公共卫生研究摘要 (2026-02-17)
共收录 55 篇研究文章
1. Walking promotion in healthy pregnant women and perinatal outcomes: a multivariate analysis comparing active and sedentary mothers.
期刊: Journal of obstetrics and gynaecology : the journal of the Institute of Obstetrics and Gynaecology 发表日期: 2026-Dec 链接: PubMed
摘要
Regular physical activity during pregnancy is associated with important maternal health benefits, yet the specific impact of walking on labour and neonatal outcomes remains unclear. Although walking is the most common form of exercise among pregnant women, evidence linking walking levels to obstetric and neonatal results is still limited. We aim to explore the relationship between walking activity level in the third trimester of pregnancy (T3) and obstetric and neonatal outcomes. This was a secondary analysis of the Walking_Preg Project (WPP) randomised clinical trial registered in the U.S. National Library of Medicine Trials registry (https://clinicaltrials.gov/study/NCT03735381). Participants were healthy, low-risk pregnant women who were not previously physically active. They were given pedometers and physical activity recommendations. The sample was classified at T3 as physically active (≥7,500 steps/day) or sedentary (<7,500 steps/day) according to Tudor-Locke and Bassett’s index to classify pedometer-determined physical activity in healthy adults. Multivariate analyses were conducted to compare obstetric and neonatal outcomes between active and sedentary women. 41 pregnant women walked at least 7,500 steps per day in T3, while 137 did not reach that activity level. The crude and adjusted multivariate models showed an inverse relationship between walking ≥7,500 steps/day in T3 and unplanned caesarean delivery (adjusted OR 0.27, 95% CI 0.05-1.47) as well as a positive relationship with induction of labour (adjusted OR 1.10, 95% CI 0.46-2.61) and neonatal weight (adjusted B coef = 97.55, 95% CI -64.03-259.14; p = 0.23). However, statistical significance was not reached. In this secondary analysis, no statistically significant associations were observed between walking activity during the third trimester and obstetric or neonatal outcomes. Given the low adherence to the walking program and the exploratory nature of the analysis, these findings should be interpreted with caution and require confirmation in larger, adequately powered studies. This study examined whether walking in late pregnancy influences labour or newborn outcomes. We analysed healthy, previously sedentary pregnant women who were classified as active if they walked ≥7,500 steps per day in the third trimester. In this study, we did not find clear differences in obstetric or newborn outcomes between women who walked more and those who walked less during the third trimester. However, because relatively few women achieved higher walking levels, the results are uncertain, and further research in larger studies is needed to better understand whether walking in late pregnancy influences birth outcomes.
2. Global & Community Health: Diagnosis and Management of Multiple Sclerosis in Nepal: Overcoming Barriers Through Local Adaptations.
期刊: Neurology 发表日期: 2026-Mar-24 链接: PubMed
摘要
Multiple sclerosis (MS) is the most common demyelinating disease of the CNS and disproportionately affects younger individuals, yet it remains underdiagnosed and undertreated in many low and middle-income countries. We describe key barriers to timely diagnosis and effective management of MS in Nepal, including limited public and clinician awareness; restricted access to neurologic care, MRI, and essential laboratory testing; and the high cost of long-term treatment. We also outline practical, context-specific adaptations such as simplified diagnostic pathways, use of affordable immunosuppressive therapies, and sustained advocacy by the Multiple Sclerosis Society of Nepal to improve access and affordability. Our experience illustrates pragmatic, low-cost strategies that may support more equitable MS care in resource-constrained settings.
3. Systemic Inflammation and Recurrence After Atrial Fibrillation-Related Stroke: An Individual Participant Data Meta-Analysis.
期刊: Neurology 发表日期: 2026-Mar-24 链接: PubMed
摘要
The residual recurrence risk after atrial fibrillation (AF)-related stroke is high despite anticoagulation, thereby necessitating new therapies. The importance of inflammation in AF is increasingly recognized. However, patients with AF-related stroke were excluded from recent trials of anti-inflammatory therapies. It is uncertain whether associations between IL-6/high-sensitivity C-reactive protein (hsCRP) and poststroke recurrence are modified by AF status. In this study, we aimed to analyze the association between IL-6/hsCRP and recurrence according to AF history. We leveraged individual participant data from studies identified by systematic review. We analyzed associations between IL-6/hsCRP and recurrent stroke/major adverse cardiovascular events (MACEs) (defined as fatal or nonfatal recurrent stroke or major coronary events) using multivariable Cox regression analyses (conditional logistic regression for 1 study) adjusted for age, sex, index event, cardiovascular risk factors, and medication use, stratified by AF status. Data from 11 prospective studies with 10,080 patients (2,134 with AF, mean age 70 years, 59.3% male) were included. During 21,080 person-years of follow-up, 1,677 patients had MACEs and 1,342 had recurrent stroke. Inflammatory markers were higher in patients with AF, irrespective of stroke severity and timing of measurement, with elevated levels persisting well beyond the acute phase. hsCRP was associated with recurrent MACEs in patients with AF (adjusted risk ratio [aRR] 1.14, 95% CI 1.04-1.25, per loge-unit increase) and without AF (aRR 1.08, 1.03-1.13) (Pinteraction 0.30). There were similar associations on per-quarter analysis in patients with AF (aRR 1.51, 1.04-2.18) and without AF (aRR 1.32, 1.10-1.59) (Q4 vs Q1). No association was observed between hsCRP and recurrent stroke in either group. For IL-6, there was no evidence of interaction according to AF status for MACEs (Pinteraction 0.57) or recurrent stroke (Pinteraction 0.82). The aRR per loge unit for MACE was 1.17 (1.07-1.27) in patients without AF and 1.10 (0.91-1.34) in those with AF. The corresponding aRR for recurrent stroke was 1.15 (1.05-1.25) and 1.12 (0.91-1.37) in patients without and with AF, respectively. These data highlight the importance of inflammatory mechanisms in vascular recurrence irrespective of AF, provide rationale for the inclusion of patients with AF in trials of anti-inflammatory therapy, and support a selection approach in future trials based on elevated inflammatory marker levels, rather than stroke etiology alone.
4. A New Approach to Reliever Therapy in Asthma: Implications of the U.S. Department of Veterans Affairs and U.S. Department of Defense Clinical Practice Guideline.
期刊: Annals of internal medicine 发表日期: 2026-Feb-17 链接: PubMed
摘要
5. QUADAS-3: A Revised Tool for the Quality Assessment of Diagnostic Test Accuracy Studies.
期刊: Annals of internal medicine 发表日期: 2026-Feb-17 链接: PubMed
摘要
Assessing risk of bias and applicability is critical in diagnostic test accuracy reviews to ensure valid, relevant findings that can inform decision making and policy. This article introduces QUADAS-3, an updated version of the widely used QUADAS-2 tool that was developed in response to the latest evidence, feedback from users of QUADAS-2, and comprehensive piloting. The QUADAS-3 tool comprises 6 phases: 1) define the systematic review synthesis question, 2) define the ideal test accuracy trial for each synthesis question, 3) draw a flow diagram, 4) identify estimates of accuracy for assessment, 5) assess risk of bias and applicability, and 6) make an overall judgment. Risk of bias is assessed across 4 domains: Participants, Index Test, Target Condition, and Analysis. The first 3 domains are also assessed in terms of concerns regarding applicability to the synthesis question. Signaling questions are included to help judge risk of bias. The QUADAS-3 tool incorporates several changes compared with the previous version (QUADAS-2) which will ideally improve its validity, usability, and usefulness. Key changes from QUADAS-2 include introduction of the concept of an ideal test accuracy trial, assessment at the estimate level rather than the study level, replacement of the “Flow and Timing” domain with a new “Analysis” domain, introduction of sections on the rationale for judgments, and formal introduction of overall judgment of risk of bias and concerns regarding applicability. Some changes to domains and signaling questions have also been made.
6. QUADAS-3 Explanation and Elaboration: Guidance for Quality Assessment of Diagnostic Test Accuracy Studies.
期刊: Annals of internal medicine 发表日期: 2026-Feb-17 链接: PubMed
摘要
Assessing risk of bias and applicability is essential in diagnostic test accuracy reviews to produce reliable and relevant evidence that can guide clinical and policy decisions. To support this process, the authors have developed QUADAS-3, the latest version of the QUADAS tool, which is designed to assess the methodological strength and relevance of diagnostic test accuracy studies included in systematic reviews. This article explains how to use the QUADAS-3 tool. The article guides the reviewer through the initial stages of defining the questions and conceptualizing the ideal test accuracy trial, how the domains and signaling questions should be interpreted and assessed, and how judgments of risk of bias and concerns regarding applicability should be made. Authors of systematic reviews of diagnostic test accuracy studies should use this article as a guide for applying the QUADAS-3 tool.
7. Screening and prevention of second primary cancers by hospital-based oncology professionals.
期刊: European journal of cancer prevention : the official journal of the European Cancer Prevention Organisation (ECP) 发表日期: 2026-Feb-17 链接: PubMed
摘要
Cancer survivors face an increased risk of second primaries, but adherence to cancer screening and prevention recommendations remains limited. Post-treatment follow-up visits represent teachable moments for health promotion, including prevention of second primary cancers. We assessed practices and perceptions of second cancer screening and prevention among French hospital-based oncology health care professionals. An anonymous online survey using Likert scale was conducted. Clustering identified three prevention activity profiles (low, intermediate, high), and multinomial logistic regression explored associated factors. The median declared promotion activity of the 415 respondents was 8 for mammographic screening ([interquartile range: 5-10), 7 (2-9) for cervical cancer screening, 5 (1-7) for colorectal screening, 9 (7-10) for smoking cessation, and 7 (5-9) for alcohol control. Seventy-five percent of respondents addressed obesity management if indicated. Perceived importance and feasibility of secondary prevention activities were high [9 (7-10) and 8 (6-10)]. A high prevention activity profile was associated with greater perceived importance of secondary prevention [odds ratio (OR) per one-point Likert-scale increase = 1.1, 95% confidence interval (CI): 1.04-1.2] and its feasibility (OR = 1.1, 95% CI: 1.06-1.14); and managing head and neck cancer patients (OR = 7.64, 95% CI 1.55-37.8). Lung and sarcoma specialists were less likely to be in the high prevention activity group. Hospital-based oncology health care professionals are aware of and engaged in second primary cancer prevention, though activity levels vary. Its generalization, organization, and development could improve cancer survivors’ adherence to cancer prevention recommendations, and improve health impacts.
8. Cancer incidence and mortality trends from 2007 to 2021 in Milan.
期刊: European journal of cancer prevention : the official journal of the European Cancer Prevention Organisation (ECP) 发表日期: 2026-Feb-17 链接: PubMed
摘要
The objective of this study is to evaluate long-term cancer incidence and mortality trends in the Italian provinces of Milan and Lodi (2007-2021), with a specific focus on the impact of the COVID-19 pandemic in 2020. Data from the Milan Cancer Registry, covering 3.5 million inhabitants, were analyzed. Cancer cases were classified using International Classification of Diseases-O-3 and mortality data with International Classification of Diseases-10 codes. The age-standardized rates were then computed. Joinpoint regression estimated trends excluding 2020 to avoid distortions, including sensitivity analyses. Quality indicators were preliminarily assessed. Overall, 335 849 cases were registered (173 058 males; 162 791 females). Incidence declined among males [annual percent change (APC) -1.9%/year, 2007-2021], driven by prostate, lung, colorectal, and bladder cancers. Female incidence showed heterogeneous patterns, stabilizing and modestly decreasing in recent years (APC -0.6%/year, 2011-2021). Mortality declined steadily in both sexes (-1.9%/year in males; -2.1%/year in females). In 2020, incidence rates dropped sharply compared with 2019 (-19% males; -13% females), reflecting diagnostic delays and competing mortality, but returned to baseline in 2021. Increases were limited to thyroid and testicular cancers, which are largely linked to differences in diagnostic intensity and exposure differences. Cancer incidence decreased among males and stabilized or slightly declined among females, while mortality continued to decrease in both sexes. The abrupt 2020 reduction reflects pandemic disruptions but has a limited long-term effect. These findings confirm the crucial role of population-based cancer registries in monitoring trends and supporting health policy.
9. Go(ing) Red for Women and Fulfilling Our Commitment to Sex-Based Reporting of Cardiovascular Disease.
期刊: Circulation 发表日期: 2026-Feb-17 链接: PubMed
摘要
10. Association of Maternal Smoking During Pregnancy With Childhood Blood Pressure and Hypertension in the ECHO Cohort.
期刊: Circulation 发表日期: 2026-Feb-17 链接: PubMed
摘要
11. Editorial: A new chapter in the lasting legacy of Reviews on Environmental Health.
期刊: Reviews on environmental health 发表日期: 2026-Feb-17 链接: PubMed
摘要
12. Selection, Coding, and Context for Interpreting Social Determinants of Opioid-Use Disorder in Chronic Pain.
期刊: Anesthesia and analgesia 发表日期: 2026-Feb-16 链接: PubMed
摘要
13. Latent Threats Identified During In Situ Simulated Local Anesthetic Systemic Toxicity Crises in the Operating Room: Implications for System Safety.
期刊: Anesthesia and analgesia 发表日期: 2026-Feb-16 链接: PubMed
摘要
Latent safety threats (LSTs) in operating room (OR) crisis management contribute to serious events such as Local Anesthetic Systemic Toxicity (LAST) and represent critical yet often overlooked risks. Although prior research has focused on clinician education for diagnosing and treating LAST, far less attention has been directed toward work-system factors (eg, workflow design, communication processes, environmental supports), even though education alone is insufficient. This study advances understanding of OR crises by systematically identifying and characterizing LSTs across all phases of LAST response, from briefing and diagnosis to treatment and care planning, capturing the broader system factors that influence team performance and patient safety. Thirty-eight staff (15 anesthesiologists, 16 nurses, 7 anesthesia assistants) participated in 8 simulations. Video recordings were analyzed to identify LSTs, which were inductively coded into themes/subthemes, categorized by clinical phase (briefing, diagnosis, management, treatment, care planning) and by system factor using a modified SEIPS framework (organization, environment, tasks, tools, teams, individuals). We identified 183 LSTs, with frequency varying by clinical phase (P < .001); nearly half (90/183; 49%) occurred during Management after diagnosis. LSTs spanned all SEIPS factors, most often Environment (55/183; 30.1%), Organization (54/183; 29.5%), and Tasks (38/183; 21.3%). The most common themes were Poor Physical Layout (43/183; 23.5%) and Role Allocation Deficiencies (42/183; 23%), both directly impairing performance (eg, delays retrieving the crash cart or administering intralipid). Additional LSTs included communication breakdowns, task overload, ambiguous dosing, tool usability issues, and unclear protocols. Knowledge gaps were least common and had minimal clinical impact. The findings highlight that improving LAST crisis response requires more than clinician education. Many LSTs arise from how clinical environments are structured, how teams communicate, and how workflows unfold under pressure. To strengthen LAST crisis response and other emergency interventions, systems must be redesigned to reflect the realities of team-based care and to support clinical workflows across all phases of the response.
14. Assessment of Gastric Content Using Gastric Ultrasound in Patients on Glucagon-Like Peptide-1 Receptor Agonists: Selection Matters.
期刊: Anesthesia and analgesia 发表日期: 2026-Feb-16 链接: PubMed
摘要
15. Sonographer upper extremity posture and arm strength demands: a simulation study exploring scan location and patient size.
期刊: International journal of occupational safety and ergonomics : JOSE 发表日期: 2026-Feb-16 链接: PubMed
摘要
Work-related musculoskeletal disorder (WMSD) rates are increasing among sonographers, with high worker populations reporting pain and discomfort. Upper extremity physical demands and exposures in this cohort are largely unknown, requiring attention to enact changes that mitigate future injury risk. The purpose of this study was to quantify the effects of patient size and scan location on upper extremity postures and joint moment capability of sonographers. An a priori survey was completed by local sonographer staff. Digital human modeling (DHM) of 18 patient avatars and eight scan locations produced 144 scan scenarios. Sonographer exposure assessments were completed using rapid upper limb assessment (RULA) and the arm force field (AFF). The AFF demonstrated that a large subset of scenarios exceeded strength capabilities for 99% of the population. RULA scores of 3 or greater were present across all scans, indicating need for further investigation regardless of patient size and scan location.
16. Effectiveness of McGRATH MAC Video Laryngoscopy for First-Attempt Intubation by Anesthesia Trainees in Infants: A Randomized Controlled Trial.
期刊: Anesthesia and analgesia 发表日期: 2026-Feb-16 链接: PubMed
摘要
Tracheal intubation in infants poses unique anatomical and physiological challenges and is particularly difficult for anesthesia trainees. Video laryngoscopy has been suggested to improve intubation success, yet evidence among novice providers remains limited. We aimed to evaluate whether anesthesia trainees had a higher first-attempt success rate for tracheal intubation in infants using traditional direct laryngoscopy (DL) with a Miller or Macintosh blade, or indirect video laryngoscopy with a McGrath video laryngoscope size 1 Macintosh blade (McGrath VL). In this single-center, parallel-group, randomized controlled trial, infants (<1-year-old) scheduled for elective surgery requiring orotracheal intubation were randomly allocated to either McGrath VL or DL. All intubations were performed by anesthesia trainees under supervision. The primary outcome was the first-attempt intubation success rate. Secondary outcomes included intubation difficulty score, glottic visualization, time to intubation, and intubation-related complications. Between October 2021 and February 2024, 124 infants were enrolled and randomized (McGrath VL: n = 61; DL: n = 63). First-attempt success was achieved in 53/61 (86.9%) in the McGrath VL group and 47/63 (74.6%) in the DL group (risk difference 16.5%, 95% confidence interval [CI],3.0%-29.9%; P = .026). The Intubation Difficulty Score of 0 occurred in 30/61 (49.2%) in the McGrath VL group versus 20/63 (31.7%) in the DL group (risk difference 18.9%, 95% CI, 0.6%-37.2%), and a Percentage of Glottic Opening score of 100% was achieved in 37/61 (60.7%) in the McGrath VL group versus 23/63 (36.5%) in the DL group (risk difference 22.1%, 95% CI, 6.2%-37.9%). The overall incidence of intubation-related complications did not differ significantly between groups (McGrath VL: 5/61 [8.2%] vs DL: 7/63 [11.1%], risk difference -4.1%, 95% CI, -14.7%-6.4%); however, esophageal intubation occurred in 0/61 (0%) in the McGrath VL group versus 3/63 (4.8%) in the DL group. The McGrath VL significantly improves first-attempt intubation success in infants when used by anesthesia trainees, especially among less experienced providers. Video laryngoscopy may enhance safety and effectiveness in infant airway management. These results support its routine use by novice providers in infant anesthesia.
17. Return to work for health professionals with breast cancer as health recipients: A systematized review.
期刊: Work (Reading, Mass.) 发表日期: 2026-Feb-16 链接: PubMed
摘要
BackgroundHealth professionals are at increased breast cancer(BC) risk. Occupational factors are likely contributory, especially nightwork. Return to work for women with BC has received much attention. However, systematic review of return-to-work among health professionals with BC is lacking.ObjectiveTo perform systematized review of the return-to-work literature on health professionals with BC.MethodsPRISMA and ENTREQ guidelines were followed, searching PUBMED, CINAHL, PsycINFO and Web-of-Science.ResultsFrom 2242 publications, 33 primarily qualitative studies addressed return-to-work among health professionals with BC. Fourteen return-to-work studies included some health professionals with BC. Ten studies addressed return-to-work among health professionals with cancer; 264 of whom had BC. Of nine case-studies/self-reports of health professionals with BC, seven worked within oncology. Occasionally-mentioned baseline working conditions included long workhours, nightshifts and busy schedules/multi-tasking. Particular concerns regarding chemotherapy for health professionals were infection risk, fatigue, cognitive function and appearance, the latter often impacting BC disclosure to patients. Emotional burdens when confronting patients’ health problems while afflicted with BC were highlighted. Occasionally-implemented modifications with return-to-work were shortened workhours, nightwork elimination, modified duties or job change. Salutogenic developments with return-to-work included emotional rewards: feeling needed and enhanced sensitivity/empathy for patients with cancer. Issues surrounding the initial BC diagnosis were very delicate for health professionals. Three oncology nurses with BC were diagnosed with post-traumatic stress disorder.ConclusionsMuch more attention should be directed to the occupational needs as well as potential contributions of health professionals with BC. Participatory action research should guide intervention studies aimed at identifying the healthiest RTW options for this special cohort.
18. Statins for Primary Prevention-The Gap Between Guidelines and Patient Preferences.
期刊: JAMA internal medicine 发表日期: 2026-Feb-16 链接: PubMed
摘要
19. Measuring Public Preferences for Statin Therapy Using the Smallest Worthwhile Difference.
期刊: JAMA internal medicine 发表日期: 2026-Feb-16 链接: PubMed
摘要
This survey study uses the smallest worthwhile difference to assess US and Japanese individuals’ willingness to take statins based on expected risk-reduction benefits and burden.
20. Refining Postoperative Radiotherapy in Early-Stage Oral Squamous Cell Carcinoma: Impact of Perineural and Lymphovascular Invasion.
期刊: Annals of surgical oncology 发表日期: 2026-Feb-16 链接: PubMed
摘要
The prognostic significance of perineural invasion (PNI) and lymphovascular invasion (LVI) in early-stage oral squamous cell carcinoma (OSCC) remains uncertain. The role of postoperative radiotherapy (PORT) in this subgroup is debated. This study aimed to clarify the clinical impact of PNI/LVI and determine the effect of PORT across risk-stratified subsets of early-stage OSCC. We retrospectively analyzed 6,121 patients with pT1-2N0M0 OSCC from the Taiwan Cancer Registry (2018-2022). Patients were categorized into Group A (PNI-/LVI-) and Group B (PNI+ and/or LVI+). Clinicopathological characteristics, survival outcomes, and the effect of PORT were assessed using multivariable analysis and propensity score matching (PSM). The PNI/LVI positivity occurred in 13.5% of patients and was independently associated with poorer differentiation, greater depth of invasion (> 5 mm), T2 classification, tongue subsite, lower BMI, and female sex. Group B patients exhibited significantly lower overall survival (HR 1.45, p = 0.001) and disease-free survival (HR 1.44, p < 0.001), with inferior locoregional control versus Group A. PORT significantly improved locoregional control in Group B (p = 0.005), but no overall or disease-free survival benefit was observed, likely due to effective salvage surgery. In contrast, in Group A, PORT offered no benefit and was associated with worse outcomes. Perineural invasion and/or LVI represent key adverse prognosticators in early-stage OSCC. Postoperative radiotherapy selectively enhances locoregional control in intermediate-risk patients, but survival outcomes remain unaffected. A risk-adapted therapeutic approach is warranted, tailoring PORT to patients with adverse features and avoiding overtreatment in low-risk cases.
21. Determining the smallest worthwhile difference of beta-3 agonist treatment for overactive bladder: a benefit-harm trade-off study.
期刊: World journal of urology 发表日期: 2026-Feb-16 链接: PubMed
摘要
22. CRC-SPIN version 3.0: an updated policy model for colorectal cancer screening that includes the serrated pathway.
期刊: Journal of the National Cancer Institute 发表日期: 2026-Feb-16 链接: PubMed
摘要
Microsimulation models use empirical evidence about cancer epidemiology and screening test performance to predict the long-term effectiveness of screening regimens and are essential for developing cancer screening guidelines. Colorectal cancer (CRC) provides a clear example. CRC arises through two pathways, the adenoma-carcinoma pathway and the serrated pathway. Sessile serrated lesions (SSLs) are the primary serrated precursor lesion. SSLs are more difficult to detect and remove than adenomas. We describe version 3.0 of the Colorectal Cancer Simulated Population model for Incidence and Natural history (CRC-SPIN), which adds new information about the serrated pathway and CRC risk in adults under 50, then estimate the effectiveness of decennial colonoscopy from 45 to 75 years old. The model was calibrated using a Bayesian approach to estimate 95% credible intervals (CIs) that reflect uncertainty in predictions. The model validated well to studies of the effect of one-time screening and outcomes from surveillance colonoscopy. In the absence of screening, SSLs accounted for 10.6% (95% CI: 3.3-21.6) of CRC, increasing to 23.5% (95% CI: 7.7%-46.0%) with screening due to selective removal of adenomas. Screening was predicted to prevent 93.9% (95% CI: 92.0%-94.3%) of CRC and 95.3% (95% CI: 93.8%-96.5%) of CRC mortality. Although SSLs are less common than adenomas, they likely make up a large fraction of CRC that arises in people who participate in screening. This points to the importance of improving the ability to detect SSLs, especially large SSLs, at colonoscopy.
23. Social Engagement and Epigenetic Age Acceleration in the Health and Retirement Study.
期刊: Journal of the American Geriatrics Society 发表日期: 2026-Feb-16 链接: PubMed
摘要
This study investigated the relationship between social engagement and epigenetic age acceleration (EAA) in older adults in the United States. Participants were selected from the Health and Retirement Study (HRS). Social engagement was assessed using the 15-item social engagement scale. Thirteen epigenetic clocks based on DNA methylation data were obtained from the 2016 HRS Venous Blood Study. EAA was calculated for each clock by regressing the residual clock values on chronological age. The association between various social activities and 13 EAA was analyzed using multiple linear regression models. The average age of participants was 69.9 years, with 41.5% being male. In the fully adjusted model, more frequent engagement in social activities was linked to slower EAA in the Zhang, GrimAge, Weidner, and VidalBralo clocks. Specifically, more frequent community activities were significantly associated with slower EAA in the GrimAge clock after FDR correction. Unexpectedly, more cognitive activities were significantly associated with faster DunedinPoAm38. More physical activities were associated with slower EAA in the Zhang, PhenoAge, GrimAge, and DunedinPoAm38 clocks after FDR correction. Participants with consistent nonparticipation in overall social activities were associated with faster EAA in the Zhang clock. The findings indicate that active engagement in social activities, encompassing community, cognitive, home-based creative, and physical activities, is associated with slower EAA, marked by several clocks in older adults, providing evidence for the benefit of social activities for health and offering valuable insights for promoting “Active Aging” initiatives.
24. Safety knowledge gaps among Ethiopian health professionals: A systematic review and meta-analysis.
期刊: Work (Reading, Mass.) 发表日期: 2026-Feb-16 链接: PubMed
摘要
BackgroundThere are knowledge gaps regarding safety measures among healthcare professionals (HPs) in Ethiopia. Safety measures are critical for safeguarding HPs and clients.ObjectiveTo assess the pooled knowledge and areas of gaps related to safety measures among HPs in Ethiopia.MethodsThis systematic review and meta-analysis included published Ethiopian studies as of August 2024, sourced from June 1 to August 30, 2024. Databases included PubMed, Web of Science, Epistemonikos, Semantic Scholar, and Google Scholar. Data were extracted using Microsoft Excel and analyzed using STATA 17. A random-effects model was used to estimate pooled knowledge, and heterogeneity was assessed using the I2 statistic (I2 = 98.68%, p < 0.001). Publication bias was assessed using funnel plots, Egger’s test (P = 0.3239), and Begg’s test (P = 0.2465). We used subgroup analyses to see variation across different variables.ResultsWe included 64 studies involving 23,257 HPs. The pooled knowledge was 67.19% (95% CI: 63%-72.81%). In subgroup analysis, 77.39% were aware of COVID-19 prevention measures, and 76.55% were aware of hospital-acquired infections. Knowledge was lower for HIV prophylaxis (57.12%) and healthcare waste management (56.52%). Key consistent influencing factors included training, guideline availability, work experience, professional role, and education.ConclusionsEthiopian HPs had moderate knowledge of safety measures and relatively low knowledge of HIV prophylaxis and healthcare waste management. We recommended standardized assessment tools, targeted training interventions, and expanded coverage to underrepresented regions.
25. Interaction of genetic and lifestyle risk scores on colorectal cancer risk across five racial and ethnic populations.
期刊: Journal of the National Cancer Institute 发表日期: 2026-Feb-16 链接: PubMed
摘要
Integrating genetic and lifestyle information has the potential to greatly improve the prediction of colorectal cancer (CRC) risk. However, racial and ethnic minorities are generally underrepresented in gene-environment studies of CRC risk. We investigated the interplay of genetics and lifestyle on CRC risk in a prospective analysis of 68,397 African American, Japanese American, Latino, Native Hawaiian, and White individuals from the Multiethnic Cohort Study. Genetic predisposition was assessed using a 205-variant polygenic risk score (PRS). Lifestyle was assessed using a lifestyle risk score based on smoking, alcohol consumption, body mass index, physical activity, and diet. The independent and joint associations of the PRS and lifestyle risk score on CRC risk were evaluated using Cox regression. We identified 1,303 incident CRC cases (median 15.1-year follow-up). The highest quintile of the PRS was associated with a 2.4-fold increase in CRC risk compared to the lowest quintile (HRQ5vQ1 2.40, 95% CI 1.99-2.89). The highest quintile of the lifestyle risk score was associated with a 54% increased risk (HRQ5vQ1 1.54, 95% CI 1.26-1.88). This association was stronger among those with high genetic risk (PRS≥50%) (HRQ5vQ1 1.82, 95% CI 1.41-2.35) and non-significant among those with low genetic risk (PRS<50%) (HRQ5vQ1 1.20, 95% CI 0.88-1.64; p-interaction=0.01). Results were similar across race and ethnicity. Our study suggests that lifestyle modification may offer greater risk reduction among those at higher genetic risk. Future research is warranted to enhance the integration of genetics and lifestyle in CRC risk stratification and screening approaches across populations.
26. The NeuroBioBank whole-genome catalogue of human brain donors with central nervous system disorders.
期刊: Brain : a journal of neurology 发表日期: 2026-Feb-16 链接: PubMed
摘要
CNS diseases are a prevailing cause of morbidity and mortality worldwide, and are influenced by environmental and biological factors, including genetic risk. Here, we generated genome-wide genetic data on a large cohort of brain tissue donors with in-depth clinical and neuropathological phenotyping, allowing for broad investigations into the risk and mechanisms of these neurological, neurodevelopmental, and psychiatric conditions. This resource consists of 9,663 donors with array-based genotyping and 9,543 donors with whole-genome sequencing completed. The clinical diagnoses of these donors include 148 central nervous system diseases clustered into 15 broad categories by International Classification of Diseases-10 (ICD-10) coding. These donors were collected by six repositories comprising the National Institutes of Health NeuroBioBank, with an average participant age of 60 years. While primarily older individuals of European descent, the cohort also contains younger donors and individuals from non-European backgrounds. Variants were detected in whole-genome sequencing (WGS), normalized and annotated to describe their functional impact, resulting in 171,121,209 unique variants and 1,078,774 non-silent variants. These raw and normalized data have been made available as a neurogenomics resource in the National Institute of Mental Health Data Archive (NIMH NDA) (nda.nih.gov), combined with donor-matched deep demographic and phenotypic data from the NeuroBioBank Portal (neurobiobank.nih.gov). To illustrate applications, we replicated the strong association observed in previous studies between pathogenic CAG nucleotide repeat expansions in the HTT gene with the clinical diagnosis of Huntington’s disease, as well as associations of the APOE gene with Alzheimer’s disease, and examined the association of polygenic risk scores with the three most common disease diagnoses in the cohort.
27. Abattoir effluents crisis: groundwater pollution reality and adverse environmental impact in Umuahia South and Aba South, Nigeria.
期刊: Journal of environmental science and health. Part A, Toxic/hazardous substances & environmental engineering 发表日期: 2026-Feb-16 链接: PubMed
摘要
The study examined how abattoir effluent discharge affects groundwater quality and the environment in Umuahia South and Aba South, Nigeria. Twenty-seven groundwater samples were taken upstream, midstream, and downstream for duration of six months. Standard techniques and influential statistics in SPSS were used to analyze parameters (pH, Cl-, TSS, TDS, NH4N, NO3-, EC, PO4, and SO42-). Hence, in Umuahia South, mean values of pH (9.72 ± 0.08), Cl- (279.06 ± 76.63 to 329.58 ± 77.39), TSS (915.84 ± 12.13 to 1178.33 ± 85.70), TDS (604.62 ± 46.16 to 707.46 ± 17.21), NH4N (13.75 ± 1.07 to 16.93 ± 1.38), and PO4 (33.55 ± 1.06 to 36.47 ± 0.66) exceeded WHO limits. While in Aba South, mean values of pH (9.44 ± 0.05), Cl- (345.43 ± 76.75 to 495.96 ± 9.60), TSS (1488.28 ± 36.65 to 1673.26 ± 83.00), TDS (766.89 ± 39.40 to 981.66 ± 50.89), NH4N (11.72 ± 0.55 to 13.63 ± 0.54), PO4 (27.64 ± 4.08 to 39.14 ± 1.18) were above recommended standard. There was a significant difference between Cl-, TSS, TDS, NH4N, NO3-, EC, and SO42 at P-value <0.05 across the study area. There is a substantial positive association between pH (TDS, NH4N, PO4, Cl-), Cl- (EC, PO4), TSS (NH4N, NO3-), TDS and NH4N (EC, PO4, Cl-), and NO3- and EC (PO4 pH (TDS, NO3-), Cl- (EC, PO4), TSS (SO42), TDS, NH4N (NO3-), and NO3- (PO4) in Umuahia South and Aba South. Finally, abattoir water should be sanitized before use. Therefore, the state environmental protection agency should actively supervise slaughterhouses and assure health and safety compliance.
28. The hidden world of nanoplastics colliding with neurodegenerative diseases.
期刊: The Journal of clinical investigation 发表日期: 2026-Feb-16 链接: PubMed
摘要
29. Incorporation of new employees with recognised disabilities in a spanish bank last year: A cross-sectional study.
期刊: Work (Reading, Mass.) 发表日期: 2026-Feb-16 链接: PubMed
摘要
BackgroundSpanish companies with ≥50 employees must have ≥2% of their workforce with a recognised disability.ObjectivesThe aim of this study was to describe new employees with a recognised disability and compare them to official data and the rest of the workforce.MethodsA transversal study was carried out. 149 new employees with recognised disabilities joined a Spanish bank last year, out of 33,190 employees in Spain. Statistical analysis considered variables such as gender, age, workplace location, disability percentage, type of disability, and the need for workplace ergonomic adaptations. Data comparison of the collected data used Pearson’s Chi-square test and logistic regression.Results79% shown mild disabilities, 71% were physical disabilities and 21% were sensory disabilities. 88% didn’t require ergonomic workplace adaptations. Significant differences were found compared to the state’s working-age disability statistics: females, under 35 years, locations outside Madrid, physical disabilities, and mild disabilities (p < 0.001). Differences compared to the total workforce included females and those under 44 years (p < 0.001), and locations outside Madrid (p < 0.01).ConclusionsOnly 12% of new employees with recognised disabilities needed workplace adaptations. The process to integrate workers with disabilities is complex but it is doable. Jobs with few physical requirements are favourable for employees with recognized disabilities. It is easier in young employees, women, workers from outside Madrid, with mild disabilities and physical disabilities.
30. Development of a new index for occupational health inspections using the multi-criteria decision-making methods AHP and TOPSIS.
期刊: Work (Reading, Mass.) 发表日期: 2026-Feb-16 链接: PubMed
摘要
BackgroundOccupational health inspections are an important component of health and safety management systems.ObjectiveThe aim of this study was to develop a new index for occupational health inspections.MethodsA total of 40 ooccupational health inspectors took part in this study as a team of experts. Effective criteria and their sub-criteria in occupational health inspections were identified using the Delphi method and their weighting was determined by pairwise comparison using the AHP method to create a new inspection index. Finally, the inspections carried out by the inspectors were evaluated using the inspection index developed using the TOPSIS method.ResultsFor the first time, an occupational health inspection index with 10 criteria and 58 sub-criteria was developed in Iran. The type of work, the follow-up of inspections and their risk level were the most effective criteria for the inspection index with the weight of 0.119638, 0.115365 and 0.102246, respectively.ConclusionsIn this study, a new index for evaluating the occupational health inspections was developed, which can contribute to the development of an appropriate framework in the occupational health inspection process. Further research is needed to examine the applicability of this index.
31. Musculoskeletal health and occupational hazards in Northeast Indian farmers: A cross-sectional analysis.
期刊: Work (Reading, Mass.) 发表日期: 2026-Feb-16 链接: PubMed
摘要
BackgroundAgriculture serves as the primary livelihood in rural Northeast India where the challenging hilly terrain necessitates manual effort and labor-intensive farming practices which results in fatigue and musculoskeletal problems among the farmers.ObjectiveThis study aimed to assess the musculoskeletal disorders and their associated risk factors in labor-intensive farm activities in northeast India.MethodsA cross-sectional study was conducted involving 120 adult farmers (53 females and 67 males) aged 18 and above in Meghalaya and Manipur of northeast India. Demographic data were gathered through a structured schedule interviews and direct observation during 2021-22. The study employed the Standardised Nordic Questionnaire to measure musculoskeletal disorders and the Rapid Entire Body Assessment tool to evaluate posture and exertion in a subset of farmers (18 males, 12 females).ResultsResults indicated that 74% of workers in northeast India experienced musculoskeletal disorders, with the lower back (72.50%) being the most affected body part followed by neck (43.33%) and shoulder (40.83%). Chi-square (χ2) analysis revealed significant associations (p < 0.05) between the occurrence of overall musculoskeletal disorders and factors (education, age, and work experience). Further, multivariate logistic regression indicated that higher education level decreased the likelihood of overall musculoskeletal disorders and lower back issue. Remarkably, 35% of farmers were classified as high-risk (scoring 8-10) and 70% were classified as very high-risk (score ≥11).ConclusionsThe findings emphasize the need for ergonomic interventions and the introduction of mechanized tools to reduce -physical strain, thereby improving health outcomes and productivity among farmers in Northeast India.
32. Metal concentrations and bioaccessibility in urban community gardens with implications for human exposure.
期刊: Environmental geochemistry and health 发表日期: 2026-Feb-16 链接: PubMed
摘要
Urban agriculture is growing in popularity, but toxic metals and metalloids in garden soil raise concerns about human health risks associated with gardening. Gardeners might be exposed to toxic elements because they directly handle the garden soil and grow edible produce in it. This study examined community gardens in the City of St. Louis, Missouri, US and surrounding municipalities, areas with a history of soil contamination by metals, particularly Pb. To improve the current understanding of soil contamination patterns in garden soil and implications for exposure to metals/metalloids, the study (1) measured total metal/metalloid concentrations (Pb, As, Cd, Cu, Co, Ni, Mo, Ca, Mg, Fe, and Zn) in soil from twenty gardens, (2) tested in-vitro Pb bioaccessibility in soil samples, and (3) administered surveys to gardeners. Overall, our measurements suggest that Pb is a metal of concern in St. Louis community gardens. While soil in 21% of sampled plots contained Pb concentrations above recommended thresholds for gardens, Pb bioaccessibility was low (< 5.4% of the total soil concentration), suggesting that the Pb bioavailability in the case of accidental ingestion of soil particles was limited. Total metal/metalloid concentrations in soil varied spatially across plots within gardens, highlighting the importance of sampling multiple plots. Pb and As concentrations were positively correlated with garden age. Survey results revealed the common gardening habits, the type of produce grown in urban gardens, and exposure parameters. These findings contribute to improving the design of soil sampling, providing insights for exposure assessment, and informing contamination mitigation measures.
33. Investigating the association of menstrual symptoms and work productivity with the mediating role of emotional well-being.
期刊: African journal of reproductive health 发表日期: 2026-Feb-16 链接: PubMed
摘要
Menstrual symptoms can have profound effects on the emotional health and professional lives of women. This study aims to explore the impact of menstrual symptoms on emotional engagement, self-regulation, negative affectivity, and cognitive functioning and to acknowledge the mediating role of emotional well-being on work productivity. A cross-sectional survey was conducted among 384 working, menstruating women using validated psychological and occupational health scales. Principal Component Analysis (PCA) and Structural Equation Modelling (SEM) were applied to test the hypothesized pathways. The findings revealed that emotional engagement, self-regulation and cognitive functioning were reduced by menstrual symptoms while negative affectivity increased. Emotional well-being significantly mediated the relationship between menstrual symptoms and work productivity (β = 0.79, p < 0.001). More than half of the participants (52.9%) reported their performance was interrupted by menstrual symptoms. These results emphasize the need for workplace interventions that address both the physical and emotional challenges of menstruation. Policies such as flexible leave, counselling services, and stronger peer support systems can enhance productivity and overall employee well-being. Les symptômes menstruels ont un impact marqué sur la santé émotionnelle et la productivité professionnelle des femmes. Cette étude vise à examiner l’effet des symptômes menstruels sur l’engagement émotionnel, l’autorégulation, l’affectivité négative et le fonctionnement cognitif, ainsi que le rôle médiateur du bien-être émotionnel dans la productivité au travail. Une enquête transversale a été menée auprès de 384 femmes actives en utilisant des échelles psychologiques et professionnelles validées. L’analyse en composantes principales et la modélisation par équations structurelles ont été appliquées. Les résultats montrent que les symptômes menstruels réduisent l’engagement émotionnel, l’autorégulation et le fonctionnement cognitif, tout en augmentant l’affectivité négative. Le bien-être émotionnel joue un rôle médiateur significatif dans la relation entre les symptômes menstruels et la productivité (β = 0.79, p < 0.001). Plus de la moitié des participantes (52,9 %) ont signalé une baisse de leur performance due aux symptômes menstruels. Ces résultats renforcent la nécessité de politiques de soutien au travail, incluant des congés menstruels flexibles, des services de conseil et un meilleur soutien social afin d’améliorer le bien-être émotionnel et la productivité des femmes..
34. A comparison of scatter correction software and physical grid in supine chest radiography using a mobile X-ray system across different phantom sizes.
期刊: Radiography (London, England : 1995) 发表日期: 2026-Feb-15 链接: PubMed
摘要
Scatter radiation in mobile chest radiography reduces image contrast and diagnostic confidence. Although physical grids improve image quality, they increase radiation dose and require precise alignment. Software-based scatter correction offers a potential alternative, but its performance across varying body habitus remains uncertain. An experimental study was conducted using an anthropomorphic chest phantom at three thicknesses (23, 28, and 33 cm) to simulate patients of varying sizes, including medium, large, and extra-large. Radiographs were obtained with a physical grid and scatter-correction software using matched exposure indices. Radiation dose was evaluated via dose-area product (DAP), entrance surface air kerma (ESAK), and exposure index (EI). Quantitative image analysis included noise, signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR). Qualitative image quality was assessed by three radiologic technologists using a 5-point Likert scale for visual grading. Compared with the physical grid, the scatter-correction software reduced DAP and ESAK by 51-61 % while maintaining comparable EI values. Noise and SNR were similar or improved for medium and large phantoms, but CNR decreased significantly with increasing thickness. Visual grading scores confirmed acceptable diagnostic quality at 23 cm and 28 cm, but not at 33 cm, where physical grids remained superior. Scatter-correction software substantially reduces the radiation dose and provides diagnostically acceptable image quality for patients with medium to large body habitus. However, in larger patients, conventional grids continue to offer superior contrast and diagnostic reliability. The implementation of scatter-correction software offers significant potential for radiation dose optimisation in mobile chest radiography, specifically among patients presenting with medium to large body habitus.
35. Emotion regulation variability and chronic pain: An ecological momentary assessment study.
期刊: Behaviour research and therapy 发表日期: 2026-Feb-12 链接: PubMed
摘要
Chronic pain is a significant public health problem associated with increased healthcare utilization and decreased quality of life. Mechanistic research focused on identifying vulnerabilities for the experience and impact of chronic pain is of critical importance to understanding and managing this public health burden. Emotion regulation, a cognitive-affective process involving attempts to influence the type, timing, and intensity of emotions has been linked to pain experience across multiple studies. Yet, conceptualizations have often focused on “adaptive” vs. “maladaptive” regulatory strategies. Variability in the type, number, and frequency of emotion regulation strategies across situations and over time has been associated with positive adjustment, is a critical component of emotion regulation flexibility, and may more comprehensively capture the way emotion regulation operates in the context of chronic pain. Therefore, the current study of 48 (77.1% female; Mage = 29.92 years, SD = 5.20 years) college students with self-reported chronic pain examined the impact of pain intensity, interference, and negative affect on emotion regulation variability. Participants completed 5 surveys a day for 7 days. Mixed-effects location scale models found that higher average levels of pain intensity, interference, and negative affect were associated with a greater number of strategies used to regulate pain experience, but in an invariable manner over time. Similarly, momentary increases in pain were associated with decreased intraindividual variation in emotion regulation strategy use. Overall, the results provide empirical evidence for the importance of emotion regulation variability in understanding both the variability and underlying mechanisms of evidence-based behavioral treatments for pain, informing broader models of flexibility in pain.
36. Evaluation of Repellent Activity of an Artemisia absinthium L.-Based Topical Formulation Against Anopheles stephensi and Aedes aegypti.
期刊: Alternative therapies in health and medicine 发表日期: 2026-Feb-12 链接: PubMed
摘要
Vector-borne diseases, such as Malaria and Dengue, transmitted by mosquitoes like Anopheles stephensi and Aedes aegypti, are major public health concerns. Although synthetic repellents, particularly DEET (N, N-diethyl-m-toluamide), are commonly used to prevent mosquito bites. However, growing concerns regarding their safety and environmental impact have increased the interest in natural alternatives. This study investigates the mosquito-repellent activity of a cream formulated with essential oil and methanolic extract of Artemisia absinthium L. The repellent activity of the cream was evaluated using an Artificial Membrane Feeding System simulating human skin. Non-blood-fed female mosquitoes (5-7 days old) from Anopheles and Aedes species, starved for 12 hours, were used. The cream was applied at various concentrations on the membrane, and its efficacy was assessed and compared with DEET. The complete protection time was analysed using the Kaplan-Meier method. The test cream showed a dose-dependent repellent activity against both Anopheles stephensi and Aedes aegypti. At a concentration of 12 mg/cm², the cream provided 100% protection for 105 minutes against both species. Whereas DEET, at the same concentration, provided complete protection for 105 minutes against Aedes aegypti and 97.5% protection for 105 minutes against Anopheles stephensi. The Artemisia absinthium-based cream effectively repels both Anopheles stephensi and Aedes aegypti mosquitoes, indicating its potential as a natural alternative to synthetic repellents. However, further studies are needed to evaluate its efficacy and safety on human skin under natural conditions. Anopheles stephensi, Aedes aegypti, Unani Medicine, Mosquito repellent, Artemisia absinthium.
37. The Concept of Preventive and Social Medicine in Unani Perspective: Relevance to Modern Healthcare.
期刊: Alternative therapies in health and medicine 发表日期: 2026-Feb-12 链接: PubMed
摘要
The Unani system of medicine, rooted in Greco-Arabic traditions, emphasizes prevention, holistic care, and community well-being. While its contributions to individualized healthcare and public hygiene are well-documented historically, attention to its contemporary applicability in addressing global health challenges has remained limited. To explore the principles of preventive and social medicine (PSM) in the Unani framework, highlight their historical foundation, and assess their relevance in modern healthcare, particularly in relation to lifestyle disorders, mental health, and pandemics. A narrative review was conducted by analyzing classical Unani texts, historical contributions, and contemporary research. Emphasis was placed on Asbāb Sitta Darūriyya (six essential factors), Mizāj (temperament), and collective health practices described in Unani literature. Preventive measures in Unani medicine include dietary moderation, exercise-rest balance, Harakat-o-Sukūn Nafsānī (stress regulation), hygiene, and sanitation. Classical physicians such as Ibn Sina advocated quarantine during epidemics, while Galen emphasized sanitation and environmental health. These principles align with modern public health strategies. Recent AYUSH guidelines during the COVID-19 pandemic illustrate the potential of integrating Unani regimens and immunity-boosting interventions into mainstream healthcare. Unani medicine offers a timeless perspective on PSM. Its holistic emphasis on individual well-being, community health, and environmental balance makes it highly relevant to current global healthcare challenges. Future directions include empirical validation of Unani interventions, standardization of practices, and integration into national and global health frameworks. Unani Medicine, Preventive Health Services, Public Health, Lifestyle Diseases, Mental Health, Pandemics.
38. Health literacy in patients with colorectal liver metastases: A cross-sectional study.
期刊: European journal of oncology nursing : the official journal of European Oncology Nursing Society 发表日期: 2026-Feb-11 链接: PubMed
摘要
Health literacy influences surgical outcomes by affecting patients’ ability to understand information, manage their health and navigate the healthcare system. Yet, little is known about health literacy in patients with colorectal liver metastases. This study assessed health literacy across different domains and explored associations with sociodemographic and clinical factors aiming to identify knowledge gaps within this population. Cross-sectional. A total of 122 patients with colorectal liver metastases were recruited between December 2021 and December 2024. Health literacy was assessed using the Health Literacy Questionnaire. Descriptive statistics were used to characterize the sample and to present the overall health literacy profiles. Associations between health literacy and selected sociodemographic and clinical variables were examined using, both univariate and multivariate linear regression analyses. Participants reported the greatest challenges in the Health Literacy Questionnaire domains “ability to find good health information” (mean score 3.98 ± 0.56, range 1-5) and “appraisal of health information” (mean score 2.63 ± 0.55, range 1-4). Lower health literacy scores were significantly associated with male gender, lower educational attainment, living alone, and the presence of comorbidity. This study provides novel insights into the health literacy of patients with colorectal liver metastases and highlights the importance of identifying and addressing health literacy challenges in clinical care. Tailored communication and support may enhance treatment outcomes, particularly to vulnerable patient groups. Further research is needed to explore how health literacy impacts decision-making and treatment adherence in complex cancer care.
39. Considerations for the analysis of urinary environmental chemical concentrations during pregnancy.
期刊: Epidemiology (Cambridge, Mass.) 发表日期: 2026-Feb-06 链接: PubMed
摘要
Pregnancy physiology may impact indicators of hydration, affecting exposure assessment in gestational studies with urinary chemical biomarkers. We aimed to characterize hydration and demonstrate the impact of different methods for standardizing urinary chemical biomarker concentrations on exposure descriptives in the Human Placenta and Phthalates Study (n=303, 2017-2020), a prospective pregnancy cohort with eight study visits between 12 and 38 weeks of gestation. We assessed trajectories and predictors of hydration using urine flow rate (UFR) and specific gravity (SG). Likewise, we examined trajectories and predictors of mono-n-butyl phthalate (MBP), for which concentrations were unstandardized or standardized via UFR (analyte excretion rates), SG alone (Boeniger method), or covariate-adjusted SG (O’Brien method). We used generalized additive mixed effects models to examine trajectories. We used linear mixed effects models to investigate participant demographic and pregnancy characteristics influencing UFR and SG, and agreement between unstandardized and standardized MBP concentrations. As pregnancy progressed, specific gravity declined linearly whereas UFR varied in a nonlinear manner. Several demographic and pregnancy characteristics, notably race and ethnicity, were associated with UFR and SG. Unstandardized and standardized MBP concentrations showed good agreement, with lower agreement observed between concentrations standardized using UFR (analyte excretion rates) relative to SG (Boeniger and O’Brien methods). Nevertheless, trajectories and predictors of MBP concentrations were similar across all standardization approaches. Despite systematic variations in hydration across gestation and by demographic and pregnancy characteristics, methods commonly used for standardizing urinary concentrations of chemical biomarkers were robust to differences in the hydration indicator as well as standardization method employed.
40. Incorporating Economic Evidence in Clinical Guidelines.
期刊: Annals of internal medicine 发表日期: 2026-Feb 链接: PubMed
摘要
41. Ethical Approaches to Limiting Overall Costs for Glucagon-Like Peptide-1 Receptor Agonists for Weight Management.
期刊: Annals of internal medicine 发表日期: 2026-Feb 链接: PubMed
摘要
42. Socioeconomic Disparities in Geographic Access to Physical and Occupational Therapy Services in the United States: A Correlation With Area Deprivation and Social Vulnerability Indices.
期刊: Journal of the American Academy of Orthopaedic Surgeons. Global research & reviews 发表日期: 2026-Feb-01 链接: PubMed
摘要
Physical and occupational therapy (PT/OT) services are critical for optimizing outcomes and reducing complications after orthopaedic surgery. Lower socioeconomic status (SES) is associated with reduced access to health care and increased rates of surgical complications. The purpose of our study was to establish the relationship between SES and access to PT/OT. We compiled county-level population, land area, and business data from 2020 US Census Bureau Reports. SES data were collected from the 2020 Centers for Disease Control Social Vulnerability Index (SVI) and Area Deprivation Index (ADI). PT/OT businesses were identified using the North American Industry Classification System code 621340. Density of business by county population and land area were calculated, and regression analyses were conducted to determine a correlation between SES and these measures. Counties with greater density of PT/OT tended to be on the East Coast, whereas those with lower density were located in the Western US. A strong inverse relationship was observed between county-level ADI and PT/OT density (R2 = 0.97 and 0.94). Overall SVI displayed a variable relationship with PT/OT density. The household characteristics and SES domains of the SVI demonstrated an inverse relationship with PT/OT density (R2 = 0.68, 0.49 and R2 = 0.59, 0.28, respectively). Race and ethnicity displayed an inverse parabolic relationship with PT/OT density based on population alone (R2 = 0.83 and 0.57). However, there was a mild positive correlation between race and ethnicity when considering population and land area (R2 = 0.39 and 0.22). PT/OT services are important for postoperative care; however, notable barriers to access exist. There exists an inverse correlation between the density of PT/OT services and SES measures, particularly ADI. This may affect postoperative recovery and complication rates in orthopaedic patients.
43. Ergonomic assessment of robotic surgical platforms for urological surgery: a study endorsed by the Robotic Urological Section of the European Association of Urology.
期刊: Minerva urology and nephrology 发表日期: 2026-Feb 链接: PubMed
摘要
Work-related musculoskeletal disorders are a growing concern in surgical practice, particularly in the context of robot-assisted surgery. Physical strain can significantly impact the well-being and performance of surgeons and surgical staff. This study aimed to evaluate the prevalence and severity of surgical strain among urologists using different available surgical platforms. An anonymized, web-based survey was conducted between March and October 2024 using the REDCap platform. Distributed via professional networks and social media, the survey collected data on demographics, surgical experience, platform usage, and self-reported physical discomfort. Statistical analysis included Mann-Whitney U and Chi-squared tests, with P<0.05 considered significant. A total of 427 urologists participated. Most console surgeons (up to 83% for one robotic system variant) reported some level of physical discomfort. Discomfort was also reported by 83% of open surgeons and 80% of bedside assistants, the latter of whom had the highest incidence of injury (53%) from robotic arms. A noteworthy subset of survey respondents required physiotherapy (13-15%), medical (6-11%), or surgical (2-3.8%) interventions due to physical strain. No significant differences were observed by age or sex among console users. Ergonomic strain is prevalent among urologic surgeons, regardless of surgical platform, with bedside assistants particularly vulnerable. These findings underscore the need for ergonomic training, physical conditioning, and design improvements in surgical systems to safeguard surgeon health and maintain procedural efficacy.
44. Survey of tick control practices on public lands across 4 states reporting high incidence of Lyme disease.
期刊: Journal of medical entomology 发表日期: 2026-Jan-20 链接: PubMed
摘要
Ticks and tick-borne diseases pose a significant public health threat in the United States, particularly in the Northeast and Upper Midwest. Tick control operations are predominately focused on private residential properties. Surveys of publicly funded vector control programs have indicated that high use public lands may be viable targets for future tick control activities if funding is available. However, little is known about the feasibility of implementing tick control activities on these properties. We administered a survey to understand current tick control and tick bite prevention educational practices and potential barriers to future tick control on public lands. The survey was distributed to public land managers in Minnesota, New York, Pennsylvania, and Wisconsin and we received 129 responses. The responses indicated that tick control was undertaken on only 10% of the public lands that respondents managed. Landscape management was the most common intervention. Some (40%) of the public land managers indicated interest in using tick control methods in the future, again with landscape management being the preferred intervention. Respondents indicated that there may be significant barriers for the use of acaricides and host-targeted interventions. Currently, tick bite prevention education appears to be the primary protective measure utilized on public land, with 63% of responding land managers offering education to staff or visitors. Our survey indicates that high use public lands may present potential targets for limited tick control operations, but the potential barriers must be addressed and additional evaluation of these interventions on high use public land is required.
45. Glucose control among women with gestational diabetes and early offspring's growth.
期刊: Salud publica de Mexico 发表日期: 2026-Jan-14 链接: PubMed
摘要
To assess the association between glucose control during pregnancy and infant’s growth. Prospective study of 130 women with gestational diabetes mellitus (GDM) followed up to three months after birth. Infant’s growth was assessed as weight-for-age (WfA), weight-for-length (WfL), and length-for-age (LfA) z-scores. The association of adequate vs. inadequate glucose control with infant’s growth was evaluated using linear mixed models. Overall, glucose control during pregnancy was not associated with WfA (aβ= 0.089; 95%CI: -0.248,0.426), WfL (aβ= 0.006; 95%CI: -0.280,0.291), and LfA (aβ= 0.136; 95%CI: -0.157,0.429). We observed heterogeneity of effects by gestational age; infants with adequate control compared to inadequate had reduced WfA if they were born at ≥39 weeks. Glucose control of women with GDM might have little impact on their early offspring’s growth; however, gestational age might be relevant in terms of heterogeneity of effects. Future studies to confirm the latter findings are required.
46. A multi-dimensional index of rurality in Chile and its association with infant and neonatal mortality.
期刊: Salud publica de Mexico 发表日期: 2026-Jan-14 链接: PubMed
摘要
To construct a multi-dimensional Index of Relative Rurality (IRR) for Chile and assess its association with infant and neonatal mortality. A cross-sectional analysis was conducted using data from 343 municipalities. The IRR was calculated using four standardized components-population size, population density, urban population proportion, and travel time to service-rich areas-to reflect the complexity of rurality in Chile. Associations between the IRR and mortality outcomes were evaluated using negative binomial regression and generalized additive models. A rurality threshold was identified at approximately IRR= 0.404, beyond which the risk of infant and neonatal mortality increased notably. Municipalities with IRR values >0.50 showed elevated risks of infant mortality (RR: 1.18; 95%CI: 1.01,1.38) and neonatal mortality (RR: 1.27; 95%CI: 1.06,1.50), compared to more urban areas. While the official classification defined nearly half of municipalities as rural, the IRR captured a smaller, more specific subset of municipalities with higher mortality risk-particularly in southern macrozones. The IRR offers a more precise and data-driven approach to characterizing rurality and identifying health disparities. Its continuous design improves the detection of high-risk populations and challenges the overgeneralization of current classifications. These findings support the use of the IRR to inform targeted public health interventions and equitable policy planning.
47. [Not Available].
期刊: Salud publica de Mexico 发表日期: 2026-Jan-14 链接: PubMed
摘要
48. Epidemiological Assessment of Blood and Blood-Borne Pathogen Exposure Among Neurosurgical Health Care Workers in a Chinese Tertiary Hospital (2008-2024).
期刊: Shock (Augusta, Ga.) 发表日期: 2025-Dec-23 链接: PubMed
摘要
This study aimed to examine the prevalence of occupational exposure to blood-borne pathogens (BBPs) and assess the associated psychological impact among health care workers (HCWs) in a neurosurgery department. (1) A retrospective cross-sectional survey was conducted to assess BBP exposure trends among neurosurgical HCWs from 2008 to 2024. (2) A questionnaire-based survey was administered to HCWs with documented BBP exposure between 2022 and 2024 to assess occupational protection practices and psychological responses. (1) The cross-sectional survey identified needlestick injuries (NSIs) to the hand were the most frequent type of exposure, primarily occurring in operating rooms and among physicians with 2 to 10 years of work experience. Emergency treatment was universally administered following exposure, however, follow-up examination rates varied widely (0.00%-76.92%). Compared to the control group, HCWs with multiple BBP exposures were more likely to be formally employed, vaccinated against hepatitis B, over 24 years old, and involved in a broader range of exposure-related procedures (p < 0.05). Formal employment status emerged as an independent risk factor for repeated exposures. (2) The questionnaire survey indicated low utilization of personal protective equipment (6.25%-18.75%) and limited participation in occupational safety training (37.50%), with pre-employment training being the most common (43.75%). Risk perception varied by gender and occupation, with males demonstrating lower risk perception and nurses exhibiting the highest awareness (p < 0.05). Most respondents (68.75%) considered departmental protective equipment adequate for routine clinical operations. Following exposure, 96.88% of HCWs reported psychological distress, with moderate to severe anxiety particularly prevalent among associate chief physicians and other HCWs exposed to syphilis-positive sources. Targeted interventions are warranted to mitigate occupational BBP exposure, including enhanced safety training, emergency response drills, and departmental inspections. Ensuring access to adequate protective equipment and reinforcing procedural compliance are essential. Psychological support services and post-exposure follow-up should be prioritized for at-risk subgroups, particularly HCWs with higher professional ranks and those exposed to high-risk pathogens, to safeguard both physical and mental health.
49. [Not Available].
期刊: Salud publica de Mexico 发表日期: 2025-Nov-22 链接: PubMed
摘要
bjetivo. Estimar la prevalencia de uso de drogas ilícitas y medicamentos psicotrópicos sin indicación médica en población mexicana en 2023. Material y métodos. Se utilizó la Encuesta Nacional de Salud y Nutrición Continua 2023. Se construyeron indicadores de uso alguna vez en la vida y en el último año. Se estimó la prevalencia con intervalos de confianza al 95%. Se estratificó por grupo de edad, sexo y tamaño de la localidad. Resultados. La prevalencia de uso de drogas ilícitas alguna vez en la vida fue 14.1%. La droga ilícita más usada fue mariguana. La prevalencia de uso de medicamentos psicotrópicos sin indicación médica fue de 1.5%. Las prevalencias fueron más altas en hombres y en localidades urbanas. Conclusiones. Una de cada siete personas usó una droga ilícita alguna vez en su vida. El uso en el último año se ha mantenido constante. Los hallazgos sugieren un aumento del uso experimental, particularmente entre adolescentes, jóvenes y mujeres.
50. [Not Available].
期刊: Salud publica de Mexico 发表日期: 2025-Nov-22 链接: PubMed
摘要
Obtener un perfil actualizado del estado de salud y nutrición (nacional y regional) de las personas mayores de México. Material y métodos. Estudio descriptivo con una muestra de 4 719 personas mayores de 60 años o más de la Encuesta Nacional de Salud y Nutrición Continua 2023-2024. Se analizaron indicadores relacionados con las condiciones de salud, síndromes geriátricos y estado nutricional. El 14.8% de las personas mayores de México presentó fragilidad, 34.5% síntomas depresivos, 39.7% multimorbilidad, 12.1% anemia y 88.2% obesidad abdominal. En general, el grupo de mayor edad, las mujeres, los residentes de áreas rurales y la región sur del país exhibieron las peores condiciones para estado de salud, síndromes geriátricos y estado nutricional. Las condiciones de salud y nutrición de las personas mayores de México exhiben un alto grado de heterogeneidad, lo que implica la necesidad de diseñar políticas públicas en salud especialmente dirigidas a los grupos más vulnerables.
51. [Not Available].
期刊: Salud publica de Mexico 发表日期: 2025-Nov-22 链接: PubMed
摘要
Examinar la prevalencia y tendencia de la actividad física, comportamiento sedentario y sueño en adolescentes mexicanos, así como su asociación con factores sociodemográficos. Material y métodos. Estudio transversal con datos de adolescentes de 15-19 años de la Encuesta Nacional de Salud y Nutrición (Ensanut) 2012 a 2022-2024. Se usaron modelos lineales generalizados para comparar minutos diarios, prevalencias por encuesta y regresión logística con el fin de analizar asociaciones con factores sociodemográficos. Las mujeres, los menores de 18 años y quienes no trabajan, así como aquellos con mayor bienestar y que viven en zonas urbanas, reportaron menos minutos por día de actividad física moderada a vigorosa. El tiempo sentado por día aumentó de 2012 a 2022-2024 en casi todos los grupos. El incumplimiento de las recomendaciones aumentó en los tres comportamientos en el mismo periodo. Las mujeres, los adolescentes menores de 17 años, quienes no trabajan, con alto índice de bienestar y escolaridad, que viven en zonas urbanas y en el norte del país tuvieron mayor posibilidad de no cumplir con una o tres de las recomendaciones. Existen desigualdades en el cumplimiento de los tres comportamientos (actividad física, sedentarismo y sueño) en los adolescentes mexicanos, especialmente en mujeres, residentes en áreas urbanas, con mayor escolaridad y mayor nivel de bienestar, así como en residentes del norte del país.
52. [Not Available].
期刊: Salud publica de Mexico 发表日期: 2025-Nov-22 链接: PubMed
摘要
Estimar la prevalencia de consumo actual y excesivo de alcohol a nivel estatal en población mexicana de 10 años o más. Material y métodos. Se utilizaron datos de la Encuesta Nacional de Salud y Nutrición Continua de 2020 a 2024 para estimar prevalencias de consumo actual y excesivo de alcohol por entidad federativa, en total, por sexo y grupos de edad. La prevalencia nacional de consumo actual y excesivo de alcohol fue de 48.2 y 34.9%, respectivamente. La prevalencia de consumo de alcohol fue heterogénea entre entidades federativas, encontrando las más altas en Aguascalientes (62.9 y 44.7% de consumo actual y excesivo, respectivamente) y las más bajas en Chiapas (34.9 y 24.4%, respectivamente). Existe heterogeneidad por sexo y grupos de edad. Conclusión. Los hallazgos indican la necesidad de fortalecer acciones a nivel federal, estatal y municipal para la prevención, control y reducción del consumo de alcohol en México. Palabras clave: consumo de bebidas alcohólicas; consumo excesivo de bebidas alcohólicas; encuestas epidemiológicas; resultados estatales.
53. [Not Available].
期刊: Salud publica de Mexico 发表日期: 2025-Nov-22 链接: PubMed
摘要
Actualizar el estado de anemia y de deficiencias de micronutrimentos (DefMicro) en niñas y niños mexicanos participantes en la Encuesta Nacional de Salud y Nutrición Continua 2022-2024 (Ensanut Continua 2022-2024). Material y métodos. La Ensanut Continua es probabilística y tiene representatividad nacional. Se recolectó sangre venosa en una submuestra de 3 230 niños/as de 1-11 años (48%). La hemoglobina (Hb) se analizó en sangre total usando Hemocue. Ferritina, vitamina B12, receptores de transferrina, folato y 25[OH]D; se midieron en suero. Se realizaron análisis descriptivos en niños/as preescolares y escolares utilizando el diseño de la encuesta. Se emplearon modelos de regresión logística para identificar las características asociadas con la anemia y DefMicro. La prevalencia de anemia, deficiencia de hierro, niveles bajos de vitamina B12 y deficiencia de vitamina D fueron 8.6, 26.8, 20.2 y 9.6% en niños de 1 a 4 años; y 4, 19.5, 20.5 y 22.7% en niños de 5 a 11 años, respectivamente. Habitar en la región Sur y en áreas rurales se asoció comúnmente con mayores momios de anemia y/o DefMicro. Conclusión. Urgen intervenciones focalizadas en la suplementación de micronutrimentos que prioricen a la población infantil, de localidades indígenas y de menores condiciones de bienestar. Estos hallazgos aportan evidencia crítica y actualizada para orientar las políticas de nutrición y salud pública en México.
54. [Not Available].
期刊: Salud publica de Mexico 发表日期: 2025-Nov-22 链接: PubMed
摘要
Analizar la asociación entre sintomatología depresiva y consumo de nicotina, cannabis y alcohol en personas adultas mexicanas. Material y métodos. Se analizaron datos de la Encuesta Nacional de Salud y Nutrición 2023-2024 en personas de 20 años o más para evaluar la asociación entre el consumo de nicotina (n= 19 679; consumo no frecuente y frecuente), cannabis (n= 16 759; sí o no) y consumo excesivo de alcohol (n= 19 679; no consumo, consumo no frecuente y frecuente) con sintomatología depresiva (CESD-7; dicotomizada ≥9 o ≥5 puntos según edad). Se estimaron por separado tres modelos de regresión logística estratificados por sexo, ajustados por variables sociodemográficas y el diseño complejo de la encuesta. La sintomatología depresiva fue mayor en mujeres (20.4%) que en hombres (10.9%). En modelos ajustados, el consumo frecuente de nicotina se asoció con sintomatología depresiva en ambos sexos, hombres (RM aj = 1.73; IC95%: 1.17,2.56), mujeres (RM aj = 1.72; IC95%: 1.09,2.72) y el no frecuente sólo en mujeres (RM aj = 1.82; IC95%: 1.17,2.83). En mujeres, también se asoció el consumo de cannabis (RM aj = 2.39; IC95%: 1.01,5.64). El consumo excesivo de alcohol no mostró asociación. Otros factores asociados en ambos sexos fueron edad avanzada y nivel socioeconómico bajo/medio; además, en hombres, trabajo doméstico no remunerado y en mujeres, estar soltera. El consumo de sustancias está asociado con la presencia de sintomatología depresiva diferenciada por sexo.
55. [Not Available].
期刊: Salud publica de Mexico 发表日期: 2025-Nov-22 链接: PubMed
摘要
Describir la prevalencia de adultos con hipertensión arterial diagnosticada, tratada y controlada, a nivel nacional y por estados, además de estimar el número de personas que podrían desarrollar ECV por tener hipertensión. Material y métodos. Se analizó la información de 34 954 participantes en la Encuesta Nacional de Salud y Nutrición 2021-2024. Se estimaron prevalencias de hipertensión a nivel nacional y estatal. Utilizando la escala de riesgo Globorisk y de la OMS, se estimó el número de personas que podrían desarrollar ECV por tener hipertensión. A nivel nacional la prevalencia de hipertensión en adultos fue de 29.1%. El 62.9% de los adultos con hipertensión ya había sido diagnosticado y de los que recibía tratamiento farmacológico, 60.1% tenía presión arterial (PA) bajo control. La prevalencia más baja de hipertensión se observó en Colima (20.7%) y la más alta en Sonora (40.6%). Podrían evitarse en los próximos 10 años 1 119 060 eventos de ECV si se normalizara la PA en adultos. La hipertensión es un problema de salud pública en México y el desempeño del sistema de salud para controlar la PA de los adultos es más bajo en los estados del Norte. Se requieren estrategias poblacionales, prontas y concertadas para reducir la carga de la hipertensión en México.