公共卫生研究摘要 (2026-02-13)

共收录 57 篇研究文章

1. Involvement of the African swine fever virus protein pH108R in virion morphogenesis.

期刊: Emerging microbes & infections 发表日期: 2026-Dec 链接: PubMed

摘要

African swine fever virus (ASFV) is the causative agent of the highly contagious and devastating haemorrhagic swine disease for which there are no effective vaccines or treatments available. The ASFV infectious cycle initiates with the viral absorption and entry into the host cell, then ASFV undergoes the uncoating process, viral inner envelope and endosome membrane fusion, DNA replication and gene transcription as well as translation, subsequently ASFV morphogenesis takes place within viral factories. ASFV morphogenesis is highly complex, and the mechanisms involved in ASFV morphogenesis are not well understood at present. Here, we reported that the inner envelope protein pH108R is involved in the ASFV morphogenesis. Interestingly, the absence of pH108R results in the formation of large numbers of tubular structures and bilobulate structures, providing evidence that pH108R plays a role in ASFV morphogenesis. Furthermore, the absence of pH108R inhibits the proteolytic processing of core-shell polyproteins pp220 and pp62. pH108R is identified as associated with capsid proteins p49 and p72, displaying the function of pH108R in the assembly of the capsid. Besides, the absence of pH108R reduces the protein levels of pA104R. Additionally, the pathogenicity of the pH108R-deleted ASFV strain is attenuated in pigs compared with the parental virus. These findings elucidate the regulatory role of pH108R in ASFV morphogenesis and provide an attractive target for vaccine development.

2. Incorporating Pelvic Floor Physical Therapy in the Treatment of Obstructed Defecation Syndrome and Posterior Compartment Pelvic Organ and Rectal Prolapse: Proceedings of the Consensus Meeting of the Pelvic Floor Consortium of the American Society of Colon and Rectal Surgeons, the International Continence Society, the International Urogynecological Association, the American Urogynecologic Society, and the American Physical Therapy Association.

期刊: Diseases of the colon and rectum 发表日期: 2026-Mar-01 链接: PubMed

摘要

Obstructed defecation syndrome and posterior compartment (rectal) prolapse significantly impact patients’ quality of life. Pelvic floor physical therapy is a critical part of multidisciplinary management for these conditions, yet there is little guidance or standardization to guide providers’ referral practices, diagnostic approaches, or treatment. To develop multidisciplinary consensus-based recommendations for incorporating pelvic floor physical therapy into the treatment of obstructed defecation syndrome and posterior compartment prolapse. MEDLINE, PubMed, Embase, and the Cochrane Database of Systematic Reviews were searched for English-language studies on pelvic floor physical therapy, obstructed defecation, diagnostic criteria, imaging, and pelvic organ prolapse. Studies identified in the literature search were reviewed by multidisciplinary expert subgroups, who formulated draft statements based on the available evidence. Consensus meetings were conducted and included experts from colorectal surgery, urogynecology, physical therapy, gastroenterology, radiology, and urology. Statements were evaluated via structured discussions and voting processes. Those reaching more than 70% consensus were adopted for inclusion. Statements underwent final review and editing by the leadership of the American Society of Colon and Rectal Surgeons and the International Urogynecological Association. Consensus statements addressed referral criteria, diagnostic evaluations, therapy protocols, timing, coordination with surgery, and management of anatomical abnormalities. Fifteen statements reached consensus. Key recommendations included prompt referral to pelvic floor physical therapy for patients without contraindications, individualized therapy based on appropriate diagnostic evaluation and patient goals, timing of pelvic floor physical therapy relative to surgery, and trauma-informed patient care. Recommendations primarily reflect expert consensus due to limited high-quality evidence. Variability in practitioner expertise and geographic access to trained therapists are barriers to consistent implementation. These recommendations provide structured guidance for integrating pelvic floor physical therapy into the management of obstructed defecation syndrome and rectal prolapse. Additional research and standardized training are essential to optimize patient outcomes.

3. Detection and characterization of alterations in miRNA in urine of firefighters.

期刊: Toxicological sciences : an official journal of the Society of Toxicology 发表日期: 2026-Feb-12 链接: PubMed

摘要

Firefighters are exposed to high levels of toxic chemicals when fighting fires, and previous studies have established these men and woman have a significantly elevated risk for various cancers. Improved risk management for firefighters requires identification of biomarkers indicative of physiological response. Micro-RNAs (miRNA) have emerged as a promising noninvasive prognostic and diagnostic biomarkers for various diseases. Here we isolated miRNA from the urine of a large dataset of firefighters, collected pre- and post-fire exposure as well as from healthy non-firefighter controls. miRNA was analyzed by microarray using the Affymetrix GeneCHIP miRNA 4.0 array. Analysis revealed 23 human miRNAs were significantly up-regulated and 25 significantly down-regulated in firefighters compared to control samples (analysis 1). Gene targets of these miRNAs were analyzed using the Online Database for Annotation, Visualization, and Integrated Discovery (DAVID) and found to cluster in several pathways and disease associations with smoking, cancer, and inflammatory diseases. Furthermore, we performed a longitudinal analysis of samples from firefighters that provided a sample prior to a fire exposure and immediately after a fire (analysis 2). This analysis found 20 miRNAs that were significantly up-regulated post fire exposure. Of these, 5 were also up-regulated in firefighters vs control samples (hsa-miR-1268b, hsa-miR-4433b-3p, hsa-miR-4253, hsa-miR-6824-5p, and hsa-miR-3188). Again, analysis of gene targets of these miRNAs found association of mostly the same pathways and disease processes found in analysis 1. These findings are consistent with epidemiological evidence for increased risks associated with firefighting and offer a proof of concept and framework for the use of miRNA in urine as biomarkers for health risk assessment associated with firefighting.

4. From Relf v. Weinberger to Drive-Through Delivery: Unpacking Democratic Responsiveness and Administrative Levers in U.S. Sterilization Policy.

期刊: Journal of health politics, policy and law 发表日期: 2026-Feb-12 链接: PubMed

摘要

Female sterilization occupies a paradoxical place in reproductive policy. When chosen freely, it is a safe and effective contraceptive method, yet has also been deployed as a tool of coercion and state control. This dual legacy makes the United States, where sterilization remains more common than other high-income democracies, an important case for examining how public accountability and policy design shape permanent contraceptive use. From a theoretical perspective, highly visible, accountability-driven interventions such as the 1974 Relf v. Weinberger case might be expected to generate larger behavioral changes than less visible administrative reforms, though prior scholarship offers mixed expectations about the relative influence of legal visibility versus economic incentives. To test these competing expectations, we analyze a harmonized panel of contraceptive surveys from 190 nations (1965-2010) and apply the synthetic-control method. We examine the behavioral impact of Relf as a democratic accountability event and contrast it with a later unrelated administrative change in U.S. hospital reimbursement policy in the 1990s. We find that the public outrage and litigation following Relf produced formal consent safeguards but were associated with limited changes in the national sterilization rates. In contrast, the 1990s payment reforms, aimed at cost containment, were associated with a sustained national decline. Together, these contrasting impacts suggest that reforms driven by court decisions and financial architecture may influence entrenched policies through different, potentially complementary, channels. Taken together, the findings affirm the important role of administrative levers alongside legislative activism, levers often overlooked in reproductive rights debates despite their capacity to reshape clinical practice.

5. Suspect List-Guided High-Throughput Screening (SLIG-HTS) Identifies Environmental Substances Associated with Advanced Embryonic Developmental Timing.

期刊: Environmental science & technology 发表日期: 2026-Feb-12 链接: PubMed

摘要

Retardation of embryonic development by environmental contaminants has been extensively documented, whereas coordinated advancement in developmental timing has received far less attention despite its risks to organisms as well. To address this gap, we developed a Suspect List-Guided High-Throughput Screening strategy that integrates literature-informed suspect list construction with developmental trend-guided, stage-resolved end points evaluation to identify environmental substances associated with advanced embryonic developmental timing across a broad chemical space. By retrospectively screening over 9,300 toxicity records from public repositories, we curated a suspect list of 46 substances linked to affect developmental timing-related end points. Experimental validation in zebrafish confirmed that 27 compounds (58.7%) significantly affected at least one stage-resolved morphological end point, including epiboly progression, somite formation, and/or yolk sac dynamics. Notable, the sulfonamide antibiotics sulfadiazine (SDZ) and sulfamethoxazole (SMZ) exhibited pronounced effects at environmentally relevant concentrations (from ng/L to low μg/L). Exploratory transcriptomic analyses further revealed coordinated pathway-level responses related to neuromuscular and cardiovascular development, supporting a shift in overall developmental timing rather than overt toxicity. Furthermore, eight additional sulfonamides produced comparable effects, suggesting a potential class-wide phenomenon. Together, our integrated approach identified a set of environmental substances associated with advanced embryonic developmental timing at environmentally relevant levels and highlighted their potential ecological relevance.

6. Management of Behavioral and Psychological Symptoms of Dementia: Nonpharmacologic and Pharmacologic Interventions.

期刊: Annual review of clinical psychology 发表日期: 2026-Feb-12 链接: PubMed

摘要

Mounting evidence supports the efficacy of nonpharmacologic or psychosocial interventions for reducing behavioral and psychological symptoms of dementia (BPSD), identifies the comparative risks and benefits of psychotropic medication, and underscores the importance of deprescribing psychotropic medications. However, evidence from clinical settings indicates that uptake of nonpharmacologic interventions and potential overuse of medications remain problematic. We begin by discussing the importance of exploring potential contributors to BPSD, using person-centered language to describe BPSD, implementing holistic and person-centered care plans, measuring clinically important changes in BPSD, and considering social determinants of health when assessing and managing BPSD; we also discuss the historical context informing how clinicians manage BPSD. Next, we compare and contrast nonpharmacologic and pharmacologic approaches to managing BPSD, evaluate their individual and comparative efficacy, and describe recommendations for intervention deprescribing or deimplementation. Lastly, we discuss strengths and limitations of the current evidence supporting BPSD management as well as recommendations for future research.

7. Which US States Are Most Generous in Their Medicaid Policies and Why?

期刊: Journal of health politics, policy and law 发表日期: 2026-Feb-12 链接: PubMed

摘要

Why are some states more generous in their welfare programs than others? Although widely studied in comparative political economy, this question has been less applied to U.S. health policy. Delegation of Medicaid administration to the states has produced substantial variation in program generosity, but the sources of this variation remain underexplained. This paper analyzes predictors of Medicaid generosity using longitudinal data from 2000-2020 on state eligibility and enrollment rules. We test several political economy theories, including left power resources, racial/ethnic heterogeneity, political culture, and partisan politics. Findings show strong variation in generosity across states and generosity categories, though overall generosity has increased over time. Political culture-particularly conservative attitudes-has the most consistent negative effect on generosity. Racial heterogeneity also suppresses generosity. By contrast, Democratic trifectas and union strength show no consistent effects, while Republican trifectas correlate with higher administrative burden and reduced eligibility, but less consistently than mass attitudes. Overall, political culture more consistently shapes Medicaid generosity than party control, suggesting that public preferences for limited government play a key role in shaping state policy. The paper concludes by discussing implications for the present moment as the scope of Medicaid coverage is poised to be dramatically reduced.

8. Are Aging Clocks Based on Routine Clinical Indicators Trustworthy and Applicable? A Systematic Review and Critical Appraisal.

期刊: The journals of gerontology. Series A, Biological sciences and medical sciences 发表日期: 2026-Feb-12 链接: PubMed

摘要

Aging clocks based on routine clinical indicators have emerged as a cost-effective tool for assessing biological age. This systematic review aims to summarize the characteristics and critically appraise these available aging clocks. Studies that developed aging clocks for adults (≥18 years) based on routine clinical indicators were retrieved from six databases (PubMed, EMBASE, Web of Science, CNKI, Wanfang Data, and Sinomed) up to June 18, 2024. The PROBAST+AI tool was used to assess the methodological quality, risk of bias, and applicability of included aging clocks. All the results were narratively summarized. Fifty-nine studies involving 81 aging clocks were included, of which 71 (87.7%) were developed using single-country datasets predominantly from China, the United States, Korea, and the United Kingdom. Notably, 31 aging clocks (38.3%) were developed with neither internal nor external validation. The majority of aging clocks were rated as having high concern regarding quality and high risk of bias, even including those published in high-impact journals. Only three aging clocks (3.7%) from two studies were rated as having low concern regarding quality and applicability during development, and two of these (4.0%) from one study further demonstrated low risk of bias and low concern for applicability during model evaluation. Future research should prioritize validating the promising aging clocks in target populations rather than developing new ones, adhere to the PROBAST+AI and TRIPOD+AI guidelines for methodological rigor and transparent reporting, and provide reproducible and user-friendly model codes and tools.

9. COPD Management in Primary Care: Underutilisation of Nursing Consultations.

期刊: Journal of clinical nursing 发表日期: 2026-Feb-12 链接: PubMed

摘要

To describe the clinical profile, comorbidity burden, follow-up and healthcare utilisation in patients labelled as having Chronic Obstructive Pulmonary Disease (COPD) in Primary Care (PC) nursing consultations. Real-world data COPD, retrospective, observational study using routinely collected data in electronic health records (EHR). This study adheres to the STROBE reporting guidelines for cross-sectional studies. Three Primary Care centres in Catalonia, Spain, belong to the Catalan Health Service. All patients aged ≥ 15 years with a recorded diagnosis of COPD in their EHR, excluding institutionalised individuals and those deceased before study onset. Final sample: 474 patients (105 women, 369 men; mean age 70 years) from a reference population of 28,000 individuals. Data included socio-demographics, smoking/alcohol, mMRC dyspnea, inhaled therapy/adherence, spirometry, comorbidities, Adjusted Morbidity Groups (GMA), active COPD care plans and 12-month healthcare use. EHR showed a high rate of missing data in follow-up variables (inhaler adherence 28.5%; dyspnea 17%-20%). Despite that, all participants were ‘labelled’ as COPD, most of them lacked spirometric confirmation. Active smoking was highly prevalent (52.3% women, 45.0% men). Hypertension, obesity and osteoarthritis were the most common comorbidities; anxiety, depression, osteoporosis and thyroid disorders were more frequent in women. Higher GMA complexity correlated with more Primary Care visits, especially nursing consultations, particularly in patients with cardiovascular disease and diabetes (p < 0.001) for 12 months follow-up. No significant differences between groups were found in urgent or hospital care use. EHR-labelled COPD patients with cardiometabolic comorbidity received more structured nursing follow-up and more annual visits than without. Improving EHR recording, integrating spirometry with the EHR, and prioritising high-complexity profiles could enhance monitoring, treatment optimisation and equity-nursing consultations are a key lever. No patients or members of the public were directly engaged in the study design or data analysis. Nevertheless, the research was motivated by patient needs and aims to improve healthcare services.

10. Mindfulness for heart and mind: Mindfulness-based blood pressure reduction randomized clinical trial for depression symptoms.

期刊: Health psychology : official journal of the Division of Health Psychology, American Psychological Association 发表日期: 2026-Feb-12 链接: PubMed

摘要

This study evaluated the effects of the Mindfulness-Based Blood Pressure Reduction (MB-BP) program on depression symptoms in individuals with elevated blood pressure (BP). Exploratory analyses examined whether childhood abuse or neglect moderated these effects. Adults with elevated BP (n = 201; ≥120/80 mmHg) were randomized to MB-BP (n = 101) or enhanced usual care (n = 100) and followed for 6 months. MB-BP trained participants in mindful self-regulation skills-self-awareness, attention control, and emotion regulation-and applied these skills to modifiable determinants of BP and depression symptoms, such as diet, physical activity, alcohol use, and stress reactivity. Depression symptoms were assessed using the Center for Epidemiologic Studies Depression Scale-Revised. Outcome assessors were blinded to group assignments. Participants (58.8% female, 81.1% non-Hispanic White, mean age 59.5years) in the MB-BP group had a 1.65-point greater reduction in Center for Epidemiologic Studies Depression Scale-Revised scores at 6 months versus controls (95% CI [-2.79, -0.51], Cohen’s d = 0.29). Exploratory analyses revealed sizable reductions in depression symptoms for participants exposed to high parental neglect (-2.25, 95% CI [-4.18, -0.31]) and modest reductions in those with low neglect (-0.78, 95% CI [-2.28, 0.70]), with a formal test for interaction p value of .011. High abuse exposure was associated with depression symptom improvements (-2.34, 95% CI [-4.58, -0.10]), as was low abuse exposure (-1.49, 95% CI [-4.08, 1.10]), with a test for interaction p value of .079. MB-BP significantly reduced depression symptoms in individuals with elevated BP, with preliminary evidence suggesting amplified benefits for those with early-life adversity, particularly neglect. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

11. "Thoughts and Prayers": The (Non) Effect of Partisan Responses to Mass Shootings on Public Opinion.

期刊: Journal of health politics, policy and law 发表日期: 2026-Feb-12 链接: PubMed

摘要

Experts consider gun violence a public health crisis in the United States. Its increasing magnitude has pressured some Republican lawmakers to reconsider their responses to these events, moving away from sending condolences of “thoughts and prayers” to the victims and moving towards alternative, policy-oriented rhetoric. Ample literature in political science finds that how politicians speak about issues can shape voters’ viewpoints on them. Could a Republican move away from “thoughts and prayers” rhetoric soften the cleavage on second amendment rights and lead to gun reform? Findings from a recent survey experiment suggest otherwise. Different rhetoric by Republican politicians did not move public opinion on firearm reform. There continues to be, however, substantial baseline support for several policies that would likely reduce gun violence. We comment on the implications of these findings on the politics of firearm policy reform in America.

12. Boron Clusters Versus Adamantane: A Comparative Study of Inorganic and Organic Scaffolds Against Resistant Influenza A.

期刊: ChemMedChem 发表日期: 2026-Feb-12 链接: PubMed

摘要

A series of adamantane-based amino acid derivatives incorporating γ-aminobutyric acid (GABA) as a spacer, with the general structure Ad-CH2-CO-GABA-X-OMe (where X represents L-tryptophan (Trp), L-histidine (His), H-Ala-((S)-2-oxopyrrolidin-3-yl)-OMe (Pld), or L-methionine (Met)), were synthesized and evaluated in vitro for their antiviral activity against rimantadine-resistant influenza A virus strains A/Moscow/78/2020(H1N1)pdm09 and A/Cheboksary/125/2020(H1N1)pdm09. The results demonstrated that the presence of an L-tryptophan residue is crucial for effective inhibition of influenza virus replication, with the corresponding derivative exhibiting potent activity at an IC50 of 0.5 µg/mL. A comparative analysis of structural features and antiviral properties was conducted between the adamantane derivatives and analogous derivatives of the closo-decaborate anion ([B10H10]2-) functionalized with identical amino acid residues Na2[B10H9-O(CH2)2O(CH2)3C(O)-X-OCH3] (X = Trp, His) and spacers of comparable length. This study suggests that combining adamantane-based compounds with closo-decaborate clusters could lead to the development of highly effective therapeutic compositions with enhanced efficacy and improved safety profiles.

13. Vascular events in autoantibody-defined clusters of systemic lupus erythematosus: a 12-year prospective cohort study.

期刊: Rheumatology (Oxford, England) 发表日期: 2026-Feb-12 链接: PubMed

摘要

We recently identified four Systemic lupus erythematosus (SLE) clusters based on 13 autoantibodies used in clinical practice. In this prospective cohort study, we investigate the incidence of major cardiovascular events (MACE) and venous thromboembolism (VTE) in SLE patients stratified by clusters. Clusters were compared with each other and to matched controls. Clusters were defined at baseline: Cluster 1 dominated by anti-SSA/SSB, Cluster 2 by anti-nucleosome/Sm/RNP/dsDNA, Cluster 3 by aPL, and Cluster 4 negative for all 13 autoantibodies. SLE clinical data were collected at enrolment. Vascular outcomes were prospectively retrieved from the National Patient Register using ICD codes. Each patient was matched on birth/sex/residence to 10 controls from the Total Population Register. Subjects with previous vascular events were excluded. Hazard ratios (HR) and 95% confidence intervals from Cox proportional hazards models estimated the age-adjusted relative risks of incident vascular events. We included 461 SLE patients, mean follow-up 12.2 ± 5.6 years. Compared with reference clusters, Cluster 3 (n = 154) had the highest relative risk for MACE (HR 1.91 (95%CI: 1.01-3.58) and VTE (HR 2.69 (95%CI: 1.05-6.9). Cluster 2 (n = 105) had high risk for heart failure and VTE, similar to cluster 3, despite younger age. The lowest incidence of vascular events was observed in cluster 4 (n = 61) in comparison to the other clusters. We observed differences regarding the incidence of MACE and VTE during 12 years of follow up for four autoantibodydefined clusters. The highest incidences were seen in the aPL-dominated cluster, while the lowest were detected in the autoantibody-negative cluster.

14. Outcomes of Same-Sex Female Couples Pursuing Autologous and Reciprocal In Vitro Fertilization.

期刊: JAMA 发表日期: 2026-Feb-12 链接: PubMed

摘要

This study compares embryo transfer and pregnancy outcomes among US same-sex female couples undergoing reciprocal and autologous oocyte in vitro fertilization (IVF) cycles.

15. Concerns About Methods and Reporting in Proton Craniospinal Irradiation Trial-Reply.

期刊: JAMA oncology 发表日期: 2026-Feb-12 链接: PubMed

摘要

16. New-Onset Nonarteritic Anterior Ischemic Optic Neuropathy and Initiators of Semaglutide in US Veterans With Type 2 Diabetes.

期刊: JAMA ophthalmology 发表日期: 2026-Feb-12 链接: PubMed

摘要

Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are considered safe, effective medications for type 2 diabetes (T2D) and weight loss, used by millions worldwide. While their cardiometabolic benefits are well established, emerging observations suggest a potential association between GLP-1RA use and new-onset nonarteritic anterior ischemic optic neuropathy (NAION). To emulate a target trial evaluating the risk of NAION associated with initiation of semaglutide (GLP-1RA), compared with a sodium-glucose cotransporter-2 inhibitor (SGLT2i) as second-line therapy for T2D in a nationwide cohort of US veterans. This study was conducted nationwide using data from the Veterans Health Administration health care system between March 1, 2018, and March 1, 2025. This active-comparator, new-user, target trial emulation used cause-specific hazard ratios (HRs) that were estimated using overlap weighting to account for confounding. Participants included US veterans with T2D, current metformin use, and no prior GLP-1RA or SGLT2i use. Data analysis was conducted from July 2025 through September 2025. Initiation of semaglutide or any SGLT2i. Incident NAION, identified using International Statistical Classification of Diseases and Related Health Problems, Tenth Revision and Systematized Nomenclature of Medicine codes. A total of 102 361 US veterans met inclusion criteria, including 11 478 initiators of semaglutide and 90 883 initiators of an SGLT2i. Baseline characteristics were well balanced between treatment groups after overlap weighting (mean [SD] age, 60.1 [11.7] years; body mass index, 37.8 [6.7]; hemoglobin A1c, 7.0% [1.4]; 85.5% male and 14.5% female; 20.7% Black, 8.1% Hispanic, and 61.9% non-Hispanic White). Over a maximum follow-up of 7.5 years, 173 total incident NAION events occurred. The incidence rate of NAION was 123 per 100 000 person-years among semaglutide initiators and 67 per 100 000 person-years among SGLT2i. In 2.1 years of median follow-up, semaglutide initiators had a 2.33-fold higher risk than SGLT2i initiators (hazard ratio, 2.33; 95% CI, 1.54-3.54; P < .001). The overlap weighted incidence rate of NAION was 0.29% for semaglutide initiators and 0.13% for SGLT2i initiators, with a corresponding average treatment effect of 0.16 percentage points. In this nationwide cohort of US veterans with T2D, semaglutide initiators had a 2-fold NAION risk than SGLT2i initiators, while the absolute risk was low. Clinicians and patients should be counseled on the rare but evident increased risk of NAION after semaglutide initiation.

17. Systemic lupus erythematosus and associated organ damage in real-world settings: estimating damage scores using administrative claims data.

期刊: Clinical and experimental rheumatology 发表日期: 2026-Feb-12 链接: PubMed

摘要

The Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index (SDI) captures organ damage (OD) in patients with systemic lupus erythematosus (SLE). However, SDI is not always documented in the clinic or medical claims data. This non-interventional retrospective cohort study (GSK Study 209523) used a claims-based algorithm to estimate annual damage scores and associated economic burden in patients with SLE in Germany. Patients were identified from the Betriebskrankenkassen German Sickness Fund Database based on the first recorded SLE diagnosis code (index). A claims-based algorithm incorporating conditions listed in the SDI was used to identify OD and estimate damage scores for each follow-up year. Annual costs were estimated from inpatient and outpatient resources and stratified by a damage score point increase. Patients with SLE (n=2121; pre-existing: n=1037; newly diagnosed: n=1084) and without SLE (n=6308) were included. At baseline, 60.5% (n=1283) of patients with SLE had OD, including 55.3% (n=599) newly diagnosed patients. In Year 1, the mean damage score was 1.82 among all patients with SLE; it was similar between patients with baseline OD and pre-existing (2.76) and newly diagnosed SLE (2.89). Among patients with SLE, during years with a 1-, 2- and ≥3-point increase in damage score, median annual costs were 1.94, 3.75 and 7.84 times those in years without damage score increase. Our findings suggest that real-world administrative claims data can effectively estimate damage scores in patients with SLE, and that the increase in scores correlates with a higher economic burden.

18. Risk Factors for Valvulopathy Among Childhood Cancer Survivors.

期刊: JAMA oncology 发表日期: 2026-Feb-12 链接: PubMed

摘要

19. Don't Take Your Guns to Town? Rural Socialization and the Long-Term Politics of Firearms.

期刊: Journal of health politics, policy and law 发表日期: 2026-Feb-12 链接: PubMed

摘要

Scholars have long associated rural residency with gun ownership and conservative gun attitudes in the U.S. However, less is known about the roots and long-term stability of this relationship. Are individuals who are raised in more rural communities more likely to own weapons even when they move away? Do individuals socialized in rural communities maintain a long-term cultural attachment to guns and distinctive firearms policy attitudes? Scholars disagree about whether current rural residency versus childhood rural cultural socialization are independently related to rural gun politics. Here, we explore for the first time the relative roles of rural childhood socialization, contemporary rural residency, and rural cultural attachments to patterns of gun ownership and firearms policy attitudes. We utilize original survey data as well as the American National Elections Study to explore these questions. We find that individuals socialized in rural communities maintain their attachment to firearms and hold relatively more conservative firearms policy attitudes over their lifespan, even after moving away from rural areas. Rural cultural childhood socialization has an independent influence on the long-run politics of guns.

20. Mental Health in Times of Democratic Backsliding: Insights from Trump's Second Term.

期刊: Journal of health politics, policy and law 发表日期: 2026-Feb-12 链接: PubMed

摘要

The United States is currently experiencing democratic backsliding. In this commentary, I consider how this backsliding impairs the mental health of Americans. Surprisingly, the literature on democratic backsliding has little to say about its impact on mental health, and the literature on mental health has little to say about the role of democratic backsliding. I draw on anecdotes, news stories, polls, and real-world events from Trump’s second term to theorize about a potential connection. I highlight three ways that democratic backsliding might give rise to feelings of depression, anxiety, and to a lesser extent post-traumatic stress disorder. I then discuss how this mental toll may be felt unequally across citizens and may create a feedback loop that gives rise to more democratic backsliding. I conclude by urging scholars to build on these ideas as we collectively seek to develop and refine our understanding of this important topic.

21. Health Policy and Direct Democracy: Predictors of Successful Measures, 2010-2024.

期刊: Journal of health politics, policy and law 发表日期: 2026-Feb-12 链接: PubMed

摘要

Direct democracy is often used to shape state-level health policy, and while prior research has studied determinants of success for ballot measures generally, examination of healthcare-related measures (HRM) remains limited. This study addressed four questions: (1) are HRM more likely to pass than non-healthcare-related measures (NHRM); (2) do HRM engage voters more than NHRM; (3) do HRM draw more oppositional campaign spending than NHRM; and (4) among HRM, what characteristics predict success? We identified 96 HRM in 34 states from 2010-2024 and 352 NHRM that appeared alongside them on the same ballot (n = 448). Using regression analyses to examine campaign outcomes, ballot completion, and spending, we controlled for initiative- and election-level covariates. Sensitivity analyses adjusted for “moral issues” (i.e., measures pertaining to abortion and euthanasia) and supermajority passage requirements. Findings indicate that HRM drew greater voter engagement and were significantly more likely to pass than NHRM. Furthermore, increased oppositional spending was associated with lower odds of success for all measures. Results indicate that interest groups and voters view HRM pertaining to “morality” differently and among HRM, oppositional spending is the strongest predictor of success. Additional research is needed on voter preparedness when it comes to healthcare policy on the ballot.

22. Policy Design and Democratic Accountability.

期刊: Journal of health politics, policy and law 发表日期: 2026-Feb-12 链接: PubMed

摘要

The One Big Beautiful Bill Act of 2025 extends the 2017 federal tax cuts, with most benefits going to the top of the income spectrum while cutting social programs for lower- and middle-income households including Medicaid, Medicare, provisions of the Affordable Care Act, and SNAP. An open question is whether Republican candidates will suffer electoral punishment as a result, or whether the cuts are hidden enough for the GOP to escape electoral retribution. The OBBBA uses strategic policy design to cut social policy spending in submerged, invisible ways by taking advantage of delegation to states and to private insurers and by increasing administrative burden rather than making overt eligibility or benefit reductions. An examination of previous social policy retrenchment efforts suggests that the OBBBA has more in common with the 1996 welfare reform, which retrenched through heightened administrative burdens and real declines in funding, than it does with more overt and unsuccessful retrenchment attempts, such as cuts to Social Security in the 1980s and the 2017 ACA repeal and replace effort, whose visibility resulted in policymaker backtracking and electoral retribution. Hidden policy designs can defang opposition, diminishing democratic voice.

23. Introduction: Health Politics and Democracy.

期刊: Journal of health politics, policy and law 发表日期: 2026-Feb-12 链接: PubMed

摘要

24. Modern Management of CKM Syndrome: Use of GLP-1 Receptor Agonists in a Multidisciplinary Setting-Expert Group Recommendations from Kuwait.

期刊: Diabetes therapy : research, treatment and education of diabetes and related disorders 发表日期: 2026-Feb-12 链接: PubMed

摘要

Obesity, type 2 diabetes (T2D), cardiovascular disease (CVD), and chronic kidney disease (CKD) are overlapping conditions that drive premature morbidity and mortality worldwide. Care remains siloed and reactive despite shared risk factors and strong evidence for early intervention. To support integrated disease management, the American Heart Association (AHA) recently introduced the concept of cardiovascular-kidney-metabolic (CKM) syndrome, recognizing the bidirectional links between metabolic, kidney, and cardiovascular health. Kuwait faces one of the highest burdens of CKM-related diseases globally. Three-quarters of adults are overweight or have obesity, and 28% have diabetes, both of which are leading causes of mortality and health system strain. Yet multidisciplinary care remains limited, and innovative pharmacotherapies, including glucagon-like peptide-1 receptor agonists (GLP-1 RAs), are underused. A panel of Kuwaiti endocrinologists, cardiologists, and nephrologists convened to assess barriers to optimal CKM care and define practical recommendations. Discussions focused on current gaps in screening, care coordination, provider education, and access to therapies. Evidence on GLP-1 RAs was reviewed, considering the demonstrated benefits for weight loss, glycemic control, cardiovascular outcomes, and CKD progression. The expert group agreed that multidisciplinary, risk-stratified, and patient-centered approaches are urgently needed. Recommendations include earlier screening and diagnosis, improved integration across specialties, healthcare provider upskilling, public awareness campaigns, and broader access to GLP-1 RAs. Semaglutide was highlighted as a clinically valuable option owing to its broad efficacy and safety profile. Adopting a CKM care model tailored to Kuwait’s specific challenges, with appropriate use of GLP-1 RAs, can reduce disease burden, improve outcomes, and increase healthcare system efficiency. The local implementation of evidence-based, cross-specialty strategies is key to altering the trajectory of CKM syndrome in high-risk populations.

25. Associations of maternal dietary patterns during pregnancy with neonatal obesity among Han and Tibetan maternal-child pairs: results from a prospective birth cohort in Tibetan area.

期刊: European journal of nutrition 发表日期: 2026-Feb-12 链接: PubMed

摘要

Neonatal obesity has profound effects across the entire life. Although maternal diet and environmental exposures such as high altitude are potential influencing factors, the modulating effects of the unique high-altitude environment and distinct ethnic dietary patterns prevalent on the Tibetan Plateau remain unexplored. To investigate this association, we utilized Compositional Data Analysis (CoDA) to model dietary patterns. This study aims to investigate the associations between maternal dietary patterns during pregnancy and neonatal obesity, examining the potential modification effect by altitude and ethnicity. Furthermore, we apply the CoDA approach to quantify the impact of dietary redistribution on obesity risk. The findings are expected to inform targeted dietary interventions and public health strategies for high-risk populations. A birth cohort study encompassed 1173 pregnant women from the Tibetan Plateau. Dietary intake frequency during pregnancy was assessed using the food frequency questionnaire. Principal component analysis was used to identify the dietary patterns. Linear and logistic regression was used to examine the associations between dietary patterns and neonatal obesity. CoDA was employed to assess the association between redistribution of diet servings during pregnancy and altered risk of high ponderal index (HPI). Of the total 1173 mother-neonate pairs, 40.3% were Tibetans, 22.7% resided in ultra-high altitude areas, and 4.9% of neonates had obesity. Four dietary patterns were identified. A higher protein-fruit pattern score was significantly associated with a lower risk of HPI (OR = 0.66, 95% CI 0.47-0.93). We also observed a modification effect by altitude (Pinteraction = 0.026). Stratified by living altitude, this association was statistically significant only in Tibetans who lived in ultra-high altitude areas (OR = 0.39, 95% CI 0.20-0.69, P = 0.003). Composition of data analysis showed that when fruit consumption increased, estimated Δβ of HPI and z-score of ponderal index (PI) decreased. Higher adherence to protein-fruit dietary patterns during pregnancy was negatively associated with neonatal obesity in the Tibetans living in ultra-high altitude areas. Encouraging healthy diets during pregnancy, particularly through initiatives such as increasing fruit intake, may help to prevent neonatal obesity.

26. Long-term administration of the mutant IDH inhibitor DS-1001b suppresses the growth of IDH1-mutant glioma in vitro and in mouse xenograft models and alters epigenetic profiles.

期刊: Acta neuropathologica 发表日期: 2026-Feb-12 链接: PubMed

摘要

Heterozygous mutations in isocitrate dehydrogenase (IDH) 1 and 2 are hallmarks of astrocytoma, IDH-mutated, and oligodendroglioma, IDH-mutated, as defined by the World Health Organization Classification of Tumors of the Central Nervous System, 5th Edition. Mutant IDH confers a neomorphic enzymatic activity that converts α-ketoglutarate (α-KG) into the oncometabolite D-2-hydroxyglutarate (D-2-HG), which inhibits α-KG-dependent dioxygenases and induces a global DNA hypermethylation phenotype, also known as Glioma CpG Island Methylator Phenotype (G-CIMP). To elucidate mechanisms underlying the antitumor effects of DS-1001b-a novel, brain-penetrant, orally available inhibitor of mutant IDH1 R132H and R132C-we performed preclinical analyses using IDH1 R132H-mutant glioma cells in vitro and orthotopic mouse xenograft models (MGG152, BT142, and A1074). DS-1001b treatment reduced 2-HG levels in vitro and in vivo and significantly prolonged survival in A1074 and BT142 intracranial xenograft models (p = 0.0064 and 0.0004, respectively), confirming effective target inhibition in the brain. In vitro, prolonged DS-1001b exposure partly reversed genome-wide DNA hypermethylation and revealed that H3K4me3 modulation was mostly associated with differential gene expression, affecting pathways related to apoptosis, necrosis, cell cycle arrest, and migration in MGG152. Metabolomic analyses further demonstrated a significant reduction in asparagine in A1074, consistent with the activation of L-asparaginase-mediated pathways. Collectively, these findings indicate that sustained DS-1001b administration exerts antitumor effects in IDH1-mutant glioma mouse models and induces transcriptomic, epigenetic, and metabolic reprogramming.

27. Salivary Stress Biomarkers in Subjects With Temporomandibular Disorders (TMDs): A Meta-Analysis.

期刊: Journal of oral rehabilitation 发表日期: 2026-Feb-12 链接: PubMed

摘要

Stress is recognised as a contributing risk factor for temporomandibular disorders (TMDs), and salivary stress biomarker levels may be altered in such patients. This systematic review aimed to assess the current evidence to determine the association between salivary stress biomarkers and temporomandibular disorders (TMDs). PubMed, Cochrane, Google Scholar and Scopus were searched. Case-control and cross-sectional studies exploring the association of salivary stress biomarkers in adult subjects with TMDs were included. A random effects model was used for quantitative data analysis. Risk-of-bias was assessed using the Newcastle-Ottawa Scale (NOS). Out of 5319 studies, 16 studies met the eligibility criteria. All included studies were case-control studies; they included 549 TMD cases and 494 controls. Overall, TMD cases showed higher levels of morning unstimulated salivary cortisol compared to controls (SMD: 1.38, 95% CI: 0.40-2.36), whereas the level of evening cortisol between both groups was non-significant (SMD: 0.47, 95% CI: -0.00 to 0.95). Also, the qualitative results showed that the salivary oxidative-stress biomarker was increased in the TMD group compared to controls. The level of morning salivary cortisol seems to be increased in patients with TMDs compared to controls. This may indicate an association of salivary stress biomarkers and TMDs, although the level of evidence is very low. Therefore, further standardised studies are required to support these findings.

28. Training health professionals in smoking cessation.

期刊: The Cochrane database of systematic reviews 发表日期: 2026-Feb-12 链接: PubMed

摘要

Cigarette smoking is one of the leading causes of preventable death worldwide. There is good evidence that brief interventions by health professionals can increase smoking cessation attempts. However, as new studies become available, the effectiveness of these training programmes needs to be re-assessed to inform public policy, clinical care, and guideline recommendations. This is an update of a Cochrane review first published in 2000, and previously updated in 2012. To assess the effectiveness of training healthcare professionals to deliver smoking cessation interventions to their patients, and to assess the effects of training characteristics (such as content, setting, delivery, and intensity). We searched the following databases from inception to August 2024: Cochrane Central Register of Controlled Trials (CENTRAL); MEDLINE; Embase; PsycINFO; ClinicalTrials.gov (through CENTRAL); and the World Health Organization International Clinical Trials Registry Platform (through CENTRAL). We also searched the references of eligible studies. We included randomised trials in which the intervention was training of healthcare professionals in smoking cessation. We considered trials for inclusion if they reported outcomes for patient smoking at least six months after the intervention. Process outcomes needed to be reported. However, we excluded trials that reported effects only on process outcomes and not smoking behaviour. The critical outcome measure was abstinence from smoking six months or more after baseline, using the strictest measure of abstinence available at the longest follow-up. Prolonged or continuous abstinence was preferred over point prevalence. Our important outcome was the number of participants who made a quit attempt. Working independently, two review authors evaluated the risk of bias using the Cochrane RoB 1 tool, following guidance from the Cochrane Tobacco Addiction Group. Working independently, two review authors extracted information about the characteristics of each included study (i.e. interventions, participants, outcomes, and methods). We pooled studies using random-effects meta-analysis where possible and otherwise summarised findings using narrative synthesis in text and tables. We used the GRADE framework to assess the certainty of the evidence. We included 29 studies in the review, published between 1989 and 2024. Together, the studies provided training for over 4030 health professionals, and data for 38,178 participants. We assessed 10 studies to have an overall low risk of bias, 17 an unclear risk, and two to have an overall high risk of bias. Sixteen studies compared training of healthcare professionals in smoking cessation to no training, and assessed the effect on the number of participants abstinent at longest follow-up. High-certainty evidence indicates that smoking cessation training for healthcare professionals increases patient smoking cessation compared with no training (risk ratio (RR) 1.34, 95% confidence interval (CI) 1.08 to 1.67; I2 = 48%; 16 studies, 16,513 participants). We conducted three subgroup analyses to test the effect of specific potential sources of heterogeneity: training intensity, type of healthcare professional trained, and treatment recommended in the training; none found evidence of between-group heterogeneity. Four studies assessed the effect of high-intensity training for healthcare professionals on the number of participants abstinent at longest follow-up compared with lower-intensity training. The evidence suggests that higher-intensity training may increase smoking cessation compared with lower-intensity training, though confidence intervals were wide and included the potential for no benefit (RR 1.64, 95% CI 0.86 to 3.12; I2 = 54%; 4 studies, 1151 participants; low-certainty evidence). Three studies assessed the impact of adjuncts to training on the number of participants abstinent at longest follow-up. We found low-certainty evidence that when the healthcare professionals treating them are trained in smoking cessation, more people may quit when also provided with nicotine replacement therapy (RR 1.64, 95% CI 0.72 to 3.71; I2 = 69%; 2 studies, 1892 participants), and very low-certainty evidence that providing prompts to healthcare professionals in addition to smoking cessation training may help more people to quit (RR 1.37, 95% CI 0.69 to 2.70; I2 = 66%; 3 studies, 2429 participants). However, in both cases, confidence intervals were wide and included the potential for no benefit. High-certainty evidence supports the effectiveness of training health professionals in smoking cessation when compared with no training. Multi-component investigations incorporating new pharmacological interventions for smoking cessation (such as varenicline and bupropion) or other cessation aids alongside physician training should be considered to determine if any additional benefit in long-term abstinence can be obtained. Production of this review was supported by PhD scholarship funding from the University of Adelaide and co-funded by Houd Research Group, awarded to KS. This review was first published outside of Cochrane in 1994 and subsequently updated as a Cochrane review in 2000 (DOI: 10.1002/14651858.CD000214) and 2012 (DOI: 10.1002/14651858.CD000214.pub2). No protocol was published or registered.

29. [Taiwan working for a healthy, sustainable aging].

期刊: Lakartidningen 发表日期: 2026-Feb-12 链接: PubMed

摘要

Taiwan is addressing rapid population aging by promoting senior health and nutrition. By 2025, over 20% of its population is aged 65 or older. For this reason, Taiwan launched Community Nutrition Promotion Centres in 2017, that are now operating in all counties. The community nutritionists guide seniors on balanced diets using adapted traditional recipes. They also offer nutrition screenings and promote physical activity. In 2023, Taiwan passed the Nutrition and Healthy Diet Promotion Act and showcased its efforts at a 2025 APEC conference. Taiwan is setting a regional example for healthy, sustainable aging.

30. Removal of volatile organic compounds by chemical filters significantly inhibited the development of atopic dermatitis symptoms in mice: Potential implications for air-conditioning systems in healthcare environments.

期刊: Toxicological sciences : an official journal of the Society of Toxicology 发表日期: 2026-Feb-12 链接: PubMed

摘要

Volatile organic compounds (VOCs) are increasingly implicated in systemic diseases, but their contribution to skin disorders such as atopic dermatitis (AD) remains unclear. This study assessed VOC concentrations in medical environments, their effects on AD development, and the efficacy of VOC removal using chemical filters. Total VOC levels were monitored in three types of veterinary hospitals. AD-like lesions were induced in female NC/Nga mice by repeated dermal application of tolylene diisocyanate or house dust mite ointment, with or without topical exposure to a VOC mixture (10 μg/mL). Clinical parameters, including dermatitis scores, transepidermal water loss, and skin thickness, were measured weekly, and immunological and histological analyses were performed. VOC monitoring revealed that one hospital exhibited concentrations exceeding 400 μg/m³. In the mouse model, direct VOC exposure significantly aggravated keratinocyte inflammation and worsened AD symptoms. Application of chemical filtering systems effectively reduced VOC levels in real clinical settings, and their use in the experimental model suppressed AD development. However, therapeutic application of VOC removal showed only limited effects on systemic immunological markers. These findings suggest that VOCs present in healthcare environments may contribute to the onset and progression of AD. Incorporating VOC-removing filters into air-conditioning systems could serve as a preventive strategy to improve the management of allergic skin diseases.

31. Cardiovascular disease risk among long-term testicular cancer survivors following contemporary cisplatin-based chemotherapy.

期刊: Journal of the National Cancer Institute 发表日期: 2026-Feb-12 链接: PubMed

摘要

Testicular cancer survivors (TCS) experience excess cardiovascular disease (CVD) incidence and mortality. To address the urgent need for new risk prediction tools, we evaluated the AHA’s 2024 PREVENT-equation among 1,759 TC survivors (TCS; median baseline age = 37 years). Baseline median 10- and 30-year CVD risks were 1.3% and 9.1%. Among evaluated survivors with follow-up (N = 737; median age = 45), each 5% increase in 10-year PREVENT risk conferred 2.94-fold odds (95%CI = 1.99-4.35, P < .001) of incident CVD. Those with 10-year PREVENT absolute risk defined as intermediate-high (≥7.5% per AHA) had 12.11-fold higher odds (P < .001). Associations were strongest after four cycles of etoposide/cisplatin (EPX4) (OR = 4.93, P < .001), possibly driven by lower eGFR and slightly older age (P < .001 each), and among TCS without vigorous baseline physical-activity (OR = 4.25, P < .001). EPX4 patients were among those less engaged in activity (P = .005). PREVENT equations, utilizing routine measures, can identify high-risk TCS, highlighting physical-activity as a key modifiable factor for early intervention.

32. How Do Egocentric Sexual Networks Affect Male Migrants' HIV Sexual Behavior Patterns in Gender-Imbalanced China? The Moderating Role of Migration and Neighborhoods.

期刊: Archives of sexual behavior 发表日期: 2026-Feb-12 链接: PubMed

摘要

In gender-imbalanced China, migrant populations are a high-risk group for HIV transmission. Informed by the social-ecological model, this study investigated the association between egocentric sexual networks and HIV sexual behavior patterns, evaluating the moderating effects of migration experiences and neighborhood characteristics among male migrants in China’s gender imbalance context. Data from two cross-sectional surveys conducted in 2017 in China, targeting never-married men in rural areas and male migrants (married and unmarried) in urban settings, were collected. The study included 713 respondents aged 28 and above with rural household registration (hukou) and migration experience. Utilizing latent category analysis, based on their sexual risk behaviors, 33.4% of respondents were classified into high-risk patterns for HIV infection. Multivariate logistic regression models showed that egocentric sexual network characteristics, including sexual network size, partner age, and partner type, were significantly associated with high-risk HIV sexual behavior patterns. Residence in high-risk neighborhoods reinforced or strengthened the association between egocentric sexual networks and high-risk patterns, but migration experiences weakened this association. The analysis revealed heterogeneity in HIV sexual behavior patterns and associated factors between never-married and married male migrants, highlighting significant implications for HIV prevention efforts targeting populations facing the challenges of gender imbalance. Policymakers and public health providers should incorporate egocentric sexual network factors associated with HIV risk, as well as the roles of neighborhood characteristics and migration experiences, into the consideration of comprehensive HIV intervention.

33. Integrating computational and biological approaches for the discovery of putative MmpL3 inhibitors against Mycobacterium tuberculosis.

期刊: Molecular diversity 发表日期: 2026-Feb-12 链接: PubMed

摘要

34. Understanding the burden of endocrine and metabolic disorders in Prader-Willi syndrome: data from the Italian registry.

期刊: Journal of endocrinological investigation 发表日期: 2026-Feb-12 链接: PubMed

摘要

35. Plant-derived betaine enhances barrier integrity and immune responses in canine intestinal epithelial cells and macrophages under endotoxin challenge.

期刊: Journal of animal science 发表日期: 2026-Feb-12 链接: PubMed

摘要

Interest in the utilization of novel plant-based extracts for supporting gut health and nutrition in companion animals is growing. The effect of betaine on canine intestinal barrier integrity and immune-related gene and protein expression by epithelial and macrophage-like cells was evaluated under conditions of inflammatory challenge from lipopolysaccharide (LPS) We evaluated: 1) the effect of betaine pre-treatment (0 to 1,000 µg/mL for 24 h) on the viability of canine intestinal epithelial MCA-B1 and macrophage-like DH82 cells; 2) epithelial barrier function of LPS-challenged MCA-B1 cells pre-treated with betaine, by measurement of 4-kDa fluorescein isothiocyanate (FITC-dextran (FD4) flux); 3) gene and protein expression of tight junction proteins and adhesion molecules using quantitative reverse transcription polymerase chain reaction (qRT-PCR) and proteomics; 4) anti and pro-inflammatory and regulatory gene expression in LPS-challenged, betaine pre-treated, MCA-B1, DH82 and peripheral blood mononuclear cells (PBMCs) and; 5) the phagocytic activity of DH82 cells pre-treated with betaine. No cytotoxicity of betaine against MCA-B1 or DH82 cells were observed. Betaine pre-treatment of MCA-B1 reduced FD4 permeability compared with untreated cells (P < 0.05), accompanied by increased (mRNA) expression of claudin-1 (P < 0.001) and E-cadherin (P < 0.05) and increased protein expression of junctional adhesion molecules (P < 0.05), vinculin (P < 0.05) and aquaporin-3 (AQP3; P < 0.01). Betaine pre-treatment of LPS-challenged cells also increased the expression of regulatory cytokines TGF-β1 (P < 0.01), TGF-β2 (P < 0.01), and IL-33 (P < 0.05) in MCA-B1 cells and reduced the expression of IL-6 (P < 0.05) and MyD88 (P < 0.01) in DH82 cells compared with untreated cells. Additionally, betaine enhanced the phagocytic activity of DH82 cells (P < 0.01) compared with untreated cells. Confirmatory studies in vivo are needed but these results suggest that plant-derived betaine has potential as a nutritional supplement for companion animals to support gut health and immunity. Betaine is a natural compound found in plants and animals with bioactive properties that help cells tolerate environmental stress. Studies in rats and humans have shown it has anti-inflammatory properties and can support gut health including barrier integrity. While its benefits for humans and livestock are well-known, its effects on pets are less studied. This study investigated how betaine affects gut health and immunity in dogs, using a cell model approach. The results indicated that administration of betaine to dog intestinal cells and to macrophages (a type of immune cell) under conditions of inflammation (provided by stimulation with an endotoxin called lipopolysaccharide) increased anti-inflammatory markers and fortified the gut barrier by increasing the level of proteins required to maintain gut barrier intact. The phagocytic activity (capacity to eliminate pathogens, foreign particles and cellular debris) of macrophages was also increased by betaine, suggesting an enhanced immune response. These results suggest that betaine could have potential as an effective supplement in the diets of companion animals for supporting gut health and immunity.

36. Effects of Wildfire Smoke Exposure on Health Parameters and Inflammatory Responses of Beef-on-Dairy Calves.

期刊: Journal of animal science 发表日期: 2026-Feb-12 链接: PubMed

摘要

The increasing frequency and intensity of wildfires in the western United States have raised concerns about the health and welfare of livestock exposed to wildfire smoke. This study evaluated the physiological, clinical, and immunological responses of beef-on-dairy calves naturally exposed to wildfire smoke. Eighteen Simmental × Jersey calves approximately 1 month of age were monitored from June to October 2022 in a commercial dairy farm in Vale, Oregon. Air quality was tracked daily, and blood samples and health scoring data were collected monthly before the wildfire (baseline; 3 sampling), weekly for four weeks immediately post-wildfire (2 sampling) and late post-wildfire (2 sampling). Samples were analyzed for cortisol, ceruloplasmin, haptoglobin, immunoglobulins A and M, and cytokines IL-1β, IL-6, IL-10, and TNF-α. A local wildfire event (Amelia Road fire; September 8-10) increased fine particulate matter (PM2.5 > 35 µg/m³) for four consecutive days in the study location (44.6 ug/m3). Wildfire smoke exposure induced clear physiological and immune changes. Plasma cortisol concentrations peaked immediately after smoke exposure (10.9 ng/mL; P = 0.007), reflecting an acute stress response. Ceruloplasmin concentrations increased progressively following exposure (P < 0.001), whereas haptoglobin remained unchanged (P = 0.17). Immunoglobulin A and M concentrations increased (P < 0.001) over time, suggesting systemic and mucosal immune activation in response to inhaled particulate matter. Cytokine responses included increased (P ≤ 0.04) IL-1β, IL-6, and IL-10 levels, supporting a transient pro-inflammatory response balanced by anti-inflammatory regulation. No effect was detected for TNF-α (P = 0.56). Clinically, calves remained afebrile but exhibited mild respiratory signs, primarily nasal discharge, immediately following smoke exposure. Collectively, results demonstrate that even short-term exposure to wildfire smoke elicits stress, inflammatory, and immune responses in cattle, despite the absence of obvious clinical disease. These findings highlight wildfire smoke as an underrecognized environmental stressor capable of influencing cattle physiology and immune function. Understanding these subclinical effects is critical to inform management and mitigation strategies aimed at protecting livestock health and productivity during wildfire events. Wildfires have become more frequent and prevalent. While most are removed from the fire itself, the resultant smoke can travel hundreds of kilometers, affecting humans and animals far from the fires. Wildfire smoke exposure, even when mild and transient, elicited measurable physiological and immunological responses in calves, including increased cortisol, ceruloplasmin, immunoglobulins and cytokines coupled with clinical signs such as nasal discharge. These findings demonstrate that wildfire smoke inhalation acts as an environmental stressor capable of triggering systemic and mucosal immune activation in cattle. Understanding these responses is essential, as it may compromise animal health and productivity under increasing wildfire frequency. Results highlight the need for proactive management strategies, such as early monitoring of air quality, timely health assessments, and mitigation practices to minimize the negative impacts of smoke exposure on livestock health, welfare, and performance.

37. Thyroid/parathyroid function and fluoride: role of mitochondrial DNA and SOD genetic variations.

期刊: Journal of endocrinological investigation 发表日期: 2026-Feb-12 链接: PubMed

摘要

Emerging evidence indicates excessive fluoride exposure damage thyroid/parathyroid, with oxidative stress and mitochondrial dysfunction as crucial mechanisms. However, epidemiological research on their involvement in fluoride-induced thyroid/parathyroid dysfunction and modification of oxidative stress-related SNPs are insufficient. Therefore, we conducted a cross-sectional study (n = 401) among children aged 7-13 in areas with drinking water fluoride exposure in Tongxu County, Henan Province, China. This study examined the associations between urinary fluoride (UF) levels and thyroid/parathyroid function in children, as well as mediation effect of DNA copy number (mtDNA-CN) and interactions between UF and superoxide dismutase (SOD) SNPs. The population was divided into two groups based on children safety guidance of UF (WS/T 256-2005), with respective UF levels of 0.73 mg/L and 2.21 mg/L. Results revealed that for each 1 mg/L increase in children UF, thyroid volume (Tvol) increased by 0.34 cm3 (95%CI: 0.21, 0.46), parathyroid hormone (PTH) levels decreased by 1.40 ng/L (95%CI: -0.21, 0.17), mtDNA-CN reduced by 0.13 unit (95%CI: -0.22, - 0.04). Notably, in girls, the UF-Tvol association was partially mediated by relative mtDNA-CN (mediation proportion = 33.08%). Additionally, the GG genotype carriers of SOD2 rs4880 exhibited a larger Tvol (P = 0.017). The TT carriers of SOD3 rs13306703 exhibited higher PTH levels (P < 0.001). GMDR analysis identified an interaction between SOD2 rs4880, SOD3 rs10370 polymorphisms, and UF on Tvol. These findings linked fluoride exposure to thyroid function change in children. mtDNA-CN partially mediating the UF-Tvol association in girls. Genetic variants in SOD2 and SOD3 may modify the effect of fluoride exposure on thyroid.

38. Optimizing forage particle size enhances rumen function and body condition in Atlas Brown dry cows under semi-arid conditions.

期刊: Tropical animal health and production 发表日期: 2026-Feb-12 链接: PubMed

摘要

39. Quality of life in oncology drug approvals: evidence from Swiss decisions in relation to global regulatory trends.

期刊: Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation 发表日期: 2026-Feb-12 链接: PubMed

摘要

In oncology, health-related quality of life (HRQoL) is along with overall survival a decisive clinical element in regulatory and clinical decision-making. Consequently, health authorities are increasingly interested in HRQoL data when evaluating new cancer treatments, as it promises to better capture patient-relevant outcomes. Although strongly encouraged by regulatory agencies such as the FDA, EMA and Swissmedic, the inclusion of HRQoL data in regulatory submissions by pharmaceutical companies remains sparse due to variability in data quality, reporting standards, methodological rigor, and operational constraints. We retrospectively analysed 342 Swissmedic-approved oncology applications (2001-2020) to assess the volume, role, and trends of HRQoL data. For each application, we recorded HRQoL inclusion, domains based on the WHO framework, measurement instruments, and differences across document types and application categories. HRQoL data appeared in 216 of 342 reports (63.2%). Inclusion was higher for new active substances (69.4%) than indication extensions (59.6%). Physical health dominated (87.1% of applications), while psychological (20.2%), social (1.8%), and environmental (6.7%) domains were rarely reported. Of 216 applications including HRQoL, only 62 (28.7%) suggested a benefit, 8 (3.7%) demonstrated a clinically meaningful improvement, and just 2 (0.9%) were reflected in product labels. Although HRQoL reporting in Swiss oncology submissions is increasing, it is still mostly limited to physical health. Our findings suggest underreporting of more universal HRQoL domains and limited regulatory utility mostly due to incomplete information and underuse of HRQoL integration in the statistical analysis plan by pharmaceutical companies, issues that align with challenges documented across international agencies.

40. Evaluating the Return on Investment of U.S. Army Holistic Health and Fitness Performance Teams: A Matched Difference-in-Differences Study of Readiness and Economic Outcomes.

期刊: Sports medicine (Auckland, N.Z.) 发表日期: 2026-Feb-12 链接: PubMed

摘要

Holistic Health and Fitness (H2F) is the United States Army’s largest force modernization initiative aimed at preserving combat power by optimizing soldier readiness across five domains: physical, mental, nutritional, sleep, and spiritual. At the core of this effort are H2F Performance Teams (HPTs): embedded, interdisciplinary subject matter experts, composed of strength and conditioning coaches, athletic trainers, physical and occupational therapists, registered dietitians, and mental readiness professionals. These teams operate within brigades to deliver proactive, preventive, and performance-enhancing interventions that reduce injury risk, accelerate rehabilitation, improve fitness and cognitive performance, and sustain deployability. This evaluation quantified the return on investment (ROI) of embedded HPTs across 56 matched active-duty brigades (28 HPT-resourced, 28 controls), encompassing over 1,000,000 soldiers from fiscal year (FY) 2019 through FY2023. A quasi-experimental, presence-based difference-in-differences framework estimated multiyear treatment effects for musculoskeletal injury (MSKI) referrals and profiles, behavioral health (BH) and substance abuse (SA) profiles, Army Combat Fitness Test (ACFT) pass/failure rates, Army Body Composition Program (BCP) noncompliance, and Rifle Marksmanship Qualification (RMQ). Outcome deltas were monetized using validated cost-per-case benchmarks from military/government reports and peer-reviewed studies. A 10,000-draw Monte Carlo simulation, incorporating triangular distributions and a ρ = 0.15 Gaussian copula, modeled fiscal uncertainty, interdomain dependency, and force-wide extrapolation. Despite significantly worse baseline odds pre-resourcing, HPT brigades reversed all major readiness disadvantages by FY2023. MSKI referral odds declined 61% (odds ratio [OR] 1.16 → 0.45), SA profile odds dropped 79% (OR 1.92 → 0.41), and BH > 90-day profile odds fell 44% (OR 1.51 → 0.84). ACFT failure odds decreased 22% (OR 1.05 → 0.82), RMQ expert qualification odds increased 33% (OR 1.21 → 1.60), BCP failure odds decreased 12%, and RMQ failure odds declined 28%. Annually, per brigade, these effects translated to 1363 adverse events avoided and 37,484 duty days restored. Using domain-specific cost estimates, a 10,000-draw Monte Carlo simulation estimated mean annual cost avoidance of $14.06 M per brigade (95% CI $12.25-16.19 million), with 99.05% of draws exceeding a 4:1 ROI. Duty day restoration and expert RMQ gains added $10.38 million (95% CI $8.15-13.00 million) in readiness value. Combined, annual total economic value reached $24.44 million per brigade (ROI = 8.15:1; 95% CI 7.17-9.27), with force-wide extrapolation yielding $5.28 billion in annual total Army returns. Every $1 invested in HPTs returns $8.15 in value ($4.69 in cost avoidances and $3.46 in readiness improvements). Embedded HPTs produce robust, statistically significant, multidomain improvements in readiness, performance, and cost efficiency. These estimates exclude long-horizon returns such as retention, disability deferral, or downstream system savings-suggesting total ROI is significantly underestimated. This study indicates HPTs are core readiness infrastructure. Their full-scale implementation is a strategic imperative for modernizing force sustainment and preserving the Army’s most critical asset: the soldier.

41. Protective effect of extra virgin olive oil (EVOO) consumption on the physical component of health-related quality of life in aging adults.

期刊: European journal of nutrition 发表日期: 2026-Feb-12 链接: PubMed

摘要

42. Physical Activity Types and Sarcopenia Components Among Middle-Aged and Older People: A Cross-Sectional Study.

期刊: Calcified tissue international 发表日期: 2026-Feb-12 链接: PubMed

摘要

43. Show Me the "Mino:" In Vitro Efficacy of Minocycline on Clinical Gram-Negative Bacterial Isolates.

期刊: Microbial drug resistance (Larchmont, N.Y.) 发表日期: 2026-Feb-12 链接: PubMed

摘要

There are limited oral treatment options available for resistant Gram-negative bacterial (GNB) infections. Minocycline, a second-generation tetracycline antibiotic, offers good bioavailability and broad-spectrum coverage that may be an option for GNB infections. We conducted a retrospective review of minocycline susceptibility testing performed on GNB isolates at the Mayo Clinic reference lab between 2013 and 2022. Minocycline susceptibility was evaluated with a focus on difficult-to-treat organisms and relevant anatomic source. Organisms included resistant isolates of Escherichia coli and Klebsiella pneumoniae; high-risk ampC-derepressors, including Citrobacter freundii, Enterobacter cloacae, and K. aerogenes; and clinically challenging non-Enterobacterales, Acinetobacter species, Achromobacter species, and Stenotrophomonas maltophilia. Of 217,206 GNB isolates, 18,148 Enterobacterales (EB) and 8,190 non-Enterobacter isolates were tested for minocycline susceptibility. Of these, 80% of all EB and 92% of non-EB isolates were susceptible. Among E. coli isolates with ceftriaxone, ciprofloxacin, meropenem, or multidrug resistance, minocycline susceptibility was 78%, 76%, 70%, and 70.9%, respectively. Among the K. pneumoniae isolates with ceftriaxone, ciprofloxacin, meropenem, or multidrug resistance, minocycline susceptibility was 46%, 38%, 37%, and 39.3%, respectively. 85% of C. freundii, 81% of E. cloacae, and 85% of K. aerogenes isolates were susceptible to Minocycline. 83.5% of Achromobacter species isolates, 66% of Acinetobacter species isolates, and 99.1% of S. maltophilia isolates were susceptible. Our study reports the largest collection of minocycline susceptibility findings in GNB. Minocycline showed in vitro activity against many difficult-to-treat GNB isolates, including ceftriaxone- and multidrug-resistant E. coli and some K. pneumoniae isolates, common Amp-C-producing species, and non-fermenting GNB, including Stenotrophomonas, Acinetobacter, and Achromobacter.

44. Incorporating Pelvic Floor Physical Therapy in the Treatment of Obstructed Defecation Syndrome and Posterior Compartment Pelvic Organ and Rectal Prolapse : Proceedings of the Consensus Meeting of the Pelvic Floor Consortium of the American Society of Colon and Rectal Surgeons, the International Continence Society, the International Urogynecological Association, the American Urogynecologic Society, and the American Physical Therapy Association.

期刊: International urogynecology journal 发表日期: 2026-Feb-12 链接: PubMed

摘要

45. Early F-53B Exposure Induces Autism Spectrum Disorder-like Hypomyelination and Oligodendrocytes-Derived Exosomal Protein-Dependent Axonal Energy Imbalance.

期刊: Environmental science & technology 发表日期: 2026-Feb-12 链接: PubMed

摘要

Recent epidemiological evidence links prenatal exposure to chlorinated polyfluorinated ether sulfonate (F-53B) to autism spectrum disorder (ASD)-associated neurodevelopmental deficits. However, mechanisms underlying F-53B-induced ASD-like pathology and oligodendrocyte dysfunction remain unclear. In this study, we exposed Sprague-Dawley rats to F-53B (0, 8, 80, 800 μg/kg/d from preconception through postweaning) and compared adverse outcomes to a valproic acid-induced ASD model. We found that F-53B crossed the blood-brain barrier, deposited in offspring brain, and induced ASD-like neurobehaviors, including social deficits, stereotypic behaviors, memory impairments, and reduced novelty preference. Neuropathologically, F-53B triggered hippocampal and callosal hypomyelination, delayed oligodendrocyte maturation, and disrupted neuronal mitochondrial cristae. Interestingly, plasma oligodendrocytes-derived exosomes (ODEXs) from F-53B-exposed offspring failed to restore neuronal adenosine triphosphate (ATP) levels and mitochondrial membrane potential in vitro. Proteomic profiling of ODEXs identified suppression of ATP synthesis-related proteins, notably chromodomain helicase DNA binding protein 8 (an ASD-characterized biomarker) and ATP citrate lyase. Molecular docking suggested F-53B could bind to their amino acid residues. Downregulation of these proteins in the hippocampus and corpus callosum aligned with behavioral and myelination abnormalities in rat offsprings. Our study establishes ODEX-mediated ATP synthesis disruption as central to F-53B-induced ASD-like pathology, urging reevaluation of perfluorooctanesulfonate alternatives for neurotoxicity.

46. A prospective study of periconceptional perceived stress and rate of miscarriage.

期刊: Human reproduction (Oxford, England) 发表日期: 2026-Feb-12 链接: PubMed

摘要

To what extent is perceived stress during preconception and pregnancy associated with miscarriage incidence? Perceived stress during early pregnancy, but not preconception, was associated with higher miscarriage incidence. Some studies have found that higher stress levels are associated with miscarriage risk. However, many of these studies were retrospective, focused on occupational stress only, and/or suffered from under-ascertainment of miscarriage. Pregnancy Study Online (PRESTO) is an ongoing prospective preconception cohort study that recruited participants during 2013-2025. Eligible participants were females aged 21-45 years, who resided in the USA or Canada and were trying to conceive without fertility treatments. Eligible partners were males aged ≥21 years. We collected data on perceived stress using the 10-item version of the Perceived Stress Scale (PSS-10) during preconception (every 8 weeks) and early pregnancy for female participants and during preconception only for male participants. We identified pregnancies and miscarriages on bimonthly follow-up questionnaires during preconception and additional questionnaires during early and late pregnancy and postpartum. We fit Cox proportional hazards regression models to estimate hazard ratios (HR) and 95% CIs for the effect of preconception PSS-10 scores (n = 11 189 female and 2656 male participants) and early pregnancy PSS-10 scores (n = 8319 female participants) on miscarriage incidence, adjusting for potential confounders. About 20% of the pregnancies ended in miscarriage, with the loss occurring at a median of six gestational weeks. Preconception PSS-10 scores in the female or male partner were not appreciably associated with miscarriage incidence. Female PSS-10 scores during gestational weeks 5-8 were strongly associated with higher miscarriage incidence: adjusted HRs for PSS-10 scores of 10-14, 15-19, 20-24, and ≥25 vs <10 in gestational weeks 5-8 were 1.38 (95% CI: 1.07, 1.77), 1.17 (95% CI: 0.89, 1.52), 1.35 (95% CI: 1.00, 1.83), and 2.05 (95% CI: 1.40, 2.99), respectively. In week-specific analyses, an association existed during weeks 4-8 and peaked at week 7. Our results may be susceptible to reverse causation, unmeasured confounding by nausea and vomiting in pregnancy, and exposure misclassification. Interventions aimed at decreasing stress during early pregnancy may be effective at reducing miscarriage incidence, but confirmation of our results in randomized studies is warranted. This work was supported by the Eunice Kennedy Shriver National Institute of Child Health and Human Development (R01-HD086742, R01-HD105863). Lauren Wise has received in-kind donations for primary data collection in PRESTO from ChartNeo.com. The other authors have no conflicts to report. N/A.

47. Establishment and validation of a novel risk stratification scale in adult IgA vasculitis nephritis: a cohort study based on a systematic review and meta-analysis.

期刊: Clinical and experimental rheumatology 发表日期: 2026-Feb-06 链接: PubMed

摘要

This study aimed to develop and validate a risk stratification scale for unfavourable outcomes in adult patients with IgA vasculitis nephritis (IgAVN). The derivation cohort in this study was constructed using the existing prognosis data from adult IgAVN cohorts. We extracted the risk factors and their hazard ratios. Only statistically significant risk factors were included in our final risk stratification scale. Then this study validated the risk stratification scale in an external cohort of Chinese patients. The performance of the risk stratification scale was evaluated by the receiver operating characteristic (ROC), calibration, decision, and Kaplan-Meier curves. Ten cohorts involving 1,814 adult patients with IgAVN were included in this meta-analysis. Serum albumin (ALB), estimated glomerular filtration rate (eGFR), endocapillary hypercellularity (E1), and tubular atrophy/interstitial fibrosis (T1/2) were included in the risk stratification and scored according to their weightings (maximum score: 6.5). An external cohort comprising 133 patients was used to validate the risk stratification scale. The area under the curve (AUC) value of the scoring scale was 0.88 (95%CI: 0.78-0.99), with a sensitivity of 0.79 (95%CI: 0.49-0.95) and specificity of 0.89 (95%CI: 0.82-0.94), at a cut-off value of 3. The calibration, decision, and Kaplan-Meier curves further confirmed the robust performance of the risk stratification scale. In this study, we established a simple and practical tool to identify adult IgAVN patients at high risk of unfavourable outcomes. Reasonable use of the risk stratification scale can help make early clinical decisions and facilitate the development of precision medicine.

48. Research priorities to improve classification of sleep-wake disorders.

期刊: Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine 发表日期: 2026-Feb-06 链接: PubMed

摘要

The International Classification of Sleep Disorders (American Academy of Sleep Medicine, 2023) [1] is the major nosological system for sleep-wake disorders. It is developed by content experts, employing an evidence-based approach to the formulation of diagnostic criteria and related text. However, through this process, ICSD-3-TR task force members and work group chairs identified areas that lack adequate data for formulation of diagnostic criteria, resulting in diagnostic ambiguity and uncertainty. In this article, this panel reports the identified key issues, presents currently available data, and suggests research strategies to improve accuracy and reliability of diagnosis.

49. Availability of Higher-Level Neonatal Care in Rural and Urban US Hospitals, 2010-2022.

期刊: JAMA network open 发表日期: 2026-Feb-02 链接: PubMed

摘要

This cohort study examines changes in the availability of higher-level neonatal care between 2010 and 2022 at rural and urban hospitals with childbirth services in the US.

50. PREVENT Equation Performance in Asian and Native Hawaiian and Other Pacific Islander Groups.

期刊: JAMA network open 发表日期: 2026-Feb-02 链接: PubMed

摘要

In 2023, the PREVENT (Predicting Risk of CVD Events) equations were introduced to estimate 10-year risk of total cardiovascular disease (CVD). However, their accuracy in individual Asian or Native Hawaiian and Other Pacific Islander ethnic groups remains unknown. To evaluate the risk prediction accuracy of the PREVENT base and full equations in Asian and Native Hawaiian and Other Pacific Islander ethnic groups. This retrospective cohort study was conducted among adults aged 30 to 79 years without CVD who self-reported as being non-Hispanic White, Asian, or Native Hawaiian and Other Pacific Islander and were active Kaiser Permanente Southern California members as of September 30, 2009. Participants were followed up through 2019. Non-Hispanic Asian adults were further disaggregated into ethnic groups. Analysis was performed between February and June 2025. The main measures were the PREVENT base equation (age, total and high-density lipoprotein cholesterol, systolic blood pressure, body mass index, estimated glomerular filtration rate, diabetes, smoking, and lipid and antihypertensive medication) and the PREVENT full equation (base plus hemoglobin A1c, urine albumin-creatinine ratio, and Social Deprivation Index). The main outcome was the 10-year incidence of total CVD, atherosclerotic CVD, and heart failure. Estimated risks were compared with observed events using the Harrell C index and mean calibration (predicted to observed event ratios). The study cohort consisted of 542 848 adults, including 424 277 non-Hispanic White adults (mean [SD] age, 55.6 [11.8] years; 235 722 [55.6%] female), 110 855 non-Hispanic Asian adults (mean [SD] age, 52.5 [11.9] years; 66 292 [59.8%] female), and 7716 non-Hispanic Native Hawaiian and Other Pacific Islander adults (mean [SD] age, 51.4 [11.9] years; 4 398 [57.0%] female). A total of 31 556 CVD events occurred during 10 years. For total CVD, the PREVENT base equation demonstrated good discrimination across non-Hispanic White (C index, 0.764; 95% CI, 0.761-0.767), non-Hispanic Asian (C index, 0.773; 95% CI, 0.765-0.779) and non-Hispanic Native Hawaiian and Other Pacific Islander (C index, 0.757; 95% CI, 0.733-0.780) groups. Among Asian ethnic groups, C indexes for the PREVENT base equation ranged from 0.738 (95% CI, 0.701-0.774) in Vietnamese adults to 0.806 (95% CI, 0.787-0.826) in Chinese adults. The PREVENT full equations showed consistent results. The PREVENT base and full equations generally overestimated total CVD, atherosclerotic CVD, and heart failure risk in non-Hispanic Asian (mean calibration, 0.96-1.33) and underestimated risk in non-Hispanic Native Hawaiian and Other Pacific Islander (mean calibration, 0.74-0.96) and non-Hispanic White (mean calibration, 0.63-1.03) populations. In this retrospective cohort study, the PREVENT base and full equations demonstrated overall strong performance in predicting 10-year cardiovascular risk. However, notable differences were observed across disaggregated Asian and Native Hawaiian and Other Pacific Islander ethnic groups, underscoring the importance of recognizing heterogeneity within these populations when applying risk prediction models.

51. Medical Costs and Productivity Losses of Atrial Fibrillation Among US Privately Insured Employees.

期刊: JAMA network open 发表日期: 2026-Feb-02 链接: PubMed

摘要

Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia and a major factor underlying US health care costs. While its clinical burden is well documented, the full economic impact of AF-particularly among working-age adults with productivity losses-remains underexplored. To estimate medical costs and productivity losses associated with AF among privately insured US employees and assess whether this burden varies by sex and rurality. This cross-sectional study used 2021 Merative MarketScan Commercial Claims and Health and Productivity Management Databases. The sample included adults aged 18 to 64 years with continuous enrollment in noncapitated, employer-sponsored insurance and no pregnancy-related diagnoses. Analyses were conducted during January to July 2025. Diagnosis of AF, defined by 1 or more inpatient or emergency department claims or 2 or more outpatient claims with International Classification of Disease, Tenth Revision, Clinical Modification code I48. Primary outcomes were total all-cause annual medical costs and productivity losses. Medical costs were disaggregated into emergency department, inpatient, outpatient, and prescription costs. Productivity losses included sick leave, short-term disability, and long-term disability; days were observed directly, and dollar-valued costs were estimated by applying national average wages. All outcomes were prespecified. Propensity score overlap weighting was applied to balance covariates. Among 1 612 398 individuals (mean [SD] age, 44.00 [11.11] years; 623 335 female [38.66%]; 1 489 709 [92.39%] living in an urban area), 10 190 (0.63%) were diagnosed with AF. AF was associated with $11 392.55 (95% CI, $10 649.70-$12 135.38) in incremental annual medical costs, primarily from outpatient care ($7058.81 [95% CI, $6563.89-$7553.72] for services and $1874.58 [95% CI, $1600.61-$2148.56] for prescriptions). Compared with those without AF, those with AF had 0.97 (95% CI, 0.02-1.93) excess sick leave days and 2.93 (95% CI, 2.14-3.72) excess short-term disability days, translating to productivity-related costs of $269.81 (95% CI, $144.65-$397.77) for sick leave and $570.51 (95% CI, $471.21-$669.81) for short-term disability. Long-term disability outcomes did not differ significantly. Females incurred higher AF-related emergency (mean difference, $422.61; 95% CI, $178.32-$666.89) and inpatient care costs (mean difference, $1588.67; 95% CI, $466.23-$2711.12) than males. In this cross-sectional study of privately insured employees, AF was associated with $11 393 in higher medical costs per person, with outpatient care accounting for the largest share, and $840 in higher productivity losses per person. These findings underscore the need to improve outpatient treatment and reduce AF-related workplace disruptions for working-age adults.

52. Resolving plasmid-encoded carbapenem resistance dynamics and reservoirs in a hospital setting through nanopore sequencing.

期刊: Microbial genomics 发表日期: 2026-Feb 链接: PubMed

摘要

The growing resistance of Enterobacterales to last-resort antibiotics such as carbapenems puts a significant burden on healthcare systems, also due to plasmids driving a rapid spread of carbapenem resistance. We here evaluate the use of long-read nanopore sequencing to investigate carbapenem resistance dynamics and the role of plasmid transfers and environmental reservoirs in the hospital setting. Over 13 months, routine clinical diagnostics identified recurring isolates of carbapenem-resistant Citrobacter species carrying Klebsiella pneumoniae carbapenemases (KPCs) and/or OXA-48-like carbapenemases from patient screening and hospital drain samples. While routine diagnostic approaches provided limited insights into the carbapenem resistance dynamics, we show that near-complete de novo assembly of chromosomes and plasmids by long-read nanopore sequencing allowed for high-resolution strain identification, plasmid profiling, and antibiotic resistance gene detection. Notably, genomically nearly indistinguishable Citrobacter freundii of the high-risk sequence type ST91 genomes were recovered from screening samples collected in the same hospital room 1 year apart. We further provide evidence of a KPC-2-encoding IncN plasmid that is likely to have spread across bacterial species and between patient and drain isolates, which emphasizes the role of contaminated drains in the persistence and dissemination of antimicrobial resistance within the hospital environment. Overall, this study demonstrates the value of long-read nanopore sequencing for uncovering the complex dynamics of carbapenem resistance spread and persistence in the hospital setting and its potential implications for infection prevention and control.

53. Information Needs for Artificial Intelligence Chatbot on Prenatal Care Among Women of Advanced Maternal Age: A Thematic Analysis.

期刊: Nursing open 发表日期: 2026-Feb 链接: PubMed

摘要

This study aimed to investigate the information needs for artificial intelligence chatbot-based interventions on prenatal care among pregnant women of advanced maternal age. This study employed a qualitative research method using thematic analysis. Participants were pregnant women of advanced maternal age aged 35 and older who attended childbirth classes or used midwifery services in three cities. Participants were recruited through purposive sampling from September 23, 2023, to February 24, 2024, until saturation was reached. Semi-structured interviews were conducted with a total of 13 participants. The analysis was conducted in accordance with Braun and Clarke’s six phases of thematic analysis: familiarisation with the data, generating initial codes, searching for themes, reviewing themes, defining and naming themes, and producing the report. Four central themes were identified that described prenatal care information needs for AI chatbots, as follows: (1) Information needs for an AI chatbot supporting advanced maternal age pregnancy; (2) childcare; (3) postpartum recovery; and (4) breastfeeding promotion. These findings highlight the importance of developing an accessible, interactive, and empathetic AI chatbot-based prenatal care application that can provide reliable information and support to improve maternal and fetal health among women of advanced maternal age. The themes identified in this study offer concrete guidance for developing an AI chatbot that delivers relevant support for postpartum recovery, breastfeeding, newborn emergencies, and child health management among pregnant women of advanced maternal age. The study follows the Consolidated Criteria for Reporting Qualitative Research (COREQ) guidelines. No patient or public contribution.

54. Results of a pilot randomized controlled trial of CBT-I for veterans with serious mental illness and insomnia.

期刊: Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine 发表日期: 2026-Jan-29 链接: PubMed

摘要

For Veterans living with a serious mental illness (SMI), insomnia is prevalent and harmful. Cognitive Behavioral Therapy for Insomnia (CBT-I) is an effective treatment, but Veterans with SMI experience significant environmental, psychological, and systemic barriers to receiving and benefiting from it. There is limited clinical guidance on using CBT-I with Veterans with SMI. We developed provider guidelines and patient materials for conducting CBT-I when these barriers are present for people with SMI (CBT-I for SMI) and evaluated the acceptability and preliminary efficacy of CBT-I for SMI in an assessor-blind randomized controlled trial. Forty-seven Veterans with insomnia and SMI were randomized to either CBT-I for SMI (n = 26) or Health and Wellness (HW; n = 21), an active control condition. At baseline, post-treatment, and 3-month follow-up, participants completed: actigraphy and daily sleep diaries for two weeks and self-report measures of insomnia and functioning. At 3-month follow-up, participants completed satisfaction ratings of treatment. CBT-I for SMI participants had high treatment satisfaction and attendance. At post, compared to HW, CBT-I caused statistically significantly greater reductions in diary-measured time-in-bed, increases in diary-measured sleep efficiency, reductions in actigraphy-measured time-in-bed and total sleep time, and improvements in self-reported insomnia severity and sleep-related functioning; relative to CBT-I, HW improved community participation. CBT-I for SMI is acceptable to Veterans with SMI and improves sleep and functioning. Future research should examine how sleep mediates effective functional gains, identify how CBT-I could be integrated within recovery centers, and develop preventative interventions to curtail insomnia-associated functional decline. People with serious mental illnesses experience challenges to receiving and benefiting from Cognitive Behavioral Therapy for Insomnia. To support providers and patients, we developed guidelines and materials for navigating these challenges while conducting Cognitive Behavioral Therapy for Insomnia with people with serious mental illness. In the first study to compare Cognitive Behavioral Therapy for Insomnia conducted with our materials and guidelines to an active treatment control, we found that our guideline-led Cognitive Behavioral Therapy for Insomnia improved self-reported insomnia severity, sleep-related functioning, and actigraphy and diary-measured sleep of Veterans with serious mental illness and insomnia. Veterans with serious mental illness can participate in, derive satisfaction from, and benefit from Cognitive Behavioral Therapy for Insomnia when this treatment is appropriately tailored.

55. Chronopharmacology-Driven Precision Therapies for Time-Optimized Cardiometabolic Disease Management.

期刊: Biology 发表日期: 2026-Jan-28 链接: PubMed

摘要

Cardiometabolic diseases, including hypertension, type 2 diabetes, dyslipidemia, and obesity, along with their cardiovascular complications, remain leading causes of morbidity and mortality worldwide, imposing significant public health, economic, and societal burdens. Conventional pharmacological therapies often show limited efficacy and increased adverse effects because they do not account for the body’s intrinsic circadian rhythms, which regulate organ function, drug absorption, and metabolism. Chronopharmacology, which aligns treatment timing with these biological rhythms, offers a strategy to enhance therapeutic outcomes. This review presents a comprehensive analysis of chronopharmacology principles applied to cardiometabolic disease management, integrating molecular, physiological, and clinical perspectives. It examines how core clock genes and tissue-specific circadian patterns influence drug action and absorption and summarizes evidence-based time-optimized interventions for hypertension, diabetes, dyslipidemia, obesity, and multimorbid patients. Furthermore, the review highlights emerging innovations, including artificial intelligence-guided dosing, circadian-biomarker-informed therapy selection, and wearable digital devices for real-time monitoring of biological rhythms. By synthesizing mechanistic and clinical insights, circadian-aligned treatment strategies are shown to improve drug efficacy, reduce adverse effects, and support the development of precision, rhythm-based therapeutics, offering a practical framework for personalized cardiometabolic disease care.

56. Macrophage Depletion by Intracerebroventricular Administration of Clodronate-Liposome Attenuates the Development of Angiotensin II-Salt-Induced Neurogenic Hypertension in Rats.

期刊: JMA journal 发表日期: 2026-Jan-15 链接: PubMed

摘要

The increase in peripheral angiotensin II level results in neurogenic hypertension with brain inflammation. Macrophages in the cerebrospinal fluid (CSF) influence neuroinflammation through communication between the peripheral and central nervous systems. However, the role of macrophages in neurogenic hypertension development remains unclear. We hypothesized that macrophages in the CSF have a role in the development of angiotensin II-initiated neurogenic hypertension. Sprague-Dawley rats with radio-telemetry pressure transducers underwent surgery for the subcutaneous implantation of either saline- or angiotensin II-filled osmotic minipump. They received an intracerebroventricular injection of either phosphate-buffered saline-liposome as a control or clodronate-liposome to deplete macrophages. Postoperatively, rats received 2% salt diet for 14 days. Different groups of rats underwent a hexamethonium challenge test at 7-9 days after treatment initiation to evaluate their sympathetic tone. Rats with angiotensin II-salt treatment demonstrated a time-dependent arterial pressure increase. Rats receiving angiotensin II-salt treatment with clodronate-liposome had delayed arterial pressure increases and lower mean arterial pressure (91 ± 4 mmHg) than rats receiving control-liposome (111 ± 4 mmHg) on day 8. The angiotensin II-salt treatment increased the peak depressor response to intravenous hexamethonium injection, messenger RNA expression of interleukin-6 and transforming growth factor-ß, and number of Iba1-positive cells in the brainstem. Intracerebroventricular injection of clodronate-liposome attenuated the angiotensin II-salt-induced increases in the depressor response, gene expressions, and cell number. Our data suggest that macrophages in the CSF are involved in the development of angiotensin II-salt-induced neurogenic hypertension by modulating brain inflammation.

57. Coping with heat: exploring psychometric properties and relationships of a heat-related health literacy scale.

期刊: Health promotion international 发表日期: 2026-Jan-07 链接: PubMed

摘要

Climate change and rising temperatures are increasingly threatening public health, underscoring the need for effective strategies to manage heat-related risks. Promoting heat-related health literacy (HRHL) is crucial, yet no validated scale exists to measure it. We developed a 20-item HRHL scale and tested it in a cross-sectional survey of 407 adults in Germany (50.6% female, M = 58.0, SD = 12.0 years). The scale was tested using exploratory structural equation modeling with a bootstrapping approach and reduced to 16 items (Cronbach’s alpha = 0.96). A four-factor structure (finding, understanding, appraising, and applying heat-related health information) with a higher first-order factor with good fit indices (CFI = 0.97, TLI = 0.96, RMSEA = 0.06, SRMR = 0.03) was found. About 36% of respondents reported inadequate or problematic HRHL. The scale showed small but significant associations between understanding/appraising and heat wave knowledge, while all HRHL factors were moderately related to heat wave practice and behavior. The newly developed scale, which has been tested for its psychometric properties, can be used as a basis for epidemiological studies. It would subsequently allow the relationships between the targeted health behavior and constructs, such as heat-related practices and behaviors, to be further substantiated.