公共卫生研究摘要 (2026-02-11)
共收录 50 篇研究文章
1. Timing and Intensity of Rehabilitation Services During Acute Stroke Hospitalization: Impacts on Functional Recovery and Community Discharge.
期刊: The American journal of occupational therapy : official publication of the American Occupational Therapy Association 发表日期: 2026-Mar-01 链接: PubMed
摘要
Improving functional recovery and supporting safe discharge pathways after stroke are key priorities in acute care, yet the delivery of rehabilitation services during hospitalization remains poorly understood. To examine the associations between rehabilitation service delivery factors and two outcomes, functional status at discharge and community discharge. Retrospective observational study using electronic medical record (EMR) data (2018-2021). Regression analyses were stratified by occupational therapy (OT) and physical therapy (PT) cohorts. Thirteen-hospital health system in Colorado. Adults hospitalized with ischemic stroke who received occupational therapy (n = 713) or physical therapy (n = 979). Primary outcomes were (1) discharge function using Activity Measure for Post-Acute Care “6-Clicks” scores and (2) community discharge (yes or no). Independent variables included time to evaluation, time to treatment, and daily therapy intensity. Among OT recipients, each additional day of delay between evaluation and the first therapy session was associated with lower odds of community discharge (odds ratio [OR] = 0.927, p = .032) whereas greater therapy intensity was associated with higher odds (OR = 1.396, p = .034). These same factors were also associated with higher discharge function (p < .05). In the PT model, earlier evaluation was significantly associated with improved discharge mobility (p = .006), although no other therapy factors were significant. Findings suggest that timely and intensive OT services during acute hospitalization may improve functional outcomes and increase community discharge rates. EMR-derived therapy metrics provide clinically relevant insight and may inform hospital-based rehabilitation strategies. Plain-Language Summary: This study looked at how early and intensive occupational therapy during a hospital stay for stroke affects a person’s ability to function and return home. Using hospital records from more than 1,600 patients, the study found that patients who received earlier and more intense OT were more likely to regain independence and go home rather than to a facility. These results suggest that not just receiving therapy but how and when it is delivered plays a big role in recovery. This could help hospitals better support patients during stroke recovery.
2. Effects of the Color Narrative Preventive Intervention Using Occupational Storytelling: A Randomized Controlled Trial.
期刊: The American journal of occupational therapy : official publication of the American Occupational Therapy Association 发表日期: 2026-Mar-01 链接: PubMed
摘要
Enhancing purpose in life is vital in cognitive interventions for older adults, yet its application in occupational therapy remains limited. To evaluate the effectiveness of the occupation-focused Color Narrative program compared with common Japanese community-based preventive care. Randomized controlled trial. Community centers. Community-dwelling older adults (N = 44). The Color Narrative program included group-based storytelling using 100 color cards as prompts (90 min), independent engagement in meaningful occupations (3 mo), and group reflection (90 min). Control participants attended health education and group recreational activities (90 min each). Primary outcomes included cognitive function (Mini-Mental State Examination- Japanese version [MMSE-J]) and purpose in life (Life Engagement Test [LET]). Secondary outcomes included domain-specific cognitive functions (Digit Span, Tapping Span, Symbol Search, Wisconsin Card Sorting Test), meaning in life (Meaning in Life Questionnaire-Short Form), functional status (FRAIL Scale, Frenchay Activities Index, 12-item Short-Form Health Survey). A two-way analysis of variance showed significant interactions for MMSE-J, F(1.76, 73.89) = 4.531, p = .017, η2p = .097, and LET, F(1.56, 58.78) = 8.743, p = .001, η2p = .172. Post hoc tests revealed declined and stable MMSE-J scores in the control and intervention groups, respectively (corrected p = .031, Cohen’s d = 0.80). LET scores increased in the intervention group (corrected p = .041, Cohen’s d = 0.78). The Color Narrative program enhanced purpose and prevented cognitive decline, highlighting the significance of occupational therapy in preventive care. Plain-Language Summary: This study investigated the impact of the Color Narrative program on improving cognitive health and a sense of purpose in life among older adults. The program included group-based storytelling using 100 color cards as visual prompts, personalized goal setting, and independent engagement in meaningful occupations over 3 mo, followed by a group reflection session. Compared with individuals who participated in a standard community-based health education and recreation program, the participants in this program maintained cognitive function and reported an increased sense of purpose. The findings revealed the significance of maintaining cognitive function and purpose in life in improving older adults’ overall well-being. These findings highlight the unique role of occupational therapy, especially the Color Narrative program, in promoting preventive care and supporting healthy aging within communities.
3. Addressing Climate Change Impacts on Vector-Borne Infectious Diseases: Can Artificial Intelligence Help?
期刊: The American journal of tropical medicine and hygiene 发表日期: 2026-Feb-10 链接: PubMed
摘要
Human-induced climate change caused by fossil fuel-derived greenhouse gas emissions has disrupted global ecosystems, shifted disease-vector populations, and expanded vector-borne diseases into previously unaffected areas. As these changes occur, traditional epidemiological surveillance and control mechanisms face major challenges. Artificial intelligence (AI) is an emerging technology in epidemiology and public health that offers the promise of analyzing and interpreting vast datasets far more comprehensively than traditional methods. In this manuscript, we examine how artificial intelligence can enhance vector-borne disease prediction and surveillance, strengthen vector control and public health response, and support clinical and laboratory diagnostic capabilities in the context of a changing climate. Despite its environmental trade-offs, AI offers transformative potential to help humanity adapt to the coming climate impacts on infectious diseases.
4. Association of Climate Variables with Plasmodium vivax and Plasmodium falciparum Malaria Cases in Mandoto, Madagascar: A Statistical Modeling Study.
期刊: The American journal of tropical medicine and hygiene 发表日期: 2026-Feb-10 链接: PubMed
摘要
The Mandoto District in the central highlands of Madagascar experiences year-round transmission of Plasmodium vivax (P. vivax) and Plasmodium falciparum (P. falciparum). Monthly malaria case data from 27 health centers across Mandoto between 2019 and 2024 were analyzed alongside meteorological data to understand transmission dynamics and forecast potential influences of climate change using descriptive, cross-correlation, and seasonal autoregressive integrated moving average forecast models. Over a period of 6 years, 276,318 rapid diagnostic tests (RDTs) were performed, yielding a 39.6% positivity rate, totaling 109,428 malaria cases. After 2021, when multispecies RDTs became available, 71.5% of cases were attributed to P. falciparum, and 28.5% were attributed to P. vivax. Both species were co-endemic across all health centers, with the western region experiencing a higher transmission risk. Malaria cases peaked in January, with a second peak from April to June after the rainy season, and declined between July and September. Precipitation and temperature effectively revealed the seasonality of malaria dynamics, thereby improving model accuracy. Plasmodium falciparum exhibited stronger associations with precipitation and temperature variability. The present study highlights that combining time-series modeling with precipitation and temperature data can help predict malaria cases and support timely planning and resource allocation.
5. Clinical Group Students/Trainees Essay Contest Winner "A Rising Leader: Bangladesh".
期刊: The American journal of tropical medicine and hygiene 发表日期: 2026-Feb-10 链接: PubMed
摘要
The American Committee on Clinical Tropical Medicine and Travelers’ Health’s Students/Trainees Leadership Group launched their essay contest in 2025 to encourage the involvement of emerging voices in tropical medicine in key issues shaping the field’s present and future. The following authors’ won for their essay addressing the following prompt: “the role of international cooperation in combating tropical diseases.” These essays were reviewed by a panel of clinician judges with experience in tropical medicine and writing, and the winning entries reflect both academic excellence and practical insight. Together, the two winning essays show the wide scope of tropical medicine from policy and prevention to diagnosis and treatment and the shared responsibility to confront these challenges wherever they arise.
6. Exploring Self-Management-Based Mobile Health User Typologies and Associations Between User Types and Satisfaction With Key Mobile Health Functions: Comparative Study of Various Fitness and Weight Management App User Types.
期刊: JMIR medical informatics 发表日期: 2026-Feb-10 链接: PubMed
摘要
Exploring user satisfaction is crucial for enhancing and ensuring the sustainable development of mobile health (mHealth) apps, particularly in the fitness and weight management sectors. Analyzing user types and developing user profiles are valuable for understanding differences in satisfaction. However, prior research lacks a classification of user types based on self-management characteristics and an analysis of satisfaction disparities among these types. This study analyzes user heterogeneity from a self-management perspective among fitness and weight management app users by identifying user types and constructing profiles. It further explores differences in satisfaction with the functional design of these mHealth apps across user types. First, 8 feature indicators were selected based on the Health Belief Model and the Behavior Change Wheel to evaluate users’ levels of health knowledge and beliefs, as well as self-regulation related to self-management. Existing research was integrated to categorize mHealth app functional design into 5 categories: health guidance, health education, health monitoring, social features, and gamification. Second, a questionnaire survey was used to collect data on users’ 8 health management characteristics and their satisfaction with the 5 functional design categories. A total of 2518 responses were collected, of which 1025 were included in the analysis. Cluster analysis was conducted to classify users into distinct types based on the 8 health management characteristics, and user profiles were constructed according to the distribution of these characteristics within each type. Finally, the Kruskal-Wallis test was used to analyze differences in satisfaction across user types with respect to the 5 functional design categories of mHealth apps. Cluster analysis revealed that users could be categorized into 6 types based on the 8 self-management characteristics: positively proactive energizers, proactive intenders, negatively proactive energizers, low health management demanders, potential health management demanders, and passive attitude holders. Significant differences were observed across all 8 health management characteristics among the 6 user types (all P<.001). The Kruskal-Wallis test indicated significant variations in user satisfaction with the 5 functional designs of mHealth apps: H(4)=445.388, (P<.001). Overall, users reported the highest satisfaction with health guidance and health monitoring (median 4.00, IQR 1.00) and the lowest satisfaction with gamification (median 3.00, IQR 1.00). Positively proactive energizers, proactive intenders, and negatively proactive energizers demonstrated the highest satisfaction with health education and health guidance (median 4.00). Potential health management demanders, proactive intenders, positively proactive energizers, and negatively proactive energizers reported the highest satisfaction with health monitoring (median 4.00). Proactive intenders reported the highest satisfaction with social features and gamification (median 4.00). Users of mHealth apps exhibit diverse types, with significant differences in health management characteristics and satisfaction with the 5 functional designs of fitness and weight management apps. This study clarifies individual-level differences in user satisfaction with mHealth apps.
7. Decomposition of socioeconomic inequalities in fruit and vegetable consumption in Pakistan: A 20-Year analysis using copula-based decomposition.
期刊: Biodemography and social biology 发表日期: 2026-Feb-10 链接: PubMed
摘要
This study examines changes in fruit and vegetable consumption (FVC) across socioeconomic groups in Pakistan over two decades, using data from the Household Integrated Income and Consumption Surveys (HIICS) conducted in 1998-99 and 2018-19. Using a copula-based decomposition approach, the study disaggregates FVC inequality into structure and composition effects. The findings show an average per capita increase of 120.88 grams in FVC, with gains of 23.41, 20.86, and 153.31 grams at the 10th, 50th, and 90th percentiles, respectively. This favorable change was mainly driven by compositional effects, particularly shifts in household income, size, and education. While higher income and larger households are positively associated with FVC, the education of the household head shows a negative association, warranting further investigation. To improve dietary quality and reduce the risk of chronic disease, the findings underscore that policy efforts should focus on income enhancement, targeted nutrition education - especially for larger households - and correcting misperceptions about the health benefits of fruits and vegetables. The findings suggest that policymakers should raise household income, promote nutrition education, and introduce fair food subsidies.
8. Telemedicine versus in-person primary care visits for upper respiratory infections: Comparison of antibiotic prescribing.
期刊: Journal of telemedicine and telecare 发表日期: 2026-Feb-10 链接: PubMed
摘要
IntroductionAntibiotic resistance is a growing public health threat, resulting in challenges in effectively treating bacterial infections. Primary care providers account for the majority of antibiotic prescriptions, highlighting their critical role in antimicrobial stewardship. As telemedicine becomes more prevalent in primary care, there is limited data on how this shift has influenced antibiotic prescribing behavior. Our objective was to examine differences in antibiotic prescription rates for upper respiratory infections (URIs) between in-person and telemedicine appointments in a large primary care health system.MethodsIn this retrospective cohort study, we included patients 18 years and older treated in primary care clinics in the Greater Atlanta area from May 2020 to September 2023. Eligible encounters were billed with a diagnostic code related to URI. The main measures included patient demographics, insurance status, and visit modality. A multivariable logistic regression model evaluated differences in antibiotic prescriptions by visit type.ResultsThere were 33,008 (66%) in-person visits and 16,965 (33.9%) telemedicine visits, totaling 49,973 encounters. The average age of patients was 56.8 (SD 17.5) years, 67.1% patients were female, and 37.6% were Black. There were no significant differences in antibiotic prescribing between telemedicine and in-person appointments (adjusted odds ratio 1.00, 95% CI 0.14-4.86, P > 0.5).DiscussionRates of antibiotic prescribing did not differ significantly between in-person and telemedicine primary care visits for URI. As a healthcare quality indicator, this result provides evidence that in-person and telemedicine appointments are comparable modalities of patient care.
9. Systematic assessment of obesity-related risk factors in renal cancer etiology: A longitudinal risk and mendelian randomization analysis.
期刊: PLoS medicine 发表日期: 2026-Feb-10 链接: PubMed
摘要
Excess body adiposity is an established cause of renal cancer, but underlying molecular pathways mediating this relationship remain unclear. This study aimed to systematically evaluate a panel of obesity-related risk factors as potential mediators in renal cancer etiology. We used two complementary approaches to evaluate obesity-related risk factors in renal cancer etiology: (i) direct risk factor assessment in longitudinal cohorts and (ii) genetically proxied risk factors through two-sample mendelian randomization (MR). Direct risk-factor association-analyses (i.e., cohort analyses) were based on the UK Biobank cohort study (472,337 cohort participants, including 1,382 incident renal cancer cases diagnosed during 5,586,414 person years of follow-up) and the Northern Sweden Health and Disease Study (NSHDS) for fasting insulin (204 pairs of cases and controls, ongoing recruitment and follow-up since 1985). We used Cox proportional hazards regression models to evaluate the association between risk factors and renal cancer risk with adjustment for age, sex, center of recruitment, education, smoking and alcohol drinking status. Two-sample MR analyses were based on a genome-wide association study (GWAS) of renal cancer (27,213 cases, 486,846 controls). We used the inverse-variance weighted (IVW) approach to estimate the association between risk factors and renal cancer risk. Mediation analyses were performed for traits displaying directionally consistent associations with renal cancer risk in both the cohort and MR analyses using the product method. We found consistent positive associations with renal cancer risk for fasting insulin (odds ratio per standard deviation increment [ORMR]: 2.24, 95% confidence interval [95% CI]: 1.19, 4.22; p = 0.01; hazard ratio per standard deviation increment [HRcohort]: 1.43, 95% CI: 1.02, 2.00; p = 0.04), triglycerides (ORMR: 1.11, 95% CI: 1.05, 1.17; p < 0.001, HRcohort: 1.23, 95% CI: 1.11, 1.38; p < 0.001), diastolic blood pressure (DBP) (ORMR: 1.14, 95% CI: 1.04, 1.26; p < 0.001, HRcohort: 1.11, 95% CI: 1.05, 1.17; p < 0.001) and consistent inverse associations with renal cancer risk for sex-hormone binding globulin (SHBG) (ORMR: 0.80, 95% CI: 0.70, 0.90; p < 0.001, HRcohort: 0.67, 95% CI: 0.58, 0.76; p < 0.001) and high-density lipoprotein (HDL) cholesterol (ORMR: 0.93, 95% CI: 0.88, 0.98; p < 0.001, HRcohort: 0.72, 95% CI: 0.66, 0.77; p < 0.001). The main limitation of this study was that we had limited statistical power to evaluate some risk factors. Our study highlights roles for fasting insulin, HDL cholesterol, DBP, triglycerides and SHBG in mediating the relationship between body adiposity and renal cancer risk.
10. Evaluating the Effectiveness of the Motivational Interviewing-Based Wellness Coaching for Kids and Families (WC4K) Program in Pediatric Obesity Care: Protocol for a Cluster Randomized Pragmatic Trial.
期刊: JMIR research protocols 发表日期: 2026-Feb-10 链接: PubMed
摘要
The increasing prevalence of severe obesity among youth and the early onset of comorbidities highlight the urgent need for effective solutions to support behavior and lifestyle changes. Motivational interviewing (MI), a client-centered counseling technique, has shown promise in improving obesity-related outcomes and is now recommended by the American Academy of Pediatrics as a key component of behavioral interventions for children with overweight and obesity. This study aimed to describe the design and baseline characteristics of the Wellness Coaching for Kids and Families (WC4K) program, an MI-based behavioral health intervention integrated into pediatric primary care within a large integrated health care system. This trial aims to inform broader implementation strategies for other health care systems. We are conducting a cluster randomized pragmatic trial across 50 pediatric clinics within Kaiser Permanente Southern California. Clinics were randomized to either the intervention arm (n=24, 48.00%) or the usual care arm (n=26, 52.00%), targeting children aged between 3 and 8 years with overweight or obesity. Pediatricians in intervention clinics received MI training and referred families to centralized health coaches for tailored telephone counseling. Key behavioral targets include increased fruit and vegetable intake, reduced consumption of sugar-sweetened beverages, increased physical activity, and reduced screen time. The primary outcome is a change in BMI-for-age, measured as relative distance from the median using electronic medical record data. Secondary outcomes include parent-reported behavior change indicators. The source population includes 150,482 children from clinics serving predominantly low-income and racial and ethnic minority populations. After randomization, intervention and control clinics were similar in demographics (standardized mean differences <0.2 for key variables), with 77,481 (51.49%) children in the WC4K intervention clinics and 73,001 (48.51%) children in the control clinics. In the total clinic population, 36.58% (55,052/150,482) of the children were overweight or with obesity. Enrollment started in fall 2022, study results are expected in spring 2027. If the trial results indicate success in reducing BMI and improving health behaviors, WC4K may offer a scalable and sustainable model for integrating behavioral health coaching into pediatric primary care. By leveraging MI-trained pediatricians and centralized health coaching, WC4K has the potential to facilitate meaningful lifestyle changes in children with overweight or obesity. ClinicalTrials.gov NCT05143697; https://clinicaltrials.gov/study/NCT05143697. DERR1-10.2196/78792.
11. Effect of Du-Moxibustion Combined With Spine-Pinching Therapy on Cognitive Frailty in Older Adults With Prefrailty: Protocol for a Randomized Controlled Trial.
期刊: JMIR research protocols 发表日期: 2026-Feb-10 链接: PubMed
摘要
Cognitive frailty (CF), characterized by the coexistence of mild cognitive impairment and physical frailty in the absence of dementia or other neurodegenerative diseases, is a significant risk factor for dementia and functional decline in older adults. Although Du-moxibustion has shown potential benefits in improving CF, the effect of spine-pinching therapy remains underexplored. This study aims to evaluate, for the first time, the efficacy and safety of Du-moxibustion combined with spine-pinching therapy in older adults with prefrailty and CF. This is a prospective, single-center, randomized, single-blind, 4-arm parallel controlled trial. A total of 156 older adults with prefrailty and CF will be recruited and randomly assigned to 1 of 4 groups: routine care group, Du-moxibustion group, spine-pinching group, or combined intervention group. The intervention will last for 8 weeks. The primary outcome is the change in Montreal Cognitive Assessment score. Secondary outcomes include the Fried frailty phenotype, Barthel Index (activities of daily living), 15-item Geriatric Depression Scale, 36-item Short Form Health Survey, global frailty status, and traditional Chinese medicine syndrome scores. Outcome assessments will be performed at baseline (wk 0), midintervention (wk 6), postintervention (wk 8), and follow-up (wk 12). Recruitment for this study is scheduled to commence in March 2026 and will end in June 2027 (recruitment and intervention). All follow-up and data collection activities will be finalized by October 2027. Results are anticipated to be completed in the first quarter of 2028. This study is expected to provide high-quality evidence for the clinical efficacy of Du-moxibustion combined with spine-pinching therapy in managing CF and contribute to the integration of traditional Chinese medicine external therapies in the promotion of healthy aging. Although the single-blind design may introduce expectancy bias, strict randomization procedures and standardized interventions will enhance the reliability and scientific rigor of the results.
12. Gaps in dengue fever knowledge, attitude, and practices amonghealthcare professionals in southeastern Iran.
期刊: PLoS neglected tropical diseases 发表日期: 2026-Feb-10 链接: PubMed
摘要
Dengue fever (DF) is one of the most important arboviral diseases and causes significant morbidity and mortality worldwide. Healthcare professionals (HCPs) play a crucial role in the prevention, diagnosis, and control of DF. This study aims to assess the knowledge, attitude, and practices (KAP) of HCPs regarding DF management in Kerman Province, southeastern Iran. This cross-sectional analytical study was conducted from April to August 2024 in Kerman Province, southeastern Iran. Healthcare professionals (HCPs) from different occupational categories participated. Data were collected using a Persian online questionnaire (www.porsline.ir) covering demographic characteristics and KAP related to DF. The survey link was distributed via social media, email, and official channels. Data were analyzed using SPSS version 24, applying descriptive statistics and multivariable logistic regression, with statistical significance set at α = 0.05. A total of 307 HCPs participated, with most being female (73.9%) and aged 30-49 years (66.1%). Overall, 30.9% of participants demonstrated a high level of knowledge, with the highest proportion observed among central-level health professionals (41.4%). Additionally, 66.1% and 92.2% of participants scored favorable attitude and practices toward DF, respectively. Multivariable analysis showed that central-level HCPs had significantly higher odds of having good knowledge compared to peripheral staff (AOR: 2.12, 95% CI: 1.06-4.25, P = 0.03). This study revealed moderate knowledge but generally positive attitudes and strong preventive practices among HCPs in Kerman Province. Significant gaps were identified in transmission and vector control as well as inappropriate prescribing knowledge, underscoring the need for continuous medical education and dissemination of updated treatment guidelines. While central-level staff demonstrated higher knowledge, peripheral-level staff and specialists showed notable deficiencies, highlighting the importance of tailored training initiatives. Strengthening diagnostic confidence, community engagement skills, and evidence-based clinical management will be essential to enhance preparedness and ensure effective dengue prevention and control in this high‑risk region.
13. Comparative Cost-Effectiveness Analysis of Multiple First-Line Treatments for HER2-Negative Unresectable Advanced or Recurrent Gastric Cancer in Japan.
期刊: PharmacoEconomics - open 发表日期: 2026-Feb-10 链接: PubMed
摘要
HER2-negative unresectable advanced or recurrent gastric cancer (GC) has a poor prognosis. This study evaluated the comparative cost-effectiveness of multiple first-line treatment options from the Japanese healthcare payer perspective. A partitioned survival model was developed to estimate the cost-effectiveness of each regimen. Hazard ratios were derived from a network meta-analysis to project long-term costs and quality-adjusted life years (QALYs) gained. Regimens included pembrolizumab plus chemotherapy (Pem + Chemo); zolbetuximab plus chemotherapy (Zolb + Chemo); nivolumab plus chemotherapy (NIVO + Chemo); 5-fluorouracil, oxaliplatin, and levofolinate (FOLFOX); capecitabine and oxaliplatin (CapeOx); S-1 and oxaliplatin (SOX), capecitabine and cisplatin (Cape + CDDP); and S-1 and cisplatin (S-1 + CDDP). Cost parameters were obtained from a Japanese medical claims database. Incremental cost-effectiveness ratios (ICERs) were calculated for each regimen. Sensitivity analyses were conducted to assess parameter uncertainty. Scenario analysis was conducted by incorporating tislelizumab, which is approved and recommended in countries outside Japan. On the basis of the base-case analysis, CapeOx, SOX, Pem + Chemo (5-FU + CDDP, CapeOx), and Zolb + CapeOx were located on the efficiency frontier. The ICER of SOX versus CapeOx was USD 85,649/QALY. Pem + Chemo versus SOX had an ICER of USD 345,103/QALY. Zolb + CapeOx versus Pem + Chemo had an ICER of USD 1,637,571/QALY. Probabilistic sensitivity analysis showed SOX had the highest probability (40.33%) of being the most cost-effective. At a willingness-to-pay threshold of USD 100,000/QALY (Japan’s HTA upper reference), SOX was identified as the most cost-effective first-line treatment for HER2-negative unresectable advanced or recurrent GC in Japan.
14. Effect of a law amendment on dosimeter wearing in medical radiation workers: observational study.
期刊: Insights into imaging 发表日期: 2026-Feb-10 链接: PubMed
摘要
To evaluate the impact of a law amendment that reduced the eye lens dose limit on the use of personal dosimeters among radiation workers in medical settings. A repeated cross-sectional survey was conducted at medical institutions across three periods: before the law amendment (control) and during the promulgation and implementation periods. Surveyors (radiological technologists) at each participating medical institution recorded dosimeter-wearing status among radiation workers. Data were collected via mail or email and analysed. The observed workers included physicians, nurses, and radiological technologists. The surveys were collected from 1194 workers in the control period, 1374 in the promulgation period, and 1194 in the implementation period, totalling 3762 workers. Post-law amendment, the overall wearing rate of primary personal dosimeters significantly increased from 64.6% to 77.9% (p < 0.001). Significant increases in wearing rates were observed among physicians and radiological technologists (p < 0.001). Among occupations, physicians showed the lowest wearing rates across all periods (control: 35.8%, promulgation: 56.7%, implementation: 62.6%), whereas radiological technologists showed the highest (control: 92.7%, promulgation: 98.5%, implementation: 99.5%). Regarding physician specialities, orthopaedic surgery exhibited the lowest compliance (control: 11.3%, promulgation: 35.4%, implementation: 24.7%). The proportion of workers without provision of a personal dosimeter declined from 5.9% to 1.9% (p < 0.001). Despite overall improvement following the law amendment, low compliance among physicians, particularly in orthopaedics, indicates the need for targeted interventions. Although dosimeter-wearing rates improved after Japan’s eye dose limit revision, persistent low physician compliance-especially in orthopaedics-highlights the need for targeted strategies to strengthen radiation protection in clinical practice. The effect of reduced eye dose limits on dosimeter use remains unclear. Personal dosimeter usage increased significantly after the law amendment. Compliance remained low among orthopaedic physicians despite regulatory tightening. Targeted interventions are needed for low-compliance groups to ensure radiation protection.
15. Strategies for Identifying Core Components of Programs: an Exploratory Descriptive Component Case Study of a Teen Pregnancy Prevention Program.
期刊: Prevention science : the official journal of the Society for Prevention Research 发表日期: 2026-Feb-10 链接: PubMed
摘要
Studies of program components (i.e., the ingredients that make up programs) have risen from obscurity to join mainstream program evaluation approaches over the last two decades. Researchers and policymakers are interested in leveraging information about the effectiveness of program components to better address the needs of programs’ intended populations and reduce disparities in outcomes. Identifying which components are responsible for improving outcomes can inform evaluation design, measurement, and the state of the evidence as well as program development, adaptation, fidelity, and scale-up. This paper summarizes strategies for conducting components research, and anchors those emerging best practices in a components case study of a teen pregnancy prevention program. It offers applied guidance on ways to define and operationalize components, and best practices in measurement and analysis that have emerged from this work. This paper will help guide the prevention field toward conducting more and better research that yields consensus about which components are most important for program effectiveness.
16. In Vitro Percutaneous Absorption of Dehydroacetic Acid and Benzoic Acid From Pig Skin Using the Franz Diffusion Cell System.
期刊: Journal of applied toxicology : JAT 发表日期: 2026-Feb-10 链接: PubMed
摘要
Dehydroacetic acid (DA) and benzoic acid (BA) are used as preservative agents in cosmetics in Korea at maximum concentrations of 0.6% and 0.5%, respectively. Prior to conducting the percutaneous absorption study, analytical methods were developed and validated for the quantification of DA and BA in various matrices including swab (SW), stratum corneum (SC), full-thickness skin (dermis + epidermis, SK), and receptor fluid (RF). These methods demonstrated excellent linearity (r2 = 0.9992-0.9998 for DA, 0.9996-0.9999 for BA), high accuracy (91.53%-111.70% and 96.04%-101.47%), and acceptable precision (1.90%-10.16% and 1.30%-5.48%), in accordance with regulatory validation guidelines. Percutaneous absorption was evaluated using a Franz diffusion cell system with dermatomed dorsal minipig skin. Lotion formulations containing DA (0.12%, 0.24%, and 0.6%) and BA (0.1%, 0.2%, and 0.5%) were topically applied at 10 mg/cm2. After 24 h of exposure, concentrations of each compound in the matrices were quantified using liquid chromatography-tandem mass spectrometry (LC-MS/MS). The total percutaneous absorption rates of DA were 104.13% ± 5.86%, 91.42% ± 4.05%, and 101.18% ± 7.82% for the 0.12%, 0.24%, and 0.6% formulations, respectively. For BA, the corresponding absorption rates were 65.85% ± 5.80%, 51.54% ± 8.97%, and 79.10% ± 5.65%. This indicates that DA and BA were mostly absorbed through the skin within the permitted concentration limits, suggesting that consideration of skin absorption rate is important when evaluating the safety of preservative exposure through the skin.
17. Multiomics Insights into the Ecotoxicological Effects of Soil Microplastics on Crop Plants.
期刊: Journal of agricultural and food chemistry 发表日期: 2026-Feb-10 链接: PubMed
摘要
Microplastics (MPs) have become pervasive contaminants. This is due to plastic mulching, wastewater irrigation, and sludge application. Concentrations of MPs in intensive farming regions have been recorded at 41,741 particles/kg. MPs are absorbed by crop roots and leaves and then travel to reproductive organs. In these organs, they cause oxidative stress, genotoxicity, and toxicity, which disrupts nutrient uptake, photosynthesis, and crop yield. This review summarizes 20 years (2003-2024) of studies on MP-distribution in soil-crop systems and their phytotoxicity mechanisms, highlighting the pioneering role of multiomics methods. Genomic analyses show that MPs cause DNA damage and change the expression levels of stress-response genes. Transcriptomics identifies disrupted pathways. These pathways are in carbohydrate metabolism, plant hormones, and antioxidant defense. Proteomics uncovers post-translational modifications. These affect nutrient transporters. Metabolomics further highlights disturbances in glycolysis, amino acid synthesis, and ROS-scavenging metabolites. Despite these advances, integrating multiomics data sets to elucidate systemic “gene-protein-metabolite” networks remains challenging. Key knowledge gaps include MP-protein binding mechanisms, the development of crop-specific biomarkers, and the interaction of MPs with costressors. Future research should prioritize integrated transcriptomic-metabolomic profiling to identify stress-response pathways, use X-ray crystallography to map MP-protein interactions, and develop MP-resilient crop varieties. Multiomics integration is essential for decoding the toxicity of the MPs and formulating mitigation strategies to safeguard the sustainability of agriculture.
18. Post-stroke cognitive impairment is associated with poorer return-to-work outcomes in working-aged stroke survivors: A systematic review.
期刊: Clinical rehabilitation 发表日期: 2026-Feb-10 链接: PubMed
摘要
ObjectivesTo examine the relationship between post-stroke cognitive impairment and return-to-work outcomes in working-aged stroke survivors and evaluate cognitive assessment methods used in included studies.Data sourcesMEDLINE, EMBASE, CINAHL, and APA PsycINFO databases were searched from 2003 to October 2025 according to PRISMA guidelines.Review methodsTwo reviewers independently screened titles and abstracts for inclusion. Data extraction and quality appraisal was completed by two reviewers. Narrative synthesis was completed due to substantial heterogeneity across studies.ResultsThirty-nine studies met inclusion criteria (observational studies (n = 33), qualitative (n = 5) and randomised control trial (n = 1)). Stroke severity was predominantly mild. Post-stroke cognitive impairment prevalence across study cohorts ranged from 17.5% at 28 days to 89% at 7 years with considerable variance in assessments and timing (range 2 days to 7 years). Concentration, memory and processing speed impairments were most frequently reported. Return-to-work rates ranged from 7.5% to 100%, with no clear trends for time post-stroke or stroke sub-type. Cognition was the most commonly associated variable influencing return-to-work outcomes followed by stroke severity, mood and functional status. The invisible nature of post-stroke cognitive impairment and limited awareness among employers and clinicians was highlighted.ConclusionPost-stroke cognitive impairment is commonly associated with poorer return-to-work outcomes even following milder stroke. Despite high detection, post-stroke cognitive impairment often remains hidden. This review highlights the substantial variation in post-stroke cognitive assessment practices and lack of intervention studies. Findings emphasise the need for consistent assessment and management of post-stroke cognitive impairment and increased awareness of its considerable negative impact on employment outcomes.PROSPERO: CRD42023462322.
19. Spatial distribution of timely treatment for cervical cancer: Socioeconomic inequalities and disparities in healthcare service availability in Brazil.
期刊: Cancer epidemiology 发表日期: 2026-Feb-09 链接: PubMed
摘要
Cervical cancer is one of the leading causes of cancer-related death among women in countries with lower socioeconomic levels. In Brazil, it represents the third most common type of cancer and the fourth leading cause of death, excluding non-melanoma skin cancers. Delays in initiating oncologic treatment have remained frequent even after the implementation of Law No. 12,732, which mandates treatment initiation within 60 days of diagnosis. To analyze the spatial distribution of the proportion of cervical cancer cases that started treatment within 60 days after diagnosis and to assess its spatial correlation with contextual socioeconomic indicators and healthcare service availability in Brazil. Ecological study included the 133 Intermediate Regions of Urban Articulation during the post-enactment period of Law No. 12,732 (2013-2019). The dependent variable-the proportion of cases initiating treatment within 60 days-was obtained from the Integrated Cancer Hospital Registry. Socioeconomic variables were extracted from the Atlas of Human Development in Brazil, while data on medical density and health service availability were obtained from the National Registry of Health Establishments and the Outpatient Information System of the Brazilian Unified Health System. Spatial clustering was evaluated using Global Moran’s I and the Local Indicator of Spatial Association. Multivariate analysis employed spatial regression models with global effects. The proportion of cervical cancer cases that initiated treatment within 60 days was 40.4 % (95 % CI: 39.9 %-40.9 %). A positive spatial correlation was observed between timely treatment and cytopathological test density (p = 0.00523), while a negative correlation was found with the population aging rate (p < 0.001). Regions with lower population aging rates and greater availability of cytopathological exams were associated with higher compliance with the “60-day law.” These findings highlight the influence of socioeconomic context and healthcare service distribution on timely access to cervical cancer treatment.
20. Estimates of cancer incidence to 2025 in Italy: Numbers and rates.
期刊: Cancer epidemiology 发表日期: 2026-Feb-09 链接: PubMed
摘要
We forecasted the incidence of malignant tumours in Italy in 2025, using the most representative estimates of incidence rates and recent trends in cancer incidence available. A comparison with estimates for 2025 obtained using different assumptions and data sets is also presented. 34 cancer registries (81 % of the Italian population) were used to estimate incidence rate trends in 2013-2017, by cancer types, sex, and age. The stratified incidence rates were projected until 2025 by applying trends in the same strata, using a linear regression model with the calendar year as an independent variable. We estimated 362,100 new cancer cases in Italy in 2025 (182,300 in men, 179,800 in women). Prostate is the most frequent cancer site in men (31,200 cases; age-standardised incidence rates-ASR=92.3 per 100,000), followed by lung (27,100, ASR=80.9), bladder, and colon-rectum (23,000 cases each; ASR=69.0). 55,900 women were estimated to be diagnosed with breast cancer (ASR=159.0 per 100,000), 18,900 with colorectal (ASR=47.0) and 16,400 with lung cancers (ASR=41.0). Our estimates were slightly lower than those based on other assumptions and/or different datasets (i.e., ECIS/GLOBOCAN ones). More effective anti-smoking campaigns are needed to halt the predicted increase in smoking-related cancers among women.
21. Associations of maternal education with suggested childhood cancer risk factors: Findings from the Childhood Cancer and Leukemia International Consortium (CLIC).
期刊: Cancer epidemiology 发表日期: 2026-Feb-09 链接: PubMed
摘要
Causes of childhood cancer remain poorly understood. Using data from the case-control studies of the Childhood Cancer and Leukemia International Consortium (CLIC), we explored how maternal education as a key socioeconomic status (SES) indicator, varies across studies/countries and contributes to understanding of potential environmental and lifestyle risk factors. Control group data from cancer-free children matched by diagnosis date of cases from 16 studies were included, using both interview-based and health registry sources. Maternal education, the primary SES measure used in previous analyses with pooled CLIC data, was categorized as low, medium, or high according to the International Standard Classification of Education. Multinomial logistic regression assessed associations between maternal education and perinatal/lifestyle factors, calculating crude and adjusted odds ratios (ORs) and 95 % confidence intervals (CIs) for high vs. low education. Maternal education levels varied across studies and over time, with the highest proportions of highly educated mothers in the U.S. and lowest in Costa Rica, Italy, and Egypt. Higher maternal education was generally positively associated with higher birthweight, breastfeeding, daycare attendance, and maternal prenatal alcohol consumption. Higher maternal education was generally inversely associated with lower birthweight, younger maternal age, paternal occupational pesticide exposure, maternal prenatal smoking, and having more siblings. The direction of associations for older maternal age and for caesarean delivery differed substantially across regions. Exclusion of mothers < 21 years at birth of the index child had little effect on the results. This multi-country analysis supports the use of maternal education for adjustment as a proxy for SES, showing largely consistent associations with various behaviors and exposures. While the direction of associations was generally consistent, the strengths varied sometimes considerably by geographical region. These findings support the inclusion of maternal education as a covariate in analyses of childhood cancer risk when pooling CLIC studies.
22. Bio-psycho-social situations suitable for the use of teleconsultation in general practice: a doctor-patient mirror study.
期刊: Family practice 发表日期: 2026-Feb-07 链接: PubMed
摘要
Few studies on teleconsultation (TC) have focused on comparing the points of view of general practitioners (GPs) and patients. To explore bio-psycho-social situations suitable for TC according to GPs and patients. A qualitative study, with thematic analysis, was conducted. Data were collected through individual, semi-directed face-to-face or remote interviews with GPs and patients. The interview guide was validated by a steering committee that included patients. Maximum variation sampling of established GPs and patients was based on diversification criteria. Thirteen patients and eleven physicians were included in this study. The main condition for TC was a pre-established relationship of trust. It was used on an Ad hoc basis as an alternative to face-to-face consultations. Patients and GPs identified that the use of TC should be the result of a shared decision. Participants agreed on the situations in which the use of TC could be justified: to respond to one-off, specific requests, for benign reasons or reasons not requiring a physical examination. Patients considered their health experience and level of health literacy to be strong determinants of TC use. Participants noted the risk of TC widening certain inequalities in access to care. Patients and doctors have identified the same suitable situations and the need to respect certain prerequisites. TC seems appropriate when its use is the result of a prior shared decision between patient and GP.
23. In vivo biocompatibility of poly-N-isopropylacrylamide (PNIPAM) hydrogels in Wistar rats: Hematological, biochemical, and histopathological assessments.
期刊: Tissue & cell 发表日期: 2026-Feb-07 链接: PubMed
摘要
In vitro regeneration of different tissues requires the synthesis of a scaffold material and the compatibility with the desired cell type to achieve a functional unit for transplantation. Poly-N-isopropylacrylamide (PNIPAM) and cationic copolymers hydrogels are effective scaffolds, supporting cell in vitro adhesion and development without cytotoxicity. This study aimed to analyze the in vivo biocompatibility of PNIPAM and PNIPAM co-3 % APTA (3-((acrylamidopropyl) trimethyl-ammonium chloride, APTA)) 3D architecture implanted in female and male Wistar rats. Hydrogel half-discs were implanted in subcutaneous pockets of 3 rats per treatment group (control (without hydrogel), PNIPAM, and PNIPAM co-3 % APTA) for 30 days. The healing process was monitored and after 30 days, the rats were sacrificed following an approved animal care protocol. Blood samples were collected for hematological and biochemical analyses and hydrogels, kidneys, liver, and spleen samples for histopathological evaluation. The results showed no alterations in the healing process in all the animals evaluated. Hematological parameters, liver enzyme activities, nitrogenous waste products and histopathological studies showed no changes across all experimental groups. PNIPAM and PNIPAM co-3 % APTA hydrogels are biocompatible in a female and male murine model over a 30-day period, maintaining stable hematological, biochemical, and histological parameters without alterations.
24. Introducing Minimally Invasive Tissue Sampling to Ascertain Cause of Death in Children and Stillbirths in Central Mozambique.
期刊: The American journal of tropical medicine and hygiene 发表日期: 2026-Feb-03 链接: PubMed
摘要
Minimally invasive tissue sampling (MITS) has been used as an alternative to complete autopsy to track causes of death (CoDs) in South Asia and sub-Saharan Africa as part of the Child Health and Mortality Prevention Surveillance program. However, community acceptance, rapid identification of deaths, and adequate functional laboratory infrastructures (e.g., pathology, conventional microbiology, and molecular microbiology) are critical for successful implementation. We describe the experience of implementing MITS in an urban district with socioeconomic and cultural diversity in Zambézia Province, central Mozambique. For successful implementation of mortality surveillance using MITS, high-level advocacy involving the Provincial Government and all stakeholders as well as engagement and sensitization of all segments of the communities, including traditional healers, community leaders, and mass media, were critical for the acceptability of the procedure. Additionally, social and behavior studies were conducted to assess perceptions, sociocultural factors, acceptability, and feasibility of the MITS procedure. These studies helped adapt the MITS protocol to the local context to minimize the risk of misunderstanding the mortality surveillance using MITS procedures. There was significant investment in capacity building, including financial support for laboratory equipment acquisition and maintenance, reagents, and consumables required for microbiological screening protocols of MITS and to support the needs for diagnostics of patients with severe disease seeking care. Experiences from Quelimane and other sites and data generated in the Countrywide Mortality Surveillance for Action to support evidence-based decision-making processes on health policy were critical for the community to understand the benefit of determining young children CoD to guide future interventions.
25. A SARS-CoV-2 variant-induced NTD-targeting antibody enhances viral infection via a distinctive binding mode.
期刊: PLoS pathogens 发表日期: 2026-Feb 链接: PubMed
摘要
SARS-CoV-2 infection elicits both neutralizing and non-neutralizing monoclonal antibodies (mAbs), primarily targeting to the N-terminal domain (NTD), receptor-binding domain (RBD), and S2 subunit of the spike protein. Notably, a unique subset of NTD-targeting mAbs isolated from prototype Wuhan-Hu-1 strain infected donors displayed a capacity of facilitating the viral infection independent of the fragment crystallizable (Fc) region in vitro. However, the rapid evolution of SARS-CoV-2 variants, particularly with NTD mutations, has led to widespread immune evasion. Whether SARS-CoV-2 variants could still induce NTD-targeting infection-enhancing antibodies (NIEAs) remains unclear. Here, we identified a distinctive NIEA, ConD-854, from a Delta variant primarily infected donor, with broad infection-enhancing activities against most pre-Omicron variants but not against post-Omicron variants. Structural and functional analysis revealed that ConD-854 enhanced the viral infection through an Fc-independent bivalent binding mechanism with a largely shared recognition epitope, but its heavy-light chain orientation was nearly perpendicular relative to the reported prototype strain-induced NIEAs. Collectively, our findings demonstrated that the primary infection of Delta variant could still induce the NIEAs targeting the similar epitope as those elicited by prototype strain infection. Mutations in Delta NTD were located outside the infection-enhancing epitope and did not affect the induction of NIEAs. Remarkably, we defined a distinctive structural paradigm for an NIEA to recognize the viral epitope. These results enriched our understanding of antiviral antibodies and provided insights for future vaccine design.
26. State minimum wages and food insecurity among households receiving government food assistance.
期刊: Epidemiology (Cambridge, Mass.) 发表日期: 2026-Jan-30 链接: PubMed
摘要
While the Supplemental Nutrition Assistance Program (SNAP) aims to reduce food insecurity among low-income households, nearly half of recipients remain food insecure. Increasing state minimum wages could help improve food security, but because SNAP benefits are income-dependent, net effects are unclear. Using the U.S. Current Population Survey Food Security Supplement (2002-2019), we linked households interviewed in two consecutive Decembers to create a two-year panel. The primary sample included SNAP recipient households with at least one adult working in year 1. The exposure was the average effective state minimum wage (2019 dollars), for each state and year. We estimated prevalence differences (PD) in food insecurity per $1 increase in minimum wage using a within-household linear fixed-effects model adjusting for time-varying economic confounders and concurrent safety-net policies. We investigated variation in the effect by household and family structure, race/ethnicity, and educational attainment using stratified models. Overall estimates were most compatible with protective effects (PD per 10,000 households: -298, 95% CI: -673, 77). The strongest protective estimates were for senior-headed (-1,472, 95% CI: -2,869, -76), Hispanic (-865, 95% CI: -1,638, -92), and some-college households (-988, 95% CI: -1,664, -312). Estimates for Indigenous households were imprecise and possibly harmful (900, 95% CI: -736, 2,537). Most other subgroup estimates were near zero. Increased minimum wages may modestly support food security for working SNAP households. As SNAP benefit rules evolve, these findings suggest that minimum-wage policies can complement and reinforce the program’s goals to protect low-income households from food hardship.
27. Trajectories of Cognitive Decline in Patients with Calcified Neurocysticercosis: A Population-Based, Prospective, Longitudinal Study in a Highly Endemic Setting.
期刊: The American journal of tropical medicine and hygiene 发表日期: 2026-Jan-27 链接: PubMed
摘要
The long-term cognitive consequences of calcified neurocysticercosis (NCC) remain poorly understood. This population-based study investigates cognitive trajectories in individuals with calcified NCC in coastal Ecuador. Utilizing repeated Montreal Cognitive Assessment (MoCA) screenings, the study evaluates whether calcified NCC independently contributes to cognitive decline and the role of hippocampal atrophy (HA) in this context. Among 720 community dwellers ages 40 years old and older, 85 (12%) had calcified NCC. The mean interval between baseline and first follow-up MoCA was 3.27 ± 1.07 years and between baseline and second follow-up MoCA was 10.87 ± 1.22 years. Of 720 participants, 617 (86%) completed the first follow-up MoCA, and 464 (75%) of them also had the subsequent follow-up MoCA. Proportions of NCC patients included in follow-ups were consistent with their representation at baseline. Baseline MoCA scores (β: 0.40; 95% CI: -0.48 to 1.29) or rates of MoCA decline at follow-up visits (β: 0.17; 95% CI: -0.67 to 1.0) did not differ significantly between NCC and non-NCC participants after adjusting for relevant covariates. The magnetic resonance imaging substudy showed that 31 of 83 NCC cases and 40 of 283 controls had HA (adjusted odds ratio: 2.63; 95% CI: 1.15-4.11). Additionally, HA was significantly associated with lower MoCA scores at baseline (β: -1.86; 95% CI: -2.98 to -0.74) and follow-up (β: -2.76; 95% CI: -3.83 to -1.69). These results suggest that calcified NCC alone was not associated with cognitive decline over time. However, NCC-associated HA emerged as a major determinant of poor cognitive performance.
28. Environmental Presence of Burkholderia pseudomallei at Military Sites in an Endemic Region: Implications for Future Deployments and Studies.
期刊: The American journal of tropical medicine and hygiene 发表日期: 2026-Jan-27 链接: PubMed
摘要
The footprint of melioidosis is expanding globally, but its historical roots are in Southeast Asia and northern Australia. Melioidosis has long been described in military personnel deployed to melioidosis-endemic regions; however, the magnitude of the risk has not been quantified, and the nature of infecting events remains speculative. As with infections in the endemic population, the greatest concern is for inhalational melioidosis. Soil and air at four military locations in the highly melioidosis-prevalent environment of Darwin, Northern Territory, Australia, were sampled. Burkholderia pseudomallei (B. pseudomallei) was recovered from soil in all four sites but not from air samples. Genotyping revealed four B. pseudomallei sequence types (STs), with each ST recognized in human melioidosis cases from the region. Further systematic air sampling for B. pseudomallei is required both during the monsoonal wet season and under other circumstances, including aircraft with vertical takeoff and landing capabilities, to better understand the risk of inhalational melioidosis.
29. Deletion involving exon 18 of RPGRIP1 is a major cause of achromatopsia.
期刊: Retina (Philadelphia, Pa.) 发表日期: 2026-Jan-22 链接: PubMed
摘要
To evaluate the prevalence of achromatopsia (ACHM) associated with variants of RPGRIP1, especially c.2710+374_2895+78del (RPGRIP1-ex18-DEL), and to confirm that these phenotypes were consistent with ACHM in Japanese patients. This retrospective observational study involved a review of medical records from 52 patients across 47 Japanese families; all clinically diagnosed with ACHM. Causative variants for ACHM were identified in 39 families via whole-exome sequencing, whole-genome sequencing, or polymerase chain reaction: PDE6C (13 families), RPGRIP1-ex18-DEL (11 families), CNGA3 (11 families), CNGB3 (2 families), and GNAT2 (2 families). Patients with ACHM associated with RPGRIP1-ex18-DEL variants did not exhibit significant difference in phenotype, including spherical equivalent refractive error, best-corrected visual acuity (BCVA), fundus appearance, ellipsoid zone grading of optical coherence tomography, and fundus autofluorescence pattern, compared to those with variants in CNGA3 or PDE6C at baseline (all, P > 0.05). For five ACHM patients with RPGRIP1-ex18-DEL variants, no change in BCVA or ellipsoid zone grading was noted over a follow-up period of >10 years (all, P > 0.05). Variants in RPGRIP1-ex18-DEL are unique hotspots with a high prevalence among Japanese patients with ACHM. Clinical findings in these patients are consistent with those in patients with ACHM from other causative genes.
30. Etidronate May Reduce Residual Calcification in Porcine Neurocysticercosis.
期刊: The American journal of tropical medicine and hygiene 发表日期: 2026-Jan-20 链接: PubMed
摘要
Residual brain calcifications that occur after antiparasitic treatment in neurocysticercosis (NCC) can serve as foci of enduring neuroinflammation and associated seizures. Etidronate, a first-generation bisphosphonate, has exhibited efficacy in reducing the formation of ectopic brain calcification. In the present proof-of-concept study, its effects on post-treatment calcifications were evaluated in 12 pigs naturally infected with NCC, confirmed via magnetic resonance imaging. All animals received albendazole plus praziquantel for 5 days, either alone (n = 6) or with etidronate (20 mg/kg/day for 2 weeks, then 10 mg/kg/day for 8 weeks; n = 6). Eight months post-treatment, the animals were euthanized for ex vivo brain computed tomography, histology, and scanning electron microscopy of calcified lesions. Etidronate reduced the risk of calcification by 21% (risk ratio = 0.79; 95% CI: 0.65-0.90; P = 0.020); however, there was considerable individual variability in the magnitude of this risk reduction, as well as significantly decreased calcium and phosphorus content in granulomas. Etidronate was well tolerated and may serve as an adjunctive therapy to reduce residual calcification after antiparasitic treatment in NCC.
31. The Cost of Annual and More Frequent Than Annual Mass Drug Administration for Trachoma in Two Districts in Amhara, Ethiopia.
期刊: The American journal of tropical medicine and hygiene 发表日期: 2026-Jan-20 链接: PubMed
摘要
Ethiopia accounts for 59% of the global trachoma burden. To eliminate trachoma as a public health problem by 2030, modified mass drug administration (MDA) strategies have been proposed, including more frequent than annual MDA. In the present study, the cost of the “child MDA” (CMDA) strategy, defined as an initial community-wide MDA treatment followed by another treatment targeting children aged 6 months to 9 years, was estimated in the Lasta and Wadilla districts, Amhara, Ethiopia. A micro-costing analysis was conducted from a payer perspective, documenting the total financial and economic cost, cost per person treated, and cost per treatment. The cost per person treated was calculated by dividing the total cost by the total number of people treated during the community-wide MDA distribution. The cost per treatment was calculated by dividing the total cost by the total number of treatments distributed overall. The total financial cost of implementing the CMDA strategy in Lasta and Wadilla was $106,427, corresponding to a financial cost per person treated of $0.41 and a financial cost per treatment of $0.32. In Lasta, 168,175 treatments were distributed at a financial cost of $61,978, corresponding to a cost per person of $0.48 and a cost per treatment of $0.37. In Wadilla, 169,248 treatments were distributed at a financial cost of $44,449, corresponding to a cost per person of $0.34 and a cost per treatment of $0.26. This information is useful to stakeholders considering the CMDA strategy in similar contexts and may contribute to future cost-effectiveness analyses of the strategy.
32. Ultrasound-derived muscle variables and physical function in older adults: A scoping review.
期刊: Archives of gerontology and geriatrics 发表日期: 2026-Jan-20 链接: PubMed
摘要
Evidence on use of ultrasound to assess muscles in older adults, and its relation to clinically relevant measures is diverse and inconsistent. To map and synthesize evidence on use of ultrasound-derived muscle variables and their associations with measures of physical function in older adults. A scoping review was conducted in accordance with PRISMA-ScR and JBI guidance. MEDLINE, Cochrane, Embase, Scopus, CINAHL, and grey literature was searched. Eligible studies included adults ≥65 years, including frail cohorts, reporting association between ultrasound-derived muscle variables (muscle thickness (MT), cross-sectional area (CSA), echo intensity (EI), pennation angle (PA), fascicle length (FL), or shear-wave elastography (SWE)) and physical function measures (handgrip strength (HGS), sit-to-stand (STS), gait speed (GS), timed up-and-go (TUG), or short physical performance battery (SPPB)). Seventy studies met inclusion criteria. Mapping revealed that rectus femoris MT at mid-thigh was most frequently examined, with considerable protocol variation. Most studies used cross-sectional designs, and frail cohorts were underrepresented. MT and CSA showed weak to moderate associations with muscle strength-related measures (HGS and STS) and generally very weak to weak associations with physical performance-related measures (GS, TUG, SPPB). Evidence for EI, SWE, PA, and FL was limited and inconsistent. Current evidence provides limited support for ultrasound-derived muscle variables as markers of physical function in older adults. Muscle thickness and cross-sectional area capture aspects of muscle strength but insufficiently reflect physical performance. Establishing harmonized protocols and exploring responsiveness in frail populations, in longitudinal studies are critical steps for future research and clinical application.
33. Seroprevalence and Risk Factors for Taenia solium Cysticercosis and Taeniasis among Children in Nigeria, 2018.
期刊: The American journal of tropical medicine and hygiene 发表日期: 2026-Jan-15 链接: PubMed
摘要
Children are vulnerable to Taenia solium, a parasitic tapeworm causing cysticercosis (a common cause of epilepsy) and taeniasis. We sought to better understand T. solium prevalence and associated risk factors in Nigeria using data from a 2018 nationally representative household survey estimating HIV incidence. We used a multiplex bead assay to determine the seroprevalence of T. solium IgG antibodies to T24H (cysticercosis) and rES33 (taeniasis) for 32,494 children aged <15 years. Positive antibodies against each antigen were detected in children from all states, with an overall antibody seroprevalence of 6.0% for T24H (range, 1.4-19.3%) and 2.8% for rES33 (range, 0.5-5.3%). Despite state-level variations, overall prevalence for each disease was higher in the north than in the south. We found greater odds of cysticercosis seropositivity among individuals with lower socioeconomic status (aOR = 2.07; 95% CI = 1.53-2.80) when comparing lowest to highest wealth quintile; with increasing age, showing higher odds in children aged 5-9 years (aOR = 2.06; 95% CI = 1.77-2.34) and 10-14 years (aOR = 2.58; 95% CI = 2.22-2.99) compared with children aged <5 years; among households with pig ownership (aOR = 1.35; 95% CI = 1.00-1.83) compared with those without pigs; and among individuals living in rural areas (aOR = 1.26; 95% CI = 1.06-1.51) compared with those in urban areas. For taeniasis, we found significant associations for children in the lowest wealth quintile (aOR = 1.89; 95% CI = 1.30-2.76) and those from pig-owning households (aOR = 1.48; 95% CI = 1.01-2.17). Significant taeniasis prevalence rates were identified even in predominantly Muslim populations. Targeted public health strategies to increase awareness of T. solium infections, highlighting hand hygiene and proper sanitation practices, and improved pig management can help reduce transmission.
34. Ensuring the Public Health Impact of Malaria Vaccination in High-Transmission Settings.
期刊: The American journal of tropical medicine and hygiene 发表日期: 2026-Jan-15 链接: PubMed
摘要
Two vaccines against Plasmodium falciparum, RTS,S and R21, have been recommended for widespread implementation by the World Health Organization. Both vaccines displayed safety and efficacy in clinical trials, and early RTS,S pilot implementation results suggested reductions in severe disease and death. However, RTS,S efficacy was lower in higher transmission settings during trials. Between- and within-site analyses suggest that reduced efficacy was partially due to greater natural immunity development in control groups in higher transmission settings, resulting in temporary periods of negative efficacy beginning approximately three years after the primary vaccine series. Results from RTS,S pilot implementation and seasonal administration for both vaccines are promising, but study designs have thus far precluded the identification of similar periods of negative efficacy. Because we expect delayed malaria cases of unknown severity in vaccinated individuals during implementation in high-transmission settings, we recommend enhanced surveillance and interventions that supplement malaria vaccination to strengthen prevention.
35. A Novel Method for the Rapid and Efficient Preparation of Polymerase Chain Reaction Template DNA from Filter Paper Blood Samples.
期刊: The American journal of tropical medicine and hygiene 发表日期: 2026-Jan-15 链接: PubMed
摘要
Filter paper blood samples (i.e., dry blood spots [DBSs]) have been widely used for pathogen detection, especially in malaria control and elimination. Dried blood spot-based polymerase chain reaction (PCR) testing has also been increasingly used for diagnosis and gene monitoring. The current method of DNA extraction from DBSs is limited in practical application because of its low efficiency, time-consuming procedure, and high cost. Accordingly, a hemolysis preservation (HP) method was developed and compared with the most commonly used Tween-Chelex method and spin-column method kit (QIAamp DNA Mini) under equivalent conditions by extracting template DNA from the same batch of Plasmodium falciparum density-gradient DBSs. The HP method yielded the highest DNA recovery volume (557.32 ng/µL of blood) and the lowest limit of detection (LOD; equivalent to 0.1 parasites/µL) from DBSs with the minimum blood volume (4-5 µL) using the simplest reagent. Additionally, it had the shortest time (∼50 minutes) and the lowest cost ($0.27 per sample). The LOD of the direct PCR method also reached a value of 0.11 parasites/µL. Therefore, the DBS PCR test conducted using the HP method can detect asymptomatic low-density Plasmodium infection and is a cost-effective option in resource-deficient areas.
36. "Here Versus There: A Summer Vacation Story".
期刊: The American journal of tropical medicine and hygiene 发表日期: 2026-Jan-08 链接: PubMed
摘要
The American Committee on Clinical Tropical Medicine and Travelers’ Health’s Students/Trainees Leadership Group launched its essay contest in 2025 to encourage the involvement of emerging voices in tropical medicine in key issues shaping the field’s present and future. The following authors won for their essays addressing the following prompt: “Tropical Medicine in the 21st Century” These essays were reviewed by a panel of clinician judges with experience in tropical medicine and writing, and the winning entries reflect both academic excellence and practical insight. Together, the two winning essays reveal the wide scope of tropical medicine, from policy and prevention to diagnosis and treatment, and the shared responsibility to confront these challenges wherever they arise.
37. Bayesian multi-cell type models for the analysis of complex immune cell populations with application to ovarian cancer.
期刊: Briefings in bioinformatics 发表日期: 2026-Jan-07 链接: PubMed
摘要
To understand how the tumor immune microenvironment (TIME) impacts clinical outcomes and treatment response, researchers have been leveraging single-cell protein multiplex imaging techniques. These technologies measure multiple protein markers simultaneously within a tissue sample, providing a more complete assessment of the TIME. However, statistical challenges arise from the over-dispersed and zero-inflated nature of the data and from relationships among different immune cell populations. To address these challenges, we developed a Bayesian hierarchical method using a beta-binomial (BB) distribution to model the abundance of multiple immune cell types simultaneously while incorporating relationships and immune cell differentiation paths. We applied the model to data from three large studies of high-grade serous ovarian tumors (Nurses’ Health Study I/II: N = 321, African American Cancer Epidemiology Study: N = 92, University of Colorado Ovarian Cancer Study: N = 103). We examined associations between cancer stage, age at diagnosis, and debulking status and the abundance of immune cell populations. We compared the multi-cell type model to individual cell type analyses using a Bayesian BB model. The multi-cell type model detected more associations, when present, with narrower credible intervals. To support broader application, we developed an R package, BTIME, with a detailed tutorial. In conclusion, the Bayesian multi-cell type model is flexible in how relationships between cell types are incorporated and can be used for cancer studies that interrogate the TIME.
38. Potent Monoclonal Antibodies Against Circulating Yellow Fever Virus Strains from Donors Immunized with the 17D Vaccine.
期刊: The American journal of tropical medicine and hygiene 发表日期: 2026-Jan-07 链接: PubMed
摘要
Yellow fever (YF) causes approximately 50,000 deaths annually worldwide and is transmitted by infection with the yellow fever virus (YFV), which is endemic in Sub-Saharan Africa and tropical South America. The live-attenuated YFV 17D vaccine, developed in 1937, is essential to control YFV transmission, but the finite shelf life and manufacturing constraints of egg-based vaccine production, the rare but severe adverse events, and the lack of effective therapeutic options for YF disease highlight the need for new YFV vaccines and therapies. Potent YFV antibodies that neutralize circulating strains could be promising passive immunizations or treatments and guide nonreplicating YF vaccine development. In this study, we captured and screened natively paired heavy and light chain antibody libraries from two donors immunized with the YFV 17D vaccine. Yeast surface display libraries were generated and stained using YF virus-like particles purified by chromatographic techniques. Three anti-YFV antibodies were identified with potent neutralizing activity against circulating strains from Western Africa and South America, including one potent antibody with a neutralizing half-maximal inhibitory concentration of <5 ng/mL against the 17D vaccine strain. These new YFV antibodies have the potential to serve as YFV outbreak countermeasures for treatment or prevention and guide future vaccine efforts.
39. Mpox in US Immigration and Customs Enforcement Detention Facilities during 2022 Global Outbreak.
期刊: The American journal of tropical medicine and hygiene 发表日期: 2026-Jan-06 链接: PubMed
摘要
US Immigration and Customs Enforcement (ICE) detention centers are hot spots for infectious disease spread, as manifested during the COVID-19 pandemic. Mpox cases among ICE detainees during the 2022 global outbreak were investigated and a Freedom of Information Act request for mpox testing data from January to November 2022 was submitted, focusing on demographic and clinical information. Seven detainees across five facilities in Texas, Arizona, and New Jersey were tested. Two detainees tested positive, revealing a 28.6% positivity rate. One detainee received antiviral treatment. Overall, few migrant detainees have been evaluated for mpox. The limited number of mpox tests suggest that additional cases of mpox may have been missed. Adequate resources for mpox testing, treatment, and prevention within detention facilities are critical to limit spread among migrants.
40. Comparisons of factors correlated with successful smoking cessation between middle-aged and older smokers.
期刊: PloS one 发表日期: 2026 链接: PubMed
摘要
As the elderly population expands, smoking cessation becomes increasingly vital due to their heightened risk of adverse health effects. This study investigated the factors influencing successful smoking cessation among older smokers (≥65 years) in Taiwan, comparing them with those in middle-aged smokers (40-64 years). We conducted a retrospective cohort study involving participants aged 40 and above who engaged in smoking cessation therapies in Taiwan from 2012 to 2022. The primary outcome was self-reported smoking status six months post-treatment. Using logistic regression with generalized estimation equations, we calculated the adjusted odds ratios for successful cessation, considering various individual and ecological factors. Among 263,641 middle-aged patients (442,133 treatment sessions) and 42,650 older smokers (67,372 treatment sessions), cessation success rates were 39.59% and 45.22%, respectively. Overall, both groups shared similar factors influencing cessation success. However, shorter smoking duration was more strongly associated with quitting among older smokers (adjusted odds ratio, aOR=1.35; 95% CI = 1.22-1.50), whereas varenicline (aOR=1.33; 95% CI = 1.26-1.40), bupropion (aOR=1.24; 95% CI = 1.19-1.30), and higher urbanization (aOR=1.29; 95% CI = 1.26-1.33) had greater effects among middle-aged smokers. While the underlying mechanisms of smoking cessation were similar across age groups, the relative influence of smoking duration, medication counseling, and institutional urbanization differed. These findings highlight the need for tailored interventions within the Tobacco Cessation Program, focusing on medication adherence and continuous counseling for middle-aged smokers, and improving accessibility and health management support for older adults.
41. Appraising the HIV prevention cascade methodology to improve HIV prevention targets: Lessons learned from a general population pilot study in east Zimbabwe.
期刊: PLOS global public health 发表日期: 2026 链接: PubMed
摘要
Multiple HIV Prevention Cascades (HPC) formulations have been proposed to assist advocacy, monitoring of HIV prevention implementation and research to identify ways to increase use of HIV prevention methods. Schaefer and colleagues proposed a unifying formulation suitable for widespread use across different populations which could be used for routine monitoring or advocacy. Robust methods for defining and interpreting this HPC formulation using real world data are necessary to aid promotion and utilisation of this framework to address necessary gaps in primary HIV prevention method use. We used 2018-19 data from the Manicaland Pilot HIV Prevention Cascades Study in eastern Zimbabwe to validate the HPC framework for pre-exposure prophylaxis (PrEP), voluntary medical male circumcision (VMMC), female and male condoms, and combination prevention. Validation involved: (1) testing feasibility of populating the HPC; (2) comparing simple vs. complex HPC measures using 2-sample proportion tests; and (3) using logistic regression to assess whether HPC cascade bars predicted prevention use and whether sub-bars explained loss from the HPC. It was possible to populate the HPC for individual and combined prevention methods using pilot survey data. Most steps were associated with prevention method usage outcomes, except for VMMC. There were significant overlaps between individuals reporting positive responses for the main motivation bar and those citing barriers to motivation. To refine the HPC’s access bar definition, it is suggested to consider individuals who report access barriers. While the HPC framework identifies barriers to individual prevention methods, challenges arise in identifying those for combined prevention. Our study successfully utilised questionnaires from the Manicaland HPC pilot survey to measure the HPC for individual and combined prevention methods. In conclusion, it is feasible to populate this framework using general population survey data and designated questionnaire modules. We propose a final formulation of the HPC, and questionnaire modules and methods to create it. With proper promotion, such as through measurement within national to local population surveys, the HPC framework can allow comparison of prevention method use, identification of intervention targets and enhance prevention services, aiding in the crucial reduction of HIV incidence.
42. Socioeconomic status and depressive symptoms among older adults in China: The mediating role of cognitive function, lifestyle and social participation.
期刊: PloS one 发表日期: 2026 链接: PubMed
摘要
Socioeconomic status (SES) is a key risk factor for depression in older adults, while cognitive function, lifestyle and social participation also have an impact on depression. This study aimed to investigate the mediating role of cognitive function, lifestyle and social participation in the association between SES and depressive symptoms among older adults in China. Data were derived from the Chinese Longitudinal Healthy Longevity Survey (CLHLS) (2017-2018). A total of 7595 community-dwelling adults aged ≥65 years were included. Depressive symptoms were assessed using the 10-item Center for Epidemiologic Studies Depression Scale (CES-D-10). SES was measured as a composite index incorporating education level, occupation, and self-rated economic status. Cognitive function was evaluated via the Mini Mental State Examination (MMSE). Lifestyle and social participation scores were constructed based on relevant questionnaire items. Mediation analysis was performed to explore the indirect effects of cognitive function, lifestyle, and social participation on the association between SES and depressive symptoms. The prevalence rate of depressive symptoms (CES-D-10 score ≥10) was 41.1%. After adjusting for sociodemographic and health-related covariates, SES was negatively associated with depressive symptoms (β = -0.887, P < 0.001). SES had a significant mediating effect on depression in older adults respectively, through cognitive function (relative mediating effect = 8.0%, β = -0.071, 95%CI: -0.095 ~ -0.048), lifestyle (19.9%, β = -0.177, 95%CI: -0.213 ~ -0.140) and social participation (7.6%, β = -0.068, 95%CI: -0.095 ~ -0.042). Additionally, sequential mediating effects were observed for “cognitive function → lifestyle” (1.0%, β = -0.009, 95%CI: -0.012 ~ -0.006), “cognitive function → social participation” (1.0%, β = -0.009, 95%CI: -0.014 ~ -0.006), “lifestyle → social participation” (1.4%, β = -0.012, 95%CI: -0.018 ~ -0.007), and “cognitive function → lifestyle → social participation” (0.1%, β = -0.001, 95%CI: -0.001 ~ -0.001). SES influences depressive symptoms in Chinese older adults through both direct and indirect pathways. The findings highlight the need for multifaceted interventions targeting cognitive function enhancement, healthy lifestyle promotion, and social participation facilitation, particularly among socioeconomically disadvantaged older populations, to mitigate depressive symptoms and promote healthy aging.
43. Validation of visual analogue scales to assess occupational stress compared to the Karasek questionnaire: A cross sectional study.
期刊: PloS one 发表日期: 2026 链接: PubMed
摘要
The Job Demand-Control-Support (JDCS) model is one of the most important tools for assessing work-related stress. However, its complexity highlights the need for simpler instruments, such as the Visual Analog Scale (VAS), for rapid assessment in occupational medicine. To validate three VAS corresponding to the main JDCS dimensions: job demand, job control, and social support. We conducted an observational cross-sectional validation study using a self-administered questionnaire completed twice, a week apart, at the participants’ convenience, to perform test-retest. We analysed 155 participants (60 for test and retest), mostly women around 40 years. Acceptability was excellent, with high response rates. Internal consistency analysis revealed moderate correlations between VAS and JDCS model main dimensions. Reliability assessed by Lin’s concordance correlation coefficient was acceptable for the VAS and higher for the JDCS. Mean VAS scores indicated significant differences between low and high demand, control, and social support, with cut-off values of 58, 71.5 and 63.5 respectively. For external validity, we mainly found high agreement between VAS and JDCS. VAS are valid, quick, easy to use, and reliable tools for the assessment of job demand, job control and social support in daily clinical practice for primary prevention and diagnosis. Based on our findings, easier-to-remember cut-offs could be proposed at 60, 70, and 60 for VAS job demand, VAS job control, and VAS social support, respectively. However, when results are over the determined cut-off, we encourage the use of JDCS questionnaire. ClinicalTrials.gov NCT05871411.
44. Monocyte clusters suggestive of a chronic inflammatory phenotype are associated with reduced endothelial function in Veterans with respiratory symptoms.
期刊: PloS one 发表日期: 2026 链接: PubMed
摘要
Exposure to airborne hazards during deployment is associated with persistent respiratory symptoms among military veterans even years after deployment. Circulating monocytes, key components of the innate immune response, are implicated in inflammatory processes that may be sustained long after such exposures and contribute to related health issues. This cross-sectional study, conducted years after deployment, aimed to characterize monocyte activation profiles in veterans with deployment-related respiratory symptoms and investigate associations with physiological markers of pulmonary and vascular function. Circulating monocyte immunophenotype, pulmonary function, and brachial artery flow-mediated dilation (FMD) were assessed in 82 previously deployed veterans. Using principal component and hierarchical clustering analyses, we identified two distinct monocyte activation phenotypes: Cluster 1, characterized by elevated CD87, CD11b, and CD163, and cluster 2 which expressed markers of non-classical monocytes and CD195, indicative of a chronic inflammatory phenotype. Veterans in cluster 2 exhibited impaired endothelial-dependent vasodilation (FMD/NMD ratio; p = 0.02) and elevated airway resistance (R5; p = 0.01), despite normal pulmonary function. These findings suggest an association between distinct monocyte activation profiles and measures of microvascular and airway dysfunction in this cohort, potentially reflecting sustained inflammation secondary to environmental exposure. These observed associations underscore the need for further research into the role of monocytes in these long-term physiological changes. Elucidating the mechanistic pathways by which these monocyte phenotypes may contribute to persistent physiological alterations is critical and could inform future strategies for identifying at-risk veterans or exploring novel immunomodulatory approaches if such links are further substantiated.
45. A Baseline Mixed-Methods Study to Inform Seasonal Malaria Chemoprevention Delivery in a Semi-Nomadic Population in Turkana, Kenya.
期刊: The American journal of tropical medicine and hygiene 发表日期: 2025-Dec-30 链接: PubMed
摘要
After the expansion of the World Health Organization’s guidelines on eligibility for the seasonal malaria chemoprevention (SMC), the government of Kenya prepared to implement SMC for a first time in Turkana Central Subcounty in 2024. To inform the design of SMC, we conducted a baseline qualitative and quantitative study. Using stratified cluster sampling, we enrolled 198 households with children of ages 6 months to 5 years and tested all individuals six months and older using a rapid diagnostic test (RDT) and polymerase chain reaction (PCR) for Plasmodium falciparum. We performed 78 key informant interviews; 31 focus group discussions with community health workers, elders, and caretakers of children; and 60 in-depth interviews with caretakers. Prevalence of P. falciparum infection was 21% (9-42%) by RDT and 21% (11-38%) by PCR. Prevalence varied across villages, with the highest positivity of 73% by PCR. Although SMC was perceived positively, the identified challenges included physical access (households far from village centers, pastoralists, children living in the streets), stigma (children living with disabilities, households with members struggling with alcohol use), and acceptability (traditionalists, highly educated households). Despite the high malaria burden in the region, SMC may be a feasible approach to reduce its burden and transmission. However, implementation of SMC should be tailored, combining centralized distribution with door-to-door delivery and outreach to pastoralists and people living in the interior. Using existing grassroots structures, such as pastoralist leadership structures and religious and group leaders, and intensive mobilization will be critical for success of this intervention.
46. Need for Real-World Evaluation of Malaria Vaccines and Reliable Vaccination Records in Africa.
期刊: The American journal of tropical medicine and hygiene 发表日期: 2025-Dec-30 链接: PubMed
摘要
Evaluating the real-world effectiveness of the newly approved malaria vaccines, RTS,S/AS01 and R21/Matrix-M, is critical for informing vaccine policy, especially in areas not represented in the original clinical trials. Observational study designs such as cohort studies using the target trial emulation framework or the test-negative design offer promising approaches for estimating vaccine effectiveness in the real world. However, both designs require accurate, individual-level vaccination data, which remains a major challenge in many African countries. Strengthening electronic immunization registries, alongside continued efforts to improve the quality and completeness of paper-based immunization records, is essential in African countries, not only for the evaluation of current vaccines such as RTS,S/AS01 and R21/Matrix-M, but also in preparation for future malaria vaccines, to support robust vaccine monitoring and decision-making.
47. Improving the Long-Term Outcomes of Individuals with Melioidosis: Are Premature Deaths in Survivors Preventable?
期刊: The American journal of tropical medicine and hygiene 发表日期: 2025-Dec-30 链接: PubMed
摘要
The case fatality rate of melioidosis in Australia is now less than 10%; however, many survivors of melioidosis die at an early age, soon after their hospital discharge. It is unclear whether more comprehensive, longitudinal healthcare could improve these patients’ long-term outcomes. This study examined 290 consecutive individuals who survived their initial admission to an Australian referral hospital with culture-confirmed melioidosis between 2016 and 2024. They were followed for a median (interquartile range [IQR]) of 2.3 (0.9-4.2) years; 61/290 (21%) died at a median (IQR) of 0.8 (0.3-3.0) years after their diagnosis of melioidosis; the median (IQR) age at death was 65 (54-80) years. In multivariate analysis, active malignancy (hazard ratio [HR]; 95% CI): 4.09 (2.06-8.11), P <0.001), chronic kidney disease [HR (95% CI): 3.52 (1.91-6.48), P <0.001], immunosuppression [HR (95% CI): 2.01 (1.02-3.98), P = 0.04], or chronic lung disease [HR (95% CI): 1.93 (1.09-3.42), P = 0.02] at the time of the individual’s initial presentation with melioidosis was associated with death after hospital discharge. Only one individual without significant underlying comorbidity died during follow-up. The cause of death could be determined in 43/61 (71%) and was frequently due to established, complex comorbidity; on review of the medical record, only 4 (9%) of these 43 deaths were felt to be preventable. Many Australians who survive melioidosis die soon after discharge at a relatively young age. Few of these deaths are easily preventable, but a diagnosis of melioidosis remains an opportunity to identify important comorbidities and optimize the patients’ longitudinal care to reduce their subsequent morbidity and mortality.
48. Prevalence of Subclinical Carotid Atherosclerosis in Adults from the Colombian Caribbean Coast: Results from the Cartagena Cohort Study.
期刊: The American journal of tropical medicine and hygiene 发表日期: 2025-Dec-23 链接: PubMed
摘要
Cardiovascular diseases (CVD) is a public health issue in low- and middle-income countries. Identification of subclinical carotid atherosclerosis (SCA) might contribute to the prevention of life-threating cardiovascular events. This study aimed to describe SCA prevalence in adults from the southern Caribbean. A cross-sectional analysis was conducted with 653 adults ages 18-80 years old. Participants provided sociodemographic and medical history, including cardiometabolic and respiratory health data, and underwent fasting blood tests and ultrasound imaging to assess carotid atherosclerosis. The prevalence of SCA was 29.5%. Subjects with SCA were 15.6 years older (P <0.001), had less education (P <0.001), and had lower socioeconomic levels (P <0.001) than those without SCA. Smoking was more frequent among subjects with SCA compared with non-SCA adults. Age (odds ratio [OR]: 1.01, P <0.0001), weight (OR: 1.002, P = 0.02), and income (OR: 0.99, P = 0.005) were associated with SCA prevalence. Current smoking was associated with higher frequency of atherosclerotic plaque (OR: 1.05, P = 0.042). In conclusion, SCA was highly prevalent among adults from the southern Caribbean. These findings might contribute to identifying vulnerable groups to CVD living in low- and middle-income settings.
49. Acute Undifferentiated Febrile Illness in Hospitalized Adults in Western and Central Provinces, Sri Lanka: High Levels of Coinfections and Clinical Misdiagnoses of Etiology.
期刊: The American journal of tropical medicine and hygiene 发表日期: 2025-Dec-18 链接: PubMed
摘要
Acute undifferentiated febrile illness (AUFI) is an important cause of admission to hospitals in the tropics. We prospectively recruited inpatients with AUFI at three hospitals in Western (n = 540) and Central (n = 260) Provinces, Sri Lanka from January 2022 to May 2023. We obtained clinical and environmental exposure data, blood cultures, acute blood samples, and nasopharyngeal samples at enrollment and convalescent blood samples. Laboratory testing for dengue and influenza viruses, Leptospira, Rickettsia, and Orientia was conducted. Laboratory-confirmed etiology of AUFI was ascertained in 576 of 800 cases (72%). Dengue (n = 189/540), leptospirosis (n = 173/540), and scrub typhus/rickettsial infection (n = 57/540) were principal etiologies of AUFI in Western Province. Dengue (n = 69/260), leptospirosis (n = 61/260), and scrub typhus/rickettsial infection (n = 35/260) were causes of AUFI in Central Province. In both provinces, 82 of 800 cases of AUFI were because of influenza. There were no culture-confirmed cases of melioidosis or enteric fever. Of AUFI admissions, 96 of 800 were because of coinfections, with leptospirosis co-infection (n = 63/800) being most frequent. False-positive scrub typhus lateral flow immunoassays were seen in 22 of 234 patients with confirmed leptospirosis. 84 of 274 dengue cases and 118 of 289 leptospirosis cases diagnosed and managed clinically (before laboratory diagnosis) were incorrect diagnoses. Clinical diagnosis of AUFI is often suboptimal, and coinfections are common in our study areas. The need for widespread availability of comprehensive molecular and serological testing of AUFI patients is highlighted.
50. Seroprevalence of Hepatitis B and C Virus Infections in Bukavu, Eastern Part of the Democratic Republic of the Congo: Trends and Cohort Age Effect.
期刊: The American journal of tropical medicine and hygiene 发表日期: 2025-Dec-16 链接: PubMed
摘要
The epidemiological profile of hepatitis B (HBV) and hepatitis C (HCV) infections has not yet been sufficiently documented in the Democratic Republic of the Congo (DRC). The aim for the present study was to provide a descriptive analysis of HBV and HCV seroprevalence and assess trends, as well as any possible cohort effects in Bukavu, situated in the eastern DRC. Using laboratory data from the Provincial General Reference Hospital of Bukavu, the results of all HBV (hepatitis B surface antigen) and HCV (anti-HCV antibodies) serological tests performed between January 2019 and December 2023 were analyzed. Patients were grouped by possible complications and divided into age groups to assess trends and the cohort age effect. Of the 38,033 specimens tested, 807/19,333 (4.2%) and 321/18,700 (1.7%) tested positive for hepatitis B surface antigen and anti-HCV antibodies, respectively. Both infections were more prevalent in male participants than in female participants. The average age of patients was higher for those with HCV than for those with HBV (P = 0.0001). For HCV in particular, prevalence comparison between patients born before and after 1960 revealed a statistically significant difference: 10.5% versus 0.8% (P <0.0001). The profile analysis of the viral HBV and HCV epidemiology in Bukavu revealed significant changes over the years related to the degree of exposure to risk factors. These changes could explain the observed sex-related disparities regarding prevalence, as well as the cohort age effect clearly observed for HCV infections.