公共卫生研究摘要 (2026-02-10)
共收录 54 篇研究文章
1. Coviretinopathy: COVID-19-induced VEGF-dependent retinopathy.
期刊: Proceedings of the National Academy of Sciences of the United States of America 发表日期: 2026-Feb-17 链接: PubMed
摘要
COVID-19 has been associated with high prevalences of retinal diseases in humans. However, cellular and molecular mechanisms that underlie the COVID-19-associated retinopathy remains unknown. Here, we deployed a mouse COVID-19 model to investigate the causative link between SARS-CoV-2 infection and retinopathy development. Our data showed that COVID-19-induced pulmonary hypoxia triggered systemic hypoxia and markedly augmented VEGF expression levels in the retina and plasma. High VEGF levels altered vascular structures and functions in the retina, resulting in neovascularization, vascular disorganization, and increased leakiness. We deployed a terminology of coviretinopathy to accurately describe these COVID-19-induced pathological changes in the retina. Consequently, blocking VEGF by a specific neutralizing antibody (VEGF blockade) completely ablated the COVID-19-associated vascular changes in the retina. Together, these findings provide mechanistic insights into the COVID-19-associated retinopathy and propose a therapeutic paradigm for effective treatment of coviretinopathy.
2. Physicians Are Not Providers: The Ethical Significance of Names in Health Care: A Policy Paper From the American College of Physicians.
期刊: Annals of internal medicine 发表日期: 2026-Feb-10 链接: PubMed
摘要
More than 25 years ago, Pellegrino and Relman noted the increasing commercialization of the learned professions, anticipating what many physicians are increasingly experiencing today: an impairment of their ability to practice in accordance with standards of medical ethics and professionalism. These hurdles to the physician’s ability to do right by the patient contribute to what leaders in medicine and the American College of Physicians have called deprofessionalization. An example is the use of the term provider to describe physicians and other health professionals. The use of this terminology has been reviewed in medical journal articles but has not been adequately explored as a matter of ethics and professionalism. Through that lens, this paper examines the trends, significance, and implications for patients, physicians, and health care of the use of the term provider.
3. A Mixed-Methods Study of End-of-Life Care in Assisted Living During the COVID-19 Pandemic: National Survey of Administrators and In-Depth Interviews With Bereaved Next of Kin.
期刊: Journal of applied gerontology : the official journal of the Southern Gerontological Society 发表日期: 2026-Feb-09 链接: PubMed
摘要
Using a national survey of assisted living administrators (n = 2,084) and interviews with residents’ bereaved next of kin (n = 30), we describe policies administrators reported complying with at the worst of the COVID-19 pandemic and explore relationships between COVID-19-related policies and bereaved next-of-kin’s perceptions of end-of-life care quality, integrating findings to develop a comprehensive examination of end-of-life care in assisted living. During the pandemic, most administrators reported allowing compassionate care visits and hospice services. Next of kin described limited visitation and external care services and declines in residents’ physical, mental, and social well-being, emphasizing the difficulty of missing precious time together. This study examines next-of-kin experiences of residents who died during the COVID-19 pandemic, providing evidence to inform future infection control policies.
4. Patient and Clinician Perspectives on Expanding Telehealth Use for Older Adults Across the Cancer Control Continuum: Mixed Methods Study.
期刊: JMIR cancer 发表日期: 2026-Feb-09 链接: PubMed
摘要
Reliance on telehealth increased dramatically during the COVID-19 pandemic, introducing new opportunities to consider the use of telehealth across the cancer control continuum. However, patient, clinician, and staff perspectives about the types of cancer care appointments that are considered appropriate and the clinical care needs to support expanded remote care services are limited. Understanding older adults’ diverse technology needs and perspectives is especially important given that they comprise a large and growing proportion of patients with cancer. This study aimed to describe the perceptions and experiences of older patients with cancer and their clinical care team members regarding the expansion of telehealth use across the cancer control continuum and to solicit suggestions about how to support telehealth use for cancer care delivery. Using a convergent mixed methods design, we surveyed and interviewed patients aged ≥60 years, clinicians, and staff at a comprehensive cancer center in the southern United States between December 2020 and November 2021. Interview questions were rooted in the sociotechnical model, which proposes 8 interrelated dimensions representing factors influencing the design, use, and outcomes associated with health information technologies. Patient survey domains included telehealth experience and satisfaction and factors affecting telehealth perceptions and use; clinician survey domains included contexts of telehealth appropriateness, training, and barriers and facilitators to telehealth service provision. Survey data were analyzed using descriptive statistics. Qualitative data were thematically analyzed using a combined deductive and inductive approach. We received completed surveys from 128 patients (567 invited) and 106 clinicians and staff (146 invited). We completed 14 patient (29 invited) and 20 clinician and staff (22 invited) interviews. Across all participants, most agreed or strongly agreed that multiple cancer care appointment types should be offered via telehealth, including discussing treatment side effects (75/102, 73.5% of patients and 66/94, 70.2% of clinicians and staff), results communication (71/102, 69.6% of patients and 65/94, 69.1% of clinicians and staff), and treatment follow-up (67/102, 65.7% of patients and 52/93, 55.9% of clinicians and staff). In interviews, participants elaborated on factors influencing the appropriateness of telehealth versus in-person appointments, including symptom severity, type of cancer, and purpose of the appointment. Many patient and staff suggestions focused on ways to address digital literacy gaps, while clinicians recommended improving clinic workflows, infrastructure, and training. Overall, clinicians, staff, and older patients with cancer all responded positively toward expanding telehealth use across multiple cancer and appointment types across the cancer control continuum. Older adults with cancer are generally interested in telehealth for cancer care, especially if strategies to address digital literacy gaps are incorporated. Clinicians and staff members expressed specialized training and infrastructure needs to optimize telehealth uptake and service delivery.
5. Barriers and facilitators to healthcare access for adults with learning disabilities and autistic adults in England: A scoping review and meta-aggregation.
期刊: Journal of intellectual disabilities : JOID 发表日期: 2026-Feb-09 链接: PubMed
摘要
Background: Adults with learning disabilities and autistic adults in England face significantly higher rates of premature mortality, 22 years earlier for those with learning disabilities and over 6 years earlier for autistic adults. Barriers to healthcare access contribute to missed diagnoses and treatments. There, the aim of this review was: What are the barriers and facilitators to healthcare appointment attendance for adults with learning disabilities and autistic adults in England? Methods: A systematic search across ten databases (March 2023; updated June 2024) identified 1,727 papers. Studies were included if they reported qualitative evidence on clinical appointment accessibility for autistic adults or adults with learning disabilities in England. Fifteen studies were included and critically appraised. Findings were synthesised using Joanna Briggs Institute meta-aggregation and interpreted through a socio-ecological lens. Findings and Conclusions: Facilitators included flexible booking systems, positive healthcare professional attitudes, and the ability to develop a positive and trusting relationship between HCPs and the person they were supporting. Barriers existed at individual, relational, organisational, and policy levels, including poor communication, inadequate appointment systems, and lack of professional knowledge. Recommendations include enhanced staff training, use of liaison nurses, flexible appointment systems, and accessible communication. Policy and structural changes are needed, though further evaluation of their impact is essential.
6. Digital Inequalities in the Use of eHealth Services in European Public Health Care Systems: Systematic Review of Observational Studies.
期刊: Journal of medical Internet research 发表日期: 2026-Feb-09 链接: PubMed
摘要
European public health care systems are expanding eHealth tools such as teleconsultations, online appointment bookings, and electronic health records to improve efficiency and access to health care. However, their use depends on factors such as digital skills and internet access, which are unequally distributed across socioeconomic and demographic determinants. Most existing evidence on these inequalities is qualitative or outside universal health care systems. This systematic review aims to synthesize quantitative evidence on social inequalities in access to and use of eHealth services within European public health care systems. Specifically, we sought to identify which social determinants were most consistently associated with unequal use of online appointment booking, teleconsultations, electronic health records, and eHealth portals, across major social determinants of health. A systematic search was conducted across PubMed, Scopus, Web of Science, and PsycINFO for studies published in English or Spanish between 2015 and October 2025. Eligible quantitative studies included adults (≥18 years) using public health care systems in European countries. The primary outcome was differential access to or use of eHealth tools by social determinants in any level of care. Screening and data extraction were independently performed by 3 reviewers using Rayyan, resolving disagreements through consensus. Data extracted covered study design, population, eHealth tools, social determinants, and outcomes. Risk of bias was evaluated using Joanna Briggs Institute tools. Due to study heterogeneity in digital tools and inequality dimensions, results were synthesized narratively by tool type and social inequality factors. Point estimates and 95% CIs were extracted when available. Of the 2366 records retrieved, 18 observational studies met the inclusion criteria: 13 cross-sectional, 3 prevalence, 1 retrospective cohort, and 1 ecological cohort. Publication output increased from 2020 onward, mostly driven by cross-sectional studies from northern and western Europe. Findings revealed consistent social gradients in eHealth use: older adults, individuals with lower educational or socioeconomic level, ethnic minorities, and those with limited digital skills or poorer health were less likely to use eHealth tools. Most studies were rated as high quality (78%), and the remainder as moderate, heterogeneity in designs, outcomes, and populations may limit generalizability. Digital transformation in European public health systems has not benefited all groups equally. This review highlights persistent social inequalities in the use of key digital health tools. While many included studies were of high quality, heterogeneity in study designs, populations, and outcomes, as well as risk of bias, limits causal inference and the direct translation of findings into policy and practice. The findings nonetheless reveal systematic patterns of exclusion that are highly relevant for policy. Emphasizing an intersectional approach and standardizing measures of digital access will be essential to develop effective, equity-focused policies that ensure inclusive digital health services for all.
7. Predictors of alcohol use and consequences among college women reporting adult sexual violence: Posttraumatic stress symptoms, urgency, and drinking motives.
期刊: Journal of American college health : J of ACH 发表日期: 2026-Feb-09 链接: PubMed
摘要
Objective: To examine associations between post-traumatic stress symptoms (PTSS), impulsivity, drinking motives, and alcohol outcomes among college women who experienced adult sexual violence. Participants: 122 college women from a large southeastern university, predominantly White (90.2%), ages 18-24, reporting adult sexual violence and weekly alcohol consumption. Methods: Participants completed validated measures assessing PTSS, positive and negative urgency, coping and enhancement drinking motives, alcohol use, and alcohol consequences. Path analysis tested direct and indirect associations among these variables. Results: PTSS had significant direct effects on negative urgency and coping motives, and indirect effects on alcohol consequences via these variables. Positive urgency had a significant effect on enhancement motives, which subsequently was significantly associated with alcohol outcomes. Standardized coefficients ranged from β = .22 to .47 across significant pathways, indicating moderate effect sizes. Coping motives, unexpectedly, correlated negatively with alcohol use but positively with consequences. Conclusions: Findings underscore the distinct roles of negative and positive urgency and drinking motives in influencing alcohol outcomes among college women survivors of sexual violence, highlighting implications for targeted interventions.
8. Maternal expression and breast milk transfer of an mRNA- encoded monoclonal antibody in a murine model of cholera.
期刊: PLoS neglected tropical diseases 发表日期: 2026-Feb-09 链接: PubMed
摘要
Breast milk confers infants with immunity to a multitude of pathogens reflective of prior maternal infections and vaccinations. However, in outbreak situations where infants may be vulnerable to lethal infections due to gaps in the maternal immune repertoire, a case can be made for supplementing breast milk with one or more pathogen-specific monoclonal antibodies (mAbs) with known prophylactic or therapeutic activity. As oral delivery of recombinant IgG and IgA mAbs to infants has proven challenging, we investigated the use of mRNA-lipid nanoparticle (LNP) technology to stimulate pathogen-specific mAbs in milk. mRNA encoding the Vibrio cholerae O1 specific mAb, ZAC-3, as a human IgG1 or dimeric IgA2, was encapsulated in lipid nanoparticles (LNP) and administered parenterally to lactating and non-lactating female mice. A single intravenous administration of mRNA-LNPs resulted in high and sustained expression of functional ZAC-3 IgG1 in the blood and breast milk of lactating dams. ZAC-3 IgA2 levels were lower and more transient. ZAC-3 IgG1 (but not IgA2) was also detected in the serum of suckling pups at levels proportional to those in the mothers, demonstrating successful transfer of functional antibodies to newborns. Levels of ZAC-3 IgG1 and IgA2 were not sufficient to limit intestinal colonization of V. cholerae O1 when pups were separated from dams following intragastric challenge; however, a significant reduction in bacterial burden was observed when challenged pups remained with dams for continuous breastfeeding. Our findings highlight the potential of mRNA-based mAb platforms in the maternal-newborn context, while acknowledging the need for optimized antibody isotypes, dosing, and tissue-specific delivery to improve mucosal immunity.
9. The impact of the Lancet Commission definition of obesity on its prevalence and implications on long-term cardiovascular-kidney-metabolic outcomes in East Asians: Observational study of two community-based cohorts.
期刊: PLoS medicine 发表日期: 2026-Feb-09 链接: PubMed
摘要
The Lancet Commission proposed an update in January 2025 on the definition of obesity which requires at least one anthropometric measurement in addition to body mass index (BMI) to confirm excess adiposity. Also, the presence of obesity-related organ dysfunction is used to differentiate between clinical and pre-clinical obesity. We evaluated how applying the Lancet Commission proposed definition of obesity, which required an additional anthropometric measurement to verify excess adiposity, would affect its prevalence, and its implications on the cardiovascular-kidney-metabolic health. We used two representative Chinese community-based cohorts and compared five categories of participants with (i) clinical obesity, (ii) preclinical obesity, (iii) BMI ≥25 kg/m2 without confirmed excess adiposity, (iv) overweight and (v) normal/underweight in the cross-sectional cohort for cardiometabolic risk profiles and in the longitudinal cohort for long-term cardiovascular-kidney-metabolic outcomes. In the cross-sectional cohort, the prevalence of obesity was 44.5% in men and 26.7% in women defined by the Asian BMI cutoff of ≥25.0 kg/m2, and decreased to 33.8% and 24.1%, respectively, using the Lancet Commission criteria (BMI ≥ 25.0 kg/m2 and elevated waist circumference). Applying the Lancet Commission criteria would reclassify a portion of individuals who are initially classified as having obesity based on BMI criteria alone (BMI ≥ 25.0 kg/m2) but with normal waist circumference to be non-obese (category iii). The individuals falling into category iii had an adverse cardiometabolic health profile which was intermediate among the five categories regarding insulin resistance and visceral adiposity (falling between categories ii and iv). In the longitudinal cohort with a median follow-up of over 20 years, people with clinical obesity had the poorest cardiovascular-kidney-metabolic outcomes including all-cause mortality, whereas those reclassified as non-obese had an intermediate risk of adverse cardiovascular-kidney-metabolic outcomes among the five categories. The main limitation of the study was that all participants were Chinese and findings might not apply to other ethnic groups. Adoption of the Lancet Commission criteria would classify a small proportion of individuals with BMI of ≥25.0 kg/m2 as non-obese. People with clinical obesity identified by the revised criteria had the highest risks of cardiovascular-kidney-metabolic outcomes including all-cause mortality, whereas individuals reclassified as non-obese had intermediate risks of cardiovascular-kidney-metabolic outcomes between those in pre-clinical obesity and overweight categories.
10. Resilience as a Mediator in a Web-Based Intervention (MINDxYOU) to Reduce Stress Among Health Care Professionals: Stepped-Wedge Cluster Randomized Trial.
期刊: JMIR mental health 发表日期: 2026-Feb-09 链接: PubMed
摘要
The mechanisms through which mindfulness and third wave-based digital programs exert their effects on stress reduction remain poorly understood. Identifying these mediators is essential to optimize their implementation, particularly in health care settings. This approach is particularly relevant for health care professionals, who are constantly exposed to high levels of emotional demands, work overload, and risk of burnout, especially in the aftermath of the COVID-19 pandemic. Despite the growing need for scalable and accessible mental health support in this population, such digital programs remain scarce and underused. The primary aim of this study was to analyze the psychological mechanisms through which the MINDxYOU online program may contribute to stress reduction among health care professionals, focusing on a mediation model. Specifically, we explored if variables such as resilience and facets of mindfulness, compassion, and acceptance mediated the effects of the intervention on perceived stress. In a stepped-wedge cluster randomized design, 357 health professionals from health centers in Aragon and Málaga, Spain, were recruited. They were divided into 6 clusters, 3 per region, and randomly assigned to one of the 3 sequences, each starting with a control phase and then transitioning to the intervention phase (the MINDxYOU program) after 8, 16, or 24 weeks. This self-guided, web-based program, designed to be completed over 8 weeks, included weekly contact (via WhatsApp, call, or email) from the research team to promote adherence. Participants were assessed on the web every 8 weeks for 5 assessments. Perceived stress was the study’s primary outcome, with additional measures of clinical factors (anxiety, depression, and somatization) and process variables (resilience, mindfulness, compassion, and acceptance). Mediation models using mixed-effects regressions and bootstrap resampling (1000 iterations) were applied to analyze the direct and indirect effects of the treatment on psychological outcomes. Resilience emerged as the most consistent and significant mediator, exerting a relevant indirect effect on reducing stress (β=-1.41; P=.02), anxiety (β=-0.88; P=.03), and depression (β=-0.97; P=.01), even in multivariate models. Mindfulness facets such as observing, describing, and nonreacting also showed significant, albeit less consistent, mediating effects. In contrast, compassion and acceptance were weakly associated and did not play a significant mediating role. These results demonstrate resilience as the key psychological mediator. Strengthening resilience through online interventions appears to be a crucial pathway for reducing stress and emotional symptoms in this population. Specific mindfulness skills may also contribute to the intervention’s therapeutic effect, although with less robust evidence.
11. Generative AI Chatbots as Digital Adjuncts for Sexual Health Information After Prostate Cancer in Men Who Have Sex With Men: Auto-Netnographic Study.
期刊: JMIR cancer 发表日期: 2026-Feb-09 链接: PubMed
摘要
Sexual health concerns following prostate cancer treatment are common yet often insufficiently addressed in clinical practice, particularly among men who have sex with men. These individuals may face additional barriers stemming from heteronormative assumptions, limited disclosure, and a lack of culturally tailored information. As generative artificial intelligence (GenAI) chatbots become increasingly accessible, patients are using these systems to seek sensitive health information outside traditional care settings. While prior research has focused on the accuracy and safety of chatbot-generated health advice, less attention has been paid to how responses are framed and experienced in sexual minority contexts. This study aimed to describe and compare how 4 GenAI chatbots respond to questions about sexual health following prostate cancer treatment, with a focus on the needs of a gay man, and to interpret these responses using netnographic and actor-network theory perspectives. A qualitative exploratory study using auto-netnography was conducted. In February-March 2025, the first author interacted once with 4 widely used GenAI chatbots-ChatGPT (GPT-4o; Open AI), Claude (3.5 Sonnet; Anthropic), Copilot (GPT-4 Turbo; Microsoft), and Gemini (2.0 Flash; Google)-while assuming the role of a simulated “mock patient.” Two standardized prompts were used verbatim across all platforms: an initial prompt addressing sexual health concerns after prostate cancer treatment and a supplementary prompt focusing on sexual minority-specific issues, including same-sex practices. Chatbot outputs were treated as system-generated data and analyzed qualitatively, integrating system-generated text with reflexive experiential engagement and attention to interactional framing, emotional attunement, specificity, and performative features. The analysis did not assess clinical effectiveness, safety, or generalizability. Across platforms, chatbot responses addressed treatment-related sexual health concerns using generally inclusive language, with variation in emotional tone, specificity, and cultural sensitivity. Interactional features included the scope and framing of clinical information, encouragement of dialogue, self-care advice, and explicit discussion of same-sex sexual practices. No obvious fabricated claims were identified; however, contextual inaccuracies were observed. Responses were mapped along 2 intersecting continua-logical-to-empathetic orientation and general-to-specific framing-yielding 4 interactional styles: structured overview, rational clarity, compassionate perspective, and compassionate precision. This 4-quadrant framework served as an interpretive heuristic and does not constitute an evaluation of quality or effectiveness. The findings indicate that contemporary GenAI chatbots, when used as digital adjuncts, may enact communication styles that can be perceived as supportive, culturally sensitive, and LGBTQI+ (lesbian, gay, bisexual, transgender, queer, and intersex)-inclusive in specific sexual health interactions. Although these systems lack ethical consciousness and cannot replace professional care, their performative responses may complement clinical practice by facilitating reflection and access to sensitive information. The study highlights how care-like meanings may emerge through sociomaterial interactions between users and artificial intelligence systems rather than demonstrating generalized performance or clinical reliability.
12. Flash-Tailored Pt Single-Atom Interfaces for Electrochemical Sensing of Clothianidin with Toxicological Insights.
期刊: ACS applied materials & interfaces 发表日期: 2026-Feb-09 链接: PubMed
摘要
Ensuring food safety requires both reliable detection of chemical contaminants and evaluation of their potential health risks. Clothianidin (CLO), a widely used neonicotinoid insecticide, is of particular concern due to its environmental persistence, bioaccumulation potential, and associated toxicological risks. Here, an ultrarapid and scalable strategy for constructing highly exposed, atomically dispersed platinum single-atoms interface on porous graphene-like carbon frameworks (Pt SA/CFs) in just 2 min is proposed. The process involves the decomposition of glucose and H2PtCl6, generating a porous carbon structure with uniformly dispersed Pt atoms in a single step. The resulting Pt SA/CFs exhibit exceptional catalytic activity, enabling highly sensitive and rapid electrochemical detection of CLO with a detection limit of 1.61 μM. Additionally, recovery rates from spiked real samples ranged from 92.87% to 105.65%, further highlighting the method’s potential for CLO detection in practical applications. These results not only overcome the limitations of conventional analytical methods but also provide a cost-effective solution for on-site pesticide residue analysis. Furthermore, by integrating network toxicology, the molecular mechanisms underlying CLO-induced respiratory toxicity are found, offering valuable insights into its potential health risks. This work presents a time-efficient synthesis of single-atom Pt for rapid neonicotinoid detection and integrates network toxicology to establish a framework for risk assessment in food safety regulation.
13. Association Between Availability of Fruits and Vegetables in Neighborhood Food Stores and Weight Among Residents of Low-Income Urban Public Housing: Cross-Sectional Study.
期刊: JMIR formative research 发表日期: 2026-Feb-09 链接: PubMed
摘要
This cross-sectional study examined the presence of food stores and availability of fruits and vegetables in food stores with weight among urban public housing residents. While there was no association between average number of fruits or vegetables in food stores and weight, there were positive associations between number of convenience stores and weight and between number of general merchandise stores and weight.
14. Knowledge about Chagas disease among Primary Health Care professionals in a municipality located in northeastern Brazil.
期刊: PLoS neglected tropical diseases 发表日期: 2026-Feb-09 链接: PubMed
摘要
Knowledge about Chagas disease (CD) among health professionals is essential to control this public health problem. The objective was to evaluate the knowledge about CD among these professionals. A descriptive cross-sectional study was conducted between April and September 2023, in the city of Irecê, Bahia State, Brazil. Data were collected using a standardized questionnaire and analyzed descriptively. Of the 257 participants, 226 (87.9%) claimed to know the etiological agent, although only 173 (76.5%) recognized it as a protozoan. Regarding the modes of transmission, all workers recognized the vector-borne route, but only 102 (39.7%) identified the vertical route. The majority of workers identified the heart as the affected organ (n = 255; 99.2%). The most identified signs/symptoms in the acute phase were fever (n = 196; 76.6%) and edema (n = 218; 85.2%); in chronic cases, it was recognized that they can be asymptomatic, but the majority recognized that electrocardiographic changes and congestive heart failure may be present. Regarding etiological treatment, 175 (72.0%) acknowledged its existence, but 122 (65.9%) could not state the recommended medication; and for 189 (73.5%), CD is incurable. Regarding the vector insect, 210 (82.0%) reported knowing it. Concerning the service to which located triatomine bugs should be sent, 165 (65.7%) identified the Zoonoses Control Center, and that the precaution to be taken when handling triatomine bugs was to protect their hands; for 234 (91.8%) of the participants, the procedure in case of a triatomine bite in humans was to perform serological tests, and 243 (94.6%) had never had access to information about CD. The health workers’ knowledge about CD was incipient and differed among occupational categories. For accurate surveillance of CD, training should be offered to health professionals, covering everything from signs/symptoms to the investigation of household and entomological contacts.
15. Expanding the molecular epidemiology of melioidosis in North Central Vietnam.
期刊: PLoS neglected tropical diseases 发表日期: 2026-Feb-09 链接: PubMed
摘要
Cases of melioidosis have been recorded for many years in Vietnam though it is still not a nationally reportable disease in Vietnam. More research is needed to understand the disease ecology and public health impacts of melioidosis in the country. To this aim, broadening the knowledge base of strains and epidemiology of infections in relation to genotypes present in the soil reservoir can tell us about the propensity of Burkholderia pseudomallei genotypes to transmit from soil to humans. Thirty-five clinical B. pseudomallei isolates, ten from soil, one from swine, and one from a bear were collected by the Institute of Microbiology and Biotechnology, Vietnam National University and sequenced at the National Institute of Hygiene and Epidemiology in Hanoi. The clinical strains were isolated from melioidosis patients from Ha Tinh in each month of 2020 (except July). There were 15 STs identified and four of the clinical isolates were new sequence types (ST) as determined by traditional seven marker multi-locus sequence typing (MLST) analysis. Twenty of the thirty-five (57%) clinical strains isolated in this study were ST 41, with ST 41 isolates obtained throughout the year and across Ha Tinh province with core genome (cg) MLST identifying finer scale differences. ST 41 was recovered from one soil sample approximately 1 year after the clinical isolates. cgMLST analysis and whole genome SNP analysis revealed nucleotide differences among strains in Ha Tinh historically contextualizing them in Vietnam and globally. As melioidosis moves towards a reportable disease in Vietnam, molecular epidemiological methods can connect human, veterinary, and environmental genotypes of concern.
16. BDNF and NLRP3 signaling differentially regulate formation and retrieval of nitrous oxide (N2O)-related rewarding memory in dorsal hippocampus CA3 region.
期刊: International immunopharmacology 发表日期: 2026-Feb-08 链接: PubMed
摘要
The formation and retrieval of reward memories within the hippocampus are critical mechanisms underlying the development of substance use disorder. Nitrous oxide (N2O), an inhalant with significant abuse potential, is believed to hijack these processes, yet the precise hippocampal mechanisms remain unknown. Here, we reported that N2O-related memory stages are differentially regulated by BDNF and NLRP3 signaling in the dorsal hippocampus CA3 region. First, we found that N2O exposure induces conditioned place preference (CPP) and preferentially increases the activity of hippocampal CA3 neurons. Furthermore, N2O concurrently enhances both the BDNF expression and the microglia activity in hippocampal CA3 region. The mechanisms are involved in activation of both BDNF-TrkB-pAKT and the microglia-NLRP3 signaling pathways. Interestingly, knockdown of BDNF expression in the CA3 region reduces retrieval, but not formation stage, of CPP behavior. Whole-cell patch-clamp recordings further demonstrated that CA3-specific BDNF knockdown abolishes the N2O-induced potentiation of glutamatergic transmission. Finally, both pharmacological microglial inhibition and germline NLRP3 deletion prevented the N2O-induced formation stage of CPP behavior. Our study elucidates a novel, stage-specific regulatory mechanism in which BDNF-TrkB-pAKT and the microglia-NLRP3 signaling within the hippocampal CA3 differentially governs the retrieval versus formation of N2O reward memory, revealing distinct targets for therapeutic intervention.
17. Effectiveness of soil remediation intervention of abandoned used lead-acid battery recycling sites to reduce lead exposure among children: A three-arm pretest-posttest non-equivalent comparison group trial.
期刊: International journal of hygiene and environmental health 发表日期: 2026-Feb-08 链接: PubMed
摘要
Lead exposure remains a substantial risk to public health, especially among children, in low- and middle-income countries. This study assessed the efficacy of a soil remediation intervention on reducing blood lead level (BLL) among children living near an abandoned used lead-acid battery (ULAB) recycling site in Mirzapur, Bangladesh. We conducted a pretest-posttest, non-equivalent comparison group study with 167 children aged 6 months to 12 years across three study arms (ULAB intervention, ULAB control, and non-ULAB control). Blood and environmental samples were collected at baseline and 12 months post-intervention. BLL was analyzed by Graphite Furnace Atomic Absorption Spectrophotometry, and environmental lead levels were assessed using portable X-ray fluorescence analyzer. Over the 12-month post-intervention period, geometric mean BLLs declined from 90.1 to 70.4 μg/L in ULAB intervention group, from 88.5 to 81.1 μg/L in ULAB control group, and from 42.8 to 37.8 μg/L in non-ULAB control group. Difference-in-differences analysis revealed a 15% greater BLL decline in the intervention arm compared to the ULAB control arm and 11% greater BLL decline in the intervention arm compared to the non-ULAB control arm. Subgroup analysis in the intervention arm revealed that older children (>5 years), those living closer to the site (<200m), and those with higher baseline BLL (>median) experienced the greatest reduction in BLL. The soil remediation intervention significantly reduced BLLs in children. However, levels remained above the CDC reference value of 35 μg/L, highlighting the need for broader and sustained public health initiatives to reduce lead exposure.
18. Global trends, regional disparities and key determinants of neonatal sepsis: A pan-database analysis from 1990 to 2021.
期刊: Computers in biology and medicine 发表日期: 2026-Feb-08 链接: PubMed
摘要
Neonatal sepsis (NS) poses a significant global health challenge, with mortality rates ranging from 11% to 19%. Despite its substantial burden, there is currently a lack of systematic understanding of the global epidemiological trends and influencing factors of NS. We conducted a comprehensive pan-database analysis integrating data from 18 international databases across 201 countries (1990-2021). Through advanced statistical modeling, including correlation analyses, risk parsimonious modeling, and confounder adjustments, we examined temporal trends, regional disparities, and key determinants of NS. While NS prevalence increased annually due to improved detection, age-standardized rates showed consistent declines. For NS incidence, novel correlates included European ancestry (strongest), systolic/diastolic blood pressure, and inverse associations with Human Development Index. We developed a parsimonious model incorporating diastolic blood pressure, Global Hunger Index, and European ancestry, which showed strong cross-regional predictive capability (r = 0.727). For mortality, socioeconomic factors were primary correlates: positive associations with Global Hunger Index and food insecurity, and inverse associations with Inequality Adjusted HDI. This first comprehensive global analysis reveals that NS outcomes are determined by both medical and socioeconomic factors. While blood pressure metrics and genetic factors influence incidence, mortality is primarily driven by socioeconomic determinants. These findings suggest that reducing NS burden requires a dual approach: enhancing medical care while addressing fundamental socioeconomic disparities, particularly in resource-limited regions.
19. Dual drivers of riverine nitrogen transformation: Microbial-plankton community assembly and environmental interactions.
期刊: Journal of environmental management 发表日期: 2026-Feb-08 链接: PubMed
摘要
Nitrogen cycling is a critical process for maintaining the ecological function and water quality stability of river ecosystems. However, under increasing anthropogenic disturbances, its transformation pathways and ecological response mechanisms have become increasingly complex. The water-sediment interface, as a biogeochemically active zone for nitrogen transformations, is influenced by both environmental factors and biological processes. Yet, the drivers of its multi-pathway nitrogen cycling remain unclear, particularly under multi-modal and multi-factor interaction scenarios. This study employed co-occurrence network analysis, random forest modeling, and coupled matrix and tensor factorization (CMTF) to identify biological-environmental associations, screen key taxa and environmental factors influencing different nitrogen cycling pathways, and explore the latent core drivers and mechanisms underlying multi-path nitrogen transformation processes. The co-occurrence network indicated that nitrogen transformations in surface water are more dynamically and jointly regulated by rapid physicochemical fluctuations and multi-trophic interactions. The random forest results showed denitrification and nitrogen fixation were strongly responsive to salinity, NH4+ and NO3-, while phytoplankton and zooplankton primarily influenced organic nitrogen transformation, assimilation, and ANRA pathways. Microbial communities mainly participated in inorganic nitrogen transformation processes. CMTF further resolved three major ecological mechanisms: (1) reductive processes associated with nitrogen fixation and the DNRA pathway primarily driven by environmental factors, (2) nitrification processes jointly governed by microbial communities, oxygenated and nutrient conditions, (3) organic nitrogen transformation and ANRA processes co-regulated by biological activity and environmental factors. This study elucidates the differential ecological drivers of nitrogen cycling pathways in river systems, enhances the understanding of multi-pathway nitrogen dynamics in complex ecosystems, and provides theoretical insights for watershed nitrogen pollution control and ecosystem management.
20. Impacts of Seasonal Mass Drug Administration in School-Aged Children on Chronic Malaria Infections in Burkina Faso.
期刊: The American journal of tropical medicine and hygiene 发表日期: 2026-Feb-05 链接: PubMed
摘要
School-aged children constitute an important asymptomatic reservoir for Plasmodium and may harbor the parasite through malaria transmission seasons in the absence of treatment. As WHO guidelines do not recommend chemoprevention for this group, there is a need to understand how such interventions could impact malaria transmission dynamics. This study investigated seasonal transmission patterns and the potential of mass drug administration (MDA) at the onset of the dry season to interrupt malaria transmission. Monthly parasitological surveys were conducted in Burkina Faso rural localities during the dry season targeting two cohorts of school-aged children: one of children uninfected at baseline who received no treatment and another of parasitemic asymptomatic children who received a full treatment dose of artemether-lumefantrine. Monthly blood samples were collected and analyzed using microscopy and polymerase chain reaction. Parasite diversity and drug resistance were assessed with msp1/msp2 typing and pfcrt/pfmdr1 genotyping, and entomological monitoring evaluated mosquito vector dynamics and infection status. Our results revealed that 93% of uninfected individuals remained Plasmodium infection free. Among treated individuals, 91% remained negative during follow-up. The prevalence of persistent infections among parasitemic individuals was stable over time at 5-9% in both cohorts. msp1/msp2 genotyping revealed the same haplotypes over time within participants, and analysis of drug-resistance markers showed low frequencies of mutations associated with antimalarial resistance. Our findings demonstrated that malaria transmission is interrupted during the dry season and that early MDA can effectively prevent infection, with over 90% of participants remaining parasite free, highlighting its potential to disrupt transmission dynamics.
21. Trichinellosis after Raw Bear Eyeball Consumption.
期刊: The American journal of tropical medicine and hygiene 发表日期: 2026-Feb-05 链接: PubMed
摘要
Trichinellosis, a zoonotic parasitic disease, is usually transmitted through raw or undercooked muscle tissue. We report a 25-year-old hunter from Hokkaido, Japan, who acquired trichinellosis by consuming a raw bear eyeball, a tissue previously presumed to be parasite-free. He developed fatigue and rash within 3 days, followed by fever and myalgia 9 days after consumption. Serology confirmed trichinellosis, and treatment with albendazole led to full recovery. Among five hunters who consumed meat from the same bear, only the two who ate raw eyeballs developed the disease, whereas those who ate only cooked meat remained asymptomatic. This appears to be the first report of trichinellosis linked to raw bear eyeballs. Clinicians and public health practitioners should be aware that any uncooked tissue may carry an infection risk. These findings underscore the need for vigilance against unconventional transmission routes and culturally sensitive education for accurate diagnosis and prevention.
22. Ecologic Factors Contributing to West Nile Virus Hyperendemicity in Central South Carolina: An Integrated Vector-Human-Environmental Study.
期刊: The American journal of tropical medicine and hygiene 发表日期: 2026-Feb-05 链接: PubMed
摘要
West Nile virus (WNV) is an endemic arboviral infection in the United States that has undergone phylogenetic evolution since its introduction 25 years ago. An integrated vector-human-pathogen study was conducted in the summer of 2023 to unearth contemporary Culex quinquefasciatus habitat patterns and human transmission spillover foci in South Carolina, a state with historically little WNV data. A serosurvey revealed WNV seroprevalence 10 times the national average (22% versus 2%, respectively), with unusual epidemiologic risk factors. Female Culex quinquefasciatus WNV positivity was low (2.7%), with viral phylogenetics 100% homologous to the WN02 clade. Mosquito vectors clustered in affluent urban neighborhoods with greater tree canopy cover and abundant waterbodies. Culex quinquefasciatus abundance was greatest when climate variance was nominal in the 72 hours preceding collection. An unusual bimodal mosquito temporal pattern was observed, reflecting changing climate patterns. The present comprehensive WNV study reveals emerging transmission factors as WNV continues to evolve and persist in the southeastern United States.
23. Epidemiology of Canine Visceral Leishmaniasis in Federal District - Brazil (2005-2022): Investigation of Factors Associated with Seroprevalence.
期刊: The American journal of tropical medicine and hygiene 发表日期: 2026-Feb-04 链接: PubMed
摘要
Leishmaniasis is a neglected tropical disease that primarily occurs in developing countries. This disease is caused by more than 20 species of the genus Leishmania. To face this problem, Brazil’s health authorities establish control of the canine reservoir through serological surveys and sacrifice of seropositive dogs. This study aimed to evaluate the serodiagnosis process and registration of canine visceral leishmaniasis (CVL) cases by the Environmental Health Surveillance Directorate (EHSD) of Federal District, Brasilia, the capital city of Brazil. We analyzed the EHSD database from 2005 to 2022. The database contained 52,266 records, with an overall positivity of 15.78%. The results indicated a risk association between the variables sex, age, fur size, and symptomatic state with CVL seropositivity. In the binomial logistic regression model, being male, being older than 6 years, and having a short fur increased the odds of a positive diagnosis. Among the clinical signs recorded, skin lesions were the most sensitive in indicating the presence of CVL (62.4%). The factor with the highest specificity was alopecia around the eyes (83.6%). The administrative regions with an incidence of human cases were the same as those with a high seroprevalence of CVL between 2011 and 2022.
24. Factors Associated with Human Papillomavirus Vaccination Uptake Among Adolescent Girls in Uganda.
期刊: The American journal of tropical medicine and hygiene 发表日期: 2026-Feb-04 链接: PubMed
摘要
Human papillomavirus (HPV) vaccination has been shown to reduce the HPV-related cervical cancer burden. The aim for the present study was to investigate the factors associated with the uptake of HPV vaccination among adolescent girls aged 13-18 years seeking health services at a health center in Uganda. This cross-sectional study was conducted at Naguru Teenage Information and Health Center, an adolescent clinic of Kiswa Health Center III in Kampala, Uganda. Information was obtained from 134 adolescent girls aged 13-18 years who were seeking services at the center. Bivariate and multivariable analyses were conducted to identify factors associated with HPV vaccine uptake. The uptake of a single dose of the HPV vaccine was 18.7% (25/134). Factors associated with HPV vaccine uptake included being from an ethnic group such as the Acholi/Lango (adjusted prevalence ratio [aPR] = 0.3; 95% CI: 0.09-0.6), being from an ethnic group such as Basoga (aPR = 0.2; 95% CI: 0.08-0.8), parents’ level of knowledge (aPR = 0.3; 95% CI: 0.1-0.8), perception of HPV vaccine benefits (aPR = 0.3; 95% CI: 0.1-0.9), knowledge of the location of the nearest HPV vaccination site (aPR = 0.3; 95% CI: 0.1-0.8), distance to the healthcare facility (aPR = 0.5; 95% CI: 0.2-0.7), and healthcare worker recommendations (aPR = 0.3; 95% CI: 0.1-0.7). The uptake of the HPV vaccine was low. There is a need to conduct awareness campaigns for parents, adolescents, and the community about the benefits of the HPV vaccine. This will increase HPV vaccine uptake and reduce the burden of cervical cancer in the community.
25. Chronic Pediatric Diseases in Remote Villages of French Guiana Over a 9-Year Period.
期刊: The American journal of tropical medicine and hygiene 发表日期: 2026-Feb-04 链接: PubMed
摘要
Twenty percent of French Guiana’s population lives in remote villages surrounded by tropical forests, accessible only by plane or boat. Some specialists, including pediatricians, regularly visit these villages for consultation purposes. The main objective for the present study was to provide an epidemiological description of childhood diseases that require follow-up or consultation with pediatricians in remote health centers. A descriptive, retrospective, multicenter study of pediatricians’ consultations in these health centers was conducted from January 1, 2011 to December 31, 2019. A total of 1,458 patients were included in the current study. In 2011, at the beginning of the pediatric missions, 91 patients had at least one consultation with a pediatrician, whereas in 2019, 319 patients were seen by a pediatrician in remote health centers. Sixty-two percent of pediatric consultations were single. Twenty-three deaths were recorded between 2011 and 2019, representing 1.4% of all children seen by the pediatricians. Forty-five percent of the children were under 2 years old at the time of their first consultation. The most common diseases were cardiac, infections, developmental delays, prematurity, and genetic diseases, including sickle cell disease. The current study revealed that the rate of children being followed up by pediatricians in the field is high. Children with chronic conditions can be followed up regularly, and additional investigations or support can be provided as needed. However, this comprehensive study highlights the difficulties pediatricians face in providing care, often due to external factors, such as a lack of healthcare infrastructure, cultural and linguistic differences, and educational and social difficulties, and emphasizes the need to reduce these barriers.
26. Incidence and Viral Etiology of Acute Respiratory Infections and Pneumonia among Children Under Two Years: A Birth Cohort Study in Dhaka, Bangladesh.
期刊: The American journal of tropical medicine and hygiene 发表日期: 2026-Feb-04 链接: PubMed
摘要
Globally, acute respiratory infections (ARI), including pneumonia, remain the leading infectious causes of morbidity and mortality among children under-two years of age. We conducted this longitudinal birth cohort study in a low-income urban community in Dhaka, Bangladesh, to estimate the incidence of ARI and pneumonia and assess their viral etiology. From May 2015 to March 2016, 447 children were enrolled and followed till 2022. In this analysis, we included data from the first two years of children’s lives, which contributed to a total observation of 778 child-years. Nasopharyngeal wash samples were collected during symptomatic episodes, which were tested using rRT-PCR for rhinovirus (RV), respiratory syncytial virus (RSV), human metapneumovirus (hMPV), influenza virus, human parainfluenza virus (HPIV), and adenovirus. We calculated incidence rates using Poisson-based methods with 95% confidence intervals (CI) and stratified age-specific rates into three groups: 0 to <6 months, 6 to <12 months, and 12 to 24 months. A total of 2,335 ARIs and 314 pneumonia episodes were documented. At least one respiratory virus was detected in 71% of ARI and 75% of pneumonia episodes. RV was the most frequently detected virus (54% in ARI, 40% in pneumonia), followed by RSV, HPIV, and influenza. The incidence of viral ARI was 212/100 child-years (95% CI: 202-223), and that of viral pneumonia was 30/100 child-years (95% CI: 27-35). The observed incidence of viral ARI and pneumonia during early childhood underscores the need for targeted interventions. Future research should examine environmental and socioeconomic influences, assess preventive strategies, and improve early detection and treatment.
27. Patients from Remote Health Centers Referred to Cayenne Emergency Department: A One-Year Observational Study.
期刊: The American journal of tropical medicine and hygiene 发表日期: 2026-Feb-04 链接: PubMed
摘要
French Guiana has developed a health organization to respond to its geographical situation. Remote health centers provide primary and emergency care in isolated areas. The limited technical facilities at the remote health centers result in a significant number of patient transfers to the Cayenne emergency department (ED). The objective of this study was to describe the epidemiology and management of patients transferred to Cayenne ED. A retrospective observational study was conducted from January 1 to December 31, 2019, and it included all patients transferred from remote health centers to Cayenne ED. All sociodemographic, prehospital, hospital, and referral data were collected; 842 patients were transferred by remote health centers to the Cayenne ED. The male/female ratio was 1.27, with an age of 36 (±23) years old. The two main modes of transportation used were helicopter (36%) and plane (22%). The most frequent reasons for transfer were trauma (28%), digestive (9%), respiratory (9%), and infectious (8%) conditions. Patients were hospitalized in 71% of cases. Among patients who were not hospitalized, 7% did not require further examination or specialist advice in the ED. Our work underlines the important use of airborne resources, particularly medical ones; they were initially intended for the management of vital emergencies, but they are also used for nonurgent situations. The geography and road access in French Guiana make alternative means of transport difficult. Our work identifies a number of areas for optimizing care to decrease the number of transfers: improving biomedical equipment, improving imaging equipment, and use of telemedicine.
28. Submicroscopic Burden of Zoonotic Plasmodium knowlesi Malaria on Mursala Island and Plasmodium falciparum and Plasmodium vivax Transmission in Mainland North Sumatra, Indonesia.
期刊: The American journal of tropical medicine and hygiene 发表日期: 2026-Feb-04 链接: PubMed
摘要
Accurate molecular tools are essential for estimating zoonotic malaria transmission in Southeast Asia. This study applied ultrasensitive reverse-transcriptase real-time polymerase chain reaction (PCR) to detect zoonotic malaria in febrile patients from health facilities across three mainland districts (Batubara, Tanjung Balai, and Central Tapanuli) and separately on Mursala Island, North Sumatra, Indonesia. Among 64 participants on Mursala, 7 (10.9%) adults had Plasmodium knowlesi infections (including 5 agricultural workers and 2 adults with severe WHO anemia), and 2 (3.1%) adults had Plasmodium vivax infections. All were negative by microscopy and panparasite lactate dehydrogenase rapid diagnostic tests. No P. knowlesi infections were identified among 947 participants from mainland sites; PCR detected confirmed Plasmodium species in 26%, including P. vivax (17.5%) and Plasmodium falciparum (7.5%), with 30% of cases being submicroscopic. No Plasmodium cynomolgi infections were identified. Plasmodium knowlesi transmission is low in North Sumatra; however, it may cause WHO-defined severe malaria. Molecular diagnostics remain crucial for identifying zoonotic malaria and should be integrated into surveillance systems to inform public health control measures.
29. Dengue Vaccine Effectiveness: Results from a 6-Year Population-Based Cohort Study in Southern Brazil.
期刊: The American journal of tropical medicine and hygiene 发表日期: 2026-Feb-04 链接: PubMed
摘要
The alarming growth of dengue worldwide, as well as its social and economic impact, has necessitated effective responses for its control. Brazil, the second country to use Dengvaxia® (Sanofi Pasteur, Paris, France) after the Philippines, has offered the vaccine to ∼500,000 residents in 30 municipalities, with ∼300,000 being vaccinated. In this population-based cohort study, the vaccine’s effectiveness (VE) is reported after a 6-year follow-up for a vaccination campaign. The primary outcome was probable dengue case (PDC). Laboratory-confirmed dengue, serotype, warning signs, and hospitalization were considered secondary endpoints. Approximately 60% of participants received at least one vaccine dose. A total of 50,658 PDCs were identified, of which 15,131 were laboratory-confirmed dengue cases. Overall, the VE was 34% (95% CI: 33% to 35%) for PDCs and 20% (95% CI: 17% to 23%) for laboratory-confirmed cases. Greater VE was observed in older individuals. Vaccination was effective in reducing dengue virus (DENV)-1 and DENV-4 cases but not DENV-2 cases. No DENV-3 cases were registered. Among the 1,129 hospitalizations, 619 (54.8%) occurred within the vaccinated population, including 16 severe cases, whereas 510 (45.2%) hospitalizations occurred within the non-vaccinated population, with 18 severe cases. The VE for PDC hospitalizations was 16.5% (95% CI: 5.5% to 26.3%). Five and nine dengue-related deaths occurred within the vaccinated and non-vaccinated populations, respectively. The low incidence of severe cases and warning signs compromised accuracy. Vaccination with at least one dose was associated with approximately a one-third reduction in PDC incidence and a significant reduction in DENV-1 and DENV-4 cases. Despite the VE falling below 50%, vaccination may be justifiable in regions with high disease burden.
30. Associations of Schistosoma mansoni Infection, Latent Tuberculosis, Host Interferon-γ Concentrations, and Praziquantel Treatment in Tanzanian Adults.
期刊: The American journal of tropical medicine and hygiene 发表日期: 2026-Feb-04 链接: PubMed
摘要
Latent tuberculosis infection (LTBI) and Schistosoma mansoni are common in Africa, and helminth-induced immunomodulation may affect LTBI detection. This study aimed to assess whether S. mansoni infection affects LTBI detection by the QuantiFERON-TB Gold Plus (QFT-Plus) assay and alters serum interferon-γ (IFN-γ) concentrations in response to Mycobacterium tuberculosis (Mtb) antigens at baseline and after 1 year, during which participants with S. mansoni infection received praziquantel treatment. At baseline, 65 individuals with schistosome infection had lower average IFN-γ concentrations in TB1-stimulated QFT-Plus supernatants compared with 83 uninfected individuals (10.4 versus 51.9 pg/mL, P = 0.038). Although not statistically significant, QFT-Plus test positivity rate was unexpectedly slightly higher among adults with schistosome infection at baseline (26.2% versus 18.1%, P = 0.24). The incidence over 12 months was higher posttreatment in participants initially infected with S. mansoni compared with those uninfected (13.9% [n = 5/36] versus 4.2% [n = 2/48], P = 0.13). By 12 months, IFN-γ concentrations were comparable between the two groups (53.8 versus 33.5 pg/mL, respectively, P = 0.56). Individuals who cleared S. mansoni infection experienced a nearly 12-fold increase in IFN-γ levels relative to those who remained uninfected, although this difference did not reach statistical significance (P = 0.17). In conclusion, baseline S. mansoni infection was associated with suppressed IFN-γ responses to Mtb antigens, suggesting helminth-induced immune dampening. Praziquantel treatment may partially restore TB-specific immune responses and facilitate LTBI detection. These findings highlight the potential role of S. mansoni as a critical cofactor affecting LTBI diagnosis in schistosomiasis-endemic regions.
31. Varying Malaria Rapid Diagnostic Test Accuracy by Regional Transmission Level and Demographics in Tanzania.
期刊: The American journal of tropical medicine and hygiene 发表日期: 2026-Feb-04 链接: PubMed
摘要
Malaria remains a significant global health burden, with ∼263 million cases across 83 countries. It is essential to quickly and accurately detect cases to control the spread of the disease. Given the widespread use of malaria rapid diagnostic tests (mRDTs) for case management and surveillance, it is crucial to understand test reliability. Clarifying how mRDT results differ from real-time polymerase chain reaction (qPCR) test results, as well as the nature of additional variance by test manufacturer, will be useful for reducing measurement bias. After comparing three national standard mRDTs and a research mRDT with qPCR results from a 2021 cross-sectional study in Tanzania, differences were found in terms of age, sex, and regional malaria transmission rate. The research test underperformed overall, with poor sensitivity across transmission strata. After comparing the research mRDT to standard mRDTs, the odds ratios indicated that transmission intensity may affect mRDT agreement and diagnostic performance. These results offer pertinent information on test accuracy and decrease outcome misclassification for malaria prevalence.
32. Burden of Antibiotic Resistance in Hospitalized Children in Kenya: Associations with Mortality, Hospital Stay, and Treatment Costs.
期刊: The American journal of tropical medicine and hygiene 发表日期: 2026-Feb-04 链接: PubMed
摘要
Antimicrobial resistance poses a growing threat to pediatric care, yet data on its clinical and economic burden in low-resource settings remain limited. The impact of antibiotic-resistant infections on mortality, hospital stay, and treatment costs was assessed among children admitted to a national referral hospital in Kenya in the present study. A retrospective review of medical records for pediatric patients (0-12 years) hospitalized with bacterial infections between January 2017 and December 2021 was conducted. Diagnoses included gastroenteritis, pneumonia, sepsis, urinary tract infections, meningitis, and others. Data on treatment, laboratory testing, outcomes, hospital stays, and costs were abstracted. Statistical analyses included Kaplan-Meier survival curves, Cox regression, and mixed-effects negative binomial and generalized linear models. Among 1,608 patients, 63% were infants, and 38% were referrals. Gastroenteritis (46%) and pneumonia (28%) were the most common diagnoses. Antibiotic-resistant infections occurred in 27% of participants and were associated with higher mortality (26% versus 9% in susceptible participants) and an attributable risk of 17%; the population attributable fraction was 65%. After adjustment, resistance was associated with increased mortality (HR 1.44), longer hospital stays (60% increase), and higher treatment costs (33% increase). Antimicrobial resistance significantly increases mortality, hospital stays, and healthcare costs in pediatric patients. Strengthening diagnostics, antimicrobial stewardship, and policy interventions is critical to address this threat.
33. Clinical Management, Epidemiology, and Recurrence of Human Cystic Echinococcosis in a Secondary-Level Hospital in Cusco, Peru.
期刊: The American journal of tropical medicine and hygiene 发表日期: 2026-Feb-04 链接: PubMed
摘要
Peru has the highest incidence of human cystic echinococcosis (CE) in South America, and most cases are reported in the central and southern Peruvian Andes, including the Cusco region. We reviewed medical records of patients with CE admitted between 2010 and 2019 to a level 2 hospital in Sicuani. We collected data on surgical management and recurrence. Records from 115 patients were included; their median age was 25 years old (interquartile range [IQR], 16-46), and 60% were female. Most patients (68.7%) presented with a single liver cyst. The Gharbi classification was used in 75 of 107 patients (70.1%) with an ultrasound and 91 of 142 cysts (64.8%). Thirty-one (34.1%) were classified as Gharbi I, 33 (36.3%) were classified as Gharbi II, 21 (23.1%) were classified as Gharbi III, and 6 (6.6%) were classified as Gharbi IV. Presurgical complications were reported in 41.7%; 102 patients underwent surgery. In 51.5%, one secondary CE prevention measure was documented, and 9.3% had two. Postsurgical cyst recurrence was reported in 16.5% at a median of 32.3 months (IQR, 3.9-46.6), and readmission was reported in 12.7%. In the multivariable analysis, having three or more cysts (odds ratio, 6.26; 95% CI, 1.10-39.85) was associated with postsurgical recurrence. Advanced and complicated CE and postsurgical recurrence were common in Sicuani. Standardization of ultrasound staging-guided clinical management along with secondary CE prevention measures could effectively decrease the disease burden linked to clinical care, improving outcomes and decreasing costs.
34. Baseline Anti-Dengue IgG Seroprevalence in a Pediatric Brazilian Population Before TAK-003 Vaccination.
期刊: The American journal of tropical medicine and hygiene 发表日期: 2026-Feb-04 链接: PubMed
摘要
Dengue remains a major public health challenge in Brazil, with recurrent outbreaks placing a strain on healthcare systems. The TAK-003 vaccine offers a promising control strategy, particularly for children. This cross-sectional study evaluated the seroprevalence of anti-dengue IgG in 643 children and adolescents aged 4-16 years in Dourados, Brazil, before being administered the TAK-003 vaccine. Capillary blood samples were collected on filter paper and analyzed using ELISA; sociodemographic data were obtained through questionnaires. Overall, 20.5% of participants were seropositive. Seropositivity increased with age, with 27.7% among those aged 13-16 years testing positive compared with 13.4% among children aged 4-8 years. Male sex was associated with lower IgG levels. The age-related increase in anti-dengue IgG seroprevalence reflects cumulative exposure to the virus during childhood and adolescence, highlighting the need for immunization strategies tailored to age. These findings emphasize the importance of baseline anti-dengue IgG seroprevalence data to guide vaccination, assess effectiveness, and monitor antibody-dependent enhancement risks.
35. Evaluation of Strongyloides stercoralis Ss-IR Recombinant Antigen Using a Bead-Based Immunoassay.
期刊: The American journal of tropical medicine and hygiene 发表日期: 2026-Feb-04 链接: PubMed
摘要
Infection with the soil-transmitted helminth Strongyloides stercoralis is typically asymptomatic but can result in life-threatening hyperinfection syndrome in immunocompromised individuals. To improve serological tests for strongyloidiasis, we evaluated the Ss-IR antigen using a multiplex bead assay and compared this assay to the commonly used Ss-NIE antigen. We assessed assay sensitivity and specificity using the following serum panels: sera from United States-bound refugees (57 positive stool polymerase chain reaction [PCR], 88 negative PCR) departing from Thailand-Burma border camps (panel 1); sera from individuals from Argentina with stool PCR confirmed S. stercoralis (panel 2, n = 50); and presumed negatives from the United States with no travel history (panel 3, n = 185). The Ss-IR antigen demonstrated sensitivities of 90.0% and 89.5% and specificities of 98.9% and 89.8% in panels 1, and panels 2 and 3, respectively. When compared with Ss-NIE, the Ss-IR antigen demonstrated superior sensitivity, area under the curve, and reproducibility than Ss-NIE, supporting more extensive validation for surveillance use.
36. The Presence of Leishmania infantum DNA in Sand Flies Reflects Their Proximity to Human and Canine Visceral Leishmaniasis.
期刊: The American journal of tropical medicine and hygiene 发表日期: 2026-Feb-04 链接: PubMed
摘要
Visceral leishmaniasis (VL) is a vector-borne disease caused by Leishmania infantum infections in Brazil, and Lutzomyia longipalpis is its main vector. It is not well understood how L. infantum circulates between three hosts of public health importance: dogs, humans, and sand flies. The focus of this study was to determine the detection rate of L. infantum DNA in sand flies and evaluate the relative contribution of the three hosts as sand fly blood sources. Insects were collected using light traps in households with recent history of human VL, close neighbors of VL cases, and households with no recent history of human VL. DNA was extracted from single sand fly guts and L. infantum DNA, and sources of blood were identified by quantitative polymerase chain reaction (qPCR) using specific cytochrome B. Among 248 female sand flies captured, qPCR detected L. infantum DNA in 56% of them. Sand flies captured in households with recent history of human VL or VL endemic neighbors were, respectively, 3.73 (95% CI: 1.64-8.48; P = 4.92e-04) or 6.38 (95% CI: 3.37-12.09; P = 4.62e-10) times more likely to carry L. infantum DNA compared with sand flies captured in houses with no history of VL. Dog blood was most common, but multiple blood sources were detected in individual flies. Our findings reaffirm the role of dogs as L. infantum reservoirs in northeast Brazil. These findings highlight the importance of topical insecticides as measures to prevent canine L. infantum infection and limit the risk of human infection.
37. Detecting Angiostrongylus cantonensis Eosinophilic Meningitis with Highly Sensitive Quantitative Polymerase Chain Reaction-Report of Five Cases in Southern India.
期刊: The American journal of tropical medicine and hygiene 发表日期: 2026-Feb-04 链接: PubMed
摘要
Although more than 30 case reports of eosinophilic meningitis have been attributed to Angiostrongylus cantonensis (A. cantonensis) in India, only three have been microbiologically confirmed (via polymerase chain reaction [PCR] or immunoblot testing). In seven ocular infections and two brain abscesses reported, A. cantonensis was identified on the basis of the morphology of recovered worms. Here, five cases of Angiostrongylus eosinophilic meningitis (AEM) in children and adults are reported, diagnosed via the detection of A. cantonensis DNA in cerebrospinal fluid using the AcanR3990 quantitative PCR (National Institutes of Health, Bethesda, MD). All patients responded to management with steroids and albendazole. When AEM cases reported from India were reviewed and mapped, the majority were reported from southern Indian states. Managing and preventing this emerging zoonosis in these areas requires 1) access to accurate and timely diagnostics, 2) increasing awareness among clinicians, and 3) risk assessment with public health officials on acquiring infections from water and food contaminated by gastropods and other paratenic hosts.
38. Shift work and risk of chronic kidney disease: A systematic review and meta-analysis.
期刊: Social science & medicine (1982) 发表日期: 2026-Feb-02 链接: PubMed
摘要
This systematic review and meta-analysis is aimed to critically evaluate and quantify the association between shift work and chronic kidney disease (CKD). We searched PubMed, Embase, and Web of Science through May 2025 for observational studies examining shift work-including night or rotating shifts-and CKD outcomes among adults. Eligible outcomes included reduced estimated glomerular filtration rate (eGFR), proteinuria, or albuminuria. Study quality was assessed using the Newcastle-Ottawa Scale, and meta-analyses were performed where feasible. Twelve studies were included in this systematic review. Most studies defined CKD as eGFR below 60 mL/min/1.73 m2 or presence of albuminuria, although outcome definitions varied. Meta-analysis of 6 studies found that shift workers had significantly higher odds of CKD (pooled odds ratio: 1.43; 95% CI: 1.06-1.92) compared to non-shift workers. Risk of bias was moderate to low across studies. Heterogeneity was modest, and no significant publication bias was detected. Shift work is associated with a modestly increased risk of CKD. Circadian disruption and related metabolic disturbances may underlie this relationship. Given the widespread prevalence of shift work and the global burden of CKD, these findings support the need for targeted occupational health surveillance and preventive strategies for shift-working populations.
39. Health Equity in Undergraduate Prelicensure Nursing Education: Curricular Document Analysis.
期刊: The Journal of nursing education 发表日期: 2026-Feb 链接: PubMed
摘要
A nursing workforce who can provide effective and excellent care by addressing complex factors influencing health equity is needed. Education plays an important role in preparing nurses to take up this challenge; however, whether key health equity topics are included in nursing curriculum is largely unknown. Directed content analysis and descriptive statistics were conducted to describe if and to what extent health equity topics related to governance and policy, history and historic context, and cultural and social values were explicitly presented in curricular documents across three nursing programs. Health equity content was identified in many of the 197 course documents; however, the amount of content varied widely, and important areas to be strengthened were identified. There remains opportunity to center health equity as a focus in nursing curricula. The American Association of Colleges of Nursing Essentials is a timely framework for assessing and enhancing equity content.
40. Assessing human brucellosis infection rates in high-risk occupational groups.
期刊: Journal of infection in developing countries 发表日期: 2026-Jan-31 链接: PubMed
摘要
Human brucellosis is a significant zoonotic disease with a substantial public health impact, particularly among individuals in high-risk occupations such as veterinarians, farmers, and laboratory workers. Despite its global prevalence, data on the occupational risk of brucellosis, particularly in specific regions like the Kurdistan region, remains limited. This study aimed to investigate the prevalence of Brucella infections among different occupational groups in Erbil, Kurdistan. A cross-sectional study was conducted from July to December 2023, involving 350 human blood samples collected from participants with various occupations in Erbil. Brucella infection was assessed using the Rose Bengal Test (RBT) and bacterial culture method. The results were analyzed with a focus on the association between occupation, gender, residence, and age; with the prevalence of Brucella infection. The overall prevalence of Brucella infection was 10.9% by RBT and 8.9% by bacterial culture. Veterinarians and veterinary assistants had the highest infection rates (16.0% RBT, 14.0% culture). Gender and residence had no significant impact on infection rates, although rural residents exhibited slightly higher prevalence. The age group 31-40 years showed the highest positivity rates, but differences across age groups were not statistically significant. The prevalence of brucellosis in Erbil has remained stable over the past decade. High-risk occupations, particularly veterinarians and laboratory workers, require targeted preventive measures, including the use of personal protective equipment. This study emphasizes the need for enhanced occupational health strategies to reduce the risk of brucellosis in vulnerable groups.
41. Individual and interaction effects of health determinants on health-related quality of life in Korean adults aged 50-81 years: A causal Bayesian network analysis.
期刊: PloS one 发表日期: 2026 链接: PubMed
摘要
Health-related quality of life (HRQoL) reflects physical and mental well-being and is increasingly important in aging populations, yet traditional approaches often fail to capture the complex causal pathways among its determinants. We analyzed 2,566 adults aged 50-81 years from the Korean Genome and Epidemiology Study using the Short Form-12 (Physical Component Summary [PCS] and Mental Component Summary [MCS]). A causal Bayesian network was learned using the PC algorithm of Spirtes and Glymour with hierarchical constraints to ensure causal interpretability. We then estimated the causal effects of each variable on tail-defined outcomes-poor (bottom quartile) and good (top quartile) PCS and MCS-and quantified pairwise interaction effects. The network revealed how upstream factors propagate through direct and indirect pathways to shape HRQoL. Notably, PCS and MCS shared common upstream causes but showed no direct causal connection. Quantifying these causal pathways through relative risk (RR) estimates revealed the magnitude of individual factor effects. For poor PCS, severe insomnia (RR = 1.98), high stress (RR = 1.45), low physical activity (RR = 1.39), and multimorbidity (RR = 1.36) were the principal risk factors. For poor MCS, high stress (RR = 3.28) and severe insomnia (RR = 2.72) dominated. Notably, low BMI increased poor MCS risk (RR = 1.20), consistent with frailty pathways. The patterns for good outcomes largely mirrored these findings, with favorable levels showing protective effects. Interaction analyses revealed substantial synergistic effects: severe insomnia with high stress increased poor MCS probability by 6.44 percentage points (pp) beyond additivity, while high stress with physical inactivity added 4.77 pp. For good MCS, low insomnia with low stress (+4.72 pp) and low BMI with exercise (+4.21 pp) showed synergy, whereas stress with inactivity exhibited antagonism (-4.00 pp). These results support integrated interventions that combine sleep improvement, stress reduction, physical activity promotion, and multimorbidity management to improve HRQoL in aging populations.
42. Stakeholder perspectives on depression management: A design thinking exploration for person-centered digital health.
期刊: PloS one 发表日期: 2026 链接: PubMed
摘要
eHealth has the potential for managing depression and enhancing quality of life. Identifying end user needs and employing participatory methodologies that actively engage all stakeholders can improve user experience, usability and effectiveness. Six face-to-face empathy workshops were conducted in three Spanish autonomous communities (Catalonia, Andalusia and Canary Islands) using design thinking methodologies, involving individuals with depression and mental health professionals. Data were analyzed using an iterative and inductive analysis approach. To explore the perspectives of people diagnosed with depression and healthcare professionals involved in its management, using a design thinking methodology. Thirteen individuals with depression (10 women, average age 49.15, SD: 18.10) and 17 mental health professionals (11 women, average age 40.21, SD: 12.15) participated in empathy workshops. Three key themes emerged: the daily experience of depression, the potential of technology in managing depression, and emerging challenges to address. The intensity and daily experience of depressive episodes were influenced by various factors. Technologies, when used as a complement to face-to-face care, showed potential for managing depression. However, there were associated risks and challenges that need to be addressed. It is essential to identify and understand the needs of end users and incorporate the perspectives of all stakeholders in the design and development of digital health interventions.
43. "Being a man is like being put in a box": A qualitative study of adolescent boys' and young men's understanding and experiences of mental health in an urban community in South Africa.
期刊: PLOS mental health 发表日期: 2026 链接: PubMed
摘要
Adolescent boys and young men (ABYM) in South Africa face a high burden of unmet mental health needs but are often overlooked in research and practice. Economic and racial inequalities, masculine norms, and limited access to targeted mental health promotion services may hinder their ability to understand psychological distress, seek support, and engage with psychosocial services. This qualitative study explored how ABYM in Alexandra, South Africa, perceive and experience mental health, to inform future interventions. Semi-structured interviews were conducted with 24 participants, including 12 adolescent boys (ages 15-19) and 12 male youth mentors and staff from a local adolescent health organization. Interviews were analyzed using reflexive thematic analysis. Participants were often unfamiliar with the term mental health but described distress through everyday language grounded in social and emotional experience. Their conceptualizations of mental health were shaped by family and community environments, gendered expectations, and a mix of psychological and supernatural explanations. Rigid masculine norms associated mental health challenges with weakness, discouraged emotional expression and help-seeking, and placed early and significant pressure on boys to succeed in school or sports to make money and fulfil the male provider role. Despite these pressures, many participants expressed personal views that challenged dominant norms, for example, valuing emotional expression and open conversations with trusted adults or peers about mental health. However, stigma and a lack of youth- and male-friendly services remained significant barriers to accessing formal support. Our findings highlight the need for gender-sensitive, culturally grounded mental health programming for ABYM. Interventions should involve youth in design and delivery, build on familiar coping strategies, normalize emotional expression among boys, and promote the attributes of good mental health. Embedding support within community or recreational settings may reduce stigma, improve engagement, and strengthen adolescent boys’ mental health and well-being in low-resource urban contexts.
44. Recent Advances in Medicinal Plant Research for Mitigating Aluminium Toxicity.
期刊: Journal of environmental pathology, toxicology and oncology : official organ of the International Society for Environmental Toxicology and Cancer 发表日期: 2026 链接: PubMed
摘要
Aluminium is the third common metal of the earth, yet, it is physiologically non-essential and its higher levels on regular exposure can be harmful to the human body, affecting many vital organ systems. Environmental aluminium contamination and toxicity thereof is regarded as a ‘silent killer’ to the mankind as it is associated with the precipitation of several serious health complications chiefly involving nervous, blood and musculoskeletal systems. Various medicinal plants have been reported to possess aluminium toxicity ameliorative effects. A compilation of research published over the past 21 years on the protective properties of medicinal plants against the toxicity of aluminium is made. Thirty-four such plants reportedly have the ability to mitigate the toxicity of experimental aluminium in animals/cells/tissues leading to marked improvement of aluminium-induced pathophysiological complications, by multiple mechanisms; the prime typical modes inter alia are modulation of oxidative stress-inflammatory pathways and anti-cholinesterase activity. Thus, recent advances in this field of study may help to develop a potential nutraceutical or phytotherapeutic candidate against aluminium toxicity and neurodegenerative diseases for humans.
45. Sex and rank in public service hierarchies: Rank distribution in Ghana's health and security services.
期刊: PloS one 发表日期: 2026 链接: PubMed
摘要
This study analyses leadership patterns in Ghana’s health and security institutions since 1992, with a particular emphasis on the sex composition of senior positions in the Ghana Health Service, the Armed Forces, and the Police Service. A mixed-methods approach was employed, comprising a qualitative literature review, quantitative analysis of the Ghana Police Service rank hierarchies, assessment of the Military Occupational Physical Assessment Test in relation to Military Occupational Specialties, and content analysis of relevant sections of the Affirmative Action Act (2024). In 2025, women represented 39% of doctors (5,068/12,900), 30% of police officers (12,945/43,968), and 15% of soldiers (2,400/16,000) in Ghana. Leadership in the Ghana Armed Forces remained male-dominated, with fewer than five female Generals among 115 in the forces and only one female Inspector-General of Police since 1992. Statistical analysis of police rank distribution showed a significant association between sex and rank (χ², p < 0.05), indicating persistent disparities in career progression. Findings highlight systemic institutional barriers affecting women’s advancement in Ghana’s health and security sectors. Targeted institutional reforms aligned with the requirements and merit-based principles of the Affirmative Action Act (2024) are necessary to address the disparities and strengthen equitable representation.
46. Temporal relationship of suicide-related internet searches and suicide rates in Korea: A prewhitened cross-correlation analysis.
期刊: PloS one 发表日期: 2026 链接: PubMed
摘要
Suicide-related internet search patterns may reflect population-level behavioral responses to suicide risk. This study investigated the temporal associations between suicide-related internet search volumes and weekly suicide rates in Korea using rigorous time-series methodologies. Weekly suicide rates and search volumes for 25 suicide-related terms were obtained from national mortality records and Naver DataLab for two distinct periods: 2016-2019 and 2020-2023. Prewhitening was applied to mitigate spurious correlations, followed by cross-correlation analyses to assess temporal relationships at lags ranging from 0 to 8 weeks. Searches for “psychiatry” and “workplace stress” demonstrated consistent contemporaneous correlations across both study periods. During the 2020-2023 period, significant contemporaneous associations were also observed for prevention-related terms (e.g., “suicide crisis counseling,” “1577-0199,” “psychological counseling”), “fatigue,” “suicide urges,” and “suicide death benefit.” In contrast, “depression” exhibited a significant association only during the 2016-2019 period. Across all findings, the observed effect sizes were modest. Specific internet search terms, particularly those related to suicide prevention resources and occupational stress, exhibit temporal associations with population-level suicide rates. These findings suggest that monitoring online help-seeking behaviors and work-related stressors could serve as useful indicators for public health planning, although further research is required to elucidate underlying mechanisms and determine practical applications.
47. What is the perceived relationship between boredom and substance use among persons who are unhoused?
期刊: PLOS mental health 发表日期: 2026 链接: PubMed
摘要
While there is much research suggesting that there is an association between the experience of boredom and the use of substances, the mechanisms which govern this relationship are largely unknown. This study was employed to generate an enhanced understanding of the relationship between boredom and substance use among persons who are unhoused living in high-income nations. A secondary analysis of 18 qualitative interviews from persons experiencing homelessness was conducted utilizing reflexive thematic analysis. Sen’s Capabilities Approach was used as a framework to guide this abductive analysis. The central essence of participant interviews was: “idle hands here are the devil’s playground”. Within this essence, two themes were generated: 1) the contextual conditions influencing substance use; and 2) substances as an escape from boredom The experience of boredom was identified by participants as a factor that increased the propensity to engage in substance use. Numerous mechanisms influencing this relationship were identified. This study illustrates the importance of providing unhoused persons with opportunities to engage in meaningful activities to alleviate the boredom that factors so heavily into their lives. The findings of this research emphasize the importance of addressing boredom among persons experiencing homelessness and may be used to better inform policy, practice, and future research endeavors.
48. Unmasking the impact: Racial microaggressions and the health consequences for Latinas in the United States.
期刊: PLOS mental health 发表日期: 2025 链接: PubMed
摘要
Researchers conducted an exploratory analysis of the relationship between perceived racial microaggressions and physical and mental health outcomes among Latinas living in the United States. The history of discrimination in the US has created lasting health disparities. Racial microaggressions, subtle forms of discrimination directed towards people of color, have become ubiquitous in the U.S. Research focused on Latinas is limited. This study used a descriptive and analytical cross-sectional design, collecting data online from December 2021 to February 2022, using the Racial Microaggressions Scale (RMAS). A Canonical Correlation Analysis (CCA) was conducted using the six RMAS sub-scales (Foreigner, Sexualization, Criminality, Low Achieving, Invisibility and Environmental) and three DASS (Depression, Anxiety and Stress). The sample included 659 self-identified Latinas’ data representing 36 states. The full model was statistically significant Wilks’s λ = .907 criterion, F (18, 1887.05) = 3.65, p < .001. with the r2 type effect size was.093. Another CCA was conducted using the six microaggressions sub-scales previously mentioned as predictors of physical health outcomes using the Physical Health Questionnaire (PHQ) which has four sub-scales. This model was also statistically significant using the Wilks’s λ = .872 criterion, F(24, 2286.23) = 3.82, p < .001. This study found that perceived racial microaggressions in the forms of Low Achieving and Sexualization were associated with negative health outcomes for Latinas in the forms of increased anxiety, and gastrointestinal problems. In addition, when Environmental microaggressions are present the overall effects are lessened. In addition, when Environmental microaggressions are present the overall effects are lessened. Findings revealed that perceived racial microaggressions, particularly Low Achieving and Sexualization, are associated with negative health outcomes for Latinas, particularly including increased anxiety, and gastrointestinal issues, while Environmental microaggressions mitigated these effects.
49. Determinants of early mental health help-seeking among women in Bangladesh: A nationally representative bootstrapped regression analysis.
期刊: PLOS mental health 发表日期: 2025 链接: PubMed
摘要
Mental health is a critical public health concern, shaping emotional, psychological, and social well-being. Depression and anxiety are the most common and preventable mental disorders, can be significantly improved by early interventions and proper care. This study investigates help-seeking behavior at early stage (mild to moderate anxiety and depression) and its determinants among Bangladeshi women. Special focus is given to media exposure as a potential enabler of early support. We used Bangladesh Demographic and Health Survey (BDHS) data 2022 and utilized bootstrapped fixed-effect logistic regression model to detect the determinants. Only 20.8% of the women in this study (Weighted N = 3181) reported seeking help at least once. Compared to women with no education, those with secondary or higher education were respectively 1.41 and 1.55 times more likely to seek help (95% CI = 1.07 - 1.87 and 1.04 - 2.28 respectively)). In reference to Barisal, residents of Khulna (aOR = 2.76, 95% CI = 1.70-4.65) showed the highest increase in help-seeking odds. Working women had significantly greater odds of seeking help (aOR = 2.17, 95% CI: 1.52-3.07). Internet users were twice as likely to seek help (95% CI: 1.52-2.75), while smartphone users showed lower odds (aOR = 0.64, 95% CI: 0.46-0.88). Watching Television showed no significant (aOR = 1.08, 95% CI = 0.88, 1.36) impact on help-seeking behaviour. There are alarmingly low levels of help-seeking among Bangladeshi women facing early-stage anxiety and depression, with housewives being the least likely to seek support. Education, employment, decision making autonomy, and internet usage significantly influenced help-seeking behavior. Despite widespread access, television remains a neglected tool in mental health promotion. An integrated, culturally sensitive strategy with combination of mass media, peer support, equitable responsibilities, education, and policy have the potential to empower women and spark early help-seeking for mental health.
50. Psychotropic deprescribing across different prescribing professions in New Mexico and Louisiana.
期刊: PLOS mental health 发表日期: 2025 链接: PubMed
摘要
This study aimed to assess differences in the rates of deprescribing between prescribing psychologists, psychiatrists, and primary care physicians. MarketScan private insurance claims were used to develop a longitudinal active-comparator, prevalent-user cohort of patients who were treated with a psychotropic medication from psychologists, psychiatrists, or primary care physicians for at least 90 days in New Mexico or Louisiana (states where psychologists can prescribe) between 2005-2021. The type of provider (psychologist, psychiatrist, or primary care physicians) who prescribed the psychotropic medication was the exposure of interest. Three measures of deprescribing were used as outcomes: deprescribing without replacement, complete discontinuation of prescribing, or a sustained reduction in the prescribed days’ supply. Patient demographic and clinical characteristics during the six months prior to their initial prescription were measured as covariates. Inverse propensity of treatment weighting was used to adjust for baseline differences between provider groups, creating two weighted analytic cohorts with covariate balance: psychologists versus psychiatrists and psychologists versus primary care physicians. We estimated doubly-robust Cox Proportional Hazards models for each deprescribing measure in both cohorts. Prescribing psychologists deprescribed without replacement more than psychiatrists (Hazard ratio [95% CI] = 1.13 [1.06, 1.20]) and less than primary care physicians (0.73 [0.69, 0.78]). Conversely, they reduced the days’ supply less often than psychiatrists (0.79 [0.69, 0.91]) and more than primary care physicians (1.64 [1.42, 1.90]). There were no differences in complete discontinuation between provider types. Prescribing psychologists deprescribe at a rate between psychiatrists and primary care physicians. Findings varied depending on the deprescribing measure used, suggesting psychotropic-specific deprescribing measures are needed.
51. Lifestyle habits associated with elevated depressive symptoms among healthcare workers during the COVID-19 pandemic.
期刊: PLOS mental health 发表日期: 2025 链接: PubMed
摘要
This study sought to explore the relationship between lifestyle changes among healthcare workers during the COVID-19 pandemic and positivity on the Center for Epidemiologic Studies-Depression Scale (CES-D). We also hypothesized that physical inactivity which may have occurred under such behavioral restrictions would have had a particularly strong impact on CES-D positivity, and verified this hypothesis. This observational cohort study was carried out as a component of the mandatory health checkup program for employees at Juntendo University Hospital in Tokyo, Japan.in 2022. All 4,786 employees included in the study. Among them, 4700 valid responses and 4436 consents to the study were obtained. The prevalence of CES-D in 2022 was 32.5%, higher than that in 2019 before the COVID-19 pandemic (27.5%). Moreover, we summarized the 2022 employee variables for each CES-D result (negative vs. positive group). A notable difference was identified between the two groups concerning. age, sex, BMI, occupation, living alone, total working hours, and sleep duration. Logistic regression analysis was performed using the binary category as the outcome variable (i.e., CES-D positive findings). The factors related to positive CES-D that were not present in 2019 but only in 2022 were items such as “To smoke cigarettes” and “Less than 4,000 steps.” We obtained results that support our hypothesis, such as the possibility that the impact of the “new lifestyle” on step count could affect depressive symptoms. Additionally, we were able to obtain findings that suggest a relationship between the pandemic’s impact and depressive symptoms. When restrictions on movement are relaxed, immediate rebuilding of better lifestyle habits is necessary to maintain good mental health among healthcare workers.
52. Developing the Mental Health Sensitive School Concept: Insights from focus group discussions.
期刊: PLOS mental health 发表日期: 2025 链接: PubMed
摘要
The ongoing war has exacerbated mental health challenges among students and educators in Ukraine, placing increased strain on the psychological support system within schools. While school-based psychological services have been integrated into Ukraine’s education system since 1993, they remain underfunded, understaffed, and structurally isolated from broader school policies and external healthcare services (also, with no clear focus on mental health). This study explores the development of a Mental Health-Sensitive School Concept (MHSS), which seeks to integrate mental health considerations into educational environments using a systemic and participatory approach. A qualitative research design was employed, using 12 FGDs with 205 participants across five Ukrainian regions. The participant pool included school administrators, teachers, psychologists, social pedagogues, and students. Discussions focused on mental health awareness, intervention feasibility, implementation barriers, and stakeholder roles. Thematic analysis was applied to synthesise key findings. Stakeholders strongly supported integrating mental health initiatives within school policies but highlighted critical challenges such as limited resources, staff burnout, stigma, and a lack of structured mental health training for teachers. Key thematic areas identified included mental health awareness and stigma reduction, school-based interventions, policy development, capacity-building, and adaptation to crisis contexts. The study emphasised the need for structured policy support, expanded psychological services, and improved teacher training to foster a sustainable and trauma-informed MHSS framework. The findings underscore the urgent need for systemic reforms to embed mental health considerations into school environments. The study proposes a tiered intervention model encompassing mental health promotion, prevention, early psychological support, and structured referral mechanisms. Successful implementation will require policy endorsement, financial investment, and multi-stakeholder collaboration. Future research should evaluate the long-term impact of the MHSS on student and educator well-being.
53. Mental health and addiction concerns in northern Ontario: A cross-sectional study of sociodemographic predictors, access barriers, and service needs.
期刊: PLOS mental health 发表日期: 2025 链接: PubMed
摘要
Access to mental health and/or addiction (MHA) services is limited in rural and remote regions, especially in geographically diverse areas such as Ontario, Canada. Moreover, available services may not be able to address the unique needs of those seeking support. To effectively address local MHA service needs, it is necessary to understand predictors of MHA concerns and the experiences of those accessing care in rural areas such as northern Ontario. The current study focused on individuals living in northern Ontario and aimed to 1. Identify sociodemographic factors that predict their MHA concerns; 2. Identify common barriers experienced by those seeking MHA services; and 3. Explore their MHA support needs. Survey data were collected online from 500 northern Ontario residents (aged 18+) between January and March 2022. Univariate statistics were used to describe MHA service access, barriers, and needs, and adjusted multiple logistic regression was conducted to assess predictors of MHA concerns. Younger age (Odds Ratio (OR) = 0.972), low socioeconomic status (middle: OR = 0.491; high: OR = 0.436), identifying as non-straight/non-heterosexual (straight/heterosexual: OR = 0.336), identifying as married (unmarried: OR = 0.507), and dissatisfaction with social support (OR = 6.410) were significant predictors of MHA concerns. Although most (76.8%) of the sample reported MHA concerns, less than a quarter of the sample accessed support. Most frequently accessed services tended to be less specialized, and most frequently reported access barriers were mainly systemic. The current study describes predictors of MHA concern as well as the unique MHA-service-related experiences and needs of northern Ontario residents. These findings may be considered in efforts to develop MHA tools and supports that align with local needs.
54. Mental health burden among healthcare workers in Kintampo North Municipal Hospital: A descriptive analysis of stress, depression, and anxiety based on Job Demands-Resources (JD-R) model.
期刊: PLOS mental health 发表日期: 2025 链接: PubMed
摘要
Mental health disorders among healthcare workers remain a growing concern, particularly in under-researched settings. While global evidence has documented the burden of these disorders, there is limited empirical data from Kintampo North Municipality. This study assessed the prevalence and correlates of stress, depression, and anxiety among health workers in Kintampo North Municipal Hospital. A hospital-based cross-sectional study involving 316 healthcare workers was conducted at Kintampo North Municipal Hospital. Standardised tools, including the Perceived Stress Scale (PSS-10), Beck Depression Inventory (BDI-21), and Beck Anxiety Inventory (BAI-21), were used to assess stress, depression, and anxiety, respectively. Descriptive statistics, Pearson’s chi-square tests, and multivariate logistic regression analyses were performed using STATA 17. Variables with p ≤ 0.25 in the bivariate model were included in the multivariate model. Adjusted odds ratios (AORs) with 95% confidence intervals (CIs) were reported at a significance level of p < 0. 05. The prevalence of clinically significant stress, depression, and anxiety was 66.5% (95% CI: 61.20 - 71.70), 63.6% (95% CI: 58.30 - 68.90), and 87.9% (95% CI: 84.40 - 91.60), respectively. Key correlates across all the three mental health disorders included job dissatisfaction, rotational shifts, increased workload, chronic illness, alcohol consumption, extended working hours, limited sleep, male gender, and specific occupational roles such as nurses, allied health personnel, physicians, emergency medical technicians, and dispensary technicians. The high burden of the three mental health disorders among healthcare workers in Kintampo North Municipal Hospital highlights deep systemic and occupational challenges within the health system. While these findings point to the resilience of staff working under resource constraints, they also signal the need for targeted institutional reforms. Expanding access to workplace mental health support, ensuring flexible scheduling, reducing mandatory overtime, and addressing job dissatisfaction and workload inequities could be essential to foster a healthier, more sustainable healthcare workforce in Ghana and similar contexts.