公共卫生研究摘要 (2026-02-04)
共收录 51 篇研究文章
1. Actions to bridge the workforce and blood supply gaps - Response to "Health promotion for blood donors: A scoping review".
期刊: Public health in practice (Oxford, England) 发表日期: 2026-Jun 链接: PubMed
摘要
2. Effects of graded phosphate deficiency and vitamin D intervention on growth, bone metabolism, and mineralization in a rat model of neonatal-onset metabolic bone disease.
期刊: JBMR plus 发表日期: 2026-Mar 链接: PubMed
摘要
To investigate the dose-dependent effects of neonatal-onset phosphate deficiency on bone growth and mineralization and assess whether supraphysiological vitamin D3 or calcitriol can rescue skeletal defects. Newborn Sprague-Dawley rats were randomly assigned to 7 diets: phosphate-free (0P), low phosphate (1/2P), normal phosphate (NP), calcium-free (0Ca), phosphate/vitamin D-free (0P/D), and 0P/D supplemented with either supraphysiological vitamin D3 (0P/D + D3) or calcitriol (0P/D + calcitriol). Longitudinal radiographic assessments were performed before euthanasia at 6-8 wk. Serum analyses measured phosphate (sP), calcium (sCa), phosphotropic hormones, and bone turnover markers. Tibial growth plates were examined by H&E staining, micro-CT, and histomorphometry. The 0P group developed severe hypophosphatemia, rickets-like growth plate widening, osteopenia, and growth retardation. The 1/2P group showed similar hypophosphatemia but no growth impairment and non-significant reductions in bone mass. The 0Ca group exhibited hypocalcemia, secondary hyperparathyroidism, and high bone resorption, yet maintained normal growth and intermediate mineralization. Vitamin D interventions normalized sP but worsened bone loss and growth impairment compared to the 0P group. Biochemically, sP correlated positively with bone formation markers and negatively with fibroblast growth factor-23 (FGF23); vitamin D showed dual effects on bone turnover. Phosphate sufficiency during the early postnatal period is critical for bone mineralization and growth in neonatal rats. Isolated calcium deficiency caused a distinct osteomalacic phenotype with preserved growth. Supraphysiological-dose vitamin D metabolites corrected hypophosphatemia but failed to rescue-and may have exacerbated-skeletal defects, cautioning against vitamin D monotherapy without concurrent phosphate supplementation.
3. Skin Uptake of 131I in a Veterinary Practice.
期刊: Health physics 发表日期: 2026-Mar-01 链接: PubMed
摘要
Accidental trace 131I skin contamination resulted in an intake to a veterinary nuclear medicine technician at Colorado State University (CSU). The resulting dose to the technician was determined through an in-vivo measurement of radioactivity in the thyroid. Inhalation and ingestion of the isotope were ruled out due to the chemical nature of the 131I, as determined by a previous study. The CSU Radiation Control Office performed measurements of the technician’s thyroid daily and then weekly to quantify the uptake [2.2 kBq (60.1 nCi)] as well as the effective half-life of 131I (7.61 days) for the technician. Establishing a technician-specific effective half-life by graphing in-vivo measurements also showed near agreement with established effective half-life determinations specified in ICRP 30 for inhalation. The university assessed the committed dose equivalent (CDE) to the thyroid using three different methods and assigned a the highest CDE calculated (4.1 mSv), and an SDE of 0.22 mSv from external contamination. The average of the CDE calculated via each method was 3.68 ± 0.38 mSv. A comparison of the 3 thyroid dose calculation methods resulted in a 10% coefficient of variation. Close agreement between the various calculations demonstrates that any of these methods would be sufficient in determining a committed effective dose to the thyroid, while providing a level of confidence to the technician that the determination is accurate and appropriate. A key aspect of this report is how even trace amounts of radioiodine on intact skin can result in measurable doses.
4. Evaluating the Impact of Toolbox Training on Health Professionals in Radiation Environments: A Randomized Controlled Trial.
期刊: Health physics 发表日期: 2026-Mar-01 链接: PubMed
摘要
In recent years, the use of radiation diagnostics, treatment services, and many areas of health services has become widespread with technological developments. The widespread use of radioactive substances and radiation-producing devices in health services has increased the need for effective radiation protection programs, and the need for training in terms of the applicability of these programs is also increasing. This randomized controlled trial was conducted to evaluate the effect of on-the-job toolbox training defined as a short, informal safety meeting led by a supervisor that focuses on specific workplace hazards or safe work practices on the knowledge, practices, and safety-related behaviors of healthcare professionals working in radiation environments. Sixty-three participants from the radiology units of a university hospital in Hatay, Türkiye, were randomly assigned to an intervention group (n=33) or a control group (n=30). The intervention group received brief, face-to-face training sessions using visual materials in their work environments. Data was collected before and after the training and at two follow-up periods. After the training, radiation protection knowledge increased significantly in the intervention group (p<0.001), while no change was observed in the control group. Observational assessments revealed that there was an improvement in practice scores in the intervention group and that the gains were largely maintained over time. Additionally, adverse event reporting, an important quality indicator, increased significantly in the intervention group, indicating increased safety awareness. These results confirm that toolbox training is an effective method for improving both knowledge and safe practices among healthcare professionals. Its brief, practical, and workplace-based format contributes to increased engagement and retention of learning. The findings support the integration of toolbox training into in-service training programs as a complement or alternative to traditional methods. Future studies should examine its long-term effectiveness and applicability in a variety of healthcare settings.
5. Retrospective Reconstruction of Biological Dose in Early Radiation Accident Cases Through Chromosomal Translocations Analysis Using G-Banding.
期刊: Health physics 发表日期: 2026-Mar-01 链接: PubMed
摘要
To analyze stable chromosomal aberrations and reconstruct the biological dose in 6 victims of the Henan “4.26” 60Co radiation accident, 9 and 20 years after irradiation. G-banding chromosomal specimens were prepared using conventional culture and trypsin digestion methods. Stable chromosomal aberrations in six victims were analyzed with an automated chromosome scanning system and karyotype analysis software to estimate the biological dose based on chromosomal translocation indicators. The number of stable chromosomal aberrations per cell at the two follow-ups demonstrated a significant dose-effect relationship with the radiation dose. A noticeable increase in translocations per cell was observed 20 years after the accident compared with 9 years. At 9 years post-irradiation, the mean absorbed doses for four cases, estimated from translocations per cell, were similar to those estimated from dicentrics plus rings at 5 days post-irradiation, while a slight decrease was observed in one case. At 20 years post-irradiation, the mean absorbed dose based on translocations per cell for five cases was essentially the same as the dose estimated from dicentrics plus rings at 5 days post-irradiation. The G-banding approach, characterized by its simplicity and low cost, is feasible for analyzing chromosomal translocations and retrospectively reconstructing the biological dose of early radiation accidents.
6. Molecular and Serological Detection of Coxiella burnetii in Small Ruminants in Northeastern Brazil.
期刊: Veterinary medicine and science 发表日期: 2026-Mar 链接: PubMed
摘要
Coxiella burnetii, the causative agent of Q fever in humans, is an important worldwide pathogen. The main reservoirs for the bacterium are ruminants, specifically sheep and goats, which act as major shedders of the bacterium in the environment. In addition, the bacterium causes significant economic losses on small ruminant farms due to abortion and other reproductive disorders, such as weak neonates or stillborn animals. Transmission between animals and humans can occur mainly through the inhalation of aerosols, direct contact with products of labour or fomites, or through the vectorial route (ticks), which is less common. To evaluate the presence of C. burnetii antibodies in small ruminants, 76 serum samples, with 34 from sheep and 42 from goats were collected and analysed by ELISA. Furthermore, to explore the dynamics of C. burnetii excretion routes in sheep and goat flocks, vaginal, milk, and fecal samples were collected from 92 animals with 60 from goats and 32 from sheep. We also explored environmental contamination in the animals’ pens. The seroprevalence was 31.5% (24/76). The highest frequencies found in qPCR were in vaginal swabs (30.4%-28/92), followed by milk (26%-24/92), and lastly, in faeces (8.6%-8/92). None of the environmental samples were positive in qPCR. The data indicates that C. burnetii is actively circulating among sheep and goats in the region. The bacterium is disseminated through multiple transmission routes, affecting flock health and posing a significant occupational risk to farm workers involved in sheep and goat operations. SUMMARY: Serology indicates that one-third of the sheep and goats had previously been infected with Coxiella burnetii. qPCR analysis revealed the ongoing presence of C. burnetii in all evaluated flocks, each with a previous history of reproductive disorders. These results indicate the need for preventive measures and control of C. burnetii infection in small ruminants.
7. Bolstering the Pathway to Promote Scientific Workforce Diversity: The UCSF Mid-Career Development Program.
期刊: Academic medicine : journal of the Association of American Medical Colleges 发表日期: 2026-Feb-03 链接: PubMed
摘要
Academic medical institutions face longstanding challenges in recruiting and retaining historically excluded, midcareer research faculty. Although progress in recruiting has been documented, retention has focused on individuals rather than a system-level approach. The University of California San Francisco (UCSF) Mid-Career Development Program was launched in 2020 to advance and retain historically excluded research faculty (scholars) and their historically excluded mentees via a novel program that provided faculty discretionary funding of $150,000 per person over 2 years, a structured career development curriculum, networking with executive campus leaders, personalized and peer group mentorship, and sponsorship. A formative evaluation in 2024 collected baseline and follow-up data on scholars’ and mentees’ academic output and leadership attainment. Between 2020 and 2024, 7 midcareer scholars and 35 mentees have benefited from the program. The first 2 cohorts of scholars documented academic rank and step advancements; scholarly outcomes, including 119 articles and $2.3 million new National Institutes of Health (NIH) career awards; and key campus and national leadership roles. These changes reflected not only standard accumulated academic experience but also increased leadership opportunities previously unavailable to participants. Multiplier effects were documented among the scholars’ primary mentees, who were awarded $2 million in NIH career awards and published 194 peer-reviewed manuscripts, for an overall program total of 313 articles. This model program showed a return on its initial $1.05 million investment: for every dollar spent, the program generated $3.10 in NIH funding-a 310% return on investment. Program leaders and UCSF executive leadership are working to promote program sustainability. Additionally, collection of comparison data for program outcomes among participants and comparable faculty applicants for the program, who met criteria and were not enrolled due to space limitation, is being planned to enhance the pilot program results and, if successful, scale to other sites.
8. Diverging trajectories of Depressive Symptoms After Retirement: The Moderating Role of Social Engagement.
期刊: The journals of gerontology. Series B, Psychological sciences and social sciences 发表日期: 2026-Feb-03 链接: PubMed
摘要
Retirement marks a major life transition that can influence psychological well-being in later life. Although previous studies have examined the mental health consequences of retirement, less is known about how depressive symptoms evolve before and after retirement and whether these trajectories differ by levels of social engagement. This study investigates longitudinal changes in depressive symptoms surrounding retirement and examines whether social engagement moderates these changes. Data were drawn from 10,233 older adults across seven waves of the Korean Longitudinal Study of Ageing, yielding 53,865 person-observations. An individual-level fixed-effects event-study approach was employed to account for unobserved, time-invariant characteristics. Interaction models were used to assess whether the association between time to retirement and depressive symptoms varied by levels of informal social contact. Depressive symptoms showed no notable change before retirement but rose sharply afterward, which persisted for more than four years after retirement. However, retirement is not uniformly harmful; clear heterogeneity emerged by level of informal social engagement. Individuals with low social engagement experienced sustained increases in depressive symptoms that did not return to pre-retirement levels even after four years. In contrast, those with high social engagement exhibited only a temporary rise in depressive symptoms, primarily around the second year after retirement. Findings highlight the emotional toll of retirement and the protective role of social engagement in buffering against sustained psychological decline. Promoting opportunities for informal social connection may be critical to supporting emotional well-being during the retirement transition, particularly among those at risk of social isolation.
9. The Impact of Hearing Loss on Annual Incident Age-Associated Dementia Cases and Quality of Life in the US.
期刊: The journals of gerontology. Series A, Biological sciences and medical sciences 发表日期: 2026-Feb-03 链接: PubMed
摘要
One-third of persons age 60 y+ have hearing loss, and hearing loss is a leading preventable risk factor for dementia. We estimated the number of age-associated dementia cases attributable to hearing loss in 2022. We used DeciBHAL, a validated microsimulation\of hearing loss that includes age- and sex-specific annual probabilities of incident hearing loss (0·1-10·4%) and dementia (0·3-7·1%). Utility decrements are incorporated yearly, based on hearing loss (-0·13 to -0·31) and dementia severity (-0·04 to -0·42), to calculate quality-adjusted life-years (QALYs). We estimated dementia incidence for persons with and without hearing loss by removing the estimated proportion attributable to hearing loss (adjusted incidence risk ratio, 2·0 [range: 1·5-2·5]). We projected two cohorts: the general US population and a hypothetical US population without hearing loss (counterfactual). We applied model-projected dementia incidence and utility among both cohorts to the 74,190,000 US adults >60 y and without dementia in 2022. Model-projected incident cases of dementia are 412,000/year (males) and 523,000/year (females). In the simulation without hearing loss, dementia cases/year fall to 339,000 for males and 455,000 for females projecting that 141,000 new dementia cases in 2022 would be attributable to hearing loss. In probabilistic sensitivity analysis, 95% of simulations projected the proportion of dementia cases attributable to hearing loss were 11·5-23·6% for males and 6·7-18·7% for females. Hearing loss and associated dementia reduced life-time QALYs by 1.38 for females and 1.69 for males. Model-projected estimates support that hearing loss prevention could substantially reduce new dementia cases and should be a priority.
10. Mindfulness-based interventions for gambling disorder: A systematic review.
期刊: Journal of behavioral addictions 发表日期: 2026-Feb-03 链接: PubMed
摘要
Gambling disorder (GD) presents significant psychological, financial, and social consequences. Mindfulness-based interventions (MBIs) have emerged as promising adjunctive treatments. However, the evidence base remains heterogeneous. The present systematic review evaluated the current empirical literature on MBIs for GD, focusing on their efficacy, methodological quality, and limitations. Scopus, PubMed, Web of Science, EBSCO, and PsycINFO were searched for English-language studies published between 2012 and April 2025. The final sample comprised 12 studies: five randomized controlled trials, one controlled pilot study, two repeated-measures studies, one mixed-methods study, and three single-group pretest-posttest studies. A narrative synthesis evaluated MBI impacts. MBIs consistently reduced gambling frequency and cravings while enhancing psychological outcomes. Studies combining mindfulness with cognitive behavioral therapy showed significant declines in problem gambling behavior. Psychological distress and cravings also decreased notably across interventions. The mindfulness components employed varied in focus and application, adding nuance to outcome interpretation. However, it remains unclear to what extent the observed effects can be attributed to mindfulness-specific mechanisms. MBIs show promise as a complementary treatment for gambling disorders, although small sample sizes and methodological limitations suggest a need for more robust research.
11. School Readiness Promotion in Primary Care: Latino Parent Feedback on Interventions and Programs.
期刊: Journal of developmental and behavioral pediatrics : JDBP 发表日期: 2026-Feb-03 链接: PubMed
摘要
To explore the feasibility and acceptability of interventions to promote school readiness (SR) in primary care through qualitative analysis of “SR Design Maps” created by Latino families. Caregivers participated in design thinking to assess benefits, barriers, and desirable characteristics of eight SR interventions to create a final SR Design Map. Qualitative analysis included a content analysis to determine the frequency of each intervention and deductive theme analysis to create a summary of key features, content, and timing preferences. Two coders completed analysis in the source language. Participants included 32 Latino caregivers from four Oregon clinics with primarily US born children with preschool experience. Most caregivers were monolingual Spanish or bilingual-speakers, born in Mexico, with a high school education or higher. Across 16 distinct “SR Design Maps,” 100% included SR Coaching, preschool navigation, library information, and a community coordinator; most included a SR Checklist (92%), TipsByText (88%), and parent groups (81%). The most desired and feasible interventions were Coaching, preschool navigation, SR Checklist, library information, and TipsByText. A “future state” model compiles caregiver preferences from birth to age 5 years. Latino families gave detailed feedback to integrate multiple SR interventions from pregnancy to 5-year-old well-child visits. Families were most interested in an overview of SR skills (SR Checklist), tips for early math and literacy at home (SR Coaching, TipsByText), preschool information and application support, and reminders about library programs. These findings inform a culturally responsive package of interventions to promote SR in primary care.
12. Identification of cellular hierarchy in paediatric acute myeloid leukaemia: The Japan Children's Cancer Group trial (JCCG AML-12).
期刊: British journal of haematology 发表日期: 2026-Feb-03 链接: PubMed
摘要
RNA sequencing from 262 patients with paediatric acute myeloid leukaemia (AML) (JPLSG AML-12) was deconvoluted employing adult single-cell RNA-sequencing signatures and Zeng’s method, which defined five cellular hierarchy subtypes: primitive, leukaemic stem/progenitor cell (LSPC)-Cycle, ProMono-like, granulocyte-monocyte progenitor (GMP)-like and intermediate. Principal component analysis revealed two main axes that distinguish paediatric from adult AML, with notable LSPC-Cycle and ProMono-like phenotype enrichment. LSPC-Cycle (>25% cycling stem-like cells) had proliferative and quiescent LSPCs, frequent French-American-British (FAB)-M7 and worst prognosis (overall survival odds ratio vs. GMP-like: 11.33). Morphology was related to the primitive (FAB-M0), GMP-like (M2/M4) and ProMono-like (M5) groups. Genomic patterns aligned with hierarchy: CBFA2T3::GLIS2, MYB::GATA1 and MECOM high expression in LSPC-Cycle; CBFB::MYH11, NUP98::NSD1 and NPM1 in the intermediate; and DEK::NUP214 and NUP98::KDM5A were concentrated in the primitive group. bZIP CEBPA and FLT3-ITD mutations clustered in the intermediate and primitive groups. Most of RUNX1::RUNX1T1 clustered in the intermediate group, whereas KMT2A::MLLT3 hierarchy differed with MECOM expression level. Paediatric AML comprised more primitive cells, rarely with mono-like/cDC-like dominance. LSPC-Cycle, FLT3-ITD and NUP98::KDM5A were considered independent prognostic factors in multivariate analysis. Findings indicate the prognostic relevance of cellular hierarchy and the importance of integrating hierarchy-specific molecular profiles for improved risk stratification and treatment formulation.
13. Connected Dads, Healthy Teens: A Pilot Study of an Online Father-Teen Program to Support Teens' Sexual Health.
期刊: Journal of sex research 发表日期: 2026-Feb-03 链接: PubMed
摘要
The purpose of this study was to evaluate the acceptability, feasibility, and preliminary efficacy of Connected Dads, Healthy Teens, a 4-week online father-teen program designed to promote healthy communication and decision-making about sex and relationships. A pilot sample of 53 fathers and 50 of their high-school aged teens participated in this program and took pre- and post-test surveys. Participants reported high levels of program feasibility and acceptability. Preliminary efficacy assessment from fathers and teens showed statistically significant increases in sexual health knowledge, and frequency and comfort with father-teen communication. Fathers showed increased self-efficacy for father-teen communication and teens showed increased self-efficacy for communication with a partner. Our findings suggest that the Connected Dads, Healthy Teens program may help fathers and teens to learn sexual health information and communicate about sex and relationships, which has potential to reduce teens’ sexual risk behaviors and bolster their sexual health.
14. Endogenous GIP signaling is indispensable for DPP-4 inhibitor-mediated metabolic control in mice.
期刊: Journal of diabetes investigation 发表日期: 2026-Feb-03 链接: PubMed
摘要
Dipeptidyl peptidase-4 (DPP-4) inhibitors enhance circulating levels of biologically intact incretins, yet the relative contribution of glucose-dependent insulinotropic polypeptide (GIP) to their metabolic effects remains incompletely understood. While glucagon-like peptide-1 (GLP-1) has long been emphasized in incretin biology, emerging evidence suggests important physiological roles for GIP. This study investigated whether endogenous GIP signaling is indispensable for the glucose-lowering and anti-obesity effects of DPP-4 inhibition. Male Gipr+/+ and Gipr-/- mice were treated with anagliptin or linagliptin under normal diet or high-fat diet (HFD) conditions. Glucose tolerance, insulin secretion, incretin levels, body weight, and adiposity were assessed. To confirm GLP-1 pathway integrity, dulaglutide was administered to a subset of animals. DPP-4 inhibition significantly improved glucose tolerance and attenuated body-weight gain in HFD-fed Gipr+/+ mice, without affecting food intake. These effects were abolished in Gipr-/- mice, despite similar elevations in circulating biologically intact GIP and GLP-1. Under normal diet, DPP-4 inhibitors enhanced early-phase insulin secretion and lowered glucose levels in Gipr+/+ mice, but not in Gipr-/- mice. Importantly, dulaglutide restored glucose-lowering effects in Gipr-/- mice, confirming preserved GLP-1 receptor function. Endogenous GIP signaling is essential for both glucose-lowering and anti-obesity actions of DPP-4 inhibitors in mice. GLP-1 elevation alone is insufficient to compensate for GIP receptor deficiency. These findings refined the mechanistic understanding of DPP-4 inhibitors, highlighted the physiological importance of GIP, and suggested context-dependent metabolic actions of incretins.
15. A Culturally Tailored Diabetes Self-Management Education Program With Mobile Health Integration for Chinese Americans With Type 2 Diabetes: Development and Pilot Evaluation Study.
期刊: JMIR formative research 发表日期: 2026-Feb-03 链接: PubMed
摘要
Although progress has been made in improving the efficacy of Diabetes Self-Management Education (DSME) programs, there remains a dearth of research on culturally adapted, evidence-based DSMEs for Chinese Americans (CAs) with type 2 diabetes. Through collaborative partnerships with 2 large community recreation centers and the AHMC Hospital Network in San Gabriel Valley, California, we developed and pilot-tested a culturally tailored DSME program with integrated mobile health (mHealth) technology, entitled Culturally Appropriate Strategies for Chinese Americans with Diabetes (CASCADe). The CASCADe program utilized a combined, theoretically driven, and community-participatory approach and was developed based on information gleaned from focus groups, semistructured interviews, and a questionnaire survey conducted among CA patients with diabetes, physicians, and nurses, as well as from extensive literature reviews of evidence-based program curricula. A single-group pre- and posttest design with a 3-month study period was then employed to assess the program’s preliminary efficacy. The study protocols were registered on ClinicalTrials.gov. The CASCADe program consisted of (1) a home visit in the first month for training in monitoring device use and WeChat app (a mobile instant-messaging platform widely used in the Chinese population) usage, as well as for acquiring family support; (2) 8 weekly sessions over the following 2 months, delivered in a combined format of group classes, games, group exercises, videos, and discussions; and (3) WeChat follow-up involving education tips, monitoring data summaries, and group discussions after each of the 8 weekly sessions. Topics covered in the weekly sessions included recognition of diabetes and its complications, risk factors, nutrition knowledge, dietary practices, exercise, behavioral self-monitoring, medication adherence, and stress management. The monitoring system used a smartphone to coordinate cloud-based data transmission from a set of wireless devices to capture daily monitoring data on physical activity, body weight, blood pressure, and blood glucose levels. Behavioral self-monitoring was further facilitated by the WeChat app, which provided daily messages related to the diabetes education curriculum; weekly summary reports of monitoring data; feedback; bidirectional 1-on-1 communication between intervention providers and participants; and group discussions among participants regarding readings and the implications of monitoring results. The pre- and postcomparison from the 3-month pilot trial showed a significant reduction in glycated hemoglobin (HbA1c; 7.48 vs 7.09, P=.03), with all but 1 participant demonstrating a reduction and 7 out of 12 (58%) achieving a >0.5 decrease in HbA1c. Significant improvements were also observed in self-efficacy in diabetes management (6.59 vs 8.01, P=.003), quality of life (3.21 vs 3.69, P=.005), and stress-coping skills (3.18 vs 3.74, P=.01) at 3 months after baseline among CA patients with type 2 diabetes. Our pilot study demonstrated the feasibility of implementing the CASCADe program among CAs to improve diabetes self-management skills and yielded promising results, warranting further evaluation in a larger randomized trial. ClinicalTrials.gov NCT04737499; https://clinicaltrials.gov/ct2/show/NCT04737499.
16. Probiotic Lactobacillus johnsonii RS-7 Alleviates Intestinal Inflammation Via the TLR4/MyD88/NF-κB Signaling Pathway.
期刊: Probiotics and antimicrobial proteins 发表日期: 2026-Feb-03 链接: PubMed
摘要
Developing novel probiotics can help in preventing livestock diarrhea and associated intestinal diseases. Lactic acid bacteria (LAB) are symbiotic intestinal bacteria, which contribute to gastrointestinal tract health. An LAB strain, designated L. johnsonii RS-7, was isolated from the feces of healthy adult pigs and was resistant to acidic conditions and bile salts. In vitro evaluation showed significant antioxidant and anti-inflammatory properties, suggesting its potential application in alleviating intestinal inflammation. An artificially induced colitis model was established in mice to investigate the efficacy of L. johnsonii RS-7. Results indicated that mice administered water containing 3% DSS developed pronounced colitis symptoms, characterized by weight loss, elevated disease activity index, shortened colon length, microvilli shedding, tight junction disruption, reduced goblet cell counts, suppression of anti-inflammatory cytokines, activation of pro-inflammatory cytokines and the TLR4/MyD88/NF-κB signaling pathway, and impaired gut microbiota diversity. These suggest that oral administration of L. johnsonii RS-7 significantly alleviated colitis symptoms. In summary, L. johnsonii RS-7 acted as a probiotic by inhibiting activation of the TLR4/MyD88/NF-κB pathway.
17. Hyponatraemia in heart failure: a mechanistic approach to contemporary management.
期刊: Heart failure reviews 发表日期: 2026-Feb-03 链接: PubMed
摘要
Hyponatraemia remains the most prevalent electrolyte disturbance in heart failure, complicating clinical management and correlating with adverse outcomes. While traditionally viewed as a biomarker of disease severity, mounting evidence suggests that hyponatraemia reflects specific pathophysiological mechanisms that demand targeted intervention alongside standard decongestion strategies. This mini review synthesises contemporary evidence to provide clinicians with an updated, mechanistically grounded approach to hyponatraemia in heart failure. We emphasise the critical distinction between dilutional hypervolaemic states driven by arginine vasopressin dysregulation and depletional hypovolaemic states arising from aggressive diuresis or sodium losses. Recent trials challenge longstanding practices: fluid restriction in stable chronic heart failure shows no quality-of-life benefit despite guideline recommendations, whilst emerging biomarkers such as early urine chloride offer promise in identifying diuretic resistance. We critically appraise the role of vasopressin antagonists, which correct sodium biochemically but lack mortality benefit, and explore oral urea as a pragmatic alternative supported by recent observational data. For acute severe presentations, we detail hypertonic saline protocols with strict correction limits and discuss proactive desmopressin strategies to prevent osmotic demyelination. Important knowledge gaps persist, including optimal diagnostic algorithms in diuretic-exposed patients, patient-centred outcome data for sodium-correcting therapies, and validation of safe-correction protocols. Overall, this review equips clinicians to integrate mechanistic understanding with evidence-based practice whilst identifying priorities for future investigation.
18. Relationships between consumption of theobromine in cocoa products and cardiovascular risk factors in 2015-2020 National health and nutrition examination survey.
期刊: European journal of nutrition 发表日期: 2026-Feb-03 链接: PubMed
摘要
Cocoa is a significant source of theobromine, a bioactive compound proposed to provide cardiovascular protection. However, relatively few studies have provided conclusive evidence of the potential beneficial health effects. The aim of this study was to determine the relationship between the consumption of cocoa products containing theobromine and cardiovascular risk factors in the U.S. population sample using 2015-2020 National Health and Nutrition Examination Survey (NHANES) data. This cross-sectional study included 8531 individuals aged 20-70 years and 3808 people in a fasting sub-sample. Theobromine and cocoa product intake levels were obtained from 24-h dietary recalls and linked to the Food and Nutrient Database for Dietary Studies database. Primary outcomes included systolic and diastolic blood pressure, hypertension, serum total, HDL and LDL cholesterol, triglyceride, glycohemoglobin, insulin, plasma glucose, and high-sensitivity C-reactive protein (hs-CRP). Linear regression models were applied to analyze the associations between theobromine or cocoa product consumption and cardiovascular risk factors. The consumption of cocoa was not associated with cardiovascular disease risk factors compared to non-consumption. The amounts of cocoa consumed were inversely associated with glycohemoglobin levels (mean ± SE, - 0.04 ± 0.02% per 100 g, P = 0.04). Theobromine intake (vs. no intake) was positively associated with serum insulin (1.85 ± 0.85 μU/mL; P = 0.03). Theobromine levels consumed were inversely associated with glycohemoglobin (- 0.05 ± 0.03% per 100 mg, P = 0.04), serum triglycerides (- 5.4 ± 2.73 mg/dL, P = 0.05), and hs-CRP levels (- 0.26 ± 0.12 mg/L, P = 0.04). These associations were also mostly observed in people with healthier profiles. Increased cocoa consumption is associated with reduced glycohemoglobin levels, while higher theobromine intake is associated with reduced triglyceride, glycohemoglobin, and hs-CRP levels compared to a lower intake. The positive link between theobromine intake, as opposed to no intake, and serum insulin required further investigation. Overall findings support the inclusion of cocoa-derived compounds in healthy diets.
19. Liver specific-inhibition of LPCAT3 ameliorates metabolic dysfunction-associated steatotic liver disease.
期刊: Journal of molecular medicine (Berlin, Germany) 发表日期: 2026-Feb-03 链接: PubMed
摘要
The membrane unsaturation in the liver is associated with abnormal biosynthesis and accumulation of cholesterol and triglycerides, which is a hallmark of metabolic dysfunction-associated steatotic liver disease (MASLD). The lysophosphatidylcholine acyltransferase 3 (LPCAT3) incorporates arachidonic acid (AA) into the membrane phospholipids and increases the degree of unsaturation. The metabolites of AA are involved in the lipogenesis under high nutrient conditions. However, the mechanistic insights by which LPCAT3 contribute to lipogenesis and MASLD remain unknown. This study found that LPACT3 is upregulated in the liver tissues of diet-induced MASLD and associated with a prominent increase in the arachidonic acid content in the liver, expression of lipogenic genes, and enlargement of liver cells filled with lipid droplets. Most importantly, the prostaglandin E2 (PGE2) was notably elevated in the plasma of the high-fat-fed mice. Gene silencing of LPCAT3 notably depleted the AA and PGE2 in the hepatocytes and attenuated the high-palmitic acid and glucose-induced accumulation of triglycerides and cholesterol. Exogenous addition of PGE2 markedly reversed the reduced triglyceride and cholesterol accumulation in the LPCAT3 silenced cells. These results indicate that the LPCAT3-arachidonic acid-PGE2 axis plays a crucial role in lipogenesis in response to excess nutrients in the liver. Most importantly, targeted pharmacologic therapy using GalNac-LPCAT3 siRNA specifically inhibits LPCAT3 expression in the liver and protects against high-fat-induced inflammation, lipogenesis and hepatic dysfunction without affecting hepatic VLDL secretion. This GalNAc-LPCAT3 siRNA biomimetic combined represented safe, effective, and versatile carriers for developing hepatocyte-specific gene therapeutics and preventing MASLD.
20. [Guideline-based diagnostics and treatment of peripheral arterial occlusive disease : Updates in the current guidelines, implications of the German hospital reform and practice-relevant knowledge for all surgeons].
期刊: Chirurgie (Heidelberg, Germany) 发表日期: 2026-Feb-03 链接: PubMed
摘要
Peripheral arterial occlusive disease (PAOD) is a frequent manifestation of atherosclerosis associated with high morbidity and mortality. This article summarizes the current recommendations of the German S3 guidelines “Diagnostics, treatment and follow-up of PAOD” (Association of the Scientific Medical Societies in Germany, AWMF 2024) and discusses the implications of the ongoing hospital reform. Key diagnostic modalities include patient history taking, clinical examination, ankle-brachial index measurement and duplex ultrasonography. In cases of suspected chronic limb-threatening ischemia (CLTI), the WIfI score enables a structured risk assessment for amputation. Treatment management emphasizes strict secondary prevention (low-density lipoprotein, LDL < 3,1 mmol/l, smoking cessation), supervised exercise training and optimized antithrombotic therapy (clopidogrel is preferred; dual pathway inhibition for high-risk patients or after revascularization). Revascularization can be performed endovascularly or surgically and increasingly in specialized centers. The German Hospital Reform supports the centralization of complex procedures and the expansion of outpatient care, thereby underscoring the pivotal role of nonvascular surgical departments in early detection and coordinated referral. Die periphere arterielle Verschlusskrankheit (pAVK) ist eine häufige Manifestation der Atherosklerose mit hoher Morbidität und Mortalität. Der Beitrag fasst die aktuellen Empfehlungen der S3-Leitlinie „Diagnostik, Therapie und Nachsorge der pAVK“ (AWMF 2024) zusammen und beleuchtet die Auswirkungen der Krankenhausreform. Diagnostisch stehen Anamnese, klinische Untersuchung, Ankle-Brachial-Index (ABI) und Duplexsonographie im Vordergrund; bei Verdacht auf chronisch extremitätengefährdende Ischämie (CLTI) ermöglicht der WIfI-Score eine strukturierte Risikoeinschätzung des Amputationsrisikos. Therapeutisch werden strikte Sekundärprävention (LDL [Low-Density-Lipoprotein] < 3,1 mmol/l, Rauchstopp), strukturiertes Gehtraining und eine optimierte antithrombotische Therapie (Clopidogrel bevorzugt; „dual pathway inhibition“ bei Hochrisiko oder nach Revaskularisation) empfohlen. Revaskularisationen erfolgen endovaskulär oder chirurgisch, zunehmend in spezialisierten Zentren. Die Krankenhausreform stärkt Zentralisierung komplexer Eingriffe und Ambulantisierung, wodurch die Rolle nichtgefäßchirurgischer Abteilungen in Früherkennung und Überleitung betont wird.
21. [Allergic bronchopulmonary aspergillosis-essential knowledge for radiology].
期刊: Radiologie (Heidelberg, Germany) 发表日期: 2026-Feb-03 链接: PubMed
摘要
Allergic bronchopulmonary aspergillosis (ABPA) is a rare but potentially severe hypersensitivity reaction to Aspergillus fumigatus, primarily affecting patients with asthma or cystic fibrosis. Early diagnosis is crucial to prevent irreversible lung damage. High-resolution computed tomography (HRCT) is the standard imaging method for detecting bronchiectasis and other typical findings. Common features include central, saccular bronchiectasis, mucus impaction, and centrilobular micronodules. Radiological assessment must be closely integrated with clinical and laboratory parameters. The revised 2024 International Society for Human and Animal Mycology (ISHAM) criteria further emphasize the diagnostic importance of radiological features. High-attenuation mucus (HAM) is considered a highly specific finding and may confirm the diagnosis. Modern classification systems allow more precise disease staging. HRCT provides extremely high sensitivity for the radiological hallmarks of ABPA. Detection of HAM is regarded as nearly pathognomonic. Fleeting infiltrates and reversible changes are reliably visualized. Correlating radiological findings with laboratory parameters significantly improves diagnostic accuracy. HRCT remains the indispensable imaging modality for diagnosing and monitoring ABPA. In cases of clinical suspicion, early HRCT of the thorax should be performed. A combination of radiological findings and serological criteria is recommended to confirm the diagnosis. HRCT can be used to detect reversible infiltrates and assess response to treatment. KLINISCHES/METHODISCHES PROBLEM: Die allergische bronchopulmonale Aspergillose (ABPA) ist eine seltene, aber potenziell folgenschwere Überempfindlichkeitsreaktion auf Aspergillus fumigatus, die vor allem bei Patient*innen mit Asthma oder zystischer Fibrose vorkommt. Eine frühzeitige Diagnose ist entscheidend, um irreversible Lungenschäden zu verhindern. Die hochauflösende Computertomographie (HRCT) ist das Standardverfahren zur Detektion von Bronchiektasen und weiteren typischen Befunden. Häufig zeigen sich zentrale, sakkuläre Bronchiektasen, Mukusimpaktionen und zentrilobuläre Mikronoduli. In den 2024 revidierten ISHAM-Kriterien wurde die Bedeutung radiologischer Befunde weiter gestärkt. Der Nachweis von hyperdensen Mukusimpaktionen („high-attenuation mucus“, HAM) gilt als hochspezifischer Hinweis und kann die Diagnose sichern. Moderne Klassifikationssysteme erlauben eine präzisere Einordnung. LEISTUNGSFäHIGKEIT: Die HRCT besitzt eine extrem hohe Sensitivität für die radiologischen Zeichen einer ABPA. Der Nachweis von HAM wird als nahezu pathognomonisch beschrieben. Flüchtige Infiltrate und reversible Veränderungen sind zuverlässig darstellbar. Die Korrelation von radiologischen Befunden mit laborchemischen Parametern verbessert die diagnostische Treffsicherheit erheblich. Die HRCT bleibt das unverzichtbare bildgebende Verfahren zur Diagnose und Verlaufsbeurteilung der ABPA. EMPFEHLUNGEN FüR DIE PRAXIS: Bei klinischem Verdacht sollte eine frühzeitige HRCT des Thorax erfolgen. Zur Diagnosesicherung empfiehlt sich eine Kombination aus radiologischen Befunden und serologischen Kriterien. Mittels HRCT können reversible Infiltrate detektiert und das Therapieansprechen beurteilt werden.
22. Oxygen-Dependent Cascade Defluorination of GenX via Synergistic Mechanism of Singlet Oxygen and Nitrogen Oxide Radicals in Fe3+/Fe2+ Redox Cycling.
期刊: Environmental science & technology 发表日期: 2026-Feb-03 链接: PubMed
摘要
Hexafluoropropylene oxide dimer acid (GenX), a perfluorooctanoic acid substitute, poses environmental risks due to its persistence and toxicity. Effective defluorination methods are crucial, especially in clarifying reactive species’ roles in carbon-skeleton disruption versus C-F bond cleavage. We present a novel UV/Fe(NO3)3 system that integrates ligand-to-metal charge transfer (LMCT), reactive nitrogen species (RNS), and singlet oxygen (1O2) to achieve 90% GenX degradation in 1 h and 99% defluorination in 6 h. Mechanistic studies under controlled atmospheres reveal a hierarchical pathway: Fe3+-triggered LMCT initiates C-C bond disruption, decarboxylation, and ether-oxygen bond cleavage, while nitrate-photolysis-derived RNS accelerates this process via electron transfer (ET). Fe2+-mediated conversion of O2 to 1O2 drives C-F bond scission, revealing an oxygen-dependent cascade defluorination involving Fe3+/Fe2+ redox cycling and RNS. Oxygen availability raises defluorination from 8 to 99%. Density functional theory calculations confirm that the Fe2+ activation of triplet O2 to 1O2 lowers the defluorination barrier by 118.8 kcal/mol. This approach works across diverse water matrices, achieving >88% defluorination of eight per-/polyfluoroalkyl substances (PFAS) within 12 h and remains robust in treating fluorochemical effluents. Using acidic iron-containing pickling wastewater as an in situ reagent enables >90% GenX defluorination, offering a closed-loop, additive-free, scalable solution for sustainable PFAS remediation.
23. Response to "Correspondence regarding 'Geospatial analysis of open-source intelligence data to early detect laboratory-acquired infections, using the 2019 brucellosis laboratory leak in China as a case study'".
期刊: Infection 发表日期: 2026-Feb-03 链接: PubMed
摘要
24. Absence of anti-HEV antibodies in donkeys in Algeria: a first serological survey.
期刊: Veterinary research communications 发表日期: 2026-Feb-03 链接: PubMed
摘要
Paslahepevirus balayani (Hepatitis E virus, HEV) is an emerging zoonotic pathogen with a wide host range, yet its circulation in African equids remains poorly understood. This study provides the first serological investigation of HEV in donkeys in Algeria, aiming to assess exposure levels and identify potential infection-related risk factors. Between 2019 and 2024, 183 donkeys were sampled across three northeastern provinces (Mila, Souk-Ahras, and Tébessa), representing diverse agroecological conditions and including both working donkeys and animals used in cross-border smuggling. Individual data on age, sex, health status, body condition, movement history, and season were recorded. Sera were screened using a proprietary recombinant antigen, which is highly conserved across different HEV strains. All samples tested negative for anti-HEV antibodies. The sample size exceeded the minimum required to detect the highest seroprevalence previously reported in donkeys (12.22%), supporting the epidemiological significance of the negative findings. The absence of seropositivity may reflect limited regional exposure to known HEV reservoirs, local husbandry practices, and environmental conditions that reduce infection risk. These results suggest that HEV is currently not circulating at detectable levels in donkeys from northeastern Algeria. Broader studies, including molecular approaches and additional species, are recommended to clarify HEV ecology in the region.
25. Environmental sustainability of ultrasound-guided core-needle breast biopsy: a survey on current practices by the European Society of Breast Imaging (EUSOBI).
期刊: Insights into imaging 发表日期: 2026-Feb-03 链接: PubMed
摘要
In the context of a global appraisal of the environmental impact of radiology, this survey among members of the European Society of Breast Imaging (EUSOBI) investigated procedural aspects of ultrasound-guided core-needle breast biopsy that may impact its environmental sustainability. A 25-item online questionnaire, developed by a panel of nine breast imaging experts, was distributed from September 25th to December 25th, 2024, within the EUSOBI mailing list and social media platforms. The survey investigated materials routinely used for ultrasound-guided core-needle biopsies, waste disposal practices, the relationship between perceived procedural hygiene levels and self-reported frequency of post-procedural infectious complications, and results’ communication methods. Replies were analysed with descriptive and non-parametric statistics. Among the 787/823 respondents (95.6%) who routinely perform ultrasound-guided core-needle biopsy, most (460/787, 58.4%) perceived to attain aseptic conditions, without significant associations (p = 0.334) of hygiene levels with post-procedural infectious complications (never seen by 549/776 respondents, 70.7%). For most disposable materials, the majority of respondents used no more than one unit per procedure, including sterile gloves (551/787, 70.0%), sterile drapes (651/787, 82.7%), and sterile gel packets (729/787, 92.6%), also avoiding to use prepackaged biopsy kits (424/787, 53.9%). However, most respondents did not use recycling bins (404/787, 51.3%) and employed at least one resource-intensive modality to communicate benign results (in-person or by letter, 584/787, 74.2%). Procedural aspects of ultrasound-guided core-needle biopsy carrying an environmental impact vary widely. In the absence of significant associations between perceived hygiene levels and post-procedural infectious complications, resource-intensive habits could be safely streamlined to improve sustainability. This EUSOBI survey demonstrates that, despite widely varying procedural aspects in ultrasound-guided core-needle breast biopsy, higher perceived sterility levels are not associated with fewer infections, highlighting opportunities to safely reduce resource use and environmental impact. This EUSOBI survey investigated how procedural habits and the use and amount of material in ultrasound-guided core-needle breast biopsy impact its environmental sustainability. Procedural aspects varied widely among the 787/823 respondents who routinely perform ultrasound-guided core-needle breast biopsy. While some economically driven sustainable behaviours are already in place, there are several opportunities to reduce materials use and waste. As no association was found between perceived hygiene levels and post-procedural infections, resource-intensive hygiene-related practices could be streamlined to improve sustainability.
26. The Light-Eye-Brain Axis: Neurobiological Links Between Mood Disorders and Myopia-A Narrative Review.
期刊: Ophthalmology and therapy 发表日期: 2026-Feb-03 链接: PubMed
摘要
Light is a major environmental signal that shapes circadian rhythms, mood regulation, and ocular growth through a network of non-visual photoreceptive pathways. Increasing evidence suggests that photic information, particularly as decoded by intrinsically photosensitive retinal ganglion cells (ipRGCs), converges on central circuits governing both affective states and refractive development. To integrate these cross-system interactions, we propose the conceptual framework of a “light-eye-brain axis,” which outlines how environmental light cues are encoded by the retina and subsequently modulate neuroendocrine, autonomic, and inflammatory processes. Within this framework, mood disturbances may contribute to myopic progression through altered light-exposure behaviors, neurotransmitter imbalance, hypothalamic-pituitary-adrenal axis instability, and impaired neuroplasticity, whereas high myopia may increase vulnerability to anxiety or depressive symptoms through shared neural and immune pathways. Taken together, this integrative perspective highlights how light-dependent signaling shapes both emotional and refractive outcomes, and provides a conceptual foundation for future mechanistic studies as well as evidence-informed approaches to optimizing light exposure in the context of mood and visual health.
27. Emissions and leachate profile of MSW disposal sites of metropolitan cities of Pakistan using LandGEM model.
期刊: Carbon balance and management 发表日期: 2026-Feb-03 链接: PubMed
摘要
The rapid increase in municipal solid waste (MSW) generation across urban centers in Pakistan, combined with insufficient waste management infrastructure, presents a significant environmental and public health challenge. This study assesses methane emissions and leachate generation from major MSW dumpsites in Rawalpindi and Lahore, two of Punjab province’s largest cities. Emissions were estimated and projected over a 50-year active timespan using the U.S. EPA LandGEM model following IPCC 2006 guidelines. Cumulative emissions from Lahore’s solid waste disposal (SWD) systems were calculated at approximately 133,446 Gg, equivalent to 108 Mt CO₂-eq, with contributions comprising 26% methane, 73% carbon dioxide (CO₂), and 0.2% non-methane organic compounds (NMOCs). In contrast, Rawalpindi’s SWD systems generated 958 Gg (or 7.8 Mt CO₂-eq) over their operational life, exhibiting a similar emissions profile. Two unmanaged Lahore sites-LD2 (1643 Gg CH₄) and MB1 (1383.9 Gg CH₄)-emerged as the most significant methane emitters across both cities. These results underscore the urgent need for targeted waste management strategies, particularly the deployment of methane capture technologies and effective leachate treatment systems. The study highlights the substantial greenhouse gas emissions and groundwater contamination risks posed by unmanaged landfills. To mitigate these impacts and align with national climate goals, the adoption of site-specific policies and sustainable waste-to-energy solutions is imperative.
28. A critical review of surfactant-enhanced aquifer remediation for DNAPLs: residual morphology, governing factors, and removal mechanisms.
期刊: Environmental geochemistry and health 发表日期: 2026-Feb-03 链接: PubMed
摘要
Dense non-aqueous phase liquids (DNAPLs) are pervasive pollutants in groundwater systems and exhibit complex migration behavior and phase transitions. The presence of residual-phase DNAPLs often leads to persistent concentration tailing and rebound effects, which significantly hinder effective remediation. The efficacy of surfactant-enhanced aquifer remediation (SEAR) in removing residual-phase DNAPLs is hampered by a complex interplay of influencing factors. This review systematically analyzes DNAPL migration and retention, identifying the residual phase as the critical barrier to successful remediation. SEAR performance depends critically on surfactant properties, aquifer media, and hydrodynamic conditions, leading to variable outcomes. A comprehensive analysis of residual phase DNAPL migration mechanisms reveals that DNAPL movement is predominantly controlled by the interplay of gravitational, capillary, and viscous forces. This paper presents a force-balance analytical framework connecting DNAPL displacement to key remediation parameters. Remediation success relies on identifying and regulating dominant forces under site-specific conditions, while aquifer heterogeneity and coupled parameters add complexity in three-dimensional field settings. Thus, multi-parameter interactions need systematic evaluation. Large-scale research on multi-parameter coupling mechanisms is currently lacking, and future efforts should address this to advance precise DNAPL remediation strategies.
29. Hazards and mitigation measures of applying biochar in water, soil, plants, animals and atmospheric for environmental safety.
期刊: Environmental geochemistry and health 发表日期: 2026-Feb-03 链接: PubMed
摘要
The multifaceted utility of biochar in environmental applications stems from its porous structure, ample surface area, and rich oxygen-containing functional groups. However, interactions between biochar and its surroundings can lead to the release of potentially harmful components, necessitating a comprehensive understanding of environmental impacts. This review categorizes adverse biochar effects on their detrimental components, surface attributes, structure, and size, delving on water, soil, plants, animals and atmospheric ecosystems. It also presents different methodologies for detecting environmental risks associated with biochar application, offering guidance for future toxicity assessment and avoidance strategies. Biochar created via high-temperature pyrolysis under limited oxygen can harbor various known contaminants and emerging threats (persistent free radicals and metal cyanides), posing risks like phytotoxicity, cytotoxicity and neurotoxicity. The ecotoxic potential of biochar concerning specific contaminants, comprehensive strategies to mitigate this entire spectrum of contaminants within biochar are lacking. This review comprehensively explores the formation mechanisms of these contaminants and their potential risks to ecosystems and underscores the need for effective contamination control strategies during biochar production. It emphasizes the significance of designing pyrolysis units that ensure separation of pyrolysis liquids from solids, minimizing organic contaminant condensation onto biochar. Reducing total levels of PTE holds promise through strategies such as co-pyrolysis of biomass containing both metal-rich and metal-free components, complemented by the inherent decrease in PTE levels with higher pyrolysis temperatures. With these recommended strategies, there is potential to produce biochar posing minimal environmental risks, empowering sustainable applications in diverse environmental contexts.
30. Non-linear associations of blood volatile organic compounds (VOCs) with sleep health and mortality in American adults: data from the National health and nutrition examination survey (NHANES) 2007-2012.
期刊: International archives of occupational and environmental health 发表日期: 2026-Feb-03 链接: PubMed
摘要
This study aimed to shed light on the potential relationships between blood volatile organic compounds (VOCs) and sleep health as well as mortality. We employed generalized linear (GL), restricted cubic spline (RCS), weighted quantile sum (WQS), quantile-based g-calculation (QGC), and Bayesian kernel machine regression (BKMR) models to assess the relationship between blood VOCs-including bromoform (NHANES code: LBXVBF), bromodichloromethane (LBXVBM), chloroform (LBXVCF), dibromochloromethane (LBXVCM), and methyl tert-butyl ether (LBXVME)-and sleep health indicators (trouble sleeping, sleep disorders, and insufficient (< 6 h/day) or excessive (> 9 h/day) sleep) in participants from the NHANES 2007-2012. The Cox proportional hazards regression model was also used for survival analysis. The baseline profile categorized by sex showed that women had a higher prevalence of trouble sleeping, whereas men were more prone to insufficient sleep. We did not observe significant linear-correlations between VOCs and both increased sleep duration and poor sleep patterns, as shown by the weighted linear/logistic regression models. The RCS regression model indicated significant non-linear relationships (P for non-linear < 0.05) between certain VOC and sleep health. Adjusted QGC analysis highlighted LBXVBF as a crucial factor related to poor sleep quality (weighted 0.733). The BKMR analysis showed a positive trend between VOC levels (55th to 75th percentiles) and poor sleep pattern. Furthermore, the adjusted COX-RCS analysis identified LBXVME (P for non-linear = 0.0359) as a risk factor for all-cause mortality. This study investigated the non-linear association between VOC exposure and sleep function, suggesting that VOC exposure may be linked to poor sleep patterns among U.S. adults.
31. Medical Student Experiences of the Flows of Compassion in Medical Education: A Systematic Review and Meta-Aggregation.
期刊: Academic medicine : journal of the Association of American Medical Colleges 发表日期: 2026-Feb-03 链接: PubMed
摘要
Compassion is crucial for effective, patient-centered care, but its development in medical education is challenging due to its complexity, with explicit and implicit teaching approaches. A qualitative synthesis is needed to explore nuances and foster sustainable compassion in medical students. This review aims to investigate perceptions and experiences of the flows of compassion (from others, for others, and self-compassion) in medical education. For this qualitative systematic review and meta-aggregation, systematic searches were conducted using 7 major databases for studies published before July 5, 2024 (search date). Studies reporting qualitative data on the perceptions and experiences of medical students, educators, clinicians, or other relevant knowledge users with compassion in medical education were considered eligible. Two independent reviewers performed all screening as well as quality appraisal, data extraction, and certainty of evidence assessments for included studies with multiple relevant results. Meta-aggregation was guided by the Joanna Briggs Institute approach, forming categories from extracted results and synthesized findings overall. In total, 151 studies were included, from which extracted qualitative results were grouped into 30 categories, making 12 synthesized findings. Structured training and positive role modeling enhance compassionate care, whereas barriers such as burnout, negative role models, and restrictive clinical cultures hinder compassion. Formal and hidden curricula must integrate longitudinal compassion education, from assessments and clerkship instruction to faculty development, to foster compassion in medical education. Integrating both cultural and structural changes in medical education may enhance the flows of compassion.
32. Blood, Faith, and Medicine: The Christian World and the History of Transfusion in Europe and North America.
期刊: Journal of religion and health 发表日期: 2026-Feb-03 链接: PubMed
摘要
Blood has long held a central place in both religious symbolism and medical practice, carrying meanings that range from life, purity, and covenant to danger, impurity, and death. This article examines the historical relationship between blood, medicine, and Christian thought, focusing especially on how Christian traditions interpreted the emergence of blood transfusion. The study adopts a historical narrative approach, analyzing primary and secondary sources from Europe and North America. After outlining the theological meanings of blood-covenant, sacrifice, redemption, purity, and danger-the article traces key milestones in the scientific development of transfusion from early modern legends to twentieth-century advances. Particular attention is given to the ways in which various Christian denominations responded to transfusion as it entered clinical practice. While Catholic, Orthodox, Anglican, Lutheran, Reformed, and Methodist communities gradually embraced transfusion as a legitimate therapeutic act aligned with principles of charity and the preservation of life, other groups, most notably Jehovah’s Witnesses, adopted a restrictive interpretation of biblical texts that led to the rejection of transfusion and generated significant ethical and legal debates. By integrating medical history with theological perspectives, this article demonstrates that the reception of transfusion within Christian cultures was shaped not only by scientific progress but also by enduring religious understandings of blood as a symbol of life, redemption, and moral responsibility.
33. Evaluation of the relationship between noise exposure and arterial blood pressure and lipid profile disorders in wood industry workers: a cross-sectional study.
期刊: International archives of occupational and environmental health 发表日期: 2026-Feb-03 链接: PubMed
摘要
34. Reliability and validity of the Persian version of the arm function in multiple sclerosis questionnaire-short form (AMSQ-SF) for assessing upper limb function in multiple Sclerosis patients.
期刊: Disability and rehabilitation 发表日期: 2026-Feb-03 链接: PubMed
摘要
Upper extremity function is crucial for daily living activities. This study aimed to validate the Persian version of the 10-item Arm Function in Multiple Sclerosis Questionnaire-Short Form (AMSQ-SF) in individuals with multiple sclerosis (MS). In this cross-sectional study involving 201 individuals with MS, the AMSQ-SF was evaluated for reliability (test-retest in 50 participants) and construct validity against a battery of established performance-based and patient-reported outcome measures. Spasticity and disability levels were employed to evaluate the questionnaire’s ability to differentiate between various subgroups. The Persian AMSQ-SF demonstrated excellent reliability (ICC(2,1) = 0.94) and internal consistency (α = 0.95). Its strong construct validity was evidenced by correlations in the hypothesized directions with measures of grip strength, quality of life, self-reported function, dexterity, and fatigue. It differentiated patients with and without spasticity and various disability levels (p < 0.001). Clinically useful cutoff scores were established to classify impairment severity (mild ≥16, moderate ≥20, severe ≥26) with high sensitivity (70-81%) and specificity (85-95%). The AMSQ-SF demonstrates strong validity and reliability as a questionnaire for individuals with MS, suitable for use in both research and rehabilitation settings. The Arm Function in Multiple Sclerosis Questionnaire-Short Form (AMSQ-SF) is a concise, 10-item tool adapted from the original 31-item version, designed to assess upper limb function in people with multiple sclerosis (MS).Its brevity makes it a practical and cost-effective instrument for efficient clinical assessment and monitoring.Due to its excellent test-retest reliability (ICC(2,1) = 0.94), clinicians can confidently use the Persian AMSQ-SF to track changes in upper limb function over time or in response to interventions.Therapists should apply the established cutoff scores (mild: ≥16, moderate: ≥20, severe: ≥26) to interpret individual results and tailor the intensity of rehabilitation accordingly.
35. Cumulative chemical risk and associated toxic effect classes across US industries from regulatory inspections.
期刊: Annals of work exposures and health 发表日期: 2026-Feb-02 链接: PubMed
摘要
Workers are often exposed to multiple chemical agents, which should be accounted for in risk assessment. However, few data are yet available to prioritize specific agents, toxic effects, or industries for cumulative risk assessment (CRA). This study aimed to characterize the cumulative chemical risk in US workplaces using over 600,000 exposure measurements carried out in numerous industries by the Occupational Safety and Health Administration (OSHA), to quantify the frequency of cumulative risk exceedances, and to identify recurring combinations of agents associated with these elevated risks. Data on airborne exposure to 195 chemical agents from the OSHA database for the period 1971 to 2021 were grouped by workplace situation (WS, a job title within a company within a calendar year) to observe the co-presence of chemicals. WSs were then linked via their chemicals to one or several toxicological classes from MiXie, a tool which systematically associates several hundreds of chemicals to a standard list of 24 toxicological classes. CRA was then conducted for all WSs across toxicological classes by calculating the agent-specific hazard quotients (HQ, ratio of a chemical measurement to its occupational exposure limit) and summing them into the WS- and class-specific hazard index (HI, sum of HQ of chemicals relevant to a toxicological class). WSs with HI > 1 were flagged as “hazardous,” and hazardous WSs with all HQ < 1 were flagged as “missed risk” as assessment of a single agent would not have detected overexposure. Frequent itemset mining (FIM) was used to identify frequent combinations of chemicals in hazardous multiexposed WSs, by toxicological class and across 51 industry groups. From 607,676 measurements, 38,512 unexposed WSs and 123,118 exposed WSs were identified. Among the latter, 33% were considered multiexposed (median 3 agents/WS). The following toxicological classes were associated with more than half of all exposed WSs: Carcinogenicity and/or mutagenicity (60%), central nervous system damage (58%), lower airway damage (54%), and upper airway damage (53%). Toxicological classes co-occurred frequently across WSs, with 94% of WSs linked to ≥2 classes. Clustering analyses revealed strong co-association patterns, especially between irritation effects (eyes/airways) and between metal-related effects (blood/kidney/nervous system). Across the 24 toxicological classes, the proportion of hazardous WSs among multiexposed WSs was highest for carcinogenicity and/or mutagenicity (65%), while the proportion of missed risk among hazardous multiexposed WSs was highest for ototoxicity (19%). Among all industries, the highest proportion of hazardous multiexposed WSs was in boat building and repairing (81%), while the highest proportion of missed risk was in general industrial machinery and equipment (30%). FIM revealed recurring hazardous combinations of agents-primarily involving solvents and metals-which varied across toxicological classes and industries (eg toluene/xylene and copper compounds/iron oxides frequent for upper airway damage; toluene/styrene/acetone frequent for boat building and repairing). Overall, our study suggests that workers in US workplaces are often exposed to hazardous combinations of chemical agents targeting a wide variety of organ systems. Our results should help prioritize industries and agents likely necessitating CRA.
36. Travel Time to Opioid Treatment Programs in Connecticut-Still Waiting for Methadone.
期刊: JAMA network open 发表日期: 2026-Feb-02 链接: PubMed
摘要
37. Blended Delivery of a Primary Care Parenting Program for Child Development: A Randomized Clinical Trial.
期刊: JAMA network open 发表日期: 2026-Feb-02 链接: PubMed
摘要
There is substantial evidence that programs that build parents’ abilities to support early learning benefit children’s development. Evidence is needed on how to integrate and scale these programs within government services. To determine whether a parenting program implemented by government primary health care services and combining in-person and remote delivery benefits children’s development and parenting attitudes and behaviors. In this single-blind randomized clinical trial, enrollment began in July 2022 in primary health care centers in Jamaica. The intervention was phased in from September 2022 to August 2023 and lasted 8 months. Data collection ended in April 2024. Families with children aged 3 to 28 months from communities served by the centers were identified by health staff. Following eligibility checks and informed consent, families were randomly assigned to intervention or waiting list control. The intervention aimed to strengthen parents’ skills in helping their child learn through play and responsive interactions. Community health workers used a curriculum with age-appropriate play and language activities and made fortnightly contacts with families, alternating between home visits and telephone calls. Child development was measured with the Griffiths Mental Development Scales and parenting behaviors (involvement, responsivity, acceptance, and learning materials) with the Home Observation for Measurement of the Environment (HOME). Effect size (ES) was calculated by dividing the regression coefficient by the pooled-sample SD. A total of 627 children were enrolled (311 intervention and 316 control; 322 [51.4%] male). At follow-up, 491 children (78.3%) were assessed, 237 (76.2%) of those in the intervention group and 254 (80.4%) in the control group. Children’s mean (SD) age at follow-up was 27.0 (5.8) months in the control and 27.0 (6.1) months in the intervention group. A total of 393 mothers (62.7%) had completed secondary school. There were no significant differences in follow-up rate or characteristics between groups. Intention-to-treat multivariate regression analyses with inverse probability weights showed benefits for children’s overall developmental quotient (ES, 0.17 SD; 95% CI, 0.01-0.33 SD), fine motor ability score (ES, 0.19 SD; 95% CI, 0.03-0.36 SD), and parent behaviors (HOME score ES, 0.25 SD; 95% CI, 0.08-0.41 SD). In this randomized clinical trial of a parenting program delivered through primary health care, the intervention benefited child development and parenting. Findings suggest combining in-person and remote methods may be a useful strategy for scaling. ISRCTN Registry Identifier: ISRCTN11059214.
38. Reproductive Shifts and Ovarian Cancer Risk in Women Aged 40 Years or Older.
期刊: JAMA network open 发表日期: 2026-Feb-02 链接: PubMed
摘要
Reproductive factors are associated with ovarian cancer risk, but their influence may differ across menopausal status and birth cohorts. To examine the associations between reproductive factors and ovarian cancer risk stratified by menopausal status and birth cohort. This nationwide population-based cohort study obtained data from the National Health Insurance Service (NHIS), a single-payer system covering 97% of the population in South Korea. Women aged 40 years or older who underwent NHIS health screening in 2009 and had reproductive, clinical, and other data were included and followed up until ovarian cancer diagnosis, death, or December 31, 2022. Data were analyzed in March 2025. Age at menarche, parity, breastfeeding duration, oral contraceptive use, age at menopause, total reproductive span, and hormone replacement therapy use. Incident ovarian cancer identified from NHIS claims with International Statistical Classification of Diseases and Related Health Problems, Tenth Revision codes C56, C57, and C48 and confirmed through the Rare/Intractable Disease Registry (code V193). Cox proportional hazards regression models estimated hazard ratios (HRs) and 95% CIs. A total of 2 285 774 women (932 637 [40.8%] premenopausal, 1 353 137 [59.2%] postmenopausal; mean [SD] age, 54.9 [10.85] years) were included in the final analytic cohort. The mean (SD) follow-up duration overall was 10.7 (2.99) years, and 10 729 ovarian cancer cases were identified during follow-up. Early menarche (aged ≤12 vs >16 years) was associated with higher ovarian cancer risk in both premenopausal women (HR, 1.37; 95% CI, 1.16-1.61) and postmenopausal women (HR, 1.24; 95% CI, 1.00-1.54). Parity of 2 or more births was associated with lower risk in both groups (HR, 0.68 [95% CI, 0.58-0.79] and 0.71 [95% CI, 0.60-0.85]). Breastfeeding for 12 months or longer and oral contraceptive use for 1 year or longer were associated with lower risk in premenopausal women but not postmenopausal women (HR, 0.86 [95% CI, 0.77-0.96] and 0.75 [95% CI, 0.61-0.93]). Among postmenopausal women, later menopause (at age ≥55 years; HR, 1.36 [95% CI, 1.11-1.66]), longer reproductive span (≥40 years; HR, 1.21 [95% CI, 1.09-1.34]), and hormone replacement therapy use for 2 to 5 years (HR, 1.20 [95% CI, 1.07-1.34]) were associated with higher risk. Parity-related risk reduction was attenuated in the 1960s birth cohort (HR, 1.07; 95% CI, 0.52-2.19; P for interaction = .36). This cohort study found that reproductive factors were associated with ovarian cancer risk, with distinct patterns across menopausal status and birth cohorts. These findings highlight the need for tailored prevention strategies in aging, low-fertility populations.
39. Socioeconomic Status and Postpartum Depression Risk After the Dobbs v Jackson Women's Health Organization Decision, Based on State Trigger Laws.
期刊: JAMA network open 发表日期: 2026-Feb-02 链接: PubMed
摘要
The 2022 Supreme Court decision in Dobbs v Jackson Women’s Health Organization resulted in immediate abortion bans or severe restrictions in 22 US states. While mental health consequences of restricted abortion access have been suggested, their distribution across socioeconomic strata remain unclear for postpartum depression (PPD) among Medicaid populations. To assess associations of state-level abortion bans enacted after Dobbs with the incidence of PPD, focusing on socioeconomic status (SES) differences. This retrospective cohort study used a difference-in-differences (DD) analysis for Medicaid claims data from Kythera Labs (approximately 60% of US Medicaid population) from January 2019 to December 2024. Women and adolescents aged 12 to 55 years with pregnancies resulting in live births or stillbirths were stratified into SES terciles based on zip code-level census data. State-level abortion bans or restrictions implemented after Dobbs, defined by residence in trigger law states. The primary outcome was incidence of PPD within 12 months following delivery, identified through validated claims-based algorithms. The study comprised 102 597 individuals pre-Dobbs (mean [SD] age, 27.21 [5.82] years; 47 305 individuals in trigger states and 55 292 individuals in nontrigger states) and 61 113 individuals post-Dobbs (mean [SD] age, 27.48 [5.92] years; 30 451 individuals in trigger states and 30 662 individuals in nontrigger states). Individuals in trigger states were younger than individuals in nontrigger states both pre-Dobbs (mean [SD] age, 26.53 [5.69] years vs 27.97 [5.84] years) and post-Dobbs (mean [SD] age, 26.61 [5.77] years vs 28.34 [5.94] years). Both pre- and post-Dobbs, individuals in trigger states were more likely to reside in rural areas (pre-Dobbs: 10 562 individuals [22.33%] vs 10 079 individuals [18.23%]; post-Dobbs: 6739 individuals [22.13%] vs 5220 individuals [17.02%]) and low-SES areas (pre-Dobbs: 20 136 individuals [42.57%] vs 13 771 individuals [24.91%]; post-Dobbs: 12 924 individuals [42.44%] vs 7283 [23.75%]); they were less likely to have obstetrical complications (pre-Dobbs: 31 243 individuals [66.05%] vs 42 780 individuals [77.37%]; post-Dobbs: 21 052 individuals [69.13%] vs 24 577 individuals [80.15%]) or maternal complications (pre-Dobbs:7732 individuals [16.34%] vs 10 839 of individuals [19.60%]; post-Dobbs: 5779 of 30 451 individuals [19.04%] vs 6508 individuals [21.17%]). Women with lowest SES residing in trigger states experienced a 9.0% relative increase in PPD diagnoses post-Dobbs vs similar women in nontrigger states (DD coefficient, 0.090; 95% CI, 0.035-0.146; P = .001). No associations were observed in middle or high SES groups. In this cohort study, state-level abortion bans following Dobbs were associated with a disproportionate increase in the risk of PPD among women and adolescents in low-SES communities. These findings underscore the need for targeted mental health support and policy interventions to mitigate the unequal burden of such legislation on vulnerable populations.
40. Travel Time to Methadone Treatment Via Personal Vehicle vs Public Transit.
期刊: JAMA network open 发表日期: 2026-Feb-02 链接: PubMed
摘要
The requirement for in-person, often daily, attendance at opioid treatment programs (OTPs) makes travel times a barrier to methadone treatment. Research on methadone accessibility has primarily focused on travel via personal vehicle, and there is uncertainty about public transit travel time to methadone treatment. To estimate travel time via personal vehicle vs public transit to methadone treatment in the state of Connecticut. This cross-sectional study included geospatial analysis of median travel time to nearest OTP via personal vehicle and public transit from all census block groups (CBGs). This study took place in the state of Connecticut in 2023. Participants were all CBGs in Connecticut. Participants were characterized by racial and ethnic demographics; household income; car ownership; urban, suburban, or rural designations; and per-capita opioid overdose deaths. The primary outcome was the median travel time to nearest OTP by via personal vehicle and public transit. Spatial error models using k-nearest neighbor spatial weight matrices were estimated to assess the associations between sociodemographic characteristics and travel times for each transportation mode (personal vehicle vs public transit) at the CBG level. From the centroids of the 2702 CBGs in Connecticut, the median (IQR) travel time to the closest OTP was 11.0 (7.5-16.3) minutes by personal vehicle and 41.7 (31.0-49.5) minutes via public transit, with 1431 CBGs (53%) lacking access to public transit or having high public transit times (>60 minutes or no trip available). Travel times via public transit increased along the urban-rural gradient and across CBGs with an increasing percentage of non-Hispanic White residents. Median (IQR) travel times to an OTP from the 489 CBGs with the highest per-capita overdose death rates were 8.2 (5.9-11.7) minutes by personal vehicle and 37.6 (27.8-48.5) minutes by public transit, with 166 (34%) lacking public transit access. The findings of this cross-sectional study of barriers to access to methadone treatment suggest that areas with high overdose death rates, low car ownership, and high public transit travel times should be targets for interventions (eg, mobile services or greater use of take-home doses for patients) to lower travel-based barriers to methadone. Current federal statutes and regulations governing methadone provision are the greatest barrier, as they directly require often daily transit to opioid treatment clinics. Reducing this barrier requires policy changes.
41. Risk of Cardiorespiratory Events Following Respiratory Syncytial Virus-Related Hospitalization.
期刊: JAMA network open 发表日期: 2026-Feb-02 链接: PubMed
摘要
Respiratory syncytial virus (RSV) may trigger cardiorespiratory events in adults. To assess the risk of cardiorespiratory events in the 180 days following RSV-related hospitalization compared with a control period in adults. This self-controlled case series study had an observation period from January 1, 2017, through March 31, 2024. Data were obtained from the deidentified Optum Market Clarity Dataset, including RSV-related hospitalization and associated outcomes, which were identified based on diagnosis codes. Adults with 1 or more RSV-related hospitalizations and 1 or more cardiorespiratory events (myocardial infarction [MI], stroke, chronic obstructive pulmonary disease [COPD] exacerbation, congestive heart failure [CHF] exacerbation, and arrhythmia) were included. RSV-related hospitalization. A conditional Poisson regression model was fitted to compare the incidence of cardiorespiratory events during the risk period (ie, ≤180 days after RSV-related hospital index date) and control periods (ie, >21 days before or >180 days after the index date). Incidence rate ratios (IRRs) and 95% CIs were estimated and adjusted for time-varying covariates. A total of 11 887 patients (mean [SD] age, 69.4 [15.5] years; 7303 females [61.4%]) with RSV-related hospitalization were included. An increased risk was associated with each cardiorespiratory event during the first 14 days following RSV-related hospitalization, with the highest IRR estimates observed in the initial 7 days. For MI, the IRRs were 8.7 (95% CI, 6.7-11.2) during days 1 to 7, decreasing to 5.2 (95% CI, 3.7-7.2) during days 8 to 14 and 2.6 (95% CI, 1.6-4.3) during days 15 to 21. For stroke, the IRRs were 7.4 (95% CI, 5.5-10.1), 5.9 (95% CI, 4.2-8.3), and 3.7 (95% CI, 2.3-5.9) during the first 3 weeks with a similar pattern for CHF exacerbation (12.5 [95% CI, 10.5-14.8], 4.1 [95% CI, 3.1-5.5], and 2.4 [95% CI, 1.6-3.6], respectively). For COPD exacerbation and arrhythmia, the IRRs decreased during the first 3 weeks from 23.1 (95% CI, 20.2-26.5) through day 7 to 1.3 (95% CI, 0.8-2.4) during days 15 to 21 and from 16.5 (95% CI, 14.5-18.7) to 1.6 (95% CI, 1.1-2.5), respectively. This study demonstrated that RSV, similar to influenza and SARS-CoV-2, was associated with an increased risk of cardiorespiratory events 2 weeks following RSV-related hospitalization, and some conditions had significant risk elevations up to 180 days after admission. The findings reinforce the need to increase RSV immunization in adults.
42. Estimated Effectiveness of 2024-2025 COVID-19 Vaccination Against Severe COVID-19.
期刊: JAMA network open 发表日期: 2026-Feb-02 链接: PubMed
摘要
As SARS-CoV-2 JN.1 lineage descendants continue to evolve, evaluating COVID-19 vaccine effectiveness (VE) against severe COVID-19 remains important to guide vaccination strategies. To estimate the VE of the 2024-2025 COVID-19 vaccines against COVID-19-associated hospitalization and severe in-hospital outcomes overall and by time since dose (7-89, 90-179, and ≥180 days), JN.1 descendant lineage (KP.3.1.1, XEC, LP.8.1), and spike protein mutations associated with immune evasion. This multicenter, test-negative, case-control study conducted by the Investigating Respiratory Viruses in the Acutely Ill Network included adult patients (aged ≥18 years) hospitalized between September 1, 2024, and April 30, 2025, at 26 hospitals in 20 US states. Case patients presented with COVID-19-like illness and positive SARS-CoV-2 nucleic acid or antigen test results; control patients had COVID-19-like illness but tested negative for SARS-CoV-2. Receipt of a 2024-2025 COVID-19 vaccine at least 7 days before illness onset. Main outcomes were COVID-19-associated hospitalization and severe in-hospital outcomes (supplemental oxygen therapy, acute respiratory failure, intensive care unit admission, and invasive mechanical ventilation or death). Logistic regression was used to estimate the odds of vaccination in case and control patients, adjusting for demographics, clinical characteristics, and enrollment region. The VE was estimated as (1 - adjusted odds ratio) × 100%. A total of 8493 patients (median [IQR] age, 66 [54-76] years; 4338 female [51.1%]), including 1888 case patients with COVID-19 (among whom 951 [50.4%] had successful whole-genome sequencing, including 348 [36.6%] with KP.3.1.1, 218 [22.9%] with XEC, and 134 [14.1%] with LP.8.1 infections) and 6605 control patients were enrolled. Vaccine effectiveness against COVID-19-associated hospitalization was 40% (95% CI, 27%-51%), and protection was sustained through 90 to 179 days after vaccination. Vaccine effectiveness was higher against the most severe outcome of invasive mechanical ventilation or death at 79% (95% CI, 55%-92%). It was 49% (95% CI, 25%-67%) against hospitalization with KP.3.1.1, 34% (95% CI, 4%-56%) against XEC, and 24% (95% CI, -19% to 53%) against LP.8.1, with increasing median time since dose receipt among vaccinated case patients due to sequential circulation patterns (60, 89, and 141 days, respectively). The VE was similar against lineages with spike protein S31 deletion (41% [95% CI, 22%-56%]) and T22N and F59S substitutions (37% [95% CI, 9%-57%]). In this multicenter, case-control analysis of VE, 2024-2025 COVID-19 vaccines may have provided protection against hospitalizations and severe in-hospital outcomes as multiple JN.1 descendant lineages circulated. Monitoring COVID-19 VE, including stratifying by SARS-CoV-2 lineage and spike protein mutations, remains important to guide COVID-19 vaccine composition and recommendations.
43. Depression and Crime Across Different Neighborhoods in the Swedish General Population.
期刊: JAMA network open 发表日期: 2026-Feb-02 链接: PubMed
摘要
Depression and factors reflecting neighborhood social structure (ie, socioeconomic deprivation, ethnic heterogeneity, residential mobility, and urbanicity) have each been linked to criminal convictions. However, how the association between depression and crime varies across different neighborhood types, and the extent to which it reflects unmeasured familial confounding, remains unclear. To examine whether the association between depression and violent and nonviolent criminal convictions varies across neighborhood types, and to assess the extent to which unmeasured familial factors contribute to the association. This population-based matched cohort and sibling-comparison study used data from Swedish national registers from 1986 to 2020. Follow-up spanned from 2001 to 2020. Statistical analyses were performed from January to November 2025. The cohort included individuals with a diagnosis of depression, each matched to 5 population controls without depression by birth year, sex, and neighborhood type. Outpatient depression diagnosis (International Statistical Classification of Diseases and Related Health Problems, Tenth Revision codes F32-F33.9) recorded from 2001 to 2020. The primary outcomes were violent and nonviolent criminal convictions after diagnosis, identified through the National Crime Register. Conditional logistic regression estimated odds ratios (ORs) across 4 neighborhood types (resource-limited, rural low-diversity, urban professional, and urban affluent neighborhoods), with sibling comparisons used to assess familial confounding. Among 571 470 matched individuals, 95 245 (36 297 male [38.1%]; median [IQR] age at first diagnosis, 20 [17-24] years) had depression. Depression was associated with increased odds of both violent and nonviolent convictions across all neighborhood types in unadjusted models. After adjustment for prior convictions, substance use disorder, and attention-deficit/hyperactivity disorder, associations remained significant in all but resource-limited neighborhoods (violent conviction OR, 1.14 [95% CI, 0.97-1.33]; nonviolent conviction OR, 1.01 [95% CI, 0.92-1.11]). A second sample included 42 585 individuals with depression and their full siblings without depression (total, 85 170 individuals). Sibling comparisons showed partial attenuation, indicating that familial confounding accounted for some, but not all, of the associations. Sibling-matched estimates were largely consistent with fully adjusted general population-matched estimates (eg, violent convictions in rural low-diversity neighborhoods: sibling-matched OR, 1.50 [95% CI, 1.33-1.69] vs general population-matched OR, 1.51 [95% CI, 1.39-1.65]). In this cohort study of the Swedish general population, the association between depression and criminal convictions varied across neighborhood types and was partially explained by familial factors. These findings underscore the relevance of considering contextual and familial influences and may offer insights for prevention and intervention strategies responsive to neighborhood social environments.
44. Cost-Effectiveness of Pregabalin, Duloxetine, and Milnacipran vs Amitriptyline for Moderate to Severe Fibromyalgia.
期刊: JAMA network open 发表日期: 2026-Feb-02 链接: PubMed
摘要
Fibromyalgia (FM) is a chronic pain condition associated with substantial quality-of-life impairments and economic burden. Although multiple pharmacologic options are recommended in clinical guidelines, the relative cost-effectiveness of off-label amitriptyline compared with FDA-approved treatments remains poorly defined due to a scarcity of direct economic comparisons and the use of heterogenous outcome measures in the extant literature. To evaluate the cost-effectiveness of pregabalin, duloxetine, and milnacipran compared with amitriptyline in adults with moderate to severe FM. Decision analytical model using a Markov cohort state transition model to estimate lifetime costs and quality-adjusted life-years (QALYs) for each investigated pharmacologic strategy. Model inputs included treatment-specific transition probabilities, utility values, and direct and indirect costs for each health state, which were derived from published sources. The simulated cohort reflected adults (aged ≥18 years) with moderate to severe FM. Data were analyzed between September 2024 and February 2025. Amitriptyline (25-100 mg), pregabalin (150, 300, 450, and 600 mg), duloxetine (60 and 120 mg), and milnacipran (100 and 200 mg), evaluated from US health care payer and societal perspectives. Expected lifetime cost, QALYs, incremental cost-effectiveness ratios (ICERs), and incremental net monetary benefit (iNMB) at willingness-to-pay (WTP) thresholds of $50 000, $100 000, and $150 000 per QALY. The simulated cohort included predominantly women (94.4%), had a mean (SD) age of 48.4 (10.4) years, and was parameterized using demographic distributions derived from published FM populations. From the US health care payer perspective, duloxetine 120 mg was associated with increased QALYs versus amitriptyline at slightly higher cost (ICER, $1536 per QALY), while pregabalin 450 mg was dominated by duloxetine 120 mg. When societal costs were considered, duloxetine 120 mg and pregabalin 450 mg were cost saving relative to amitriptyline. Amitriptyline remained both more effective and less costly than milnacipran, lower doses of pregabalin and duloxetine, and no treatment. At a $100 000 WTP threshold, iNMB for duloxetine 120 mg was $40 375 from the health care payer perspective and $70 063 from the societal perspective; for pregabalin 450 mg, iNMB was $21 211 and $40 190 for the health care payer and societal perspectives, respectively. In this decision analytical model, duloxetine 120 mg was the preferred strategy across perspectives; pregabalin 450 mg was economically favorable relative to amitriptyline only when societal costs were included. Amitriptyline provided greater net benefit than milnacipran and the lower doses of pregabalin and duloxetine. These findings may help inform the selection of value-based treatments for moderate to severe FM.
45. Validation of Claims-Based Algorithms to Classify Thoracic Radiation Therapy Courses.
期刊: JCO clinical cancer informatics 发表日期: 2026-Feb 链接: PubMed
摘要
Routinely collected administrative data provide insights into health care utilization and outcomes but lack detailed clinical information, such as the specific site and intent of radiation therapy (RT). This study aimed to validate claims-based algorithms to accurately identify thoracic RT (TRT) and curative-intent RT in administrative databases. Patients at our institution with lung cancer and any RT Current Procedural Terminology (CPT) code from October 2015 to January 2024 were analyzed. RT claims were organized by treatment episode, and RT details were manually abstracted from the electronic health record to classify episodes as TRT or non-TRT and curative or noncurative. A priori algorithms were defined as the presence of respiratory motion management codes, >14 treatment codes (except for stereotactic body RT [SBRT] courses), with or without exclusive thoracic malignancy diagnosis codes. Positive predictive value (PPV) was computed for each episode, stratified by modality (three-dimensional conformal RT [3DCRT], intensity-modulated RT [IMRT], and SBRT). Algorithms were considered acceptable if the lower bound of the Clopper-Pearson 95% CI for PPV exceeded 70%. A total of 3,846 RT episodes were analyzed. The primary a priori TRT algorithm achieved a PPV of 97% (95% CI, 96 to 98) for IMRT, 99% (95% CI, 97 to 99) for SBRT, and 87% (95% CI, 81 to 92) for 3DCRT. Performance declined when exclusive thoracic malignancy diagnosis codes were excluded. For curative-intent RT, PPVs were 87% for IMRT, 90% for SBRT, and 55% for 3DCRT. Clinically informed algorithms can accurately identify TRT in claims data, achieving high PPVs particularly for IMRT and SBRT courses. These algorithms can be applied in claims databases to assess RT toxicity and effectiveness. External validation across diverse data sets will be important to confirm generalizability.
46. Cost Analysis of Physical Activity Interventions Among Latino Older Adults: A Systematic Review and Policy Recommendations.
期刊: Journal of gerontological nursing 发表日期: 2026-Feb 链接: PubMed
摘要
The current systematic review examined how community-based physical activity (PA) interventions for Latino older adults assessed intervention costs, health care utilization costs, and overall cost-effectiveness. Five databases were searched for U.S.-based studies published from 2021 to 2025 that (a) assessed community-based PA interventions; (b) evaluated cost-effectiveness, reported intervention cost, and utilization data; (c) included populations aged ≥55 years; and (d) focused on Latino/Hispanic participants. Data were extracted on cost measurement methods, health care utilization metrics, and economic evaluation outcomes. Few eligible studies met full criteria, and most interventions reported general program costs, whereas only a few incorporated health care utilization or conducted formal cost-effectiveness analyses. Programs that measured PA improvements generally demonstrated favorable cost patterns but lacked standardized reporting. Among the few interventions that included Latino participants, results were typically reported in combination with other racial or ethnic groups, limiting the ability to interpret cost and cost-effectiveness outcomes specific to Latino older adults. The limited and inconsistent economic evaluation of community-based PA programs for Latino older adults highlights the need for more studies to evaluate intervention, utilization costs, and cost effectiveness reporting. Strengthening economic evaluations can guide resource allocation, support culturally tailored program development, and promote translating trial-based evidence into practical public policy for healthy aging.
47. Neurosurgical care for pediatric isolated severe traumatic brain injury in American College of Surgeons Committee on Trauma-verified pediatric trauma centers is accompanied by improved outcomes compared with care in adult trauma centers.
期刊: The journal of trauma and acute care surgery 发表日期: 2026-Jan-21 链接: PubMed
摘要
The American College of Surgeons Committee on Trauma level verification system directs severely injured patients to specialized centers, a strategy that has been associated with improved outcomes. The correlation between outcome of pediatric trauma patients requiring surgical procedures and verification status of the treating institution is not well established. This study aims to examine the association between outcomes following isolated severe traumatic brain injury (iSTBI) and pediatric trauma center (PTC) verification status. This study analyzed data from the American College of Surgeons Trauma Quality Improvement Program for pediatric patients (<18 years) from 2013 to 2021 with iSTBI, defined as a head Abbreviated Injury Scale score ≥3 for intracranial pathology and Abbreviated Injury Scale score ≤1 in all other regions, resulting from blunt trauma and requiring neurosurgical intervention. Patients treated at Level I or Level II adult trauma centers without pediatric verification (ATCs) were compared with those treated at PTCs. Demographics, injury characteristics, and outcomes were collected. Inverse probability weighting was applied to adjust for baseline differences. A total of 1,894 pediatric patients with surgically managed iSTBI, of whom 53% (n = 1,007) receiving treatment at a PTC, were included for further analysis. Following inverse probability weighting, treatment at a PTC correlated with a 30% lower risk of in-hospital mortality (relative risk, 0.70; 95% confidence interval, 0.55-0.90; p = 0.005) and a 63% decrease in the probability of failure-to-rescue (relative risk, 0.37; 95% confidence interval, 0.22-0.65; p < 0.001], in comparison to treatment at an ATC. Pediatric patients with iSTBI requiring neurosurgical intervention experience significantly reduced mortality and failure-to-rescue rates when treated at the American College of Surgeons Committee on Trauma-verified PTCs compared with ATCs. Therapeutic; Level III.
48. Reply to: Blood-Brain Barrier Heterogeneity in NRG BN007: Implications for Immunotherapy Delivery.
期刊: Journal of clinical oncology : official journal of the American Society of Clinical Oncology 发表日期: 2026-Jan-16 链接: PubMed
摘要
49. When the System Is the Treatment: Rethinking Nonpharmacologic Breakthroughs in Oncology.
期刊: Journal of clinical oncology : official journal of the American Society of Clinical Oncology 发表日期: 2026-Jan-16 链接: PubMed
摘要
50. Prediction of one-year cognitive decline via self-perceived memory in older adults during the COVID-19 pandemic.
期刊: JAR life 发表日期: 2026 链接: PubMed
摘要
Subjective memory complaints (SMC) are associated with increased risk of cognitive decline and dementia. SMCs are also influenced by mood and anxiety symptoms, which increased among older adults during the COVID-19 pandemic. We investigated whether a single-item SMC measure predicts one-year cognitive decline and whether this predictive relationship remained stable during the early COVID-19 period (2020). We analyzed longitudinal data (2011-2023) from the National Health And Aging Trends Study (NHATS), an annual survey of Medicare beneficiaries in the United States. Mixed-effects models assessed the association between self-perceived memory worsening and next-year cognitive outcomes, and tested whether this association differed in 2020. A total of 33,244 observations from 6676 elderly individuals were included. Higher age, male sex, non-white race, education at or below high school level, lower scores on basic and instrumental activities of daily living, poorer social activity, anxiety symptoms, lower annual income, and self-perceived memory decline each predicted worse cognitive function one year later. However, the interaction between self-perceived memory decline and the COVID-19 pandemic (in 2020) was not significant. A single-item measure of self-perceived memory decline effectively predicts next-year cognitive decline in older adults, independent of the broader social impacts observed during the 2020 COVID-19 pandemic.
51. Alcohol-Related Hospitalizations From 2016 to 2022.
期刊: JAMA network open 发表日期: 2025-Dec-01 链接: PubMed
摘要
Unhealthy alcohol use contributes to a high rate of mortality. While alcohol use increased during the COVID-19 pandemic, recent trends in alcohol-related hospitalizations are unknown. To examine US trends in the rate and outcomes of alcohol-related hospitalizations from 2016 to 2022. This serial cross-sectional study examined hospitalizations among adults aged 18 years or older who were sampled in the National Inpatient Sample, weighted to reflect nationally representative estimates. Data were examined from April to October 2025. The primary outcome was alcohol-related hospitalizations, defined using discharge diagnosis codes. Hospitalizations were categorized as primary alcohol use disorder (AUD), primary alcohol-related medical complication, and secondary alcohol-related diagnosis based on discharge diagnosis codes. Secondary outcomes included in-hospital mortality, length of stay, cost of hospitalizations, and discharge disposition. This study included a weighted 12 912 240 alcohol-related hospitalizations (age 50 to 64 years, 40.4% [95% CI, 40.3%-40.5%]; male, 71.5% [95% CI, 71.4%-71.6%]; Black, 15.6% [95% CI, 15.3%-15.9%]; Hispanic, 11.2% [95% CI, 10.9%-11.4%]; White, 64.9% [95% CI, 64.5%-65.3%]). From 2016 to 2022, the annual rate of alcohol-related hospitalizations per 100 000 remained stable from 721 in 2016 to 688 in 2022 (annual percentage change [APC], -0.43; 95% CI, -1.28 to 0.49) but increased from 70 to 83 among hospitalizations for alcohol-related medical complications (APC, 3.56; 95% CI, 2.19 to 4.94). Trends across demographic groups differed by reasons for hospitalization. In-hospital mortality increased from 2.4% (95% CI, 2.3% to 2.5%) in 2016 to 3.1% (95% CI, 3.0% to 3.2%) in 2022 (P < .001). Mean length of stay increased from 5.6 (95% CI, 5.6 to 5.7) to 6.2 (95% CI, 6.1 to 6.3) days (P < .001), and the rate of self-directed discharges increased from 5.0% (95% CI, 4.8% to 5.2%) to 6.3% (95% CI, 6.1% to 6.5%) (P < .001). Hospitalization costs increased even after accounting for inflation and amounted to $32.6 billion in 2022. In this serial cross-sectional study of nationally representative administrative data from 2016 and 2022, the rate of alcohol-related hospitalizations was stable while mortality, length of stay, and health care costs all increased. Preventive efforts are needed to improve outcomes and reduce health care spending by reducing population-level alcohol consumption and engaging patients in AUD treatment before progression to alcohol-related hospitalizations.