公共卫生研究摘要 (2026-02-14)
共收录 54 篇研究文章
1. Association of Systemic Inflammatory Markers With Cerebral Small Vessel Disease Progression: A Community-Based Prospective Study.
期刊: Neurology 发表日期: 2026-Mar-24 链接: PubMed
摘要
Inflammation is an established risk factor in the development of cerebral small vessel disease (CSVD). This study aimed to investigate the associations between neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), and systemic immune-inflammation index (SII) with progression of CSVD. This prospective cohort study used data from the PolyvasculaR Evaluation for Cognitive Impairment and vaScular Events study between 2017 and 2024. Participants were excluded for a history of stroke or cancer or because of missing data on baseline systemic inflammatory markers or follow-up neuroimaging for CSVD. Baseline systemic inflammatory markers were calculated by neutrophils, monocytes, lymphocytes, and platelets count data, and categorized into 4 groups according to the quartiles. The progression of total CSVD burden, using Wardlaw and Rothwell ratings, along with progression of specific MRI markers were assessed between baseline and wave 3 follow-up (∼4.7 years). Assessment of the associations was performed using log-binomial regression models. The median follow-up duration was 4.7 years (interquartile range 4.5-4.8), and 2,267 participants were included. At baseline, the mean age of the participants was 60.4 years, with 50.6% being male. An elevation in NLR was associated with progression of total CSVD burden (Wardlaw: adjusted relative risk [aRR] 1.23, 95% CI 1.08-1.41; Rothwell: aRR 1.29, 95% CI 1.11-1.50) and incident cerebral microbleeds (CMBs) (aRR 1.43, 95% CI 1.16-1.78). High level of MLR was associated with incident lacunes (aRR 1.88, 95% CI 1.28-2.77) and incident CMBs (aRR 1.33, 95% CI 1.08-1.65). High level of SII was associated with progression of total CSVD burden (Wardlaw: aRR 1.15, 95% CI 1.01-1.31; Rothwell: aRR 1.17, 95% CI 1.01-1.35) and incident CMBs (aRR 1.34, 95% CI 1.10-1.64). Linear associations between these markers and progression of CSVD were demonstrated by restricted cubic spline analysis. This community-based prospective study demonstrated that elevated NLR, MLR, and SII were associated with progression of total CSVD burden and progression of white matter hyperintensity, incident lacunes, and CMBs over ∼4.7 years, supporting their potential to provide additional context for CSVD preventive considerations. Limitations include study’s single-city population and the lack of dynamic changes in inflammatory markers.
2. Autoimmune Diseases and Incident Spontaneous Subarachnoid Hemorrhage: A Swedish Population-Based Cohort Study.
期刊: Neurology 发表日期: 2026-Mar-24 链接: PubMed
摘要
Compelling evidence documents an association between autoimmune diseases and several types of cardiovascular diseases. Knowledge on whether autoimmune diseases may increase the risk of subarachnoid hemorrhage (SAH), a rare but severe type of cerebrovascular event, is very limited. The aim of this study was to determine the association between autoimmune diseases and SAH. We conducted a nationwide cohort study including individuals who were parents of all live births recorded in the Swedish Medical Birth Register during 1973-2014 and who were alive, resided in Sweden, and had no history of SAH at study baseline. We obtained data on autoimmune diseases, SAH, and covariates through linkage to several population-based registers and followed participants from January 1, 2001, until SAH diagnosis, death, emigration, or December 31, 2023. We used Cox proportional hazards models to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) for SAH in relation to autoimmune diseases. Among the 3,824,528 study participants (mean age at baseline 38.1 (±13.2) years, 55.2% female), 608,043 (15.9%) had a record of any autoimmune disease before or during the study period; 10,311 (0.3%) were diagnosed with SAH over the follow-up period of 83.5 million person-years. Overall, any autoimmune disease was associated with an increased risk of SAH (HR = 1.18; 95% CI 1.11-1.25). Several categories, as well as some specific autoimmune diseases, that is, type 1 diabetes (HR = 1.36; 95% CI 1.15-1.61), rheumatoid arthritis (HR = 1.29; 95% CI 1.10-1.50), systemic lupus erythematosus (HR = 1.49; 95% CI 1.01-2.21), psoriasis vulgaris (HR = 1.18; 95% CI 1.04-1.33), multiple sclerosis (HR = 1.35; 95% CI 1.02-1.78), primary biliary cirrhosis (HR = 2.66; 95% CI 1.57-4.49), and IgA nephropathy (HR = 1.42; 95% CI 1.08-1.87), were associated with an increased risk of SAH. This study suggested that a broad range of autoimmune diseases may be involved in the etiology of SAH. If confirmed by future research, the results may inform the development of targeted SAH prevention strategies for individuals with autoimmune diseases; however, reliance on register-based diagnoses and the lack of detailed lifestyle information such as smoking may have led to misclassification and residual confounding.
3. Elimination of the Black Box Warning on Menopausal Hormone Therapy.
期刊: Obstetrics and gynecology 发表日期: 2026-Feb-13 链接: PubMed
摘要
In 2003, the U.S. Food and Drug Administration (FDA) issued a black box warning on menopausal hormone therapy (MHT) products based on putative harm of secondary outcomes and incompletely collected and adjudicated data from the Women’s Health Initiative (WHI) oral conjugated equine estrogens and medroxyprogesterone acetate study. Despite the specific parameters and limitations of the WHI study, these warnings were inappropriately generalized across all doses, formulations, and routes of administration, including local vaginal therapies, under the mandate to prescribe the “lowest effective dose for the shortest duration.” After 22 years of clinical controversy, the U.S. Department of Health and Human Services and the FDA announced removal of the boxed warning on November 10, 2025. This decision was based on the FDA’s independent and comprehensive review of the scientific literature, deliberations from an expert panel on July 17, 2025, and a 60-day public comment period. The FDA’s transition to product-specific labeling, the removal of the mandate for the lowest effective dose for the shortest duration, and the inclusion of guidance on the optimal timing of MHT initiation within 10 years of menopause or before age 60 years, represent critical steps toward evidence-based menopause management. By replacing misleading information with accurate data, this regulatory shift facilitates individualized benefit-risk assessments and empowers shared decision making. Ultimately, these updates ensure that MHT use is optimized for the specific needs of each patient, integrating modern risk assessment with the latest clinical evidence to improve long-term health outcomes.
4. Migration Effects on Cognition: Protocol for the Aging in Kerala Americans Research Study.
期刊: JMIR research protocols 发表日期: 2026-Feb-13 链接: PubMed
摘要
In the United States, Asian American people represent the fastest growing population group, and are highly diverse linguistically, culturally, and demographically. Yet, in most national studies, Asian American groups are aggregated, masking potential health disparities. Racial and ethnic minorities, especially first-generation immigrants, are also at a particularly elevated risk of cognitive impairment. The Aging in Kerala Americans Research (AKKARE) study aims to examine both positive and negative migration effects on health in the first-generation Kerala American population, focusing on cognition and dementia. We will assess the effect of immigrant and cultural factors and social relations on cognitive aging from epidemiological, biological, and vascular perspectives. This protocol describes the study design and procedures for the AKKARE study. The AKKARE study proposes to enroll 400 older first-generation Kerala American individuals from the tristate area. A smaller subset of these participants will complete blood tests (n=360) and neuroimaging studies (n=160). We will assess the role of immigration and cultural effects on cognitive function, mood, and quality of life, as well as biological and vascular aging. We will conduct follow-up assessments at 12-month intervals for up to 5 years. The AKKARE study (grant #1R01AG084567-01) was funded by the US National Institutes of Health in 2024 and received approval from the Stony Brook University Institutional Review Board to start the study in 2025. Enrollment began in September 2025. As there is presently a lack of fundamental data on the epidemiology in diseases of aging in Indian American immigrants, the AKKARE study will provide new insights into factors of risk and resilience associated with cognitive impairment in this group and in the broader older adult population. DERR1-10.2196/85493.
5. The Potential Impact of Federal Funding Cuts on Access to Pre-Exposure Prophylaxis in Atlanta, Georgia: Geographic Modeling Study.
期刊: JMIR public health and surveillance 发表日期: 2026-Feb-13 链接: PubMed
摘要
Despite major biomedical advances in HIV testing, prevention, and treatment, annual HIV transmissions in the United States remain above 30,000. Geographic access to pre-exposure prophylaxis (PrEP) is critical to HIV prevention efforts, particularly in regions with high HIV burdens, such as metro-Atlanta. Community-based organizations (CBOs) play a central role in delivering culturally competent prevention services, yet many rely on federal funding that is increasingly unstable. Understanding the potential impact of CBO closures on geographic access to PrEP is essential for anticipating inequities and informing policy. The aim of this study was to estimate how hypothetical closures of federally funded CBOs providing PrEP affect geographic access to PrEP clinics by car and public transit across metro-Atlanta and to assess whether impacts differ by community racial/ethnic composition. We identified 71 PrEP-providing clinics in metro-Atlanta (August 2025), including 12 CBOs. Using 3 simulated closure scenarios in which 25% of CBOs were randomly closed, we calculated one-way travel times from 2466 census block group (CBG) centroids to the nearest PrEP-providing clinic. Travel times were estimated for car and public transit across 3 weekdays and timepoints and then averaged per CBG. Two-sided paired t tests were used to compare the change in travel time compared to baseline. Logistic regression assessed associations between racial/ethnic plurality and increased travel times. Under baseline conditions, 100% of CBGs had car access to a PrEP clinic within 30 minutes compared to only 41.6% (1027/2466) via public transit. Across closure scenarios, 732 CBGs (29.6%; representing over 1 million residents) experienced increased transit times (mean increase 1.2 minutes; range 0.0-11.6; P<.001), and 7 CBGs lost transit access entirely. For car travel, 1184 CBGs (48%; representing approximately 1.7 million residents) experienced increased drive times (mean increase 0.5 minutes; range 0.0-6.4; P=.03). Black-plurality CBGs had higher odds of increased drive times compared to White-plurality CBGs (odds ratio 1.37, 95% CI 1.15-1.63). Even limited closure of CBO PrEP providers meaningfully reduces geographic access to HIV prevention services, disproportionately affecting communities already experiencing transportation and HIV-related vulnerabilities. Sustained federal investment in CBOs is essential to preserve equitable PrEP access and prevent avoidable HIV infections.
6. Trauma across pediatric ages: a retrospective analysis of age-stratified epidemiology, injury patterns, and outcomes in pediatric cervical spinal cord injury using the National Trauma Data Bank.
期刊: Journal of neurosurgery. Pediatrics 发表日期: 2026-Feb-13 链接: PubMed
摘要
Pediatric cervical spinal cord injury (cSCI) is a severe form of trauma with age-dependent anatomical and physiological risks that affect treatment strategies and outcomes. Due to the lack of comprehensive national-level data, this study aimed to evaluate age-specific differences in epidemiology, injury patterns, and clinical outcomes in pediatric patients with traumatic cSCI. The authors performed a retrospective analysis using the National Trauma Data Bank (2007-2018) to identify pediatric patients (≤ 18 years old) with traumatic cSCI and stratified them into newborns/infants, toddlers, children, and adolescents. The primary outcome was early mortality. Multivariable logistic regression identified predictors of mortality, complications, and discharge outcomes, adjusting for relevant clinical variables. A total of 4696 pediatric patients with cSCI were identified. While adolescents (71.9%) and children (20.5%) accounted for most cases, newborns/infants and toddlers had higher mortality rates (25.6% and 22.1%, respectively; p < 0.001). Motor vehicle traumas predominated in younger children, whereas firearm injuries were more common in adolescents. Younger groups experienced significantly longer intensive care unit stays, extended ventilator use, and higher complication rates. Toddlers (OR 1.86, p = 0.014), critical injury severity (OR 3.60), and Glasgow Coma Scale (GCS) scores of 3-5 (OR 51.51) were associated with significantly higher odds of death. Greater injury severity and lower GCS scores were also associated with a higher risk of complications. Use of protective devices and venous thromboembolism prophylaxis were associated with lower mortality. Among pediatric patients with cSCI, infants and toddlers predominantly experienced motor vehicle-related and more severe injury, and worse clinical outcomes, which requires aggressive early management and age-appropriate trauma protocols. In contrast, firearm and recreational injuries were more common among adolescents, reinforcing the necessity of targeted prevention and community education. These findings highlight the importance of age-specific strategies in both clinical care and injury prevention for this high-risk population.
7. Determinants of Equitable Data Governance for African, Caribbean, and Black Communities in Health Research in High-Income Countries: Protocol for a Scoping Review.
期刊: JMIR research protocols 发表日期: 2026-Feb-13 链接: PubMed
摘要
African, Caribbean, and Black (ACB) communities in high-income countries continue to experience persistent health inequities, driven by systemic anti-Black racism, socioeconomic disadvantage, and exclusion from health decision-making. Historically, data have been extracted from ACB communities without transparency, accountability, or community ownership. These inequitable practices have produced data systems that reinforce harm rather than promote equity. Equitable data governance, which promotes community ownership over data collection, access, and use, is increasingly recognized as a critical but underresearched determinant of health equity. This protocol outlines the methodology of a scoping review to identify and synthesize evidence on the determinants of equitable data governance in health research involving ACB communities in high-income countries. The review follows the 6-stage Arksey and O’Malley methodological framework, supplemented with updated guidance from the Joanna Briggs Institute. The searches were conducted in the Ovid MEDLINE, Ovid Embase, EBSCO CINAHL, APA PsycInfo, and Scopus databases. Peer-reviewed articles are considered, with no limits placed on study design, publication type, or date. Multiple reviewers will independently extract data by using a standardized form. A 3-phase thematic mapping process, conceptually informed by critical race theory, intersectionality, and community-based participatory research principles, will be conducted to analyze the data, generate themes, and interpret findings. The final comprehensive database searches were completed on December 17, 2024. The search strategy targeted literature on data management, governance, sharing, security, and ethical principles in relation to ACB populations in high-income countries. A total of 4365 records were screened at the title and abstract level, after deduplication, of which 247 studies were deemed potentially relevant and advanced to full-text screening. Following full-text screening and reference list searching a total of 15 articles were deemed eligible for analysis. The data extraction stage is scheduled to overlap and occur between November 2025 and February 2026. The thematic mapping and stakeholder consultations processes are scheduled between December 2025 and February 2026. The final review and manuscript submission are expected by March 2026, with dissemination activities planned for mid-2026. This review will synthesize existing information on key pillars, barriers, facilitators, promising data governance policies and practices, and recommendations relevant to ACB communities. The findings may inform the expansion of Ontario’s Engagement, Governance, Access, and Protection guidelines and support tailored research and national data governance frameworks. The review is expected to contribute to policy, research, and community-led data initiatives. Dissemination will occur through academic publications, conferences, and community-based knowledge-sharing events. As the review relies solely on publicly available data, ethics approval is not required. OSF Registries 10.17605/OSF.IO/Z82AY; https://osf.io/z82ay. PRR1-10.2196/82403.
8. Incidence, prevalence, burden, and disability rate of neural tube defects in sub-Saharan Africa, 1990-2021: understanding epidemiology.
期刊: Journal of neurosurgery. Pediatrics 发表日期: 2026-Feb-13 链接: PubMed
摘要
Neural tube defects (NTDs) represent a significant global concern, impacting an estimated 300,000 individuals each year. Sub-Saharan Africa (SSA) is considerably affected due to various biopsychosocial factors, dietary issues such as folic acid deficiency, and fumonisin-contaminated maize consumption, and sex-based disparities. This study sought to understand epidemiology and trends in NTD in SSA from 1990 to 2021. The Global Burden of Disease database was utilized to obtain epidemiological data on the variables of interest, which included disability-adjusted life years (DALYs), incidence, prevalence, and mortality of patients with NTD in SSA. The countries in SSA were divided into 4 separate regions-Central, Eastern, Western, and Southern-based on the designations by the African Union. Variations in measurements of NTDs between regions in SSA were assessed using R Studio, and statistical significance was determined with a threshold p value of < 0.05. The global burden of NTDs was significantly lower than the burden of NTDs in Central, Eastern, and Western SSA (p < 0.0001). Among the regions, Southern SSA experienced better outcomes in terms of DALYs, mortality, incidence, and prevalence, compared to the other regions of SSA (p < 0.001). When a sex-specific burden analysis was performed, female sex was associated with higher DALYs and mortality of NTDs within SSA, especially in Western SSA (p < 0.0001). Other regions of the world, including North America, Latin America and Caribbean, Europe and Central Asia, and Middle East and Northern Africa, also showed associations between female sex and higher DALYs and mortality of NTDs (p < 0.05). When the incidence and prevalence of NTDs was analyzed, there were mixed results, as female sex was associated with higher and lower rates in different regions of the world. Understanding the epidemiology of NTDs in SSA underscores the need for quality interventions that not only increase disease awareness and healthcare access but strive for prevention. With identification of the multifaceted factors contributing to NTDs and promotion of proactive health practices, significant strides could be made toward reducing the incidence of NTDs. Partnerships between governments and international agencies are vital to mobilize resources and reduce the burden and related health disparities.
9. Patient Preferences for Technology-Assisted Patient-Reported Outcomes Measurement of Mental Health Symptoms Among Veterans: Cross-Sectional Survey.
期刊: Journal of participatory medicine 发表日期: 2026-Feb-13 链接: PubMed
摘要
The Veterans Health Administration is promoting patient-reported outcome measure (PROM) collection for measurement-based mental health care. Understanding veteran preferences about how and when to complete PROMs is critical to support their implementation. We examined veteran preferences for timing and use of different technology platforms to complete mental health-related PROMs. We invited a national sample of 1373 veterans to complete a survey; 858 (62.5%) responded. Surveys asked about veteran preferences for how and when to complete mental health-related PROMs. We characterized responses using descriptive statistics and estimated multiple logistic regression models to examine associations between veteran demographic and health characteristics and preferences for completing PROMs. Most veterans preferred completing PROMs between appointments (607/801, 75.8%) using features of a patient portal (410/801, 51.2%), during appointments (589/801, 73.5%) verbally (413/801, 51.6%), and while at the medical center (480/801, 59.9%) on paper (189/801, 23.6%) or a tablet computer (180/801, 22.5%). Hispanic (vs non-Hispanic) veterans had 3.32 (95% CI 1.04-10.58) times higher odds of preferring to complete PROMs at the medical center, and veterans with lower (vs higher) socioeconomic status had lower odds (odds ratio 0.61, 95% CI 0.40-0.93) of preferring to complete PROMs in between appointments but 1.97 (95% CI 1.23-3.16) times higher odds of preferring to complete PROMs during appointments. As the Veterans Health Administration and other health care systems seek to expand the integration of PROM data into health care services, adaptive and flexible approaches to PROM administration that align with patient preferences, including those that leverage technology platforms in the remote collection of these data, may bolster implementation. Our results indicate that such implementation efforts should consider patient ethnicity and socioeconomic status. Our findings further suggest that these efforts could benefit from incorporating PROM administration into online patient portals, developing mobile health apps that support PROM completion through patients’ personal devices in between clinical encounters, and engaging care team members in PROM administration during appointments.
10. Healthy dietary patterns, longevity genes, and life expectancy: A prospective cohort study.
期刊: Science advances 发表日期: 2026-Feb-13 链接: PubMed
摘要
Associations between healthy dietary patterns and life expectancy remain unclear. Here, we reported the prospective associations of five dietary patterns with mortality and life expectancy in 103,649 UK Biobank participants. Over a median follow-up period of 10.6 years, 4314 total deaths were documented. Alternate Healthy Eating Index-2010, Alternate Mediterranean Diet (AMED), healthful Plant-based Diet Index (hPDI), Dietary Approaches to Stop Hypertension, and Diabetes Risk Reduction Diet (DRRD) were associated with lower all-cause mortality and longer life expectancy, with DRRD showing slightly stronger associations than hPDI. Compared with the bottom quintile, achieving the top quintile of dietary scores was associated with 1.9 to 3.0 years of life gained at 45 years in men and 1.5 to 2.3 years in women. The life gained was longest in DRRD for males and AMED for females. The significant associations remained when accounting for genetic susceptibility. Our findings underscore the advantages of healthy dietary patterns in prolonging life expectancy, regardless of longevity genes.
11. Dinner observations of parent sensitivity and pressuring feeding practices with preschool-age children.
期刊: Journal of pediatric psychology 发表日期: 2026-Feb-13 链接: PubMed
摘要
Family mealtimes play an important role in children’s social and emotional learning. Parents who use controlling feeding practices, such as feeding pressure, are more likely to have children who struggle to self-regulate their food intake. Little research has examined the connections between global parenting sensitivity and the use of feeding pressure. The current study aimed to investigate whether global parental sensitivity in mothers and fathers was related to the frequency of parental feeding pressure and examined day-to-day variability in the associations of these constructs. We recorded videos of a week of mealtime interactions in 100 families with a 3- to 5-year-old child and coded observed parental sensitivity and feeding pressure used at each meal. We used multilevel modeling to test for (a) variability in mothers’ and fathers’ mealtime sensitivity at the within-person level and (b) the relationship between mothers’ and fathers’ sensitivity and pressuring feeding practices each day. We found that mother and father sensitivity varied day-to-day. This variability was related to daily fluctuations in feeding pressure. This result was also seen between families, such that families with more sensitive mothers and fathers showed less feeding pressure with their children than in families with less sensitive parents. These results have implications for the importance of parental sensitivity for children’s mealtime experience.
12. Global research status of the impact of neutrophil extracellular traps on tumor from 2004 to 2023: A bibliometric and visualized analysis.
期刊: Medicine 发表日期: 2026-Feb-13 链接: PubMed
摘要
Tumors are a major threat to human life and health. Neutrophil extracellular traps (NETs) have become a research focus in this context, especially regarding their role in tumor progression. Since the concept of NETs was introduced in 2004, its implications for tumor research have attracted significant scholarly attention. This study aims to explore research trends and cutting-edge hotspots in NETs and tumors through bibliometric analysis and provide new ideas for clinical applications. We searched for literature on NETs and tumors published between 2004 and 2023 using the Web of Science database. Microsoft Excel 2019 was used for statistical analysis of influential articles, journals, authors, organizations, countries, and co-cited references. VOSviewer (version 1.6.16) and CiteSpace (V.5.8.R3) were employed for visualizing research data. The analysis covered 790 articles authored by 4768 individuals from 1134 organizations in 56 countries. China and the United States are the leading contributors. The mechanism of NETs in tumor occurrence and development is likely linked to coagulation, inflammation, and infection. Hot topics in research include dendritic cells and thrombosis, with a shift from laboratory studies to clinical applications, suggesting a growing focus on treatment over etiology. This study offers the most comprehensive bibliometric analysis of NETs and tumors to date. Future research may focus on developing targeted therapies that block the interaction between NETs and tumors, offering a new direction for cancer treatment.
13. Translation, cultural adaptation, and validation of the Japanese version of the quality of life assessment in spina bifida for adults.
期刊: Journal of patient-reported outcomes 发表日期: 2026-Feb-13 链接: PubMed
摘要
The QUAlity of Life Assessment in Spina bifida (QUALAS) is a self-administered questionnaire that measures health-related quality of life. The Japanese versions of QUALAS for children and teenagers with spina bifida (SB) have been validated. This study aimed to develop and validate the reliability and validity of the Japanese version of QUALAS-A (QUALAS-A-J), the adult version of the instrument. The participants were adults with SB aged ≥ 18 years. The results of cognitive interviews and a preliminary survey conducted on 16 participants were analyzed to confirm the face and content validity of the responses, and the item wording was modified. The revised questionnaire was administered from April to December 2022. The survey requested responses regarding demographics, QUALAS-A-J, and the World Health Organization Quality of Life Scale (WHOQOL-26). We then calculated descriptive statistics and correlation coefficients, and conducted exploratory factor analysis and Student’s t-test. Cronbach’s α and retests were used to determine reliability and intraclass correlation coefficients (ICCs), respectively. Valid responses were received from 133 participants (52% female; mean age, 31.3 ± 10.5 years). Factor analysis indicated a 12-item, three-factor structure. Three items related to sexual activity that had low variance estimates were eliminated. Two factors converged on the same items as the original version; the correlation coefficients for QUALAS-A-J and WHOQOL-26 domains were 0.36 ≤ r ≤ 0.72, which confirmed discriminability for two domains. In all three domains, health-related quality of life was higher for those without than for those with urinary incontinence, validating known-groups validity. Cronbach’s α was 0.66-0.88 and the ICCs were > 0.8, thereby confirming reliability. The present study evaluated the reliability of QUALAS-A-J, which has three domains, 12 items, and two original and one new structure. Adults with spina bifida (SB) in Japan have lacked a specific questionnaire to measure their health-related quality of life (HRQOL), which has hindered a complete understanding of their unique needs. Japanese versions of the QUAlity of Life Assessment in Spina bifida (QUALAS) questionnaire already exist for children and teenagers; developing a Japanese version of the QUALAS for adults (QUALAS-A) would complete this important age-specific series of assessments. Therefore, we developed and validated a Japanese version of the QUALAS-A questionnaire (QUALAS-A-J), a tool for assessing HRQOL in adults with SB, and then confirmed its reliability and cultural appropriateness (some sexuality-related questions were removed from the original QUALAS-A). The QUALAS-A-J is a trustworthy 12-item questionnaire with three key areas: “Health and Relationship”, “Esteem”, and “Bladder and Bowel”. This questionnaire completes a comprehensive set of HRQOL measures across all age groups and could serve as a valuable tool for health-care professionals in Japan by aiding the provision of improved assessments and support to adults with SB.
14. A Novel Chronotype-Based Mediterranean Diet Pyramid: An Updated Representation by the Italian Society of Endocrinology (SIE) and the Italian Society of Dietetics and Clinical Nutrition (ADI).
期刊: Current nutrition reports 发表日期: 2026-Feb-13 链接: PubMed
摘要
15. From Signal to Systems Change: The Convergence of Epidemiology and Implementation Science in Precision Cardiovascular Medicine.
期刊: Circulation. Population health and outcomes 发表日期: 2026-Feb-13 链接: PubMed
摘要
16. Anxiety-Free Public Dentistry for Adults With Disabilities by Using Head-Mounted Virtual Reality Technology: Protocol for a Feasibility Mixed Methods Study.
期刊: JMIR research protocols 发表日期: 2026-Feb-13 链接: PubMed
摘要
Oral disease remains a global public health concern, disproportionately affecting socioeconomically disadvantaged populations. Adults with disabilities or health conditions face additional barriers to dental care, including physical accessibility, communication challenges, and heightened anxiety. These factors contribute to care avoidance and poorer oral health outcomes. While virtual reality (VR) has shown promise in reducing procedural anxiety in pediatric and private dental settings, its application in adult public dentistry, particularly for people with disabilities, remains underexplored. This study aims to evaluate the feasibility, usability, and acceptability of Smileyscope, a Therapeutic Goods Administration-approved head-mounted VR headset, in reducing dental anxiety and enhancing care experiences for adults with disabilities in public dental clinics. A mixed methods convergent design will be implemented across community dental sites in Victoria, Australia. In total, 50 adult patients and up to 10 dental staff members will be recruited. Primary feasibility indicators include recruitment rate (≥60% consent), completion rate (≥80% System Usability Scale [SUS] completion), and usability threshold (mean SUS ≥68). The primary analysis will be descriptive, with 95% CIs reported. Quantitative data will be collected using the visual analog scale for willingness, the SUS, and the technology acceptance model questionnaire. Qualitative data from semistructured interviews will be thematically analyzed. The study is co-designed with a disability advocate and integrates lived experience throughout all phases, including recruitment, evaluation, and dissemination. The project was funded in 2025, and ethics approval was granted by Peninsula Health Human Research Ethics Committee (project ID 117565). Data collection is scheduled for October 2025 to March 2026 at the participating community dental sites. Primary feasibility estimates and qualitative themes are expected to be submitted for publication in mid‑2026. This protocol outlines a feasibility study that will inform scalable models for VR integration into public dental services. The findings will contribute to improved oral health equity and patient-centered care, advancing the evidence base for inclusive digital health innovation in dentistry. PRR1-10.2196/85916.
17. Biochar Reduces Nanoplastics Uptake by Lettuce and Alleviates Its Toxicity to the Plant.
期刊: Journal of agricultural and food chemistry 发表日期: 2026-Feb-13 链接: PubMed
摘要
The accumulation of micro- and nanoplastics (MPs/NPs) in croplands threatens food quality and human health. This study investigates the effectiveness of pristine biochar (BC) and iron-doped biochar (Fe-BC), produced from pine sawdust via one-step pyrolysis, in reducing NPs uptake by lettuce (Lactuca sativa L. var. adela). Fe-BC exhibited greater porosity, higher surface area, and a slightly positive surface charge compared to BC. Using Pd-doped NPs, we confirmed that NPs can penetrate roots and translocate to leaves, accumulating more in older tissues. Soil application of 3 wt % BC or Fe-BC significantly lowered leaf NPs concentrations, with Fe-BC showing a greater reduction, by approximately 60% (from 0.90 to 0.36 mg/kg). While both BC and Fe-BC demonstrated a capacity for alleviating NPs-induced metabolic disturbances and partially restoring soil enzyme activities, Fe-BC presents a more promising amendment for mitigating NPs contamination and protecting crop quality.
18. Prenatal Exposure to Artificial Light at Night and the Offspring's First 1000-Day Growth: A Prospective Metabolomic and Gene-Environment Interaction Study.
期刊: Environmental science & technology 发表日期: 2026-Feb-13 链接: PubMed
摘要
Our previous exposome study suggested associations between prenatal exposure to artificial light at night (ALAN) and offspring weight and fat growth during the first 1000 days. This study aims to further explore the underlying biomechanism and modifying effects of maternal genetic regulators. Among 1944 mother-child pairs from the Shanghai Birth Cohort, meet-in-the-middle, mediation, and enrichment analyses were combined with the early pregnancy untargeted metabolome to explore potential biological links between prenatal ALAN exposure and early life growth. Maternal polygenetic risk scores (PRS) for glucose- and lipid-metabolism-related phenotypes were constructed and dichotomized (high/low) to examine gene-environment interactions. We identified 35 mediating metabolites between prenatal ALAN exposure and growth outcomes, which were enriched in neural signal transduction-related pathways and associated with the circadian rhythm. The effects of ALAN exposure on fetal and child growth were more pronounced among mothers with high PRS levels for fasting glucose, HbA1c, and triglycerides. To sum up, prenatal ALAN exposure may be associated with reduced weight and adiposity gains during the first 1000 days. These associations may be partly explained by disturbances in maternal circadian rhythms and appeared more pronounced among mothers with high genetic predispositions to glucose and triglyceride levels.
19. Integration of the Integrate, Design, Assess, and Share Framework in Developing the Environmental Health Literacy Toolkit Paraben-Free & Me: Protocol for a Randomized Controlled Trial.
期刊: JMIR research protocols 发表日期: 2026-Feb-13 链接: PubMed
摘要
Endocrine-disrupting chemicals, such as parabens, are commonly found in personal care products (PCPs). Exposure to parabens is linked to several significant health risks, such as reproductive disorders, breast cancer, infertility, and hormone imbalances. Women are particularly vulnerable to these effects due to their higher use of PCPs containing parabens. Despite these risks, Canada lacks regulatory frameworks for the use of parabens in PCPs, relying instead on consumer awareness for reducing exposure. Previous studies have highlighted that many women remain unaware of parabens, exhibiting low risk perception and limited knowledge, which restricts behavior change toward safer choices. To address this gap, this project developed the Paraben-Free & Me educational toolkit using the integrate, design, assess, and share framework. Toolkit development methodology involved empathizing with target users, defining specific behaviors, grounding the data in the health belief model, ideating implementation strategies, prototyping, gathering user feedback, and building a minimum viable product. The Paraben-Free & Me toolkit includes multimedia resources such as blog posts, interactive quizzes, videos, podcasts, and forums aimed at increasing knowledge, risk perceptions, and health beliefs and facilitating paraben-free behaviors. This toolkit shows potential to inform women about endocrine-disrupting chemicals, reduce exposures, and improve health outcomes.
20. Profiling loads worn by a state police service while on duty.
期刊: Work (Reading, Mass.) 发表日期: 2026-Feb-13 链接: PubMed
摘要
BackgroundLaw enforcement officers are required to wear and carry loads as part of their occupation. Research detailing differences in loads carried across occupational subgroups in law enforcement is limited.ObjectiveThe aim of this study was to profile the loads carried by an Australian State police agency and investigate whether any occupational subgroup, or sex-based, differences existed.MethodsData from 88 officers across five different stations from the same agency were collected. Officers were weighed in their uniforms without, and with, their duty load. Duty load was calculated as both absolute and relative values. Independent samples t-tests were used to investigate differences between sexes. An ANOVA was used to compare loads between occupational subgroups. Alpha levels were set at 0.05.ResultsFemale officers were significantly shorter and lighter than male officers, carried significantly lighter absolute loads but similar relative loads. General Duties (9.47 ± 1.67 kg) and Bicycle officers (10.38 ± 0.37 kg) carried and wore significantly heavier absolute loads than plain clothes officers (6.71 ± 2.26 kg), while specialist police carried significantly heavier loads than all subgroups (15.72 ± 2.13 kg). A similar trend was found in relative loads (General Duties = 11.1 ± 2.1%, specialist police = 17.0 ± 3.6%) except for Bicycle officer relative loads (10.9 ± 1.6%) which were not significantly heavier than those of plain clothes officers (7.9 ± 2.9%).ConclusionDifferent subgroups of officers carry and wear different loads. These differences warrant consideration especially when considering the chronic impacts of wearing these loads across a career. Optimised load fit and physical conditioning are recommended to mitigate the occupational impacts of carrying these loads.
21. [Role of trauma surgery in the emergency department from the perspective of the occupational accident insurance physician procedure].
期刊: Unfallchirurgie (Heidelberg, Germany) 发表日期: 2026-Feb-13 链接: PubMed
摘要
The emergency department (ED) represents the central point of entry for trauma surgical care of occupational, school and commuting accidents within the German hospital system. In addition to providing acute medical treatment, the ED plays a crucial role as an interface to the occupational accident insurance health system. In particular, the transition physician (D-physician) system entails specific structural, procedural and documentation-related requirements that are largely shaped by trauma surgery. This article analyzes the role of trauma surgery in the ED from the perspective of the D‑physician. It outlines the legal framework and care structures of the D‑physician system, the distinction from general emergency care and the importance of interdisciplinary interfaces and standardized decision-making processes. Special emphasis is placed on the management of complex injury patterns in the context of the injury type and severe injury type procedures as well as on the integration of trauma surgery into modern concepts of clinical acute and emergency medicine. The aim of this article is to highlight the key role of trauma surgery in the ED and to identify practice-relevant aspects for ensuring high-quality, legally compliant and efficient care of patients covered by the occupational accident insurance. Die Zentrale Notaufnahme (ZNA) ist das zentrale Eingangstor für die unfallchirurgische Versorgung von Arbeits‑, Schul- und Wegeunfällen im deutschen Krankenhauswesen. Neben der medizinischen Akutversorgung kommt ihr eine besondere Bedeutung als Schnittstelle zum berufsgenossenschaftlichen Heilverfahren zu. Insbesondere das Durchgangsarzt(D-Arzt)-Verfahren stellt spezifische strukturelle, prozessuale und dokumentarische Anforderungen, die maßgeblich durch die Unfallchirurgie geprägt werden. Der vorliegende Beitrag analysiert die Rolle der Unfallchirurgie in der ZNA aus der Perspektive des D‑Arztes. Dargestellt werden die rechtlichen Grundlagen des D‑Arzt-Verfahrens, die Abgrenzung zur allgemeinen Notfallversorgung sowie die Bedeutung interdisziplinärer Schnittstellen und standardisierter Entscheidungsprozesse. Ein besonderer Fokus liegt auf der Steuerung komplexer Verletzungsmuster im Kontext des Verletzungsarten- und Schwerstverletzungsartenverfahrens sowie auf der Einbindung der Unfallchirurgie in moderne Konzepte der klinischen Akut- und Notfallmedizin. Ziel ist es, die unfallchirurgische Schlüsselrolle in der ZNA herauszuarbeiten und praxisrelevante Aspekte für eine qualitativ hochwertige, rechtssichere und effiziente Versorgung von Berufsgenossenschafts(BG-)Patientinnen und -Patienten aufzuzeigen.
22. Pharmacokinetics, safety and tolerability, and efficacy of hyaluronidase-facilitated subcutaneous immunoglobulin 10% (HyQvia®) in Japanese patients with primary immunodeficiency diseases.
期刊: Immunological medicine 发表日期: 2026-Feb-13 链接: PubMed
摘要
This phase 3 open-label study (jRCT2031210457; NCT05150340; January 2022-August 2023) evaluated pharmacokinetics, safety and tolerability, and efficacy of recombinant hyaluronidase-facilitated subcutaneous immunoglobulin (fSCIG) 10% in Japanese patients with primary immunodeficiency diseases (PID) transitioning from intravenous immunoglobulin (IVIG) or conventional SCIG (cSCIG). Patients received fSCIG 10% (HyQvia®) with dose ramp-up (Epoch 1) and 3- or 4-week dosing intervals (Epoch 2; 24 weeks). Assessments included IgG trough levels, infusion-related tolerability, validated acute serious bacterial infections (VASBIs), and treatment-emergent adverse events (TEAEs). Sixteen patients completed the study (median age: 21 years; range: 5-62). Prior treatments included cSCIG (62.5%), IVIG (31.3%), and SCIG (human) 20% solution (Ig20Gly; Cuvitru®) (6.3%). Geometric mean IgG trough levels during the evaluation period (Epoch 2) remained stable across all visits (1254-1351 mg/dL, 3-week dosing; 874-937 mg/dL, 4-week dosing). No tolerability events or VASBIs were observed. Annual infection rate was 2.74 per patient-year. TEAEs related to fSCIG 10% occurred in 68.8% of patients, all mild or moderate. No serious TEAEs related to fSCIG 10% or deaths occurred. No TEAEs led to study discontinuation. fSCIG 10% effectively maintained IgG levels, prevented infections, and was well tolerated in Japanese patients with PID transitioning from IVIG or cSCIG.
23. Emergence of xylazine in accidental overdose deaths, impaired drivers, sexual assaults, and public intoxications within San Francisco.
期刊: The International journal on drug policy 发表日期: 2026-Feb-12 链接: PubMed
摘要
Xylazine, a veterinary sedative and alpha-2 adrenergic receptor agonist not approved for human use, has emerged as a significant adulterant in the illicit fentanyl supply across the United States. While its presence has been well documented on the East Coast, systematic reporting from California remains limited. This study characterizes the emergence, prevalence, and concentration trends of xylazine in forensic casework in San Francisco from 2022 January to 2024 December, and describes polysubstance patterns associated with its use. We retrospectively analyzed up to thirty-six (36) months of routine comprehensive toxicological testing for over 200 drugs/metabolites performed on all xylazine-positive accidental overdose deaths (AOD), driving under the influence of drugs (DUID), drug-facilitated sexual assault (DFSA), and public intoxication (PI) cases within the City and County of San Francisco, totaling 314 cases. Xylazine detections increased across all case types from 2023 to 2024 and rose steadily in AOD cases from 2022 through 2024. The majority of xylazine-positive cases were AOD. Mean and peak xylazine concentrations demonstrated year-to-year increases, with peak AOD blood and urine concentrations observed up to 31 and 2100 ng/mL, respectively. All xylazine-positive cases co-occurred with fentanyl, a fentanyl precursor or metabolite, or a fentanyl analog. Additionally, 71% of these cases involved five to eight additional drug classes. Xylazine has rapidly infiltrated the San Francisco illicit fentanyl supply and is frequently present in polysubstance use patterns. Rising prevalence and increasing concentrations indicate evolving market dynamics, with implications for overdose risk and forensic and public health surveillance.
24. Risk behaviors and prevalence of hepatitis B and C among people who inject drugs in Georgia: integrated bio-behavioral survey (IBBS).
期刊: The International journal on drug policy 发表日期: 2026-Feb-12 链接: PubMed
摘要
Injection drug use (IDU) poses significant public health risks, including the transmission of blood-borne infections such as hepatitis B (HBV) and hepatitis C (HCV). This study aims to evaluate the prevalence of risk behaviors associated with IDU and the prevalence of HBV and HCV among people who inject drugs (PWID) in Georgia. A cross-sectional study was conducted in seven cities of Georgia in 2022, involving 2005 PWID aged ≥18 years. Participants were recruited using respondent-driven sampling. Data were collected through face-to-face interviews and blood samples were collected for HCV/HBV testing. The majority of study participants (98.6%) were males, 63.2% were older than 40 years, and 51.3% had a history of imprisonment. 24.4% reported using a needle/syringe previously used by someone else. HCV seropositivity was found in 58.1% of respondents, with 32.1% of anti-HCV positive individuals testing positive for HCV RNA. HBV surface antigen was detected in 2.5%. Only 7.5% reported being vaccinated for hepatitis B and 27.8% expressed willingness to be vaccinated. 33.9% had HCV treatment history. HCV prevalence was significantly higher among males, older PWID, those with a history of incarceration and history of sharing needles used by others. Our findings highlight the high prevalence of HCV and low HBV vaccination rates among PWID in Georgia, emphasizing the need for strengthened harm reduction strategies. Expanding sterile injection access, integrating HBV vaccination, and removing structural barriers are key to improving prevention and testing efforts and linkage to care.
25. Air pollution and ischemic stroke across socioeconomic groups in the Netherlands.
期刊: The Science of the total environment 发表日期: 2026-Feb-12 链接: PubMed
摘要
While air pollution is an established risk factor for ischemic stroke (IS), evidence on differential susceptibility across population subgroups remains limited. We investigated how associations between long-term air pollution exposure and IS risk varied across socioeconomic groups and urbanicity levels. This population based cohort study included 11.9 million adults ≥18 years with linked residential exposure data for PM2.5, PM10, and NO2. Socioeconomic position was assessed using individual-level and area-level indicators including welfare, education, employment history, and composite scores. Time-varying Cox proportional hazards models examined associations between annual average air pollution at home addresses and incident IS risk across socioeconomic and urbanicity groups. During 2014-2019 follow-up, 152,868 incident IS cases were identified. Air pollution exposure was associated with increased IS risk for all pollutants: hazard ratios (HR) 1.07 [95% CI: 1.06; 1.08] per 5.0 μg/m³ PM2.5, 1.06 [1.05; 1.07] per 5.0 μg/m3 PM10, and 1.08 [1.08; 1.09] per 10 μg/m³ NO2. Associations were stronger in rural to moderately urbanised versus highly urbanised areas. Socioeconomic differences were most pronounced in rural to moderately urbanised areas, with consistently higher HRs among lower socioeconomic groups (e.g., lowest area-level education: HR 1.16 [1.08; 1.25] per 5.0 μg/m³ PM2.5), while disparities were minimal in highly urbanised areas. Air pollution’s impact on IS risk varies significantly by socioeconomic position and urbanicity, with lower socioeconomic groups in rural to moderately urbanised areas showing increased vulnerability. These findings emphasize considering geographic and socioeconomic contexts in air pollution health assessments.
26. Suicidal Mental Imagery in Suicide Attempters: A Cross-Sectional Study.
期刊: The primary care companion for CNS disorders 发表日期: 2026-Feb-12 链接: PubMed
摘要
Objective: To examine the prevalence and clinical correlates of suicidal mental imagery among individuals who have attempted suicide in India. Methods: This cross-sectional study included 63 participants who recently attempted suicide. Assessments included the Mini-International Neuropsychiatric Interview, Version 6, suicidality subscale; Patient Health Questionnaire-9; Beck Suicide Intent Scale; Scale for Assessment of Lethality of Suicide Attempt; and a sociodemographic data questionnaire. Data were collected from June 2023 to April 2024. Results: The majority of participants were unemployed, educated, unmarried, and from nuclear families and rural backgrounds. Common attempt methods were drug overdose and poisoning. Of the participants, 79.4% reported past mental illness. Suicidal mental imagery was present in 38.1% of participants. Associations were found with female sex, unemployment, past mental illness, and higher depression/suicidality scores. Conclusions: The relationship between depression, suicidality, and mental imagery suggests that addressing imagery could be important for treatment and prevention. Prim Care Companion CNS Disord 2026;28(1):25m04071. Author affiliations are listed at the end of this article.
27. Sinonasal disease in lung transplant recipients: A retrospective study at a single lung-transplant center in Japan.
期刊: Auris, nasus, larynx 发表日期: 2026-Feb-12 链接: PubMed
摘要
Infectious complications are a leading cause of morbidity and mortality post-lung transplantation. Chronic rhinosinusitis (CRS) frequently occurs in patients with conditions that are common indications for lung transplantation. Proactive management of sinonasal disease may help to reduce airway colonization and improve clinical outcomes after lung transplantation, but CRS prevalence, clinical features, and management strategies in lung transplant recipients are poorly studied. Thus, we sought to clarify the prevalence, clinical characteristics, and management strategies of chronic rhinosinusitis (CRS) among lung transplant recipients at a single lung-transplant center in Japan, with particular attention to regional differences in disease etiology and management. We included 272 patients who underwent or were scheduled to undergo lung transplantation at the University of Tokyo Hospital between 2015 and 2024. Patient demographics, underlying respiratory diseases, pre- or posttransplant sinonasal status, and otolaryngological management data were collected. CRS was diagnosed based on the EPOS 2020 criteria, which incorporate clinical symptoms, endoscopic findings, and radiological evidence. We evaluated CRS prevalence and its associations with specific pulmonary diagnoses, surgical intervention rates, and clinical outcomes. CRS was identified in 7.2 % (16/222) of pre-transplant and 13.8 % (8/58) of post-transplant patients. Significantly higher CRS prevalence was observed in patients with bronchiectasis (53.8 %, odds ratio [OR] 17.7, p < 0.001) and diffuse panbronchiolitis (60.0 %, OR 18.5; p = 0.005), suggesting that ciliary dysfunction is a major risk factor for CRS. Imaging predominantly revealed maxillary and ethmoid sinus involvement. Fungal balls were noted in approximately 10 % of patients. Endoscopic sinus surgery was performed in refractory CRS cases, which resulted in good postoperative outcomes, with preservation of lung graft function and absence of surgery-related complications and opportunistic infections. Although based on a limited number of surgical cases, histopathological examination of the surgical specimens revealed a predominance of neutrophilic and non-eosinophilic inflammation. CRS is a clinically significant and relatively common complication in Japanese lung transplant recipients, particularly in those with underlying ciliary dysfunction. These findings highlight distinct regional differences in disease phenotypes and management approaches for CRS in lung transplant recipients. Systematic otolaryngological evaluation and timely intervention for CRS, including endoscopic sinus surgery, may help to prevent severe infections and optimize post-lung transplant outcomes.
28. Source identification of sub-10 nm particles through air dispersion modeling.
期刊: The Science of the total environment 发表日期: 2026-Feb-12 链接: PubMed
摘要
Previously reported rooftop ambient aerosol measurements in Raleigh, NC, USA, detected episodic events where sub-10 nm particle number concentrations (PNC) exceeded 3.73 × 105 cm-3. Their small size and temporally stable modal diameter (sometimes persisting for days) indicated origins from nearby primary emission sources rather than mesoscale new particle formation (NPF) events. To investigate potential sources, simulations were conducted using the U.S. Environmental Protection Agency’s Gaussian plume-based model, AERMOD. Campus surveys and Google Earth analyses identified three candidate sources near the measurement site, including two combined heat and power (CHP) facilities with high-efficiency natural gas turbines and heat recovery steam generators that provide energy to NC State’s campus. Distinct point sources were modeled for each facility using an emission factor of 5 × 10-4 g s-1. The study explored source contributions under varying micrometeorological conditions (e.g., wind speed, wind direction, solar radiation, and planetary boundary layer height). Wind pattern analysis revealed distinct plumes from individual power plants reaching the receptor site. Statistical analyses confirmed wind direction and speed as the strongest predictors of modeled mass concentrations, and that observed PNC profiles during NPF and particle burst events are fundamentally distinct. Exceptionally high sub-10 nm particle growth rates were observed during plume transport, averaging 104-120 nm hr-1. These findings reveal that expanding deployment of CHPs for distributed power generation may pose unrecognized health risks through sub-10 nm particle emissions with demonstrated respiratory and neurological impacts. New emission standards may be needed to address ultrafine particle production from natural gas combustion technologies.
29. Multivariate analysis on simulated moisture damage emission to indoor air.
期刊: The Science of the total environment 发表日期: 2026-Feb-12 链接: PubMed
摘要
Moisture damage in buildings is a significant source of indoor air problems, releasing e.g. volatile organic compounds (VOCs) and microbially produced VOCs (MVOCs), which can cause unpleasant odors and health symptoms. However, interpreting MVOCs as indicators of mold is challenging due to their various sources and limitations in analytical methods. The objective of this study was to identify the most critical factors influencing VOC emissions from moisture-damaged wall structures into the indoor environment via structural air leakages. The research was conducted using the VTT Indoor Air Quality (IAQ) Simulator and analyzed with Principal Component Analysis (PCA). The IAQ simulator was used to investigate the transport of airborne impurities from mold-contaminated wall structures in realistic building conditions and the systematic manipulation of key environmental parameters. The resulting dataset was subjected to multivariate analysis to identify the most influential factors contributing to IAQ degradation in moisture-damaged structures. The key conclusions revealed that material relative humidity was the most significant single factor affecting all VOC concentrations; higher humidity consistently increased emissions. Four specific ketones (2-pentanone, 2-hexanone, 2-heptanone, and 2-octanone) were clearly identified as originating from microbial growth, with their concentrations being significantly higher in the presence of active mold growth. Pressure differentials had only a borderline effect on gypsum board emissions, while the insulation layer showed no significant impact on any of the identified VOC components. These findings underscore the critical role of relative humidity in determining indoor VOC profiles and highlight the value of multivariate methods in assessing mold-related indoor air problems.
30. Comparative evaluation of an original microhaplotype panel and its expanded version for human identification and ancestry inference in Brazilian and admixed American populations.
期刊: Forensic science international. Genetics 发表日期: 2026-Feb-10 链接: PubMed
摘要
Microhaplotypes are an emerging kind of genetic markers composed of SNPs in closely linked allelic combinations, typically spanning up to 300 bp. When analyzed using next generation sequencing, they are considered a promising alternative to STRs in complex forensic casework involving mixed samples and degraded DNA. This study presents the first application of MPS to analyze microhaplotypes in 1165 individuals from a highly admixed urban Brazilian population (SABE cohort, São Paulo city). These data were derived from a WGS dataset, generated with a target coverage of 30 × using Illumina HiSeq X sequencing platforms. We evaluated the performance of the original panel of 130 microhaplotypes (MH-Base) and developed an expanded panel (MH-Plus) by incorporating additional SNPs into MH-Base loci to enhance marker informativeness. Forensic parameters and ancestry inference accuracy were assessed for both panels and compared with other genomic marker sets previously applied to the same cohort, including high-density SNP datasets. Additionally, we investigated the performance of both MH panels in AMR populations from the 1000 Genomes Project (ACB, ASW, CLM, MXL, PEL, PUR). MH-Plus improved all forensic parameters obtained with MH-Base. They showed greater potential for mixture deconvolution in Brazilian and recently admixed American populations, with CPD and CPE values exceeding those obtained with traditional STRs. The MH-Base panel provided ancestry estimates that were slightly better aligned with WGS reference values in the SABE cohort (4-parental model) and in AMR populations (3-parental model). In addition, the results obtained with the MH-Base panel in the SABE cohort validated the forensic and ancestry inference findings from a previous study conducted in another admixed Brazilian population (Ribeirão Preto - São Paulo), in which the same loci were genotyped using array-based methods and imputation tools. This study, therefore, contributes to consolidating a robust microhaplotype-based framework for forensic and anthropological applications in admixed Latin American populations.
31. Characteristics associated with first anti-seizure medication prescribed in a cohort of adults with newly diagnosed epilepsy.
期刊: Seizure 发表日期: 2026-Feb-05 链接: PubMed
摘要
Anti-seizure medication (ASM) is the primary treatment modality in epilepsy. There exist evidence-based recommendations published by the American Academy of Neurology and American Epilepsy Society for ASM selection in epilepsy, but these medication recommendations are inconsistently followed. We sought to examine predictors of recommended first ASM in newly diagnosed adults with epilepsy. We conducted a retrospective cohort study of adults (≥18 years) newly diagnosed with epilepsy in New York, identified using validated ICD-CM codes, for the period 2011 to 2019. The primary outcome of interest was use of an AES/AAN guideline-informed ASM, and exposures of interest included patient characteristics (e.g. age), provider characteristics (e.g. specialty) and structural characteristics (e.g., practice setting). Multivariable Poisson regression for risk ratios modeled the probability of being prescribed a neutral/recommended or non-recommended ASM, adjusting for covariates. 2340 adults with newly diagnosed epilepsy were prescribed an ASM within 1-year. The most frequently prescribed ASM was levetiracetam (45.5%), which aligns with recommendations. However, 39% were prescribed a non-recommended medication. The prescription of a recommended ASM was associated with older age at diagnosis (relative risk (RR) 1.01; 95% confidence interval (CI) 1.00-1.01), Black race (RR 1.12; 95% CI 1.03-1.23), being in a relationship (vs. divorced/separated/single or widowed) (RR 1.13; 95% CI 1.06-1.22) and a history of stroke (RR 1.19; 95% CI 1.05-1.34). Prescriptions from physician trainees (vs. non-trainees) were more likely to align with recommended ASMs (RR 1.15; 95% CI 1.06-1.25), with no differences by physician specialty. Inpatient setting was associated with fewer recommended ASM prescriptions (vs. outpatient setting) (RR 0.82; 95% CI 0.75-0.89). There was no difference between emergency department and outpatient prescriptions. Understanding where/why less favorable ASM prescription may occur is important to target potential prescribing interventions. In this study, recommended ASM prescriptions were associated with patient, prescriber and setting characteristics. Notably, trainees prescribed recommended/neutral ASM more often, which underscores the importance of prescriber education in improving prescribing practices.
32. Towards an interaction physiology: Unpacking the inferential property of language use.
期刊: Patient education and counseling 发表日期: 2026-Feb-05 链接: PubMed
摘要
Dialogues between clinicians and patients constitute complex, dynamic systems comparable to human physiology. While human physiology focuses on the internal regulation of the body, interaction physiology focuses on the observable regulation between participants who are talking with each other. We draw attention to just one fundamental property of interaction physiology, namely that interaction is a continuous process of participants inferring meaning from what each other says and does. We unpack several sequences from authentic clinical dialogues to exemplify such inferential processes. Each contribution in a dialogue serves a function and meaning beyond its literal sense, indeed it has meaning potential, in that its meaning is dependent on the sense that interlocutors make of it, based on its immediate context (i.e., what has happened so far in the conversation and the broader context of time, purpose, and setting). Concrete, practical implications for clinicians are the following: to appreciate what is gained by paying close attention to what the patient says and does; to notice possible misalignments in understanding; to use opportunities that dialogue offers to bring the topic of understanding to the fore. For researchers, particularly ones who are not working within established analytical traditions, awareness of inferential processes entails developing the discipline (and humility) of differentiating between one’s own inferences as an observer and the participants’ displayed inferences while they respond to each other in real time. We suggest that clinicians need communication recommendations to help them make sense of their interactions with patients in situ, supporting their ability to pay attention to what each patient is saying and doing in the moment. Such advice depends on distilling and promoting practice from a solid foundation of basic research on language use.
33. Perinatal mental health conditions among U.S. active component service women, 2016-2022.
期刊: MSMR 发表日期: 2026-Feb-04 链接: PubMed
摘要
Although mental health conditions are the leading underlying cause of maternal mortality, there is limited research on the prevalence of perinatal mental health conditions among active duty service women (ADSW). In this study of live-born deliveries among U.S. ADSW (n=62,729) with pregnancy start and end dates (i.e., dates of last menstrual period and infant delivery, respectively) from October 1, 2016 through December 31, 2021, International Classification of Diseases, 10th Revision, Clinical Modification diagnosis codes were used to identify mental health conditions: trauma and stressor-related disorders, anxiety and panic disorders, depressive disorders, suicidal ideation or attempt, and eating disorders. Data were collected through 1 year postpartum, until December 31, 2022. The prevalence of diagnosed mental health conditions from 1 year prior to pregnancy through 1 year postpartum was 33.8%. Trauma and stressor-related disorders were most prevalent (23.1%), followed by anxiety and panic disorders (16.9%), depressive disorders (14.6%), suicidal ideation or attempt (1.6%), and eating disorders (0.4%). The prevalence of mental health conditions was higher in the postpartum period (22.0%) compared to pregnancy (18.4%) and prior to pregnancy (15.0%). Overall, higher prevalence of these conditions was found among non-Hispanic Black ADSW (37.4%), and those who were unmarried (38.4%), never deployed (34.9%), or in the Army (37.4%) and Navy (36.4%). One in 3 active duty service women were diagnosed with a mental health condition in the year preceding pregnancy through 1 year postpartum. Overall, non-Hispanic Black and junior enlisted active duty service women demonstrated higher prevalences of mental health conditions compared to all other racial and ethnic groups and military ranks.
34. Measuring the use of spoken plain language by clinicians in healthcare encounters: A scoping review.
期刊: Patient education and counseling 发表日期: 2026-Feb-04 链接: PubMed
摘要
Poor communication in clinical encounters impacts both clinical and patient outcomes. We aimed to summarize the available data on the measurement and use of clinician-spoken plain language, as well as the associations between elements of plain language use and patient outcomes. Using Arksey and O’Malley’s framework, we conducted a scoping review of the published literature through November 2024 including any analysis of clinician use of plain language in English-based clinical encounters. We assessed study quality using the Joanna Briggs Institute cross-sectional assessment tool. We summarized our findings qualitatively. From 4398 unique citations, we found 36 papers (utilizing 34 distinct datasets) meeting our criteria. Studies were published from 2007 to 2023 and included 1225 clinicians total (range: 2-214) across many clinical settings. Study quality was mixed, although most (28/36, 77.8 %) measured plain language outcomes using reliable methods. Use of medical terminology was measured in 21/36 (58.3 %) studies, where all used manual methods to count terms, and some supplemented (5/21, 23.8 %) with automation. Median medical terms per encounter was 19.5 (range: 2.4-72.3), but interpretation was limited since encounter length varied substantially. Language complexity was measured in 15/36 (41.7 %), primarily using methods designed for written text. The average transcript grade level was 6.3 (range: 2.7-9.8; sixth grade). Only 4/36 (11.1 %) reported findings back to clinicians. This review offers insight into an emerging area of research in measuring clinician-spoken plain language. Significant heterogeneity exists in the elements that are measured, methods used, and findings. Future research should account for variation in encounter length. The use of automated analysis methods is growing, but limited, in this field. Measuring clinician-spoken plain language is an emerging area with potential applications in medical and continuing education. Real-world implementation may be supported through standardization of measurement methods and delivering results back to clinicians.
35. Trends in the prevalence of obesity among U.S. active component service members and civilians, 2013-2023.
期刊: MSMR 发表日期: 2026-Feb-04 链接: PubMed
摘要
Trends in obesity among U.S. active component service members (ACSMs) and civilians are relevant to military recruitment and retention, as excess body weight is a common disqualification for military service. This study utilized measured height and weight data from the Military Health System Data Repository for ACSMs (cumulative n=12,262,745) and the National Health and Nutrition Examination Survey for civilians ages 17-62 years (cumulative n=19,334). Accounting for the design of each data source, the prevalence of obesity (body mass index≥30 kg/m2) and body mass index (BMI) distributions were calculated. Joinpoint software and polynomial regression regression were used to assess trends over time. From 2013 through 2023, obesity prevalence increased among ACSMs, from 14.7% to 24.2%. Although obesity rates among civilians were consistently higher, this gap narrowed over the course of the decade. The same pattern was seen in young men (ages 17-24 years). Civilians have greater proportions within the highest classes of BMI than ACSMs. Persistently high obesity prevalence among ACSMs overall and in young men, particularly since 2019, may affect military recruitment, retention, and ultimately, strength and readiness. From 2013 through 2023, the prevalence of obesity increased significantly among U.S. ACSMs, 2019 to 2023 in particular, while prevalence among civilians remained consistently high. The pattern of obesity is especially relevant in young men, the largest source of potential and newly accessed military recruits.
36. Associations Between Sleep Disorders and Age-related Macular Degeneration: A Systematic Review and Meta-analysis.
期刊: Retina (Philadelphia, Pa.) 发表日期: 2026-Feb-03 链接: PubMed
摘要
To evaluate the relationship between sleep disorders, including insomnia and obstructive sleep apnea (OSA), personal chronotype, and age-related macular degeneration (AMD). We systematically reviewed articles in PubMed, EMBASE, and Web of Science that provided information on AMD and sleep disorders, whether qualitative or quantitative. We systematically screened the abstracts of potentially eligible studies and subsequently assessed the full-text reports of those deemed relevant in detail. The study adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Twenty-two studies were included in our final review. OSA was associated with a higher risk of AMD, based on seven studies (HR 1.43; 95% CI 1.14-1.79 p < 0.001; I2 = 96%). The analysis showed a statistically significant association between the morning person chronotype and an increased odds of AMD (OR 1.19; 95% CI 1.10-1.30; p < 0.001; I2 = 0%). We found little to no association between sleep duration and insomnia. Our meta-analyses, although based on a limited number of studies, indicate that sleep disorders, particularly OSA, are associated with increased odds of developing AMD. However, further research is needed to understand how sleep duration affects disease progression and to determine the benefits of treating sleep disorders for AMD.
37. Enabling microbial electrolysis cell scale-up via electrochemistry-, hydrodynamic-, and microbial ecology-informed framework.
期刊: Water research 发表日期: 2026-Feb-03 链接: PubMed
摘要
Microbial electrolysis cells (MECs) can produce green hydrogen while removing organic contaminants from liquid waste streams by leveraging the metabolic activity of electroactive microorganisms. Despite their potential in a sustainable, circular economy, large-scale MECs that can treat relevant volumes of wastewater have failed to deliver performance proportional to their lab-scale counterparts. The reason behind this lower performance at scale remains unclear. In this study, we developed a combined electrochemistry-, hydrodynamic-, and microbial ecology-informed framework to analyze and optimize MEC performance during scale-up, enabling accurate quantification of major limitations and the identification of strategies to overcome them, ultimately facilitating equivalent performance at scale. Applying this framework to the scale-up of a zero-gap MEC from 9 cm2 electrode area to 100 cm2 electrode area, resulted in similar maximum current densities in a 100 cm2 MEC (21.7 ± 1.1 A/m2) compared to a 9 cm2 system (25.1 ± 2.7 A/m2), as well as equivalent hydrogen production rates of 69.3 L/L-d (100 cm2) and 67.7 ± 2.4 L/L-d (9 cm2). COMSOL flow dynamics simulations were used to scale up the reactor configuration without negatively affecting electrolyte velocity and distribution in the cell, minimizing the increase in internal resistances during scale-up (11.7 ± 0.5 mΩm2 at 9 cm2; 19.7 ± 1.3 mΩm2 at 100 cm2). Microbial community structures were assessed at both scales using high-throughput sequencing, highlighting the differences of populations across electrode dimensions and operational parameters. The framework presented here accelerates the development of effective strategies toward the scale-up of MECs by furthering the understanding of how electrochemical, hydrodynamic, and microbial ecology parameters change as the reactor dimension is increased. Ultimately, this approach contributes to advancing electrochemical biotechnology toward practical deployment in energy-efficient wastewater treatment systems.
38. Predictors and Economic Impact of Red Blood Cell Transfusion in Cardiac Surgery: A Simulated Cost Reduction Model for Preoperative Anemia Management.
期刊: Acta medica portuguesa 发表日期: 2026-Feb-02 链接: PubMed
摘要
Red blood cell (RBC) transfusions are frequent in cardiac surgery and are associated with higher morbidity, mortality, prolonged hospitalization, and increased healthcare costs. Several patient- and procedure-related factors have been identified as transfusion predictors. Studying these predictors in specific populations allows more accurate risk stratification and tailored clinical decision-making. RBC transfusions represent a significant economic burden for healthcare systems due to increased resource utilization and hospital costs overall. The aim of this study was to identify independent risk factors of RBC transfusion, evaluate its economic impact, and estimate potential cost savings from eliminating preoperative anemia. We conducted a retrospective cohort study at a tertiary hospital in Portugal, including 661 adults who underwent elective cardiac surgery between April 2020 and April 2021. The primary outcome was the need for at least one RBC transfusion during hospitalization. Secondary outcomes included 30-day mortality, infection, acute kidney injury, prolonged mechanical ventilation, intensive care unit stay, hospital length of stay (LOS), and hospital costs. Independent risk factors were identified using multivariable logistic regression. An economic analysis compared costs between transfused and non-transfused patients. To estimate potential cost reductions, a simulation model was developed assuming the elimination of preoperative anemia and applying the observed transfusion patterns of non-anemic patients to the entire cohort. Red blood cell transfusion occurred in 41.3% of patients. The identified predictors were preoperative anemia (OR 3.67; 2.00 - 6.74), female sex (OR 2.06; 1.22 - 3.48), higher EuroSCORE II (OR 1.15; 1.03 - 1.29), longer cardiopulmonary bypass time (OR 1.01; 1.00 - 1.02) and lower intraoperative nadir hemoglobin (OR 0.48; 0.40 - 0.58), after adjusting for postoperative hemorrhage. Transfused patients had longer hospital stays (median 10 vs 8 days) and higher costs (median increase of €2264.44). After adjustment for infection and prolonged ventilation, transfusion was no longer independently associated with LOS. Eliminating preoperative anemia could prevent 47 transfusions, reduce 94 hospital days, and save €106 429 over 13 months overall. Red blood cell transfusion was associated with longer hospital stays, likely due to higher infection rates and prolonged mechanical ventilation. Correcting preoperative anemia could potentially reduce transfusion rates and related hospital costs in cardiac surgery.
39. [Prevalence of Dementia and Cognitive Decline in Portuguese Residential Care Homes: A Cross-Sectional Study].
期刊: Acta medica portuguesa 发表日期: 2026-Feb-02 链接: PubMed
摘要
Dementia is one of the leading causes of dependency among older people and poses a critical challenge for long-term care systems. Despite the importance of the issue, national data on the prevalence of dementia in residential care homes remain limited. A cross-sectional, observational, and institution-based study was conducted within the framework of the SINDIA project. The study was based on an online survey addressed to the technical directors of residential care homes for older people in Portugal, carried out between January and July 2024. The questionnaire collected information on institutional characteristics (sector, territorial location, base monthly fee, dementia specialization, and total number of residents) and on the prevalence of formally diagnosed dementia cases and of cognitive decline without a recorded diagnosis. Data were analyzed using the R software (version 4.1.2). Mean percentages and 95% confidence intervals (Student’s t-method), weighted by NUTS-2 region, were calculated. A hierarchical cluster analysis (Ward’s method) was also performed to identify distinct institutional profiles. On average, 31.7% of residents had a formal dementia diagnosis and 22.3% showed signs of undiagnosed cognitive decline, resulting in 50.2% of the resident population presenting some degree of cognitive impairment, after data cleaning. The proportion varied across territories, institutional sectors, monthly fees and self-reported specialization. A cluster analysis identified three distinct institutional profiles, with a majority group of facilities characterized by lower diagnostic formalization, especially in the non-profit sector and among lower-cost institutions. The findings are suggestive of a very high prevalence of cognitive impairment in Portuguese residential care homes. These results highlight the need for public policies aimed at improving early diagnosis, enhancing staff training, and reducing territorial and institutional inequalities in the response to dementia. Introdução: A demência é uma das principais causas de dependência entre pessoas idosas e representa um desafio crítico para os sistemas de cuidados de longa duração. Apesar da relevância do tema, os dados nacionais sobre a prevalência de demência em estruturas residenciais para pessoas idosas permanecem escassos. Métodos: Realizou-se um estudo transversal, observacional e de base institucional, integrado no projeto SINDIA. O estudo baseou-se num inquérito online dirigido às direções técnicas das estruturas residenciais para pessoas idosas em Portugal, conduzido entre janeiro e julho de 2024. O questionário recolheu informação sobre características institucionais (sector, localização territorial, valor-base da mensalidade, especialização em demência, número total de residentes) e sobre a prevalência de demência diagnosticada e de declínio cognitivo sem diagnóstico registado. As análises foram efetuadas com o programa R (versão 4.1.2), tendo sido calculadas percentagens médias e intervalos de confiança a 95% (método t de Student), ponderados por região NUTS-2. Procedeu-se ainda a uma análise de clusters hierárquica (método de Ward) para identificar perfis institucionais diferenciados. Resultados: Em média, 31,7% dos residentes apresentavam diagnóstico de demência e 22,3% suspeita de declínio cognitivo sem diagnóstico registado, totalizando 50,2% da população residente, após eliminação de algumas observações da amostra. A proporção variou segundo o território, o sector institucional, o valor da mensalidade e a especialização na demência autoidentificada. Uma análise de clusters revelou três perfis institucionais distintos, destacando-se um grupo maioritário de ERPI com baixa formalização diagnóstica, sobretudo no sector solidário e em instituições com preços mais reduzidos. Conclusão: Os resultados apontam para uma elevada prevalência de demência e de declínio cognitivo sem diagnóstico registado em contexto de estruturas residenciais para pessoas idosas em Portugal. Estes resultados reforçam a necessidade de políticas públicas que promovam o diagnóstico precoce, a qualificação das equipas e a redução das desigualdades territoriais e institucionais na resposta à demência.
40. [Mental Health Training for Judges and Magistrates of the Public Prosecutor's Office].
期刊: Acta medica portuguesa 发表日期: 2026-Feb-02 链接: PubMed
摘要
41. Effectiveness of face shields in preventing the spread of airborne diseases through coughing: a CFD simulation study.
期刊: Annals of work exposures and health 发表日期: 2026-Feb-02 链接: PubMed
摘要
This study evaluates the protective efficacy of face shields as Personal Protective Equipment in limiting the spread of airborne diseases, such as COVID-19. Computational fluid dynamics simulations using a simplified two-dimensional model were conducted to systematically evaluate the influence of shield coverage angles, wearer orientation angles, and droplet sizes on droplet infiltration into the risk zone-the area between the shield and the face. The simulations tracked the movement of approximately 36,900 particles, representing a cough event, under various configurations of shield geometry and head alignment. Results show that face shields have the potential to reduce droplet exposure compared to no protection, with larger coverage angles providing high protection in forward-facing scenarios. However, particles infiltrated the risk zone in oblique orientations and with smaller coverage angles, highlighting vulnerabilities under certain conditions. Furthermore, the vulnerability is increased when the inhalation is considered. Overall, the study offers insights into the limitations and benefits of face shields, providing evidence-based guidelines for their more effective use in both healthcare and public settings.
42. An offline-first electronic health record for vulnerable populations: A mixed-methods feasibility study.
期刊: PLOS digital health 发表日期: 2026-Feb 链接: PubMed
摘要
While there is a growing body of research showing that Electronic Health Records (EHRs) can improve health outcomes in limited resourced settings, these EHRs often require continual access to an internet connection and are challenging to customize and deploy. To address these challenges, Hikma Health (HH) has designed a free, open-source and offline-first EHR for physicians providing care in low-resource settings. This paper describes a mixed-methods study to understand the feasibility of the HH EHR in two clinics that care for displaced or rural populations in Lebanon and Nicaragua. Clinic demographics and metrics were collected through REDCap and descriptive statistics were analyzed. Using a framework analysis, in-depth interviews were conducted at both sites until thematic saturation. Interviews were coded by three authors with an inter-rater reliability kappa score of 7.6. Quantitative data showed that after about three hours of training and three weeks of use, participants were comfortable using the HH EHR and the HH EHR decreased patient interview times by three minutes. Quantitative data showed that these findings were due to the ease and simplicity of the modular workflows. However, when used in settings that required syncing multiple times during a patient’s encounter with different clinicians, the system faced challenges due to inconsistent network connectivity and the design of the sync functionality. The HH EHR was a feasible solution for offline-first settings. Both clinical sites observed that the implementation of the EHR enhanced documentation, decreased medical errors, and improved patient outcomes through tracking medications and diseases.
43. Sleep and smartphone use: Within and between-person relationships from an objective longitudinal smartphone and wearable data donation study.
期刊: PLOS digital health 发表日期: 2026-Feb 链接: PubMed
摘要
Poor sleep is common and detrimental to health. Smartphone use is often noted as a sleep disruptor, but evidence remains limited and inconsistent. This necessitates research focused on objective, longitudinal designs, as well as analytical approaches that can reveal lagged and reciprocal relationships that capture within- and between-person effects. To address these gaps, the current study investigated within- and between-person lagged and reciprocal effects of sleep duration and smartphone use of 68 participants through longitudinal and objective data donated from iPhones and Apple Watches across 14 consecutive days. Apple Watches objectively measured total sleep and sleep stage durations (REM, core, and deep sleep), while iPhones assessed total smartphone use duration and in-bed smartphone use. Two Dynamic Structural Equation Models (DSEMs), one with total sleep and one with sleep broken down into three sleep stages, were conducted. At the within-person level, more total smartphone use increased same-day in-bed smartphone use, β = .25 (95% CI .20, .31), which in turn led to more same-day overall sleep, β = .08 (95% CI .02, .14). Additionally, results indicated stable between-person habits, with strong day-to-day associations for each variable with its own next-day value, β = .53-.82 (95% CI .47, .88). Findings contradict the perspective of smartphones as sleep disruptors, despite leaving open whether this added sleep means poorer rest or a real benefit of in-bed smartphone use. Furthermore, the strength of the between-person results emphasizes the importance of habits in this relationship. In studying day-to-day smartphone use and sleep, these findings provide nuanced empirical insights supporting health and policy recommendations regarding smartphone use and sleep hygiene.
44. Exploring primary characteristics of occupational hearing loss in female manufacturing workers: A cross-sectional study.
期刊: The Journal of the Acoustical Society of America 发表日期: 2026-Feb-01 链接: PubMed
摘要
As occupational hearing loss (OHL) is a concern among women, a cross-sectional study was conducted. Individual noise exposure energy and temporal structure were quantified using the 8 h continuous equivalent A-weighted sound pressure level (LAeq,8h) and kurtosis (β). High-frequency noise-induced hearing loss (HFNIHL) and noise-induced hearing impairment (NIHI) were calculated. The HFNIHL and NIHI prevalences were 13.45% and 13.20%, respectively. Hearing loss was symmetrically distributed, with the most significant threshold shifts occurring at 4.0 kHz. The OHL prevalence was significantly higher in individuals exposed to non-steady rather than steady noise. A marked increase in OHL prevalence was observed among women exposed to non-steady noise for 3 to 10 years. The steady noise group exhibited an increase, followed by a plateau or decline. Key influencing factors for women’s OHL were LAeq,8h, age, and kurtosis, with odds ratios (ORs) ranked as follows: ORLAeq,8h > ORAge > ORKurtosis. After adjusting for kurtosis in LAeq,8h, the model fit (Akaike Information Criterion) of the dose-response relationship improved significantly. These findings suggested that female manufacturing workers were at high risk of OHL with significant clinical characteristics. Noise kurtosis could accelerate and exacerbate women’s OHL development. Kurtosis adjustment for noise level could effectively evaluate women’s OHL.
45. The European burden of breast cancer in 2022.
期刊: European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology 发表日期: 2026-Jan-19 链接: PubMed
摘要
As one of the most prevalent malignancies affecting European women, breast cancer continues to impose a substantial public health burden. This study utilizes the latest estimates from the Global Cancer Observatory 2022 to quantify this impact across European countries. The age-standardized incidence rate (ASIR) and age-standardized mortality rate (ASMR) per 100,000 person-years were computed through direct age standardization using the Segi-Doll World standard population as a reference. Associations between the Human Development Index (HDI) and disease indicators were evaluated with Pearson’s correlation coefficient. Estimates of future burden through 2050 were generated based on projected demographic trends. In 2022, Europe reported an estimated 557.9 thousand new breast cancer cases and 144.5 thousand deaths. Russian Federation reported the highest incidence (78.8 thousand) and deaths (22.1 thousand). France (metropolitan) had the highest ASIR (105.4/100,000) while Cyprus had the highest ASMR (18.6/100,000). ASMR increased with age, surged in individuals over 75 in Europe. Albania had the earliest ASIR peak age at 45-59 years (142.0/100,000). A positive correlation was observed between HDI and incidence rates. Projections suggest that by 2050, Germany, Russian Federation and France (metropolitan) will bear the highest disease burden, with Luxembourg and Cyprus experiencing over 48 % rise in incidence and 70 % rise in mortality rates. Breast cancer remains a major health challenge in Europe, with wide inter-country disparities. Rising incidence and mortality in some Central and Eastern countries underline persistent inequalities, emphasizing the need for coordinated prevention, early detection, and equitable care.
46. The post-activation performance enhancement effect of different plyometric training modalities on short-distance sprinting: An acute randomized crossover study.
期刊: PloS one 发表日期: 2026 链接: PubMed
摘要
This study aimed to investigate the effects of different plyometric training modalities [vertical jump plyometric training (VJ-PT), horizontal jump plyometric training (HJ-PT), and combined jump plyometric training (CJ-PT)] on post-activation performance enhancement (PAPE) in short-distance sprint performance. A randomized crossover design was employed, with 12 participants (sex: male; age:19.6 ± 0.9; BMI:24.9 ± 3.85). recruited for this study. Participants underwent three training interventions: VJ-PT, HJ-PT, and CJ-PT. Each training protocol consisted of 2 sets × 6 repetitions of one of the jump training modalities. The Smart Speed system was used to assess 5-meter sprint performance pre-intervention and at 4, 8, 12, and 16 minutes post-training. Repeated-measures ANOVA and Pearson correlation analyses were conducted using SPSS 26.0 and JASP 18.3. No significant effects were observed for time (F = 1.43, p = 0.23), intervention (F = 0.32, p = 0.72), or interaction (F = 1.03, p = 0.41). However, VJ-PT demonstrated moderate effect sizes for 5-meter sprint performance across post-training time points, with larger effects observed at 4-8 minutes. HJ-PT and CJ-PT exhibited small negative effects, with no significant PAPE effects detected. Furthermore, Pearson correlation analysis indicated no significant associations between sprint performance and the time to peak PAPE after any exercise (P > 0.05). This study provides preliminary insights into the short-term effects of different plyometric-based conditioning activities (CAs) on short-distance sprint performance. Vertical jump plyometric training showed potential benefits, though findings are limited by small sample size and no control group. Horizontal and combined training did not produce significant PAPE effects, likely due to differences in time-to-peak and cumulative fatigue. Future studies should include a larger sample size, further investigate responses in both sexes, control for confounding factors, and use surface electromyography to clarify the interactions between CA types and recovery.
47. Mapping disparities in diabetic eye exam adherence using geographic information systems.
期刊: PloS one 发表日期: 2026 链接: PubMed
摘要
Diabetic retinopathy is a leading cause of preventable vision loss in adults, and timely retinal screening is essential for early detection and intervention. However, adherence to diabetic eye exam guidelines remains suboptimal, particularly in underserved populations. Geographic Information Systems (GIS) offer a novel approach to visualizing disparities in eye care access and adherence. We conducted a retrospective, cross-sectional study of 15,656 patients with diabetes mellitus (aged 18-75) receiving care in a university-based health system in Monroe County, NY, from November 2020 to November 2021. Eye exam adherence was determined using Healthcare Effectiveness Data and Information Set (HEDIS) criteria. Patient-level demographics and ZIP-code-level socioeconomic data were analyzed using ordinary least squares (OLS) regression. GIS choropleth maps were used to visualize regional variations in eye exam adherence and associated demographic and socioeconomic indicators. Overall, 31.5% of patients were non-adherent to HEDIS eye exam standards. Non-adherence rates varied significantly by ZIP code (range: 13-50%) and were strongly associated with higher poverty (R² = 0.50, p < 0.0001), unemployment (R² = 0.17, p = 0.008), and lower educational attainment (R² = 0.50, p < 0.0001). Non-adherence also increased with higher proportions of Hispanic (R² = 0.24, p = 0.001) and non-Hispanic Black residents (R² = 0.45, p < 0.0001), and decreased with higher proportions of non-Hispanic White residents (R² = 0.45, p < 0.0001). GIS mapping identified an urban cluster of ZIP codes with consistently high non-adherence and socioeconomic risk profiles, as well as a rural outlier with high non-adherence but differing demographic characteristics. Our findings highlight geographic, socioeconomic, and racial disparities in diabetic eye exam adherence. GIS can serve as a powerful tool to identify high-risk populations and inform targeted outreach strategies aimed at reducing vision loss in vulnerable communities.
48. Health-related quality of life in patients on maintenance hemodialysis: Evidence from southern Iran using EQ-5D-5L and KDQOL-SF.
期刊: PloS one 发表日期: 2026 链接: PubMed
摘要
Hemodialysis (HD) is a common treatment for end-stage renal disease (ESRD) but is often accompanied by markedly reduced health-related quality of life (HRQoL). This study aimed to assess HRQoL and its determinants among HD patients. In this cross-sectional study, 203 adult HD patients in Bandar Abbas, Iran, were evaluated. HRQoL was measured via the EQ-5D-5 L index, EQ-VAS, and SF-12 physical (PCS) and mental (MCS) component summary scores. Multivariable linear regression models, identified factors significantly associated with HRQoL. The mean (SD) EQ-5D-5 L index, EQ-VAS, PCS, and MCS scores were 0.50 (0.47), 64.9 (23.7), 42.3 (8.1), and 42.3 (9.0), respectively. Individuals with higher levels of education demonstrated significantly better EQ-5D-5L index scores (β: 0.24, 95% CI: 0.06 to 0.41 for <6 classes; β: 0.22, 95% CI: 0.03 to 0.40 for 6-12 classes; β: 0.33, 95% CI: 0.13 to 0.52 for >12 years). Being divorced/widowed (β: -20.5, 95% CI: -35.7 to -5.3) or retired/disabled (β: -22.5, 95% CI: -41.6 to -3.3) showed a statistically significant association with reduced EQ-VAS scores. Having supplemental insurance was significantly linked to higher PCS scores (β: 2.4, 95% CI: 0.1 to 4.6), whereas current tobacco use was linked to lower MCS scores (β: -3.7, 95% CI: -7.4 to -0.02). A duration of dialysis ≥5 years was significantly associated with lower EQ-5D-5 L index scores (β: -0.17, 95% CI: -0.31 to -0.04). Comorbidities, age, and sex were not significantly associated with any of the HRQoL measures. HRQoL among HD patients in southern Iran was markedly reduced and influenced by socioeconomic, lifestyle, and treatment-related factors. Enhancing patient education, expanding insurance coverage, addressing gaps in social support, and incorporating lifestyle interventions-such as smoking cessation-may be associated with modest improvements in HRQoL outcomes in this population.
49. Lifestyle and environmental risk factors for myopia in children: Evidence from a large-scale cross-sectional study in Shandong, China.
期刊: PloS one 发表日期: 2026 链接: PubMed
摘要
Myopia has emerged as a pressing global public health issue, with a particularly sharp rise observed among school-aged children. This period represents a critical window for implementing timely, evidence-based interventions to slow myopia progression and mitigate the risk of high myopia. This study aimed to investigate the prevalence and associated risk factors of myopia among children aged 9-12 years in Shandong Province, China, with a specific focus on the roles of demographic characteristics, environmental exposures, and behavioral patterns. A cross-sectional survey was conducted in 2024 using a stratified cluster sampling design. A total of 77,629 children from 16 cities were enrolled. Data collection included standardized visual acuity assessments and structured questionnaires. Multivariate logistic regression models were used to examine the associations between behavioral factors and myopia. Only variables that showed significant associations in univariate (chi-square) analyses were included in the models, without additional adjustment for other potential confounders. The overall prevalence was 41.24%, increasing with age and reaching 44.34% at 12 years. Significant demographic risk factors included female sex (OR=1.030,95%Cl = 1.001-1.060), urban residency (OR=1.045,95%Cl = 1.014-1.077), and parental myopia, particularly when both parents were affected (OR=1.320,95%Cl = 1.270-1.372). Behavioral risk factors included reading while lying down (OR=1.093,95%Cl = 1.035-1.154), screen exposure exceeding three hours per day (OR=1.058,95%Cl = 1.010-1.109), and homework duration over three hours per day (OR=1.072,95%Cl = 1.033-1.112). Protective factors comprised outdoor activity five or more times per week (OR=0.898,95%Cl = 0.865-0.932), maintaining proper posture during reading and writing (OR=0.925,95%Cl = 0.898-0.952), screen viewing distance over three meters (OR=0.933,95%Cl = 0.905-0.961), and sleeping at least eight hours per night (OR=0.918,95%Cl = 0.876-0.961). These findings underscore the multifactorial etiology of myopia, shaped by environmental, and behavioral influences. They highlight the urgent need for comprehensive and targeted interventions, particularly for high-risk groups. This study provides robust empirical evidence to inform region-specific myopia control strategies and supports the development of public health policies aimed at improving pediatric vision health.
50. The influence of paternal preconception health on birth defects and head circumference: A scoping review.
期刊: PLOS global public health 发表日期: 2026 链接: PubMed
摘要
While paternal environmental exposures and lifestyle factors can influence sperm epigenetic states and affect fetal development, this area of research remains relatively underexplored. This comprehensive scoping review aimed to identify, compile, and analyze the literature on paternal preconception health and its impact on fetal development, specifically related to congenital birth defects (CBDs) and head circumference. We conducted a scoping review following the Joanna Briggs Institute methodology and a published protocol. Five databases were searched for articles that included men in the preconception period and outcomes for CBDs and head circumference. Studies were published in English up to July 16, 2025. Two independent reviewers screened titles and abstracts and extracted data from eligible studies using Covidence. Forty-eight studies were included in the review. We identified several paternal factors associated with CBDs, including paternal physical health (metabolic syndrome, viral infections, cancer), smoking and alcohol use, and environmental exposures (solvents, metals, pesticides). Most medications were not associated with increased risks; however, metformin and diazepam were identified as potential risk factors for increased CBD risk. The limited studies on head circumference also suggest a potential relationship; however, the findings are not widely applicable due to the small number of included studies. We also identified important knowledge gaps and methodological limitations that require further research to advance this field. Our findings indicate that paternal preconception health and exposures-particularly paternal health, substance use, environmental factors, and certain medications-significantly influence offspring health outcomes, including congenital defects and infant head circumference. These findings highlight the need to expand preconception counselling and preventive strategies to explicitly include fathers, with targeted efforts to improve paternal health, eliminate tobacco and alcohol use, and reduce occupational and environmental exposures. Incorporating paternal health into preconception frameworks is essential to understanding mechanistic pathways, decreasing congenital risks, and developing precision strategies for improving reproductive and neonatal outcomes.
51. Undergraduate occupational therapy students' perceptions of their preparedness for splinting in hand rehabilitation: An exploratory study at the University of KwaZulu-Natal.
期刊: PloS one 发表日期: 2026 链接: PubMed
摘要
Hand rehabilitation, particularly splinting, is a key area in occupational therapy. However, existing literature suggests that students often feel inadequately prepared, particularly concerning splinting in hand rehabilitation. This highlights the need for further research and improvements. This research explored the perceptions held by undergraduate occupational therapy students regarding splinting in hand rehabilitation at the University of KwaZulu-Natal, with the aim of informing curriculum improvements. The novelty of this study lies in its focus on the University of KwaZulu-Natal, providing institution-specific insights that are currently underexplored in the literature, using Kolb’s Experiential Learning Theory, to contextualise this study. This qualitative study gathered data from 3rd and 4th year occupational therapy students at the University of KwaZulu-Natal using purposive sampling. The Consolidated Criteria for Reporting Qualitative Research (COREQ): a 32-item checklist for interviews and focus groups was followed. The data were collected through semi-structured interviews using a piloted question guide and thematic analysis was used to analyse the data. Ethical clearance was received for this research. This research comprised 16 participants: n = 5 males and n = 11 females, all of whom were undergraduates. The number of physical clinical fieldwork blocks completed by the participants ranged from two to three. The number of splints made during these blocks ranged from no splints to four or more. Four distinctive themes emerged: student readiness and preparedness, challenges in splinting, comparison of readiness in 3rd and 4th year, and suggested solutions to bridge the gaps. Despite acquiring theoretical knowledge, students felt underprepared and uncertain due to limited clinical opportunities, inadequate supervision, and minimal hands-on practice during fieldwork. This lack of confidence and competence may deter students from pursuing specialisation in hand rehabilitation. To address these gaps, students recommended strategies such as increasing practical time dedicated to splinting, introducing training earlier in the program, expanding the splinting curriculum to cover a broader range of splint types, and strengthening university support structures, which align with existing literature, that emphasises the crucial role of hands-on experience in fostering confidence and competence. These findings have implications for curriculum development and suggest the need for policy reforms prioritising clinical competency in undergraduate occupational therapy education.
52. Caregiving activities causing occupational low back pain in Japanese social welfare facilities and hospitals.
期刊: PloS one 发表日期: 2026 链接: PubMed
摘要
Occupational low back pain (LBP) has increased in Japanese social welfare facilities and hospitals. Understanding its occurrence is the first step in addressing this issue. This study investigated the caregiving activities that cause occupational LBP incidents in these contexts. The study analyzed 2,722 incidents of occupational LBP among staff in social welfare facilities and hospitals resulting in four or more days absent from work. Data were extracted from accident occurrences and causes in the 2018-2019 Reports of Worker Casualties. The caregiving situations related to the occupational LBP incidents at each facility were then analyzed. Approximately half of the occupational LBP incidents surveyed occurred during transfer assistance. This assistance was mainly associated with eating, bathing, and toileting in both facilities and frequently occurred during patient transfers between a bed and a wheelchair. In social welfare facilities, nontransfer assistance also contributed significantly, which included bathing, toileting, childcare, diaper changing, lying, standing, sitting, walking, and car transportation. In hospitals, nontransfer assistance such as providing support for lying, diaper changing, medical care, and sitting were occupational LBP risk factors. Furthermore, most incidents of occupational LBP occurred among staff who worked alone during day shifts. Caregiving activities involving transfer assistance, such as bathing, toileting, and eating, were common risk factors in social welfare facilities and hospitals. However, the specific nontransfer assistance activities contributing to occupational LBP varied by facility. To effectively reduce the incidence of occupational LBP, prevention strategies should focus on these high-risk activities according to facility type and the types of caregiving required.
53. Enhanced dust removal via the synergy of a standing wave acoustic field and high-pressure spray: An integrated experimental and numerical study.
期刊: PloS one 发表日期: 2026 链接: PubMed
摘要
Occupational exposure to respirable coal dust poses severe health risks in underground mining operations, primarily through the development of coal workers’ pneumoconiosis (CWP)-a progressive and irreversible pulmonary disease. To address this challenge, we developed an innovative dust suppression system that integrates ultrasonic atomization with acoustic agglomeration technology. The system operates via a dual-phase mechanism: ultrasonic atomization generates ultrafine water droplets (<10 μm) to form a heterogeneous dust-droplet dispersion, while high-frequency standing wave fields (20 kHz) concentrate airborne particles spatially, thereby enhancing interphase collisions between droplets and dust. The resulting agglomerates are subsequently removed by a high-pressure spray. System performance was systematically evaluated through scaled laboratory experiments that examined three critical operational parameters: nozzle orifice diameter (0.4-0.8 mm) of the high-pressure spray system, acoustic power density (60-180 W) utilized to generate the standing wave field, and duct airflow velocity (0.25-0.75 m/s). Numerical simulations integrating acoustic dynamics with CFD-DEM modeling were employed to elucidate particle trajectories and the spatiotemporal evolution of dust-droplet agglomerates within the coupled acoustic-flow field. Experimental results demonstrate a greater than 10% improvement in PM2.5 removal efficiency compared to conventional high-pressure spray systems. This enhancement is attributed to the synergistic effects of acoustic focusing and droplet entrapment. The study establishes a foundational framework for the development of acoustically enhanced pretreatment systems and offers a practical strategy for reducing respirable dust exposure in underground mining environments.
54. Decoding uterine contractility: from physiology to pathology, through emerging technologies.
期刊: Reproductive biomedicine online 发表日期: 2025-Oct-30 链接: PubMed
摘要
Uterine contractility has emerged as a potential key element in the orchestration of female reproductive functions, with specific motility patterns seemingly aligning with hormonal fluctuations throughout the menstrual cycle. These dynamic contractility profiles appear to facilitate various stages of conception, underscoring the importance of maintaining physiological uterine kinetics for fertility. Altered uterine contractility might thus contribute to cases of unexplained infertility. By offering a comprehensive reappraisal of uterine contractility across both physiological and pathological contexts, this review has been undertaken to challenge conventional fertility paradigms. The review outlines uterine anatomy and details the genesis and regulation of uterine contractions, emphasizing the electrophysiological role of uterine pacemaker cells, namely interstitial Cajal-like cells. It also provides a thorough overview of current methodologies for assessing uterine contractility, focusing on non-invasive ultrasound-based approaches, and discussing both innovative applications of established techniques and entirely novel diagnostic methods. The review then evaluates the various physiological uterine contractility patterns observed across the menstrual cycle, and finally presents evidence supporting potential causal links between impaired uterine contractility and fertility-threatening uterine pathologies. Since the directionality of this association remains uncertain, longitudinal studies are needed to determine whether alterations in uterine contractility precede or are a consequence of uterine disease. This is a distinction with critical implications for both treatment and prevention strategies in reproductive medicine.