公共卫生研究摘要 (2026-02-05)
共收录 59 篇研究文章
1. Impact of Etiology on Mortality and Recovery in Patients With Status Epilepticus.
期刊: Neurology 发表日期: 2026-Mar-10 链接: PubMed
摘要
Although etiology is considered central to outcomes in status epilepticus (SE), previous studies often lacked standardized classification and adjustment for confounders, particularly withdrawal of life-sustaining treatment (WLST). This study examined the association between SE etiology, mortality, and neurologic recovery using the International League Against Epilepsy (ILAE) classification while accounting for confounders and WLST. This 2-center observational study included adults (≥18 years) with SE treated at the University Hospitals of Basel and Geneva from 2015 to 2023. Etiologies were classified as acute symptomatic, remote symptomatic-unprovoked, progressive CNS disorders, epilepsy without additional triggers, or cryptogenic. Demographics, SE type, SE severity score, Charlson Comorbidity Index, treatment data, complications, and WLST were assessed. The primary outcome was in-hospital mortality; secondary outcomes were 30-day mortality and recovery to premorbid neurologic function at discharge. Associations were assessed using Poisson regression with robust error variance, adjusted for age, nonconvulsive SE (NCSE) with coma, comorbidity, and center. Among 967 patients (median age 67 years, interquartile range 54-78; 46.5% female), SE was terminated in 95%, with 48.5% of patients recovering to premorbid function. Acute symptomatic SE accounted for 34.2%, remote symptomatic SE for 27.6%, SE due to progressive CNS disorders for 14.4%, epilepsy without additional triggers for 16.7%, and cryptogenic SE for 7.1%. In-hospital and 30-day mortality were 7.9% and 13.9%, respectively, while 48.5% recovered to premorbid function. Etiology was associated with neurologic recovery, with intracranial hemorrhage (relative risk [RR] 0.49, 95% CI 0.35-0.67) and acute symptomatic SE (RR 0.71, 95% CI 0.60-0.83) being associated with reduced likelihood of recovery, whereas known epilepsy was associated with increased likelihood of recovery (RR 1.40, 95% CI 1.23-1.60). NCSE with coma (11.9%) was independently associated with higher in-hospital and 30-day mortality and reduced recovery across all ILAE etiology groups. WLST did not significantly alter these associations. Etiology was associated with neurologic recovery but not with short-term mortality after adjustment for confounders and WLST. By contrast, NCSE with coma showed the strongest association with adverse outcomes. This suggests that while etiology informs prognosis for recovery, SE type, particularly NCSE with coma, is the more critical determinant of survival.
2. Evaluating the Modified Barthel Index for Policy and Practice in Reablement: Lessons From Australia's Short-Term Restorative Care Program.
期刊: Australasian journal on ageing 发表日期: 2026-Mar 链接: PubMed
摘要
The Modified Barthel Index (MBI) is the sole reporting metric required by the Australian Government for the Short-Term Restorative Care program (STRC). This study investigated the suitability of the MBI as an outcome measure of functioning/self-care ability in the older Australian reablement context. This was a retrospective cohort study where historical data from 921 participants involved in the STRC between January 2018 to March 2023 were collected from an aged care provider located in Australia. This study compared STRC program responders and non-responders based on MBI across a range of demographic variables. Additionally, Generalised Linear Modelling was performed to investigate the utility of the MBI to inform changes to the delivery of the intervention. Although the MBI was able to show significant differences between responders and non-responders at baseline (p ≤ 0.05), this is likely due to the sample size used. It was identified that the MBI suffers from a ceiling effect in the studied population. Therefore, the ability of the MBI to inform evidence-based changes relating to program delivery is limited. This study provides a solid evidence base to guide the implementation of assessments in future programs and studies. This is due to the identification of limitations of the sole reporting metric used in the program. Based on findings throughout this manuscript, a range of standardised assessments dependent on the participant’s goals should be implemented in future programs, such as the Restorative Care Pathway in the Support at Home program.
3. Comparative Effectiveness of Disease-Modifying Treatments in Double Seronegative Neuromyelitis Optica Spectrum Disorder.
期刊: Neurology(R) neuroimmunology & neuroinflammation 发表日期: 2026-Mar 链接: PubMed
摘要
Double seronegative NMOSD (DS-NMOSD) lacks approved disease-modifying treatments, and limited data exist on optimal relapse-prevention strategies. In this multicenter, international, retrospective cohort study, we sought to compare the real-world effectiveness of anti-CD20 agents vs nonspecific immunosuppressants as disease-modifying strategies for relapse prevention in DS-NMOSD. A retrospective cohort database was constructed using standardized data collection from medical records across collaborating centers in the United States, Brazil, the United Kingdom, Thailand, Turkiye, and China. Patients meeting IPND-2015 NMOSD criteria with negative serum aquaporin-4 and myelin oligodendrocyte glycoprotein antibody testing via cell-based assays and at least 12 months of follow-up were reviewed. The primary outcome was the incidence rate ratio (IRR) of relapses; secondary outcomes included the annualized relapse rate (ARR) and time to relapse. A total of 103 patients with DS-NMOSD met study criteria, with a median follow-up of 6 years. Anti-CD20 therapy was associated with a significantly lower IRR (0.02, 95% CI 0.01-0.04) and ARR (0.17, 95% CI 0.07-0.40) compared with nonspecific immunosuppressants (0.76, 95% CI 0.40-1.43) after adjusting for covariates. Survival analysis demonstrated a prolonged relapse-free interval with anti-CD20 agents. Our findings support the use of B-cell depletion as a potentially superior relapse-prevention strategy in DS-NMOSD, highlighting its potential as a first-line therapy. This study provides Class IV evidence that, in patients with DS-NMOSD, treatment with a DMT reduces relapse incidence rate ratio compared with no treatment and anti-CD20 DMTs are associated with a lower relapse incidence rate ratio compared with nonspecific immunosuppressants.
4. Cardiomyocyte-Derived USP20 Attenuates Diabetic Cardiomyopathy by Facilitating the Degradation of STING and Mitigating STING-Mediated Inflammation.
期刊: FASEB journal : official publication of the Federation of American Societies for Experimental Biology 发表日期: 2026-Feb-15 链接: PubMed
摘要
Although extensive clinical and basic research has been conducted on diabetic cardiomyopathy (DbCM), the therapeutic efficacy for this condition remains significantly limited. Ubiquitin-specific peptidase 20 (USP20), a deubiquitinating enzyme, plays an essential role in regulating protein ubiquitination and modulating various cellular processes. In this study, we aimed to investigate the effect of USP20 on the pathogenesis of DbCM, which may provide a novel therapeutic target for its treatment. The cardiomyocyte-specific USP20 conditional knockout (USP20CKO) mice were employed in this study. The type 2 diabetes mouse model was established using db/db leptin receptor-deficient mice and high-fat diet/streptozotocin-induced mice. USP20 expression was downregulated in the myocardium of diabetic mice. Cardiomyocyte-specific USP20 deficiency aggravated cardiac remodeling and myocardial dysfunction in diabetic mice. LC-MS/MS analysis, along with Co-IP results, demonstrated the interaction between stimulator of interferon genes (STING) and USP20. In mechanism, USP20 directly binds to STING and promotes its degradation through the autophagy pathway by deubiquitinating p62 via its active site C154, thereby alleviating the myocardial inflammation and improving ventricular remodeling and heart failure induced by diabetes.
5. Transboundary water conflicts, cooperation, and pathways forward.
期刊: Proceedings of the National Academy of Sciences of the United States of America 发表日期: 2026-Feb-10 链接: PubMed
摘要
6. Wildfire smoke PM2.5 and mortality rate in the contiguous United States: A causal modeling study.
期刊: Science advances 发表日期: 2026-Feb-06 链接: PubMed
摘要
The relationships between chronic exposure to wildfire smoke PM2.5 (particulate matter with aerodynamic diameter of ≤2.5 μm) and mortality remain poorly understood, with causal evidence being particularly scarce. In this ecological study, we used a doubly robust method, incorporating flexible generalized propensity score estimation that captured potential nonlinearity and interactions among confounders and relaxed the distribution form assumption for exposure, to estimate the effects of annual exposure to wildfire smoke PM2.5 on all-cause and cause-specific mortality in the contiguous United States from 2006 to 2020. We found that wildfire smoke PM2.5 was associated with increased mortality rate for all studied outcomes, except for deaths from transport accidents or falls, which served as negative outcome controls. Wildfire smoke PM2.5 was responsible for ~24,100 all-cause deaths per year in the contiguous United States. The exposure-response curve for all-cause mortality increased monotonically, with no evidence of a “safe” threshold. Among the six cause-specific outcomes, mortality from neurological disease showed the greatest increase per 0.1 μg/m3 increase in smoke PM2.5 exposure. Our study provided robust evidence for the chronic effect of wildfire smoke PM2.5 on mortality, underscoring the urgent need for targeted measures to mitigate the substantial and escalating burden of wildfires.
7. Where Are the Gaps in Diabetes Care? An Evidence Gap Mapping of the Diabetes Patient Journey in Indonesia.
期刊: Tropical medicine & international health : TM & IH 发表日期: 2026-Feb-04 链接: PubMed
摘要
Understanding the diabetes patient journey, from awareness, screening, diagnosis, treatment, adherence and control, is crucial for improving outcomes. However, in many low- and middle-income countries, including Indonesia, data across this continuum of care remain limited due to limited health information exchange capacity. This study aimed to map and estimate the prevalence of true diabetes and key touchpoints along the patient journey to identify gaps in diabetes management in Indonesia. We applied an evidence gap mapping approach by systematically searching relevant literature published between 1 January 2014, and 27 March 2025, in PubMed, Web of Science, Scopus and Embase, complemented by unstructured searches of government websites. Evidence was visualised using a chord diagram, bar chart and heatmaps. Random-effects meta-analyses were used to estimate pooled prevalence, stratified by study setting and sample representativeness relative to the national population. Among 94 records, none fully applied diabetes patient journey frameworks and most of the evidence was assessed as low quality. Screening was the least studied touchpoint and awareness missed nationally representative data. Pooled prevalence estimates were: true diabetes 13% (95% confidence interval (CI): 9%-17%), awareness 71% (95% CI: 54%-85%), screening 19% (95% CI: 0%-55%), diagnosis 15% (95% CI: 6%-27%), treatment 89% (95% CI: 80%-95%), adherence 59% (95% CI: 49%-69%) and control 31% (95% CI: 25%-36%). Prevalence rates were generally lower in studies conducted in the general population using nationally representative samples. Pooled prevalence across touchpoints and subgroups decreased after excluding low-quality studies, although heterogeneity within subgroups remained high. Evidence gap mapping offers a practical approach to generating local patient journey data in countries with limited health information exchange capacity. Specifically for Indonesia, a comprehensive consideration of the diabetes patient journey is lacking. Barriers exist across all touchpoints, particularly in the general population.
8. Using Smartphone-Based Digital Phenotyping to Predict Relapse in Serious Mental Disorders Among Slum Residents in Dhaka, Bangladesh: Protocol for a Machine Learning Study.
期刊: JMIR research protocols 发表日期: 2026-Feb-04 链接: PubMed
摘要
Serious mental illnesses (SMIs) are associated with high relapse rates and limited access to continuous care, particularly in low-resource settings such as urban slums. Traditional clinical monitoring is constrained by accessibility and scalability challenges. Digital phenotyping, through passive smartphone data, offers a novel approach to predict relapse by capturing real-world behavioral changes. This study aims to evaluate the feasibility and predictive value of smartphone-based digital phenotyping for detecting relapse in individuals with SMIs living in the Korail slum of Dhaka, Bangladesh. This prospective 6-month cohort study will recruit 430 participants diagnosed with SMIs who own Android (Google LLC) smartphones. Passive data (eg, screen time, mobility, and call or text frequency) will be continuously collected using a custom-built app (DataDoc). Monthly active data, including symptom and functioning assessments, will be collected via self-report and clinical engagement. Machine learning models will integrate these data to detect early warning signs and predict relapse trajectories. This study was funded by the NIHR (National Institute for Health and Care Research; award number NIHR200846) in October 2022. Data collection commenced in August 2025 and is ongoing. A total of 14 participants have been recruited, as of January 2026. Preliminary data analysis is ongoing, with expected results to be published in fall 2026. This study is one of the first to apply smartphone-based digital phenotyping and machine learning for relapse prediction in low- and middle-income countries’ slum settings. The findings will inform scalable, low-cost digital interventions to address the mental health treatment gap in underresourced communities.
9. A review of the Vets on Farm Programme: supporting veterinarians and farmers following the 2023 North Island weather events in Aotearoa New Zealand.
期刊: New Zealand veterinary journal 发表日期: 2026-Feb-04 链接: PubMed
摘要
To review the Vets on Farm (VoF) programme, provided to support veterinarians and farmers after New Zealand’s North Island weather events of early 2023, by interviewing participating veterinarians and farmers about their experiences with the programme, and to use their responses to develop recommendations to optimise support following future natural hazard events. Within the VoF programme, veterinarians had conducted multiple on-farm visits to provide services (farm systems review, feed budgeting, disease management) and collect diagnostic samples.Subsequently, between October 2024 and January 2025, semi-structured interviews were conducted with participating veterinarians and farmers. Interviews covered background information about the respondent, delivery of and services offered/received via VoF, effects and outcomes of VoF, support, and suggestions for future support programmes. Interviews were audio recorded and transcribed. Thematic analysis was used to identify themes and sub-themes, based on which recommendations were developed. Nine veterinarians and seven farmers from six regions in the North Island were interviewed. Themes were identified in relation to the following topics: benefits and challenges for veterinarians, benefits and challenges for farmers, programme design, and management. Benefits reported by veterinarians included improved relationships with farmer clients, better knowledge of their needs, opportunities to offer clients an expanded range of resources, and satisfaction at being able to help. Challenges included increased demands on time and workload, lack of guidance on selection of participating farmers, and ending the programme without appearing to abruptly withdraw support. Benefits for farmers included strong engagement with their veterinarian, relevant and timely advice on farm management, information from diagnostic test results, and social support. Challenges included workload, stress, and some mismatches between farmer needs and the services available. The general principle of the VoF support was well received. The in-depth interviews provided rich information and a high level of agreement between veterinarians and farmers. The framework of VoF, including its templates, systems, resourcing and communications, may provide a valuable resource basis for future programmes; however, greater flexibility around allocation of money per farm, testing and services would have allowed better tailoring to farm-specific needs. Follow-up evaluation of farm performance would provide valuable information on the effectiveness of interventions and emerging needs. Veterinary work with clients following extreme events includes providing social support. Training and supervision for veterinarians’ social support role needs consideration.
10. Patients' Attitudes and Beliefs Toward Artificial Intelligence Use in Cancer Care: Cross-Sectional Survey Study.
期刊: JMIR cancer 发表日期: 2026-Feb-04 链接: PubMed
摘要
Artificial intelligence (AI) is being rapidly integrated into oncologic care, yet little is known about how patients perceive these applications. Understanding patient perceptions is critical to ensuring AI applications align with their needs and preferences. This study aimed to evaluate oncology patients’ attitudes and beliefs on the use of AI across clinical touchpoints in cancer care. We conducted a cross-sectional survey study with adult oncology patients from September to December 2024. The survey assessed patients’ comfort with AI use across 8 clinical touchpoints of cancer care (eg, screening, diagnosis, treatment) on a 5-point Likert scale (1=very uncomfortable to 5=very comfortable). Patients also rated their concerns about AI, including potential harms related to its use (eg, medical errors, privacy breaches), on a 3-point Likert scale (1=not concerned to 3=very concerned). Of 383 patients approached, 330 (86.2% response rate) participated; 184 (55.9%) were male, 162 (49.4%) were aged 65 years or older, 35 (10.8%) were Black, 40 (12.1%) were Hispanic or Latino, and 233 (72.6%) were actively receiving cancer treatment. Patients were most comfortable with AI use in cancer screening (80.2%) and supportive care applications, including exercise (78.2%), diet (74.8%), and herbs/supplements (72.4%). Patients were least comfortable with AI use to assist with diagnosis (70.4%), symptom management (67.5%), treatment planning (64.8%), and prognosis (61.5%). Nonetheless, about half (49.7%) were at least somewhat concerned with the use of AI in cancer care, most commonly about the loss of human interaction and medical errors. Although the majority of oncology patients had a favorable view of AI in cancer care, nearly half had concerns about potential harms. Incorporating patient perspectives into AI development is essential for patient-centered and high-quality cancer care.
11. Lessons Learned About Digital Health Tool Acceptability Among Rural Older Adults: Systematic Review Guided by the Technology Acceptance Model.
期刊: JMIR aging 发表日期: 2026-Feb-04 链接: PubMed
摘要
Digital health tools are increasingly vital in rural health care due to widespread hospital closures and the rapid adoption of telehealth during the COVID-19 pandemic. Rural older adults, a uniquely vulnerable population, face barriers to accessing these tools due to rurality and usability challenges. Although a growing body of literature examines the acceptability and usability of digital tools among rural older adults, no study has synthesized this research to establish best practices. This study aims to review existing literature on digital health tools for rural older adults, highlighting key lessons learned about their acceptability and identifying strategies to improve usability for this population. Following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, this study reviewed literature that investigated the role of digital health tools on the health outcomes of rural older adults (ie, at least 60 years old). The literature was retrieved from 5 electronic databases through June 2023. This study and all reviewed literature were conducted in the United States. Guided by a systematic process, 2 reviewers assessed relevant articles for eligibility, analyzed data, and extracted relevant content. The extracted findings were organized according to the evidence-based technology acceptance model, which assesses the acceptability of a technology by its usefulness, ease of use, and intention to use. The preliminary title review produced 7728 results, and 38 eligible manuscripts were included in the final review. Studies included both rural older adults and providers of rural older adults as participants. Digital health tools included, but were not limited to, videoconferencing, phone calls, telehealth monitoring, telemedicine appointments, and computer-based interventions. Findings on the usefulness of digital health tools by rural older adults were mixed. While digital health tools were useful for overcoming barriers to accessing care, these tools were less useful for rural older adults with limited digital literacy. Additionally, some studies described that the technology was easy but difficult to use when faced with environmental barriers, equipment issues, and discomfort with the technology. Rural older adults often reported an intention to use the technology after the study. Yet, on a few occasions, participants who preferred in-person care visits or did not have buy-in on the technology reported no intention to use the technology again. Our review highlights that rural older adults and their providers generally view digital health tools as acceptable for delivering care and, in some cases, as a viable alternative to in-person clinic visits. While certain barriers impacted the acceptance of these tools among rural older adults, many of these challenges were not directly linked to their age or rural location; thus, they are potentially applicable to urban older adults. PROSPERO CRD42021287924; https://www.crd.york.ac.uk/PROSPERO/view/CRD42021287924.
12. Cost-effectiveness of the adjuvanted respiratory syncytial virus prefusion F protein (RSVPreF3) vaccine in Japanese adults aged 50-59 years at increased risk of severe RSV disease and those aged ≥60 years.
期刊: Expert review of vaccines 发表日期: 2026-Feb-04 链接: PubMed
摘要
Respiratory syncytial virus (RSV) can cause substantial morbidity and mortality in adults aged 50-59 years at increased risk of severe RSV disease due to specific underlying conditions (i.e. ‘50-59 years at-increased-risk [AIR] population’), and in older adults aged ≥60 years (i.e. ‘≥60 years population’). A static multi-cohort Markov model estimated cost-effectiveness of adjuvanted RSVPreF3 vaccination versus no vaccination among the 50-59 years AIR and ≥60 years populations in Japan, over a five-year time horizon from a healthcare payer perspective. Japan-specific RSV epidemiology and healthcare resource utilization parameters were used; vaccine efficacy was derived from the phase 3 AReSVi-006 trial (NCT04886596). Adjuvanted RSVPreF3 vaccination was cost-effective: in the 50-59 years AIR population, 49,280 RSV cases were prevented and 4333 quality-adjusted life years (QALYs) gained, at an incremental cost-effectiveness ratio (ICER) of Japanese yen (JPY) 2,770,558/QALY; in the ≥60 years population, 2,111,080 RSV cases were prevented and 205,543 QALYs gained, at an ICER of JPY 2,613,241/QALY. Vaccination was more cost-effective when including productivity losses from RSV-ARI. Scenario and sensitivity analyses results were robust. RSV vaccination may provide substantial health benefits and be a cost-effective intervention to reduce RSV burden in adults in Japan. What is the context?Respiratory syncytial virus (RSV) is a leading cause of acute respiratory infections (ARIs) in Japan. RSV can be life-threatening in older adults and adults with chronic illnesses, who are at increased risk of severe RSV disease. The adjuvanted RSVPreF3 vaccine is an approved RSV vaccine in Japan, and evidence of its cost-effectiveness (i.e. whether benefits of vaccination are worth the money spent) could support health policies that improve public access to vaccination to prevent RSV disease.What is new?A mathematical model used the latest adjuvanted RSVPreF3 vaccine clinical data to estimate the public health impact and cost-effectiveness of vaccination in adults aged 50–59 years with chronic illnesses and in older adults aged ≥60 years. Public health benefits were evaluated by the number of RSV-related ARIs, healthcare resource usage and deaths prevented with vaccination. Costs included vaccination costs and healthcare expenditure savings from RSV prevention.What is the impact?The model estimated that vaccinating 45–47% of adults aged 50–59 years with chronic illnesses in Japan with the adjuvanted RSVPreF3 vaccine could prevent approximately 50,000 RSV cases, 3700 hospitalizations and 145 deaths over five years. Among older adults aged ≥60 years, vaccinating 52–66% could prevent approximately 2 million RSV cases, 290,000 hospitalizations and 13,000 deaths. Vaccination with adjuvanted RSVPreF3 was cost-effective in both target groups, based on the typical cost-effectiveness threshold in Japan. RSV vaccination may thus be a cost-effective way to reduce the burden of RSV locally.
13. Transformer-Based Topic Modeling: Characterizing Cannabis Product Adverse Experiences Self-Reported as Requiring Medical Attention on Reddit.
期刊: Journal of medical Internet research 发表日期: 2026-Feb-04 链接: PubMed
摘要
This study uses keyword filtering, a transformer-based algorithm, and inductive content coding to identify and characterize cannabis adverse experiences as discussed on the social media platform Reddit and reports a total of 1177 self-reported adverse experiences requiring medical attention.
14. Double-checking in the safe administration of medicines: Policy and practice in English hospitals.
期刊: Journal of health services research & policy 发表日期: 2026-Feb-04 链接: PubMed
摘要
ObjectivesDouble-checking medication administrations is one of the most frequently used strategies to prevent errors and associated harm. This practice is time-consuming, introduces repeated interruptions into the care process and lacks evidence of effectiveness. Double-checking is widespread in hospitals worldwide. In England, double-checking happens despite there being no regulatory requirement except for intravenous drugs and medicines that require complex calculations. Many hospital Trusts have assimilated double-checking over the past 25-30 years in response to recommendations from the investigation of medication administration errors. There is currently no national picture in England of the extent to which organisational policies stipulate double-checking, the variation in double-checking policy or how closely double-checking is perceived to be conducted in accordance with policies. This study set out to address these gaps in our understanding.MethodsAn online survey was distributed to a network of Medication Safety Officers (MSOs) and Freedom of Information requests were sent to 118 English NHS acute hospital Trusts for policies underpinning medicines administration. Data were analysed to address the research questions.ResultsPolicies were received from 94 acute NHS Trusts (80% response rate) and 48 MSOs submitted a survey response (39% response rate). Double-checking policies vary considerably between Trusts. MSOs perceived that it is common in practice for double-checking not to be conducted in accordance with policy. All reviewed Trust policies required double-checking for controlled drugs. Further to this, many required double-checking for specific medicines or in particular circumstances. Most commonly, these were intravenous medicines, medicines administered to children, medicines requiring complex calculations and cytotoxic or chemotherapeutic medicines. However, policies varied considerably around administration of injectable medicines and insulin to adults. A minority of policies specified that ‘intravenous fluids’ needed to be double-checked. Most policies neither emphasised nor explained the importance of the independent nature of double-checking. There was also a great deal of variation between Trust policies in the medicines exempt from double-checking requirements.ConclusionsThe variation between policies identified by the present study might reflect a lack of robust evidence underpinning the practice of double-checking. Research is needed to understand if double-checking is effective at preventing medication errors and, if it is, the exact circumstances in which it is effective, to facilitate the standardisation of double-checking policies. Identifying circumstances in which double-checking is ineffective may justify the removal of some existing policies and could reduce nurse workload to free up time for patient-focused care.
15. Perceived platform surveillance, mental health and road risk among couriers and food delivery workers: Evidence from Wuhan, China.
期刊: Traffic injury prevention 发表日期: 2026-Feb-04 链接: PubMed
摘要
While platform surveillance of work processes is common in the gig economy, the subjective perception of surveillance varies among workers with different characteristics. This study uses the survey data of couriers and food delivery workers to explore the impact of perceived platform surveillance on road risks (risky riding and traffic crashes), and examines the mediating effect of mental health in this relationship, attempting to establish an explanatory framework among these factors. The survey was conducted using a respondent-driven sampling method and included 801 couriers and food delivery workers in Wuhan, China. Propensity score matching was used to construct comparable perceived and unperceived groups prior to subsequent logit regression analysis. Causal mediation analysis was employed to examine the mediating effect of mental health in the relationship of perceived platform surveillance and road risk. The findings revealed that couriers and food delivery workers with higher socioeconomic status and greater work experience were more likely to perceive platform surveillance, which led them to higher odds of risky riding and traffic crashes. Mental health, as a mediator of the negative impact of perceived platform surveillance on road risk, contributed 14.2% of the total effect on risky riding and 17.2% of the total effect on traffic crashes, respectively. The study underscored the heterogeneity in the perception of platform surveillance among couriers and food delivery workers, which contributed to disparities in mental health and road risk consequences. Policy implications included enhancing the ethical accountability of platform algorithms, improving riders’ safety awareness, and establishing a collaborative, multi-stakeholder road safety system.
16. Prediction of First and Multiple Antiretroviral Therapy Interruptions in People Living With HIV: Comparative Survival Analysis Using Cox and Explainable Machine Learning Models.
期刊: JMIR medical informatics 发表日期: 2026-Feb-04 链接: PubMed
摘要
The Cox proportional hazards (CPH) model is a common choice for analyzing time-to-treatment interruptions in patients on antiretroviral therapy (ART), valued for its straightforward interpretability and flexibility in handling time-dependent covariates. Machine learning (ML) models have increasingly been adapted for handling temporal data, with added advantages of handling complex, nonlinear relationships and large datasets, and providing clear practical interpretations. This study aims to compare the predictive performance of the traditional CPH model and ML models in predicting treatment interruptions among patients on ART, while also providing both global and individual-level explanations to support personalized, data-driven interventions for improving treatment retention. Using data from 621,115 patients who started ART between 2017 and 2023, in Kenya, we compared the performance of the CPH with the following ML models-gradient boosting machine, extreme gradient boosting, regularized generalized linear models (Ridge, Lasso, and Elastic-Net), and recursive partitioning-in predicting first and multiple treatment interruptions. Explainable surrogate technique (model-agnostic) was applied to interpret the best performing model’s predictions globally, using variable importance and partial dependence profiles, and at individual level, using breakdown additive, Shapley Additive Explanations, and ceteris paribus. The recursive partitioning model achieved the best performance with a predictive concordance index score of 0.81 for first treatment interruptions and 0.89 for multiple interruptions, outperforming the CPH model, which scored 0.78 and 0.87 for the same scenarios, respectively. Recursive partitioning’s performance can be attributed to its ability to model nonlinear relationships and automatically detect complex interactions. The global model-agnostic explanations aligned closely with the interpretations offered by hazard ratios in the CPH model, while offering additional insights into the impact of specific features on the model’s predictions. The breakdown additive and Shapley Additive Explanations explainers demonstrated how different variables contribute to the predicted risk at the individual patient level. The ceteris paribus profiles further explored the time-varying model to illustrate how changes in a patient’s covariates over time could impact their predicted risk of treatment interruption. Our results highlight the superior predictive performance of ML models and their ability to provide patient-specific risk predictions and insights that can support targeted interventions to reduce treatment interruptions in ART care.
17. Social, environmental and policy contexts affecting the feasibility and acceptability of improving household flooring for better health in rural Kenya.
期刊: PLoS neglected tropical diseases 发表日期: 2026-Feb-04 链接: PubMed
摘要
Homes with unimproved floors (earth, sand, or clay) are associated with increased risks of soil-transmitted parasites and enteric infections, leading to higher morbidity and reduced quality of life. This study explored the enablers and barriers to adopting improved flooring (sealed, washable, and durable) in three culturally diverse regions of Kenya - Narok, Bungoma, and Kwale - to mitigate disease burdens. Between August 2021 and July 2022, we conducted 24 focus group discussions with homeowners, stratified by age, gender, and floor type. Additionally, 28 key informant interviews with local government officials, microfinance representatives, and masonry trainers in Kwale and Bungoma provided contextual insights. Transcribed data underwent thematic analysis. In the study areas, most homes were constructed by residents themselves using traditional techniques and locally sourced materials. Despite awareness of the health risks, unimproved floors remained widespread. In Bungoma and Kwale, financial constraints and competing household priorities were primary barriers to flooring improvements, while in Narok, cultural identity contributed strongly to the rejection of changes in traditional houses. Key enablers included perceived health benefits and social status, while feasibility depended on the affordability and availability of materials and skilled labour. Strengthening the role of local artisans and leveraging their social influence were seen as effective strategies to shift perceptions on cost and feasibility. Improved collaboration between health and built-environment sectors could enhance community trust and support environmental disease management. Communities in Kwale and Bungoma were more receptive to improved flooring, while cultural practices and preferences in Narok posed significant adoption challenges. For receptive communities, affordable flooring technologies are critical to overcoming financial barriers, while behaviour change initiatives should address cultural and perceptual concerns. However, clinical evidence on locally generated health benefits is needed to support policy decisions and budget allocations for flooring interventions.
18. Effect of Digital Health Interventions on College Students' Lifestyle Behaviors: Systematic Review.
期刊: Journal of medical Internet research 发表日期: 2026-Feb-04 链接: PubMed
摘要
College students undergo a critical transition from adolescence to adulthood, during which lifestyle behaviors such as physical activity, sedentary behavior, diet, and sleep are key determinants of long-term health. Digital health interventions (DHIs) are increasingly recognized as a promising strategy for improving these behaviors among college students. This systematic review aims to evaluate the effectiveness and applicability of DHIs targeting lifestyle behaviors among college students by analyzing intervention objectives, modalities, functionalities, outcomes, and other key characteristics. In accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) 2020 guidelines, multiple scientific databases, including Scopus, Web of Science, PubMed, MEDLINE, PsycINFO, SPORTDiscus, ProQuest Central, APA PsycArticles, ERIC, and Academic Search Premier, were searched for studies published between January 2010 and December 2025 (initial search: August 5, 2025; updated search: December 27, 2025). The inclusion criteria were original empirical studies on DHIs targeting lifestyle behaviors (physical activity, sedentary behavior, diet, and sleep) among college students, published in English. Studies focusing on nondigital interventions, lacking sufficient methodological details, or not reporting lifestyle behavior-related outcomes were excluded. Quality assessment was conducted in 2 stages: all studies were first evaluated using the Mixed Methods Appraisal Tool (2018 version), followed by Risk of Bias 2 for randomized controlled trials and Joanna Briggs Institute critical appraisal tools for nonrandomized studies. A narrative synthesis was used to present and synthesize the findings. A total of 2998 records were retrieved, of which 46 publications met the inclusion criteria. These included 30 (65%) studies related to physical activity, 26 (57%) studies to diet, 10 (22%) studies related to sedentary behavior, and 6 (13%) studies related to sleep. This review enabled an examination of the effects of DHIs on college students’ lifestyle behaviors. DHIs primarily used mobile apps, web-based platforms, and mobile communication technologies, with core functionalities such as education, guidance, monitoring, and prompting. DHIs were more effective in improving physical activity and diet; however, evidence for reducing sedentary behavior and improving sleep remained limited. Of the 46 studies, 31 (67%) reported positive effects, with larger sample sizes and intervention durations of 8-16 weeks being associated with more favorable outcomes. This review focuses on college students, addressing a gap in the literature that often centers on general adult populations. Unlike previous reviews that focus on a single behavior, this study integrates multiple lifestyle behaviors and evaluates DHIs across diverse modalities and functionalities. These contributions help refine future DHIs for college students and inform health promotion strategies in higher education. Although DHIs show potential for improving lifestyle behaviors, evidence of their long-term effectiveness remains limited. Future interventions should prioritize multibehavior integration, interactivity, and population-differentiated design to enhance precision, sustainability, and equity. This study has several limitations, including issues related to sample representativeness, intervention refinement, and methodological rigor. PROSPERO CRD420251119078; https://www.crd.york.ac.uk/PROSPERO/view/CRD420251119078.
19. Effects of Digital Health Interventions to Promote Safer Sex Behaviors Among Youth: Systematic Review and Bayesian Network Meta-Analysis.
期刊: Journal of medical Internet research 发表日期: 2026-Feb-04 链接: PubMed
摘要
Youth aged 15-24 years carry a disproportionate HIV/sexually transmitted infections (STIs) burden. In recent years, different modalities of digital health interventions (DHIs) have been explored to promote safer sex behaviors among youth, but their comparative effectiveness across modalities and relative to nondigital interventions (NDIs) remains unclear. This study aimed to compare DHI modalities on safer sex behaviors and HIV/STI incidence, rank modalities using Bayesian network meta-analysis (NMA), and position their effectiveness relative to NDIs. A systematic review and Bayesian NMA of randomized controlled trials were conducted by comprehensively searching PubMed, EMBASE, Web of Science, and Cochrane Library (inception to November 2025). Eligible studies were those that enrolled youth aged 15-24 years and evaluated mobile app-based intervention, telecommunication-based intervention (TCI), static web-based intervention (SWI), or interactive online-based intervention (IOI)-with an NDI or another DHI. Primary outcomes were condom use at last sexual contact, consistent condom use, and proportion of condom use. Secondary outcomes included condom use self-efficacy, number of sexual partners, and STI incidence (including HIV). Risk of bias was assessed with the Cochrane Risk of Bias 2 tool, and certainty of evidence with GRADE/CINeMA (Confidence in NMA). Bayesian random-effects NMAs estimated odds ratios (ORs) with 95% credible intervals (CrIs), and complementary frequentist NMAs provided 95% CIs and 95% prediction intervals. Twenty-four randomized controlled trials (20,134 participants) were included, forming treatment networks across 5 intervention types. TCI was the only intervention that significantly improved condom use at last sex compared with NDI (OR 1.13, 95% CrI 1.02-1.26). For consistent condom use, SWI and IOI outperformed TCI (SWI vs TCI: OR 1.77, 95% CrI 1.03-3.06; IOI vs TCI: OR 1.68, 95% CrI 1.02-2.76). For the proportion of condom use, IOI outperformed SWI (OR 1.34, 95% CrI 1.01-1.80), and mobile app-based intervention ranked highest in probability rankings, though estimates lacked precision. For STI incidence, NDI was associated with fewer STIs than SWI (OR 0.61, 95% CrI 0.46-0.82). This is the first NMA to compare the effectiveness of DHIs on condom use and HIV/STI outcomes among youth populations. It demonstrates that the impact of DHIs on HIV prevention varies substantially by intervention modality and outcome type. While TCI demonstrates the most consistent improvement in condom use at last sex, SWI and IOI may be more effective for promoting consistent condom use, though estimates remain imprecise. However, wide prediction intervals and low-certainty evidence suggest that self-reported behavioral changes may not translate into reductions in HIV/STI incidents without integration with offline services and broader structural support. Future trials might consider including standardized outcome indicators and longer follow-up to generate more precise estimates of the effectiveness of DHIs and guide generalization of youth-centered digital HIV/STIs prevention.
20. How Message Framing and Subsidy Design Shape Hearing Health Care Decisions Among Older Adults With Hearing Loss: Evidence From a Mixed-Methods Approach.
期刊: Journal of speech, language, and hearing research : JSLHR 发表日期: 2026-Feb-04 链接: PubMed
摘要
This study aims to examine how message framing and subsidy design influence hearing health care (HHC) services utilization among older adults with hearing loss (HL) in rural China. The mixed-methods study used a survey experiment design in the quantitative phase and semistructured interviews in the qualitative phase. A survey experiment tested older adults and their family members’ responses to gain-/loss-framed messages and in-kind/co-payment subsidies, followed by in-depth interviews with 68 participants. Loss-framed messages increased hearing screening willingness (p < .05) more than gain-framed messages, but neither affected hearing aid adoption. In-kind subsidies increased hearing aid uptake willingness (p < .01), whereas co-payment discouraged family recommendations (p < .05). The interviews further illustrated key barriers to HHC services, including viewing HL as normal aging, stigma concerns, and financial constraints. Integrating message framing, subsidy schemes, and behavioral intervention strategies is recommended to enhance the uptake of HHC services. Policymakers should use loss-framed messages for hearing screening promotion and provide in-kind subsidies for hearing aid adoption. Equally important are efforts to improve hearing health literacy, alleviate financial constraints, and implement patient-centered decision making in HHC services.
21. Effectiveness of the Web-Based Support Program Based on the Health Promotion Model in Pregnant Women with Preeclampsia.
期刊: Maternal and child health journal 发表日期: 2026-Feb-04 链接: PubMed
摘要
The study was conducted to determine the effect of a web-based support program based on the Health Promotion Model (HPM) on healthy lifestyle behaviors, self-efficacy, and prenatal distress in pregnant women with preeclampsia. The study was conducted with 82 pregnant women diagnosed with preeclampsia, 41 of whom were in the web-based support group and 41 in the control group. Participant introduction form, Healthy Lifestyle Behaviors Scale-II (HLBS-II), Self-Efficacy Scale (SES), Prenatal Distress Scale (PDS), pregnant women’s self-monitoring form, and postpartum assessment form were used for data collection. The increase in the total scores of the HLBS-II and the SES and the decrease in the total score of the PDS was found to be statistically significant in the pregnant women in the web support-based group after the web support. The HPM-based web-based support program improved healthy lifestyle behaviors and self-efficacy and reduced prenatal stress levels of pregnant women with preeclampsia but did not contribute to neonatal outcomes. SIGNIFICANCE: Pregnant women diagnosed with preeclampsia often face heightened physiological and psychological challenges. This study demonstrates that a web-based support program structured around the Health Promotion Model (HPM) significantly improves healthy lifestyle behaviors and self-efficacy while reducing prenatal distress in this high-risk population. These findings suggest that digital health interventions are effective, accessible tools for enhancing maternal well-being. By integrating such platforms into standard obstetric care, healthcare providers can offer continuous, evidence-based support that empowers patients to manage their condition more effectively outside of clinical settings.
22. Registration accuracy of amyloid/tau-PET to brain MRI using modified SPM method.
期刊: Annals of nuclear medicine 发表日期: 2026-Feb-04 链接: PubMed
摘要
23. Beyond Evidence Supremacy: Reclaiming the Clinician's Role through the Integration of Structural and Existential Approaches in Daily Practice.
期刊: Modern rheumatology 发表日期: 2026-Feb-04 链接: PubMed
摘要
24. Long COVID Between People With and Without HIV: a Statewide Cohort Analysis.
期刊: Journal of acquired immune deficiency syndromes (1999) 发表日期: 2026-Feb-04 链接: PubMed
摘要
This study aims to compare the risks of a panel of long COVID manifestations between people with HIV (PWH) and people without HIV (PWoH). Using integrated statewide electronic health record data from the HIV cohort and COVID-19 tester cohort, we identified COVID-19-positive individuals by HIV status between March 02, 2020, and January 15, 2022, in South Carolina. A total of 13 diagnosis groups encompassing 131 potential long COVID categories were identified. We used inverse probability weighting based on propensity scores to balance covariates between the PWH and PWoH, including age, sex, race, and vaccination status. Cox Proportional Hazard regression models were used to estimate the risk of each diagnosis group examined. Among a total of 838,520 COVID-19 positive individuals, 2,662 were with HIV, and 835,858 were without HIV. The prevalence of any long COVID diagnosis was 16.3% and 10.6% for PWH and PWoH, respectively. Compared with PWoH, PWH were found to be at a higher risk of at least one of the long COVID diagnosis groups (HR = 1.29, 95%CI: 1.09-1.54) and the highest risk was for diseases of the nervous system (HR = 2.04, 95%CI: 1.42-2.92), followed by mental disorders (HR = 1.78, 95%CI: 1.12-2.82) and respiratory system (HR = 1.78, 95%CI: 1.18-2.69). Our study highlights the consistent and elevated LC burden in PWH, emphasizing the importance of sustained follow-up for COVID-19 survivors to improve their clinical outcomes and prevent morbidity of LC.
25. On-feet isometric bracing maintains cerebral arterial blood velocity during lower body negative pressure via preload augmentation.
期刊: Experimental physiology 发表日期: 2026-Feb-04 链接: PubMed
摘要
Orthostatic stress reduces venous return and stroke volume (SV), risking cerebral hypoperfusion despite autonomic compensation. Although lower-limb counterpressure manoeuvres improve cerebral perfusion in upright posture, their effects on cerebral blood velocity (CBV) during lower-body negative pressure (LBNP) and the associated mechanisms are not fully defined. We therefore tested whether isometric lower-limb contraction is associated with preservation of CBV during LBNP, accompanied by attenuated effects of preload reduction. Thirteen healthy young adults (age: 25 ± 5 years; 5 women) completed randomized trials under two conditions: off-feet (saddle support, relaxed legs) and on-feet (isometric bracing against a footplate with slight knee flexion). Each condition included 6 min exposures to -30 and -50 mmHg. Systemic vascular conductance declined with increasing LBNP, whereas mean arterial pressure (MAP) was maintained in both conditions. At -50 mmHg, CBV decreased off-feet but was preserved on-feet; SV fell less and the compensatory rise in heart rate (HR) was attenuated on-feet. Repeated-measure correlations showed that CBV tracked SV (rrm = 0.388, P = 0.002) and end-tidal CO2 (rrm = 0.318, P = 0.012), was inversely related to HR (rrm = -0.448, P = 0.001) and was unrelated to MAP (rrm = -0.003, P = 0.980) or systemic vascular conductance (rrm = 0.193, P = 0.129). Thus, isometric lower-limb engagement is associated with preservation of CBV during LBNP, in a manner consistent with preload-mediated effects rather than augmented peripheral vasoconstriction. These findings are consistent with proposed mechanisms underlying physical counterpressure manoeuvres and support simple lower-limb isometric actions to improve orthostatic tolerance.
26. Investigating the Relationship Between Food, Housing, and Transportation Insecurity and Chronic Disease Among US Women Using Nationally Representative Data.
期刊: American journal of health promotion : AJHP 发表日期: 2026-Feb-04 链接: PubMed
摘要
PurposeTo examine the association between the social determinants of health (SDOH) and hypertension, diabetes, heart disease, and anxiety and/or depression among adult US women.DesignCross-sectional survey.Setting2022 Health Information National Trends Survey (HINTS).SampleWomen aged ≥18 years (N = 3535) participated from the U.S.MeasureOutcome variable was diagnosis of diabetes, hypertension, heart disease, and mental illnesses. Covariates included sociodemographic characteristics along with food, housing, and transportation insecurity.AnalysisSeparate weighted bivariate and multivariate logistic regression models were used to examine the unadjusted and adjusted odds ratios (AORs) associations between insecurities and chronic conditions, controlling for sociodemographic characteristics.ResultsHypertension (35.4%) and anxiety/depression (33.4%) were the most reported chronic conditions. Approximately 27% of the sample experienced all three forms of insecurity concurrently. Women with anxiety or depression had elevated levels of food, housing, and transportation insecurity (11.3%, 7.4%, 7.5%) than those with other chronic conditions. Adjusted models indicated that all three types of insecurity were significantly associated with chronic conditions. Food, housing, transportation, and any insecurity nearly doubled the odds of reporting any chronic condition (AOR = 2.15, 2.44, 1.70, and 2.20, respectively).ConclusionFindings highlight a strong association between SDOH and chronic conditions among women, necessitating the implementation of targeted policies and interventions to address sex-related health inequities to improve women’s health.
27. Rethinking Multiple Myeloma Treatment: The Biological and Clinical Insights Guiding Immune-Based Combinations.
期刊: Blood cancer discovery 发表日期: 2026-Feb-04 链接: PubMed
摘要
The standard of care for multiple myeloma has rapidly evolved to include immune-based therapies. However, achieving durable immune control and long-term survival, particularly in high-risk patients, remains difficult. In this article, we review the immune effects of existing and emerging therapies, dissect key drivers of resistance, highlight rational combinations and treatment-sequencing strategies, and summarize ongoing clinical trials that aim to optimize durable immune control. We discuss how the application of these biological and clinical insights may help us rethink multiple myeloma treatment to fully eradicate residual disease and elicit sustained natural and/or synthetic tumor-specific immunity. Preclinical and clinical insights are reshaping how immune-based therapies are used in multiple myeloma. This review explores how optimizing the integration of natural and synthetic immunity can support a shift from disease control to deep, durable immune eradication, paving the way for personalized immune strategies tailored to individual immune profiles.
28. Allogeneic Hematopoietic Cell Transplantation for Aplastic Anemia: A Single Institution Experience Across Six Decades.
期刊: Blood advances 发表日期: 2026-Feb-04 链接: PubMed
摘要
Since the introduction of allogeneic bone marrow transplantation (BMT) for aplastic anemia, major advances have included refinements in conditioning regimens, graft-versus-host disease (GVHD) prophylaxis, high-resolution human leukocyte antigen (HLA) typing, pre-transplant transfusion practices, and general supportive care. We present a comprehensive retrospective single-center cohort study of 607 children and adults who underwent allogeneic transplantation for aplastic anemia over six decades at a single BMT center. We highlight key temporal changes in conditioning for related donor transplants, GVHD prophylaxis, and HLA matching that correspond with improved non-relapse mortality, reduced GVHD rates, and better overall survival among HLA-matched related and unrelated donor transplants. This work provides a historical perspective on the evolution of BMT for aplastic anemia for HLA-matched related and unrelated donor recipients and identifies persistent barriers to curative therapy, including patient age and donor availability. Further studies are needed to clarify the role of anti-thymocyte globulin in conditioning regimens, improve GVHD prevention and management, and expand use of alternative donors.
29. Phase 1 and preclinical studies reveal safety, pharmacokinetics, and efficacy of intranasal delivery of the influenza antibody CR9114.
期刊: Science translational medicine 发表日期: 2026-Feb-04 链接: PubMed
摘要
Systemic administration of influenza virus-specific monoclonal antibodies achieves low concentrations in the nasal mucosa, the portal of infection. Intranasal administration may be more relevant for preventing infection, but the pharmacokinetics of intranasal influenza antibodies is unknown. We present results of preclinical studies and first-in-human phase 1 trials of the intranasally administered CR9114, an anti-hemagglutinin stem antibody that protects against influenza A and B viruses. We tested safety and tolerability of different schedules and doses; pharmacokinetics in nasal mucosal lining fluid of the nose and nasopharynx, saliva, and serum; and ex vivo functionality. We evaluated in vivo efficacy of CR9114 in mice and nonhuman primates. Intranasal CR9114 was safe and well tolerated across all doses and schedules. The half-life of CR9114 in the nose was ~3 hours. Steady-state concentrations were rapidly attained and sustained with multidosing. Trough concentrations were up to 92-fold higher with twice-daily administration compared with once-daily administration. Pharmacokinetics of intranasal CR9114 in nonhuman primates mirrored that of humans better than mice. Postdose nasal samples potently bound hemagglutinin from diverse strains of influenza A and B viruses and, particularly at the 10-milligram dose, neutralized A/H1N1, A/H5N1, and A/H3N2 more potently than baseline samples. Twice-daily administration of CR9114 protected nonhuman primates against influenza virus challenge with the same intranasal formulation and device as used in humans, providing evidence for the efficacy of intranasal multidosing. Together, these study findings characterize the pharmacokinetics of CR9114 after intranasal administration and provide proof of concept that intranasal antibodies can elicit efficacious passive immunity against influenza viruses.
30. Tailoring the Interfacial Microenvironment of Atomically Dispersed Zinc to Boost Electron Transfer Process for Water Purification.
期刊: Environmental science & technology 发表日期: 2026-Feb-04 链接: PubMed
摘要
Introducing environmentally benign Zn single-atom catalysts (SACs) in Fenton-like reactions to induce electron transfer processes (ETP) holds great potential in advanced water remediation technologies. However, precise coordination of Zn SACs is highly required to selectively trigger the ETP pathway. Herein, under the guidance of density functional theory (DFT) predictions, we constructed asymmetric Zn-N3Cl sites on N-doped carbon (NC) to unlock the electron-transfer reactivity of redox-inert Zn while maintaining structural robustness. Compared with the symmetric Zn-N4 system, the Zn-N3Cl system achieved a higher sulfamethoxazole (SMX) removal rate and PMS utilization efficiency by 4.4 and 2.3 times, respectively. Mechanism studies revealed that Cl doping significantly altered the electronic structure of Zn sites, thereby promoting their electron transfer capacity. The strongly polarized Zn-N3Cl sites exhibited a notably enhanced interaction with PMS, facilitating the formation of Zn-N3Cl/PMS* with high redox potential and lowering the energy barrier of the rate-determining step (RDS) for ETP. The Zn-N3Cl system demonstrated outstanding catalytic reactivity toward various environmental interferences over a wide pH range. Notably, this system remained effective for the continuous flow-through treatment of pharmaceutical wastewater, coupling high catalytic reactivity and structural robustness. Our rational design of environmentally benign materials offers a blueprint for sustainable water remediation.
31. Safety and Impacts of Physical Activity for Individuals Living With Hypermobility Spectrum Disorders and Hypermobile Ehlers-Danlos Syndrome: Protocol for a Scoping Review.
期刊: JMIR research protocols 发表日期: 2026-Feb-04 链接: PubMed
摘要
Although physical activity (PA) participation has known health benefits, many individuals with hypermobility spectrum disorders (HSD) and hypermobile Ehlers-Danlos syndrome (hEDS) have difficulties participating in PA. HSD/hEDS affect approximately 1 in 500 people and are more prevalent in females. HSD/hEDS may result in frequent joint injuries, chronic pain, and generalized fatigue. These symptoms, and a fear of new or reinjury, may result in barriers to PA participation. Overall, there is limited research on PA in this population. Previous exercise reviews have not included structured PA such as sports and occupational activities; unstructured PA such as play, household, or leisure activities; or younger ages, including children. Additionally, some females with HSD/hEDS report experiencing more frequent joint injuries and worsening pain and fatigue during times of hormonal transitions, such as puberty, pregnancy, as well as cyclically across the menstrual cycle. Some females also report improvements in symptoms and a reduction in injury frequency following menopause. The impacts of PA during these times of changing hormone levels for females living with HSD/hEDS are uncertain. A clear understanding of what types of structured and unstructured PA are safe and helpful for individuals of all ages with HSD/hEDS, and if PA should be adapted during times of female hormonal changes, is lacking. We propose a scoping review protocol to map and synthesize the evidence regarding considerations that may impact structured and unstructured PA participation in HSD/hEDS for individuals of all ages and during times of female hormonal transitions. A scoping review will be conducted using Covidence (Veritas Health Innovation Ltd) and Microsoft Excel (Microsoft Corp) to map the evidence regarding the impacts of PA on safety, physical health, and quality of life. These outcomes will be assessed using the World Health Organization International Classification of Functioning, Disability and Health framework. The database search was performed on August 22, 2024, and updated on September 8, 2025. Data extraction started in September 2025 and is ongoing. The results are expected to be published by August 2026. This proposed scoping review will aid in defining critical research directions regarding PA in HSD/hEDS, which may help inform guidelines outlining the risks and benefits of structured and unstructured PA. This review will also help define existing evidence for age-specific and hormone-related considerations regarding the impacts of PA in this population. This is particularly important as PA may help ameliorate the physical and mental symptoms associated with HSD/hEDS and may improve quality of life for these individuals across the lifespan.
32. Clinical Manifestations, Long-Term Trends, and Risk Factors for Treatment Failure in Native Vertebral Osteomyelitis: A 26-Year Mayo Clinic Experience.
期刊: Clinical infectious diseases : an official publication of the Infectious Diseases Society of America 发表日期: 2026-Feb-04 链接: PubMed
摘要
Native vertebral osteomyelitis (NVO) is a life-threatening spinal infection with rising incidence and significant morbidity. Despite its growing burden, long-term data on clinical characteristics, management trends, and outcomes remain limited. We conducted a 26-year multicenter retrospective cohort study of adults (≥18 years) diagnosed with NVO at Mayo Clinic sites between 1999-2024. Demographic, microbiologic, treatment, and outcome data were analyzed across five time periods. Predictors of treatment failure were assessed using a multivariable competing risk model. Among 1,255 patients (median age 67; 66% male), lumbosacral involvement was most common (65%), and 21% had multilevel involvement. Pathogens were identified in 77%, most commonly S. aureus (49%; MSSA 37%, MRSA 13%). Over time from 1999-2004 to 2020-2024, Gram-negative bacilli increased from 6% to 14% (p=0.048).Comorbidities including chronic kidney disease (10% to 21%), active chemotherapy (6% to 11%), and immunosuppression (8% to 17%) increased significantly. Additionally, 1-year treatment failure declined (16% to 10%). In multivariable analysis, diabetes mellitus (sHR 1.92, 95% CI 1.18-3.13) and multilevel involvement (sHR 1.67, 95% CI 1.17-2.38) were associated with increased incidence of treatment failure, while concurrent infections (sHR 0.57, 95% CI 0.37-0.87) and higher Charlson Comorbidity Index (CCI) (sHR 0.62, 95% CI 0.43-0.90) were associated with lower failure. This large multicenter cohort highlights increasing host complexity, shifting microbiology, and predictors of failure, emphasizing the importance of early risk stratification and tailored strategies, such as multidisciplinary evaluation and close follow-up of high-risk patients to improve outcomes.
33. Mindfulness-Based Self-Management Program Using a Mobile App for Patients With Pulmonary Hypertension: Single-Arm Feasibility Study.
期刊: JMIR cardio 发表日期: 2026-Feb-04 链接: PubMed
摘要
Mindfulness-based interventions have been applied across various chronic illnesses, but no tailored program exists for individuals with pulmonary hypertension (PH). This study aimed to develop and evaluate the feasibility of a mindfulness-based self-management program for patients with PH, delivered online to accommodate their limited mobility. A single-arm pre-post study was conducted using an 8-session, weekly videoconference program incorporating PH self-management education and elements of mindfulness-based cognitive therapy. A mobile app linked to an Apple Watch was used to support symptom monitoring and mindfulness awareness. Outcomes included PH-related symptoms, quality of life (emPHasis-10), depression (Patient Health Questionnaire-9 [PHQ-9]), anxiety (Generalized Anxiety Disorder 7-item scale [GAD-7]), resilience (Connor-Davidson Resilience Scale [CD-RISC]), and loneliness (UCLA Loneliness Scale-short version). Assessments occurred at baseline, week 4, and program completion. Exit interviews explored perceived changes and experiences. Twelve participants (mean age 41.8, SD 10.5 years; range 26-56 years) were enrolled, and 9 completed the program (75% retention). Participants valued the online format and Apple Watch integration, while noting a need for optional on-demand sessions. Qualitative analysis identified themes such as increased self-awareness, use of meditation for pain management, and enhanced self-compassion. Quantitative analysis showed significant changes across 3 time points (baseline, week 4, and week 8) for emPHasis-10 (χ²₂=9.74; P=.008) and CD-RISC (χ²₂=7.27; P=.03). Trends toward change were observed for PHQ-9 (χ²₂=4.75; P=.09) and GAD-7 (χ²₂=5.07; P=.08), but week 12 data were limited (n=5). No significant changes in loneliness were observed. The program appeared to support patients with PH in managing symptoms and emotions and suggested potential improvements in quality of life. These preliminary findings warrant evaluation in a future randomized controlled trial.
34. Occupational Health and Safety Training: Perceptions of Barriers and Needs Among Municipal Urban Cleaners and Their Supervisors/Managers; A Qualitative Study Across 5 European Countries.
期刊: New solutions : a journal of environmental and occupational health policy : NS 发表日期: 2026-Feb-04 链接: PubMed
摘要
Municipal Urban Cleaners (MUCs) perform an essential yet hazardous work, but evidence on how to design Occupational Health and Safety (OHS) training that truly reflects their real-world barriers, risks, and learning needs remains limited. This qualitative study, conducted as part of the MUC-Training for Health initiative, explored barriers, occupation-attributed health implications, perceptions, and attitudes toward OHS, and training needs. Ten focus groups were held with 74 MUCs and their supervisors/managers across 5 European countries, and the data were analyzed using thematic analysis. Participants identified substandard working facilities, insufficient or unsuitable equipment, understaffing, inconsistent safety practices, limited knowledge of protective measures, and inaccurate information as major barriers. Both psychosocial and physical risks were frequently emphasized. Across all settings, tailored, practical, and motivating face-to-face training was viewed as essential. Designing effective OHS training requires a nuanced understanding of MUCs’ daily realities, occupational risks, and preferences to ensure engagement, accessibility, and relevance.
35. Epigenetic Modulation by Vitamin C and in Prenatal Depression: Implications for Offspring Health.
期刊: Current medical science 发表日期: 2026-Feb-04 链接: PubMed
摘要
Prenatal depression is a prevalent mental health disorder that adversely affects maternal well-being and offspring health. Emerging evidence suggests that vitamin C (L-ascorbic acid), a key antioxidant, may influence this process through the regulation of DNA methylation (DNAm)-a critical epigenetic mechanism governing gene expression. This review summarizes current research on the role of vitamin C in modulating DNAm and explores its potential to mitigate the intergenerational impacts of prenatal depression. We analyze findings indicating that vitamin C may alleviate depressive symptoms and improve offspring health outcomes via epigenetic pathways. Furthermore, we highlight existing research gaps and propose future directions for investigation. By elucidating the interplay between vitamin C, epigenetic regulation, and prenatal depression, this article aims to provide novel insights for developing nutritional strategies to enhance maternal mental health and promote offspring well-being.
36. Gender, empathy, and aggressive behavior toward nurses: A moderation analysis.
期刊: Nursing outlook 发表日期: 2026-Feb-03 链接: PubMed
摘要
The intersection of gender and empathy remains a pivotal focus in contemporary sociological discourse. Few studies have examined gender differences in aggressive behavior within healthcare settings. To explore the association between empathy, feelings, thoughts, gender, and aggressive behavior toward nurses, and the role of gender in the association between empathy and aggressive behavior. A cross-sectional study utilized a self-report questionnaire (completed by 555 participants). A three-step hierarchical linear regression was conducted to assess the unique effect of the explanatory variables on aggressive behavior. Empathy, positive feelings, and negative thoughts were found to explain aggressive behavior. Gender was a moderating factor between empathy and aggressive behavior. The effect was more pronounced among men than women as empathy increased. Empathy is a crucial buffer against aggressiveness, with a strong effect among men. Intervention programs may benefit from boosting empathic competencies that address gender-related differences in socialization and emotional expression.
37. Resistome, virulome and mobilome of clinical carbapenemase-producing Acinetobacter baumannii strains isolated in Togo.
期刊: International journal of medical microbiology : IJMM 发表日期: 2026-Feb-03 链接: PubMed
摘要
Genomics have become crucial in addressing the public health challenges posed by antimicrobial resistance (AMR). In this study, we performed the first whole-genome sequencing (WGS) and genomic analyses of clinical Acinetobacter baumannii (A. baumannii) strains isolated at the Sylvanus Olympio University Teaching Hospital in Lomé, Togo. This prospective study, conducted from April 19 to September 02, 2019. Susceptibility profiles were obtained using the Kirby-Bauer disc diffusion method, and the nine studied carbapenem-resistant A. baumannii strains were subjected to next generation sequencing (NGS) using an Illumina platform. All isolates exhibited resistance to imipenem, ticarcillin, clavulanic acid, cefotaxime, and ciprofloxacin, but remained susceptible to colistin, tigecycline, and rifampicin. The study identified five A. baumannii ST1 strains, two ST103 strains, one ST52 strain, and one ST1153 strain. The number of AMR genes per strain ranged from six to 24, whereas the number of virulence genes per strain varied from 32 to 67. Each isolate contained at least one plasmid, with the number of plasmids per isolate ranging from one to four per isolate. The carbapenemase-producing genes blaOXA-23, blaOXA-58, blaOXA-68, blaOXA-69, blaOXA-70, blaOXA-91, and blaNDM-1 were identified, along with blaCTX-M-15 and other antibiotic resistance genes. Additionally, multidrug efflux system genes, including adeCFGHIJKLMNS, abeSJ, and amvA, and a wide array of virulence and biofilm-forming genetic determinants were found in all isolates. Eleven integrons were detected, featuring aac(3)-Ia, sat-2, and dfrA1 cassettes. Tn6018, carrying the mercury resistance gene merR and czcD (Co/Zn/Cd efflux system), and Tn2007, carrying blaOXA-23, were present in six genomes. Four Ghanaian genomes were most closely related to the A. baumannii ST1 and ST103 strains reported in this study. Furthermore, several multidrug resistance plasmids and one virulence and AMR hybrid plasmid (accession number JBFMWK020002174.1) were identified. This study provides valuable insights into clinical A. baumannii in Togo, underscoring the need for more frequent genomic studies in sub-Saharan countries to effectively monitor and combat AMR in Africa.
38. Incident and prevalent peripartum mental illness in mothers with multiple sclerosis and other chronic diseases in Sweden.
期刊: Multiple sclerosis and related disorders 发表日期: 2026-Feb-03 链接: PubMed
摘要
Findings conflict regarding the risk of peripartum mental illness in women with multiple sclerosis (MS) and how this compares to the risk among women with other chronic diseases. We compared the incidence and prevalence of peripartum mental illness among women with MS, epilepsy, inflammatory bowel disease (IBD), diabetes, and women without any of these diseases (comparators). Using population-based Swedish administrative health data we selected women with MS, epilepsy, IBD, diabetes, and comparators who had deliveries between 2002 and 2019. Using validated case definitions for peripartum mental illness we estimated the incidence and prevalence of mental illness during the period encompassing pregnancy and the first post-partum year. We compared incidence and prevalence between cohorts using crude estimates and unadjusted Poisson regression. We included 1096,814 women (1936 MS; 7709 epilepsy; 7731 IBD; 7182 diabetes; 1072,256 comparators). Mean (SD) age at conception was 30.1 (5.1) years. Compared to comparators, mothers with MS had a higher incidence of any mental illness (incidence rate ratio [IRR] 1.36; 1.04-1.78), as did mothers with epilepsy (1.78; 1.58-2.00), IBD (1.46; 1.28-1.66) and diabetes (1.61; 1.41-1.83). Mothers with MS, epilepsy, IBD and diabetes also had a higher incidence and prevalence of depression and bipolar disorder than comparators. Mothers with epilepsy had higher incidence rates of anxiety, and higher prevalence ratios of any mental illness and anxiety than mothers with MS. Women with MS, epilepsy, IBD and diabetes have a similarly elevated incidence and prevalence of peripartum mental illness as compared to mothers without these conditions.
39. Tracing microplastic footprints in Bangladesh's largest baors (Oxbow Lake): First insights into characterization, ecological risks, and implications for aquatic health.
期刊: Ecotoxicology and environmental safety 发表日期: 2026-Feb-03 链接: PubMed
摘要
Microplastics (MPs) contamination has emerged as a pressing global environmental challenge, yet freshwater ecosystems remain critically understudied compared to marine systems. Addressing this gap, the present study provides the first comprehensive assessment of MP occurrence, characterization, and ecological risks across water, sediment, and biota in Bangladesh’s Oxbow Lakes (Baors). Samples from three major lakes-Bukbhara, Marjat, and Jhanpa-revealed alarming MP concentrations: 36.0-356.0 items/L in water, 398.0-2763.0 items/kg in sediment, and 3.0-24.0 items/individual in biota. Fibers dominated the morphology, with multi-colored MPs detected in all matrices. Polypropylene (PP) and polyethylene (PE) were the primary polymers, likely originating from household waste, agricultural runoff, and fishing activities. Pollution indices (PLI >1; Nemerow Pollution Index (NPI) indicating moderate to severe levels) confirmed substantial contamination, while polymer-based risk assessments highlighted ecological threats ranging from low (Grade-I) to very high (Grade-V). Biota hazard indices further indicated species-specific risks, with O. mossambicus showing the highest MP accumulation in muscle tissues and A. grammepomus the lowest. Importantly, dietary exposure analysis revealed that children ingest MPs at rates 3.67 times higher than adults via biota consumption. This pioneering study quantifies MP pollution in Bangladesh’s freshwater ecosystems and underscores its ecological and human health implications, calling for urgent mitigation strategies to safeguard aquatic biodiversity and public health.
40. From exposure models to multi-organ toxicity of 6PPD-quinone in mice: A mini-review.
期刊: Ecotoxicology and environmental safety 发表日期: 2026-Feb-03 链接: PubMed
摘要
Emerging evidence positions 6PPD-quinone (6PPD-Q) as a global environmental contaminant, with confirmed toxicity to various species and widespread detection in human biological samples. Despite these observations, toxicological understanding of 6PPD-Q in mammals remains fragmented and inconsistent. Therefore, this review integrates current evidence from murine models within an “exposure-toxicokinetics-organ toxicity” framework, revealing exposure route-dependent toxicokinetics and toxicological outcomes. Moreover, 6PPD-Q perturbs lipid metabolism, mitochondrial function, and immune homeostasis mechanistically. Crucially, evidence suggests sex-dependent differences in the toxicological profile of 6PPD-Q; males tend to display higher peak concentrations and faster clearance, whereas females show prolonged systemic retention and reproductive toxicities. However, the majority of this toxicological evidence has been obtained from high-dose or artificial exposure paradigms, sex-dependent susceptibility and the molecular-to-systemic integration of inter-organ crosstalk are insufficiently addressed. Future research should, therefore, prioritize physiologically or environmentally relevant chronic-exposure models, integrating physiologically based pharmacokinetic (PBPK) modeling with multi-omics approaches to better delineate inter-organ axis mechanism. Such an approach will be of great importance to transform descriptive toxicology into predictive, preventive science with direct environmental and public health impact.
41. Effectiveness of physical exercise on osteosarcopenia in older adults: A systematic review.
期刊: Geriatric nursing (New York, N.Y.) 发表日期: 2026-Feb-03 链接: PubMed
摘要
Osteosarcopenia is a geriatric syndrome characterized by the coexistence of sarcopenia and osteopenia/osteoporosis, which can lead to frailty and mortality. The effectiveness of physical exercise on osteosarcopenia, particularly on muscular and skeletal parameters, remains unclear. This systematic review aimed to analyze the impact of exercise interventions on osteosarcopenia in older adults and to describe the diagnostic methods used in different clinical trials. Randomized clinical trials conducted in older adults (≥65 years) diagnosed with osteosarcopenia were included, sourced from PubMed, Embase, Cochrane, and Scopus databases without language or publication year restrictions, up to July 2024. Osteosarcopenia was defined as the coexistence of sarcopenia and osteopenia/osteoporosis based on dual-energy X-ray absorptiometry (DXA) criteria. Exercise interventions of at least four weeks were considered, with comparisons to non-exercise control groups. This systematic review followed the PRISMA guidelines and was registered in PROSPERO (CRD42016043310). A total of 250 articles were identified, but only four studies met the eligibility criteria, involving 195 participants. All included studies utilized resistance training (RT) as the exercise intervention. The most common diagnostic criteria for osteosarcopenia were based on the T-score of the lumbar spine and/or femur, measured via DXA, using World Health Organization cut-off points for bone mineral density (BMD) and the criteria from the European Working Group on Sarcopenia in Older People for sarcopenia. RT was found to be effective in increasing strength and muscle mass in older adults diagnosed with osteosarcopenia, though it did not significantly improve physical performance. There are few studies on this topic, making it difficult to draw definitive conclusions regarding the effectiveness of physical exercise in older adults with osteosarcopenia. Resistance training showed positive results, particularly in improving strength and muscle mass. PROSPERO REGISTRATION NUMBER: https://www.crd.york.ac.uk/PROSPERO/view/CRD42020215659.
42. Corrigendum to "Co-designing peer-to-peer support in oncology: A participatory study on the development of the PaRole OncO France model" [Patient Educ. Couns. 143 (2026) 109415].
期刊: Patient education and counseling 发表日期: 2026-Feb-03 链接: PubMed
摘要
43. Hyperuricemia-induced renal fibrosis: Mechanisms and advances in pharmacological studies using uricase-deficient animal models.
期刊: Experimental and molecular pathology 发表日期: 2026-Feb-03 链接: PubMed
摘要
The high incidence of hyperuricemia (HUA) is largely attributed to imbalances between uric acid production, distribution, and excretion. HUA can lead to renal fibrosis, which in turn causes a progressive decline in kidney function and the development of serious conditions such as chronic kidney disease (CKD). Therefore, the effective prevention and treatment of HUA-induced renal fibrosis is of critical importance. Elevated serum uric acid acts as a key trigger for HUA-induced renal fibrosis, while uric acid accumulation in kidney tissues, especially in the medulla, may play an even essential role in this process. However, few studies have focused on the role of tissue uric acid, even though increased tissue uric acid can activate macrophages and mediate chronic inflammation as well as other mechanisms that initiate or worsen renal fibrosis. Moreover, current clinical drug interventions yield unsatisfactory outcomes and are often associated with numerous adverse effects, emphasizing the urgent need for new therapeutic agents. In recent years, the use of clinically relevant uricase-deficient animal models in pharmacological studies has increased, potentially representing the forefront of research in HUA-induced renal fibrosis. However, a comprehensive review of these studies is still needing. This review explains how uric acid affects the kidney and induces renal fibrosis, summarizes the underlying mechanisms to inform clinical diagnosis, treatment, and drug development, and consolidates the current status of clinical therapies and pharmacological research using uricase-deficient animal models, with the aim of identifying promising agents for the effective prevention and treatment of HUA-induced renal fibrosis.
44. 6PPD-Q exposure promotes hepatocellular carcinoma progression and confers resistance to ferroptosis.
期刊: Ecotoxicology and environmental safety 发表日期: 2026-Feb-03 链接: PubMed
摘要
Tire antioxidant degradation product N-(1,3-dimethylbutyl)-N’-phenyl-p-phenylenediamine quinone (6PPD-Q), an emerging environmental pollutant, has been suggested to influence tumor-related biological processes; however, its role in HCC remains unclear. Here, we evaluated the effects of 6PPD-Q on HCC cells by assessing transcriptomic profiles, proliferation, migration, and erastin-induced/Ferrostatin-1-inhibited ferroptosis, and interrogated the regulatory role of zinc finger X-linked duplicated family zinc finger C (ZXDC) using knockdown and overexpression approaches. 6PPD-Q markedly promoted HCC cell proliferation and migration while reducing sensitivity to erastin-triggered ferroptosis. Mechanistically, ZXDC expression was upregulated by 6PPD-Q in HCC cells and served as a prognostic indicator. Moreover, ZXDC acted as a critical mediator of these pro-tumorigenic and anti-ferroptotic effects: ZXDC knockdown attenuated 6PPD-Q-induced proliferation and migration while promoting ferroptosis, whereas ZXDC overexpression further suppressed ferroptosis. In parallel, multi-algorithm immune infiltration analyses showed that the 6PPD-Q-related gene risk score was significantly associated with multiple immune populations, with macrophage M0 cells showing a significant positive correlation with the risk score (R = 0.30, p < 0.001). Collectively, these findings identify a 6PPD-Q/ZXDC axis that links environmental exposure to HCC malignant progression and ferroptosis resistance, suggesting ZXDC as a potential biomarker and intervention target for HCC prevention and therapy.
45. Nonfasting lipid testing: all the good reasons to do it, and potential physician and patient behaviors preventing its implementation.
期刊: Current opinion in lipidology 发表日期: 2026-Feb-03 链接: PubMed
摘要
The purpose of this report is to summarize evidence supporting the use of nonfasting lipid testing for cardiovascular risk assessment, the potential reasons nonfasting lipid testing predicts cardiovascular risk better than fasting measurement, and to provide a preliminary survey of the status of adoption of nonfasting lipid testing by individual physicians and patients. There is increased awareness of the importance of remnant lipoprotein cholesterol, which is increased after eating, as a key factor predicting risk for ischemic vascular disease. Nonfasting lipid measurement is now recommended in guidelines and consensus statements worldwide, but has not yet been adopted in many countries. Preliminary evidence suggests physician’s practice of requesting a fasting glucose along with a lipid profile is decreasing over time, but still limits implementation of nonfasting lipid testing. Patient’s perception of the optimal conditions for lipid testing as well as their preferred time of day to perform the test may also be limiting adoption of nonfasting measurements. Nonfasting testing is now accepted as the preferred method of lipid measurement for cardiovascular risk prediction and lipid target achievement. Further acceptance of nonfasting lipid testing requires increased awareness by physicians and patients of the rationale for this recommendation.
46. Highly sensitive electrochemical sensor based on hydrazine-functionalized metal-organic framework for simultaneous determination of Pb2+ and Cd2+ in food and environmental samples.
期刊: Talanta 发表日期: 2026-Feb-03 链接: PubMed
摘要
Heavy metals, such as Pb2+ and Cd2+, pose significant risks to human health and ecosystems due to their toxicity and bioaccumulation. This study presents a novel electrochemical sensor utilizing a hydrazine-functionalized metal-organic framework (MOF-Hydrazine) modified glassy carbon electrode for the simultaneous detection of Pb2+ and Cd2+ ions in food and environmental samples. The MOF-Hydrazine composite, synthesized via a solvothermal method, exhibits high surface area, tunable porosity, and enhanced electrocatalytic properties, enabling superior sensitivity and selectivity. Square wave anodic stripping voltammetry (SWASV) was employed, optimized through Plackett-Burman and Box-Behnken designs, to achieve detection limits of 0.0005 nmol L-1 for Pb2+ and 0.004 nmol L-1 for Cd2+, surpassing many conventional methods. The sensor demonstrated excellent linearity (0.002-200 nmol L-1 for Pb2+, 0.01-100 nmol L-1 for Cd2+), repeatability (RSD <2.43%), and stability (retaining >94% response after four weeks). Real-sample analysis of food and water matrices showed results consistent with ICP-OES, with no significant interference from common ions. This cost-effective, rapid, and sensitive sensor offers a sustainable alternative for trace metal monitoring, with potential for portable, on-site applications in environmental and food safety assessments.
47. Agricultural film microplastics counteract root exudate-induced cadmium behavior changes in soil revealed by PLS-PM analysis.
期刊: Ecotoxicology and environmental safety 发表日期: 2026-Feb-03 链接: PubMed
摘要
Microplastics (MPs), as emerging contaminants, have attracted increasing global attention. MPs in the soil might interact with the root exudates, thus influencing the environmental behavior of cadmium (Cd). However, their complex roles and impact mechanisms are unclear. This study investigated how polyethylene agricultural film microplastics (PE MPs) and ramie root exudates (RE) affect Cd behaviors, soil properties, and microbial diversity. The results revealed that RE increased Cd availability with changing soil properties, enzymes activity and microbial community structure. The addition of PE MPs decreased acid extractable Cd, plant-available Cd and toxicity characteristic leaching procedure (TCLP) Cd by 3.88%-7.41%, 18.92%-28.04% and 3.06%-16.50%, respectively, while PE MPs increased soil pH and soil aggregate mean diameter. Meanwhile, the activity of urease, phosphatase, catalase and the bacterial community abundance were changed by PE MPs. Compared to the only RE treatments, PE MPs decreased the abundance of Acidobacteria, Bacteroidetes and Actinobacteria but increased the activity of Proteobacteria in the soil. The Partial Least Squares Path Modeling (PLS-PM) showed that PE MPs could mitigate Cd availability increase induced by RE, through altering soil characteristics and bacterial community structure. This is the first study investigating the combined effects of PE MPs and RE on Cd behaviors in soil. This study suggests that PE MPs might counteract RE-induced changes in heavy metal activity, which is of significance for the safe production of agricultural products and soil phytoremediation.
48. PAH exposure and associated health risks can be high at a fire site both during fire and long after the fire is extinguished.
期刊: Annals of work exposures and health 发表日期: 2026-Feb-02 链接: PubMed
摘要
The International Agency for Research on Cancer has recently classified occupational exposure as a firefighter as carcinogenic (group 1A). Even though the occupation of firefighter is associated with high exposure to pollutants, it is challenging to carry out exposure studies to assess health risks due to the extreme conditions associated with firefighting. Routine monitoring of occupational exposure to polycyclic aromatic hydrocarbons (PAHs) via active sampling of air is thus not feasible; however, polyurethane foam (PUF) passive air samplers are robust enough to enable monitoring of PAH in occupations such as firefighting. Two measurement campaigns were carried out at a firefighter training facility in Sweden. In the first, PAH concentrations in air were measured for firefighters, observers, and post-fire workers during fire extinguishing exercises. A wide range of PAH exposures were found; firefighters’ exposures were highest (8,300 to 760,000 ng m-3), followed by those of observers (1,600 to 11,000 ng m-3) and post-fire workers (120 to 3,600 ng m-3). In the second, PAH concentrations in air were measured inside 2 burned out sheds for 38 d, starting 3 h after the end of the fire extinguishing exercise. Gas-phase PAH concentrations inside the shed after the fire was extinguished subsided rapidly initially but were high even a week after the fire (3,000 ng m-3) and were 15 to 20 times higher than ambient air levels after more than a month. Mechanical agitation or stirring ashes during post-firework may lead to elevated exposure to the more carcinogenic PAHs, which have higher molecular weights. The results indicate that PAH exposure can be high at a fire site both during the fire and for weeks after the fire is extinguished. Simple preventive measures such as postponing investigation of a fire site for at least a week and wearing respiratory protection can decrease occupational exposure to PAHs.
49. Bacterial Communities as Modulators of Innate Immune Signalling: An In Vitro Perspective on Toll-Like Receptor Activation.
期刊: Environmental microbiology reports 发表日期: 2026-Feb 链接: PubMed
摘要
Investigating the work-environmental microbiome is critical for assessing occupational risk associated with exposure to microorganisms. The present study examined the bacterial composition of inhalable dust from waste sorting plants and explored their potential to induce Toll-like receptors (TLR) in vitro, thereby providing insights into the immunomodulatory potential of complex microbial communities from occupational settings. These findings highlight how few dominant bacterial species shape the immune activation properties of the overall bacterial community, where less abundant taxa play a crucial role in immune modulation through TLR activation. The strong association between TLR activation and rare yet highly inductive bacterial taxa demonstrates their potential immunological significance, suggesting that even low-abundant microbes may have a disproportionate impact on immune responses and occupational health outcomes.
50. Factors Associated With the Retention of Allied Health Professionals in Regional and Rural Public Health Services in Victoria, Australia: A Survival Analysis.
期刊: The Australian journal of rural health 发表日期: 2026-Feb 链接: PubMed
摘要
To examine patterns of retention among the allied health workforce in rural and regional Victoria and identify demographic, professional and service-level factors associated with workforce exit. De-identified administrative human resources data were extracted from participating public and community health services. Employment records included profession, age at commencement, employment dates and service characteristics. Individuals were followed from first recorded employment until workforce exit or censoring at 31 December 2024. Retention was analysed using Kaplan-Meier survival analysis. Cox proportional hazards regression was used to estimate adjusted hazard ratios for workforce exit. Retrospective cohort study using multi-site administrative employment data, analysed with Kaplan-Meier survival curves and Cox proportional hazards regression. Public health and community health services across the Loddon Mallee region of Victoria, Australia. A total of 1815 allied health professionals and assistants were employed between 2015 and 2022. Time to workforce exit, annual turnover, stability rates, survival probabilities and time points to 25% and 45% attrition. One in four staff left within 2 years of employment, and fewer than 55% remained after approximately 4.5 years. Turnover risk was similar across hospital types and sub-regions, indicating that geography exerted only modest influence. Age and profession were the strongest predictors of retention: staff aged under 25 had the highest exit risk, while those aged 25-45 were significantly more likely to remain. Staff aged 55-65 had greater risk of exit, reflecting late-career transitions. Dietitians showed the lowest retention, whereas psychologists, occupational therapists, physiotherapists, speech pathologists and exercise physiologists had higher survival probabilities. Retention varied by age and profession but not by service type or region. Early attrition within the first 2 years is a significant workforce challenge. Profession-specific career pathways, early-career supports and late-career succession planning are needed, alongside stronger system-level monitoring of allied health workforce stability.
51. Global assessment of insulin and oral hypoglycaemic agent accessibility and affordability: A cross-sectional survey of international diabetes federation member countries.
期刊: Diabetes & metabolic syndrome 发表日期: 2026-Jan-31 链接: PubMed
摘要
To examine global stakeholder perspectives on the availability, affordability, and access barriers to insulin and oral hypoglycaemic agents (OHAs), based on a cross-sectional survey of International Diabetes Federation (IDF) member associations. A mixed-methods online survey was conducted among designated informants from 86 IDF member associations across 131 responses. The questionnaire covered medicine availability, reimbursement mechanisms, affordability, and access constraints. Quantitative data were analysed descriptively, and open-ended responses were thematically analysed. In cases of multiple responses from the same country, all were included to capture diverse perspectives. Insulin analogues were reported as available in 68.8% of settings, with full reimbursement in 63.5%. Biguanides and sulfonylureas were the most available OHAs. Major access barriers included high out-of-pocket costs, limited insurance coverage, supply disruptions, and insufficient patient education. Regional representation was uneven, with over-representation from South and Central America and under-representation from South-East Asia; thus, subgroup comparisons should be interpreted with caution. Substantial perceived disparities in access to diabetes medicines persist across countries, particularly in low- and lower-middle-income settings. These findings reinforce the urgent need for improved financing, strengthened supply chains, and integrated patient-centred strategies. This study contributes to the global evidence base by providing a contemporary, policy-relevant snapshot of diabetes medicine access challenges in 2024-2025, supporting national and international efforts to close equity gaps.
52. Antimicrobial resistance and genomic characteristics of avian Pasteurella multocida.
期刊: Poultry science 发表日期: 2026-Jan-28 链接: PubMed
摘要
Pasteurella multocida, the cause of fowl cholera, poses a significant economic threat to poultry. The escalation of antimicrobial resistance (AMR) in this pathogen, driven by drug misuse, is a serious concern. Crucially, a comprehensive understanding of AMR patterns, molecular epidemiology, and virulence in Chinese avian strains is still lacking. This study aimed to elucidate the phenotypic and genomic characteristics of P. multocida strains isolated from avian in Zhejiang Province, China. Twenty avian-origin P. multocida strains isolated in Zhejiang Province were subjected to antimicrobial susceptibility testing, whole-genome sequencing, and virulence assessment. Resistance was most frequent to florfenicol (65%) and tetracycline (50%). Multi-Locus Sequence Typing analysis revealed that ST471 and its closely related variant ST129 collectively constituted the dominant clonal group. A total of 13 resistance genes belonging to 5 major classes were identified, with floR (75%), sul2 (50%), and tet (B) (50%) exhibiting the highest prevalence. In the Galleria mellonella model challenged with 1.5 × 10⁷ CFU/larva, ST471 strains exhibited a slower killing rate compared to ST129 strains, while the ST7 strain demonstrated low virulence. This study demonstrates the increasing prevalence of avian P. multocida in China, specifically the sustained circulation of ST129 and the recent emergence of ST471, particularly in ducks. These findings underscore the urgency of continuous monitoring of strain dissemination and the evolution of multidrug resistance, providing a scientific basis for precise and rational antimicrobials use in farms and for blocking the spread of potentially high-risk strains.
53. Prolonged grief and psychological distress among the public amidst the ongoing hostage crisis following the october 7 attack.
期刊: Psychiatry research 发表日期: 2026-Jan-27 链接: PubMed
摘要
The October 7, 2023, terrorist attack in Israel led to over 1,200 civilian deaths and the abduction of 251 individuals to Gaza. While prior studies have documented the psychological toll on directly affected populations, the broader emotional impact of the ongoing hostage crisis on the general public remains unclear. This study explored how public concern for the hostages relates to psychological distress and functional impairment, focusing on prolonged grief-like responses in the context of unresolved national uncertainty. A nationally representative sample of 515 Israeli adults completed self-report questionnaires at two time points: August 2023 (pre-attack) and May 2025. Measures included anxiety, depression, PTSD symptoms, cumulative stress, emotional burnout, and daily functioning. Concern for the hostages was rated on a 4-point scale. Symptoms associated with Prolonged Grief Disorder (PGD) were measured using an adapted PG-13 scale. Multivariate analyses controlled for baseline distress and trauma exposure. Higher concern levels were significantly associated with elevated distress across all symptom domains. Approximately half of the participants (48.7%) reported elevated levels of PGD-like symptoms in relation to the hostage situation, exhibiting significantly higher psychological symptoms and lower functional well-being, including poorer sleep, reduced concentration, and diminished optimism and hope. Findings indicate that the prolonged hostage crisis constitutes a collective psychological burden marked by ambiguous loss and unresolved national trauma. This form of distress affects even those without direct exposure. Mental health efforts may therefore benefit from addressing distress related not only to direct trauma and bereavement, but also to prolonged uncertainty and symbolic loss.
54. Pt single-atom catalyst-Enhanced aerogenous reaction for pressure signal-based immunochromatographic test strip.
期刊: Talanta 发表日期: 2026-Jan-23 链接: PubMed
摘要
The illicit proliferation of fentanyl, a synthetic opioid drug with extremely strong addiction, has triggered severe public health crisis and social challenge. Conventional detection methods for this drug usually suffer from insufficient sensitivity and operational complexity. Herein, a single-atom catalyst (SAC)-driven pressure sensing strategy was developed by integrating amorphous Fe2O3-supported Pt SAC with immunochromatographic test strip for sensitive immunoassay of fentanyl. The unique twisted structure of Fe2O3 carriers provides large specific surface area and numerous defective sites for anchoring the metallic active sites. Pt SACs were anchored onto the carriers via robust Pt-O coordination bonds, endowing the improved loading stabilization and extremely high utilization efficiency of active sites. Compared to regular Pt nanoparticles, this Pt SAC-based pressure signal tag possesses superior catalase-like activity, decomposing hydrogen peroxide with 5-time faster aerogenous kinetics. Thus this immunochromatographic test strip using Pt SAC as signal tag exhibits extremely high sensitivity with a detection limit of 2.97 pg mL-1. Fentanyl in urine, saliva, and electronic cigarette liquid was detected with recoveries of 82.10 %-117.5 %, verifying its reliability for real sample detection. It is a pioneer work for usage of SAC in boosting aerogenous reaction for pressure sensing, and opens a pathway for field screening of abused drug.
55. Effect of an internet-based, mobile terminal-supported, family-participatory early rehabilitation model on sleep improvement and stigma prevention in critically ill patients: A randomized controlled trial.
期刊: Sleep medicine 发表日期: 2026-Jan-08 链接: PubMed
摘要
This study aimed to evaluate the efficacy of an internet-based, family-participatory early rehabilitation (IFPER) model on improving sleep quality, preventing illness-related stigma, and alleviating procedural pain in critically ill patients. In this single-center randomized controlled trial, 204 adult ICU patients were assigned to the IFPER group (n = 102) or the standard care group (n = 102). The IFPER group received a structured program where trained family members conducted rehabilitation activities guided by a mobile application, in addition to standard care. The primary outcome was the change in sleep efficiency from baseline to ICU discharge, measured by polysomnography (PSG). Secondary outcomes included other PSG parameters, Social Stigma in Critical Illness (SSCI) scores, and daily procedural pain scores (assessed using the Numeric Rating Scale or Critical-Care Pain Observation Tool). A total of 196 patients completed the study. The IFPER group demonstrated a significantly greater improvement in sleep efficiency compared to the standard care group (mean difference, 15.8 %; 95 % CI, 12.5 %-19.1 %; P < 0.001). The IFPER group also showed a higher percentage of REM sleep, fewer arousals (P < 0.01), significantly lower SSCI scores (25.4 ± 5.1 vs. 38.2 ± 6.3, P < 0.001), and consistently lower procedural pain scores (P < 0.05). An internet-based, family-participatory early rehabilitation model significantly improves sleep architecture, reduces perceived social stigma, and alleviates procedural pain in critically ill patients, representing a promising non-pharmacological strategy to enhance recovery in the ICU.
56. Disentangling trait and developmental chronotype across the lifespan: An augmented regression-based approach to norms for morningness-eveningness scales.
期刊: Sleep medicine 发表日期: 2026-Jan-05 链接: PubMed
摘要
Chronotype manifests trait-like dispositions and age-related developmental shifts; yet the psychometrics of existing morningness-eveningness (ME) scales do not reflect the distinctness of these influences. Three issues contribute to this construct-measurement mismatch: assumed age-invariance of reliability and validity, uniform cutoffs across age/sex, and unwarranted conflation of trait and developmental ME. We aimed to exemplify solutions for these issues and deliver age-stratified psychometrics and augmented regression-based norms (RBN) that disentangle trait and developmental ME for the European Portuguese CSM. Multi-cohort data from Portuguese residents/native speakers were pooled. Reliability (N = 2890; 12-94 years) and validity (n = 1880; 12-75 years) were examined overall and across five age groups. Hierarchical step-down regression selected predictors for the augmented RBN. Predictive performance was compared with conventional whole-sample norming on sleep timing and mental-health outcomes. Age-stratified analyses showed adolescents and older adults diverged from overall reliability and validity patterns; nevertheless, indices were adequate. RBN included linear and quadratic age in adolescence and, in adulthood, an additional Age × Sex interaction. Augmented scores’ disentangled trait and developmental components better predicted validity indicators and mental-health outcomes than conventionally normed scores. A public calculator returns ME z-scores, percentiles, and a 9-category chronotype classification for trait, developmental, and combined chronotype. Augmented RBN for the CSM deliver trait, developmental, and combined ME scores and classifications that improve prediction and offer clinical utility for exploring vulnerabilities to psychological distress, sleep problems, and cognitive complaints. The approach may generalize to other ME scales.
57. A call to action to close the global digital divide in nursing: Clinical nursing information systems and standardized terminologies in low and middle-income countries.
期刊: Health informatics journal 发表日期: 2026 链接: PubMed
摘要
Clinical Nursing Information Systems (CNISs) and Standardized Nursing Terminologies (SNTs) significantly enhance the quality of care, promote interoperability, and enable measurable nursing outcomes. However, their adoption remains inconsistent, particularly in low- and middle-income countries (LMICs). This commentary reframes the existing gap as an issue of equity and systems design while providing a feasibility-prioritized roadmap tailored for LMICs. The article supports a sequenced approach that distinguishes between short-term actions and longer-term initiatives. Short-term actions include stabilizing infrastructure, developing open-source CNIS models, initiating terminology localization pilots, implementing essential data privacy safeguards, and providing targeted in-service training. In contrast, longer-term initiatives involve establishing national standards and exchanges, securing sustainable financing, cultivating leadership pipelines and curricula, and promoting cross-border interoperability and evaluation. Furthermore, it delineates various financing mechanisms-including concessional loans, performance-based grants, and collective procurement-while also addressing strategic considerations related to policy and governance frameworks. The commentary concludes with an explicit call to action: policymakers, donors, nursing leaders, educators, and vendors must collaborate to integrate structured nursing data into routine care and national platforms. Bridging this gap will render nursing work more visible, enhance decision support, and foster learning health systems within hospitals and communities worldwide.
58. Phenotypic impacts of treatment-selected mutations in HIV-2 protease on darunavir and lopinavir susceptibility: Evaluating genotypic HIV-2 drug resistance tools.
期刊: PLOS global public health 发表日期: 2026 链接: PubMed
摘要
Compared to HIV-1, HIV-2 infection is characterized by lower viral loads and slower decline in CD4 cells, however the majority of people living with HIV-2 (PLWH2) progress to AIDS and will benefit from antiretroviral therapy. Mutations leading to protease inhibitor (PI) resistance in HIV-2 are poorly characterized, but have important implications for second-line therapy. We evaluated the phenotypic drug susceptibility impacts of HIV-2 protease changes which are identified in genotypic resistance tools. We generated a library of 54 full length HIV-2ROD9 clones that included 21 individual protease mutations, alone or in various combinations. We generated eight additional clones containing combinations of changes observed in PI-treated PLWH2. We tested the clones in a single-cycle PI assay to determine darunavir (DRV) and lopinavir (LPV) EC50, and calculated fold change resistance relative to wild-type HIV-2ROD9. Four of the 21 amino acid changes tested alone conferred PI resistance: V47A and T56V conferred 4.1 and 2.9-fold resistance, respectively, to LPV, I50V conferred 4.6-fold resistance to DRV, and I54M conferred 5.5-fold resistance to DRV and 2.2-fold resistance to LPV. Other changes either lowered the EC50 or caused no change. Some combinations including V47A, I50V, I54M, or T56V also conferred resistance, with EC50 values 4.4 to 17-fold higher than wild-type. Six of eight PLWH2-derived strains were replication-competent: five exhibited resistance to LPV (>8.8-fold resistance), and three exhibited resistance to DRV (>4.7-fold). HIV-1 and HIV-2 are not equivalently susceptible to all antiretroviral agents and do not utilize identical pathways to resistance. We provide phenotypic evidence supporting the resistance role of changes in HIV-2 protease which do not have HIV-1 analogues, as well as evidence that analogues of “major” resistance changes in HIV-1 may have no resistance impacts in HIV-2, despite apparent treatment selection. These results should inform the HIV-2 genotypic resistance tools and help improve treatment for PLWH2.
59. Radiation safety among female orthopaedic surgeons: A survey of current knowledge and practices.
期刊: Bulletin of the Hospital for Joint Disease (2013) 发表日期: 2025-Dec-01 链接: PubMed
摘要
The objective of this study was to survey a cross-section of US female orthopaedic surgeons evaluating their education and attitudes on radiation safety and adherence to safety recommendations. An online survey was distributed to female orthopaedic surgery faculty through the Forum, a society for women in orthopaedic surgery, and through internal institutional education networks (residency and fellowship programs). The first component of the survey gathered demographic information including practice setting, US state, and years in practice. The second component was a 10-question knowledge assessment. The third component captured personal experiences among respondents including satisfaction with radiation safety training, radiation safety practices, and level of concern regarding exposure risk. Responses from 66 participants from differing geographic locations were collected using Research Electronic Data Capture. Sixty-six female orthopaedic surgeons from 21 states completed the survey. Regular dosimeter usage was reported by 24.2% of respondents, and 36.4% of respondents reported always having well-fitted radiation protective equipment provided. The majority (56.1%) stated that they worry about the risks of radiation to their health. Regarding their radiation safety training, 60.6% of respondents rated their training as unsatisfactory or extremely unsatisfactory, and 90.9% of respondents stated that they think training efforts for radiation safety can improve. Female orthopaedic surgeons demonstrated an inadequate knowledge of adherence to radiation safety protocols and the majority expressed concern with long-term radiation exposure, particularly regarding health and pregnancy risk. To enhance radiation safety awareness and adherence among female orthopaedic surgeons, strategies should be tailored to this demographic, fostering confidence in their knowledge of radiation exposure and bolstering safety measures.