公共卫生研究摘要 (2026-02-07)
共收录 62 篇研究文章
1. Use of Brain MRI in Cerebral Adrenoleukodystrophy: International Recommendations for Screening, Monitoring, and Research.
期刊: Neurology 发表日期: 2026-Mar-10 链接: PubMed
摘要
Cerebral adrenoleukodystrophy (CALD) is a common manifestation of adrenoleukodystrophy (ALD) in men. Early detection of CALD lesions through MRI screening is critical to allow for therapeutic action preventing severe disability and death. While the frequency of brain MRI monitoring has been addressed by international recommendations, no consensus currently exists regarding which MRI sequences should be used in a real-world setting for screening and follow-up of CALD lesions. The aim of this study was to establish guidelines for the MRI protocol in clinical practice and to identify priority sequences for research use, thereby promoting intercenter harmonization. A modified Delphi procedure was used to achieve consensus on MRI protocols for ALD screening, lesion monitoring, and research applications among experts with experience in brain imaging in ALD. Questionnaires allowed experts to indicate whether they considered sequences as core, optional, or research, or to express agreement (5-point scale ranging from completely disagree to completely agree) with specific statements. Topics where no agreement was reached were discussed during online consensus meetings. Thirty experts from 9 countries participated and agreed that the core screening protocol for ALD in adults and children should include at least 3D T1-weighted, spin-echo T2-weighted, 3D fluid-attenuated inversion recovery, and diffusion-weighted imaging (DWI). Postcontrast T1-weighted imaging should be performed systematically in specific clinical scenarios. Experts supported using DWI alongside the Loes score and postcontrast imaging to assess lesion progression. A research protocol was defined, prioritizing diffusion tensor imaging, MR perfusion, and quantitative volumetric analyses. This international project harmonizes the ALD MRI protocol, thus offering a practical framework to screen and monitor lesions, which will improve clinical decision making. It also identifies MRI sequences that should be prioritized in future research. Future research on MRI in ALD should focus on topics where no consensus has yet been reached in this project.
2. Identifying genome-by-childhood trauma interactions for depression using a forest-based approach in the UK Biobank and Adolescent Brain Cognitive Development Study.
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
Depression is shaped by both genetic and environmental factors, but genome-wide interaction studies (GWIS) often lack power to detect complex gene-environment (G × E) interactions. We applied a forest-based machine learning approach to 38,018 UK Biobank (UKB) participants, examining interactions between 285,677 single-nucleotide polymorphisms (SNPs) and three trauma types (childhood, adult, and catastrophic trauma). While GWIS detected no significant interactions, we identified 8,225 potentially important SNP-environment pairs across 1,732 genes, with childhood trauma contributing most prominently. Stratified heritability was higher among childhood trauma-exposed individuals (13.3%) versus those unexposed (6.0%). Many identified genes overlapped with known psychiatric risk loci and accounted for most of the SNP-based heritability. Thirteen top genes were replicated in the Adolescent Brain Cognitive Development Study. Our findings highlight the polygenic G × E nature of depression and the critical role of childhood trauma in modulating genetic risk, demonstrating the value of forest-based methods in detecting complex gene-environment interactions.
3. Challenges for a Maternal-Care Health Recommender System in Indonesia: Formative Preimplementation Qualitative Study.
期刊: JMIR formative research 发表日期: 2026-Feb-06 链接: PubMed
摘要
Maternal evaluation during routine antenatal care visits may reduce maternal morbidity and mortality by identifying and addressing issues early on. A health recommender system could help health professionals and pregnant women monitor daily health parameters, provide tailored recommendations, and support timely antenatal care. This study aims to qualitatively analyze challenges in the preimplementation of health recommender system for maternal care in Indonesia as perceived by multiple stakeholders, including health care providers, patients, health system managers, government officers, and technology vendors. The methodology used a qualitative approach, where qualitative data were obtained from interviews of 37 respondents from multiple stakeholders, consisting of 15 health workers and 15 patients from private and government health care facilities, 4 officers from government health offices, 2 directors of health application vendors, and 1 manager from a private health clinic. These semistructured interview results were analyzed using thematic analysis. This qualitative study identifies key challenges in implementing a health recommender system for maternal care in Indonesia across the people, process, infrastructure, and policy dimensions. Intercoder reliability for the coding process demonstrated almost perfect agreement (Cohen κ=0.90), supporting the consistency of the coding process. Six major challenges were revealed, mostly regarding skill, accuracy, completeness, timeliness, cost, and standardization. These 6 major challenges were mentioned 96 times, accounting for 64.43% of all codes extracted from the interviews. These findings emphasize the value of user involvement in system design to meet health care professionals’ and patients’ needs, technical advancements to foster trust and support effective decision-making, as well as enhanced data accuracy, reliable and timely service delivery, cost management, and clear regulatory standards. This formative, preimplementation qualitative study highlights the importance of involving users in system design and future implementation to meet the needs of health care professionals and patients. Reducing input errors and improving system reliability are critical to building trust and supporting effective point-of-care decision-making and, in later phases, facility-level monitoring as part of public health surveillance. Adherence to regulatory standards and the establishment of standardized guidelines will be key to enabling broader implementation. Further usability, feasibility, and pilot studies are required before any evaluation of effectiveness.
4. Human Papillomavirus Vaccine Perceptions Among Noncollege Young Adults and TikTok Influencers: Qualitative Study.
期刊: JMIR formative research 发表日期: 2026-Feb-06 链接: PubMed
摘要
Human papillomavirus (HPV) vaccination is a proven and effective tool for preventing several types of cancers, yet vaccination rates among young adults remain suboptimal, particularly among those not enrolled in 4-year colleges. This population can be more difficult to reach due to fewer established institutional touchpoints, limited engagement with campus-based health services, and greater variability in access to preventive care. At the same time, social media has become a dominant source of information for young adults, with TikTok (ByteDance) emerging as one of the most widely used platforms. Approximately 41% of TikTok’s users are between the ages of 16 and 24 years, making it a potentially important channel for public health communication. However, little is known about how noncollege young adults perceive HPV-related content on TikTok, or how influencers themselves view their role in communicating about vaccination. This study explored the perspectives of young adults and TikTok influencers regarding the dissemination and reception of HPV vaccine information on TikTok. The goal was to assess the potential of leveraging influencers as trusted messengers for this hard-to-reach population. Researchers conducted 5 focus groups with noncollege young adults, stratified by gender and vaccination status. Each group included 5-8 participants, resulting in a total of 34 individuals. Participants who reported being extremely hesitant about the HPV vaccine were excluded to focus on those more receptive to information. In parallel, researchers recruited 9 TikTok influencers who reached audiences aged 18-25 years and conducted in-depth individual interviews. Influencers represented a diverse mix of identities, follower counts, and content genres, providing varied perspectives on engagement with health-related topics. Across the focus groups, young adults described regularly encountering or actively seeking health-related information online, with TikTok emerging as a primary or supplementary source for some. However, very few participants reported seeing content specifically related to HPV vaccination. Despite this gap, most expressed openness to such content if it was delivered in a relatable, authentic manner and included concise, relevant facts. Influencers echoed the importance of authenticity, emphasizing that their credibility is grounded in genuine connections with their audiences. Many described frequent, meaningful exchanges with followers about sensitive issues, suggesting comfort in addressing health topics. Influencers noted that they would be willing to share HPV-related content under certain conditions, including alignment with existing content, personal relevance, or participation in a structured campaign or partnership. Findings suggest that TikTok may be a promising platform to engage noncollege young adults in HPV vaccination messaging. The strong parasocial relationships influencers maintain with their audiences could position them as effective messengers on sensitive health topics. Strategic collaborations with influencers, coupled with carefully crafted, authentic content, may help bridge communication gaps and support increased awareness of HPV vaccination in this underserved population.
5. Developing Consumer Consensus on Remote Assessment and Management of Physical Function in Older Adults (RAMP): International Modified Delphi Process.
期刊: JMIR aging 发表日期: 2026-Feb-06 链接: PubMed
摘要
Remote health care delivery, including the use of digital health interventions, is emerging as a tool for assessing and managing physical function, but its design and implementation often overlook the needs and preferences of older adult end users. The primary aim of this modified Delphi process was to develop consumer consensus on preferences for remote assessment and management of physical function in older adults. Research and consumer experts of the Remote Assessment and Management of Physical Function in Older Adults (RAMP) Working Group co-developed the Round 1 Delphi survey, which was advertised to consumers (adults aged ≥60 years) via international clinical and research networks and social media between August and November 2023. The online survey presented 23 Delphi statements for which respondents reported their level of agreement using an 11-point Likert scale (0-10; scores ≥7 indicated agreement). Statements were classified as having “strong agreement” and achieving consensus if ≥80% of participants indicated agreement. Statements classified as having “moderate” (70%-80% of participants indicated agreement) or “low” (<70% of participants indicated agreement) agreement were revised or rejected. Revised statements were presented to participants in Round 2 (January to February 2024), and the final consensus statements were consolidated into recommendations. A total of 654 consumers (75.7% female) with a mean age of 69.0 (SD 6.0) years from 15 countries (5 continents) were included in analyses in Round 1. Of 23 statements, 13 achieved consensus, with the strongest agreement observed for statements relating to the importance of physical function for quality of life and performing activities of daily living (6 statements; agreement 97.6%-99.5%). Two statements regarding privacy and security concerns when using technology (agreement 20.8%) and the inability to perform physical function assessments or exercise at home (agreement 15.5%) were rejected with low agreement. The remaining 8 statements (agreement 49.5%-79.5%) were modified into 7 new statements for the Round 2 survey, which was completed by 526 (80.4%) respondents from Round 1. Five of seven Round 2 statements were accepted with strong agreement (agreement 80%-82.7%), including the importance of addressing personal preferences for self- versus clinician-led remote interventions, group versus individual exercise, and availability of necessary resources (eg, technology and exercise equipment). Eighteen statements achieved consensus and were translated into 7 recommendations highlighting that older adults recognize physical function as a health priority, would value more information about it, and are willing to participate in remote assessment and management interventions (including via digital health) to maintain or improve it. These recommendations also reinforce that interventions should be easily accessible and meet individual preferences of consumers.
6. Forecasting the rise of middle meningeal artery embolization for chronic subdural hematoma patients: United States projections from 2022 to 2050.
期刊: Journal of neurosurgery 发表日期: 2026-Feb-06 链接: PubMed
摘要
Chronic subdural hematomas (cSDHs) are increasingly common in aging populations, driven by the rising use of anticoagulant and antiplatelet therapies. Middle meningeal artery embolization (MMAE) is a promising minimally invasive treatment. This study projects the future US incidence of cSDH through 2050 and estimates MMAE demand based on hematoma size criteria. The authors utilized data from the National Inpatient Sample from 2016 to 2019 to calculate age-specific incidence rates of cSDH. Institutional CT scans of the head from a level I comprehensive trauma center were analyzed to determine the distribution of cSDH sizes and MMAE eligibility thresholds (5, 8, 10, and 15 mm). Population projections were obtained from the 2023 datasets of the US Census Bureau. Among 531 institutional cSDH patients, the mean hematoma thickness was 13.0 ± 13.3 mm, with 75.0% exceeding 5 mm, 56.3% exceeding 8 mm, and 14.3% exceeding 15 mm. Using the > 8-mm eligibility threshold, the projected MMAE population increases from 39,294 patients in 2022 to 44,596 by 2050 (13.5% increase, p < 0.0001). If a more generous > 5-mm threshold is applied, projections rise from 52,338 in 2022 to 59,401 in 2050 (p < 0.0001). Conversely, applying a high-severity > 15-mm threshold yields a smaller but still substantial cohort, increasing from 7594 to 8618 over the same period (p < 0.0001). Total cSDH cases are expected to grow from 69,794 in 2022 to 79,212 in 2050. The projected increase in cSDH and the corresponding rise in MMAE-eligible patients signify a substantial emerging public health challenge. Anticipating a 13.5% growth in incidence by 2050, these findings emphasize the urgent need for proactive healthcare planning and resource allocation to accommodate the escalating demand for specialized interventions like MMAE.
7. Content Validation of an Electronic Health Record-Based Diabetes Self-Management Support Tool for Older Adults With Type 2 Diabetes: Qualitative Study.
期刊: JMIR diabetes 发表日期: 2026-Feb-06 链接: PubMed
摘要
Older adults with diabetes frequently access their electronic health record (EHR) notes but often report difficulty understanding medical jargon and nonspecific self-care instructions. To address this communication gap, we developed Support-Engage-Empower-Diabetes (SEE-Diabetes), a patient-centered, EHR-integrated diabetes self-management support tool designed to embed tailored educational statements within the assessment and plan section of clinical notes. This study aimed to validate the clarity, relevance, and alignment of SEE-Diabetes content with the Association of Diabetes Care & Education Specialists 7 Self-Care Behaviors framework from the perspectives of older adults and clinicians. An interdisciplinary team conducted expert reviews and qualitative interviews with 11 older adults with diabetes and 8 clinicians practicing in primary care (family medicine) and specialty diabetes care settings at a Midwestern academic health center. Patients evaluated the readability and relevance of the content, while clinicians assessed clarity, sufficiency, and potential clinical utility. Interview data were analyzed using inductive thematic analysis, and descriptive statistics were used to summarize participant characteristics. Patients (mean age 72, SD 4.9 y; mean diabetes duration 26, SD 15 y) reported that the SEE-Diabetes statements were clear, relevant, and written in plain language that supported understanding of self-care recommendations. Clinicians (mean 13, SD 9.5 y of diabetes care experience) viewed the content as concise, clinically appropriate, and well aligned with patient self-management goals and the Association of Diabetes Care & Education Specialists 7 Self-Care Behaviors framework. Both groups identified the tool’s potential to enhance patient engagement and patient-clinician communication, while noting opportunities to improve the specificity of language, particularly within medication-related content. SEE-Diabetes demonstrated content validity as a practical, patient-centered digital health tool for supporting diabetes self-management communication within EHR clinical notes. The findings support its use as a complementary approach to reinforce self-care communication in routine clinical practice and highlight areas for refinement to enhance personalization.
8. Role of hip and lumbar flexion angles in stiffness-related disabilities with activities of daily living after lumbar spine surgery.
期刊: Journal of neurosurgery. Spine 发表日期: 2026-Feb-06 链接: PubMed
摘要
The aims of this study were to clarify the relationship between the combined forward flexion capacity of the lumbar spine and hip joint, referred to as TrunkAflex, and Lumbar Stiffness Disability Index (LSDI) scores in patients following lumbar spine surgery, and to assess whether TrunkAflex better reflects disabilities with activities of daily living (ADL) than the number of fused segments or lumbar spine flexion alone. This prospective, cross-sectional, multicenter study included 147 patients who underwent lumbar spine surgery and completed LSDI questionnaires. Lateral radiographs were obtained in the maximum seated flexion position. Radiographic parameters included pelvic incidence (PI)-corrected lumbar lordosis in flexion (PI-LLflex), representing lumbar spine flexion ability, pelvic femoral angle in flexion (PFAflex), representing hip joint flexion ability, and TrunkAflex, defined as the angle between the axis of the L1 vertebral body and the proximal femoral shaft, mathematically expressed as the sum of PI-LLflex and PFAflex. Correlation analyses were used to determine the relationships between LSDI and these parameters. Subgroup analyses were performed to compare the lumbar fusion (upper instrumented vertebra [UIV] at L1 or below) and thoracolumbar fusion (UIV at T12 or above) groups. The LSDI score was significantly correlated with the number of fused segments (r = 0.328, p < 0.01), and PI-LLflex showed a significant correlation with LSDI (r = -0.354, p < 0.01). However, TrunkAflex demonstrated the strongest correlation with LSDI (r = -0.491, p < 0.01). Subgroup analysis revealed that PI-LLflex was more influential in the lumbar fusion group, while PFAflex was more impactful in the thoracolumbar fusion group. Nevertheless, TrunkAflex consistently showed the strongest correlation with LSDI across all groups. Notably, TrunkAflex was minimally influenced by PI, making it a practical and consistent parameter for trunk forward flexion assessment. This study demonstrated that the combined forward flexion ability of the lumbar spine and hip joint, represented by TrunkAflex, is a stronger predictor of LSDI scores than the number of fused segments or lumbar spine flexion alone, irrespective of the fusion range. Preoperative assessment of hip joint function is particularly important when planning long-segment fusion, and adjusting surgical strategies to preserve appropriate TrunkAflex may contribute to better postoperative ADL outcomes.
9. Problematic Alcohol Use Among Adolescents in Germany: Representative Cross-Sectional Study.
期刊: JMIR public health and surveillance 发表日期: 2026-Feb-06 链接: PubMed
摘要
Alcohol is a widely used psychoactive substance, and its use constitutes a major public health challenge due to its immediate and long-term adverse effects on various health-related outcomes. Adolescence has been identified as a particularly vulnerable phase regarding alcohol use. Although consumption rates in this age group have declined in Germany over the past decades, a plateau has been reached, and there is a continued need for interventions to further reduce consumption rates. This study aimed to assess problematic alcohol use among adolescents in Germany and explore associations with sociodemographic and psychosocial characteristics, particularly with health literacy, to inform future interventions tailored to the specific needs of this target group. In a cross-sectional quota-based survey, 2006 adolescents (aged 12-17 years) completed an online survey (n=1406) or face-to-face interview (n=600) assessing the frequency of weekly alcohol use, the presence of problematic alcohol use (German version of the Car-, Relax-, Alone-, Forget-, Friends-, Trouble- questionnaire [CRAFFT-d]), sociodemographic information, and health literacy (European Health Literacy Survey instrument [HLS-EU-Q16]). Based on their CRAFFT-d and HLS-EU-Q16 scores, participants were identified as exhibiting problematic alcohol use (vs no problematic alcohol use) and inadequate or problematic health literacy levels (vs adequate health literacy levels), respectively. Chi-square tests were computed to analyze differences between different groups (as defined by the sociodemographic factors, weekly alcohol consumption frequency, and health literacy) in terms of problematic alcohol use (binary CRAFFT-d outcome). Approximately 20% (390/2006) of the participants reported consuming alcohol on at least 1 day per week, and 12.7% (255/2006) of the sample met the CRAFFT-d screening criterion for problematic alcohol use. Problematic alcohol use was significantly associated with gender (χ21=20.96, V=0.10; P<.001), age (χ22=85.88, V=0.21; P<.001), subjective social status (χ22=8.23, V=0.06; P=.02), and migration background (χ21=5.60, V=0.05; P=.02), but there were no significant associations with level of education (χ21=3.43, V=0.04; P=.06), and health literacy (χ21=1.54, V=0.03; P=.21). In addition, participants who reported more frequent alcohol consumption per week, also met the screening criterion for problematic alcohol consumption more frequently (χ27=698.65, V=0.59; P<.001). The findings demonstrate that problematic alcohol use is more common in boys than girls, in older vs younger adolescents, in those with high or low (vs intermediate) social status, in individuals with (vs without) a migration background, and in those who drink alcohol more frequently. These results emphasize the necessity of implementing targeted prevention strategies that address the specific risk profiles of adolescents concerning alcohol consumption.
10. Assessment of Syphilis Screening Following Policy Implementation in an Outpatient Clinic Setting as an Outbreak Response Activity.
期刊: Journal of public health management and practice : JPHMP 发表日期: 2026-Feb-06 链接: PubMed
摘要
Between 2020 and 2022, the US saw sharp increases in syphilis cases, particularly among American Indian and Alaska Native (AI/AN) people. In July of 2023, the Indian Health Service (IHS), the federal agency charged with providing health care services to AI/AN people, recommended annual syphilis screening for all people aged 13 to 64 years to address the nationwide syphilis outbreak. To assess annual syphilis screening policy recommendation changes at an outpatient clinical facility in 1 IHS clinical service unit and associated case finding outcomes between May 2022 and May 2025. A retrospective analysis of medical and public health records related to syphilis screening and positivity as a public health practice activity. An outpatient clinical facility in 1 IHS clinical service unit in South Dakota. Any 13- to 64-year-old person who had at least 1 visit to primary care services at the facility. Individuals were eligible for inclusion once for each year analyzed. A total of 27 282 unique visits were analyzed. Implementation of an annual syphilis screening policy for those aged 13 to 64 years. Percentage change in syphilis screening coverage. Syphilis screening coverage increased by 57% overall after policy implementation, including increased coverage among females, males, all age groups, and pregnant people. A total of 354 cases of syphilis were newly diagnosed. After implementation of a facility-based annual syphilis screening policy for those aged 13 to 64 years, screening coverage for syphilis increased nearly 60% and over 350 cases of syphilis were identified during a syphilis outbreak in the community. In this outbreak setting, increased screening facilitated case finding and represents an important component of overall outbreak response efforts.
11. What are Canadians eating? A call to action for national surveillance and monitoring of dietary intakes in Canada.
期刊: Applied physiology, nutrition, and metabolism = Physiologie appliquee, nutrition et metabolisme 发表日期: 2026-Feb-06 链接: PubMed
摘要
A diet of low quality has profound repercussions on health and healthcare costs. Canada has implemented several policies to shift population dietary intakes. Yet, monitoring - an essential component of policy implementation - has been undervalued in Canada’s nutrition and health policy, with only two comprehensive national nutrition-focused surveys in the last 50 years. This commentary calls on the Canadian government to implement continuous nationally representative dietary intake monitoring. We demonstrate the importance of dietary intake surveillance for informing evidence-informed nutrition policy. Investments in nationally representative dietary intake monitoring are essential for impactful policies that lead to a healthier Canada.
12. Maintaining Spiritual Wellness in Today's Public Health Workforce.
期刊: Journal of public health management and practice : JPHMP 发表日期: 2026-Feb-06 链接: PubMed
摘要
13. Demographic Variation in Prenatal Care Coordination Receipt and Resulting Birth Outcomes:: Evidence From the Wisconsin Medicaid Population.
期刊: Journal of public health management and practice : JPHMP 发表日期: 2026-Feb-06 链接: PubMed
摘要
Medicaid-funded obstetric care coordination services improve birth outcomes. Whether these benefits vary by race/ethnicity or urbanicity is uncertain. We examined whether the associations between Wisconsin Medicaid’s Prenatal Care Coordination (PNCC) program and birth outcomes varied by race/ethnicity and urbanicity. Data came from a statewide cohort of birth records and linked Medicaid claims. The treatment was PNCC receipt during pregnancy for the birthing parent (none; assessment/care plan; service receipt). Covariate-adjusted conventional and sibling fixed effects linear probability models computed associations between PNCC treatment and birth outcome risks. We stratified models on birthing parent race/ethnicity (American Indian/Alaska Native non-Hispanic [NH]; Asian/Pacific Islander NH; Black NH; Hispanic; White NH; multiple NH; other NH) or on residence county urbanicity (large central metro; large fringe metro; medium metro; small metro; micropolitan; noncore). Wisconsin, US. A total of 249 502 Medicaid-paid births (2010-2019). Preterm birth (PTB; gestational age <37 weeks). Low birth weight (LBW; <2500 g). Bias-limiting sibling fixed effects estimates indicated that PNCC’s benefit is greatest among Black NH births and large central metro births. For Black NH births, PNCC service receipt was associated with a 3.3 percentage point (pp) reduction (95% CI: -4.5, -2.1pp) and a -2.9pp reduction (95% CI: -4.0, -1.7pp) in the risks of PTB and LBW, respectively. For large central metro births, PNCC service receipt was associated with a 2.7pp reduction (95% CI: -3.7, -1.7pp) and a -2.4pp reduction (95% CI: -3.4, -1.5pp) in the risks of PTB and LBW, respectively. Estimates suggest that PNCC services were most effective in Black NH and urban populations. This motivates policy to improve PNCC outreach and impact in populations that stand to benefit from care coordination during pregnancy.
14. Knowledge, Attitudes, Practices, and Vaccination Willingness Toward Mpox (Monkeypox) Among Chinese Medical Students: Cross-Sectional Study.
期刊: JMIR public health and surveillance 发表日期: 2026-Feb-06 链接: PubMed
摘要
Mpox (monkeypox) remains a global public health threat. However, data on mpox-related knowledge, attitudes, and practices (KAP) and vaccination willingness among Chinese medical students, who are key future health care practitioners, remain lacking. This study aimed to investigate systematically the KAP and mpox vaccination willingness of Chinese medical students and identify the factors influencing their vaccination decisions. A nationwide cross-sectional survey was conducted from November 2023 to March 2024. An anonymous self-designed questionnaire was used to assess basic information, KAP toward mpox, vaccination-related behaviors, and willingness. Categorical data were presented as frequency (constituent ratio). The normality of continuous variables was assessed using the Kolmogorov-Smirnov test. Continuous variables that did not conform to a normal distribution were presented as median (IQR). Data were analyzed using the chi-square test, 2-tailed t test, ANOVA, Kruskal-Wallis H test, and multinomial logistic regression. Among the 4098 participants, 84.63% (n=3468) accepted mpox vaccination. The median scores of KAP toward mpox were 43 (IQR 33-50), 33 (IQR 32-36), and 20 (IQR 19-24), respectively, with a median score of 73 (IQR 68-79) for vaccination-related practices. Multinomial logistic regression showed that factors associated with vaccination hesitancy (vs acceptance) included male individuals (odds ratio [OR] 1.416, 95% CI 1.158-1.732), being an only child (OR 1.340, 95% CI 1.098-1.635), no history of COVID-19 in family or friends (OR 1.520, 95% CI 1.161-1.991), no influenza vaccination (OR 1.429, 95% CI 1.146-1.783), and low mpox knowledge (OR 0.948, 95% CI 0.941-0.955). Factors associated with vaccination rejection (vs acceptance) included male sex (OR 1.641, 95% CI 1.003-2.686), high academic grade (OR 1.442, 95% CI 1.154-1.802), family or friends working on COVID-19 frontlines (OR 2.243, 95% CI 1.337-3.764), no internship experience (OR 2.049, 95% CI 1.076-3.901), presence of organic diseases (OR 3.733, 95% CI 1.778-7.838), and low mpox knowledge (OR 0.954, 95% CI 0.938-0.971). Good self-reported health status was a protective factor against refusal (OR 0.748, 95% CI 0.580-0.965). The high willingness to receive mpox vaccination among Chinese medical students and its determinants, as identified in this study, carry clear implications for both education and policy. These findings inform the design of targeted health education programs for students and guide the development of evidence-based prevention strategies on campuses during public health emergencies.
15. Subjective Cognitive Decline Among Adults Aged ≥45 Years-United States, 2023.
期刊: Journal of public health management and practice : JPHMP 发表日期: 2026-Feb-06 链接: PubMed
摘要
In 2025, an estimated 7.2 million Americans aged ≥65 years had Alzheimer’s disease. Subjective cognitive decline (SCD) is an early indicator of possible future dementia. Using 2023 Behavioral Risk Factor Surveillance System data, this study described the SCD prevalence among US adults aged ≥45 years. Estimates were examined by selected characteristics, state, and SCD-related features, including worry, functional limitations, and discussions about SCD with a health care provider. Overall, SCD prevalence was 16.9% (95% confidence interval [CI] = 16.5-17.3). Among those reporting SCD, 59.3% (95% CI = 57.9-60.7) were worried about it and 42.8% (95% CI = 41.4-44.1) reported having discussed SCD with a health care provider. Engaging health care providers about concerns related to memory loss or increasing confusion is a key to early identification, diagnosis, and management. These findings emphasize the need for targeted public health efforts to support individuals with SCD-especially among high-risk populations.
16. Gender differences in superior hypogastric plexus block via the sacral notch approach for chronic pelvic pain: A retrospective CT-based observational study.
期刊: Medicine 发表日期: 2026-Feb-06 链接: PubMed
摘要
Chronic pelvic pain is a common and multifactorial clinical syndrome that markedly impairs quality of life in both men and women. Superior hypogastric plexus block (SHGPB) is an effective minimally invasive treatment. The sacral notch approach, a modification of the transdiscal technique, offers a more direct and technically simple puncture pathway. However, sex-related pelvic anatomical differences may affect puncture parameters, and imaging-based evidence remains limited. This study aims to evaluate sex-related differences in key anatomical and technical parameters of SHGPB via the sacral notch approach based on computed tomography imaging and explore the potential clinical value of puncture angle, puncture distance, and the SHGPB index for preoperative assessment and individualized approach selection. This retrospective study analyzed abdominal computed tomography images of 200 patients (100 males and 100 females). Measured parameters included: the angle between the simulated needle trajectory and the sagittal plane; the distance from the skin entry point to the target point; and the SHGPB index, defined as the ratio of the inter-posterior superior iliac spine distance to the transverse diameter of the L5 vertebral body. Parameters were compared between sexes using appropriate statistical tests. The angle between the puncture trajectory and the sagittal plane was 25.33 ± 7.26° (range, 10.70-44.40°) in males and 27.18 ± 8.44° (range, 11.90-52.00°) in females, with no significant difference (P > .05). The puncture distance was 13.43 ± 1.53 cm (range, 10.20-17.60 cm) in males and 13.29 ± 2.39 cm (range, 9.90-32.70 cm) in females, also without significant difference (P > .05). However, the SHGPB index was significantly lower in males (1.75 ± 0.23; range, 1.24-2.33) than in females (1.96 ± 0.24; range, 1.53-2.63; P < .05). The sacral notch approach is characterized by a relatively small puncture angle and a straightforward puncture pathway. Puncture angle and distance remain stable across sexes, whereas the SHGPB index shows significant sex-related differences. The SHGPB index may serve as an important imaging marker for preoperative evaluation of pelvic anatomy and individualized selection of the puncture approach, with potential clinical value in the interventional management of chronic pelvic pain.
17. Changes in college students' physical fitness pre- and post-COVID-19 pandemic.
期刊: Medicine 发表日期: 2026-Feb-06 链接: PubMed
摘要
This study specifically evaluated physical fitness trends among college students in Jiangxi province from 2018 to 2020, amid the emergence and influence of the COVID-19 pandemic. A cohort of 20,202 students (5622 boys and 14,580 girls) from a Jiangxi-based university underwent standardized physical fitness testing. Differences across years were analyzed using Kruskal-Wallis H and Wilcoxon Signed-rank tests, with stratification by sex and body composition. The overall fitness scores increased significantly during the study period. However, cardiorespiratory endurance declined markedly in both genders (boys’ 1000 m: +25.4 seconds; girls’ 800 m: +21.5 seconds). Concurrently, the overweight prevalence among boys increased progressively (2018:11.9%; 2019:13.8%; 2020:14.4%), while upper-body strength remained critically low (pull-ups: ~5). Contrastingly, 2020 saw improvements in vital capacity, standing long jump, and sit-and-reach across both genders, and in boys’ 50-m dash performance (-0.08 seconds). The COVID-19 pandemic significantly impaired cardiorespiratory endurance despite overall fitness gains. Future interventions should prioritize the development of indoor-compatible endurance training protocols for restricted environments.
18. Structural barriers to work-family reconciliation in surgery: a gendered analysis of career disruption and care responsibilities.
期刊: Updates in surgery 发表日期: 2026-Feb-06 链接: PubMed
摘要
Despite increasing numbers of women entering surgical training, gender disparities in surgical careers persist. Female surgeons remain underrepresented in leadership roles and face challenges related to family responsibilities. This study investigates gender-specific differences in surgical careers, family planning, caregiving responsibilities, and perceived institutional support in Germany. A nationwide cross-sectional survey was conducted among 432 board-certified surgeons and residents from various surgical specialties in Germany. A 68-item questionnaire assessed demographics, career stage, family planning, childcare responsibilities, work models, and perceived career barriers. Analyses included descriptive statistics, chi-square tests, t-tests, and regression models adjusted for age and institutional background. Female surgeons were significantly more likely to work part-time (OR 12.03, 95% CI 4.19-50.87), interrupt training due to parental leave, and experience prolonged specialization (OR 1.74, 95% CI 1.03-2.96). Nearly half (46.2%) postponed childbearing for career reasons (OR 4.72, 95% CI 2.34-10.23), and 82.5% reported negative career impacts from motherhood (OR 11.22, 95% CI 4.77-30.0). Women also reported greater domestic burdens, physical (OR 2.32, 95% CI 1.32-4.17) and emotional exhaustion (OR 2.61, 95% CI 1.39-5.20). Reassignment to non-surgical duties during pregnancy occurred in 46.4% (n = 44). Structural and cultural barriers constrain gender equity in surgery. Family responsibilities disproportionately affect female surgeons’ careers, contributing to slower advancement and increased burnout. Reforms such as flexible work models, accessible childcare, transparent promotion pathways, and mentorship are critical for fostering equal opportunity and retaining female talent for surgical leadership.
19. Increased burden of systemic hypertension among pediatric patients with moyamoya disease: a population-based analysis of prevalence and incidence.
期刊: Journal of neurosurgery. Pediatrics 发表日期: 2026-Feb-06 链接: PubMed
摘要
The association between moyamoya disease (MMD) and hypertension has been studied as hospital-based case series without comparison to the general population. The aim of this study was to compare the prevalence and incidence of hypertension between pediatric patients with MMD and the general pediatric population. Data from the South Korea National Health Insurance Service was used to compare hypertension prevalence and incidence between pediatric patients with MMD (2008-2019) and the general pediatric population (2010). MMD was defined using ICD-10 code I67.5 and the Rare and Intractable Disease code V128. Hypertension was identified by ICD-10 codes I10-I15 alongside antihypertensive medication claims. Prevalence and incidence rates were calculated for each year and age group (1-4, 5-9, 10-14, and 15-19 years). Indirect standardization was used to calculate prevalence and incidence rate ratios between the pediatric MMD cohort and the general population. The study included 3645 pediatric patients (2041 female, mean age 11.26 years) with MMD. Compared with the general pediatric population, there was a higher proportion of patients in the 5-14 years age range and more females in the MMD cohort. Chronic kidney disease, diabetes, renal artery stenosis, hyperthyroidism, and lupus were more prevalent comorbidities in patients with MMD. Hypertension prevalence and incidence were consistently higher in patients with MMD across all age groups. The standardized prevalence ratio was 43.79 (95% CI 40.56-47.01), indicating that patients with MMD had nearly 44 times higher prevalence of hypertension than expected. The standardized incidence ratio was 31.33 (95% CI 27.39-35.27), indicating that patients with MMD had approximately 31 times higher incidence of hypertension than expected. Pediatric patients with MMD in the Korean population have a significantly higher hypertension burden and risk, emphasizing the need for prioritized hypertension management.
20. A comparison of F/TAF and F/TDF as HIV pre-exposure prophylaxis in a predominantly cisgender women population in East and South Africa: a randomised, factorial, non-inferiority trial.
期刊: Journal of acquired immune deficiency syndromes (1999) 发表日期: 2026-Feb-06 链接: PubMed
摘要
F/TAF was shown to be non-inferior to F/TDF as pre-exposure prophylaxis (PrEP) in men, but approval was not extended to cisgender women. We report the results of PrEPVacc, in which a predominantly female population was randomly allocated to receive daily oral F/TDF or F/TAF for ∼6 months within a HIV-1 prophylactic vaccine trial. Five study sites in three African countries (Uganda, Tanzania, South Africa). The two regimens were compared by the averted infections ratio (AIR) - the proportion of infections averted by F/TAF relative to F/TDF. The counterfactual HIV incidence, an essential component of this metric, was derived from a preceding registration cohort. Dried blood spots (DBS) were collected at regular timepoints for later assessment of tenofovir diphosphate levels in selected sub-populations. 1380 participants (697 F/TDF, 683 F/TAF) were included in the primary analysis (total follow-up 709.2 person-years); 87% were cisgender women. Three HIV infections (0.86/100 person-years) occurred in the F/TAF group versus two in the F/TDF group (0.56/100 person-years). The counterfactual HIV incidence was estimated to be 2.59/100 person-years (90% CI 1.86-3.52), giving an AIR of 0.85 (90% CI 0.31-1.66). Based on the week 8 DBS sample , only an estimated 14% of participants were classified as taking 2-3 tablets per week and 9% ≥4 tablets per week. Despite similar HIV incidence rates, the non-inferiority of F/TAF was not demonstrated, probably due to low statistical power primarily driven by low adherence. However, there is compelling evidence from multiple studies supporting the efficacy of F/TAF as PrEP regardless of sex.
21. Discovery of Novel CBP/p300 and BRD4 Dual-Target PROTACs with Potent Antitumor Activity in Prostate Cancer.
期刊: Journal of medicinal chemistry 发表日期: 2026-Feb-06 链接: PubMed
摘要
CBP/p300 and BRD4 synergistically drive prostate cancer progression. Here, we report the rational design, synthesis, and biological evaluation of novel PROTACs capable of simultaneously degrading CBP/p300 and BRD4. The representative compounds 10h and 29c induced robust degradation of both targets with DC50 values ranging from 8.8 pM to 10.5 nM in PC-3 prostate cancer cells, accompanied by marked downregulation of c-Myc and acetylated H3K27. Both compounds displayed potent antiproliferative activity across multiple cancer cell lines, with higher potency than NEO2734, paclitaxel (PTX), and ARV-771. In a PC-3 xenograft mouse model, compound 29c achieved dose-dependent tumor growth inhibition (TGI) of up to 81.5% at a low dose of 0.2 mg/kg, administered every other day, significantly surpassing the efficacy of NEO2734 and PTX at higher doses. Together, 29c, a highly efficient CBP/p300 and BRD4 dual-target degrader, demonstrates significant therapeutic potential in prostate cancer and warrants further development.
22. Hope for the Heart&s Lonesome Hunt-Metabolic Roadblocks and Cardiac Electrical Instability in Long-Chain Fatty Acid Oxidation Deficiency.
期刊: American journal of physiology. Heart and circulatory physiology 发表日期: 2026-Feb-06 链接: PubMed
摘要
23. Unraveling the Toxicological Effects of Hydroxyacetone─A Reaction Product in Electronic Cigarette Aerosols.
期刊: Chemical research in toxicology 发表日期: 2026-Feb-06 链接: PubMed
摘要
Hydroxyacetone was previously detected at high concentrations (up to ∼12 mg/mL) in electronic cigarette (EC) aerosols, including those derived from products associated with adverse health effects. Given the limited understanding of its inhalation toxicology, we investigated hydroxyacetone’s impact on human airway epithelial cells. Acute exposures at the air-liquid interface (ALI) using 3D EpiAirway tissues─a surrogate for human tracheobronchial epithelium─were analyzed via proteomics. Differential expression analysis identified numerous affected proteins, with enrichment pointing to alterations in mitochondrial function and actin cytoskeletal disruption as major targets. Ingenuity Pathway Analysis (IPA) highlighted “Mitochondrial Dysfunction” and “NRF2-Mediated Oxidative Stress” among top toxicological categories, and “Nuclear Cytoskeletal Signaling” as a key canonical pathway. To validate and extend these findings, submerged cultures of BEAS-2B cells were exposed to hydroxyacetone (0.01-10 mg/mL) and assessed for mitochondrial activity, oxidative stress, and F-actin integrity. At 1 mg/mL, mitochondrial membrane potential and reactive oxygen species (ROS) increased, with elevated hydrogen peroxide detected in the culture medium. At 10 mg/mL, mitochondrial activity declined significantly, accompanied by cell rounding and apoptotic blebbing within 2 h. F-actin destabilization occurred at 1, 3.33, and 10 mg/mL, with cytoplasmic and perinuclear filaments more affected than cortical actin. Findings from ALI and submerged models were concordant, supporting hydroxyacetone-induced mitochondrial stress, oxidative damage, and cytoskeletal disruption. These results suggest that hydroxyacetone concentrations found in EC aerosols may contribute to respiratory toxicity and warrant further investigation.
24. Animal-associated jumbo phages as widespread and active modulators of gut microbiome ecology and metabolism.
期刊: Science advances 发表日期: 2026-Feb-06 链接: PubMed
摘要
Huge phages are widespread in the biosphere, yet their prevalence and ecology in the human gut remain poorly characterized. Here, we report Jug (jumbo gut) phages with genomes of 360 to 402 kilobase pairs that comprise ~1.1% of the reads in human gut metagenomes, and are predicted to infect Bacteroides and/or Phocaeicola. Although three of the four major groups of Jug phages shared >90% genome-wide sequence identity, their large terminase subunits exhibited only 38 to 57% identity, suggesting horizontal acquisition from other phages. Over 1500 genomes of Jug phages were recovered from human and animal gut metagenomes, revealing their broad distribution, with largely shared gene content suggestive of frequent cross-animal-host transmission. Jug phages displayed high gene transcription activities, including the gene for a calcium-translocating P-type ATPase not detected previously in phages. These findings broaden our understanding of huge phages and highlight Jug phages as potential major players in gut microbiome ecology.
25. Mechanistic Insights of BPA Alternatives on PPARγ Binding and the Consequence on Adipocyte Differentiation.
期刊: Environmental science & technology 发表日期: 2026-Feb-06 链接: PubMed
摘要
The obesity epidemic is increasingly linked to environmental factors like endocrine disrupting chemicals (EDCs). Bisphenol A (BPA), a known EDC, has been suspected to be linked to adiposity through activation of peroxisome proliferator activated receptor gamma (PPARγ), a key regulator of adipogenesis. Though many BPA alternatives have been introduced as substitutes, their effects on metabolic health remain unclear. This study aimed to investigate the mechanistic interactions of 11 BPA alternatives with PPARγ and their adipogenic potential. Using a PPARγ reporter assay, we assessed the binding affinity and activation potential of BPA alternatives, followed by X-ray crystallography of two potent activators, 4-benzyloxyphenyl 4-hydroxyphenyl sulfone (BPS4BE) and bisphenol PH (BPPH). Additionally, adipogenesis was assessed via a human mesenchymal stem cells (hMSCs) differentiation assay. Results revealed that the alternatives BPPH and BPS4BE potently activated PPARγ (BMD20 (μM): 0.23 and 0.34 respectively). Both significantly induced adipogenesis and a positive correlation was found between PPARγ activation and adipogenic differentiation. Crystallography revealed distinct binding modes for BPPH and BPS4BE compared to rosiglitazone, indicating partial agonism. These findings raise significant concerns about the safety of BPA alternatives and underscore the need for structure-based risk assessment to ensure safer substitutes.
26. Environmental Dose MEOHP Promotes Bladder Cancer Progress through Hybrid EMT Mechanism: Based on the Adverse Outcome Pathway.
期刊: Environmental science & technology 发表日期: 2026-Feb-06 链接: PubMed
摘要
Di(2-ethylhexyl) phthalate (DEHP) is one of the major plasticizer pollutants, and numerous studies have reported the harmful effects of DEHP on human health. However, the effects of urinary DEHP metabolites on the progression of bladder cancer remain unclear. Here, we aimed to identify the representative chemical and explore its effect and mechanism on bladder cancer progression with epidemiological and experimental methods based on the adverse outcome pathway (AOP). The quantile-based g-computation (QGC) model showed a positive association between urinary plasticizer metabolites and bladder cancer risks in older men (NHANES 2005-2018), with mono(2-ethyl-5-oxohexyl) phthalate (MEOHP, the secondary-metabolite of DEHP) identified as a main driver factor. We treated human bladder cancer cells with MEOHP at environmentally relevant concentrations (10, 100, and 1000 nM) and found that 100 nM MEOHP exposure activated a hybrid EMT (epithelial-mesenchymal transition) phenotype. Mechanically, we confirmed that the environmental dose of MEOHP increased nuclear transposition of YAP and β-catenin (molecular initiating event, MIE), thereby sustaining the hybrid EMT phenotype of bladder cancer cells through a series of key events. Our study first investigated the effects of plasticizer secondary metabolite on bladder cancer progression, highlighting the potential damage to urinary system health caused by the metabolites of environmental chemicals and providing a new perspective for the toxicity assessment of pollutants in the future.
27. A proposed preintervention framework for neurosurgery in children with medically refractory hypertonia: a scoping review.
期刊: Journal of neurosurgery. Pediatrics 发表日期: 2026-Feb-06 链接: PubMed
摘要
Pediatric movement disorders (PMDs) frequently require escalating neurosurgical therapies. Institutional studies describe local preintervention evaluation for selected PMDs; however, no international consensus guidelines exist. The authors aimed to review preintervention screening for PMDs and present a suggested preintervention framework for children with PMDs who might benefit from neurosurgery. A scoping review was performed according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) 2020 guidelines adapted for scoping reviews (PRISMA-ScR) and the JBI scoping methodology to compile information about the preoperative evaluation of PMDs across various institutions. Data were synthesized and a preintervention framework was developed. Twenty-one studies were included. Presurgical evaluations included multidisciplinary evaluation, imaging, physical therapy, occupational therapy, gait analysis, nutritional analysis, and genetic analysis. These data were used to create presurgical algorithms for pediatric hypertonia defined by dystonia, spasticity, or mixed hypertonia. Each diagnosis-specific algorithm guides the clinician through the recommended evaluation and toward the appropriate neurosurgery. An evidence-based, structured, diagnosis-related presurgical algorithm for PMDs could mirror existing approaches for medically refractory epilepsy and improve patient care via standardization of indications, workup, and recommendations. This scoping review identifies gaps in all major aspects regarding the presurgical workup of PMDs and suggested surgical plans.
28. Occupational and Psychosocial Risk Factors for Depression Among Truck Drivers: A Systematic Review.
期刊: Issues in mental health nursing 发表日期: 2026-Feb-06 链接: PubMed
摘要
Depression among professional truck drivers may be driven by isolation, irregular schedules, and high job demands. This systematic review identified occupational and psychosocial risk factors for depression in adult truck, heavy goods vehicle (HGV), or lorry drivers. PubMed, PsycINFO, Web of Science, and Embase were searched for observational studies assessing work or psychosocial exposures and depression via validated measures or clinical diagnosis. Screening was conducted in duplicate; data extraction was verified by a second reviewer; risk of bias was assessed using the JBI cross-sectional checklist. Because heterogeneity precluded meta-analysis, we used direction-of-effect vote counting. Seven cross-sectional studies (n = 1,591) from six countries were included; reported prevalence ranged from 13.6% to 59.1%. Consistent positive associations were found for high work demands (longer hours, tight deadlines), safety hazards in driving conditions (e.g., poor roads, accident history, distraction), and lock of occupational support (job dissatisfaction, limited supervisor support, wage-earning vs. self-employment). Psychosocial isolation (loneliness, low engagement) showed strong links to depressive symptoms. Poor sleep quality and stimulant use were associated with higher risks, while better self-rated health was protective; evidence for age and substance use was mixed. Findings highlight modifiable work and social conditions and the need for longitudinal and interventional research.
29. Concept Analysis of Orthorexia Nervosa.
期刊: Issues in mental health nursing 发表日期: 2026-Feb-06 链接: PubMed
摘要
This study analyzes orthorexia nervosa (ON), an eating disorder marked by a rigid fixation on “healthy” eating. Proposed by Steven Bratman in 1997, ON shares restrictive patterns with anorexia or bulimia but is driven by food purity pursuit rather than weight control. Using Walker and Avant’s conceptual analysis approach, key attributes include obsessive attention to food quality, strict dietary rules, guilt or anxiety over deviations, and social or occupational impairment. Antecedents like social media influence, perfectionism, and fitness culture may contribute, while consequences range from malnutrition and physical decline to psychological distress and isolation. Existing assessment tools are reviewed for reliability and validity. The study emphasizes refining diagnostic criteria, improving measurements, and developing nursing interventions to support affected individuals.
30. Providers' Experiences in Implementation of Friendship Bench: A Problem-Solving Therapy-Based Mental Health Intervention Adapted for People on Methadone Maintenance Treatment Who Live with HIV in Vietnam.
期刊: AIDS and behavior 发表日期: 2026-Feb-06 链接: PubMed
摘要
People who inject drugs (PWID) living with HIV in Vietnam experience a high prevalence of common mental disorders (CMDs), which negatively impact their health, treatment adherence and overall quality of life. To address the mental health care needs of this vulnerable population, we adapted and piloted Friendship Bench, a problem-solving therapy-based mental health intervention, for people on methadone maintenance treatment (MMT) who live with HIV and have CMDs in 6 MMT clinics in Hanoi, Vietnam, in 2021-2023. This paper aims to explore the experience of implementing aFB and the possibility of aFB expansion from the perspectives of the intervention providers who were directly involved in the delivery of the aFB program. We conducted formal in-person interviews with aFB providers including doctors (n = 6), counselors (n = 10) and supervisors (n = 2)following aFB intervention completion. Collected data was coded using NVivo 12.0 and thematic analysis was applied. All respondents were satisfied with and praised the aFB. Most providers reported that the aFB was beneficial to both overall and mental health of the MMT patients with HIV. All counselors shared that problem-solving therapy in the aFB was new for them; nevertheless, their counseling skills improved significantly after delivering the aFB sessions. All respondents were optimistic about the expansion of the aFB in other clinics. Application of aFB as a mental health intervention for care and treatment for MMT and ART patients could be a promising approach for Vietnam to address mental health care needs for this vulnerable population. Clinical Trial Number: NCT04790201 registered 3/10/2021.
31. Seasonal variation in BMI outcomes at 6 months: secondary analyses of a multidisciplinary healthy lifestyle programme for children and adolescents with obesity.
期刊: World journal of pediatrics : WJP 发表日期: 2026-Feb-06 链接: PubMed
摘要
While international evidence suggests seasonal variations may influence outcomes of interventions for pediatric obesity, data for Aotearoa New Zealand are limited. We examined seasonal variations in changes in body mass index standard deviation score (BMI SDS) in young people with obesity enrolled in an intervention programme. We studied 397 children and adolescents (median = 10.1 years; range 3.7-16.8 years) from Whānau Pakari, a multidisciplinary community-based healthy lifestyle programme (initially a randomised clinical trial that subsequently transitioned into the regional childhood obesity service). Participants were stratified by season at entry and 6-month BMI SDS changes (Δ) were evaluated. Lifestyle factors were also assessed. Data were analysed using traditional linear models and machine learning (random forest). 68% of participants had BMI SDS reductions at 6 months (mean = - 0.16 SDS; P < 0.0001). Linear models showed seasonal variations in programme effectiveness, with BMI SDS reductions among summer (- 0.17 SDS), autumn (- 0.19 SDS) and winter (- 0.18 SDS) but not among spring entrants. Random forest modelling identified higher baseline BMI SDS and younger age as the most influential predictors of greater 6-month reductions in BMI SDS. Season of entry was more important than any single lifestyle factor; spring entrants exhibited attenuated reductions relative to other seasons. The season at programme entry was an important factor associated with intervention effectiveness. Spring entry was associated with attenuated BMI SDS reductions, likely due to the inclusion of the summer holidays within the 6-month intervention. These findings highlight the need for targeted support during such unstructured periods to improve participant outcomes.
32. Comprehensive risk profiling of occupational harmful factors in the ceramic industry: a case study from Iran.
期刊: Environmental science and pollution research international 发表日期: 2026-Feb-06 链接: PubMed
摘要
This study aimed to develop a comprehensive risk profile of four key occupational harmful factors-heat stress, inadequate illumination, noise, and respirable dust-within a representative ceramic manufacturing facility in Iran. Standardized instruments and protocols were used to assess four physical harmful factors. Dust concentration was measured via NIOSH 0600 using SKC pumps and nylon cyclones. Noise levels were recorded with a type 2 sound level meter (Extech 407732). Illuminance was measured with a GM1040 lux meter at a height of 0.85 m, and heat stress was evaluated using a wet-bulb globe temperature (WBGT) meter. The risk ratio (RR) was calculated for each harmful factor as a single risk index. An integrated risk assessment followed, incorporating RR values, the number of exposed workers, and exposure duration. Prioritization of harmful factors and similar exposure groups (SEGs) was performed using the Pareto principle. The findings revealed that the average levels of noise, illumination, respirable dust, and temperature in the studied ceramic industry were 82.88 dB(A), 114.83 lx, 4.15 mg/m3, and 21.01 °C, respectively. The RR matrix analysis identified respirable dust exposure as a high-risk factor, with a prioritization index exceeding 386%. In comparison, noise was classified as a medium-risk factor, with priority levels ranging from 321 to 386%. In contrast, poor illumination and heat stress were categorized as low-risk factors (integrated risk assessment (IRI) < 321%). Among the SEGs, the packing occupational group exhibited the highest comprehensive risk profile (IRI ≥ 379%) and was consequently identified as the top priority for control interventions in accordance with the Pareto principle. This risk-based framework offers a systematic approach for prioritizing occupational health interventions and optimizing resource allocation in industrial environments. Clinical trial number: This is not applicable.
33. Sarcopenia Affects the Clinical Efficacy of Immune Checkpoint Inhibitors in Gastric Cancer Patients: a Systematic Review and Meta-Analysis.
期刊: Journal of gastrointestinal cancer 发表日期: 2026-Feb-06 链接: PubMed
摘要
34. Availability and content of discharge summaries for primary care physicians of extracorporeal membrane oxygenation-treated patients: An observational study.
期刊: Australian critical care : official journal of the Confederation of Australian Critical Care Nurses 发表日期: 2026-Feb-05 链接: PubMed
摘要
Extracorporeal membrane oxygenation (ECMO) is a complex, costly, and uncommon life-saving treatment for critically ill patients with severe cardiac and/or respiratory failure in intensive care units, though its use has increased in recent years. Survivors frequently experience long-term physical, cognitive, and psychological challenges and require support from a wide range of healthcare providers and facilities, many of whom may have limited experience with ECMO. Timely and comprehensive discharge communication is essential to ensure continuity and quality of care across settings. The aims of this study were to assess the proportion of patients treated with ECMO who had a documented primary care physician or clinic on file and to evaluate the inclusion of clinical information in their hospital discharge summaries. This multi-centre retrospective observational study included adults treated with ECMO and discharged alive from four tertiary hospitals between January 1, 2021, and December 31, 2022. Patients who died in hospital or were transferred to another acute facility were excluded. Data were collected through medical records’ review and linkage with the EXCEL Registry. Of the 150 participants who met eligibility criteria (mean age: 48 years, 72.7% male), 126 (84%) had a documented primary care physician or clinic. Among the 148 (98.7%) medical discharge summaries, the primary diagnosis was recorded for all participants, ECMO use was recorded for 147 (99.3%) participants, discharge destination for 142 (95.9%), hospital follow-up plans for 136 (91.9%), and ECMO indications for 135 (91.2%). Discharge medications were recorded in 131 (88.5%) cases, and a hospital contact person was provided in 95 (64.2%) cases. In contrast, intensive care unit-specific and ECMO-specific recommendations were reported in only 23 (15.5%) and 8 (5.4%) summaries, respectively. These findings highlight the need to improve discharge communication to better support primary care physicians in delivering coordinated care following hospital discharge.
35. Concept of Urolithiasis in Unani Medicine: Traditional Approaches and Contemporary Insights.
期刊: Advances in mind-body medicine 发表日期: 2026-Feb-05 链接: PubMed
摘要
Urolithiasis is a common condition that leads to serious health complications. Urinary stones have afflicted humans for millennia, with records dating back to 4800 BC. Preventing renal stone recurrence remains a common human health concern. Renal stones have been linked to an increased risk of chronic end-stage renal disease, renal failure, cardiovascular disorders, diabetes, and hypertension. Although conventional medicine provides multiple treatment options, Unani medicine offers an alternative approach, focusing on herbal remedies and holistic therapeutic practices. This paper explores the Unani perspective on urolithiasis, examining its conceptualization and therapeutic approaches. It provides an overview of urolithiasis pathophysiology, associated risk factors, preventive measures, differential diagnosis, and its management. A systematic review was conducted by scrutinizing classical Unani texts and contemporary scientific knowledge. Classical texts like Kāmil us Sana’, Al Qānūn fit Tibb, Zakhīra Khw̄arzim Shāhi, Kitāb Al Miah, Ghina Muna, Kitab al Mukhtārāt fit Tibb, Kitāb ut Taisīr, and Kitāb al Kullīyāt were surveyed and examined. Conventional databases, including PubMed, Elsevier, Scopus, Benthem Science, Web of Science, ScienceDirect, and Google Scholar, were explored and scanned using the terms “urolithiasis” and Hīṣāt al Kulya. Manuscripts were assessed from both theoretical and clinical perspectives on urolithiasis, and these were featured in the study. Unani medicine, rooted in humoral theory, emphasizes health and disease based on the Kayfiyāt (qualities): hot, cold, dry, and wet, rather than molecular explanations. The holism-based principles already validated through diverse research data demonstrate a rational approach to treatment with practical relevance. While modern medicine may differ in methodology, it can benefit from Unani’s empirical observations. This paper explores the Unani perspective on Urolithiasis, showcasing its clinical relevance even today. Bladder calculi, Botanical medicine, Renal stone, Urolithiasis, Unani medicine.
36. Corrigendum to 'Distribution of trace elements as electroactive species for environmental monitoring of estuarine waters in Pará river (AAmazonia, Brazil)' [Chemosphere, volume 390 (2025) 144714].
期刊: Chemosphere 发表日期: 2026-Feb-05 链接: PubMed
摘要
37. Longitudinal trends in the past 30-day co-use of nicotine/tobacco, alcohol, and cannabis among youth and adults in the PATH study.
期刊: Addictive behaviors 发表日期: 2026-Feb-03 链接: PubMed
摘要
The co-use of substances confers risks above single-product use and has significant public health implications. This study investigated trends in past 30-day co-use of nicotine/tobacco products with alcohol and cannabis in the US using Population Assessment of Tobacco and Health Study data from Waves 4-6 (December 2016-November 2021). All wave 4-6 PATH participants age 15+ were included in analyses. Changes across wave in past 30-day co-use of cigarettes, e-cigarettes, and other tobacco products (OTP; cigars, filtered cigars, smokeless, hookah, snus, and cigarillo) with alcohol and cannabis, moderated by age (15-17,18-24, 25-34,35-64, 65+), and controlling for demographics were investigated. Changes in co-use of tobacco products with cannabis and alcohol varied across age and product. Cigarette and alcohol co-use was most prevalent across all adult ages, with rates declining over time among young adults (18-24, 25-34) but stable in older adults (65+). Rates of e-cigarette and alcohol co-use increased among young adults, possibly supplanting alcohol and cigarette co-use. E-cigarette and alcohol co-use was the most popular pattern of co-use in youth, with initially increasing and then declining prevalence. Co-use of e-cigarette and cannabis increased at Wave 5 among those 15-17, 18-24, and 25-34, although this increase lessened in all groups except those age 25-34 at Wave 6. Cigarette and cannabis co-use rates, and co-use rates of OTP with both cannabis and alcohol were generally stable or decreasing. Findings highlight the complex interplay between substance use patterns and developmental stages and the dynamic nature of co-use in ever-evolving tobacco and cannabis marketplaces.
38. Treating those not ready to quit smoking: Doing harm while trying to help?
期刊: Addictive behaviors 发表日期: 2026-Feb-03 链接: PubMed
摘要
Motivation-phase smoking treatment can increase treatment reach and abstinence in persons unmotivated to quit smoking. However, Motivation-phase treatment is modestly and inconsistently effective. This research aims to identify factors that may influence the effectiveness of the two intervention components most commonly used in Motivation-phase treatment: nicotine replacement therapy (NRT) and reduction counseling. An exploratory, secondary analysis of a 4-factor, randomized trial enrolled 577 primary care patients who were willing to reduce, but not quit, smoking. Participants were randomized to the following interventions: smoking reduction counseling, nicotine mini-lozenge, behavioral activation counseling, and 5Rs-motivational counseling. Using a precision medicine approach, machine learning analyses determined whether demographic and smoking variables identified persons more likely to benefit from the interventions with regard to 24-hour quit attempts, entry into cessation treatment, and self-reported 7-day point prevalence abstinence at 1 year. Quitting self-efficacy predicted the likelihood of making a quit attempt and entering cessation treatment. At high levels of self-efficacy (>3.5 out of 5), there were no significant effects of interventions. At low levels of self-efficacy (≤3.5 out of 5), receiving reduction counseling reduced the odds of making a quit attempt (OR = 0.51, p = 0.002), and receiving mini-lozenge reduced the odds of entering cessation treatment (OR = 0.55, p = 0.02). No significant effects were found for smoking abstinence. Baseline quitting self-efficacy may identify persons who will not be aided by standard Motivation-phase treatment and thus require a different therapeutic approach. These results raise questions about whom to treat, and how to treat, individuals who decline cessation treatment.
39. End-of-life care for forensic psychiatric patients: Ethical, legal, and systemic challenges in integrating palliative approaches.
期刊: Journal of forensic and legal medicine 发表日期: 2026-Feb-03 链接: PubMed
摘要
End-of-life (EOL) care for patients with serious mental illness (SMI) in forensic mental health settings remains a critical yet underexplored area of healthcare. Individuals with SMI experience significant health disparities, including reduced life expectancy due to preventable chronic illnesses. These challenges are compounded in forensic settings by legal constraints, systemic neglect, and limited access to palliative care services. This narrative review examines the unique barriers to EOL care in forensic psychiatric institutions. Key issues explored include diagnostic overshadowing, restricted patient autonomy, and the absence of integrated palliative care models. Additionally, ethical and legal dilemmas, such as involuntary treatment and advance care planning (ACP), are analysed in the context of forensic mental health. Best practices for improving EOL care in forensic psychiatric settings include the integration of multidisciplinary palliative care teams, trauma-informed approaches, and the development of hospice and alternative care models. Policy and systemic recommendations highlight the need for early palliative care consultations, legal reforms that balance patient rights with public safety, and enhanced staff training in EOL care competencies. Despite these proposed interventions, significant gaps remain in research, particularly in evaluating the effectiveness of palliative interventions in forensic settings. Addressing these gaps is crucial to ensuring forensic psychiatric patients receive compassionate, dignified, and ethically sound EOL care.
40. Developing Digital Literacy Through a Social Media Health Campaign.
期刊: Nursing education perspectives 发表日期: 2026-Feb-03 链接: PubMed
摘要
This article describes a project that integrates social media into an introductory nursing course. Students work together to develop health promotion campaigns on social media platforms. The project fosters active learning, encouraging critical thinking, teamwork, communication, and creativity. Student engagement is high, with positive feedback received on the quality of the campaigns and the development of essential professional skills. This innovative approach demonstrates the potential of social media as a powerful tool for enhancing student learning and preparing nurses for the challenges of the digital health landscape.
41. Embracing a New Frontier: Generative AI in Nursing Education.
期刊: Nursing education perspectives 发表日期: 2026-Feb-03 链接: PubMed
摘要
This article explores the educational implications of incorporating generative artificial intelligence (AI) into a prelicensure baccalaureate nursing program, demonstrating how AI-enhanced resources can bridge gaps in nursing education and improve workflow efficiency. Student feedback affirms the efficacy of our approach, highlighting improved readability and alignment of course materials. The accuracy and ethical considerations of AI-generated content are also discussed. Generative AI has the potential to revolutionize nursing education by fostering adaptive learning environments and preparing students for a health care landscape focused on preventative care and wellness promotion.
42. The effect of timing and tempo of adrenarche on depression and anxiety in adolescence: A prospective cohort analysis.
期刊: Psychoneuroendocrinology 发表日期: 2026-Feb-02 链接: PubMed
摘要
A considerable proportion of life-time depression and anxiety emerges during childhood and adolescence. Some research has shown that pubertal maturity is associated with depression and anxiety. While most research has focused on gonadarche, the earlier phase of adrenarche remains less explored and understood. We aimed to examine the effects of timing and tempo of adrenarche on incidence and chronicity of depression and anxiety during adolescence. Data were from the Child to Adult Transition Study (CATS), a longitudinal population-based cohort from Melbourne, Australia. CATS recruited Grade 3 students in 2012, who were followed up annually across adolescence. Adrenarchal timing was modelled as the level of adrenal hormones (DHEA, DHEAS, and testosterone) relative to peers at age 9 and tempo as the adrenal hormone progression rate relative to peers between 9 and 12. Incidence and chronicity of common mental disorders were defined using self-reported depressive and anxiety symptoms collected annually from age 12-18. G-computation was used to adjust for confounding. Missing data were handled via multiple imputation using chained equations. The study comprised 667 females and 572 males. Depression incidence (76 % females, 44 % males) and chronicity (34 % females, 7 % males) and anxiety incidence (69 % females, 36 % males) and chronicity (29 % females, 7 % males) were more common in female adolescents than males. Regardless of using DHEA, DHEAS, or testosterone as the index for adrenarche, the risk ratios for the association between timing and tempo of adrenarche and the incidence and chronicity of depression or anxiety were close to null and 95 % confidence intervals were inconclusive. This study did not identify a meaningful effect of adrenarchal timing and tempo on depression and anxiety in adolescents, suggesting that individual differences in adrenarche may not influence risk for later significant mental health difficulties.
43. Mycoplasma bovis isolates from Chinese dairy farms: Analysis of genomic features, antimicrobial resistance, and virulence-associated structural differences.
期刊: Veterinary microbiology 发表日期: 2026-Feb-02 链接: PubMed
摘要
Mycoplasma bovis (M. bovis) is an emerging major bovine pathogen, causing economic losses worldwide in the dairy and beef industry. In this study, whole-genome sequencing was performed on 47 representative isolates collected from 11 provinces in China between 2018 and 2023, and the data were compared with 86 global reference genomes. Core SNP phylogeny and core genome multilocus sequence typing (cgMLST) showed that Chinese isolates were mainly attributed to type I spectrum, ST-52 was the dominant type (87.5 %), with high overall homology and geographical clustering. Annotation of virulence factors identified six categories of functional genes, while Chinese isolates displayed varying degrees of deletions within the vsp family and the adhesion-immune modulation region (Mbov_0723-Mbov_0735). Functional validation using representative strains-PZJS01 (complete), PZNX02 (partially undetected), and PZHLJ02 (large-fragment undetected)-demonstrated that PZJS01, which harbors an intact pathogenicity island, exhibited stronger invasiveness and significantly induced host cell apoptosis (∼28 %). These findings indicate that this structural region may play a critical role in the pathogenic process. Antimicrobial susceptibility testing revealed that Chinese isolates were generally resistant to erythromycin (97.9 %) and tylosin (59.6 %), and all strains were non-susceptible to oxytetracycline, showing a pattern of multidrug resistance. In contrast, doxycycline and tiamulin exhibited favorable in vitro activity based on MIC testing. This study systematically elucidates the clonal dissemination patterns, virulence evolution, and antimicrobial resistance risks of M. bovis in China, providing scientific evidence for the development of control strategies and vaccine design.
44. Women's Preferences for Home-Based Self-Sampling or Clinic-Based Testing for Cervical Cancer Screening.
期刊: JAMA network open 发表日期: 2026-Feb-02 链接: PubMed
摘要
While home-based self-sampling for cervical cancer screening is an evidence-based strategy proven to increase screening access and uptake, it is not currently recommended in the US despite recent Food and Drug Administration approval of the first at-home self-sampling device. Little nationally representative research has examined preference for and drivers of home-based self-sampling over clinic-based testing (the standard of care). To assess women’s perspectives about, reasons for considering, and factors associated with preferring at-home self-sampling for cervical cancer screening. This population-based cross-sectional study used data from the 2024 Health Interview National Trends Survey (HINTS 7), a nationally representative survey of the civilian, noninstitutionalized US adult population offered between March and September 2024. Respondents included in this study were individuals aged between 21 and 65 years who were eligible for cervical cancer screening per the US Preventive Services Task Force guidelines and who self-reported their gender identity. Respondents who indicated not needing cervical cancer screening or who did not report their preference for any screening modality (home-based self-sampling or clinician-collected sampling) were excluded. Data were analyzed from May 12 to 25, 2025. Age, race and ethnicity, income, educational level, sexual orientation, marital status, health insurance, urbanicity of residence, trust in the health care system, past-year number of visits to a health care practitioner, and prior experience of discrimination or prejudice when getting medical care. The main outcome was preference for at-home vaginal self-sampling over clinic-based testing, measured using the HINTS 7 question, “If you had choice, how would you prefer to do the cervical cancer screening test?” Responses were: preference to have a health care practitioner do the test in his or her office, preference to self-collect specimen for the test at home, not knowing which option to choose, and not applicable. Weights were assigned to improve representativeness of the general US adult population. The proportion of individuals who reported preferring either screening modality was estimated using weighted percentages. Survey-weighted odds ratios (ORs), adjusted for covariates, were calculated to identify factors associated with preference for at-home self-sampling. Among the 2300 women included (mean [SD] age, 45.5 [29.2] years), most were married or living as married (weighted percentage, 58.2% [95% CI, 56.5%-60.0%]), health insured (91.9%; 95% CI, 90.7%-93.1%), and educated up to some college (61.6%; 95% CI, 60.1%-63.0%). Overall, 462 (20.4%; 95% CI, 17.4%-23.4%) preferred at-home self-sampling, 1402 (60.8%; 95% CI, 57.2%-64.4%) preferred clinic-based testing, and 436 (18.8%; 95% CI, 15.5%-22.1%) were uncertain about their choice. Non-Hispanic Black respondents (adjusted OR [AOR], 0.45; 95% CI, 0.21-0.96) had lower odds of preferring at-home self-sampling compared with non-Hispanic White individuals. Women who had experienced prejudice or discrimination when getting medical care had higher odds (AOR, 1.94; 95% CI, 1.16-3.22) of preferring at-home self-sampling. The most commonly self-reported reasons for preferring at-home self-sampling were privacy (54.9%; 95% CI, 49.8%-60.0%), time constraints (35.1%; 95% CI, 29.0%-41.2%), and fear of embarrassment (33.4%; 95% CI, 28.0%-38.8%). In this cross-sectional study, marginalized populations, individuals with low income, and individuals who do not trust the health care system were more likely to prefer at-home self-sampling for cervical cancer screening or not know which option to choose. To address cervical cancer inequities and increase screening uptake, the findings suggest US guidelines should incorporate home-based self-sampling as an alternative to clinic-based testing, women’s education and empowerment should be enhanced, and tailored interventions focusing on high-risk groups are needed to increase awareness and self-confidence in performing home-based self-sampling.
45. Modeling Individual-Level Uncertainty From Missing Data in Multifactorial Breast Cancer Risk Prediction.
期刊: JCO precision oncology 发表日期: 2026-Feb 链接: PubMed
摘要
Multifactorial breast cancer (BC) risk prediction models use a range of predictors to estimate an individual’s chance of developing BC. Data on risk factors are often incomplete, and point estimates calculated when data are missing can mask considerable uncertainty. Quantifying this uncertainty is critical for effective risk communication. We used Monte Carlo simulation methods to estimate the distribution of 10-year BC risk for individuals with missing data, using the BOADICEA multifactorial model as an example. Multivariate imputation by chained equations with large representative reference data sets was used to sample missing covariates. We developed a framework for estimating the uncertainty distribution, uncertainty intervals (UIs), and probability of reclassification, which can be applied to any given individual with missing risk factor data. This was applied to estimating individual-level uncertainty distributions and quantifying the probability of reclassification when groups of risk factors are measured, for a range of example women. Women with limited risk factor data had considerable uncertainty in their estimated BC risk, and 95% UIs spanned all risk categories. This was especially relevant for women classified as moderate-risk, such as those with strong family history or a moderate-risk pathogenic variant. Reclassification probability in this case was as high as 57.5%, with 95% UI of 0.9% to 9.3% for the 10-year risk from age 40 years. Risk certainty improved with additional data collection, particularly genetic information or mammographic density measurement. Our results demonstrate that, in some cases, there is considerable probability of reclassification after collecting missing data. Methodology presented here can identify situations where it would be most beneficial to collect additional information, to enable better informed clinical decision making.
46. Zhi-Chuan-Ling alleviates OVA-induced allergic asthma by suppressing M2 macrophage polarization via the PI3K/AKT/mTOR/STAT6 pathway.
期刊: Phytomedicine : international journal of phytotherapy and phytopharmacology 发表日期: 2026-Feb-01 链接: PubMed
摘要
Allergic asthma, predominantly driven by Th2 immune responses, is a chronic respiratory disease that poses a significant threat to human health. Zhi-Chuan-Ling (ZCL), a traditional Chinese medicine widely used for the treatment of asthma and wheezy bronchitis, has been shown to relieve airway constriction and suppress airway inflammation. However, its mechanisms in regulating macrophage polarization, a key Th2-driven inflammatory process, remain unclear. This study aimed to assess the therapeutic effects of ZCL on allergic asthma and to investigate its molecular mechanisms in modulating macrophage polarization. The chemical profile of ZCL was characterized by high-performance liquid chromatography (HPLC). An ovalbumin (OVA)-induced mouse model of allergic asthma was established to assess the anti-asthmatic effects of ZCL. Mechanistic studies included hematoxylin-eosin (H&E) and Masson’s trichrome (MT) staining, immunofluorescence (IF), ELISA, flow cytometry (FCM), transcriptomic profiling, Western blotting (WB), and in silico molecular docking to predict binding interactions of key ZCL compounds with target proteins involved in M2 macrophage polarization and airway inflammation. ZCL treatment significantly alleviated asthma symptoms and reduced airway inflammation in vivo. Mechanistically, ZCL inhibited M2 macrophage polarization by modulating the PI3K/AKT/mTOR/STAT6 signaling pathway. Molecular docking analysis revealed favorable binding of major ZCL compounds to PI3K, AKT, mTOR, and STAT6, supporting their potential role in modulating these signaling molecules. ZCL protects against allergic asthma by suppressing M2 macrophage polarization through the PI3K/AKT/mTOR/STAT6 axis and by directly interacting with key pathway proteins, thereby attenuating airway inflammation and remodeling. These findings provide both functional and molecular evidence for the therapeutic potential of ZCL in allergic asthma.
47. Ethyl ferulate suppresses choroidal neovascularization by accelerating Keap1 degradation through the inhibition of PSMD14-mediated deubiquitination.
期刊: Phytomedicine : international journal of phytotherapy and phytopharmacology 发表日期: 2026-Jan-30 链接: PubMed
摘要
Choroidal neovascularization (CNV) is a leading cause of central vision impairment with limited treatment options. Ethyl ferulate is a natural compound with antioxidant and anti-angiogenic properties; however, its application for treating CNV and the underlying mechanisms remain largely unexplored. The aim of this study was to evaluate the therapeutic effects of ethyl ferulate on CNV and elucidate the underlying molecular mechanisms involved. A laser-induced CNV mouse model received intravitreal injection of ethyl ferulate. Ocular evaluations included fundus fluorescein angiography, optical coherence tomography, and H&E staining. Mechanistic studies in retinal pigment epithelial (RPE) cells employed western blotting, co-immunoprecipitation, surface plasmon resonance, molecular docking, RT-qPCR, and chromatin immunoprecipitation, while anti-angiogenic activity in human umbilical vein endothelial cells utilized proliferation, migration, and tube formation assays. Intravitreal injection of ethyl ferulate significantly suppressed neovascularization in mice with laser-induced CNV in vivo, and conditioned medium from ethyl ferulate-treated ARPE-19 cells inhibited the proliferation, migration, and tube formation of endothelial cells in vitro. Mechanistically, the proteasome 26S subunit non-ATPase 14 (PSMD14) bound to and stabilized Keap1. Ethyl ferulate, however, reduced the expression of the deubiquitinase PSMD14, promoting Keap1 ubiquitination and degradation, which activated the Nrf2 antioxidant pathway. Furthermore, enrichment of the transcription factor MAZ was detected in the promoter region of PSMD14, which enhanced PSMD14 transcription. Ethyl ferulate treatment downregulated MAZ expression, thereby reducing PSMD14 transcription. Inhibition of the deubiquitinase PSMD14 to activate the Keap1/Nrf2 pathway may represent a mechanism by which ethyl ferulate suppresses CNV, supporting its promising prospects as a potential therapeutic candidate for CNV.
48. Epigenetic and fragment-based profiling across CDK4/6 inhibitors in first-line HR+/HER2- metastatic breast cancer. An ancillary analysis of the MAGNETIC.1 study.
期刊: Breast (Edinburgh, Scotland) 发表日期: 2026-Jan-27 链接: PubMed
摘要
CDK4/6 inhibitors (CDK4/6i) in combination with endocrine therapy (ET) represent the standard of care for hormone receptor-positive, HER2-negative (HR+/HER2-) metastatic breast cancer (MBC) patients. However, no head-to-head randomized trials have directly compared palbociclib, ribociclib, and abemaciclib. Moreover, predictive biomarkers of resistance to CDK4/6i remain largely undefined. This study aimed to evaluate circulating tumor DNA (ctDNA)-based epigenetic and fragmentomic biomarkers as potential predictors of response and resistance in patients receiving CDK4/6i. We conducted a biomarker-driven analysis within the prospective, multicenter MAGNETIC.1 study, enrolling 149 patients with HR+/HER2- MBC treated with first-line endocrine therapy and a CDK4/6 inhibitor. Plasma samples were collected at baseline and during treatment (3 and 6 months). Droplet digital PCR was used to assess ESR1 promoter methylation and ACTB fragmentomic profiles. Progression-free survival (PFS) and overall survival (OS) were evaluated, and molecular dynamics were compared between treatment groups. After a median follow-up of 34.8 months, no statistically significant differences in PFS or OS were observed between ribociclib and palbociclib treated patients, although ribociclib was associated with numerically longer PFS and higher survival rates. At the molecular level, palbociclib treatment was characterized by transient increases in ESR1 promoter methylation at the first evaluation and a rebound in ACTBshort fragment levels at six months relative to baseline. These dynamic patterns were not observed among patients receiving ribociclib. ctDNA-based methylation and fragmentomic profiling revealed exploratory, treatment specific molecular dynamics, highlighting biological differences between CDK4/6 inhibitors. These findings support the feasibility of liquid biopsy-based biomarker studies in this setting, although their potential clinical relevance remains preliminary and requires validation in larger cohorts with earlier and more granular on-treatment timepoints.
49. Xiao-Yao-San suppresses psychological distress-related colorectal cancer metastasis and enhances antitumor immune responses through regulating gut microbiota-bile acid axis.
期刊: Phytomedicine : international journal of phytotherapy and phytopharmacology 发表日期: 2026-Jan-12 链接: PubMed
摘要
Psychiatric disorders are recognized as risk factors for tumor progression and metastasis in colorectal cancer (CRC). Xiao-Yao-San (XYS), a traditional Chinese herbal formula with antidepressant properties, has been reported to inhibit CRC growth and modulate gut microbiota. However, its efficacy and underlying mechanisms in preventing metastasis remain unclear. The antimetastatic effect of XYS was assessed in a chronic restraint stress (CRS)-induced CRC model. XYS-associated gut microbiota was evaluated using 16S ribosomal RNA (rRNA) sequencing. Peripheral bile acid (BA) profiles were analyzed through targeted metabolomics. Fecal microbiota and commercial bacterial strains were anaerobically cultured to identify bile salt hydrolase (bsh)-expressing bacteria. XYS-mediated antitumor immune responses were determined via flow cytometry, immunohistochemistry, and cytotoxic T lymphocytes (CD8⁺ T cells)-murine colon adenocarcinoma cell line (MC38) co-culture assays. Administration of dried XYS decoction powder reduced liver metastatic nodules and prevented body weight loss in CRS-induced CRC mice, while also alleviating depressive-like behaviors and lowering serum stress hormone levels. High-dose XYS (2 g/kg/day) produced antimetastatic and antidepressant effects comparable to those of sertraline, although these effects were largely abolished in mice treated with antibiotic cocktails. XYS significantly modulated gut microbiota composition and serum BA profiles, particularly by restoring bsh-expressing bacteria in the cecum and increasing the proportion of free BAs. XYS also reshaped the immune landscape within metastatic foci, where enhanced antitumor CD8⁺ T cell responses were strongly associated with the altered BA profile. Among these, hyocholic acid (HCA), a free BA elevated by XYS, suppressed liver metastasis in vivo, alleviated exhaustion and restored effector function of CD8⁺ T cells in metastatic tumor microenvironment (TME), together with dose-dependently enhanced CD8+ T cell cytotoxicity against tumor cells in vitro. XYS prevents psychiatric disorder-associated CRC metastasis and strengthens antitumor immune responses by regulating bsh-expressing gut bacteria and their derived BA profiles. These findings thus offer a novel mechanistic rationale for the potential use of XYS in treating CRC patients with comorbid psychiatric disorders.
50. Third-trimester diet and prenatal depression in the MADRES cohort.
期刊: Nutrition (Burbank, Los Angeles County, Calif.) 发表日期: 2026-Jan-11 链接: PubMed
摘要
Poor dietary intake has been linked to depression during pregnancy, but little research has examined this in Hispanic populations. We examined third-trimester associations of study-derived dietary patterns with odds of prenatal depression and depressive symptoms in pregnant, low-income Hispanic women. Participants (N = 587) were drawn from the Maternal and Developmental Risks from Environmental and Social Stressors (MADRES) cohort in Los Angeles, CA. Diet was assessed using a 24-h recall tool. Women were assigned quartile rankings based on adherence to two previously derived dietary patterns: vegetables, oils, and fruit (VOF; healthier) and solid fats, refined grains, and cheese (SRC; less healthy). Depressive symptoms were defined using the Center for Epidemiological Studies-Depression Scale score, and a dichotomized depression outcome was defined as Center for Epidemiological Studies-Depression Scale scores ≥16. Eighteen percent of participants were classified as depressed at the third-trimester visit. Women with the greatest adherence to the healthier dietary pattern (VOF) had 59% lower odds of depression (OR = 0.41, 95% CI: 0.19, 0.86) relative to women with the lowest adherence to this dietary pattern, after adjustment for covariates. Additionally, women with moderately high (third quartile) adherence to the VOF dietary pattern had 16.9% lower depressive symptoms (95% CI: -30.5%, -0.8%) compared with women with the lowest VOF adherence. Women with the highest VOF adherence had similar, non-statistically significant lower depressive symptoms (Beta = -10.4%, 95% CI: -25.7%, 8.1%). Our results indicate that there are important relationships between a healthy diet and lower depression in late pregnancy, and suggest that nutritional counseling and improved neighborhood access to healthy food may be important for maternal mental health.
51. Liuwei Dihuang pills suppress hepatocellular carcinoma via PI3K/AKT/TP53 pathway: Integrating network pharmacology, metabolomics, and experimental validation.
期刊: Phytomedicine : international journal of phytotherapy and phytopharmacology 发表日期: 2026-Jan-05 链接: PubMed
摘要
Hepatocellular carcinoma (HCC) remains a significant global health challenge with limited treatment options. Liuwei Dihuang Pills (LWPs), a classic Traditional Chinese Medicine formula, have demonstrated potential anti-tumor effects; however, their bioactive components and mechanisms of action against HCC remain unclear. Network pharmacology identified 20 core targets of LWPs, and Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) analyses indicated pro-apoptotic activity via the PI3K/AKT and TP53 pathways. In vivo studies confirmed tumor growth inhibition, biochemical index regulation, and regulation of the PI3K/AKT/TP53 axis. Metabolomics revealed alterations in amino acid and carbohydrate metabolism. In vitro, LWPs-containing serum (LWPs-S) on the PI3K/AKT/TP53 pathway, suppressing Huh7 cell proliferation, migration, and invasion, inducing G1-phase arrest, elevating reactive oxygen species (ROS) levels, and engaging apoptosis-related pathways. Among various extracts, LWPs alcohol extract emerged as the principal anti-HCC fraction. A total of 77 components were identified in LWPs alcohol extract, including 17 blood‑absorbed and 6 tumor‑absorbed plant monomer compounds. Molecular docking demonstrated strong binding affinities of specific monomers from LWPs alcohol extract to PI3K, AKT and TP53. Collectively, these findings elucidate how LWPs promote HCC apoptosis through key pathways and provide experimental evidence supporting the pivotal role of the alcohol extract, offering a scientific basis for the rational development of LWPs.
52. Simple anthropometric indicators compared with DXA-assessed visceral adiposity for screening brown adipose tissue activity in adult women.
期刊: Nutrition (Burbank, Los Angeles County, Calif.) 发表日期: 2026-Jan-05 链接: PubMed
摘要
Brown adipose tissue (BAT) activation increases energy expenditure and is associated with reduced body adiposity and improved cardiometabolic health. Therefore, we hypothesized that anthropometric parameters, particularly those reflecting central adiposity, could serve as indirect and straightforward markers for screening BAT activity. We evaluated the performance of anthropometric indicators, such as body mass index (BMI), waist circumference (WC), neck circumference (NC), sagittal abdominal diameter (SAD), waist-to-hip ratio (WHR), waist-to-height ratio (WHtR), neck-to-height ratio (NHtR), SAD-to-height ratio (SADHtR) and body roundness index (BRI), for screening of BAT activity (assessed by infrared thermography) in 122 adult women exposed to cold (for 2 h in an 18°C room), considering visceral adipose tissue (VAT) measured by dual-energy X-ray absorptiometry (DXA) as the harmful indicator of abdominal adiposity. Using multiple linear regression adjusted for age and physical activity level, and receiver operating characteristic (ROC) curves, we found that BMI, SAD, WC, and WHtR were the best indirect screeners of BAT activity, performing as well as VAT (p > 0.05 for all). These indicators may serve as practical proxies of BAT activity, potentially aiding in the development of strategies for metabolic disease intervention and prevention.
53. 'I gotta Feeling': Exploring the effects of a smartphone app (Feelee) to enhance adolescents' emotion regulation in forensic outpatient settings: A multiple single-case experimental design.
期刊: PloS one 发表日期: 2026 链接: PubMed
摘要
Adolescents in forensic outpatient care often face a complex interplay of emotional and cognitive challenges, which is also reflected in current challenges within treatment approaches. Mobile health (mHealth) interventions have shown increasing value in forensic settings, although empirical evidence remains limited. One particular mHealth app that may address current challenges in forensic outpatient care is Feelee, which provides daily emotion regulation practice through self-reported emotional check-ins and passively collected smartphone sensor data. Given the potential but still limited evidence for mHealth apps in forensic settings, this study aimed to provide first thorough evaluation of the Feelee app as an addition to treatment as usual to enhance emotion regulation skills among adolescents in forensic outpatient care. A multiple single-case experimental ABA design was applied, consisting of a 2-week baseline (phase A1), 4-week intervention (phase B), and 2-week follow-up (phase A2), combining quantitative and qualitative methods. Twenty-two adolescents (aged 12-23) completed daily assessments of emotion regulation. Secondary outcomes focused on emotional developmental mechanisms and treatment-related factors, measured at pre-, post-, and follow-up. Semi-structured interviews with adolescents and clinicians explored experiences with Feelee and its integration into treatment. Results showed a significant improvement in the emotional recognition during the intervention phase. No improvements were found in emotion suppression and impulse control, while reflection and distraction showed reversed outcomes. At follow-up, secondary outcomes indicated increases in positive emotion differentiation, emotional awareness, and self-reflection. Treatment motivation remained stable, while therapeutic alliance improved. Qualitative findings highlighted increased emotional insight, a alongside technical difficulties and limited discussion of Feelee data during sessions. These findings suggest that Feelee may particularly be valuable in the early stages of emotion regulation by enhancing emotional recognition. Future research should explore longer-term use and actively involve clinicians in the integration of app data to maximize therapeutic relevance and impact. Trial registration Central Committee on Research Involving Human Subjects NL-OMON54390 and ClinicalTrials.gov NCT06509360.
54. Feeding pattern and associated factors among children aged 6-23 months in the Tahtay Maichew district, northern Ethiopia.
期刊: PLOS global public health 发表日期: 2026 链接: PubMed
摘要
The first one thousand days of life are a critical window of opportunity for children’s health and development. Nutritional deficiencies during this time can have serious consequences for the child’s health and development, with limited chances for correction later. For example, inadequate feeding among children can lead to consequences such as stunting, wasting, impaired immunity, and delayed cognitive development. Therefore, this study aimed to determine meal frequency and associated factors among children aged 6-23 months in the Tahtay Maichew district, northern Ethiopia. We conducted a community-based cross-sectional study involving 981 randomly selected mothers of children aged 6-23 months. Data were collected using a structured, interviewer-administered questionnaire. The children’s meal frequency was determined by asking mothers how many times their child had eaten food in the 24 hours preceding the survey. We used binary logistic regression with backward elimination to identify factors associated with children’s meal frequency. Overall, 68% (95% CI: 64.9, 70.9%) of the children received adequate meal frequency. Being from a rich household (p = 0.013, 95% CI = 1.12, 2.59), having growth monitoring follow-up (p < 0.001, 95% CI = 1.44, 2.88), good mother’s knowledge of child feeding (p < 0.001, 95% CI = 1.59, 3.22), and having a birth preparedness plan (p < 0.046, 95% CI = 1.013, 4.339) were associated with adequate meal frequency. The proportion of children who did not receive adequate meal frequency was significantly high. Being from a wealthy household, undergoing growth monitoring follow-up, having a knowledgeable mother regarding child feeding, and having a birth preparedness plan were associated with adequate meal frequency. In conclusion, our findings highlight the need to improve child meal frequency through enhancing maternal knowledge of child feeding, strengthening growth monitoring and promotion services, and improving socioeconomic status, as indicated by the wealth index.
55. Applying Virtual Community Engagement Studio to Inform a Dyadic Text Message Intervention for Diet, Physical Activity, and Sleep After Cancer.
期刊: Cancer control : journal of the Moffitt Cancer Center 发表日期: 2026 链接: PubMed
摘要
IntroductionThe purpose of this study was to use a Virtual Community Engagement Studio (V-CES) model to develop and refine short message service (SMS) content in English and Spanish related to dietary quality, physical activity, and sleep hygiene intended for individuals with cancer and their caregivers.MethodsCommunity expert stakeholders participated in an English or Spanish V-CES and provide actionable feedback on the content and delivery of 180 previously developed SMS messages.ResultsParticipants were nine stakeholders representative of the Southern Arizona cancer care community (eg, survivors, caregivers, healthcare providers, community health workers). SMS as a health promotion intervention strategy in context of cancer survivorship was viewed as accessible and appropriate. Actionable feedback from the V-CES included using positive affirmations, incorporating motivational strategies, using relatable language, and emphasizing evidence. Spanish language SMS should consider regional context during translation. Stakeholders recommended that two SMS be sent daily to dyads between 8:00 am and 7:00 pm, at relevant times for each behavior.ConclusionFuture research will test the SMS for feasibility and acceptability among survivor-caregiver dyads. The V-CES model is an innovative approach for developing and refining dyadic health behavior interventions and may be beneficial for future research to engage communities.
56. Discovery of a regulatory polymorphism in the bovine PICALM gene associated with milk αS1-casein concentration.
期刊: Animal genetics 发表日期: 2025-Aug 链接: PubMed
摘要
57. Psychometric Testing of the Updated Self-Care of Heart Failure Index Version 8.0 Using Item Response Theory.
期刊: The Journal of cardiovascular nursing 发表日期: 链接: PubMed
摘要
Self-care is essential in adults living with heart failure (HF). The landscape of HF management has changed considerably over the past few years, and as such, we modernized an existing measure of HF self-care. The purpose of this study was to test the psychometric properties of the revised Self-Care of Heart Failure Index (SCHFI) version 8.0 using item response theory. A cross-sectional descriptive study was designed and conducted in the United States to test the psychometric properties of the 26-item SCHFI 8.0. We used item response theory-based approaches to determine which items contributed sufficient information to our understanding of the 3 behavioral domains: self-care maintenance (ie, routine healthy behaviors), self-care monitoring (ie, monitoring for signs and symptoms), and self-care management (ie, responding to signs and symptoms when they occur). We also used classic test theory approaches to compare results between the SCHFI 8.0 and prior versions. Participants included 217 adults with HF (mean age = 43 ± 15 years; 54.4% male, 56.2% White, 58% HF with reduced ejection fraction). Based on item response theory, items providing insufficient information within each behavioral domain were identified and removed from the SCHFI 8.0 during recalibration resulting in an abbreviated 23-item measure. The SCHFI 8.0 was most reliable at middle-to-low levels of each behavioral domain. Based on classic test theory, the self-care maintenance, self-care monitoring, and self-care management domains had Cronbach α values of 0.86, 0.90, and 0.88, respectively, and the theoretical structure of the SCHFI 8.0 was confirmed with factor analysis. The 23-item SCHFI 8.0 is a valid, reliable and abbreviated measure that is ready to use and freely available on the website www.self-care-measures.com.
58. Effect of race and sex on lupus diagnosis in primary care: A randomized factorial survey study.
期刊: PloS one 发表日期: 2026 链接: PubMed
摘要
Systemic lupus erythematosus (SLE) is a heterogeneous autoimmune rheumatic disease whose epidemiology and clinical prognosis vary by race and sex. Observed disparities in SLE may be partly attributable to cognitive processes in clinical decision-making, which can influence diagnostic accuracy and clinical management. We aimed to examine variation in primary care physicians’ (PCP) diagnosis and management of SLE when all content of a clinical case is identical, apart from race and sex. We distributed an online randomized factorial survey from 04/11/2024-06/10/2024 to PCPs across the US. Participants were presented with one of four possible SLE vignettes - Black female, White female, Black male, White male - for which all other clinical content was identical. Block randomization was used to randomly modify the race (Black/White) and sex (female/male) of the SLE “case”. Primary outcomes were correct text-based responses for SLE diagnosis at initial case presentation and after reviewing additional lab results. Secondary outcomes were participants’ review time and planned next steps (treatment, referral, tests) as a proxy for cognitive bias and certainty, respectively. We calculated descriptive statistics for all outcomes stratified by assigned randomized factor and used chi-square tests to evaluate between-group differences. 1031 PCPs (42.7% women, mean age 52.1 ± 12.1 years) completed the case. At initial presentation, 63.9% of participants correctly identified SLE as a differential diagnosis. An initial diagnosis of SLE significantly differed by the race and sex of the case (p < 0.001), with the highest proportion of correct diagnoses occurring for Black female cases (72.2%) and lowest for White male cases (55.3%). Median review time for correct initial diagnoses was longest for White male cases (175 s). After participants reviewed lab results, the overall proportion assigning a final diagnosis of SLE (63.9%) remained unchanged from the initial diagnosis. A patient’s race and sex may influence diagnostic accuracy and clinical decision-making for SLE in primary care. The observed variation in diagnostic accuracy, which aligns with the descriptive epidemiology of SLE, highlights the need for targeted interventions to ensure equitable diagnostic processes.
59. A novel framework for integrative hair longevity management.
期刊: European journal of dermatology : EJD 发表日期: 2026-Jan-01 链接: PubMed
摘要
Hair ageing is a multifactorial process involving progressive deterioration of hair follicle structure and function, leading to reduced density, diameter, and overall hair quality. Inspired by advances in longevity science, the emerging concept of hair longevity shifts focus from reactive treatment of visible hair loss to proactive preservation of follicular health. Androgenetic alopecia (AGA), the most common form of non-scarring alopecia, illustrates hair ageing through mechanisms including follicular miniaturization, microinflammation, oxidative stress, and intrinsic cellular senescence. Despite the prevalence and psychological burden of age-related hair thinning, especially among women, preventive approaches remain underdeveloped. An analysis of 102 articles published between 2003 and October 2025 synthesized by an international expert working group and a comprehensive literature analysis allowed to establish a conceptual framework for hair longevity. The proposed model identifies nine hallmarks of hair ageing, grouped into structural, metabolic, and signalling dysfunctions influenced by genetic, hormonal, environmental, and lifestyle factors. Building on this framework, this work proposes an integrative approach to AGA management that incorporates pharmacological treatments, cosmetic formulations, nutritional supplementation, medical devices, and lifestyle-based strategies. Emphasizing prevention as well as treatment, the concept of hair longevity introduces opportunities for earlier intervention, improved patient education, and development of innovative, multi-targeted formulations to support lifelong scalp and hair health.
60. Diverse enteric bacterial, viral, and parasitic pathogen genes are shed in animal feces in Indiana.
期刊: PloS one 发表日期: 2026 链接: PubMed
摘要
Southern Indiana has intensive livestock production, yet species-resolved fecal pathogen and pathogen associated gene profiles are limited. At 10 sites in southern Indiana (April-June 2024), we collected 128 fecal specimens from 10 hosts: pigs (n = 12), horses (12), cats (12), chickens (12), dogs (22), white-tailed deer (12), sheep (12), goats (12), cows (12), and humans (10). We extracted and assayed total nucleic acids using a custom 43-target TaqMan Array Card (RT-qPCR). Flotation microscopy was performed on pig and dog stools for helminth ova. In-silico specificity checks were conducted for selected targets due to potential for cross reactivity between pathogen species. Most samples (60%, 75/126) were positive for ≥1 target, including enteropathogenic Escherichia coli (eae) 16% and shiga toxin genes (stx1 10%, stx2 6.3%). Higher prevalence of genes associated with specific pathogens and gut microbes in specific animals was common, including E. coli O157:H7 in pigs (42%) and sheep (8.3%); Campylobacter coli in chickens (36%) and Klebsiella pneumoniae in humans (60%) and dogs (9.1%). We found the protozoa Giardia in 15% of samples (notably dogs 32%, cows 33%) and Cryptosporidium in 14% (cats 55%, cows 25%, chickens 27%). Most (55%) chicken samples were positive for Plasmodium, which aligned with evidence of locally circulating avian haemosporidians. The Ascaris lumbricoides assay was positive only in pigs (17%), and we identified Ascaris type eggs in 92% of pig samples via microscopy, suggesting our Ascaris lumbricoides assay cross reacted with Ascaris suum supporting detection of the swine lineage (A. suum). We detected the class 1 integron-integrase gene (intI1) in 43% of stools, concentrated in chickens, pigs, and horses. These findings suggest animal feces poses a public health hazard in Southern Indiana and indicate the need for targeted One Health studies to better understand the public health risks of specific exposures and animal feces management practices (e.g., farm storage capacity, land application timing, soil incorporation/injection, tile-drain proximity).
61. The impacts of climate change on occupational health and work among outdoor workers: A scoping review.
期刊: PLOS global public health 发表日期: 2026 链接: PubMed
摘要
Climate change has a significant impact on human health and productivity at work. Environmental changes, including extreme temperatures and natural disasters, contribute to psychological pressures and physical impairments which affect quality of life and well-being. This scoping review examines the effect of climate change on human health in occupational settings. A systematic search of MEDLINE, CINAHL, Embase, and PsycINFO identified empirical studies that analyzed the impacts of climate change on human health in relation to work. Eligible studies included employed individuals aged 18-65, peer-reviewed studies published between 2000 and 2024, and evidence linking climate change to occupational health outcomes. Studies underwent title, abstract, and full-text screening. The scoping review, registered with the Open Science Framework, includes 62 studies. Three overarching themes emerged: (1) climate change and mental health; (2) climate change and physical health; and (3) climate change and work. Research has demonstrated the association of psychological distress with extreme weather events, occupational stress, and anxiety among outdoor workers. Physical health risks associated with higher temperatures include chronic dehydration, heat-related illnesses, and other injuries. Climate change also negatively impacts work productivity, leading to increased labour shortages and subsequent economic losses. Climate change has complex effects on the physical and mental health of workers, with significant implications for productivity and safety in the workplace. Despite growing evidence, targeted interventions remain limited. Future studies should examine the long-term health consequences, develop standardized alleviation strategies, and implement policies to protect employees from climate-related occupational hazards.
62. Maternal prenatal infection and childhood leukaemia: a Childhood Cancer and Leukemia International Consortium (CLIC) meta-analysis.
期刊: International journal of epidemiology 发表日期: 2025-Aug-18 链接: PubMed
摘要
Maternal prenatal infections may affect fetal development, increasing the immunological vulnerability of offspring to childhood leukaemia (CL). The role of maternal infections in CL is unclear and might vary by subtype (lymphoblastic, ALL; myeloid, AML) or other characteristics. Understanding this potentially modifiable risk factor could inform prevention strategies. Seventeen hospital- and population-based case-control studies of children born in 1972-2019 within the Childhood Cancer and Leukemia International Consortium with self-questionnaires or health-registry data on maternal infection were included (13 638 cases; 26 870 controls). Meta-analyses assessed CL and maternal infection (overall, viral, bacterial, respiratory, influenza/cold, urinary, genital) stratified by subtype, infection timing, race and ethnicity, and diagnosis age. The adjusted meta-analysis odds ratio (OR) for any maternal prenatal infection was 1.13 [95% confidence interval (CI) 0.91-1.40], with similar estimates for ALL and AML. Infection-specific estimates varied. ORs for first-trimester infections were highest for CL and ALL, but not AML, although all CIs contained one. We found modest risk differences between White and Hispanic/Latino children, most notably for CL diagnosed at <2 years (White children: OR 1.25, 95% CI 1.02-1.53; Hispanic/Latino children: OR 0.79, 95% CI 0.34-1.81, subgroup difference P = .05), with similar differences for viral and respiratory/influenza/cold infections. Although findings only modestly support an association between maternal prenatal infections and CL, some infections might increase the risk more markedly in young White children compared with Hispanic/Latino children. Risk patterns across race and ethnicity, type, and timing of maternal prenatal infection merit further investigation, as do studies with documented exposure information.