公共卫生研究摘要 (2026-01-20)
共收录 60 篇研究文章
1. Leveraging machine learning to predict de novo skin malignancy following lung transplantation.
期刊: Lung cancer management 发表日期: 2026-Dec 链接: PubMed
摘要
This study aimed to predict post-transplant malignancy risks at multiple levels among lung transplant recipients using machine learning (ML) and to identify key clinical and immunogenetic predictors. A dataset of 30,917 lung transplant recipients with no prior cancer history was analyzed using pre-, peri-, and post-transplant variables. Multiple ML algorithms-gradient boosting, random forest, neural networks, and logistic regression-were applied to predict: (1) overall de novo malignancies (DNM), (2) skin versus non-skin cancers, and (3) skin cancer subtypes, including basal cell carcinoma (BCC) and squamous cell carcinoma (SCC). Gradient boosting achieved the highest AUC for overall malignancies (0.746) and skin versus non-skin cancers (0.642), while random forest performed best for BCC versus SCC classification (AUC = 0.726). Significant predictors included HLA-DR alleles (DR52, DR1, DR53), A locus mismatch, recipient ethnicity, BMI, serum albumin, CMV/EBV serostatus, and cardiac-related measures (LV remodeling, cardiac output, prior cardiac surgery). Additional subtype predictors included peak PRA Class I sensitization, insulin signaling, donor-derived transfusions, and waiting list duration. ML-driven predictive modeling enables personalized assessment of post-transplant malignancy risk, supporting early detection, targeted surveillance, and optimized long-term care for lung transplant recipients. Machine Learning Models Predict De Novo Malignancies in Lung Transplant Recipients: using a national cohort of 30,917 lung transplant recipients, gradient boosting achieved the highest AUC for overall malignancy prediction, as well as skin vs. non-skin cancers; random forest excelled in distinguishing classified basal cell carcinoma (BCC) versus squamous cell carcinoma (SCC).Key Immunogenetic Predictors Identified: HLA-DR52 linked to reduced overall malignancy risk; HLA-DR1 and A locus mismatch associated with higher skin cancer risk; HLA-DR53 tied to increased SCC over BCC likelihood.Clinical and Demographic Risk Factors: Recipient ethnicity (white highest for skin cancers), EBV serostatus, CMV IgG positivity, BMI, serum albumin, age, male gender, and cardiac measures (e.g., output, LV remodeling, prior surgery) emerged as significant across malignancy levels.Skin Cancer Subtype-Specific Insights: Low peak PRA Class I sensitization, donor-derived transfusions, lower serum albumin, and shorter waiting list duration favored SCC over BCC; donor non-insulin use reduced SCC odds relative to BCC.Potential for Personalized Surveillance: Models enable risk stratification using pre-, peri-, and post-transplant variables, supporting targeted screening and optimized immunosuppression to improve long-term outcomes.
2. A data-driven approach for mitigation of fecal pathogen infections from unsafe WASH practices.
期刊: One health (Amsterdam, Netherlands) 发表日期: 2026-Jun 链接: PubMed
摘要
Fecal pathogen infections remain a major public health challenge in low- and middle-income countries, where unsafe water, inadequate sanitation, and poor hygiene persist. Northeastern Thailand continues to experience a high burden of helminth infections linked to deficient water, sanitation, and hygiene (WASH) conditions. Evidence-based identification of combined WASH thresholds is needed to support effective interventions and progress toward Sustainable Development Goal 6. A cross-sectional study was conducted among 520 households across 18 communities in Tongkhop city, Sakon Nakhon Province, Thailand. Primary data from household surveys, key-informant interviews, and field observations were integrated with disease-surveillance records. A multilevel generalized linear model was applied to assess associations between WASH indicators and infection prevalence. Model-predicted outcomes were further analyzed using response surface methodology to quantify nonlinear interactions and identify optimal WASH thresholds. Infection prevalence exceeded 40 cases per 1000 population in communities relying on untreated water, infrequent fecal-sludge emptying, and low hygiene compliance. Substantial risk reductions were observed when household water treatment exceeded 40 %, fecal-sludge emptying frequency reached 35-40 %, and handwashing compliance before meals surpassed 80 %, while raw-fish consumption remained below 50 %. The response-surface analysis revealed clear nonlinear synergies among WASH components, indicating that coordinated improvements were more effective than isolated interventions. This study demonstrates that integrating multilevel modeling with response surface analysis enables quantitative identification of critical WASH thresholds for reducing fecal-pathogen infections. The findings highlight the importance of coordinated improvements in water safety, sanitation management, and hygiene behaviors to mitigate environmental transmission pathways. These results provide actionable, data-driven guidance for public health planning and support the environmental dimension of the One Health framework in advancing SDG 6.
3. Tetrachlorobisphenol A Induces Programmed Cell Death and Senescence in Vascular Endothelial Cells.
期刊: Cell biology international 发表日期: 2026-Feb 链接: PubMed
摘要
Tetrachlorobisphenol A (TCBPA) is an organic compound extensively utilized in industrial production as an alternative to Tetrabromobisphenol A (TBBPA). Currently, TCBPA has been frequently detected in various environmental media. TCBPA residues have been detected in environmental samples, prompting concerns about its potential toxicological impact on human health. This study focuses on the potential impact of TCBPA on vascular health, particularly its effects on vascular endothelial cells. Through CCK8 and EdU assays, we observed that TCBPA treatment inhibited the proliferation of vascular endothelial cells. Further studies showed that TCBPA triggers an inflammatory response in vascular endothelial cells, including IL-6, IL-1β, and TNF-α. Additionally, TCBPA was found to trigger oxidative stress in vascular endothelial cells, as evidenced by increased levels of reactive oxygen species (ROS). Further studies demonstrated that TCBPA led to programmed necrosis and senescence in vascular endothelial cells. Mechanistically, we discovered that ROS-induced mitochondrial Z-DNA played a critical role in this process. Our findings suggest that TCBPA may inhibit vascular endothelial cell proliferation, posing a potential risk for vascular damage. This study highlights the importance of regulating TCBPA usage to minimize potential health risks.
4. GRADE Guidance: Update on Developing Good Practice Statements in Guidelines.
期刊: Annals of internal medicine 发表日期: 2026-Jan-20 链接: PubMed
摘要
Despite published guidance by the GRADE (Grading of Recommendations Assessment, Development and Evaluation) Working Group on the use of good practice statements (GPSs), their appropriate development remains challenging. This article provides updated guidance with nuanced operationalization. The updated guidance was developed on the basis of examples and iterative discussions. The lead authors refined the approach according to the feedback from GRADE Working Group meetings and presented the summary of the results to all attendees of the GRADE Working Group meeting for feedback in September 2023 and for final approval in September 2024. The 5 signaling questions from the original guidance were leveraged, and the authors recommend that guideline developers select relevant Evidence to Decision criteria to assess the potential downstream consequences of implementing the statement. They have updated the definition of a GPS, classifying GPSs into the following 3 categories: those grounded in ethics and human rights; those grounded in essential principles, practices, and protocols; and those grounded in established scientific evidence. Practical examples accompany the steps as they relate to each type of GPS. In addition, the authors introduce a tool to streamline GPS development and enhance the reporting process. This GRADE guidance article provides an update on when and how to develop a GPS. Adherence to the guidance will add to the trustworthiness of guidelines and may facilitate reducing the inappropriate use or overuse of the GPS.
5. Misconceptions About Whether Seeking Mental Health Care Jeopardizes Lawful Firearm Ownership: A National Survey.
期刊: Annals of internal medicine 发表日期: 2026-Jan-20 链接: PubMed
摘要
6. Long-Term Mpox Sequelae 11 to 18 Months After Acute Illness : A Cohort Study in Two U.S. Cities.
期刊: Annals of internal medicine 发表日期: 2026-Jan-20 链接: PubMed
摘要
Little was known about persistent sequelae of mpox before the 2022 multinational clade II mpox virus outbreak. To characterize post-mpox sequelae 11 to 18 months after acute mpox diagnosis and compare outbreak-associated psychosocial and behavioral impact between at-risk persons who had or did not have mpox. Cohort study. New York City, New York, and Houston, Texas. Adults attending HIV, pre-exposure prophylaxis, or sexually transmitted infection clinics diagnosed with mpox during May 2022 to January 2023 (post-mpox) or at risk for but never diagnosed with mpox (no-mpox). All participants completed psychosocial and behavioral self-assessments. A clinician also assessed post-mpox participants by clinical history and physical examination; persisting mpox physical sequelae were classified by tissue affected and effect on appearance or function. Associations between post-mpox physical sequelae and medical history, acute mpox severity, and sociodemographic characteristics were assessed using marginally adjusted probabilities (presented as risk ratios with 95% CIs). A total of 154 post-mpox and 201 no-mpox participants were enrolled. The proportion of participants reporting increased psychobehavioral symptoms was generally similar between groups. Fifty-eight percent (89 of 154) of post-mpox participants had at least 1 persistent sequelae; 56% (86 of 154) were appearance related, of which 51% (44 of 86) occurred at 2 or fewer sites. Thirteen percent (20 of 154) of post-mpox participants had functional sequelae, of whom 50% (10 of 20) and 35% (7 of 20) had ongoing anorectal and urinary dysfunction, respectively. Participants may not be representative of mpox-affected and susceptible populations. Findings may over- or underestimate frequency or severity of severe mpox sequelae. Post-mpox sequelae frequently persisted 11 to 18 months after acute mpox, with limited body distribution or physical morbidity but with continued social and sexual effects. Centers for Disease Control and Prevention.
7. Digital Cognitive Behavioral Therapy for Chronic Insomnia in South Korea: Cost-Effectiveness Analysis Using Decision Tree and Markov Modeling Based on a Secondary Analysis of a Randomized Clinical Trial.
期刊: JMIR mHealth and uHealth 发表日期: 2026-Jan-19 链接: PubMed
摘要
Insomnia is a prevalent sleep disorder characterized by difficulty initiating or maintaining sleep and is associated with substantial health and economic burdens. Although cognitive behavioral therapy (CBT) is recommended as the first-line treatment, pharmacotherapy remains widely used despite adverse effects and significant indirect costs related to impaired productivity and workplace safety. Digital therapeutics delivering CBT through mobile platforms have emerged as scalable alternatives to improve access and outcomes. Somzz is a commercially available, domestically developed digital therapeutic that delivers CBT-based interventions for insomnia via a mobile app. This study evaluated the cost-effectiveness of Somzz compared with conventional insomnia treatment combining CBT and pharmacotherapy from both health care system and societal perspectives in South Korea. A decision-analytic model integrating a short-term decision tree with a Markov model was developed to compare costs and outcomes of digital CBT via Somzz versus conventional care in 2023. The model simulated a 27-week time horizon (three treatment cycles) and applied an annual discount rate of 4.5%. Clinical inputs, including remission probabilities and health utility values, were derived from a published randomized clinical trial comparing digital CBT delivered via Somzz with sleep hygiene education. Additional inputs, including health care resource use and unit costs, were obtained from published literature and national sources. Health outcomes were measured in quality-adjusted life years (QALYs). The cost analysis included direct medical costs and indirect costs related to absenteeism, productivity loss, and workplace accidents attributable to insomnia. Incremental cost-effectiveness ratios (ICERs) were estimated in 2023 South Korean Won (KRW). Deterministic one-way and probabilistic sensitivity analyses were conducted to assess uncertainty. From a health care system perspective, digital CBT via Somzz resulted in modestly higher costs and improved health outcomes compared with standard care. Over approximately 6.5 months, Somzz generated an additional 0.0092 QALYs per patient at an incremental cost of KRW 79,691 (US $61.87), yielding an ICER of KRW 8,719,727 (US $990,883) per QALY gained. This estimate was well below the Korean willingness-to-pay threshold of KRW 30,000,000 (US $23,192.91) per QALY. From a societal perspective, digital CBT was cost-saving, producing a negative ICER due to reductions in health care utilization, workplace accidents, and productivity losses associated with higher remission rates. Sensitivity analyses identified intervention costs and remission probabilities as key drivers; however, digital CBT remained cost-effective across all scenarios under willingness-to-pay thresholds of KRW 30,000,000 and KRW 15,000,000 per QALY. Digital CBT for insomnia offers favorable clinical and economic value in South Korea. Using Korean clinical trial data and locally relevant societal cost inputs, this study provides policy-relevant evidence supporting early integration of digital CBT into routine insomnia care, employer health strategies, and national digital health policy. World Health Organization International Clinical Trials Registry Platform KCT0007292; https://trialsearch.who.int/Trial2.aspx?TrialID=KCT0007292.
8. Addressing missing data in real-world administrative health datasets.
期刊: European journal of cardiovascular nursing 发表日期: 2026-Jan-19 链接: PubMed
摘要
Administrative health data provide valuable insights into healthcare, but missing data remains a major barrier to ensuring the veracity of findings. This paper presents a structured approach to addressing missingness in administrative datasets, focusing on data assessment and statistical methods. Using causal diagrams and understanding the types of missing data to guide appropriate analytical strategies aligned with the Treatment And Reporting of Missing data in Observational Studies (TARMOS) framework. A real-world example demonstrates multiple imputations in large-scale health research. By promoting transparent and rigorous methods, this methods paper enhances the reliability and policy relevance of administrative data-based healthcare research.
9. Donor-Recipient Epstein-Barr Virus Serostatus and Time-Varying Risk of Posttransplant Lymphoproliferative Disorder in Kidney Transplant Recipients.
期刊: Transplant infectious disease : an official journal of the Transplantation Society 发表日期: 2026-Jan-19 链接: PubMed
摘要
Prior studies and guidelines emphasize PTLD-risk for Epstein-Barr virus (EBV) mismatched (D+/R-) recipients. However, risk among D-/R- kidney recipients remains poorly defined. We evaluated PTLD-risk by donor-recipient EBV serostatus, including D-/R-, and time-varying impact of PTLD on mortality in kidney transplant recipients. This retrospective cohort included deceased donor kidney transplants from the US Scientific Registry of Transplant Recipients (2003-2023). Recipient and donor-recipient EBV serostatus were categorical exposures. Time-to-PTLD was analyzed using Kaplan-Meier methods and adjusted Cox models, stratified into 0-1, 1-2, and 2-3 years to address non-proportional hazards. Secondary outcomes included mortality and all-cause graft failure (ACGF), with PTLD modeled as a time-dependent exposure. Effect modification across key subgroups was evaluated. Among 309 585 recipients (2.35 million person-years), 3147 PTLD events (1.1%) occurred, largely within the first year. Incidence was highest for D+/R- (3%) and D-/R- (1.8%) (p < 0.001). First-year PTLD-risk was highest for D+/R- (HR 17.8 [95% CI: 10.4, 30.5]) and D-/R- (HR 8.2 [95% CI: 4.2, 15.8]) recipients. PTLD was associated with increased mortality (HR 4.5 [95% CI: 4.3, 4.8]) and ACGF (HR 3.7 [95% CI: 3.5, 3.9]), with relatively higher mortality-risk for pediatric recipients (ratio of HRs 1.5). Among 82 detailed PTLD cases, most were B-cell (89%), monoclonal (63%), and EBV-positive (78%), with mixed WHO class and site-involvement. EBV D+/R- recipients experienced highest and sustained 3-year PTLD-risk, while D-/R- recipients faced previously under-recognized early risk. PTLD was strongly linked to mortality and ACGF, refining counselling and supporting targeted surveillance for high-risk groups.
10. A Context-Adapted Diabetes Prevention Program (Small Steps for Big Changes) in Australia: Protocol for a Hybrid Implementation-Effectiveness Study.
期刊: JMIR research protocols 发表日期: 2026-Jan-19 链接: PubMed
摘要
With type 2 diabetes rates escalating worldwide, including in Australia, effective, acceptable, sustainable, and scalable diabetes prevention programs are needed. Small Steps for Big Changes (SSBC) is a Canadian-developed, community-delivered diet and exercise counseling intervention for individuals at risk of type 2 diabetes. The 3- to 6-week intervention can be delivered by trained non-health professionals, with all SSBC coaches receiving training in the delivery of the program, including motivational interviewing. However, the suitability and feasibility of the program in the Australian context are unknown. To address this gap, funding has been secured to adapt, implement, and evaluate SSBC in Australia (SSBC Australia), providing evidence on its effectiveness, acceptability, and implementation in this context. The aim of the study is to describe the protocol for the type 2 cluster nonrandomized single-arm hybrid effectiveness-implementation trial of SSBC Australia. SSBC Australia will be delivered and evaluated in 5 community-based sites across 2 organizations in South-East Queensland, Australia. One organization (1 site) will trial training students on clinical and project placements as coaches. The evaluation period is 4 years. For the first 2 years, sites receive funding for program delivery, after which, ongoing delivery will be self-funded. The recruitment target is 500 participants completing the 6-session intervention across the 5 sites within 2 years, with approximately 50 coaches trained. Data will be collected from the organization, site, coach, and client using a variety of methods (surveys, objective assessments, interviews, site audits, website analytics, meeting minutes, and project tracking). The integrated Practical, Robust, Implementation Sustainability Model and Reach, Effectiveness, Adoption, Implementation, Maintenance framework and the Affordability, Practicality, Effectiveness and Cost-Effectiveness, Acceptability, Side-Effects/Safety, and Equity criteria will guide implementation and evaluation and inform iterative adaptations as required. Data will be collected on the context for delivery; adoption and reach (number of coaches and clients and their characteristics); effectiveness of the coach training and the intervention (client pre- and post changes in measured clinical indicators [body composition, cardiorespiratory fitness, strength, and balance], self-reported health behaviors [movement behaviors, healthy eating, and program behaviors], psychosocial indicators [self-efficacy and social supports], quality of life, diabetes status, and health care use); implementation of the coach training and program delivery (fidelity and acceptability); and maintenance of program delivery (sites) and client outcomes at 3, 6, and 12 months post end-of-program. Ethics approval and trial registration were completed. All 5 sites have been recruited and undergone preimplementation evaluation, with SSBC Australia coach training underway. Client recruitment started in September 2025. This study will provide evidence whether the contextually adapted SSBC diabetes prevention program can be successfully implemented and is effective within an Australian context. Findings will inform potential expansion to additional community sites and health service contexts. Australian and New Zealand Clinical Trials Registry ACTRN12624001194550; https://tinyurl.com/588jkmva. DERR1-10.2196/81195.
11. Response to Letter to the Editor, "Association Between Immunotherapy and Overall Survival in Malnourished Patients with Advanced Non-Small Cell Lung Cancer: A Nationwide Retrospective Cohort Study in Japan".
期刊: Nutrition and cancer 发表日期: 2026-Jan-19 链接: PubMed
摘要
12. Scaling Up a Diabetes Prevention Program in Geographically and Ethnoculturally Diverse Urban Regions of Canada: Protocol for a Hybrid Type 2 Implementation-Effectiveness Study.
期刊: JMIR research protocols 发表日期: 2026-Jan-19 链接: PubMed
摘要
It is estimated that type 2 diabetes (T2D) impacts an estimated 5.3 million Canadians, despite the condition being largely preventable. Laboratory-based diabetes prevention programs (DPPs) have limited effectiveness when translated into community settings due to their low-quality delivery and inability to reach people in the community most in need. To date, no community-based DPPs have been implemented nationwide across Canada. Small Steps for Big Changes (SSBC) is a diet and physical activity counseling intervention that significantly reduces the risk of developing T2D and has been designed for feasible delivery by community-dwelling peers. To ensure maximum public health impact, SSBC must be optimally implemented, demonstrate effectiveness for diverse groups, and be sustainable over time. This project aims to adapt SSBC and evaluate the implementation, effectiveness, and sustainability of SSBC in diverse urban communities across Canada. A hybrid type 2 implementation-effectiveness study design using multiple and mixed methods will be used to evaluate the implementation and effectiveness of SSBC over 6 years in partnership with 11 regional Young Men’s Christian Associations across 8 provinces in Canada. Beginning in 2024, we will (1) adapt and implement SSBC in diverse urban cities across Canada; (2) examine the implementation (including implementation strategies), effectiveness, and cost-effectiveness of SSBC (2024-2028); and (3) determine the sustainability of SSBC at each delivery location (2028-2029). Data will be collected from SSBC clients, coaches, site leads, and senior leadership municipality partners. The project will be overseen by an advisory group and 3 committees focused on sex, gender, and inclusivity; program evaluation; and diabetes prevention engagement. This study has received ethical approval from the University of British Columbia Clinical Research Ethics Board (H23-01930). Funding for this project began in October 2022, and Institutional Review Board approval was obtained in October 2023. Program implementation within each region is occurring in a phased approach, with partners beginning program delivery in one site (2024-2025) before expanding to any additional locations (2025-2027). Program enrollment occurs continuously during the implementation phase across all sites. From 2024-2025, a total of 13 delivery sites began program delivery, 722 participants have enrolled in the program, and 406 have begun the program (153/342, 44.7% non-Western or Eastern European; 80/345, 23.2% men or 82/347, 23.6% male). An additional 13 sites have confirmed they will launch the program in 2026. This study will demonstrate that SSBC can be scaled up nationwide to effectively and equitably reduce the Canadian population-level risk of T2D. This work will determine best practice implementation determinants, outcomes, and strategies critical for sustaining DPP implementation across Canada and beyond. Project findings will be shared with municipality partners and will be copresented with partners and SSBC clients to community organizations, local interested parties, and academics. ClinicalTrials.gov NCT06440395; https://clinicaltrials.gov/study/NCT06440395. DERR1-10.2196/80276.
13. Of hot springs and holobionts: linking hot spring bathing behavior, parasitism, and gut microbiome in Japanese macaques.
期刊: Primates; journal of primatology 发表日期: 2026-Jan-19 链接: PubMed
摘要
Japanese macaques at Jigokudani Snow Monkey Park, Nagano, exhibit hot spring bathing behavior (HSBB) during the cold season. HSBB is known to aid thermoregulation and reduce stress, but its impact on host-associated biota in nonhuman primates remains unexplored. In this study, conducted between December 2019 and March 2021, we investigated the relationship between HSBB and lice load, gastrointestinal (GI) parasitism, and the gut microbiome in Japanese macaques at Jigokudani. Fecal samples were collected from sixteen adult females (9 bathers and 7 non-bathers) varying by age, reproductive status, and social rank. Nit-picking rates, used to estimate lice load, differed between bathers and non-bathers in submerged and non-submerged areas. We detected four GI helminths and at least one protozoan parasite, but did not observe noticeable differences in the probability of infection or abundance of these endoparasites between bathers and non-bathers. Finally, the alpha and beta diversity of the gut microbiome did not differ between bathers and non-bathers, but we identified four microbial genera that were significantly more abundant in non-bathers. These findings suggest that HSBB may influence host-(micro)organism relationships. Further research is needed to explore potential health outcomes associated with HSBB.
14. High prevalence of treatable transthyretin cardiac amyloidosis in cardioembolic stroke: the first systematic cohort study.
期刊: Journal of neurology 发表日期: 2026-Jan-19 链接: PubMed
摘要
While atrial fibrillation is the leading cause of cardioembolic stroke in elderly patients, the underlying cardiac substrate often remains unidentified. Transthyretin cardiac amyloidosis (ATTR-CA), a treatable cardiomyopathy affecting predominantly elderly males, causes atrial fibrillation and carries high thromboembolic risk but remains largely unrecognized among stroke physicians. With disease-modifying therapies now available, identifying ATTR-CA as a cause of cardioembolic stroke has become increasingly important. To determine ATTR-CA prevalence and identify clinical indicators enabling systematic screening for this underdiagnosed cardiomyopathy, we performed a single-center retrospective cohort study of 143 consecutive patients with cardioembolic stroke among 430 ischemic stroke admissions. Patients with clinical suspicion underwent ⁹⁹ᵐTc-pyrophosphate scintigraphy for ATTR-CA diagnosis. ATTR-CA was diagnosed in 14/143 patients (9.8%; 95% confidence interval: 5.4-16.0%). Notably, 50% of patients were newly diagnosed with ATTR-CA following stroke presentation. Compared with non-CA patients (n = 129), ATTR-CA patients demonstrated: male predominance (79% vs. 49%, p = 0.048), two-fold higher levels of troponin T (median 0.058 vs. 0.029 ng/mL, p = 0.035), characteristic biventricular hypertrophy, reduced left ventricular ejection fraction, and elevated E/e’ ratio. Musculoskeletal manifestations, including spinal stenosis (57%), carpal tunnel syndrome (57%), and Popeye sign (75%), were highly prevalent. ATTR-CA was found in nearly 10% of elderly patients with cardioembolic stroke, with half remaining undiagnosed until stroke presentation. Cardiac hypertrophy, elevated troponin levels, and musculoskeletal manifestations provide practical screening indicators for stroke physicians. Given the availability of disease-modifying therapies, these findings emphasize the importance of systematic ATTR-CA screening in cardioembolic stroke populations.
15. Clinical and genetic characterization of REEP6-associated retinopathy in a Japanese cohort.
期刊: Japanese journal of ophthalmology 发表日期: 2026-Jan-19 链接: PubMed
摘要
To characterize the clinical and genetic features of REEP6-associated retinopathy in 8 Japanese patients from 7 families STUDY DESIGN: Retrospective, multicenter cohort study METHODS: Biallelic REEP6 variants were identified by use of whole-exome sequencing in patients with inherited retinal dystrophy (IRD). Comprehensive ophthalmic assessments were performed in all the patients. Among a nationwide cohort of 2011 patients with IRD, 8 patients from 7 families were found to carry biallelic REEP6 variants. Four distinct variants were identified: c.223G>A, p.Glu75Lys; c.268G>C, p.Val90Leu; c.280_281del, p.Leu94ValfsTer86 (novel frameshift), and c.598+1G>A. Five families (Families 1-5) carried the compound heterozygous p.Val90Leu and c.598+1G>A variants. The other two had either homozygous c.598+1G>A (Family 6) or compound heterozygous p.Glu75Lys/p.Leu94ValfsTer86 (Family 7). In Families 1-5, the patients exhibited relatively mild phenotypes with limited to peripheral retinal degeneration in the younger patients and gradual posterior pole involvement in the older patients. Optical coherence tomography revealed well-preserved outer retinal layers at the macula, and good visual acuity was maintained even in some of the older patients. In contrast, the 2 patients in Families 6 and 7 exhibited more severe phenotypes, including macular atrophy and visual acuity decline. The combination of p.Val90Leu and c.598+1G>A variants was associated with a milder phenotype, supporting the hypothesis that p.Val90Leu is a hypomorphic variant. These findings expand the clinical and genetic spectra of REEP6-associated retinopathy, particularly among East Asian populations.
16. Negotiating Care and Coercion: Parental Experiences of Involuntary Psychiatric Hospitalization in Japan.
期刊: Culture, medicine and psychiatry 发表日期: 2026-Jan-19 链接: PubMed
摘要
This article explores how parents in Japan navigate the entangled terrain of caregiving and coercion in the context of involuntary psychiatric hospitalization. Drawing on qualitative interviews with parents whose children were hospitalized without consent, this study foregrounds the complex moral and emotional labor that caregiving entails under conditions of limited institutional support and deep-rooted familial responsibility. The analysis identified two recurring patterns in post-hospitalization relationships: one in which caregiving bonds are sustained but increasingly strained and the other in which hospitalization catalyzes shifts in family dynamics, enabling new forms of distance or reconfiguration. These trajectories were shaped not only by the child’s condition but also by the presence or absence of external support, including care quality, and by parents’ internal struggles with guilt, obligation, and ambivalence. By situating these narratives within Japan’s long-standing reliance on the family as the primary site of psychiatric care, this article contributes to the debate on care, agency, and coercion in psychiatric contexts. It calls for closer attention to how families navigate moral uncertainty and negotiate caregiving roles within a system where family involvement is not only common but often prioritized in the admission process, particularly in cases of hospitalization for medical care and protection.
17. Sweetened Beverage Consumption is Associated With Sleep Duration and Timing in Young Adolescents.
期刊: Health promotion practice 发表日期: 2026-Jan-19 链接: PubMed
摘要
This study examines cross-sectional relationships between sugar-sweetened beverage (SSB) consumption and sleep in early adolescents using rigorous assessments and accounting for caffeine consumption. It was hypothesized that greater SSB consumption would be associated with shorter sleep duration, greater sleepiness, lower sleep quality, and later bedtimes and waketimes on weekdays and weekends. The sample included 288 middle school students (Mage = 12.09 years; 54% female; 48% Black; 37% White; 10% Hispanic/Latino; and 5% other racial-ethnic groups) recruited from 15 public middle schools in the Birmingham metropolitan area. Sleep duration, as well as wake and bedtimes, were calculated from 7-day actigraphy. During the same 7 days, SSB and caffeine consumption were measured with daily assisted 24-hour food recalls. Multiple regression analyses showed that after controlling for sociodemographics, physical activity, energy intake, and caffeine consumption, greater SSB consumption was associated with shorter weekday sleep duration (β = -.19; CI = [-.28, -.05]). Furthermore, higher SSB consumption was linked to later bedtimes (β = .19; CI = [.05, .33]). Results suggest that youth who drink more SSBs have disruptions in sleep timing on weekdays and weekends that may contribute to shorter sleep duration. To improve adolescent sleep, continued efforts are needed to reduce overall SSB consumption through nutrition education in schools and communities.
18. MTX pathway gene variants, erythrocyte methotrexate polyglutamates, and treatment outcomes in rheumatoid arthritis.
期刊: Biomolecules & biomedicine 发表日期: 2026-Jan-19 链接: PubMed
摘要
Rheumatoid arthritis (RA) exhibits significant inter-patient variability in response to and toxicity from methotrexate (MTX). The clinical utility of erythrocyte methotrexate polyglutamates (MTXPGs) and MTX-pathway pharmacogenetics remains uncertain. This study investigates the relationships between MTX-pathway gene polymorphisms, erythrocyte MTXPG levels, and MTX treatment outcomes in RA. In a single-center, cross-sectional cohort study conducted in southern Fujian from 2017 to 2020, we analyzed 140 Han Chinese RA patients who had been receiving stable low-dose oral MTX (7.5-15 mg/week) for at least three months. Genotyping was performed using MassARRAY, and MTXPG levels 1-6 were quantified in red blood cells via LC-MS/MS. Data on treatment efficacy (measured by ACR20 and clinical scales) and MTX-related adverse drug reactions (ADRs) were collected, with associations analyzed through univariate and multivariable models. MTXPG levels 1-3 were detectable in all patients, while longer-chain MTXPGs were infrequent. The SLCO1B1 521T>C polymorphism was independently associated with lower levels of MTXPG1 (B=-1.119), MTXPG2 (B=-0.924), and total MTXPG (B=-0.849), all with P-values ≤0.045. However, MTXPG levels did not correlate with MTX efficacy or ADRs. The GGH 401C>T polymorphism was associated with a reduced ACR20 response (OR=0.421, p=0.021) and higher visual analog scale (VAS) and patient global assessment (PGA) scores. Additionally, the variants SLCO1B1 521T>C and ABCB1 3435C>T were linked to higher scores in the Patient Health Global Assessment (PHGA) and Health Assessment Questionnaire (HAQ). In this low-dose MTX cohort, erythrocyte MTXPGs did not predict clinical outcomes. However, variants in SLCO1B1, GGH, and ABCB1 emerged as exploratory candidate markers for MTX response, warranting validation in larger prospective cohorts.
19. The Role of the Boston Keratoprosthesis in Severe Ocular Surface Disease and Autoimmune Diseases.
期刊: Seminars in ophthalmology 发表日期: 2026-Jan-19 链接: PubMed
摘要
To synthesize contemporary evidence on Boston KPro outcomes in autoimmune cohorts and outline practical strategies to improve anatomic retention and visual results. A review. The Boston keratoprosthesis (KPro) is the most widely implanted artificial cornea and a critical option for visual rehabilitation in patients at high risk of graft failure. Autoimmune disorders, including Stevens-Johnson syndrome (SJS), Sjögren’s disease (SjD), ocular mucous membrane pemphigoid (OMMP), and ocular graft-versus-host disease (oGVHD), create highly inflammatory, cicatricial ocular surface environments characterized by severe dry eye, limbal stem cell deficiency, and corneal neovascularization, all of which undermine conventional keratoplasty. While selected patients with a relatively “wet” and medically quiet surface can benefit from Type 1 KPro, most end-stage cicatricial phenotypes are better served by Type 2 KPro or alternative mucous-membrane-covered devices. Across studies, autoimmune etiology is consistently associated with higher rates of tissue melt, infectious/sterile keratitis, retroprosthetic membrane, glaucoma, and vitreoretinal complications compared with non-autoimmune eyes. A structured perioperative bundle, systemic disease quiescence for ≥3 months, rheumatology co-management, prophylactic glaucoma drainage devices when indicated, long-term bandage contact lens wear, and intensified antibiotic ± antifungal prophylaxis appear to mitigate risk. Emerging approaches (biologics, donor-carrier crosslinking, γ-irradiated tissue, and newer KPro designs) show promise but require standardized endpoints and multicenter registries. Despite substantial challenges, the Boston KPro remains a vision-restoring option for carefully selected autoimmune patients when performed within multidisciplinary programs using rigorous preventive protocols.
20. Associations between serum PFAS concentrations and beta cell function and insulin resistance in adult females.
期刊: The Journal of clinical endocrinology and metabolism 发表日期: 2026-Jan-19 链接: PubMed
摘要
Epidemiological evidence of exposure to precursor and alternative, per- and polyfluoroalkyl substances (PFAS) and metabolic health outcomes is lacking. To quantify associations between concentrations of 31 PFAS and metabolic biomarkers of glucose homeostasis and beta cell function. We used data from a 2018-2021 follow-up of the Maternal-Infant Research on Environmental Chemicals (MIREC) study, which included measurements of serum concentrations of PFAS and metabolic biomarkers in samples provided by 274 adult female participants. Our primary outcomes were composite measures of pancreatic beta cell function (proinsulin to insulin [PI:INS] and proinsulin to C-peptide [PI:CP] ratios) and insulin resistance (homeostatic model assessment for insulin resistance [HOMA-IR] and triglyceride-glucose [TyG] index). We used multivariable linear regression models to quantify the percent difference in outcome measures. PFAS with >50% detection [n=17] were log2-transformed; PFAS with 10-50% detection [n=14] were dichotomized at the limit of detection. We used quantile g-computation (qgcomp) and weighted quantile sum regression (WQS) to evaluate PFAS mixtures. We also modelled arithmetic sums of 17 PFAS detected in >50% of participants (Σ17PFAS) and 7 PFAS specified in the National Academies of Sciences, Engineering and Medicine report (Σ7PFAS). Each doubling of Σ7PFAS, PFOS, and PFHxS was associated with a 5-9% increase in PI:INS ratio. Σ7PFAS, but not the Σ17PFAS, was also positively associated with the PI:INS ratio in qgcomp models. We observed inverse associations between Σ7PFAS and HOMA-IR and fasting insulin. Many results were of small magnitude or imprecise. In this cross-sectional analysis, exposure to certain legacy, alternative, and precursor PFAS were associated with beta cell dysfunction.
21. Deciphering the role of commercial nanofiltration membranes in removing 30 per-and polyfluoroalkyl substances: performances, mechanisms and implications.
期刊: Environmental technology 发表日期: 2026-Jan-19 链接: PubMed
摘要
Per- and polyfluoroalkyl substances (PFASs) are bioaccumulative and highly stable in ecosystems, posing potential toxicity risks to human health. Membrane treatment has become a critical research area in current treatment technologies for PFASs. In this study, we selected five commercial nanofiltration (NF) membranes to investigate the performance of the membrane structure on treating 30 PFASs in simulated and industrial wastewater. The results indicated that the rejection of 30 PFASs exceeded 65% for all membranes. The performances of NF90 and DK membranes were better than others, whereas the treatment efficiency of the NF270 membrane was the lowest for most PFASs. Under the experimental conditions, NF90 membrane exhibited the highest surface negative charge and the lowest molecular weight cut-off (MWCO), resulting in relatively stronger electrostatic repulsion and size exclusion effects, which were the key factors influencing PFASs removal efficiency. For all membranes, the rejections were higher for PFASs with long carbon chains and strong hydrophobicity. The treatment efficiencies were higher for PFSAs with smaller pKa and LogKow, compared to PFCAs with the same carbon chain length, showing that electrostatic repulsion and hydrophobic interactions resulted in better efficiency. Furthermore, coexisting pollutants in the actual wastewater could have different impacts on the treatment outcomes by influencing factors such as pH and blocking membrane pores. This work presents an environmentally friendly and efficient method for removing PFASs from wastewater and provides insights into the separation mechanism of NF membranes for dozens of PFASs.
22. Implementing disciplined collaboration in the life sciences.
期刊: FEBS letters 发表日期: 2026-Jan-19 链接: PubMed
摘要
Collaboration has become an essential pillar of modern biological research. From international genome initiatives to interdisciplinary multi-omics projects, research in the life sciences increasingly relies on (multi)institutional teamwork. Yet, many collaborations fail to deliver on their promises of innovation, efficiency, and scientific impact. Morten T. Hansen’s concept of ‘disciplined collaboration’ (2009) offers a valuable framework for understanding why collaboration sometimes hinders rather than helps research productivity. In this article, Hansen’s principles are repurposed to the context of biological research in universities and research institutes. It is substantiated that selective, well-managed, and strategically aligned collaborations, rather than indiscriminate cooperations, lead to sustainable scientific advancement. The discussion of this paper explores the four major barriers to effective collaboration in academia, the three organizational levers proposed by Hansen, and the evaluative processes necessary for implementing disciplined collaboration in research environments. Finally, Hansen’s views on institutional strategies are adapted to cultivate collaborative excellence within life science research in academic institutions.
23. Periodontal regeneration with enamel matrix derivative and decortication: A retrospective analysis of one year clinical and radiographic outcomes.
期刊: Journal of periodontology 发表日期: 2026-Jan-19 链接: PubMed
摘要
Intrabony periodontal defects present a clinical challenge. Decortication, also called intramarrow penetration (IMP), intended to stimulate angiogenesis and to enhance the healing environment, has demonstrated benefits in bone augmentation but remains insufficiently investigated in periodontal regenerative procedures, especially in combination with enamel matrix derivative (EMD). This retrospective cohort study included patients treated with EMD alone (control group) or with EMD combined with IMP (test group). The primary outcome was clinical attachment level (CAL) gain at 12 months. Secondary outcomes included probing pocket depth (PPD), gingival recession (REC), keratinized tissue width (KTW), and radiographic parameters such as defect depth (rDD), defect width (rDW), and defect angle (rANG). Linear regression with generalized estimating equations (GEE) was used to account for clustering, with Bonferroni correction for multiple comparisons. The significance was set at α = 0.05. A total of 29 patients (39 teeth) were included. Both groups exhibited statistically significant improvements in clinical and radiographic parameters between baseline and 12 months (p < 0.05). In the test group, the mean PPD decreased by 3.86 ± 1.73 mm, the CAL gain was 3.18 ± 1.30 mm, and the REC increased by 0.68 ± 1.21 mm; radiographically, rDD and rDW were significantly reduced, whereas rANG did not change significantly. Similarly, in the control group, PPD decreased by 3.47 ± 1.33 mm, CAL gain was 2.82 ± 1.29 mm, REC increased by 0.65 ± 1.00 mm, and significant reductions in rDD and rDW were observed. No statistically significant differences were found between the two groups for any parameter at 12 months (p > 0.05). The adjunctive use of IMP did not significantly enhance the clinical or radiographic outcomes achieved with EMD alone. However, the comparable outcomes achieved in more challenging baseline conditions indicate that the technique merits further investigation in future randomized controlled studies. Treating bone defects caused by periodontitis remains a clinical challenge, even with established regenerative techniques such as enamel matrix derivative (EMD). This retrospective study evaluated whether combining EMD with intramarrow penetration (IMP), a technique used to stimulate bleeding and to improve the regenerative environment, could enhance clinical and radiographic outcomes. Thirty‐nine intrabony defects were treated with either EMD alone or EMD plus IMP. After 12 months, both groups showed significant improvements in probing depth, attachment level, and bone fill. No statistically significant differences were found between the groups. However, the IMP group began with more severe defects and achieved comparable outcomes, suggesting a possible benefit in complex cases. These findings confirm the effectiveness of EMD and indicate that IMP may have a role in selected situations, although larger, prospective studies are needed to clarify its contribution.
24. Association between work-from-home frequency and prolonged sedentary behavior: A longitudinal study among Japanese desk workers in the post-COVID-19 pandemic era.
期刊: Work (Reading, Mass.) 发表日期: 2026-Jan-19 链接: PubMed
摘要
BackgroundThe COVID-19 pandemic has intensified the adoption of work from home (WFH) practices, raising concerns about their potential impact on sedentary behavior (SB). Although one previous study has suggested an association between WFH frequency and prolonged SB, the causal relationship and whether the findings hold true in situations where COVID-19 infection control measures have been mitigated remain unclear.ObjectiveTo investigate whether frequent WFH is associated with prolonged SB and to explore whether the strength of this association differs according to individual characteristics.MethodsProlonged SB was defined as sitting for ≥8 h per day, and WFH frequency was categorized into low (none or one to three times per month), middle (one to three times per week), and high (four times per week or almost every day) groups. Multivariate logistic regression was adopted to analyze the association between WFH frequency and prolonged SB.ResultsParticipants in the middle and high frequency WFH groups were 1.69 and 1.88 times more likely to experience prolonged SB, respectively than those in the low frequency group. The subgroup analysis showed that this association was particularly strong among full-time employees in non-managerial positions, males, and employees working 40 h or more per week, meaning that the odds ratio was higher than in other subgroups.ConclusionsThis study shows a longitudinal association between frequent WFH and prolonged SB among Japanese desk workers. Furthermore, interventions aimed at reducing SB should focus on high-risk groups to mitigate potential health risks in the post-pandemic work environment.
25. "Tapping" into neural inhibition in focal hand dystonia: an evaluation of a finger-tapping task using TMS and fMRI.
期刊: Journal of neurology 发表日期: 2026-Jan-19 链接: PubMed
摘要
Focal hand dystonia (FHD) is a task-specific movement disorder characterized by involuntary muscle contractions during skilled hand use. Impaired intracortical inhibition is a core feature of FHD, yet its relationship to functional brain activity during motor tasks remains poorly understood. This study combined transcranial magnetic stimulation (TMS) and functional MRI (fMRI) to investigate the relationship between intracortical inhibition, as measured by the cortical silent period (cSP), and task-based brain activation in individuals with FHD. Sixteen individuals with FHD and 18 age-matched healthy controls completed cSP assessments and fMRI. Participants performed self-paced finger tapping with each hand separately. For FHD participants with left-hand symptoms (n = 4), left-right labels were flipped during analysis so that right-hand data represented the symptomatic hand and left-hand data represented the non-symptomatic hand across all participants. We analyzed activation in sensorimotor regions and tested voxel-wise correlations between cSP duration and BOLD responses. FHD participants demonstrated greater activation in the inferior parietal lobule (IPL) within the posterior parietal cortex (PPC) during both right- and left-hand finger tapping. Notably, during left-finger tapping (non-symptomatic hand), cSP duration positively correlated with cerebellar activation, suggesting altered integration of inhibitory circuits during motor execution. No such correlations were found during right-finger tapping (symptomatic hand) or for control participants. These findings suggest that individuals with FHD may selectively recruit cerebellar sensorimotor circuits to modulate inhibition during movement of the non-symptomatic hand, though this pattern was not observed during movement of the symptomatic hand. The cerebellum may play a central role in adaptive motor control in FHD. Future work should leverage symptom-inducing tasks and alternative inhibitory markers to further clarify these mechanisms.
26. Longitudinal associations of meteorological parameters during winter months in Sweden with self-reported symptoms of anxiety in the spring.
期刊: International journal of biometeorology 发表日期: 2026-Jan-19 链接: PubMed
摘要
Anxiety symptoms may be affected by environmental factors. Changes in weather patterns have been linked to various mental health outcomes, but research focusing on wintertime and anxiety is still sparse. Thus, we investigate longitudinal associations between solar radiation, precipitation, and snow days during winter-time and self-reported anxiety symptoms in the following spring. We used data from 14,237 participants of the Swedish Longitudinal Survey of Health who responded to surveys in spring 2016 and 2018. Symptoms of anxiety was assessed using SCL-ANX4, a subscale of the Symptom Checklist-25. Data on the daily solar radiation and precipitation was averaged over November to January and linked to the health data and residence at municipal level for each participant. For snow days, sum of days with snow over the 3-month period was used. Within-individual design using conditional logistic regression was used. Models were adjusted for age, region, and the remaining meteorological variables. Although odds ratios for anxiety in association with 3-month average solar radiation (OR 0.90, 95% CI 0.65-1.24) and precipitation (OR 0.91, 95% CI 0.79-1.05) were on the protective side, these associations were not statistically significant. We neither observed associations between snow days and anxiety symptoms, nor any significant effect modification by age, sex, civil status, job strain, occupational position, region, type of questionnaire, alcohol use, or physical activity (p-values for interactions > 0.05). Our findings do not demonstrate associations between wintertime weather conditions and symptoms of anxiety and call for further research from different geographical areas and populations.
27. Community-Led Responses to Mpox Among Gay, Bisexual, and Queer Men in Canada: Mapping the Collaboration of Community-Based Organizations, Public Health, and Clinicians.
期刊: Qualitative health research 发表日期: 2026-Jan-19 链接: PubMed
摘要
Since 2022, a global mpox outbreak in non-endemic countries, including Canada, has spread rapidly, mainly affecting gay, bisexual, and queer men (GBQM). With mpox primarily transmitted through sexual and close physical contact, concerns emerged over the replication of early responses to HIV/AIDS, which was initially labeled as a “gay disease,” perpetuating ongoing negative stereotypes and discrimination against GBQM. To prevent potential social and health-related stigmatization, institutional actors, including public health authorities, community-based organizations (CBOs), and clinical bodies, collaborated to provide guidance and promote culturally informed responses. We aimed to examine how health institutional collaborations were formed and maintained as challenges emerged during Canada’s mpox outbreak response. We conducted 30 online individual interviews and six small focus groups with 48 CBO practitioners, public health personnel, and clinical providers across Canada. Data were analyzed using institutional ethnography and actor-network theory, through indexing, which involves categorizing and consolidating categories. We mapped four interrelated networks of coordination: assembling the network through existing HIV infrastructures; co-developing public health messaging to increase cultural sensitivity to GBQM’s lived experiences; negotiating vaccine eligibility criteria to reflect community realities; and mobilizing networks to deliver vaccines in GBQM community-friendly settings. Regional differences in public health infrastructure influenced the development of coordination, messaging, and access to care. Findings highlight how relational infrastructures developed for HIV were reactivated and repurposed during the mpox response. Investing in and maintaining strong community and public health relationships outside of crisis periods can improve future responses to health emergencies affecting GBQM communities and other marginalized populations.
28. Genetics and Brain Health in Adults With Congenital Heart Disease: A Consensus Statement From the ACHD/Neuro 2024 Conference.
期刊: Journal of the American Heart Association 发表日期: 2026-Jan-19 链接: PubMed
摘要
With improvement in medical and surgical care, the number of adults with congenital heart disease (CHD) is soaring. Adults with CHD commonly have impairments in brain health. However, significant gaps in knowledge remain regarding the relevant types and prevalence of neurologic and psychiatric risk and their associated risk factors. We sought to review current evidence, identify gaps in knowledge, and develop key next steps to improve scientific understanding and clinical care. Three working groups-Genetics and Brain Health, Characterizing Neuropsychological and Psychological Outcomes, and Neuropsychological and Psychosocial Interventions-were composed of multidisciplinary experts in relevant clinical and research domains, as well as adults with CHD. Each group identified 5 key knowledge gaps and associated next investigations needed to address those gaps. For Genetics and Brain Health, 5 key knowledge gaps were identified: lack of a standardized neuroimaging protocol for adults with CHD, need to understand neuroradiological-pathological-neuropsychological correlates, role of gene-environment interactions, what can be learned from brain health risk models from other groups, and how existing multimodal approaches influence risk and neuroresilience. Adults with CHD can benefit from routine assessment of brain health, as well as increased clinical and basic research into the underlying factors that contribute to risk and neuroresilience for neurologic and psychiatric sequalae. Multidisciplinary collaborative efforts that incorporate adults with CHD across the research cycle are essential for all key next steps.
29. Physical and mental health upon reentry: The importance of social contact in prison for wellbeing during reintegration.
期刊: Public health 发表日期: 2026-Jan-18 链接: PubMed
摘要
Incarceration is associated with adverse mental and physical health outcomes that are exacerbated during the post-release period. Social contact with loved ones during imprisonment-such as in-person visits, phone calls, and written correspondence-may play a key role in mitigating the health consequences of incarceration and promoting health upon release. The current study assesses how social contact during incarceration may mitigate health issues during the reentry period. The study uses data from a sample of 475 men incarcerated in Texas prisons interviewed prior to release and again one month into the reentry period. Ordered logistic regression models of in-prison social contact types (i.e., in-person visitation, sending/receiving mail, and making/receiving phone calls) and four groups of people (i.e., family members, friends, gang associates, and anyone else) who visited the incarcerated person in the last six months before prison release are utilized to predict self-reported physical health and mental health approximately four weeks post-release. Mostly consistent with our hypotheses, findings reveal that in-person visitation during incarceration is positively associated with better physical health following release (odds ratio [OR] = 1.61; 95 % Confidence Interval [CI] = [1.05, 2.47]). Additionally, a closer examination of the in-person visitation groups revealed that visits from family members, but not the other three groups (i.e., friends, gang members, or anyone else), were positively associated with better self-reported physical health (OR = 1.88; 95 % CI = [1.28, 2.75]) and mental health (OR = 1.64; 95 % CI = [1.14, 2.37]). The results affirm and highlight the unique role of familial relationships in promoting wellbeing during reentry. To promote in-person visitation, correctional systems should consider efforts to overcome key barriers and stressors related to family visits. Identifying individuals who lacked positive visitation experiences could inform targeted wraparound practices that prioritize counseling around family reunification and social connections with loved ones.
30. Impact of ban and ordinances against indoor smoking on the proportion of smoke-free establishments in restaurants, izakaya, and bars in Japan: Interrupted time-series analysis of restaurant database.
期刊: Public health 发表日期: 2026-Jan-18 链接: PubMed
摘要
To protect workers and individuals from second-hand smoke exposure, Japan’s national indoor smoking ban was enforced on April 1, 2020. However, certain exemptions were made for eating and drinking establishments. Local ordinances restricted these exemptions to increase their effectiveness. We aimed to evaluate the 2-year impact of the national ban and local ordinances on indoor smoking policies in eating and drinking establishments over a 2-year period. Panel data analysis. From a commercial database of eating and drinking establishments, we used area-level summary data of 320,693 establishments for August 2016 and individual establishment data extracted biannually between January 2020 and December 2022 (n = 329,322 to 403,133). We calculated the category-specific and weighted proportions of smoke-free establishments. We analysed the short-term and trend changes using an interrupted time-series analysis. The proportion of smoke-free establishments increased after the national ban (+5.7 % points). Local ordinances restricting the exemption for the establishments with non-family employees enhanced the impact of the national ban (+7.8 % points). In December 2022, the proportions of smoke-free establishments were 68.3 % in restaurants, 70.2 % in cafés, 32.8 % in izakaya, and 25.0 % in bars. The indoor smoking ban has promoted indoor smoke-free policies in eating and drinking establishments in Japan. However, many establishments, nearly two-thirds of izakaya and bars, remain smoking-allowed, probably owing to exemptions and non-compliance. To effectively reduce second-hand smoke exposure in eating and drinking establishments, it is necessary to minimise exemptions by revising laws or enforcing additional ordinances and promoting compliance with these legislations.
31. Activation of nuclear Ca2+-dependent gene expression by CRAC channel Ca2+ nanodomains.
期刊: Cell reports 发表日期: 2026-Jan-17 链接: PubMed
摘要
Oscillations in the levels of second messengers are observed throughout the phylogenetic tree, with signaling information encoded in the frequency of the spikes. Different biological targets respond to different frequencies of oscillation, leading to the concept of frequency counting. The most widely observed and best understood oscillatory second messenger is cytosolic Ca2+. Ca2+ oscillations are generated in all cell types, are seen throughout the life of a cell, and are indispensable for diverse biological processes ranging from fertilization to cell death and myriad responses in between including excitation-transcription coupling through Ca2+-dependent gene expression. The widely expressed Ca2+-dependent transcription factors nuclear factor (NF) of activated T cells (NFAT) and NF-κB are recruited by different Ca2+ oscillation frequencies, increasing the signaling bandwidth through the universal Ca2+ messenger. Here, we show that Ca2+ nanodomains near Ca2+ channels at the cell surface are central to gene expression. Cytosolic Ca2+ oscillations are not necessary for Ca2+-dependent gene expression, provided Ca2+ nanodomains near Ca2+ release-activated Ca2+ (CRAC) channels are formed. Our results establish that a fundamental unit of excitation-transcription coupling is the Ca2+ channel nanodomain at the cell surface.
32. Unveiling synergy in ultrasound-assisted enzymatic extraction: Role of treatment sequence and biomass complexity.
期刊: Ultrasonics sonochemistry 发表日期: 2026-Jan-16 链接: PubMed
摘要
Emerging extraction methods, such as enzyme-assisted extraction (EAE) and ultrasound-assisted extraction (UAE), are considered safer and more sustainable alternatives to conventional techniques, due to their reduced solvent usage. Nevertheless, their application remains limited due to their low efficiency and sensitivity to environmental conditions. To overcome these drawbacks, ultrasound-assisted enzymatic extraction (UAEE) has been proposed as an alternative synergistic approach to improve biomass disruption. In this study, the effect of ultrasound on the susceptibility of pectic substrates to enzymatic degradation was evaluated using both purified pectin and pectin-rich complex matrices (grapefruit peels and apple pomace). The extent of enzymatic degradation was assessed by monitoring the release of reducing sugars, while microscopic evaluation of the cell microstructure, the total phenolic release (TPC) and metal element release were quantified to support the findings. Results indicate that ultrasonic pre- and post-treatments had no significant impact on pectin hydrolysis. In contrast, when ultrasound was applied during the enzymatic reaction, the extent of hydrolysis increased, but only in the case of the complex matrices, indicating a synergistic effect. The increased release of calcium and potassium ions suggested that ultrasound induced an enzymatic cofactor release from biomass, contributing to improved enzyme activity. Similar degradation of the cell microstructure was observed in the case of ultrasonic post treatment, although without improved hydrolysis of cell-wall pectin. This implies that prior enzymatic action weakened the matrix, making it more fragile. This is the first study to investigate the impact of plant matrix structure on the synergistic effect of the ultrasound-enzyme combination.
33. Key factors controlling transport of biochar colloids in porous media and the mutual effects with coexisting contaminants.
期刊: Journal of contaminant hydrology 发表日期: 2026-Jan-14 链接: PubMed
摘要
Large-scale application of biochar (BC) has been considered as an effective strategy for carbon sequestration, soil quality improvement, and water/soil remediation. Once introduced into soils, BC can disintegrate or fragment through physical, chemical and biological processes, resulting in the formation of BC colloids (BCCs) with particle size ranging from 1 to 1000 nm. Due to the small size, large surface area, and high surface activity, BCCs exhibit stronger colloidal stability in aquatic environments and higher mobility in porous media than the bulk BC particles. In particular, BCCs have much higher adsorption affinity for various contaminants, and thus may serve as vehicles for facilitating contaminants transport, posing potential risks to the environment and human health. In this review, we summarize the current state of knowledge on the transport of BCCs influenced by (1) the intrinsic physicochemical properties of BCCs (i.e. pyrolysis temperature, size, aging effect), (2) solution chemistry (i.e. pH, ionic strength, ionic composition), (3) inorganic/organic colloids (i.e., minerals, humic/fulvic acid), (4) flow conditions (i.e. flow velocity), and (5) properties of porous media (i.e. grain size, media type and surface properties, moisture and mineral content). In addition, differing from previous works, this review provides a systematic analysis of BCCs transport through an integrated lens of governing mechanisms and mathematical models, with a dedicated focus on the mutual effects between BCCs and contaminants-a critical yet underexplored area determining their combined environmental fate. Finally, this work concluded with remarks on the importance of BCCs transport in porous media and directions for future research.
34. Smoking and the comorbidity trajectory of cardiometabolic and mental disorders: A multi-state model.
期刊: General hospital psychiatry 发表日期: 2026-Jan-13 链接: PubMed
摘要
Cardiometabolic diseases (CMDs) and mental disorders (MDs) exhibit high comorbidity and result in a substantial disease burden. The impact of smoking, a risk factor for both diseases, on the comorbidity trajectory remains unclear. We conducted a prospective cohort study involving 355,488 UK Biobank participants, utilizing multi-state models to explore the potential impact of smoking status on all transition stages. Smoking status were classified as never, previous, and current. Incident CMDs (ischaemic heart disease, stroke, and diabetes) and MDs (depression and anxiety) were ascertained via linkage to hospital inpatient records, primary care data, self-reports, and death registries. Across all pathway, current smokers had higher transition probabilities than previous smokers and never-smokers. Compared to the effects on incident MDs or CMDs from baseline, current smoking was associated with higher risks of transitions from MDs to comorbid CMDs (HR = 1.63; 95% CI: 1.34-1.98), from CMDs to comorbid MDs (HR = 1.45; 95% CI: 1.20-1.76), and from comorbidity to death (HR = 2.43; 95% CI: 1.79-2.29). In contrast, smoking cessation attenuated this risk (HRs range: 0.45-0.93). Moreover, current and previous smoking were associated with average life expectancy reductions of 6.88 years (95% CI: 4.78-8.98) and 0.84 years (95% CI: 0.59-2.27), respectively, among 45-year-old participants with comorbidity. The associations between smoking and the comorbidity trajectory were robust in sensitivity analyses. Current smoking has stronger impacts on transitions to comorbidity than on the first occurrence of CMDs or MDs. While current smoking increases the risk of death, smoking cessation mitigates the loss of life expectancy.
35. Prehospital and Emergency Care Perspectives to Define Pediatric Critical Illness and Injury.
期刊: The western journal of emergency medicine 发表日期: 2026-Jan-09 链接: PubMed
摘要
Timely identification of critically ill or injured children in prehospital and emergency settings remains a persistent challenge due to developmental variability, low case volumes in emergency medical services (EMS), and contextual limitations during field assessments. Existing frameworks to identify at-risk children often fail to capture the nuances of pediatric presentations, particularly in resource-limited or mass casualty settings. We aimed to explore prehospital and hospital-based clinician perspectives to inform a Delphi survey for the development of a consensus-driven definition of pediatric critical illness and injury. We conducted a qualitative study using one semi-structured interview and two focus groups with participants with expertise in pediatric prehospital and hospital acute care. Participants were presented with a list of tools commonly used to assess the severity of illness in children in the emergency department and hospital-based settings. Interviews were conducted virtually, transcribed, coded using an iterative process, and thematically analyzed. We used key themes to inform the structure and priorities for a future Delphi survey. Six of the 12 invited participants took part in the study. Five major themes emerged: 1) prehospital indicators of critical illness (e.g., seizure, intravenous placement, cardiopulmonary resuscitation; 2) in-hospital markers of severity (e.g., air medical transport, intubation, diagnostic findings); 3) perceptions of existing triage tools (e.g., limited awareness or utility among paramedics); 4) differences in assessment approaches across roles and settings; and 5) specific triage challenges during mass casualty or disaster scenarios. Paramedics emphasized clinical actions as indicators of acuity, while physicians cited diagnostic findings and broader contextual indicators. Across roles, there was more agreement on the limitations of current triage and illness severity tools than on their utility. We gained insights into key gaps in current pediatric triage systems, including limited applicability of existing tools in prehospital settings, variability in comfort with pediatric interventions, and the lack of alignment between paramedic action-based indicators and physician reliance on diagnostic findings. Role-specific experiences influence how critical status is assessed and highlight the value of integrating multidisciplinary insight. These findings inform future work focused on the development of consensus-based outcome measures that align with decision-making across prehospital and hospital environments.
36. Incidence of Solar Retinopathy and Photokeratitis in US Emergency Departments Surrounding the April 2024 Total Solar Eclipse.
期刊: The western journal of emergency medicine 发表日期: 2026-Jan-09 链接: PubMed
摘要
Viewing a solar eclipse without proper eye protection can lead to ocular injuries such as solar retinopathy or photokeratitis. The April 8, 2024, solar eclipse in the southern and eastern United States presented a rare opportunity to assess the public health impact of such events on eye-related emergency department (ED) visits. We identified a total of 1,774 ED visits for eye injuries across both periods. There were 853 visits before the eclipse and 921 visits after, showing no statistically significant difference (X2 = 1.432, P > .05) between the two time periods. We identified a total of 1,774 ED visits for eye injuries across both periods. There were 853 visits before the eclipse and 921 visits after. The chi-square statistic (X2 = 1.432, degree of freedom = 1, P > .05) indicated no statistically significant difference in the incidence of eye injuries between the two time periods. Despite concerns regarding eclipse-related eye injuries, we found no statistically significant increase in ED visits for ocular pain or photokeratitis following the April 8, 2024, solar eclipse. These results suggest that public education campaigns promoting safe eclipse viewing may have been effective. Ongoing efforts are warranted to continue promoting ocular safety during future eclipses.
37. Comparison of Unhoused and Domiciled Patients Evaluated for Trauma in a Level II Trauma Center.
期刊: The western journal of emergency medicine 发表日期: 2026-Jan-09 链接: PubMed
摘要
California has one of the highest rates of homelessness in the United States. Unhoused individuals often have complex medical and behavioral health disorders, frequently complicated by substance use disorders. They have a significant risk of sustaining traumatic injuries. This report compares unhoused and domiciled patients treated at our Northern California trauma center. In this retrospective analysis of trauma patients we used data extracted from our institution’s Trauma Quality Improvement Program Trauma Registry for January 1, 2019-April 22, 2022 and compared characteristics of unhoused and domiciled individuals. All unhoused patients in the registry were included in the analysis, as well as an equal number of domiciled patients who were randomly selected during the same time frame. We described and compared demographic and clinical characteristics. Of 8,529 patients in the registry, 181 (2.1%) were unhoused, and we selected 181 domiciled patients to compare. Unhoused patients were more likely male (83% vs. 61%, P < .001) and younger (48.8 ± 12.3 vs. 55. 8 ± 23.7 years, P <.001). Both cohorts had similar Injury Severity Scores. However, unhoused patients had a higher rate of hospital admissions (76.8% vs. 61.9%, P <.001) and longer hospital stays than domiciled patients (4.0 [IQR 2.0-9.0] days vs. 3.0 [IQR 1.0-6.0] days, respectively; P = .02). A higher proportion of unhoused patients received alcohol-(85.6% vs. 74.6%, P = .01) and drug screening (56.4% vs. 30.4%, P < .001) than domiciled patients. Of those screened for urine drugs, unhoused patients had a higher positive rate (76.5% vs. 50.9%, P < .001). Unhoused patients were more frequently injured by assault (30.4% vs. 8.8%, P < .001) or pedestrian strike (21.5% vs. 3.3%, P < .001), whereas more domiciled patients were injured in falls (46.4% vs. 21.5%, P < .001) and motor vehicle accidents (29.8% vs. 8.3%, P < .001). Falls were most common in the oldest quartile for both groups. In both cohorts, a “sharp object” was the most common mechanism of assault injury (40.0% vs. 37.5%, respectively). Assault by firearm occurred in 14.5% of unhoused and 18.8% of domiciled patients. Overall mortality was 2.2%, with no significant difference between groups (1.7 vs. 2.8%, P = .70). Unhoused patients were predominantly younger males with a higher incidence of substance use disorder and greater likelihood of injuries from assault and pedestrian strikes. Falls and assault with a sharp object were common in both cohorts. Unhoused patients were admitted more often and stayed longer in the hospital. Understanding the complexities of these patients can guide local and regional prevention and treatment measures.
38. Association of systemic inflammatory markers with post-stroke epilepsy after ischemic stroke: A competing risk analysis.
期刊: Seizure 发表日期: 2026-Jan-07 链接: PubMed
摘要
Post-stroke epilepsy (PSE) is a serious long-term complication of ischemic stroke, yet early identification of patients at risk remains challenging. Systemic inflammatory biomarkers may reflect underlying epileptogenic processes. This study explored the association between neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and hemoglobin-to-lymphocyte ratio (HLR) and the subsequent development of PSE in a large, long-term cohort. We retrospectively analyzed 1445 adult patients hospitalized for acute ischemic stroke between 2014 and 2017 at a university-affiliated center. Patients with prior epilepsy were excluded. Blood counts within 2 days of admission were used to calculate NLR, PLR, and HLR. PSE was defined as the occurrence of at least one unprovoked seizure beyond 7 days post-stroke. A competing risk model was used to assess associations, accounting for death as a competing event. Over a median follow-up of nearly 7 years, 43 patients (2.98 %) developed PSE. Median NLR was higher in the PSE group than in the non-PSE group (3.45 vs. 2.94; nominal p = 0.036). In multivariable competing risk analysis, continuous NLR was nominally associated with PSE (subdistribution hazard ratio [SHR] = 1.048, 95 % CI 1.002-1.100; p = 0.040). As an exploratory sensitivity analysis, NLR > 7 was also associated with increased PSE incidence (SHR = 2.20, 95 % CI 1.11-4.35; p = 0.024). PLR and HLR did not show associations with PSE. The PSE group also experienced higher mortality and longer hospital stays. NLR, an inexpensive and readily available inflammatory marker, was nominally associated with the development of PSE after ischemic stroke. These findings are exploratory and hypothesis-generating, supporting further investigation into the role of systemic inflammation in post-stroke epileptogenesis.
39. Turning heterogeneity of statistical epistasis networks to an advantage.
期刊: Briefings in bioinformatics 发表日期: 2026-Jan-07 链接: PubMed
摘要
Epistasis detection is hindered by multiple challenges, including the proliferation of analytic tools and the diverse methodological choices made in Genome-Wide Association Interaction Studies (GWAIS). These factors often produce inconsistent and only partially overlapping results, with individual methods emphasizing distinct aspects of epistasis. Although comparative evaluations of GWAIS approaches exist, they generally do not identify the factors responsible for methodological discrepancies or assess their implications for biomedical research. Consequently, it remains unclear which features of GWAIS strategies contribute most to these differences and which methods are most appropriate for revealing specific genetic architectures. Here, we present a workflow designed to characterize heterogeneity in GWAIS results and derive practical recommendations systematically. First, we assess non-replicability by comparing single nucleotide polymorphisms-pair rankings and Statistical Epistasis Networks (SENs)-graphs in which nodes represent genetic loci and edges denote epistatic interactions-to identify clusters of protocols with similar outcomes. SENs provide a structured framework for visualizing and comparing variation in epistasis detection, enabling prioritization of interactions recurrently identified across methods. Second, we propose strategies to reduce heterogeneity and enhance robustness, with particular emphasis on interpretability. Notably, we demonstrate that differences among SENs can be informative rather than disadvantageous, as they yield complementary perspectives on disease genetics. Finally, we highlight the benefits of informed SEN aggregation, showing how this approach can strengthen the utility of GWAIS for elucidating biological mechanisms relevant to disease prevention, diagnosis, and management.
40. Association between enacted discrimination and high-risk sexual behaviors among men who have sex with men: the mediating role of sexting.
期刊: The journal of sexual medicine 发表日期: 2026-Jan-07 链接: PubMed
摘要
41. BHMnet: Bayesian high-dimensional mediation analysis with network information integration for correlated mediators.
期刊: Briefings in bioinformatics 发表日期: 2026-Jan-07 链接: PubMed
摘要
We consider identifying a small yet meaningful set of active mediators from a high-dimensional pool of potential mediators, commonly derived from “-omics” or imaging data. In these contexts, mediators are often correlated or exist network structures, which present unique opportunities to improve efficacy by using this valuable information. To this aim, we develop a Bayesian method that accommodates both high dimensionality and correlations among the mediators. Our approach flexibly learns the interconnection between the mediators while improving estimation accuracy by incorporating external knowledge about these relationships. Simulation studies demonstrate the effectiveness of the proposed method compared with alternative approaches. The analysis of the environmental toxicity data provides new insights into the intermediate effects of molecular-level traits.
42. Illuminating the Value of Palliative Care in Cancer.
期刊: Annals of internal medicine 发表日期: 2026-Jan 链接: PubMed
摘要
43. Persistence of Effects of Behavioral Interventions on Reducing Overuse of Care in Older Patients After Discontinuation.
期刊: Annals of internal medicine 发表日期: 2026-Jan 链接: PubMed
摘要
44. Pregnancies in Women With Long-Chain Fatty Acid Oxidation Disorders: Results of a European and North American Survey.
期刊: Journal of inherited metabolic disease 发表日期: 2026-Jan 链接: PubMed
摘要
Long-chain fatty acid oxidation disorders (lcFAODs) are genetic disorders of energy metabolism that are associated with a risk of metabolic decompensation, especially during catabolic episodes. With improvement in diagnostics and treatment, more women with lcFAODs now reach child-bearing age. So far, little is known about the risk and outcome of pregnancies, particularly in women with more severe forms of lcFAODs. We performed an international web-based survey among health care professionals involved in the care of individuals with lcFAODs and collected data on 89 pregnancies in 39 women (mild VLCAD deficiency n = 8, severe VLCAD deficiency n = 10, LCHAD deficiency n = 4, CPT2 deficiency n = 14, CPT1 deficiency n = 3). There were 72 live births, 12 spontaneous miscarriages, and one stillbirth at 41 weeks of gestation. Four women were still pregnant at the time of the survey. In 25 women, the diagnosis was known before the first pregnancy, whereas 14 had at least one pregnancy before diagnosis. Most women remained metabolically stable during pregnancy, although 19% of women had at least one metabolic decompensation during pregnancy. Forty-one percent of babies were delivered by spontaneous vaginal delivery, 33% after induced labor, and 19% by an elective Caesarean section. Most deliveries were uncomplicated, with preventive i.v. glucose infusions given in 50%. However, 21% of mothers developed a metabolic decompensation in the postpartum period. No maternal deaths were reported. In conclusion, our data show that the outcome of pregnancies in lcFAOD patients is generally favorable, despite a significant risk of metabolic decompensation during the postpartum period.
45. The Roles of Transformational Leadership in Nurses' Retention and the Quality of Nursing Care: A Cross-Sectional Study.
期刊: SAGE open nursing 发表日期: 2026 链接: PubMed
摘要
Nurses are central to healthcare delivery, and their retention is a key factor associated with the quality of nursing care (QONC). Leadership style is considered one of the organizational factors related to nurses’ work outcomes. This study aimed to examine the associations between perceived nurse leaders’ transformational leadership style, nurses’ retention, and perceived QONC, as well as their relationships with selected demographic and professional characteristics among registered nurses working in selected hospitals in Jordan. A cross-sectional design was used in accordance with the Strengthening the Reporting of Observational Studies in Epidemiology (2014) guidelines. Data were collected using the Global Transformational Leadership Scale, the Revised Casey-Fink Nurse Retention Survey, and the QONC questionnaire. Nurses reported moderate perceived levels of transformational leadership (Mean = 3.26 ± 0.054). The perceived level of nurse retention was satisfactory (Mean = 2.90 ± 0.026), while the perceived QONV ranged from moderate (Mean = 2.10 ± 0.044) to high (Mean = 1.48 ± 0.035). A strong, positive, and statistically significant association was found between perceived transformational leadership and nurses’ retention (r = 0.527, p < 0.01). Nurses with 16 years or more of experience in their current department reported significantly higher perceptions of transformational leadership than those with fewer years of experience (F = 2.46, df = 4, p = 0.045). The findings demonstrate significant associations between perceived transformational leadership, nurse retention, and perceived QONC. These results suggest that transformational leadership is an important organizational factor related to nurses’ work perceptions and outcomes. Healthcare administrators and policymakers may consider emphasizing transformational leadership principles within leadership development and professional training programs and fostering supportive work environments aligned with these principles.
46. The Clinical Effect of Combined Needle-Embedding Therapy for Patients with Lifestyle-Related Dry Eye Disease.
期刊: Journal of visualized experiments : JoVE 发表日期: 2025-Dec-30 链接: PubMed
摘要
Dry eye disease (DED) is a multifactorial, chronic ocular surface disorder with a rising global prevalence. It has become an important public health concern that requires appropriate management and prevention. However, standardized and effective treatments for DED remain limited. This study introduces a combined approach using needle-embedding therapy and conventional nursing care as a novel intervention for patients with DED. Patients received traditional treatments, including warm compresses, eyelid massage, and artificial tear therapy, followed by the insertion of disposable sterile thumbtack needles into six predefined acupoints. Each needle was left in place for 24 h before removal. Tear meniscus height and tear film breakup time were recorded in real time during treatment. This article describes the standard operating procedure and clinical outcomes of the combined needle-embedding therapy in patients with lifestyle-related DED, aiming to evaluate its feasibility and therapeutic efficacy. According to the statistical results, this combined therapy alleviated DED symptoms, promoted ocular surface recovery, and enhanced patient comfort and quality of life.
47. Establishment of a Modified Ferric Chloride-Induced Superior Sagittal Sinus Thrombosis.
期刊: Journal of visualized experiments : JoVE 发表日期: 2025-Dec-30 链接: PubMed
摘要
Cerebral venous thrombosis (CVT) is a rare but potentially life-threatening neurological disorder. Animal models offer critical platforms for investigating their pathophysiology and evaluating potential therapies. In this study, we present a modified rat model of superior sagittal sinus (SSS) thrombosis using a FeCl₃-soaked suture technique. Male Sprague-Dawley rats (220-250 g) underwent a paramedian scalp incision and creation of a 1 cm cranial bone window over the SSS. Compared to the traditional midline incision, this approach prevents adhesion among the incised skin, the bone window, and the underlying dura mater. Additionally, it avoids the interference caused by suture knots located over the SSS, thereby improving the quality of ultrasound imaging. A 2-0 silk suture soaked in 40% FeCl3 was applied directly onto the exposed sinus for two consecutive 5-min intervals. Compared to the traditional FeCl3-filter paper method, this technique minimizes direct chemical injury to the parasagittal cortex. Laser speckle contrast imaging was employed to assess cerebral venous perfusion before and after FeCl3 application. A significant reduction in blood flow confirmed successful thrombosis. Seven days post-surgery, thrombus formation and hemodynamic changes were evaluated via high-resolution ultrasound and analyzed using Vevo LAB software, which provided volumetric and hemodynamic data of the thrombus. This modified model offers a reproducible, minimally invasive, and imaging-compatible approach for preclinical CVT research.
48. Qingzao Jiufei Decoction in the Regulation of TGF-β/Smad Signaling in Idiopathic Pulmonary Fibrosis.
期刊: Journal of visualized experiments : JoVE 发表日期: 2025-Dec-30 链接: PubMed
摘要
This study aimed to investigate the therapeutic effects of Qingzao Jiufei Decoction (QJD) on idiopathic pulmonary fibrosis (IPF) and its regulatory mechanism involving the TGF-β/Smad signaling pathway. Rats were divided into six groups: control, model, pifenidone (PFD), QJD Low Dose (QJD-L), QJD Medium Dose (QJD-M), and QJD High Dose (QJD-H). IPF was induced using bleomycin. Histopathological and ultrastructural changes in the lung tissue were analyzed. Levels of α-smooth muscle actin (α-SMA), collagen I (COL-1), fibronectin (FN1), TGF-β1, Smad2/3, and p-Smad2/3 proteins were measured. A TGF-β1-induced HFL-1 cell model was used to investigate the effects of QJD on the expression of α-SMA, COL-1, and FN1. Additionally, the TGF-β1 signaling agonist SRI-011381 was used to further determine the role of the TGF-β/Smad signaling pathway. Results: In vivo, compared with the control group, rats in the model group showed significantly reduced dietary and water intake, along with an increased lung coefficient. Lung tissue showed infiltration of inflammatory cells, thickening of alveolar walls, and marked signs of fibrosis. Additionally, edematous alveolar type II epithelial cells with severe fibrosis were observed, characterized by swollen and deformed intracellular organelle structures and a reduced number of rough endoplasmic reticulum. Levels of α-SMA, COL-1, FN1, TGF-β1, and p-Smad2/3 were significantly elevated. Treatment with QJD or PFD markedly alleviated BLM-induced symptoms. In vitro, whereas TGF-β1 induction significantly upregulated the expression of FN1, COL-1, and α-SMA, these effects were significantly attenuated by QJD treatment. Activation of the TGF-β/Smad signaling pathway with the TGF-β1 agonist SRI-011381 increased FN1, COL-1, and α-SMA expression and aggravated pulmonary fibrosis. However, QJD reversed the fibrotic effects induced by SRI-011381, suggesting that QJD ameliorates pulmonary fibrosis by inhibiting TGF-β/Smad signaling pathway. The findings of this study suggest that QJD attenuates and reverses the progression of pulmonary fibrosis by modulating the TGF-β/Smad signaling pathway.
49. Serial Killing Assay Using Longitudinal Impedance-Based Tumor Cell Viability Measurement - A Useful Method to Assess T Cell Performance.
期刊: Journal of visualized experiments : JoVE 发表日期: 2025-Dec-30 链接: PubMed
摘要
Chimeric antigen receptor (CAR) cell therapy has revolutionized the treatment of specific hematologic malignancies. However, a significant portion of patients experience relapse because of antigen loss, antigen downregulation, or T cell exhaustion. These challenges highlight the need for functional assays that can evaluate the killing capacity and persistence of CAR T cells under chronic antigen stimulation. Serial killing assays, which measure the ability of CAR T cells to repeatedly eliminate tumor targets, offer valuable insights into the durability and potency of CAR T cell responses. Here, we present an impedance-based assay using the Real-Time Cell Analysis (RTCA) system to quantify CAR T cell-mediated serial killing in vitro. Tumor cells are repeatedly seeded and allowed to adhere to assay-specific E-plates before the addition of CAR T cells at defined effector-to-target (E:T) ratios. The platform continuously monitors tumor cell viability without labels, capturing dynamic cytotoxicity with high temporal resolution. Core readouts include Cell Index (CI) kinetics, tumor-cell killing rate, and time-to-target clearance. The progressive decline in killing capacity observed upon repeated tumor-target engagements serves as a marker of acquired CAR T cell dysfunction, often termed T cell exhaustion. Together, these metrics allow precise evaluation of CAR T cell function at various E:T ratios and enable direct comparison among different CAR T cell constructs or co-treatments over time. To enhance cost efficiency, we developed a plate-washing procedure that enables the reuse of assay E-plates without compromising assay performance or data integrity. The optimized workflow reduces assay cost while preserving analytical robustness. This approach enables affordable and scalable preclinical assessment of CAR T cell function, facilitating improvements in cell-therapy design.
50. Emergency Department Presentations of West Nile Virus.
期刊: The western journal of emergency medicine 发表日期: 2025-Dec-24 链接: PubMed
摘要
Maricopa County, Arizona, experienced its largest West Nile virus outbreak in 2021, with 1,487 cases and 101 deaths, in the midst of the COVID-19 pandemic. We sought to describe initial presentations of emergency department (ED) patients ultimately diagnosed with West Nile virus and determine how often patients presented to the ED before their diagnosis. To assist with disease recognition during future outbreaks, we examined in detail cases where emergency physicians initially did not suspect West Nile virus. We reviewed records from May-December 2021 for patients with a positive West Nile virus result and at least one ED visit within 15 days. Data included age, sex, race, Emergency Severity Index (ESI) score, number of ED visits, chief complaint, vital signs, blood or cerebrospinal fluid (CSF) testing, diagnosis, and disposition. We excluded cases with only immoglobulin G-positive results or outpatient tests, leaving 147 cases. Among 147 ED West Nile virus cases, the median patient age was 67 years, with patients being predominantly male (66.7%) and White (97.3%). The most common presenting chief complaints included fever (23.8%), headache (17.7%), and generalized weakness (11.6%). Emergency physicians initiated testing for the virus in 63 cases (42.9%). Patients dispositioned (n = 84, either discharged or admitted) from the ED without initiation of testing tended to be older (median 73 vs 62 years, P < .001), with higher triage respiratory rate (mean 19.4 vs 18.3 breaths per minute, P = .05) and lower triage oxygen saturation (median 96% vs 97%; P =.02). Emergency physicians predominantly performed CSF testing (n = 42 patients) over serum testing (n = 21 patients). Patients tested via CSF had lower ESI scores than those tested via serum (ESI score of 1-2 45.3% vs 14.3%, P = .03). Emergency physicians did not initiate testing in 57.1% of initial ED encounters of patients ultimately found to have West Nile virus. During West Nile virus outbreaks, emergency physicians should stay vigilant for less acute presentations, such as generalized weakness in elderly patients, along with typical presentations including fever and headache, to avoid delayed diagnosis.
51. Seven Steps for Emergency Physicians to Dismantle Access Barriers and Build Equitable Care Systems.
期刊: The western journal of emergency medicine 发表日期: 2025-Dec-23 链接: PubMed
摘要
52. Women with Suicidal Ideation, Substance Use Disorder, or Intimate Partner Violence in the Emergency Department: Retrospective Analysis of Contraceptive Documentation.
期刊: The western journal of emergency medicine 发表日期: 2025-Dec-23 链接: PubMed
摘要
Prior research demonstrates that emergency department (ED) patients with suicidal ideation (SI), substance use (SUD), and/or intimate partner violence (IPV) have disproportionate adverse outcomes for both women and infants. The 2013 Hague Protocol suggested that children with caregivers with the above characteristics are also more likely to suffer from child maltreatment. Of all pregnancies in this group, as many as 90% are unintended. We hypothesized that women with SI/SUD/IPV have gaps in care access, high levels of unscheduled care use, and reduced ED contraceptive inquiry, which if addressed could potentially improve outcomes. We conducted a chart review of 62,284 ED visits from 2018-2021 from a suburban four-hospital system in the Southern United States. We compared women of reproductive age (15-44) with SI/SUD/IPV (4,776) against controls (57,508). The exposures were defined as women with SI, SUD, and/or IPV. We analyzed results using the chi-square test (χ2) with Bonferroni adjustment to test for independence and logistic regression. Women suffering from SI/SUD/IPV who present to the ED have contraceptive status less frequently documented compared to controls without these factors (39.5 vs 51.7%, RR 0.77, CI, 0.74-0.79, P < .001). They also have reduced access to care, with higher rates of uninsurance (32.7 vs 26.1%, P < .001), more care in the acute care environment, longer ED length of stay (LOS) (mean was 10.38 vs 3.87 hours, P < .001), higher hospitalization rates (61.0 vs 8.7%, P < .001), and higher 30-day ED revisits (11.8 vs 8.8%, P < .001), even after adjusting for the Social Vulnerability Index, acuity, age, and obesity (adjusted odds ratio 1.52 95% CI 1.36-1.70 P < .001). Despite significant morbidity coupled with reduced access to ambulatory care and disproportionately increased ED use, little ED contraceptive documentation exists. This practice contributes to inequity, given the increased number of unintended pregnancies and greater need of contraceptives in women with suicidal ideation/substance use disorder/intimate partner violence.
53. Case Study and Qualitative Analysis of Emergency Department Community Advisory Council on Intimate Partner Violence.
期刊: The western journal of emergency medicine 发表日期: 2025-Dec-23 链接: PubMed
摘要
As part of a quality improvement initiative, our emergency department (ED) implemented a community advisory council consisting of leaders from five community-based organizations (CBO) that provide services for survivors of intimate partner violence. We used qualitative interviews with participants from the organizations to evaluate the council by identifying factors that promoted and hindered their engagement in this partnership between the community and the ED as well as best practices for future collaborations METHODS: We conducted five, 30-minute semi-structured interviews, one for each CBO representative on the council. Interview questions were based on validated toolkits for evaluating community-based participatory research. We conducted thematic analysis using a barriers and facilitators framework. Our focus on building relationships within the community advisory council facilitated collaboration between the ED and the CBOs. We identified structural barriers to and facilitators of the relationship-building process, as well as four behaviors that promoted relationship-building within the council. These behaviors included a joint problem-solving orientation, a culture of curiosity, shared empathy between emergency clinicians and CBO members, and a deeper understanding of barriers to caring for survivors of intimate partner violence in the ED. Themes regarding the impact of the council included the results of tangible projects as well as cultural shifts in the ED as perceived by leaders of the CBOs. We share a case study of a collaboration between the ED and community-based organizations that illustrates barriers to and facilitators of engagement by leaders of these organizations in community-healthcare partnerships. The ED is a short but meaningful stop in recovery for many survivors, and a warm handoff to a CBO can be an essential next step in their care. When rooted in mutually respectful, trusting relationships, ED-CBO partnerships have the potential to enable survivor-centered, quality improvement efforts that work to improve the continuum of care between the ED and the community.
54. Association of Shock Index and Variants with Mortality in Acute Pulmonary Embolism.
期刊: The western journal of emergency medicine 发表日期: 2025-Dec-23 链接: PubMed
摘要
Pulmonary embolism (PE) is common with potential for morbidity and mortality. Several PE risk-stratification tools exist; however, more granular and patient-specific indicators of potential decompensation or short-term mortality that can be easily obtained are needed for the bedside clinician to further sub-stratify risk and inform management decisions. We sought to determine the association of early emergency department (ED) measurement of the shock index (SI) and SI variants (modified SI, SI to peripheral oxygen saturation ratio, age-adjusted SI, respiratory-adjusted SI, and double product) and mortality among patients with acute PE. This was an observational case-control study of adult patients who presented to the ED at a single health system (January 2021-April 2023) and had PE response team (PERT) activation for newly diagnosed acute PE. We evaluated the association of 30-day in-hospital mortality with the SI (heart rate/systolic blood pressure) and variants of the SI-modified SI = heart rate/mean arterial pressure; SI to peripheral oxygen saturation ratio = SI/peripheral oxygen saturation; age-adjusted SI = age x SI; respiratory-adjusted SI = SI x (respiratory rate/10); double product = systolic blood pressure x heart rate-in addition to the Simplified Pulmonary Embolism Severity Index (sPESI) and European Society of Cardiology (ESC) risk schema. We used the area under the receiver operating characteristic curve (AUC) to assess discriminatory efficiency of the SI and each variant with the primary outcome. Multivariable logistic regression measured the association between SI and variants with 30-day mortality. Of 121 patients included in the study, 12 (9.9%) died. The SI and variants were all significantly different between survivors and non-survivors (P < .05), while the sPESI was not different (P = .30). The age-adjusted SI had the highest discriminatory efficiency for mortality (AUC 0.82; 95% CI, 0.71-0.93), followed by the SI (AUC 0.78; 0.67-0.89), the SI/peripheral oxygen saturation (AUC 0.77; 0.65-0.90), double product (AUC 0.76; 0.61-0.91), modified SI (AUC 0.75; 0.61-0.90), ESC risk schema (AUC 0.71; 0.52-0.90), and the respiratory-adjusted SI (AUC 0.70; 0.54-0.87). Among patients presenting to the ED who had a PERT activation for acute PE, the age-adjusted SI had the highest discriminatory efficiency for mortality, followed by the SI and its other variants. Further investigation regarding use of the age-adjusted SI for prognostication of acute PE and implications on PE management is warranted.
55. Mapping Five Years of #FOAMed: Trends, Engagement, and Shifting Topics on Twitter/X.
期刊: The western journal of emergency medicine 发表日期: 2025-Dec-19 链接: PubMed
摘要
Free Open Access Medical Education (FOAMed) has emerged as a prominent component of online medical communication, with X (formerly Twitter) serving as an active hub for professional exchange among clinicians. Despite its reach and influence, few longitudinal studies have examined how FOAMed content and engagement patterns evolve over time. In this study we aimed to analyze thematic shifts and user interaction trends in #FOAMed tweets over a five-year period. We conducted a retrospective bibliometric and natural language processing (NLP) study of 6,000 high-engagement, English-language tweets tagged with #FOAMed, posted between January 1, 2020-December 31, 2024. Each month, the 100 tweets were selected from Twitter’s “Top” tab and manually curated. We used latent Dirichlet allocation (LDA) to identify thematic clusters. Hashtag usage and engagement metrics were assessed using descriptive statistics and linear regression. We identified 10 distinct topics were identified through LDA modeling: point-of-care ultrasound (POCUS) education; neuro-radiology, cardiology-electrocardiogram (ECG); nephrology; and intensive care unit; ultrasound; prehospital/policy; webinars and learning; resuscitation scenarios; pediatric imaging; medical student education; and critical care and publications. Topic prevalence shifted over time: Early tweets focused on COVID-19 and critical care, while later years showed increasing attention to prehospital care, diagnostics, and POCUS. Mean tweet engagement peaked in 2023 (236.9 ± 914.6). Notably, hashtags such as #POCUS and #MedEd showed substantial increases in both usage and engagement, with #MedEd reaching a peak mean engagement of 287.7. In contrast, COVID-19 declined steadily, both in frequency (from 126 tweets in 2020 to just six in 2023) and in engagement (mean: 67.1 → 18.5). Spearman correlation analysis revealed that hashtag count had a weak but statistically significant correlation with engagement (ρ = 0.047, P < .001), suggesting that content quality, rather than volume, was the primary driver of visibility. FOAMed discourse on Twitter/X remains dynamic, responsive to clinical priorities and shaped by peer interaction. Natural language processing and topic modeling are valuable tools to uncover longitudinal trends in digital medical education, reinforcing Twitter/X’s role in informal, real-time learning communities.
56. Assessment of Mental Health in Healthcare Workers Involved in Care of Victims of the 2017 Las Vegas Mass Shooting.
期刊: The western journal of emergency medicine 发表日期: 2025-Dec-19 链接: PubMed
摘要
Mass shooting incidents (MSI) are single events injuring four or more victims, and they occur in the United States on average every 12.5 days. Studies have examined the psychological impact of MSIs on witnesses and surviving victims. However, the mental health of healthcare workers involved in the care of MSI victims requires further examination. We explored the association between work-related stress and symptoms of depression, anxiety, and post-traumatic stress disorder (PTSD) in healthcare workers involved in the 2017 Las Vegas mass shooting. Surveys were distributed to 170 healthcare workers involved in the care of victims of the largest MSI in US history, the 2017 Las Vegas Route 91 Harvest Festival (58 people killed, 413 wounded bv gunshot or shrapnel). Fifty healthcare workers (29.4% response rate; 68% female), 29-71 years of age, responded to demographic questions followed by the Beck Anxiety Inventory, Beck Depression Inventory-II (BDI-II), Patient Health Questionnaire-9 (PHQ-9), PTSD Checklist for the Diagnostic and Statistical Manual of Mental Disorders, 5th Ed, and the Health & Safety Executive Management Standards Indicator Tool, between October 15, 2022-March 15, 2023. Results showed that work-related stress was significantly associated with symptoms of depression (BDI-II: P < .001, 22.9% variance; PHQ-9: P < .05, 20.5% variance) and PTSD (P < .001, 26.8% variance). No significant differences in symptom severity (work-related stress, anxiety, depression, and PTSD) were found between participants involved in critical care and non-critical care (P > .05). In addition, healthcare workers reported higher symptoms of depression (5.18 vs 2.91, P < .001), and lower symptoms of anxiety (8.84 vs 22.35, P < .05) than normative data of the general population. Healthcare workers reporting a higher risk of work-related stress were more likely to report more symptoms of depression and PTSD. Healthcare workers involved in critical and non-critical care reported similar symptoms of anxiety, depression, PTSD, and work-related stress. Moreover, healthcare workers involved in the care of the Las Vegas mass shooting victims were more likely to report more symptoms of depression and fewer symptoms of anxiety than samples of the general population. Given the novelty of this study, the unpredictability of MSIs, and the current limitations, we offer recommendations for future studies.
57. Women's and healthcare providers' experiences of contraceptive counselling: a qualitative systematic review.
期刊: Sexual & reproductive healthcare : official journal of the Swedish Association of Midwives 发表日期: 2025-Dec-05 链接: PubMed
摘要
Persistent inequalities shape women’s access to and experiences of contraceptive care. Improving care quality requires a clearer understanding of women-provider interactions. This study aimed to synthesise women’s and healthcare providers’ experiences of contraceptive counselling. This qualitative systematic review with inductive thematic synthesis followed the JBI methodology. Eligible studies in English, Portuguese, or Spanish published from database inception to 16 June 2025 were identified in CINAHL Ultimate, MedicLatina, MEDLINE Ultimate, the Psychology and Behavioral Sciences Collection, and Scopus. An initial limited search, development of search terms, and comprehensive database searches were undertaken; the PRISMA flow diagram summarised study selection. Two reviewers independently appraised quality using the JBI Critical Appraisal Checklist for Qualitative Research, and extracted data on study objectives, design, setting, participants, and main themes using a standardised form. Nine studies met the inclusion criteria. Six explored women’s experiences, two examined healthcare providers’ experiences, and one addressed both. Three overarching themes emerged: Contraceptive Engagement, Woman-Provider Relationship, and Decision-Making Process. Women and healthcare providers identified economic constraints, religious beliefs, and information gaps as common obstacles to contraceptive engagement. Healthcare providers emphasised woman-centred care, aligning with women’s preference for non-judgemental, proactive, and respectful counselling. The decision-making process was the most prominent theme, with informed and respected decisions serving as central facilitators. High-quality counselling requires recognising women’s needs and adopting empowerment strategies. Integrating these insights into services and expanding counselling delivered by trained healthcare providers are essential to improve access and quality. Further research should inform education and training programmes.
58. Planetary-health literacy and mental wellbeing in Czech adolescents: insights from the HBSC survey 2022.
期刊: Central European journal of public health 发表日期: 2025-Dec 链接: PubMed
摘要
Planetary-health literacy (PHL), the knowledge, motivation and social support required to safeguard both human and environmental health, may help adolescents cope with climate-related distress and adopt sustainable behaviours. Evidence on the linkage between PHL and mental health from Central and Eastern Europe is lacking. The aim of the study was to describe PHL in Czech adolescents by sex, grade and family affluence, examine its association with mental-health indicators, and explore links with selected environment-relevant behaviours. Cross-sectional data were drawn from the nationally representative Health Behaviour in School-aged Children (HBSC) 2022 survey (n = 4,195, 50.8% boys, ages 13 and 15 years). PHL was measured with an 11-item HBSC optional package yielding three sub-scales (knowledge, action, perceived pro-environmental social norms). Outcomes were wellbeing (WHO-5), life satisfaction (Cantril’s ladder), and psychological complaints (HBSC symptom checklist). Fruit and vegetable intake plus cigarette and e-cigarette use served as behavioural correlates. Girls scored higher than boys on all PHL domains (Cohen d = 0.10-0.19). Thirteen-year-olds reported more action and stronger social norms than fifteen-year-olds (p < 0.001); socioeconomic gradients were small. In fully adjusted models, social norms were positively associated with wellbeing (β = 1.42, 95% CI: 1.12-1.72) and life satisfaction (β = 0.10, 0.08-0.13), and inversely with psychological complaints (β = -0.27, -0.33 to -0.21). Knowledge showed weak adverse relations with wellbeing and complaints, whereas action was associated with wellbeing only. Higher PHL related to daily fruit and vegetable consumption and inversely to intensive e-cigarette use; effect sizes were modest. Perceived pro-environmental social norms appear most tightly related to adolescent mental health, while overall PHL is slightly associated with sustainable dietary patterns and lower use of e-cigarettes. School curricula that combine climate education with collaborative, action-oriented projects may therefore deliver co-benefits for planetary and psychological health in Central and Eastern Europe.
59. Protocol and Statistical Analysis Plan for the Vasopressin for Septic Shock Pragmatic (VASSPR) Cluster-Crossover Randomized Trial.
期刊: CHEST critical care 发表日期: 2025-Dec 链接: PubMed
摘要
Guidelines recommend vasopressin as the preferred second-line vasopressor for treatment of septic shock. However, the optimal threshold for vasopressin initiation is unclear. Does a treatment strategy using a lower or a higher threshold for initiation of vasopressin as a secondary vasopressor decrease the incidence of 28-day mortality for patients with septic shock? The Vasopressin for Septic Shock Pragmatic (VASSPR) trial is a multicenter, open-label, cluster-randomized, multiple cluster-crossover pragmatic clinical trial being conducted in 13 hospitals in Utah and Idaho. The trial compares a strategy for septic shock management recommending initiation of fixed-dose vasopressin as a secondary vasopressor at a lower threshold (when the total dose of other vasopressors reaches 0.1 mg/kg/min norepinephrine equivalents [NEEs]) to a strategy initiating vasopressin at a higher threshold (when other vasopressors reach 0.4 mg/kg/min NEEs). All adult patients with septic shock at study hospitals are enrolled in the trial and assigned to the treatment strategy in place at the study hospital when and where they start vasopressor treatment for suspected or confirmed septic shock. Individual patient care, including adherence to the assigned vasopressin initiation strategy, occurs at the discretion of each patient’s treating clinicians. The primary outcome is 28-day all-cause mortality. The key secondary outcome is renal replacement therapy-free days to day 28. This article describes the protocol and statistical analysis plan for the conduct and analysis of the VASSPR trial. The VASSPR trial will provide important data to guide vasopressor management for patients with septic shock. Prespecification of the trial protocol and statistical analysis plan before completion of enrollment is important for rigorous trial conduct and reporting. ClinicalTrials.gov; No.: NCT06217562; URL: www.clinicaltrials.gov.
60. Functionality and protection of personal data when using Ukrainian-language mHealth apps.
期刊: Polski merkuriusz lekarski : organ Polskiego Towarzystwa Lekarskiego 发表日期: 2025 链接: PubMed
摘要
Aim: to assess the functionality of mHealth apps with a Ukrainian interface and their compliance with personal data processing requirements. Matherials and Methods: we employed methods such as Overview, Data Retrieval and Analysis. The study is also based on overviewing and analyzing data of 40 mHealth apps. Results: a study of 40 Ukrainian-language mHealth apps was conducted: 27.5% work only on Android, 72.5% on Android and iOS. There were identified 24 functions, among which the most common are arranging an appointment with a doctor (in 17 apps), online doctor consultation (in 12 apps), searching and reserving medicines (in 12 apps). Only 20 apps have a privacy policy, but most do not provide sufficient details on data processing. Only 9 apps have requirements for user data deletion, and 12 have mechanisms for withdrawing consent to data processing. Conclusions: as a result of the study, there were detected risks for users of mHealth apps due to insufficient transparency of privacy policies, the lack of precise mechanisms for transferring personal data to third parties, withdrawal of personal data processing consent, and data deletion requirements.