公共卫生研究摘要 (2026-01-31)
共收录 58 篇研究文章
1. Physical activity and general medical knowledge of adult residents of the silesian voivodeship.
期刊: Annals of medicine 发表日期: 2026-Dec 链接: PubMed
摘要
The aim of the study was to assess the relationship between the physical activity and medical knowledge of adult residents of the Silesian Voivodeship. 1,638 (100%) adult residents of the Silesian Voivodeship were analyzed. The group was divided as follows: Group A - people not related to medical professions, Group B - people practicing medical professions: doctors, midwives, nurses/nurses, paramedics, pharmacists, laboratory diagnosticians, Group C - the entire study group. The research method used was an original survey questionnaire containing questions about physical activity and socio-demographic data, supplemented with a standardized International Physical Activity Questionnaire (IPAQ). For the purposes of the study, the respondents’ general medical knowledge was checked. The physical activity of the surveyed inhabitants of the Silesian Voivodeship was slightly better in the group of people performing medical professions compared to people not related to them, however, in both groups it was insufficient and required improvement. A higher level of general medical knowledge among the surveyed residents of the Silesian Voivodeship was not associated with the level of physical activity in the respondents, neither in terms of regularity nor intensity.
2. Attributable Mortality of Late-Onset Sepsis in the Neonatal ICU According to Gestational Age: A Historical Propensity Score Matched Cohort Study.
期刊: Nursing in critical care 发表日期: 2026-Mar 链接: PubMed
摘要
Late-onset sepsis is a major cause of morbidity and mortality in NICUs. This study reports the attributable mortality of late-onset sepsis across different gestational age groups. The objective of this study is to assess the attributable mortality of neonatal late-onset sepsis according to gestational age. A matched cohort study using a 10-year, single-centre historical cohort with propensity score matching to reduce confounders. Attributable mortality was determined in the total matched cohort and by gestational age: extremely preterm (< 28 weeks), very preterm (28-32 weeks + 6 days), late preterm (33-36 weeks +6 days) and full-term (≥ 37 weeks). The matched cohort included 4210 neonates. Attributable mortality of late-onset sepsis in the total cohort was 6.1% (95% CI, 4.7-7.8). It was highest in neonates born between 28 and 36 weeks: 7.1% (95% CI, 4.5-9.8) for very preterm, 8.1% (95% CI, 5.1-11.1) for late preterm and 2.8% (95% CI, 0.01-5.8) for term neonates. For extremely preterm newborns, it was 6.6% (95% CI, -1.1 to 14.5). Late-onset sepsis significantly impacts neonates, particularly those born between 28 and 36 weeks, even after adjusting for confounders. Larger-scale studies are needed to further understand the impact across gestational ages. Integrating gestational age into risk stratification tools may improve prevention, early detection and management of neonatal late-onset sepsis. Gestational age-specific risk profiles enable targeted monitoring and timely intervention for neonates at greatest risk of sepsis. Personalised care strengthens prevention and management, while nursing expertise in this context is vital for early detection and reducing mortality.
3. Discontinuation of Renin-Angiotensin System Inhibitors and Risk of End-Stage Renal Disease and Cardiovascular Outcomes Among Patients With Type 2 Diabetes and Chronic Kidney Disease: A Nationwide Taiwanese Cohort Study.
期刊: Pharmacoepidemiology and drug safety 发表日期: 2026-Feb 链接: PubMed
摘要
This nationwide cohort study examined the effects of discontinuation versus continuation of renin-angiotensin system inhibitors (RASis) on major renal and cardiovascular outcomes after the estimated glomerular filtration rate (eGFR) decreased to below 45 mL/min/1.73 m2 in patients with type 2 diabetes and treated with RASis. Using linked Taiwanese databases with claims and clinical data, we identified patients with type 2 diabetes who used RASis during 2016-2020, and either discontinued or continued RASis within 180 days when their eGFR fell below 45 mL/min/1.73 m2. The outcomes of interest included end-stage renal disease (ESRD), myocardial infarction, stroke, heart failure, and all-cause mortality. We estimated the hazard ratios (HRs) and 95% confidence intervals (CIs) for RASi discontinuation versus RASi continuation using on-treatment and intention-to-treat analyses and inverse probability weighting to adjust for baseline and time-varying covariates. We identified 251 853 eligible patients, of whom 37 108 (15%) discontinued RASis and 214 745 (85%) continued RASis. The on-treatment HR associated with RASi discontinuation was 2.52 (95% CI, 2.33-2.73) for ESRD, 1.18 (1.08-1.30) for myocardial infarction, 1.28 (1.19-1.37) for stroke, 1.18 (1.13-1.24) for heart failure, and 1.77 (1.70-1.84) for all-cause mortality. Results from the intention-to-treat analysis were similar, albeit more conservative. Findings remained consistent across eGFR strata (≥ 30 to < 45 and < 30 mL/min/1.73 m2), urine albumin-creatinine ratio categories (≥ 300 and < 300 mg/g), and patient subgroups with various baseline characteristics. Our results support continuing RASi treatment even when the eGFR declines to below 45 mL/min/1.73 m2 based on potential renal, cardiovascular, and survival benefits. In this nationwide Taiwanese cohort of over 250 000 patients with type 2 diabetes who used RASis and experienced a decrease of eGFR to below 45 mL/min/1.73 m2, RASi discontinuation was associated with an increased risk of ESRD, myocardial infarction, stroke, heart failure, and all‐cause mortality compared to RASi continuation.
4. Determinants of Sprint Ability Change During Maturation in Developing Children.
期刊: European journal of sport science 发表日期: 2026-Feb 链接: PubMed
摘要
This study aimed to clarify changes in sprint ability and spatiotemporal variables with maturation in children and to identify key determinants from anthropometric and muscle strength perspectives. Ninety-eight young soccer players aged 7.6-17.9 years underwent a 30-m sprint test, anthropometric measurements, muscle thickness (MT) and maximal voluntary contraction (MVC). Maturity offset (MO) was calculated as the difference between the chronological age and estimated age at peak height velocity (PHV). Breakpoint (BP) in maximal sprint speed (MSS) development was identified at +1.1 years of MO, and the participants were classified into pre- and post-BP groups. A significant correlation was found between MSS and MO in the pre-BP group, but was no longer observed in the post-BP group. Although step length (SL) was positively correlated with MO in the pre-BP group, this correlation was not observed and step frequency (SF) showed a positive correlation in the post-BP group. Multiple regression analysis revealed that in the pre-BP group, leg length (LL) was the only significant predictor of MSS, primarily by influencing SL. By contrast, in the post-BP group, MVC and MT emerged as significant predictors of MSS, mainly by influencing SF. In conclusion, this study identified a key developmental BP at +1.1 years of MO and demonstrated a shift in the determinants of sprinting ability from reliance on anthropometric growth before this point to a dominance of neuromuscular factors.
5. Survival Benefit of Adjuvant Radiotherapy After Surgery in Patients With T1-2N1M0 Hypopharyngeal Squamous Cell Carcinoma: A Dual-Cohort Analysis of SEER and Institutional Data.
期刊: Cancer medicine 发表日期: 2026-Feb 链接: PubMed
摘要
The optimal therapeutic strategy for patients with T2-3N0-3 M0 or T1N1-3 M0 hypopharyngeal squamous cell carcinoma (HPSCC) and the use of postoperative radiotherapy with or without systemic therapy for patients with T1-2N1M0 HPSCC remain controversial. We aimed to determine whether these additional treatments improve the prognosis in HPSCC. We retrospectively analyzed the databases held by the SEER (surveillance, epidemiology, and end results) program and a tertiary referral center in China to evaluate the survival outcomes of surgical intervention for T2-3N0-3 M0 and T1N1-3 M0 HPSCC and of postoperative radiotherapy for T1-2N1M0 disease. The SEER contained data for 1235 patients with T2-3N0-3 M0 or T1N1-3 M0 HPSCC, of whom 220 underwent surgery as their first treatment and 737 received non-surgical treatment. There was no statistically significant difference in overall survival (OS) between these two groups. Data were also available for 30 patients in the SEER who were treated by surgery alone (n = 11), surgery plus postoperative radiotherapy (n = 7), or surgery plus postoperative radiotherapy with systemic therapy (n = 12). Similarly, 23 patients at our hospital were identified to have been treated by surgery alone (n = 7), surgery plus postoperative radiotherapy (n = 10), or surgery plus postoperative radiotherapy with systemic therapy (n = 6). The SEER data indicated that postoperative radiotherapy improved OS (hazard ratio 0.281, 95% confidence interval 0.079-0.998; p = 0.036). This finding was supported by the data from our hospital, although the improvement in OS was not statistically significant (hazard ratio 0.360, 95% confidence interval 0.057-2.261; p = 0.224). Postoperative radiotherapy with systemic therapy seemed not to improve OS beyond that achieved by postoperative radiotherapy alone. There was no significant difference in OS in patients with T2-3N0-3 M0 or T1N1-3 M0 HPSCC according to whether or not they underwent surgery as first-line treatment. Surgery plus postoperative radiotherapy was associated with a more favorable prognosis than surgery alone in patients with T1-2N1M0 HPSCC.
6. Development of a Modified Textbook Outcome in Evaluating Robot-Assisted Middle Pancreatectomy: A Real-World Study of RMP Surgery in a High-Volume Pancreatic Disease Center.
期刊: Cancer medicine 发表日期: 2026-Feb 链接: PubMed
摘要
We aimed to, for the first time, assess the value of modified textbook outcome (mTO) in robot-assisted middle pancreatectomy (RMP) procedures. Pancreatic fistula remains to be the major complication after RMP. Textbook outcome (TO) is introduced to capture the most desirable surgical outcomes. The value of TO in RMP surgery remains unknown. All patients who underwent RMP in our center from 2010 to 2023 were enrolled in the study. Baseline characteristics, operative outcomes, and oncological outcomes were collected and analyzed. Textbook outcome was calculated separately for each patient and analyzed. The mTO was defined by the absence of modified post-operative pancreatic fistula (mPOPF), postpancreatectomy hemorrhage (PPH), severe complications (Clavien-Dindo ≥ III), readmission, and in-hospital mortality (IHM). The overall mTO rate and mPOPF rate of 209 patients were 73.68% and 15.79%, respectively. Patients who achieved modified textbook outcomes have shorter post-operative hospitalization days (median (IQR), 17 (9) vs. 34 (26), p < 0.001). Passing the learning curve leads to a reduction of the mPOPF rate and an increase of the mTO rate. Modified textbook outcome is a practical metric for evaluating ideal surgical outcomes in RMP surgery. Follow-up multi-center clinical research is necessary to evaluate this indicator even further.
7. Icosapent ethyl reduces CVD risk in cardiovascular-kidney-metabolic syndrome: REDUCE-IT CKM.
期刊: American journal of preventive cardiology 发表日期: 2026-Feb 链接: PubMed
摘要
Cardiovascular-kidney-metabolic (CKM) syndrome was recently identified as a cardiometabolic disorder that incorporates chronic kidney disease with the metabolic syndrome (MetS). REDUCE-IT (Reduction of Cardiovascular Events with Icosapent Ethyl-Intervention Trial) was an international, double-blind, placebo-controlled trial that randomized hypertriglyceridemic (TG, 150-499 mg/dL) statin-treated patients with established cardiovascular disease (CVD) or diabetes and multiple CVD risk factors to icosapent ethyl (IPE) or placebo (4 grams/day). It is unknown if renal insufficiency added to MetS confers incremental CVD risk in secondary prevention patients without diabetes and if IPE lowers that risk. The current study evaluated the secondary prevention patient subgroup with a history of MetSyn, but without diabetes at baseline (n=2860). In the subset of patients with CVD and MetS without diabetes, subjects were divided into the following groups: eGFR < 60 mL/min/1.73 m2 (n=565), eGFR ≥ 60 to < 90 mL/min/1.73 m2 (n=1686), and eGFR ≥ 90 mL/min/1.73 m2 (n=609). Event rates of the primary and secondary trial endpoints were compared in placebo subjects with higher vs lower baseline eGFR, and the effect of IPE on these endpoints was also compared within each of the three subgroups. In the placebo arm, CKM was associated with increased risk of the primary composite endpoint at eGFR < 90 mL/min/1.73 m2 (Hazard Ratio [HR], 1.44 [95% CI, 1.05, 1.96]; P=0.02) and at eGFR < 60 mL/min/1.73 m2 (HR, 1.87 [95% CI, 1.31, 2.69]; P=0.0005) compared with MetS patients with normal kidney function (eGFR ≥ 90 mL/min/1.73 m2). A similar trend but without statistical significance was observed for eGFR ≥ 60 to < 90 mL/min/1.73 m² (HR, 1.30 [95% CI, 0.94, 1.79]; P=0.11) compared with MetS patients with normal kidney function. In patients with CKM (eGFR < 60 mL/min/1.73 m2) adjusted for age and sex, treatment with IPE compared with placebo was associated with significant reductions in the primary composite endpoint (HR, 0.55 [95% CI, 0.38, 0.78]; P=0.0009) and in the key secondary composite endpoint (HR, 0.52 [95% CI, 0.35,0.79], P= 0.002). Treatment with IPE was associated with an absolute risk reduction of 11.2% and number needed to treat of 9 patients to prevent an initial primary composite endpoint event over the study period. In this REDUCE-IT analysis of secondary prevention patients without diabetes at baseline, the recently defined CKM syndrome was associated with incremental CVD risk compared with MetS and normal renal function. Treatment with IPE substantially reduced CVD risk in MetS patients with renal insufficiency (i.e., CKM) and CVD.
8. Impact of gender medicine on antibiotic research and use: a narrative review of existing evidence.
期刊: Expert opinion on drug metabolism & toxicology 发表日期: 2026-Jan-30 链接: PubMed
摘要
Sex and gender differences may significantly impact health outcomes, yet their role in antibiotic therapy remains underexplored. Despite the urgent threat of antimicrobial resistance, limited evidence exists on how biological, pharmacokinetic, and sociocultural differences affect antibiotic efficacy, safety, and usage. This gap is critical, as women are often underrepresented in clinical trials, leading to suboptimal treatment strategies and a higher incidence of adverse drug reactions. This narrative review synthesizes current evidence on these disparities. We explore the biological basis for differential immune responses and drug pharmacokinetics, sociocultural drivers of prescribing patterns, gender-specific infections, and the intersection of gender with antimicrobial resistance. The review also addresses antibiotic use in pregnancy and highlights the profound lack of data for both cisgender and transgender women due to their exclusion from research. Sex-aware prescribing is a practical and necessary step toward equitable care. Key obstacles include historical underrepresentation of women in trials and insufficient sex-disaggregated data. We advocate for powering future trials for sex-specific analyses, updating clinical guidelines, and using decision support tools for dose adjustments. Integrating a gender lens into all levels of antimicrobial stewardship is essential to move from simply describing disparities to actively closing them.
9. Net Clinical Benefit of Extended Dual Pathway Inhibition in Chronic Coronary Syndrome as Classified by the 2024 ESC Criteria: a COMPASS Substudy.
期刊: European heart journal. Cardiovascular pharmacotherapy 发表日期: 2026-Jan-30 链接: PubMed
摘要
Extended dual pathway inhibition (DPI) with aspirin and rivaroxaban is recommended in high-risk patients with chronic coronary syndrome (CCS). In the 2024 update of the European Society of Cardiology guidelines on CCS, the high-risk criteria were revised. In the COMPASS cohort, we evaluated net clinical benefit of DPI according to baseline risk as defined by the ESC criteria in CCS patients. CCS patients randomized to aspirin alone or DPI (n=15,429) were risk stratified using the 2024 ESC criteria. Endpoints included major adverse cardiovascular events (MACE), all-cause death, fatal/critical organ bleeding, and composite adverse events (MACE and bleeding). Net clinical benefit was the 30-month absolute risk difference combining MACE and bleeding. High-risk status was associated with higher 30-month incidences of MACE (6.4% vs. 5.0%, HR 1.33, 95% CI 1.09-1.63) and composite adverse events (7.1% vs. 5.7%, HR 1.31 [1.09-1.58]), but not all-cause death or bleeding. DPI reduced MACE (low-risk: HR 0.66 [0.45-0.95]; high-risk: HR 0.77 [0.66.-0.91]; p-value for interaction 0.42) and all-cause death (low-risk: 0.78 [0.53-1.14]; high-risk: HR 0.78 [0.64-0.94], p-value for interaction 0.99). DPI provided similar net clinical benefit in low-risk (30-month risk difference -1.77% [-3.88-0.33], HR 0.79 [0.56-1.11]) and high-risk patients (30-month risk difference -2.06% [-3.20–0.91], HR 0.80 [0.69-0.93]; p-value for interaction 0.94). In CCS patients, DPI reduced all-cause death and MACE while increasing major bleeding. The 2024 ESC criteria performed poorly in terms of distinguishing patients at high vs. low ischemic risk, making them inadequate to provide guidance for DPI use.
10. Process evaluation of an integrated personalized eHealth programme after total and unicompartmental knee arthroplasty-Results of the multicenter ACTIVE randomized controlled trial.
期刊: Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA 发表日期: 2026-Jan-30 链接: PubMed
摘要
Patients receiving knee arthroplasty often experience limited guidance in resuming daily life activities. The ACTIVE (enhAncing soCietal parTicipation with an IndiVidualized integratEd care programme) trial evaluated the effectiveness of an intervention designed to enhance recovery and return to daily activities in working-age knee arthroplasty patients. We conducted a process evaluation assessing whether the intervention was delivered as intended and exploring patient experiences, attitudes and the factors that explain how and why the intervention unfolded in practice, to guide future improvements in both the intervention and its implementation. A process evaluation was carried out alongside the multicenter randomized controlled ACTIVE trial. Data were analysed using the Linnan and Steckler framework, measuring reach, dose delivered, dose received and patients’ attitudes throughout the follow-up. Among patients in the intervention group only, data were collected using questionnaires, a study database and a logbook of the eHealth programme. We additionally performed six interviews with patients to gather in-depth information regarding positive and negative experiences with the intervention. A total of 145 patients were randomized to the intervention group, of which 133 started follow-up. All components of the intervention were delivered as planned, and 100% of eligible patients received access to the eHealth programme. Adherence was high, with 99% of patients logging into the programme at least once. Patients reported that the intervention was supportive and motivating. The activity tracker was scored highest with a mean of 7.8 (standard deviation [SD] 1.4) and 7.9 (1.4) out of 10 at 6 weeks and 6 months postoperatively, respectively. Patients with disabling comorbidities or atypical recovery trajectories felt that recovery recommendations did not adequately address their specific needs. The intervention was delivered and used as intended and seems ready for successful implementation for working-age knee arthroplasty patients with a typical course of recovery. To accommodate patients with atypical recovery trajectories, the intervention should incorporate greater flexibility. N/A.
11. Oral Health-Related Quality of Life and Oral Health Status among Myanmar Refugees in Resettlement Camps in Hyderabad, Telangana - An Evaluative Study.
期刊: Indian journal of dental research : official publication of Indian Society for Dental Research 发表日期: 2026-Jan-30 链接: PubMed
摘要
There is a high prevalence of oral disease and unmet oral healthcare needs in refugee population. This study aims to correlate Oral Health-Related Quality of Life (OHRQoL) with dentition and periodontal status among Myanmar refugees in resettlement camps in Hyderabad, Telangana. The study included Myanmar refugees aged 18 years and above who were registered under United Nations High Commissioner for Refugees (UNHCR) Refugee mandate and have refugee status card. Also, only participants who can read and understand the Burmese language and gave written consent were included. Validated Myanmar translated version of OHIP-14 was used to assess OHRQoL. Dentition and periodontal status were examined by single calibrated examiner according to WHO criteria. Caries prevalence in this group of 208 participants was found to be 64.9% with a mean DMFT of 3.59 ± 3.7. Multiple logistic regression analysis reveals that a history of dental visits had significantly higher odds of poor OHRQoL (OR = 4.45; P = 0.00). Variables like age (OR = 0.30; P = 0.00), absence of gingivitis (OR = 0.11; P = 0.03) and periodontal pocket (OR = 0.32; P = 0.00) showed significantly lower odds for poor OHRQoL in this population. This study concluded that compromised oral health conditions among Myanmar refugees significantly affected their OHRQoL. This study also highlights the urgent need to address oral healthcare needs of this refugee population.
12. New Insights from Perinatal HIV: A Way Forward for HIV Cure Research.
期刊: The Journal of infectious diseases 发表日期: 2026-Jan-30 链接: PubMed
摘要
13. The silver tsunami and the elective arthroplasty crisis: How geriatric trauma overruns public surgical capacity.
期刊: Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA 发表日期: 2026-Jan-30 链接: PubMed
摘要
Across Europe, orthopaedic departments face a growing disequilibrium: the sharply rising volume of geriatric trauma requiring urgent intervention versus the continued necessity for high-value elective total joint arthroplasty to restore mobility, independence and quality-adjusted life years (QALYs). In most public systems, the escalation in proximal femoral fractures-driven by demographic shifts -absorbs operative capacity previously allocated to elective arthroplasty. Although trauma surgery should, by definition, be prioritised, the resulting displacement of elective total joint arthroplasty (TJA) increasingly undermines the principles of value-based care. This editorial discusses the drivers of this development, highlights the clinical and health-economic consequences and outlines practical strategies that European health systems should consider to maintain timely trauma care without sacrificing access to elective arthroplasty.
14. One Year Cholecalciferol and Calcium Supplementation Improve BMD But Not Trabecular Bone Score in Asymptomatic Hypovitaminosis D.
期刊: Clinical endocrinology 发表日期: 2026-Jan-30 链接: PubMed
摘要
The bone health significance of incidentally detected low serum 25(OH)D in clinically asymptomatic individuals is debatable. We investigated the changes in bone mineral density (BMD) and trabecular bone score (TBS) after 1 year of cholecalciferol and calcium supplementation in asymptomatic individuals with low serum 25(OH)D and TBS. Interventional longitudinal study at the tertiary-care centre. The study subjects were 50 healthy individuals (age 45 ± 9 years, BMI 26.7 ± 3.9 kg/m2 and M:F = 29:21) with serum 25(OH)D < 50 nmol/L and low TBS (< 1.310) followed from an earlier study designed for generating TBS norms for Asian Indians. Participants received supervised 60,000 IU of cholecalciferol/week for 8 weeks, followed by 60,000 IU/month for the next 10 months and 500 mg daily elemental calcium. Serum 25(OH)D and related biochemical parameters, BMD, and TBS were evaluated before and after 6- and 12-months of supplementation. Changes were analysed using a generalised estimating equation. Mean serum 25(OH)D (nmol/L) showed a significant rise following supplementation (29.1 ± 11.7 at baseline to 68.8 ± 47.4 and 63.2 ± 22.2 at 6- and 12-months, respectively). Serum intact PTH, osteocalcin, and alkaline phosphatase showed a significant decrease within 6 months of supplementation. BMD improved significantly from baseline at lumbar-spine, total-hip, and femoral-neck at 6- and 12-months after supplementation (p < 0.01 for all). However, the mean TBS showed no significant change following cholecalciferol and calcium supplementation. One year of cholecalciferol and calcium supplementation in asymptomatic individuals resulted in a significant rise in serum 25(OH)D, which was associated with increased BMD but not TBS.
15. A European vision for telemedicine in cancer care: policy and patient perspectives from the eCAN Joint Action.
期刊: Health economics, policy, and law 发表日期: 2026-Jan-30 链接: PubMed
摘要
Telemedicine is increasingly playing a vital role in European health systems, offering great potential for improving healthcare access and outcomes. Funded between September 2022 and December 2024, the Joint Action ‘Strengthening eHealth including telemedicine and remote monitoring for health care systems for CANcer prevention and care’ (eCAN JA) provided evidence-base for person-centred implementation of telemedicine services among cancer patients in the European Union (EU). Through a mixed-method approach, this foresight study gathered insights from key decision-makers in 14 EU Member States and eight cancer patient associations via two surveys and a joint workshop, conducted within the Sustainability Work Package (WP4) of the eCAN JA. Our results show that EU Member States and cancer patients view telemedicine as a useful and complementary tool, however, not as a replacement for in-person services for cancer care. The policy recommendations from our study can be summarised as follows: (i) develop legal frameworks to complement in-person care with telemedicine; (ii) improve digital literacy and information technology infrastructure while ensuring privacy and health equity; and (iii) engage patients in the co-design of telemedicine services. Implementing these recommendations will enhance the integration of telemedicine into cancer care in Europe.
16. Smartphone addiction and health promotion lifestyle in university students: a cross-sectional analytical study.
期刊: Primary health care research & development 发表日期: 2026-Jan-30 链接: PubMed
摘要
Smartphones have become essential, making our daily lives more manageable; however, excessive use may cause problems. University students are particularly vulnerable to smartphone addiction. This study examines the relationship between smartphone addiction and health-promoting lifestyles among university students. A cross-sectional study was conducted with 911 students at Dokuz Eylul University, Izmir, Turkey. Data were collected via Smartphone Addiction Scale-Short Version (SAS-SV) and Health Promotion Lifestyle Profile II (HPLP II). The printed forms were used, and the researcher administered the survey in person and recorded the responses. Prevalence of smartphone addiction was 34.1%. Several factors were significantly associated, including female gender (p = 0.049), being single (p = 0.042), self-perceived smartphone addiction (p < 0.001), daytime sleepiness (p < 0.001), and poor sleep quality (p < 0.001). Students with smartphone addiction had significantly lower HPLP II scores (p = 0.001).Logistic regression analysis showed that gender was no longer a significant factor. Those without a partner (OR: 1.47, 95% CI: 1.07-2.03), those who considered themselves smartphone addicts (OR: 6.86, 95% CI: 4.99-9.42), and those with daytime sleepiness (OR: 1.52, 95% CI: 1.08-2.14) had higher odds of smartphone addiction. Higher HPLP II scores were protective against smartphone addiction (OR: 0.99, 95% CI: 0.98-0.99). This study highlights that students with smartphone addiction engage in less health-promoting behaviours and experience poor sleep quality and daytime sleepiness. Self-perceived smartphone addiction was strongly associated with actual addiction, while a healthier lifestyle appeared to have a protective effect. There is a need for strategies to promote healthy habits and reduce smartphone addiction among university students.
17. Association of the Naples Prognostic Score With Functional Outcomes and the Mediating Effects of PhenoAge Acceleration in Patients With Acute Ischemic Stroke or Transient Ischemic Attack: A Nationwide Registry Study.
期刊: Journal of the American Heart Association 发表日期: 2026-Jan-30 链接: PubMed
摘要
The Naples Prognostic Score (NPS), a novel inflammatory and nutritional score, has attracted widespread attention in the prognosis of various diseases but remains unclear in acute ischemic stroke or transient ischemic attack. We aimed to investigate the association between NPS and poor functional outcomes and test whether PhenoAge acceleration (PAA) mediates or jointly contributes to the relationships. This prospective cohort study included patients with acute ischemic stroke or transient ischemic attack from the CNSR-III (Third China National Stroke Registry). The NPS (range, 0-4) was calculated based on serum albumin, total cholesterol, neutrophil/lymphocyte ratio, and lymphocyte/monocyte ratio, and categorized as low (0), medium (1 or 2), or high (3 or 4). Logistic regression was used to assess the association between NPS and poor functional outcomes (modified Rankin Scale [mRS] score, 2-6/3-6). Mediation analyses were performed to explore the role of PAA. A total of 7932 patients from the CNSR-III were included in the analysis. High NPS was significantly associated with poor functional outcomes at 3 months (adjusted odds ratio [OR], 1.69 [95% CI, 1.13-2.52], P=0.010 for mRS 3-6; adjusted OR, 1.31 [95% CI, 1.00-1.71], P=0.048 for mRS 2-6). PAA partially mediated the observed association, with mediation proportions of 13.90% and 12.82% for mRS 3 to 6 and 2 to 6 at 3 months, respectively. Patients with both high NPS and PAA ≥0 had the highest risks of poor outcomes (adjusted OR, 2.16 [95% CI, 1.73-2.70] for mRS 3-6; adjusted OR, 1.51 [95% CI, 1.25-1.84] for mRS 2-6). Similar results were observed at 1 year. Incorporating combined NPS and PAA into the basic model improved predictive performance for short- and long-term poor functional outcomes. High NPS was associated with increased risk of poor functional outcomes at 3-month and 1-year follow-ups in patients with acute ischemic stroke or transient ischemic attack. This association was partially mediated and jointly influenced by PAA.
18. Development and Validation of the Predicting Risk of Ischemic Stroke in Malignancy Estimation Tool.
期刊: Journal of the American Heart Association 发表日期: 2026-Jan-30 链接: PubMed
摘要
The risk of ischemic stroke is highest during the first year following a new diagnosis of cancer, but no tools exist to identify patients at highest risk. Using linked clinical and administrative databases, we conducted a population-based retrospective cohort study of adults in Ontario, Canada, with newly diagnosed cancer from 2010 to 2021. Patients were randomly selected for prediction model derivation (60%) or validation (40%). The final model predicting ischemic stroke within 1 year following cancer diagnosis was derived using multivariable Fine-Gray regression with candidate predictors selected via backward elimination. Subdistribution-adjusted hazard ratios and 95% CIs were calculated, where all-cause mortality was treated as a competing event. Performance of the prediction model was assessed in the validation cohort based on the C statistic and calibration plots for discrimination and calibration, respectively. There were 698 566 eligible patients, with 418 911 in the derivation cohort and 279 576 in the validation cohort. The overall rate of stroke per 1000 person-years was 6.7 (95% CI, 6.4-6.9). The final model included 22 predictors, including age, sex, demographic factors, cancer characteristics, and treatment characteristics. Discrimination was good, with a C statistic of 0.73. The model was well calibrated, with points following the desired 45-degree line. We derived and validated the PRIME (Predicting Risk of Ischemic Stroke in Malignancy Estimation) tool with good discrimination for ischemic stroke in patients with a new cancer diagnosis. The model was built into an online calculator (https://study.ohri.ca/PRIME/) and has the potential to stratify patients with cancer based on their risk of stroke within a year following their diagnosis.
19. Heart-Brain Axis: Subclinical Cardiovascular Changes and Brain Health.
期刊: Journal of the American Heart Association 发表日期: 2026-Jan-30 链接: PubMed
摘要
Complex bidirectional interactions between the nervous and cardiovascular systems are integrated through the heart-brain axis, a physiological pathway that governs both neural regulation of cardiovascular function and cardiovascular influences on brain health. Emerging evidence indicates that even in the absence of overt disease, subclinical changes in the heart, aortic arch, and extracranial arteries contribute to brain injury and cognitive vulnerability. This review synthesizes current knowledge on how subclinical heart-brain axis dysfunction affects brain structure and function, highlighting the roles of central and autonomic neural pathways as well as hormonal signaling in driving neurological decline. Key biomarkers linked to silent brain injury, cognitive decline, and dementia are discussed, emphasizing their potential for early risk stratification and as targets for preventive interventions. We also outline mechanistic pathways connecting subclinical heart-brain axis dysfunction to adverse brain outcomes, identify major gaps in current evidence, and propose priorities for future research and clinical trials aimed at early detection and risk reduction to preserve brain health.
20. Cross-community community-based participatory research: A scoping review.
期刊: American journal of community psychology 发表日期: 2026-Jan-30 链接: PubMed
摘要
In the United States (US), communities that share the reality of relatively poor health are often on differing sides of a growing political divide. Might community-based participatory research (CBPR) promote inter-community understanding and mutual support? We conducted a scoping review of English-language literature on CBPR in the United States that utilized what we term “purposeful diversity.” By purposeful diversity, we mean studies that intentionally involved partnerships with communities of differing race/ethnicity, socioeconomic status, geographic regions, gender/sexual orientation, religions or age in order to achieve a specific result. Only 41 partnerships (described in 65 papers) met our review criteria. Purposeful diversity in ethnicity/race was most common. Community advisory boards, community co-investigators, and community membership on steering committees were prevalent forms of community participation. Frequently, reasons for involving diverse partners were not given; those offered most often were the disproportionate burden of poor health on the communities participating. While many partnerships reported benefits of diversity, the only benefit frequently mentioned was success in recruiting diverse participants. Fewer than 40% of partnerships addressed challenges from working with diverse communities; barriers to communication and understanding were the most common. Fewer than 20% of partnerships reported strategies to address these challenges. Even fewer documented results of such strategies or methods they used to explore the influence of community diversity. Despite the focus of CBPR on structural disadvantage and the possibility of structural change, the potential of this approach for addressing inter-community conflict is virtually unexplored.
21. The Ethics of Wegovy in Pediatric Mental Health.
期刊: Bioethics 发表日期: 2026-Jan-30 链接: PubMed
摘要
Semaglutide (Wegovy), a glucagon-like peptide-1 receptor agonist (GLP-1 RA), has attracted global attention for its appetite-suppressing and weight-loss effects. Approved by the U.S. FDA in 2022 for adolescents aged 12 and older, it has since been authorized in several other countries. Despite this, its use among youth remains limited, with ongoing concerns about its long-term safety, efficacy, and suitability during periods of growth and development. Advocates see Wegovy as an important tool for addressing pediatric obesity and its psychological burdens, while critics caution against widespread use in such a vulnerable population. This paper examines an underexplored ethical dimension of Wegovy’s use in children: its impact on mental health. We argue that Wegovy may offer mental health benefits for children-such as reducing weight stigma, improving self-esteem, and avoiding invasive interventions such as bariatric surgery. However, these potential benefits are constrained by barriers to access, supply shortages, risks of misuse, and the possibility of reinforcing stigma and class-based discrimination. In light of these considerations, we argue that while Wegovy offers promising health benefits for children, its long-term effects on growth, development, and mental health remain uncertain, warranting further study before definitive policy decisions are made. If future evidence confirms its value, it is our view that access should be equitable and accompanied by reforms to reduce stigma, regulate prescribing, and prevent misuse. Until then, clinicians should prescribe cautiously, ensuring clear medical need and implementing safeguards against risks such as weight regain, treatment interruption, and bias in care.
22. Efficacy and Safety of Prophylaxis With a Plasma-Derived von Willebrand Factor/Factor VIII Concentrate (Wilate) in Patients With Type 3 von Willebrand Disease-A WIL-31 Study Sub-Analysis.
期刊: European journal of haematology 发表日期: 2026-Jan-30 链接: PubMed
摘要
The WIL-31 study demonstrated efficacy and safety of prophylaxis with the plasma-derived von Willebrand factor/factor VIII concentrate wilate in von Willebrand disease (VWD) of all types and was the only prospective study with an on-demand run-in study as an intra-individual comparator. This subgroup analysis examines the efficacy of wilate prophylaxis in patients with type 3 VWD in WIL-31. Patients received 20-40 IU/kg wilate prophylaxis 2-3 times weekly for 12 months. Twenty-two patients in WIL-31 had type 3 VWD. Mean total annualized bleeding rate (ABRs) during on-demand versus prophylaxis was 37.1 versus 5.2 (86% reduction). During prophylaxis, 115 bleeds occurred, most (95%) of which were minor; the most common bleeding site was the nose (40% of bleeds). Mean overall spontaneous ABRs during on-demand versus prophylaxis were 26.5 versus 2.8 (89% reduction); mean treated spontaneous ABRs were 20.3 versus 1.4, respectively (93% reduction). ABRs were reduced further during the second 6 months of prophylaxis versus the first 6 months. Results were consistent in subgroups by age. No serious adverse events related to study treatment and no thrombotic events were observed. Prophylaxis with wilate was effective and well tolerated in patients with type 3 VWD, in all age groups. NCT04052698; https://clinicaltrials.gov/study/NCT04052698.
23. Per-Protocol Analysis of Chlorthalidone Versus Hydrochlorothiazide for Cardiovascular Event Prevention-Diuretic Comparison Project.
期刊: Journal of the American Heart Association 发表日期: 2026-Jan-30 链接: PubMed
摘要
The DCP (Diuretic Comparison Project), a pragmatic trial, evaluated whether chlorthalidone compared with hydrochlorothiazide would reduce the risk of nonfatal cardiovascular disease or noncancer-related death. The intent-to-treat analysis found no difference in such comparison (hazard ratio, 1.04 [95% CI, 0.94-1.16]). The objective of the current study is to estimate the per-protocol effect of chlorthalidone (12.5/25 mg daily) compared with hydrochlorothiazide (25/50 mg daily) in preventing major adverse cardiovascular events among older patients with hypertension. The effect of adhering to treatment strategies was assessed by censoring at first instance of nonadherence, defined as a gap (>90-day gap in drug coverage), switch (switching between study medications), and discontinuation (stop taking chlorthalidone/hydrochlorothiazide altogether for >90 days before the end of the study). The primary outcome was a composite of nonfatal myocardial infarction, stroke, heart failure resulting in hospitalization, urgent coronary revascularization for unstable angina, and noncancer-related death. Using inverse probability weighting, we evaluated the per-protocol effect of chlorthalidone and hydrochlorothiazide using DCP trial data. Nonadherence was found in 5476 (40%) participants; among 8047 (60%) adherents, 3905 (49%) were randomized to chlorthalidone and 4142 (51%) to hydrochlorothiazide. After censoring time when participants deviated from the assigned treatments, the estimated 5-year risk ratio of the composite primary outcome of nonfatal cardiovascular disease and noncancer-related death was 1.36 (95% CI, 0.96-2.12) in chlorthalidone compared with hydrochlorothiazide. The per-protocol analysis indicated a lower risk with hydrochlorothiazide compared with chlorthalidone in preventing nonfatal cardiovascular disease and noncancer-related death; however, this difference was not statistically significant using dispensation data to identify adherence. URL: https://www.clinicaltrials.gov; Unique identifier: NCT02185417.
24. Systemic Embolic Events in Atrial Fibrillation: An Individual Patient Data Meta-analysis of 71 683 Participants Randomized to NOAC Versus Warfarin.
期刊: Circulation 发表日期: 2026-Jan-30 链接: PubMed
摘要
Systemic embolic events (SEEs) are a serious but underrecognized complication of atrial fibrillation. Although non-vitamin K antagonist oral anticoagulants prevent ischemic stroke (IS), their efficacy in SEE and the clinical characteristics of patients who experience SEE remain poorly understood. We analyzed individual patient data from 4 pivotal randomized trials enrolling patients between 2005 and 2010 comparing non-vitamin K antagonist oral anticoagulants versus warfarin in atrial fibrillation. We characterized the incidence, clinical features, management, and outcomes of clinically overt SEE and compared results in these patients with patients who had an IS. Among 71 683 patients, 188 experienced SEE (26 with concurrent IS), yielding an annualized event rate of 0.13% per patient-year, compared with 1.25% per patient-year for IS (n=1797). Among 171 patients with SEE as their first event, median age was 75 years (interquartile range, 68-80), 49.7% were female, and mean±SD CHA2DS2-VASc score was 4.7±1.5. Compared with IS, patient with SEE had higher rates of peripheral arterial disease (PAD, 16.5% versus 5.4%; P<0.001), previous myocardial infarction (24% versus 17%; P=0.02), previous vitamin K antagonist exposure (57% versus 46%; P=0.007), worse renal function (median creatinine clearance 58 versus 62 mL/min; P=0.02), and higher incidence of nonparoxysmal atrial fibrillation (86% versus 80%; P=0.047). Interventions (surgical or percutaneous) were performed in 62 patients (31%). Standard-dose non-vitamin K antagonist oral anticoagulants reduced the risk of SEE by 29% compared with warfarin over a median follow-up of 25.2 months (interquartile range, 17.5-32.0; hazard ratio, 0.71 [0.51-0.99]; P=0.04). Thirty-day mortality after SEE was similar to IS (18% versus 17%), and SEE was associated with a nearly 3-fold increased risk of long-term mortality compared with patients without SEE or IS (hazard ratio, 2.85 [95% CI, 2.11-3.85]). Independent predictors of SEE included peripheral artery disease, smoking, nonparoxysmal atrial fibrillation, female sex, previous myocardial infarction, previous stroke or transient ischemic attack, vitamin K antagonist experience, and renal dysfunction. In this large individual patient data meta-analysis, non-vitamin K antagonist oral anticoagulants significantly reduced the risk of SEE compared with warfarin. Although SEEs were approximately one-tenth as frequent as IS, they were associated with comparable mortality and substantial morbidity.
25. Objective Assessment of Laryngopharyngeal Reflux in Laryngeal Contact Granuloma.
期刊: The Laryngoscope 发表日期: 2026-Jan-30 链接: PubMed
摘要
To determine the prevalence and characteristics of objectively confirmed laryngopharyngeal reflux (LPR) in patients with laryngeal contact granuloma (LCG) using 24-h hypopharyngeal-esophageal multichannel intraluminal impedance-pH (HEMII-pH) monitoring, and to compare patient and disease features by reflux status. This retrospective study included patients diagnosed with LCG who underwent 24-h HEMII-pH monitoring. Reflux episodes were classified by acidity (acid, weakly acidic, weakly alkaline) and posture (upright, recumbent). Clinical characteristics, reflux episode profiles, lesion laterality, and Reflux Symptom Index (RSI) scores were compared between reflux-positive and reflux-negative patients. Among 41 patients, 25 (61.0%) were reflux-positive and 16 (39.0%) were reflux-negative, with no hypopharyngeal reflux event detected. The pH-based classification of reflux events identified a predominance of weakly acidic (46.2%) and weakly alkaline (44.3%) episodes; acidic events were uncommon (9.5%). Most reflux events occurred during upright periods (94.8%), with only 5.2% during recumbent position. Among unilateral lesions, a higher proportion of hypopharyngeal reflux-positive cases involved the left side (76.2% left, 23.8% right), while reflux-negative cases showed no lateral preference (60.0% left, 40.0% right). Symptom screening with the RSI had limited discrimination for hypopharyngeal reflux status (sensitivity 50.0%, specificity 46.7%, PPV 60.0%, NPV 36.8%). Our findings highlight the limitations of symptom-based diagnosis and empiric acid suppression in patients with LCG. Pre-treatment 24-h HEMII-pH monitoring can provide a more evidence-based initial approach than routine empiric therapy and supports individualized behavioral interventions.
26. Green synergy: a novel deep eutectic solvent in eco-friendly air-assisted solidified floating drop microextraction for ultrasensitive lead determination.
期刊: Analytical methods : advancing methods and applications 发表日期: 2026-Jan-30 链接: PubMed
摘要
A novel and green analytical technique was developed to determine lead in water, wastewater, and food samples. A new hydrophobic deep eutectic solvent (HDES) contains 2,2’-(1H-benzo[d]imidazole-1,2-diyl) diphenol (BIP) and 1-dodecanol. This HDES was used as a synergistic solvent for air-assisted solidified floating organic drop microextraction (AA-SFODME). After extraction and preconcentration, lead was quantified using graphite furnace atomic absorption spectrometry (GFAAS). The method demonstrated excellent analytical performance, with a wide linear range of 0.05-950 µg L-1 and an enhancement factor (EF) of 50.0. The limits of detection (LOD) and quantification (LOQ) were 0.02 µg L-1 and 0.06 µg L-1, respectively. The accuracy of this method was confirmed by analyzing certified reference materials (CRMs). Furthermore, the applicability and sustainability of the procedure were evaluated and compared. The Blue Applicability Grade Index (BAGI), the Sample Preparation Metric of Sustainability (SPMS), and the Environmental, Performance, and Practicality Indicator (EPPI) tool scores were 75.0, 8.84, and 81.5, respectively. The results show significant improvement in environmental friendliness compared to previously reported methods for similar sample types.
27. Association Between Living Environmental Factors and Stroke in Middle-Aged and Older Chinese Adults: A Nationwide Prospective Cohort Study.
期刊: Journal of the American Heart Association 发表日期: 2026-Jan-30 链接: PubMed
摘要
The synergistic effects of multiple environmental factors on stroke remain unknown. The aim of this study was to explore the relationship between multiple living environment factors and stroke in middle-aged and older Chinese adults. This study used data of the CHARLS (China Health and Retirement Longitudinal Study). Living environmental factors included ambient fine particulate matter, indoor fuel use, tap water use, room temperature, and residence type. Stroke was ascertained by self-reported physician-diagnosed stroke. Cox proportional hazard regression models were applied to explore the association between living environmental risk factors and stroke events in a cohort analysis. Multiple sensitivity analyses were used to test the robustness of the present finding. A total of 6483 participants from CHARLS (mean age: 58.17 years; female: 54.17%) were included in the 7-year follow-up. Individuals in the middle-risk (adjusted hazard ratio [HR], 0.73 [95% CI, 0.58-0.90]) and low-risk groups (adjusted HR, 0.56 [95% CI, 0.39-0.80]) demonstrated a 27% and 44% reduction in stroke risk, respectively, compared with the high-risk reference group, when evaluating the synergistic effects of residential environmental exposures. In the fully adjusted continuous model, each 1-unit increment in living environmental quality scores was associated with a 15% lower risk of stroke incidence (adjusted HR, 0.85 [95% CI, 0.78-0.91]). The results of the sensitivity analysis confirmed that our findings are robust. Living environmental quality is significantly associated with stroke. Poor living quality may increase the risk of stroke. Future studies should focus more on the synergistic effects of exposure to living environmental factors.
28. ZBTB20 coordinates the proliferation-differentiation switch of incisor epithelial progenitor cells.
期刊: Development (Cambridge, England) 发表日期: 2026-Jan-30 链接: PubMed
摘要
The continuous growth of mouse incisors depends on the tightly coordinated proliferation and terminal differentiation of dental epithelial progenitors within the labial cervical loop (laCL). However, the molecular mechanisms governing the balance between these processes remain elusive. In this study, we identify the transcription factor ZBTB20 as a novel regulator of the proliferation-differentiation switch. ZBTB20 is predominantly expressed in the undifferentiated progenitors within laCL during late embryonic and postnatal stages. Conditional deletion of Zbtb20 in dental epithelium resulted in delayed enamel mineralization, reduced enamel volume, and excessive incisor growth. These defects were associated with enhanced proliferation and migration of transit-amplifying progenitor cells, as well as delayed pre-ameloblast and ameloblast differentiation. Integrated analysis of RNA sequencing and CUT&Tag revealed that ZBTB20 directly regulates the expression of key components of several signaling pathways, including ectodysplasin A (Eda), Notch, and Sonic Hedgehog (Shh). Our findings highlight the essential role of ZBTB20 in orchestrating the interplay among multiple signaling pathways and provide new insights into the transcription network governing the proliferation-differentiation switch of dental epithelial progenitors during incisor development.
29. Stroke, Small-Vessel Disease, and Occupation: Systematic Review and Data Analysis.
期刊: Journal of the American Heart Association 发表日期: 2026-Jan-30 链接: PubMed
摘要
Novel risk factors for stroke, such as occupation, are increasingly under exploration. We investigate if specific occupational exposures and settings increase the risk of developing small-vessel disease (SVD), including SVD-related strokes. We performed a systematic review on stroke-occupation associations and then analyzed data from patients presenting to Lothian stroke services with mild ischemic stroke (modified Rankin Scale score ≤2). We performed magnetic resonance imaging and inquired about occupational status. We assessed relationships between high-risk occupations (per Control to Substances Hazardous to Health guidelines) and standard occupational classifications (per Standard Occupational Classifications criteria) against white matter hyperintensity volumes, SVD score, and stroke subtype. Our systematic review identified 37 papers assessing occupations/broad occupational classifications (n=13), psychosocial work-related factors (n=11), and occupational exposure to hazardous substances (n=13). We then analyzed data from 414 participants and found, after adjustment for age, hypercholesterolemia, socioeconomic status, years of education, hypertension, diabetes, and smoking history, that high-risk occupations were associated with higher SVD scores (odds ratio, 1.64 [95% CI, 1.07-2.54]; n=357; P=0.02) but not for lacunar stroke subtype (odds ratio, 1.03 [95% CI, 0.64-1.67]; n=358; P=0.90) or white matter hyperintensity volume (% intracranial volume) (β=-0.003 [95% CI, -0.015 to 0.008]; n=357; P=0.60). Examples of high-risk occupations include drivers, engineers, and skilled trade workers. No associations were found for standard occupational classifications. This systematic review shows limited data on stroke-occupation associations. Our analysis showed that high-risk occupations are associated with higher SVD scores but not stroke subtype. URL: www.crd.york.ac.uk/PROSPERO; Unique Identifier: 42024466671.
30. Corneal Structural and Response to Elevated CO2 Concentrations in Occupational Environment: FTIR and Chemometric Evidence of Proteins and Lipids Remodeling.
期刊: Journal of applied toxicology : JAT 发表日期: 2026-Jan-29 链接: PubMed
摘要
This study investigates the effects of occupational carbon dioxide (CO2) exposure on corneal tissue through Fourier transform infrared (FTIR) spectroscopy and chemometric analysis. Human activities have significantly increased atmospheric CO2 levels, leading to potential health risks, particularly in confined environments such as mining, submarines, and enclosed workspaces. While CO2 exposure is commonly associated with respiratory and cardiovascular effects, its impact on ocular health remains underexplored. Rats were exposed to three different CO2 concentrations (3%, 5%, and 10%) in a controlled chamber for 8 h per day over a 30-day period. Second derivative analysis of corneal FTIR spectra revealed significant alterations in protein secondary structures, lipid composition, and phosphate group alterations, indicating CO2-induced biochemical changes. Notably, exposure led to a shift in the amide I band from 1650 to 1643 cm-1, suggesting a transition from α-helix to random coil structures in corneal proteins, which compromises tissue integrity. Changes in lipid hydrocarbon chain vibrations and increased gauche rotamers indicated disruptions in membrane order and fluidity. Additionally, phospholipid and nucleic acid modifications were observed, potentially affecting cellular stability. The study provides valuable insights into corneal bio-molecular alterations due to CO2 exposure, contributing to a deeper understanding of environmental and occupational eye health risks.
31. Phosphorylation of α‑Synuclein Fibrils at S129 Changes DNAJB1 Binding as Probed by Solid-State NMR.
期刊: JACS Au 发表日期: 2026-Jan-26 链接: PubMed
摘要
Amyloid fibrils formed by the protein α-synuclein are implicated in the pathogenesis of synucleinopathies. In addition to their rigid cross-β core, these fibrils have intrinsically disordered regions on their surface, which are important for interactions with other cellular components, such as chaperones. Chaperones play a vital role in preventing and reversing amyloid formation in neurodegenerative diseases. How they recognize misfolded proteins is an active field of research. DNAJB1 is a cochaperone that recognizes fibrils and recruits other chaperones such as Hsp70 and Apg2, which collectively disaggregate fibrils formed by α-synuclein, tau, and huntingtin. Because DNAJB1 was reported to bind the C-terminus of α-synuclein and S129 in this C-terminus is predominantly phosphorylated in patient-derived fibrils, we wanted to determine the effect of this post-translational modification on DNAJB1 binding. Using electron micrographs, NMR spectroscopy, and binding assays, we show that phosphorylation at S129 reduces the dynamics of the intrinsically disordered C-terminus of α-synuclein fibrils and increases the binding of DNAJB1 to this very C-terminus. MD simulations further suggest that the reduced dynamics is due to increased interaction of the phosphorylated C-terminus with the fibril core. DNAJB1 binds the exact same region at the C-terminus, indicating the phosphorylation at S129 might have a dual effect of reducing fibril surface dynamics and increasing chaperone recognition.
32. Exploring the capacity of smoking cessation services in the Philippines.
期刊: Tobacco prevention & cessation 发表日期: 2026 链接: PubMed
摘要
In the Philippines, smoking prevalence among adult smokers is slowly decreasing from 23.8% in 2015 to 19.5% in 2021. Despite this decline, evidence shows that while two-thirds of smokers consider quitting, only half receive quit advice from healthcare providers. This study aims to assess the readiness and capacity of health facilities to deliver smoking cessation services in alignment with Administrative Order (AO) 2021-0031 of the Department of Health (DOH). This study followed a cross-sectional design. From August to September 2023, we administered an online questionnaire to health facilities nationwide (n=618) in the Philippines to assess the current status of smoking cessation services across all levels of care regarding physical capacity, technical capacity, and availability of resources. In this descriptive study of 618 surveyed facilities, only 346 (55.99%) provide smoking cessation services. Among these (n=346), 52.02% (n=180) have certified basic tobacco intervention (BTI) providers, 21.97% (n=75) have certified intensive counseling providers, 88.73% (n=307) screen for tobacco use, 39.60% (n=137) assess for nicotine dependence, 53.18% (n=184) provide intensive counseling, 14.45% (n=50) prescribe pharmacotherapy, 66.47% (n=230) do not have directories or established referral networks, 54.34% (n=188) are aware of the DOH Quitline, and 7.51% (n=26) are aware of mobile-based cessation (mCessation) programs. This study highlights the limited capacity of health facilities in the Philippines to deliver smoking cessation services. Our findings suggest several areas for strengthening, including developing cessation infrastructure, expanding designated cessation clinics, targeting awareness campaigns to promote existing services, and expanding access to comprehensive cessation services training programs. Further research can explore and evaluate the effectiveness of these measures to create a stronger basis for resource allocation and policy implementation.
33. On the use of synthetic data for healthcare AI in Africa: Technical performance, governance challenges, and policy readiness.
期刊: Digital health 发表日期: 2026 链接: PubMed
摘要
Synthetic data has emerged as a promising solution to overcome the shortage of clinical datasets needed for training healthcare artificial intelligence (AI) models. This study examined how synthetic data can support AI development in Africa’s healthcare by analyzing its technical performance, fidelity limitations, and governance implications within low-resource health systems. A Critical Literature Review was conducted on scholarly and technical literature focused on the use of synthetic data for AI in healthcare across African settings. Databases searched included Scopus, Web of Science, PubMed, and Google Scholar. Thematic analysis identified trends in synthetic data generation, fidelity, domain adaptation, and adoption challenges in African healthcare AI. Drawing on interdisciplinary evidence, the analysis demonstrates how addressing technical challenges, improving synthetic data fidelity, leveraging domain adaptation techniques, and confronting practical adoption barriers are critical to enhancing the reliability and applicability of synthetic data for AI-driven healthcare in Africa. Four themes emerged from the analysis. First, hybrid synthetic-real datasets consistently outperform synthetic-only models. Second, fidelity gaps introduced bias risk and misclassification. Third, domain adaptation remains underused in low-resource contexts. Fourth, infrastructure gaps, weak regulation, and clinician skepticism hindered the adoption of synthetic data. Synthetic data can enhance AI-enabled healthcare in Africa if it is embedded within regulatory frameworks, validated through hybrid modeling, and supported by investment in infrastructure and capacity-building. This study highlights the intersection of synthetic data, healthcare AI, data fidelity, domain adaptation, and governance considerations in African health systems, underscoring the need for robust health technology assessment processes.
34. Quit attempts and cessation support among youth smokers in Saudi Arabia: A cross-sectional analysis of the 2022 Global Youth Tobacco Survey.
期刊: Tobacco induced diseases 发表日期: 2026 链接: PubMed
摘要
Tobacco use among adolescents continues to pose a major public-health challenge in Saudi Arabia. Despite national prevention efforts and declining smoking rates, many youths remain vulnerable to nicotine addiction and experimentation with emerging products such as shisha and e-cigarettes. Understanding factors that influence quit attempts and cessation awareness is essential to guide effective school- and community-based tobacco-control interventions. This study assessed the prevalence of quit attempts and identified behavioral and environmental correlates of cessation motivation among Saudi youth using data from the 2022 Global Youth Tobacco Survey. A cross-sectional analysis was conducted using data from 6983 students aged 11-17 years who participated in the 2022 Global Youth Tobacco Survey. Weighted analyses described tobacco-use patterns and cessation behaviors. Chi-squared tests examined bivariate relationships, while multivariable logistic regression identified independent factors associated with quit attempts, including adjusting for age, sex, parental and peer smoking, and media exposure. Significance was defined as p<0.05. Approximately 33% of respondents had ever used tobacco or nicotine, and 10.8% were current users. Among those who used tobacco within the past 12 months (n=411), 77.4% had attempted to quit, 64% wanted to stop, and 79.8% had received advice to quit. Factors associated with quit attempts included having no close friends who smoke (AOR=4.38; 95% CI: 1.73-11.07), exposure to school-based anti-tobacco lessons (AOR=3.25; 95% CI: 1.51-6.99), noticing health warnings on shisha packs (AOR=2.59; 95% CI: 1.02-6.55), and exposure to tobacco imagery in media (AOR=3.19; 95% CI: 1.64-6.17). Most Saudi youth who use tobacco express a desire to quit, and social context strongly influences their cessation behavior. Reinforcing school-based anti-tobacco education, expanding adolescent cessation programs, and strengthening policy enforcement could further reduce tobacco use and improve cessation outcomes among young people.
35. Rapidly Expanded EBV-Specific T Cells for the Treatment of Refractory EBV Reactivation and EBV-Related Lymphoproliferative Disorders.
期刊: Open forum infectious diseases 发表日期: 2026-Jan 链接: PubMed
摘要
Latent Epstein-Barr virus (EBV) infection is asymptomatic in most adults but can be associated with lymphoma, particularly in immunocompromised patients. Options are limited for patients with EBV viremia disease refractory to B-cell depleting antibodies or chemotherapy. Cellular therapies targeting EBV have shown promise in treating EBV-associated malignancies and restoring anti-EBV immunity. This is a phase I/II clinical trial in 9 patients, along with 3 additional single-patient trial cases, evaluating patient-specific manufacturing and administration of virus-specific T cells (VSTs) from various sources for the treatment or prevention of EBV-related lymphoma. The VSTs were produced from autologous and allogeneic peripheral blood mononuclear cells (PBMCs) using synthetic viral peptides stimulation. Three patients were allogeneic hematopoietic stem cell transplant (HCT) recipients, 4 were solid organ transplant (SOT) recipients, and 2 were nontransplant patients with EBV-associated lymphoma. VSTs were successfully manufactured from healthy donors and demonstrated strong and specific reactivity to EBV. Six patients achieved or maintained complete responses (3 SOT and 3 HCT) while 3 did not respond to therapy (1 SOT recipient and 2 nontransplant patients), resulting in an overall response rate of 67% (86% in transplant patients). One patient died of noninfusion related complications during the study follow-up period. Cell infusions were well tolerated with no treatment-related serious adverse events reported. These results strengthen previously published results using VSTs from healthy donors and further support the development of EBV-specific T cell therapies to treat refractory EBV reactivation and EBV-associated malignancies, particularly in transplant recipients.
36. Digital transformation of the harm reduction sector-"Here4UScotland" a case study of a virtual supervised consumption.
期刊: Digital health 发表日期: 2026 链接: PubMed
摘要
This study explores the potential of digital technologies in reducing drug-related deaths through virtual supervised drug consumption. It assesses barriers, enablers, and strategies for adopting a remote supervision service app, Here4UScotland, fostering user engagement and ownership. A mixed-methods evaluation was undertaken, using semi-structured interviews, focus groups, and quantitative data. Interviews and focus groups were undertaken with 26 participants. The Technology, People, Organizations, and Macro-environmental framework guided data collection and analysis, while the Transformative Technology Integration in Health conceptual model enabled analysis of the relationship between digital technology and service delivery. Qualitative data were thematically analyzed. The app was piloted in Aberdeen (Scotland) from January to December 2023. Twenty-five users received smartphones and logged 74 calls. Qualitative findings identified user concerns about privacy versus the need for real-time support, challenges in integrating new features, and the impact of police involvement on trust in digital services. The app’s functionality and user engagement highlighted the need for ongoing support and improved system integration. Interviews highlighted the importance of relationships, training, and strategic outreach in successfully delivering digital harm reduction services. Technological features, such as location tracking, offer real-time support but raise privacy concerns. Organizational and macroeconomic factors, including marketing, outreach, and law enforcement involvement, may impact service effectiveness and should be considered in future app implementations. Despite challenges, digital tools have enhanced accessibility and support in overdose prevention. Future research should explore cultural differences in digital adoption and improve communication strategies to maximize user engagement.
37. Relationship Between Caregiver Burden and Sense of Coherence in Home-Based Family Caregivers.
期刊: Occupational therapy international 发表日期: 2026 链接: PubMed
摘要
Family caregivers often face significant challenges, such as insufficient sleep, fatigue due to aging, difficulty engaging in social activities, and fewer interactions with friends and neighbors. However, some family caregivers manage to maintain active lifestyles while providing home care. This study is aimed at exploring the relationship between family caregivers’ sense of coherence (SOC) and their perception of caregiving burden. This cross-sectional study recruited 74 family caregivers of community-dwelling older adults who used day-care insurance services; 64 were included in the final analysis. Data were collected using a questionnaire that included the SOC-13 scale, rated on a 5-point Likert scale. Multiple regression analysis was conducted to identify the factors influencing caregivers’ perception of caregiving burden, with SOC subfactors serving as explanatory variables. Comprehensibility, one of the SOC subscales, showed a significant negative association with caregiver burden, and the association was strengthened after adjustment (Model 2: B = -0.376, β = -0.534, p = 0.005). Daily caregiving hours were positively associated with burden, whereas meaningfulness and manageability were not significant. This study highlights the importance of comprehensibility in influencing caregivers’ sense of burden. The findings provide valuable insights into the relationship between caregivers’ SOC and their perceived caregiving burden. Moreover, they emphasize the relevance of this relationship to the field of occupational therapy, as occupational therapists can play a key role in enhancing caregivers’ comprehensibility, thereby helping them alleviate the caregiving burden through targeted interventions. These findings underscore the importance of promoting comprehensibility among family caregivers to alleviate their perceived burden and support sustained caregiving. Occupational therapy interventions focused on improving caregivers’ understanding of the caregiving process can contribute to better mental and physical health outcomes, benefiting both caregivers and care recipients.
38. Using Community-Based Participatory Research Strategies to Promote Liver Cancer Prevention.
期刊: Social sciences 发表日期: 2025-Nov 链接: PubMed
摘要
Hispanic, Asian, and African Americans are disproportionately affected by liver cancer, viral hepatitis B (HBV), and viral hepatitis C (HCV), in part because of barriers to liver cancer awareness and prevention. We implemented a community-based, culturally tailored initiative to raise awareness and promote uptake of behaviors for liver cancer prevention, early diagnosis, monitoring, and treatment. Guided by community-based participatory research (CBPR) principles and built on well-established collaboration with community-based organizations, we actively engaged the community advisory board (CAB), community health workers, and community members in multiple phases of (1) a community-based educational initiative, (2) a city-wide bus campaign, and (3) community health fairs. This multilevel initiative saw notable changes in community members’ knowledge of liver cancer, viral hepatitis, lifestyle behaviors like dietary patterns, and uptake of screening tests for HBV/HCV. Additionally, the comprehensive engagement of CAB, healthcare workers, and community members significantly benefited community capacity building on cancer research and health promotion. These CBPR-guided community initiatives had remarkable positive impacts on promoting liver cancer awareness and prevention among underserved racial/ethnic minorities. The academic-community relationships built on and strengthened through shared power, mutual respect, and trust serve as the foundation for sustainable community growth and empowerment.
39. Unravelling the paradox of vitamin C research in sepsis.
期刊: Critical care and resuscitation : journal of the Australasian Academy of Critical Care Medicine 发表日期: 2025-Sep 链接: PubMed
摘要
Professor Rinaldo Bellomo’s lasting impact on critical care research stems from his commitment to structured, biologically grounded research programs over isolated studies. His work on vitamin C in sepsis exemplifies this approach. While early enthusiasm grew around combination therapies involving vitamin C, Rinaldo championed a cautious, rigorous, and methodical investigation. He worked closely with collaborators to address key methodological issues, including dosing, stability, and the design of appropriate control groups, which ultimately led to the international VITAMINS trial. This landmark study compared vitamin C, hydrocortisone, and thiamine to hydrocortisone alone in septic shock and found no clinical benefit. Rinaldo embedded a pharmacokinetic substudy to confirm supraphysiological serum vitamin C levels, ensuring biological plausibility of the trial design. Beyond clinical research, he fostered translational research with the Florey Institute using a preclinical sheep model of sepsis. This collaboration uncovered critical mechanisms of septic acute kidney injury and led to the development of mega-dose sodium ascorbate therapy. The program progressed from proof-of-concept to a double-blind pilot randomised trial in septic shock and now underpins a national multicentre phase Ib and II clinical trials. Rinaldo’s legacy is defined by scientific rigour, mentorship, and humility. His visionary, disciplined approach remains a model for impactful research and continues to guide ongoing efforts to advance care for critically ill patients.
40. Patient safety incidents in the psychiatric inpatient setting: determinants, consequences, and strategies. A systematic review.
期刊: Frontiers in psychiatry 发表日期: 2025 链接: PubMed
摘要
Patient safety in psychiatric inpatient settings remains an underexplored area despite the heightened vulnerability of this population to preventable harm. This review aimed to provide an updated and comprehensive overview of Patient Safety Incidents (PSIs) in psychiatric inpatient settings, identifying their types, contributing factors, preventive strategies, consequences, and mitigating actions. A systematic search was conducted in PubMed, Embase and Scopus for primary studies published from 2000 onward. A total of 92 studies were included. Data were synthesized using the World Health Organization’s International Classification for Patient Safety as the guiding framework. The most frequently reported PSIs included behavior-related incidents (self-harm, suicide attempts, and patient aggression), medication-related events, and patient falls. Contributing factors were predominantly linked to patient characteristics (e.g., psychiatric symptoms), staff performance and communication issues, organizational shortcomings (e.g., inadequate protocols), and environmental hazards (e.g., unsafe physical infrastructure). Preventive actions primarily focused on improving safety culture, staff training, and environmental modifications. However, only a minority of studies described intervention outcomes or reported quantitative data. This review highlights significant gaps in evidence-based interventions tailored to psychiatric care, as well as a lack of research from long-term care settings and low- and middle-income countries. To enhance patient safety in psychiatry, future efforts should prioritize the development and implementation of targeted strategies, multidisciplinary collaboration, integration with general patient safety initiatives, and robust quantitative evaluation. Strengthening safety culture across psychiatric facilities is essential to reduce harm and improve care quality for this high-risk population. https://www.crd.york.ac.uk/PROSPERO/, identifier CRD42023389235.
41. Indigenous women's mental health across the life course: a global policy brief for rights-based, culturally safe care.
期刊: Frontiers in global women’s health 发表日期: 2025 链接: PubMed
摘要
Indigenous women experience distinctive mental health risks that accumulate across the life course under the continuing impacts of colonization, gendered violence, and systemic racism. Drawing on recent mandates from the United Nations Permanent Forum on Indigenous Issues and the World Health Assembly’s Resolution 76.16 (2023), as well as community-based exemplars such as Partners In Health’s women-led peer models, this policy brief applies the analytical dimensions of the National Collaborating Centre for Healthy Public Policy to synthesize evidence, contextual factors, and feasible policy options. It identifies disproportionate burdens in suicide rates, perinatal depression, caregiver stress, and menopausal symptom severity, alongside a persistent lack of validated Indigenous-specific screening tools and gender-disaggregated data. The brief recommends an integrated, rights-based strategy that funds Indigenous governance of culturally safe mental health services across the life course, builds an Indigenous Women’s Mental Health Data Strategy grounded in data sovereignty, embeds traditional knowledge and place-anchored healing in coverage policies, and extends targeted support for caregiving and menopausal transitions. Implementing these measures would operationalize reconciliation commitments, reduce documented inequities, and generate long-term social and economic benefits for communities and health systems alike.
42. Adapting the EAT-Lancet diet for West Africa: protein quality and micronutrient inadequacies improved through nutrient dense foods.
期刊: Frontiers in nutrition 发表日期: 2025 链接: PubMed
摘要
The EAT-Lancet planetary health diet was designed as a universal nutritionally adequate diet with minimal environmental impact. We aim to assess and propose revisions to increase its nutrient adequacy in the context of West Africa based on the local food supply. We created a model EAT-Lancet diet using nutrient composition data from the FAO’s Food Composition Tables for Western Africa (WAFCT). Median energy and nutrient profiles of EAT-Lancet diet food groups were calculated using WAFCT foods (n = 596). Protein content was adjusted using the Protein Digestibility Corrected Amino Acid Score (PDCAAS). We multiplied the recommended EAT-Lancet diet intake for each food subgroup by these medians to determine daily nutrient intake. Nutrient adequacy was determined based on alignment with the FAO Codex nutrient reference values for adults. The Nutrient Rich Food (NRF) index, based on priority micronutrients, defined nutrient density. Isocaloric revisions were made to the EAT-Lancet diet to enhance its nutrient adequacy using WAFCT foods. Total energy of the modeled diet was 2,516 kcal/day. Total protein was 87 g/day while PDCAAS corrected protein was 62 g/day. Micronutrient shortfalls were observed for zinc, calcium, and vitamin A but not for iron, folate, and vitamin B12. Increasing intake of nutrient-rich liver, small dried fish, and pulses, while reducing whole grains and tree nuts, achieved micronutrient adequacy. When analyzed using foods available in West Africa, the EAT-Lancet diet may provide adequate protein but not vitamin A, zinc, and calcium. Future iterations of the diet should consider including categories for micronutrient dense foods to ensure adequacy.
43. Intercropping reshapes soil stress resistance and growth promotion capabilities through rhizosphere exudates in conjunction with the microbiome.
期刊: Frontiers in microbiology 发表日期: 2025 链接: PubMed
摘要
Terrestrial plants can affect the growth and health of neighboring plants through interspecific interactions. Long-term monoculture in agricultural and pastoral production can lead to the occurrence of soil-borne diseases, depletion of nutrients, and a decline in soil microbial diversity, thereby affecting the sustainable development of cultivated ecosystems. In this study, we employed three cultivation patterns: monoculture of Melilotus officinalis (L.) Pall. (M. officinalis), monoculture of Avena sativa L. (A. sativa), and intercropping of M. officinalis and A. sativa. To introduce ecologically protective plants into cultivated ecosystems and investigate the effects of plant root exudates on the recruitment of rhizosphere microbiota of neighboring plants, as well as the disease resistance and growth promotion capabilities of intercropping, we conducted non-targeted metabolomics and metagenomics analyses on root exudates and soil microbiota. The sequencing data obtained provided strong evidence for the interaction mechanisms between root exudates and microorganisms in intercropping ecosystems. We observed that in intercropping ecosystems, the abundance and variety of root exudates were more similar to those of the crop plants. The differential metabolites between intercropping and A. sativa were inclined to be chemically defensive, while those between intercropping and M. officinalis were more inclined to promote material synthesis. Compared with A. sativa, intercropping enhances the alpha and beta diversity of soil microbial communities, particularly increasing the enrichment abundance in pathways such as the bacterial secretion system, sulfur metabolism, and phenylpropanoid biosynthesis, which is closely associated with the suppression of soil-borne pathogens. Compared with M. officinalis, intercropping further enhanced the synthesis of plant-available substances in the soil, driving microorganisms to optimize the levels of carbon, nitrogen, and trace elements in the soil. In comparison, intercropping had a significant impact on the aggregation of soil-specific microorganisms, which can optimize nitrogen utilization to promote plant growth and enhance plant defense and stress tolerance. The results of this study will provide a theoretical basis for cultivated ecosystems and sustainable land management.
44. Feedback systems as interferers in perfectionism: a systematic literature review.
期刊: Frontiers in psychiatry 发表日期: 2025 链接: PubMed
摘要
Perfectionism is a multidimensional construct characterized by the striving for exceptionally high standards and critical self-evaluation. It can manifest in both adaptive and maladaptive forms. Feedback systems exert a considerable cognitive influence on individuals as the emotional and behavioral responses to feedback are often shaped by its valence-positive or negative. This study aimed to examine the relationship between feedback systems and perfectionism, including its various dimensions, and to assess how specific interventions influence perfectionistic traits. A systematic literature review was conducted following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines across six academic databases: PubMed, PsycINFO, Scopus, ScienceDirect, EBSCO, and ERIC. The initial search yielded 441 articles. After applying the inclusion and exclusion criteria, 24 studies were selected for detailed analysis. A clear association emerged between feedback valence and perfectionism. Four major outcome domains were identified as dependent variables: emotional response, behavior, task performance, and physiological (biomarker) indicators. Among adaptive perfectionists, positive feedback was linked to improved behavioral outcomes, whereas negative feedback elicited negative emotional and performance-related consequences. In contrast, maladaptive perfectionists showed a heightened vulnerability to negative feedback, displaying impaired emotional regulation, decreased performance, and elevated stress-related physiological markers. Feedback directed at individuals with perfectionistic traits elicits distinct psychological and physiological responses. While positive feedback can foster beneficial outcomes in adaptive perfectionists, negative feedback-especially in maladaptive perfectionists-can have substantial adverse effects, highlighting the importance of developing individualized feedback strategies as part of the clinical and therapeutic interventions for individuals with perfectionistic vulnerability. https://www.crd.york.ac.uk/prospero/, identifier CRD420251015998.
45. Schismogenesis in anxiety spectrum disorders: a biopsychosocial perspective.
期刊: Frontiers in psychiatry 发表日期: 2025 链接: PubMed
摘要
Anxiety spectrum disorders (ASDs) often have an unsatisfactory prognosis, suggesting the opportunity for complementary explanatory frameworks to advance their therapeutics. This text advocates for a framework rooted in cybernetics and complex systems theory, which views the mind, brain, and social networks as deeply interdependent systems. A characteristic feature of such systems is the operation of similar organizational principles and laws across different levels of analysis, a phenomenon termed isomorphism. Thus, the mind, brain, and social systems operate under isomorphic principles, requiring a critical balance between stability (homeostasis) and the capacity for change (homeodynamics) to successfully adapt to environmental perturbations. From this perspective, the central challenge under stress is to prevent excessive fragmentation and functional dissociation, a process termed schismogenesis in cybernetics. ASDs are, therefore, reconceptualized as biopsychosocial dissociations stemming from a schismogenic mechanism. This framework posits that mental health is contingent upon maintaining a dynamic equilibrium between connectedness and independence across social, mental, and neural levels. It also suggests that any intervention promoting reintegration can be therapeutic when dissociation occurs. While single-component psychosocial approaches may suffice for mild cases of ASDs, the ideal therapeutic plan for severe or refractory cases should be rapidly implemented, personalized, multicomponent and synchronous.
46. A pilot study for an integrated diabetes screening, referral, and care program within a low-income community in Mexico.
期刊: Frontiers in clinical diabetes and healthcare 发表日期: 2025 链接: PubMed
摘要
To determine the feasibility and acceptability of a coordinated community-based intervention for low-income adults with type 2 diabetes (T2D) that included (1) screening and referral, (2) shared decision-making (SDM), and (3) diabetes self-management education and support (DSMES). Participants were screened for T2D through a mobile health unit in a low-income community in Guadalajara, Jalisco, Mexico, and referred for follow-up in a primary care health center serving that community. Primary care physicians (PCPs) within the health center were trained on SDM for T2D, and community health workers (CHWs) were trained to deliver DSMES. Feasibility was measured by the number of community members screened and referred for care, the number of PCPs implementing SDM, and the number of CHWs hired and trained on DSMES. Acceptability was assessed by the percentage of participants who completed the 3-month DSMES program. Potential clinical impact was determined by effect sizes of changes in HbA1c between baseline and 3 months. Other measurements included waist circumference (WC), body weight, diabetes distress, and diabetes self-care activities, assessed at baseline, and at 1 and 3 months during the study period. With respect to feasibility, all PCPs from the clinic completed the SDM training and were able to implement it in their primary practice. The DSMES training was completed by 4 (50%) of CHWs, and 3 were selected to deliver the course to study participants. Related to acceptability, 182 community members were screened, of which 42 were eligible for participation and 23 were successfully enrolled. Out of six programmed sessions, average participant attendance was 80% with 60.9% of participants retained at three months. Changes in HbA1c from baseline to 3 months were 10.1 ± 2.7 to 9.4 ± 3.1. The use of community screening to refer low-income people living with T2D to a clinic-based SDM and DSMES intervention was feasible with large effect sizes for changes in HbA1c. The high attrition rates suggest that alternative strategies may be necessary to keep patients engaged in care.
47. Transforming health equity through academic integration: ripple effects of high-impact practices in CBPR with refugee-origin Montagnard youth.
期刊: Frontiers in public health 发表日期: 2025 链接: PubMed
摘要
This community case study describes an innovative model of academic integration, the integration of university-based high-impact practices (HIPs) with Community-Based Participatory Research (CBPR)-an approach rooted in co-learning, shared power, and mutual benefits-to advance health equity for low-income Asian American refugee-origin communities (LIAACRO) in central North Carolina. The Montagnard Hypertension Project (MHyP), a community-initiated collaboration, embedded five HIPs, service learning, undergraduate research, diversity/global learning experiences, internships, and capstone projects, within a CBPR framework to bring community partners into academic spaces as cultural experts and co-researchers. This academic integration enabled Montagnard college students (MCS) to access institutional resources, gain research competencies, and lead culturally responsive health outreach. Montagnards, an indigenous people from Vietnam’s Central Highlands, experience persistent invisibility in U.S. health and social systems due to data aggregation and the Asian American “model minority” myth. Through the MHyP, the MCS leveraged their cultural knowledge and lived experiences to co-develop culturally and linguistically appropriate research protocols, design and implement community health promotion initiatives, facilitate intergenerational dialogue, and document traditional practices. Using a ripple effects framework, we retrospectively assess multilevel changes (individual, community, and institutional) that extend beyond the project’s scope. Findings demonstrate how carefully and strategically integrating HIPs can strengthen CBPR’s principles of co-learning, shared leadership and decision-making, empowerment, and mutual benefit. The model offers a replicable pathway for public health researchers and practitioners to engage marginalized communities in ways that promote educational advancement, community values and empowerment, and institutional transformation. This case contributes to the field by showing how academic institutions and public health practitioners can reimagine and successfully mobilize institutional resources, including curricula, internal funding, and campus spaces, to support sustainable, equity-driven community engagement.
48. Quality of life and disease burden in tuberous sclerosis and comparison with the population with idiopathic autism spectrum disorder: an investigation conducted through questionnaires and clinical data collection in the pediatric population.
期刊: Frontiers in psychiatry 发表日期: 2025 链接: PubMed
摘要
Tuberous sclerosis complex (TSC) is a rare genetic disease involving major neurological and neuropsychiatric symptoms that can impact quality of life. This study aimed to examine the quality of life and disease burden of a pediatric TSC cohort and compare them with those of a population of individuals with idiopathic autism spectrum disorder (ASD). Caregivers completed the Tuberous Sclerosis-Associated Neuropsychiatric Disorders (TAND) Checklist and the Pediatric Quality of Life Inventory™ (PedsQL) Report. To examine quality of life, caregivers also completed the TSC Quality of Life (TSCQoL) questionnaire, which was created specifically for this study to investigate the emotional, economic, and time-related impact of TSC. We recruited 66 individuals with TSC (average age, 9.8 ± 4.5 years) and 63 individuals with idiopathic ASD (8.4 ± 4.4 years). We found a reduction in quality of life and a significant economic investment in 50% and 55% of TSC patients, respectively. These aspects were significantly more prevalent in individuals with cognitive impairment, ASD, sleep disorders, and epilepsy. Individuals with idiopathic ASD exhibited worse quality of life in the social domain (p = 0.004), while the syndromic ASD group demonstrated worse overall quality of life (p = 0.041) and experienced a greater loss of school days (p = 0.039). Despite its lack of validation, the TSCQoL scale was established as an exploratory tool that consistently highlighted, along with the PedsQL, clinical factors that most impact quality of life. Quality of life was low in the TSC population, and this was strongly correlated with neuropsychiatric manifestations and epilepsy. Through comparison with idiopathic ASD, we observed a greater impact of the syndromic condition on disease burden.
49. Long-term plastic mulching exacerbates the co-limitation of carbon and phosphorus in farmland by altering physicochemical properties and microbial interactions.
期刊: Frontiers in microbiology 发表日期: 2025 链接: PubMed
摘要
Prolonged plastic film mulching causes plastic residue accumulation and microplastic (MP) formation, compromising soil structure and causing contamination. This study examined mulching duration effects (0, 5, 10, 15 years) on soil MPs, physicochemical properties, microbial communities, and nutrient limitations at 0-20 cm and 20-40 cm depths in maize soils of western Jilin, China. Mulching duration significantly increased MP abundance. Film-like MPs dominated, progressively fragmenting into smaller sizes over time. Long-term mulching enhanced soil moisture and EC (Electrical Conductivity) but decreased SOC (Soil Organic Carbon) and TN (Total Nitrogen), while increasing TP (Total Phosphorus) and AP (Available phosphorus). Microbial responses diverged: bacterial diversity and network complexity rose with enhanced cooperation, whereas fungal networks showed intensified competition. Extracellular enzyme stoichiometry indicated aggravated microbial co-limitation by C (Carbon) and P (Phosphorus), driven by MP-induced SOC depletion and altered P dynamics. SEM (Structural Equation Modeling) revealed that plastic mulching directly altered soil physicochemical properties through MPs accumulation, while indirectly regulating microbial community composition, ultimately exacerbating C-P co-limitation in microbial metabolism. The study highlights soil health risks from long-term mulching and highlights the necessity to seek alternatives such as biodegradable films to mitigate soil health risks associated with long-term plastic mulching.
50. Highly compartmentalized microbiomes in blueberry microhabitats.
期刊: Frontiers in microbiology 发表日期: 2025 链接: PubMed
摘要
Blueberries are considered a superfood because of their rich content of vitamins, antioxidants, and fiber, supporting multiple health benefits. Plants host complex microbiomes that play crucial roles in resistance to pathogens, productivity, and stress tolerance. Despite its importance, a comprehensive characterization of the microbiota across all major compartments of cultivated blueberry (Vaccinium corymbosum) is still lacking. Using high-throughput sequencing of marker genes, we provide the first integrative survey of fungal and bacterial communities associated with three distinct plant compartments: rhizosphere, leaf surface, and fruit surface, as well as the bulk soil, across 100 samples, generating datasets of over 4,000 unique fungal and 38,000 unique bacterial amplicon sequence variants (ASVs). We found clear compartment differentiation, with pronounced shifts in richness, diversity, and taxonomic composition between belowground and aboveground compartments. Alpha diversity peaked in bulk soils and declined progressively toward aboveground tissues. We further detected minimal overlap across compartments, with only 9 fungal and 12 bacterial ASVs shared across all compartments. These findings challenge the soil-origin hypothesis for aboveground microbiota. Blueberry plants harbor highly compartmentalized microbial communities shaped by selective environmental and physiological filtering. Our findings provide a baseline for future development of targeted, compartment-specific bioinoculants aimed at enhancing beneficial microorganisms for blueberry cultivation.
51. Insomnia in seasonal affective disorder: considering the use of benzodiazepines with a focus on lormetazepam.
期刊: Frontiers in psychiatry 发表日期: 2025 链接: PubMed
摘要
Seasonal affective disorder (SAD) occurs in two main forms: winter-pattern SAD, associated with depressive symptoms during shorter, darker days; and summer-pattern SAD, linked to mood disturbances during longer, hotter days. SAD may develop into a chronic condition with recurring depressive episodes. Risk factors for SAD include geographic latitude, age, gender, genetic predisposition, and lifestyle. Sleep disturbances, such as insomnia, hypersomnia, and circadian rhythm disruptions, are common and can amplify emotional symptoms. This review explores the clinical features and management strategies for insomnia associated with SAD, focusing on the potential of benzodiazepines (BZDs), in particular lormetazepam. Controversies surround current nonpharmacological and pharmacological strategies for managing sleep disorders in SAD. This review emphasizes the importance of using more effective treatments for insomnia associated with SAD, currently an unmet need. In particular, clinical evidence supports the potential benefits of intermittent hypnotic BZDs to treat insomnia. Among the BZDs, short-term or intermittent use of lormetazepam is an effective treatment option in the management of insomnia. Insomnia associated with SAD is an important symptom to monitor because it impacts the patient’s quality of life. BZDs, including lormetazepam, are a standard short-treatment option for insomnia that could improve the sleep symptoms associated with SAD. Comparative clinical trials of the efficacy and safety of lormetazepam in this patient population are required to confirm this.
52. Associations of environmental tobacco smoke with ADHD and executive function in early adulthood: results from a cross-sectional study.
期刊: Frontiers in psychiatry 发表日期: 2025 链接: PubMed
摘要
Secondhand smoke (SHS) and thirdhand smoke (THS) have been shown to increase the risk of physical health and mental health. However, the impact of SHS and THS exposure on ADHD symptoms and executive function remain to be elucidated. Online surveys were used to recruit participants at a Chinese vocational college. The frequency of contact with smokers or detecting tobacco odors in residential environments was used to define SHS exposure, whereas the frequency of contact with surfaces contaminated by smokers was used to define THS exposure. The associations of SHS and THS exposure with the risk of ADHD symptoms and the executive function (Behavioral Regulation Index, BRI; Metacognitive Index, MI; Global Executive Composite, GEC) scores were evaluated by logistic regression analysis or linear regression analysis. The rate of SHS and THS exposure was 87.7% and 76.9%, with 8.2% stating SHS exposure ≥15 min at least 1 day/week. After adjustment for confounding variables, SHS exposure (≥15 minutes on ≥1 day/week) had higher odds of ADHD symptoms (OR, 1.31; 95% CI, 1.02-1.67), and higher BRI score (β, 2.34; 95% CI, 0.95-3.73), higher MI score (β, 3.12; 95% CI, 1.29-4.95), higher GEC score (β, 5.46; 95% CI, 2.26-8.66). Additionally, the higher the frequency of SHS/THS exposure and the greater the number of surrounding smoker, the higher risk of ADHD symptoms and the poorer executive function (P trend <0.001). SHS and THS exposure were related to the occurrence of ADHD symptoms and impaired executive function among young adults at a Chinese vocational college in this cross-sectional study. Further researches are warranted to validate these associations in more diverse populations.
53. Wastewater surveillance in the military: how deployed members of the armed forces can monitor outbreaks on military vessels.
期刊: Frontiers in epidemiology 发表日期: 2025 链接: PubMed
摘要
This perspective piece explores the potential to implement wastewater surveillance on military vessels to improve disease monitoring and prevention. We examine five key topics: (1) recent studies of wastewater surveillance on military bases and training centers; (2) best practices for confined populations (e.g., colleges, prisons, hospitals, and low-income and middle-income countries) and their transferability to military settings; (3) current technologies enabling deployed personnel to conduct wastewater surveillance without advanced microbiological training; (4) key questions the military should address to prevent future outbreaks on vessels; and (5) unique ethical considerations surrounding implementation. This work aims to inform military decision-makers considering the adoption of wastewater surveillance programs.
54. Non-pharmacological interventions to support return to education and work for adolescent and young adults (AYAs) following a cancer diagnosis: a scoping review protocol.
期刊: HRB open research 发表日期: 2025 链接: PubMed
摘要
This scoping review will explore and chart the evidence relating to non-pharmacological interventions that support education and/or employment for adolescent and young adults (AYAs) following a cancer diagnosis. The number of newly diagnosed AYAs with cancer is increasing and so too is the number of AYAs living with and beyond cancer. In line with missed schooling and long-term side-effects of treatment, it is unsurprising that this group may under-perform academically and be at higher risk of unemployment in comparison to their peers. Developing an overview of existing interventions to support education and/or employment for this cohort, is therefore important. Studies that explore non-pharmacological interventions that support education and/or employment for AYAs (aged 15-39 years at cancer diagnosis) post-cancer diagnosis. Interventions can be group-based, individual, and/or online in format, and can be vocational, psychosocial, physical, educational or multidisciplinary in nature. Qualitative, quantitative, mixed methods studies, case studies, observational studies, reports and theses will be included. This scoping review will follow the Joanna Briggs Institute (JBI) methodology for scoping reviews. Databases to be searched include EMBASE, Web of Science, Medline (OVID), CINAHL, and PsycInfo, with no limitation on publication date. Grey literature will be searched, limited to the first 100 searches on Google Scholar. Titles and abstracts will be screened and two independent reviewers will review identified fill-texts. A data extraction tool will be used for data extraction.
55. Work- and hydration-related health outcomes prevalence among USA construction workers: evidence from the national survey.
期刊: Frontiers in public health 发表日期: 2025 链接: PubMed
摘要
Construction workers face elevated risks of heat-related illnesses, yet hydration and rest break policies remain inconsistent across regions and are not federally mandated. To evaluate the association between occupational conditions and hydration-related health outcomes among national construction workers, focusing on regional disparities and policy relevance amid increasing ambient temperatures. We analyzed 2023 National Health Interview Survey data, focusing on adults employed in the construction industry (n = 1,231) versus other industries (n = 16,241). We assessed participant self-reported back pain, diagnosed fatigue, cognitive difficulty, injury, and general health, while using regional indicators with higher temperatures, and the 2023-2024 national record-breaking heatwave, as hydration proxies. Weighted descriptive statistics, multivariate regression models, and sensitivity analyses were used to examine associations. West region construction workers had the largest negative associations with back pain (β = -0.18), injury (β = -0.52), cognitive difficulty (β = -0.15), and better general health (β = -0.09), followed by the Midwest and Southern region workers for back pain and better general health. Workers’ race, sex, educational attainment, Body Mass Index (BMI), and marital status play a crucial role in workers’ reported health outcomes, with non-Hispanic Asians at higher odds of severe back pain, fatigue, and cognitive difficulty. Hydration access is a critical, yet underregulated factor in preventing heat-related health outcomes in occupational settings across the USA. There is an urgent need for enforceable national standards mandating water and rest breaks for construction workers, particularly in high-heat regions given recent policies that have removed water breaks in the Southern region.
56. Interconnected associations of occupational burnout, anxiety, and sleep quality in oilfield workers.
期刊: Frontiers in public health 发表日期: 2025 链接: PubMed
摘要
Occupational burnout and poor sleep quality are increasingly prevalent among oilfield workers, exposed to high-stress environments and irregular shifts. Emerging evidence indicates that anxiety may mediate the link between burnout and sleep disturbances, though empirical data in this group remain limited. A cross-sectional survey was conducted among 1,617 oilfield workers in Shaanxi Province, China. Sleep quality, anxiety, and occupational burnout were assessed using the Pittsburgh Sleep Quality Index, Symptom Checklist-90, and Maslach Burnout Inventory-General Survey, respectively. Logistic regression, correlation analysis, restricted cubic spline models, and bootstrapped mediation analyses were used to evaluate associations and mediation effects. Among participants, 52.75% experienced occupational burnout. In the total population, occupational burnout were significantly associated with sleep quality (OR = 1.611, 95% CI: 1.291-2.010, P < 0.001). Sex-stratified analyses yielded consistent findings, with females showing stronger associations (OR = 1.919, 95% CI: 1.244-2.959) compared with males (OR = 1.492, 95% CI: 1.144-1.946). Restricted cubic spline analysis revealed a nonlinear dose-response relationship between occupational burnout and the odds of sleep quality (P for nonlinear = 0.002). Mediation analysis showed that anxiety is consistent with a significant indirect association between occupational burnout and sleep quality, accounting for 33.08% of the total association. Occupational burnout and anxiety are key correlates for sleep quality among oilfield workers, with anxiety serving as a significant potential mechanism. Early identification and targeted interventions addressing both occupational burnout and psychological distress are important considerations for improving sleep quality and alleviating occupational health in high-risk work environments.
57. Longitudinal trajectories and risk factors of insomnia symptoms among Chinese bus drivers.
期刊: Frontiers in public health 发表日期: 2025 链接: PubMed
摘要
This study investigated the three-year prevalence and longitudinal trajectories of insomnia symptoms among bus drivers and examined key sociodemographic-health-related factors and psychosocial predictors, with the aim of informing targeted preventive strategies. A total of 11,576 bus drivers from 22 companies in Guangdong participated in three online surveys at T1 (August-December 2019), T2 (October-December 2021), and T3 (October-December 2023). The surveys assessed demographics, insomnia symptoms, and psychosocial factors. Two-stage multivariate logistic regression models were employed to examine risk factors associated with adverse trajectories. Prevalence of insomnia symptoms declined steadily from 12.5% at T1 to 7.8% at T3. Five distinct trajectories were identified: resistance (78.5%), chronic dysfunction (1.9%), delayed dysfunction (4.7%), recovery (9.4%), and relapsing/remitting (5.5%). Sociodemographic and psychosocial distress factors (e.g., age, lower financial status, job burnout, family dysfunction) significantly increased the risk of general insomnia and adverse trajectory membership. Crucially, a history of severe physical illness was a strong determinant of chronic risk, while exercising for 30 min daily was significantly associated with a higher likelihood of recovery. Our study offers insights into the longitudinal trajectories of insomnia symptoms and their associated risk factors among Chinese bus drivers. These findings carry important implications for designing trajectory-specific occupational health interventions and refining public transportation management strategies.
58. Predictors of nutritional health risks among midwives in the context of midwifery work.
期刊: Frontiers in public health 发表日期: 2025 链接: PubMed
摘要
Specific occupational factors among midwives-such as shift work, night duties, and significant professional responsibilities-are likely to contribute to a high perceived workload within this group. These factors may increase the risk of nutrition-related health issues, including abnormal body weight and disordered eating behaviors. The study aimed to assess the prevalence and key occupational predictors of such risks in this population. A cross-sectional preliminary study was conducted among 703 midwives in Poland. Disordered eating behaviors were evaluated using the Eating Attitudes Test-26 (EAT-26), while workload intensity was measured with the Quantitative Workload Inventory (QWI). Data were analyzed using non-parametric statistical tests and a Classification and Regression Tree (C&RT) model with V-fold cross-validation to identify the most influential predictors of nutritional health risk. A Classification and Regression Tree (C&RT) model was used to identify key predictors of nutritional health risk, defined as meeting at least one of the following criteria: abnormal BMI, EAT-26 score > 20, behavioral indicators of disordered eating, or a history of treatment for an eating disorder. Of the participants, 56.76% (n = 399) were classified as being at nutritional health risk. The most salient predictors included work experience (more than 17.5 years), duration of night shift work, and QWI score. Night shift work alone was not a significant factor in the model. Work experience and workload intensity are key predictors of nutrition-related health risks among midwives. These findings highlight the need for workplace-level policies that address long-term workload burden-such as schedule optimization, limits on prolonged night-shift exposure, and improved access to psychological and nutritional support. Future research should further examine modifiable organizational factors and evaluate targeted interventions aimed at reducing nutrition-related risks in midwifery settings.