公共卫生研究摘要 (2026-01-18)
共收录 55 篇研究文章
1. The Associations of Sucrase-Isomaltase Hypomorphic Variants With Long-Term Outcomes and Dietary Intake in an Australian Irritable Bowel Syndrome Population Educated on the FODMAP Diet: A Cross-Sectional and Retrospective Study.
期刊: United European gastroenterology journal 发表日期: 2026-Feb 链接: PubMed
摘要
Hypomorphic variants of sucrase-isomaltase (SI) have been associated with irritable bowel syndrome (IBS) in adults, but how their presence influences therapeutic outcomes is uncertain. To investigate the frequency of sucrase-isomaltase hypomorphic variants in patients with IBS and their association with short- and long-term outcomes after initiation of a FODMAP diet. Clinical outcomes in patients with IBS were retrospectively examined at mean 7.1 (range 2.5-13.4) years after being educated on a FODMAP diet by a gastrointestinal dietitian and their current food intake (Comprehensive Nutrition Assessment Questionnaire) and gastrointestinal symptoms were documented at interview. DNA extracted from whole blood samples was analysed with the Illumina Global Screening Array for sucrase-isomaltase hypomorphic variants. Of 72 participants (62% female, median age 59 years), 54% had at least one hypomorphic variant of which 85% were single-carriers. On adjusted binary logistic regression analysis, no differences were noted across SI hypomorphic genotypic groups for retrospective analysis of initial response to a FODMAP diet or long-term symptom control. Current dietary intakes of sucrose or starch were not different between non-carriers and carriers, were directly related to FODMAP intake and did not differ in carriers according to adequacy of symptom control. Findings in those with diarrhoea-predominant IBS (n = 29) were similar to the those in the whole group. Too few double-carriers (n = 6) precluded the definition of associations. The presence of single sucrase-isomaltase hypomorphic variants is common but was not associated with short- or long-term outcomes or dietary intake for patients with IBS who were taught a FODMAP diet.
2. Analysis of risk factors for recurrence in children with asthmatic bronchopneumonia during remission and discussion on the therapeutic effect of diprophylline combined with budesonide.
期刊: Pakistan journal of pharmaceutical sciences 发表日期: 2026-Feb 链接: PubMed
摘要
Asthmatic bronchopneumonia (ABP) is a common lower respiratory tract infection in infants and young children. Although most of the children have a good prognosis, more than 30% of the cases still face the risk of recurrence during the remission period and are prone to progress to airway hyperresponsiveness disease. The aim of this study is to evaluate the efficacy and safety of dihydroxypropylline (DPL) combined with budesonide (BUD) in the treatment of pediatric ABP, and to analyze the independent risk factors for recurrence during remission, so as to provide a basis for clinical prevention and treatment. This randomized controlled trial evaluated DPL combined with BUD for ABP in 80 children (40 per group) treated for 7 days. The experimental group received DPL (0.1g/day IV) plus BUD (1mg twice daily by nebulization); controls received DPL alone. Primary outcomes included clinical efficacy and inflammatory markers. The combination therapy showed higher total efficacy (95.0% vs. 85.0%, p=0.136) and significantly reduced inflammatory markers (WBC: 6.96±1.45 vs. 9.78±1.09×109/L, p<0.001). Multivariate analysis identified breastfeeding duration ≤3 months (OR=2.64, 95%CI: 1.16-6.91), malnutrition (OR=2.54, 95%CI: 1.14-5.54) and tobacco exposure (OR=3.84, 95%CI: 1.65-6.72) as independent recurrence risk factors. DPL combined with BUD can quickly relieve the clinical symptoms and reduce the level of inflammation in children with ABP, with good safety. More attention should be paid to breastfeeding support, environmental tobacco control and nutritional intervention to reduce the risk of relapse during remission.
3. Chain-of-Thought Reasoning Improves ChatGPT's Diagnostic Accuracy in Radiology.
期刊: Canadian Association of Radiologists journal = Journal l’Association canadienne des radiologistes 发表日期: 2026-Feb 链接: PubMed
摘要
4. Age at first marriage, menopause status and cervical cancer risk in a middle eastern country: a national cancer registry-based case-control study.
期刊: Cancer causes & control : CCC 发表日期: 2026-Jan-17 链接: PubMed
摘要
Cervical cancer ranks as the fourth leading cause of cancer-related morbidity and mortality among women worldwide. Despite its global significance, evidence on cervical cancer risk factors in Kuwait remains limited. This case-control study aimed to identify factors associated with cervical cancer among women in Kuwait. A total of 50 cervical cancer cases were recruited from the Kuwait Cancer Control Center, and 155 controls were selected from public-sector employees in a 1:3 ratio. Data were collected using a structured questionnaire. Adjusted odds ratios (ORadj) and 95% confidence intervals (CI) were estimated through multivariable logistic regression analysis. Compared with controls, cases were more likely to have first marriage at a younger age (< 25 vs. ≥ 25 years) (ORadj = 5.52; 95% CI: 1.34-22.82, p = 0.018), to be unaware of HPV vaccine availability (ORadj = 7.63; 95% CI: 1.60-36.39, p = 0.011) or tended to be in menopause (ORadj = 5.17; 95% CI: 1.64-16.33, p = 0.005). These associations were adjusted for the smoking status (ever vs. never). Younger age at first marriage, being in menopause, and unawareness of HPV vaccine availability were independently associated with an increased risk of cervical cancer. These findings should be regarded as preliminary and hypothesis-generating, offering a foundation for further research on this important women’s health issue in Kuwait and comparable settings. Larger studies are warranted to confirm these results and to identify additional determinants of cervical cancer risk.
5. Sleep midpoint, social jetlag, and cancer risk in the Cancer Prevention Study-3.
期刊: Cancer causes & control : CCC 发表日期: 2026-Jan-17 链接: PubMed
摘要
Sleep timing and regularity are associated with various health and performance outcomes, but limited research has investigated the relationship of these sleep dimensions with cancer incidence. The objective of this study was to investigate the associations of sleep midpoint and social jetlag with cancer risk among US adults. The Cancer Prevention Study-3 is a large prospective study of US adults aged 30-65 years. At the first triennial follow-up (2015), participants were asked to report the average time they spent sleeping during a 24-h weekday and weekend, respectively. Sleep midpoint was calculated as the wake time minus half of sleep duration on a weekday and weekend to create a 5:2 weekday:weekend weighted average which was categorized as < 2:30AM, 2:30- < 3:30AM (referent), and ≥ 3:30AM. Social jetlag measures were calculated to estimate the difference in sleep midpoint on the weekend and weekday and categorized as < 1 h (referent), 1- < 2 h, and ≥ 2 h. Cancer incidence was determined via linkage to state registries; follow-up time ended at the time of cancer diagnosis or death or end of follow-up (12/31/2020). We used multivariable Cox proportional hazards models to estimate adjusted hazard ratios and 95% confidence intervals adjusted for socio-demographics, socioeconomic status, comorbidities, and lifestyle behaviors. A total of 5,537 incident cancer cases were reported among 145,386 CPS-3 participants. We found no statistically significant associations of sleep midpoint or measures of social jetlag with overall cancer or breast cancer-specific risk. Our findings suggest no significant associations of sleep midpoint and social jetlag with cancer risk.
6. Impact of psychiatric disorders on treatment adherence and overall survival in patients with Hodgkin lymphoma: a retrospective cohort study.
期刊: Cancer causes & control : CCC 发表日期: 2026-Jan-17 链接: PubMed
摘要
Psychiatric comorbidities are common in patients with Hodgkin lymphoma (HL) and may influence treatment adherence and survival outcomes. This study aimed to evaluate the impact of psychiatric disorders on overall survival and treatment adherence in HL patients. A retrospective cohort study was conducted including 139 HL patients treated at the General Hospital of Mexico “Dr Eduardo Liceaga.” Clinical, demographic, and psychiatric data were collected. Overall survival was analyzed using Kaplan-Meier curves and Cox proportional hazards models adjusted for Ann Arbor stage, treatment adherence, and psychiatric disorders. Treatment adherence was assessed, and its association with survival was explored using time-varying hazard ratios. Among 139 patients, those with psychiatric disorders exhibited significantly worse overall survival (HR 6.80, 95% CI 1.32-34.95, p = 0.022). Adherence to treatment was independently associated with improved survival (HR 0.05, 95% CI 0.02-0.16, p < 0.001). Time-varying analysis showed the highest hazard ratio for psychiatric disorders during the early follow-up period. Psychiatric disorders are independently associated with poorer overall survival in patients with Hodgkin lymphoma, partly mediated by reduced treatment adherence. Early recognition and integrated psychosocial interventions may improve treatment continuity and survival outcomes.
7. Contaminating the evidence: the reproducibility crisis and fraud in infectious disease research.
期刊: Infection 发表日期: 2026-Jan-17 链接: PubMed
摘要
Irreproducible and fraudulent research is an enormous problem that decreases the public’s trust in biomedical science. Unfortunately, infectious disease (ID) research has not escaped the reproducibility crisis and investigator maleficence. This article describes the scope of the problem, explores some of the reasons why investigators commit research fraud, and discusses the surprising lack of oversight by relevant stakeholders including the National Institutes of Health (NIH), scientific journals, and academic institutions. Finally, a novel solution for tackling fraud in ID research is proposed.
8. Spinal deformity following surgery for paediatric intramedullary spinal cord tumours.
期刊: Child’s nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery 发表日期: 2026-Jan-17 链接: PubMed
摘要
Spinal deformity (SD) in children with intramedullary spinal cord tumours (IMSCT) can occur at presentation or postoperatively due to neurogenic and mechanical factors on a background of future spinal growth. Deformity is associated with pain, functional decline and reduced quality of life but spinal instrumentation can compromise MRI tumour surveillance. This study aims to identify risk factors for SD amongst children operated for low-grade IMSCT to identify any modifiable risk factors and help guide pre-operative counselling and surveillance. Cases of benign IMSCT in patients under 16 were identified from a prospectively collected institutional operative database. Review of electronic medical records was then undertaken for details of presenting symptoms, SD at diagnosis, histology, surgical approach (laminectomy/laminoplasty). High grade tumours and previously operated tumours were excluded. Outcome measures comprised spinal alignment at last follow-up and any additional interventions (bracing or surgery) to address deformity. Data was analysed using Excel and SPSS. 45 patients satisfied the inclusion criteria. Mean age at index surgery was 7.1 years, and at last follow up 13.8 years. At presentation, 38% had SD (N = 17/45), 11% torticollis (n = 5/45), 64% pain (n = 30/45) and 43% weakness (n = 19/45). Tumour location was thoracic (40%, n = 18/45)), cervicothoracic (33%, n = 14/45) and cervical (27%, n = 12/45). Tumour histology included low-grade astrocytoma (66%, n = 30/45), glioneuronal tumour (13%, n = 6/45), ependymoma (7%, n = 3/45), cavernoma (4%, n = 2/45), haemangioblastoma (2%, n = 2/45) and neuroenteric cyst (2%, n = 1/45), Laminoplasty was performed in all cases, 51% (n = 23/45) crossing a junctional level. Postoperative MRI confirmed total resection in 51% (n = 23/45). 43% received adjuvant therapy (n = 19/45). 85% (n = 38/45) wore a post-operative spinal orthosis for mean duration 5.27 months (range 1.5-36 months). Postoperative SD occurred in 69% (n = 31/45) of which 48% (n = 15/31) developed following surgery, typically within 2.6 years of follow up. 42% required further bracing (n = 19/45) and 31% underwent spinal fusion (n = 14/45) at an average of 5.5 years post-resection. Patients presenting with SD were significantly more likely to require spinal fusion (p = < 0.01). Thoracic location and the presence of a syrinx were also risk factors for progressive SD. SD is common in children with low-grade IMSCT in children affecting one third at presentation and two thirds post-operatively with one third requiring spinal fusion for deformity correction. Risk factors include: SD at presentation, thoracic cord location and presence of syrinx.
9. Lack of association between cytomegalovirus infection and liver fibrosis in patients with biliary atresia after the Kasai procedure.
期刊: Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology 发表日期: 2026-Jan-17 链接: PubMed
摘要
Biliary atresia (BA) is a serious condition and the leading cause for liver transplantation in children. The exact cause for BA is currently unknown, with one suggested mechanism being a viral infection. Cytomegalovirus (CMV) is the most common viral infection in BA patients and was previously known to be associated with worse outcomes, including liver fibrosis. Our study aimed at investigating the association between CMV infection and liver fibrosis in BA patients who underwent the Kasai procedure at our institution. This study was a retrospective analysis of medical records from BA patients who underwent the Kasai procedure between January 2019 and July 2024 at our hospital. Our study involved 15 male and 23 female BA patients. The proportion of CMV-infected patients (n = 11) was lower than that of the non-CMV-infected BA patients (n = 27). The association between CMV infection status and liver cirrhosis (p = 1.0) was statistically insignificant. However, the age at the Kasai procedure showed a statistically significant association with cirrhosis (p = 0.027; odds ratio [OR] = 7.20; 95% confidence interval [CI] = 1.27-40.7). Moreover, a multi-variate analysis revealed a strong association between the age at the Kasai procedure and liver cirrhosis (p = 0.029; OR = 7.37; 95% CI = 1.22-44.42). Our study’s findings suggest that CMV infection might not significantly affect the degree of liver fibrosis in BA patients following the Kasai procedure. Furthermore, the age at which the Kasai procedure is performed might influence the development of liver cirrhosis in these patients. These insights could reshape our understanding of BA and guide future research and clinical practice.
10. Machine Learning-Based Identification of Exosome-Associated Diagnostic Biomarkers in Acute Myocardial Infarction and in Silico Drug Prioritization.
期刊: Cardiovascular drugs and therapy 发表日期: 2026-Jan-17 链接: PubMed
摘要
Acute myocardial infarction (AMI) is a major global health burden, with current diagnostic biomarkers often limited by delayed elevation and low specificity. Exosomes have emerged as promising non-invasive biomarkers for cardiovascular diseases. Transcriptomic datasets from the Gene Expression Omnibus were integrated with candidate exosome-related gene sets to identify differentially expressed exosome-related genes (DEEGs) in AMI. Functional enrichment analyses were performed to explore biological functions. Machine learning algorithms including LASSO, Random Forest, and SVM-RFE were applied for feature selection. A diagnostic classification model was constructed and its discriminatory performance was evaluated. In silico drug prioritization was performed using the DSigDB database and molecular docking analysis. Plasma-derived exosomes from AMI patients and healthy controls were isolated for experimental validation, followed by quantitative real-time PCR analysis of candidate genes. A total of 273 differentially expressed genes were identified, including 27 DEEGs. Enrichment analysis revealed pathways related to neutrophil activation, NOD-like receptor signaling, and extracellular matrix organization. Six key genes, including S100A9, MMP9, FN1, NLRP3, CD55, and ITLN1 were selected as candidate diagnostic biomarkers. The multigene model demonstrated good diagnostic discrimination within the merged training cohort, while individual genes retained diagnostic value in an independent dataset. Several candidate compounds, including losartan, metoprolol, and pioglitazone, showed favorable binding affinities to key targets in molecular docking analyses. Transmission electron microscopy and nanoparticle tracking analysis confirmed the successful isolation of plasma exosomes, and qRT-PCR revealed significantly elevated expression of the six candidate genes in AMI-derived exosomes. This integrative study identifies a set of exosome-associated genes with potential diagnostic relevance in AMI and provides exploratory in silico drug candidates targeting these biomarkers. These findings are hypothesis-generating and warrant further validation in large, prospectively collected cohorts and functional studies before clinical application.
11. A novel loop-mediated isothermal amplification assay coupled with lateral flow assay for differential detection of Brucella spp from Brucella abortus S19 vaccine strain.
期刊: Veterinary research communications 发表日期: 2026-Jan-17 链接: PubMed
摘要
A Loop-Mediated Isothermal Amplification (LAMP) assay coupled with Nucleic-acid Lateral Flow Immunoassay (NALFIA) was developed to differentiate B. abortus S19, the vaccine strain, from other Brucella Species, including wild-type B. abortus. LAMP assay was carried out by targeting the eryC gene, which is absent in B. abortus S19. Specific ligands on the test and control lines of the LFA strip were spotted. The presence of a colored band only on the control line indicated the presence of B. abortus S19. In contrast, a colored line on both test and control lines indicated the presence of other Brucella Species. The assay was found to be very specific, as it did not cross-react with any other bacterial genera. The assay was found to be very sensitive, and the limit of detection was found to be 1.76 pg of genomic DNA of bacteria. In spiked milk samples, the assay could detect 2.89 × 103 CFU of bacteria. Thus, the assay, which has discriminatory power in the detection of B. abortus S19 and other Brucella Species, can be used as nucleic acid-based DIVA in clinical samples of suspected cases of bovine brucellosis, which can be a potential source of transmission in both humans and animals.
12. Smoking, plasma concentration, antipsychotic polypharmacy and adverse drug reaction burden in clozapine outpatients.
期刊: The Australian and New Zealand journal of psychiatry 发表日期: 2026-Jan-17 链接: PubMed
摘要
Clozapine is the most effective therapy for treatment-resistant schizophrenia, yet adverse drug reactions (ADRs) limit its use. The concurrent ADR burden in outpatients and its relation to psychotropic polypharmacy, tobacco smoking and measured clozapine exposure has not been well characterised. We conducted a retrospective, cross-sectional review of medical records for 360 adults receiving maintenance clozapine at a dedicated outpatient clinic. Adverse drug reactions (ADRs) were ascertained using a standardised patient checklist alongside clinical measures. We used multivariate logistic regression to estimate the association between antipsychotic polypharmacy and the presence of ADRs, and negative binomial regression to quantify its association with ADR burden. We conducted a log-linear model to evaluate dose-concentration compensation in tobacco smokers. At the clinic visit, 89.6% had ⩾1 symptomatic ADR. The most prevalent were metabolic syndrome (71.8%), hypersalivation (64.7%) and tachycardia (61.2%). Antipsychotic augmentation (51.4%) was independently associated with ADRs (adjusted odds ratios [aOR] = 3.38, 95% confidence interval [CI] = 1.41-8.06) and a 28% higher ADR count per person (incidence-rate ratio [IRR] = 1.28, 95% CI = 1.11-1.48). Smokers received higher doses yet had lower plasma concentrations, suggesting incomplete dose compensation for CYP1A2 induction and had higher odds of antipsychotic augmentation (odds ratio [OR] = 2.50, 95% CI = 1.53-4.10). In maintenance clozapine care, persistent ADRs were common and were more frequent in patients receiving antipsychotic augmentation. Smokers were under-exposed to clozapine and were more likely to receive antipsychotic augmentation. Services should implement structured ADR surveillance and prioritise therapeutic drug monitoring-guided dose optimisation, particularly in smokers, before considering antipsychotic augmentation.
13. Health consequences of paternal incarceration using a future-treated control group.
期刊: Health & justice 发表日期: 2026-Jan-17 链接: PubMed
摘要
14. Sex-difference in chewing difficulty and the risk of obstructive sleep apnea among middle-aged and older adults.
期刊: Sleep & breathing = Schlaf & Atmung 发表日期: 2026-Jan-17 链接: PubMed
摘要
Chewing difficulty may reflect orofacial factors linked to obstructive sleep apnea (OSA) risk, yet evidence remains limited, especially regarding sex differences. This study examined the association between perceived chewing difficulty and OSA risk according to sex. The study used five-year (2019-2023) data from the Korean National Health and Nutrition Examination Survey, including 16,105 participants aged ≥ 40 years (6,965 males and 9,140 females). Chewing difficulty was assessed on a five-level scale, and OSA risk was determined using the STOP-Bang questionnaire. A significant interaction between sex and chewing difficulty (p = 0.0387) in the model prompted sex-stratified analyses. Multivariable and multinomial logistic regression models were used to estimate adjusted odds ratios (ORs) and 95% confidence intervals (CIs). Among participants, 62.7% of males and 18.5% of females were classified as having middle-to-high risk of OSA. In adjusted models, chewing difficulty was significantly associated with higher OSA risk (OR: 1.28, 95% CI: 1.11-1.48) in females but not in males, with stronger associations observed at higher OSA risk levels (middle-risk, OR: 1.26, 95% CI: 1.09-1.46; high-risk, OR: 1.86, 95% CI: 1.09-3.18). This association persisted when chewing difficulty was analyzed as a graded variable, showing a trend of increasing association with greater severity (p < 0.0001 for trend). In females, higher levels of chewing difficulty were associated with increased OSA risk. These findings suggest that chewing difficulty could be explored as a potential factor in identifying individuals at higher risk of OSA.
15. Integrated bioinformatics and experimental validation identify FOXQ1, GRIN2D, and SCNN1B as novel biomarkers for distinguishing high-risk sessile serrated lesions from hyperplastic polyps.
期刊: Journal of molecular histology 发表日期: 2026-Jan-17 链接: PubMed
摘要
16. Global trends in patient-reported outcomes and quality-of-life research for breast cancer: a 20-year bibliometric study.
期刊: Cancer causes & control : CCC 发表日期: 2026-Jan-17 链接: PubMed
摘要
To conduct a 20-year bibliometric analysis of patient-reported outcomes (PROs) and quality-of-life (QoL) research in breast cancer, with focus on evolving priorities in women-centered care, global equity gaps, and implications for survivorship policy. A bibliometric analysis of publications from 2005 to 2024 was conducted using Web of Science. Following clear inclusion criteria (English articles focusing on PROs/QoL in breast cancer), we analyzed 1857 publications using CiteSpace and VOSviewer to map co-citation networks, keyword bursts, and collaboration patterns. A bibliometric analysis of 1,857 publications (2005-2024) revealed exponential growth in PROs and QoL research for breast cancer, with a notable surge after 2012. The United States led in output (30%) and influence, while China ranked second in volume but demonstrated lower citation impact. European nations such as France and Spain exhibited high per‑paper influence. Memorial Sloan Kettering Cancer Center was the most productive institution, yet the University of California, San Francisco achieved the highest average citations per paper. Supportive Care in Cancer published the most studies, while the Journal of Clinical Oncology was the most co‑cited. Seminal works-including the BREAST‑Q and EORTC QLQ modules-were the most frequently co‑cited references. Keyword evolution reflected a conceptual shift: early research emphasized “randomized trial” and “adjuvant therapy,” whereas recent trends prioritize “mental health” and “immediate breast reconstruction,” signaling a broader integration of psychosocial and patient‑centered outcomes. While innovations in PRO tools and survivorship science mark clear progress, the field remains constrained by a Western-centric paradigm that perpetuates inequities in addressing the needs of racial minorities, young patients with fertility concerns, and populations in resource-limited settings. Future efforts require inclusive research governance with strengthened LMIC leadership, contextualized priority-setting to bridge cross-cultural validity gaps, and strategic digital health integration to advance equitable patient-centered care beyond survival metrics.
17. Cross national comparison of memory function before and after a cancer diagnosis in the United States and England.
期刊: Journal of cancer survivorship : research and practice 发表日期: 2026-Jan-17 链接: PubMed
摘要
The long-term memory aging of middle-aged and older cancer survivors is not fully understood and is largely limited to the United States (US) context. We compared long-term memory trajectories before and after an incident cancer diagnosis with the memory trajectories of similarly aged cancer-free adults in the US and England. Incident cancer diagnosis and memory (immediate and delayed recall) were assessed during biennial interviews in the US Health and Retirement Study (HRS; n = 13,037) and the English Longitudinal Study of Ageing (ELSA; n = 8,579) from 2002 to 2018. Within country, multivariable adjusted linear mixed-effects models estimated the standardized memory trajectories in participants with and without cancer. Prior to diagnosis, cancer survivors had a memory advantage compared to cancer-free individuals, within each country (difference for cancer survivors in the US: 0.10 SD units [95% CI: 0.05, 0.14] and in England: 0.14 SD units [95% CI: 0.07, 0.20]). Cancer survivors in the US experienced an acute decline in memory function immediately following diagnosis (-0.08 SD units; 95% CI: -0.11, -0.04), which was not experienced by cancer survivors in England (0.01 SD units; 95% CI: -0.04, 0.07). Long-term post-diagnosis memory trajectories were similar for cancer survivors and cancer-free participants alike in both countries. The acute decline in memory function associated with a new cancer diagnosis among cancer survivors in the US, but not England, warrants future studies to investigate explanations for this cross-national difference, such as differences in healthcare systems and treatment. Results can generate hypotheses to identify contextual risk factors to improve cognitive aging of cancer survivors.
18. Leveraging the role of families in decision-making to inform a program of HPV-based self-collection for cervical screening in Tamil Nadu, India: a qualitative study.
期刊: Cancer causes & control : CCC 发表日期: 2026-Jan-17 链接: PubMed
摘要
Collectivist cultures often perceive health seeking and decision-making to be less individual and more communal, with most decisions made in consultation with a spouse or other family members. These dynamics are further complicated by heightened cultural sensitivities for women seeking care for reproductive needs. Our study explored community perceptions of cervical screening and recommendations for self-collection for Human Papillomavirus (HPV) testing in south India. We conducted eight focus group discussions (FGDs) with 54 men (mean age 48 years) and 10 FGDs with 67 women (mean age 58 years) belonging to rural, urban poor and tribal communities in Tamil Nadu. We used a framework analysis method for coding using the World Health Organization (WHO) framework for assessing barriers to health service coverage, the Capability Opportunity Motivation-behavior (COM-B) model, and the Theoretical Framework of Acceptability (TFA). Stigma, familial hierarchies, gendered norms and challenges with accessing health facilities contributed to delayed care for women with gynecological symptoms and hindered screening. Both men and women supported the idea of self-collection for their family members, although doubts were raised regarding accuracy, and usefulness for asymptomatic women. Participants suggested group counseling, community-based screening, peer motivation and easily accessible follow-up assessments for ensuring wide coverage. These findings informed the design and implementation of a cervical screening trial using self-collection, in the same locations. Screening programs need to address accessibility and acceptability barriers to cervical screening through family involvement, leveraging family support for the entire screening pathway from screening to follow-up.
19. Paid sick leave and cancer-related outcomes in the U.S. workforce: evidence from a scoping review.
期刊: Cancer causes & control : CCC 发表日期: 2026-Jan-17 链接: PubMed
摘要
Paid sick leave policies vary significantly across the United States and are known to influence access to and utilization of health services. However, little is known about how access to paid sick leave affects cancer-related outcomes such as screening, diagnosis, treatment adherence, and survivorship care. This scoping review aimed to systematically map the literature on the association between paid sick leave and cancer-related outcomes among working adults in the United States and to identify gaps to inform future research and policy. The following databases were searched: PubMed, Embase, CINAHL, and Scopus. Eligible studies included quantitative research conducted in the U.S. that evaluated paid sick leave in relation to any cancer-related outcome. Study findings were synthesized narratively and thematically, and critical appraisal of included studies was conducted. A total of 11 studies were included in the review. The majority of studies focused on cancer screening adherence (N = 9/11) and found a positive association between access to paid sick leave (either via self-report or at a state/municipal level) and cancer screening rates for breast, colorectal, and cervical cancers (N = 7/9). Treatment and survivorship outcomes were infrequently analyzed. Policymakers should consider implementing paid sick leave mandates to ensure timely initiation of cancer screening among working adults, a critical priority given rising rates of some early-onset cancers, including colorectal cancer.
20. Exploring perceived gender disparities in neurology career: insights from an Italian survey.
期刊: Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology 发表日期: 2026-Jan-17 链接: PubMed
摘要
The percentage of women neurologists is steadily increasing globally. Nevertheless women still face lower and slower levels of career progression and are less likely to reach leadership positions. In order to obtain a better understanding of the gender gap in the area of neurology in Italy, the Gender Equality Committee of the Italian Society of Neurology (SIN) conducted a survey among the society members. Members of the SIN were invited to complete an anonymous online survey. The questions were grouped into different sections covering work environment, research, academic career, scientific societies, work/life balance and gender equality perception. The questions were structured using Likert-type scales. A total of 237 subjects (64.1% women; mean age 42.5 ± 13.6 years), representing 6.4% of the SIN members, participated in the survey. A significantly higher percentage (p < 0.0001) of women than men reported that gender influences career progression (51.5% vs 5%), academic career (91.8% vs 57.1%), access to research facilities (37.5% vs 17.1%), authorship of scientific articles (34.2% vs 8.6%), selection of contributions and speakers within scientific societies (37.9% vs 16.2%), and work-life balance (76% vs 37.5%). Overall, women felt that gender equality was poor in all the different sections. In Italy women neurologists face a wide range of gender disparities affecting their professional and personal lives in the hospital and academic settings. Even if the low response rate could have affected the results, improving gender equality should be a priority in the near future.
21. Integration of Lifestyle Medicine Into Primary Care: A Comprehensive Review.
期刊: Public health reports (Washington, D.C. : 1974) 发表日期: 2026-Jan-17 链接: PubMed
摘要
Lifestyle medicine is an evidence-based approach that uses therapeutic lifestyle interventions as the primary method for preventing, treating, and reversing chronic diseases. According to the Centers for Disease Control and Prevention, 6 in 10 adults have at least 1 chronic condition and 4 in 10 adults have 2 or more chronic conditions, contributing to substantial morbidity, mortality, and escalating health care costs. Chronic conditions are responsible for 8 of the 10 leading causes of death in the United States, with lifestyle factors playing a critical role in their prevalence. This topical review synthesizes current literature on the integration of lifestyle medicine into primary care, emphasizing its 6 core pillars: optimal nutrition, physical activity, restorative sleep, risky substance avoidance, connectedness, and stress management. This review discusses evidence for the effectiveness of lifestyle medicine in chronic disease prevention and management, outlines barriers to its widespread adoption, and explores implementation strategies. This review also discusses the public health implications of scaling lifestyle medicine within primary care settings, underscoring its potential to reduce the risk of noncommunicable diseases and enhance quality of life. Although lifestyle medicine presents a promising strategy to address the growing chronic disease epidemic, achieving its full potential requires policy support, interdisciplinary collaboration, and improved training for health care professionals. By addressing the root causes of chronic diseases, lifestyle medicine offers a pathway toward improved population health and health equity.
22. Associations of growth trajectories from birth to two years of age with adolescent blood pressure: the mediating role of current BMI in the follow-up of an antenatal micronutrient supplementation trial.
期刊: European journal of pediatrics 发表日期: 2026-Jan-17 链接: PubMed
摘要
While early-life growth patterns are thought to be pivotal for long-term cardiovascular health, their specific links to adolescent blood pressure (BP) and potential mediators remain unclear. We aimed to examine the associations of growth trajectories from birth to age two with systolic and diastolic BP in adolescence, and to quantify the proportion mediated by concurrent adolescent BMI. In a prospective birth cohort in rural China, we repeatedly measured infant weight and length at birth and at 1, 3, 6, 9, 12, 18, and 24 months of age. Adolescent BP was measured and converted into percentiles. We used group-based trajectory modeling to identify early-life weight-, length-, BMI- and weight-for-length z-score trajectories and examined their associations with adolescent BP. A general causal mediation estimated the natural indirect effects and corresponding proportions mediated through adolescent BMI. Among the 1388 infants enrolled, 741 (60.9% male; mean age, 11.26 (SD, 0.57) years old) were followed at adolescence. Greater and rapid BMI and weight-for-length growth trajectories were statistically associated with elevated adolescent BP and BP percentiles, with adjusted mean differences ranging from 2.32 to 5.29 mmHg. Adolescent BMI mediated a substantial portion (up to 85%) of the association with systolic BP, but it showed no significant mediating effect for diastolic BP.Conclusion: Rapid adiposity growth in infancy predicts elevated adolescent BP. Since adolescent BMI did not fully explain this association, especially for diastolic BP, preventive interventions within the first 1000 days may be critical for lifelong cardiovascular health beyond managing later childhood weight. Trial registration: ISRCTN08850194, retrospectively registered December 14, 2006. https://www.isrctn.com/ISRCTN08850194?q=ISRCTN08850194&filters=&sort=&offset=1&totalResults=1&page=1&pageSize=10 . What is Known • Childhood body mass index (BMI) is positively associated with blood pressure at later life. What is New • This study identifies distinct weight, length, BMI, and weight-for-length growth trajectories from birth to two years of age and links rapid weight-related growth trajectories to elevated blood pressure in early adolescence. • Using causal mediation analysis, it shows adolescent BMI largely mediates the association for systolic, but not diastolic, blood pressure, highlighting interventions within the first 1000 day for lifelong cardiovascular health beyond managing later childhood weight.
23. The Role of Information Uses and Trust in COVID-19 and Influenza Vaccine Hesitancy Among Undergraduate Students in the United States and Republic of Korea: A Cross-Sectional Study.
期刊: Journal of transcultural nursing : official journal of the Transcultural Nursing Society 发表日期: 2026-Jan-17 链接: PubMed
摘要
As the COVID-19 vaccine transitions into an annual immunization, it is important to understand the factors contributing to vaccine hesitancy and uptake. This study aims to examine how information source use and trust are associated with COVID-19 and influenza vaccine hesitancy and influenza vaccine uptake. This cross-sectional study surveyed undergraduate students aged 18-25 years between August 29, 2023, and February 20, 2024. A total of 230 participants were included in the analysis. Chi-square tests and multivariable logistic regression were used. Using Internet, professional sources, friends/co-workers, and social media was associated with vaccine hesitancy and uptake. Cross-national comparisons showed that US students reported lower COVID-19 but higher influenza vaccine hesitancy than Koreans. Information use and trust were associated with vaccine attitudes and behaviors in vaccine- and country-specific ways. Tailored strategies should strengthen professional channels, engage family networks, and optimize Internet and social media for vaccine communication.
24. Inflammatory pain alters colorectal motility via spinal oxytocinergic pathways.
期刊: American journal of physiology. Gastrointestinal and liver physiology 发表日期: 2026-Jan-17 链接: PubMed
摘要
Gastrointestinal motility is regulated primarily by the enteric and the central nervous systems. Our previous studies revealed that central circuits regulating colorectal motility partially overlap with those involved in pain modulation, suggesting functional interactions between the nociceptive modulatory pathway and the autonomic regulatory pathway of colorectal motility. Here, we examined whether peripheral inflammatory pain alters the neural components of the descending pathway regulating colorectal motility. Complete Freund’s adjuvant (CFA) was administered unilaterally into the hind paw of rats to induce inflammation. Colorectal motility was assessed in vivo under anesthesia with α-chloralose and ketamine. In sham-treated rats, intraluminal administration of capsaicin, a noxious stimulus to the colorectal lumen, enhanced colorectal motility. In contrast, the capsaicin-induced colorectal motility response was suppressed in rats 3 days after CFA treatment. This suppression was rescued by the intrathecal administration of a GABAA receptor antagonist or an oxytocin (OXT) receptor antagonist. Furthermore, spinal OXT administration and chemogenetic activation of OXT neurons in naïve rats elicited a marked inhibition of capsaicin-induced motility responses of the colorectum. Notably, the inhibitory effect of activated OXT neurons was abolished by the intrathecal administration of a GABAA receptor antagonist. These results indicate that the descending OXT pathway becomes operative in response to persistent pain caused by peripheral inflammation and that the inhibitory effect on colorectal motility may involve local GABAergic transmission within the spinal cord. These changes may reduce parasympathetic outflow to the colorectum and contribute to defecation disorders involving central neural mechanisms.
25. Recruitment of individuals into a type 2 diabetes prevention program: the relative effectiveness and cost of different recruitment strategies used for the randomised controlled trial testing an Australian Lifestyle Change Program (AUS2PREVENT).
期刊: Pilot and feasibility studies 发表日期: 2026-Jan-17 链接: PubMed
摘要
Governments worldwide consider randomised controlled trials (RCTs) as the accepted gold standard design to evaluate healthcare interventions. However, enrolling participants into RCTs can be challenging, with recruitment processes serving as a crucial determinant of any clinical trial or program’s success. This study aimed to characterise the relative effectiveness and cost of different strategies used to recruit individuals into a randomised controlled trial of an Australian Lifestyle Change Program (AUS2PREVENT) to prevent or delay type 2 diabetes in South Australia. Targeted recruitment over a 12-month period through General Practitioner (GP) clinics was the primary strategy used to recruit individuals at risk of, or with prediabetes. After protocol amendments, around 25,000 individuals were identified as having prediabetes and being potentially eligible for the trial from 279 GP clinics across metropolitan Adelaide. Additional channels that were used to recruit high-risk individuals included radio, online media (e.g. Facebook, Instagram, webpages), email distribution lists, and member-oriented magazines/ newsletters associated with the supporting health and community organisations. Of the 1393 expressions of interest, 587 individuals completed the pre-screening survey and reported the referral channel. Radio, email, and online media generated the greatest number of individuals expressing interest in the trial (284 vs 151 vs 91, respectively) and accounted for the final 67 individuals who were enrolled and randomised. Only 4 individuals reported being referred by their GP. Promotion through radio, GP clinics, and online media was the costliest strategy. Although feasibility precision targets were achieved, continuing to recruit for a fully powered main trial to demonstrate the effectiveness of the AUS2PREVENT Program under current timelines and resources was not viable, and underscores the need for major design or strategy changes. Effective, timely, and cost-efficient recruitment for preventive health trials requires an adaptive, multi-channel strategy tailored to high-risk populations, supported by strong coordination among health organisations, trust-building efforts, and substantial marketing resources. The trial is registered on the Australian New Zealand Clinical Trials Registry (ANZCTR), Universal Trial Number U1111-1220-5636.
26. Incidence, risk factors and preventive strategies for post-operative recurrence of Crohn's disease: A retrospective propensity-matched cohort analysis.
期刊: Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology 发表日期: 2026-Jan-17 链接: PubMed
摘要
Crohn’s disease (CD) is characterized by recurrence following surgical resection. We assessed the post-operative recurrence rates, plausible risk factors and the prophylactic measures for prevention of the same. This retrospective cohort included CD patients who underwent ileocolic resection from 2005 to 2021 with ≥ 1 year follow‑up to evaluate the association between post-operative endoscopic surveillance and recurrence‑free survival. Surveillance patients were matched 1:1 to non‑surveillance controls using nearest‑neighbor propensity scores estimated from a logistic regression model that included age, sex, smoking, disease behavior and location, surgical approach, appendectomy history, prior anti-tubercular therapy and pre-operative prophylaxis (caliper = 0.20 SD of the logit; no replacement). Recurrence-free survival was analyzed by Kaplan-Meier curves, log-rank test and adjusted hazard ratios from multi-variable Cox regression. Of 90 patients (60% male; median follow‑up 45 months, interquartile range (IQR) 20.75-72), ileal stricturing disease predominated; clinical recurrence occurred in 51% (median recurrence‑free survival 61 months). One and three‑year clinical recurrence rates were 23.3% and 36.3%, respectively; one and three‑year endoscopic recurrence rates were 30.1% and 42.8%, respectively. In the propensity‑matched cohort, endoscopic surveillance was associated with a 34% relative reduction in the hazard of clinical recurrence (HR 0.66; 95% CI 0.32-1.38). Surveillance‑guided prophylaxis achieved 81.3% recurrence‑free survival at 24 months. Active smoking independently increased endoscopic recurrence risk (HR 2.96; 95% CI 1.18-7.38; p < 0.001). Endoscopy-driven post-operative surveillance with timely initiation or escalation of prophylaxis and smoking cessation was associated with longer recurrence‑free survival.
27. Reduced Gaze-Stimulus Synchrony to a Rhythmic Children's Song in Young Children With Autism: A Recurrence Quantification Analysis Approach.
期刊: Journal of autism and developmental disorders 发表日期: 2026-Jan-17 链接: PubMed
摘要
To examine the characteristics of gaze behavior, particularly gaze-stimulus synchrony, and their association with developmental levels in young children with autism spectrum disorder (ASD). Eye-tracking data were obtained from 52 children with ASD, 58 with global developmental delay (GDD), and 55 typically developing (TD) children, aged 18 to 48 months, while they viewed a video of a girl rhythmically clapping and moving to a song. Area of interest (AOI) analysis was performed to assess visual fixation patterns throughout the task, and recurrence quantification analysis (RQA) was used to evaluate gaze-stimulus synchrony. Correlation analyses were further conducted to examine the associations between AOI, RQA measures and developmental levels. Children with ASD demonstrated significantly reduced visual fixation on the whole face and mouth-and-nose AOIs compared to TD children. RQA revealed that the ASD group exhibited significantly lower [Formula: see text], indicating less sustained gaze-stimulus synchrony. Both RQA and AOI measures were significantly associated with developmental level in the ASD group. The findings highlight reduced visual engagement and gaze-stimulus synchrony in young children with ASD compared to their TD peers, and indicate that gaze-based metrics may serve as potential objective markers of developmental functioning. The results underscore the utility of diverse analytic approaches, such as RQA, in uncovering temporal characteristics of gaze behavior. Future research should include nonsocial stimuli to determine whether reduced gaze-stimulus synchrony reflects domain-general atypicalities in visual processing.
28. Cancer Risk and Mortality Following Kaposi Sarcoma Among People with HIV in the United States, 2000 to 2019.
期刊: Cancer causes & control : CCC 发表日期: 2026-Jan-17 链接: PubMed
摘要
People with HIV (PWH) have increased Kaposi sarcoma (KS) risk. Among 2,645 PWH with KS in the United States HIV/AIDS Cancer Match Study, subsequent cancer risk was elevated 2.8-fold (95% confidence interval [CI]: 2.4-3.3) compared to PWH without KS. Mortality after KS declined 2000-2002 and 2012-2015 (hazard ratio = 0.64; 95%CI: 0.55-0.74).
29. Lactiplantibacillus plantarum P16 mitigated murine colitis through modulation of immune response and gut microbiota.
期刊: AMB Express 发表日期: 2026-Jan-17 链接: PubMed
摘要
Probiotics show potential for preventing and mitigating inflammatory bowel disease (IBD), though their efficacy and mechanisms are strain-specific. This study aimed to elucidate the protective mechanism of Lactiplantibacillus (L.) plantarum P16 against dextran sulfate sodium (DSS)-induced ulcerative colitis (UC). The strain exhibited high gastrointestinal tolerance, with survival rates of approximately 86% in artificial gastric fluid (pH 3.0) and 94% in 0.3% bile salt after 3 h of incubation. Moreover, L. plantarum P16 showed stronger adhesion to Caco-2 cells, indicating a high potential for intestinal colonization. In a DSS-induced colitis model, L. plantarum P16 administration alleviated colitis by reducing the disease activity index (DAI), suppressing pro-inflammatory cytokines (TNF-α, IL-6, IL-1β), and mitigating colonic tissue damage while preserving epithelial barrier integrity. Additionally, L. plantarum P16 treatment increased short-chain fatty acid (SCFA) levels. 16 S rRNA amplicon sequencing of cecal content revealed that L. plantarum P16 supplementation restored gut microbial homeostasis by elevating the abundances of Firmicutes and Verrucomicrobiota, particularly Akkermansia, while reducing the proportions of Bacteroides and Helicobacter. These findings demonstrated that L. plantarum P16 could alleviate colitis by ameliorating intestinal inflammation and restoring gut microbiota dysbiosis, proposing a novel perspective of L. plantarum P16 for UC management.
30. PTEN/PI3K/AKT Axis Mediates Aflatoxin B1-Induced Intestinal Injury via Dual Regulation of Apoptosis and Necroptosis in Jejunal Epithelial Cells.
期刊: Journal of agricultural and food chemistry 发表日期: 2026-Jan-17 链接: PubMed
摘要
Aflatoxin B1 (AFB1), the most toxic and widely distributed aflatoxin, poses considerable health hazards to both animals and humans. Following oral intake, the gastrointestinal tract is the primary site of contact. Our study shows that AFB1 exposure markedly alters the gut microbiota composition, mainly by reducing the population of beneficial bacteria. It also increases PTEN expression and suppresses the downstream PI3K/AKT signaling pathway both in jejunal and IPEC-J2 cells, promoting apoptosis and necroptosis. In addition, AFB1 impaired intestinal barrier function by decreasing expression of ZO-1 and Occludin. Notably, the PTEN-specific inhibitor VO-Ohpic can effectively alleviate the above changes induced by AFB1, confirming PTEN’s key role. Our study has first elucidated the mechanism by which AFB1 induces intestinal damage through disrupting gut microbiota structure and the “PTEN/PI3K/AKT─epithelial barrier” axis, providing new targets and theoretical basis for the prevention and treatment of AFB1 poisoning.
31. Ventricular-arterial coupling in community-dwelling individuals and athletes with cervical spinal cord injury.
期刊: Journal of applied physiology (Bethesda, Md. : 1985) 发表日期: 2026-Jan-17 链接: PubMed
摘要
Background: Cervical spinal cord injury (SCI) removes descending sympathetic control over the heart and vasculature which alters cardiovascular function. Ventricular-arterial coupling (VAC) provides insight into the heart’s mechanical and energetic efficiency by evaluating the interaction between cardiac contractility (end-systolic elastance; Ees) and arterial elastance (Ea). This study investigated VAC in non-athletes (SCI-NA) and athletes (SCI-A) with cervical SCI, and able bodied (AB) controls. We additionally validated non-invasive estimation of Ees with catheter derived assessments in rodents with SCI. Methods: Data were collected on SCI-NA (9M,2F), SCI-A (12M,2F) and AB (10M,5F) individuals. Cardiac contractility was estimated using single beat Ees(sb) and an alternative assessment of contractility derived from the left ventricle outflow tract (contractility(LVOT)). Ea was determined with the standard Simpson´s biplane method (Ea(Simp)) and with Doppler (Ea(Doppl)). VAC was determined for each method as VAC(sb)= Ea(Doppl)/ Ees(sb) and VAC(LVOT)= Ea(Simp)/contractility(LVOT))). Associations between contractility(LVOT) and catheter Ees in rats were assessed with linear regression and intraclass correlation coefficient (ICC). Results: Compared to AB, contractility(LVOT) was lower in SCI-NA (p<0.001) and SCI-A (p=0.04). Ea(Simp) was higher in SCI-NA versus SCI-A and AB (all p<0.01). As such, SCI-NA exhibited a higher VAC(LVOT) versus AB (p<0.001) and SCI-A (p=0.002). In rodents, we found excellent agreement between contractility(LVOT) and Ees (ICC 0.880; p=0.002). Conclusion: SCI-NA exhibit an elevated VAC due to lower contractility(LVOT) and higher Ea, suggesting an uncoupling of the heart and vasculature. SCI-A exhibit preserved VAC despite a lower contractility(LVOT) than AB suggesting that chronic exposure to exercise maintains coupling between the heart and vasculature.
32. Fenitrothion: an up-to-date review of the environmental occurrence, exposure, toxicity, and molecular mechanisms.
期刊: Environmental geochemistry and health 发表日期: 2026-Jan-17 链接: PubMed
摘要
Fenitrothion (FNT) is a widely used organophosphorus pesticide with low toxicity to humans and animals. Due to its wide application in agriculture, the distribution and toxic effects of FNT have received increasing attention. This review comprehensively assesses environmental levels and human exposure to FNT. FNT can be absorbed into the human body through various routes, including ingestion, dermal contact, and inhalation. Humans are exposed primarily through their diet. It has been shown in previous studies that FNT has several toxic effects, such as neurotoxicity, endocrine disruption, hepatotoxicity, immunotoxicity, reproductive toxicity, and developmental toxicity. FNT also induces oxidative stress, apoptosis, and inflammatory responses, which are crucial mechanisms underlying its multiple toxicities. This review will help to fill the gaps in knowledge related to the exposure, toxicity, and toxicity mechanisms of FNT and provide a scientific and theoretical basis for the environmental management of FNT.
33. Urinary metabolites of 1,3-butadiene, benzene and toluene and colorectal cancer incidence: a clinical case-control study.
期刊: Cancer causes & control : CCC 发表日期: 2026-Jan-17 链接: PubMed
摘要
Workplace exposure to volatile organic compounds (VOCs) has been shown to have a positive association with colorectal cancer (CRC) mortality. Benzene, 1,3-butadiene, and toluene are known carcinogens for other cancers. However, the effect of non-occupational VOC exposures on CRC is unknown. A clinical case-control study was performed. CRC cases were enrolled; controls were those patients seen for routine screening. Participants completed a detailed questionnaire and provided urine samples. Urinary VOC metabolites were measured for metabolites of: benzene metabolites (MU, PPMA, PMA), 1,3-butadiene (DHBMA, MHBMA1, MHBMA3), and toluene (BMA) for 43 CRC Cases and 104 controls. Concentrations were creatinine normalized and dichotomized as high or low. Logistic regression was used to estimate Odds Ratios (ORs) of CRC with 95% Confidence Intervals (CI) comparing high to low exposure adjusted for confounding factors. High levels of the MHBMA3 had 2.62 (95% CI 1.09, 6.31) times higher odds of having CRC compared to those with low levels after confounding adjustment. The adjusted ORs of CRC were elevated for Benzene PPMA (OR = 2.12 95%CI 0.92, 4.88). The metabolites BMA, MU, PMA, and other metabolites of 1,3-butadiene were not associated with CRC. MHBMA3 (a metabolite of 1,3-butadiene) was associated with a higher incidence of CRC independent of smoking and other CRC risk factors. Non-smoking sources of 1,3-butadiene, such as environmental sources, may contribute to increasing CRC incidence. Additional epidemiologic studies are needed to confirm this observation. Further laboratory studies are required to identify potential biologic mechanisms specific to MHBMA3 and colorectal carcinogenesis.
34. Occurrence and distribution of microplastics in water, sediment, and aquatic insects of the Owena River, Osun state, Nigeria.
期刊: Environmental monitoring and assessment 发表日期: 2026-Jan-17 链接: PubMed
摘要
Microplastic pollution in freshwater ecosystems poses a growing threat to biodiversity and human health. Microplastics (0.5-5 mm), derived from the degradation of larger plastics or manufactured as microbeads, can accumulate in aquatic organisms and serve as indicators of ecosystem health. This study investigated the abundance, shapes, and colors of microplastics in water, sediment, and aquatic insects from the Owena River, Osun State, Nigeria, to assess spatial trends and ecological implications. Monthly sampling was carried out between July 2024 and June 2025 across the up, middle, and down sections of the river. Aquatic insects were identified to order level, while microplastics were visually identified under a stereomicroscope without spectroscopic confirmation. Results revealed widespread microplastic contamination, with concentrations increasing from the up section towards the down section in both water and sediment. Fragments were the most abundant shape, and black particles dominated color composition. Hemiptera and Odonata were the most represented insect orders, indicating potential bioaccumulation pathways within the aquatic food web. This study provides the first report of microplastic occurrence in aquatic insects of the Owena River, Nigeria, and underscores the urgent need for improved plastic waste management to safeguard freshwater biodiversity and ecosystem health.
35. Rationale and design of MUSIC-HFpEF: a phase 1b, pilot trial evaluating the safety and pharmacodynamic effects of AAV1.SERCA2A in heart failure with preserved ejection fraction.
期刊: Heart failure reviews 发表日期: 2026-Jan-17 链接: PubMed
摘要
Heart failure with preserved ejection fraction (HFpEF) has limited therapeutic options. Abnormal calcium handling through impaired sarcoplasmic/endoplasmic reticulum Ca2+ ATPase 2a (SERCA2a) activity contributes to diastolic dysfunction. AAV1.SERCA2A, an Adeno-Associated Virus Serotype 1 (AAV1) vector encoding SERCA2a, may improve myocardial relaxation in HFpEF. Modulation of SERCA2a of Intra-myocytic Calcium Trafficking in Heart Failure With Preserved Ejection Fraction (MUSIC-HFpEF) is a Phase 1b, open-label, multicenter trial (NCT06061549) currently enrolling 10 patients with hemodynamically confirmed HFpEF. Patients receive a one-time intracoronary infusion of AAV1.SERCA2A. The primary objective is to assess safety and tolerability; secondary endpoints include effects on resting and exercise hemodynamics, echocardiographic measures of relaxation, N-terminal pro-B-type natriuretic peptide (NT-proBNP), and functional status. MUSIC-HFpEF is the first-in-human trial of SERCA2a gene therapy in HFpEF. Findings will inform the feasibility, safety, and potential clinical benefit of targeted gene therapy in this population. The study is enrolling participants and aims to clarify the safety profile and potential benefits of administering a single dose of AAV1.SERCA2A to individuals with HFpEF.
36. Integrative approaches to river ecosystem assessment and restoration: a review of methodologies and strategies for coherent implementation.
期刊: Environmental monitoring and assessment 发表日期: 2026-Jan-17 链接: PubMed
摘要
River ecosystems are vital to Earth’s biogeography and environmental health by facilitating material cycling, energy transfer, and information exchange. However, human activities, including hydraulic engineering, land use changes, industrial and agricultural expansion, and overfishing, have significantly disrupted natural river morphology and ecological patterns. These interventions have altered the river’s physical and chemical properties, resulting in biodiversity loss and ecosystem services degradation, prompting increased global attention to river ecological management. This review analyzes the major threats to river ecosystems, emphasizing their collective and interconnected impacts on ecosystem degradation. Current international methods for ecological assessment and restoration are critically evaluated, noting their effectiveness at small to medium scales but limitations when applied to entire river systems. To address these challenges, the review proposes an integrated approach combining macroscopic ecological restoration measures with microscopic analyses of river feedback mechanisms. This holistic perspective considers both upstream and downstream activities, as well as complex interactions between human interventions and river ecosystems. The paper aims to provide new insights for river ecology research, inform policymaking, and suggest future research directions. By advocating for a more comprehensive understanding of river ecosystems, this review contributes to the development of sustainable and effective river governance practices.
37. Predictors of HIV risk and their implications for targeted interventions among long-distance truckers: A formative study.
期刊: International journal of STD & AIDS 发表日期: 2026-Jan-17 链接: PubMed
摘要
38. Effects of nitrogen and phosphorous concentrations on PHA synthesis by PNSB enriched phototrophic mixed microbial culture.
期刊: Bioprocess and biosystems engineering 发表日期: 2026-Jan-17 链接: PubMed
摘要
Global economic burden due to plastic pollution is estimated to be over $3 trillion annually. Bioplastics derived from bacteria-synthesized biopolymers like polyhydroxyalkanoates (PHAs), are a remarkably versatile sustainable alternative. Research on optimal growth-conditions for microbial PHA-synthesis fed-on sustainable substrates, particularly by phototrophic-mixed-cultures (PMC) enriched with purple non-sulphur bacteria (PNSB) is essential. This study intends to understand the effect of nitrogen and phosphorus concentrations on PHA-production by PMC grown using fuel synthesis wastewater (FSW) (organic by-product of Fischer-Tropsch process) as substrate. Stoichiometric quantification and 16 S metagenomic sequencing followed by statistical and bioinformatic analysis were done. High PHA-production (65-82% of biomass) is observed to be induced by Low-Nitrogen conditions enriching Rhodopseudomonas, Paludibacter and Pleomorphomonas and a Low-Phosphorus condition enriching Rhodopseudomonas, Rhodoplanes and Lentimicrobium. Analysis of metabolic-potential revealed 16 enzymes (of 8 different PHA-synthesis-pathways) inherent within the genomes of bacteria enriched by these culture conditions. This study identifies optimal nitrogen and phosphorus concentrations and the corresponding microbial-composition of FSW substrate-grown PMC-system to maximize PHA-production in a laboratory-scale bioprocess.
39. The Weight of the Storm: Using Weighting Methods to Determine the Effect of Hurricane Harvey on Mental Health Outcomes in Harris County, Texas.
期刊: Public health reports (Washington, D.C. : 1974) 发表日期: 2026-Jan-17 链接: PubMed
摘要
Nonprobability sampling, commonly used in disaster research, can lead to incorrect estimates or limit the generalizability of results. We collected data through the Texas Flood Registry (TFR) and used raking and propensity score weighting to provide insight into the effect of Hurricane Harvey (hereinafter, Harvey) on Harris County, Texas. From April 2018 through October 2020, residents of areas affected by Harvey enrolled in the TFR completed a survey on their storm-related experiences (n = 20 653). Using logistic regression, we assessed the relationship between Harvey-related exposures and distress among Harris County residents (n = 12 279). We used raking to adjust the sample distribution to reflect demographic characteristics of Harris County and propensity scores to address confounding. Of respondents, 56% and 43% reported home damage and income loss due to Harvey, respectively. From April 2018 through April 2020, respondents completed the Impact of Event Scale questionnaire (n = 10 631), with 23% reporting symptoms consistent with severe distress related to Harvey. The raking-adjusted odds ratio of greater Harvey-related distress was 6.21 (95% CI, 5.44-7.09) times higher among residents who had home damage than among those who did not and 2.92 (95% CI, 2.59-3.30) times higher among those who had economic loss than among those who did not. We found consistent associations between adverse storm experiences and Harvey-related distress across unweighted and weighted approaches. We recommend using raking to adjust a nonprobability sample to better reflect population demographic characteristics and obtain general trends of postdisaster exposures and outcomes. We recommend using propensity scores when outcomes may be related to unmeasured confounding.
40. Proteomic Profiling of Alveolar Macrophages Identifies Loss of Lysosomal Content as an Indicator of Nanofiber-Induced Frustrated Phagocytosis.
期刊: Small (Weinheim an der Bergstrasse, Germany) 发表日期: 2026-Jan-17 链接: PubMed
摘要
Toxicological research on inhalable fibers, such as asbestos, has identified material morphology (i.e., length and diameter) and bio-persistence as drivers of adverse health effects (e.g., fibrosis, lung cancer, mesothelioma). Although nanofibers may meet these criteria, their small diameters may enable them to adopt different shapes, affecting their toxicity. While nanofiber pathogenicity is still assessed using animal models, the development of alternative in vitro methods relies on a mechanistic understanding of toxicity. Here, we address nanofiber-induced protein changes in alveolar macrophages by analyzing whole cell lysates and supernatants of NR8383 cells exposed to silicon carbide nanofibers, Mitsui-7 carbon nanotubes, and Printex-90. While all materials elicited a similar dose-dependent cytotoxicity, there was a nanofiber-specific release of TNF-α and glucuronidase. Proteomic profiling after treatment with low, non-cytotoxic concentrations confirmed the inflammatory response and revealed a release of 20 lysosomal, luminal hydrolases, including six cathepsins, into the extracellular supernatant. In cell lysates, these hydrolases were decreased, while membrane-associated lysosomal proteins remained unchanged, suggesting that macrophages engulfing long nanofibers release lysosomal content from open membrane pouches during frustrated phagocytosis. Additionally, 17 biomarkers of nanofiber-induced toxicity were identified as potential targets for predictive, animal-free screening. These early markers may be of value for assessing nanofiber toxicity.
41. Burnout Syndrome Predictors in Nursing Professionals During and After the COVID-19 Pandemic: A Prospective Cohort.
期刊: Journal of clinical nursing 发表日期: 2026-Jan-17 链接: PubMed
摘要
To analyse predictors of burnout in nursing professionals during and after the COVID-19 pandemic. Cohort study. A two-phase study conducted during the COVID-19 pandemic’s peak (2020) and post-vaccination period (2022). Data from nursing professionals of four hospitals in southern Brazil included sociodemographic, occupational, lifestyle, and health variables, and Maslach Burnout Inventory responses. Multivariate logistic and linear regression analyses were used to identify independent predictors of burnout syndrome. The study was approved by the Research Ethics Committee (approval no. 4.152.027). A sample of 163 participants were assessed at two distinct time points. In 2020, 9.2% of nursing professionals experienced burnout syndrome, decreasing slightly to 7.4% in 2022. As for the burnout dimensions, emotional exhaustion was reported by 27% of professionals in 2020 and 26.4% in 2022. Depersonalisation affected 28.2% during the pandemic and 25.2% afterward. Low professional accomplishment was identified in 29.4% of professionals in 2020, increasing to 30.1% in 2022. Distinct predictors were identified for overall burnout and its specific dimensions. The main predictors included: perceiving a mental health impact from the pandemic, previous mental health issues, recent medical leave, and working directly with COVID-19 patients. Burnout syndrome remained stable post-pandemic. Key predictors were identified, highlighting the need for preventive mental health interventions. Identifying predictors of burnout in nursing professionals supports the development of targeted interventions to protect mental health, improve job satisfaction, and enhance the quality of patient care during and after health crises. This study fills a gap in post-pandemic research by identifying predictors of burnout in nursing professionals. It supports the development of policies and interventions to protect mental health and improve working conditions in Brazilian hospitals. STROBE guidelines for cohort studies. Participants contributed only through data collection.
42. Influence of coping mechanisms on occupational stressors among Jordanian oncology nurses: a correlational study.
期刊: BMC nursing 发表日期: 2026-Jan-17 链接: PubMed
摘要
Oncology nurses are at particular risk for closely related types of distress, such as compassion fatigue, burnout, occupational stress, and moral distress, because they are often the ones who must carry out what they consider to be medically futile treatments that may cause pain in a dying older patient. This study aimed to examine the influence of selected coping mechanisms on occupational stressors among oncology nurses in Jordan. A descriptive, correlational, cross-sectional design was employed. Data were collected between February and March 2024 from oncology nurses working in three major teaching hospitals in Jordan. Occupational stressors were assessed using the Nurse Stress Scale (NSS), and coping mechanisms were measured using the Brief COPE. Descriptive statistics, Pearson correlation analysis, and hierarchical multiple regression analysis were used to examine relationships between occupational stressors and coping mechanisms. Pearson correlation analysis revealed a statistically significant moderate positive correlation between the NSS Death and Dying subscale and the Brief-COPE Problem-Focused Coping subscale (r = 0.254, p < 0.01). A significant positive correlation was also found between overall coping mechanisms and occupational stressors (r = 0.33, p < 0.01). Regression analysis further demonstrated that coping mechanisms were significant predictors of occupational stressors (β = 0.441, p < 0.001). The findings indicate that higher coping scores were associated with higher stress levels, suggesting that coping strategies were more frequently employed in response to elevated occupational stress rather than serving as a protective factor. Jordanian oncology nurses who experience higher stress levels related to death and dying are more likely to employ problem-focused coping strategies, such as actively addressing challenges, seeking solutions, and obtaining support. Although these coping strategies are adaptive, the overall high stress levels observed suggest that occupational stress remains a serious concern for nurses’ well-being and professional performance.
43. Reducing Work-Related Screen-Time in Healthcare Workers During Leisure Time (REDUCE SCREEN) - A Randomized Controlled Trial.
期刊: Journal of medical systems 发表日期: 2026-Jan-17 链接: PubMed
摘要
The ubiquitous availability of work-related applications on personal devices makes healthcare workers prone to working during leisure time. We tested the hypothesis that an intervention to reduce work-related screen time during a weekend off reduces stress in healthcare workers. Pragmatic parallel design randomized controlled trial between November 2021 and November 2023. Healthcare workers using a smartphone with a work email application were eligible. Randomization was 1:1 to no treatment or a threefold educational intervention to: 1) activate automated responses to emails received, 2) reduce screen time, and 3) uninstall work applications from personal devices. The primary outcome was the change in participants’ stress from pre- to post-weekend, measured with the Perceived Stress Scale-10. The secondary outcome was device screen time. Among 815 enrolled participants, 520 responded to the post-intervention survey. The median [Q1, Q3] change from baseline Perceived Stress Scale-10 scores was -2 [-7, 0] in controls and -4 [-9, 0] in the intervention group. The mean difference (intervention - control) in post-intervention Perceived Stress Scale-10 scores, adjusted for baseline stress, was -1.6 (95% CI: -2.6, -0.6; P = 0.002). The median [Q1, Q3] change from baseline screen time was 0 [-2, 1] hours in the controls and -1 [-3, 0] hours in the intervention group. A three-pronged educational intervention targeting work-related screen time among healthcare workers doubled stress reduction during a non-work weekend. Stress reduction in the intervention group was mediated by reduced screen time. Future research should investigate long-term effects and broader implementation of such interventions to promote well-being in the healthcare workforce. Trial Registration: https://clinicaltrials.gov/study/NCT05106647 . Identifier: NCT05106647, Registration date: November 4, 2021.
44. Socioeconomic Status and Dental Care Utilization in Older Adults: A Comparison Between Australia and Japan.
期刊: Journal of public health dentistry 发表日期: 2026-Jan-16 链接: PubMed
摘要
With the growing emphasis on incorporating dental care into universal health coverage (UHC) worldwide, it is essential to understand the extent to which UHC can improve access to needed health services without financial hardship. Dental care services should be included in monitoring progress toward UHC, but are often left out, even in countries with UHC. This study will compare socioeconomics-related inequalities in dental care utilization among older Australians and Japanese, who experience contrasting universal dental insurance systems. We used data from Australia and Japan to estimate socioeconomics-related inequalities in dental care utilization as the Slope Index of Inequality (SII) and the Relative Index of Inequality (RII) for community-dwelling adults aged 65 years and older. Socioeconomic status was measured using equivalized income and educational attainment. Dental care utilization was defined as visiting a dentist within the past 12 months. The study included 6104 Australian participants (mean age 73.8 years) and 19,043 Japanese participants (mean age 74.9 years). Income-related inequalities in dental care utilization were higher in Australia [SII (0.22, 95% CI = 0.18-0.27); RII (1.48, 95% CI = 1.36-1.59)] than in Japan [SII (0.16, 95% CI = 0.14-0.19); RII (1.28, 95% CI = 1.24-1.33)]. We found a similar pattern in educational attainment. Notwithstanding the differences between the two dental care systems, the lack of UHC in dental care in Australia may be a contributing factor to greater inequalities in dental care utilization among older adults.
45. A mixed methods cross-sectional study of peer support needs and barriers among multiple sclerosis caregivers in Ireland.
期刊: Journal of health psychology 发表日期: 2026-Jan-16 链接: PubMed
摘要
Peer support may help improve the wellbeing of informal caregivers, although little work has explored this in the context of multiple sclerosis (MS). This study explored peer support needs and experiences among MS caregivers in Ireland. A cross-sectional mixed methods survey of 27 MS caregivers, designed with public and patient involvement, measured peer support engagement, sociodemographic and care characteristics, caregiver burden, social support, loneliness and wellbeing. Data were analysed using descriptive, correlational and content analysis. Most caregivers expressed a desire for peer support, with few having participated in online or in-person peer support. Barriers to engagement included a lack of promotion of opportunities. While low levels of social support and wellbeing were reported, no clear associations between peer support needs and these variables were identified. Although peer support shows promise, more research and improvements in the provision of MS caregiver peer support are needed.
46. Is lower training frequency more effective? Dose-response relationship of in-season flywheel resistance training on vertical jump and sprint performance in male team-sport athletes: a meta analysis.
期刊: BMC sports science, medicine & rehabilitation 发表日期: 2026-Jan-16 链接: PubMed
摘要
The purpose of this study is to systematically review and meta-analyze the effects of in-season flywheel resistance training (FRT) compared to traditional resistance training (TRT) on vertical jump and linear sprint performance in team-sport athletes. Additionally, this study aims to explore the moderating effects of training parameters (such as frequency, intensity, and duration) on training outcomes. This systematic review and meta-analysis followed PRISMA guidelines and was registered in PROSPERO. Five databases were searched for randomized controlled trials comparing in-season flywheel resistance training (FRT) with traditional resistance training (TRT) on vertical jump and sprint performance in team-sport athletes. Risk of bias was assessed using the Cochrane RoB 2 tool, and evidence quality was graded using the GRADE approach. Data were analyzed using Review Manager and Stata, with subgroup and sensitivity analyses performed. Publication bias was evaluated using funnel plots and Egger’s test. Seven randomized controlled trials with 199 male athletes were included. The overall risk of bias was moderate, and evidence quality was low. Flywheel resistance training (FRT) significantly improved countermovement jump (CMJ) height (SMD = 0.46, p < 0.01) and had a small positive effect on linear sprint performance (SMD = -0.38, p = 0.02). Subgroup analyses indicated that CMJ performance improved with training programs consisting of more than 12 sessions, a duration of 5-10 weeks, and a training frequency of less than twice per week. No significant subgroup effects were observed for sprint performance. Sensitivity analyses confirmed the robustness of the results, and no publication bias was detected. Compared with TRT, FRT is more effective in enhancing CMJ performance and linear sprint speeds over specific distances in male team-sport athletes during the in-season. Training protocols characterized by low frequency (≤ 2 sessions per week) and a total of around 12 sessions appear to facilitate better athletic adaptations. Future research should include female athletes and investigate long-term interventions to further refine the application strategies of FRT in in-season training.
47. Sustainable enhancement of apricot (Prunus armeniaca L.) yield, quality through foliar application of potassium silicate and glycine.
期刊: Journal of the science of food and agriculture 发表日期: 2026-Jan-16 链接: PubMed
摘要
Apricot (Prunus armeniaca L.) is a nutritionally valuable subtropical fruit with high economic importance; however, being highly perishable limits its marketability and profitability. Sustainable preharvest management strategies are essential to enhance fruit quality and resilience to environmental stress. Therefore, a research study was conducted for two consecutive years (2022-2023) using a 4 × 4 factorial randomized complete block design. Apricot fruit trees were applied with four potassium silicate (PS) concentrations (0, 1, 3, and 5 mL L-1) and four glycine treatments (0, 400, 600, and 800 mg L-1), at the fruit set and pit hardening stages. Results showed that moderate PS at 3 mL L-1 with 600-800 mg L-1 glycine significantly improved fruit weight (78%), volume (55%), and yield per plant- (32.8 kg; a 64% increase over the control), while reducing the number of fruits per kilogram by 13%, indicating larger average fruit size. Preharvest decay was reduced by approximately 60%, alongside improvements in firmness (by 100%) over the control, total soluble solids (TSS; 16-19%), TSS-acid ratio (64%), juice pH (0.65 units), and sugar accumulation, compared with control treatment. Antioxidant activity increased by 37%, flavonoids by 51%, proline by 116%, and catalase and peroxidase activities by 22%. Principal component analysis identified 3 mL L-1 PS with 600 mg L-1 glycine as the most effective combination. These findings demonstrate that the synergistic preharvest application of PS and glycine has enhanced apricot yield, fruit quality, and storability, offering an eco-friendly alternative to conventional chemical treatments. © 2026 Society of Chemical Industry.
48. Musculoskeletal complaints and psychosocial stress factors in emergency medical services: a differentiated gender comparison.
期刊: Journal of occupational medicine and toxicology (London, England) 发表日期: 2026-Jan-16 链接: PubMed
摘要
Working in emergency medical services involves a high level of physical and psychological stress. The proportion of female professionals in the German emergency medical services has been steadily increasing in recent years. This gender-comparative study therefore aims to identify potential differences and similarities in the stress profiles of men and women across different age groups regarding physical and psychosocial complaints. A total of 201 employees (132 male, 69 female) from the emergency medical services in one German federal state (Hesse) voluntarily participated in this survey, which included the Nordic Musculoskeletal Questionnaire (NMQ), the Copenhagen Psychosocial Questionnaire (COPSOQ) and the Sources of Occupational Stress in Firefighters and Paramedics (SOOS-14) questionnaire. In addition to comparing all variables between genders and different age groups, a total score was calculated based on a Rasch model for the items of the COPSOQ and SOOS-14. Correlations were performed with sociodemographic data as well as well-being (total COPSOQ score) and individual stress levels (total SOOS-14 score). The prevalence of physical complaints was highest in the cervical spine at 72.6%, with women affected significantly longer (p ≤ 0.01; female: 42% > 30 days/12 months vs. male: 16.7% > 30 days/12 months). This corresponded with the subjective perception of 74.1% of respondents who regularly had to perform heavy physical work. Overtime was worked regularly by 94.6%, and 51.2% perceived emotional stress to be above average. No significant differences were found in occupational stressors and psychosocial factors across all age and gender groups, except for the diversity evaluation between genders, with women reporting higher levels of variety in their work (p < 0.01). Sleep interruptions and poor nutrition were the most important job-related stress factors for both genders. An above-average level of pride (74.6%) and meaningfulness (73.2%) compensated for this high workload. Correlations were particularly evident among female participants between higher weight (p < 0.01; rho = -0.39), and higher body mass index (p < 0.01; rho = -0.37) and health status. Men’s well-being and occupational stress was more severely impaired by higher weekly working hours and larger amount of active service (p < 0.01; rho = 0.3) in older men and high body mass index (p < 0.01; rho = 0.4) in younger men. Women in particular rate their health as similar to that of their male colleagues despite higher physical stress - especially in younger women - with obesity negatively influencing their self-assessment. For older male employees, higher mental stress and strain at work is associated with long working hours. Psychosocial factors such as professional pride and meaningfulness appear to serve as important resilience resources for both genders. Future analyses should therefore be multidimensional. The online version contains supplementary material available at 10.1186/s12995-025-00495-0.
49. The use of care home environments to meet culture-specific needs of culturally and linguistically diverse residents with dementia: an integrative review using the ICF framework.
期刊: International journal for equity in health 发表日期: 2026-Jan-16 链接: PubMed
摘要
Increasing global migration creates new challenges for multicultural societies in providing equitable care. Culturally and linguistically diverse (CALD) people who move into care homes find themselves in an environment where health professionals do not speak their language and the access to cultural activities is limited. This may increase loneliness and social isolation. When designing care home environments for CALD residents with dementia, culture is a key consideration. The aim of this integrative review is to highlight what elements of the care home environment are reported to meet culture-specific needs of CALD residents with dementia, and how. A search strategy which included terms for care homes, forms of dementia and CALD people was developed, and a systematic search was carried out in six databases. Eligible articles were original peer-reviewed studies published between 2013 and 2024 and contained examples of how care home environments have been used to meet culture-specific needs of CALD residents. All screenings and extractions were carried out by two independent researchers. The search resulted in 4311 records. After the screening process, 27 articles met the eligibility criteria. The review findings are categorized according to components of the WHO’s International classification of functioning, disability and health (ICF). Results linked to the ICF component Activities and participation stress the importance of communication in the resident’s preferred language, social and supportive relationships and culturally relevant activities, while the component Environmental factors highlights the significance of ethnic food and support from culturally competent care professionals and family members. This integrative review underlines the complexity of using environments to meet culture-specific needs of CALD residents with dementia. The findings highlight the importance of bilingual staff, culturally relevant activities and inclusive environments in enhancing communication, building interpersonal relationships and reducing frustration among CALD residents. Collaborations between culturally competent staff, family members and members of cultural communities also facilitate meeting social and cultural needs of these residents. This review offers suggestions on how environments in care homes can be adapted for CALD residents and encourages further research to find practical solutions for equitable care. A study protocol is registered on Prospero (CRD42023492906).
50. Predicting the progression of difficult-to-treat rheumatoid arthritis by a machine learning scoring system, from the FIRST registry.
期刊: RMD open 发表日期: 2026-Jan-16 链接: PubMed
摘要
This study aimed to develop and validate a prediction model for the future progression of difficult-to-treat rheumatoid arthritis (D2T RA) and support the precise use of biologic and targeted synthetic disease-modifying antirheumatic drugs (b/tsDMARDs). Data were analysed from 1221 patients with rheumatoid arthritis in the FIRST registry, a multicentre collaborative database, who initiated their first b/tsDMARD. 25 prediction models for D2T RA were generated using 43 baseline characteristics prior to initiating the first b/tsDMARD. Model performances were tested. A scoring system based on the selected model was designed and internally validated for use in routine clinical practice. Among the 1221 patients, 193 (15.8%) progressed to D2T RA after a median of 54.0 months. These patients had higher tender joint count, global assessment, pain scale, Health Assessment Questionnaire score and Clinical Disease Activity Index score and more frequent coexisting lung disease. Among the machine learning models tested, Lasso logistic regression performed best (area under the curve 0.71), identifying pain scale, erythrocyte sedimentation rate and coexisting lung disease as key predictors. The scoring system based on these predictors demonstrated comparable performance. Among patients identified as high risk for D2T RA by the scoring system, interleukin-6 receptor inhibitors (IL-6Ri) significantly reduced D2T RA progression (relative risk (RR): 0.48). This study developed and validated a scoring system to predict D2T RA progression and identify patients at high risk and suggested the advantages of IL-6Ri. This system may advance precision medicine in RA and may contribute to controlling unmet needs.
51. Study of naïve and switched memory B cell level in Egyptian patients with common variable immunodeficiency.
期刊: The Egyptian journal of immunology 发表日期: 2026-Jan 链接: PubMed
摘要
Common variable immunodeficiency (CVID) is one of the primary immunodeficiency disorders. The phenotype of peripheral blood memory B cells is a useful tool in the classification of patients into clinically and functionally relevant groups. This study aimed to assess the level of naïve and switched memory B cells level and their correlation with the clinical phenotypes and complications in patients with CVID. This case control study included 30 adult patients with CVID and 30 normal controls, matched for age and sex. Complete blood count, cluster of differentiation 3 (CD3)+, CD4+, CD8+ T cells and CD19+27-IgD+ for naïve B cells and CD19+27+IgD- switched memory B cells levels were assessed. The mean age of the onset of symptoms was 16.9±15.1 years, the mean age of diagnosis was 27.30±14.39 years, with a diagnostic delay of 10.43±10.29 years, and the body mass index was significantly lower in CVID group. Infections including (upper respiratory tract infection, chronic diarrhea, pneumonia and bronchiectasis) were the most frequent phenotypes. CD4+, CD4+/CD8+ T cells, CD19+ and CD19+27+IgD- switch memory B cell, IgG, IgA, and IgM were significantly lower in CVID group than in the control group (p < 0.001 and p < 0.015, respectively). CD8+ T cells and CD19+27-IgD+ naïve B cells were significantly higher in the CVID group (p < 0.001). CD19+27-IgD+ naïve B cells level was significantly lower in cases with bronchiectasis with low baseline serum IgG in lymphadenopathy group (p=0.049), and higher level of CD3+ T cells in cases with splenomegaly. There was no significant difference in laboratory results in CVID patients presented with autoimmune diseases, Granulomas nor enteropathy. In conclusion, high level of CD19+27-IgD+ naïve and low level of CD19+27+IgD- switch memory B cells are characteristic features of CVID. Moreover, the reduced CD19+27-IgD+ naïve B cells level can be a predictor of the development of bronchiectasis in CVID patients.
52. Rural emergency hospitals: Emerging patterns of adaptation and community perception.
期刊: The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association 发表日期: 2026-Jan 链接: PubMed
摘要
Rural hospitals face persistent financial challenges that often threaten their survival. To address this, the 2023 “Rural Emergency Hospital” (REH) designation offers Critical Access Hospitals and hospitals with fewer than 50 beds enhanced Medicare reimbursement and annual facility payments if they discontinue inpatient services while maintaining outpatient care and a 24-hour emergency department. This study evaluates the characteristics of hospitals that choose REH conversion and examines the perceived community impact of the change. We analyze Centers for Medicare & Medicaid Services cost report data to compare converting hospitals to eligible nonconverting hospitals. We also conduct a content analysis of 33 news articles and phone interviews with local rural residents to assess how REH conversions are presented in the media and perceived in communities. Hospitals that converted to REH status had low inpatient volumes, occupancy rates, and revenues, suggesting they were positioned to benefit financially from eliminating inpatient services. Content analysis revealed that news articles were primarily neutral in tone (54.5%), with most (90%) describing the financial benefits of conversion. Interviews with rural residents highlighted negative perceptions of local health care and revealed that many preferred not to use their local REH even when available. REH designation may provide financial lifelines to rural hospitals with declining inpatient demand, but community skepticism and limited willingness to use REHs may constrain their role in sustaining health care access. The long-term effectiveness of this policy may depend on addressing both financial viability and community trust in rural health care delivery.
53. Dynamics of Lifestyle Counseling for Chronic Diseases Within and Between General Practices and Social Work Services Causal Loop Diagram and Points for Improvement.
期刊: Journal of primary care & community health 发表日期: 2026 链接: PubMed
摘要
A healthy lifestyle can slow the progression of chronic conditions and improve quality of life. Lifestyle counseling in Dutch general practices can be further optimized, among other factors by improving collaboration with social work services. To achieve this, it is important to map out the system of lifestyle counseling within and between general practices and social work services, as well as to identify opportunities for improvement. Semi-structured individual interviews were conducted with 3 general practitioners (GPs) and 6 practice nurses (PNs), as well as 5 group interviews with in total 15 professionals from social work services. Participants were based in the city of Nijmegen, the Netherlands. The interviews were conducted between March and August 2024. A thematic analysis was performed which resulted in themes and subthemes. Hereafter, the interviews were re-read to examine relationships between subthemes. The themes, subthemes, and relationships formed the basis for developing a causal loop diagram (CLD) and identifying areas for improvement. The CLD was subsequently reviewed through a member check with the same professions. The system of lifestyle counseling within and between general practices and social work services consists of the following main themes; addressing lifestyle within general practices, referral to social work services from general practices, GP/PNs’ overview and knowledge about social work services, contact between GP/PNs and social work services, and patient status exchange between GP/PNs and social work services. These main themes include interrelated variables which facilitate or impede referrals from general practices to social work services, which is illustrated by the CLD. For example, the more patient status information is shared, the better the GP/PNs’ understanding of the available social work services. The CLD illustrates multiple factors that influence the system of lifestyle counseling in and between general practices and social work services. The CLD, together with the improvement points identified in the interviews, leads to actionable strategies to enhance collaboration between general practices and social work services. These strategies include increasing GP/PNs’ understanding of the role and activities of social work services, exchange information, as well as strengthening mutual familiarity and facilitating personal contact between professionals in both domains.
54. Glycaemic Status Modifies the Association Between Cardiometabolic Index and Cardio-Kidney Outcomes: A Multi-Cohort Analysis.
期刊: Diabetes/metabolism research and reviews 发表日期: 2026-Jan 链接: PubMed
摘要
This multi-cohort study evaluated whether the cardiometabolic index (CMI)-a composite of waist-to-height ratio and triglyceride-to-HDL cholesterol ratio-serves as an early predictor of cardio-kidney risk and whether its predictive value varies across glycaemic states. We analysed 327,902 adults in the UK Biobank to examine the association of CMI with baseline cardio-kidney comorbidities, incident cardio-kidney events (CKE)-defined as the composite occurrence of cardiovascular and chronic kidney outcomes, and mortality. Baseline comorbidities was assessed using logistic regression, and Cox models with stratified analyses and restricted cubic splines (RCS) evaluated prospective associations. Findings were externally validated in CHARLS and NHANES. Machine-learning survival models further assessed predictive performance. Higher CMI was associated with baseline cardio-kidney comorbidities (OR 2.25, 95% CI 2.10-2.42). Among 303,113 participants free of cardiovascular and/or kidney disease at baseline, CMI predicted incident CKE (HR 2.18, 95% CI 2.01-2.38; median follow-up 14.3 years), all-cause death (HR 1.10, 95% CI 1.06-1.14; 15.8 years), and cardio-kidney death (HR 1.55, 95% CI 1.37-1.76; 15.8 years). The strength of associations was greatest in normoglycemia and progressively attenuated in prediabetes and diabetes. RCS analyses revealed nonlinear dose-response relationships, with steep increases in CKE and cardio-kidney mortality below CMI thresholds (∼0.70 and ∼0.95) and more gradual rises thereafter. Results were directionally consistent in external cohorts, particularly for cardio-kidney comorbidities and incident CKE. ML models demonstrated strong discrimination and consistently ranked CMI among the top predictors of incident CKE. CMI is a simple, robust predictor of cardio-kidney risk especially in earlier metabolic states, with particularly strong prognostic value in normoglycaemic individuals where excess risk appears at lower CMI levels.
55. Effects of Exercise Duration and Intensity on Maximal Exercise Capacity Over 6 Months in Coronary Heart Disease and Type 2 Diabetes-A Secondary Analysis of the LeIKDTrial.
期刊: Scandinavian journal of medicine & science in sports 发表日期: 2026-Jan 链接: PubMed
摘要
Exercise training is recommended in coronary heart disease (CHD) and type 2 diabetes (T2DM) patients alike; however, uncertainty remains on the influence of exercise intensity and duration in older patients with both entities. To address this, we performed a secondary analysis including 201 patients (67.9 ± 8.2 years; 84.1% men) from the LeIKD trial (NCT038359), which introduced 6 months of home-based telemedicine-supported exercise intervention in patients with CHD and T2DM. We assessed the relationships between exercise duration and intensity with change in peak oxygen uptake (V̇O2peak) (simple and multiple regression analyses, α = 0.05). V̇O2peak increased by 0.42 mL/kg/min per hour of endurance exercise/week (95% CI: 0.17-0.66, p = 0.001). Exercise intensity was not significantly associated with the change in V̇O2peak (p = 0.10). In a subgroup of patients with high adherence (≥ 66.7% of prescribed total duration and meeting prescribed exercise duration in ≥ 50% of weeks of intervention), a 10% increase in exercise intensity (mean % heart rate reserve (HRR)) was associated with an increase in V̇O2peak of 0.26 mL/kg/min (95% CI: 0.00-0.52; p = 0.05). Longer training duration within the initial 2 weeks of intervention was significantly associated with high adherence over 6 months (increased likelihood per 10 min/week: OR of 1.09 [95% CI: 1.05-1.14], p < 0.001). Therefore, exercise duration but not intensity influences changes in V̇O2peak during exercise intervention in a high-risk population of older patients with CHD and T2DM. In patients with high adherence to exercise duration, higher exercise intensity led to an additional increase in V̇O2peak. Training duration within the first 2 weeks was an important predictor of long-term adherence. Trial Registration: https://www.clinicaltrials.gov: Identifier: NCT038359.