher in AD patients compared to healthy individuals. Here, we assessed: i) effects of subchronic DDE exposure on serum Aβ-42/40, brain Aβ pathology, and cognition in 5xFAD mice, and ii) impact of prenatal DDE exposure on midlife plasma Aβ-42/40 in humans. Six-week-old male 5xFAD mice were exposed to 3 mg/kg p,p’-DDE or corn oil every 3 days for 90 days. At 4.5 months, mice were sacrificed post-behavioral testing; brains were drop-fixed for staining, hippocampi dissected, and serum collected for biochemical assays. For prenatal p,p’-DDE exposure, offspring born into the Child Health and Development Studies (CHDS) were recruited in 2010 for follow-up (∼50 years), completing cognitive tests and providing blood samples. Plasma Aβ-42/40 ratio in midlife was measured using the Quanterix N3PA kit (N = 160). In DDE-exposed 5xFAD mice, MSD analysis showed significantly elevated Guanidine-HCl (GuHCl)-soluble Aβ42 (∼100-fold) and formic acid (FA)-soluble Aβ42 (∼5-fold), indicating increased insoluble Aβ. Serum Aβ-42/40 was significantly reduced by 31% in DDE-exposed mice and was correlated with elevated brain Aβ42 in the GuHCl (r = -0.42) and FA fractions (r = -0.40). DDE-exposed mice displayed working memory deficits, performing 20% worse in Y-maze, which correlated with low serum Aβ-42/40 (r = 0.42). In the CHDS cohort, higher prenatal DDE was associated with lower midlife Aβ-42/40. In logistic models, the Odds Ratio for estimating lower Aβ-42/40 was 2.6 and 3.2 for DDE tertiles 2 and 3, respectively. The test for trend across DDE tertiles was significant (p = 0.04). Higher prenatal DDE was also associated with lower midlife Wechsler Digit Symbol Substitution Task score (β = -0.0221). These findings show that DDE is an active metabolite of DDT and has lasting neurological effects on the amyloid system and cognition. This translational evidence highlights the role of early-life environmental exposures in AD risk and opportunities for early interventions to prevent disease progression.
54. IMPACT OF LEARNING ATTITUDES ON LEARNING ENGAGEMENT AMONG MEDICAL STUDENTS AT A VOCATIONAL COLLEGE: A CASE STUDY OF MEDICAL STATISTICS.
期刊: Georgian medical news 发表日期: 2025-Nov 链接: PubMed
摘要
This study aimed to identify factors influencing learning attitudes and study engagement among vocational medical students and to further analyze the impact of learning attitude on study engagement. A total of 243 first-year students enrolled in the Medical Statistics course at our institution participated in the study. They were assessed using the Chinese versions of the Statistical Attitudes Towards Teaching Survey (SATS-36) and the Utrecht Work Engagement Scale for Students (UWES-S). Linear regression analysis was employed to examine the effect of learning attitude on study engagement. Significant differences were observed in both the total learning attitude scores and overall study engagement scores based on students’ perceptions of course interest, practicality, and teaching quality (all P<0.05). A significant difference was also found in the vigor dimension of study engagement between only children and non-only children (P=0.036). Multivariate linear regression analysis indicated that mean scores for the cognitive component, interest, and effort in learning attitude had a significant positive effect on total study engagement scores, whereas the mean score for perceived difficulty had a significant negative effect. The overall levels of learning attitude and study engagement among the vocational students were moderate. Cultivating positive learning attitudes may help enhance students’ study engagement.
55. THE EFFICACY OF SENSORY-ADAPTED DENTAL INTERVENTIONS FOR CHILDREN WITH DEVELOPMENTAL DISABILITIES AND SENSORY SENSITIVITIES.
期刊: Georgian medical news 发表日期: 2025-Nov 链接: PubMed
摘要
Children diagnosed with autism spectrum disorder (ASD) are often more sensitive to environmental stimuli, particularly light, sound, and touch, which can provoke significant anxiety and behavioral resistance during dental visits, thereby contributing to poor oral health. To assess the efficacy of sensory adapted dental environments (SADEs) and related interventions to reduce dental anxiety by improving behavioral cooperation of children with ASD based on peer-reviewed evidence. English language studies published between January 2010 and June 2025 were retrieved from the PubMed, ScienceDirect, and Google Scholar databases using the keywords “autism spectrum disorder,” “sensory adapted dental environment,” “multisensory,” “dental anxiety,” and “occupational therapy.” Reports were limited to randomized controlled trials, quasi experimental studies, observational research, and systematic reviews involving children with ASD or other developmental disabilities. Data were assessed qualitatively. Evidence indicates that SADEs consistently reduced physiological and behavioral signs of dental anxiety. A large crossover trial involving 162 autistic children reported that visual, auditory, and tactile adaptations significantly reduced stress during dental cleanings. Modifications (dimmed lighting, nature sounds, slow motion projections, and deep pressure wraps) were effective. A 2024 study involving neurotypical children found improved behavior and reduced anxiety in the SADE group, along with lower heart rates and higher oxygen saturation. A randomized trial of children with Down syndrome demonstrated that a multisensory waiting room significantly reduced heart rate and anxiety scores. While the primary focus was ASD, some comparative studies involving neurotypical children and children with Down syndrome were reviewed due to their relevance to sensory-processing mechanisms Meta-analyses of five studies found that SADEs significantly lowered psychophysiological markers of anxiety Conclusion: Current evidence supports the efficacy of SADEs to reduce anxiety and enhance cooperation of children with ASD. These interventions are cost-effective, feasible, and easily tailored to individual sensory profiles. Future research is recommended to examine long-term outcomes, implementation in community settings, and integration with behavioral approaches.
56. The risk of cardiovascular, cerebrovascular and thromboembolic events after community-acquired pneumonia among adults: a systematic literature review.
期刊: European respiratory review : an official journal of the European Respiratory Society 发表日期: 2025-Jan 链接: PubMed
摘要
Community-acquired pneumonia (CAP) may prompt long-term complications. We reviewed the absolute and relative risks of cardiac/vascular events after pneumococcal (PCAP) and all-cause CAP (aCAP) in adults. We searched Embase and PubMed for publications from high-income countries between 2000 and 2021, comparing the relative risk of cardiac/vascular events after CAP in adults to those without CAP. We also reviewed event risks among patients with CAP. In this review, CAP has been used as an umbrella term, including both PCAP and aCAP. We included 19 of 6917 identified publications. CAP was independently associated with cardiovascular disease (CVD), including heart failure and acute coronary syndrome, as well as deep-vein thrombosis and pulmonary embolism. The relative risk for cardiac/vascular events in the year post-CAP ranged from 1.4 to 4.1 compared to non-CAP patients. The highest risk occurred immediately after the CAP episode, but the risk remained elevated for years. The risk for CVD <1 year post-CAP was 4.6% in individuals aged 45-64 years and 17.9% for those aged 65+ years. The cumulative risk of cardiac/vascular events after CAP increased with time of follow-up and comorbidities. Cardiac/vascular events occur frequently after CAP and the association persists beyond the acute phase of infection. Public health evaluations of interventions for the prevention of CAP should consider these long-term sequelae.
57. Impacts of diabetes mellitus in the workplace: an integrative review of occupational and economic factors.
期刊: Revista brasileira de medicina do trabalho : publicacao oficial da Associacao Nacional de Medicina do Trabalho-ANAMT 发表日期: 2025 链接: PubMed
摘要
Diabetes mellitus is a highly prevalent chronic condition worldwide and has a substantial impact on workers’ quality of life and productivity. Its consequences extend beyond clinical manifestations and reach broader social and economic dimensions. Additionally, the workplace can function as a risk factor for the development or worsening of the disease. The aim was to examine the impacts of diabetes mellitus in occupational settings and identify the main work-related factors associated with its occurrence and productivity outcomes. This integrative review was conducted through searches in the Virtual Health Library and PubMed using Portuguese and English descriptors related to diabetes, occupational health, risk factors, and workplace medicine. Studies published in English or Portuguese and relevant grey literature were included. The findings were organized into two thematic categories: economic impact and occupational factors associated with diabetes. Diabetes mellitus was associated with substantial productivity losses, increased absenteeism, presenteeism, and early retirement. Occupational factors such as shift work, long working hours, chronic stress, low job control, and effort-reward imbalance were identified as determinants of type 2 diabetes. A scarcity of studies addressing how workplace conditions influence the management of type 1 diabetes was observed. It was concluded that diabetes mellitus should be recognized as a significant occupational health concern. Implementing workplace health policies, organizational interventions, and health-promotion programs may contribute to disease prevention and to preserving workers’ functional capacity. O diabetes mellitus é uma doença crônica de alta prevalência global, que compromete a qualidade de vida e a produtividade dos trabalhadores. Seus impactos extrapolam o campo clínico, alcançando dimensões sociais e econômicas relevantes. Além disso, o ambiente de trabalho pode atuar como fator de risco para o desenvolvimento ou agravamento da doença. O objetivo foi analisar os impactos do diabetes mellitus no contexto ocupacional e identificar os principais fatores laborais associados à sua ocorrência e aos desfechos produtivos. Esta revisão integrativa foi conduzida com buscas nas bases Biblioteca Virtual em Saúde e PubMed, utilizando descritores em português e inglês relacionados a diabetes, saúde ocupacional, fatores de risco e medicina do trabalho. Foram incluídos estudos publicados em inglês ou português, bem como literatura cinzenta pertinente ao tema. Os resultados foram organizados em duas categorias temáticas: impacto econômico e fatores ocupacionais associados ao diabetes. O diabetes mellitus mostrou-se associado a perdas significativas de produtividade, maior absenteísmo, presenteísmo e aposentadoria precoce. Fatores ocupacionais como trabalho em turnos, jornadas prolongadas, estresse crônico, baixa autonomia e desequilíbrio esforço-recompensa foram identificados como determinantes do diabetes tipo 2. Observou-se escassez de estudos sobre a influência do ambiente laboral no manejo do diabetes tipo 1. Concluiu-se que o diabetes deve ser reconhecido como um agravo ocupacional relevante. A implementação de políticas de saúde no trabalho, intervenções organizacionais e programas de promoção da saúde pode contribuir para a prevenção da doença e para a preservação da capacidade laborativa dos trabalhadores.