公共卫生研究摘要 (2026-02-06)
共收录 59 篇研究文章
1. Intense solar radiation constrains plant species richness in global grasslands.
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
The search for predictors of plant diversity has challenged scientists for decades. Here we identify intense photosynthetically active radiation (PAR) as a major factor constraining plant species richness in global grasslands. We show that the strength of the negative relationship between species richness and PAR increases with increasing elevation and that species richness is more strongly correlated with intense PAR than with UV-B radiation, climate variables, and atmospheric nitrogen deposition. In addition to species richness, plant biomass was also negatively correlated with PAR at higher elevations, indicating that intense PAR also constrains plant biomass in montane grasslands. Furthermore, we show that the decrease in plant species richness with increasing PAR is mainly caused by a decrease in species richness of forbs, sedges, and rushes. In contrast, species richness of grasses was only negatively correlated with PAR at high elevations, and species richness of legumes was not significantly correlated with PAR. Our results suggest that PAR constrains plant species richness in global grasslands and limits the extent to which plant species of specific functional groups can migrate uphill in response to climate warming.
2. Comparative Modeling of Recent and Projected Trends in the Incidence and Mortality of Uterine Cancer.
期刊: Obstetrics and gynecology 发表日期: 2026-Feb-06 链接: PubMed
摘要
To aid in cancer control and prevention activities by developing, calibrating, and validating three distinct natural history simulation models of uterine cancer, a growing public health concern. To perform comparative analyses, we developed two state-transition microsimulation models and a multistage clonal expansion model of uterine cancer. The models simulate uterine cancer incidence and mortality. All three models were calibrated to common data on the incidence of uterine cancer from the Surveillance, Epidemiology, and End Results (SEER) 18 database. Each model accounts for changing trends in hysterectomy and obesity over time and simulates incidence and mortality for endometrioid and nonendometrioid tumors and uterine sarcoma. After calibration, we projected the incidence and mortality of uterine cancer to 2050. The three uterine cancer models were well calibrated to population data and produced comparable results for projecting the burden of disease through 2050. Among non-Hispanic White women aged 40 years or older, the models project that by 2050 the incidence of uterine cancer will rise to 76.1-81.8 per 100,000 woman-years, up from 2018 SEER incidence of 60.0 per 100,000 woman-years. Among non-Hispanic Black women, new cases will rise to 90.3-107.2 per 100,000 woman-years, up from 2018 SEER incidence of 61.3 per 100,000 woman-years. Within these populations, incidence-based mortality will increase to 11.3-12.3 deaths per 100,000 woman-years for non-Hispanic White women and to 28.2-35.7 deaths per 100,000 woman-years for non-Hispanic Black women. Three distinct mathematical simulation models of uterine cancer have been calibrated to observed population-based incidence and mortality. All three models project substantial and continued increases in the incidence and mortality of uterine cancer.
3. Target Trial Emulation for Regulatory and Clinical Decision Making in Cancer.
期刊: Journal of clinical oncology : official journal of the American Society of Clinical Oncology 发表日期: 2026-Feb-05 链接: PubMed
摘要
Randomized trials provide evidence for regulatory and clinical decision making in oncology. However, trials cannot answer every important clinical question. Evidence gaps often persist in under-represented or small patient populations and for questions about head-to-head comparisons of active treatments, complex treatment strategies (including treatment sequencing and other dynamic treatment strategies), and long-term or rare outcomes. To address these questions, clinicians and researchers increasingly turn to observational (real-world) data. The target trial framework provides a systematic approach for designing observational analyses that attempt to emulate a hypothetical pragmatic trial. This process requires that investigators specify the key components of the causal question as elements of the target trial protocol: eligibility criteria, treatment strategies, assignment procedures, follow-up, outcomes, and causal contrasts. Explicitly emulating the target trial helps investigators avoid common study design flaws that can lead to immortal time and selection bias. Although the target trial framework helps to avoid such design-related biases, it cannot eliminate biases due to inherent data limitations, such as confounding and measurement error. Here we review target trial emulation to supplement evidence from randomized trials and inform regulatory and clinical decision making in oncology. Understanding the strengths and limitations of the target trial framework improves the integration of real-world evidence into modern cancer care.
4. Association of Fall-Risk Factors and Margin of Stability While Tripping in Community-Dwelling Older Adults: Experimental Pilot Study.
期刊: JMIR formative research 发表日期: 2026-Feb-05 链接: PubMed
摘要
Falls are a leading cause of injury among older adults, often resulting from dynamic balance disturbances. It is influenced by a complex interplay of intrinsic and extrinsic fall-risk factors. To identify individual fall risks, it is important to understand the underlying associations. This study aimed to build an experimental setup modeling selected factors leading to a loss of balance, measured by the margin of stability (MoS) in an ecologically valid real-world example (tripping). Additionally, these analyses aimed to assess the feasibility and safety of the protocol and to explore the use of the MoS as part of a prototypical dynamic fall-risk model to differentiate between fall-risk groups. Nineteen community-dwelling older adults (mean age of 71, SD 3.67 y; n=7, 37% women) completed the tripping protocol involving perturbations under various conditions. Clinical assessments were used to identify relevant fall-related intrinsic fall-risk factors. MoS was measured using an 8-camera motion capture system. Receiver operating characteristic analyses determined the ability of MoS to distinguish between low and high fall-risk groups. Approximately one-quarter of participants discontinued before or at the start of the tripping scenario because of discomfort or fear of perturbations, indicating that perceived safety is an important feasibility factor. Perturbations significantly disrupted MoS, with a median MoS of -106.05 (IQR -181.40 to -41.50) mm during the perturbed step compared to 114 (IQR 81.20-155.20) mm in the preperturbation step. Recovery steps showed progressive stabilization, with the second recovery step achieving a median MoS of 88.45 (IQR 47.50-137.80) mm. The second recovery step exhibited the highest predictive accuracy for fall-risk differentiation, with area under the curve values reaching 82.3% during slow walking with a series of right-sided perturbations. In contrast, fast walking with random perturbations yielded lower area under the curve values (64.9%). Slow walking conditions generally demonstrated the clearest separation between fall-risk groups. This pilot and feasibility study demonstrates the applicability of a tripping paradigm to perturb MoS in older adults and provides preliminary insights into its association with fall-risk indices. While the protocol proved safe and feasible for fit older adults, perceived safety limited full participation. The findings are exploratory and intended to guide the design of larger prospective studies rather than to establish predictive conclusions. These data suggest that MoS during controlled tripping may help differentiate fall-risk strata, but confirmation will require adequately powered studies in more diverse and frailer older populations-and across multiple real-world scenarios-before any clinical implementation can be considered.
5. A Scientif ic Overview of Worldwide Research Activities on Trauma in Mental Health Nursing.
期刊: Issues in mental health nursing 发表日期: 2026-Feb-05 链接: PubMed
摘要
The number of studies on trauma in psychiatric nursing is steadily increasing. An annual growth rate of 7.7% is observed in publications, and the highest number of publications is expected to be reached in 2025. This trend highlights the growing significance of trauma-related research on psychiatric nursing. This study aimed to examine the quantitative and qualitative characteristics of publications on trauma in the field of psychiatric nursing from a bibliometric perspective. The Web of Science database was used for this research. In this study, a bibliometric analysis, which is a methodological approach used to determine the scope of knowledge in a specific field and evaluate productivity, was applied. Data were collected by screening studies published up to June 2025, the study date, without time limitation, using the keyword combination “mental health nursing” OR “psychiatric nursing” AND “trauma.” In this study, 523 trauma studies and reviews conducted in the field of psychiatric nursing between 1996 and 2025 were identified, and the analysis was completed using 461 studies in accordance with the exclusion criteria. The analysis revealed 1,630 authors, 383 research articles, and 78 reviews/systematic reviews, with an average of 16.5 citations per publication. A noticeable increase has been observed in the participation of psychiatric nurses in trauma research. It is recommended that nursing professionals conduct more research to examine trauma processes by considering biopsychosocial factors and developing ethically sound approaches for both patients and healthy individuals. What is already knownPsychiatric nurses work in high-stress environments and frequently work with traumatized patients.Although progress has been made in understanding and addressing trauma in psychiatric nursing, there remains a critical need for continued research.What this paper adds to existing knowledge?It is seen that the highest number of publications in the field of psychiatric nursing were made in 2023.It was determined that the most frequently used keywords were trauma, mental health and mental health nursing.It was observed that one of the journals in which the most articles were published was the Issues In Mental Health Nursıng.Implications for practice These findings indicate that although progress has been made in understanding and addressing trauma in psychiatric nursing, there remains a critical need for ongoing research, policy development, and practical interventions aimed at ensuring both nurses and patients’ safety and well-being in mental-health settings.
6. Navigating the Complexity of Lung Cancer Surveillance Practices: Qualitative Pilot Study on Provider Perspectives.
期刊: JMIR cancer 发表日期: 2026-Feb-05 链接: PubMed
摘要
Surveillance is noted to be an important part of survivorship to detect recurrence and/or second primary lung cancer (SPLC) at a curable stage. However, current surveillance guidelines remain controversial, and the factors providers consider in clinical decision-making are neither well-defined nor consistently applied. In order to inform the qualitative protocol for a larger national study, this pilot study aimed to understand the factors that influence lung cancer surveillance and how providers view risk stratification as a potential tool to inform surveillance practices. Semistructured interviews were conducted between October 2023 and July 2024 with purposively sampled providers involved in treating and surveilling patients with lung cancer from the US-based Palo Alto Veterans Affairs Medical Center and Stanford Medicine and its affiliate clinics. Providers were recruited through both email outreach and in-person invitations. Interviews were transcribed by an external transcription service and analyzed through a qualitative inductive content analysis approach to identify themes. In total, 11 physicians and 2 advanced practice providers (N=13) participated in interviews. The majority were from medical specialties (n=8, 61.5%), and the average number of years of practice as a provider was 9 years. A total of 3 themes were identified that describe the clinicians’ sentiments about current surveillance practices and how a risk stratification tool could be used in screening for recurrence and/or SPLC. Clinicians consider a variety of clinical and nonclinical factors (category 1: factors that influence clinical decision making) and highlighted limits of a risk stratification tool, including concerns about generalizability, accuracy, and validity (category 2: sentiments toward a hypothetical risk stratification tool). Finally, concerns were raised about how delivering risk stratification data might impact patient anxiety, misinterpretation, and adherence to surveillance plans (category 3: delivery of risk stratification data to patients). This qualitative analysis highlights the complexity of lung cancer surveillance decision-making and provider concerns about tool accuracy and delivery. While risk stratification tools may support surveillance decisions, their further development must address data quality, accuracy across diverse clinical and nonclinical risk factors, and effective patient-level data delivery. Doing so will facilitate the practical implementation of risk stratification tools to improve surveillance of SPLC and recurrence.
7. Stigmatized Minds, Neglected Care? A Global Analysis of Schizophrenia-Related Stigma.
期刊: Issues in mental health nursing 发表日期: 2026-Feb-05 链接: PubMed
摘要
The research on schizophrenia and stigma within the nursing discipline is experiencing a notable increase. This trend underscores the escalating significance of addressing schizophrenia and stigma within the nursing profession. This study aimed to examine the quantitative and qualitative characteristics of publications on schizophrenia and stigma in the field of nursing from a bibliometric perspective. The data of this bibliometric analysis. The data were retrieved using the keyword combination “schizophrenia” and “stigma,” encompassing studies published up to July 2025, the date of the study, without imposing any temporal restrictions. In this study, 290 schizophrenia and stigma research articles/reviews conducted in the field of nursing between 1997 and 2025 were identified, and 274 articles were included in accordance with the exclusion criteria. The analysis revealed that there were 874 authors, 243 research articles, and 31 reviews/systematic review articles, with an average of 18.4 citations per publication. The findings indicate that, despite advancements in comprehending and addressing stigma associated with schizophrenia within the nursing profession, there remains a significant need for continued research, policy formulation, and practical interventions. It is advisable for nursing specialists to engage in further research on schizophrenia and the mechanisms of stigmatization. The findings indicate that, despite advancements in comprehending and addressing stigma associated with schizophrenia within the nursing profession, there remains a significant need for continued research, policy formulation, and practical interventions. These efforts are essential to ensure the safety and well-being of both nurses and patients in mental health care environments.
8. Family-Based Digital Lifestyle Intervention for Hispanic Adolescents and Their Parents: Iterative Co-Design and Development Study.
期刊: JMIR formative research 发表日期: 2026-Feb-05 链接: PubMed
摘要
Hispanic youth in the United States have the highest rates of pediatric obesity and do not often meet national guidelines for physical activity and dietary intake. Family-based interventions can improve health outcomes in both youth and their parents and are highly relevant to Hispanics due to the cultural value of familismo (familism). However, few existing family-based obesity prevention interventions for Hispanics target adolescents and their parents, and those that do are not designed to facilitate widespread reach. This study describes the development of Healthy Juntos (Healthy Together), a family-based intervention for Hispanic adolescents and their parents that leverages the web and smartphone technology to prevent the onset of adolescent obesity by promoting healthy lifestyle behaviors (physical activity and diet). We used an iterative co-design process guided by the Integrate, Design, Assess, and Share (IDEAS) framework, which outlines 10 phases for developing digital interventions. Hispanic adolescents at risk for obesity and their parents (n=90; 45 dyads) participated across different phases of the intervention development process. We conducted qualitative interviews to understand their needs and preferences and to gather feedback on a series of intervention prototypes (conceptual, paper and minimally functional, and fully functional). Participants reported using technology for their health in limited ways (eg, to search for medical symptoms and recipes). They described the importance of having interactive and social features as part of a family-based digital health intervention. Their suggestions related to content, functionality, and aesthetics resulted in a fully functional prototype of a digital lifestyle intervention for Hispanic adolescents and their parents. The iterative co-design process was crucial for refining the Healthy Juntos intervention. Our next steps are to evaluate its feasibility, acceptability, and preliminary effects through a pilot randomized controlled trial.
9. Comment on "the usefulness of the follicle-preserving sign in differentiating between benign, borderline, and malignant ovarian tumors on magnetic resonance imaging".
期刊: Japanese journal of radiology 发表日期: 2026-Feb-05 链接: PubMed
摘要
10. Vascularization and maturation of kidney organoids: a comprehensive review of technological trends and challenges.
期刊: Journal of artificial organs : the official journal of the Japanese Society for Artificial Organs 发表日期: 2026-Feb-05 链接: PubMed
摘要
Chronic kidney disease is a global health issue, and novel therapeutic alternatives to dialysis and kidney transplantation must be developed. Human-induced pluripotent stem cell-derived kidney organoids recapitulate developmental processes and mimic kidney-like structures in vitro and have thus attracted attention for treating chronic kidney disease. However, the limited vascularization and immaturity of human-induced pluripotent stem cell-derived kidney organoids remain major barriers to their clinical application. The latest technological advances and specific challenges in kidney organoid vascularization and maturation were thoroughly examined in this review. Diverse approaches were considered, including coculturing with endothelial cells, in vivo transplantation, applying biomaterials and microfluidic systems, controlling molecular signaling, and metabolic reprogramming. However, issues persist such as low reproducibility, lack of standardization, insufficient functional evaluations, and inadequate safety assessments. Future studies should focus on developing multifactorial and strategies for integrating multiple cell types, establishing maturation assessment criteria, and verifying the long-term functionality and safety of three-dimensional bioprinting technologies. Technologies for the vascularization and maturation of kidney organoids show promise as foundational methods for use innovative regenerative medicine and the development of drug discovery therapies.
11. Personal reflection on future of psychiatry.
期刊: International review of psychiatry (Abingdon, England) 发表日期: 2026-Feb-05 链接: PubMed
摘要
History of Psychiatry can be of help, not only not to repeat the mistakes of the past, but also to find good heuristic sources in old books. A constant feature of medicine that goes back to the foundation of its scientific roots, thousands of years ago, is the fact that the body cannot be separated from the mind, and the individual cannot be separated from the group. Hence, the bio-psycho-social triangle will stay and be reinforced in the future. Promotion of health and prevention of illnesses are an absolute necessity in the whole of medicine, especially in Psychiatry. A good healthy lifestyle is not only a must for physical health, but also for mental health. If the source of illnesses is not turned off, then, whatever numbers of health (including mental) workers we have available, it will never be enough. Among the 3 main components of mental health, the social and cultural one is of essence and will probably prevail in the future, especially in low- and middle-income countries. Finally, physical exercise is essential for a good mental health and will stay as such. Artificial intelligence will also become a major player in our profession.
12. Differential effects of GVHD therapies on intestinal epithelium.
期刊: Blood advances 发表日期: 2026-Feb-05 链接: PubMed
摘要
Graft-versus-host disease (GVHD), an often-fatal complication of allogeneic hematopoietic stem cell transplantation (HCT), is driven by inflammatory injury that damages target organs of gastrointestinal (GI) tract, skin and liver. Effective therapies must not only suppress GVHD reactivity of donor lymphocytes but permit regeneration of the damaged epithelium, particularly in the GI tract. Systemic corticosteroids are the standard first-line treatment for GVHD due to their powerful immunosuppressive and anti-inflammatory properties but may retard epithelial repair. Ruxolitinib, a selective JAK1/2 inhibitor, is an approved therapy for steroid-refractory GVHD, although its direct effects on epithelial repair are unknown. Intestinal stem cells (ISCs) that are critical for maintaining gut integrity and barrier function are key cellular targets of GVHD. We employed both ileal and colonic organoid cultures to study the direct effects of methylprednisolone and ruxolitinib under conditions that controlled the strength of the GVH reaction. Ruxolitinib prevented inflammatory apoptosis in both human and murine organoids and preserved ISC function and proliferation, while corticosteroids offered no protection and in fact suppressed proliferation. This study highlights the importance of GVHD therapies that facilitate epithelial repair and regeneration, protect target tissues and suppress alloreactivity of donor T cells.
13. Tailoring Cu+-Ov-Ti Ensembles with Electrophilic O- Species for Enhanced Catalytic Toluene Oxidation.
期刊: Environmental science & technology 发表日期: 2026-Feb-05 链接: PubMed
摘要
The acceleration of industrialization has driven the increased emission of volatile organic compounds (VOCs), posing significant threats to both the ecological environment and public health. The deficiency of reactive oxygen species fundamentally restricts the low-temperature catalytic toluene combustion in transition-metal oxide catalysts. Herein, we report a strategy for intelligently designing active Cu+-Ov-Ti ensembles by coupling isolated Cu with adjacent oxygen vacancy, which can synergistically activate chemisorbed O2 into reactive superoxide species (O2-). The defective Cu/TiO2-x catalyst exhibited remarkable catalytic performance for toluene oxidation, achieving a T90 of 225 °C, significantly 100 °C lower than that of the pristine Cu/TiO2 catalyst. The low coordination geometry and electron transfer within Cu+-Ov-Ti ensembles synergistically activated O2 to form the Cu-(O-O)ad-Ti bridged superoxide O2- intermediate with an elongated O═O bond. In addition, the distinctive Cu-(O-O)ad-Ti bridging structure with localized electrons facilitated the chemisorbed O2 dissociation into electrophilic monatomic O- species, which subsequently nucleophilically attack the methyl C-H of toluene. These benzyl alcohol-derived Ph-CH2-O- intermediates can be readily and flexibly converted into reactive benzaldehyde and benzoic acid species, which were available for subsequent aromatic ring-opening reactions. This study not only advances mechanistic insights into the Cu+-Ov-Ti ensembles and electrophilic O- species in toluene catalytic oxidation but also establishes a design Cu+-Ov-Ti principle for engineering efficient VOC elimination catalysts.
14. Chemical Clustering Analysis of Ambient and Emission Source Particulate Matter Reveals Compositional Determinants of Pulmonary Toxicity Responses.
期刊: Chemical research in toxicology 发表日期: 2026-Feb-05 链接: PubMed
摘要
Comparative toxicological studies of heterogeneous particulate matter (PM) samples are needed to evaluate the influence of particle chemistry on pulmonary toxicity outcomes. Here, groups of mice were exposed by oropharyngeal aspiration of a 100 μg dose of one of seven PM samples, including three coarse and two fine ambient air PM, and 2 fine emission source PM. Acute inflammatory and lung injury markers in the bronchoalveolar lavage fluid (BALF) were assessed. A weighted chemical correlation network analysis (WCCNA) clustered PM chemical constituents into four modules based on comodulation within samples. These modules and their components were then correlated with lung toxicity end points. One module represented the highest levels of zinc, lead, copper, and tin, and was strongly correlated with BALF neutrophils, macrophage inflammatory protein-2, and several markers of lung injury. A second module represented the highest levels of several toxic transition metals including magnesium, nickel, vanadium, and cobalt, and was strongly correlated with pro-inflammatory interleukin-6, in addition to neutrophils, albumin, and lactate dehydrogenase. A third module, represented by high levels of elemental carbon, nitrate, sulfate, and phosphate, was correlated with pro-inflammatory tumor necrosis factor-α (TNF-α), in addition to BALF protein and other lung injury markers. The final module consisted of 7 elements associated with the 3 coarse crustal PM samples, and these individual elements exhibited moderate correlations with BALF neutrophils and TNF-α. Toxic transition metals produced the greatest effects on lung toxicity, followed by anions and carbon species. These studies demonstrated that chemical and toxicological assessments of heterogeneous samples of PM produce clusters of chemical constituents that can be correlated with separate toxicological outcomes.
15. Enhancing Caregivers' Quality of Life Through a Web-Based Person-Centered Solution (TechQoL4Carers): Protocol for a Mixed Methods Pilot Trial.
期刊: JMIR research protocols 发表日期: 2026-Feb-05 链接: PubMed
摘要
Informal care is a social challenge that impacts the daily life and quality of life (QoL) of caregivers. While care has evidence of positive aspects, it can also have negative impacts on mental, physical, economic, and social well-being. Nowadays, health, social, and care systems for informal caregivers are needed, from a person-centered perspective, to promote their QoL, health, and empowerment. Technology is a promising tool to provide personalized services. This study aims to develop an innovative care-centered technology solution to enhance caregivers’ QoL, care impact, occupational balance, health self-management, and empowerment. A mixed methods pilot trial was designed as a single-arm open-label study. Participants will be caregivers of people with disabilities or older people, recruited through direct care centers. Caregivers will engage in a participatory process of developing, testing, and validating the TechQoL4Carers project platform, CuidaconTIC; a web-based platform to improve their QoL, impact of care, occupational balance, health self-management, and empowerment. The development of this trial will refine the CuidaconTIC platform, which is based on person-centered development, participatory design techniques, and an iterative process. A total of 54 caregivers will participate in a 3-month intervention involving the use of the CuidaconTIC platform and the Xiaomi Smart Band 7 wristband. Standardized assessment tools (EQ-5D-5L, Care-Related Quality of Life, Zarit Burden Interview, Caregiver Strain Index, Occupational Balance Questionnaire-Spanish Version, Psychological Empowerment Instrument, and the System Usability Scale) and a self-designed tool (Satisfaction-Q) will be used at 3 time points to collect information about usability, satisfaction, and project variables. Continuous information will be obtained from the platform (My week-Q) and the wearable wristband (physical activity and sleep). An interview will be conducted to gain in-depth knowledge about participants’ perspectives. This study was approved by the Ethics Committee for Research and Teaching of the Universidade da Coruña (2023_019) and registered on ClinicalTrials.gov. Participation will be entirely voluntary, with informed consent obtained from each participant. Detailed information sheets and informed consent forms will be provided. The data of the participants will be collected in a pseudonymized form. Once the study has been completed, any possibility of participant identification will be eliminated. Financial support for this project was received on December 1, 2022. This protocol was submitted after data collection but before analysis. Data collection began in May 2024 and ended in March 2025. By October 2025, 62 participants had been recruited. We expect to publish our results in June 2026. This protocol focuses on the study of the social challenge of quality of life of caregivers, mostly women, and on reducing the digital gap and promoting inclusion, through a service that places people and care at the center.
16. Ergonomic evaluation and redesign of a makeshift vehicle repairing cart.
期刊: Work (Reading, Mass.) 发表日期: 2026-Feb-05 链接: PubMed
摘要
BackgroundTraditional vehicle-repairing carts in India present ergonomic challenges and occupational health and safety issues. Operators experience discomfort and strain due to difficulties in pushing the cart over long distances and in organising tools and setting up workstations.ObjectivesTo redesign the makeshift vehicle repairing cart by incorporating ergonomic principles and relevant anthropometric data of target users, aiming to reduce physical fatigue and improve usability.MethodsErgonomic evaluations were conducted to identify areas of discomfort, focussing on body parts affected. The operators expressed postural discomfort in different parts of the body like the lower back, neck, shoulder, forearm, wrist, ankle, and foot.ResultsResearchers made recommendations for the proper layout of the tools, provision for manipulating the vehicle in a better manner with ergonomically designed handles, and provision of a modular workstation detachable from the main unit. Accordingly, three concept prototypes were suggested.ConclusionThe manufacturer adopted all three concepts in principle for the new design to improve ergonomics and design of cart for user comfort.
17. Empowering operators: Ergonomic advances in cylindrical lawnmower design.
期刊: Work (Reading, Mass.) 发表日期: 2026-Feb-05 链接: PubMed
摘要
BackgroundLawnmower operators are exposed to high noise and hand-arm vibration (HAV) during their work, which originates mainly from the engine and rotating parts. Higher exposure causes intangible issues for the well-being of the operators, results in immediate and long-term effects on the health, comfort, and safety of the operators.ObjectiveThe study involved measuring noise and HAV from a powered cylindrical lawnmower, developing retrofittable interventions, and evaluating noise and HAV levels with the interventions, and compared their effectiveness using a health risk assessment.MethodsThe study was done at three speeds and two modes of operation. The measured noise and HAV amplitudes exceeded the permissible limits of international standards. Higher amplitudes were observed at resonant frequencies of the ear and hand. To mitigate the exposure and increase the safe working hours of the operators, two interventions were developed and retrofitted to the existing lawnmower. The noise and HAV were measured with interventions and compared against pre-intervention phase. Operator’s physiological, psychophysical, and postural parameters were also assessed in the lawnmower operation.ResultsThe developed interventions reduced the noise level from approximately 95 dB(A) to 85 dB(A), satisfying it within internationally permissible limits. HAV has been reduced from 23 ms-2 to below 10 ms-2, thereby increasing the safe exposure time by approximately 2.3 times with interventions. However, the operator’s physiological, psychophysical, and postural parameters remained unchanged as operational requirements remained the same.ConclusionNoise and HAV reduction through interventions provided a safer working environment for the lawnmower operators.
18. A ready-to-use microsensor based on SERS technique for deltamethrin and its metabolite determination toward point-of-care diagnostics.
期刊: Mikrochimica acta 发表日期: 2026-Feb-05 链接: PubMed
摘要
19. Vasopressor use in the intensive care unit: What matters most to patients and families.
期刊: Australian critical care : official journal of the Confederation of Australian Critical Care Nurses 发表日期: 2026-Feb-04 链接: PubMed
摘要
Vasopressors are essential medications used in the intensive care unit (ICU) to maintain blood pressure in patients with life-threatening hypotension. While vasopressors can be lifesaving, they carry potential risks, such as reducing blood flow to certain organs and increasing the work that the heart must do to pump blood to the body. Despite their frequent use, little is known about how patients, families, and the public perceive the benefits and risks of vasopressor therapy. The objective of this study was to explore perspectives of former ICU patients, their families, and the public on the use, and benefits, and risks of vasopressor therapy in the ICU. We conducted a qualitative study using interviews and focus groups with 25 participants: nine former ICU patients (36%), eight family members (32%), and eight public members (32%). Participants received education on hypotension and vasopressor use before discussions. Topics included factors influencing willingness to receive vasopressors, perceived benefits and risks, and priority outcomes. Data were analysed using inductive content analysis. Perspectives were influenced by three contextual factors: (i) level of consciousness during vasopressor administration; (ii) pre-existing health conditions or medications; and (iii) life stage. Willingness to undergo therapy was shaped by a focus on stabilisation and survival, perceived low risk of side effects, belief that side effects could be managed, and trust in clinicians. Participants also expressed concerns about social, physical, and mental wellbeing challenges following vasopressor therapy. While vasopressors were broadly accepted as lifesaving, participants emphasised the importance of aligning treatment decisions with long-term outcomes. Many of the themes identified overlap with general ICU survivorship concerns, highlighting the need for improved communication about risks and benefits and patient-centred discussions regarding ICU therapies and post-ICU outcomes.
20. Melatonin inhibits ferroptosis by activating CREB-GPX4/ferritin axis in cigarette smoke-induced chronic obstructive pulmonary disease.
期刊: International immunopharmacology 发表日期: 2026-Feb-04 链接: PubMed
摘要
Chronic obstructive pulmonary disease (COPD) is a global public-health concern due to its currently high morbidity and mortality. Cigarette smoke (CS) exposure, the primary inducer of COPD, can provoke ferroptosis in lung epithelial cells. Melatonin, a neurohormone, has potential anti-inflammatory and anti-oxidative capacities. In this study, we investigated the protective effects of melatonin on CS exposure-induced COPD mice, and its underlying mechanisms of actions. The results showed that CS exposure caused obvious lipid peroxidation and the accumulation of ferrous (Fe2+) with the decreased expression of melatonin receptor (MT), thus triggered ferroptosis of lung epithelial cells in vitro and in vivo. In vitro, melatonin upregulated xCT, GPX4 and ferritin (FTH1/FTL) expression, reversed the CSE-induced ferroptosis depending on activated MT with the elevated phosphorylation of cAMP response element-binding protein (CREBser133). CREB knockdown (KD) caused melatonin failure to upregulate GPX4 and FTH1/FTL expression, thus did not inhibit CSE-induced ferroptosis of airway epithelial cells. Moreover, after suppressing the transcriptional regulation of p-CREB, melatonin again failed to promote GPX4 and FTH1/FTL expression and inhibit CSE-induced ferroptosis. The mechanistic dissection showed that melatonin led to the nuclear translocation of p-CREB which in turn bound to the promoter regions of GPX4 and FTH1/FTL genes, promoted their expression. In CS-induced COPD mice, melatonin alleviated pulmonary inflammation, emphysema and airway remodeling, improved lung function via activating the CREB-GPX4/ferritin signaling axis and inhibiting ferroptosis of pulmonary epithelial cells. Taken together, our findings indicates that melatonin inhibits CS-induced ferroptosis via activating CREB-GPX4/ferritin axis depending on activated MT. These findings can help lead to promising protective strategies for COPD.
21. Who understands a child's pain better? A comparison of oncology and non-oncology nurses' knowledge and attitudes toward pediatric pain assessment and management.
期刊: Journal of pediatric nursing 发表日期: 2026-Feb-04 链接: PubMed
摘要
Comprehensive continuous assessment and effective pain management for pediatric pain are important. To assess the differences between oncology and non-oncology nurse knowledge and attitudes toward pediatric pain. A descriptive cross-sectional study was conducted in three public hospitals and included nurses who provided oncology and/or non-oncology care in pediatric departments. The sample included 207 nurses. More than half of nurses (n = 142, 68.6%) had not attended any workshop related to pediatric pain management. Both oncology and non-oncology nurses exhibited low mean of knowledge and attitude toward pediatric pain assessment and management, however, oncology nurses scored significantly higher (t = 12.13, p < .001). Among oncology nurses, higher PNKAS scores were associated with younger age (ꞵ = -0.575, p = .003), longer nursing experience (ꞵ = 0.642, p = .016), having children (ꞵ = 0.402, p = .010), and reliance on child status (ꞵ = 0.206, p = .044) and parent verbalization (ꞵ = 0.236, p = .027). Targeted educational interventions, particularly for non-oncology nurses focusing on child-centric assessment and supported by mentorship and clear clinical policies, are essential to bridge this knowledge-attitude gap and improve pediatric pain outcomes. This study underscores the critical need to implement standardized, mandatory pain management education for all pediatric nurses, with a focus on training in non-verbal pain assessment techniques. Findings emphasize that all nurses need to apply culturally sensitive approaches to overcome sociocultural barriers to effective pain relief.
22. Effect of a health literacy education program on the health literacy of parents of children with disabilities in special education and rehabilitation centers.
期刊: Journal of pediatric nursing 发表日期: 2026-Feb-04 链接: PubMed
摘要
This study aimed to examine the preliminary results of a health literacy education program on the health literacy of parents of children with disabilities in special education and rehabilitation centers. The study employed a single-group pre- and posttest research design. It was conducted with parents of children receiving services at four special education and rehabilitation centers affiliated with a district national education directorate. First, the questionnaires were administered, and the data were collected. Then, a 6-week health literacy training program was conducted. After the program, the data were collected again and analyzed using the paired-sample t-test and the McNemar’s test. The pretest mean health literacy score was 30.19 ± 8.08, which increased to 36.63 ± 8.42 at posttest (p < .001). Following the educational program, 44 participants demonstrated enhancement in their health literacy levels and transitioned from the inadequate or problematic category to the adequate category in their post-assessment results (p < .001). The study successfully achieved this objective, thereby demonstrating a positive impact of the training program on the health literacy of parents of disabled children. The significance of this study lies in addressing the research gap concerning parents of children with disabilities in special education. The program had a positive impact on the health literacy of participating families.
23. Gaps in the Electronic Medical Record May Contribute to Low Participation in Lung Cancer Screening.
期刊: The Journal of surgical research 发表日期: 2026-Feb-04 链接: PubMed
摘要
Best Practice Advisories (BPAs) are electronic medical record (EMR) tools that help increase uptake of recommended health care behaviors, such as cancer screenings, by identifying eligible patients and alerting providers. However, incomplete/inaccurate documentation within the EMR can be a potential barrier to BPA utility. The purpose of this work was to investigate the effectiveness of a BPA tool to identify eligible patients for lung cancer screening (LCS) using available EMR smoking histories. Retrospective observational review was conducted of a BPA programmed to identify LCS-eligible patients at a single quaternary, LCS-accredited, academic medical center. Programming targeted patients aged 50-77 y classified as “current” or “former smokers,” excluding patients with recent lung computed tomography scans and/or lung cancer diagnoses. Data analyzed included frequency of BPA activation and the associated smoking history. Descriptive statistics were used to analyze outcomes. Between January 2017 and December 2021, there were 25,172 BPA activations, of which 11,701 were removed because they occurred outside a clinical/telehealth visit. This left 14,101 BPAs linked to 3150 patients. EMR information was not sufficient to calculate pack-year history for 48.9% (1541/3150), and the LCS order rate was 2.5% (78/3150). Although pulmonary disease specialists accounted for 13.7% (236/1721) of total LCS orders, the BPA did not activate for them. Incomplete EMR data entry may contribute to the complexities of identifying LCS-eligible patients. This highlights the value of improving the completeness of EMR smoking history data and conducting targeted BPA audits to understand optimal activation parameters to improve clinician orders for LCS.
24. Focus on and venting of emotion mediate the pathway from maternal child abuse to adulthood depression severity.
期刊: Child abuse & neglect 发表日期: 2026-Feb-04 链接: PubMed
摘要
Exposure to parent-perpetrated child abuse is a risk factor for adulthood major depressive disorder (MDD). Coping strategies may be a plausible mechanism underlying this relationship. The current study examined whether positive reinterpretation (PR), focus on and venting of emotion (FVE), and behavioral disengagement (BD) mediated the relationship between maternal or paternal abuse and adulthood MDD symptoms. Data from 3294 community-dwelling adults were collected across three waves, with each interval nine years apart. Structural equation mediation modeling examined whether each unique coping strategy at Wave 2 mediated the relationship between maternal or paternal abuse at Wave 1 and MDD symptoms at Wave 3, controlling for baseline MDD symptoms. Both Wave 1 maternal and paternal abuse were entered simultaneously into each of the three mediation models. PR did not mediate the relationship between recalled parent-perpetrated child abuse and MDD severity (standardized β = 0.001 to 0.002). BD and FVE mediated the relationship between maternal abuse and MDD severity (β = 0.006 to 0.020) but not paternal abuse (both βs = -0.003). Maternal abuse was associated with higher BD and FVE (β = 0.175 to 0.628), which were both associated with increased MDD severity (β = 0.086 to 0.112). BD and FVE are possible mechanisms linking childhood experiences to adulthood MDD severity. Identifying maladaptive coping as mediators highlights its role in shaping long-term mental health. Targeting these coping patterns may help reduce the enduring impact of child abuse on adult mental health, reinforcing the importance of early prevention.
25. Prediction models for maltreatment risk: TRIPOD/PROBAST compliance, calibration, and fairness-A systematic review.
期刊: Child abuse & neglect 发表日期: 2026-Feb-04 链接: PubMed
摘要
Prediction models for child maltreatment risk are increasingly used to support decisions in child protection, yet concerns remain about methodological quality, transparency, calibration, and equity, particularly when tools are derived from administrative data. To systematically review prediction models for child maltreatment risk and evaluate adherence to TRIPOD, risk of bias and applicability using PROBAST, and the extent of evidence on calibration, external validation, and fairness. We included quantitative studies that developed or validated multivariable prediction models for maltreatment-related outcomes in child protection or public health contexts. Electronic databases and registers (2010-2025) were searched for studies reporting model performance. Two reviewers independently screened records, extracted data, and appraised reporting using TRIPOD and risk of bias/applicability using PROBAST. Owing to heterogeneity in outcomes, model types, and data sources, findings were synthesized narratively. Fourteen studies met inclusion criteria. Most used administrative or clinical datasets and logistic regression or machine learning models, achieving moderate to high discrimination. Five themes emerged: partial TRIPOD adherence; frequent analysis-domain bias; limited calibration and decision-analytic evaluation; sparse external validation and model updating; and uneven fairness auditing. Current maltreatment prediction models show promising discrimination but are constrained by incomplete reporting, methodological weaknesses, and limited evidence on calibration, transportability, and equity. Future work should align with TRIPOD and PROBAST, embed validation and calibration, and incorporate fairness auditing.
26. Febrile seizure risk following monovalent COVID-19 mRNA vaccination in US children aged 2-5 years.
期刊: Vaccine 发表日期: 2026-Feb-04 链接: PubMed
摘要
To evaluate febrile seizure risk following monovalent COVID-19 mRNA vaccination among children aged 2-5 years. The primary analysis evaluated children who had a febrile seizure outcome in the 0-1 days following COVID-19 vaccination. A self-controlled case series analysis was performed in three commercial insurance databases to compare the risk of seizure in the risk interval (0-1 days) to a control interval (8-63 days). The exposure of interest was receipt of dose 1 and/or dose 2 of monovalent COVID-19 mRNA vaccinations. The primary outcome was febrile seizure (0-1 day risk interval). A conditional Poisson regression model was used to compare outcome rates in risk and control intervals and estimate incidence rate ratios (IRR) and 95% confidence intervals (CIs). Meta-analyses were used to pool results across databases. The primary meta-analysis found a statistically significant increased incidence of febrile seizure, in the 0-1 days following mRNA-1273 vaccination compared to the control interval (IRR: 2.52, 95% CI: 1.35 to 4.69, risk difference (RD)/100,000 doses = 3.22 (95% CI -0.31 to 6.75)). For the BNT162b2 vaccination, the IRR was elevated but not statistically significant (IRR: 1.41, 95% CI: 0.48 to 4.11, RD/100,000 doses = -0.25 (95% CI -2.75 to 2.24). Among children aged 2-5 years, the analysis showed a small elevated incidence rate ratio of febrile seizures in the 0-1 days following the mRNA-1273 vaccination.
27. Non-emerging primary trial results from the Bandim health project.
期刊: Vaccine 发表日期: 2026-Feb-04 链接: PubMed
摘要
28. Inhibiting ubiquitin-specific protease 38 safeguards against diabetic nephropathy by limiting tubular epithelial cell ferroptotic death through the suppression of IREB2-mediated iron overload.
期刊: International immunopharmacology 发表日期: 2026-Feb-04 链接: PubMed
摘要
Kidney tubular cell death caused by elevated blood sugar levels plays a significant role in the progression of diabetic nephropathy (DN). Recent studies have highlighted ferroptosis, a form of regulated cell death, as a critical mechanism underlying tubular cell death in DN. Ubiquitin-specific protease 38 (USP38) has been identified as a key modulator of the ferroptosis process; however, its role in renal tubular cell ferroptosis and DN progression remains unexplored. This study aimed to investigate whether USP38 adjusts ferroptosis in renal tubular cells and its impact on DN progression, elucidating the underlying mechanisms involved. USP38 levels were markedly increased in HK-2 cells stimulated with high glucose (HG) and in the kidneys of diabetic mice. Knockdown of USP38 mitigated HG-induced damage and fibrosis while inhibiting ferroptosis in HK-2 cells; conversely, overexpression of USP38 exacerbated these effects. Further investigations revealed that USP38 modulated the expression of iron metabolism-related proteins, including responsive element binding protein 2 (IREB2), ferritin heavy chain 1 (FTH1), ferritin light chain (FTL), and transferrin receptor protein 1 (TfR1). Mechanistically, USP38 was found to directly interact with IREB2 and regulate both its ubiquitination and stability. Moreover, overexpression of IREB2 significantly reversed the inhibitory effect of USP38 silencing on ferroptosis. In vivo experiments demonstrated that USP38 knockdown alleviated renal damage, fibrosis, and inflammation while suppressing iron overload and ferroptosis in DN mice. In conclusion, USP38 mediates renal tubular cell ferroptosis under HG conditions through IREB2-mediated iron overload. Targeting USP38 to prevent tubular epithelial cell ferroptosis may effectively mitigate DN progression, providing a novel regulatory mechanism and potential therapeutic target for this disease.
29. Long-term immunogenicity of alternative HPV vaccine schedules and the effect of an additional dose given three to five years post-primary vaccination.
期刊: Vaccine 发表日期: 2026-Feb-04 链接: PubMed
摘要
We assessed antibody persistence and the impact of an additional dose administered 42-60 months after initial vaccination. Girls initially vaccinated at ages 9-10 with two doses of quadrivalent HPV vaccine participated in two randomized trials: The 0-6-42HPV study which compared a quadrivalent and bivalent additional dose given at 42 months; The 0-6-60ICI-VPH study compared no additional dose to a quadrivalent dose at 60 months. HPV16/18 antibody detection and geometric mean concentrations (GMCs) were assessed (M9ELISA). Overall, 526 girls provided a blood sample. All had detectable HPV16/18 antibodies 10 years post-initial vaccination. An additional dose at 42 versus 60 months led to similar GMCs, both with higher immune responses compared to 2-dose group participants. Compared to the quadrivalent, the bivalent induced significantly higher HPV18 GMCs, which has unknown clinical significance. Two-dose schedule and delayed quadrivalent or bivalent additional doses are highly immunogenic, supporting long-term immunogenicity of alternative and mixed vaccination schedules.
30. Advanced paternal age at birth and risk of cyanotic congenital heart defects in the United States.
期刊: Maturitas 发表日期: 2026-Feb-02 链接: PubMed
摘要
Limited inconsistent evidence suggests a potential association between advanced paternal age (APA) and simple congenital heart defects, which often resolve without surgical interventions, in offspring. There is no reported potential relationship between APA with major cardiac defects like cyanotic congenital heart defects (CCHD). This study evaluated the association between APA (age at birth ≥40 years) and the occurrence of CCHD among livebirths in the USA, accounting for maternal and other potential confounding factors. Data were from the National Vital Statistics System, comprising 9.9 million singleton first-time livebirths among mothers and fathers aged ≥15 years from 2016 to 2023. Logistic regression models were used to estimate odds ratios (OR) and 95% confidence intervals (CI). From 2016 to 2023, the proportion of births to fathers with APA increased from 7.5% to 7.9%. A greater proportion of fathers with APA had offspring with CCHD (62.0 vs. 53.1 per 100,000), used infertility treatment (9.5% vs. 2.3%), and their partners were also older (34.6 vs. 27.0 years). In models adjusted for paternal factors (age, race and ethnicity, and education), APA was associated with a modest elevated odds for CCHD (OR = 1.22, 95% CI 1.11-1.34) which remained significant after further control for maternal pre-pregnancy sociodemographic and health factors (OR = 1.12, 95% CI 1.01-1.25). However, additional adjustments for infertility treatment attenuated the observed association (OR = 1.08, 95% CI 0.98-1.20). The findings of this large population-based study suggest no association between APA and CCHD after accounting for important confounders, including maternal factors and infertility treatment.
31. Growth Trajectories in Infants From Families With Plant-Based or Omnivorous Dietary Patterns.
期刊: JAMA network open 发表日期: 2026-Feb-02 链接: PubMed
摘要
The safety of plant-based family diets, particularly vegan diets, during pregnancy and infancy is debated. Large population data on infant growth are scarce. To examine whether family dietary patterns (vegan, vegetarian, and omnivorous) are associated with growth trajectories, weight, and length among infants. This retrospective cohort study used data collected from January 1, 2014, through December 31, 2023, from a national network of public family care centers in Israel providing health and developmental surveillance for infants. Singleton births of infants gestational age 32 weeks or later without congenital malformations or birth weight less than 1500 g were followed up for 24 months. The data were analyzed between November 17, 2024, and December 6, 2025. The family diet as recorded at least 6 months after delivery. The primary outcome was infant length. Secondary outcomes included weight, head circumference, stunting (length-for-age z score less than -2), underweight (weight-for-length z score less than -2), and overweight (weight-for-length z score >2). Growth trajectories were analyzed using linear mixed-effects models, and nutritional status at birth, early infancy (ie, first 60 days of life), and 24 months were analyzed using logistic regression. Among 1 198 818 infants (mean [SD] gestational age, 39.2 [1.5] weeks; 53.2% male), 98.5% were from omnivorous households; 0.3% from vegan households, and 1.2% from vegetarian households. Differences in early-infancy length and length-for-age z scores among dietary groups were small (World Health Organization z score ≤0.3), and stunting prevalence was similar across groups (from 7.0% in the vegan and vegetarian groups to 7.1% in the omnivorous group), while underweight was more common in infants in the vegan vs omnivorous groups (adjusted odds ratio, 1.37 [95% CI, 1.15-1.63]). By age 24 months, stunting prevalence declined to 3.1%, 3.4%, and 3.9% in omnivore, vegetarian, and vegan groups, respectively, with no significant differences among the groups. Underweight and overweight were also low, with no differences by dietary group at age 24 months. Mean differences for weight, length, and head circumference were clinically minor (World Health Organization z score <0.2) and diminished further in adjusted longitudinal models. In this cohort study, infants from vegan households had growth patterns similar to those from omnivorous households, with a higher odds of early underweight that decreased by age 24 months. In the context of developed countries, these findings seem reassuring. Further research should examine vegan diet quality and the impact of nutritional counseling during pregnancy and infancy in supporting optimal infant development.
32. Application of the Population Health Institute Model of Health for Identifying Cancer Catchment Area Priorities.
期刊: JCO clinical cancer informatics 发表日期: 2026-Feb 链接: PubMed
摘要
The University of Wisconsin Population Health Institute (PHI) Model of Health, grounded in models developed over a decade ago, provides a framework for prioritizing health-related investments including setting agendas, implementing policies, and sharing resources for improving community health and health equity. The model includes multiple determinants of health and two broad health outcomes (length and quality of life). We adapted the PHI Model of Health to cancer outcomes. Using county-level publicly available data, health factor summary measures were derived in three areas: health infrastructure including health promotion and clinical care, physical environment, and social and economic factors. A composite health factor z-score was calculated as the weighted (40%, 15%, and 45%, respectively) average of the summary measures for each county, and k-means clustering was used to create unequally sized county groups with lower (healthier) to higher (less healthy) z-scores. We fit age-adjusted negative binomial regression models to estimate rate ratios and 95% CI for cancer mortality in relation to county health factor cluster. Age-adjusted cancer mortality rates increased across the 10 county health factor clusters for all-cancers as well as for lung, colorectal, breast, and prostate cancers. Rate ratios generally increased across the 10 health factor clusters for all cancers combined and for specific cancer types. Compared with counties with the most favorable health factor conditions, the counties with the least favorable conditions had an all-cancer mortality rate ratio of 1.49 (95% CI, 1.39 to 1.60). The PHI model of health adapted to cancer outcomes provides an approach for linking community-specific conditions to the interventions that hold promise to directly address drivers of the cancer burden.
33. Health Care Worker Perspectives After New Electronic Health Record Implementation in an Oncology Ambulatory Clinic: Qualitative and Quality-Improvement Insights.
期刊: JCO clinical cancer informatics 发表日期: 2026-Feb 链接: PubMed
摘要
Electronic health record (EHR) systems aim to improve efficiency, care coordination, and patient safety, yet implementation often introduces workflow challenges and staff burden. In 2024, the Cancer Centre of Southeastern Ontario (CCSEO), a regional academic cancer center in Canada, transitioned from a hybrid paper-electronic system to a fully integrated regional EHR. Although hospital EHR adoption has been studied, limited research has examined its impact within ambulatory oncology care, particularly among nonphysician staff, or how institutions responded to the findings. Our study explored oncology healthcare worker perspectives on EHR implementation at CCSEO and identified resulting quality-improvement (QI) initiatives. Using purposeful maximum variation sampling, we recruited clinical, administrative, and research staff. Semistructured interviews explored workflow efficiency, documentation burden, staff wellness, patient safety, communication, and training. Data were audio-recorded, transcribed, and analyzed thematically using MAXQDA. Nineteen interviews were conducted until thematic saturation. Three major themes emerged. (1) Efficiency and workflow: Staff valued consolidated records and regional connectivity but reported navigation complexity, time burden, duplicate orders, reliance on multiple programs, and frequent workarounds. (2) Staff and patient wellness: Staff noted limited training, increased workload, cognitive overload, and reliance on peer support contributed to burnout. (3) Patient safety: Identified risks included order and medication errors, communication breakdowns, poor system visualization, imaging delays, and wristband or labeling issues. Several QI initiatives were implemented in response, including education and navigation rounds, formation of working groups, and integration of artificial intelligence. EHR implementation introduced both benefits and challenges in oncology workflows. Findings informed multidisciplinary QI initiatives targeting role-specific training, workflow optimization, and safety, offering a framework for other cancer centers transitioning to new EHR systems.
34. Expanding newborn screening through genomics.
期刊: Journal of the American Association of Nurse Practitioners 发表日期: 2026-Feb-01 链接: PubMed
摘要
Newborn screening (NBS) is one of the most significant public health achievements, traditionally using biochemical and physiologic tests to detect rare but treatable conditions. The emergence of genomic sequencing technologies, including whole-genome sequencing (WGS), now offers the ability to identify thousands of variants underlying pediatric disorders. These advances create new opportunities to transform NBS but also raise important clinical, ethical, and policy challenges. This article explores the implications of genomic NBS for advanced practice nursing, with a focus on lessons from the NIH-funded BabySeq Project and the policy precedent set by Florida’s 2025 Sunshine Genetics Act, the first statewide, publicly funded WGS-NBS program in the United States. BabySeq demonstrated that genomic sequencing can identify actionable variants in approximately 9% of infants, yet it also exposed ethical tensions regarding disclosure of adult-onset findings and the contested concept of “family benefit.” Florida’s Sunshine Genetics Act expands NBS beyond the federal Recommended Uniform Screening Panel, aiming to reduce diagnostic odysseys and promote equity of access. However, unresolved issues persist, including informed consent, return of uncertain or adult-onset findings, and data stewardship. For nurse practitioners, the integration of genomic sequencing into NBS underscores new roles in parental education, consent counseling, care coordination, and long-term follow-up. Ensuring equity, cultural sensitivity, and alignment with professional guidelines will be essential to implementation. WGS in NBS has the potential to improve outcomes for children and families by enabling earlier diagnosis and intervention. Nurse practitioners, as frontline providers in primary care and pediatrics, are uniquely positioned to support families through genomic education, ethical decision making, and care navigation. Building workforce genomic competency and advocating for equitable policies are critical to realizing the promise of genomic NBS in clinical practice.
35. Shaping immunity: Genetic diversity as a key resource for crop protection.
期刊: PLoS pathogens 发表日期: 2026-Feb 链接: PubMed
摘要
36. Exploring the Relationship Between Neighborhood Disadvantage and ICU Delirium Characteristics.
期刊: Critical care explorations 发表日期: 2026-Feb-01 链接: PubMed
摘要
Delirium is a neuropsychiatric syndrome characterized by fluctuating disturbances in attention and awareness, associated with worse clinical outcomes and higher mortality. Previous research studies have noted an association between geographic disadvantage and delirium, but it is unknown if this association extends to critically ill adults. This study aimed to explore the relationship between geographic disadvantage and ICU delirium characteristics. We performed a secondary analysis of data collected from an National Institutes of Health-funded clinical trial, the Pharmacologic Management of Delirium study. Adults 18 years old or older admitted to the ICU who experienced delirium based on the Confusion Assessment Method for the ICU (CAM-ICU) were included. None. The study population included 326 participants: 54.5% were female and 48% Black, with a mean age of 60.3 years, mean Acute Physiology and Chronic Health Evaluation II score of 20, and in-hospital mortality rate of 12.3%. The area deprivation index (ADI), a composite measure of geographic disadvantage derived from census data that yields a national percentile score ranging from 1 to 100 (with higher scores representing greater disadvantage), was obtained for each participant’s address. Main outcome variables included delirium duration, which was assessed by the number of delirium- and coma-free days (DCFDs), and delirium severity, which was assessed by mean CAM-ICU-7 scores. Analysis of covariance models were used to examine differences in DCFDs and mean CAM-ICU-7 scores between ADI quintiles while controlling for demographic and clinical variables. Other clinical outcomes of interest included discharge home rates and in-hospital mortality. The sample was heavily skewed toward higher national ADI percentile scores (indicating greater disadvantage); only 11.7% of patients had an ADI score lower than 50. Our regression analyses did not reveal any associations between ADI quintile and DCFDs or mean CAM-ICU-7 scores, or between ADI quintile and discharge home rates or in-hospital mortality. However, the Black race was associated with longer delirium duration and greater delirium severity in the first week of ICU hospitalization. Our study did not find an association between geographic disadvantage and delirium duration or severity in the ICU. However, an association with race was observed, highlighting the need for further research into how socioeconomic determinants of health relate to delirium.
37. Effectiveness of adding manual therapy to exercise for pain and disability in chronic non-specific low back pain: A systematic review and meta-analysis.
期刊: Musculoskeletal science & practice 发表日期: 2026-Jan-30 链接: PubMed
摘要
Manual therapy and therapeutic exercise are both recommended for chronic non-specific low back pain, the additional benefit of combining them is uncertain. To systematically review the effects of adding manual therapy to therapeutic exercise compared to exercise alone on pain intensity and functional disability in adults with chronic non-specific low back pain. A systematic review and meta-analysis of randomized controlled trials included adults aged 18-65 years with chronic non-specific low back pain (≥12 weeks). Interventions combined joint-based manual therapy (spinal mobilization and/or manipulation) with therapeutic exercise involving stretching, strengthening, motor control, and endurance training. Main outcomes were pain intensity and functional disability at short-, medium-, and long-term follow-up. PubMed, PEDro, Cochrane Library, CINAHL, and Web of Science were searched up to February 2025. Evidence certainty was rated using GRADE. Five trials (n = 260) were included. Low-quality evidence indicated no significant short-term pain reduction with manual therapy plus exercise versus exercise alone (SMD = -0.87, 95 % CI: -1.87 to 0.12, I2 = 90 %). Moderate-to low-certainty evidence showed greater improvement in disability with combined therapy at short- (SMD = -0.73, 95 % CI: -1.05 to -0.42, I2 = 0 %) and long-term follow-up (SMD = -1.13, 95 % CI: -2.06 to -0.19, I2 = 80 %). Manual therapy combined with therapeutic exercise does not appear to provide substantial additional short-term improvements in pain intensity when compared to exercise alone. However, significant benefits were identified for functional disability in both short- and long-term outcomes PROSPERO REGISTRATION: CRD42023413778.
38. Defining circadian health: Conceptual framework and development of a circadian health index.
期刊: Sleep medicine reviews 发表日期: 2026-Jan-28 链接: PubMed
摘要
Circadian rhythms are key determinants of physical and mental health at the nexus of physiology and behavior. Classically, endogenous circadian rhythms are characterized according to three principal dimensions: circadian phase, amplitude and stability. From a behavioral perspective, the timing and regularity of nychthemeral behaviors represent two additional dimensions, and we propose as a sixth dimension the sleep complaints arising from a circadian disruption due to a mismatch between circadian physiology and nycthemeral behaviors. This article reviews each of these dimensions and examines their interactions, along with their effects on sleep and health. On this basis, we propose an integrated definition of circadian health. We then review both, objective (melatonin, temperature, actimetry) and subjective (sleep diaries, self-report questionnaires) tools for assessing each of the circadian health dimensions. Finally, we propose a novel tool aimed at assessing those circadian health dimensions as well as the computation of a composite index to quantify circadian health, along with a graphical representation to visualize it. While further validation is still needed, this proposal will help clinicians and researchers better decipher circadian rhythms and their impact on mental and physical health and may offer new opportunities for public health promotion in both general and clinical populations.
39. Conium Maculatum, one plant, four presentations: A case series.
期刊: The American journal of emergency medicine 发表日期: 2026-Jan-24 链接: PubMed
摘要
Conium maculatum poisoning presents a critical medical emergency that is characterized by rapid clinical deterioration. This invasive plant, native to Europe, Western Asia, and North Africa, poses significant public health risks due to its striking resemblance to edible species such as parsley and wild carrot. The plant’s toxic piperidine alkaloids induce a biphasic toxidrome: initial nicotinic overstimulation manifesting as autonomic hyperactivity, progressing to potentially fatal respiratory depression through neuromuscular paralysis. The clinical picture of Conium maculatum poisoning can vary greatly with symptom profiles ranging from respiratory depression to cardiac arrhythmia and even erythematous skin reactions. Clinical outcomes depend heavily on early recognition of the characteristic symptom progression and immediate supportive intervention. This study emphasizes the critical need for increased clinical vigilance when evaluating potential plant poisonings, especially in endemic regions of Conium maculatum. Moreover, it highlights the diverse presentation profiles in Conium maculatum poisoning, as seen in this case series, where four cases were characterized by different presentations, some of which possessed unique features including cardiac arrest and an erythematous rash.
40. Investigation of Toxoplasma gondii and human papillomavirus in paraffin-embedded spontaneous abortus materials.
期刊: American journal of clinical pathology 发表日期: 2026-Jan-05 链接: PubMed
摘要
Toxoplasma gondii and human papillomavirus (HPV) can cause spontaneous abortus. This study aimed to investigate the prevalence of these pathogens in formalin-fixed, paraffin-embedded placenta samples from women diagnosed with spontaneous abortus. A total of 288 formalin-fixed, paraffin-embedded placenta tissue blocks stored in the archives of Etlik City Hospital Pathology Laboratory were included in the study between October 1, 2022, and June 23, 2023. The presence of T gondii and HPV in formalin-fixed, paraffin-embedded placenta samples was investigated using real-time polymerase chain reaction. The T gondii DNA was not detected in the samples. However, anti-T gondii IgG antibody was positive in 10.4% (11/106) of the patients. Human papillomavirus DNA was positive in 5.4% of the samples, with HPV 18 and HPV 31/58/66 being the most frequently detected HPV types. Our study revealed that HPV could infect the placenta by detecting high-risk HPV in placental samples. However, no relationship was found between HPV positivity and previous stillbirth or spontaneous abortus. Prospective studies with larger populations are needed to further understand the role of these factors in the cause of spontaneous abortus.
41. Acute liver injury in hospitalized children: clinical and etiological profile from a tropical country.
期刊: Journal of tropical pediatrics 发表日期: 2026-Jan-02 链接: PubMed
摘要
Clinical spectrum of children presents with acute liver injury (ALI) is quite wide, ranging from asymptomatic enzyme elevation to severe hepatic dysfunction. This study aimed to evaluate the clinical and etiological profile and outcomes of children 1 month to 12 years presented with ALI at a tertiary care hospital in North India. This prospective observational study enrolled 132 children with AL. Detailed clinical evaluation, liver function tests, and etiological workups were performed. The severity of ALI was classified based on liver enzyme levels, and patient’s diagnosis and outcomes were assessed. Among the enrolled children (47.7% female, mean age 69.3 months), fever (85.6%) was the most common presenting symptom. ALI severity was classified as mild (29.5%), moderate (15.1%), and severe (55.3%). The leading cause of ALI was Acute Viral hepatitis (37.1%), followed by Enteric fever (21.9%) and Dengue fever. Non-Hepatotropic viruses such as Influenza, Adenovirus were identified in 11 (8.3%). Infants primarily presented with mild ALI related to viral infections, whereas children aged 1-5 years and >5 years had higher proportions of severe ALI. Follow-up investigations at two weeks showed improvement in 77.1% of patients, while 22.9% had persistent liver enzyme elevation. Infectious causes, particularly viral hepatitis, remain the predominant etiology of ALI in Indian children. Severe ALI was frequently associated with viral hepatitis, Enteric fever and dengue. In addition, Non-hepatotropic viruses are important cause of ALI. Consideration of these common illnesses is important to avoid unnecessary investigations and parental anxiety.
42. [Position statement on the development of research by nursing professionals in Argentina].
期刊: Medicina 发表日期: 2026 链接: PubMed
摘要
Modern nursing has evolved into a profession, and its contribution to healthcare is unquestionable. In Argentina, despite favourable changes, the nursing profession has yet to produce research knowledge that has an impact on health. In this document, the Asociación de Escuelas Universitarias de Enfermería de la República Argentina (AEUERA) provides recommendations for the development and implementation of policies to foster the development of health research by nursing in Argentina. The analysis of relevant evidence, academic discussion, and consensus among the participants of the AEUERA research commission led to the formulation of principles and recommendations. Five outlined principles underpin 20 recommendations. These principles represent the values that support a rigorous research practice, grounded in a robust scientific background and tailored to population needs. For Argentine nurses to investigate priority health problems, AEUERA recommends: 1) to guarantee access to scientific training programs with the same standards as other professions within the Argentine scientific system, 2) to guarantee access to doctoral scholarship programs, 3) to create job positions, protected by regulation, for nurse scientists, 3) to provide funding to conduct studies guided by both local and global health priorities. The implementation of these recommendations requires a sustained education and health policy to promote research training for this professional group. AEUERA urges decision-makers to consider these recommendations in their strategic planning for the sector. La enfermería moderna ha evolucionado hasta consolidarse como una profesión cuya contribución al cuidado de la salud es indispensable. En Argentina, si bien se están produciendo avances favorables, la profesión de enfermería aún no puede producir conocimiento científico de impacto en salud. En este documento, la Asociación de Escuelas Universitarias de Enfermería de la República Argentina (AEUERA) presenta recomendaciones orientadas a la elaboración e implementación de políticas que promuevan el desarrollo de investigación en salud por parte de enfermería. Estas recomendaciones surgen del análisis de evidencia relevante, la discusión académica y el consenso alcanzado por la comisión de investigación de AEUERA. Se establecen cinco principios que fundamentan 20 recomendaciones. Los principios expresan valores fundamentales para una práctica de investigación rigurosa, basada en una sólida formación científica y orientada hacia las necesidades de la población. Para que la enfermería argentina contribuya efectivamente a la investigación de problemas prioritarios de salud, AEUERA recomienda: 1) garantizar el acceso a programas de formación científica con estándares equivalentes a los de otras disciplinas del sistema científico argentino, 2) garantizar el acceso a becas doctorales, 3) crear cargos específicos para enfermeros/as investigadores/as protegidos por la regulación y 4) destinar financiamiento para estudios alineados con prioridades en salud locales y globales. La implementación de estas recomendaciones requiere una política de educación y salud sostenidas que promuevan la formación científica dentro del colectivo profesional de enfermería. La AEUERA exhorta a los responsables de las políticas a considerar estas propuestas en la planificación estratégica del sector.
43. A cluster level study for the identification of the disparities in birth intervals between rural and urban areas of Bangladesh.
期刊: PloS one 发表日期: 2026 链接: PubMed
摘要
Like most developing countries, it is pivotal to identify factors associated with birth intervals in Bangladesh for intervening programs to reduce maternal and under-five children deaths. In this study, an attempt has been made to examine the socioeconomic and demographic factors that influence birth intervals in rural and urban Bangladesh. For this purpose, the secondary data extracted from Bangladesh Demographic and Health Survey (BDHS), 2017-18 and 2022 have been utilized where a two-stage stratified sampling technique is used for data collection. The sample has been considered based on the information available on the birth interval for the last child of mothers. We have applied the Product-Limit approach, Log-rank test and the popular semi parametric frailty regression model that takes into account the possible correlation among observations from the same cluster. Slight disparity has been observed in the median birth intervals between urban (64 months, 2017-18; 67 months, 2022) and rural mothers (60 months, 2017-18; 63 months, 2022). In both datasets, age at marriage, women’s decision making autonomy, and division have been emerged as significant determinants of the birth intervals in rural and urban Bangladesh. In the 2017-18 data, the effect of partner’s education is limited to urban areas, while religion shows significance only in rural areas. Meanwhile, in the 2022 data, the wealth index and spousal age difference become significant only in rural areas. It is recommended that the government invest in programs to enhance women’s autonomy, since women’s greater autonomy significantly delays subsequent births in both rural and urban areas. According to the most recent 2022 data, rural women from middle class and rich families have significantly longer birth intervals compared to the poor families, hence promotion of family planning counseling should be more strongly promoted to them. In addition, analysis using 2022 data reveals that in rural areas, birth intervals initially shorten as the spousal age difference increases, then subsequently lengthen after a certain threshold; therefore, family planning initiatives in this area should incorporate guidance on selecting a proper age gap at marriage, which might contribute to longer birth intervals.
44. Geriatrics needs among rural older Veterans receiving virtual mental health services.
期刊: The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association 发表日期: 2026-Jan 链接: PubMed
摘要
Rural older Veterans have limited access to specialty care. In the Veterans Health Administration (VHA), tele-geriatric mental health (tele-GMH) services provide mental health care to older Veterans through regional telehealth hubs. However, older Veterans may still face gaps in access to geriatric medicine and specialty services, exacerbating unmet needs at the intersection of mental and physical health. We assessed unmet needs for geriatric medicine and related specialty services for rural older Veterans served by tele-GMH. We surveyed 32 clinicians in 6 VHA geographic regions who referred Veterans to tele-GMH services in fiscal year 2023, 25 of whom served rural Veterans. We also conducted semi-structured interviews with 11 tele-GMH clinicians. Survey data were summarized using descriptive statistics, and interviews were analyzed utilizing rapid qualitative analysis. We also described workflows of tele-GMH clinicians as they align with the “4Ms” of age-friendly care (Mentation, Medications, Mobility, What Matters). Referring clinicians serving rural Veterans reported lower access to geriatricians than those serving both rural and nonrural Veterans (14.3% vs 36.4%, respectively). Reported access to additional specialty services, as well as local aging services, was also limited. Based on interviews, facilitators for connecting Veterans to services included tele-GMH clinicians’ knowledge of local resources. Tele-GMH clinicians reported barriers including high demand, geography, and frequent staff turnover. Tele-GMH clinicians highlighted the utility of the 4Ms to enhance quality of care. Integrating geriatric medicine into tele-GMH programs supports the delivery of high-quality, age-friendly health care, optimizing VHA workforce capacity and improving care coordination within VHA and non-VHA systems.
45. [Evaluation of reproductive and developmental toxicity: its importance in the preclinical phase of new vaccines].
期刊: Medicina 发表日期: 2026 链接: PubMed
摘要
Preclinical trials in laboratory animals, particularly those aimed at evaluating potential effects on reproduction and offspring development, have gained importance in recent years due to the development of new drugs and vaccines intended for both children and individuals of reproductive age. The current challenge lies in the need for reliable and rapidly obtainable data to enable the transition of new compounds to clinical phases and eventual approval. Since pregnant and breastfeeding women are often excluded from clinical vaccine trials, including those assessing toxicity, there is limited knowledge about this vulnerable population and their offspring. In this context, preclinical studies designed to assess the effects of vaccine and therapeutic candidates on reproduction and development must rely on in vivo models that accurately replicate key aspects of the pathogenesis observed in human disease. When evaluating the reproductive toxicity of vaccines, it is essential not only to assess potential effects on fertility, embryogenesis, development, and reproduction, but also to consider the interactions of the vaccine with the immune system of both the mother and her offspring. This review updates and describes preclinical studies in laboratory animals for new vaccines, particularly those developed against COVID-19, highlighting published studies on reproductive and developmental toxicity, as well as the current regulatory framework governing such studies. Los ensayos preclínicos en animales de laboratorio, especialmente aquellos dirigidos a evaluar los posibles efectos asociados a la reproducción y desarrollo de la descendencia, han cobrado importancia en los últimos años a partir del desarrollo de nuevos fármacos y vacunas requeridos tanto para niños como personas en edad fértil. La problemática actual reside en la necesidad de contar con datos confiables y de rápida obtención para permitir que el nuevo compuesto pase a la fase clínica y posterior aprobación. Dado que las mujeres embarazadas y lactantes suelen quedar excluidas de los ensayos clínicos de vacunas, incluidos los referidos a toxicidad, existe escaso conocimiento relacionado a esta población vulnerable y su descendencia. En este sentido, para los estudios preclínicos destinados a evaluar los efectos de los candidatos vacunales y terapéuticos sobre la reproducción y el desarrollo, resulta fundamental contar con modelos in vivo que reproduzcan los aspectos claves de la patogenia observada en la enfermedad humana. En la evaluación de la toxicidad reproductiva de las vacunas, no solo es fundamental analizar los posibles efectos sobre la fertilidad, la embriogénesis, el desarrollo y la reproducción, sino que también resulta esencial considerar las interacciones de la vacuna con el sistema inmunológico tanto de la madre como de su descendencia. En esta revisión se actualizan y describen los estudios preclínicos en animales de laboratorio para nuevas vacunas, en particular las diseñadas contra el COVID‐19, destacando aquellos sobre toxicidad reproductiva y del desarrollo publicados, como así también la normativa vigente para los mismos.
46. [Botulinum toxin type A in the preventive treatment of chronic migraine: experience in a headache center in Argentina].
期刊: Medicina 发表日期: 2026 链接: PubMed
摘要
Chronic migraine (CM) is one of the most disabling neurological diseases, with a marked impact on quality of life and the use of health resources. In Argentina, there is no published real-life data on the use of botulinum toxin type A; onabotulinumtoxinA (onabotA), in chronic migraine. The objective was to describe the clinical outcomes of patients with CM treated with onabotA at a specialized headache center in Argentina. We conducted a retrospective review of electronic medical records of all patients treated with onabotA between January and December 2021. Data collected included demographics, medication overuse, prior preventive therapies, headache diaries, treatment response, and adverse events. A total of 394 patients were analyzed (91% women; mean age 46 years). Medication overuse was present in 66% (n=241). Forty percent (n=160) reported end-of-dose deterioration. Adverse events were reported by 4% (n=15), none requiring discontinuation. Among the 162 patients who completed headache diaries, 65% achieved ≥50% reduction in monthly headache days, and 34% reversed medication overuse. OnabotA was safe, well tolerated, and effective in reducing headache frequency and medication overuse in CM patients. Our findings are consistent with pivotal trials and real-world studies and represent the first published experience in Argentina. Introducción: La migraña crónica (MC) es una de las enfermedades neurológicas más discapacitantes, con un marcado impacto en la calidad de vida y en la utilización de recursos sanitarios. En Argentina, no existen datos publicados de vida real sobre el uso de toxina botulínica tipo A; onabotulinumtoxinA (onabotA), en migraña crónica. El objetivo fue describir los resultados clínicos de pacientes con MC tratados con onabotA en un centro especializado en cefaleas de Argentina. Materiales y métodos: Se realizó un estudio observacional retrospectivo mediante revisión de historias clínicas digitales de pacientes con MC tratados con onabotA en el servicio de cefaleas de la institución, entre enero y diciembre de 2021. Se registraron datos epidemiológicos, sobreuso de analgésicos, duración del tratamiento, respuesta clínica y eventos adversos. Resultados: Se analizaron 394 pacientes (91% mujeres, edad media 46 años). El 66% presentaba sobreuso de analgésicos y el 40% refirió deterioro de fin de dosis. Entre quienes completaron el diario de cefaleas (n=162), el 65% alcanzó una reducción ≥50% en los días de cefalea mensuales y el 34% revirtió el sobreuso de analgésicos. Los eventos adversos fueron poco frecuentes (4%) y no motivaron la discontinuación del tratamiento. Conclusión: Nuestros resultados respaldan la eficacia y seguridad de onabotA en la prevención de la MC en la práctica clínica, en concordancia con los ensayos pivotales y estudios internacionales de vida real. Este trabajo constituye el primer reporte de experiencia local en Argentina.
47. Neurological burden of COVID-19: a study of cerebrovascular events in a Brazilian tertiary hospital.
期刊: Medicina 发表日期: 2026 链接: PubMed
摘要
Neurological complications, particularly cerebrovascular diseases, have emerged as a significant concern in patients with coronavirus disease (COVID-19). Understanding these characteristics is essential for improving the clinical management and outcomes. This observational study analyzed data from patients hospitalized at Hospital da Irmandade da Santa Casa de Misericórdia de São Paulo between 2020 and 2021. We included patients aged ≥18 years with a confirmed SARS-CoV-2 infection and a diagnosis of cerebrovascular disease within 60 days of symptom onset. Clinical, demographic, and outcome data were collected and analyzed. Among the 1998 patients with confirmed COVID-19, 550 (27.5%) presented with neurological symptoms. Fifty patients were diagnosed with cerebrovascular disease: 27 (54%) had ischemic stroke, 20 (40%) had hemorrhagic stroke, and three (6%) had cerebral venous thrombosis. Patients with neurological symptoms had significantly higher mortality rates and longer hospital stays than those without neurological symptoms. This study highlights the severity and clinical impact of cerebrovascular events in COVID-19 patients. These findings reinforce the need for early neurological evaluation, and underscore the importance of accessible and cost-effective strategies for surveillance, prevention, and timely intervention in high-risk populations. Introducción: Las complicaciones neurológicas, en particular las enfermedades cerebrovasculares, han surgido como una preocupación importante en pacientes con enfermedad por coronavirus (COVID‐19). Comprender estas características es esencial para mejorar el manejo clínico y los resultados. Materiales y métodos: Este estudio observacional analizó datos de pacientes hospitalizados en el Hospital da Irmandade da Santa Casa de Misericórdia de São Paulo entre 2020 y 2021. Incluimos pacientes ≥18 años con infección confirmada por SARS‐CoV‐2 y un diagnóstico de enfermedad cerebrovascular dentro de los 60 días posteriores al inicio de los síntomas. Se recopilaron y analizaron datos clínicos, demográficos y de resultados. Resultados: Entre los 1998 pacientes con COVID‐19 confirmada, 550 (27.5%) presentaron síntomas neurológicos. Cincuenta pacientes fueron diagnosticados con enfermedad cerebrovascular: 27 (54%) presentaron accidente cerebrovascular isquémico, 20 (40%) accidente cerebrovascular hemorrágico y tres (6%) trombosis venosa cerebral. Los pacientes con síntomas neurológicos tuvieron tasas de mortalidad significativamente más altas y estancias hospitalarias más prolongadas que aquellos sin síntomas neurológicos. Conclusion: Este estudio destaca la gravedad y el impacto clínico de los eventos cerebrovasculares en pacientes con COVID‐19. Estos hallazgos refuerzan la necesidad de una evaluación neurológica temprana y subrayan la importancia de estrategias accesibles y rentables para la vigilancia, la prevención y la intervención oportuna en poblaciones de alto riesgo.
48. [Clinical factors associated with pneumococcal vaccination in adults with diabetes].
期刊: Medicina 发表日期: 2026 链接: PubMed
摘要
Diabetes mellitus increases the risk of invasive pneumococcal disease. Vaccination is recommended but coverage remains low. Descriptive cross-sectional study of 308 diabetic adults in Argentina. Associations were analyzed with chi-square and crude odds ratios. Complete vaccination prevalence was 25.65%. It was associated with age (p=0.0001), diabetology followup (p=0.0091), frequent visits (p=0.0037), and >5 years since diagnosis (p=0.0004). HbA1c 7-9% was borderline (p=0.058) but not significant in OR (p=0.08). Coverage is low. Stronger links to healthcare favor vaccination. Proactive strategies are needed. Introducción: La diabetes mellitus incrementa el riesgo de enfermedad neumocócica invasiva. Las guías recomiendan la vacunación sistemática, pero la cobertura suele ser baja. Materiales y métodos: Estudio transversal descriptivo realizado en 2023 con 308 adultos con diabetes tipo 1 y 2 afiliados al Plan de Salud de un hospital universitario. Se analizaron variables clínicas y de seguimiento. Se usaron chi cuadrado y odds ratios crudos. Resultados: La prevalencia de vacunación completa fue 25.7%. Se asoció con edad (p=0.0001), seguimiento diabetológico (p=0.0091), visitas frecuentes (p=0.0037) y más de 5 años desde el diagnóstico (p=0.0004). HbA1c entre 7‐9% tuvo asociación limítrofe (p=0.058) pero no significativa en OR (p=0.08). Discusión: La cobertura es baja. La vinculación con el sistema de salud favorece la vacunación. Se requieren estrategias activas para mejorarla.
49. Water, sanitation, and depressive symptoms in Indonesia: The mediating role of life satisfaction.
期刊: PloS one 发表日期: 2026 链接: PubMed
摘要
Access to clean water and adequate sanitation is vital for public health. However, the effects of water and sanitation on depressive symptoms remain insufficiently explored among the general population in low- and middle-income countries (LMICs). This study aims to examine the links between sanitation conditions and depressive symptoms, and to evaluate the mediating role of life satisfaction (LS) among adults in Indonesia. We used the fifth wave of the Indonesian Family Life Survey (IFLS-5) dataset with participants aged 15 and above (mean: 37.32 years; SD: 14.93), collected in September 2014/March 2015. Depressive symptoms were measured using the CES-D-10 scale. Five sanitation indicators were included: drinking water, water source, toilet facilities, liquid waste disposal and safe waste disposal methods. Structural equation modelling (SEM) was employed to estimate the direct and indirect pathways linking sanitation factors and depressive symptoms through LS, adjusting for age and sex. The study involved 31,446 participants, of whom 7,312 (23%) were classified as having depressive symptoms. In the first SEM model, drinking water (β = 0.023, p < 0.001), water source (β = 0.033, p < 0.001), toilet facilities (β = 0.039, p < 0.001), sewage disposal (β = 0.027, p < 0.001) and waste disposal method (β = 0.021, p < 0.005) were directly associated with depressive symptoms. In the second SEM model, which included LS as a mediator, the direct effects remained consistent: drinking water (β = 0.013, p < 0.05), water source (β = 0.054, p < 0.001), toilet facilities (β = 0.068, p < 0.001), sewage disposal (β = 0.022, p < 0.001) and waste disposal method (β = 0.046, p < 0.001). Additionally, unimproved sanitation was significantly linked to lower LS and LS was strongly associated with depressive symptoms across all sanitation factors (β ≈ 0.124-0.126, p < 0.001). Poor water and sanitation are associated with a higher risk of depressive symptoms among Indonesian adults, with LS as a partial mediator of this relationship. These findings highlight the need to incorporate water and sanitation improvements into national mental health and public health policies.
50. Bridging the gap: Multi-sector perspectives on human, domestic animal, and wildlife leptospirosis in Ontario, Canada.
期刊: PloS one 发表日期: 2026 链接: PubMed
摘要
Although leptospirosis is one of the most common zoonotic diseases worldwide, limited surveillance and poor coordination between human and animal health sectors have resulted in scarce and disparate data on its occurrence. Strengthening integrated surveillance requires cross-sector collaboration, beginning with the engagement of key organizations. The aims of this study were to 1) determine key health experts’ awareness and risk perceptions of leptospirosis and of zoonotic disease surveillance in Ontario, Canada, and 2) examine key components of engagement, such as perceived value and interest, during the initial stages of developing an integrated leptospirosis surveillance framework. A web-based survey was sent to 543 experts in human, animal, and environmental health in Ontario, and analyzed using a mixed-methods approach to identify key factors influencing perceptions of leptospirosis, including views on Leptospira distribution, the impact of human behavior, and the influence of environmental conditions. Leptospirosis was recognized as a health threat in Ontario by 90% (74/82) of respondents, and 91% (70/77) indicated that current surveillance efforts are inadequate. A higher proportion of animal health sector respondents identified leptospirosis as a threat to human (93%, 37/40) and animal health (90%, 44/49) compared to public health sector respondents (76%, 25/33 and 83%, 25/30, respectively). All participants (81/81) acknowledged the benefits of integrated surveillance over the current siloed approach. Our findings highlight that key public and animal health experts perceive leptospirosis as a health threat in Ontario and support more integrated disease surveillance to better respond to this emerging zoonotic pathogen.
51. Study on dynamic wetting and synergistic effect of surfactants on bituminous coal surface in coal mines.
期刊: PloS one 发表日期: 2026 链接: PubMed
摘要
With the continuous advancement of green mining initiatives in China, dust control during coal mining has become a critical issue for occupational health and ecological environmental safety. In response to the issues of coal dust pollution generated during coal mining and the inefficiencies of water spray dust suppression, this study investigates the fundamental mechanism by which multi-component surfactants synergistically form a stable adsorption layer on bituminous coal surfaces. The research employs macro-scale surface tension measurements, dynamic contact angle analysis, XPS spectroscopy, SEM for microstructural morphology, and molecular dynamics simulations. The results identify the optimal formulation as a 1:1 volume ratio mixture of 0.2% SDS and 0.1% CDEA. The synergistic effect of hydrogen bonding and electrostatic interactions first promotes the formation of a complex between the sulfate group of SDS and the amide group of CDEA. This complex then packs more efficiently, leading to an increased molecular density at the interface. The surface tension of the system is reduced to 35.23 mN/m, while the adhesion work and immersion work of the solution on the bituminous coal surface reach their maximum values. The spreading work is -0.48 mN/m, closest to the threshold of spontaneous spreading. This research offers theoretical support for developing a new generation of high-performance and environmentally friendly dust suppressants.
52. Teachers' perspectives on barriers and motivators to physical activity participation in children from ethnic minority groups in Newcastle upon Tyne: A qualitative study.
期刊: PloS one 发表日期: 2026 链接: PubMed
摘要
Physical inactivity among children in Western countries, especially children from ethnic minority groups, is a global health concern. Schools provide an ideal setting to address children’s physical activity needs, with teachers playing a major role. Therefore, the aim of this study was to explore teachers’ perspectives on barriers and motivators to physical activity participation in children from ethnic minority groups and to determine through their suggestions, how schools can be better supported to provide a physical activity-enabling environment. A purposive sample of eight primary school teachers in the Northeast of England, United Kingdom, participated in semi-structured interviews conducted through a combination of face-to-face and virtual settings. Reflexive thematic analysis identified seven barriers and nine motivators to physical activity, distributed across different levels of the socio-ecological theory. At the intrapersonal level, motivators included fun and wellbeing, whereas barriers included behavioural issues, and increased screen time. The interpersonal level encompassed influences of friends, parents, and teachers. At the institutional level, in-school activities were identified as motivators. At the community level, environmental influence and perceptions of safety were identified as barriers. At the public policy level, government/local council and resources were identified as both barriers and motivators. Notably, the teachers’ perspectives align with previous findings on barriers and motivators to physical activity among children from ethnic minority groups in the Northeast of England, while contributing to policy-level insights. These policy-level insights highlight the importance of staff training, government funding, and sports infrastructure improvements.
53. Does ChatGPT enhance equity for global health publications? Copyediting by ChatGPT compared to Grammarly and a human editor.
期刊: PloS one 发表日期: 2026 链接: PubMed
摘要
English language copyediting poses significant barriers to global health authors in academic publishing. Editing is too expensive for most researchers in low-income countries, and large language models (LLMs) like ChatGPT may offer a cost-effective alternative. The technology, however, has been criticized for its biases and inaccuracies. In a preliminary, in-depth case comparison, we compared the number and quality of corrections made by U-M GPT, a secure, University of Michigan-hosted generative AI tool, to those from Grammarly and a human editor to text from two draft papers written by Ugandan sexual and reproductive health researchers. Overall, U-M GPT made about three times as many corrections compared to the human editor and about ten times more than Grammarly. U-M GPT was the least discriminating in terms of quality: only 61% (51/83) of its corrections were judged as improvements. Despite this, U-M GPT has advantages, such as a broad scope of correction types, fast turnaround, and no cost. Its disadvantages, which reflect shortcomings of LLMs more broadly, include the need for prompt engineering skill, careful review of corrections, and high environmental costs due to energy consumption. Additional concerns involve data privacy and content moderation policies that restrict discussions on topics deemed as sensitive; these included words related to sexual and reproductive health. Although LLMs could improve equity, efficiency, and productivity, several important issues should be considered when using the technology. Larger follow-up investigations are needed to confirm our findings. Authors using LLMs should consult journal guidelines and disclose their use.
54. Streamlining psychosocial risk assessment: An exploratory adaptation of the COPSOQ III for Flemish healthcare workers.
期刊: PloS one 发表日期: 2026 链接: PubMed
摘要
Healthcare workers are particularly vulnerable to psychosocial stress due to high emotional and cognitive demands, staffing shortages, and complex care responsibilities. The Copenhagen Psychosocial Questionnaire (COPSOQ III) is a widely used tool for assessing psychosocial risks at work, but its extended Flemish version has not been systematically evaluated in healthcare settings, and evidence on its psychometric performance in this context remains limited. This exploratory study aimed to examine the factor structure and internal consistency of the extended Flemish version of the COPSOQ III among healthcare workers in Flanders, Belgium, and to provide initial psychometric evidence. A cross-sectional survey was conducted among 242 employees across three healthcare institutions. Construct validity was examined through exploratory factor analysis (EFA) on polychoric correlations (oblimin rotation) to derive a revised factor structure of the extended Flemish COPSOQ III. Internal consistency of the resulting dimensions was assessed using Cronbach’s alpha, ordinal alpha, and McDonald’s omega (total and hierarchical). Multiple imputation was used in sensitivity analyses to evaluate the robustness of the factor structure and reliability estimates to missing data. A preliminary confirmatory factor analysis (CFA) was conducted as a supplementary, internal check of the proposed structure, rather than as a full confirmatory validation, given the limited sample size. EFAs supported retention of the original COPSOQ III domain framework while indicating meaningful within-domain refinements, including merged, split, and reallocated dimensions; the number of dimensions was reduced from 45 to 34. Most resulting dimensions showed acceptable internal consistency (ordinal α and ω_total generally ≥ 0.70), although a small number of brief scales showed lower reliability. Sensitivity analyses using multiple imputation yielded highly similar factor solutions and reliability estimates. Domain-specific CFAs provided preliminary support for the revised structures with acceptable fit on commonly used indices (e.g., CFI/TLI, RMSEA, SRMR), but these results should be interpreted cautiously as internal checks rather than definitive confirmation. This exploratory study suggests that the extended Flemish version of COPSOQ III, with an adapted and more parsimonious structure, shows generally acceptable reliability and promising, though preliminary, evidence of construct validity for assessing psychosocial risks in healthcare settings. The adapted structure enhances its practical applicability while preserving theoretical integrity. Further research with larger and more diverse samples is recommended to confirm these findings in broader occupational contexts, test the stability of the proposed structure, and explore the utility of shorter versions in broader occupational contexts.
55. Genetics to Improve Outcomes in Schizophrenia (GENios): A within-case molecular genetic study protocol.
期刊: PloS one 发表日期: 2026 链接: PubMed
摘要
Despite significant progress in understanding the genetic basis of schizophrenia, there is a clear gap in our understanding of the genetics of outcomes in schizophrenia, particularly those prioritised by people with the condition. This has impeded progress towards precision psychiatry for schizophrenia and the improvement of outcomes. As genomic cohorts continue to increase in number, size, diversity, and phenotypic detail, sufficient data are now available to enable within-case studies focusing on the genetic basis of outcomes in schizophrenia. The GENios programme of research will use existing and new data to undertake large-scale genomic studies of schizophrenia outcomes. The project focuses on four key outcomes that were prioritised for research by individuals with lived experience of schizophrenia and align with priorities identified in the literature: antipsychotic treatment response; hospital admissions; occupational functioning; and social functioning. The aims of this project are to understand the genetic contributions to these outcomes in schizophrenia to (i) advance current understanding of the biological mechanisms that drive variability in outcomes, (ii) highlight novel drug targets, and (iii) identify genomic predictors of outcomes that can be leveraged for precision medicine. The GENios project has been granted ethical approval and collaborators are required to have the appropriate ethical permission in place to contribute data to the project. Findings from this study will be interpreted and disseminated with the involvement of lived experience experts in scientific publications and conferences as well as to wider non-scientific communities. Schizophrenia is a severe mental illness that affects how people think, feel, and behave. Whilst current treatments help with some symptoms and effects of the disorder, many people continue to struggle with poor long-term outcomes. Outcomes like repeated hospital stays, difficulties with socialising and relationships, and difficulties with finding and maintaining employment. People with lived experience of schizophrenia have identified some outcomes as research priorities. These research priorities are treatment response, hospital admissions, day-to-day living (e.g. having a job), and having relationships. Many people with schizophrenia are given antipsychotic medications to treat ‘positive’ symptoms (such as unusual (false or disturbing) thoughts and beliefs, and seeing and hearing things that are not there). These medications work for some people but around 25% to 30% of people with the disorder have symptoms that are not helped by standard antipsychotic treatments. These symptoms are classed as treatment-resistant. Many more people find that antipsychotic medications do not help with ‘negative’ symptoms (such as feeling emotionally blank and having trouble with motivation) and difficulty with cognitive abilities (such as concentrating, planning, and memory). This project, called GENios, aims to understand why outcomes differ between people with schizophrenia by looking at their genetics. We understand that social factors play an important role in outcomes but this project is specifically focused on genetics. We will analyse data from people with schizophrenia with an aim to uncover the genetic factors that influence outcomes by using data has already been collected by other research projects. We are carrying out this research in order to identify how genes and knowledge of people’s genetics can help develop healthcare that is more tailored to an individual, so-called precision psychiatry. A plain English glossary of terms is included (S1 Table) to help explain technical language used in the main text.
56. Hidden risks associated with occupational pesticide exposure in women with breast cancer: High frequency of the Luminal B molecular subtype and occurrence of poor prognostic features.
期刊: PloS one 发表日期: 2026 链接: PubMed
摘要
Human pesticide exposure is a common event in countries with strength conventional agriculture, such as Brazil. Despite evidence on the negative impact of pesticides on human health, the country stands out among the top three pesticide consumers globally. The implications of this scenario on rural workers health, particularly women, is completely neglected, resulting in chronic illness such as breast cancer. In this study, we analyzed the impact of occupational/household chronic exposure to pesticides on the clinicopathological profile of breast cancer in rural women from Paraná southwest, a predominantly rural landscape with large pesticide uses. A total of 349 women were included in the study. After a structured interview, women were categorized as exposed (n = 208) or unexposed (n = 141) to pesticides. Clinicopathological data were collected from medical records. Descriptive and inferential statistical methods were used to characterize and compare the sample. The Chi-square test and Fisher’s exact test were used to evaluate differences between the molecular subtypes and clinicopathological variables of patients. Exposed patients had a prevalence of the Luminal B subtype (32.83%), while unexposed patients had a prevalence of the Luminal A molecular subtype (37.78%, p <= 0.05). Exposed patients also had higher disease recurrence (10.19%), chemoresistance (21.26%), than unexposed patients (p <= 0.05). Breast cancer patients exposed to pesticides were also more likely to have distant metastases (1.4 times) and lymph node invasion (1.3 times) compared to patients not exposed. These findings indicate that pesticide exposure favors the occurrence of more aggressive breast cancer.
57. Dementia incidence and prevalence in older adults with HIV: A 23-year retrospective cohort study.
期刊: AIDS (London, England) 发表日期: 2025-Dec-02 链接: PubMed
摘要
To compare dementia incidence and prevalence by HIV status, race/ethnicity, and sex. Retrospective cohort, 2000-2023. Adults with HIV aged ≥50 years and 1:20 matched individuals without HIV from Kaiser Permanente, a U.S. healthcare system, were included. Dementia diagnoses were identified via electronic health records. We estimated rates of incident dementia diagnoses and prevalence, overall and by time period (2000-2004, 2005-2009…2020-2023) using Poisson regression, and assessed trends using Joinpoint regression. Covariate-adjusted rate ratios compared dementia by HIV status, with sub-analyses stratified by race/ethnicity and sex. Among 24,762 people with HIV and 494,963 people without HIV (86.9% men, 45.5% White, 23.1% Black, 20.3% Hispanic), incident dementia diagnoses declined from 2000-2023 in both people with and without HIV (-7.68% and -2.70% per period, respectively). Overall, the incidence of dementia diagnosis was higher in people with HIV (adjusted incidence rate ratio [aIRR]=1.72, 95% CI=1.59-1.85). In the most recent period (2020-2023), this difference was not statistically significant (aIRR=1.16, 95% CI=0.99-1.35), partly due to increases in diagnoses among people without HIV during this period. Dementia prevalence remained higher in people with HIV, overall (adjusted prevalence ratio [aPR]=1.71, 95% CI=1.61-1.82) and in 2020-2023 (aPR=1.59, 95% CI=1.46-1.73), with similar patterns by race/ethnicity and sex. Incident dementia diagnoses have declined in people with HIV and are approaching those of people without HIV, with consistent trends across demographic subgroups. However, prevalence remains elevated, likely reflecting excess risk from earlier years. These findings highlight the need for sustained attention to cognitive health and the integration of dementia-related services in HIV care.
58. Preoperative Anesthesia Evaluation in a Patient With Hyperthyroidism and a Mediastinal Mass: A Case Report.
期刊: A&A practice 发表日期: 2025-Dec-01 链接: PubMed
摘要
Untreated hyperthyroidism can lead to thyroid storm, a medical emergency with high mortality. This case report discusses a patient with untreated hyperthyroidism undergoing evaluation before elective resection of a mediastinal mass in the preoperative anesthesia setting. The preoperative anesthesia provider’s systematic assessment and timely endocrinology referral with subsequent management of the thyroid disease shifted the trajectory of the patient’s treatment, and ultimately prevented an unnecessary, invasive surgical procedure. The value of advanced practice providers in the preoperative anesthesiology clinic setting is highlighted.
59. Sleep quality and disturbance during the COVID-19 pandemic among people with HIV globally: associations with social determinants of health.
期刊: AIDS (London, England) 发表日期: 2025-Nov-28 链接: PubMed
摘要
To examine the impact of COVID-19 on sleep quality and sleep disturbance and explore the relationship between social determinants of health, clinical factors, and sleep quality and sleep disturbance in a global sample of people with HIV (PWH). Cross-sectional prospective international observational study to examine the social, mental, and physical health impacts of COVID-19 on sleep health of PWH. A modified version of the Adolescent Trials Network (ATN) COVID Questionnaire was utilized to collect sleep quality and social determinant of health data in adult PWH. Sleep disturbance was determined from a single item from the Fear of COVID-19 Scale. A series of logistic regressions were conducted to explore the relationship of social determinants of health with decreased sleep quality and disturbance. A sample of 1,601 PWH from four continents (Africa, Asia, North America, and South America) were included with 61% male, a mean age of 44.18 (±13.67) and living with HIV for an average of 12.8 years (±9.6). During the COVID-19 pandemic, 26.8% of participants experienced decreased sleep quality and 27.1% experienced sleep disturbance with the highest prevalence among participants residing in Africa. Individuals with decreased access to resources (food and money) were 0.23 times more likely to have decreased sleep quality compared to individuals with increased access to resources (p < 0.001). PWH with no education were 2.83 times more likely to experience sleep disturbance than those with at least some post-secondary education (p < 0.001). Our findings demonstrate the COVID-19 pandemic significantly impacted sleep quality and disturbance in PWH.