公共卫生研究摘要 (2026-01-21)
共收录 58 篇研究文章
1. Vaccine expression systems and maternal/neonatal factors: Impacts on hepatitis B immunization efficacy in preterm infants.
期刊: Human vaccines & immunotherapeutics 发表日期: 2026-Dec 链接: PubMed
摘要
The global rise in preterm infants presents specific challenges for hepatitis B prevention. Although hepatitis B vaccination is recommended, detailed understanding of immunogenicity patterns and influencing factors requires further investigation. We analyzed 699 preterm infants completing the hepatitis B vaccination series to assess immunogenicity via geometric mean concentration (GMC) and seroprotection rate (SPR). The regimen was highly immunogenic, with an overall SPR of 99.43% (GMC: 986.36 mIU/mL) and 95.28% of infants achieving high-level protection (anti-HBs ≥100 mIU/mL). Though SPR was consistently high across subgroups, notable GMC variations emerged: infants with gestational age <28 weeks markedly higher GMC (3,735.59 mIU/mL) than more mature subgroups. Statistically significant GMC differences were noted between immunization protocols, with uniform schedules yielding higher values (1,281.26 mIU/mL) than mixed approaches (691.91 mIU/mL; P < .001). Preterm infants of HBsAg-positive mothers maintained a high SPR (96.55%) despite a lower GMC (572.18 mIU/mL). This study confirms that hepatitis B vaccination induces a robust immune response at 1 to 2 months post-vaccination in preterm infants. Observed variations in antibody response magnitude related to vaccine expression system may inform optimization of initial vaccination strategies for preterm populations.
2. Response to Comment on Yuan et al. Associations of Concurrent Hypertension and Type 2 Diabetes With Mortality Outcomes: A Prospective Study of U.S. Adults. Diabetes Care 48:1241-1250.
期刊: Diabetes care 发表日期: 2026-Feb-01 链接: PubMed
摘要
3. "Community Voices": Something New in Diabetes Care.
期刊: Diabetes care 发表日期: 2026-Feb-01 链接: PubMed
摘要
4. Medication Adherence in the Glycemia Reduction Approaches in Diabetes: A Comparative Effectiveness Study (GRADE).
期刊: Diabetes care 发表日期: 2026-Feb-01 链接: PubMed
摘要
To address previous inconsistencies in reports of differential adherence to diabetes medications, we examined medication adherence and evaluated treatment group differences in a substudy of participants in the Glycemia Reduction Approaches in Diabetes: A Comparative Effectiveness Study (GRADE). GRADE participants (type 2 diabetes duration <10 years, HbA1c 6.8%-8.5%, on metformin alone) were randomly assigned to add insulin glargine, glimepiride, liraglutide, or sitagliptin. Adherence was measured semiannually for 3 years using a validated three-item scale (0-100, lowest to highest adherence) in a substudy (N = 1,739). Analyses included evaluation of adherence over time and testing treatment group differences in adherence and in the association between adherence and primary (HbA1c ≥7.0%) and secondary (HbA1c >7.5%) glycemic outcomes. Overall mean ± SD adherence (average of participant-level mean ± SD) was high over 3 years of follow-up at 88.7 ± 10.01, on a scale of 0-100, and decreased slightly by 3 years relative to baseline (-2.0 ± 14.7; P < 0.0001). No intergroup differences were observed until 3 years, when adherence was 5% and 3% higher for the glimepiride and sitagliptin groups, respectively, than for liraglutide (both P < 0.05). Over follow-up and across groups, a 10-point decrease in adherence was associated with 15% and 19% increased risk of reaching primary (HbA1c ≥7.0%) and secondary (HbA1c >7.5%) glycemic outcomes (both P < 0.0001). Lower adherence was somewhat more predictive of the secondary outcome for those assigned to glargine or liraglutide, compared with glimepiride or sitagliptin (each P < 0.05). No other comparisons were significant. Medication adherence was consistently high in GRADE. Observed treatment group differences were small and of unclear clinical significance. Overall, lower adherence robustly predicted worsening glycemic control, highlighting the importance of ongoing assessment.
5. Comment on Yuan et al. Associations of Concurrent Hypertension and Type 2 Diabetes With Mortality Outcomes: A Prospective Study of U.S. Adults: Diabetes Care 2025;48:1241-1250.
期刊: Diabetes care 发表日期: 2026-Feb-01 链接: PubMed
摘要
6. Sleep loss induces cholesterol-associated myelin dysfunction.
期刊: Proceedings of the National Academy of Sciences of the United States of America 发表日期: 2026-Jan-27 链接: PubMed
摘要
The increasing prevalence of sleep deprivation poses a public health challenge in modern society. Manifestations of reduced alertness, such as slowed reaction times and increased errors, are well-documented behavioral indicators of sleep loss (SL). Yet, the biological consequences of sleep deprivation and their role in behavioral impairment remain elusive. Our study reveals significant effects of sleep deprivation on myelin integrity. As a result, we identify increased conduction delays in nerve signal propagation, hindered interhemispheric synchronization, and impaired cognitive and motor performance associated with SL. By profiling oligodendrocyte transcriptome and lipidome, we observe SL-induced endoplasmic reticulum stress and lipid metabolism dysregulation, particularly affecting cholesterol homeostasis. Boosting cholesterol transport to myelin sheaths prevents SL effects on nerve signal propagation and behavior. Our findings highlight a possible role of oligodendrocyte cholesterol dysregulation in behavioral deficits associated with SL and unveil a novel target for intervention.
7. Real-time spatiotemporal tracking of infectious outbreaks in confined environments with a host-pathogen agent-based system.
期刊: Proceedings of the National Academy of Sciences of the United States of America 发表日期: 2026-Jan-27 链接: PubMed
摘要
Deadly infection outbreaks in confined spaces, whether it is a COVID-19 outbreak on a cruise ship or measles and stomach flu outbreaks in schools, can be characterized by their rapid spread due to the abundance of common spaces, shared airways, and high population density. Preventing future outbreaks and developing efficient mitigation protocols can benefit from advanced computational modeling approaches. Here, we developed an agent-based modeling approach to study the spatiotemporal dynamics of an infection outbreak in a confined environment caused by a specific pathogen, and to determine effective containment protocols. The approach integrates the 3D geographic information system of a confined environment, behavior of the hosts, key biological parameters about the pathogen obtained from the experimental data, and the general mechanics of host-pathogen and pathogen-fomite interactions. To assess our approach, we applied it to the historical data of infectious outbreaks caused by norovirus, H1N1 influenza A, and SARS-CoV-2 viruses. Our AI-GIS Infection Dynamics (AGID) model accurately predicted daily infection numbers, correctly identified the day when the CDC vessel sanitation protocol would be triggered, singled out key biological parameters affecting the infection spread, and propose pathogen-specific changes to existing containment protocols. Our work advances the understanding of infection spread on cruise ships while offering insights applicable to other similar confined settings, such as nursing homes, schools, and hospitals. By providing a robust framework for real-time outbreak modeling, this study proposes more effective containment protocols and enhances our preparedness for managing infectious diseases and emerging pathogens in confined environments.
8. Posttraumatic Growth in Adolescents With Mood Disorders and Non-Suicidal Self-Injury: A Qualitative Study.
期刊: Journal of psychosocial nursing and mental health services 发表日期: 2026-Jan-23 链接: PubMed
摘要
To investigate the posttraumatic growth (PTG) process of adolescents with mood disorders and non-suicidal self-injury (NSSI) to inform precision nursing interventions. Four rounds of semi-structured interviews were conducted with 12 adolescents diagnosed with mood disorders and NSSI at a tertiary psychiatric hospital from June 2024 to February 2025. Data were analyzed via constructivist grounded theory. Four sequential PTG stages emerged: (1) conflict and release; (2) de-construction and reconstruction; (3) activation and validation; and (4) growth and transformation. As PTG progresses dynamically and nonlinearly, nurses should track stage-dependent changes and provide phase-specific guidance to support cognitive reorganization and personal growth.
9. Vasectomy and the Risk of Prostate Cancer.
期刊: The Journal of urology 发表日期: 2026-Jan-20 链接: PubMed
摘要
10. Prenatal Exposure to Wildfire and Autism in Children.
期刊: Environmental science & technology 发表日期: 2026-Jan-20 链接: PubMed
摘要
Chronic health effects of wildfire PM2.5 on neurodevelopmental outcomes are largely unknown. Therefore, the effects of wildfire PM2.5 on autism were assessed in a southern California-based pregnancy cohort using Cox proportional hazard models. Exposure was estimated from 2006 to 2014 at maternal addresses across pregnancy and individual trimesters using three metrics: (1) mean wildfire PM2.5 concentration, (2) number of days of smoke exposure, and (3) number of waves of smoke exposure. Analysis was restricted to days over specific PM2.5 concentration thresholds (3 and 5 μg/m3). Nonmovers during pregnancy (75% of cohort) were assessed in sensitivity analyses. There were 3356 autism diagnoses by age 5. Autism risk was associated with increased number of wildfire-exposed days during the third trimester and was strongest for nonmovers. Nonmover hazard ratios (HR) with exposure to 1-5, 6-10, and >10 wildfire days in the third trimester (compared to none) were 1.108 (95% CI: 1.010,1.215), 1.118 (0.957,1.307), and 1.225 (1.043,1.440), respectively. HR per wildfire wave increase (>3 μg/m3 for 2 consecutive days) during the third trimester were 1.073 (1.009,1.140) and 1.267 (1.054,1.205) for the entire cohort and nonmovers, respectively. There was no association with the mean wildfire PM2.5 concentration alone. Prenatal exposure to wildfire smoke may increase risk of autism among children.
11. Persistent Frequent Emergency Department Use Before and During the COVID-19 Pandemic: A Longitudinal Study of One Million Users.
期刊: Medical care 发表日期: 2026-Jan-20 链接: PubMed
摘要
To examine changes in persistent emergency department (ED) use by adult frequent ED (FED) users over time comparing prepandemic versus peripandemic periods, and to identify distinct characteristics of individuals who remained FED users over time during the pandemic versus the prepandemic era. We conducted a retrospective, secondary, longitudinal analysis in Texas, following 2 cohorts of ED users over 36 months (cohort 1: March 2017-February 2020; cohort 2: March 2019-February 2022). The main outcomes were whether a baseline FED (≥9 ED visits/12 mo) user remained a FED user persistently over the next 24 months and whether they were persistent FED users prepandemic or peripandemic. Multivariable regressions estimated changes in persistent FED use across cohorts and assessed differences between individuals who remained persistent FED users during the pandemic compared with the prepandemic period. All-payer Texas Hospital ED Research Data File from 2016 to 2022. About 1 million individuals had at least one ED visit in the baseline years, totaling 4.6 million visits. Overall, FED users accounted for 8% of all ED users but over 40% of visits. Although more than half of FED users at baseline exhibited persistent FED use over the next 24 months, there was a 7% decline in the proportion of return FED users after the onset of COVID-19 which was statistically significant (AOR=0.82; 95% CI=0.80-0.84), and this effect was more pronounced when patients with any COVID-19-related ED visit during the study period were excluded (AOR=0.10; 95% CI=0.09-0.11). Individuals aged 45 years or older, those with congestive heart failure and diabetes with complications, and those with public insurance (when COVID-19-related visits were excluded) had higher odds of remaining persistent FED users during the pandemic. Many FED users will seek ED care for multiple years, given their medical complexity. Future research should identify heterogeneous subgroups among persistent FED users to tailor interventions towards their needs.
12. Systemic Therapy in Patients With Metastatic Castration-Resistant Prostate Cancer: ASCO Living Guideline, Version 2026.1.
期刊: Journal of clinical oncology : official journal of the American Society of Clinical Oncology 发表日期: 2026-Jan-20 链接: PubMed
摘要
Living guidelines are developed for selected topic areas with rapidly evolving evidence that drives frequent change in recommended clinical practice. Living guidelines are updated on a regular schedule by a standing expert panel that systematically reviews the health literature on a continuous basis, as described in the ASCO Guidelines Methodology Manual. ASCO Living Guidelines follow the ASCO Conflict of Interest Policy Implementation for Clinical Practice Guidelines. Living Guidelines and updates are not intended to substitute for independent professional judgment of the treating clinician and do not account for individual variation among patients. See appendix for disclaimers and other important information (Appendix 1 and Appendix 2). Updates are published regularly and can be found at www.asco.org/genitourinary-cancer-guidelines.
13. Gender Concordance and Patient Outcomes in Indian Telemedicine: Retrospective Cross-Sectional Quantitative Study of 286,000 Consultations.
期刊: Journal of medical Internet research 发表日期: 2026-Jan-20 链接: PubMed
摘要
Gender concordance (GC) between patients and physicians has been linked to trust and satisfaction in traditional health care. However, its role in telemedicine, especially in culturally complex settings like India, is underexplored. In India’s culturally diverse and gender-sensitive context, understanding GC becomes particularly relevant for specialties such as gynecology, dermatology, psychiatry, and urology, where discussions often involve intimate or stigmatized concerns. Despite rapid telemedicine expansion, little empirical evidence exists on whether GC affects patient-reported outcomes in this context. This study examined whether GC significantly influences patient satisfaction and self-reported recovery in teleconsultations across India, with a focus on specialty-specific effects in culturally sensitive specialties. We conducted a retrospective cross-sectional analysis of 286,196 anonymized teleconsultation records from a national telemedicine platform (January 2023-December 2024) spanning across 20 medical specialties using binary logistic regression. Records missing gender or satisfaction data were excluded from the analysis; recovery analyses included only consultations with completed day-21 follow-up surveys (n=1170, 0.4%). Outcomes included patient satisfaction (ratings 4-5 on a five-point scale) and self-reported recovery at follow-up. Logistic regression models (Stata 17.0) tested associations between GC and outcomes, controlling for consultation time, duration, and physician experience. Subgroup analyses were conducted for the top 5 specialties. Each record included key data on consultation duration, timing, physician experience, specialty type, patient satisfaction rating, and self-reported recovery status. The study excluded the pediatrics specialty from the analysis to control for the parental bias. Of the 286,196 consultations, 164,008 (60.4%) were gender-concordant. Overall, 261,213 of 286,196 (91.3%) patients reported good satisfaction. GC had a statistically significant negative association with patient satisfaction (odds ratio [OR] 0.87, 95% CI 0.85-0.90; P<.001). Across gender, the male doctor received higher satisfaction. In gynecology, female patient-female doctor pairs had significantly higher odds of reporting recovery (OR 4.53, 95% CI 0.8-25.3; P=.099). Overall, consultation timing (OR 0.99, 95% CI 0.998-0.999; P<.001) and patient satisfaction (OR 20.13, 95% CI 12.06-35.38; P<.001) were stronger predictors of self-reported recovery than GC. GC in telemedicine has a context-dependent impact. While it does not independently predict clinical recovery, it meaningfully shapes patient satisfaction. These findings highlight that gender sensitivity training and context-specific communication approaches may enhance telemedicine experiences in culturally sensitive domains. Integrating awareness of gender dynamics into telehealth design and policy could strengthen patient trust and engagement in virtual care. Future research should explore specialty-specific dynamics and improve follow-up response rates to better assess clinical outcomes.
14. Communication Challenges and Mitigation Strategies in Primary Care Virtual Consultations: Qualitative Study.
期刊: Journal of medical Internet research 发表日期: 2026-Jan-20 链接: PubMed
摘要
The growing reliance on virtual consultations in primary care has reshaped traditional general practitioner (GP)-patient communication dynamics, presenting new challenges that affect care quality and safety. This study explores communication challenges and gaps, particularly relevant to virtual consultations compared with face-to-face interactions, as well as identifying mitigation strategies from both GPs’ and patients’ perspectives. This qualitative study employed 4 online focus group discussions with a purposive sample of UK-based GPs and patients. Data were analyzed using a deductive-inductive thematic approach with NVivo software. The extended Shannon-Weaver communication model and the Capability, Opportunity, Motivation and Behavior model guided the analysis of communication challenges and mitigation strategies, respectively. The Consolidated Criteria for Reporting Qualitative Research were followed to ensure rigorous reporting. A total of 21 participants (12 patients and 9 GPs) took part in 4 online focus group discussions, 2 for patients and 2 for GPs. Six key themes on communication challenges emerged: 5 aligned with the extended Shannon-Weaver communication model (related to the sender-encoder, message, channel, receiver-decoder-feedback, and context), and a new one was inductively identified (patient autonomy and inclusivity). GPs, as senders, highlighted missing visual cues, affecting message clarity in remote communication channels. Patients, as receivers, reported difficulties explaining symptoms remotely, reduced emotional connection, and perceived empathy, linked to contextual challenges and the need for inclusive communication. Mitigation strategies were mapped to the Capability, Opportunity, Motivation and Behavior model: capability (training/resources), opportunity (triage/tools), and motivation (patient engagement/system adaptability), with participants emphasizing tailored training, standardized approaches, and flexible models to support effective and inclusive virtual communication. This study highlights communication gaps in virtual consultations and proposes actionable mitigation strategies. Tailored use of virtual modalities, supported by structured training and policy efforts, is essential to ensure effective and safe remote communication.
15. Assessing Integrated Care Mechanisms in Taiwan's Long-Term Care System: A Study of Care Management Service Providers.
期刊: Journal of gerontological social work 发表日期: 2026-Jan-20 链接: PubMed
摘要
To response to Taiwan’s LTC 3.0 reform, this study assessed integration levels in 252 Tier A care centers using the TwSASI tool. Results showed care coordination scored highest, while information systems scored lowest. Regression analysis revealed that the length of time an agency has held Tier A designation significantly enhanced overall integration. While formal email communication and government platforms positively influenced coordination and resource integration, frequent collaboration with Tier B agencies negatively impacted information integration. The findings underscore that organizational experience, effective communication channels, and robust digital infrastructure are critical for optimizing integrated long-term care services.
16. The association of cataract surgery with risk of falls and fractures among medicare enrollees with cataract.
期刊: The journals of gerontology. Series A, Biological sciences and medical sciences 发表日期: 2026-Jan-20 链接: PubMed
摘要
Falls and fractures are a significant public health concern linked to visual impairment. Cataracts are the most common cause of visual impairment in older adults and can be corrected with cataract surgery. This study evaluated whether cataract surgery reduces the one-year risk of falls/fractures in Medicare beneficiaries with cataract. Using 2019-2021 claims data from a nationally representative cohort of 940,233 Medicare fee-for-service enrollees (66+ years), we identified those with untreated cataract in 2019 and grouped them into those with and without cataract surgery in 2020. Using the surgery date (surgery group) or a randomly assigned date in 2020 (non-surgery group) as the index date, we identified incident falls/fractures (outpatient, emergency department, or inpatient) during the following 365 days. We used a propensity score-based (with average treatment effect on the treated weights) linear probability regression model to estimate the association of cataract surgery with the risk (likelihood) of falls/fractures, accounting for observed differences between those with and without surgery. Without surgery, the estimated likelihood of falls/fractures was 8.86% (95% CI: 8.53-9.18%). Cataract surgery was not associated with a significant difference in the risk of falls/fractures (risk difference= -0.15 percentage points; 95% CI: -1.0, 0.74). Similar findings were observed for subgroups by race and ethnicity, frailty, and fall/fracture history. Cataract surgery was not significantly associated with one-year risk of falls/fractures in Medicare beneficiaries. Future studies should evaluate fall risk over a longer follow-up period or the impact of surgery on self-reported falls not captured by the healthcare system.
17. Bridging the knowledge gap: Thai parents' perspectives on dengue infection and its vaccination and the need for targeted promotion.
期刊: PLoS neglected tropical diseases 发表日期: 2026-Jan-20 链接: PubMed
摘要
Dengue infection is endemic in Thailand, with children being the most impacted group. Various measures, including the dengue vaccine (recently recommended in Thailand since 2017 for Dengvaxia and 2023 for Qdenga), have been implemented to prevent and manage the disease. However, the rate of infection among Thai children is still high. This study explored Thai parents’ knowledge and attitudes toward dengue infection and its preventive vaccine, guided by the 4C Model for vaccine hesitancy. This cross-sectional study employed a questionnaire survey, utilizing five investigator-developed instruments. Survey items were grouped into the components of the 4C Model. Data analysis involved descriptive, Pearson’s correlations, and Binary Logistic Regression statistics. Among 400 participating parents in this study, high positive attitudes toward general childhood vaccination (mean score = 41.18/60) and a high level of dengue infection knowledge (mean score = 9.08/12) were observed. Common prevention methods included destroying larval breeding sites and mosquito bite prevention. Most parents viewed dengue infection as a serious disease (mean score = 7.65/10), perceiving impacts like children’s school absenteeism (93%) and parental work time off (80.75%). Regarding government management of dengue, a substantial proportion (~35%) expressed no opinion. Parents exhibited an intermediate level of dengue vaccine knowledge (mean score = 5.06/10), with most unaware of its effectiveness or complex recommendations. Most (63.5%) expressed dengue vaccine acceptance, with 9.75% having vaccinated their children and 59.56% planning to do so. All 4C model components except Calculation were weakly but significantly correlated with parents’ dengue vaccine acceptance, with Complacency being the strongest (r = -.149, p = .05). Only Complacency independently predicted dengue vaccine acceptance among Thai parents (OR=0.897, p = .031). This study provides insights into Thai parents’ understanding of dengue and its vaccine in children. Findings offer a basis for developing targeted public health campaigns and communication strategies to promote dengue vaccine use in children, and to inform public policy on vaccine affordability.
18. Navigating Postacute Care Options for Patients After Hospital Discharge: A Review.
期刊: JAMA internal medicine 发表日期: 2026-Jan-20 链接: PubMed
摘要
Approximately 25% to 40% of hospitalized adults are discharged to receive postacute care (PAC) either at home through home health (HH) or in skilled nursing facilities (SNFs), inpatient rehabilitation facilities (IRFs), or long-term acute care hospitals (LTACHs). An overview of various PAC settings is needed to help hospital-based clinicians collaborate most effectively with patients, caregivers, and an interdisciplinary care team to promote high-quality PAC and facilitate better PAC transitions. PAC settings vary in their eligibility requirements and in the intensity and complexity of services they provide. HH provides intermittent in-home support for homebound individuals with skilled needs. SNFs provide housing, daily nursing care, rehabilitative services, and medical supervision, although the medical care provided is often a dramatic step down from hospital-based acute care. IRFs provide intensive rehabilitation, most commonly for individuals with specific diagnoses (eg stroke, hip fracture, or spinal cord injury). LTACHs care for patients with medically complex conditions who require prolonged hospital-level care for services (eg, ventilator weaning, complex wound management). Discharge planning to PAC should be guided by clinical needs, caregiver support, and the values and preferences of patients and caregivers; yet it is often opaque and influenced by external factors such as insurance coverage and geography. Clinicians should proactively recognize PAC needs, advocate for specific PAC settings for targeted situations, and assist on selecting an appropriate PAC facility, especially for patients with insurance restrictions. Moreover, PAC admissions frequently represent a pivotal time period for individuals with serious illness, during which a subsequent poor prognosis becomes clear. Therefore, PAC stays represent an opportunity for clinicians to revisit prognosis with patients and caregivers, engage in goals of care conversations, and clarify plans for the future. To provide patient-centered care and help facilitate better transitions for patients and caregivers, hospital-based clinicians have a responsibility to understand the different types of PAC settings and actively participate in discharge planning.
19. The Diversity Effect of Psychological Resilience on the Relationship between Bullying Victimization and Multiple Psychological Symptoms Among Chinese Adolescents: A Large-Scale Regional Study.
期刊: Child psychiatry and human development 发表日期: 2026-Jan-20 链接: PubMed
摘要
This study aimed to explore the relationship between bullying victimization and multiple psychological symptoms among Chinese adolescents and to evaluate the moderating role of psychological resilience in this relationship. Using large-scale regional data from a county in northeastern China (N = 22,264), we identified bullying victimization subtypes through latent class analysis (LCA), quantified comorbidity risks via multinomial logistic regression, and examined the moderating effects of resilience across subgroups. Three victimization profiles emerged: non-victimized (80.9%), moderately victimized (13.6%), and poly-victimized (5.5%) groups. Compared to the non-victimized group, the moderately victimized group demonstrated higher odds ratios (ORs) for multiple psychological symptoms (all three symptoms: OR = 6.872; any two symptoms: OR = 4.470; any one symptom: OR = 2.610). The poly-victimized group exhibited significantly higher odds across all symptom categories (all three symptoms: OR = 43.678; any two symptoms: OR = 18.246; any one symptom: OR = 5.974). Resilience demonstrated heterogeneous moderation effects: it showed no significant interaction in the moderately victimized group, whereas it was associated with significant risk amplification in the poly-victimized group (OR = 1.040, p < 0.001). Bullying victimization is significantly associated with concurrent psychological symptoms. However, resilience does not universally buffer against stress. For adolescents subjected to severe poly-victimization, high levels of resilience appear to amplify psychological risks instead of providing a buffering effect. The findings suggest that tailored intervention strategies should prioritize victimization severity rather than adopt a universal resilience-promotion approach.
20. Transcriptomic Profiling Reveals Mechanisms of Anoikis Resistance in Spheroid-Cultured Human Umbilical Cord Mesenchymal Stem Cells.
期刊: Tissue engineering and regenerative medicine 发表日期: 2026-Jan-20 链接: PubMed
摘要
Mesenchymal stem (stromal) cells are a promising cell source for regenerative medicine, but their therapeutic efficacy is often limited by poor engraftment and survival post-transplantation. One major contributing factor is anoikis, a form of apoptosis triggered by cell detachment from the extracellular matrix. Spheroid culture systems have shown potential to enhance cell survival and stemness, yet the mechanisms by which they confer resistance to anoikis remain unclear. We established spontaneous spheroids from human umbilical cord-derived mesenchymal stem (stromal) cells (UC-MSCs) and performed RNA-sequencing analysis to compare gene expression profiles between spheroid and monolayer cultures. Differentially expressed genes were identified and subjected to GO and pathway enrichment analyses. Functional assays included the use of PI3K/Akt and HIF-1 pathway inhibitors to dissect their role in anoikis regulation. Expression levels of apoptosis-related genes were validated by qRT-PCR. Spheroid UC-MSCs exhibited significantly enhanced resistance to anoikis. Transcriptomic analysis revealed upregulation of both pro-apoptotic and anti-apoptotic genes, suggesting a balanced but regulated apoptotic threshold. Downregulation of executioner genes such as BAX, BAK1, and FADD, along with activation of PI3K/Akt and HIF-1α pathways, suggested effective suppression of apoptotic execution. Inhibitor experiments confirmed these pathways as key contributors to anoikis resistance. Our findings demonstrate that spheroid formation promotes a survival-permissive gene expression profile in UC-MSCs, driven in part by PI3K/Akt and hypoxia signaling. These insights advance the understanding of spheroid-mediated anoikis resistance and may inform strategies to enhance stem cell-based therapies.
21. Non-communicable disease burden among adults with and without HIV in Botswana.
期刊: AIDS (London, England) 发表日期: 2026-Jan-20 链接: PubMed
摘要
- Non-communicable disease (NCD) prevalence has increased as age distributions in populations shift to older ages, including in countries with high HIV burden. We assessed NCD prevalence in Botswana, and its association with human immunodeficiency virus (HIV) and age.
- We analyzed cross-sectional data from the Fifth Botswana AIDS Impact Survey 2021, a nationally-representative, population-based survey conducted from March to August 2021.
- People aged 15-64 years old underwent HIV testing and self-reported NCDs. We assessed weighted prevalence and age-stratified logistic regression regarding the associations between HIV status, age, and reported NCDs.
- In total, 14,581 respondents were analyzed, of whom 49.2% were male, 20.7% had HIV, 16.4% had ≥1 NCD. People with HIV (PWH) were more likely to be female (64.2% versus 47.3%), 45 years or older (45% vs 17.8%), and report having ≥1 NCD (20.2% vs 15.4%), hypertension (14.2% vs 10.3%), kidney disease (2.6% vs 0.6%), and cancer (1.4% vs 0.3%) compared to people without HIV, respectively. PWH had lower age-adjusted odds of reporting having ≥1 NCD [aOR (95% CI): 0.8 (0.6, 0.9)], diabetes [aOR: 0.6 (0.4, 0.8)], hypertension [aOR: 0.7 (0.6, 0.8)], and heart disease [aOR: 0.6 (0.3, 0.9)]. PWH had higher odds of kidney disease [aOR: 3.2 (2.1, 4.8)] and cancer [aOR: 2.1 (1.3, 3.2)].
- Prevalence of reporting at least one NCD was higher among PWH than the general population but differed by age. Health officials could benefit from considering these trends when designing targeted interventions for PWH.
22. Submaximal running with blood flow restriction induces similar muscle oxygenation responses relative to maximal unrestricted running.
期刊: Physiology international 发表日期: 2026-Jan-20 链接: PubMed
摘要
To examine muscle oxygenation during running with and without blood flow restriction (BFR). Fifteen aerobically trained males randomly completed four, three-minute running bouts at 70%BFR, 80%BFR, and 90%BFR of their top speed with BFR and 100%NOBFR of their top speed without BFR. Oxygenated hemoglobin (O2Hb), deoxygenated Hb (HHb), total Hb (tHb), Hb difference (HbDiff) and muscle tissue oxygenation (StO2) were assessed continuously throughout the running bouts. Separate two-way, 4 (Intensity [70%BFR, 80%BFR, 90%BFR, 100%NOBFR]) × 3 (Time [120, 150, and 180 s]), repeated-measure ANOVA models were constructed to examine O2Hb, HHb, tHb, HbDiff, and StO2 responses. O2Hb decreased (120- [65.25 ± 6.58%] > 150-s [63.72 ± 6.75%]), while HHb increased (120- [14.4 ± 12.55%] < 150- [16.91 ± 12.6%] < 180-s [18.26 ± 12.87%]) (P < 0.001). tHb was similar across time (P = 0.159) and between intensities (P = 0.454). HbDiff decreased (120- [73.56 ± 6.54%] > 150- [71.66 ± 6.61%] > 180-s [70.98 ± 6.93%]). StO2 decreased and then plateaued (120- > 150- and 180-s) during the 70%BFR (51.87 ± 5.09% > 51.20 ± 5.37% and 51.02 ± 5.21%) (P = 0.004), 80%BFR (52.2 ± 3.93% > 51.34 ± 4.17% and 51.01 ± 4.09%) (P = 0.008), and 100%NOBFR (51.69 ± 4.6% > 50.84 ± 4.87% and 50.62 ± 4.89%) (P < 0.001) bouts, while there were no differences for 90%BFR (P > 0.05). Submaximal running with BFR induced similar responses as maximal running without, despite large differences (i.e., ≤30%) in running speed.
23. HLA Heterozygosity Influences Colorectal Cancer Risk and Survival Outcome.
期刊: Gastroenterology 发表日期: 2026-Jan-20 链接: PubMed
摘要
24. Deglycosylation Enhances the Toxicity of Plant-Derived Glycosyl Bisphenol A during Gastrointestinal Digestion.
期刊: Environmental science & technology 发表日期: 2026-Jan-20 链接: PubMed
摘要
Bisphenol A (BPA) is one of the most used plasticizers and a known endocrine disrupting chemical. In plants, BPA is easily conjugated to form conjugates such as glycosyl BPA, and humans can be exposed to such conjugates when ingesting BPA-contaminated plant foods. This study considered the potential of deconjugation of glycosyl BPA in a simulated human gastrointestinal tract system and evaluated the subsequent changes in biological activity using the Caco-2 colon cell model. Glycosyl BPA was found in both soil and lettuce with concentrations ranging from not detected (ND) to 82.51 ng/g dry weight in edible plant tissues, and the level of glycosyl BPA was correlated significantly with that of BPA. Gastrointestinal digestion triggered progressive deglycosylation of glycosyl BPA with the deconjugation rate significantly higher in the intestinal phase (41.7-47.8%) than the gastric phase (13.4-23.3%). Deglycosylation of glycosyl BPA was associated with decreased Caco-2 cell activity and increased markers of oxidative stress and inflammatory responses in the cell. The re-released BPA may be key to the increased toxic effects. These findings highlight the underestimated health risks posed by plant-derived conjugated xenobiotics through transformation reactivation in the human digestive system.
25. Development and validation of an LC-MS/MS method for analysing doxycycline in medicated fish-feed and evaluation of top-coating procedures.
期刊: Food additives & contaminants. Part A, Chemistry, analysis, control, exposure & risk assessment 发表日期: 2026-Jan-20 链接: PubMed
摘要
Antimicrobials are widely used to control diseases in fish farming. Irregular use of these substances can reduce treatment efficacy and contaminate aquatic environments, promoting the emergence and spread of antimicrobial-resistant bacteria. Doxycycline, a broad-spectrum antimicrobial active against both Gram-positive and Gram-negative bacteria, is authorised for use in aquaculture in several countries and represents a promising therapeutic option. However, to date, no studies have investigated its incorporation into fish feed or its potential to leach into the environment. This study aimed to develop, optimise, and validate an LC-MS/MS method to detect doxycycline in medicated feed and to evaluate top-coating procedures to ensure treatment efficacy while minimising leaching into the environment. The LC-MS/MS method was optimised using a Plackett-Burman design to determine the optimal sample extraction conditions and, subsequently, validated, demonstrating selectivity, precision (CV < 3.5%), accuracy (recovery of 98.4-102%), and linearity (R2 > 0.99, 1.6-8.3 g kg-1). Two top-coating procedures using ethyl cellulose and gelatine polymers were evaluated; both achieved high incorporation efficiency (70%) and homogeneous drug distribution within feed pellets (CV < 2%). Leaching-tests showed that the top-coatings effectively retained doxycycline, with leaching rates below 5% after 15 min of immersion. Overall, these approaches may enhance treatment efficacy and mitigate the environmental impact, promoting the responsible use of antimicrobials in fish farming in accordance with the One Health concept.
26. Ambient Air Pollution, Greenness and Frailty in an Elder Asian Population: A Multi-Center Study with Long-Term Exposure.
期刊: The journals of gerontology. Series A, Biological sciences and medical sciences 发表日期: 2026-Jan-20 链接: PubMed
摘要
Long-term exposure to air pollution has been linked to adverse health outcomes in older adults; however, its association with frailty, particularly the potential protective role of environmental factors such as greenness, remains insufficiently investigated. Data from the Healthy Aging Longitudinal Study in Taiwan, which included 5336 community-dwelling individuals aged 55 years and older, were analyzed. Frailty was assessed using modified criteria from the Cardiovascular Health Study. Exposure to air pollutants was estimated using land use regression model with machine learning methods. Greenness was quantified using the normalized difference vegetation index (NDVI). Logistic regression models were used to examine associations between environmental exposures and frailty after adjustment for demographic, health, and lifestyle confounders. Exposure to PM2.5 and NO2 during the 1 to 9 years preceding the assessment was significantly associated with an increased risk of frailty and prefrailty. Conversely higher NDVI values exhibited a protective effect. Mutually adjusted models confirmed the robustness of the effects of PM2.5, indicating its influence persisted for up to 3 years. The aOR for PM2.5 was 1.103 per 10 µg/m³ increment for 3 year prior to the assessment, corresponding to an excess risk of 10.3% per 10 µg/m³ increase. Long-term exposure to PM2.5 related to frailty in older adults, whereas greenness provides protective benefits. These findings indicate the importance of developing public health policies aimed at improving air quality and promoting greening in ensuring healthy aging.
27. Nurses' Plans and Actions to Advocate for Legislation to Phase Out Use of Select Di(2-Ethylhexyl) Phthalate Plastic Supplies in Health Services Delivery in North Carolina.
期刊: Policy, politics & nursing practice 发表日期: 2026-Jan-20 链接: PubMed
摘要
BackgroundNurses have professional responsibilities to advocate for environmentally healthy practices and have rights to work in healthy environments. Many medical supplies are made with polyvinyl chloride, which is softened and made more flexible by adding phthalates, such as di(2-ethylhexyl) phthalate (DEHP). Patients, nurses, and other health workers are exposed to these toxins through dermal, inhalation, ingestion, and/or parenteral administration. Phthalates are classified as carcinogenic, mutagenic, reprotoxic, and endocrine-disruptors.PurposeThe purpose of our project is to develop a nurse-led advocacy plan focused on drafting, introducing, and passing a bill banning use of medical supplies made with DEHP and related plasticizers in North Carolina (NC) health systems and engaging nurses and other stakeholders in advocating for this policy change to protect the health of patients, employees, and the planet.Advocacy PlanWe developed a health policy advocacy plan describing the issue; goal; interest groups; partners; scientific evidence; advocacy strategies; and expected outcomes. We engaged our project partners in implementing successful advocacy efforts. On March 31, 2025, NC House Bill 592, Toxic-Free Medical Devices Act of 2025, was introduced in the NC General Assembly. The Senate version was signed into law on July 3, 2025.DiscussionNurses are well-positioned to advocate for policies that protect health by addressing primary drivers of health, including environmental risk factors. Our nurse-led health policy advocacy plan and actions supported the development and passing of a bill that protects patients and health services workers from DEHP and other toxic plasticizers linked to numerous health problems.
28. Preliminary Study on the Effectiveness of Small Group Activities for Older Adults with Cognitive Decline: A Comparison of Social Interaction and Leisure Activities in Hospitals.
期刊: Occupational therapy in health care 发表日期: 2026-Jan-20 链接: PubMed
摘要
This pilot study examined the effectiveness of group activities on older adults aged 65 years and older with cognitive decline who were hospitalized due to bone fractures. The study used a quasi-experimental pre/post-test design with non-randomized group assignment. The group activities, which included social interaction and leisure activities, were conducted twice weekly over eight sessions. Both activity groups showed significant improvement in occupational function and social interaction, with a large effect size. Additionally, the social interaction group showed improvements in behavioral and psychological symptoms of dementia and occupational disruptiveness. No significant differences were found in all assessment tools between groups. With these preliminary results, future studies are warranted to conduct more precise and systematic surveys to rigorously examine the effectiveness and validity of these interventions.
29. A Randomized Controlled Trial of Augmented Reality with and Without Robotic Priming in Stroke Rehabilitation.
期刊: NeuroRehabilitation 发表日期: 2026-Jan-20 链接: PubMed
摘要
BackgroundRobotic therapy (RT) and augmented reality (AR) have each demonstrated benefits for stroke rehabilitation. Despite the potential priming effect of robotics, no study has investigated whether robotic priming of AR provides additive effects compared to AR or conventional therapy.ObjectiveThis study examined the effects of AR with and without robotic priming compared with dose-matched control.MethodsIn this exploratory trial (N = 33), participants were allocated to robotic-primed AR (RT + AR), AR, or conventional therapy (CT). Outcomes were the Fugl-Meyer Assessment-Upper Extremity (FMA-UE), Berg Balance Scale (BBS), Chedoke Arm and Hand Activity Inventory (CAHAI), and Stroke Impact Scale (SIS). Patient-reported pain and fatigue were recorded.ResultsAll groups improved in motor recovery and balance immediately after therapy. RT + AR exceeded AR (p = 0.037, η2=0.19) and CT (p = 0.039, η2=0.19) on FMA-UE at post-test and remained superior to CT at follow-up (p = 0.03, η2=0.20). For the BBS, both RT + AR (p = 0.016, η2=0.18) and AR (p = 0.004, η2=0.24) outperformed CT at post-test, and AR retained superiority at follow-up (p = 0.02, η2=0.21). RT + AR surpassed CT on CAHAI (p = 0.046, η2=0.18) and SIS (p = 0.04, η2=0.19) at post-test, with a trend favoring RT + AR on SIS at follow-up (p = 0.06, η2=0.18). No severe adverse responses were observed.ConclusionRobotic priming of AR improved more than AR and CT in motor impairments. AR was beneficial for improving balance. Results of this study should be interpreted with caution and may not be generalized to stroke survivors with different characteristics. There was a lack of multiplicity adjustments in this small exploratory trial. Further research is needed to validate the findings based on larger multicenter trials.
30. Long-Term Exposure to Air Pollution and Risk and Prognosis of Motor Neuron Disease.
期刊: JAMA neurology 发表日期: 2026-Jan-20 链接: PubMed
摘要
Air pollution exposure has been associated with an increased risk of neurodegenerative diseases; however, evidence is limited for motor neuron disease (MND), especially regarding disease progression. To determine whether long-term exposure to air pollution is associated with the risk and prognosis of MND. This population-based, nested case-control study used Swedish health register data of incident MND cases diagnosed between 2015 and 2023 with up to 8 years of follow-up. Participants included patients with MND, 5 age- and sex-matched population controls without MND per patient with MND, and full siblings of the patients with MND. Data were analyzed between November 6, 2024, and November 4, 2025. Mean yearly concentrations of particulate matters of 2.5 µm or less, 10 µm or less, or 2.5 to 10 µm in diameter (PM2.5, PM10, PM2.5-10) and nitrogen dioxide (NO2) were assessed at the residential address using a spatiotemporal model to approximate accumulated air pollution exposure. Association between air pollution and risk of MND was assessed by comparing cases to both population and sibling controls. Flexible parametric survival models estimated the association between air pollution exposure and the risk of mortality (or use of invasive ventilation) after MND diagnosis (case-only analyses). Based on the rate of decline in the ALS Functional Rating Scale-Revised (ALSFRS-R) score and its subscores after diagnosis, patients were classified into fast (upper 25th percentile) or slow (lower 75th percentile) progression. Logistic regression was used to assess air pollution exposure and the risk of fast progression. The study included 1463 patients with MND, 7310 population controls, and 1768 sibling controls. The mean (SD) age for all patients with MND was 67.3 (11.7) years, and 814 (55.6) were male. In the population comparison, long-term air pollution was associated with an increased risk of MND; per IQR increase in the 10-year average level, the odds ratio was 1.21 (95% CI, 1.09-1.34) for PM2.5, 1.30 (95% CI, 1.19-1.42) for PM2.5-10, 1.29 (95% CI, 1.18-1.42) for PM10, and 1.20 (95% CI, 1.12-1.29) for NO2. A higher level of PM10 or NO2 was associated with a higher hazard of mortality, whereas a higher level of all PMs was associated with faster functional decline, particularly motor and respiratory functions, after MND diagnosis. The findings of this case-control study suggest that air pollution, even at relatively low levels typical of Sweden, may contribute both to the risk of developing MND and disease prognosis after MND diagnosis.
31. Proportionality and the process of decision-making around ICU admission: A narrative review of the ethical complexities of navigating from "can" to "ought".
期刊: Journal of critical care 发表日期: 2026-Jan-19 链接: PubMed
摘要
To identify sources of ethical tension emerging around ICU admission decision-making. To assess the potential role for clinical ethics applications in building clinician capacity to identify and navigate these tensions along with an appropriate core principle for framing ethical considerations. We performed a search of Ovid Medline, CINAHL and PubMed databases. Keywords and MeSH headings included “intensive care admission”, “decision-making”, “conflict” and “clinical ethics” for the period January 1, 2005 to January 1, 2025. Additional papers were identified from reference lists and formulated into a narrative synthesis of themes describing shared ethical tensions. We then undertook further review of the bioethics literature to identify practical solutions based on clinical ethics consultation and an appropriate normative lens to apply to balancing considerations. Clinical ethics approaches have been employed to understand sources of ethical tension and improve the process of decision-making around ICU admission. Clinicians’ difficulty weighing benefits and burdens of treatments emerged as a potentially modifiable deficit. Proportionality emerged as a more appropriate way than futility or rescue imperatives to frame the value of ICU admission. Uncertainty emerged as an important modifiable contributor to decision-making challenges. Moral case deliberation as an example of a clinical ethics approach shows promise as an education tool and a way to build decision-making capacity and trust between ICU and other clinicians. Proportionality is a suitable approach to framing benefit and weighing competing tensions. Further research is required to explore the impact of these elements on navigating shared ethical tensions.
32. Safety boots' impact on comfort, mobility, performance, musculoskeletal disorders, slips, and falls in Canadian construction.
期刊: Applied ergonomics 发表日期: 2026-Jan-19 链接: PubMed
摘要
Construction is a hazardous industry, with slips, falls, and musculoskeletal disorders (MSDs) among the most common occupational hazards. Safety boots are vital for reducing these risks and enhancing workers’ comfort, mobility, and overall performance. Therefore, this study examines associations between winter safety boot features and construction workers’ comfort, performance and mobility, slips, falls, and MSDs due to slips and falls. Cross-sectional survey data from 110 Canadian construction workers were analyzed using descriptive, bivariate, and multivariable logistic regression analyses. Boots’ arch support, shaft flexibility, and inside warmth were the most consistently associated features across outcomes. Poor arch support was associated with lower comfort (OR = 0.09) and performance and mobility (OR = 0.089), and higher odds of falls (OR = 4.843) and MSDs due to slips and falls (OR = 3.255). Limited ankle inversion was linked to higher risks of slips, falls, and MSDs; the corresponding ORs for workers with “no limitation” were 0.126, 0.286, and 0.161, respectively, while boots with cold interiors were associated with higher odds of slips (OR = 5.657) and lower comfort (OR = 0.213). These findings suggest the potential importance of prioritizing adequate arch support, balanced shaft flexibility, and inside warmth in safety boot design, which may help enhance comfort and performance and mobility while reducing slips, falls, and MSD-related risks.
33. How do residents perceive alcohol availability and its impact on drinking behaviour? A qualitative study.
期刊: Health & place 发表日期: 2026-Jan-19 链接: PubMed
摘要
Reducing alcohol availability has been identified as a potential approach to reduce alcohol use and related harm. In order to regulate alcohol availability at a local level, it is important to involve communities in decision-making and ensure interventions are locally acceptable and appropriate. To do this, we need to improve our understanding of how residents conceptualise alcohol availability and its impact on behaviours. This paper uses data collected in Scotland, a country with particularly high levels of alcohol-related harm, to explore the perspectives of residents, on local alcohol availability and how it might affect drinking behaviours. We conducted 11 online focus groups with 45 participants, living in nine strongly contrasting neighbourhoods in Scotland, characterised by varying levels of alcohol retail density change, urbanity and deprivation. We explored participants’ perceptions of their local alcohol environment and alcohol availability, and any perceived relationship between alcohol availability and alcohol-related behaviours. Participants challenged established notions that alcohol availability is characterised primarily by density of alcohol outlets. According to our participants, availability is about accessibility, ease of purchase and ubiquity of alcohol. Residents drew distinctions between areas of varying deprivation and conceptualised alcohol availability as complex, characterised by market segmentation, and related to price, advertising and the wider environment. This is one of the few papers to explore residents’ perspectives of local alcohol availability and its relationship with alcohol use. It highlights that residents view alcohol availability as encompassing more than just the physical presence of outlets, recognising also the variety of outlet types and the connections between availability, pricing, and advertising. Policies to reduce local availability should consider residents’ perspectives and account for contextual factors such as shifts in the retail landscape and the availability of alcohol-free recreational alternatives.
34. Association of state happiness with mortality: Evidence from a prospective cohort study in Japan.
期刊: Health psychology : official journal of the Division of Health Psychology, American Psychological Association 发表日期: 2026-Jan-19 链接: PubMed
摘要
The aim of this study was to examine whether the association between happiness and all-cause mortality persists after adjustment for health status and sociodemographic factors in Japanese adults. The study addressed the gap in understanding the relationship between happiness and mortality in Japanese populations. A total of 3,187 adults from Minami-Izu, Japan, were included in a prospective study tracking all-cause mortality from October 2016 to October 2023. Happiness was assessed using a single-item, self-report measure of state emotional well-being. Sociodemographic factors (age, sex, marital status, education, and economic status) and health status (body mass index and physical function) were considered as covariates. Binary logistic regression models were used to examine the association between happiness and mortality, adjusted for these factors. During the follow-up, 277 participants died. The risk of all-cause mortality was higher in those who reported being unhappy compared with those who reported being happy after adjustment for age and sex (OR: 2.69, 95% CI: 1.63-4.44) and also significantly higher in those who reported being unhappy compared with those who reported being happy after adjustment for age, sex, all socioeconomic factors and health status (OR: 1.85, 95% CI: 1.09-3.16). Sensitivity analyses excluding deaths within the first year showed consistent results. Happiness is independently associated with reduced mortality risk, even after adjustment for sociodemographic and health status factors. These findings highlight the importance of promoting positive well-being in Japanese populations. (PsycInfo Database Record (c) 2026 APA, all rights reserved).
35. Unpacking the link between adverse childhood experiences and mental health disparities among Chinese men who have sex with men: The mediating role of filial piety and internalized homophobia.
期刊: Child abuse & neglect 发表日期: 2026-Jan-19 链接: PubMed
摘要
While growing evidence links Adverse Childhood Experiences (ACEs) to mental health disparities among sexual minorities, the mechanisms underlying this relationship, particularly in Chinese context, remain insufficiently understood. The intersection of ACEs, cultural values, and internalized stigma among Chinese men who have sex with men (MSM) represents a critical, yet underexplored, area of investigation. This study aimed to examine the relationship between ACEs and depressive symptoms among Chinese MSM, focusing on the serial mediating effects of filial piety (pragmatic obligations and compassionate reverence) and internalized homophobia. Participants were recruited between October 2023 and May 2024 from a gay-friendly NGO in Zhejiang Province, China, with 1085 MSM completing a self-administered, anonymous questionnaire after screening for eligibility. Serial mediation analyses were conducted using PROCESS macro model 80 with bootstrapping procedures to test direct and indirect effects. The study confirmed the significant total effect of ACEs on depressive symptoms (b = 0.8327, p < 0.001). Analysis revealed distinct mediating pathways through compassionate reverence (β = 0.0696, 95% CI [0.0222, 0.1238]) and internalized homophobia (β = 0.0622, 95% CI [0.0288, 0.1039]). A significant negative serial mediation effect was observed through pragmatic obligations and internalized homophobia (β = -0.0177, 95% CI [-0.0311, -0.0079]), revealing the complex role of cultural values in mental health outcomes. These findings emphasize the complex interplay between ACEs, cultural values, and sexual identity in shaping mental health outcomes among Chinese MSM. They suggest the need for culturally sensitive interventions that address both traditional values and sexual identity concerns.
36. Anticipatory guidance for parents following paediatric intensive care: a scoping review and environmental scan of recovery-focused resources.
期刊: Intensive & critical care nursing 发表日期: 2026-Jan-19 链接: PubMed
摘要
To map and critically appraise anticipatory guidance interventions and resources for parents following PICU discharge, examine how they address recovery challenges, and identify gaps to inform parent-centred resource development. Database search across EBSCO (MEDLINE, CINAHL, PsychINFO), Embase, Scopus, Web of Science, and Cochrane Library for studies published January 2000-June 2025. Environmental scan via targeted and Google searches. Five tools assessed delivery, understandability, actionability, quality, and readability. Of 1752 records, four studies and nine digital resources met inclusion criteria (n = 271 parents). Formats included phone calls, brochures, in-person conversations, plus websites, webpages, downloadable content, and videos, from university children’s hospitals (n = 10), and organisations (n = 3) across the US (n = 9), UK (n = 3), and Australia (n = 1). Three key findings emerged: (1) support for how parents’ access, understand, and use information was inconsistent; (2) resources prioritised functional (reading/comprehension), over interactive (communication, application) or critical health literacy (evaluation, advocacy); (3) system-level health literacy strategies were limited. There is an urgent need to strengthen anticipatory guidance by embedding health literacy principles across design and delivery. This includes addressing organisational barriers to access and equity through co-design, plain language, and culturally responsive approaches. Beyond information provision, a deliberate focus on capability building can empower parents as active partners in care, ultimately improving outcomes for children and families. Anticipatory guidance following PICU discharge must move beyond information provision toward capacity building that supports parents to apply, evaluate, and act on information. Embedding health literacy principles - plain language, readability testing, co-design, and cultural responsiveness - into resource development is critical to ensure accessibility and equity. Clinician education and integration into routine workflows are equally important to optimise resource impact. A universal precautions approach offers a practical strategy for health services to ensure all families, regardless of literacy level, receive clear, actionable, and supportive guidance.
37. A pilot feasibility randomized clinical trial of a culturally adapted accelerated group treatment for posttraumatic stress, insomnia, and nightmares in firefighters.
期刊: Psychological trauma : theory, research, practice and policy 发表日期: 2026-Jan-19 链接: PubMed
摘要
Firefighters experience frequent traumatic events and occupational stressors, increasing risk for posttraumatic stress disorder (PTSD), insomnia, and nightmares, which are frequently comorbid and interrelated. However, firefighter schedules and mental health stigma limit engagement in weekly therapy. The present study was a randomized pilot feasibility trial of an integrated, accelerated, culturally adapted treatment for firefighters with clinically significant PTSD, insomnia, and nightmare symptoms. Participants (N = 49) were randomized to immediate or delayed treatment. Treatment integrated written exposure therapy for PTSD and cognitive behavioral therapies for insomnia and nightmares and was delivered in a 4-day group therapy “workshop” with one individual session before and after the workshop. Participants completed diagnostic interviews at baseline and 1-month posttreatment and self-report surveys through 3-month posttreatment. Most indices of program feasibility were positive despite logistical challenges impacting enrollment and treatment uptake. In addition, there were large group by time interaction effects for reductions in symptoms of PTSD (g = 1.70) and insomnia (g = 1.47) and a medium effect for nightmares (g = 0.72). Improvements in symptoms of all three targeted disorders and depressive symptoms were maintained through 3-month posttreatment. This study supports the efficacy of accelerated, integrated PTSD and sleep disorder treatment. To our knowledge, this is the first controlled study of a culturally adapted mental health intervention for firefighters. (PsycInfo Database Record (c) 2026 APA, all rights reserved).
38. Health effects of shooting and blasting exercise - a short-term longitudinal study.
期刊: Journal of occupational and environmental medicine 发表日期: 2026-Jan-19 链接: PubMed
摘要
Respiratory complaints during indoor training among elite professional soldiers. During a four-hour period (3*15 min) eighteen male healthy non-smoking Caucasians practiced enemy neutralization and building security. At each session 65-246 blanks and dummy hand grenades were used and no respiratory protection. Each soldier underwent blood sampling and spirometry testing before and after the training session and monitored own exposure. The mean (range) exposure of total dust was 18.1 (6.0-25.5) mg/m3, Cu 17.4 (9.4-28.4) ug/m3 and Zn 165.1 (63.4-328.7) ug/m3. Mean (95% CI) post-values for Forced Expiratory Volume after 1 second and Forced Vital Capacity were -130 mL (-180; -80) and -120 mL (-170; -70) lower than corresponding pre-values. Blood concentration of neutrophils increased from 48% to 57%. Respiratory protection equipment is recommended in future indoor training sessions.
39. ANA-12 restores testicular health by local neurochemicals in passive smoking/nicotine-exposed preclinical adult rats.
期刊: F&S science 发表日期: 2026-Jan-19 链接: PubMed
摘要
To investigate the therapeutic potential of ANA-12 in restoring testicular health by modulating local neurochemical balance in adult rats of passive smoking, secondhand smoking or environmental tobacco smoke/nicotine exposure. Preclinical rodent models mimicking a real-life human smoking scenario. Post-acclimatization, adult male rats of 250-300 g body weight were randomized into passive smoking, oral nicotine, ANA-12 pre-treatment, and healthy unexposed controls. Rats were exposed to passive smoking through a whole-body inhalation chamber and oral nicotine through gavage with/without intraperitoneal administration of ANA-12 at differential dosages prior to passive smoking/nicotine exposure for a period of 4- and 12-week studies. Testes histopathology, DNA damage potency, and fertility indices alongside redox homeostasis and expressions of local neurotransmitter dopamine and its receptors D1 and D2, and neurotrophic factor, brain-derived neurotrophic factor (BDNF) and its receptor, tyrosine kinase beta (Trk-β) in testes, comet assay in whole blood, and serum cotinine levels. Compared with the healthy unexposed controls, passive smoking and oral nicotine exposure dose- and time-dependently disrupt developing spermatogonia, spermatocytes, and spermatids of the seminiferous tubules and basement membrane; reduce sperm count with concomitant higher deoxyribonucleic acid (DNA) damage; and upregulate BDNF/Trk-β and dopamine/D1 expressions, as well as oxidative stress with subsequent antioxidant depletion in testes. In contrast, regardless of the duration of exposure, ANA-12 pre-treatment significantly restores germ cells of the seminiferous epithelium, improves spermatogenesis, downregulates aberrant local neurochemical systems, and maintains redox homeostasis in the testicular milieu. These results are in accordance with the whole blood DNA damage and serum cotinine levels, a biomarker of nicotine exposure. The results offer a novel insight into therapeutic interventions for passive or secondhand smoking- or environmental tobacco smoke-induced male reproductive impairment via regulation of BDNF-dopaminergic signaling and antioxidant balance in testes by ANA-12, leading to improved fertility potential and overall testicular health, which could establish the modulation of the brain-testes axis, implicated in nicotine addiction. This study holds translational potential of ANA-12 for the management of smoking- or nicotine-related male infertility of individuals unable or unwilling to quit smoking.
40. Predictors of serum per- and polyfluoroalkyl substances (PFAS) levels among U.S. career firefighters.
期刊: Journal of occupational and environmental medicine 发表日期: 2026-Jan-19 链接: PubMed
摘要
To identify potential predictors of serum concentrations of per- and polyfluoroalkyl substances (PFAS) among a cohort of U.S. firefighters. Serum PFAS concentrations were measured in 2,056 U.S. structural firefighters between July 2023 and October 2024. Data on demographics, lifestyle behaviors, occupational exposures, and fire agency policies were collected through individual and fire agency surveys and evaluated for associations with serum PFAS concentrations. Plasma and/or blood donation, drinking water source, military service, post-fire on-scene decontamination, turnout gear storage and transportation, rank, using aqueous film-forming foam, and carpet in fire station living quarters were all significant predictors of at least one PFAS chemical (p ≤ 0.05). Both individual and departmental predictors of serum PFAS concentrations were identified. These findings can help guide the selection of PFAS exposure reduction activities by firefighters.
41. An evaluation of ForenSeq DNA Signature Prep iiSNP mixture interpretation using a probabilistic genotyping method.
期刊: Forensic science international. Genetics 发表日期: 2026-Jan-17 链接: PubMed
摘要
The analysis of autosomal short tandem repeat markers (STRs) using capillary electrophoresis (CE) technology remains the dominant method for forensic investigations globally. However, next-generation sequencing technologies are increasingly being adopted as they enable simultaneous amplification of both STR and SNP (single-nucleotide polymorphisms) loci in large panels, amongst other benefits. Unlike STRs, which are highly variable or polymorphic, the majority of SNPs are biallelic, meaning there are only two allelic variants. A single SNP marker on its own is unlikely to provide as much evidentiary value as a single STR marker. However, the interpretation of SNP markers from mixed DNA evidence is computationally simpler than that of STR markers because they do not produce stutter artefacts and, being biallelic, there are fewer possible genotype combinations. SNPs are increasingly recognised as valuable markers, complementary to STRs, and have been proven to be useful for applications including kinship analyses, informing ancestry, providing phenotypic characters for investigative leads, or forensic investigative genetic genealogy. The most common approach for the interpretation of autosomal STR (aSTR) profiles developed using CE technology within the US, UK, and Australasia is now based on probabilistic genotyping methods. Some of these published and tested models have been applied to aSTR profiles developed using NGS technologies and in this paper, we investigate the application of one such model (STRmix™ NGS) to the interpretation of mixed SNP profiles. Comparisons of likelihood ratios (LRs) assigned to donors and non-donors show expected trends in single-source profiles. However, in more complex mixtures, the system’s ability to differentiate between true and false donors diminishes quickly. This is consistent with theoretical limitations for biallelic markers. While this study is limited to the 94 iiSNPs (identity informative SNPs) included in the ForenSeq kit, the findings suggest that simple SNP profiles can be interpreted within the existing STRmix™ NGS framework. This provides another potential tool for SNP profile analysis and lays the foundation for future joint interpretation of STR and SNP markers, or assays with more SNP markers.
42. Knowledge, awareness and practices regarding human papillomavirus vaccine amongst secondary school girls and mothers in North India.
期刊: European journal of obstetrics, gynecology, and reproductive biology 发表日期: 2026-Jan-15 链接: PubMed
摘要
Lack of awareness about cervical cancer, its aetiology and preventive measures are barriers to disease control. To study the knowledge, attitudes and practices of adolescent girls and their mothers regarding cervical cancer, human papillomavirus (HPV) vaccine, and preventive strategies. A quasi-experimental studyamongst girls aged 15-18 years and their mothers. In total, 110 girls and 100 mothers, who gave their consent, were given a pre-intervention questionnaire to assess baseline knowledge and attitudes towards cervical cancer, HPV vaccine, and preventive strategies. Printed educational material was provided. A post-intervention survey was undertaken after a minimum gap of 2 weeks. Ninety-one girls and 82 mothers with a diverse demographic profile completed the study. Pre-intervention findings revealed notable baseline awareness of cervical cancer, albeit with limited understanding of associated symptoms and preventive measures, including HPV vaccination. Post-intervention, knowledge regarding the symptoms of cervical cancer increased significantly among girls (p = 0.000), and awareness of early detection of cervical cancer increased significantly among mothers (p = 0.002). Knowledge about Pap smear tests increased among girls (p = 0.000). An increase in vaccination was seen in girls at the end of the study, but the difference was not significant (pre-intervention 23.1 %, post-intervention 31.9 %; p = 0.045). Significant improvements were observed in adolescent girls and mothers regarding awareness of symptoms and early detection of cervical cancer.
43. Seroprevalence, molecular characterization, biotyping, and associated risk factors of bovine viral diarrhea in dairy cattle in Bangladesh.
期刊: Research in veterinary science 发表日期: 2026-Jan-13 链接: PubMed
摘要
Bovine viral diarrhea virus (BVDV) is globally endemic, with the ability to establish persistent infection (PI) being central to its complex epidemiology. Currently the genetic variability of BVDV in Bangladesh remains poorly understood. This study involved a survey in commercial dairy herds in the south-eastern part of Bangladesh in 2024/2025. A total of 373 blood samples were collected from cattle in 24 dairy herds. Serum and buffy coat samples were analyzed using antibody-ELISA and RT-qPCR targeting the 5’-UTR region, followed by sequencing. The MDBK cell line was used for virus isolation and biotyping. Herd and animal-level seroprevalences were 83.3% and 15.3%, respectively, while the corresponding viremic rates were 79.2% and 11.0%. Analysis of 41 sequences identified nine distinct BVDV-1 subgenotypes (1a, 1b, 1c, 1d, 1e, 1 k, 1p, 1o, and 1v), with BVDV-1b (41.5%) and BVDV-2a (14.6%) predominating. Additionally, five HoBiPeV-a pestiviruses were detected. Among antigen-positive cattle, 38 (92.68%) were identified as transiently infected and 3 (7.3%) were confirmed as PI. Six (14.6%) and 27 (65.9%) were identified as cytopathic and non-cytopathic biotypes, respectively. Risk factors for BVDV seropositivity included: female sex (OR: 3.0), clinical disease in the past three months (OR: 2.4), crowding (OR: 2.9), and lack of dedicated clothing for farm workers (OR: 5.7). Active infection was associated with calves (OR: 6.2), heifers (OR: 2.3), stunted growth (OR: 3.0), technician-performed artificial insemination (OR: 10.4), and frequent neighboring farm visits (OR: 3.1). This study has provided data crucial for formulating prevention and control strategies against BVDV to safeguard the Bangladeshi dairy industry.
44. Genomic analysis reveals potential involvement of the brain-retina axis in regulating chicken feeding behavior.
期刊: Poultry science 发表日期: 2026-Jan-12 链接: PubMed
摘要
Feeding behavior is a fundamental biological process closely linked to development, growth, metabolism, and immune regulation in animals. In livestock production, it serves as both an indicator of health status and a selection criterion for breeding programs aimed at improving feed efficiency and adaptive behavior. However, the genetic basis and regulatory mechanisms governing these traits remain poorly understood. In this study, we investigated the genomic architecture of feeding behavior in 205 slow-growing yellow broilers using whole-genome sequencing and high-resolution behavioral phenotyping recorded by automated feeders. Six feeding behavior traits - average daily feed intake, number of daily visits, daily feeding duration, feeding duration per visit, feed intake per visit, and feeding rate - along with 17 production traits in 205 slow-growing yellow broilers were analyzed. SNP-based heritability estimates ranged from 0.30 to 0.69, indicating moderate to high genetic control. Phenotypic and genetic correlations showed significant positive correlations with residual feed intake, suggesting their potential as breeding indicators of feed efficiency. Genome-wide association studies (GWAS) identified seven single nucleotide polymorphisms (SNPs) and three structural variants (SVs) significantly associated with time-related and intake-related feeding traits. Functional annotation and regulatory element prediction highlighted candidate genes, including SMARCC1, SLC15A2, SEMA5B, LRIG1, ARHGAP39, HSPBAP1, and MAPK15, which, based on public databases, were expressed across multiple tissues but showed relatively higher levels in neuro-related tissues, with the retina emerging as a common site of high expression. These genes are involved in chromatin remodeling, neuropeptide transport, retinal development, and stress response, supporting a potential regulatory role of the brain-retina axis in feeding behavior. Together, our findings identify candidate genomic loci and biological pathways associated with feeding behavior, providing new insights into the neural regulation of appetite and valuable molecular targets for genetic improvement of feed efficiency and animal welfare in poultry breeding.
45. Parental Age and Childhood Allergy Risk.
期刊: JAMA network open 发表日期: 2026-Jan-02 链接: PubMed
摘要
Allergic diseases in children are influenced by gene-environment interactions. Although advanced parental age has been associated with genetic and epigenetic changes, its relationship with childhood allergy risk remains unclear. To examine the association between parental age at childbirth and the risk of allergic diseases in early childhood. This nationwide, multicenter, population-based, prospective birth cohort study used data from the Japan Environment and Children’s Study (JECS). Participants were enrolled at 15 regional centers in Japan between January 2011 and March 2014, with follow-up data collected at child ages 1, 2, and 4 years. The present analysis was conducted from July 8, 2024, to February 4, 2025. Eligible participants were singleton live births with data on parental age and allergic outcomes. Physician-diagnosed allergy outcomes were collected via parental report. House dust mite (HDM) sensitization was assessed in a subcohort. The primary outcomes were physician-diagnosed food allergy, wheeze, asthma, and eczema at ages 1, 2, and 4 years. The secondary outcome was HDM sensitization at ages 2 and 4 years. Adjusted odds ratios (ORs) were calculated using multivariable logistic regression after multiple imputation for missing values. A total of 34 942 mother-child pairs were included; the mean (SD) maternal age at entry was 31.0 (4.7) years, and 17 892 mothers (51.2%) had a medical allergy history. The prevalence of food allergy at age 1 year was 6.6% (95% CI, 6.4%-6.9%), decreasing with maternal age. Compared with children of mothers aged 25 to 29 years, those of mothers aged 35 to 39 years (OR, 0.79; 95% CI, 0.70-0.90) and aged 40 years and older (OR, 0.59; 95% CI, 0.44-0.79) had lower odds of food allergy. Children of parents both aged 35 years or older had lower odds of wheezing at age 4 years (OR, 0.89; 95% CI, 0.82-0.95). HDM was assessed in 1991 children at age 2 years and 1840 children at age 4 years, and children of older mothers also had lower odds of HDM sensitization (children of mothers aged 30-34 years, OR, 0.76; 95% CI, 0.59-0.98; children of mothers aged 35-39 years, OR, 0.68; 95% CI, 0.50-0.91). In this cohort study of 34 942 mother-child pairs, children of older mothers had reduced odds of food allergy, wheezing, and HDM sensitization in early childhood, suggesting that advanced maternal age may be protective against the development of allergic diseases in early childhood.
46. Process of Addressing Advance Care Planning With African American Family Caregivers of Nursing Home Residents Diagnosed With Alzheimer's Disease and Related Dementias.
期刊: Research in gerontological nursing 发表日期: 2026 链接: PubMed
摘要
To explore advance care planning (ACP) and end-of-life (EOL) communication and decision-making experiences of African American family caregivers of nursing home residents with Alzheimer’s disease and related dementias (ADRD). The study used a descriptive qualitative design with semi-structured interviews. African American family caregivers of nursing home residents diagnosed with ADRD with documented POLST were interviewed. Sixteen participants were recruited from eight nursing homes in a large Midwestern city. Three major themes were developed and highlighted that ACP and EOL conversations occurred at different points within the health care system and were facilitated by family caregivers’ knowledge of residents’ wishes for EOL care and the faith/spirituality of the family caregiver/resident. Conversations were challenged by caregivers’ lack of understanding of medical terminology and lack of providers available to educate them. ACP and EOL decision-making with African American family caregivers of nursing home residents with ADRD is a process that is affected by nursing home challenges, such as physician shortage. In making ACP and EOL decisions, African American family caregivers relied on their faith as well as their knowledge of wishes the resident with ADRD had verbalized or documented.
47. Prenatal Cannabis Use and Neonatal Outcomes: A Systematic Review and Meta-Analysis.
期刊: Obstetrical & gynecological survey 发表日期: 2026-Jan-01 链接: PubMed
摘要
Over the last 20 years, rates of cannabis use among pregnant people have increased significantly, making cannabis the most commonly used illegal substance in the antenatal period. THC, the active ingredient in cannabis, crosses the placental barrier and binds to endocannabinoid receptors on fetal organs. However, because definitive data on the risks of prenatal cannabis use remain limited, many clinicians do not counsel patients on this topic. This study provides an updated assessment of the association between prenatal cannabis use and pregnancy, fetal, and neonatal outcomes, adjusting for tobacco use and other confounders. The authors updated their previous systematic review and meta-analysis to include cohort or case-control studies published between November 2021 and April 2024 in MEDLINE, CINAHI, PsycInfo, Global Health, and the Cochrane Database of Systematic Reviews. Studies were included if they compared cannabis use versus no or less use during pregnancy and adjusted for confounders. Two independent researchers assessed each study for eligibility, risk of bias, and certainty-of-evidence ratings. Primary outcomes were preterm birth (PTB), small for gestational age (SGA), low birth weight (LBW), and perinatal morbidity. The results were analyzed to determine effect sizes and adjusted odds ratios, incorporating frequency of cannabis use when possible. Fifty-one publications were included, 8 of which were new additions since the prior analysis, yielding a total sample of 21,146,938 patients. Among the 20 studies evaluating LBW (N=1,763,753), cannabis use was associated with higher odds of LBW (OR, 1.75; 95% CI, 1.41-2.18). In 5 studies reporting dosage, heavy users had an even greater risk (OR, 2.36; 95% CI, 1.50-3.7). Twenty studies evaluated PTB (N=20,938,125), showing increased risk among cannabis users (OR, 1.52; 95% CI, 1.26-1.83), with a stronger association among heavy users (OR, 1.95; 95% CI, 1.40-2.73). Six studies assessed perinatal mortality (N=16,868,920), finding elevated odds among users (OR, 1.29; 95% CI, 1.07-1.55), though this association was not significant in analyses restricted to heavy use, leading to a low certainty-of-evidence rating. Four studies evaluated SGA (N=4,520,474) and reported increased odds among cannabis users (OR, 1.57; 95% CI, 1.36-1.81), with similar findings in heavy-use analyses (OR, 1.63; 95% CI, 1.35-1.96). Overall, the findings suggest with moderate certainty that prenatal cannabis use increases the risk of LBW, PTB, and SGA, and with low certainty that it increases perinatal mortality. The addition of recent studies expanded the sample size and supported a dose-dependent association, strengthening confidence in the results. The strengths of the review include its clinically relevant outcomes, strict exclusion criteria, and adjustment for key confounders such as tobacco. The limitations included heterogeneity between studies and gaps in collected data.
48. What Trainees Infer About Patients When Making Opioid Prescribing Decisions: A Qualitative Interview Study.
期刊: A&A practice 发表日期: 2026-Jan-01 链接: PubMed
摘要
The opioid crisis has been a factor that has significantly impacted pain management practices, leading to cautious opioid prescribing among physicians. This study explores how anesthesiology trainees navigate pain treatment decisions, focusing on how patient characteristics influence opioid prescribing behaviors. We found that trainees initially relied on “red flags” to assess a patient’s propensity to abuse opioids. However, trainees’ judgements were also shaped over the course of the clinical encounter on an individual basis. The study found no clear racial differences in prescribing decisions but highlighted the complex interplay between medical indications, patient behaviors, and socioeconomic factors in the trainees’ assessments.
49. Protocol of the digital long COVID study: A single-center, registry-based, feasibility and clinical evaluation study to investigate a 12-week digital intervention program for people affected by post-COVID-19 condition.
期刊: PloS one 发表日期: 2026 链接: PubMed
摘要
Up to 400 million individuals globally are estimated to experience persistent symptoms, including fatigue, muscle pain, and brain fog, following severe acute respiratory syndrome coronavirus type 2 infection. These persistent symptoms are referred to as Post-COVID-19 condition if they last for more than 12 weeks after infection and persist for at least 8 weeks and often causing significant distress and burden. The underlying pathological mechanisms have not yet been fully elucidated. Due to the heterogeneity of the disease a multifactorial origin is highly likely. Overall, evidence on optimal management is limited, and no medication has yet proven to be effective. Current symptom management and treatment guidelines suggest a biopsychosocial perspective and emphasize multidisciplinary approaches. Comprehensive interventions, adequate treatment access, and appropriate resources remain insufficiently available and implementing digital interventions might help mitigate these limitations. This protocol details a single-site feasibility and clinical evaluation study aiming to bridge this gap. By implementing an exploratory, open-label, digital interventional approach this study investigates the feasibility and efficacy of a 12-week program delivered by a cloud-based application. The program consists of 13 modules encompassing a wide range of topics (e.g., energy management, self-care, stress management) and includes informational (e.g., psychoeducational content) and interactive (e.g., exercises, self-reflection diaries) components. Customization options align the material with participant needs. A dedicated feedback section in each module captures feedback regarding usability and feasibility. Participants are monitored and checked for adherence throughout the study. The primary outcome is the post-intervention change in functional capacity measured by the World Health Organization Disability Assessment Schedule 2.0. All participants provide written informed consent. Key results from the study will be published in peer-reviewed journals.
50. Perinatal Management of Esophageal Varices.
期刊: Obstetrical & gynecological survey 发表日期: 2026-Jan-01 链接: PubMed
摘要
Physiological changes in pregnancy pose unique challenges for cirrhosis and portal hypertension, particularly during the third trimester and intrapartum setting. Pregnancy may increase the risk of worsening of esophageal varices and life-threatening variceal hemorrhage. Therefore, it is important that clinicians recognize risk factors for appropriate referral and management for delivery planning to mitigate risks associated with acute variceal bleeding in pregnancy. Review preconception counseling, antepartum surveillance, and intrapartum management of patients with esophageal varices, while emphasizing professional societal guidelines. A literature review identified relevant research, review articles, databases, and societal guidelines. Optimal management of esophageal varices in pregnancy requires an individualized, multidisciplinary team. Preconception counseling should include a screening endoscopy within 1 year of conception; with pregnancy, a second-trimester upper endoscopy should be considered. Small varices may be managed with a beta-blocker and surveillance. Medium and large varices should be managed with therapeutic endoscopy. Counseling regarding the mode of delivery is individualized, and attempting vaginal birth is acceptable in patients at low risk of variceal bleeding and with an anticipated short duration of the second stage of labor. Cesarean deliveries may be considered for patients with intensive care coordination needs and a high risk for variceal bleeding. Postpartum follow-up should include appropriate follow-up with Hepatology, contraception counseling, and follow-up for other comorbidities. Optimal management for patients with esophageal varices due to cirrhosis and portal hypertension requires highly individualized care. Clinical advancements, as well as a steady increase in rates of cirrhosis in reproductive-aged women, has led to a higher prevalence of clinicians caring for these patients.
51. Factors associated with and socioeconomic inequalities in underweight, overweight and obesity among adults aged 18-49 years in Lesotho: Evidence from the 2023-2024 Demographic and Health Survey.
期刊: PLOS global public health 发表日期: 2026 链接: PubMed
摘要
The coexistence of underweight and overweight/obesity within populations presents a major public health concern for low- and middle-income countries undergoing rapid nutrition transition. In Lesotho, limited evidence exists on the prevalence, determinants, and socioeconomic inequalities of these conditions among adults. This study utilized data from the nationally representative 2023-2024 Lesotho Demographic and Health Survey (LDHS), comprising 5,457 adults aged 18-49 years. Body mass index (BMI) was categorized as underweight (<18.5 kg/m2), normal weight (18.5-24.9 kg/m2), and overweight/obese (≥25.0 kg/m2). Weighted prevalence estimates, multinomial logistic regression, and concentration indices were used to examine associated factors and socioeconomic inequalities. Among adults aged 18-49 years in Lesotho, 15.2% were underweight, 48.2% had normal BMI, and 36.6% were overweight or obese. The prevalence of underweight was more common among men (22.6%), younger adults (18-29 years, 15.9%), and urban residents (17.2%). Conversely, overweight/obesity was more prevalent among women (54.8%), adults aged 40-49 years (47.9%), and individuals in the highest wealth quintile (51.0%). Multivariable analyses showed that older age, female sex, higher education, ever being married, and higher wealth index were significantly associated with overweight/obesity, while males and younger adults were more likely to be underweight. Concentration index analysis indicated no significant inequality in underweight [Concentration Index: 0.003, p > 0.05] but a significant pro-rich inequality for overweight/obesity (Concentration Index: 0.218, p < 0.001). Lesotho is undergoing a double burden of malnutrition, characterized by persistent underweight among men and younger adults, alongside an increasing prevalence of overweight and obesity among women and individuals in higher socioeconomic strata. Integrated, gender-sensitive, and equity-focused nutrition strategies are needed to address both forms of malnutrition. Strengthening the implementation of the national Food and Nutrition Policy and the Non-Communicable Disease Strategic Plan is essential to mitigate the rising burden of non-communicable diseases.
52. Serum mercury, lead, cadmium, and arsenic and incidence of type 2 diabetes among adults: A nested case-control study.
期刊: Clinical nutrition (Edinburgh, Scotland) 发表日期: 2025-Dec-29 链接: PubMed
摘要
We aimed to prospectively examine the associations of serum mercury, lead, cadmium, and arsenic with type 2 diabetes. This is a nested case-control study within a cohort of employees (n = 4754), who underwent comprehensive health checkups and provided blood samples, between 2008 and 2009. Serum cadmium, lead, mercury, and arsenic levels were measured using inductively coupled plasma mass spectrometry. During a 5-year follow-up period, type 2 diabetes was identified by plasma glucose, HbA1c, or self-report. Using the incident density method, two controls were randomly matched to each case by age, sex, and health checkup date, resulting in 325 cases and 611 controls with measurements of serum metal(loid)s. A conditional logistic regression model was used to estimate the odds ratio and 95% CI of type 2 diabetes across the quartiles of these metal(loid)s. Higher serum mercury concentrations were associated with higher odds of type 2 diabetes after adjusting for job section, shift work, smoking, alcohol consumption, leisure-time physical activity, family history of diabetes, BMI, hypertension, and serum concentrations of long-chain omega-3 fatty acids, vitamin D, magnesium, selenium, lead, cadmium, and arsenic. The odds ratios (95% CIs) for the lowest to the highest quartiles of serum mercury were 1 (reference), 1.15 (0.70, 1.90), 1.41 (0.85, 2.36), and 1.98 (1.13, 3.47), respectively (Ptrend = 0.01). There were no associations between serum cadmium, lead, and arsenic and type 2 diabetes. Our findings suggest that individuals with higher concentrations of serum mercury were more likely to develop type 2 diabetes.
53. Linking Children and Adolescents With TB Disease to HIV Services in 16 PEPFAR-supported High TB/HIV-Burden Countries in Sub-Saharan Africa, October 2018-September 2022.
期刊: The Pediatric infectious disease journal 发表日期: 2025-Nov-25 链接: PubMed
摘要
Promptly identifying children and adolescents living with both tuberculosis (TB) disease and human immunodeficiency virus (HIV) and ensuring they receive antiretroviral treatment (ART) can reduce TB/HIV-associated mortality. We reviewed linkage of children and young adolescents with TB to HIV services at clinical sites in 16 high TB/HIV-burden sub-Saharan African countries supported by the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR). PEPFAR monitoring, evaluation and reporting data describing persons <15 years of age with TB disease during October 2018-September 2022 were reviewed. Indicators included known HIV status (proportion of clients with TB who have known HIV status), HIV positivity (proportion with TB and known HIV status who have HIV, including those newly identified and those already diagnosed with HIV) and ART linkage (proportion with TB/HIV coinfection who were receiving ART). Data were collected quarterly except for ART linkage (collected annually starting in October 2021). Trend performance of indicators during the 4-year period by quarter and annual performance, stratified by sex, age, geographic region and ART status in the final year are described. Among children and adolescents <15 years old with TB during October 2018-September 2022, known HIV status quarterly coverage increased (90% [October-December 2018] to 91% [July-September 2022]); HIV positivity decreased (22%-14%), including newly positive (7%-4%); and ART coverage increased (90%-97%). In total, during October 2021-September 2022, among 73,183 children with TB, 93% (n = 67,968) had a known HIV status, of which 14% (9295/67,968) were positive (4% newly identified [2730/67,968] and 10% already diagnosed [6565/67,968]). Of 9295 with TB/HIV, 97% (9050/9295) were currently or newly started on ART. Known HIV status was lower among infants <1 year (74%, 4883/6605), and ART linkage was lower among children aged <1 (93%, 502/542) and 1-4 years (93%, 2791/2993). These findings highlight effective PEPFAR-supported integration of HIV services into TB services; however, gaps among young children persist. While HIV positivity decreased among children and adolescents with TB, universal HIV testing of those with TB remains an important strategy to close pediatric HIV treatment gaps and reduce mortality in high-burden countries.
54. Association of NRF-2 changes in plasma and pericardial fluid with renal injury in patients undergoing cardiac surgery.
期刊: Cirugia y cirujanos 发表日期: 2025 链接: PubMed
摘要
This study was conducted to investigate the levels of nuclear factor (erythroid derivative 2)-like 2 (NRF-2), kidney injury molecule 1 (KIM-1), and heme oxygenase-1 (HO-1) in pericardial fluid (PF) and systemic circulation of patients undergoing cardiac surgery. This study included 40 patients undergoing cardiac surgery and 40 healthy individuals. PF and venous blood samples were obtained from the patients and renal function tests, HO-1, KIM-1, NRF-2, antioxidant, and oxidative stress parameters were studied. A statistically significant difference was found in the NRF-2, KIM-1, HO-1, total antioxidant status, total oxidant status, and oxidative stress index measurements in the plasma of the patient and control groups and in the PF of the patients (p < 0.01). Compared to the control group, NRF-2, KIM-1, and HO-1 were found to be lower in the patient’s plasma and PF. In the patient group, NRF-2, KIM-1, HO-1, and KIM-1 were higher in PF compared to plasma. In the future, intrapericardial drug administration may improve cardiac function and prevent the adverse cardiorenal syndrome on the kidney. Investigar los niveles del factor nuclear (derivado eritroide 2) similar 2 (NRF-2), la molécula de lesión renal 1 (KIM-1) y la hemooxigenasa 1 (HO-1) en el líquido pericárdico y en la circulación sistémica de pacientes sometidos a cirugía cardiaca. En este estudio participaron 40 pacientes sometidos a cirugía cardiaca y 40 individuos sanos. Se obtuvieron muestras de líquido pericárdico y sangre venosa de los pacientes y se estudiaron las pruebas de función renal, HO-1, KIM-1, NRF-2 y los parámetros antioxidantes y de estrés oxidativo. Se encontró una diferencia estadísticamente significativa en las mediciones de NRF-2, KIM-1, HO-1, estado antioxidante total (TAS), estado oxidante total (TOS) e índice de estrés oxidativo (OSI) en el plasma entre los grupos de pacientes y de sujetos control, y en el líquido pericárdico de los pacientes (p < 0.01). En comparación con el grupo de control, se observó que NRF-2, KIM-1 y HO-1 eran más bajos en el plasma y en el líquido pericárdico de los pacientes. En el grupo de pacientes, NRF-2, KIM-1 HO-1 y KIM-1 eran más elevados en el líquido pericárdico que en el plasma. En el futuro, la administración intrapericárdica de fármacos puede mejorar la función cardiaca y prevenir el síndrome cardiorrenal adverso sobre el riñón.
55. Evaluation of mediastinal lymphadenopathy from long-term radiological findings in COVID-19.
期刊: Cirugia y cirujanos 发表日期: 2025 链接: PubMed
摘要
Mediastinal lymphadenopathy (MLAP) has been reported in post-COVID-19 patients. In this study, the relationship between post-COVID-19 infection and MLAP was investigated in patients who had been diagnosed with MLAP and decided to undergo surgery. The study included the records of 140 patients who had been diagnosed with MLAP and were decided for surgical treatment. Demographic findings, reverse transcription-polymerase chain reaction (PCR) test results, chest X-ray, thorax computed tomography (CT) findings, positron emission tomography (PET)-CT findings, and histopathological results were recorded. SUVmax value above 2.5 was 15 times more common in patients with positive PCR test results than in patients with negative results. Abnormal chest X-ray results were associated with a 9.3-fold increase in the number of patients, and the number of patients with abnormal pathology results was 33.9 times higher than those with normal results. Post-COVID-19 and MLAP (SUVmax 3-5) were shown to be associated independently of age, gender, comorbidities, and disease outcomes. MLAP lesions in patients with COVID-19 demonstrated SUVmax values that were 10-fold higher compared to patients without COVID-19. Determining reliable SUVmax values in patients with severe COVID-19 may help guide clinical decisions, tailor therapeutic approaches, and avoid unnecessary surgical indications. Se ha informado linfadenopatía mediastínica en pacientes que se recuperan de COVID-19. Nuestro objetivo fue investigar si la linfadenopatía mediastínica encontrada en pacientes con neumonía grave por COVID-19 al menos 6 meses después de la infección está asociada con la enfermedad. El estudio incluyó los registros de 140 pacientes a quienes se les había diagnosticado MLAP y se decidió que recibirían tratamiento quirúrgico. Los hallazgos demográficos se compararon mediante los resultados de RT-PCR, TC de tórax y PET-CT. Un valor de SUVmax superior a 2,5 fue 15 veces más frecuente en pacientes con resultados positivos en la prueba PCR que en aquellos con resultados negativos. Los resultados anormales en la radiografía de tórax se asociaron con un aumento de 9,3 veces en el número de pacientes, y el número de pacientes con resultados anormales en las pruebas de anatomía patológica fue 33,9 veces mayor que el de aquellos con resultados normales. Se demostró que la presencia de MLAP (SUVmax 3-5) tras la COVID-19 se asocia independientemente de la edad, el sexo, las comorbilidades y la evolución de la enfermedad. Las lesiones de MLAP en pacientes con COVID-19 mostraron valores de SUVmax 10 veces superiores a los de los pacientes sin COVID-19. Determinar valores fiables de SUVmax en pacientes con COVID-19 grave puede ayudar a orientar las decisiones clínicas, personalizar los enfoques terapéuticos y evitar indicaciones quirúrgicas innecesarias.
56. Integrated pulmonary index in pediatric sedation for endoscopy: a prospective cohort study.
期刊: Cirugia y cirujanos 发表日期: 2025 链接: PubMed
摘要
Integrated pulmonary index (IPI™) is a device working with fuzzy logic principle that analyzes patient’s end-tidal carbon dioxide (ETCO2), respiratory rate (RR), peripheral oxygen saturation (SpO2), and pulse rate and provides a number between 1 and 10. We aimed to investigate the usefulness of IPI monitor in pediatric patients. After the Investigational Review Board approval pediatric patients undergoing gastrointestinal endoscopy under sedation were recruited. Propofol (Group P) and ketamine (Group K) were used for sedation. The primary outcome measure was average periprocedural IPI values. Secondary outcome measures were recovery time, endoscopist, and anesthetist satisfactions. Correlation of IPI values with physiological parameters was examined as well. Periprocedural IPI scores were comparable between the groups (6.3 [4.9-7] vs. 6.8 [5.3-7.6] in Group P and Group K, respectively, p = 0.153). Recovery time was significantly longer in Group K (p < 0.001). Endoscopist and anesthetist satisfaction scores were comparable. Low IPI scores were significantly associated with low ETCO2, RR, and SpO2 values (p < 0.001). IPI monitor is a valuable tool in the monitorization of the pediatric patients undergoing sedation with propofol and ketamine. Both drugs are associated with comparable IPI scores. ETCO2, RR, and SpO2 values are measured lower in patients with low IPI scores (1-3 points). El índice pulmonar integrado (IPI™) es un dispositivo que funciona con el principio de lógica difusa para analizar el dióxido de carbono al final de la espiración (ETCO2), la frecuencia respiratoria (FR), la saturación periférica de oxígeno (SpO2) y la frecuencia cardiaca (FC), y proporciona un número entre 1 y 10. Nuestro objetivo fue investigar la utilidad del monitor IPI en pacientes pediátricos. Tras la aprobación por la Junta de Revisión de Investigaciones, se reclutaron pacientes pediátricos sometidos a endoscopia gastrointestinal bajo sedación. Para la sedación se utilizó propofol (grupo P) o ketamina (grupo K). La medida de resultado primaria fueron los valores medios del IPI periprocedimiento. Las medidas de resultado secundarias fueron el tiempo de recuperación y la satisfacción del endoscopista y del anestesista. También se examinó la correlación de los valores del IPI con los parámetros fisiológicos. Las puntuaciones del IPI periprocedimiento fueron comparables entre los grupos (6.3 [4.9-7] en el grupo P frente a 6.8 [5.3-7.6] en el grupo K; p = 0.153). El tiempo de recuperación fue significativamente mayor en el grupo K (p < 0.001). Las puntuaciones de satisfacción del endoscopista y del anestesista fueron comparables. Unas puntuaciones bajas del IPI se asociaron significativamente con valores bajos de ETCO2, FR y SpO2 (p < 0.001). El monitor IPI es una herramienta valiosa para la monitorización de los pacientes pediátricos sometidos a sedación con propofol o ketamina. Ambos fármacos se asocian a puntuaciones de IPI comparables. Los valores de ETCO2, FR y SpO2 son más bajos en pacientes con puntuaciones de IPI bajas (1-3 puntos).
57. An evaluation of factors which affect recurrence and malignancy of sinonasal papillomas.
期刊: Cirugia y cirujanos 发表日期: 2025 链接: PubMed
摘要
Sinonasal papillomas are rare benign tumors. They challenge otorhinolaryngologists due to their high recurrence rate and malignant transformation. The aim of this study was to investigate the clinical and demographic factors associated with recurrence and/or malignancy of sinonasal papillomas. This retrospective study included 49 patients who were operated on between 2014 and 2020. Clinical and demographic characteristics of the patients were retrieved from the patients’ records. The recurrence rate was determined to be 12.2% and the malignancy rate was 8.2%. Recurrence was significantly higher in females, the advanced stage (T3 and T4), and papillomas located in the maxillary sinus. The recurrence rate was significantly lower in patients treated with the endoscopic surgery. Factors affecting malignancy were the presence of dysplasia and extension out of the paranasal sinuses. The results of this study showed that the factors affecting recurrence were gender, papilloma stage, type of surgery performed, and whether the tumor extended to the paranasal sinuses. Los papilomas sinonasales son tumores benignos poco frecuentes. Suponen un reto para los otorrinolaringólogos por su elevada tasa de recurrencia y transformación maligna. Investigar los factores clínicos y demográficos asociados con la recurrencia y con la malignidad de los papilomas sinonasales. Estudio retrospectivo que incluyó 49 pacientes operados entre 2014 y 2020. Las características clínicas y demográficas se recuperaron de los registros de los pacientes. Se determinó una tasa de recurrencia del 12.2% y una tasa de malignidad del 8.2%. La recurrencia fue significativamente mayor en las mujeres, en los estadios avanzados (T3 y T4) y en los papilomas localizados en el seno maxilar. La tasa de recidiva fue significativamente menor en los pacientes tratados con cirugía endoscópica. Los factores que afectaron a la malignidad fueron la presencia de displasia y la extensión fuera de los senos paranasales. Los resultados de este estudio muestran que los factores que afectaron la recidiva fueron el sexo, el estadio del papiloma, el tipo de cirugía realizada y si el tumor se extendía a los senos paranasales.
58. Basic and combined peripheral biomarkers have no predictive and prognostic value in breast cancer patients undergoing pre-operative systemic therapy.
期刊: Cirugia y cirujanos 发表日期: 2025 链接: PubMed
摘要
The main goal in breast cancer patients receiving neoadjuvant chemotherapy (NAC) is to achieve a pathologic complete response (pCR). Our study examines whether neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), monocyte/lymphocyte ratio (MLR), NLR/PLR, systemic immune-inflammation index (SII), systemic inflammation response index (SIRI), and pan-immune-inflammation-value (PIV) indices can be used to determine pCR and prognosis. The study included 228 patients who received NAC for breast cancer between 2010 and 2021. Fifty-nine (25.9%) patients had pCR to NAC. In univariate analysis, a significant difference was found between clinical node status, estrogen receptor, progesterone receptor, human epidermal growth factor receptor 2 (HER2), breast cancer molecular subtypes, and pCR (p < 0.05). However, in multivariate analysis, only breast cancer molecular subtypes and HER2 status were significantly associated with pCR (p < 0.05). Our study did not find a significant relationship between NLR, PLR, MLR, NLR/PLR, SII, SIRI, and PIV indices and pCR, disease-free survival, and overall survival in breast cancer patients who received NAC. El propósito principal en las pacientes con cáncer de mama que reciben quimioterapia neoadyuvante (NAC) es lograr una respuesta patológica completa (RPC). Nuestro estudio examina si el índice neutrófilos/linfocitos (INL), el índice plaquetas/linfocitos (IPL), el índice monocitos/linfocitos (IML), la ratio INL/IPL, el índice de inmunidad-inflamación sistémica (IIS), el índice de respuesta inflamatoria sistémica (IRIS) y el valor de pan-inmuno inflamación (VPI) pueden utilizarse para determinar la RPC y el pronóstico. El estudio incluyó 228 pacientes que recibieron NAC por cáncer de mama entre 2010 y 2021. Cincuenta y nueve (25.9%) pacientes tuvieron RPC a NAC. En el análisis univariante, se encontró una diferencia significativa entre el estado de los ganglios clínicos, el receptor de estrógenos, el receptor de progesterona, el receptor del factor de crecimiento epidérmico humano 2 (HER2), los subtipos moleculares de cáncer de mama y la RPC (p < 0,05). Sin embargo, en el análisis multivariante solo los subtipos moleculares de cáncer de mama y el estado de HER2 se asociaron significativamente con la RPC (p < 0.05). Nuestro estudio no encontró una relación significativa del INL, el IPL, el IML, la INL/IPL, el IIS, el IRIS y el VPI con la RPC, la supervivencia libre de enfermedad y la supervivencia global en pacientes con cáncer de mama que recibieron NAC.