公共卫生研究摘要 (2026-01-16)
共收录 57 篇研究文章
1. A longitudinal study of supportive care needs among Chinese parents of children with acute lymphoblastic leukemia.
期刊: Asia-Pacific journal of oncology nursing 发表日期: 2026-Dec 链接: PubMed
摘要
To determine parents’ supportive care needs trajectories over the first 8 months following their children’s diagnosis and identify the predictors of these trajectories. Overall, 100/112 Chinese parents of children newly diagnosed with ALL were recruited. The parents’ supportive care needs were tracked at four key time points when the needs were most likely to change: post-diagnosis, induction remission phase, consolidation therapy phase, and post-acute treatment. Latent class growth modeling (LCGM) or growth mixture model (GMM) was used to identify trajectories within each of six needs domains of supportive care needs. Logistic regression was used to identify factors predicting trajectory patterns. Overall, parents’ supportive care needs peaked immediately after diagnosis, declined throughout treatment, and stabilized between the consolidation and post-acute stages. Notably, the trajectories of each domain varied across parent subgroups. Three health care and informational needs trajectories, two daily care and communication needs trajectories, two psychological and spiritual needs trajectories, two medical service needs trajectories, three economic needs trajectories, and two emotional needs trajectories were identified. The class membership was significantly associated with parents’ education level, employment status, the family’s residency area, average monthly household income, type of medical payment, daily caregiving time, age of child, single child, parents’ self-efficacy, and caregiving ability (P < 0.05). This study identified the dynamic evolution and distinct trajectories of parents’ supportive care needs, along with their key predictors. The findings provide a solid foundation for developing stage- and population-specific interventions, offering practical guidance for optimizing family-centered care and informing supportive policy formulation in pediatric oncology settings.
2. Methodological Advances in GC-MS for Complex Plant Matrices: Profiling Essential Oils From Apiaceae Flora.
期刊: Rapid communications in mass spectrometry : RCM 发表日期: 2026-Apr-15 链接: PubMed
摘要
Charmatography based pphytochemical extraction to identify and quantification of volatile bioactive compounds providing chemical profiling to evaluate their pharmacological significance. The component composition of essential oils of Bilacunaria microcarpa (M. Bieb.) Pimenov & V.N.Tikhom. and Peucedanum ruthenicum M. Bieb. distributed in the flora of Azerbaijan was studied using the method of gas chromatography-mass spectroscopy. In the composition of the essential oil of B. microcarpa, 70 components were found, of which 59 were identified; the mains of them are beta-phellandrene (12.86%), beta-pinene (10.18%), O-cymol (8.84%), L-borneol (7.85%), 1R-alpha-pinene (7.64%), caryophyllene (7.37%), beta-caryophyllene oxide (4.43%), and β-elemene (3.97%). In the essential oil of P. ruthenicum that were also identified, 60 of them were major components, of which are m-cymene (14.08%), beta-myrcene (13.34%), limonene (9.01%), 2-methylenebornane (6.68%), acetylcyclopentanone (4.39%), 1R-alpha-pinene (3.90%), and cryptone (3.77%). Antifungal activity of both B. microcarpa and P. ruthenicum species, as well as their aqueous extracts and essential oils, was revealed. It was found that the studied plants and their aqueous extracts exhibit fungistatic activity on the growth of Trichoderma lignorum and Aspergillus niger fungal colonies, whereas B. microcarpa and their aqueous extracts exhibit fungicidal action on Fusarium oxysporum, and essential oils of the studied species in all concentrations exhibited absolute fungicidal action against this fungus, Aspergillus niger.
3. Nitrogen Isotope Analysis of Aliphatic and Aromatic Amines by GC-C-IRMS and the Application for Tracing Atmospheric Organic Amine Sources.
期刊: Rapid communications in mass spectrometry : RCM 发表日期: 2026-Apr-15 链接: PubMed
摘要
Compounds-specific stable isotope analysis (CSIA) is an advanced tool for assessing the sources and fates of organic amines in environments. The use of gas chromatography-combustion-isotope ratio mass spectrometry (GC-C-IRMS) remains constrained by the thermal stability, high polarity, and the typically low environmental concentrations of organic amines. The development of suitable derivatization strategies for polar organic amines can broaden the applicability of GC-C-IRMS. To establish a nitrogen stable isotope analytical method for polar organic amines in the atmosphere, derivatization with isobutyl chloroformate (IBCF) reagent was adopted. Method performance was evaluated using six aliphatic amines and three aromatic amines. The derivatization method demonstrated good reproducibility, high linearity, and no detectable isotopic fractionation. Accurate and precise nitrogen stable isotope measurements were achieved using the IBCF derivatization reagent. Deviations of δ15N values from reference measurements obtained by elemental analyzer-isotope ratio mass spectrometry (EA-IRMS) were small (< 0.3‰) and within the typical uncertainty of GC-C-IRMS (< 0.6‰). Method detection limits (MDLs) for the nine organic amines ranged from 2.06 to 4.12 nmol N injected on column. The applicability of the developed method was demonstrated through analysis of atmospheric methylamine (MA). The measured δ15N values of MA varied significantly across sources, ranging from -11.6‰ to -9.1‰ for vehicular exhaust, -20.2‰ to -15.7‰ for coastal samples, and -26.7‰ to -22.2‰ for municipal solid waste sanitary sources, indicating that δ15N values effectively distinguish MA sources.
4. A platform for generating clinical intelligence from routine health data in hospitals: PICTURE.
期刊: Future healthcare journal 发表日期: 2026-Mar 链接: PubMed
摘要
The proliferation of electronic health records has led to an increasing volume of routine data about patients, their conditions and clinical interventions. While these data are widely used by clinicians to inform treatment, there is little standardised aggregation for clinical support or operational insights. This research explores a possible approach to redressing this. We describe a scalable ‘clinical intelligence tool’ allowing researchers and managers to aggregate and analyse routine data in a generalised form, generating on-demand analyses for clinical planning and hospital operations. We demonstrate a proof-of-concept implementation, called PICTURE. In addition to detailing the architecture of this tool, we show how it can address analytics questions, such as providing an informatics consult to address clinicians’ questions. We show that aggregating health record data in a clinical intelligence tool has the potential to improve clinical practice, healthcare provider operations and more. The key innovations are the generalisation and standardisation of analytical methods for reuse across a range of EHR data; the use of generic data models to support the reusability and composability of analyses; and the approach of developing analytic functionality with open-source languages and modern software development practices.
5. Association of postoperative haemoglobin with adverse outcomes in patients undergoing cardiac surgery: a retrospective single centre cohort study.
期刊: BJA open 发表日期: 2026-Mar 链接: PubMed
摘要
Preoperative anaemia is an important risk factor for adverse outcomes in cardiac surgery, however data on postoperative anaemia is sparse. The aim of this study is to characterise the association of postoperative haemoglobin with 30-day mortality and morbidity after cardiac surgery. We performed a retrospective cohort study of adults (age ≥18 yr) undergoing coronary revascularisation, valve surgery, or a combination at Toronto General Hospital from 2016 to 2020. We analysed the association between nadir postoperative day 1 (POD1) haemoglobin as a continuous and binary variable (haemoglobin ≤80 g L-1), with a primary composite outcome of 30-day mortality, stroke, myocardial infarction, acute kidney injury, sternal wound infection, or a combination. The secondary outcome was the incidence of adverse events. The primary outcome was analysed using logistic regression, secondary using Poisson regression; adjusted models accounted for clustering and confounders. We included 5960 patients. On POD1, mean haemoglobin was 90.1g L-1 (standard deviation 15.2) and 1794 patients (30%) had haemoglobin ≤80 g L-1. Red blood cells were transfused to 49% of the cohort, and to 90% of patients with POD1 haemoglobin ≤80 g L-1. Each 10 g L-1 decrease in POD1 haemoglobin increased the odds of the primary outcome (adjusted odds ratio [OR] 1.15 [1.05-1.25], P<0.001), as did haemoglobin ≤80 g L-1 (adjusted OR 1.44 [1.19-1.75], P<0.001). For adverse events, each 10 g L-1 decrease in haemoglobin was associated with an increased incidence rate ratio (IRR) (adjusted IRR 1.14 [1.07-1.20], P<0.001), as was haemoglobin <80 g L-1 (adjusted IRR 1.33 [1.16-1.54], P<0.001). In postoperative cardiac surgical patients, progressive decreases in postoperative haemoglobin are associated with increased risk of mortality and major morbidity at 30 days.
6. Back on track, but still benched: Long-term impact of patellar dislocation on sport and function - A retrospective cohort study.
期刊: Journal of orthopaedics 发表日期: 2026-Mar 链接: PubMed
摘要
To assess the long-term clinical outcomes following patellar dislocation, including patients with primary and recurrent dislocations and those treated surgically. A retrospective cohort study of patients with patellar dislocation between January 2019 and December 2022. Participants completed a questionnaire >6 months after their most recent dislocation or >1 year following patellar stabilization surgery. The primary outcome was the Kujala score. Secondary outcomes included the Tegner Activity Scale, Knee Self-Efficacy Scale (K-SES), Patient Acceptable Symptom State (PASS), and the Sporting Activity Questionnaire (SAQ). Comparisons were made between primary dislocations, recurrent dislocations, and those who underwent surgery. 228 participants were included: 66 with primary dislocation, 88 with recurrent dislocations, and 74 who had undergone surgery. The median Kujala score was 89 (78-96) for primary, 82 (72-92) for recurrent, and 78 (65-89) for the surgical group (p < 0.001). The SAQ showed a decline in high-impact sport participation and an increase in no sport participation from pre-to post-injury. These changes were statistically significant in the recurrent group (p < 0.001) and the surgery group (p < 0.001), but not in the primary group (p = 0.143). According to PASS, 49 % of participants reported dissatisfaction with their current knee function. Patellar dislocations may cause long-term physical limitations and reduced sports participation, with about half of patients dissatisfied with knee function after 2-3 years. Surgery does not appear sufficient to restore patients to full physical function.
7. Acinetobacter enrichment shapes composition and function of the bacterial microbiota of field-grown tomato plants.
期刊: mSphere 发表日期: 2026-Jan-15 链接: PubMed
摘要
Tomato is a staple crop and an excellent model to study host-microbiota interactions in the plant food chain. In this study, we describe a “lab-in-the-field” approach to investigate the microbiota of field-grown tomato plants. High-throughput amplicon sequencing revealed a three-microhabitat partition, phyllosphere, rhizosphere, and root interior, differentiating host-associated communities from the environmental microbiota. An individual bacterium, classified as Acinetobacter sp., emerged as a dominant member of the microbiota at the plant-soil continuum. To gain insights into the functional significance of this enrichment, we subjected rhizosphere specimens to shotgun metagenomics. Similar to the amplicon sequencing survey, a “microhabitat effect,” defined by a set of rhizosphere-enriched functions, was identified. Mobilization of mineral nutrients, as well as adaptation to salinity and polymicrobial communities, including antimicrobial resistance genes (ARGs), emerged as a functional requirement sustaining metagenomic diversification. A metagenome-assembled genome representative of Acinetobacter calcoaceticus was retrieved, and metagenomic reads associated with this species identified a functional specialization for plant-growth promotion traits, such as phosphate solubilization, siderophore production, and reactive oxygen species detoxification, which were similarly represented in a tomato genotype-independent fashion. Our results revealed that the enrichment of a beneficial bacterium capable of alleviating plant abiotic stresses appears decoupled from ARGs facilitating microbiota persistence at the root-soil interface.IMPORTANCETomatoes are at center stage in global food security due to their high nutritional value, widespread cultivation, and versatility. Tomatoes provide essential vitamins and minerals, contribute to diverse diets, and support farmer livelihoods, making them a cornerstone of sustainable food systems. Beyond direct dietary benefits, the intricate relationship between tomatoes, their associated microbiota, and antimicrobial resistance gene (ARG) is increasingly recognized. Tomato plants host diverse microbial communities in association with their organs, which influence plant health and productivity. Crop management impacts the composition and function of these communities, contributing to the prevalence of ARGs in the soil and on the plants themselves. These genes can potentially transfer to human pathogens, posing a food safety and public health risk. Understanding these complex interactions is critical for developing sustainable agricultural practices capable of mitigating the impact of climatic modifications and the global threat of antimicrobial resistance.
8. Machine learning-based typing of Clostridium botulinum group III by FT-IR spectroscopy.
期刊: Microbiology spectrum 发表日期: 2026-Jan-15 链接: PubMed
摘要
This study aimed to investigate the utility of Fourier-Transform Infrared Spectroscopy (FT-IRS) for differentiating Clostridium botulinum (C. botulinum) based on its botulinum neurotoxin (BoNT)-encoding gene type and its potential as an epidemiological tool for investigating botulism outbreaks. A total of 110 botulinum neurotoxin-producing clostridia (BNPC) strains, including reference, animal isolates, and human outbreak strains, were analyzed in four replicates using the IR Biotyper system (IRBT). Samples preparation was carried out according to the manufacturer’s instructions. Similarity analysis was performed by hierarchical cluster analysis (HCA), principal component analysis (PCA), and linear discriminant analysis (LDA). The artificial intelligence capabilities of the IRBT software were applied to develop a classifier for C. botulinum differentiation at toxin-serotype or subtype level. HCA, PCA, and LDA showed a good clustering of strains belonging to the same type. In accordance with the lineages evidenced in whole-genome sequencing (WGS) studies, types A, B, and F BNPC appeared clearly separated from types C, CD, DC, and D. Considering only C, CD, DC, and D types, the highest discriminatory power is achieved in the wavenumber range 1,800-1,500 cm-1. Four different clusters were detected. Support vector machine algorithm with linear kernel (Linear SVM) showed the highest accuracy of discrimination at the BoNT type level with an accuracy of 97%. Although these preliminary results need to be confirmed with a higher number of strains, the IRBT system proved to be a very promising, user-friendly, and cost-effective tool for C. botulinum typing, and the application of machine learning algorithms represents a novel approach for BNPC typing.IMPORTANCEBotulism outbreaks represent a significant threat to public and animal health. Rapid and accurate typing methods are essential for effective epidemiological investigations, source tracing, and the implementation of appropriate control measures. Current methods for botulinum neurotoxin serotyping are often time-consuming, expensive, and require specialized expertise. Our research demonstrated that FT-IRS, a rapid, user-friendly, and cost-effective technique already well established in microbiology for broader bacterial characterization, can be successfully adapted for this crucial task. The use of a commercially available system like the IRBT significantly enhances the potential for widespread adoption of this methodology in routine diagnostics and surveillance.
9. Real-world Evidence of Self-reported Treatments, Signs, and Symptom Burden in Chronic Hand Eczema: Findings from the Multinational CHECK Study.
期刊: Acta dermato-venereologica 发表日期: 2026-Jan-15 链接: PubMed
摘要
Chronic hand eczema is a multifactorial disease that can impact quality of life considerably. This observational questionnaire study aimed to investigate real-world treatments and patients’ experiences of disease burden across the broad severity spectrum represent-ed by the general chronic hand eczema population. The study included 1,948 individuals from 6 countries (mean age 43.2 years; 64.5% females) with self-reported physician-diagnosed chronic hand eczema. Ongoing treatment was reported in 68.6%, which included systemics or phototherapy (with or without topicals; 10.7%), topical corticosteroids (with or without additional topicals; 36.0%) and other topical treatments (no topical corticosteroids; 21.8%). At survey time, 43.0% were in flare state. About half, 51.1%, reported moderate to severe disease signs (past week). Treatment with topical corticosteroids was suboptimal in 9.7% of those with moderate to severe disease. Experience of symptoms was common, particularly itch. Symptom burden differed significantly between groups with different treatments and severity levels; it was highest among those reporting systemics/phototherapy and those for whom topical corticosteroids were suboptimal. The results indicate that, despite a high treatment rate, chronic hand eczema is associated with a considerable disease burden that varies significantly across the severity spectrum. A particularly high burden in treatment stages beyond topical corticosteroids indicates a need for more effective management of symptoms.
10. Socioeconomic and Structural Barriers to Addressing Obesity in Communities: A Scientific Statement From the American Heart Association.
期刊: Circulation 发表日期: 2026-Jan-15 链接: PubMed
摘要
The obesity epidemic continues largely unabated, affecting more than one-third of the US population and disproportionately burdening individuals from socioeconomically disadvantaged populations. Numerous factors contribute to the high prevalence of obesity, including socioeconomic and structural barriers impeding primordial and primary prevention efforts. Despite broad recognition that social determinants of health are key drivers of obesity, the importance of socioeconomic and structural factors as contemporary barriers to individual-, community-, and population-level obesity prevention and intervention efforts remains underappreciated. This scientific statement highlights multilevel barriers to obesity prevention and management, with an emphasis on social determinants of health, societal culture, and shared biases that may interfere with the success of healthy weight management programs. The assessment includes a comprehensive review of policy and community-level strategies used to address the obesity epidemic and identifies key areas for future research.
11. Imaging in Plasma-Cell Neoplasms: Italian Experts' Recommendations.
期刊: European journal of haematology 发表日期: 2026-Jan-15 链接: PubMed
摘要
Using suboptimal imaging modalities on the detection of bone and extra-bone myeloma lesions affects disease status recognition and early treatment decisions. Moreover, a systematic search of the evidence was not provided alongside the recommendations. The objective of this study was to assess the current real world imaging practices in Italy, influencing factors, and barriers to adopting international imaging guidelines for MGUS and MM (reported as plasma cell disorders, PCD) and to develop evidence-based, country-specific recommendations for imaging assessment of PCD patients. A national project was launched in 2024, involving experts from 32 hematology centers and 5 radiology services. A survey was conducted and a Delphi panel comprising 23 experts was used to reach a consensus on the developed recommendations. A total of 25 recommendations were finally formulated. The survey revealed that suboptimal imaging modalities were significantly contributing to the under-recognition of bone and extra-bone lesions in myeloma, leading to suboptimal disease status assessment and treatment decisions. The study emphasizes the importance of adopting effective imaging modalities to improve disease detection and guide treatment decisions in PCD patients. A country-specific, evidence-based set of imaging recommendations has been developed to address existing challenges in the adoption of international imaging guidelines.
12. Associations between the microbiome and immune responses to an adenovirus-based HIV-1 candidate vaccine are distinct between African and US cohorts.
期刊: mSystems 发表日期: 2026-Jan-15 链接: PubMed
摘要
Optimization of prophylactic vaccine regimens to elicit strong, long-lasting immunity is an urgent need highlighted by the COVID-19 pandemic. Stronger vaccine immunogenicity is frequently reported in individuals living in high-income countries compared to individuals living in low- and middle-income countries. While numerous host genetic and immune factors may influence vaccine responses, geographic restrictions to vaccine effectiveness may also be influenced by the intestinal microbiota, which modulates host immune systems. However, the potential role of the gut microbiota on responses to HIV-1 vaccines has not yet been explored. We analyzed the bacteriome by targeted 16S sequencing and the virome by virus-like particle sequencing of 154 fecal samples collected from healthy individuals in Uganda, Rwanda, and the United States early (week 2) and late (week 26) after vaccination with multivalent adenovirus serotype 26 (Ad26)-vectored mosaic HIV-1 vaccines. Vaccination did not affect the enteric bacteriome or virome regardless of geographic location. However, geography was the major driver of microbiota differences within this cohort. Differences in overall bacterial and viral diversity and in specific microbial taxa, including Bacteroidota and Bacillota, between participants from the United States and East African countries correlated with differential immune responses, including specific antibody titers, antibody functionality, and cellular immune responses to vaccination regimens. These findings support the microbiota as a putative modifier of vaccine immunogenicity.IMPORTANCEOur research examined how gut bacteria might influence vaccine effectiveness in different parts of the world. We studied adults from the United States, Rwanda, and Uganda who received an experimental HIV vaccine. We found that participants from East Africa had more diverse gut bacteria than those from the United States, but their immune responses to the vaccine were weaker. This is the first study to directly show this relationship between higher gut bacterial diversity and reduced vaccine effectiveness in the same group of people. We also identified specific types of bacteria that were linked to either stronger or weaker immune responses. These findings are particularly relevant now as we use vaccines globally to fight diseases like COVID-19, as they suggest that regional differences in gut bacteria Bacteroidota and Bacillota might help explain why vaccines work better in some places than others. This could inform how we design and test future vaccines.
13. Future Prospects for Using Clinical Phenotypes in Tuberculosis Precision Medicine-An Approach for Clinical Management.
期刊: Clinical infectious diseases : an official publication of the Infectious Diseases Society of America 发表日期: 2026-Jan-15 链接: PubMed
摘要
Developing shorter treatment regimens for tuberculosis requires careful characterization of the clinical phenotype, which is defined by patient characteristics, radiological extent of disease, mycobacterial burden, drug susceptibility, and host response. Advances in ‘omics and model-informed precision dosing, as well as integrated algorithms using artificial intelligence, need to be adapted and validated in clinical trials to improve classification of patients for stratified treatment. When treatment is initiated based on the clinical phenotype, monitoring of treatment response can be improved by quantification of bacterial load, transcriptomic and epigenetic biosignatures for sputum-free monitoring, and assessing disease burden by radiological and symptom scoring tools. Many of these tools are suitable for high-endemic settings. Such integrated monitoring allows prompt drug adjustments for rapid reduction in bacterial load, which prevents development of drug resistance and achieves relapse-free cure even with shorter treatment.
14. Impact of mutations affecting 4'-fluorouridine susceptibility on fitness and treatment outcomes for Venezuelan equine encephalitis virus.
期刊: Journal of virology 发表日期: 2026-Jan-15 链接: PubMed
摘要
Venezuelan equine encephalitis virus (VEEV) is a prototypical encephalitic alphavirus. Members of the Alphavirus genus are found across the globe, transmitted by arthropod vectors, and cause significant disease burdens in humans and animals. There are currently no FDA-approved antivirals for human use against any member of the Alphavirus genus. While a vaccine exists against chikungunya virus (CHIKV), a member of the arthritogenic alphaviruses, FDA-approved vaccines are not available for other members of this genus, particularly the encephalitic alphaviruses such as VEEV, Eastern equine encephalitis virus, and Western equine encephalitis virus. 4’-Fluorouridine (4’-FlU, EIDD-2749) was recently identified as a broad-spectrum antiviral against multiple RNA viruses, including alphaviruses. 4’-FlU can potently inhibit VEEV-TC83 replication, with submicromolar potency in cell culture. However, the emergence of antiviral resistance represents a hurdle for antiviral drug development and the implementation of effective treatment strategies. Here, we have identified novel mutations in the VEEV nsP4 RNA-dependent RNA polymerase that reduce susceptibility to 4’-FlU, including P187A, Q191L, L289F, and T296I. We rebuilt each mutation in recombinant VEEV-TC83 and characterized the effects of these mutations on fitness and pathogenicity. In addition, we assessed the impact of mutations reducing sensitivity to 4’-FlU in a mouse model. Although mutations against 4’-FlU arise quickly in vitro, treatment can still alleviate severe disease and lethal encephalitis. Together, these data highlight the promising therapeutic potential of 4’-FlU for the treatment of alphavirus encephalitis.IMPORTANCEVenezuelan equine encephalitis virus (VEEV) is a mosquito-spread virus that can cause encephalitis in people and animals. There are no FDA-approved countermeasures to treat VEEV infections in humans. 4’-Fluorouridine (4’-FlU) is currently being developed to treat multiple viral infections, including VEEV. A major problem with antivirals is the appearance of virus populations that are less susceptible to treatment. In this study, we treated infected mice with 4’-FlU and measured how well the compound inhibited virus replication and prevented severe disease. In addition, we identified mutations in VEEV’s polymerase that confer reduced susceptibility to 4’-FlU. We then assessed if viruses encoding for these mutations were still pathogenic. Although VEEV can develop mild resistance to 4’-FlU in vitro, administration of 4’-FlU still reduced severe disease and prevented lethality in the animals infected with viruses that possess mutations that decrease susceptibility to 4’-FlU. These results suggest that 4’-FlU has strong potential as a future treatment for alphavirus infections.
15. Effect of Direct-from-blood Bacterial Testing on Antibiotics Administration in Adults Presenting With Acute Infection: A Randomized Trial.
期刊: Clinical infectious diseases : an official publication of the Infectious Diseases Society of America 发表日期: 2026-Jan-15 链接: PubMed
摘要
For hospitalized adults receiving empiric antibiotic therapy, antibiotic de-escalation prevents unnecessary exposure and adverse effects. Whether use of direct-from-blood bacterial testing facilitates earlier antibiotic de-escalation and improves clinical outcomes has never been evaluated in a randomized trial. Between December 2023 and December 2024, this pragmatic randomized trial compared direct-from-blood bacterial testing with blood cultures (intervention group) to blood cultures alone (usual care group) in adults with suspected infection receiving empiric intravenous vancomycin in the emergency department of an academic medical center. The primary and secondary outcomes were time from randomization to last dose of intravenous vancomycin and systemic antipseudomonal beta-lactam antibiotics, respectively. Among 500 patients enrolled, the time from randomization to results of bacterial testing from blood (direct-from-blood test, gram stain, or negative culture) was a median of 5.2 days shorter (95% CI, 5.1-5.2) in the direct-from-blood test group (median 0.4 days; IQR, 0.3-0.5) than the usual care group (median, 5.5 days; IQR, 5.2-5.6). The time between randomization and the last dose of intravenous vancomycin did not differ between the direct-from-blood test group (median, 12.5 hours; IQR, 0.79-57.8) and the usual care group (median, 19.0 hours; IQR 0.9-64.8) (HR, 1.08; 95% CI, .90-1.28; P = .42), nor did the time to last dose of systemic antipseudomonal beta-lactam antibiotics (HR, 1.04; 95% CI .87-1.24). Clinical outcomes were also similar. Among adults with suspected infection receiving empiric intravenous vancomycin in the emergency department, use of direct-from-blood bacterial testing did not shorten the duration of intravenous vancomycin or antipseudomonal beta-lactam antibiotics.
16. Genomic insights into Ceratobasidium sp. associated with vascular streak dieback of woody ornamentals in the United States using a metagenomic sequencing approach.
期刊: Microbiology spectrum 发表日期: 2026-Jan-15 链接: PubMed
摘要
Woody ornamentals are integral to urban landscapes and play important roles in habitat restoration and ecological conservation, yet their national and international trade facilitates the spread of plant diseases with significant ecological and economic consequences. Vascular streak dieback (VSD) recently emerged on woody ornamentals in the United States and was found to be associated with the fungal pathogen Ceratobasidium sp. (Csp), but little is known about its genomic diversity and associated microbial communities. We thus applied metagenomic sequencing to 106 symptomatic samples that had tested positive for Csp and had been collected from 34 woody ornamental species in seven states. Taxonomic profiling identified Csp as the only putative pathogen of which we recovered 17 high-quality draft genomes. Phylogenomic and pangenome analyses revealed that U.S. Csp isolates form a tight genetic cluster, distinct in gene content from C. theobromae, a pathogen of cacao, avocado, and cassava in Southeast Asia. Comparative analyses highlighted gene content differences, including candidate effectors and secondary metabolite clusters, which may underlie host interactions and offer diagnostic targets. These findings provide the first genomic insights into the U.S. Csp population, suggest the recent introduction of a single genetic lineage with a broad host range, and establish a framework for improved detection, monitoring, and management of VSD in woody ornamentals. Identification of the pathogen that causes an emerging disease, be it of humans, animals, or plants, is a prerequisite to develop effective treatment and/or management practices and to try to control the disease outbreak to prevent further pathogen spread. Vascular streak dieback (VSD) is an emerging disease of ornamental bushes and trees in the United States. Identification of the pathogen has been hindered by the difficulty in growing the fungal pathogen found to be associated with diseased plants in pure culture. Here, we succeeded in sequencing the DNA of the likely pathogen directly from plant tissue or from the fungal mass growing out of collected plant tissue. The sequences were assembled into genomes, which allowed us to precisely identify the pathogen, compare it to related pathogens of other plants, and predict how it causes disease. These results can now be used to inform management and control of VSD.
17. Silver nanoparticle-antimicrobial peptide supramolecular nanocomposite coating improves implant osseointegration under mechanical loading.
期刊: Nanomedicine (London, England) 发表日期: 2026-Jan-15 链接: PubMed
摘要
Long-term implant success depends on preventing infection and achieving initial stability, yet many antimicrobial coatings impair osseointegration, and most animal models overlook the impact of mechanical loading. To overcome the limitations of static in vivo models that do not reflect the mechanical environment of dental implants, this study developed a loaded animal model that evaluates the osteogenic properties of an Ag-GL coating under clinically relevant biomechanical forces. Silver nanoparticles (AgNPs) were synthesized with a redox reaction, while the antimicrobial peptide GL13K was self-assembled into nanofibers that adsorbed AgNPs, forming the Ag-GL nanocoating on titanium. A loaded rat tibial mini-implant infection model compared uncoated and Ag-GL-coated implants for bone microarchitecture, implant stability, peri-implant infection, and mineralization. Preosteoblasts cultured on Ag-GL coatings showed reduced cytotoxicity, healthy cell morphology, increased osteogenic differentiation, and increased matrix mineralization. Micro-CT analysis revealed increased bone formation around Ag-GL-coated implants, and the pull-out test demonstrated superior implant stability. Higher bone mineral apposition rates (MAR) and bone area (BA) were observed around Ag-GL-coated implants. Ag-GL nanocoating exhibited substantial osteogenic properties and osseointegration in vitro and in vivo, suggesting its potential to improve implant outcomes in dental applications by enhancing bone integration and stability in a loading model.
18. Iterative Modification and Finalization of a Patient Decision-Aid for Immunosuppressive Medication Treatment Decision-Making in Systemic Lupus Erythematosus by a Racially Diverse Patient Group.
期刊: Journal of clinical rheumatology : practical reports on rheumatic & musculoskeletal diseases 发表日期: 2026-Jan-15 链接: PubMed
摘要
To describe the patient-feedback process for iterative modification and finalization of the systemic lupus erythematosus (SLE) decision-aid. We invited SLE patients during their regular outpatient visits to review the English or Spanish version of the SLE decision-aid on a touchpad computer. They provided qualitative and quantitative feedback on style, content, and usefulness of SLE decision-aid. Twenty-two racially diverse SLE patients, from 2 academic medical centers, reviewed the SLE decision-aid. Most patients found SLE decision-aid easily understandable, clear, and concise. Patients found a variety of different content interesting, such as the sections on steroids, and premenopausal women, and how the graphs helped them understand the information. The content helped patient understanding and provided clarity about SLE management. All the people with SLE found the information in the lupus decision-aid important. Most respondents (>75%) each agreed that the use of SLE decision-aid would have made a difference in their initial treatment or strongly agreed that it is important to start treatment to prevent kidney damage. Patient feedback contributed significantly to iterative modification and finalization of the SLE decision-aid, which kept it relevant to all SLE patients.
19. Green synthesis of corn stalk-derived carbon dots for enhanced wound healing.
期刊: Journal of materials chemistry. B 发表日期: 2026-Jan-15 链接: PubMed
摘要
Skin injuries are common health concerns, with excessive reactive oxygen species (ROS) accumulation and inflammation in the wound area hindering the healing process. This underscores the urgent need for wound dressings with antioxidant and anti-inflammatory properties. In this study, inspired by the concept of waste valorization, carbon dots (CDs) were synthesized from corn stalks via a hydrothermal method. The results demonstrated that the CDs exhibited in vitro antioxidant activity and promoted the proliferation and migration of oxidative-damage fibroblasts. In vivo experiments further revealed that CDs reduced early-stage ROS accumulation, downregulated inflammation, and accelerated acute wound healing by promoting angiogenesis. Moreover, CDs effectively blocked the Toll-like receptor 4 (TLR4)-mediated nuclear factor kappa B (NF-κB) signaling pathway by promoting the dephosphorylation of IκBα and inhibiting the nuclear translocation of the p65 protein, thereby reducing the expression of pro-inflammatory cytokines. This study integrates agricultural waste utilization with biomedical material development, providing a dual solution to both the environmental issues associated with straw burning and the advancement of novel medical nanomaterials. It offers a strategic approach to agricultural pollution management and medical material innovation, strongly promoting the synergy between green chemistry and sustainable medicine.
20. Clinical practice guidelines for reporting nail fold videocapillaroscopy: a Delphi consensus on behalf of the Italian Society of Rheumatology study group on capillaroscopy.
期刊: Clinical and experimental rheumatology 发表日期: 2026-Jan-15 链接: PubMed
摘要
In clinical practice, standardised reporting of nailfold videocapillaroscopy (NVC) findings is lacking, making the interpretation and comparison of results difficult. We aimed to achieve a national consensus on how to describe NVC findings in routine clinical practice. A web-based Delphi consensus study was conducted among members of the Study Group on Capillaroscopy and Microcirculation in Rheumatic Diseases of the Italian Society of Rheumatology (CAPSIR). The study was based on items derived from a previous systematic review and international consensus by the EULAR Study Group on Microcirculation in Rheumatic Diseases (SG_MC/RD). A total of 40 items were proposed during the Delphi process, which was completed by 52 participants from different Italian regions. An agreement was reached on 23 items covering different aspects of the NVC examination: general aspects (2 items), description of the fingers examined (3 items), possible confounding factors (2 items), device description (2 items), image quality (1 item) and details of the NVC examination (13 items). Sixteen of these were considered mandatory for inclusion in the NVC practice report, and 7 were considered optional. The proposed NVC checklist covers 23 relevant issues in clinical practice, including 16 mandatory items grouped into five categories. This national consensus will improve the reproducibility and generalisability of NVC reporting in daily clinical practice. Furthermore, the outcomes of this NVC consensus process will inform the next European web-based Delphi consensus study, to be conducted among the member countries of the EULAR SG_MC/RD.
21. Generation and characterization of a Cre-Inducible MAP3K1 Gain-of-Function Model.
期刊: Disease models & mechanisms 发表日期: 2026-Jan-15 链接: PubMed
摘要
MAP3K1 is a multifunctional signaling kinase implicated in diverse biological processes. Although its Gain-of-Function (GoF) mutations contribute to multiple human diseases, including 46,XY disorders of sex development (DSDs), mechanistic studies have been limited due to the lack of physiologically relevant in vivo models. To address this gap, we generated a Cre-inducible Map3k1TG transgenic mouse carrying V5- and TurboID-tagged Map3k1 cDNA. Upon tamoxifen-induced Cre activation, Map3k1TG;Rosa26-CreERT2 fetuses displayed tamoxifen dose-dependent lethality and developmental abnormalities, including reduced body size, digit fusion, tail shortening and epidermal thickening, demonstrating broad developmental impact of MAP3K1 overexpression. Male fetuses additionally exhibited impaired sexual differentiation, with reduced anogenital distance and decreased Sertoli and germ cell populations. Mechanistically, MAP3K1 induction activated both MAPK and WNT/β-catenin pathways, leading to β-catenin displacement from plasma membrane in keratinocytes in vitro, and in epidermal and germ cells in vivo. TurboID-based proximity labeling further revealed cytoskeletal-associated proteins as MAP3K1 interactors, consistent with biochemical and imaging evidence showing MAP3K1 colocalization with actin filaments and centrosomes. These findings establish Map3k1TG as a versatile in vivo platform for dissecting MAP3K1 GoF mechanisms in development and diseases.
22. Healthcare Access and Health Status by Primary Source of Health Insurance and Occupation.
期刊: American journal of industrial medicine 发表日期: 2026-Jan-15 链接: PubMed
摘要
In the United States, health insurance is strongly associated with healthcare access and health status. How health insurance source, healthcare access, and health status differ by occupation has received less attention. We used responses to the 2022 and 2023 Behavioral Risk Factor Surveillance System to estimate the prevalence of primary health insurance source, healthcare access/unmet healthcare needs, and health status by demographic characteristics and major occupation among respondents employed for wages or self-employed. We generated prevalences and adjusted prevalence ratios (PRs) to examine healthcare access and self-reported health status for workers in each occupation and to understand the impacts of adjustment for demographic characteristics (age, sex, race/Hispanic ethnicity), health insurance source, and household income. Overall, being insured was associated with better healthcare access and self-reported health status. Workers with employer-sponsored insurance or non-group private insurance were least likely to report unmet healthcare needs or to rate their health status as fair or poor. The uninsured were most likely to report unmet healthcare needs. The four occupations with at least 25% of workers uninsured (Farming, Fishing and Forestry; Building and Grounds Cleaning and Maintenance; Food Preparation and Serving; and Construction and Extraction) had statistically significant unadjusted PR elevations for all unmet healthcare need measures and for fair or poor general health. After sequential adjustment for demographic covariates and then primary insurance source, statistically significant elevations remained for being unable to afford needed care and for reporting fair or poor general health in most low-wage occupations. Final adjustment, adding household income, eliminated these remaining elevations for most occupations. Both healthcare access and health status vary by health insurance status and source, which are differentially distributed by occupation. Workers in lower-wage occupations may have trouble affording medical care, even if insured. Affordable, comprehensive health insurance coverage, along with wages adequate to cover needed care, could help ensure the health and continued employability of all workers.
23. Effectiveness of non-pharmacological treatments in lowering blood pressure in pregnant women with hypertension: A systematic review.
期刊: African journal of reproductive health 发表日期: 2026-Jan-14 链接: PubMed
摘要
Hypertension in pregnant women is a leading cause of maternal morbidity and mortality globally, particularly in developing countries. This systematic review evaluates the effectiveness of non-pharmacological treatments in reducing blood pressure in pregnant women with hypertension. The articles analyzed were sourced from multiple databases between 2013 and 2023, focusing on hypertensive disorders in pregnancy and non-pharmacological treatments. After screening and eligibility assessment, six relevant studies were included. The results revealed that non-pharmacological interventions, such as yoga therapy, Qur’anic recitation (Murottal therapy), lavender aromatherapy combined with classical music, the Go-Yoga application, and foot massage with warm water immersion infused with lemon, effectively lowered blood pressure in pregnant women. These interventions primarily work by promoting relaxation, reducing stress, and improving cardiovascular function and hormonal balance. In conclusion, non-pharmacological treatments offer safe and effective alternatives for managing hypertension during pregnancy. However, further research with larger sample sizes is needed to confirm their long-term safety and efficacy. L’hypertension chez les femmes enceintes est l’une des principales causes de morbidité et de mortalité maternelles dans le monde, en particulier dans les pays en développement. Cette revue systématique évalue l’efficacité des traitements non pharmacologiques pour réduire la tension artérielle chez les femmes enceintes hypertendues. Les articles analysés proviennent de plusieurs bases de données entre 2013 et 2023, se concentrant sur les troubles hypertensifs pendant la grossesse et les traitements non pharmacologiques. Après sélection et évaluation de l’éligibilité, six études pertinentes ont été incluses. Les résultats ont révélé que les interventions non pharmacologiques, telles que la yogathérapie, la récitation coranique (thérapie Murottal), l’aromathérapie à la lavande associée à la musique classique, l’application Go-Yoga et le massage des pieds par immersion dans de l’eau chaude infusée au citron, ont efficacement réduit la tension artérielle chez les femmes enceintes. Ces interventions agissent principalement en favorisant la relaxation, en réduisant le stress et en améliorant la fonction cardiovasculaire et l’équilibre hormonal. En conclusion, les traitements non pharmacologiques offrent des alternatives sûres et efficaces pour la prise en charge de l’hypertension pendant la grossesse. Cependant, des recherches supplémentaires sur des échantillons plus importants sont nécessaires pour confirmer leur innocuité et leur efficacité à long terme.
24. The effect of the COVID-19 pandemic on vaccines and vaccination-related beliefs in Türkiye: A cross-sectional study.
期刊: African journal of reproductive health 发表日期: 2026-Jan-14 链接: PubMed
摘要
It was aimed to determine the beliefs and opinions of the people participating in our research about vaccination and to assess whether the COVID-19 pandemic process affected their belief and opinion about vaccination, and if so, in which direction. This descriptive cross-sectional study conducted a Family Health Centre in Kütahya. In this study, a questionnaire form were used to determine opinions about vaccination practices. Of the 377 people participants, 184 (48.8%) were male and 193 (51.2%) were female. While 313 (83%) of the participants were positive, 10 (2.7%) had negative opinions about vaccines and 54 (14.3%) were undecided. After the COVID-19 pandemic, the opinion of 27.3% (n:103) of the participants about vaccination has changed compared to before. It was found that 64 (63.1%) of 103 people who had a change in their opinion of vaccination had a positive change. According to our work, the risks posed by the pandemic have caused positive changes in overall vaccination opinion of the participants. Cette étude descriptive transversale, menée dans un centre de santé familiale de Kütahya, visait à déterminer les croyances et opinions des participants concernant la vaccination et à évaluer si la pandémie de COVID-19 les avait influencées, et le cas échéant, dans quel sens. Un questionnaire a permis de recueillir les opinions sur les pratiques vaccinales. Parmi les 377 participants, 184 (48,8 %) étaient des hommes et 193 (51,2 %) des femmes. 313 participants (83 %) avaient une opinion positive, 10 (2,7 %) une opinion négative et 54 (14,3 %) étaient indécis. Après le début de la pandémie, l’opinion de 27,3 % des participants (n = 103) a évolué. Parmi ces 103 personnes, 64 (63,1 %) ont vu leur opinion évoluer positivement. D’après nos travaux, les risques liés à la pandémie ont induit une évolution positive de l’opinion générale des participants concernant la vaccination.
25. Plasma proteomic profiling identified prognostic indicators with therapeutic potential for colorectal cancer.
期刊: Carcinogenesis 发表日期: 2026-Jan-14 链接: PubMed
摘要
Plasma proteins have been reported as predictors and potential targets for reducing colorectal cancer (CRC) risk. However, their potential roles in CRC prognosis remain unexplored. We measured plasma levels of 367 neuro-related proteins in CRC patients from the West China Hospital (WCH) cohort (N=150, median follow-up=46.72 months) via proximity extension assay. The least absolute shrinkage and selection operator (LASSO) penalized Cox regression identified five overall survival (OS) - and eleven disease-free survival (DFS) - associated proteins, and the multi-protein signature for OS prediction was then validated in the UK Biobank (UKB) cohort (N=1,133). To overcome possible effects from confounders, we then employed Mendelian Randomization analysis leveraging protein quantitative trait loci (pQTLs) to investigate associations between genetically determined protein concentration and OS and cancer-specific survival (CSS) of CRC in the UKB. We found that multi-protein signature developed in the WCH cohort (c-index=0.784, 95% CI=0.713-0.855) showed significant discriminative ability in the external UKB cohort (c-index=0.616, 95%CI=0.559-0.673). A significant association between genetically determined PD-L1 and OS (p=0.043, HR=1.53, 95%CI=1.01-2.29) was observed, although we did not find strong evidence for colocalization. Additionally, single-cell and spatial transcriptome analyses illustrated PD-L1 expression localized predominantly to epithelial cells and immune cells (especially myeloid cells) in CRC tissue. The potential interactions of identified proteins were evaluated in the STRING database. Druggability evaluation also supported PD-L1 as a potential therapeutic target for CRC. Taken together, this study established multi-protein signatures for CRC prognosis and identified plasma PD-L1 as a possible biomarker and therapeutic target.
26. Trends in prenatal care among pregnant women in the Marrakesh province, Morocco.
期刊: African journal of reproductive health 发表日期: 2026-Jan-14 链接: PubMed
摘要
This analytical cross-sectional study assessed the evolution of maternal health indicators in the Marrakech province by comparing data from 2014-2015 and 2020-2022. A total of 1,070 pregnant women were surveyed in three health facilities using a self-administered questionnaire and non-probability accidental sampling. Statistical analyses (Chi-square, Student’s t-tests, and logistic regression with Wald tests) were performed using SPSS 21.0. The results showed a significant improvement in prenatal care utilization over time. The percentage of women completing four recommended antenatal visits (ANC) increased from 36.9% to 49.5%, and early initiation of care in the first trimester rose from 55.3% to 82.8%. Completion rates of ANC1, ANC3, and ANC4, as well as the medicalization of consultations, also improved significantly. Logistic regression revealed strong associations between the 2020-2022 period, rural residence, and enhanced maternal health indicators. These findings underscore the positive impact of public health strategies and the resilience of Morocco’s health system during the COVID-19 pandemic. Cette étude analytique transversale a évalué l’évolution des indicateurs de santé maternelle dans la province de Marrakech en comparant les données des périodes 2014–2015 et 2020–2022. Au total, 1 070 femmes enceintes ont été interrogées dans trois établissements de santé à l’aide d’un questionnaire auto-administré et selon un échantillonnage non probabiliste accidentel. Les analyses statistiques (tests du Chi carré, test t de Student et régression logistique avec tests de Wald) ont été réalisées à l’aide du logiciel SPSS 21.0. Les résultats ont mis en évidence une amélioration significative de l’utilisation des soins prénatals. Le pourcentage de femmes ayant complété les quatre consultations prénatales recommandées (CPN) est passé de 36,9 % à 49,5 %, tandis que l’initiation précoce du suivi au premier trimestre a augmenté de 55,3 % à 82,8 %. Les taux de complétion des CPN1, CPN3 et CPN4, ainsi que la médicalisation des consultations, se sont également améliorés de manière significative. La régression logistique a révélé des associations fortes entre la période 2020–2022, la résidence rurale et l’amélioration des indicateurs de santé maternelle. Ces résultats soulignent l’impact positif des stratégies de santé publique et la résilience du système de santé marocain durant la pandémie de COVID-19.
27. Determinants of postpartum lactation insufficiency in caesarean section in Chinese mothers: A cross-sectional study.
期刊: African journal of reproductive health 发表日期: 2026-Jan-14 链接: PubMed
摘要
This study explored the status of postpartum lactation in caesarean section mothers and identified the factors that influence lactation insufficiency. A total of 265 mothers who delivered via cesarean section between November 2021 and November 2022 were followed for six months. Lactation efficiency was measured by collecting daily milk output using a breast pump from postpartum days 1 to 10; insufficient lactation was defined as a total daily milk volume <500 mL on day 10. Lactation typically began between 25 and 48 hours postpartum (45.1%), with a delayed onset of lactogenesis incidence of 19.6% and an overall lactation insufficiency rate of 48.3%. Multivariate logistic regression analysis identified advanced maternal age (>35 years), excessive weight gain during pregnancy (≥5.6 kg/m²), high postpartum pain scores (≥4), gestational diabetes mellitus, and postpartum depression as significant risk factors for insufficient lactation. In contrast, early skin-to-skin contact and suckling significantly reduced the risk. Furthermore, infants in the exclusive breastfeeding group showed significantly better nutritional outcomes, as measured by the Kaup index, compared to partially or non-breastfed infants. These findings underscore the need for targeted clinical interventions during the perinatal period, including effective pain management, mental health support, and promotion of early breastfeeding, to enhance lactation outcomes among cesarean section mothers. Cette étude a exploré la situation de l’allaitement post-partum chez les mères ayant accouché par césarienne et a identifié les facteurs influençant l’insuffisance lactée. Un total de 265 mères ayant accouché par césarienne entre novembre 2021 et janvier 2022 ont été suivies pendant six mois. L’efficacité de l’allaitement a été mesurée en collectant la quantité quotidienne de lait produite à l’aide d’un tire-lait du premier au dixième jour post-partum ; l’insuffisance lactée a été définie par un volume de lait quotidien total <500 mL au dixième jour. L’allaitement a généralement commencé entre 25 et 48 heures après l’accouchement (45,1 %), avec une incidence de retard de la lactogenèse de 19,6 % et un taux global d’insuffisance lactée de 48,3 %. L’analyse de régression logistique multivariée a identifié l’âge maternel avancé (>35 ans), un gain de poids excessif pendant la grossesse (≥5,6 kg/m²), des scores élevés de douleur post-partum (≥4), le diabète gestationnel et la dépression post-partum comme des facteurs de risque significatifs pour une lactation insuffisante. En revanche, le contact peau-à-peau précoce et l’allaitement au sein ont significativement réduit ce risque. De plus, les nourrissons du groupe d’allaitement exclusif ont montré de meilleurs résultats nutritionnels, mesurés par l’indice de Kaup, par rapport aux nourrissons partiellement ou non allaités. Ces résultats soulignent la nécessité d’interventions cliniques ciblées pendant la période périnatale, comprenant une gestion efficace de la douleur, un soutien en santé mentale et la promotion de l’allaitement précoce, afin d’améliorer les résultats de l’allaitement chez les mères ayant accouché par césarienne.
28. CoxMDS: multiple data splitting for high-dimensional mediation analysis with survival outcomes in epigenome-wide studies.
期刊: Briefings in bioinformatics 发表日期: 2026-Jan-07 链接: PubMed
摘要
Causal mediation analysis investigates whether the effect of an exposure on an outcome operates through intermediate variables known as mediators. Although progress has been made in high-dimensional mediation analysis, current methods do not reliably control the false discovery rate (FDR) in finite samples, especially when mediators are moderately to highly correlated or follow non-Gaussian distributions. These challenges frequently arise in DNA methylation studies. We introduce CoxMDS, a multiple data splitting method that uses Cox proportional hazards models to identify putative causal mediators for survival outcomes. CoxMDS ensures finite-sample FDR control even in the presence of correlated or non-Gaussian mediators. Through simulations, CoxMDS is shown to maintain FDR control and achieve higher statistical power compared with existing approaches. In applications to DNA methylation data with survival outcomes, CoxMDS identified eight CpG sites in The Cancer Genome Atlas that are consistent with the hypothesis that DNA methylation may mediate the effect of smoking on lung cancer survival, and two CpG sites in the Alzheimer’s Disease Neuroimaging Initiative that are consistent with the hypothesis that DNA methylation may mediate the effect of smoking on time to Alzheimer’s disease conversion.
29. Estimating the causal effect of redlining on present-day air pollution.
期刊: Biometrics 发表日期: 2026-Jan-06 链接: PubMed
摘要
Recent studies have shown associations between redlining policies (1935-1974) and present-day fine particulate matter (PM${2.5}$) and nitrogen dioxide (NO$_2$) air pollution concentrations. In this paper, we move beyond associations and investigate the causal effects of redlining using spatial causal inference. Redlining policies were enacted in the 1930s, so there is very limited documentation of pre-treatment covariates. Consequently, traditional methods failed to sufficiently account for unmeasured confounders, potentially biasing causal interpretations. By integrating historical redlining data with 2010 PM${2.5}$ and NO$2$ concentrations, our study seeks to estimate the long-term causal impact. Our study addresses challenges with a novel spatial and non-spatial latent factor framework, using the unemployment rate, house rent and percentage of Black population in 1940 US Census as proxies to reconstruct pre-treatment latent socio-economic status. We establish identification of a causal effect under broad assumptions, and use Bayesian Markov Chain Monte Carlo to quantify uncertainty. Our causal analysis provides evidence that historically redlined neighborhoods are exposed to notably higher NO$_2$ concentration. In contrast, the disparities in PM${2.5}$ between these neighborhoods are less pronounced. Among the cities analyzed, Los Angeles, CA, and Atlanta, GA, demonstrate the most significant effects for both NO$2$ and PM${2.5}$.
30. Estimating optimal dynamic treatment regimes with Gaussian process emulation.
期刊: Biometrics 发表日期: 2026-Jan-06 链接: PubMed
摘要
Identifying dynamic treatment regimes (DTRs) is a key objective in precision medicine. Value search approaches, including (Bayesian) dynamic marginal structural models offer an attractive approach to estimation by mapping candidate regimes to their expected outcome. As parametric models for the expected outcomes may be mis-specified and lead to incorrect conclusions, a grid search over candidate DTRs has been proposed, but this may be computationally prohibitive and also subject to high uncertainty in the estimated value function. These inferential challenges can be addressed using Gaussian process ($\mathcal {GP}$) optimization methods with estimators for the causal effect of adherence to a specified DTR. We demonstrate how to identify optimal DTRs using this approach in a variety of settings, including when the value function is multi-modal and show that the $\mathcal {GP}$ modeling approach that recognizes noise in the estimated response surface leads to improved results as compared to a grid search approach. Further, we show that a grid search may not yield a robust solution and that it often utilizes information less efficiently than a $\mathcal {GP}$ approach. The proposed approach is used to understand tailoring of HIV therapy to optimize CD4 cell counts.
31. Creating a roadmap to fast-track human-centric non-animal methodologies via innovative funding mechanisms and strategic partnerships.
期刊: ALTEX 发表日期: 2026 链接: PubMed
摘要
32. Social Determinants of Health, Biological Aging, and Their Impact on Frailty Risk: Mediation and Interaction Effects Analysis.
期刊: Geriatrics & gerontology international 发表日期: 2026-Jan 链接: PubMed
摘要
Social determinants of health (SDoH) are often associated with frailty outcomes, yet the potential role of biological aging (BA) in this relationship remains unclear. This study quantified BA-mediated (PhenoAge, Klemera-Doubal method biological age [KDM-Age]) pathways linking SDoH to frailty and assessed the predictive performance of the biological aging models for risk stratification. Data from 10 763 participants in the National Health and Nutrition Examination Survey (NHANES) were analyzed. A composite SDoH score (0-8) was constructed across eight socioeconomic domains. Associations were evaluated via multivariable logistic regression, restricted cubic splines (RCS), and mediation analyses. XGBoost was trained to assess predictive performance and feature contributions. Each unit increase in SDoH score elevated frailty odds by 30%, with PhenoAge and KDM-Age mediating 1.19% and 1.25% of the association, respectively. High SDoH (> 6) synergized with accelerated BA to amplify frailty risk (RERI > 1). Age stratification showed null effects in adults > 75 years, supporting gerontological transition theories. SDoH adversity accelerates biological aging, synergistically amplifying frailty risk.
33. The Gwangju Alzheimer's & Related Dementias (GARD) cohort: Over a decade of Asia's largest longitudinal multimodal study.
期刊: Alzheimer’s & dementia : the journal of the Alzheimer’s Association 发表日期: 2026-Jan 链接: PubMed
摘要
Alzheimer’s disease (AD) is a major public health concern in Korea, with a high prevalence among older adults. A community-based longitudinal study is essential for tracking disease progression, identifying biomarkers, and developing targeted prevention and treatment strategies. The Gwangju Alzheimer’s & Related Dementias (GARD) cohort was established to address these needs through a multimodal approach. Participants aged ≥60 years undergo comprehensive clinical evaluations, neuroimaging, and biospecimen collection for multi-omics analyses (genomics, transcriptomics, proteomics, and metagenomics) at baseline and systematic follow-up visits. From over 17,000 screened individuals, 12,877 were enrolled. Baseline diagnoses include 5,123 cognitively unimpaired (CU), 3,250 mild cognitive impairment (MCI), and 2,125 AD dementia. The resource includes magnetic resonance imaging scans (n = 10,843) and extensive multi-omics data: genomic (n = 10,775), proteomic (n = 116), and microbiome (n = 595). The integrated GARD dataset provides a powerful and scalable resource for identifying novel biomarkers, understanding disease heterogeneity, and advancing precision medicine for AD. Gwangju Alzheimer’s & Related Dementias (GARD) is a large-scale, longitudinal, community-based cohort study in South Korea. The study focuses on early detection and monitoring of dementia progression. GARD includes cognitive testing, imaging, biospecimens, and multi-omics data. We aim to identify Korean-specific biomarkers predictive of cognitive decline. Supports East Asian insights and fills gaps in global Alzheimer’s research.
34. Early-life influences on the risk for later-life Alzheimer's and non-Alzheimer's dementia: A nearly full life course prospective cohort study.
期刊: Alzheimer’s & dementia : the journal of the Alzheimer’s Association 发表日期: 2026-Jan 链接: PubMed
摘要
Dementia prevention research has largely used educational attainment as a proxy for early-life. Given the known influence of early-life exposures on brain development, more attention to early-life exposures is warranted. We employ the Wisconsin Longitudinal Study, a nearly full life course cohort study, to examine the influence of prospectively measured early-life risk factors for dementia in later life. We find that early-life risk factors that precede high school completion, rather than early adulthood post-secondary schooling, exert influence on later-life dementia. Household parental resources influence non-Alzheimer’s disease (AD), but not AD, dementia risk. In contrast, markers for adolescent cognitive reserve (cognitive and academic performance measures) influence AD dementia risk, in part, by modifying genetic risk. Using education as a proxy for early-life exposures conceals specific mechanisms that influence distinct dementia etiologies and are separately intervenable. Education’s influence may be confined to the early-life and adolescent period, where brain development is especially malleable. Educational attainment is commonly used as a proxy for early-life risk factors for dementia. Given known early-life influences on brain development, more attention to the period is warranted. Early-life parental income influences non-AD dementia risk. Early-life cognition and academic performance influence AD dementia risk. Using educational attainment as a proxy for early-life exposures conceals separate intervenable risk factors.
35. Family Experiences of Living With Frontline Healthcare Workers During the COVID-19 Pandemic in the United Kingdom: Perspectives From the Black and Asian Community.
期刊: Interdisciplinary perspectives on infectious diseases 发表日期: 2026 链接: PubMed
摘要
Black and Asian healthcare workers (HCWs) faced heightened COVID-19 exposure early in the pandemic due to overrepresentation on the frontline compared to other ethnic groups. This study explored the experiences of Black and Asian household members in the United Kingdom living with these HCWs during the COVID-19 pandemic, focussing on the impact of increased risks and challenges. This study utilised one-on-one interviews with six HCWs’ household members. Participants were recruited through a snowballing sampling strategy. The study employed interpretative phenomenological analysis (IPA) to explore and interpret the meanings participants attributed to their experiences. The findings highlighted emotional and mental impacts experienced by household members, linked to their ethnic background and living with HCWs. The research found that FMs feared contracting the virus from their HCWs, along with feelings of vulnerability, hopelessness and helplessness. While participants took precautions, they relied on faith and called for specific support, policy changes and reassurance to reduce anxiety. This study underscores the importance of healthcare organisations addressing the concerns of HCWs from Black and Asian communities and their household members in future pandemics. It recommends establishing platforms within healthcare settings for these workers to voice safety and protection concerns. The study highlights the need for representative channels to listen to their issues and suggests educational seminars to help families manage fears and emotional distress. Ultimately, the research aims to guide policy changes and interventions that offer comprehensive support, ensuring HCWs and their household members are prepared to face health crises with resilience and well-being.
36. Profile and predictors of metabolic syndrome among young adults attending a Medical College in Quetta City, Pakistan.
期刊: Journal of pharmaceutical policy and practice 发表日期: 2026 链接: PubMed
摘要
Anthropometry and biochemical parameters as diagnostic measures of metabolic syndrome (MetS) are of high repute in clinical settings. However, statistics capable of predicting MetS explicitly in young adults are the least discussed in the literature. We, therefore, aimed to establish the profile and identify the associated predictors of MetS among young adults enrolled in a public medical institute in Quetta city, Pakistan. This was a cross-sectional study. Along with the demographics, anthropometric measures were examined as per World Health Organization’ criteria. Biochemical measures were assessed using standardized protocols. In addition to the non-parametric tests, the binary logistic regression was used to identify the predictors of MetS. For all analyses, p < 0.05 was taken significantly. Three hundred and fifty-one young adults responded to the study with a response rate of 77.1%. Majority of the respondents were females (55%) with 19 years age (82.1%) dominating the cohort. Almost 50% of the respondents had higher triglyceride levels and high-density lipoproteins were below normal in 42.7%. Nearly 31% were obese and 25% had higher HbA1c. Logistic regression analysis revealed fourteen independent variables that accounted for 75.2% of the model explanation. Glycated haemoglobin and body mass index were identified as significant predictors of MetS (adjusted OR = 5.014, p < 0.001 and adjusted OR = 3.323, p < 0.042, respectively). An increase in HbA1c level and body mass index of one point was associated with the development of MetS by a factor of 5.014 and 3.323 respectively. The prevalence of MetS was high, whereas HbA1c and BMI were shaped as predicting factors of MetS. Therefore, while addressing MetS-related issues among young adults, healthcare and preventive professionals, and policymakers should consider the identified factors while designing individualized or targeted interventions.
37. A qualitative study to explore the perspectives of key stakeholders regarding pharmaceutical pictograms in Pakistan.
期刊: Journal of pharmaceutical policy and practice 发表日期: 2026 链接: PubMed
摘要
This qualitative study in Pakistan aims to gather perspectives from health regulators, pharmaceutical manufacturers, and healthcare professionals regarding the implementation of pharmaceutical pictograms. An exploratory qualitative study design was used to conduct this study across all provinces of Pakistan. The study adopted a constructivist approach to examine stakeholders’ subjective interpretations and to ensure methodological transparency, Consolidated Criteria for Reporting Qualitative Research (COREQ) guidelines were used as reporting guidelines. The data were collected from three main groups through in-depth, face-to-face interviews. The study participants were recruited using a purposive convenience sampling technique. Data analysis was conducted using an inductive thematic analysis approach to draw conclusions aligned with the study objectives. A total of 57 respondents participated in the study, including 13 doctors, 15 pharmacists, 15 health regulators, and 14 manufacturers. Analysis of the data yielded five themes and sixteen subthemes. The five key themes were extracted including the current status of pharmaceutical pictograms, the impact of pharmaceutical pictograms, the significance of pharmaceutical pictograms on patients and the healthcare system, and challenges in the implementation of pharmaceuticals. The majority of the respondents demonstrated a better understanding of the term ‘pharmaceutical pictograms,’ but awareness of standardised systems (USP and FIP) was limited. However, several implementation challenges were identified, including a lack of government recognition and policy support, insufficient training and knowledge among healthcare professionals, and financial or resource constraints. Stakeholders emphasised national policy, training, and awareness to integrate pharmaceutical pictograms. The key stakeholders strongly favoured the implementation of pharmaceutical pictograms, recognising their potential to enhance patient comprehension, adherence, and overall safety in Pakistan. However, their adoption is limited by insufficient awareness, policy support, and resources. Addressing these challenges through national policies, professional training, and awareness initiatives is essential for the successful adoption of pictograms in the healthcare system.
38. Copper Nanocluster-Decorated Magnesium Silicate-Based Microneedle Enhances Antimicrobial Effects and Tissue Remodeling for Diabetic Wounds.
期刊: Small science 发表日期: 2026-Jan 链接: PubMed
摘要
Diabetic skin lesions, as one of the most common complications of diabetes, present chronic nonhealing wounds that face dual challenges of antibiotic-resistant bacteria threat and insufficient microenvironment regulation due to hyperglycemic conditions, bacterial infections, and multiple pathological factors (e.g., hypoxia and reactive oxygen species (ROS) accumulation and growth factor deficiency). This study develops a microneedle (MN) system integrated with copper nanocluster-decorated magnesium silicate nanoparticles (denoted as MS@Cu MNs), which enables efficient diabetic wound healing via a synergistic multimechanism strategy. Leveraging the unique enzyme-mimetic activity of copper nanoclusters (CuNCs) and the angiogenic properties of magnesium silicate nanoparticles (MS NPs), the engineered MS@Cu nanocomposites demonstrate: 1) broad-spectrum antibacterial efficacy (sterilization rate >99.9%), 2) microenvironment regulation via simultaneous hypoxia mitigation, ROS scavenging, and angiogenesis promotion, and 3) enhanced fibroblast proliferation and migration through PI3K-AKT signaling pathway activation. The MN system using γ-polyglutamic acid (γPGA) as a matrix exhibits both superior mechanical strength and excellent biodegradability. In vivo studies demonstrated accelerated closure of infected diabetic wounds in animal models, with histological analysis revealing robust mature collagen deposition and tissue regeneration. This study develops an integrated strategy for chronic diabetic wound management, combining potentiated antibacterial activity with targeted microenvironment remodeling.
39. The correlation between brain response and subjective annoyance under natural sound masking of road traffic noise.
期刊: The Journal of the Acoustical Society of America 发表日期: 2026-Jan-01 链接: PubMed
摘要
Urban road traffic noise is a growing environmental concern, and noise masking offers an alternative solution. However, the underlying neural mechanisms of natural sound masking of noise remain unclear. Here, the brain’s physiological responses to natural sound masking (birdsong and water sound) were explored using functional near-infrared spectroscopy. The functional connectivity between brain regions was analyzed by graph-theoretical network analysis, and the subjective annoyance was correlated with brain activation and graph-theoretical network parameters. Results revealed that masking conditions significantly reduced annoyance compared to the road traffic noise condition. Birdsong and water sound masking increased activation in the right superior temporal gyrus and right middle temporal gyrus, which is positively correlated with the annoyance reduction percentage. Birdsong masking globally decreased the connections between brain regions and neighboring regions at the group level, which is negatively correlated with the annoyance reduction percentage. These findings demonstrate that natural sound masking can modulate brain network topology and functional connectivity, offering insights into effective noise-masking strategies.
40. Effects of Electronic Sports on Community-Dwelling Older Adults With Mild Cognitive Impairment: A Randomized Controlled Study.
期刊: Geriatrics & gerontology international 发表日期: 2026-Jan 链接: PubMed
摘要
Electronic sports (eSports) are sports in which multiple players compete in video games with a defined set of rules. This may have an impact on cognitive function or psychiatric symptoms in older adults with mild cognitive impairment (MCI); however, it has not been extensively studied. This study aimed to examine whether eSports could improve cognitive function and psychiatric symptoms in older adults with MCI. This was a single-blind, two-arm, randomized controlled study. Thirty-four community-dwelling older adults with MCI were randomly assigned to either the intervention (60 min once a week for 8 weeks) or control group. Participants were assessed for cognitive function (global cognition, attention, and executive function) and psychiatric symptoms (depression and apathy) before and after the intervention. Changes in prefrontal cortex activation during verbal fluency tasks were also preliminarily examined in some participants using functional near-infrared spectroscopy (fNIRS). Both groups showed improved global cognition; however, the group interaction was not significant. No significant changes in attention, executive function, or psychiatric symptoms were observed in either group. Hemodynamic data showed no significant changes in the prefrontal cortex activation pre- and post-intervention in the two groups as well. The effects of eSports on cognitive function and psychiatric symptoms in older adults with MCI could not be confirmed in the present study. The potential of eSports to enhance cognition and alleviate psychiatric symptoms in older adults warrants further investigation through larger, rigorously designed studies to establish its efficacy.
41. Development of a clinical tool to identify patients with early inflammatory arthritis at high risk of employment loss: analysis from the National Early Inflammatory Arthritis Audit.
期刊: Rheumatology advances in practice 发表日期: 2026 链接: PubMed
摘要
Work disability is an early consequence of inflammatory arthritis. Preventive interventions exist but access is limited, highlighting the need for risk stratification. We aimed to develop a tool using routinely collected data to identify patients at greatest risk of employment loss. This cohort study used data from the National Early Inflammatory Arthritis Audit. Patients ≥16 years with early inflammatory arthritis (EIA), enrolled May 2018-April 2025, employed at diagnosis and with three-month follow-up were included. The outcome was self-reported employment loss at 3 months. Predictors were occupation (manual vs non-manual), age, sex, disease activity (DAS28 > 5.1), mental health (anxiety/depression) and musculoskeletal burden (MSKHQ ≤25v > 25). Employment loss was modelled using Poisson regression. Model discrimination, calibration and bootstrap validation were assessed. A risk score was derived and stratified into low, medium and high-risk groups. Of 11 894 patients with EIA, 6036 were employed at baseline and 1662 had complete work-outcome data. At 3 months, 168(10.1%) reported employment loss. Manual workers had higher risk than non-manual (14.1% vs 7.8%). In multivariable analysis, manual work (IRR: 1.54, 95% CI: 1.15-2.06), older age (per 10 years: IRR: 1.65, 95% CI: 1.43-1.90), high musculoskeletal burden (IRR: 1.55, 1.10-2.19) and anxiety/depression (IRR: 1.45, 1.02-2.06) were associated with employment loss, whereas DAS28 was not. The optimal model (age, occupation, musculoskeletal and mental health) showed good discrimination (C-statistic 0.710) and calibration. An 8-point score stratified patients into low (2.5%), medium (9.1%) and high-risk (19.5%). Employment loss in EIA is driven by occupation, age, musculoskeletal symptoms and mental health. A risk tool incorporating these domains can stratify patients and guide targeted interventions.
42. Coronary Artery Calcium Score as a Predictor of Cardiovascular Disease Events and Mortality Among Asymptomatic Working-Age Adults: A Systematic Review.
期刊: Cureus 发表日期: 2026-Jan 链接: PubMed
摘要
The Coronary Artery Calcium (CAC) score is primarily used in asymptomatic individuals at intermediate risk for developing cardiovascular disease (CVD), particularly when there is uncertainty whether to initiate statins or intensify primary prevention measures. In this systematic review, we examined the value of the CAC score as a predictor of incident CVD events and mortality among asymptomatic working-age adults. We reviewed studies published from November 2009 to December 2022 examining asymptomatic adults 18-65 years of age. A total of 908 studies were identified. After the elimination of 578 and 326 studies based on abstract and full-text review, respectively, we examined four studies that met the inclusion criteria. Two of the studies showed that any CAC score above zero was associated with a four- to fivefold increased risk of incident cardiac events. In addition, we found that increasing CAC score was associated with a higher risk of incident cardiac events and/or all-cause mortality in a dose-response relationship documenting a strong criterion of causality. Furthermore, one of the studies elicited a higher discriminatory power of the CAC score compared to the Framingham and the Atherosclerotic Cardiovascular Disease (ASCVD) risk scores in distinguishing high-risk from intermediate-risk individuals for all-cause mortality. Our review showed that the CAC score is predictive of elevated risk for incident CVD events and mortality among asymptomatic working-age adults. However, prospective studies are warranted to perform cost-benefit analyses on the utility of CAC scoring as a screening tool in the general population.
43. Diabetes knowledge levels among patients in Mhlontlo, South Africa: A quantitative study.
期刊: South African family practice : official journal of the South African Academy of Family Practice/Primary Care 发表日期: 2025-Dec-19 链接: PubMed
摘要
There is a high prevalence of diabetes in South Africa and a related increase in poor treatment outcomes among people with diabetes. Poor glycaemic control is often associated with a lack of knowledge of self-management. The study aimed to assess diabetes knowledge levels among patients in the Mhlontlo Municipality in the OR Tambo District of the Eastern Cape province in South Africa. The study used a quantitative descriptive cross-sectional design. A convenience sample was taken of patients ≥ 18 years of age with Type 2 diabetes at a Community Health Centre and a district hospital. Data were analysed using SPSS 29, with descriptive statistics and chi-square tests applied. A total of 172 respondents were surveyed. Most respondents (57.6%) were female and most (54.2%) obtained information from healthcare facilities. Respondents demonstrated a moderate level of diabetes knowledge, with an overall median score of 62.5% across all question categories. A total of 41.3% respondents had a high level of knowledge, 29.1% had moderate knowledge levels and 29.6% had low knowledge levels. Using chi-square tests of association, tertiary-level education, younger age (between 18 and 29 years) and being employed were significantly associated with high knowledge levels. Health facilities in Mhlontlo should focus on providing health education for people aged more than 50 years to improve diabetes self-management.Contribution: This study contributes to previously unavailable context-specific information on diabetes knowledge levels among patients in Mhlontlo.
44. Evaluating the implementation of group empowerment for people with type 2 diabetes at Grassy Park Community Day Centre, Cape Town: A convergent mixed-methods study.
期刊: South African family practice : official journal of the South African Academy of Family Practice/Primary Care 发表日期: 2025-Dec-18 链接: PubMed
摘要
Diabetes is a major contributor to the burden of disease in South Africa, but glycaemic control is poor. Group empowerment and training (GREAT) for people with type 2 diabetes is a cost-effective intervention in our setting. The aim was to evaluate the implementation of GREAT for diabetes at a primary care facility in Cape Town. A convergent mixed-method study evaluated implementation outcomes over 6 months. A programme theory model was used to prospectively plan implementation. Semi-structured individual interviews were held with healthcare workers, focus group interviews with patients and sessions were observed to evaluate adoption, feasibility, fidelity and sustainability. Quantitative data evaluated reach, cost and aspects of fidelity. Qualitative data analysis used ATLAS.ti and the framework method. Data were analysed deductively according to the pre-determined implementation outcomes. Key stakeholders agreed that GREAT was acceptable and appropriate and encouraged adoption. Initial implementation reached 35 patients in four groups and 65% of those invited attended. Only 29% attended all four sessions. Fidelity of the intervention to the training manual was good. Several contextual factors influenced the feasibility of implementation (e.g. support of management, space for group sessions, integration with appointment system, effect on number of walk-in patients, streamlined referral system). Incremental operational costs were trivial (R30/month), while opportunity costs were higher (R26 252/month). Sustainability will be related to ongoing managerial and staff buy-in and adjustment of the implementation strategies to overcome some of the barriers. The study identified 30 determinants of successful implementation outcomes.Contribution: Can guide future implementation in similar contexts as GREAT for diabetes is scaled-up in Cape Town and scaled-out to other provinces in South Africa.
45. Knowledge, attitudes and practices of primary care nurses regarding human immunodeficiency virus pre-exposure prophylaxis in Mhlontlo sub-district municipality, Eastern Cape, South Africa.
期刊: South African family practice : official journal of the South African Academy of Family Practice/Primary Care 发表日期: 2025-Dec-18 链接: PubMed
摘要
Pre-exposure prophylaxis (PrEP) is key for preventing human immunodeficiency virus (HIV) transmission, but uptake is limited, especially in rural areas of South Africa. Nurses in primary healthcare (PHC) play a vital role in delivering PrEP, yet little is known about their knowledge, attitudes and practices (KAP) in this area. A cross-sectional analytic study was conducted among 178 nurses from three healthcare facilities in the Mhlontlo sub-district of the OR Tambo District, Eastern Cape. A structured, self-administered questionnaire was used to assess demographic variables, PrEP-related knowledge, attitudes and practices. While 78.7% of participants were aware of PrEP, only 43.3% demonstrated comprehensive knowledge, and just 46.6% had ever initiated a client on PrEP. Community health centre (CHC) nurses demonstrated significantly better knowledge and practice than those in district hospitals (p 0.001). Attitudes were generally positive, with 91.4% agreeing that PrEP is an effective HIV prevention method. However, 73.1% believed it could lead to increased transmission of sexually transmitted infections (STIs). The study identified barriers to PrEP implementation, including lack of training (57.9%), protocol shortages (25.3%) and insufficient time (40.4%). Primary care nurses demonstrate a high level of awareness and positive attitudes towards PrEP; however, knowledge and practice gaps persist. Primary care providers’ capacity building through targeted training, integration and improved human and healthcare resources is vital to enhancing PrEP implementation for national HIV prevention.Contribution: This study highlighted the frontline primary care providers’ vital roles in the PrEP for prevention of HIV infection in resource-limited rural healthcare settings.
46. Global Mapping of Evidence on Vaccination Related Education Through School Based Curriculum: A Systematic Scoping Review.
期刊: Delaware journal of public health 发表日期: 2025-Dec 链接: PubMed
摘要
Educating school children about vaccination as a part of health promotion intervention is one of the strategies to improve vaccination acceptance. The aim of this scoping review is to describe the range of school-based education interventions related to vaccination and particularly about efforts to include such education in school curricula. This systematic scoping review was conducted based on the methodological framework proposed by Arskey and O’Malley. Searches were performed in four databases from Nov 1, 2004 to Nov 30, 2024. Databases were systematically searched for published articles on school education on vaccination. Two independent authors screened the articles followed by data extraction using MS-Excel tool. Out of total identified 18,706 articles, only six articles met the inclusion criteria. All studies were focused on developed countries and most were experimental studies. Interventions were delivered by teachers or researchers and reported general improvements in vaccine knowledge as well as of vaccine-specific interventions. This review documented the outcomes on a curriculum based on immunity and vaccine related concept in school education. The review also highlights the ad hoc approach of health promotion during the vaccine specific knowledge dissemination in school. Formalizing health education could be a long-term strategy for better public health outcomes which face numerous challenges due to vaccine hesitancy or denial. Structured school curriculum on vaccination is warranted to sustain the knowledge on vaccination and its effect on community.
47. A Study Protocol for the X-SIAGA Intervention: A Cluster Randomized Trial to Improve Household Preparedness for Disease X and Outbreaks in Selangor's Indigenous Community.
期刊: Cureus 发表日期: 2025-Dec 链接: PubMed
摘要
Proactive preparedness strategies are more effective than reactive responses in minimizing the negative impacts of health emergencies, including outbreaks. Despite their potential to enhance community resilience, household preparedness initiatives are limited in Malaysia. The focus is primarily on flood disasters, often overlooking marginalized communities, such as indigenous groups. In Selangor, these communities live near forest edges and depend on the forest for livelihood, increasing their risk of exposure to zoonotic and novel threats such as Disease X. They also face challenges such as socioeconomic status, poor living conditions, healthcare barriers, and societal marginalization, making them particularly vulnerable to severe impacts from outbreaks. This study aims to evaluate the effectiveness of X-SIAGA, a newly developed intervention package, in improving household preparedness for Disease X and potential outbreaks among indigenous communities in Selangor, Malaysia. This study will be a two-arm, parallel, single-blinded, cluster-randomized trial using multistage and simple random sampling to evaluate the effectiveness of X-SIAGA. The primary outcome is Household Outbreak Preparedness scores, with secondary outcomes including Cognitive Preparedness scores and Preparedness Behaviour scores. District and village clusters will be selected using multistage sampling and randomly assigned interventions via computer-generated numbers. Ninety-six households from eight villages are planned for recruitment, split evenly between the intervention and control groups. The intervention group will receive X-SIAGA along with educational brochures, while the control group will receive only the brochures. Outcome measures will assess changes from baseline to immediately after and one- and three-month post-intervention or control. As this is a study protocol, results are not yet available. The study is designed to assess changes in Household Outbreak Preparedness scores (primary outcome), as well as Cognitive Preparedness scores and Preparedness Behaviour scores (secondary outcomes). This protocol describes an intervention study that will generate evidence on the effectiveness of X-SIAGA, a novel, culturally tailored, and theory-based intervention designed to improve household preparedness for Disease X and potential outbreaks among indigenous communities in Selangor.
48. Harm Reduction Policing: A Scoping Review Examining Police Training as a Strategy to Overcome Barriers to HIV Services.
期刊: Health and human rights 发表日期: 2025-Dec 链接: PubMed
摘要
Discriminatory laws and punitive policing practices have long been known to impede access to HIV and other health services. While the 2021-2026 Global AIDS Strategy calls for decriminalizing laws targeting key and vulnerable populations, progress toward this goal has largely stalled. To better understand the potential for working with police to ensure access to HIV services, we conducted a scoping review of peer-reviewed and gray literature examining outcomes of police training published between January 2000 and August 2024. Following a review of 639 articles and reports meeting our search criteria, we found 11 peer-reviewed articles and six reports that included outcomes of police training. Our review found that well-designed police training can benefit both law enforcement and communities. It can be a cost-effective public health investment. Best practices for police training included addressing police occupational safety concerns; using trainings as opportunities to build stronger relationships between law enforcement and communities; fostering support from police leadership; and embedding training in a broader effort to change policing. While changing police is complex, our review found a body of literature describing positive outcomes from training, including increasing recognition by police of their role to protect the right to health for key and vulnerable populations.
49. [Multilevel Analysis of Value Alignment With Medical Care and Prevention Integration Among Family Doctors and Health Status of Chronic Disease Patients: The Mediating Role of Team Cohesion].
期刊: Sichuan da xue xue bao. Yi xue ban = Journal of Sichuan University. Medical science edition 发表日期: 2025-Nov-20 链接: PubMed
摘要
To explore the association between the value alignment with medical care and prevention integration among family doctors and the health status of patients with chronic diseases, and to analyze the mediating effect of team cohesion between them. SA survey was conducted in 4 cities in the eastern, central and western regions of China. In each city, chronic disease patients and their contracted family doctors were enrolled in 6 randomly selected townships or neighborhoods. Self-developed scales were used to assess the value identification with medical care and prevention integration among family doctors, as well as their team cohesion. The Chinese version of the EuroQol 5-Dimension 5-Level (EQ-5D-5L) questionnaire was used to assess the health status of patients. A multilevel regression model was applied to analyze variables at two levels-patients and family doctors. The mediating effect was analyzed using a multilevel structural equation model. A total of 5855 patients with chronic diseases and 164 family doctors were included. The correlation between value alignment with medical care and prevention integration among family doctors and the health status of patients was statistically significant (β = 0.089, 95% CI: 0.042-0.136). Team cohesion played a mediating role between them (P = 0.030), accounting for 5.23% of the total effect, with an indirect effect value of 0.054 and a 95% bootstrap confidence interval of 0.005-0.103. IIt is important to establish appropriate performance evaluation and incentive mechanisms and team collaboration mechanisms in the promotion of medical care and prevention integration, so as to improve the effect of health management for patients.
50. Musculoskeletal Challenges among Malaysian Primary Oral Healthcare Personnel.
期刊: Malaysian orthopaedic journal 发表日期: 2025-Nov 链接: PubMed
摘要
Musculoskeletal disorders (MSDs) are a critical occupational health issue, particularly among dental professionals, where repetitive tasks, prolonged postures, ergonomic challenges, and psychosocial stressors contribute to their high prevalence. Existing literature highlights musculoskeletal issues, but gaps remain in understanding their prevalence and causes among primary oral healthcare personnel in Malaysia. A multistage sampling technique was used to recruit a representative sample of 330 respondents from Malaysian primary oral healthcare personnel in various job roles within government dentistry facilities. Nordic Musculoskeletal Questionnaires (NMQ) were distributed to investigate the prevalence of musculoskeletal issues among the participants. Of the participants, 53.4% of females and 46.6% of males reported experiencing work-related musculoskeletal disorders (WR-MSD). The neck was the most affected region, with a prevalence of 65.5%. Musculoskeletal disorders were more prevalent among individuals with longer years of service, with dental officers being the most affected type of designation. This study highlights the high prevalence of musculoskeletal disorders (MSDs) among Malaysian primary oral healthcare personnel, emphasising the need for targeted ergonomic interventions and workplace practice improvements to enhance occupational health and well-being.
51. Caspases as a biomarker - similar or a different gastric cancer biology.
期刊: Polski przeglad chirurgiczny 发表日期: 2025-Aug-11 链接: PubMed
摘要
<b>Introduction:</b> Caspases play a key role in apoptosis, the disruption of which can lead to the proliferation of abnormal cell clones and tumor growth. Caspases’ role as potential biomarkers has been confirmed in relation to many types of cancer.<b>Aim:</b> In this study, the authors focused on the European population with an average incidence of gastric cancer to investigatethe importance of caspases in gastric cancer.<b>Material and methods:</b> For this purpose, we evaluated the expression of representative caspases - an effector caspase-3 as well as caspase-8 and -9 initiating the apoptosis process, studying the cases of 53 patients who had been operated on in the Department of General Surgery and Surgical Oncology from 2010 to 2014. Also, we selected patients who had not received the neoadjuvant chemotherapy. An attempt was then made to identify correlations between caspase expression and clinical or pathological features of gastric cancers. The expression was evaluated by immunohistochemical reactions using monoclonal antibodies. Statistical analysis was performed, including parametric and nonparametric tests, like Kruskal-Wallis and Spearman's rho.<b>Results:</b> The study did not confirm a significant role of caspases in gastric cancer. We found no correlation with overall survival, tumor location, clinical stage, or its grade of histopathological malignancy as defined by World Health Organization (WHO). The possibility of using the selected caspases as biomarkers was not confirmed.<b>Discussion:</b> Our observations are significantly different from those described in the literature. This may indicate differences in tumour biology in different patient populations.<b>Conclusions:</b> In the study performed by the authors of this paper, no correlation of caspase-3, -8, and -9 IRS score with clinicopathological factors and long-term survival was found to be statistically significant.
52. Mental health facility ownership and smoking cessation services: a facility-level analysis across the United States.
期刊: Frontiers in public health 发表日期: 2025 链接: PubMed
摘要
In the U.S., tobacco use affects 19.8% of adults (49.2 million) as of 2022, with rates highest among those with mental health conditions. Mental health facilities offering cessation counseling present critical opportunities to support these vulnerable populations. This study aims to examine how ownership structure influences smoking cessation counseling provision in U.S. outpatient mental health facilities. This cross-sectional study derived data on 9,645 outpatient (OPD) mental facilities from the 2019 N-MHSS-a census of all public and private mental health treatment facilities in the United States. We used multiple logistic regressions to examine how facility ownership would be associated with smoking cessation counseling provision, controlling for other facility characteristics. Models adjusted for state-level clustering for correlated random variances in service provisions across facilities in the same state. Of the outpatient facilities surveyed, 41.72% of OPD provided smoking cessation counseling. Compared to public facilities, private for-profit facilities were 30% less likely to provide smoking cessation counseling [odds ratio (OR) = 0.70, 95% confidence interval (CI) = 0.59-0.82; p < 0.05]. Private non-profit facilities were 27% less likely to provide smoking cessation counseling (OR = 0.73, CI = 0.64-0.83; p < 0.05), while controlling for other confounders. Publicly-owned facilities demonstrate higher rates of smoking cessation counseling provision compared to both private non-profit and for-profit counterparts. This disparity in service availability raises concerns for tobacco control efforts, particularly as privatization in mental healthcare continues to expand. The observed pattern suggests potential misalignment between public health priorities and service delivery in private settings. Future policy initiatives should address these gaps and investigate underlying factors driving ownership-based differences in cessation services for patients with mental illness.
53. Exploring Tobacco Vendor Perspectives on Tobacco Vendor Licensing in Lucknow, India: An Exploratory Mixed-Methods Study.
期刊: Journal of International Society of Preventive & Community Dentistry 发表日期: 2025 链接: PubMed
摘要
Tobacco vendor licensing (TVL) under India’s Cigarettes and Other Tobacco Products Act is intended to regulate tobacco sales and reduce youth access; however, implementation gaps at the local level may limit its impact. This study explored, in a purposively selected sample, tobacco vendors’ awareness, perceptions, and experiences regarding TVL in Lucknow, India. An exploratory concurrent triangulation mixed-methods design was used. A structured survey of 150 purposively selected vendors assessed demographics, awareness, and perceptions of TVL, while six in-depth interviews captured lived experiences. Quantitative data were analyzed using descriptive statistics to identify exploratory patterns, and qualitative data were examined thematically using Braun and Clarke’s framework. Integration occurred at the interpretation stage. Given the non-probability sampling, findings are not statistically inferential or generalizable. Only 26.7% of vendors reported awareness of TVL regulations, indicating a substantial information gap. Vendors who were aware of TVL tended to report more favorable views of licensing and its intended regulatory role. Qualitative analysis identified five interrelated themes: lack of awareness, positive perception of TVL’s intent, challenges in implementation, unclear enforcement mechanisms, and suggestions for improvement. Vendors highlighted financial burden, procedural complexity, and limited official communication as key barriers to compliance. These exploratory findings suggest that information deficits, procedural opacity, and weak enforcement constrain the effectiveness of TVL in Lucknow. Strengthening vendor-focused awareness, simplifying licensing processes, and ensuring consistent, transparent enforcement are essential to better align policy intent with on-ground practice.
54. Global Preferences and Determinant Variables of Caesarean Delivery Among Pregnant Women: A systematic review and meta-analysis.
期刊: Sultan Qaboos University medical journal 发表日期: 2025 链接: PubMed
摘要
A caesarean section (CS) is a lifesaving procedure. With rising rates, women’s delivery choices have become a global concern. This review assesses global CS preference and determinants. A search of 6 databases was conducted (PubMed, Medline, EMBASE, CINAHL, Google Scholar and Maternity and Infant Care) in accordance with PRISMA guidelines, including papers published between 2013 and 2024. Egger’s test and funnel plot assessed publication bias, while the I2 statistic and Cochrane Q-test evaluated heterogeneity. Subgroup analysis considered sample size, publication year and economic condition. Initially, 73 articles were identified, of which 13 were deemed suitable, with a total sample size of 22,238. The pooled global CS preference was 26%. Subgroup analysis considered economic status, publication year and sample size. Variables associated with CS preference included age >25 years (adjusted odds ratio [AOR] = 4.9, 95% confidence interval [CI]: 1.4-8.4), higher education (AOR = 1.7, 95% CI: 1.05-2.3), urban residency (AOR = 1.9, 95% CI: 1.4-2.4), lack of knowledge of CS (AOR = 2.1, 95% CI: 1.5-3.6) and prior pregnancy complications (AOR = 4.8, 95% CI: 1.4-10). The pooled global CS preference was nearly one-fourth. This review found that an age greater than 25 years, higher education, urban residency, lack of knowledge about CSs and history of previous pregnancy complications were determinant factors for preference for caesarean delivery. As a result, strengthening healthcare systems is essential to improve women’s decision-making regarding mode of delivery.
55. Whole genome sequencing analysis of Streptococcus pneumoniae populations of serotypes 10A, 11A, 12F, 15B, and 33F involved in invasive pneumococcal disease in the Czech Republic in 2013-2023.
期刊: Epidemiologie, mikrobiologie, imunologie : casopis Spolecnosti pro epidemiologii a mikrobiologii Ceske lekarske spolecnosti J.E. Purkyne 发表日期: 2025 链接: PubMed
摘要
Whole Genome Sequencing (WGS) analysis of populations of Streptococcus pneumoniae of serotypes 10A, 11A, 12F, 15B, and 33F involved in invasive pneumococcal disease (IPD) in the Czech Republic (CR) in 2013-2023. The analysed serotypes of S. pneumoniae have been included in the recently registered pneumococcal conjugate vaccines (PCV): PCV15 and PCV20. The epidemiological analysis of the incidence of selected serotypes was based on nationwide IPD surveillance data from 2013-2023. WGS was used to analyse 177 isolates of S. pneumoniae of five serotypes: 10A, 11A, 12F, 15B, and 33F recovered from IPD in CR in 2013-2023. The Illumina MiSeq platform was used for WGS. The WGS data were analysed using tools of the PubMLST database where WGS data have been publicly accessible. Epidemiological analysis of the incidence of S. pneumoniae serotypes 10A, 11A, 12F, 15B, and 33F involved in IPD showed their increase after the vaccines PCV7, PCV10, and PCV13 had been introduced in CR. IPD cases caused by serotype 10A peaked in 2015 (17 cases), serotype 11A was the most frequent cause in 2018 (19 cases), serotype 12F predominated in 2015 (18 cases), serotype 15B in 2023 (11 cases), and serotype 33F in 2015 (6 cases). During the COVID-19 pandemic, IPD cases caused by the listed serotypes declined. In the post-pandemic period, the involvement of serotypes 10A and 11A in IPD cases increased again, as did that of serotype 15B. WGS data analysis showed a clear dominance of a large and genetically compact cluster of ST-1551 among Czech isolates of serotype 10A. Czech serotype 11A isolates were assigned primarily to ST-62 or other related sequencing types. Czech serotype 12F isolates were part of three major clusters unrelated to each other (ST-218, ST-989, and ST-8060). Czech serotype 15B isolates showed a high genetic heterogeneity and belonged to three major European clusters (ST-162, ST-199, and ST-1262) with a predominance of ST-162 isolates. In our study, serotype 33F was only represented by six isolates, four of which were of ST-100. Both Czech and European populations of S. pneumoniae of different serotypes show considerable heterogeneity. They include serotypes in which related isolates of a single ST (11A) predominate, as well as serotypes that consist of several completely unrelated clusters (12F, 15B). The structures of these individual populations are continually changing over time and also differ within individual European countries. It is important to monitor S. pneumoniae populations as closely as possible and to use the data obtained to evaluate the possibilities for introducing new PCVs in the Czech Republic.
56. Significant risk of developing asbestos-related diseases in Japan's industries: An analysis of workers' compensation.
期刊: AIMS public health 发表日期: 2025 链接: PubMed
摘要
Asbestos has been used in various industries, and prolonged exposure can increase the risk of asbestos-related disease (ARD). Although the use of asbestos has been prohibited in Japan since 2012, it was imported well into the 2000s. This study aimed to identify industries in Japan whose workers are at heightened risk of developing ARD. This study was based on a comprehensive analysis of fiscal year data from the Survey of Claims and Decisions on Benefits for Asbestos-Related Health Damage and calendar year data from the Status of Pneumoconiosis Health Management Implementation in Japan. Occupations associated with asbestos exposure risk were identified using the Japan Standard Industrial Classification (Rev. 14, 2023). The incidence rate ratio (IRR) was estimated using Poisson regression analysis. This study includes 8,971,500 person-years from 2006 to 2022. Construction workers showed the strongest positive associations with all ARDs. Within the manufacturing sector, shipyard workers were particularly vulnerable to ARDs, although a notable exception to this was the positive correlation with asbestosis among workers in the ceramic industry (IRR 1.56; 95% CI 1.12-2.17). Mesothelioma is the most prevalent ARD over the past 17 years. This study suggests that, despite asbestos being banned in Japan for the past 13 years, cases of ARDs continue to occur in various industries, with construction and shipyard workers being at highest risk. Consequently, individuals with prior asbestos exposure require continuous monitoring to avoid potential adverse health consequences.
57. Development and evaluation of a participatory ergonomic intervention for the reduction of work-related musculoskeletal disorders among nurses.
期刊: AIMS public health 发表日期: 2025 链接: PubMed
摘要
Nurses are highly vulnerable to work-related musculoskeletal disorders (WMSD). This study evaluated the effects of a participatory ergonomic intervention on WMSD, sick absenteeism, and work performance among ward nurses. A multicomponent ergonomic training module, comprising educational ergonomics, health promotional activities, workstation adjustment, use of patient-assisted devices, and progressive muscle relaxation techniques, was developed based on a systematic review, focus group discussion, and discussion with ergonomic experts. A cluster quasi-experimental design was conducted, with nurses allocated into intervention (n = 45) and control (n = 30) groups, and follow-up across baseline, first, third-, and sixth-months post-intervention. The outcomes were assessed using the Nordic Musculoskeletal and Health and Work Performance Questionnaires. The intervention module was effective in reducing self-reported musculoskeletal symptoms among nurses across time, particularly neck pain [adjusted odds ratio (AOR) = 0.42, 95% CI 0.21-0.87], low back pain (AOR = 0.45, 95% CI 0.21-0.97), and shoulder pain (AOR = 0.38, 95% CI 0.17-0.88). However, the effects on relative absenteeism and relative presenteeism were only observed following adjusted analyses. While the ergonomic intervention was effective in reducing specific WMSDs among ward nurses, more research is required to delineate its potential application as a long-term strategy for addressing sick absenteeism and work performance.