公共卫生研究摘要 (2026-01-24)

共收录 51 篇研究文章

1. Health Needs and Challenges in Preventing Secondhand Smoke Exposure Among Rural Adolescents: Implications for Innovative Health Education.

期刊: The journal of nursing research : JNR 发表日期: 2026-Jan-26 链接: PubMed

摘要

Adolescents exposed to secondhand smoke (SHS) and those living with parents who smoke are at higher risk for tobacco use and adverse health outcomes. School nurses are expected to support smoke-free policies on campuses and play a prominent role in health promotion. However, few nursing studies on SHS exposure prevention have included recommended strategies for advising family smokers (AFS). This study was developed to examine the prevalence of SHS exposure among adolescents in rural areas and assess the impact of implementing a pilot program that incorporates innovative strategies for AFS. A school-based, educational intervention study was conducted in four middle schools in western coastal Yunlin County between March and September 2023. Innovative strategies for AFS were integrated into the school’s health education curricula using a 6-hour secondhand smoke prevention program. Data were collected using self-administered, anonymous questionnaires. Descriptive and inferential statistical analyses were employed to examine the factors and barriers associated with AFS. Of the 1,202 adolescents who participated at baseline, 806 (51.4% boys; mean age=13.5 years) reported living with a smoker at home (67%). Among these 806, 91.4% reported family members smoked indoors, and, after completing the AFS program, 46.9% reported having attempted to advise their family members to quit smoking or smoke outdoors. The factors identified as significantly associated with AFS included being female, practicing avoidance behaviors, and witnessing smoking on campus. Only 8.1% felt their advice was successful, with common challenges including parental refusal, being scolded, and feelings of hopelessness. Also, many of the participants reported experiencing moral dilemmas, particularly with regard to cultural values such as filial piety, when advising parents. Exposure to secondhand smoke among adolescents living in rural areas is a serious issue. Teaching them strategies on how to advise family smokers may help reduce home exposure, particularly among boys. However, in Eastern cultures, advising parents about smoking presents moral challenges due to cultural values. Regulatory changes are needed to protect youths from secondhand smoke at home.

2. Retrieving Transgender and Gender Diverse Literature: Protocol for the Development and Validation of 2 Search Hedges.

期刊: JMIR research protocols 发表日期: 2026-Jan-23 链接: PubMed

摘要

Searching for transgender and gender diverse (TGD) references within large academic databases can be a challenging process, partly due to the dynamic and diverse definitions of words and terminologies used by multiple interest holders. Search hedges are preestablished search strings that aid in the efficacy of identifying and screening relevant articles. Validated search hedges focused on TGD people and topics will aid in identifying relevant literature. This study aims to develop and validate the sensitivity and precision of 2 interdisciplinary and cross-cultural TGD search hedges designed for retrieving references from MEDLINE and APA PsycInfo, both on the Ovid platform. Searches were conducted using the finalized search hedges via Ovid on June 7, 2024, yielding 31,055 references from MEDLINE and 22,924 references from APA PsycInfo. A random sample of 2330 records from MEDLINE and 2293 records from APA PsycInfo will be independently screened by at least 2 team members. At the title and abstract screening stage, references will be excluded if they (1) use solely binary terminology to describe gender, (2) focus on psychometric measurement of gender, or (3) focus on intersex or differences of sex development (DSD) topics. References will be included if they (1) report on transgender or gender diverse people, or both, in their sample; or (2) specifically discuss TGD communities or TGD topics. References without an abstract will be categorized as No_Abstract. References in which the TGD population is unclear will be categorized as LGB_Maybe_T or Mixed_Topics. Only references in the No_Abstract, LGB_Maybe_T, or Mixed_Topics categories will proceed to the full-text screening phase. In the full-text screening phase, references will be categorized as included if they (1) clearly distinguish between sexual identity and gender identity, (2) mention or discuss TGD topics or experiences in the Methods or Results sections, (3) communicate consideration for participants’ gender self-identification and experiences, or (4) consider TGD populations as a distinct subpopulation. The results of the screening process will be used to calculate precision and sensitivity, with a targeted sensitivity of 100% and a targeted precision of 76% for each search hedge. Validation and data analysis are projected to be finished by December 2025, with results expected to be published in 2026. Rigorous and transparent knowledge synthesis processes, starting with a high-quality search hedge, can help inform and equip community members, clinicians, policymakers, and other key decision-makers with scientifically sound evidence. DERR1-10.2196/76055.

3. Development of a Mobile App (MyLepto App) to Improve Knowledge, Attitude, and Practice Regarding Leptospirosis Among Wet Market Workers in Selangor, Malaysia: Protocol for a Quasi-Experimental Study.

期刊: JMIR research protocols 发表日期: 2026-Jan-23 链接: PubMed

摘要

Leptospirosis is the most common zoonotic cause of mortality, with most of its burden occurring in tropical regions and low-income countries. It is endemic in Southeast and South Asian nations. Leptospirosis outbreaks occur after natural disasters. In Malaysia, the e-notification system of the Communicable Diseases Control Information System recorded 5217 leptospirosis cases in 2019 with 32 fatalities. The incidence rate was 15.61 per 100,000 people. Male individuals comprised 67% of leptospirosis cases, while people aged 25 to 55 years accounted for 45% of the cases. Information and perception are crucial in influencing positive behavior. Nonetheless, information on urban and rural people’s knowledge, attitude, and practice (KAP) regarding the incidence of leptospirosis is limited. We aimed to develop a mobile app with information on leptospirosis and measure its effectiveness in improving KAP regarding leptospirosis among wet market workers in Selangor, Malaysia. A 3-phase study will be conducted and includes development of a mobile app containing information about leptospirosis, analysis of its acceptability, and application of the intervention. Participants will be recruited based on specific inclusion criteria by using purposive sampling. Four wet markets in Hulu Langat district, Selangor, will be selected according to a list provided by local municipal councils. The respondents from each selected wet market will be workers aged 18 years and older. Mobile app development will begin with an idea description, storyboard creation, and content approval through the nominal group technique. The mobile app content will be constructed using the Health Belief Model theory. Subsequently, the usability of the mobile app prototype will be evaluated using the validated Malay version of the System Usability Scale questionnaire for the evaluation of mobile apps. This protocol entails a 12-week intervention stage, in which the baseline assessment is regarded as a pretest evaluation and the follow-up assessment as a posttest evaluation. Participant selection will be based on the inclusion and exclusion criteria. This study will incorporate a set of validated questionnaires created by a group of leptospirosis experts. The validated questionnaire will comprise 9 sections with open-ended questions on sociodemographic data, KAP, and mobile app requirements. Mobile app development and usability testing were completed between January 2024 and March 2025. Participant recruitment is scheduled in April to May 2025 after submission of this manuscript, with the 12-week intervention and data collection running from May to July 2025. As of manuscript submission, recruitment, data collection, and data analysis have not yet begun. Data analysis is expected to be completed by September 2025, and results are anticipated for publication in late 2025. Due to the high number of reported leptospirosis cases in the Hulu Langat district, Selangor, this intervention study will be conducted there. The development of the mobile app may contribute to improving wet market workers’ KAP regarding leptospirosis. PRR1-10.2196/75809.

4. Personal Noise and Nonoptimum Temperature Exposures and Myocardial Ischemia: Independent Effects and Two-Way Effect Modifications.

期刊: Environmental science & technology 发表日期: 2026-Jan-23 链接: PubMed

摘要

It remains unknown whether noise and nonoptimum temperature exposures are linked to myocardial ischemia, either separately or jointly. We conducted a multicenter panel study with 24 h real-time personal measurements among generally healthy middle-aged and elderly individuals to investigate potential effects of short-term personal exposures to noise and temperature on ST-segment depression event (STDE) and whether the effects of noise are modified by temperature and vice versa. Generalized linear mixed-effect model and stratified analyses were used. A total of 117 eligible participants completed 256 person-visits. We found increased risks of STDE associated with personal noise exposure and U-shaped exposure-effect relationships between personal temperature exposure and risks of STDE, both occurring over minutes to hours. The nonoptimum temperatures, including low and high temperatures, significantly enhanced the adverse effects of noise on STDE. Significant effect modifications on temperature-related STDE risk by noise were found in both the low and high temperature ranges. Exploratory analyses suggested that decreases in heart rate variability variables, reflecting autonomic imbalance, may explain exposure-related STDE occurrence. Our study identified the independent effects and two-way effect modifications of personal noise and temperature exposures on STDE risk, providing novel insights into the pathways linking these environmental factors to adverse cardiovascular outcomes.

5. Dengue and Aging: Challenges and Opportunities in Prevention and Care. A narrative review.

期刊: Emerging microbes & infections 发表日期: 2026-Jan-23 链接: PubMed

摘要

Dengue infection is a global health issue with significantly increased incidence and overall burden, especially since 2024. Specifically, epidemiological trends show a rising median age of affected individuals over 65 years/old. Older individuals face increased risks of severe disease, extended hospital stays, healthcare-associated infections, and higher mortality rates, mainly due to a decline in immune function, and multimorbidity. Antibody-dependent enhancement, cytokine dysregulation, and endothelial dysfunction exacerbate disease severity. Moreover, in older patients, dengue diagnosis can be difficult, due to atypical symptoms. To date, there are no specific prognostic markers and no specific antiviral drugs. Management requires age-specific considerations. Evidence on immunomodulatory and antiviral therapies is emerging, and vaccine efficacy and safety data in older adults remain limited, despite growing interest. With an aging global population, dengue represents an urgent clinical challenge: there is an unmet and increasing need for comprehensive, practical guidelines to help clinicians in the diagnosis, treatment, prevention, and control of dengue infection in older patients.Trial registration: ClinicalTrials.gov identifier: NCT05611710..Trial registration: ClinicalTrials.gov identifier: NCT06579755..

6. The Virginia Commonwealth University Cervical Cytology Biorepository: A Protocol for Advancing Translational Cervical Cancer Research through Biobanking.

期刊: Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology 发表日期: 2026-Jan-23 链接: PubMed

摘要

Cervical cancer remains a major global health concern, with disparities in screening access and outcomes, particularly among younger women in the United States. Although high-risk HPV infection is the primary etiologic factor, non-genetic and environmental contributors remain underexplored. We established the Virginia Commonwealth University (VCU) Cervical Cytology Biorepository to support research on cervical cancer risk, molecular biomarkers, and gynecologic health disparities. We implemented standardized protocols for recovery, processing, and long-term storage of residual ThinPrep Pap specimens from women aged 21-65 receiving routine gynecologic care across VCU Health outpatient clinics. Core elements included an opt-out consent model, an IRB-approved waiver for discarded cytology material, EHR linkage for longitudinal clinical data, and workflows for specimen recovery, aliquoting, and processing of pellet and supernatant fractions. Specimens are cryostored at -80 °C within the Goodwin Research Laboratory with quality control checks and secure data governance. The biorepository supports standardized recovery and processing of residual Pap specimens, yielding sufficient post-diagnostic volume and enabling high-quality genomic DNA extraction and metabolomic profiling. Pilot genomic and metabolomic data demonstrate that residual cervical cytology material provides adequate input for multi-omic analyses, confirming feasibility and scalability. This protocol outlines a framework for establishing a cervical cytology biobank using residual clinical specimens. The integration of biospecimens with linked clinical and demographic data enables multidimensional research into cervical cancer etiologies and other gynecologic conditions. This resource supports molecular epidemiology studies aimed at identifying biomarkers, understanding cervical cancer progression, and addressing reproductive health disparities in diverse populations.

7. Vaccine Candidates Designed to Prevent Enterotoxigenic Escherichia coli Diarrhoea: A Scoping Review of Clinical Trials Evaluating Vaccine Candidates in Development.

期刊: Tropical medicine & international health : TM & IH 发表日期: 2026-Jan-23 链接: PubMed

摘要

The primary objectives of this study are to (1) summarise the current landscape of ETEC vaccine development by describing, characterising and comparing ETEC vaccine candidates in clinical development, (2) assess key characteristics of the phases 1, 2 and 3 clinical trials that have been designed to evaluate ETEC vaccines in development and (3) compare ETEC vaccine candidates being evaluated in clinical trials to the WHO Preferred Product Characteristics (PPC) for an ETEC vaccine. To identify vaccine candidates, we searched 24 trial registries and PubMed. Searches were completed on 6 February 2024 and updated on 27 September 2024. We extracted information about the characteristics of each vaccine candidate and information about the most recently registered clinical trial for candidates in active development. We qualitatively synthesised the information available and compared each vaccine candidate to the WHO PPC. Our search returned 262 trial records and 821 publications, from which we identified 13 unique vaccine candidates with clinical development spanning three decades, with six vaccine candidates that had at least one clinical trial registered in 2014 or later. These six candidates (dmLT, dscCfAE, ETVAX, CssBA, CVD1208S-122 and ShigETEC) are in Phase 1 or Phase 2 trials with sample sizes from 50 to 4936 participants, with no Phase 3 trials registered by September 2024. Trials take place in the United States, Bangladesh and the Gambia. The candidates vary in their route of administration (oral, intradermal, intramuscular). Two candidates are being evaluated as two doses with or without a booster, and four require three doses. Three candidates are adjuvanted. Most trials are evaluating endpoints about safety and reactogenicity. We identified diverse ETEC vaccine candidates. Comparison with the PPC emphasised differences in approach and the limited information available from early-stage trials, and the importance of generating evidence for populations with a high burden of ETEC diarrhoea.

8. Novel bayesian nonparametric unsupervised learning approach to precision symptom management in cancer survivors: a re-analysis of a comparative effectiveness trial.

期刊: Journal of behavioral medicine 发表日期: 2026-Jan-23 链接: PubMed

摘要

Cancer survivors often experience multiple cooccurring symptoms such as insomnia, pain, fatigue, and anxiety; yet conventional analyses in symptom science typically analyze symptoms one at a time and thus overlook putative clusters of shared symptom experiences. We applied a novel machine learning approach to supporting tailored symptom management to cooccurring symptoms. Bayesian nonparametric (BNP) clustering was applied to discover unique subgroups of symptom profiles in cancer survivors diagnosed with insomnia (N = 160) and with cooccurring pain, fatigue, and anxiety, using secondary symptom data from a clinical trial (clinicaltrials.gov: NCT02356575) comparing cognitive-behavioral therapy for insomnia (CBT-I) and acupuncture. BNP identified survivor subgroups by recognizing shared features in symptoms that contributed to heterogeneous treatment responses at 8 weeks. Simulations evaluated sensitivity to model assumptions. BNP identified three patient subgroups: (1) “insomnia-predominant” (N = 84) with high severity insomnia alone; (2) “insomnia & pain” (n = 21) with high severity of both insomnia and pain; and (3) “high symptom burden” (n = 54) with high severity across all symptoms. CBT-I produced greater insomnia reduction among “insomnia-predominant” patients (posterior mean=-2.45, 95% Bayesian Highest Density Interval: - 4.38, - 0.35) and among “insomnia & pain” patients (- 2.66, 80% HDI: - 4.50, - 0.50). However, acupuncture produced greater pain reduction among “insomnia & pain” patients (- 1.47, 95% HDI: - 2.79, - 0.18). CBT-I and acupuncture were equally effective for all symptoms among the “high symptom burden” patients. Simulations showed that our main BNP settings accurately identified these subgroups. Unsupervised BNP learning supports interventions tailored to patients’ symptom burden and their main concerns. If further validated, BNP learning provides a roadmap for precision symptom management for cancer survivors, and broadly applicable in behavioral medicine data analysis.

9. Discrete-Event Simulation Modeling Framework for Cancer Interventions and Population Health in R (DESCIPHR): An Open-Source Pipeline.

期刊: PharmacoEconomics 发表日期: 2026-Jan-23 链接: PubMed

摘要

Simulation models inform health policy decisions by integrating data from multiple sources and forecasting outcomes when there is a lack of comprehensive evidence from empirical studies. Such models have long supported health policy for cancer, the first or second leading cause of death in over 100 countries. Discrete-event simulation (DES) and Bayesian calibration have gained traction in the field of decision science because they enable flexible modeling of complex health conditions and produce estimates of model parameters that reflect real-world disease epidemiology and data uncertainty given model constraints. This uncertainty is then propagated to model-generated outputs, enabling decision-makers to assess confidence in recommendations and estimate the value of collecting additional information. However, there is limited end-to-end guidance on structuring a DES model for cancer progression, estimating its parameters using Bayesian calibration, and applying the calibration outputs to policy evaluation. To fill this gap, we introduce the DES Modeling Framework for Cancer Interventions and Population Health in R (DESCIPHR), an open-source codebase integrating a flexible DES model for the natural history of cancer, Bayesian calibration for parameter estimation, and an example application of screening strategy evaluation. To illustrate the framework, we apply DESCIPHR to calibrate bladder and colorectal cancer models to real-world cancer registry targets. We also introduce an automated method for generating data-informed parameter prior distributions and increase the functionality of a neural network emulator-based Bayesian calibration algorithm. We anticipate that the adaptable DESCIPHR modeling template will facilitate the construction of future decision models evaluating the risks and benefits of health interventions.

10. Outcomes of a Pilot Mobile App Just-in-Time-Adaptive-Intervention Supporting Coping Skills in Trauma Affected People with HIV.

期刊: AIDS and behavior 发表日期: 2026-Jan-23 链接: PubMed

摘要

People with HIV (PWH) experience trauma and mental health burdens at higher rates than seronegative individuals. Psychosocial interventions have shown promise for improving mental health and coping among PWH, but relatively few trauma-informed, coping-focused mobile health (mHealth) interventions exist. This pilot study evaluates the preliminary outcomes of NOLA Gem, a just-in-time adaptive intervention (JITAI)-based mHealth app designed to support real-time coping among people living with HIV (PWH) in the New Orleans area. Participants were assigned to either a control or intervention group; the intervention group received access to the NOLA Gem app, which delivered psychoeducation modules and just-in-time skill suggestions based on daily diary responses over a three-week period. Both groups completed brief daily diary surveys over the 3-week period to assess stress, emotion regulation, and coping outcomes. Analyses demonstrated positive changes in treatment compared to control, particularly in the final week. From week 1 to week 3, participants in the treatment group experienced significant reductions in maladaptive coping, rumination, and PTSD symptoms compared to the control group, along with increased feelings of control over stress at both timepoints. These effects were especially pronounced among high completers, who demonstrated greater improvements in maladaptive coping, rumination, and stress control compared to both low completers and controls. High completers also showed significant decreases in overall stress and self-reported alcohol use. These preliminary findings suggest that NOLA Gem is a promising intervention for improving coping and reducing trauma-related symptoms among PWH, particularly for those who actively engage with the app.Trial Registration: ClinicalTrials.gov NCT05784714; https//clinicaltrials.gov/ct2/show/NCT05784714.

11. How Status Quo Bias Shapes Willingness, Uptake, and Adherence to PrEP Among Chinese MSM: A Behavioral Economics Perspective.

期刊: Infectious diseases and therapy 发表日期: 2026-Jan-23 链接: PubMed

摘要

Implementing pre-exposure prophylaxis (PrEP) is hindered by a significant “PrEP Cliff”, a sharp decline from willingness to uptake and adherence. This study aimed to integrate status quo bias theory with a dual-process model, seeking to understand how this bias influences the PrEP cascade among men who have sex with men (MSM) in China. A cross-sectional survey was conducted among 1022 MSM across six provinces in China from November 2024 to February 2025. Through regression models, we tested a moderated mediation framework to examine how status quo bias influenced PrEP willingness, uptake, and adherence, focusing on the mediating role of PrEP resistance intention and the moderating role of condom-use inertia. Participants were generally young (≤ 30 years; 63.1%), mostly unmarried (88.5%), and well-educated (89% with a bachelor’s degree or higher). The “PrEP Cliff” was evident, characterized by high awareness (91.3%) and willingness among non-users (58.9%), but low uptake (46.2%) and poor adherence, with 53.4% of users self-reporting lower adherence. In the initiation phase (willingness and uptake), PrEP resistance intention significantly mediated the associations of transition costs and social norms on PrEP cascade outcomes. Condom-use inertia significantly moderated this mediation pathway by strengthening the associations of transition costs (β = 0.06, 95% CI 0.01 to 0.11) and social norms (β = - 0.05, 95% CI - 0.10 to 0.00) on PrEP resistance intention. However, the mechanism shifted during the adherence phase. Adherence was instead predominantly predicted by the direct associations of transition costs (β = - 0.44, 95% CI - 0.64 to - 0.23) and social norms (β = 0.56, 95% CI 0.38 to 0.74). This study provides an evidence-based framework for clinicians and public health programs to design stage-specific interventions tailored to the distinct psychological barriers that dominate each phase.

12. Comparison of Six Data Cleaning Methods for Determining Repetitive Head Impact Exposure in Youth Tackle Football.

期刊: Annals of biomedical engineering 发表日期: 2026-Jan-23 链接: PubMed

摘要

Instrumented mouthguards (iMGs) are commonly used to quantify head acceleration event (HAE) exposure, but accurate interpretation requires rigorous data cleaning methods. This study compared six data cleaning methods for determining HAE rates and magnitudes, as well as cleaning method validity compared to the 5th method video verification in youth tackle football. Fifty athletes (ages 8-12) wore Impact Monitoring Mouthguards during games across one season. Six data cleaning methods were applied to HAEs, including uncleaned data, time-windowing, proprietary classification algorithms, video verification, and combinations thereof. Impact rate, peak linear acceleration (PLA), and peak rotational velocity (PRV) were compared across methods using rate ratios, and intra-class correlation coefficients (ICCs), and non-parametric analyses. Data cleaning methods significantly influenced HAE rate but had minimal effect on magnitude. The uncleaned dataset produced the highest HAE rate (67.75 per athlete exposure), while the most stringent method (i.e., time-windowed, proprietary algorithm-classified, video-verified data) yielded the lowest (0.70 per athlete exposure). Although the time-windowed, proprietary algorithm-classified data demonstrated high specificity (0.96), it demonstrated low sensitivity (0.37) and positive predictive value (0.39) when compared to video-verified data. Differences in PLA across methods were not significant; only one significant difference in PRV was observed. These findings highlight the impact of data cleaning on HAE quantification in youth tackle football. Although video verification remains best practice, it is resource intensive. Time-windowed, algorithm-classified data may serve as an efficient proxy in similar cohorts, though researchers should recognize its limitations. Findings support the need for standardized data cleaning methods and transparent reporting to ensure accurate and comparable HAE exposure estimates.

13. From School-Based Immunization to Family Health Centers: the Impact of a 2020 Policy Change on 13-Year-Old Tetanus-Diphtheria Vaccine Coverage in Turkey.

期刊: Health care analysis : HCA : journal of health philosophy and policy 发表日期: 2026-Jan-23 链接: PubMed

摘要

14. Effectiveness of Integrating HIV Oral Pre-exposure Prophylaxis (PrEP) and Family Planning: A Systematic Review of Initial Implementation Efforts in Low- and Middle-Income Countries.

期刊: AIDS and behavior 发表日期: 2026-Jan-23 链接: PubMed

摘要

Oral pre-exposure prophylaxis (PrEP) and family planning (FP) share key characteristics. Both are preventive, both have high efficacy but effectiveness which can be diminished by inconsistent use and both are particularly beneficial for adolescent girls and young women (AGYW) in certain lower- and middle-income countries. When the efficacy of PrEP was proven in field trials, an effort to implement PrEP programs for the populations that would most benefit from it was launched. For AGYW, making PrEP available through existing FP services was seen as a natural opportunity for integration and was the primary effort and until recently, only experience in implementation of PrEP for AGYW. In this systematic review, we attempted to discover whether the integrated delivery of PrEP and FP results in the uptake and consistent use of either or both interventions. We found that no studies that met our inclusion criteria as no valid comparison for a PrEP/FP integration was discovered. Nonetheless, valuable information on the feasibility and acceptability of PrEP was gleaned from some of these studies, much less on the impact of PrEP promotion on FP acceptance and use. Providing PrEP to eligible individuals is an urgent public health priority. Doing so while enhancing uptake and use of FP is equally important. Future studies would benefit from a more encompassing view of this important integration.

15. Epidemiological profile and clinical outcomes of patients with mucormycosis: the multicenter retromucor study from Türkiye (2004-2024).

期刊: European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology 发表日期: 2026-Jan-23 链接: PubMed

摘要

16. High-quality chromosome-scale genome assembly and adaptive evolution analysis of Yangtze endemic Coreius guichenoti.

期刊: Genes & genomics 发表日期: 2026-Jan-23 链接: PubMed

摘要

17. Promotion - The 4th P of Social Marketing: A Scoping Review of Efforts from 2010-2022.

期刊: Journal of health communication 发表日期: 2026-Jan-23 链接: PubMed

摘要

Social marketing is a recommended framework advocated by the federal government for health promotion professionals to use in the creation of programming and campaigns. Arguably the most visible element of any social marketing effort rests with its 4th “P” - promotion. This scoping review (n = 174 publications) sought to understand how social marketers around the globe over a 13-year time span promoted their ideas to target audiences. Seven promotional channel strategies were identified (print, interpersonal, mass media, online/digital, promotional materials/products, social media, and media advocacy). The most popular strategies were print and interpersonal channels. Social marketing efforts used an average of 3.86 (SD = 1.47) promotional channel strategies. However, most efforts reviewed (55.7%) did not include any images or examples of the promotional strategies they utilized. Additionally, the majority also did not list an author affiliated with a communication department/school or communication agency (82.2%). For social marketing to truly achieve its aim of promoting social good for all of society, it is important for writeups of these efforts to be less ambiguous in their descriptions of their efforts so that future promotion professionals are not having to start from scratch when seeking to communicate effectively with their populations.

18. Creative Arts to Enhance Cervical Cancer Awareness Using Art-Based Messages From a Nigerian Crowdsourcing Open Call: Qualitative Thematic Analysis.

期刊: JMIR formative research 发表日期: 2026-Jan-23 链接: PubMed

摘要

Cervical cancer is a leading cause of cancer deaths among women in Nigeria, yet awareness is low. Historically, art has served as a medium for processing emotions and sharing experiences, which can be effective in promoting health and behavior change. This study aimed to examine art submissions and social media engagement from a Nigerian crowdsourcing open call to inform co-designed strategies for cervical cancer prevention among women. This study reported following the SRQR (Standard Reporting for Qualitative Research) guideline. From October to November 2023, we launched an open call for art on social media, inviting adult women to submit artwork that raises awareness about cervical cancer prevention. Participants’ submissions were anonymized and reviewed by an independent panel of judges. A total of 6 finalists were selected to participate in a social media contest during Cervical Cancer Elimination Week, and 3 winners were identified based on total social media likes and comments, as well as grading rubric scores. We analyzed participants’ art entries through thematic analysis in six steps: (1) familiarization, (2) creating categories, (3) identifying themes, (4) reviewing themes, (5) defining themes, and (6) discussing findings. The emerging themes included using art to express emotions, to convey health-related content, and to use art as a form of self-regulation, which were further analyzed using the Relationships and Expectations domain of the PEN-3 (perceptions, enablers, and nurturers) cultural model. A total of 43 entries from participants aged 18-27 (mean 22.2, SD 2.6) years were analyzed. The entries included visuals (n=14), audiovisual (n=14), text (n=14), and audio (n=1). Most entries (42/43, 97.6%) focused on cervical cancer and human papillomavirus, covering definitions, risk factors, treatment, and prevention. Using the PEN-3 cultural model’s Relationships and Expectations domain for analysis, 62.8% (27/43) addressed “perceptions” of art as a means of mental and emotional expression, reflecting feelings such as humor, sadness, hope, faith, unity, and fear related to cervical cancer prevention. A majority (34/43, 79.1%) aimed to promote human papillomavirus screening and vaccination and were categorized as “enablers,” viewing art as a tool for health awareness, including educational resources. Additionally, 7% (3/43) included “nurturers,” representing self-regulation addressing stresses linked to having relatives with cervical cancer. Six finalist entries were shared on social media to promote cervical cancer awareness, reaching 8685 individual Instagram accounts and generating 2727 likes and 782 comments. This study used art to increase awareness about cervical cancer on social media. Art can serve as a tool for promoting health by incorporating visual, emotional, and contextual messages to influence the target audience’s behavior.

19. Methylglyoxal-derived hydroimidazolone (MG-H1) is a novel marker of insulin resistance in Japanese individuals, disturbing insulin signalling via mTORC2 in cultured myocytes.

期刊: Diabetes, obesity & metabolism 发表日期: 2026-Jan-23 链接: PubMed

摘要

Methylglyoxal-derived hydroimidazolone (MG-H1), one of the advanced glycation end-products (AGEs), has been a potential biomarker of type 2 diabetes (T2DM), which is strongly related to insulin resistance. However, the relationship between the dynamics of MG-H1 and insulin resistance has not been characterized, and its mechanism on insulin resistance is unknown. In this study, we aimed to investigate the relationship between MG-H1 and insulin resistance in the clinical study of Japanese individuals and identify the molecular mechanisms underlying MG-H1 associated phenomena in vitro. We performed the meal tolerance test (MTT) and hyper-insulinemic-euglycemic clamp analysis in 19 patients with T2DM and 19 participants without diabetes (non-DM). We measured their fasting and postprandial MG-H1 using liquid chromatography-tandem mass spectrometry (LC-MS/MS). In addition, we evaluated the effects of MG-H1 on glucose uptake and insulin signalling in C2C12 skeletal myocytes. The postprandial MG-H1 and the area under the curve (AUC) of MG-H1 in MTTs were significantly negatively correlated with the glucose disposal rate (GDR) in clamp studies both in the T2DM (r = -0.72 [p < 0.001]) and non-DM (r = -0.54 [p < 0.05]) groups. In cultured C2C12 skeletal myocytes, pre-treatment with MG-H1 inhibited insulin-stimulated phosphorylation of Akt and glucose uptake, via the activation of mechanistic target of rapamycin complex 2 (mTORC2). In clinical study findings revealed that postprandial MG-H1 was a novel marker of insulin resistance in Japanese individuals, and in vitro findings using cultured C2C12 skeletal myocytes suggested that MG-H1 disturbs insulin signalling via the mechanisms of mTORC2 activation.

20. Trends in the incidence of HPV-associated anal cancer by risk group, 1990-2019: A population-based cohort study in British Columbia, Canada.

摘要

Anal squamous cell carcinoma, caused by human papillomavirus disproportionately affects people living with HIV (PLWH), particularly gay, bisexual, and other men who have sex with men (GBM). New guidelines recommend screening and treatment of pre-cancerous lesions. We aimed to estimate anal cancer incidence by HIV status, sex, and GBM status in British Columbia, Canada. Using administrative health databases, we assessed anal cancer stratified by HIV-status, sex, and sexual orientation from 1990 to 2019. A phenotypic algorithm was used to classify GBM status. We evaluated the comparative incidence of anal cancer using Fine and Gray’s competing risks sub-distribution hazards model. Hazard ratios were estimated and adjusted for age, healthcare utilization, urbanicity, and Charlson co-morbidity index. Among 571 anal cancer diagnoses assessed, the incidence was highest among GBM with HIV (78.09 per 100,000 person-years [PY]; 95% confidence interval [CI] = 61.24-99.58) followed by heterosexual males with HIV (44.49 per 100,000 PY; 95% CI = 29.56-66.95), and females with HIV (12.05 per 100,000 PY; 95% CI = 4.52-32.11). GBM with HIV experience a 76-fold increased anal cancer risk compared with heterosexual men without HIV (aHR 76.08; 95% CI 55.14-104.97). There is an unmet need in anal cancer prevention among PLWH. Screening strategies that are sensitive, specific, acceptable, and cost-effective are necessary. This study provides the first population-based estimates of anal cancer incidence by HIV and GBM status in British Columbia, highlighting disparities and rising trends. These findings support prioritizing targeted screening programs and improving access to care.

21. Preimplantation genetic testing-M for pathogenic variant in CTC1 gene causing cerebroretinal microangiopathy.

期刊: Journal of assisted reproduction and genetics 发表日期: 2026-Jan-23 链接: PubMed

摘要

Cerebroretinal microangiopathy with calcifications and cysts (CRMCC) is an autosomal recessive genetic and multisystem disorder characterized by extensive intracranial calcifications, leukoencephalopathy, and retinal vascular abnormalities, which is primarily caused by mutations in the CTC1 gene. Preimplantation genetic testing (PGT) is a procedure that helps patients choose embryos free of chromosome abnormalities and monogenic diseases for uterine transfer, preventing serious genetic disorders from being passed on to future generations. Here we introduce a family with fetal malformations due to CRMCC. We aimed to identify the pathogenic variants in a family with fetal malformations due to CRMCC and to utilize PGT to prevent the transmission of this genetic disorder to the next generation. Whole-exome sequencing (WES) performed on the aborted fetus suggested a novel homozygous mutation in CTC1, and Sanger sequencing revealed that this mutation is inherited from the parents. The couple decided to undergo PGT for monogenic disorders to avoid disease transmission and achieve a healthy birth. Blastocyst trophectoderm biopsy was performed for whole-genome amplification and next-generation sequencing (NGS)-based PGT to select unaffected embryos, which resulted in the birth of healthy babies. This is a novel mutation of CTC1 causing CRMCC and also the first PGT case for CRMCC, which expanded the spectrum of CTC1 mutations and will provide a solution for patients to bear healthy offspring using PGT. Furthermore, our study reconfirms the importance of genetic tests in aborted fetuses and genetic counseling.

22. Internalization and Localization of Murine Norovirus in Hydroponically Grown Green Onion (Allium Fistulosum L.).

期刊: Food and environmental virology 发表日期: 2026-Jan-23 链接: PubMed

摘要

Norovirus is a leading etiological agent of foodborne illnesses globally, with fresh produce serving as a significant vector for its transmission to humans. This study investigated the internalization potential of norovirus from contaminated irrigation water, focusing on the temporal distribution, persistence, and removability of murine norovirus (MNV) in hydroponically grown green onions. Our results demonstrated that MNV rapidly internalized into the root tissues of green onions within 1 h of exposure, subsequently translocating through the vascular system to the stems and leaves. Viral loads consistently peaked in the roots and persisted for at least 21 days post-inoculation. A single water exchange procedure resulted in a gradual decrease in viral load within plant tissues, although viral genomes remained detectable for up to 21 days. Repeated water exchanges effectively cleared the virus from leaves and stems but failed to eradicate it entirely from the roots. Immunofluorescence analysis localized the virus predominantly within the vascular tissues, specifically the xylem and phloem vessels, and most notably on the rough, porous surfaces of root hairs, where viral particles persisted despite rigorous washing protocols. Collectively, these findings unequivocally demonstrate that MNV can rapidly internalize and establish a sustained, long-term presence within green onion plants, particularly concentrated in the root tissues. This underscores the imperativeness of stringent pre-harvest preventive strategies to mitigate the risk of viral contamination in hydroponic cultivation systems.

23. Genetic diversity of Theileria species identified from questing and parasitic ticks in selected areas in Qinghai, China.

期刊: Veterinary research communications 发表日期: 2026-Jan-23 链接: PubMed

摘要

Piroplasmosis caused by tick-borne piroplasm is a vital zoonotic disease that poses significant concerns for human and animal health. However, the information on the molecular prevalence of the piroplasm transmitted by ticks is limited in Qinghai, China. Here, we investigated the geographic distribution of 544 collected ticks and the genetic diversity of tick-borne piroplasm in four areas of Qinghai. The results of the tick species identification revealed that the obtained ticks were Haemaphysalis qinghaiensis, Dermacentor everestianus, D. silvarum and D. nuttalli. Nested PCR revealed that the overall prevalence of piroplasm was 25% and included Theileria luwenshuni, T. equi, T. uilenbergi, Theileria sp. OT3 and T. ovis. Furthermore, the phylogenetic trees revealed that the piroplasm carried by ticks was individually clustered with piroplasm carried by various ticks in different regions, and the genotype of T. equi was found to be type B. The present study revealed that the distributions of tick species and the piroplasm carried by ticks in some areas of Qinghai Province are high diverse and distinct spatial heterogeneity. Moreover, Theileria sp. OT3 and T. equi were first discovered in ticks distributed in Qinghai Province, indicating that the epidemic risk of piroplasm transmitted by ticks is increasing, providing a theoretical foundation for the prevention and control of tick-borne piroplasmosis in this region.

24. Evaluation of the Efficacy of Low-Concentration Gaseous Chlorine Dioxide in Inactivating Airborne H5 High Pathogenicity Avian Influenza Virus in Vivo Model.

期刊: Food and environmental virology 发表日期: 2026-Jan-23 链接: PubMed

摘要

H5 high pathogenicity avian influenza virus (HPAIV) continues to spread globally, causing several high pathogenicity avian influenza (HPAI) outbreaks in poultry and significant economic losses. Biosecurity measures that prevent the introduction of HPAIV represent a top priority for controlling HPAI outbreaks on poultry farms. Although these measures are crucial for minimizing HPAI introduction, outbreaks of viral infection on poultry farms persist, underscoring the importance of continuously improving biosecurity protocols. Therefore, safe and effective microbicide disinfectants could play an essential role in reducing viral spread by inactivating viral particles on surfaces and in the air. This study assessed the efficacy of gaseous chlorine dioxide (ClO2) against H5 HPAIV under both gaseous ClO2 inactivation setting and in vivo conditions. In the gaseous ClO2 inactivation setting, only low virus titers were recovered (< 0.5-1.5 log10 TCID50/mL) when H5 HPAIV aerosols were exposed to gaseous ClO2 (0.05 ppmv, 0.14 mg/m3) for 5 min, corresponding to an approximately 2.0-3.0 log10 reduction. Furthermore, in vivo, all chicks exposed to aerosolized H5 HPAIV, which were treated with 0.1 ppmv gaseous ClO2, survived for 14 days post-challenge, demonstrating complete protection against the virus. The minimum effective concentration of gaseous ClO2 was 0.01 ppmv for 5 min of inactivation in the inactivation setting, and 0.05 ppmv for 5 min in vivo, indicating that relatively low concentrations are sufficient for effective viral inactivation. Therefore, gaseous ClO2 was effective at inactivating aerosolized H5 HPAIV and has potential for use as a disinfectant to prevent HPAIV introduction into poultry. (245/250) words.

25. Geospatial assessment of background radiation due to 238U, 232Th, and 40K, in selected locations in Ondo and Osun States using aeroradiometric technique.

期刊: Environmental monitoring and assessment 发表日期: 2026-Jan-23 链接: PubMed

摘要

This study presents an airborne radiometric assessment of natural gamma radiation across selected areas in Ondo and Osun States, Nigeria, utilising GIS gridded airborne geological map data from Sheets 263 and 264 obtained from the Nigerian Geological Survey Agency. The data, organised in a gridded format, were analysed using Oasis Montaj software to quantify the concentrations of naturally occurring radioelements, 238U, 232Th, and 40K, and to estimate the corresponding terrestrial gamma dose rates. Results indicate that, in Sheet 264, concentrations of 238U, 232Th, and 40K range from 4.7 to Bq/kg, 20.6 to 172.7 Bq/kg, and 96.6 to 1560.50 Bq/kg, with mean values of 48.2, 81.3, and 609.0 (Bq/kg) respectively. For Sheet 263, 238U concentrations span 0.1-94.0 Bq/kg, 232Th from 5.90 to 162.70 Bq/kg, and 40K from 59.50 to 943.00 Bq/kg with the average values of 37.2, 56.9, and 331.70 (Bq/kg) accordingly. The calculated absorbed dose rates in both sheets spanned between 37.8 and 191.6 and 14.3 and 161.8 for Sheet 264 and Sheet 263 with mean values of 100.5 nGy/h and 67.8 nGy/h. The absorbed dose rate for most of the locations in the study area exceeds the global average of 59 nGy/h, with generally higher values observed in Sheet 264. The high values of standard deviation and coefficient of variation, particularly for 40K, indicate strong spatial heterogeneity in radioelement distribution, suggesting varying lithological and mineralogical compositions within the study area. The elevated levels of primordial radioelements and associated radiation doses in several locations suggest a potential public health concern due to chronic exposure to ionising radiation. Given the geological context and ongoing anthropogenic activities in the region, routine environmental monitoring is recommended to mitigate potential radiological risks to local populations.

26. Enrichment of potentially toxic elements in brazilian coal and ash: Risks to human health.

期刊: Environmental science and pollution research international 发表日期: 2026-Jan-23 链接: PubMed

摘要

Coal combustion remains an important energy source in Brazil, particularly in the southern region, where the country’s largest coal reserves are located. However, the disposal of coal and ash residues raises environmental and public health concerns due to the accumulation of potentially toxic elements (PTE). This study investigates the chemical and mineralogical composition of coal, fly ash, and bottom ash from the Candiota (RS) and Figueira (PR) power stations, focusing on PTE enrichment and the associated human health risks. Elemental and mineral compositions were determined using ED-XRF and XRD, respectively. Human health risks were assessed through the Hazard Index (HI) and Carcinogenic Risk (CR). High PTE concentrations were identified in both coal and ash samples, with notably elevated mean levels of As (579.26 mg kg⁻1), Cr (198.47 mg kg⁻1), and Pb (154.11 mg kg⁻1). Ashes exhibited significant enrichment ratios of As, Sr, Zn, and Pb (1.52 - 24.26), especially in the fly fraction. Quartz was the predominant mineral phase, while hematite and anhydrite were also detected in ash samples. The HI indicated potential non-carcinogenic effects from As, Cd, Pb, and Cr, mainly for children (HI = 0.10 - 48.96), whereas CR values for As, Cd, and Cr through ingestion (2.32E-04 - 2.20E-02 for children; 1.05E-04 -2.36E-03 for adults) exceeded recommended safety thresholds. These findings highlight the need for improved management of coal combustion residues to mitigate human exposure and health risks in coal-based energy production areas.

27. Hydroxyapatite-cellulose composites: properties, fabrication methods, and applications.

期刊: Journal of materials science. Materials in medicine 发表日期: 2026-Jan-23 链接: PubMed

摘要

Hydroxyapatite-cellulose (HAp-cellulose) composites blend the bioactivity of HAp with the flexibility and biodegradability of cellulose, offering promise in biomedical and industrial fields. In healthcare, they aid bone regeneration, drug delivery, and tissue engineering due to their biocompatibility and porosity. Industrially, they excel in water purification and eco-friendly catalysis. With advancements in 3D printing and electrospinning, these composites enable custom implants and multifunctional scaffolds. Despite challenges in optimizing properties and scalability, future research targets hybrid materials, better fabrication, and regulatory compliance. Their role in smart therapies and environmental cleanup supports global sustainability and circular economy goals. This review summarizes key developments.

28. Tracing Potentially Toxic Metals from Water to Soil, Maize, and Cow Milk: Food Chain Risks and Safety Concerns.

期刊: Bulletin of environmental contamination and toxicology 发表日期: 2026-Jan-23 链接: PubMed

摘要

This research investigated the transfer of potentially toxic metals through the agricultural food chain, from water and soil to maize, and subsequently to cow milk, at roadside (RS) and control site (CS) locations. Using atomic absorption spectrophotometry (AAS), the concentrations of Zn, Cu, Co, Mn, Mo, Fe, Pb and Cd were determined in samples of irrigation water, soil, maize and milk. Significant concentrations of Cd and Pb were detected in RS samples compared to CS samples, indicating anthropogenic inputs primarily from vehicle emissions. Milk metal concentrations at RS for Zn, Cu, Co, Mn, Mo, Fe, Pb, and Cd were 0.239, 0.001, 0.0011, 0.035, 0.001, 0.04, 0.0016, and 0.002 mg/L, respectively, while the corresponding CS concentrations were 0.288, 0.0005, 0.0008, 0.115, 0.001, 0.02, 0.0003, and 0.001 mg/L, respectively. The Contamination Factor (CF) and Bioconcentration Factor (BCF) indicated extensive transfer of trace metals in soils to maize. The health risk associated with the daily metal intakes, as assessed by the health risk dimensions (HRI), identified Cu and Cd as the most significant risks. The findings underscore the vulnerability of roadside agricultural systems to potentially toxic metal accumulation and emphasise the importance of continuous monitoring to safeguard food safety and public health.

29. Beyond genetics: how environmental stressors drive pediatric hypertension risk.

期刊: Pediatric nephrology (Berlin, Germany) 发表日期: 2026-Jan-23 链接: PubMed

摘要

Pediatric hypertension is increasing in prevalence and is associated with cardiovascular and kidney outcomes in adulthood. Beyond traditional contributors such as obesity and kidney disease, a growing body of evidence implicates environmental exposures in the early disruption of blood pressure regulation. This review aims to evaluate and synthesize current evidence on key exposure routes, including airborne pollutants, heavy metals, and endocrine-disrupting chemicals, and their impact on pediatric blood pressure regulation through biological pathways involving vascular integrity, kidney sodium handling, neurohormonal signaling, and epigenetic programming. Mechanistic studies support roles for oxidative stress, endothelial dysfunction, hormonal dysregulation, and persistent transcriptional changes in mediating exposure-related blood pressure elevations. Although pediatric data remain limited and often are derived from observational studies, the plausibility of these pathways and the developmental sensitivity of the cardiovascular system underscore the urgency for longitudinal research. Clinical and public health strategies should incorporate environmental risk assessment to better identify modifiable exposures contributing to hypertension in children.

30. [Microplastic and skin-an update].

期刊: Dermatologie (Heidelberg, Germany) 发表日期: 2026-Jan-23 链接: PubMed

摘要

Microplastics (MPs) are polymeric particles ranging from 1-5000 µm in size; while a rather limited share is intentionally manufactured, the majority is generated through abrasion during plastic use or results from environmental fragmentation of larger plastic pieces. These persistent emerging pollutants potentially harm fauna, flora, and humans. Nanoplastics (NPs) comprise identical materials but are smaller than 1 µm (1000 nm); due to their small size, they potentially cross epithelial barriers. Outlining occurrence and biological effects of micro- and nanoplastics (MNPs) on skin and mucosa and its environmental dermatologic relevance. Literature search using PubMed and Google Scholar regarding the terms ‘microplastics’, ‘nanoplastics’, ‘skin’ and “cutan” without time limit to provide a narrative review. The in vivo effects of MNPs on cutaneous physiology remain largely unknown. However, environmental MNPs may carry harmful chemicals and pathogens and there is in vitro evidence indicating proinflammatory and cytotoxic effects as well as promoting senescence. Experimental approaches investigating MNP effects on skin health face significant limitations and implementation challenges. Given the ubiquitous environmental occurrence of MNP particles, extensive research is warranted to understand their occurrence, fate, and skin health impacts. HINTERGRUND: Mikroplastik (MP) sind Kunststoffpartikel mit einer Größe zwischen 1 und 5000 µm. Sie werden zu einem kleinen Teil gezielt synthetisiert, überwiegend fallen sie aber durch Abrieb bei der Nutzung und Fragmentierung größerer Kunststoffteile an. Durch stark gestiegene Plastikproduktion und geringe Recyclingraten steigt die Menge an MP in der Umwelt. MP wird daher als „emerging pollutant“ mit potenziell negativen Auswirkungen auf Fauna, Flora und die menschliche Gesundheit angesehen. Nanoplastik (NP) besteht aus identischen Materialien hat aber eine Größe kleiner als 1 µm (1000 nm); durch diese geringe Größe kann es potenziell epitheliale Barrieren überwinden. Es erfolgt die Beschreibung des Vorkommens und möglicher Effekte von Mikroplastik und Nanoplastik (MNP) an Haut und Schleimhäuten sowie dessen umweltdermatologischer Relevanz. Durchgeführt wurde eine zeitlich unbeschränkte Literaturrecherche in den Datenbanken PubMed und Google Scholar zu den Begriffen „microplastics“, „nanoplastics“, „skin“ und „cutan“ zur Erstellung eines narrativen Reviews. Die Effekte von MNP auf die kutane Physiologie in vivo sind weitgehend unbekannt. Allerdings können MNP aus der Umwelt schädliche Chemikalien enthalten bzw. Pathogene transportieren, und In-vitro-Daten sprechen für proinflammatorische und zytotoxische Effekte sowie die Förderung zellulärer Seneszenz. Experimentelle Ansätze zur Untersuchung von MNP-Effekten auf die Hautgesundheit weisen erhebliche Limitationen und Implementierungsherausforderungen auf. Angesichts des ubiquitären Umweltvorkommens von MNP-Partikeln bedarf es weiterer Forschung, um potenzielle Auswirkungen auf die Haut zu verstehen.

31. Correction to: Forensic medical reporting of non-fatal injuries in criminal cases in the Netherlands: a mixed-methods analysis of regional practices.

期刊: International journal of legal medicine 发表日期: 2026-Jan-23 链接: PubMed

摘要

32. Blood Culture-Negative Legionella TAVR Endocarditis.

期刊: JACC. Case reports 发表日期: 2026-Jan-23 链接: PubMed

摘要

Legionella endocarditis is exceedingly rare and diagnostically challenging. We present the first confirmed case of blood culture-negative Legionella cardiaca prosthetic valve endocarditis (PVE). A 77-year-old man with prior transcatheter aortic valve replacement presented with 8 months of daily fevers, malaise, and unintentional weight loss. Serial blood cultures were negative. Multimodality imaging suggested transcatheter aortic valve replacement-PVE, with significant valvular obstruction. Plasma microbial cell-free DNA sequencing detected Legionella species, prompting targeted therapy. The prosthetic valve was explanted, and histopathology revealed numerous bacilli. Broad-range 16S rRNA sequencing confirmed Lcardiaca. This case highlights the diagnostic complexity of culture-negative Legionella PVE and the value of multimodality imaging and molecular techniques for accurate diagnosis and management. Multimodality imaging plays an integral role in the diagnosis of infective endocarditis. Molecular diagnostics should be considered early in blood culture-negative endocarditis, particularly when conventional microbiologic testing is unrevealing.

33. Effectiveness of an ambulatory interprofessional rehabilitation on occupational performance of persons with chronic pain. A registry-based longitudinal cohort study.

期刊: Clinical rehabilitation 发表日期: 2026-Jan-23 链接: PubMed

摘要

ObjectiveTo examine to what extent the Bern Ambulatory Interprofessional Rehabilitation results in statistically significant and clinically meaningful changes in self-rated quality of and satisfaction with occupational performance, health-related quality of life, pain intensity, and burden of suffering of persons with chronic pain.DesignRegistry-based longitudinal cohort study.SettingDepartment of Rheumatology and Immunology at the Bern University Hospital, Switzerland.ParticipantsA total of 172 participants with chronic musculoskeletal pain.InterventionThe Bern Ambulatory Interprofessional Rehabilitation is a biopsychosocial intervention for persons with chronic pain.Main measuresCanadian Occupational Performance Measure, Pictorial Representation of Illness and Self Measure, European Quality of Life and Health Measure Visual Analogue Scale, and Visual Analogue Scale for pain intensity.ResultsChanges over time were statistically significant and clinically meaningful for quality of occupational performance (post-treatment p ≤ 0.001, 95% confidence interval (CI) [1.62-2.31], d = 0.8; follow-up p ≤ 0.001, 95% CI [1.23-2.20], d = 0.70), satisfaction with occupational performance (post-treatment p ≤ 0.001, 95% CI [2.35-3.22], d = 0.95; follow-up p ≤ 0.001, 95% CI [1.95-3.14], d = 0.87), burden of suffering (post-treatment p ≤ 0.001, 95% CI [0.25 to -0.42], d = 0.61; follow-up p ≤ 0.001, 95% CI [0.20-0.40], d = 0.55), and health-related quality of life (post-treatment p ≤ 0.001, 95% CI [6.30-15.66], d = 0.43; follow-up p ≤ 0.001, 95% CI [3.08-15.28], d = 0.36). Changes for pain intensity were not statistically significant nor clinically meaningful (post-treatment p = 0.676, 95% CI [-3.85 to 5.45], d = 0.03; follow-up p = 0.243, 95% CI [-8.91 to 1.72], d = -0.09).ConclusionsThis study confirms the short- and mid-term effectiveness of the Bern Ambulatory Interprofessional Rehabilitation on occupational performance, burden of suffering, and health-related quality of life of persons with chronic pain.

34. Associations of Low-Back Fatigue and Pain with Trunk Motor Variability in Repetitive Lifting: A Scoping Review.

期刊: IISE transactions on occupational ergonomics and human factors 发表日期: 2026-Jan-23 链接: PubMed

摘要

Occupational ApplicationsRepetitive lifting is a major occupational risk factor for developing low back fatigue and pain. This review aimed to identify and summarize the available evidence on how trunk motor variability (MV) may serve both as a predictor of susceptibility to fatigue/pain as well as a response to fatigue/pain during repetitive lifting tasks. Higher MV may protect workers by distributing loads and preventing overuse of the same tissues, potentially reducing the incidence or severity of fatigue/pain. However, findings also indicate that the relationship between MV, fatigue, and pain is complex, with the direction of MV changing depending on task demands, pain chronicity, and adaptation. Future work should aim to understand and monitor MV in the workplace to inform interventions for injury prevention. Background: Trunk motor variability (MV) is key to understanding the development of fatigue and low-back pain (LBP) in repetitive lifting, since it addresses the versatility of neuromuscular control of the multiple vertebral segments and thus the action of numerous muscles working actively together. Our goal in this scoping review was to clarify the predictive and reactive properties of trunk motor variability in occupational lifting, to inform future research and practical interventions for preventing and managing low-back issues among manual workers.Methods: We searched for full-length original articles written in English from the following three databases: MEDLINE, Scopus, and Web of Science. The search terms were structured to capture lifting, trunk, motor variability, fatigue and LBP.Results: Sixteen studies were identified, covering both predictive associations (i.e., whether baseline differences in MV predict fatigue or pain), and reactive associations (i.e., how MV differs due to experimentally induced fatigue or the presence of pain). Most studies assessed kinematic MV (trunk angles, coordination) and a smaller subset examined kinetic variability using muscle activity measured through metrics derived from electromyography. The predictive evidence, albeit from only one study, indicates that greater baseline MV is correlated with increased lifting endurance. As a reactive variable, MV increases with acute fatigue, while chronic pain tends to reduce MV or alter its complexity and structure. Diverse methods to quantify MV limited direct comparisons between several studies.Discussion: Associations between trunk MV and fatigue/pain were in accordance with results from both isometric exercise and dynamic tasks involving other body regions, such as the upper and lower extremities. However, the generalizability of the fatigue-pain-MV associations to occupational settings is questionable given the current evidence, since the reviewed studies involved small samples of individuals performing controlled lifting tasks in laboratory environments.

35. Inactivation of airborne pathogen surrogates by triethylene glycol.

期刊: Applied and environmental microbiology 发表日期: 2026-Jan-23 链接: PubMed

摘要

The COVID-19 outbreak brought to the fore the importance of airborne transmission in spreading human infectious diseases and highlighted the need for sustainable mitigation strategies. Triethylene glycol (TEG) has been documented as having microbicidal capabilities and has been proposed as one such mitigation strategy. Aerosolized TEG exhibits antimicrobial activity against airborne microorganisms. Grignard Pure Technology was developed to safely aerosolize TEG for decontamination of enclosed spaces. Here, we show that this TEG formulation effectively inactivates airborne microorganisms, resulting in 2 to 4.5 net log reduction in concentration of viable bacteria, viruses, and mycobacteria within 30-60 min at TEG concentration (aerosol + vapor) of ~0.7 mg/m3, which is well within the range considered safe for humans. Our data also demonstrate that aerosolizing both the test organisms and the antimicrobial product provides a more accurate and relevant measure of the product’s efficacy for indoor usage than traditional surface-or solution-based disinfection assays. Accurate evaluation of antimicrobial efficacy is a crucial step in adopting novel interventions and tools to control airborne pathogens that pose a public health risk. Our findings argue that testing protocols must match the intended use of any intervention. Given the safety concerns of aerosolizing human pathogens for direct testing of airborne infectious burden, we also advance an approach for selecting suitable surrogate microorganisms based on their phenotypic and biophysical similarity to corresponding pathogenic species.IMPORTANCEDuring the COVID-19 pandemic, personal protective equipment, social distancing, and even vaccinations proved sub-optimal in controlling the spread of COVID-19. Public health practice and the hierarchy of controls emphasize primary prevention, whereby the pathogen is removed or destroyed before exposure to the public. Triethylene glycol (TEG) has the potential to inactivate airborne pathogens and limit their spread. TEG is designated a “safer chemical” by the US EPA and has been used for decades in aerosol deodorizers and theatrical special effects. This study shows that aerosolized TEG is highly effective at eliminating a wide spectrum of viable airborne pathogen surrogates at concentrations well below the threshold of safety concern. Thus, it may afford significant protection against the transmission of infectious agents with pandemic potential.

36. Co-developing a danced version of the Graded Repetitive Arm Supplementary Program (GRASP): a participatory design study with clinicians and people with stroke.

期刊: Arts & health 发表日期: 2026-Jan-23 链接: PubMed

摘要

Self-directed exercise programs empower people with stroke to engage in recovery through daily practice but often present challenges in maintaining long-term adherence. Dance can make rehabilitation exercises more engaging and help reduce the perception of efforts, due to its inherently enjoyable nature and the use of music. This project aims to identify the key considerations for developing a danced adaptation of the GRASP delivered using short video capsules to enhance upper limb motor recovery. Using a participatory research approach, co-development meetings were conducted with researchers and occupational therapists to adapt and refine the GRASP-dance. We beta-tested the GRASP-dance with two people with stroke to refine the program. Feedback from participants and co-development meeting summaries were analyzed using inductive thematic analysis. Two main themes were derived from the co-development meetings: 1) Considerations for the transposition of the GRASP into a danced version and 2) Challenges and solutions for the development of the GRASP-dance. We adapted the GRASP into a danced version, incorporating the fundamental elements of the GRASP and key considerations at the person, the environment and the dance level. The final program includes 47 video capsules across three difficulty levels along with a weekly virtual group meeting. This work emphasized the need to tailor self-directed exercise, to include a motivating artistic element, and to address key barriers to maximize stroke rehabilitation.

37. Sedentary time by occupation in a nationally representative Japanese population: a descriptive study using the National Health and nutrition survey.

期刊: Journal of occupational health 发表日期: 2026-Jan-23 链接: PubMed

摘要

Prolonged sitting time is gradually being recognized as detrimental to health. As technological advances have made workplaces increasingly sedentary, describing sitting time by occupation is useful for identifying at-risk groups and promoting occupational health. This study aimed to elucidate the differences in sedentary time according to occupation using a nationally representative sample. Self-reported total sedentary (sitting or lying down during waking hours) time was obtained from the 2013 National Health and Nutrition Survey. Occupations were classified as professionals, managers, clerks, sales, service, protective services, agricultural/forestry/fishery workers, transport/machine operators, manufacturing/construction/cleaning laborers, homemakers, and unemployed individuals. Sedentary time by occupation was compared using an analysis of covariance adjusted for age and sex. A total of 4071 workers aged 20-64 years were analyzed. Age-adjusted sedentary time was longer in men than in women. The age-adjusted sedentary time among different occupations ranged from 280 to 499 min/day. The longest age-adjusted sedentary time was observed among clerks (499 min/day), followed by managers (437 min/day). In contrast, the shortest sedentary time was observed among agricultural/forestry/fishery workers (280 min/day). Clerks and managers had longer sedentary time on weekdays than on days off, whereas other occupations, including homemakers, did not. Sedentary time differed substantially among occupations, with a variation of approximately 3.5 h per day. Prolonged sedentary time, a known health risk, may represent a substantial occupational exposure, particularly among clerical workers. Occupational health staff should monitor workers’ sedentary time to promote better occupational health outcomes.

38. Serum lipids and low back pain in male aircraft maintenance technicians: association after ergonomic exposure adjustment.

期刊: Journal of occupational health 发表日期: 2026-Jan-23 链接: PubMed

摘要

To explore the independent associations between serum lipids and low back pain (LBP) among male aircraft maintenance technicians after adjustment for ergonomic exposures. This cross-sectional study enrolled 1,713 male aircraft maintenance technicians. LBP and ergonomic exposures were assessed using the Chinese Musculoskeletal Questionnaire (CMQ) and Quick Exposure Check (QEC), respectively. We measured fasting serum lipids, including total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C). Associations were examined using binary and ordinal logistic regression models with sequential adjustments for personal and occupational covariates. The prevalence of LBP was 42.4%. After adjustment for potential confounders, the natural logarithm of TG (ln-TG) was positively associated with LBP presence (OR 1.229, 95% CI, 1.020-1.480; P=.030) and intensity (OR 1.301, 95% CI, 1.097-1.542; P=.003), while HDL-C was inversely associated with LBP presence (OR 0.639, 95% CI, 0.438-0.932; P=.020). Categorical analysis identified key factors associated with higher LBP presence, including work experience of 5-9.9 years, high/very high back exposure, moderate/high work pace, high/very high stress, and borderline-high/high TG. The adjusted odds ratios for these key ergonomic exposures were higher than those for any lipid parameter. Among male aircraft maintenance technicians, serum TG are independent correlates of LBP after adjustment for ergonomic exposures. Given that ergonomic exposures are the predominant associated factors, prevention strategies should primarily focus on ergonomic interventions, with the management of serum lipids such as TG as an adjunctive measure.

39. Nicotinamide prevents anti-PD1 immune checkpoint inhibitor-associated early stages of cardiotoxicity.

期刊: Science China. Life sciences 发表日期: 2026-Jan-14 链接: PubMed

摘要

Cardiac immune-related adverse events (irAEs) associated with anti-programmed death-1 (anti-PD1) immune checkpoint inhibitors (ICIs) are of major concern, as they can be fatal; however, their underlying molecular mechanisms remain poorly understood. In this study, we retrospectively investigated the role of anti-PD1 ICIs in the early stages of cardiotoxicity and the underlying mechanisms. We conducted in vitro and vivo experiments to investigate the underlying mechanisms. The hearts of male mice and HL-1 cells showed downregulated myocardial apolipoprotein A (Apoa) 1 and Apoa2 expression following anti-PD1 therapy. BATF transcriptionally activated Apoa1 and Apoa2 expression, and recombinant Apoa1/Apoa2 markedly improved cardiac function in anti-PD1-treated and PD1-knockout mice. Additionally, anti-PD1 therapy induced the myocardial infiltration of macrophages in male mice. These findings showed that nicotinamide could potentially preserve the left ventricular ejection fraction (LVEF) without compromising the anticancer efficacy of anti-PD1 therapy. Mechanistically, nicotinamide altered myocardial lipid metabolism and reduced the inflammation induced by anti-PD1 therapy. Findings from the randomized controlled trial involving twelve patients with cancer treated with anti-PD1 therapy confirmed a slight decrease in the LVEF and a marked increase in myocardial enzyme levels. Nicotinamide treatment effectively mitigated these changes compared with those observed in the control group. Our findings contribute to a better understanding of cardiac anti-PD1 irAEs and show that nicotinamide might be a promising preventive strategy in the early stages of anti-PD1 ICI-associated cardiotoxicity.

40. PRR11 as a newly identified oncogenic driver in retinoblastoma.

期刊: Science China. Life sciences 发表日期: 2026-Jan-14 链接: PubMed

摘要

Retinoblastoma (RB) is the most common pediatric intraocular malignancy and seriously threatens vision and survival if not treated early. However, effective targeted therapies remain unavailable owing to the lack of well-defined molecular targets beyond RB1 gene mutations. There is a critical need to identify novel therapeutic targets. Through transcriptomic analysis of four RB-related datasets (GSE125903, GSE110811, GSE97508, and GSE24673) from the Gene Expression Omnibus (GEO) database, we identified proline-rich 11 (PRR11) as a significantly overexpressed gene in RB. Single-cell transcriptomic analysis revealed that PRR11 exhibits heterogeneous expression in different RB cell types, at particularly high levels in tumor-related populations such as cone precursor-like cells and MKI67+ photo-receptorness-decreased cells. Functional studies demonstrated that PRR11 promotes RB cell proliferation and tumor growth both in vitro and in vivo. Coimmunoprecipitation mass spectrometry (co-IP/MS) revealed that OTUB1, a deubiquitinase, interacts with and stabilizes PRR11, sustaining its high expression in RB cells. The proteomic analysis further revealed that Dickkopf WNT signaling pathway inhibitor 3 (DKK3) is a downstream adaptor downregulated by PRR11. Suppression of DKK3 by PRR11 leads to aberrant activation of the Wnt/β-catenin signaling pathway, thereby upregulating cyclin D1 and promoting S/G2M cell cycle progression. These findings establish PRR11 as an oncogenic driver in RB and highlight the OTUB1-PRR11-DKK3 axis as a regulatory mechanism of Wnt/β-catenin signaling in RB tumorigenesis. Targeting PRR11 and its downstream pathways provides a potential and novel therapeutic strategy for RB treatment.

41. Lung function impairment and risk of sepsis and sepsis-related mortality: a large cohort study with over 310,000 participants.

期刊: Science China. Life sciences 发表日期: 2026-Jan-14 链接: PubMed

摘要

Hypoxia is associated with systemic inflammation and oxidative stress, both of which contribute to sepsis development, yet whether impaired lung function is associated with a higher sepsis risk remains unclear. Leveraging data from 312,805 UK Biobank participants, we assessed baseline lung function as percentages of predicted forced vital capacity (FVC) and forced expiratory volume in one second (FEV1), and defined normal lung function as FEV1⩾80% predicted and an FEV1/FVC ratio ⩾ 0.70. Multivariable Cox models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for risk of sepsis incidence and sepsis-related mortality in relation to different measures of lung function. Stratified, sensitivity, and mediation analyses were conducted to assess potential effect modifications, result robustness, and mediation effect, respectively. During a median follow-up of 13.7 years, 8,906 incident cases of sepsis and 1,664 cases of 28-day mortality following sepsis occurred. In the multivariable-adjusted model, compared with the highest quartile, the lowest quartile of FVC% predicted or FEV1% predicted was associated with an increased risk of sepsis and sepsis-related mortality (FVC% predicted: sepsis incidence, HR=1.35, 95% CI: 1.27-1.43, 28-day mortality following sepsis, HR=1.49, 95% CI: 1.29-1.72; FEV1% predicted: sepsis incidence, HR=1.42, 95% CI: 1.34-1.52, 28-day mortality following sepsis, HR=1.75, 95% CI: 1.51-2.02; all Ptrend<0.001). Similarly, compared with individuals with normal lung function, those with impaired lung function had a higher risk of sepsis and sepsis-related mortality (sepsis incidence: HR=1.33, 95% CI: 1.27-1.39; 28-day mortality following sepsis: HR=1.57, 95% CI: 1.42-1.73; both P-values<0.001). These associations remained consistent across stratified and sensitivity analyses. Mediation analyses revealed that inflammatory biomarkers, such as C-reactive protein (CRP), accounted for 1.2%-16.3% of the associations. Collectively, these findings demonstrate that lung function impairment is associated with an increased risk of sepsis and sepsis-related mortality, and these associations are partially mediated through inflammatory responses.

42. Early Adoption of Services for Health-Related Social Needs in Medicare.

期刊: JAMA health forum 发表日期: 2026-Jan-02 链接: PubMed

摘要

This cross-sectional study assesses the provision of and reimbursement or payment denials for social determinants of health risk assessment, community health integration, and principal illness navigation services in the first year they were reimbursed by Medicare.

43. Disability Diagnoses Identified by the American Community Survey 6-Question Sequence.

期刊: JAMA health forum 发表日期: 2026-Jan-02 链接: PubMed

摘要

Federal survey data collection identifies people with disabilities predominantly by using a 6-question sequence asking about different functional impairments known as the American Community Survey-6 (ACS-6). However, little is known about the specific diagnoses identified by the ACS-6 or whether they vary across demographic subgroups. To characterize the disability diagnoses identified by the ACS-6 and assess to what extent they identify a consistent population across demographic subgroups. This cross-sectional study among people with disabilities responding to the 2023 or 2024 Survey of Income and Program Participation (SIPP) assessed the prevalence of 36 different diagnosis groupings in the ACS-6 as a whole and within each of the individual questions, as well as how the identified diagnoses varied by age group, race and ethnicity, sex, and educational attainment, with further disaggregation by cognitive disability status. Data were analyzed between August 1 and September 15, 2025. Identification as people with disabilities using the ACS-6. Diagnoses reported by survey respondents as causing the functional impairments they listed in the SIPP. A total of 13 341 people with disabilities (52.2% female; mean [SD] age, 53.0 [23.0] years) responding to the SIPP were included. Among people with disabilities aged 22 to 64 years, the most common diagnoses were anxiety or obsessive-compulsive disorders (prevalence, 15.6%; 95% CI, 14.5%-16.9%), depression (15.3%; 95% CI, 14.1%-16.5%), unspecified musculoskeletal issues (13.5%; 95% CI, 12.5%-14.6%), back or spinal problems (11.6%; 95% CI, 10.6%-12.6%), and unspecified neurologic disorders (10.8%; 95% CI, 9.8%-11.8%). The most common disability diagnoses reported by respondents identified by the ACS-6 were different across age groups but similar across demographic groups defined by sex, race and ethnicity, and educational attainment. The results of this cross-sectional study suggest that the ACS-6 identifies a similar population across demographic subgroups not characterized by age but highlight substantial heterogeneity in the population of people with disabilities within these subgroups and across age groups. Contemporary debates regarding future revisions to disability data collection in federal population surveys should address the ability to account for this heterogeneity in survey design.

44. Health Care Outcomes of Homelessness Prevention Programs in Veterans Experiencing Housing Instability.

期刊: JAMA health forum 发表日期: 2026-Jan-02 链接: PubMed

摘要

Homelessness is associated with negative health outcomes and increased health care costs. The United States Department of Veterans Affairs (VA) Supportive Services for Veteran Families (SSVF) program provides housing-related financial assistance and other supports to veterans experiencing housing instability; however, little is known regarding short-term assistance interventions with a prevention focus. To estimate potential impacts of the SSVF program in mortality and health care cost outcomes over 3 years following program entry. Using observational data, outcomes were compared between veterans who enrolled in SSVF with those who did not for each month from October 2015 to December 2018. A propensity score for SSVF enrollment was calculated using observable characteristics including demographics, housing history, health care cost history, comorbidities, and geography. Using inverse probability of treatment weighting-a propensity score-based method that creates a pseudopopulation in which treatment groups are balanced on observed covariates-the potential impacts of SSVF enrollment in mortality were estimated using a Cox proportional hazards regression and health care costs with a generalized linear model over the 3 years following the trial index date. Data were from the VA electronic health record for a cohort of veterans receiving care in the VA system. Each trial drew on veterans with evidence of homelessness in structured and unstructured medical records during the previous month. Data were analyzed from November 1, 2023, to September 9, 2025. The exposure was enrollment in the SSVF program, from the Homeless Management Information System data. The main outcomes were all-cause mortality and VA health care costs. The cohort consisted of 693 383 patient-trials with 26 649 (3.8%) enrolling in SSVF (mean [SD] age, 52.7 [12.6] years; 89.6% male) and 666 734 (96.5%) in the no SSVF group (mean [SD] age, 53.8 [13.0] years; 90.8% male). Enrollment in SSVF was associated with a decrease in the risk of mortality (hazard ratio, 0.87; 95% CI, 0.82-0.92). In addition, enrollment in SSVF was associated with an increase in outpatient costs ($7534; 95% CI, $6767-$8302) and a decrease in inpatient costs (-$10 020; 95% CI, -$13 644 to -$6396). In this study, federal prevention solutions to homelessness were associated with improved health outcomes and lower inpatient costs, which should inform national policy debates within and beyond the VA.

45. Physician Network Breadth in Medicare Advantage Plans Offering Part B Premium Givebacks.

期刊: JAMA network open 发表日期: 2026-Jan-02 链接: PubMed

摘要

This cross-sectional study examines whether physician network breadth differs between Medicare Advantage giveback plans and nongiveback plans.

46. Interactive Virtual Assistant for Health Promotion Among Older Adults With Type 2 Diabetes: The IVAM-ED Randomized Clinical Trial.

期刊: JAMA network open 发表日期: 2026-Jan-02 链接: PubMed

摘要

Older patients with diabetes often experience high levels of mental distress, which may complicate diabetes management and negatively impact health outcomes. To evaluate whether an interactive virtual assistant device built with a behavioral intervention model can improve mental health and diabetes-related outcomes in older adults with diabetes. This open randomized clinical trial was conducted at an academic medical center in Brazil between June 22, 2023, and February 8, 2024. Participants aged 65 years or older with type 2 diabetes were included. Participants were randomized 1:1 to receive the interactive virtual assistant device (Smart Speaker Echo Dot, 3rd generation [Amazon]) for home use over a 12-week period or to continue with usual care. The device was programmed with a behavioral intervention model aimed at enhancing mental health and diabetes management. The primary outcome was the between-group mean difference (MD) in mental distress, assessed using the Self-Reporting Questionnaire, in which scores range from 0 to 20, with higher scores indicating greater mental distress. Secondary outcomes included quality of life (assessed using the 36-Item Short Form Health Survey), perceived stress (assessed using the Perceived Stress Scale), adherence to diabetes self-care behaviors (assessed using the Self-Care Inventory Revised questionnaire), and glycemic control (hemoglobin A1c). All outcomes were assessed at the 12-week follow-up. Among 112 participants (mean [SD] age, 72.5 [5.7] years; 71 females [63.4%]), the mean (SD) hemoglobin A1c level was 7.9% (1.5%), and outcome measures were available for 103 participants (52 in the intervention group and 51 in the usual care group). At 12 weeks, the fully adjusted mean (SE) Self-Reporting Questionnaire score was 6.29 (0.44) for participants in the intervention group and 7.75 (0.42) for those in the usual care group, resulting in a fully adjusted MD of -1.46 (95% CI, -2.73 to -0.19; P = .02), suggesting a reduction in mental distress among the intervention group. Subgroup analyses showed consistent improvement favoring the intervention across all subgroups. The intervention was also associated with improvements in quality of life (MD, 9.46 [95% CI, 3.65 to 15.26]; P = .001), adherence to diabetes self-care behaviors (MD, 3.40 [95% CI, 1.61 to 5.19]; P < .001), and glycemic control (MD, -0.48% [95% CI, -0.85 to -0.11]; P = .01). No difference was observed regarding perceived stress (MD, -3.00 [95% CI, -6.20 to 0.20]; P = .07), and no participants withdrew due to adverse events. In this randomized clinical trial of older adults with diabetes, participants in the smart speaker group showed significant improvements in mental distress, quality of life, diabetes self-care, and glycemic control. These findings suggest that this easily implemented self-management intervention could enhance health outcomes in this population. ClinicalTrials.gov Identifier: NCT05329376.

47. Opioid Treatment Programs' Medicaid Patient Retention Rates.

期刊: JAMA network open 发表日期: 2026-Jan-02 链接: PubMed

摘要

Retention on methadone and buprenorphine has been shown to be associated with reduced overdose and death. Opioid treatment programs (OTPs) are the only health care facilities in the US licensed to dispense methadone for opioid use disorder (OUD), and they increasingly prescribe buprenorphine. By measuring and comparing their patient retention rates, after adjusting for patient characteristics, OTPs can determine if their retention rate is low relative to other OTPs, which may motivate efforts to improve patient engagement and outcomes. To develop a standardized case mix-adjusted measure for evaluating Medicaid patient retention in OTPs. This cohort study used Medicaid outpatient claims and demographic data from 2018 to 2023. All OTPs in the US with at least 11 non-dually eligible Medicaid beneficiaries aged 18 years or older with an OUD diagnosis were included. Analyses were completed between January and October 2025. OUD treatment at OTPs. The percentage of an OTP’s Medicaid patients who remained in treatment at the OTP for greater than 30 days, greater than 90 days, and greater than 180 days. Retention rates were calculated for 5 measurement years (2019 through 2023; eg, July 1, 2018, to June 30, 2019) and underwent case mix adjustment using Medicaid data and patient characteristics. This study included 261 025 Medicaid beneficiaries (140 718 males [53.9%]; mean [SD] age, 39 [9.92] years) with 432 918 episodes of treatment at 1138 OTPs in measurement year 2023. The median (IQR) 30-day, 90-day, and 180-day retention rates were 61.2% (40.9%-73.5%), 41.5% (22.2%-54.8%), and 27.5% (11.4%-40.5%), respectively, in measurement year 2023. This cohort study found low retention rates and variable treatment duration across OTPs. This result indicates opportunities for quality improvement.

48. Appendectomy and Risk of Nonyphoidal Salmonella Infection in Children.

期刊: JAMA network open 发表日期: 2026-Jan-02 链接: PubMed

摘要

The appendix is thought to have immunological functions. However, its role in protecting against enteric infections such as nontyphoidal Salmonella (NTS) remains unclear in children. To investigate whether pediatric appendectomy is associated with an increased hazard of subsequent NTS infection. This was a nationwide population-based cohort study using data from Taiwan’s National Health Insurance Research Database between January 1, 2000, and December 31, 2019. Children who underwent appendectomy were matched to children without appendectomy in a 1:4 ratio based on age, sex and index date. Data were analyzed from January 2000 to December 2019. Appendectomy during childhood. The primary outcome was the incidence of NSA infection, defined as 3 outpatient or 1 inpatient diagnosis after the index date. The hypothesis that appendectomy increases susceptibility to NTS infection was specified before data collection. Cox proportional hazards models were used to estimate adjusted hazard ratios (aHRs). The cohort included 18 654 children who underwent appendectomy (mean [SD] age, 10.04 (4.17) years; 11 883 [63.7%] male) and 74 616 matched children in the control group (mean [SD] age, 9.73 [4.30] years; 47 532 [63.7%] male). Children who underwent appendectomy had a significantly higher risk of NTS infection compared with children in the control group (aHR, 1.58; 95% CI, 1.17-2.13). The risk was pronounced in children younger than 5 years (aHR, 2.00; 95% CI, 1.35-2.97). Regarding follow-up periods, the risk was elevated but not statistically significant for 1 to 4 years (aHR, 1.51; 95% CI, 0.98-2.32) and 5 or more years (aHR, 1.78; 95% CI, 0.89-3.54). In this nationwide cohort study of children in Taiwan, pediatric appendectomy was associated with an increased hazard of NTS infection in the overall population and in particular among children younger than 5 years. These findings suggest a potential need for surveillance and preventive strategies in children following appendectomy, but further studies are warranted to develop and evaluate specific interventions.

49. Multiple Maternal Chronic Conditions and Risk of Severe Neonatal Morbidity and Mortality.

期刊: JAMA network open 发表日期: 2026-Jan-02 链接: PubMed

摘要

Nearly 16% of pregnant individuals have multiple chronic conditions (MCC), and the risk of severe maternal morbidity and mortality increases in a dose-response manner with the number of preexisting conditions. However, little is known about newborn outcomes in this population. To examine the association of the number of preexisting maternal chronic conditions, as well as the presence of MCC complexity, cardiometabolic MCC, and MCC severity, with the risk of severe neonatal morbidity or mortality (SNM-M). This population-based cohort study was conducted in Ontario, Canada, among all live births from 2012 to 2021. Data were analyzed from September 2024 to November 2025. Maternal MCC measured in the 2 years before conception. Modified Poisson regression was performed to generate adjusted relative risks (aRRs) for SNM-M by the number of chronic conditions, MCC complexity (≥3 chronic conditions in ≥3 body systems), co-occurring cardiometabolic conditions, and MCC severity marked by a prenatal hospitalization for a chronic illness. Multivariable models were adjusted for age, parity, immigration status, income quintile, and rurality. The cohort comprised 1 018 968 newborns, including 20 934 to mothers with 3 or more chronic conditions (mean [SD] maternal age, 30.0 [6.3] years), 73 768 to mothers with 2 chronic conditions (mean [SD] maternal age, 30.3 [5.8] years), 276 765 to mothers with 1 chronic condition (mean [SD] maternal age, 30.7 [5.4] years), and 647 501 to mothers with 0 chronic conditions (mean [SD] maternal age, 31.0 [5.1] years). Compared with newborns of mothers with 0 chronic conditions, the aRR for SNM-M increased in a dose-response fashion in newborns of mothers with 1 (1.26; 95% CI, 1.24-1.28), 2 (1.58; 95% CI, 1.54-1.62), and 3 or more (2.01; 95% CI, 1.94-2.09) chronic conditions. The aRRs were also increased with complex MCC (1.97; 95% CI, 1.88-2.06), cardiometabolic MCC (2.67; 95% CI, 2.24-3.19), and severe MCC (3.11; 95% CI, 2.55-3.79). In this study, risks of SNM-M increased with an increasing number of preexisting maternal chronic conditions. These findings suggest that women and adolescents with MCC may benefit from preconception counseling to optimize chronic disease management, monitoring in pregnancy for earlier identification of complications, and enhanced newborn supports.

50. Stakeholder Engagement for Hepatitis C Virus Elimination.

期刊: JAMA health forum 发表日期: 2026-Jan-02 链接: PubMed

摘要

This Viewpoint describes factors necessary to eliminate hepatitis C virus, including access to point-of-care RNA testing and availability of treatment, and the stakeholders from the federal to the community level that must participate.

51. Economic Evaluation of Tobacco Treatments From the Screen ASSIST Lung Cancer Screening Trial.

期刊: JAMA network open 发表日期: 2026-Jan-02 链接: PubMed

摘要

Integrating smoking cessation interventions within lung cancer screening (LCS) programs may significantly reduce smoking-related morbidity and mortality. Data on costs and cost-effectiveness of smoking cessation interventions in the context of LCS can foster the dissemination of effective treatments. To evaluate the cost-effectiveness from a health system perspective of 8 smoking cessation treatment strategies evaluated in the context of the Screen Aiding Screening Support In Stopping Tobacco (ASSIST) trial among patients undergoing LCS in 1 large health care system. The Screen ASSIST trial used a 3-way factorial design testing the effectiveness of 8 combinations of smoking cessation treatments at a health system in Massachusetts with 11 participating LCS sites. In this economic evaluation, costs and cost-effectiveness were evaluated prospectively and contextualized through sensitivity analyses. Participants included English-speaking and Spanish-speaking patients who smoked and were scheduled for LCS between April 2019 and July 2023. Participants were randomized to 4 vs 8 counseling sessions, 2 vs 8 weeks of nicotine replacement therapy (NRT), and screening for social determinants of health (SDH) vs no screening. The primary effectiveness outcome was self-reported 7-day smoking abstinence at 6 months. Cost measures included both start-up and operating costs, with incremental cost per quit (ICQ) calculated relative to usual care. Screen ASSIST had 642 participants (mean [SD] age, 64.0 [6.5] years; 358 female [55.8%]; mean [SD] 36.8 [19.4] pack-years; mean [SD] 16.2 [8.2] cigarettes per day). Start-up costs for the program were $131 371, primarily for electronic health record programming ($124 903). Operating costs for the intervention conditions ranged from $196 272 to $274 865 for 642 participants. The ICQ of 8 counseling sessions, 2 weeks NRT, and no SDH screening was $3050 (95% CI, $1286-4815), the most cost-effective condition. Per-patient costs and ICQ would be lower in health systems serving larger patient populations. In this economic evaluation of smoking cessation treatment in LCS, 8-session counseling combined with 2 weeks of NRT was a cost-effective strategy, with a favorable ICQ relative to usual care and other treatment strategies evaluated. These findings are relevant for health systems considering integrating smoking cessation programs with LCS services.