公共卫生研究摘要 (2026-02-15)
共收录 56 篇研究文章
1. Influenza vaccine Hesitancy in older adults in China: A latent profile analysis.
期刊: Human vaccines & immunotherapeutics 发表日期: 2026-Dec 链接: PubMed
摘要
Influenza vaccination coverage among older adults in China is low. We sought to identify latent vaccine-hesitancy profiles and their correlates. This community-based cross-sectional survey from May to July 2025 involved 1773 older adults from various areas in Jiangsu province. Data were collected via Wenjuanxing and included demographics, the Influenza Vaccine Hesitancy Scale, and the vaccine literacy scale. Group differences were examined using chi-square tests and one-way ANOVA; latent profile analysis (LPA) identified vaccine hesitancy subgroups, and multinomial logistic regression estimated correlates of profile membership. Three profiles emerged: Low Hesitancy (23.0%), Moderate Hesitancy (35.0%), and High Hesitancy (42.0%). Rural residence predicted Moderate (OR = 2.030) and High (OR = 2.993) hesitancy. Lower household income and chronic disease were associated with the Moderate Hesitancy profile, whereas male sex was associated with the High Hesitancy profile. Higher interactive (OR = 0.686) and critical (OR = 0.599) vaccine literacy were inversely associated with High hesitancy.Concerns about vaccine quality predicted both Moderate (OR = 1.433) and High (OR = 1.376) groups; knowledge gaps and fear of adverse reactions concentrated in the High group. Older adults show heterogeneous vaccine hesitancy phenotypes. Uptake efforts should move beyond one-size-fits-all messaging toward segmented strategies. These strategies should integrate cost-related measures with literacy-sensitive, trust-oriented communication, prioritizing rural residents, older men, and those with chronic conditions. The reported proportions of hesitancy profiles reflect our sample only and should not be viewed as nationally representative.
2. Health behaviours and health-related quality of life among women and men with hazardous alcohol use: the Tromsø study (2015-2016).
期刊: BMC public health 发表日期: 2026-Feb-16 链接: PubMed
摘要
3. Long-term outcomes of newly diagnosed POEMS syndrome patients treated with bortezomib-based therapies.
期刊: Cancer 发表日期: 2026-Feb-15 链接: PubMed
摘要
POEMS syndrome is a rare hematologic condition with no established standard of therapy. Bortezomib, a proteasome inhibitor, has shown potential to offer significant clinical benefits for patients with newly diagnosed POEMS syndrome. However, comprehensive data on its long-term efficacy remain scarce. This study aimed to assess the long-term efficacy of bortezomib-based regimens for newly diagnosed POEMS syndrome. A total of 53 patients were enrolled in this study. Fluorescence in situ hybridization analysis was performed on CD138-selected bone marrow samples. All patients received bortezomib-based regimens as first-line therapy. Hematologic responses, vascular endothelial growth factor (VEGF) levels, neurological response rates, and long-term survival outcomes were evaluated. Patients received a median of four treatment cycles, with a median follow-up time of 92.4 months. Hematologic responses were evaluable in 42 patients, yielding an overall response rate was 85.7%, including a complete response rate of 64.3%. VEGF responses were assessed in 44 patients, with an overall response rate of 88.6% and a complete response rate of 56.8%. Median VEGF levels decreased from 944.4 pg/mL to 137.8 pg/mL. Neurological improvements were observed in 90.6% of patients, with 24.5% achieving a complete neurological response. Median overall survival (OS) and progression-free survival were not reached. The 5-year OS and progression-free survival rates were 83.0% and 67.4%, respectively. Fluorescence in situ hybridization analysis identified 1q21 gain as the most frequent abnormality in this cohort, and it was an independent prognostic factor for OS. Bortezomib-based regimens were effective and achieved favorable long-term survival outcomes for patients with newly diagnosed POEMS syndrome.
4. Co-Creating an Intersectional Water Justice Toolkit and Documentary in Cape Town, South Africa.
期刊: Health promotion practice 发表日期: 2026-Feb-14 链接: PubMed
摘要
Water justice is the equitable, reliable, and safe access to clean water and sanitation and meaningful community inclusion in water governance, which is constrained by multiple social inequities. Financial (housing) and social inequities such as gender inequitable norms and gender-based violence, land insecurity, racial discrimination, and sexuality diversity (lesbian, gay, bisexual, transgender, and queer [LGBTQ+]) exclusion perpetuate unequal access to water and sanitation for historically marginalized populations. This highlights the need for an intersectional approach to building alliances to advance water justice across diverse social movements. In Cape Town, South Africa, legacies of colonialism and apartheid continue to shape spatial and infrastructural inequalities, especially in backyards. In response, we co-developed the “Water Justice Alliance-Building Toolkit” through a community-engaged process with activists from five intersecting movements: water justice, women’s rights, housing rights, LGBTQ+ rights, and racial justice. The participatory co-production process involved filmed walk-along interviews, focus groups, arts-based workshops, and community dialogue, culminating in modular tools designed to support intersectional education, alliance-building, and advocacy. In this article, we describe the toolkit’s development, its components, and an accompanying documentary, “Its Ebbs and Flows,” which centers lived experiences of water injustice through visuals and multilingual narration. Toolkit activities, including discussion guides, artmaking, song-making, and role-play, facilitate inclusive dialogue. We conclude with implications for practice and policy, highlighting how participatory, arts-based approaches can foster more responsive health promotion strategies. By validating community knowledge and creative expression, this toolkit expands on whose expertise counts to guide a just transition and offers replicable templates for promoting health equity in climate-vulnerable settings.
5. How to build home based stroke rehabilitation using participatory action research: lessons learned from developing regional stroke networks.
期刊: Disability and rehabilitation 发表日期: 2026-Feb-14 链接: PubMed
摘要
This study aims to identify lessons learned regarding: 1) regional factors influencing the development and implementation of home-based stroke rehabilitation (HBSR) networks, during participatory action research (PAR) and 2) the role of the PAR-facilitator in this process. By developing a roadmap based on the lessons learned, we aim to support PAR-facilitators in developing HBSR using regional networks. In each region, data were collected through individual communication, group discussions, process and outcome evaluations, public consultations, and the PAR-facilitator’s logbook. Ending each project, regional evaluations and logbooks were synthesized into a process narrative. Key lessons were drawn through critical reflection sessions and translated into a revised process description (roadmap). The study showed that motivated professionals, available preconditions for stroke care coordination, and interprofessional collaboration, influenced HBSR implementation. Participants reported the PAR-facilitator playing a crucial role in process monitoring and facilitating information, collaboration and motivation. Also, PAR-methods were considered valuable. The lessons learned resulted in a roadmap describing recommended actions, methods, key considerations, and questions to support reflexivity. PAR is a promising approach for developing and implementing HBSR networks. Project success depends on prerequisites in context, professionals’ motivation and collaboration and guidance by a competent PAR facilitator. Home‑based stroke rehabilitation has strong potential and is increasingly encouraged in the Durch context, but the essential conditions required to deliver it effectively are not always in place.Rehabilitation professionals should recognize how regional conditions, such as follow-up coordination after discharge, stakeholder motivation, and collaborative structures, shape the successful delivery of home-based stroke rehabilitation.Rehabilitation professionals should tailor the development and implementation of home-based stroke rehabilitation to their local context and actively contribute to strengthening regional conditions that support collaboration.Rehabilitation professionals who aim to implement complex innovations can benefit greatly from the support of a participatory action research-facilitator with strong communication, social, scientific, and organizational skills to clarify problems, support shared decision-making, and stimulate collective ownership of solutions.Rehabilitation professionals who work with a participatory action research facilitator to develop a regional collaborative network can benefit from the structured roadmap presented in this study to navigate the complexity of developing and implementing home‑based stroke rehabilitation.
6. Concise Commentary: Does the Gut Microbiome Cause Colorectal Cancer?
期刊: Digestive diseases and sciences 发表日期: 2026-Feb-14 链接: PubMed
摘要
7. Economic evaluation of national immunization program vaccines in China: a systematic review.
期刊: Health economics review 发表日期: 2026-Feb-14 链接: PubMed
摘要
8. Inequality in Social Security Benefits: Exploring the Relationship Between Functional Disability and Subjective Well-Being Among Older Adults in China.
期刊: Journal of aging & social policy 发表日期: 2026-Feb-14 链接: PubMed
摘要
The effect of social security benefits on the relationship between instrumental activities of daily living (IADL) disabilities and subjective well-being remains unclear. This study explored the impact of baseline IADL on subjective well-being trajectories among older adults in China with the moderating role of social security benefits. Data derived from four waves of the Chinese Longitudinal Healthy Longevity Survey (n = 1,732 older adults). Multinomial logistic regression analyses were conducted with subjective well-being trajectories categorized as high, moderate, and low, stratified by the level of social security benefits (generous, moderate, none) for subgroup analysis. Results indicated none of participants in the generous social security benefits group followed a low social well-being trajectory and baseline IADLs showed no significant impact. By contrast, baseline IADLs predicted moderate and low social well-being trajectories in the moderate social security benefits group. Baseline IADLs predicted only a moderate social well-being trajectory in the group without any social security benefits. Findings highlight the effects of IADL disabilities on subjective well-being trajectories and social security benefits can mitigate this negative impact.
9. Communication regarding sudden unexpected death in epilepsy to people with epilepsy and their caregivers: A scoping review from the ILAE Sudden Unexpected Death in Epilepsy Task Force.
期刊: Epilepsia 发表日期: 2026-Feb-14 链接: PubMed
摘要
Discussing sudden unexpected death in epilepsy (SUDEP) is difficult and sensitive for health care providers (HCPs), people with epilepsy (PwE), and caregivers. This scoping review examines the literature on SUDEP communication, focusing on need, timing, content, methods, facilitators, barriers, and outcomes. We performed a thematic analysis to identify themes that summarized the perceptions of the epilepsy community regarding key elements of SUDEP communication. We identified 66 articles that met inclusion criteria. These studies included more than 5300 HCPs and 40 000 PwE and caregivers. Caregivers and PwE felt that all PwE should receive SUDEP information. However, the majority of HCPs did not discuss SUDEP. The preferred source of information was an epilepsy specialist, but PwE also valued other HCPs with whom they have a trusted relationship. There was general agreement SUDEP should be discussed at diagnosis, but limited HCP time and training were barriers. Caregivers and PwE overwhelmingly wanted information about SUDEP. Greater education and training about SUDEP for HCP may facilitate communication. Fear of causing distress was the primary barrier to SUDEP communication. However, these concerns, although valid, were often exaggerated. Even in studies that found negative emotional responses to learning about SUDEP, participants regularly reported that the benefits of knowing outweighed the short-term consequences.
10. Children's Healthy Weight State Capacity Building Program: Incorporating Nutrition Into States' Maternal and Child Health Programming.
期刊: Maternal and child health journal 发表日期: 2026-Feb-14 链接: PubMed
摘要
To describe the Children’s Healthy Weight State Capacity Building Program (CHW-SCBP) and report on progress after 3 years of program implementation. The CHW-SCBP was a 5-year cooperative agreement (2020-2025) between the Association of State Public Health Nutritionists (ASPHN) and the Health Resources & Services Administration (HRSA), with the specific objective of developing state models in maternal child health (MCH) nutrition integration, which could then be implemented and replicated in states nationwide. Three states - North Dakota, Oregon, and Wisconsin - were selected to be part of CHW-SCBP and worked with ASPHN on their specific priorities and models of MCH nutrition integration. The implementation of the CHW-SCBP program followed two strategies, based on the goals of the HRSA Notice of Funding Opportunity (HRSA-20-043): (1) the workforce strategy, focused on increasing the MCH nutrition competency of the state Title V workforce and (2) the data strategy, focused on optimizing MCH nutrition-related data sources to contribute to data-driven programs and activities related to assessment, policy development, and assurance, within states’ Title V. Activities implemented within the workforce and data strategies, as well as each state’s outcomes, are summarized and discussed. Results from Year 3 program evaluation are also included. The CHW-SCBP program successfully engaged with the three selected states, increasing the MCH nutrition competency of their Title V workforce and their knowledge and usage on MCH nutrition data. Sustainability plans need to be developed for program gains to be maintained beyond the CHW-SCBP funding period.
11. Adolescent and Young Adult Leadership and Engagement in HIV Strategy and Policy Development: Experiences from the UNICEF/WHO/UNAIDS Blueprint Collaborative.
期刊: Current HIV/AIDS reports 发表日期: 2026-Feb-14 链接: PubMed
摘要
Adolescents and young adults (AYA) face disproportionately worse outcomes along the HIV prevention and care continuum. Despite global commitments to AYA engagement, AYA remain underrepresented in research, programming, and policy development. We summarize recent innovations in AYA engagement within the HIV literature and reflect on the 2023 Blueprint Collaborative, a UNICEF/WHO/UNAIDS initiative where AYA (ages 10-30) shaped global adolescent HIV strategy. Our review found examples of AYA engagement across the intervention life cycle, including in shaping research agendas, designing interventions, and building AYA capacity for sustainability. For the Blueprint Collaborative, which featured a AYA-led evidence synthesis and global open call, we assessed AYA engagement using the RIGHTS framework. A major strength of the Blueprint Collaborative was the robust AYA engagement, moving beyond AYA consultations to AYA leadership. AYA shared decision-making authority with adults as researchers, organizers, and open call judges. Through a “learning by doing” approach, AYA gained skills in research and multidisciplinary collaboration. Blueprint results were presented to senior leadership, developed into strategy, and disseminated through publications and AYA networks. AYA leadership can provide several benefits for AYA research and programming, such as institutionalizing community engagement, improving research relevance, and advancing equity. AYA are eager and capable of driving HIV strategy and policy, but senior partners should step back to enable these opportunities. Senior partners might better serve to support AYA leadership in strategic planning to align programming with AYA priorities and build research and advocacy skills.
12. Cancer navigation in Africa: challenges, impacts, and future directions.
期刊: Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer 发表日期: 2026-Feb-14 链接: PubMed
摘要
Cancer navigation guides patients through cancer care, addressing barriers like late diagnosis, financial constraints, and emotional distress. In Africa, it supports early detection, treatment, and survivorship amid poor infrastructure and limited access. Expanding these programs can reduce mortality and improve outcomes. Cancer cases are rising rapidly in Africa and are expected to double by 2050. Access to care is hindered by limited facilities, few trained oncologists, geographic barriers, cultural stigma, high treatment costs, and lack of screening programs. Most services are urban-centered, leaving rural areas underserved. Financial hardship, poor governance, inadequate research funding, and scarce cancer registries worsen the problem. Coordinated, sustainable efforts are needed to improve cancer prevention, treatment, and care. Patient navigation significantly enhances cancer care in sub-Saharan Africa by addressing barriers to early detection, diagnosis, treatment, and support. Navigators facilitate screening, improve awareness, and coordinate care across healthcare levels. They reduce treatment delays, offer psychosocial support to patients and caregivers, and help with financial, transport, and lodging challenges. Successful programs in South Africa, Uganda, and Nigeria demonstrate improved outcomes, including increased screenings, faster diagnoses, and better treatment adherence, showcasing the transformative impact of navigation on cancer control in resource-limited settings. Strengthening cancer navigation systems is essential, focusing on healthcare infrastructure, workforce training, policy reform, and community engagement. Key strategies include expanding cancer centers, integrating trained patient navigators (both clinical and non-clinical navigators), leveraging telemedicine and AI, and increasing collaborations. Formal navigator certification, education campaigns, and improved health financing are crucial. These efforts aim to improve cancer detection, treatment, and outcomes across Africa’s diverse healthcare settings.
13. Application of the Buxton-Hanney Payback Framework to Department of War Sponsored Research on the Ukrainian Health and Trauma System Following the Russian Invasion, 2022-2025.
期刊: Military medicine 发表日期: 2026-Feb-14 链接: PubMed
摘要
In response to the February 2022 Russian invasion of Ukraine’s, international aid and foreign investment from the U.S. Government and regional allies flowed into the country. As part of this support, the Department of War (DoW) has supported multiple research initiatives aimed at strengthening Ukrainian healthcare, further advancing the objectives of the U.S.-Ukraine partnership. Given the scope of U.S. involvement, a thorough investigation into the outcomes of this critical research was essential to ensure accountability and improve resource allocation. To gauge the impact of these investments, the Center for Health Services Research at the Uniformed Services University of the Health Sciences conducted a Buxton-Hanney Payback Framework assessment, which systematically identifies the outcomes generated by these projects. From January 2025 to April 2025, the research team employed snowball sampling and grey literature review to identify principal investigators involved in DoW-funded Ukrainian health research. The team conducted virtual consultations to collect outcome data pertaining to the framework’s domains, which were catalogued into a structured data collection instrument. The team identified 7 DoW-funded projects dedicated to Ukraine’s health and trauma system. These projects yielded a total of 80 outcomes across the Buxton-Hanney framework domains, revealing a broad spectrum of impacts. These included academic knowledge outputs through publications and workforce training; policy-level contributions for healthcare; direct health benefits; and economic returns driven by workforce resilience and expansion of business operations. Identified outcomes underscore the strategic value of sustained investment in military healthcare research. Investments not only support allies but also provide crucial lessons that can strengthen healthcare delivery for the U.S. Military, particularly in dynamic and conflict-affected environments. Even in their early stages, projects demonstrated immediate value by providing real-time insights that advance the partnership’s objectives. Furthermore, this assessment advocates for the utilization of the Buxton-Hanney Framework as a standardized tool for assessing the outcomes and impacts for programs within the DoW.
14. Linking social support to Chinese kindergarten teachers' mental health: the mediating roles of emotional intelligence, emotional self-efficacy, and job burnout.
期刊: Psychology, health & medicine 发表日期: 2026-Feb-14 链接: PubMed
摘要
With the development of society and the transformation of education, the mental health of Chinese teachers, especially kindergarten teachers, is deteriorating. Although numerous theoretical frameworks and empirical studies have been devoted to exploring factors (e.g. social support, self-efficacy, job burnout, et al.) in relation to individual mental health, limited studies have jointly examined the mechanisms linking these factors to mental health outcomes. This study aimed to apply the social cognitive model of job and life satisfaction to understand Chinese kindergarten teachers’ mental health problems. A total of 1114 Chinese kindergarten teachers, whose mean age was 32.75 ± 8.36 and of whom 1073 (96.3%) were female, completed several measures concerning social support, emotional intelligence, emotional self-efficacy, job burnout, and mental health. The Harman single-factor test, descriptive statistics, correlation analysis, and structural equation modeling were used to identify key predictors and mediating pathways among these variables. The integrated social cognitive model of mental health demonstrated a strong fitness to the data across both the general sample and sub-samples categorized by teaching years and parenting experiences. Simultaneously, social support might serve as an indirect predictor of mental health problem, which was mediated primarily via job burnout, the chain links of emotional intelligence and job burnout, the chain links of emotional self-efficacy and job burnout, and the chain links of emotional intelligence, emotional self-efficacy, and job burnout. The mental health of kindergarten teachers fluctuates by a combination of social support, emotional intelligence, emotional self-efficacy, and job burnout. Therefore, constructing an emotional support system, improving teachers’ emotional literacy, and integrating teachers’ diverse learning experiences might more effectively promote their mental health.
15. Harnessing plant growth-promoting bacteria for nanoparticle biosynthesis: a systematic review of mechanisms, agricultural applications, and biomedical potential.
期刊: Bioprocess and biosystems engineering 发表日期: 2026-Feb-14 链接: PubMed
摘要
The rapid expansion of nanotechnology has opened novel opportunities to share for addressing global challenges related to food security, environmental sustainability, and human health. Conventional physical and chemical methods for the synthesis of nanoparticles (NPs) often involve hazardous chemicals, high energy demands, and poor biocompatibility. In contrast, bacterial-synthesized NPs are considered eco-friendly and multifunctional with their enormous potential in agriculture, bioremediation, and biomedical applications. The study highlights the importance of Bacteriogenic NPs as a sustainable alternative to chemically and physically produced NPs due to their reduced toxicity and lower energy consumption. Hence, bacteriogenic NPs, particularly those derived from Bacillus and Pseudomonas species, exhibit remarkable stability, biocompatibility, and multifunctional spectrum due to inherent reducing and capping biomolecules secreted by those bacteria. This review highlights the biosynthetic mechanisms, characterization techniques, and diverse applications of bacterial-based NPs. Initially, in agriculture, silver NPs synthesized by Bacillus xiamenesis enhanced rice growth while suppressing Xanthomonas oryzae, the causal agent of bacterial blight. Then, in environmental remediation, Bacillus pumilus-derived silver nanoparticles demonstrated 96.99% degradation of Congo red dye, underscoring their catalytic efficiency. And, in biomedical sciences, selenium NPs biosynthesized from Streptomyces minutiscleroticus exhibited antiviral activity against dengue virus type 1, highlighting their therapeutic promise. Key findings reveal that these NPs can enhance stress tolerance, nutrient uptake, and disease resistance, along with remediating harmful pollutants from the environment. They also exhibit strong antimicrobial and anticancer properties. Despite all these advancements, much work is still needed to optimize NPs’ yield, uniformity, and functionality, as well as environmental and health safety assessment. Integrating omics approaches and nanobiotechnology innovations may unlock new opportunities for precision agriculture, environmental restoration, and advanced therapeutics. In a nutshell, bacterially mediated nanotechnology emerges as a sustainable and transformative tool to address pressing societal and ecological concerns.
16. Knowledge and behaviours regarding the infant oral health visit among dental nurses and dental hygienists in Ireland.
期刊: European archives of paediatric dentistry : official journal of the European Academy of Paediatric Dentistry 发表日期: 2026-Feb-14 链接: PubMed
摘要
To explore the knowledge and behaviours regarding the infant oral health visit among dental nurses (DNs), including registered (RDNs) and non-registered (NRDNs), and dental hygienists (DHs) in Ireland. This cross-sectional, mixed-methods study assessed the knowledge and behaviours of Irish DNs and DHs regarding infant oral health visits. Quantitative survey data was analysed using IBM SPSS version 29, while qualitative focus group discussion was thematically analysed to explore barriers and practices in early oral health promotion. The overall response rate was 38%, with 122 responses received from 321 questionnaires distributed. Results indicated that parental education was the most common procedure performed (22.3%) and fluoride interventions were least commonly performed. Lack of parental requests (32.5%) was identified as the primary barrier. RDNs were significantly more likely to treat paediatric patients (74.5%) than DHs (40%). Those who had received both theoretical and clinical training were significantly more likely to provide care to infants (78.9%). Public DNs and DHs treated significantly more children (89.7%) than private (44.2%). Older graduates (1960-1979) were more aware of the recommended first dental visit (83.3%). The present study highlights significant gaps in the knowledge and behaviours of DHs and DNs regarding infant oral health in Ireland, with inconsistencies in education, limited clinical exposure, and low parental awareness serving as key barriers. Variability in training and practice settings, particularly the greater involvement of public-sector DNs in infant care, underscores disparities in service delivery. Additionally, inconsistent fluoride varnish application and a lack of consensus on the ideal age for a first dental visit further hinder the timely delivery of early preventive infant oral healthcare. Addressing these challenges through evidence-based education for DNs and DHs will ensure equitable access to preventive care for all infants.
17. Molecular and clinical prognostic factors in isocitrate dehydrogenase-mutant astrocytomas: Insights into biomarker-driven stratification.
期刊: Journal of neuropathology and experimental neurology 发表日期: 2026-Feb-14 链接: PubMed
摘要
CDKN2A/B homozygous deletion (HD) defines isocitrate dehydrogenase (IDH)-mutant astrocytomas as World Health Organization (WHO) grade 4 and predicts aggressive tumor behavior. To identify clinical and molecular prognostic factors in these tumors, we conducted a retrospective multi-institutional study of 106 adult patients diagnosed with IDH-mutant astrocytomas (21 grade 2, 40 grade 3 and 45 grade 4). Tumors were classified using a custom DNA/RNA next-generation sequencing panel based on the 2021 WHO classification. This resulted in an upgrade to grade 4 in 10.3% of cases previously classified as grade II or III due to CDKN2A/B HD. Multivariate analysis identified CDKN2A/B HD (hazard ratio [HR], 1.76; P = .005), MET fusions/splicing variants (HR, 5.38; P = .002), and PDGFRA alterations (HR, 3.66; P = .009) as independent predictors for poor overall survival. The accumulation of these 3 genetic events was strongly associated with unfavorable survival (P < .001) and correlated with adverse clinical features, including lower Karnofsky Performance Status and higher Ki-67 indices. Our study validates the prognostic value of the WHO 2021 classification for IDH-mutant astrocytomas and demonstrates that MET and PDGFRA alterations are independent adverse prognostic factors, comparable to CDKN2A/B HD. Their cumulative burden enables refined molecular risk stratification to guide clinical management.
18. Tailoring a national smoking cessation support programme in co-creation with (expectant) parents in vulnerable situations.
期刊: BMC public health 发表日期: 2026-Feb-14 链接: PubMed
摘要
19. Gomisin A and metformin co-treatment attenuates diabetic nephropathy and cardiovascular dysfunction by modulating the AGE/RAGE pathway in a diabetic rat model.
期刊: Molecular and cellular biochemistry 发表日期: 2026-Feb-14 链接: PubMed
摘要
Diabetic nephropathy (DN) is a severe complication of type 2 diabetes mellitus (T2DM) that is frequently accompanied by cardiovascular disease (CVD) and chronic kidney disease (CKD). The current therapeutic options for DN and CVD are limited and often produce significant adverse effects. In this study, we evaluated the renal and cardioprotective effects of natural Gomisin A, alone and in combination with metformin, in a diabetic model. While treatment with Gomisin A at 20 mg/kg slightly improved glycemic control and renal function, co-administration with metformin yielded better results. The combined treatment significantly lowered blood glucose levels and improved β-cell integrity. It also prevented renal hypertrophy and reduced inflammation, as evidenced by decreased serum creatinine, urea, phosphorus, lactate dehydrogenase (LDH), and malondialdehyde (MDA) levels. Additionally, the combination modulated the AGE/RAGE pathway, thereby downregulating NF-κB expression, reducing proinflammatory cytokines, and lowering TGF-β expression in renal tissues. Cardiac protective effects were also observed, including inhibition of myocardial thickening and hypertrophy. These findings suggest that Gomisin A and metformin work synergistically to mitigate the progression of DN and CVD, supporting the potential of Gomisin A as a nutraceutical adjunct to conventional anti-diabetic treatments.
20. Peripheral Retinal Vessel Density in Children and Adolescents with Myopia: A Deep Learning Assessment.
期刊: Ophthalmology and therapy 发表日期: 2026-Feb-14 链接: PubMed
摘要
This study investigated the effect of axial length (AL) on peripheral retinal vessel density in children and adolescents and assessed whether deep learning can detect early vascular changes in myopia. Non-mydriatic ultra-widefield imaging was used to capture retinal images. Deep learning models based on Nested U-Net and ResNet34 segmented the vasculature, quantified vessel density in 60-30° and 100-60° fields, and classified AL from fundus images. A total of 679 eyes from 396 children and adolescents were analyzed. Participants were categorized into normal (22.96 ± 0.65 mm), medium (24.69 ± 0.50 mm), and high (27.32 ± 0.80 mm) AL groups. Across both 60-30° and 100-60° fields, the temporal retina displayed higher vessel density, while the inferior retina showed lower density. The normal AL group had significantly higher density than the medium AL group (P < 0.05), which surpassed the high AL group (P < 0.05). In the 60-30° temporal region, vessel density decreased from 7.15 ± 1.17% (normal) to 6.70 ± 1.27% (medium) and 6.16 ± 1.82% (high). Deep learning classification achieved an AUC of 0.9651, with Grad-CAM highlighting the inferotemporal vasculature. As AL increases, peripheral vessel density diminishes. This pattern may suggest a potential prioritization of blood flow to the macular region, although longitudinal studies are required to confirm this hypothesis. These findings suggest that deep learning analysis of ultra-widefield images can reveal subclinical vascular changes, offering a potential tool for early detection of high myopia risk.
21. A Hispanic/Latino Community Health Worker Intervention Addressing Acculturative Stress and Resilience: Feasibility, Acceptability, and Preliminary Effectiveness.
期刊: Journal of immigrant and minority health 发表日期: 2026-Feb-14 链接: PubMed
摘要
Among Hispanic/Latino immigrants, substance abuse, intimate partner violence, HIV, and mental health form a syndemic that exacerbates health inequities. Promotoras (community health workers) play a critical role in reaching these vulnerable populations by providing culturally relevant healthcare connections. This study examines the feasibility, acceptability, and effects of an intervention by promotoras addressing acculturative stress and resilience among Hispanic/Latino immigrants to the US. The intervention consisted of four virtual sessions- two one-on-one and two group sessions- delivered by Latino/a community health workers, known as promotoras, using motivational interviewing and group coaching strategies to enhance resilience and reduce health risk behaviors. Feasibility and acceptability were assessed through study logs and post-intervention participant feedback, while a pre-post assessment measured intervention effects. A single-group, longitudinal pilot intervention design was employed. Participants included 30 young adult (18-44 years) immigrants from Latin America or the Caribbean residing in the US for ≥ 1 year. Measured variables included acculturative stress, depressive symptoms, emotional and instrumental support, pandemic stress, COVID-19 knowledge, and COVID-19 risk behaviors. Multiple analytic methods (paired sample t-test, Wilcoxon signed-rank test, McNemar’s test) were applied to assess the feasibility, acceptability, and effects of the intervention. Findings indicate high intervention satisfaction, with participants recommending increased social engagement for enhanced impact. Acculturative stress (p = .041), depressive symptoms (p = .005), and risk behaviors (p = .021) showed significant reductions, while COVID-19 knowledge and pandemic stress remained unchanged. This study supports the feasibility and scalability of the intervention in addressing syndemic behavioral and mental health conditions, with broader implications for reducing health inequities among Hispanic/Latino immigrants. Clinical Trial Registration: NCT03527654.
22. ARC-18 Alleviates Alzheimer-like Pathology and Cognitive Deficits via AdipoR1-Mediated Activation of Autophagy and Modulation of APP Processing.
期刊: Molecular neurobiology 发表日期: 2026-Feb-14 链接: PubMed
摘要
Alzheimer’s disease (AD), the most prevalent form of dementia, is characterized as a slowly progressing neurodegenerative disease marked by senile plaques and neurofibrillary tangles due to the buildup of amyloid-beta peptide (Aβ) and phosphorylated tau in the brain. It is reported that arctigenin (ATG) reduces the level of the enzyme 1 that cleaves β-site amyloid precursor protein and increases Aβ clearance by enhancing autophagy. Compound ARC-18 is a derivative of ATG. The main objective of this study is to investigate whether ARC-18 could improve cognitive function and disease progression by promoting autophagy in Alzheimer-like animal models. Three-month-old 5 × FAD mice were orally treated with the drug for three consecutive months. Water maze and novel object recognition were used to assess cognitive abilities of 5 × FAD mice. In the hippocampus of the mice’ brain, APP processing-related proteins (sAPPβ, BACE1) and autophagy-related proteins (LC3B, P62, LAMP1) were detected. N2a/APPswe cells were used to do experiments to further identify the effect and mechanisms of the drug. Our study demonstrated that ARC-18 enhances the behavioral performance of 5 × FAD mice and mitigates Aβ aggregation in the hippocampus and cortex. This effect is achieved through the activation of adiponectin receptor 1 (AdipoR1)-mediated autophagy and the reduction of Aβ production by modulating amyloid precursor protein (APP) processing. Therefore, ARC-18 holds promise as a potential therapeutic agent for Alzheimer’s disease.
23. Less Positive Parenting Appears to be a Consequence, Rather Than a Cause, of Youth Antisocial Behavior: Results from a Longitudinal Twin Study.
期刊: Research on child and adolescent psychopathology 发表日期: 2026-Feb-14 链接: PubMed
摘要
Although positive parenting in childhood consistently predicts less adolescent antisocial behavior (ASB) over time, the etiology and direction of their association remain unclear. To fill this gap, we sought to illuminate prospective associations and potential changes in the etiology of the relationship between maternal positive parenting and youth ASB from middle childhood to adolescence using a cross-lagged, twin differences design. Participants were drawn from a longitudinal study with planned missingness (1,422 twins ages 6-11 at Wave 1 and 852 twins ages 11-19 at Wave 2) within the Michigan State University Twin Registry. Phenotypic analyses indicated that more childhood ASB significantly predicted less positive parenting in adolescence, but not the reverse. Twin difference-score analyses similarly revealed that, within both monozygotic (MZ) and dizygotic (DZ) twin pairs, co-twin differences in the positive parenting received in middle childhood did not significantly predict differences in adolescent ASB. However, DZ (but not MZ) co-twin differences in childhood ASB significantly predicted differences in positive parenting during adolescence, whereby the DZ co-twin exhibiting more ASB in childhood received less positive parenting in adolescence. These results collectively suggest a child-driven, genetically mediated effect of early ASB on later positive parenting, such that genetic influences on ASB in middle childhood appear to evoke reductions in positive parenting during adolescence. Moreover, because effect sizes did not differ across zygosity, results also suggest that shared familial/environmental confounds at least partially underlie the association. These findings have important implications for interventions and etiologic models of youth ASB across development.
24. The sun-earth-health connection: a short review of potential mechanisms and implications.
期刊: International journal of biometeorology 发表日期: 2026-Feb-14 链接: PubMed
摘要
Heliobiology explores the influence of solar and geomagnetic activity on human health. This short review synthesises evidence linking solar flares, coronal mass ejections, and geomagnetic storms to cardiovascular events, autonomic dysregulation, circadian disruption, and possible neurological effects. Proposed mechanisms include melatonin suppression, cryptochrome magnetoreception, and voltage-gated calcium-channel modulation. Recent studies further support associations between geomagnetic disturbances and endothelial activation, systemic inflammation, and elevated cardiovascular mortality. The most reproducible effects involve acute cardiovascular and autonomic responses during major geomagnetic storms, whereas neurological, psychological, and infectious-disease associations remain preliminary. For clinicians, geomagnetic disturbances represent a novel environmental risk factor for vulnerable patients; for space scientists, they have direct implications for astronaut safety. Causal pathways are not yet established. Interdisciplinary collaboration is essential to refine predictive models and develop mitigation strategies for both terrestrial and extraterrestrial populations.
25. Heavy metal risk assessment of 53-day accumulated road-deposited sediments from different roads in Beijing using Monte Carlo simulation.
期刊: Environmental monitoring and assessment 发表日期: 2026-Feb-14 链接: PubMed
摘要
The ecological and health risks posed by Cu, Zn, Pb, Cd, and Cr in road-deposited sediments (RDS) were assessed for four urban road types in Beijing after 53 consecutive dry days. The evaluation integrated Monte Carlo simulation with the geo-accumulation index, potential ecological risk index, and health risk models. The results demonstrated that concentrations of all investigated heavy metals in RDS exceeded local soil background values in Beijing, with enrichment multiples reaching at least 16-fold for Zn, Pb, and Cd, and approaching tenfold for Cu and Cr. Monte Carlo simulation characterized the probability distributions of ecological and health risks and revealed significant differences in risk levels of heavy metals in RDS among different road types, even within the same pollution category. The probability of reaching a serious ecological risk was 92.00% for RDS from roads experiencing the most intensive traffic flow, and 83.22% for RDS from roads with infrequent sweeping, compared with 51.90% and 63.45% for RDS from lightly trafficked roads. Cd was identified as the dominant contributor to ecological risk in RDS from the four roads, accounting for 75.05%, 73.42%, 77.22%, and 81.07% of the overall risk, respectively. Both carcinogenic and non-carcinogenic risks were detected for heavy metals in all RDS, with higher risks observed in adults than in children. Cr was the primary contributor to health risk in RDS, with contribution rates exceeding 79%. Targeted management strategies for RDS by Monte Carlo simulation were proposed for different road types to reduce ecological and health risks from heavy metals.
26. A novel framework for groundwater quality evaluation in industrial zone using unsupervised machine learning methods.
期刊: Environmental geochemistry and health 发表日期: 2026-Feb-14 链接: PubMed
摘要
Population density, urbanization and industrialization are the rapidly increasing and it’s causes severe damages to freshwater ecosystem. The present study aims to assess the quality of groundwater using integrated methods in the industrial zone of South India. The integrated assessment of groundwater using unsupervised machine learning method associated human health risk assessment are identified as research gap in the study region. We collected 55 samples based on groundwater availability, population density, and industrial activity in summer and winter seasons. The study found that calcium-chloride and mixed calcium-magnesium-chloride types of water are the dominating category in both seasons. The groundwater pollution index (GPI) and piper trilinear and gibbs diagram indicate that evaporation, water-rock interface, and other anthropogenic activities are the dominating factors in groundwater chemistry. Analysis using the entropy water quality index (EWQI) and human health risk estimation confirmed that nitrate is the key parameter affecting groundwater sustainability. Unsupervised machine learning techniques were applied to evaluate groundwater chemistry. The principal component analysis (PCA) results revealed that seasonal variation is influenced by mineral dissolution, rainwater recharge, and anthropogenic activities. The hierarchical cluster analysis (HCA) results shows that a tight cluster forms among pH, Na, K, NO3, and F, suggesting that processes such as agricultural inputs from fertilizer use, synthetic pesticides, and natural geochemical interactions control ion exchange. The k-means clustering yielded three clusters: low-salinity fresh water, moderately mineralized water undergoing geochemical alteration, and high-hardness water indicative of specific geogenic and anthropogenic influences in both seasons. Overall, the integrated assessment of groundwater revealed that the water-rock interface, evaporation, and synthetic fertilizer use in agricultural fields are significant factors controlling groundwater quality. The key findings of this study provides clear knowledge about the nature of groundwater, influencing factors and help to improve the water resources management strategies in investigation zone.
27. Healthy Eating Scores Are Positively Associated With Physical Fitness in Military Personnel.
期刊: Military medicine 发表日期: 2026-Feb-14 链接: PubMed
摘要
Diet quality, as measured by the Healthy Eating Index, is positively associated with physical performance and fitness in elite U.S. Army Soldiers. Whether the Healthy Eating Score (HES-7), which was recently developed as an expedient proxy for determining adherence to dietary guidelines among military personnel, is also associated with physical fitness is unclear. The objective of this study was to determine the association between HES-7, eating style, physical activity, and physical fitness as measured by the Army Combat Fitness Test (ACFT) among U.S. Army Soldiers. In this cross-sectional observational study, 483 active duty Soldiers and Cadets (75% enlisted, 87% male, 26 ± 6 years) from three Army installations completed the Military Eating Behavior Survey (MEBS). Healthy Eating Score-7 (range: 0-35), 6-event ACFT (range: 0-600), eating style, and physical activity were determined from MEBS responses. Physical fitness was defined as the aggregate score from all ACFT events, which collectively assess both aerobic and anaerobic fitness. The average ACFT score and HES-7 were 496 ± 61 and 18 ± 5, respectively. In a multivariate-adjusted linear regression model, each one-point increase in HES-7 was associated with a 2-point increase in ACFT score (P < .001). Compared to those with the highest quartile of HES-7 (23-34), those in the two lowest quartiles (HES-7: first quartile = 0-14, second quartile = 15-18), reported 30 (P < .001) and 19 point (P = .004) lower ACFT scores, respectively. High protein eating style was significantly associated with a 16 point (P = .01) increase in ACFT score and a balanced diet or high protein diet was associated with a 4-point higher HES-7 (P < .05) compared to those who reported -following no specific style. A higher HES-7 and a high protein eating style were positively associated with physical fitness in this sample of Soldiers. Findings support the potential importance of diet quality and specific eating styles in physical performance of military service members.
28. Describing the communication of autistic people during experiences of distress: A scoping review.
期刊: Autism : the international journal of research and practice 发表日期: 2026-Feb-14 链接: PubMed
摘要
Autistic people can experience distress for many reasons. Some of these reasons may include unsupportive environments; experiences of trauma; sensory overload; burnout, inertia, meltdown and shutdown; pain; and mental health diagnoses such as anxiety. Little is known about how distress can impact communication and what others can do to provide support in these moments. This scoping review explores how communication is described during experiences of distress for autistic people, including communication partner strategies to support these interactions. Following a comprehensive database search, 18 articles were included in this scoping review. Firsthand perspectives of autistic people were discussed in 10 studies. Distress was most often characterized by instances of anxiety and/or stress. Eleven studies discussed non-spoken methods of communication, including gestures, facial expressions and behavioural manifestations (e.g. hitting, screaming) during experiences of distress. Identified facilitators to communication during experiences of distress included the presence of a calm, supportive environment and communicative aids. Understanding the impact distress has on communication is beneficial to both autistic people and those who support them. This review contributes to the body of literature aiming to better understand and support autistic people during moments of distress.Lay abstractPast research talks about (1) how autistic people may communicate and (2) how and why autistic people may experience periods of distress. There is not much research about the way autistic people communicate during periods of distress. We therefore looked at research exploring how autistic people of all ages communicate during periods of distress. Communication includes various methods of sending and receiving information, including spoken and non-spoken communication methods (e.g. observable behaviours, typing, gestures). We explored how often researchers collected firsthand perspectives from autistic people. We also collected information on what made communication easier, or more difficult, during periods of distress. We used a methodological approach called a scoping review to identify and evaluate 18 articles that met our criteria. The most common communication method described in the articles was non-verbal communication, including gestures, facial expressions and observable behaviours such as screaming and hitting. Firsthand autistic perspectives were included in just over half of the studies. Facilitators to communication included a calm, supportive environment and communicative aids relevant to the situation, such as a pain scale. This study will help those who support autistic people, and autistic people themselves, by showing the many ways autistic people may communicate when experiencing distress and describing strategies that can be used to support autistic people in those moments.
29. Leadership Matters: Protective Factors for Burnout in Military Healthcare Workers.
期刊: Military medicine 发表日期: 2026-Feb-14 链接: PubMed
摘要
Occupational burnout in healthcare workers, especially in military medical settings, poses risks in retention, patient safety, productivity, well-being, and military readiness. Prior research suggests that sex differences exist with burnout, yet limited data exist on how drivers of burnout interact within military contexts, especially during periods of high stress such as a global pandemic. The objective of this study is to examine sex-specific differences in burnout among military healthcare workers, including the influence of demographic factors, pandemic-related stressors, and leadership characteristics. A cross-sectional survey was administered to 424 healthcare workers employed at military medical treatment facilities between January and May 2023. Participants completed the Maslach Burnout Inventory (MBI) Health Services Survey, Adaptive Leadership with Authority Scale (ALAS), and Pandemic Experiences and Perceptions Survey (PEPS). Descriptive statistics, t-tests, chi-square analysis, Pearson correlations, and ANOVAs were conducted to assess burnout dimensions-emotional exhaustion (EE), depersonalization (DP), and personal accomplishment (PA)-in relation to leadership, demographics variables, and pandemic stressors. Among 424 respondents (308 females, 116 males), overall burnout rates did not differ significantly by sex (25% males, 20% females, P = .28). However, females reported significantly higher EE than males (91.8% vs. 81.6%, P = .015, Cramer’s V = 0.15). There were no differences in the levels of high DP (71.8% males, 64.6% females, P = .86) or low PA (10.5% males, 7.9% females, P = .67). Adaptive and supervisory leadership were protective against EE and DP for both sexes, but these effects were stronger and more consistent for females. Leadership was a protective factor against EE and low PA for females (r = -.34, P < .001; r = -.23, P < .001) and against EE for males (r = -.22, P = .027), though to a lesser extent. For males, tenure at the current position was inversely correlated with depersonalization (r = -.25, P = .01). Pandemic-related stress was more strongly associated with depersonalization in females. Role- and ethnicity-based interactions also revealed sex-specific patterns, with female physicians reporting higher EE and male depersonalization varying by healthcare role and ethnicity. This study highlights important sex-based differences in burnout profiles and associated risk and protective factors among military healthcare workers. Findings underscore the critical role of leadership, particularly for female personnel related to EE, although tenure buffered depersonalization in males. These findings highlight the need for tailored burnout prevention strategies, particularly focused on adaptive leadership development and demographic-specific interventions.
30. Validation of the Arabic Version of the Quality of Healthy Work Environment Instrument Among Nurses.
期刊: Research in nursing & health 发表日期: 2026-Feb-14 链接: PubMed
摘要
A healthy work environment is fundamental to enabling nursing professionals to deliver high-quality patient care, sustain personal well-being, and support the long-term viability of healthcare organizations. Despite its importance, the lack of culturally and linguistically validated instruments hinders accurate assessment of work environments within Arabic-speaking nursing populations. This study aimed to translate and validate the Arabic version of the Quality of Healthy Work Environment (Ar-QHWE) instrument for use among registered nurses. A methodological cross-sectional design was employed. The QHWE instrument underwent forward and backward translation in accordance with WHO guidelines to ensure linguistic and conceptual equivalence. A total of 200 registered nurses from a tertiary care hospital were recruited. Construct validity was examined through confirmatory factor analyses (CFA), while internal consistency was assessed using Cronbach’s alpha coefficients. Convergent validity was examined using average variance extracted and Pearson correlation between Ar-QHWE and job satisfaction (JS), perceived quality of care (PQC), and intention to leave (ITL). The Ar-QHWE demonstrated robust psychometric properties. CFA confirmed satisfactory model fit indices (CFI = 0.94, TLI = 0.93, RMSEA = 0.04). Cronbach’s alpha coefficients for all subscales ranged from 0.74 to 0.85, indicating high internal consistency. Test-retest reliability, as assessed by ICCs, was also excellent across subscales and for the overall scale. The convergent and discriminant validities were also good, with strong correlations between Ar-QHWE and JS, PQC, and ITL. No major floor or ceiling effects were observed, indicating appropriate score distribution. The Ar-QHWE is a psychometrically sound instrument for evaluating perceptions of a healthy work environment among Arabic-speaking nurses. Its use is recommended for research, policy development, and organizational initiatives aimed at improving workplace quality across Arabic-speaking healthcare systems.
31. Examining a multicomponent health promotion intervention among Black same gender loving men in southern ending the HIV epidemic in the U.S. jurisdictions: a randomized controlled trial.
期刊: BMC public health 发表日期: 2026-Feb-13 链接: PubMed
摘要
32. [Design and evaluation of an oral health booklet during pregnancy].
期刊: Atencion primaria 发表日期: 2026-Feb-13 链接: PubMed
摘要
The main objective of this study was to design and evaluate an oral health booklet for pregnant women, aiming to improve the prevention and monitoring of oral diseases in this group. Secondary objectives included the validation of the booklet through evaluation by dental professionals and its implementation in a population of pregnant women. Descriptive, observational, cross-sectional clinical study. The design included two phases: the creation of the booklet based on a literature review, and its evaluation through a survey of 40 dental professionals. Modifications based on feedback received led to the final version of the booklet. The study was conducted at the University Dental Clinic (COU) of Morales Meseguer Hospital in the Region of Murcia, within the oral health program of the University of Murcia aimed at pregnant women. A total of 241 pregnant women, between 10 and 31 weeks of gestation, were included in the study. They were selected through midwives from primary care centers and via social media outreach. The study used a non-probabilistic sample of pregnant women. Questionnaires, clinical histories, and oral examinations were used to collect data. Oral health habits, caries and plaque indices, and dental care recommendations were analyzed. The booklet was well accepted by professionals, and a high prevalence of caries (CAOD: 7.34) and plaque (index: 30.15) was identified among the pregnant women. The booklet is useful for the prevention and monitoring of oral health issues during pregnancy, promoting maternal-infant oral health.
33. Ginsenoside CK regulates non-alcoholic fatty liver disease by regulating liver fat metabolism and gut microbiota.
期刊: International immunopharmacology 发表日期: 2026-Feb-13 链接: PubMed
摘要
The global incidence of non-alcoholic fatty liver disease (NAFLD) is on a continuous rise, characterized by hepatic lipid metabolism disorder and gut microbiota dysbiosis. Although ginsenoside compound K (CK) exhibits hepatoprotective and anti-inflammatory activities, its specific role in the pathogenesis of NAFLD remains to be fully elucidated. In this study, a high-fat-high-cholesterol (HFHC) diet-induced NAFLD mouse model was used to investigate the protective effects of CK against the disease. The results demonstrated that CK intervention significantly attenuated HFHC diet-induced body weight gain in mice: the body weight of mice in the CK-L group (60 mg/kg) decreased by approximately 11.7%, hepatic inflammation was reduced by about 35%-45%, and lipid deposition was improved by roughly 50%-60%. Mechanistically, CK activates the peroxisome proliferator-activated receptor (PPAR) signaling pathway, regulates the expression of lipid metabolism-related genes and proteins, thereby ameliorating lipid metabolism disorder. Meanwhile, CK reverses HFHC diet-induced gut microbiota dysbiosis, upregulates the abundance of the beneficial bacterium Akkermansia, and modulates the intestinal phylum composition in NAFLD mice by increasing the proportion of Bacteroidetes and decreasing that of Firmicutes. CK regulates the occurrence and development of NAFLD via the gut-liver axis, providing experimental evidence for subsequent mechanistic research on NAFLD prevention and treatment as well as the exploration of candidate drugs.
34. Effects of a puppet-assisted house-tree-person test on fear and anxiety in children receiving chemotherapy and associated influencing factors: A projective, quasi-experimental study.
期刊: Journal of pediatric nursing 发表日期: 2026-Feb-13 链接: PubMed
摘要
This study investigated the effect of the puppet-assisted House-Tree-Person Test (HTP-T) on fear and anxiety levels in children undergoing chemotherapy treatment and the factors influencing these outcomes. The study employed a one-group pretest-posttest quasi-experimental design combined with HTP-T analysis. The study was conducted with 29 children aged 5-12 years receiving chemotherapy at the pediatric hematology-oncology outpatient clinics of a university hospital in the Eastern Black Sea Region of Türkiye during the 2022-2024 years. Data were collected using “the Demographic Information Form for Children and Parents, the Children’s State Anxiety Scale (CSA), the Children’s Fear Scale (CFS), and HTP-T”. Data analysis was performed using descriptive statistics, repeated measures ANOVA, and HTP-T analysis. Statistically significant differences were observed in children’s mean CSA (F = 3.898, p = 0.026, η2 = 0.122) and CFS (F = 5.313, p = 0.008, η2 = 0.159) scores across the pre-treatment, during-treatment, and post-treatment measurements. The HTP-T analysis revealed that children had difficulty regulating anxiety and fear, expressed concerns about family and environmental events, reported feelings of loneliness, and exhibited strong emotional attachment to their families. The study demonstrated that incorporating puppet-assisted HTP-T during chemotherapy contributed to reducing children’s fear and anxiety and offered a useful approach for identifying influencing factors. HTP-T, a therapeutic play technique incorporating puppetry and projective methods, may be effective in reducing fear and anxiety among children undergoing chemotherapy.
35. Artificial intelligence and mental health in the workplace: positive and negative impacts.
期刊: Archives of environmental & occupational health 发表日期: 2026-Feb-13 链接: PubMed
摘要
The mental health of workers is a crucial objective of occupational health and safety programs. Mental health issues in the workforce present a significant public and occupational health challenge, with considerable impacts on workers, families, employers, and society. Meanwhile, the growing integration of artificial intelligence (AI) in various work environments prompts important questions regarding its impact on workers’ mental well-being. AI can positively contribute to workplace mental health in various ways, including the early detection of fatigue, stress, and anxiety through wearable sensors. However, it also raises potential drawbacks, such as concerns about job displacement and job insecurity. Therefore, this narrative review aims to provide a comprehensive review of existing literature to highlight the potential benefits and challenges associated with the adoption of AI in the workplace and its implications for mental health.
36. 'Something about an app, you know?': narratives of everyday menstrual justice among trans and nonbinary people in Canada and the USA.
期刊: Culture, health & sexuality 发表日期: 2026-Feb-13 链接: PubMed
摘要
While critical research focused on trans and nonbinary people’s experiences with menstruation is growing, no prior work has examined how menstrual tracking apps shape experiences of menstruation within trans and nonbinary lives. Drawn from a larger feminist narrative inquiry study, the purpose of this research was to address this gap by examining six narrative accounts of menstrual tracking app use and non-use among trans and nonbinary people in Canada and the USA. These narratives illustrate how trans and nonbinary participants situated practices of engaging with, or refusing to engage with, menstrual tracking apps help mediate and sustain dignity and agency in everyday life contexts, constituting forms of what we term ‘everyday’ menstrual justice. By foregrounding narratives of both use and non-use, we illustrate how participants navigated the dual principles of menstrual justice - ‘freedom to’ and ‘freedom from’ menstruation - by negotiating autonomy, dysphoria management, pain legibility, data privacy, and self-advocacy through digital menstrual technologies. This article advances an expanded understanding of menstrual justice that accounts for the diverse micro-level ways in which individuals across gender identities self-determine how and to what extent menstruation matters in their lives.
37. Asymmetric Manual Arm Strength Evident Only in Right-Handed Individuals.
期刊: IISE transactions on occupational ergonomics and human factors 发表日期: 2026-Feb-13 链接: PubMed
摘要
Occupational ApplicationsThe results of this study have practical implications for ergonomic modeling and workplace design. It is recommended that digital human models used to predict arm strength capacities incorporate an estimated 8% strength advantage for the right hand relative to the left. This recommendation is grounded in the observed asymmetry among right-handed individuals. Importantly, left-handed individuals demonstrated minimal strength differences between limbs and would still be adequately represented and protected under this modeling assumption. Background: Handedness remains an under-examined factor in ergonomics strength-based research. Current population-level strength assumptions may overlook critical differences between dominant and non-dominant limbs.Purpose: This study examined differences in strength symmetry between right- and left-handed individuals.Methods: A total of 24 participants, with an equal number of left-handed and right-handed individuals, performed 36 maximum manual arm strength (MAS) exertions per arm. Participants exerted maximum forces in six different directions, at three distinct hand locations.Results: There were significant MAS asymmetries between the dominant and non-dominant arms for right-handed individuals, with the dominant limb being 8.2% stronger. In contrast, no significant strength asymmetries were observed in left-handed individuals, with the dominant limb only being 1.8% stronger, which may suggest neurophysiological differences or environmental adaptations to a predominantly right-handed world necessitating increased use of the right arm. Females were found to possess 64.8% of male MAS, averaged across all force directions.Conclusions: These findings show that handedness-related strength asymmetry should be considered in upper-limb strength assessments and ergonomics task design.
38. Generation of a comprehensive epigenomic atlas in clear cell renal cell carcinoma informs kidney cancer progression and heritability.
期刊: Cell reports 发表日期: 2026-Feb-12 链接: PubMed
摘要
By generating 194 epigenomic and transcriptomic datasets from 57 human tissue samples using H3K27ac and HIF2α chromatin immunoprecipitation sequencing (ChIP-seq), assay for transposase-accessible chromatin using sequencing (ATAC-seq), and RNA sequencing, we provide a comprehensive, integrated characterization of clear cell renal cell carcinoma (ccRCC) across normal, tumor, and metastatic states. Our analyses provide several insights into ccRCC biology. First, we demonstrate significant reprogramming of enhancer and HIF2α cistromes as well as chromatin accessibility during the normal-to-tumor transition, whereas localized and metastatic tumors show minimal epigenomic differences. Second, we show reactivation of kidney-specific developmental pathways driving malignancy. Third, we perform a cistrome-wide association study in ccRCC, validating five established RCC risk loci and identifying six novel loci, including a locus at 12q24 linked to SCARB1 that was functionally validated. These datasets provide new perspectives on the role of developmental pathways in ccRCC tumorigenesis, insights into epigenetic mechanisms of ccRCC heritability, and a comprehensive epigenomic atlas for the research community.
39. Understanding cognitive dysfunction in depression: perspectives and practices of UK health and social care professionals, a qualitative study.
期刊: BMJ open 发表日期: 2026-Feb-12 链接: PubMed
摘要
To explore how health and social care professionals (HSCPs) in the UK conceptualise and respond to cognitive dysfunction in depression, including its potential long-term implications for brain health and dementia risk. A qualitative, semi-structured interview study. Data was analysed using a code-book approach to thematic analysis. The study was conducted in the UK, with HSCPs from diverse professional backgrounds including general practitioner, psychology, psychiatry, mental health nursing, psychological well-being practitioner and occupational therapy. A total of 12 participants were recruited via purposive and convenience sampling. Three master themes were developed, (1) Cognitive dysfunction in depression, (2) Persistence of cognitive dysfunction and (3) Depression and dementia risk. HSCPs expressed challenges in screening for cognitive dysfunction in depression, particularly as dementia-related screening tools were used which may not be sensitive enough to detect depression-related cognitive deficits. A number of potential explanations were reported as to why cognitive dysfunction may persist after mood symptoms have lifted. These included substance misuse, role of education, neurological conditions and depression as a prodrome to dementia. Depression as a potential risk factor for poorer brain health in the context of dementia risk reduction was not communicated in clinical settings to service users. Barriers to communication included lack of evidence base on depression as a potential risk factor, as well as lack of guidance on communication practices in the context of mental health issues. Cognitive dysfunction in depression is a complex phenomenon and remains under-explored. Challenges around identification and screening indicate a need for validation studies of cognitive screening measures for use in mood disorders, as well as pilot, acceptability and feasibility trials of interventions targeting cognitive functioning in mood disorders. Mixed-methods research is warranted to understand whether guidance on communicating depression as a risk factor for brain health is required and/or justified.
40. Factors associated with disease severity in hospitalized children with Staphylococcus aureus infection.
期刊: Journal of tropical pediatrics 发表日期: 2026-Feb-09 链接: PubMed
摘要
Staphylococcus aureus is a common cause of serious infections in children, with the incidence of methicillin-resistant Staphylococcus aureus (MRSA) rising in recent decades. To identify the factors associated with disease severity in pediatric patients hospitalized with S. aureus infection in high-complexity institutions in Santander, Colombia. A cross-sectional study was conducted among children under 18 years of age with S. aureus infection who were hospitalized (2018-21). Clinical characteristics and outcomes were compared between MRSA and methicillin-susceptible Staphylococcus aureus (MSSA) infections. Factors associated with severity were identified through multivariate analysis with logistic and binomial regression. One hundred fifty-four cases of S. aureus infection were included, with 75 (48.7%) being MRSA. Among community-acquired infections, 55.7% (44/79) were caused by MRSA. Pediatric intensive care unit (PICU) admission was required in 55.8% of cases, and the infection-attributable case-fatality rate (CFR) was 1.9%. MRSA infections were associated with a greater need for vasopressor/inotropic support (prevalence ratio [PR], 2.06; 95% confidence interval [CI], 1.05-4.04; P = .036). Persistent bacteremia was associated with an increased PICU admission (PR 1.72; 95%CI: 1.19-2.46), mechanical ventilation (PR 8.63; 95%CI: 3.16-23.54), and vasopressor/inotropic support (PR 11.06; 95%CI: 4.59-26.58). S. aureus infections showed a high prevalence of MRSA, with a notable proportion of community-acquired cases. More than half required admission to PICU, but the infection-attributable CFR was low. MRSA infections and persistent bacteremia were associated with disease severity. These findings support the use of timely antibiotic therapy and reinforce the need for infection prevention and control strategies. Staphylococcus aureus is a bacterium that can cause serious infections in children. In recent years, MRSA has become more common, making treatment more challenging. Our study examined factors associated with severe illness in children hospitalized with S. aureus infections in two high-level hospitals in Santander, Colombia, from 2018 to 2021. We reviewed 154 cases, finding that 48.7% were MRSA. Community-acquired MRSA (CA-MRSA) was frequently observed (55.7%), particularly in pneumonia cases (70.6%). More than half of the children (55.8%) needed PICU admission, and 1.9% died due to their infection. MRSA infections were associated with a higher need for medications supporting heart and blood pressure function. Persistent bacteremia increased the likelihood of requiring intensive care, mechanical ventilation, and heart-support medications. Persistent bacteremia was defined as the presence of positive blood cultures obtained 72 hours or more after starting the initiation of appropriate antibiotic therapy (defined as the use of a bactericidal antibiotic at an adequate dose, according to susceptibility tests, and understood as adequate antibiotic treatment). These findings highlight the high rate of CA-MRSA and its link to severe illness, stressing the need for rapid diagnosis and timely antibiotic treatment.
41. Association between alcohol consumption and breast cancer incidence and prognosis: A systematic review and meta-analysis.
期刊: Breast (Edinburgh, Scotland) 发表日期: 2026-Feb-05 链接: PubMed
摘要
While alcohol consumption appears to influence the incidence of breast cancer (BC), its association with prognosis after a BC diagnosis remains less established. This meta-analysis aimed to explore the association between alcohol consumption on both BC incidence and outcomes. A systematic literature search was conducted up to May 1st, 2025 (CRD42025593784). Retrospective and prospective studies reporting BC incidence, recurrences, and survival outcomes in women with history of alcohol consumption were included. Analyses according to alcohol intake levels (light, intermediate, heavy consumption) were performed. Main outcomes were BC incidence, BC recurrences, BC-specific survival (BCSS), and overall survival (OS). Pooled relative risk (RR) and hazard ratio (HR) with 95% confidence interval (CI) were calculated. Out of 5208 screened records, 37 studies including 2,565,920 women were included. Among 17 studies reporting on BC incidence, any alcohol consumption was associated with an increased BC incidence (RR 1.17, 95%CI 1.09-1.26; p < 0.001). BC incidence increased proportionally with higher levels of alcohol consumption: light RR 1.13 (95%CI 1.05-1.23; p = 0.002), intermediate RR 1.28 (95%CI 1.18-1.39; p < 0.001), and heavy consumption RR 1.52 (95%CI 1.38-1.67; p < 0.001). Among 20 studies assessing BC outcomes, no associations were found between alcohol consumption and BC recurrences (RR 1.02, 95%CI 0.93-1.11) nor BCSS (HR 0.93, 95%CI 0.87-1.00), while light and intermediate alcohol consumption were associated with slightly improved OS: HR 0.85 (95%CI 0.78-0.92; p < 0.001) and HR 0.84 (95%CI 0.75-0.94; p = 0.002), respectively. Among over 2.5 million women, alcohol consumption was associated with a dose-dependent increased risk of BC, while alcohol consumption did not appear to worsen prognosis in patients with prior BC diagnosis.
42. Landscape analysis towards data quality and utility labelling in the European Health Data Space.
期刊: European journal of public health 发表日期: 2026-Feb-05 链接: PubMed
摘要
The European Health Data Space (EHDS) promotes health data sharing and secondary use across Europe. The QUANTUM project focuses on labelling data quality (DQ), utility, and maturity to support EU-wide standards within this context. This study examines current DQ assessment practices in European Data Holder institutions to inform the design of a labelling tool for the EHDS. The study explored institutional practices for DQ assurance and assessment through a survey of EU-wide Data Holders and a literature search on open-source health DQ tools with potential for labelling. The survey targeted QUANTUM partners and external institutions, addressing DQ practices and tools. The literature review followed PRISMA guidelines and combined PubMed, AI-based queries, and known sources. We obtained survey responses from 27 Institutions across 13 European countries. The results showed a high variety and heterogeneity in DQ practices and tools used, including in-house developed tools, open-source tools, commercial products, and manual procedures. Most practices allowed customization of DQ dimensions and export of DQ analyses. The systematic review identified 66 DQ tools, 53% specific to data types such as electronic health records, omics or imaging, and 47% general-purpose. The diverse DQ institutional practices and tools emphasize the need for an interoperable self-assessment DQ labelling tool that guides the measurement and completion of consolidated metrics aligned with the EHDS regulations. Based on these findings, the QUANTUM project is developing this tool to support DQ labelling of Data Holders’ datasets candidate to publication at EU Health Data Access Bodies.
43. Thirty-year trends in the prevalence and incidence of multiple sclerosis (MS) in Mazandaran Province: Application of advanced statistical methods.
期刊: Multiple sclerosis and related disorders 发表日期: 2026-Feb-02 链接: PubMed
摘要
Mazandaran province in Iran, identified as a high-prevalence area, has lacked comprehensive long-term studies on MS trends. This study aims to fill that gap by analyzing three decades of MS incidence and prevalence in Mazandaran using advanced statistical methods. This longitudinal study included clinically diagnosed MS cases from the two most populous cities in Mazandaran utilizing data from the national MS registry spanning 1994 to 2023. Prevalence and age-adjusted incidence rates were calculated, and annual percentage change (APC) was assessed using joint point regression. Bayesian statistical methods were applied for comprehensive trend analysis. A total of 1333 MS patients were identified, the mean (±sd) age at diagnosis was 28.58±8.52 years. MS prevalence increased from 0.19 per 100,000 in 1994 to 127.24 per 100,000 in 2023. The age-adjusted incidence rate rose from 0.14 (95 %CI: 0-0.5) in 1994 to a peak of 10.44 (95 %CI: 7.8-13.0) in 2018, then declined to 4.39 (95 %CI: 2.7-6.1) in 2023. The APC in MS incidence was +14.1 % until 2018, followed by a -15.32 % decrease thereafter. Significant differences in mean age, Expanded Disability Status Scale (EDSS) score and MS type were observed before and after 2018. The Bayesian methods indicated that evaluated predictors were not statistically significant for MS prevalence. This study demonstrates a marked increase in MS incidence in Mazandaran province until 2018, followed by a subsequent decline. The rising prevalence and decreasing mean age at diagnosis underscore the need for continued surveillance and further research to determine whether the recent decline in incidence will persist.
44. Adult-Onset Compared to Childhood-Onset Asthma: Multifaceted Symptoms, Comorbidity, and Healthcare Burden.
期刊: Clinical and translational allergy 发表日期: 2026-Feb 链接: PubMed
摘要
In this study, we compared symptoms, comorbidities, and healthcare burden between childhood-onset asthma (< 18 years) and early adult-onset (18-39 years) and late adult-onset asthma (≥ 40 years). Among 3546 participants with data on physician-diagnosed asthma and onset age, 46.4% were defined as adult-onset [864 (24.4%) had early adult-onset asthma (18-39 years) and 782 (22.1%) had late adult-onset asthma (≥ 40 years)], which, compared to childhood-onset asthma, presented with more complex, multi-symptom profiles, including productive cough, sputum production, but less wheezing. Allergy-related comorbidities were more common in childhood-diagnosed asthma, while chronic obstructive pulmonary disease (COPD), diabetes mellitus, hypertension, obesity, and chronic sinusitis were more common in adult-onset asthma. Adult-onset asthma also had a higher disease burden, with more frequent medication use and exacerbations. Adult-onset asthma has an underlying complexity, contributing to a vicious cycle of worsening symptoms, increased medication use, and more comorbidities.
45. International Multidisciplinary Consensus Report on Definitions, Diagnostic Criteria, and Management of Fatty Pancreas: A Joint Statement Endorsed by EPC, APA, EASD, EASL, ESGAR, ESGE, ESP, ESPCG, ESPEN, ESPGHAN, IAP, JPS, KPBA, LAPSG, and UEG.
期刊: United European gastroenterology journal 发表日期: 2026-Feb 链接: PubMed
摘要
This international, multidisciplinary consensus report represents the first effort to systematically define and characterize fatty pancreas. A key outcome of this endeavor was the recommendation to adopt “fatty pancreas” as the standardized and inclusive term to describe all forms of fat accumulation in the pancreas. This terminological consensus provides a critical foundation for unified reporting and clinical communication. Another major contribution of the report is the consensus on diagnostic imaging findings, which was based on radiological and endoscopic modalities. The proposed criteria aim to enhance consistency in clinical assessment and support the development of standardized research protocols. In addition to establishing terminology and diagnostic frameworks, the report also synthesizes current knowledge across a wide range of relevant domains. These include the etiology and epidemiology of fatty pancreas, as well as its associations with alcohol consumption, smoking, acute and chronic pancreatitis, pancreatic exocrine insufficiency, type 2 diabetes mellitus, and surgical outcomes. The potential links between fatty pancreas and neoplastic conditions such as intraductal papillary mucinous neoplasms and pancreatic cancer are also addressed, alongside the current understanding of its metabolic implications (beta-cell function and glucose homeostasis) and treatment strategies. Throughout the consensus process, a consistent theme emerged: the limited availability of high-quality, prospective clinical data. Therefore, many of the recommendations in this report are based on expert consensus rather than strong empirical evidence. As such, the statements require rigorous prospective validation before they can be adopted into routine clinical practice. This underscores a critical need for further research, particularly studies aimed at clarifying causal relationships, validating diagnostic tools, and determining the clinical relevance of fatty pancreas across diverse patient populations. This report serves as both a summary of our current understanding and a roadmap for future investigations, aiming to close existing knowledge gaps and guide evidence-based clinical practice in this emerging field.
46. Long-Term Risk of Incident Type 2 Diabetes Following SARS-CoV-2 Infection: A Population-Based Study in British Columbia, Canada.
期刊: Diabetes/metabolism research and reviews 发表日期: 2026-Feb 链接: PubMed
摘要
To assess the long-term risk of incident type 2 diabetes mellitus (T2DM) following SARS-CoV-2 infection in a large population-based cohort. We conducted a retrospective cohort study of all British Columbia residents aged ≥ 18 years tested for SARS-CoV-2 by reverse transcription polymerase chain reaction (RT-PCR) between 1 January 2020 and 31 January 2024. Individuals with pre-existing diabetes or residing in long-term care were excluded. Incident T2DM, identified more than 30 days after testing, was ascertained using a validated administrative algorithm. Inverse probability-weighted cause-specific hazard models estimated adjusted hazard ratios (HRs) for incident diabetes, accounting for death as a competing risk. Subgroup analyses examined associations by sex, age, vaccination status, COVID-19 severity, and follow-up duration. Among 2,044,421 individuals (296,390 SARS-CoV-2-positive; 1,748,031 negative), 47,704 (2.33%) incident T2DM cases were identified over a median follow-up of 874 days. Compared with the SARS-CoV-2-negative group, the risk of diabetes was higher among infected individuals (HR 1.18; 95% CI: 1.15-1.22; p < 0.0001), rising progressively with illness severity-from ambulatory to hospitalised and intensive-care cases. No evidence of association was found among the vaccinated subgroups. The excess risk persisted for up to 3 years before waning thereafter. SARS-CoV-2 infection was associated with an increased risk of incident T2DM that persisted for up to 3 years, particularly among unvaccinated and severely ill individuals. These findings highlight the importance of post-infection metabolic surveillance and the potential protective role of vaccination.
47. Translation, cross-cultural adaptation, and psychometric validation of the Malay version of the Occupational Balance Questionnaire-11 among Malaysian retirees.
期刊: Australian occupational therapy journal 发表日期: 2026-Feb 链接: PubMed
摘要
Occupational balance reflects both satisfaction with and proportional distribution of daily activities. The Occupational Balance Questionnaire-11 (OBQ11) is widely applied internationally but has not been available in Malay. Debate also persists on whether occupational balance is a unidimensional or multidimensional construct. This study aimed to translate and culturally adapt the OBQ11 into Malay (OBQ11-M) and to evaluate its psychometric properties among Malaysian retirees. The OBQ11 was translated and harmonised using established guidelines. Nine occupational therapists reviewed the content validity, and 20 retirees assessed the face validity. With 122 retirees purposively recruited, this study evaluated internal consistency, test-retest reliability, known-group validity, and concurrent validity with the Malay version of the Satisfaction With Life Scale (SWLS-M). Dimensionality was explored with exploratory factor analysis, whereas item functioning was examined with the partial credit model (PCM). There was no consumer and community involvement in the development or implementation of research or writing of this manuscript. The OBQ11-M demonstrated excellent internal consistency (α = 0.956) and good test-retest reliability (intra-class correlation coefficient [ICC] = 0.799, 95% confidence interval [CI]: 0.738-0.847). Known-group validity distinguished community-dwelling from institutionalised retirees (P < 0.001, rrb = 0.876), and concurrent validity was supported by correlation with SWLS-M (r = 0.68, P < 0.001). Parallel analysis supported a dominant unidimensional structure (66.9% variance explained), though exploratory results suggested two conceptually coherent dimensions: (i) occupational satisfaction and (ii) occupational proportion. PCM analyses indicated ordered thresholds, satisfactory fit, and high person reliability (0.896). The OBQ11-M is a reliable and valid measure of occupational balance among Malaysian retirees. Although unidimensionality is justified, the theoretical distinction between satisfaction and proportion warrants confirmatory testing in larger samples. This study explored how older people in Malaysia feel about balance in their daily lives. ‘Occupational balance’ means having the right mix of activities and feeling satisfied with how time is used. The Occupational Balance Questionnaire‐11 (OBQ11) is often used in other countries to measure this, but it is not yet available in Malay. Therefore, we translated the questionnaire into Malay (OBQ11‐M) and tested it with 122 retirees. Some lived in the community, whereas others lived in care homes. Nine occupational therapists also reviewed the questions. We checked if the Malay version was clear and reliable and gave stable results when used at two different times. We also compared it with another tool that measures life satisfaction. Our study found that the OBQ11‐M worked very well. It was consistent and stable over time and could show differences between community‐dwelling and institutionalised retirees. It is also linked strongly with life satisfaction. The results showed that the OBQ11‐M can be used as one overall score, but it may also reflect two parts: satisfaction with activities and the proportion of activities. Overall, this tool will help Malaysian health workers and researchers understand how retirees view balance in their daily activities. It may support programmes that promote healthy and meaningful ageing.
48. Repeat Behavioral Counseling, With and Without Combination Nicotine Replacement Therapy, for Smoking Cessation Among People With HIV in South Africa.
期刊: AIDS and behavior 发表日期: 2026-Jan-31 链接: PubMed
摘要
Repeating an intervention strategy consistent with the chronic disease care model has been demonstrated to be efficacious in improving cessation outcomes among smokers. However, evidence is lacking for repeat treatment outcomes among people with HIV (PWH) who smoke in low-resource settings. We evaluated outcomes among participants (n = 384) who were provided a second round of treatment after initial treatment failure in a randomized controlled trial of behavioral counseling (BC) with or without combination nicotine replacement therapy (nicotine patches and gum, cNRT). The primary outcome was self-reported smoking abstinence at 6 months after repeat treatment, biochemically verified using exhaled breath carbon monoxide (CO) and urine cotinine test. Secondary outcomes include smoking abstinence at 2 months after repeat treatment and smoking reduction, measured by changes in exhaled breath CO at 2 months and 6 months after repeat treatment. Overall, 35 (9%) participants were abstinent at 6 months post-repeat treatment, including 15 (8%) participants in the repeat BC group compared to 20 (11%) participants in the repeat BC + cNRT group. There was no significant difference in abstinence rates between repeat treatment groups (Chi Squared (χ2) = 0.23; p = 0.63), including after adjusting for potential confounders [adjusted risk ratio (aRR) = 1.16, 95% CI 0.39, 3.47; p = 0.79]. Although augmenting repeat treatment of BC with cNRT may not provide additional benefits for PWH with prior treatment failure in this population, PWH in this setting may benefit from a repeat treatment strategy of BC with or without cNRT.
49. Sequential federated analysis of early outbreak data applied to incubation period estimation.
期刊: Epidemics 发表日期: 2026-Jan-21 链接: PubMed
摘要
Early outbreak data analysis is critical for informing about their potential impact and interventions. However, data obtained early in outbreaks are often sensitive and subject to strict privacy restrictions. Thus, federated analysis, which implies decentralised collaborative analysis where no raw data sharing is required, emerged as an attractive paradigm to solve issues around data privacy and confidentiality. In the present study, we propose two approaches which require neither data sharing nor direct communication between devices/servers. The first approach approximates the joint posterior distributions via a multivariate normal distribution and uses this information to update prior distributions sequentially. The second approach uses summaries from parameters’ posteriors obtained locally at different locations (sites) to perform a meta-analysis via a hierarchical model. We test these models on simulated and on real outbreak data to estimate the incubation period of multiple infectious diseases. Results indicate that both approaches can recover incubation period parameters accurately, but they differ in terms of structure and complexity; which makes them suitable for different types of analyses or to be used in combination. We provide a framework for federated analysis of early outbreak data where the public health contexts are complex.
50. Taking SHAPE: peer educators' insights on promoting preconception health in the college setting.
期刊: Health education research 发表日期: 2026-Jan-09 链接: PubMed
摘要
Preconception health is vital for improving personal health and increasing the chances of a healthy pregnancy. However, young adults often lack awareness of its importance for their overall and future health. Peer education effectively improves knowledge, attitudes, and behaviours related to preconception health among college students. While peer education has been studied in preconception health contexts within the USA, gaps remain in the literature regarding peer educators’ lived experiences and perspectives. The Students Helping Advance Preconception Education (SHAPE) programme trains college students to serve as peer educators promoting preconception health topics to both campus and community peer learners. This study examined perspectives of the SHAPE peer educators (N = 15) themselves at a Southeastern university through focus groups and interviews. Data were collected between May and June 2025 using semi-structured focus groups and individual interviews. Rapid qualitative analysis was utilized to highlight key domains of programme implementation, peer engagement, and educator motivation and development. Educators identified challenges such as limited awareness and resource constraints and provided innovative engagement strategies. They discussed the need for ongoing training, culturally tailored resources, and institutional support. In this small exploratory sample, findings may offer insights into the value of peer perspectives in strengthening preconception health promotion initiatives.
51. Economic evaluation of an implementation intervention to increase outdoor free play in early childhood education.
期刊: Health promotion international 发表日期: 2026-Jan-07 链接: PubMed
摘要
Get Outside Get Active (GOGA) is a multi-component implementation strategy (six strategies) to increase the provision of outdoor free play opportunities in early childhood education and care (ECEC). A randomized controlled trial with 84 ECECs within New South Wales, Australia found an increase of 61 min of outdoor free play opportunities per day, per service in the intervention compared with usual care at 6-months follow-up (P = .041). This study estimated the absolute costs associated with delivery of GOGA, and cost-effectiveness in terms of cost per additional minute of outdoor free play opportunities per day, per service. Costs ($AUD) were evaluated from health and ECEC service perspectives. Total and average costs per service to deliver GOGA and costs per strategy, per ECEC were calculated. Incremental cost-effectiveness ratios (ICERs) were estimated for differences in costs and effects between intervention and usual care. The total cost of GOGA (42 intervention services) was $69 351 (average $1651 per service). Educational outreach visits were most expensive at $32 498 (average $774 per service, average one visit per service), with develop and distribute educational materials least expensive at $1490 (average $35 per service). The difference in mean cost between usual care and intervention (adjusted for baseline) was $3740 (95% CI $418, $11 218) per service, with an adjusted ICER of $64 (95% CI -$10, $809) per additional minute of outdoor free play opportunity per day, per service. Findings suggest GOGA may be considered cost-effective compared with a school-based physical activity implementation programme. Economic evaluations of similar ECEC-based programmes are recommended.
52. Impact of Primary Care Visit Frequency on Non-Urgent Emergency Department Visits in a Large Urban Medical Center.
期刊: Journal of primary care & community health 发表日期: 2026 链接: PubMed
摘要
To examine whether primary care visit frequency (PVF) is associated with non-urgent emergency department visits (NU-EDVs) at a large urban medical center, and to identify determinants of higher PVF among Emergency Department patients. We conducted a cross-sectional survey of adult ED patients (ESI ≥4 considered NU-EDV) at a Southern California Level I trauma center (September 2021-April 2024). Undergraduate research associates administered a 29-item instrument capturing demographics, utilization, barriers, trust in primary care, and comorbidities. Bivariate tests and multivariable logistic regression estimated adjusted odds ratios (aOR) for NU-EDV and for PVF ≥3 visits/year. Among 964 patients with a primary care provider, 62.9% reported <3 PCP visits/year; 59.2% presented with NU-EDV. After adjustment, PVF ≥3/year was associated with lower odds of NU-EDV (aOR 0.64, 95% CI 0.48-0.87). Medicaid/Cal insurance was associated with higher odds of NU-EDV versus private insurance (aOR 1.53, 95% CI 1.12-2.08). Determinants of PVF ≥3/year included female sex (aOR 1.39, 95% CI 1.04-1.86), older age (aOR 1.01 per year, 95% CI 1.00-1.02), Black race (aOR 2.21, 95% CI 1.17-4.19), Medicaid/Cal coverage (aOR 1.70, 95% CI 1.22-2.37), more chronic conditions (aOR 1.53 per condition, 95% CI 1.35-1.71), and lower odds with PCP distrust (aOR 0.54, 95% CI 0.30-0.96). Greater primary care engagement is independently associated with fewer NU-EDVs; however, Medicaid beneficiaries remain at elevated risk for non-urgent ED use. Improving after-hours access, care coordination, and Medicaid-eligible unscheduled primary care may further reduce avoidable ED utilization.
53. Comparing 6-Year Carbon Footprint Between GINA Track 1 and 2 Asthma Management for Adults: A Real-World Primary Care Report from Singapore to Advocate for Policy Change in Inhaler Procurement.
期刊: Journal of primary care & community health 发表日期: 2026 链接: PubMed
摘要
Global Initiative for Asthma (GINA) has recommended inhaled corticosteroid (ICS)-Formoterol as Track-1 treatment for patients. Using ICS and SABA (Short-Acting Beta-Agonist) as a reliever is an alternative Track-2 option. Both modalities are tied to type of inhaler use, dry powder inhalers (DPI) and propellent-containing metered-dose inhalers (pMDI). Compared to propellent-free DPI, pMDI have much higher carbon footprint (CF) detrimental to the environment. Leveraging on dispensed inhaler data from the electronic medical records of patients managed in primary care, the study aimed to quantify their CF using Budesonide-Formoterol (BUD-FOR) DPI alone, compared to those who were treated with BUD-FOR DPI + pMDI as a reliever. Electronic medical records from 8 public primary care clinics were analysed, covering adult asthma patients (aged ≥21) between 2018 and 2023. Data on inhaler dispensing, asthma control test (ACT) scores and rescue therapy (RT) needs were assessed. CF was computed based on inhaler canisters dispensed. Associations between treatment modality, asthma control, RT and CF were analysed using Generalized Estimating Equations. A total of 5634 patients using BUD-FOR DPI were included. Over the study period, Track-1 usage increased substantially from 466 to 2317 patients, while Track-2 rose modestly from 628 to 758. In 2023, 78.5% of patients achieved good asthma control compared to 68.7% in Track-2. The total CF per patient was substantially lower in Track-1 compared to Track-2 (3.3 vs 62.4 kgCO₂e). Patients in Track-1 had a significantly lower CF by 60 kgCO₂e (P < .001), had 1.5 times higher odds to achieve good asthma control based on ACT scores (P < .001) and had approximately 30% lower odds of receiving RT (P < .001). The average number of SABA-pMDI canisters dispensed per patient declined from 2.8 to 2.1 over the study period. BUD/FOR inhalers use per patient per year was consistently higher in Track 2 compared to Track 1, with an average difference of 1.2 canisters (5.3 vs 4.1). Patients managed under Track-1 treatment approach demonstrated significantly better asthma outcomes and lower CF. These findings highlight potential of Track-1 treatment as the preferred strategy, enabling better clinical outcomes and reduced environmental impact.
54. Parents' Decisions Regarding Digital Media Use by Their Children Under Three Years Old in the United Arab Emirates.
期刊: Infancy : the official journal of the International Society on Infant Studies 发表日期: 2026-Jan 链接: PubMed
摘要
As young children’s digital media use increases, more research on parents’ decisions, such as preferred digital content and mediation strategies, is necessary, particularly with underrepresented populations. The present study analyzed survey data on Arab parents’ decisions regarding digital media use of their children under 3 years in the United Arab Emirates. Most children did not use digital media, and those who did predominantly engaged in “watching” activities. Media content focused on early learning activities and Arabic-language videos. Most parents engaged in digital media together with their child, and joint engagement was linked to less digital media use. The results suggest Arab parents’ media decisions included consideration of content and an emphasis on co-using media with their children. Implications are suggested for policymakers, media developers, and parental guidelines.
55. Head and Neck Cancers Medical Costs in a Universal Health System: A Population-Based Case-Control Study.
期刊: Journal of otolaryngology - head & neck surgery = Le Journal d’oto-rhino-laryngologie et de chirurgie cervico-faciale 发表日期: 2026 链接: PubMed
摘要
ImportanceHead and neck cancers (HNC) impose a significant economic burden on healthcare systems. Understanding the direct medical costs across different phases of care is crucial for resource allocation and cost-effectiveness evaluations, particularly in universal healthcare settings.ObjectiveTo quantify the direct medical costs of HNC over 60 months postdiagnosis and examine cost variations by cancer subsite, stage, and treatment modality.DesignPopulation-based, matched case-control study using administrative healthcare data.SettingOntario, Canada, a province with a publicly funded universal healthcare system.ParticipantsWe included 19,832 adults diagnosed with HNC between 2007 and 2020. Each case was matched with 5 noncancer controls based on age, sex, and comorbidity.ExposuresHNC diagnosis, categorized by cancer subsite, stage, and treatment modality.Main Outcome MeasuresMean per-person direct medical costs attributable to HNC over a 63-month period, analyzed by phase of care, cancer subsite, stage, and treatment modality.ResultsThe mean per-person cost attributable to HNC over 63 months was $53,812.9 ± $762.2. Costs peaked in the first 3 months postdiagnosis ($9709.7 ± $36.1 per month) and declined over time. Larynx/hypopharynx cancers incurred the highest costs across most phases. Advanced-stage cancers were associated with increased costs, with stage IV cancers nearly doubling the costs of stage I. Multimodal treatments, particularly surgery combined with chemoradiation, resulted in the highest costs across all phases (P < .01).ConclusionsHNC results in substantial healthcare costs, with significant variations by subsite, stage, and treatment modality. The highest costs occur in the early treatment phase and remain elevated for patients requiring multimodal therapies.RelevanceThese findings provide critical data for policymakers and health system authorities to optimize resource allocation and assess cost-effectiveness. Future research should explore indirect costs and the impact of early detection strategies to reduce the economic burden of HNC.Level of evidence3.
56. Improving Asthma Management Through a Quality Improvement Program: the CARE4ALL Study.
期刊: The journal of allergy and clinical immunology. In practice 发表日期: 2025-Dec-24 链接: PubMed
摘要
Asthma control in China has been suboptimal, partly attributed to low awareness of and adherence to evidence-based best practice among some Chinese physicians. CARE4ALL (NCT05440097) aimed to improve domestic asthma control through a quality improvement program (QIP) by aligning physicians’ clinical practice with Global Initiative for Asthma (GINA) recommendations. This prospective multicenter, single-arm study enrolled 1,500 patients from 31 tertiary or secondary hospitals across China. The QIP started with comprehensive GINA education for pulmonologists and specialist nurses, followed by regular reinforcement sessions over the 48-week study period. The primary end point was the change from baseline at week 48 in the proportion of patients using ICS-based maintenance or reliever medications. At week 48, the proportion of patients using ICS-based medications increased by 12.8% from baseline (odds ratio = 1.761; 95% CI, 1.497-2.072; P < .0001). Asthma control improved substantially, and 56.6% of patients had well-controlled asthma at week 48, an increase of 30.5% from baseline. Patients’ quality of life and lung function showed significant improvements at the end of the QIP. Older age, having self-reported asthma triggers, occupational exposures, and poor treatment adherence were potential risk factors for poor asthma control at the study’s end. Poor lung function and severe or frequent symptoms were associated with poor asthma outcomes. The QIP effectively enhanced asthma management in China by increasing physicians’ adherence to GINA recommendations, which consequently improved patient outcomes. This QIP could serve as a standard model for nationwide implementation to enhance asthma care in China.