公共卫生研究摘要 (2026-01-25)
共收录 56 篇研究文章
1. Evaluation of the Perception of Deprescribing by French Pharmacy Students: A National Observational Study.
期刊: Basic & clinical pharmacology & toxicology 发表日期: 2026-Feb 链接: PubMed
摘要
The ageing population, which is often associated with polypharmacy, indicates the need for evolution within the healthcare professions. Future pharmacists must develop new skills and knowledge to meet these challenges, including during their university training. Deprescribing is an essential process for optimising drug intake and reducing the risks associated with polypharmacy, although the term remains little known in France. This study aims to assess the perceptions of pharmacy students regarding deprescribing, and to identify their training needs. A questionnaire based on an American study was distributed. Composed of seven sections, it covered knowledge, confidence, attitudes, the interprofessional role, the required resources, as well as preparedness for deprescribing and sociodemographic data. A total of 407 responses were analysed, along with the qualitative results of two open-ended questions, which were processed using thematic analysis. The results showed that, whereas 66.2% of students felt able to identify potentially inappropriate medicines (PIMs), only 29.6% expressed confidence in their ability to deprescribe these medications. While 97.5% recognised the value of deprescribing PIMs, 88.6% identified numerous obstacles to its implementation. These results highlight the need to adapt pharmacy student training to enhance their skills and confidence in this area. The ageing population and rising polypharmacy require pharmacists to develop new skills, including during their university training. Deprescribing, still little known in France, is essential to reduce medication‐related risks. This study assessed pharmacy students’ perceptions and knowledge using a questionnaire (407 responses). While two‐thirds could identify potentially inappropriate medications, fewer than one‐third felt confident deprescribing. Most students recognised its usefulness but also reported many barriers. Nearly all viewed pharmacists as key actors in the process. Overall, the findings highlight the need to strengthen pharmacy training to improve students’ skills and confidence in deprescribing.
2. Effectiveness of an online mindfulness-based stress reduction program for nurses in high-stress occupational settings during the COVID-19 pandemic.
期刊: Applied nursing research : ANR 发表日期: 2026-Feb 链接: PubMed
摘要
Frontline nurses face heavy infection control demands, rotating shifts, and psychological stress, leading to pandemic fatigue and reduced resilience. Evidence on mindfulness-based stress reduction (MBSR) for this group remains limited. To evaluate the effectiveness of an online MBSR program on pandemic-related fatigue and resilience among nurses in COVID-19-designated wards. A convergent parallel mixed-methods design was used. Sixty nurses were assigned to the MBSR (n = 30) or control (n = 30) groups. The six-week online program included weekly 90-min sessions. Data were collected at baseline (T1), week 3 (T2), and week 6 (T3). Seven MBSR participants also completed qualitative interviews. At baseline, both groups demonstrated moderate levels of pandemic fatigue and resilience. The MBSR group showed a significant reduction in pandemic fatigue at T3 (p < 0.001) but not at T2 (p = 0.057), and significant improvements in resilience at both T2 (p < 0.001) and T3 (p < 0.001). Compared with the control group, the MBSR group exhibited significantly greater reductions in fatigue at T2 (p = 0.007) and T3 (p < 0.001), as well as greater improvements in resilience at T2 (p < 0.001) and T3 (p < 0.001). Qualitative analysis further identified four themes illustrating participants’ experiences of the program. This study provides preliminary evidence that an online MBSR program may help alleviate pandemic fatigue and strengthen resilience among frontline nurses. Integrating digital mindfulness programs into occupational health initiatives could support nurses’ mental well-being and compassionate care in high-stress clinical settings. ClinicalTrials.gov identifier no. NCT06433544 (https://clinicaltrials.gov/study/NCT06433544).
3. Misophonia Symptoms in Autistic Adults.
期刊: Journal of autism and developmental disorders 发表日期: 2026-Jan-24 链接: PubMed
摘要
Misophonia is the adverse emotional reaction to everyday sounds (e.g., chewing or pen clicking). Since atypical sensory experiences are a key feature of autism, we investigated whether autistic individuals are more liable for experiencing misophonia symptoms. In addition, we explore the contribution of sensory sensitivity to misophonia symptoms in autism. Autistic adults (N = 1050) filled out the Amsterdam Misophonia Scale-Revised (AMISOS-R), the Autism Spectrum Quotient (AQ-28), and the Sensory Processing Questionnaire (SPQ). Chi-square tests were applied to compare proportion of moderate or higher AMISOS-R scores over 20 to previously reported values in the extant literature. Next we modelled the quantitative level of AMISOS-R scores as function of AQ-28 with age, sex, and co-occurring disorders. Finally, we ran a mediation model adding SPQ as a mediator. Autistic people reported moderate to extreme levels of AMISOS-R in higher proportion than the general population. In particular autistic females and those with co-occurring disorders scored higher. In quantitative models, we found that autistic traits strongly predicted misophonia symptoms after correcting for multiple covariates. Both the hearing and vision subscales of the SPQ significantly mediated the effect. The increased level of misophonia symptoms in autism and the mediation analyses suggest that autistic traits and sensory sensitivity are factors to consider for a subset of misophonia sufferers, with possible consequences for their clinical interventions.
4. Holmium laser en‑bloc vs bipolar and conventional monopolar TURBT for non‑muscle‑ınvasive bladder cancer.
期刊: International urology and nephrology 发表日期: 2026-Jan-24 链接: PubMed
摘要
This study aimed to compare the clinical safety, surgical efficacy, and oncologic outcomes of three transurethral resection techniques: the conventional monopolar transurethral resection of bladder tumor (CM-TURBT), the bipolar transurethral resection of bladder tumor (BP-TURBT), and the holmium laser en bloc resection of bladder tumor (HoL-ERBT) in patients with primary non-muscle-invasive bladder cancer (NMIBC). This retrospective single-center cohort study included consecutive patients with primary NMIBC treated between January 2020 and March 2025. All eligible patients undergoing CM-TURBT, BP-TURBT, or HoL-ERBT were analyzed. To minimize confounding related to non-random treatment allocation, the inverse probability of treatment weighting (IPTW) based on propensity scores was applied. Perioperative outcomes, complication rates, detrusor muscle inclusion, visible complete resection, and recurrence-free survival (RFS) were compared using weighted analyses. Time-to-event outcomes were assessed with IPTW-adjusted Kaplan-Meier curves and Cox regression models. After IPTW adjustment, HoL-ERBT was associated with significantly shorter resection times, lower hematuria rates, and reduced catheterization and hospitalization durations compared with CM-TURBT (p < 0.001 for all), while BP-TURBT demonstrated intermediate outcomes. Detrusor muscle inclusion was highest with HoL-ERBT (approximately 93%), compared with CM-TURBT (≈ 66%) and BP-TURBT (≈ 77%). IPTW-adjusted RFS at 12, 24, and 36 months did not differ significantly among the techniques. HoL-ERBT provides meaningful perioperative and pathological advantages over conventional TURBT techniques in NMIBC without compromising short- to mid-term oncologic outcomes. To our knowledge, this is the first study with a follow-up period exceeding 24 months. Despite procedural advantages, similar recurrence outcomes suggest that further prospective randomized trials are warranted to clarify the long-term oncologic role of HoL-ERBT.
5. Spiritual Resilience in Disasters: A Systematic Review of Indicators.
期刊: Journal of religion and health 发表日期: 2026-Jan-24 链接: PubMed
摘要
This study was conducted with the aim of identifying indicators of spiritual resilience in disasters and emergencies. In this systematic review, English and Persian-language documents were searched in databases and 32 articles were included in the study. The extracted indicators in the field of spiritual resilience in disasters and emergencies were categorized into three domains: adherence to rituals, personal growth, and a sense of social responsibility. Based on the findings of this study and subsequent complementary research, it is possible to develop an assessment tool for measuring spiritual resilience in disasters and emergencies.
6. Barriers and Facilitators to Integrating Spirituality in Childbirth Among Primary Healthcare Workers in Nigeria: An Exploratory Qualitative Study.
期刊: Journal of religion and health 发表日期: 2026-Jan-24 链接: PubMed
摘要
Spirituality is deeply embedded in childbirth experiences among Nigerian women; yet, its integration into maternity care remains limited, especially at the primary health care (PHC) level. This study explored the barriers and facilitators to integrating spirituality in childbirth among PHC workers in Ogbomoso, Nigeria. An exploratory qualitative research design was used, involving semi-structured interviews with ten purposively selected female PHC workers from selected health centers. Participants were mostly aged 41-50 years, predominantly Christian, and had 11-20 years of professional experience. Thematic analysis generated six themes as barriers to integrating spirituality: safety concerns related to harmful or unsterile spiritual items; concerns about disturbance from loud prayers disrupting the ward environment; heavy workload limiting attention to non-clinical needs; lack of training on spiritual care beyond prayer; time constraints, particularly during emergencies; and personal beliefs of health workers which sometimes conflicted with patients’ spiritual preferences. Facilitators to integrating spirituality generate four themes: strong rapport between patients and caregivers, a calm and organized clinical environment, allowing access to personal spiritual items like scriptures or prayer beads, and supportive management policies that enabled flexibility without compromising care. The findings suggest that while spirituality is valued, systemic, institutional, and individual-level factors influence its implementation. Integrating spiritual care into PHC will require targeted training, staffing improvements, clear policies, and culturally sensitive guidelines to ensure holistic and respectful maternal care.
7. Moving beyond risk ratios in sibling analysis: estimating clinically useful measures from family-based analysis.
期刊: European journal of epidemiology 发表日期: 2026-Jan-24 链接: PubMed
摘要
Findings from family-based analyses, such as sibling comparisons, are often reported using only odds ratios or hazard ratios. We demonstrate how this can be improved upon by applying the marginalized between-within framework. We provide an overview of sibling comparison methods and the marginalized between-within framework, which enables estimation of absolute risks and clinically relevant metrics while accounting for shared familial confounding. We illustrate the approach using Swedish registry data to examine the association between maternal smoking and infant mortality, estimating absolute quantities (e.g., cumulative risks), average treatment effects, attributable fractions, and numbers needed to harm (or treat). The marginalized between-within model decomposes effects into within- and between-family components while applying a global baseline across all families. Although it typically yields similar relative estimates to conditional logistic or stratified Cox regression, the model’s specification of a baseline enables the estimation of absolute measures. In the applied example, absolute measures provided more interpretable and policy-relevant insights than relative estimates alone. Code for implementation in Stata and R is provided. The marginalized between-within framework may strengthen the interpretability of family-based analysis by enabling absolute and policy-relevant estimates for both binary and time-to-event outcomes, moving beyond the limitations of solely relying on relative effect measures.
8. Blood lipids and the risk of aortic aneurysm: results from the UK Biobank study and a systematic review and meta-analysis of cohort studies.
期刊: European journal of epidemiology 发表日期: 2026-Jan-24 链接: PubMed
摘要
Circulating lipids are potentially modifiable risk factors for aortic aneurysm, however, associations between levels of specific lipids and aortic aneurysm are unclear. We analysed associations between blood lipids and aortic aneurysm in the UK Biobank and summarized the available data in a systematic review and meta-analysis of published cohort studies. Up to 429,610 participants aged 38-73 years at baseline in 2006-2010 in UK Biobank were included. Multivariable Cox regression was used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for the associations between serum/plasma lipids (total cholesterol, low-density lipoprotein [LDL] cholesterol, high-density lipoprotein [HDL] cholesterol, triglycerides, apolipoprotein A1, apolipoprotein B, and lipoprotein(a)) and risk of aortic aneurysm. PubMed and Embase databases were searched up to November 11th, 2025, to identify relevant cohort studies. Random-effects models were used to estimate summary relative risks (RRs) and 95% CIs for the associations between blood lipid levels and aortic aneurysm risk. In UK Biobank, 2,434 aortic aneurysm cases occurred during 12.3 years of follow-up. Positive associations were observed between the highest vs. lowest quintile of total cholesterol (HR 1.22, 95% CI 1.07-1.41), LDL cholesterol (1.39, 1.21-1.60), apolipoprotein B (1.52, 1.33-1.74), non-HDL cholesterol (1.50, 1.29-1.73), triglycerides (1.23, 1.06-1.42), lipoprotein(a) (1.34, 1.17-1.54) and aortic aneurysm risk, while HDL cholesterol (0.57, 0.48-0.67) and apolipoprotein A1 (0.54, 0.46-0.63) were inversely associated. Eighteen cohort studies were included in the meta-analysis. The summary RR (95% CI) per 1 mmol/L increase was 1.16 (1.10-1.22, I2 = 74%, n = 15) for total cholesterol, 1.11 (1.04-1.19,I2 = 63%, n = 4) for LDL cholesterol, 1.28 (0.98-1.67, I2 = 89%, n = 2) for non-HDL cholesterol, 0.59 (0.50-0.70, I2 = 72%, n = 5) for HDL cholesterol, 1.02 (0.95-1.10, I2 = 55%, n = 7) for triglycerides, and 1.34 (1.17-1.55, I2 = 57%, n = 4) per 50 mg/dl incrememt in lipoprotein(a). Additional positive (apolipoprotein B, non-HDL cholesterol) and inverse (apolipoprotein A1) associations were observed in high vs. low meta-analyses. These findings suggest higher levels of total cholesterol, LDL cholesterol, apolipoprotein B, non-HDL cholesterol, lipoprotein(a), and possibly triglycerides are associated with increased risk of aortic aneurysm, while higher levels of HDL cholesterol and apolipoprotein A1 are associated with lower risk.
9. The multistep pathogenic hypothesis of amyotrophic lateral sclerosis is incompatible with the epidemiological data.
期刊: European journal of epidemiology 发表日期: 2026-Jan-24 链接: PubMed
摘要
Amyotrophic lateral sclerosis (ALS) is a multifactorial neurodegenerative disease whose incidence increases with age. According to the gene-time-environment hypothesis, ALS onset occurs through the interaction between genes and environmental exposures during ageing, which may involve a continuous accumulation process. Alternatively, the multistep pathogenic hypothesis, based on the Armitage-Doll multistep model from cancer research, posits that a discrete number of specific sequential “hits” are necessary to trigger ALS. Here we analyzed three large population-based epidemiological datasets of ALS to formally test whether the ALS age-incidence curve is better described by a power law, as predicted by the Armitage-Doll model, or by an exponential function, which is generally associated to continuous accumulation of damage and is incompatible with the Armitage-Doll model. We obtained moderate-to-extreme Bayesian evidence in favor of the exponential function compared to the power law. Cancer data were instead better aligned, as expected, with the power law. These results suggest that the multistep pathogenesis hypothesis based on the Armitage-Doll model cannot be extended from cancer to ALS, because it is incompatible with the epidemiological data. This calls for a re-consideration of the current understanding of ALS pathogenesis. Our work also warns against extending the Armitage-Doll multistep model from cancer to other aging-related diseases solely based on age-incidence curves.
10. Social determinants disadvantage score and liver health in the All of Us Research Program.
期刊: European journal of epidemiology 发表日期: 2026-Jan-24 链接: PubMed
摘要
Social determinants of health (SDOH) are crucial in shaping liver health outcomes, yet comprehensive assessments that span key SDOH domains are lacking. To address this knowledge gap, we developed a Social Determinants Disadvantage Score (SDDS) and examined its association with major adverse liver conditions. We conducted a cross-sectional analysis of 117,783 participants from the All of Us Research Program. The SDDS was systematically constructed using validated questionnaires covering economic stability, education, healthcare access and quality, neighborhood and built environment, and social and community context. Each question was scored on a 0 (most advantage) to 1 (most disadvantage) scale. Total SDDS was calculated as the mean of all questions, ranging from 0 to 1. We used logistic regression models to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for the associations of SDDS with total and individual adverse liver conditions, including steatotic liver disease (SLD), metabolic dysfunction-associated steatohepatitis (MASH), alcoholic liver disease (ALD), cirrhosis, hepatocellular carcinoma (HCC), chronic hepatitis B virus (HBV), chronic hepatitis C virus (HCV), and hepatic failure based on the Electronic Health Record. Higher SDDS was associated with a higher risk of adverse liver conditions. The highest SDDS quintile (most disadvantaged) compared to the lowest SDDS quintile had an OR = 1.67 (95% CI: 1.55-1.79) for total adverse liver condition risk after adjusting for age, sex, race, and other covariates. Similar associations were observed for individual liver conditions. Per 10% higher SDDS, the adjusted OR (95% CI) was 1.25 (1.22-1.29) for SLD, 1.27 (1.19-1.35) for MASH, 1.15 (0.99-1.34) for ALD, 1.31 (1.25-1.39) for cirrhosis, 1.35 (1.15-1.59) for HCC, 1.24 (1.14-1.35) for HBV infection, 1.40 (1.33-1.48) for HCV infection, and 1.35 (1.21-1.50) for hepatic failure. Consistent associations were found for disadvantages in individual SDOH domains, score excluding missingness, and score with selected factors. The SDDS provides a comprehensive, validated tool for assessing SDOH and their associations with liver health. Our findings highlight significant associations between social disadvantage and the prevalence of adverse liver conditions, emphasizing the need for future longitudinal studies to inform targeted interventions.
11. DiNetxify-a python package for three‑dimensional disease network analysis based on electronic health record data.
期刊: European journal of epidemiology 发表日期: 2026-Jan-24 链接: PubMed
摘要
The rapid expansion of large-scale electronic health record (EHR) data has underscored the necessity for advanced analytical methods, such as disease network analyses, to comprehensively identify and interpret multimorbidity patterns and disease progression pathways. To overcome existing obstacles associated with performing sophisticated disease network analyses on EHR data, we developed DiNetxify, an open-source Python package implementing our recently introduced three-dimensional (3D) disease network analysis method ( https://hzcohort.github.io/DiNetxify/ ). DiNetxify provides a dedicated data class for handling various EHR data, comprehensive modular functions for executing complete 3D disease network analyses, and visualization functions for interactive exploration of results. The package is efficient, user-friendly, and optimized for large-scale EHR datasets. It supports diverse study designs, customizable analysis parameters, and parallel computing for enhanced performance. Through a case study utilizing UK Biobank data to investigate disease networks associated with short leukocyte telomere length, we demonstrated the capability of DiNetxify to identify meaningful disease clusters and progression patterns consistent with established knowledge while uncovering novel insights. Computationally, the software successfully completed analyses involving cohorts exceeding half a million exposed individuals within 17 h, using moderate computational resources. We thus anticipate that DiNetxify can significantly reduce technical barriers to facilitate broader adoption of advanced disease network analysis techniques by different researchers, thereby enhancing the exploration of EHR data to improve the understanding of holistic health dynamics.
12. Can too much exercise kill you? A systematic review of the risk of a cardiovascular event or death from long term strenuous exercise.
期刊: European journal of epidemiology 发表日期: 2026-Jan-24 链接: PubMed
摘要
A considerable number of studies have highlighted that engaging in physical activity (PA) improves health and reduces risk of mortality. But is there a limit? Some evidence suggests a U-shaped exposure-response in which the protective benefits of strenuous exercise eventually diminish (at some point) and the risk of a cardiovascular event or death increases, thereby questioning a linear association between exercise volume, intensity, and cardiovascular events/mortality. This review evaluates the evidence and critically appraises studies assessing whether strenuous exercise is associated with increased cardiovascular-related events from an epidemiological perspective. After a comprehensive literature search, 1,908 records were identified; 1,068 remained after deduplication. Title/abstract screening excluded 950 records; 66 full texts were assessed; 14 studies were included for critical review. Two independent assessors appraised study quality and risk of bias, focusing on exposure and outcome measurement, confounder control, and whether timeframes and follow-up were adequate to observe associations. Evidence supporting a U-shaped exposure-response was limited. No study achieved the highest quality rating. Common limitations included inconsistent intensity classification, absence of repeated exposure measurement, inconsistencies with outcome measures, insufficient follow-up to capture long-term effects, and incomplete adjustment for key confounders. The current evidence supports the benefits of regular PA, including strenuous activity, with benefits appearing to plateau at very high doses. Further rigorous epidemiological research with repeated exposure measures, standardised outcomes, adequate follow-up, and more robust control for confounding is needed.
13. Lifestyle factors and all-cause mortality in long-term cancer survivors: a population-based prospective cohort study.
期刊: European journal of epidemiology 发表日期: 2026-Jan-24 链接: PubMed
摘要
The association between healthy lifestyles and mortality in cancer survivors remains inconclusive with few evidence among long-term cancer survivors (LTCS, survived ≥ 5 years post-diagnosis). Our study aims to investigate the association between individual and combined healthy lifestyle factors and mortality in LTCS. We included 6,057 LTCS of breast, colorectal or prostate cancer from a multiple regions study in Germany. A healthy lifestyle score (HLS) comprising alcohol consumption, body mass index (BMI), physical activity and smoking was created and was classified into tertiles with higher tertile indicating healthier lifestyle. We used Cox proportional hazards regression to examine the associations of individual lifestyle factors and HLS with all-cause mortality among LTCS. A total of 2,015 death events occurred over a maximum follow-up period of 12.3 years. Compared with the lowest tertile, participants in the middle and highest tertile experienced a 27% and 32% lower mortality (middle [hazard ratio (HR), 0.73; 95% CI 0.65-0.83]; highest [HR, 0.68, 95% CI 0.61-0.76]). A significant dose-response relationship was observed (p- trend < 0.001). These associations were consistent across different demographic and clinical characteristics. In addition, full adherence to lifestyle recommendations for smoking (HR, 0.51, 95% CI 0.44-0.59), physical activity (HR, 0.78, 95% CI 0.70-0.86) and BMI (HR, 0.87, 95% CI 0.77-0.99) were significantly related to a lower mortality, after full adjustment. Adherence to an overall healthy lifestyle was associated with significantly lower all-cause mortality in LTCS, emphasizing the importance of maintaining and promoting a healthier lifestyle among LTCS.
14. Quantifying the contribution of social disconnection to the mortality gap associated with mental disorders: a decomposition analysis.
期刊: European journal of epidemiology 发表日期: 2026-Jan-24 链接: PubMed
摘要
Individuals with mental disorders face a substantially higher risk of mortality and are more likely to be lonely, socially isolated, and with low social support compared to those without mental disorders. We aimed to quantify the extent to which the observed mortality gap associated with mental disorders could be explained by these social factors. This cohort study included 162,483 participants from the Danish National Health Survey in 2013 and 2017 who were followed for six years after survey participation. Survey data on social disconnection (loneliness, social isolation, social support in the form of perceived emotional support, and a composite measure) was linked with register data on hospital-diagnosed mental disorders and mortality. We applied G-computation-based causal decomposition to compare the sex-specific relative risk of mortality associated with mental disorders under a natural course to a counterfactual scenario in which all individuals had a distribution of social disconnection similar to individuals without mental disorders. We found that social disconnection and the distribution of loneliness, social isolation, and social support accounted for 10-34% of the mortality gap associated with mental disorders among men and 2-20% among women, assuming a causal effect of social disconnection on mortality. The largest contributions were found for social isolation and loneliness, whereas the smallest were found for social support. Our results highlight the possibility that different aspects of social disconnection, especially social isolation and loneliness, could explain part of the mortality gap associated with mental disorders, with larger contributions among men than women.
15. Preserflo microshunt in a real-life UK tertiary setting: success rates, safety profile, and postoperative management.
期刊: International ophthalmology 发表日期: 2026-Jan-24 链接: PubMed
摘要
To evaluate the efficacy and safety of PreserFlo MicroShunt in a UK tertiary glaucoma centre at one year follow-up. this is a retrospective, single-centre study of eyes with glaucoma that underwent PreserFlo MicroShunt implantation. Success was defined as IOP between 6 and 21 mmHg (range 6-17 and 6-14 mmHg was also evaluated) and a reduction of at least 20% of preoperative IOP; success was defined as complete (CS) if without hypotensive medications, and as overall (OS), if with or without medications. Secondary outcomes included final IOP, final number of glaucoma drops, final BCVA. a total of 69 eyes were included in the study. The CS and OS for IOP 6-21 mmHg were achieved in 73.9% and 79.7%, respectively. For the range of IOP 6-17 mmHg, 72.5% and 78.3%, and for the range of IOP 6-14 mmHg, 55.1% and 58.0%. The mean IOP was significantly reduced from 24.7 ± 7.2 mmHg at baseline to 12.4 ± 5.0 mmHg (p < 0.0001). The most frequent adverse event was transient early hypotony (28.9%), followed by hyphaema (11.5%) and choroidal effusion (8.6%). Aqueous misdirection occurred in two pseudophakic eyes with primary angle-closure glaucoma (PACG), representing a rare but vision-threatening complication in this setting. PreserFlo MicroShunt was effective and safe in the follow-up period and achieved IOP results in the low teens.
16. A critical review of American Trypanosomiasis (AT) in dogs with the current distribution of cases in Brazil and a diagnostic approach for veterinary clinicians.
期刊: Veterinary research communications 发表日期: 2026-Jan-24 链接: PubMed
摘要
17. Beyond the Tics: Experiences of Stigma and Psychosocial Impact in Tourette Syndrome.
期刊: Child psychiatry and human development 发表日期: 2026-Jan-24 链接: PubMed
摘要
Persistent tic disorders (PTD), including Tourette Syndrome (TS), impact individuals’ lives well beyond motor and vocal tics, affecting self-beliefs, relationships, and daily functioning. This qualitative study examined stigma and discrimination experienced by youth and adults with TS, their caregivers, and healthcare providers through in-depth interviews with 35 participants. Thematic analysis revealed four major themes: limited resources and funding, widespread misconceptions and stereotypes, negative experiences shaping self-perceptions and behaviors, and the importance of supportive environments in fostering resilience. Participants reported that widespread misunderstanding and exclusion led to significant psychosocial challenges, which were often more disruptive than the tics themselves. The findings highlight the need for clinical and behavioral interventions that address broader psychosocial issues, not just symptom management. Future research should explore resilience and protective factors that may help buffer against adverse experiences and improve psychosocial outcomes. This study was pre-registered at ClinicalTrials.gov (NCT05696769) and the Open Science Framework https://doi.org/10.17605/OSF.IO/EX52G .
18. Clinical and Humanistic Burden Among Adults with Neurofibromatosis Type 1 and Symptomatic Plexiform Neurofibroma in the United States.
期刊: Neurology and therapy 发表日期: 2026-Jan-24 链接: PubMed
摘要
Neurofibromatosis type 1 with plexiform neurofibromas (NF1-PN) can cause substantial clinical morbidity, yet the overall humanistic burden in adults remains poorly characterized. This study assessed health-related quality of life (HRQoL), in addition to clinical characteristics, among adults with symptomatic NF1-PN. A cross-sectional survey was conducted among adults with NF1-PN in the USA. The survey included the following patient-reported outcome (PRO) measures: PAin INtensity Scale for Plexiform Neurofibromas (PAINS-pNF), Pain Interference Index (PII-pNF), PN quality of life measure (PlexiQoL), Patient-Reported Outcomes Measurement Information System (PROMIS), Pediatric Quality of Life Inventory (PedsQL), Work Productivity and Activity Impairment (WPAI-CIQ), and EQ-5D-5L. Among 120 participants (mean age 41.8 years, 46.7% female), 80.0% reported experiencing pain and fatigue. Over half of patients reported moderate-to-severe chronic (51.7%) and spike (83.3%) tumor pain (PAINS-pNF: mean chronic pain = 3.6 ± 2.5; mean spike pain = 6.3 ± 3.2), with considerable interference with daily activities (PII-pNF: mean = 3.1 ± 1.6). PROMIS scores indicated worse outcomes than the general population for physical function (38.4 ± 7.7), depression (59.0 ± 9.2), anxiety (60.1 ± 9.5), and fatigue (59.0 ± 10.2). Only 12.5% were employed, with 50.8% reporting disability. Among employed individuals, work productivity loss averaged 39.3% ± 30.7. Overall daily activity impact was high (55.5% ± 22.5). The mean EQ-5D-5L utility score was 0.38 ± 0.39, with 69.2% reporting moderate-to-extreme pain/discomfort and 57.5% reporting moderate-to-extreme anxiety/depression. Adults with symptomatic NF1-PN experience substantial disease burden across multiple domains, including high prevalence of pain, impaired physical and psychological functioning, reduced work productivity, and low health utility scores. These results highlight the need for integrated pharmacological, psychological, and rehabilitation interventions to support overall patient well-being.
19. The economic burden of diabetes-related visual impairment and blindness in Saudi Arabia.
期刊: Health economics review 发表日期: 2026-Jan-24 链接: PubMed
摘要
Our main objective is to measure the economic impact of managing diabetes-related visual impairment and blindness in the Kingdom of Saudi Arabia (KSA) to inform policy and resource allocation for effective disease management and prevention. We develop a prevalence-based cost of illness model using Microsoft Excel to assess the economic impact of treating diabetic-related visual impairment and blindness over a one-year period from societal perspective. The model categorizes costs according to the severity level of the condition: mild, moderate, and severe visual impairment and blindness. It encompasses direct medical expenses such as those for drug acquisitions, surgical procedures, healthcare resources, monitoring, visual aids, and psychological care, as well as indirect costs such as productivity losses in the financial year 2024. The model’s outputs provide a cumulative and detailed breakdown of the costs associated with visual impairment and blindness in KSA. Sensitivity analysis was conducted. Our economic model shows that the total economic burden of diabetes-related visual impairment and blindness in KSA in one year is SAR 150,324,912,186 ($ 81.2 billion). This cost is divided into direct and indirect medical costs estimated at SAR 101 billion ($ 54.6 billion) and SAR 49 billion ($26.5 billion), respectively. The major component is medication costs, along with patients’ productivity loss. The significant economic repercussions of diabetes-related visual impairment and blindness across individuals, households, and the Saudi healthcare system impose a substantial financial burden. These findings highlight the urgent need for investment in innovative interventions and screening programs aimed at mitigating these costs, enhancing accessibility to essential treatments, improving the quality of life of affected individuals and families, and achieving sustainable healthcare and socioeconomic development goals in the Kingdom.
20. Metabolic signatures, vitamin D, and red cell distribution width in dementia risk: UK Biobank insights.
期刊: GeroScience 发表日期: 2026-Jan-24 链接: PubMed
摘要
Red cell distribution width (RDW), reflecting erythrocyte size variability, and serum vitamin D are emerging biomarkers for dementia. We examined the independent and joint associations of RDW and 25-hydroxyvitamin D [25(OH)D] with incident dementia and the potential mediating role of plasma metabolomic profiles in a large prospective cohort study. We analyzed data from 162,606 UK Biobank participants aged ≥ 50 years and dementia-free with RDW and 25(OH)D measurements at baseline. Incident dementia was identified via electronic health records for ≤ 15 years. Cox proportional hazards models adjusted for sociodemographic, cardiovascular, and genetic factors. Mediation was assessed using generalized structural equation models based on 15 metabolomic principal components (zMETAB1-zMETAB15) derived from 249 NMR-based plasma metabolites. Higher RDW was associated with increased dementia risk (HR = 1.05; 95% CI: 1.02-1.08) and a atherogenic lipid signature (zMETAB1: Cholesteryl Esters in VLDL), while higher 25(OH)D was associated with lower risk (HR = 0.89; 95% CI: 0.86-0.92) and more favorable metabolomic profiles (zMETAB7: higher Omega-3 Fatty Acids; zMETAB12: lower Saturated Fatty Acids). zMETAB1, zMETAB2 (Free Cholesterol in Small HDL), and zMETAB4 (Phospholipids in Small HDL) significantly mediated RDW’s effect on dementia (up to 8.8%), whereas ~ 10.8% of the association with vitamin D was mediated by zMETAB1, with additional contributions from zMETAB7 and zMETAB12. Omega-3 fatty acids partially mediated both associations, while RDW and 25(OH)D did not interact significantly in relation to dementia risk. RDW and vitamin D exert opposing, non-interactive influences on dementia risk. Lipid metabolism, particularly omega-3 fatty acids, partially mediates both associations, highlighting a common metabolic pathway that could be targeted for prevention. These findings suggest that interventions aimed at increasing omega-3 intake may simultaneously modulate the effects of both RDW and vitamin D on dementia risk, offering a promising translational strategy for early risk reduction.
21. Assisted living resident quality of life questionnaire: development and validation.
期刊: Journal of patient-reported outcomes 发表日期: 2026-Jan-24 链接: PubMed
摘要
22. Surgery in Older Cancer Patients.
期刊: Current oncology reports 发表日期: 2026-Jan-24 链接: PubMed
摘要
23. Association Between Pharmaceutical Manufacturer Payments and GLP-1RA Prescribing in the United States.
期刊: Mayo Clinic proceedings 发表日期: 2026-Jan-24 链接: PubMed
摘要
24. Learning from mental health reform under political change: lessons for sustainable mental health systems from Czechia.
期刊: International review of psychiatry (Abingdon, England) 发表日期: 2026-Jan-24 链接: PubMed
摘要
Mental health policies are increasingly informed by international guidelines and evidence. However, translating these frameworks into sustained system-level change often proves difficult. This paper presents a policy learning case study examining how large-scale, deinstitutionalization-focused mental health reform was initiated and subsequently evolved in Czechia. Building on prior descriptive analyses of ESIF-supported reform, and drawing on administrative data, project documentation, evaluation reports, and qualitative feedback from 23 people with lived experience (PWLE), we analyse mental health reform as a system-level process. The analysis focuses on mechanisms shaping reform trajectories, including financing arrangements, intersectoral coordination, selected system-level outcomes, and political continuity. High-level political support and ESIF resources enabled coordinated investments in infrastructure, workforce development, service innovation, and national monitoring and analytical capacity, including the establishment of community mental health centres. Early progress included expansion of community-based services, reductions in long-term hospitalisation, improved service accessibility, increased involvement of PWLE in service design and governance, and declining population stigma. However, subsequent political changes slowed reform momentum and exposed vulnerabilities where innovations lacked stable institutional embedding and sustainable cross-sectoral support. This study shows that evidence-based mental health innovations remain vulnerable unless embedded in clinical practice, service structures, and institutional arrangements resilient to political change.
25. Unmet need for home care during the great recession: a comparative analysis of England and Ireland.
期刊: Journal of aging & social policy 发表日期: 2026-Jan-24 链接: PubMed
摘要
Home care can be costly and time consuming to provide, and there is often limited public financing available to those with care needs. As a result, many adults experience unmet need and/or gaps in home-care support. This is particularly acute during times of austerity when budget constraints further limit public spending. This study examines determinants of unmet need for home-care support among adults over 50 in England and Ireland during the Great Recession. Using data from the English Longitudinal Study of Aging and the Irish Longitudinal Study on Aging, we examine factors associated with unmet need, including the role of public financing. Findings reveal notable differences in the proportion reporting unmet need in England (38.0%) versus Ireland (66.1%). Wealth offered no clear protection against unmet need in either nation. Results regarding physical and cognitive vulnerabilities were mixed: In Ireland, activity limitations were linked to greater probability of unmet need. In England, poorer cognitive function was associated with lower probability of unmet need. Understanding the impact of public financing on unmet need during times of economic uncertainty is critical for evidence-based policymaking. Improved harmonization of international aging data is essential to support comparative analyses and facilitate international learning opportunities.
26. Quantitative dynamic evaluation of the talus-lateral malleolus distance during forward single-leg drop landing in individuals with chronic ankle instability: a cross-sectional study.
期刊: Journal of medical ultrasonics (2001) 发表日期: 2026-Jan-24 链接: PubMed
摘要
To evaluate the dynamics of the talus-lateral malleolus distance during landing and compare the results between individuals with chronic ankle instability (CAI) and healthy adults. Participants were divided into the healthy (12 adults, 12 feet) and CAI (12 adults, 12 feet) groups. Participants performed forward single-leg drop landing from a 30-cm-high box. Through the synchronization of ultrasound with a motion capture system, measurements of the talus-lateral malleolus distance and ankle joint angles were obtained during forward single-leg drop landing. The analysis interval was from 200 ms before to 200 ms after initial contact; the time was normalized to 100%. Statistical parametric mapping was employed to investigate differences in the temporal changes of the talus-lateral malleolus distances and ankle joint angles during landing between groups. A significantly longer talus-lateral malleolus distance was observed before initial contact in the CAI group (1-49%) as compared with the healthy group (p = 0.000). In addition, the ankle adduction angle before initial contact (12-61%) was larger in the CAI group than in the healthy group (p = 0.005). Our findings suggest that the talus-lateral malleolus distance increases along with the ankle adduction movement in individuals with CAI, especially before initial contact, potentially indicating high mechanical ankle instability. This study established an innovative measurement system for quantitative evaluation of the dynamics of the talus and lateral malleolus during landing. The findings of this study may contribute to a more detailed understanding of pathology and features of movement in patients with CAI.
27. Promoting lifestyle medicine for supportive care in cancer: MASCC endorsement of the ACLM cancer risk reduction and survivorship toolkit.
期刊: Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer 发表日期: 2026-Jan-24 链接: PubMed
摘要
Cancer survivors face cancer and treatment-related health challenges and are at increased risk of developing other chronic diseases, often leading to multimorbidity. Lifestyle medicine can reduce the risk and severity of up to 80% of these chronic diseases and are an important component of survivorship care. Healthy lifestyle habits - such as a plant-forward diet, regular exercise, and maintaining healthy weight - improve life expectancy in a general population with compelling evidence supporting the same benefits among cancer survivors. A new resource from the American College of Lifestyle Medicine (ACLM), the Lifestyle Medicine Cancer Risk Reduction and Survivorship Toolkit (LMCT), aims to overcome barriers by providing accessible, evidence-based lifestyle medicine resources for use at the point of care. To support oncology healthcare professionals and cancer survivors, MASCC has endorsed the ACLM Cancer Risk Reduction and Survivorship Toolkit. This editorial describes the LMCT and how it can be a resource for cancer supportive care.
28. Multicomponent program to alleviate loneliness in widowed women: study protocol for a pilot randomized controlled trial.
期刊: Archives of public health = Archives belges de sante publique 发表日期: 2026-Jan-24 链接: PubMed
摘要
29. Human Amniotic Mesenchymal Stromal Cells Promote Bone Regeneration via Regulating Ameloblastoma-Derived-Bone Marrow Mesenchymal Cells Crosstalk and Autophagy in Ameloblastoma Microenvironment.
期刊: Tissue engineering and regenerative medicine 发表日期: 2026-Jan-24 链接: PubMed
摘要
Growing evidence validates the vital function of mesenchymal stem cells (MSCs) in tumor development. Our previous findings have illustrated the role of MSCs in the invasion and recurrence of ameloblastoma. Stem cells can be transplanted to release paracrine factors in the tumor microenvironment (TME) to inhibit tumor progression and recurrence. The paracrine function of human amniotic mesenchymal stromal cells (HAMSCs) benefits bone regeneration. However, the dual function of HAMSCs in inhibiting tumor progression and promoting bone regeneration in the TME remains unknown. To analyze the role of HAMSCS in the cross-talk between mesenchymal ameloblastoma-derived cells (M-AMCs), human bone marrow mesenchymal stem cells (HBMSCs), and HAMSCs, an in vitro co-culture system of M-AMCs, HBMSCS, and HAMSCS was prepared. An in vivo ectopic transplantation model was employed further to detect the therapeutic effect of HAMSCs on bone regeneration. A high-level basal autophagy was detected in the stroma of ameloblastoma. In the in vitro co-culture models, M-AMCs suppressed the proliferation, differentiation, migration, and autophagy of HBMSCs, and conversely, HBMSCs promoted the above phenotypes of M-AMCs. HAMSCs promoted the proliferation, differentiation, migration and autophagy of the co-cultured HBMSCs. Additionally, HAMSCs mediated the cross-talk between M-AMCs and HBMSCs. The in vivo ectopic transplantation model indicated that transplanted HAMSCs promoted bone regeneration by inhibiting the growth of M-AMCs and enhancing autophagy, as well as osteogenesis in bone defects of mice. The interaction of M-AMCs and HBMSCs may be associated with ameloblastoma recurrence. HAMSCs regulate the cross-talk between M-AMCs and HBMSCs to increase the autophagic level in the TME, thus inhibiting the progression and recurrence of ameloblastoma and promoting bone regeneration. Therefore, HAMSC-based therapy provides an alternative to facilitate bone regeneration and repair of ameloblastoma-induced bone defects.
30. High Mobility Group Protein B1 Mediates the Role of the Neutrophil Extracellular Traps in the Progression of Acute Myocardial Infarction.
期刊: Cardiovascular drugs and therapy 发表日期: 2026-Jan-24 链接: PubMed
摘要
Neutrophil extracellular traps (NETs) play a crucial role in the pathogenesis of acute myocardial infarction (AMI), but the role of high-mobility group box 1 (HMGB1), a key target of the cell migration family, remains unclear. This study investigated the HMGB1-CXCR4/CXCL12 -NETs pathway in ST-segment elevation myocardial infarction (STEMI) patients and a murine myocardial infarction (MI) model, with a focus on mechanisms associated with injury and aging. Peripheral blood analysis in 29 STEMI patients revealed elevated HMGB1 and myeloperoxidase (MPO) levels compared to controls. In C57BL/6J mice subjected to permanent left anterior descending (LAD) ligation, the CXCR4/CXCL12 axis was significantly upregulated in infarcted hearts, correlating with impaired ventricular function. Deoxyribonuclease (DNase) I or glycyrrhizic acid (a HMGB1 inhibitor) attenuated NETs formation and CXCR4/CXCL12 activation. Histological, echocardiographic, and transcriptomic analyses revealed that HMGB1 promotes NETs formation, exacerbating cardiac inflammation and fibrosis. Flow cytometry of murine blood demonstrated altered CD62L/CD11b expression, suggesting age-like immunophenotypic shifts in post-MI inflammation. These findings delineate a pivotal HMGB1-CXCR4/CXCL12-NETs axis in AMI pathology, driving cardiac injury through inflammation and fibrosis, with implications for cellular aging/senescence. Targeting this pathway presents a promising therapeutic strategy for mitigating ischemia-related damage.
31. Clinical and Molecular Characterization of Five Additional Individuals With SATB2-Associated Syndrome in Guangxi.
期刊: Biochemical genetics 发表日期: 2026-Jan-24 链接: PubMed
摘要
SATB2-associated syndrome (SAS) is a multisystemic disorder characterized by developmental delay, moderate to profound intellectual disability, speech delay and/or absent speech, behavioral issues such as autistic tendencies, agitation or aggressive outbursts, self-injury, impulsivity, hyperactivity, anxiety and sleeping difficulties. Alterations in the SATB2 gene have been identified as pathogenic causes of SAS. No formal clinical diagnostic criteria have been established for SAS, and molecular disruption of SATB2 is necessary to confirm the diagnosis. To investigate the molecular pathogenesis of five sporadic patients with intellectual disability, and to delineate the comprehensive clinical characteristics of SAS patients. Whole-exome sequencing analysis was performed in five unrelated patients, and RNA analysis was employed to validate the impact of genetic variation on aberrant splicing. Five SATB2 variants were identified, three of which were novel, including three frameshift variants, one nonsense variant, and a missense variant resulting in aberrant splicing was verified by RNA analysis. A comparative analysis was conducted between the clinical features of our patients and those reported in the literature. In addition to intellectual disability and impaired speech, abnormalities in palmar creases and postnatal growth delay were highlighted as clinically significant features for the diagnosis of SAS. Language regression, as well as joints and fingers abnormalities were also observed in our cohort. Our findings demonstrate that effective mRNA analysis is helpful for understanding the pathogenic mechanisms of novel variants. This study broadens the genetic and phenotypic spectrum of SAS and enhances our knowledge to facilitate accurate genetic counseling and appropriate treatment options.
32. Glymphatic system dysfunction: a link between sleep disorders and neurodegeneration.
期刊: Psychopharmacology 发表日期: 2026-Jan-24 链接: PubMed
摘要
Sleep disturbances are closely associated with cognitive decline and an increased risk of neurodegenerative diseases in humans. This association may be mediated by glymphatic dysfunction, which could ultimately lead to cognitive deterioration. This review aims to provide an overview of current research on the impact of sleep on the functions of the glymphatic system. It analyzes the regulatory roles of the sleep-wake cycle and neurovascular coupling (NVC), along with molecular mechanisms such as astrocytic calcium signaling and aquaporin-4 (AQP4) polarization, intending to identify potential targets for preventing and alleviating cognitive decline and neurodegenerative diseases. This review summarizes the intrinsic mechanisms by which sleep regulates the metabolic waste clearance capacity of the glymphatic system, highlighting its central role in regulating glymphatic function. Furthermore, it provides a detailed overview of the significant contributions of NVC and astrocytes within this regulatory framework, as well as novel interventions targeting neurodegenerative diseases. Given that sleep disturbances are a significant factor affecting human cognitive function and neurodegenerative diseases, it is imperative to advance research in this field. Efforts should focus on deepening our understanding of the glymphatic system and its regulatory mechanisms while integrating clinical practice to explore new research directions.
33. Molecular Epidemiology, Mating Types, Clinical, and Physiological traits of Microsporum canis in Humans and Companion Animals (Cats and Dogs) in the Guiyang Region, Southwest China.
期刊: Mycopathologia 发表日期: 2026-Jan-24 链接: PubMed
摘要
To date, the transmission patterns and epidemiological characteristics of the zoonotic dermatophyte Microsporum canis in southwestern Guizhou, China, remain poorly understood. This study employed a multiphase approach integrating retrospective analysis of seven years of dermatophytosis data with a prospective cross-sectional survey of skin infections in cats and dogs conducted from February 2024 to August 2024. A total of 51 M. canis isolates-34 derived from humans and 17 from cats and dogs-were systematically analyzed to assess genotypic, phenotypic, physiological, and MAT gene distribution profiles. Sequencing of the ITS, tubb, and rpb2 loci revealed high genetic homogeneity across all isolates. With the exception of the human-derived strain JYP 21030b, in which amplification at the MAT locus failed, all isolates were identified as MAT1-1 genotype. Clinically, infections in both humans and animals were predominantly localized to the scalp. Physiological assessments revealed that animal-origin strains exhibited enhanced thermotolerance and more robust urease production compared to human-origin strains. Notably, evidence of distant hybridization between M. canis (JYP 21030b) and T. mentagrophytes var. interdigitale (JYP 21030a) was observed, accompanied by dynamic changes and diversity in mating type genes, which may correlate with distinct clinical and physiological traits. In conclusion, M. canis remains the predominant zoonotic dermatophyte responsible for dermatophytosis in humans and companion animals in this region. Despite limited molecular divergence, differences in enzymatic activity and thermal growth profiles suggest functionally driven phenotypic adaptability, with animal-origin strains demonstrating heightened environmental resilience and potential for host switching. Furthermore, the occurrence of interspecies hybridization offers a novel explanation for the paradox of low genetic variation coupled with observable phenotypic heterogeneity, thereby providing new insights into the transmission dynamics, ecological adaptation, and public health implications of M. canis.
34. Vaccines preventing neonatal sepsis: focus on group B Streptococcus, Klebsiella pneumoniae and Escherichia coli to combat rising antimicrobial resistance.
期刊: Expert review of vaccines 发表日期: 2026-Jan-24 链接: PubMed
摘要
Neonatal sepsis, a systemic infection occurring in infants within their first 28 days of life, is a leading cause of mortality globally. The burden is especially severe in low- and middle-income countries (LMICs), where incidence and mortality rates are higher than in high-resource settings. Antimicrobial resistance, driven by multidrug-resistant pathogens prevalent in LMICs, further complicates its effective management. Vaccination offers a promising strategy to prevent infections caused by common neonatal sepsis pathogens, potentially reducing sepsis incidence and mitigating resistance. This review examines the burden of bacterial pathogens, specifically Group B Streptococcus (GBS), Klebsiella pneumoniae, and Escherichia coli, responsible for neonatal sepsis, drawing from a comprehensive literature search focusing on the last ten years across major databases. It provides an overview of vaccine candidates in clinical development, highlights innovative approaches in preclinical research, and discusses the key challenges associated with vaccine strategies preventing neonatal sepsis. Given the multivalency of vaccines for neonatal sepsis, innovative technologies are under investigation. Defining correlate of protections has been critical for GBS vaccine development, and may pave the way for vaccines against K. pneumoniae and E. coli. Novel regulatory and clinical strategies, including disease-based rather than pathogen specific approaches, should be explored.
35. The Overlooked Crisis: Drug Self-Intoxication Mortality Increased at 5 Times the Rate of Suicide Mortality During the US Opioid Epidemic (1999-2023).
期刊: Mayo Clinic proceedings 发表日期: 2026-Jan-24 链接: PubMed
摘要
To examine demographic and regional variations in self-injury mortality (SIM) among individuals aged 15 years or older in the United States with mental and behavioral disorders as contributing causes of death from 1999 to 2023. Death certificates from the CDC-WONDER (Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research) database were examined from January 1, 1999, through December 31, 2023, to identify SIM (suicides and drug self-intoxication-related deaths) among individuals with mental and behavioral disorders. Age-adjusted mortality rates (AAMRs) per 100,000 persons were calculated, and temporal trends were described by calculating annual percent change and average annual percentage change (AAPC) using joinpoint regression analysis. From 1999 to 2023, a total of 639,462 SIM-related deaths were recorded among individuals with mental and behavioral disorders in the United States. The AAMR increased from 2.22 in 1999 to 24.75 in 2023 with an AAPC of 10.17% (95% CI, 9.57% to 11.27%; P<.001). Drug self-intoxication mortality (AAPC, 11.85%) increased at over 5 times the rate of suicide mortality (AAPC, 2.25%) during this period. Around 90% of these deaths were recorded among individuals with substance use disorders. Men had higher mortality rates than women, with AAMRs increasing from 3.50 in 1999 to 35.74 in 2023 among males and from 1.01 to 13.69 in females over the study period. Non-Hispanic Black individuals had the highest AAMR, which increased from 2.70 in 1999 to 41.58 in 2023, followed by non-Hispanic White persons and Hispanic or Latino groups. The Northeast region had the highest SIM-related mortality (32.15 in 2023), and urban areas had higher AAMR than rural areas (21.22 vs 18.51 in 2020). Self-injury mortality among individuals with mental and behavioral disorders-especially those with substance use disorders-has steadily increased from 1999 to 2023. This rise has been driven primarily by a sharp increase in drug self-intoxication mortality, which has grown at over 5 times the rate of suicide mortality, alongside substantial demographic disparities.
36. Comparison of Methods and Integrated Application for Efficient Campylobacter Detection in Production.
期刊: Foodborne pathogens and disease 发表日期: 2026-Jan-24 链接: PubMed
摘要
Campylobacter is a widespread foodborne pathogen that causes significant contamination across various samples. Rapid and accurate detection of Campylobacter enables timely diagnosis and assessment of contamination, helping to control the spread of the pathogen and ensure food safety. However, the heterogeneity of sample matrices and variability in contamination levels throughout the food supply chain pose substantial challenges to the efficient detection of Campylobacter. In this study, the conventional culture method was improved through the optimization of antibiotic combinations, the A6, A4, and A3 media achieved the highest detection concordance for low (99.04%), medium (98.69%), and high (99.29%) cleanliness samples, respectively. These media also yielded colony recovery counts equivalent to those obtained from antibiotic-free medium, making them suitable for application across the entire chain. The detection sensitivity, specificity, and accuracy of alternative molecular and immunological methods were subsequently evaluated using the optimized culture method for validation. Nucleic acid-based methods generally exhibited high sensitivity (0.98-1.00) and were suitable for use in the upstream and midstream stages, facilitating rapid exclusion of negative samples. Multiplex polymerase chain reaction (PCR) showed good accuracy (0.95-0.98) and allowed identification of contaminating bacteria at the species level, while integration with qPCR facilitated rapid assessment of contamination status of the matrices. Loop-mediated isothermal amplification and colloidal gold immunochromatographic assay offered on-site visualization of results with short detection times and operational simplicity. They also exhibited good accuracy for samples of medium cleanliness (0.80-0.97), making them well-suited to terminal retail applications. Collectively, this study compared and analyzed the applicability of culture-based, nucleic acid-based, and immunological detection methods for samples of varying cleanliness, proposing a comprehensive monitoring strategy to facilitate efficient and accurate detection of Campylobacter in the food supply chain.
37. Nonmetal-Doped High-Crystalline g-C3N4 Nanostructures for Visible-Light-Driven Pollutant Degradation and Biomedical Applications on anticancer.
期刊: Environmental geochemistry and health 发表日期: 2026-Jan-24 链接: PubMed
摘要
Graphitic carbon nitride (g-C3N4), a metal-free polymeric semiconductor, has attracted increasing attention for photocatalytic and biomedical applications due to its visible-light responsiveness, tunable electronic structure, and chemical robustness. However, its practical utility remains constrained by poor crystallinity, limited active surface sites, and rapid electron-hole recombination. In this study, a facile one-step calcination strategy was employed to synthesize highly crystalline, non-metal-doped g-C3N4 nanostructures with enhanced physicochemical properties. Structural and optical characterizations revealed improved crystallinity, expanded surface area, defect-rich architecture, and extended visible-light absorption. These features significantly boosted the photocatalytic performance for the degradation of Reactive Blue 222, achieving up to 89% removal within 90 min under visible light, with the degradation kinetics following a pseudo-first-order model (k = 0.97 min⁻1). Beyond environmental remediation, the modified g-C3N4 also demonstrated notable anticancer activity against HCT-15 (colon cancer) cell lines. Cytotoxicity assays revealed concentration-dependent inhibition, with IC50 values of 7.10 µg/mL, respectively, indicating its potential as a photodynamically active nanomaterial for cancer therapy. The dual functionality of visible-light-driven photocatalysis and selective anticancer activity underscores the potential of engineered g-C3N4 as a sustainable platform for integrated environmental and biomedical applications.
38. Evaluation of the heavy metal pollution in soil from Singrauli coal mine area, Madhya Pradesh, India.
期刊: Environmental geochemistry and health 发表日期: 2026-Jan-24 链接: PubMed
摘要
This study assesses the spatial variation, sources, and environmental and ecological risks of heavy metal and metalloid pollution in the surface soil of the Singrauli coal mine area, Madhya Pradesh, India. It analyses the intensity of pollution through the major pollution indices. Composite soil samples were collected from 14 sampling locations using the quartering method. Collected samples were digested and analysed for 14 elements by using Inductively Coupled Plasma Mass Spectrometry (ICP-MS). The concentration of these elements is used to compute 7 pollution Indices to determine the severity of pollution in the study area. Multivariate statistical analysis was conducted to identify the sources and processes contributing to metal pollution in the study area. The abundance of elements followed the order: Fe > Al > Mn >Ba > Zn > Cr > Cu > Ni > Pb > Co > B > As > Ag > Cd. The concentration of Cd (0.43 ± 0.18 mg/kg), Pb (15.73 ± 10.48 mg/kg), and Zn (83.00 ± 53.55 mg/kg) exceeded the mean USEPA recommended concentration for soil. The geo-accumulation Index showed a positive value for Pb (Igeo = 1.52). The enrichment factor showed a high enrichment for Mn, Cu, As, and Cd. Mean Contamination Factor values ranged between 0.03 (Ag) and 4.77 (Cd). Nemerow pollution index (NPI) values ranged from 1.08 to 5.67, suggesting slight to heavy pollution. The enrichment factor for Cd fell in a very high-risk zone (Er > 120). The potential risk index (PERI) across sites ranged from 47.46 to 275.07, suggesting a low to moderate ecological risk. Mean ERM quotient (MERMQ) values indicated the potential soil toxicity in the study area. The global implications of studying heavy metal pollution in soil, especially around coal mining areas, are widespread and impact various aspects of the environment, viz., sustainability, scientific research, agricultural productivity, human health and socio-economic development worldwide. This issue is recognised globally as a significant environmental problem that requires urgent global attention.
39. Genetic Burden in Congenital Anomalies of the Mitral and Tricuspid Valves: A Case-Control Study.
期刊: Pediatric cardiology 发表日期: 2026-Jan-24 链接: PubMed
摘要
Congenital heart disease (CHD) is the most common congenital malformation, with most cases exhibiting a multifactorial etiology involving genetic and environmental factors. Congenital anomalies of the atrioventricular valve or septum (CAAVAS) and functionally univentricular heart (FUH) are complex subtypes of CHD, where disruptions in key molecular pathways are implicated. This study investigates the genetic burden contributing to these anomalies. This case-control study included 48 participants: 24 patients diagnosed with CAAVAS or FUH and 24 healthy controls. Whole-exome sequencing (WES) was conducted to assess genetic burden by evaluating minor allele frequencies (MAF) using gnomAD and predicting functional impact of variants with REVEL scores. A secondary filtration was performed, focusing on 349 genes associated with abnormal heart valve morphology (HP:0001654) as defined by the Human Phenotype Ontology (HPO) database, to identify pathogenic variants exclusive to the case group. Genetic burden risk (GBR) analysis revealed a significantly higher median number of common variants in the case group compared to controls (p = 0.035). Genetic analysis identified variants in genes involved in contractile cardiac and cytoskeletal proteins (MYH3, ACTC1), extracellular matrix proteins (FBN1, FREM1, HSPG2), ciliary proteins (EVC2, PKD1L1), enzymes (POLG, DNASE1L3), cell-signaling proteins (TGFB2, CCDC22) and transcription factors (NKX2-5, NONO). This study highlights the significant role of genetic burden and gene variants associated with congenital mitral and tricuspid valve anomalies. Our findings reinforce the strong genetic predisposition underlying these malformations, as evidenced by the increased genetic burden in affected individuals compared to controls without CHD.
40. Single and combined exposures to glyphosate and 2,4-D herbicides: impacts on membrane integrity, cell-cycle dynamics, and nucleolar activity in Allium cepa.
期刊: Journal of toxicology and environmental health. Part A 发表日期: 2026-Jan-24 链接: PubMed
摘要
This study aimed to examine the cytogenotoxic effects of attributed to exposure to herbicides glyphosate and 2,4-D, applied individually and in combination, on root meristematic cells of Allium cepa. The tested concentrations (0.1, 1, 10, 100, or 1000 μg/L) represent environmentally realistic levels frequently detected in freshwaters. Mixtures contained equimolar concentrations of each herbicide: M-1 (0.1 + 0.1), M-2 (1 + 1), M-3 (10 + 10), M-4 (100 + 100), and M-5 (1000 + 1000). Cell viability, mitotic index, chromosomal abnormalities, and micronuclei frequencies, as well as the number of nucleoli per nucleus were determined, together with cytotoxic parameters analyzed by flow cytometry. When applied individually, both herbicides exhibited cyto- and/or genotoxic activity. The mixtures reduced cell viability and induced cytotoxic and genotoxic responses, including mutagenic effects in M-1, M-3, and M-4. Nucleolar alterations, cell cycle delays, and cell death occurred with all treatments. Most mixture responses were equal to or greater than those of the individual herbicides. Data demonstrated that, even at environmentally relevant concentrations, combined exposure to glyphosate and 2,4-D intensified cytogenotoxic effects, reinforcing the importance of the need to consider mixture toxicity in environmental risk assessments.
41. Sheep-associated Escherichia coli in Albania show high genomic similarity to European ovine lineages and a conserved core resistome.
期刊: FEMS microbiology letters 发表日期: 2026-Jan-24 链接: PubMed
摘要
Sheep and sheep products play a notable role in Albanian culture and economy, particularly in rural regions. This sector is defined by small-scale activities and often faces challenges linked to safety and productivity. These issues necessitate the development of reforms to protect public health, boost productivity, and comply with regulatory requirements. Escherichia coli is a frequent ovine commensal, with an association with pathotypes like Shiga Toxin-encoding E. coli (STEC). The relationship between ovine bacteria and antibiotic resistance further remains poorly characterized. In this study, E. coli isolates from sheep across Albania were sequenced using Oxford Nanopore Technologies™ and characterised in silico for serotype, virulence, resistance genes and phylogenetic relationships as isolates were compared to a global collection of animal and environmentally-associated genomes. Isolates exhibited diverse serotypes and a conserved resistome comprising four genes, including EC-type β-lactamases. Four isolates were Shiga toxin-positive (stx1c predominant). Phylogenetic analyses revealed high similarity with European ovine E. coli, indicating regional relatedness and potential for resistance gene dissemination. This work provides the first genomic insight into ovine E. coli in Albania and highlights their potential role in antimicrobial resistance dynamics within livestock systems. These findings are crucial to understand for the development of Albanian agricultural practices.
42. Advancing Neurorehabilitation and Recovery Through Human Movement Quantification via Wearable Sensing.
期刊: Neurorehabilitation and neural repair 发表日期: 2026-Jan-24 链接: PubMed
摘要
Wearable movement sensing has enormous potential to transform the field of neurorehabilitation and neural repair. This perspective paper discusses: (1) the case for wearable sensing as a compelling, scalable measurement tool, (2) moving from first generation to second generation research in wearable movement sensing, (3) the enormity in the potential range of use cases for wearable technology, and (4) challenges that lie ahead for moving from research space into clinical rehabilitation care. Wearable sensors, as a measurement tool, offer a data-rich avenue for measuring numerous dimensions of motor behavior in the clinic and in daily life, complementing other available tools. Second-generation research questions focus on determining how to quantify, for whom, when, and with what variable(s). Answering these second-generation questions requires substantial evidence at the individual use case level; we provide 1 exemplar variable and its evidence within stroke recovery and rehabilitation. Potential use cases for deployment of wearable movement sensors span developmental, acquired, and degenerative neurological conditions and variables extracted can be intended as digital biomarkers and/or digital clinical outcome assessments. As research progresses, we look forward to the translation of this measurement tool into routine clinical care and welcome implementation challenges related to readiness, approach, and presentation in the busy, complex, healthcare arena. Achieving the promise of wearable movement sensing will require extensive collaboration, as exemplified by Dr. Wolf, across research teams, disciplines, institutions, people with lived experience, and other stakeholders.
43. Physical Fitness with Exercise and GLP-1 Receptor Agonist Treatment Alone or Combined After Diet-Induced Weight Loss: A Secondary Analysis of a Randomized Controlled Trial in Adults with Obesity.
期刊: Sports medicine (Auckland, N.Z.) 发表日期: 2026-Jan-24 链接: PubMed
摘要
Obesity is associated with impaired physical fitness, including physical functional performance and cardiorespiratory fitness, which affect health-related quality of life and mortality. We aimed to investigate the efficacy of a moderate-to-vigorous intensity exercise program and glucagon-like peptide-1 receptor agonist treatment alone or in combination during weight maintenance for physical fitness. This is secondary analysis of a randomized controlled trial involving 193 adults with obesity (age 18-65 years, body mass index 32-43 kg/m2) without diabetes mellitus who completed an 8-week low-calorie diet and were subsequently randomized (1:1:1:1 ratio) to: exercise plus placebo; glucagon-like peptide-1 receptor agonist liraglutide 3 mg once-daily plus usual activity; exercise plus liraglutide combined; or placebo plus usual activity. The exercise program was a combination of group sessions (interval-based indoor cycling followed by circuit training) and individual sessions of moderate-to-vigorous intensity, designed to meet the World Health Organization recommendations on physical activity for health. Exercise adherence was measured with sports watches and heart rate monitors. Key secondary endpoints related to physical fitness were changes from randomization to the end of treatment (weeks 0-52) in: (1) physical functional performance (time to ascend and descend an 11-step stairway twice); (2) cardiorespiratory fitness (peak oxygen consumption normalized to fat-free mass); and (3) muscle strength (isometric knee extensor peak torque). Participants randomized to exercise performed a median 2.65 session/week (116 min/week at 79% of maximum heart rate) with no significant difference between those who received placebo or liraglutide. Compared with liraglutide alone, the combined treatment decreased time to complete a stair climb test by 1.2 s [95% confidence interval 0.6-1.9] (corresponding to 8.6%) and improved peak oxygen consumption by 3.0 mL/min/kg fat-free mass [95% confidence interval 0.5-5.5]. Exercise alone led to similar benefits, whereas liraglutide alone did not improve physical fitness. Compared with placebo (- 7.8%), relative muscle strength (strength normalized to body weight) was higher with exercise (- 0.4%), liraglutide (+ 1.0%), and the combined treatment (+ 3.3%) because of lower weight and preserved absolute strength. Structured exercise combined with glucagon-like peptide-1-based obesity pharmacotherapy led to clinically meaningful improvements in physical functional performance and cardiorespiratory fitness, in contrast to pharmacotherapy alone. EudraCT number, 2015-005585-32; ClinicalTrials.gov number, NCT04122716.
44. Development of a tool to map systemic sclerosis pain sources, characteristics, and management experiences: the SPIN pain assessment tool.
期刊: Rheumatology (Oxford, England) 发表日期: 2026-Jan-24 链接: PubMed
摘要
People with systemic sclerosis (SSc) emphasize the effect pain from multiple sources has on their quality of life. Objectives were to develop a tool to map sources of pain in SSc, determine characteristics of pain from different sources, and understand pain management experiences. We referred to existing research and clinical pain assessment tools and partnered with a 4-member Patient Advisory Team to develop an initial tool version. The tool included questions on SSc pain sources and, for each source, questions on pain source intensity and interference, temporality and predictability, sensory experience, and attempted pain management techniques. To further refine the tool, we conducted nominal group technique (NGT) sessions with people living with SSc and received feedback from healthcare providers who care for people with SSc. Finally, we conducted individual usability testing sessions with people living with SSc. We conducted 6 NGT sessions (5 English, 1 French; 22 total participants). We received feedback from 18 healthcare providers, and conducted 5 individual usability testing sessions. The final version of our Scleroderma Patient-centered Intervention Network (SPIN) Pain Assessment Tool included 18 items on pain sources (plus an “other” category), and for each pain source, 12 questions on pain intensity and interference, temporality and predictability, sensory experience, and management. The SPIN Pain Assessment Tool includes critical information on pain sources important to people with SSc. It provides a useful tool to study the epidemiology of the complex pain experience in SSc, including pain sources and how pain is experienced.
45. Work-related traumatic finger and thumb amputations: 20-year trends.
期刊: Occupational medicine (Oxford, England) 发表日期: 2026-Jan-24 链接: PubMed
摘要
Traumatic finger/thumb amputations are common and preventable occupational injuries that impose significant physical, psychological, and financial burdens. This study investigated 20-year trends in the incidence of work-related digit amputations (partial/complete) in Victoria, Australia, from 2003/2004 to 2022/2023, and analysed patient profiles and hospital burden during 2013/2014 to 2022/2023. Data were obtained from the Victorian Admitted Episodes Dataset for hospital admissions related to work-related digit amputations (2003/2004-2022/2023). Poisson regression was used to assess trends over time, while descriptive analyses were conducted to compare patient characteristics and hospital burden. Age-standardized incidence of work-related digit amputations in Victoria decreased significantly from 12.54 hospital admissions per 100 000 employed persons in 2005/2006 to 4.71 per 100 000 in 2022/2023; the modelled annual reduction was 4.655% (95% CI = -5.23%, -3.6%, P < 0.0001). A total of 2144 finger/thumb amputation-related admissions were recorded between 2013/2014 and 2022/2023, occupying 5055 bed days. Rates were similar by age band. Male rates were 10 times higher than female rates, accounting for 91% of cases. Most amputations occurred in metropolitan areas (70%), but rates/head of population were higher in regional/rural areas. Mechanical forces caused 95% of amputations, with machinery contact, being caught in objects, and powered saws the major contributors. Work-related digit amputations have significantly declined over 20 years, with male workers and those in regional/rural areas disproportionately affected. Despite the decline over time, work-related digit amputations remain common and targeted prevention strategies focusing on high-risk groups and machinery safety are needed to further reduce the incidence and burden.
46. Obesity in Rural-Dwelling Older Adults: A Scoping Review of Epidemiological Findings and Intervention Approaches.
期刊: American journal of health promotion : AJHP 发表日期: 2026-Jan-23 链接: PubMed
摘要
ObjectiveReview studies targeting obesity/overweight among older rural adults to: (1) summarize obesity prevalence and identify high-risk groups in epidemiological studies, and (2) describe the types of obesity interventions and outcomes examined in this population.Data SourceCINAHL Ultimate, PubMed, Google Scholar, MEDLINE.Study Inclusion/Exclusion CriteriaInclusion criteria: peer-reviewed intervention/epidemiological studies in English, adults aged 50+ with overweight/obesity who were rural dwellers. Exclusion criteria: review/meta-analysis articles, child/adolescent obesity, youth or adults aged <50, examining obesity with other chronic conditions, published before the year 2000.Data ExtractionStudy population/design/methodology/results, publication year (2000-2024), type of intervention, methodology of epidemiological studies.Data SynthesisStudy characteristics and outcomes were summarized in the assessment/intervention matrix tables.ResultsSeventeen articles met the inclusion criteria: 6 epidemiological studies (US = 3, overseas = 3), 7 community-based interventions, 3 remote interventions, and 1 hybrid intervention. Epidemiological studies showed that the obesity/overweight prevalence ranged from 11.2%-64.6%. Women were consistently more likely to be obese/overweight than men. While one US study found significant associations between lower educational attainment and higher obesity rates, one non-US study reported no association between educational attainment and obesity. Community-based interventions with nutrition/exercise sessions and remote/hybrid interventions were reported to support weight and/or insulin resistance management.ConclusionFuture interventions should prioritize high-risk subgroups, such as American Indians/Alaska Natives, older women, and individuals with lower educational attainment.
47. Gender differences among ophthalmology faculty members in Japanese Medical Schools: An Institution-based cross-sectional study.
期刊: Medicine 发表日期: 2026-Jan-23 链接: PubMed
摘要
This study aims to investigate the gender difference of ophthalmologists among academic positions in Japanese medical schools. An institution-based cross-sectional study was conducted. We performed a comprehensive survey assessing the gender distribution of faculty members in the departments of ophthalmology at Japanese medical schools. During the period of November 1 to 15, 2023, data were gathered from the websites of all ophthalmology departments and their affiliated hospitals. Faculty gender was determined primarily through analysis of first names and photographs when available. The gender, academic position, and employment status (full-time or part-time) of each faculty member were recorded. The study encompassed 1574 faculty members in 81 ophthalmology departments, including 453 (28.8%) females and 1121 (71.2%) males. The proportion of females varied across different academic positions, with 9.9% among professors, 21.9% among associate professors, 30.5% among lecturers, and 36.7% among research associates. There was a significant difference in the distribution of academic ranks among genders (P <.001). The odds of becoming professors were 4.41 times higher for males than for females (P <.001). The percentage of full-time and part-time positions did not differ significantly between genders overall; however, a higher percentage of female research associates worked part-time (53.2%) compared to full-time (35.4%; P = .0169). When comparing departments by the gender of their chair professors, we found that the percentage of female faculty was higher in departments with female chairs than in those with male chairs: 23.1% versus 7.7% among professors and 45.5% versus 20.2% among associate professors, respectively. The academic ranks within ophthalmology departments in Japanese medical schools are predominantly occupied by males, particularly in senior positions.
48. Novel stem cell therapy for cerebral palsy using stem cells from human exfoliated deciduous teeth.
期刊: Stem cell research & therapy 发表日期: 2026-Jan-23 链接: PubMed
摘要
Effective treatments for cerebral palsy caused by Hypoxic-ischemic encephalopathy are urgently needed. Current therapies primarily include prevention or acute intervention, leaving a major gap in the options for reversing established neurologic damage. Because of their ease of collection and unique trophic factor profile, stem cells from human exfoliated deciduous teeth (SHED) are promising candidates for cell-based therapy targeting neurological disorders. In this study, we examined the therapeutic potential of SHED in a rat model of cerebral palsy, focusing on neurogenic and functional recovery. Hypoxic-ischemic encephalopathy was induced in neonatal rats using the Rice-Vannucci method. Rats with motor impairments received intravenous SHED injections, whereas the control group received a vehicle solution. Behavioral tests assessed motor coordination and cognitive performance. Proteomic analyses and immunohistochemistry were performed to examine the underlying mechanisms. The migration and biodistribution of SHED were tracked using quantum dot-labeled SHED with in vivo imaging. Neural stem cells were cocultured with SHED to evaluate neurogenesis, followed by RNA sequencing and the analysis of trophic factors in the conditioned media. SHED treatment significantly ameliorated motor coordination, memory, and learning. Proteomic analysis revealed increased expression of proteins associated with neurogenesis in the SHED group. Histopathologic evaluations revealed enhanced neurogenesis in the hippocampal dentate gyrus and subventricular zone 2 weeks posttreatment, with increased NeuN-positive cells in the hippocampus and cortex at ten weeks. In vivo imaging revealed the migration of quantum dot-labeled SHED to the brain. Neural stem cells co-cultured with SHED in vitro exhibited higher proliferation rates. The SHED-conditioned medium contained increased levels of hepatocyte growth factor (HGF), and HGF-neutralizing antibodies suppressed the enhanced cell proliferation. RNA sequencing revealed significant alterations in genes associated with the PI3K-Akt signaling pathway. SHED treatment ameliorated motor, memory, and learning impairment in a rat model of cerebral palsy. These improvements were accompanied by enhanced neurogenesis, likely mediated by HGF secretion and activation of the PI3K-Akt signaling pathway. SHED is a promising candidate for postsymptom-onset treatment of cerebral palsy. Further studies to confirm these findings and examine the clinical utility of SHED are warranted.
49. Correction: Involvement of propionate, citrulline, homoserine, and succinate in oral microbiome metabolite-driven periodontal disease progression.
期刊: Scientific reports 发表日期: 2026-Jan-23 链接: PubMed
摘要
50. Predictive value of the Clinical Institute Withdrawal Assessment for Alcohol Scale, Revised (CIWA-Ar) score on admission for alcohol withdrawal delirium (AWD) in patients with alcohol use disorder (AUD): A prospective observational study.
期刊: Journal of addictive diseases 发表日期: 2026-Jan-23 链接: PubMed
摘要
Alcohol withdrawal delirium (AWD) is the most severe and potentially fatal manifestation of alcohol withdrawal syndrome (AWS). Early identification of patients at risk is critical for preventing medical complications and optimizing withdrawal management. Although the Clinical Institute Withdrawal Assessment for Alcohol Scale, Revised (CIWA-Ar), is widely used to assess AWS severity, its predictive value for AWD remains unclear, particularly in Asian inpatient settings. To examine the incidence of AWS and AWD among patients with alcohol use disorder (AUD) in a Japanese rehabilitation center and to identify admission factors associated with AWD onset. Among 295 consecutively admitted patients, 273 were analyzed; 22 were excluded for ongoing AWD at admission. AWS was evaluated using CIWA-Ar throughout hospitalization. Associations between admission variables and AWD onset were analyzed using logistic regression and receiver operating characteristic (ROC) analysis. Of 273 patients, 152 (55.7%) exhibited AWS and 24 (8.8%) developed AWD during hospitalization. Stepwise logistic regression identified only the CIWA-Ar score at admission as a significant predictor (odds ratio = 1.50; 95% confidence interval, 1.28-1.74; p < 0.001). ROC analysis yielded an area under the curve (AUC) of 0.906 with a CIWA-Ar cutoff of 4 (sensitivity 91.7%, specificity 84.3%). The admission CIWA-Ar score is a strong and practical predictor of AWD in AUD inpatients. Even mild withdrawal symptoms may indicate early autonomic hyperactivity and high AWD risk, underscoring the need for vigilant monitoring and timely intervention.
51. Global burden of leukemia in women of child-bearing age, 1990 to 2021: An update from the Global Burden of Disease Study 2021.
期刊: Medicine 发表日期: 2026-Jan-23 链接: PubMed
摘要
While the overall burden of leukemia has been studied, a comprehensive and up-to-date epidemiological analysis specifically focused on women of childbearing age (WCBA) using the latest global burden of disease 2021 data, particularly detailing the 4 major subtypes, is lacking. This knowledge gap limits the development of targeted healthcare policies for this unique demographic. This study aims to fill this gap by assessing the global, regional, and national burden of leukemia in WCBA from 1990 to 2021. We collected and analyzed data on acute lymphoblastic leukemia (ALL), acute myeloid leukemia (AML), chronic lymphocytic leukemia, and chronic myeloid leukemia (CML) in WCBA (aged 15-49) from the Global Burden of Disease Study 2021. We evaluated incidence, mortality, and disability-adjusted life years (DALYs), along with their age-standardized rates, categorized by age, region, country, and socio-demographic index. We also analyzed risk factors associated with leukemia-related DALYs and mortality. In 2021, an estimated 40,200 (95% UI 31.3, 45.1) new cases of leukemia among WCBA were reported globally. From 1990 to 2021, the age-standardized incidence rate declined by 22.4% (95% UI-31.2,-11.4), with larger reductions in age-standardized death rate (-34.2%; 95% UI-40.5,-25.7) and DALY rate (-43.1%; 95% UI-50.6,-30.6). The annual disease burden, in descending order, were AML, ALL, CLL, and CML. Epidemiological patterns showed significant regional differences, though CML declined across all regions. The burden of AML, CLL, and CML was positively correlated with age, while ALL peaked in the youngest (15-19) group. Risk factor analysis identified obesity (high-income, middle-aged) and occupational exposures (younger) as significant contributors. While the overall leukemia burden in WCBA has decreased globally, significant disparities persist by subtype, age, and region, with AML remaining the dominant burden. These findings underscore the need for tailored public health strategies and resource allocation to address high-risk populations and specific leukemia subtypes.
52. From bubbling to boiling over: a meta-ethnography of the process towards and during crisis from the perspectives of persons living with dementia, informal carers and healthcare professionals.
期刊: Age and ageing 发表日期: 2026-Jan-03 链接: PubMed
摘要
Crisis admissions in dementia care are increasing, often leading to negative outcomes for people with dementia, their informal caregivers and healthcare professionals. Crises arise from a complex interplay of health, behavioural, social and environmental factors. This systematic review of qualitative studies, using a meta-ethnographic approach, explores the process leading up to and unfolding during crises. Five databases were searched for studies published between January 2000 and September 2023. Study selection involved AI-assisted screening (ASReview), followed by manual review and quality appraisal using the Joanna Briggs Institute checklist. Data synthesis was guided by the Strauss and Corbin qualitative framework. Nineteen studies, mainly reflecting the perspectives of informal caregivers and healthcare professionals, were included in the analysis. The core phenomenon identified is the mechanism in which professionals, persons with dementia and informal caregivers are constantly balancing between safety and autonomy, triggered by disruptions to a previously stable situation. Two contextual factors influence this process: a proactive, collaborative attitude among healthcare professionals, and a healthcare system that often acts as a push system, limiting flexibility and responsiveness. These findings highlight the need for collaborative care approaches to prevent or manage crises more effectively, offering valuable insights for practice and policy improvements.
53. Unravelling the temporal evolution of Parkinson's disease mortality in Spanish autonomous communities (1999-2021).
期刊: Neurologia 发表日期: 2026 链接: PubMed
摘要
This observational retrospective study aimed to analyse the mortality trends of Parkinson’s disease (PD) in Spain from 1999 to 2021, by autonomous community and sex. The study collected PD mortality data from 1999 to 2021 from the National Statistics Institute of Spain. Age-standardised mortality rates were analysed by sex and age group, using joinpoint analysis to identify significant trends. Over the study period, 72907 deaths due to PD were recorded in Spain, with 51% occurring in men and 49% in women. Both men and women showed a consistent upward trend in PD mortality rates at the national level, with annual increases of 2.1% for men and 2.0% for women. Joinpoint analysis revealed significant changes in trends within specific regions. Among men, rates in Catalonia stabilised after an initial increase, whereas Madrid showed a significant increase after a period of stability. Conversely, La Rioja exhibited a notable decrease after a period of increase. Similar patterns were observed for women, with certain regions showing stable rates while others displayed an upward trend. Cantabria, Galicia, and Valencia stabilised after an initial significant increase, Madrid showed a significant increase after a period of stability, and Andalusia demonstrated an acceleration after an initial increase. Our findings underscore the significance of monitoring PD mortality trends and their varying impact across different regions and sexes. This valuable information can play a crucial role in shaping future healthcare policies and designing effective prevention strategies.
54. Patient Engagement in Mobile Health for Community-Dwelling Older Adults: A Systematic Review.
期刊: International journal of older people nursing 发表日期: 2026-Jan 链接: PubMed
摘要
Mobile health (mHealth) is being actively developed for healthcare and can be an effective intervention through active engagement. However, despite the rapidly growing older adult population, mHealth is often designed for younger populations, and there is a need to explore engagement strategies that are appropriate for older adults. Therefore, this systematic review aimed to summarise the evidence for improving older adult engagement in community-based mHealth intervention studies. Participants were community-dwelling older adults. Interventions included mHealth for self-care, self-management, health promotion or health education with no restriction on type. Eligible studies were randomised controlled trials, excluding those involving hospitalised older adults, focusing solely on treatment compliance or symptom monitoring without reporting mHealth engagement outcomes or published in non-English languages. Searches were conducted in Cochrane CENTRAL, PubMed, EMBASE and CINAHL to identify studies on December 1, 2023 (date of last searched studies). Risk of bias in the included studies was assessed using the RoB 2 tool. The focus was on presenting engagement strategies for community-dwelling older adults in a summary of findings table. Ten studies with 1293 participants were included. Delivery modes varied, with the most engagement-associated outcome being improved physical functioning. Participant dropout rates ranged from 0% to 28%. While 10 studies employed strategies to encourage ongoing engagement, none included ‘engage as early as possible’ or ‘include a plan for evaluation’. While mHealth interventions show potential, their engagement strategies remain underdeveloped. Limitations include heterogeneity in study designs and the inability to perform meta-analysis. Future research should incorporate comprehensive engagement plans and evaluation systems to optimise the use of mHealth for community-dwelling older adults. The findings highlight the need to strengthen nurses’ digital health competencies and implement tailored clinical strategies, such as early support and ongoing feedback, to promote sustained engagement and adherence to mHealth among community-dwelling older adults.
55. Psychosocial Factors Are Rarely the Focus of Rehabilitation After Hip Fracture: A Short Report of Routinely Collected Health Data.
期刊: Physiotherapy research international : the journal for researchers and clinicians in physical therapy 发表日期: 2026-Jan 链接: PubMed
摘要
Hip fracture is a serious and common injury affecting older adults with significant psychosocial impacts. However, there is little information available on the assessment and treatment of psychosocial impacts of hip fracture during rehabilitation. Our aim was to determine the extent to which psychosocial factors are: (1) incorporated into goal setting; and (2) assessment and treatment during rehabilitation after hip fracture. A retrospective data audit of patients admitted to a community rehabilitation program with a primary diagnosis of hip fracture from 30 June 2022 to 30 June 2023 in Melbourne, Australia. Data were extracted from the assessment and treatment notes of physiotherapists and occupational therapists. One-hundred included patients (59% female, mean age 81 (SD 7) years) were admitted to the community rehabilitation program an average of 41 days (SD 29) after hip fracture. All patients consulted a physiotherapist, 23 an occupational therapist, 6 a dietitian and 3 a social worker. Overall, 3 of 100 patients had a goal that focused on psychosocial functioning and 21 had a goal with a psychosocial element. A total of 96 patients had a mental health screening, but of 17 who were assessed as being ‘at risk’, 9 (53%) patients did not receive any documented psychosocial management, including 5 (29%) who declined referrals for mental health services. Apart from those patients screened as ‘at risk’ a number of patients with clinical notes indicating psychosocial concerns were recorded as receiving education (n = 16) and encouragement (n = 9). Psychosocial aspects of goals, assessment and treatment are rarely the focus of management in rehabilitation after hip fracture. More attention is needed to assess and treat psychosocial factors as part of a multidisciplinary, holistic approach to rehabilitation after hip fracture.
56. Gender differences in burnout among resident physicians in Japan: a nationwide cross-sectional study.
期刊: Academic medicine : journal of the Association of American Medical Colleges 发表日期: 2025-Dec-15 链接: PubMed
摘要
Researchers extensively studied burnout in the medical profession; however, findings on gender differences have remained inconsistent. Understanding well-being disparities between male and female resident physicians is essential for providing appropriate support and fostering a sustainable medical workforce. This study examined gender differences in burnout, depression, job stress, and job satisfaction among Japanese resident physicians in their first and second postgraduate years. The authors conducted a nationwide, cross-sectional study using data from the 2022 General Medicine In-Training Examination (GM-ITE). The analysis included resident physicians who completed the GM-ITE; it assessed burnout, job stress, and job satisfaction using single items from the Mini-Z 2.0 on a five-point Likert scale, and measured depression using the Japanese version of the Patient Health Questionnaire-2. This study categorized gender as male or female and estimated prevalence ratios (PRs) for well-being outcomes using clustered log-linear modified Poisson regression models. The final analysis included 5812 residents, of whom 31.8% were female. Compared with male residents, female residents were younger, less likely to pursue high-workload specialties, and reported fewer working hours, emergency duties, and self-study time. Well-being outcomes revealed that 17.9% experienced burnout, 29.5% reported depressive symptoms, 39.0% experienced high job stress, and 66.6% reported job satisfaction. Multivariable analysis indicated that female residents were significantly less likely to experience burnout (PR = 0.74; 95% CI, 0.65-0.84) and more likely to report job satisfaction (PR = 1.10; 95% CI, 1.05-1.13). Gender differences in depressive symptoms and high job stress were not significant. Female residents in Japan experienced lower burnout rates and higher job satisfaction than their male counterparts. These findings challenged assumptions that female gender universally correlates with poor occupational well-being outcomes in the medical field and underscored the need for gender-sensitive support strategies.