公共卫生研究摘要 (2026-02-18)

2026年02月18日

公共卫生研究摘要 (2026-02-18)

共收录 60 篇研究文章

1. International Society of Sports Nutrition position stand: effects of dietary antioxidants on exercise and sports performance.

期刊: Journal of the International Society of Sports Nutrition 发表日期: 2026-Dec-31 链接: PubMed

摘要

Following a comprehensive review, the International Society of Sports Nutrition (ISSN) has developed an official position on the role of dietary antioxidants in exercise and sport. Antioxidants play a complex, context-dependent role in vivo; they can facilitate recovery from exercise but may also hinder training adaptations when consumed at supraphysiological doses. While endogenous antioxidant systems can effectively maintain redox balance, dietary sources, particularly whole foods, can help mitigate excessive oxidative stress following intense/heavy training or inadequate recovery. The influence of dietary antioxidants depend on timing, dosage, type, and individual factors. The ISSN’s official position encompasses the following: (1) Redox balance exists on a spectrum, with mild oxidative eustress driving beneficial physiological adaptations and excessive oxidative distress impairing health, recovery, and performance; (2) Moderate levels of exercise-induced reactive oxygen and nitrogen species (ROS/RNS) can support training adaptations but excessive levels can result in muscle damage, inflammation, and reduced physical performance and immune function; (3) Endogenous and exogenous antioxidants protect cells by neutralizing free radicals and reducing oxidative damage to biomolecules; (4) FDA labeling for “antioxidant” claims applies to nutrients with established RDIs and demonstrated antioxidant activity; this typically includes vitamins C and E, β-carotene (a source of vitamin A), selenium, zinc, copper, and manganese; (5) While dietary antioxidants show potential for both direct and indirect effects, the evidence varies, and their use should be tailored to individual performance or recovery goals; (6) Long-term exercise augments endogenous antioxidant defense and should be the primary strategy for enhancing redox capacity before considering supplementation; (7) Whole foods and beverages rich in flavonoids, polyphenols, carotenoids, vitamins, and minerals are preferred antioxidant sources; (8) Dietary supplementation is best reserved for nutrient insufficiencies or deficiencies, inadequate dietary intake, or periods of high training distress; (9) Responses to supplementation vary by individual factors, such as training status, baseline antioxidant capacity, demographics, diet, and injury risk, with some antioxidant compounds offering cognitive, behavioral, or physical-related benefits; and (10) Creatine monohydrate (i.e. 0.1 g/kg/day), omega-3 fatty acids (1000-6000 mg/day EPA+DHA for 6-12 weeks), tart cherry (480 mg powder or 60-90 mL juice/day for 7-14 days), and astaxanthin (4-12 mg/day for 4-12 weeks) rank among the top nutrients for their antioxidant effects, with moderate- to high-quality evidence supporting their use in recovery or performance without interfering with training adaptations. Most others show weak or low efficacy. This position promotes an individualized, evidence-based approach, recognizing that small to moderate exercise-induced oxidative stress aids adaptation, while excess oxidative stress causes harm; it also emphasizes food-forward and dietary supplementation strategies.

2. Accidental Botulism Caused by Consumption of Vacuum-Packaged Rabbit-Head Meat.

期刊: Foodborne pathogens and disease 发表日期: 2026-Mar 链接: PubMed

摘要

With the increase of sporadic cases of foodborne botulism and the occurrence of several large incidents of botulinum contamination in food, botulism has received greater attention in clinical practice. Foodborne botulinum toxin poisoning is an acute foodborne toxic disease caused by ingestion of food contaminated with Clostridium botulinum exotoxin. We present two cases of foodborne botulism affecting a mother and daughter who were admitted to our department after consumption of vacuum-packed rabbit-head meat. The time to symptom onset was less than 24 h in the daughter (aged 8 years) and 1 week for the mother (aged 45 years). The main clinical manifestations included fatigue, dizziness, diplopia, blurred vision, ptosis, dysphagia, and slurred speech. Blood samples tested positive for botulinum toxin type A. The daughter developed pneumonia and respiratory failure and required mechanical ventilation. Treatment measures included the use of botulinum antitoxin, fluid replacement, anti-infection, and nutritional nerve therapy. Two patients eventually recovered. When botulinum toxin poisoning is diagnosed, early administration of the appropriate antitoxin is paramount. When necessary, life support for severe cases can improve the success rate. Considering that these cases of botulism were caused by the consumption of vacuum-packed rabbit-head meat, we recommend enhancing public awareness of food safety.

3. The mortality and economic benefits of achieving air pollution standards in India.

期刊: Proceedings of the National Academy of Sciences of the United States of America 发表日期: 2026-Feb-24 链接: PubMed

摘要

The presence of high levels of PM2.5 pollution is a major health threat in India. We evaluate the benefits of reducing ambient PM2.5 and household air pollution from a 2019 baseline, when over 70% of the population of India was exposed to annual average PM2.5 of more than 40 μg/m3 and 56% of households burned solid fuels for cooking. We estimate the health benefits from reduced mortality that arise when lowering ambient PM2.5 to the India standard (40 μg/m3) and to two World Health Organization (WHO) interim standards (25 μg/m3 and 15 μg/m3). The benefits of the ambient standards are moderated by the high levels of household air pollution to which people are exposed due to the concavity of the exposure-response function. We therefore examine the benefits of achieving each standard paired with a 50% reduction in the percentage of households burning solid fuels. Annual mortality reductions from the combined policies exceed 300,000 lives saved for the India standard, 500,000 lives saved for the WHO 25 μg/m3 interim standard, and 675,000 lives saved for the WHO 15 μg/m3 interim standard. The economic benefits of each of these joint policies equal 2.2%, 3.6%, and 4.9% of Indian gross domestic product (GDP), using a Value per Statistical Life of 100 times per capita GDP. Results underscore the importance of considering household air pollution when evaluating ambient standards and the synergistic benefits of combined policies when the exposure-response function is concave.

4. Foliar dewdroplet-induced redox cascades promote early flowering in Brassicaceae plants.

期刊: Proceedings of the National Academy of Sciences of the United States of America 发表日期: 2026-Feb-24 链接: PubMed

摘要

Atmospheric water inputs such as dew are often overlooked in plant biology. We show that foliar dewdrops act as biochemical microreactors that trigger flowering in Arabidopsis thaliana, a small plant from the mustard family (Brassicaceae). These droplets generate reactive oxygen species that induce intracellular nitric oxide accumulation, initiating a redox cascade that suppresses the biosynthesis of abscisic acid, which contributes to the regulation of flowering time. This occurs via S-nitrosylation-mediated activation of histone deacetylase 19, which silences AAO3 and ABA2. Analysis of over 12 million field records across the Brassicaceae family reveals a global correlation between dew point temperature and flowering time. These findings identify dewdrop chemistry as an unrecognized environmental cue that regulates developmental timing in plants.

5. Stability of epigenetic transgenerational inheritance of adult-onset disease and parturition abnormalities.

期刊: Proceedings of the National Academy of Sciences of the United States of America 发表日期: 2026-Feb-24 链接: PubMed

摘要

Previous research on the generational stability of epigenetic transgenerational inheritance was conducted through a ten-generation study of all transgenerational generations in mammals. This study demonstrated both the stability of epigenetic inheritance across generations and demonstrated a generational increase incidence of disease pathology. Building on this research, the present study follows the same lineage of rats with ancestral vinclozolin exposure through twenty generations. The findings offer important insights into long-term mammalian models of epigenetic transgenerational inheritance. Observations demonstrate an increase in differential DNA methylated regions across multiple generations. This indicates a persistent and stable transmission of epigenetic alterations. Additionally, deoxyuridine triphosphate (dUTP) transferase-mediated nick end labeling apoptosis assays revealed elevated levels of germline apoptosis in the male rats of the maternal and paternal lineages. This suggests a potential consequence of epigenetic dysregulation in spermatogenesis. Ancestrally exposed rats to vinclozolin showed significant parturition abnormalities in both the maternal and paternal lineages after 16 generations. This included maternal deaths during labor and stillbirths. Pathological assessments revealed abnormalities across multiple tissue types and an increased incidence of disease. This suggests the physiological consequences of the generational stability of epigenetic inheritance. Observations establish the generational stability of epigenetic inheritance over twenty generations in a mammalian model system; however, new pathology in later generations involving parturition abnormalities was also observed. The generational stability of transgenerational effects observed in this study has implications for human health, particularly regarding environmental toxicant exposures, reproductive health disorders, and disease susceptibility.

6. Exquisite specificity of Pks13 defines the essentiality of trehalose in mycobacteria.

期刊: Proceedings of the National Academy of Sciences of the United States of America 发表日期: 2026-Feb-24 链接: PubMed

摘要

Mycolic acids (MAs) are the major component of the mycobacterial outer membrane, a key contributor to the intrinsic resistance of mycobacteria to external insults including multiple antibiotics. After being synthesized in the cytoplasm and before reaching the outer membrane, MAs are transported across the inner membrane in the form of an acylated sugar, generally believed to be trehalose monomycolates (TMMs). Whether trehalose is the only mycolate carrier during transport is under debate, and why this highly abundant disaccharide is essential for mycobacterial growth is unclear. To address these questions, we leveraged a trehalose auxotrophic Mycobacterium smegmatis strain to investigate the biosynthetic steps affording TMMs. We show that in addition to TMMs, mature MAs are also not produced in the absence of intracellular trehalose. This is likely due to a product inhibition mechanism where unreduced MA precursors accumulate on Pks13, the protein catalyzing the ligation of mycolic acids and the sugar head group. We establish that the unreduced mycolates could only be released by trehalose, revealing exquisite Pks13 specificity, and subsequently reduced by CmrA in vitro. Furthermore, only trehalose and its analogs can reactivate MA biosynthesis in cells. Finally, by replacing trehalose with a 6-deoxy analog in cells, we demonstrate that the cord factor trehalose dimycolate is dispensable for M. smegmatis growth in vitro. Our work gives a clear depiction of how TMMs are formed and provides a compelling reason for the essentiality of trehalose, shedding light on the development of future antimycobacterial strategies.

7. GSK-3β coordinates axonal microtubule organization through Shot and Tau.

期刊: Proceedings of the National Academy of Sciences of the United States of America 发表日期: 2026-Feb-24 链接: PubMed

摘要

Glycogen Synthase Kinase 3β (GSK-3β) is a key coordinator of neuronal development and maintenance; hyperactive GSK-3β is linked to neurodevelopmental and -degenerative diseases and therefore a promising therapeutic target. In neurons, GSK-3β coordinates the cytoskeleton by phosphorylating microtubule-binding proteins. In this study, we found that tight regulation of GSK-3β kinase activity is required for the maintenance of parallel microtubule bundles in Drosophila and rat axons. Up- or downregulation of GSK-3β led to axons forming pathological swellings in which microtubule bundles disintegrated into disorganized, curled microtubules. We identified the microtubule bundling proteins Shot and Tau as key GSK-3β targets and found that GSK-3β exerted its regulatory effect on microtubule bundling through them. GSK-3β regulates the ability of Shot and Tau to attach to microtubules and/or Eb1. Misregulation of GSK-3β leads to the loss of Eb1-Shot-mediated guidance of polymerizing microtubules into parallel bundles, thus causing disorganization. We propose that microtubule disorganization during both active and inactive states of GSK-3β links its hyperactivity to neurodegeneration and may explain why global GSK-3β inhibition has failed in clinical trials.

8. Maternal Immunizations.

期刊: Obstetrics and gynecology 发表日期: 2026-Feb-18 链接: PubMed

摘要

Immunization is an essential part of preventive care for adults, including pregnant individuals. Each vaccine recommended for pregnant patients is important for the protection of the maternal-child dyad. Other vaccines provide maternal protection from severe morbidity related to specific pathogens such as pneumococcus, meningococcus, and hepatitis for at-risk pregnant individuals. Obstetrician-gynecologists and other obstetric care professionals should routinely assess their pregnant patients’ vaccination status, including their risk factors for vaccine-preventable diseases. Based on this assessment they should recommend and, when possible, administer needed vaccines to their pregnant patients. There is no evidence of adverse fetal effects from vaccinating pregnant women with mRNA-derived vaccines, inactivated virus vaccines, bacterial vaccines, or toxoids. Real-world data continue to demonstrate the safety and efficacy of such use. Certain vaccines should be given in the postpartum period.

9. Mobile App-Supported Self-Management for Chronic Low Back Pain: Realist Evaluation.

期刊: JMIR mHealth and uHealth 发表日期: 2026-Feb-17 链接: PubMed

摘要

As the world’s population ages, the prevalence of chronic low back pain (CLBP) is increasing, placing a substantial burden on individuals and health care systems. Mobile health (mHealth) apps offer a potentially scalable solution to support self-management, but little is known about how, why, for whom, and under what circumstances such tools work in real-world settings. This study aimed to test and refine 3 program theories-developed through a previous realist review-on how mobile apps support CLBP self-management. The goal was to understand the key contextual factors and mechanisms that influence when and why a digital self-management intervention may succeed or fail. A realist evaluation was conducted using one-on-one telephone interviews with 9 participants who had used the Curable app for 3 months to self-manage their CLBP. Realist interviews followed a teacher-learner cycle to explore, test, and refine the program theories. Abductive and retroductive analysis was used to develop context-mechanism-outcome configurations (CMOCs), which were synthesized into refined theories of digital self-management in chronic pain. A total of 20 CMOCs were constructed, supporting 3 overarching program theories centered on empowerment, self-management burden, and timing. First, the app was empowering when it offered credible and accessible knowledge that helped participants understand their pain, build confidence, and reduce reliance on health care providers. However, engagement depended on individual beliefs and expectations: those with strong biomedical views struggled to connect with the app’s psychosocial framing. Second, while the app could ease the burden of self-management by offering support between appointments, it could also increase burden during flare-ups, when users lacked the capacity to engage. Features such as proactive content delivery and low-demand interfaces were viewed as essential for continued use. Third, timing emerged as a key factor. Early introduction was beneficial for some, but others needed to first accept the chronicity of their condition before they were ready to engage with self-management tools. Trust in the source recommending the app also influenced engagement. While clinician endorsement was often valued-especially early in the self-management journey-participants who had experienced unmet needs or disillusionment in clinical encounters reported that peer recommendations or nonclinical sources held greater weight. This highlights the importance of aligning recommendations with individuals’ evolving relationships with authority and trust. Mobile apps like Curable (Curable Inc) can support empowerment and continuity of care in CLBP, but their success depends on personalization, timing, and relational dynamics. To prevent feelings of abandonment, such tools should be introduced as an adjunct to-rather than a replacement for-ongoing clinical support.

10. Orientia tsutsugamushi a Likely Contributor to Stillbirths and Neonatal Deaths in Bangladesh, 2017-2024.

期刊: The American journal of tropical medicine and hygiene 发表日期: 2026-Feb-17 链接: PubMed

摘要

Scrub typhus, caused by Orientia tsutsugamushi, is a mite-borne infection endemic to Asia, the Pacific Islands, and northern Australia. This study reports the first detection of O. tsutsugamushi DNA in postmortem specimens from stillbirths and neonatal deaths collected through the CHAMPS surveillance project from 2017 to 2024 in Bangladesh. O. tsutsugamushi DNA was detected in 11 cases including 1.7% of stillbirths (n = 461) and 0.7% of neonates (n = 443). Ninety percent of these deaths occurred between August and January; among stillbirths, detection was highest in cerebrospinal fluid samples (87.5%). Most stillbirths were preterm (75%) with low birth weight (87.5%), and maternal history of fever was recalled in 83.3% of stillbirth cases. These findings suggest scrub typhus may contribute to perinatal mortality in Bangladesh’s endemic regions. Scrub typhus is treatable with inexpensive antibiotics such as doxycycline; early recognition and treatment could potentially reduce stillbirths and neonatal deaths in endemic areas.

11. Local Surveillance Identifies High-Priority Gram-Negative Pathogens to Guide Antibiotic Stewardship in Ghana: A Cross-Sectional Study.

期刊: The American journal of tropical medicine and hygiene 发表日期: 2026-Feb-17 链接: PubMed

摘要

Gram-negative pathogens are notable causes of diverse human infections. This study determined the antibiotic sensitivity profile of clinical isolates of gram-negative bacteria to provide insights into high-priority pathogens that are potential threats to public health in Ghana. Gram-negative isolates from urine, stool, wound, and blood samples of consenting participants were tested against 10 antibiotics using the Kirby-Bauer disc diffusion method. Escherichia coli and Klebsiella pneumoniae were the predominant bacteria isolated from the study participants. Resistance to colistin (4%) and meropenem (20%) was less prevalent, whereas isolates resistant to ampicillin (94%), tigecycline (85.5%), and chloramphenicol (76%) were widespread in the study participants. Acinetobacter baumannii exhibited the highest resistance phenotype among the clinical isolates of Gram-negative bacteria. Our data highlight the ineffectiveness of tigecycline, ampicillin, and chloramphenicol against several gram-negative pathogens isolated from the study participants. The utilization of meropenem and colistin should be strongly monitored to avoid misuse because they represent effective antibiotics for treatment of gram-negative infections.

12. Interventions to Prevent Post-Discharge Mortality among Children in Sub-Saharan Africa: A Systematic Review.

期刊: The American journal of tropical medicine and hygiene 发表日期: 2026-Feb-17 链接: PubMed

摘要

Post-discharge mortality (PDM), defined as deaths that occur in the weeks and months after hospital discharge, remains a critical, yet under-recognized, contributor to high childhood mortality rates in sub-Saharan Africa. However, a comprehensive understanding of effective interventions to prevent PDM is lacking. The aim for the present study was to evaluate the efficacy of published interventions to prevent PDM among neonates and children aged 0-18 years in sub-Saharan Africa. A systematic review was conducted to assess the efficacy of interventions for preventing PDM. The CABI Global Health, Cochrane Reviews, Cochrane Trials, ProQuest Dissertations and Theses, Embase, PubMed, and Web of Science databases were searched without language restriction. Publications that involved interventions for preventing PDM, included children, and were conducted in sub-Saharan Africa were included in the present study. Of 4,893 publications screened, 17 were included, with 12,938 participants in total (10.6% experienced PDM). The most common interventions included supplemental feeding programs, kangaroo mother care, antibiotic use, and micronutrient supplementation. Effectiveness varied within and between intervention types. Only two interventions resulted in statistically significant reductions in PDM: vitamin A supplementation for children with pneumonia (hazard ratio: 0.51; 95% CI: 0.29-0.90; low quality of evidence) and linkage to services for children with sickle cell disease (adjusted hazard ratio: 0.26; 95% CI: 0.08-0.83; low quality of evidence). No single intervention type provided consistent benefits across studies. Most interventions targeted children with specific diagnoses; however, some strategies addressed social determinants of health. Future research must prioritize cost-effective, scalable strategies across diverse sub-Saharan African settings to accelerate the prevention of PDM among children.

13. Plasmodium knowlesi can adapt to infect Duffy-negative Erythrocytes.

期刊: Blood 发表日期: 2026-Feb-17 链接: PubMed

摘要

Plasmodium knowlesi, a zoonotic malaria species, has become a significant public health concern in Southeast Asia. In regions such as Malaysia and southern Thailand, P. knowlesi incidence has risen, even as other human malaria parasites are nearing elimination. Like its close relative Plasmodium vivax, P. knowlesi relies on Duffy-Antigen Receptor for Chemokine (DARC) as a key receptor for erythrocyte invasion. Only Duffy-positive individuals are thought to be susceptible to clinical infection. Here, we reveal that P. knowlesi possesses greater invasion plasticity than previously recognized. This parasite can bypass the need for DARC, as shown by its in vitro adaptation to invade and replicate in Duffy-negative (Fy-) erythrocytes. This adaptation is stable and independent of DARC binding, enabling the adapted parasite line to be maintained in Fy-erythrocytes and to resist inhibition by a-DARC antibodies. Genomic analysis identified a genomic recombination event between the parasite’s dbpα and dbpγ genes, resulting in a new chimeric gene dbpαγ. Using CRISPR-Cas9 targeted reversion, we were able to demonstrate that dbpαγ is essential for invasion of Fy- erythrocytes. These findings shed new light on the invasion plasticity of P. knowlesi, with implications for its potential spread beyond Southeast Asia and for understanding the complex host-cell specificity and atypical invasion pathways seen in P. vivax.

14. Effectiveness and Theoretical Foundations of mHealth Apps for Physical Activity, Healthy Eating, and Weight Loss: Protocol for a Systematic Review and Meta-Analysis.

期刊: JMIR research protocols 发表日期: 2026-Feb-17 链接: PubMed

摘要

Obesity is a significant global public health concern. Primary prevention and health promotion to encourage positive health behavior to address obesity could be delivered via mobile health (mHealth), but evidence of apps improving health outcomes over sufficient time frames to be clinically meaningful is limited. mHealth interventions for physical activity, healthy eating, and weight loss typically prioritize intention as the primary driver of behavior. This may limit their impact, as intention does not consistently translate into behavior. This review updates a previous systematic review on the effectiveness of mobile apps for health behavior change while narrowing the scope to weight management interventions to enable a more focused analysis. Our primary objective is to investigate the effectiveness of mHealth apps in improving health behaviors with respect to physical activity and healthy eating and to explore the inclusion of behavioral theories and behavior change techniques and the evidence for their effectiveness. This protocol follows the PRISMA-P (Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols) checklist, and the review will be structured using the PRISMA 2020 statement. Nine databases (PubMed, EMBASE, CINAHL, APA PsycINFO, Cochrane Library, SPORTDiscus, SCOPUS, Web of Science, and Science Direct) will be searched for studies reporting evaluation of the impact of mHealth interventions on weight loss, healthy eating, or physical activity outcomes. EndNote 21 software will be used for deduplication and initial screening, followed by manual title and abstract screening, and then full-text screening by 2 independent reviewers. Data regarding the studies, intervention characteristics, their theoretical basis (eg, use of behavior change frameworks such as the COM-B [Capability, Opportunity, Motivation-Behavior] model or the social cognitive theory), evaluation methods, and outcomes will be extracted into a predetermined form. A meta-analysis will be conducted on eligible studies (reporting control group comparisons) to synthesize evidence of their effectiveness, and the remaining quantitative data will be descriptively analyzed. The review is expected to start in December 2025 and to be submitted for publication by the end of 2026. This review will synthesize evidence on the theoretical basis underpinning mHealth interventions for enhancing physical activity, healthy eating, and weight loss and generate new insights into how particular behavior change techniques can best support intended outcomes. This will help guide the development of more impactful mobile-based interventions to support healthy behaviors that are better able to reduce the risk factors for chronic health conditions. PROSPERO CRD42024602819; https://www.crd.york.ac.uk/PROSPERO/view/CRD42024602819. PRR1-10.2196/72664.

15. Opioid Agonist Treatment Dispensing Trends Between 2018 and 2022 Across Six Canadian Provinces.

期刊: Canadian journal of physiology and pharmacology 发表日期: 2026-Feb-17 链接: PubMed

摘要

Opioid agonist treatment (OAT) is the recommended first-line therapy for individuals with opioid use disorder. The availability of different products and prescribing guidance for OAT has rapidly evolved in recent years. Therefore, we conducted a repeated cross-sectional study using pharmacy dispensing data from six Canadian provinces to examine trends in methadone and buprenorphine use between January 2018 and December 2022. Monthly population-adjusted rates of OAT recipients were calculated by province, and annual cohorts were stratified by demographic characteristics and OAT type. OAT prevalence varied across provinces, ranging from 1.03 per 1,000 in Quebec to 3.59 per 1,000 in British Columbia. Increases in OAT use between 2018 and 2022 were observed in Alberta (3.00 to 3.75 per 1,000) and Manitoba (1.68 to 2.39 per 1,000), while rates remained relatively stable elsewhere. OAT use was highest among adults aged 25-44 years, males, and residents of lower-income neighbourhoods. A notable shift toward buprenorphine prescribing was observed across all provinces, with 45% to 74% of OAT recipients dispensed a buprenorphine product in 2022. These cross-provincial differences in OAT rates likely reflect variations in opioid use disorder prevalence, prescribing practices, and access to care.

16. AI- vs Human-Based Assessment of Medical Interview Transcripts in a Generative AI-Simulated Patient System: Cross-Sectional Validation Study.

期刊: JMIR medical education 发表日期: 2026-Feb-17 链接: PubMed

摘要

Generative artificial intelligence (AI) is increasingly used in medical education, including AI-based virtual patients to improve interview skills. However, how much AI-based assessment (ABA) differs from human-based assessment (HBA) remains unclear. This study aimed to compare the quality of clinical interview assessments generated via an ABA (GPT-o1 Pro [ABA-o1] and GPT-5 Pro [ABA-5]) with those generated via an HBA conducted by clinical instructors in an AI-based virtual patient setting. We also examined whether AI reduced evaluation time and assessed agreement across participants with different levels of clinical experience. A standardized case of leg weakness was implemented in an AI-based virtual patient. Seven participants (2 medical students, 3 residents, and 2 attending physicians) each conducted an interview with the AI patient, and transcripts were scored using the 25-item Master Interview Rating Scale (0-125). Three evaluation strategies were compared. First, GPT-o1 Pro and GPT-5 Pro scored each transcript 5 times with different random seeds to test case specificity. Processing time was logged automatically. Second, 5 blinded clinical instructors independently rated each transcript once using the same rubric. Third, reliability metrics were applied. For AI, intraclass correlation coefficients (ICCs) quantified repeatability. For humans, the ICC(2,1) was calculated. Agreement was quantified using the Pearson r, Lin concordance correlation coefficient, Bland-Altman limits of agreement, Cronbach α, and ICC. Time efficiency was expressed as mean minutes per transcript and relative percentage reduction. Mean interview scores were similar across methods (ABA-o1: mean 52.1, SD 6.9; ABA-5: mean 53.2, SD 6.8; HBA: mean 53.7, SD 6.8). Agreement between ABA and HBA was strong (r=0.90; concordance correlation coefficient=0.88) with minimal bias (ABA-o1: mean 0.4, SD 2.7; ABA-5: mean 1.5, SD 5.2; limits of agreement: -4.9 to 5.7 for ABA-o1 and -8.6 to 11.7 for ABA-5). The Cronbach α was 0.81 (ABA-o1), 0.86 (ABA-5), and 0.80 (HBA); the ICC(3,1) was 0.77 (ABA-o1) and 0.82 (ABA-5); and the ICC(2,1) was 0.38 (HBA). The coefficient of variation for ABA was approximately half that of HBA (6.6% vs 13.9%). Processing time for 5 runs was 4 minutes, 19 seconds for ABA-o1 and 3 minutes, 20 seconds for ABA-5 vs 10 minutes, 16 seconds for physicians, corresponding to 58% and 67.6% reductions, respectively. ABA-o1 and ABA-5 produced scores closely matching HBA while demonstrating superior consistency and reliability. In the setting of virtual interview transcripts, these findings suggest that ABA may serve as a valid, rapid, and scalable alternative to HBA, reducing per-assessment time by over half. Applied strategically, AI-based scoring could enable timely feedback, improve efficiency, and reduce faculty workload. Further research is needed to confirm generalizability across broader settings.

17. Long-Term Prospective Cohort Study of Cervical Cancer Screening Using Triage of Women who Are Human Papillomavirus-Positive With Dual Stain and Human Papillomavirus Genotyping.

期刊: Journal of clinical oncology : official journal of the American Society of Clinical Oncology 发表日期: 2026-Feb-17 链接: PubMed

摘要

Primary human papillomavirus (HPV) testing has the best tradeoff of benefits and harms for cervical screening but requires triage to determine management among HPV positives. We conducted a prospective observational study to evaluate triage of women who are HPV-positive using dual stain (DS) and HPV genotyping. We included 9,645 consecutive women who are HPV-positive undergoing cervical screening in two periods between 2015 and 2017 in the organized cervical screening program at Kaiser Permanente Northern California. Absolute risk and clinical performance of DS and cytology for detection of cervical intraepithelial neoplasia grade 3 and greater (CIN3+) were estimated overall and by HPV genotype and by age. Cumulative absolute risk of CIN3+ was modeled over 5 years using a prevalence-incidence mixture model, which allows estimating risk accounting for differences in disease ascertainment, surveillance intervals, and compliance. The baseline risk of CIN3+ was 9.4% and 0.8% for women testing positive and negative for DS, respectively, and 6.9% and 2.0% for women testing positive and negative for cytology, respectively. Sensitivity, specificity, and predictive values for CIN3+ detection were better for DS compared with cytology over 5 years (P < .001 for all comparisons). Risk in women with HPV16-positive/negative for intraepithelial lesion or malignancy was substantially higher than the risk in women with HPV16-positive/DS-negative (7.5% v 2.9%, P < .001). DS had better triage performance compared with cytology in all age groups and in women positive for HPV types other than HPV16 or HPV18. Long-term reassurance of low risk among DS negatives suggests that DS detects molecular changes earlier in the carcinogenic pathway than cytology. DS has better risk stratification than cytology overall, within HPV risk strata, and across all screening age groups and is a better option for triage of vaccinated populations.

18. Assessing the Impact of Sociodemographic Factors on Artificial Intelligence Models in Predicting Dementia: Retrospective Cohort Study.

期刊: JMIR medical informatics 发表日期: 2026-Feb-17 链接: PubMed

摘要

Artificial intelligence (AI) is increasingly applied to health care, yet concerns about fairness persist, particularly in relation to sociodemographic disparities. Previous studies suggest that socioeconomic status (SES) and sex may influence AI model performance, potentially affecting groups that are historically underserved or understudied. This study aimed to (1) assess algorithmic bias in AI-driven dementia prediction models based on SES and sex (biological sex), (2) compare the utility of an individual-level SES measure (the Housing-Based Socioeconomic Status [HOUSES] Index) versus an area-level measure (the Area Deprivation Index) for bias detection, and (3) evaluate the effectiveness of an oversampling technique (the Synthetic Minority Oversampling Technique for Nominal and Continuous features) for bias mitigation. This study used data from two population-based cohorts: the Mayo Clinic Study on Aging (n=3041) and the Rochester Epidemiology Project (n=19,572). Four AI models (random forest, logistic regression, support vector machine, and Naïve Bayes) were trained using a 5-year observation window of structured electronic health record data to predict dementia onset within the subsequent 1-year window. Fairness and model performance were assessed using the balanced error rate (BER) across intersecting SES-sex subgroups. The Synthetic Minority Oversampling Technique for Nominal and Continuous features algorithm was applied to the training data to balance the representation of SES groups. Across both cohorts, individuals with lower SES generally exhibited higher BERs (worse performance) than high SES groups, confirming the presence of bias. In the MCSA cohort, males with high SES, as indicated by the HOUSES Index, consistently exhibited the lowest BERs across all evaluated models. Balancing the training data based on a specific SES measure showed a trend toward reducing the BER disparity when evaluated using that same measure. However, this targeted improvement demonstrated nonuniversal benefits; in some cases, it exacerbated disparities when evaluated using other, unbalanced SES measures. This pattern suggests that fairness interventions are not universally beneficial across different definitions of the protected attribute. While the balancing approach improved fairness in model performance for lower SES groups, it often came at the cost of a slight reduction in overall model performance. However, an exception was observed in the MCSA cohort when balancing based on the HOUSES Index using logistic regression, support vector machine, and Naïve Bayes, where the performances of both the high and low SES groups improved. This research highlights the importance of incorporating sociodemographic context into AI modeling in health care. The choice of SES measure may lead to different assessments of algorithmic bias. The HOUSES Index, as a validated individual-level SES measure, may be more effective for bias mitigation than area-level measures. Future AI development should integrate bias mitigation strategies to ensure models do not reinforce existing disparities in health outcomes.

19. Trust Analysis Canvas for Teaching in the Field of Digital Public Health and Medicine: Tutorial.

期刊: JMIR medical education 发表日期: 2026-Feb-17 链接: PubMed

摘要

Trust is increasingly recognized as a cornerstone for the successful implementation of digital public health initiatives, from mobile apps to the use of artificial intelligence in medicine, yet it remains underrepresented in educational curricula. In the course of our research and teaching activities in the field of trust in digital public health and medicine, we identified a gap in existing educational resources that aimed at supporting students in conducting structured trust analyses. Digitalization introduces new complexities into trust relationships, as interactions become increasingly mediated by digital tools. Preparing future professionals, therefore, demands fostering a critical understanding of how trust operates within digital systems, especially in the health sector. To address this gap, we developed and tested the first Trust Analysis Canvas for Teaching (TACT), a tool designed to guide students in conducting trust analyses of case studies in digital public health and medicine. Grounded in conceptual research on trust in health systems and health data sharing, we (1) developed the canvas content and reviewed it with two trust researchers; (2) tested and iteratively refined the tool with 23 students (3 BSc, 14 MSc, and 6 PhD) from diverse disciplines and academic levels through in-person and online focus groups at the universities of Zurich and Bern; (3) collaborated with a graphic designer to optimize its visual layout; and (4) translated the final canvas into French, Italian, German, and Spanish to ensure accessibility across disciplines, academic levels, and languages while maintaining a clear and engaging visual design. This paper introduces TACT, a canvas comprising 16 guiding questions organized around 6 core dimensions, designed to enable students from diverse disciplinary backgrounds and academic levels to engage with the complex concept of trust in a structured and guided manner, thereby addressing the identified gap in the current curricula. We outline the development process and provide a practical, step-by-step tutorial demonstrating its application through a written trust analysis of a digital health case study, supported by references to relevant literature.

20. COVID-19 Information Sources and Vaccination Status Among Californian Adults by Generation Using the 2022 California Health Interview Survey: Cross-Sectional Study.

期刊: JMIR public health and surveillance 发表日期: 2026-Feb-17 链接: PubMed

摘要

As communication technology advances and the digital divide grows, a deeper understanding of the influence of different information sources on vaccine uptake by generations can inform targeted public health interventions in times of future crisis. While the COVID-19 pandemic highlighted the role of media sources on the decision to receive vaccines, no studies have focused on the impact of the type and number of information sources in a population-based sample in California. In this study, we examined associations between Californians’ self-reported most relied upon COVID-19 information sources, categorized by type and measured as a count, and their COVID-19 vaccination status using data collected from the 2022 California Health Interview Survey. To address differences in information preferences and vaccine uptake by age, we also tested for potential effect modification of the relationship between relied upon COVID-19 information sources and vaccination status by generational membership (eg, Generation Z, millennials, Generation X, baby boomers, and Silent Generation). We conducted a secondary analysis of cross-sectional data from the 2022 California Health Interview Survey. Vaccine status (any or none) was modeled as a function of information sources (or count) controlling for important sociodemographic and health confounding variables. Interaction terms of information sources (or count) by generational status were added to the models to test effect modification, and if significant, the models were stratified by generation. All analysis was survey-weighted to account for the complex survey sampling design. Compared to relying on traditional news media for COVID-19 information, relying on word of mouth (odds ratio [OR] 0.6), social media (OR 0.62), and doctors (OR 0.41) for COVID-19 information was associated with lower odds of being vaccinated for COVID-19. A dose-response relationship was identified, with each additional information source associated with 9% higher odds of being vaccinated for COVID-19. In stratified models, social media, compared to traditional news media, was associated with lower odds of vaccination for Generation X, baby boomers, and the Silent Generation. Health information preferences, especially for traditional news media, are associated with COVID-19 vaccine uptake, and the information sources differ by generation. These findings provide information for stakeholders interested in vaccine hesitancy, health informatics, messaging strategies, health literacy, and future health information outreach programs during epidemics or pandemics. Dissemination of public health information should include multiple information sources to reach all individual preferences across different generations.

21. Perinatal Health Care Among Climate Migrant Women: Protocol for a Scoping Review.

期刊: JMIR research protocols 发表日期: 2026-Feb-17 链接: PubMed

摘要

Climate change-induced international migration has the potential to negatively impact the health and well-being of displaced populations. Pregnancy often serves as a point of entry into the health care system for migrant women; however, these women often face reduced access to maternal health care services compared to nonmigrants. In the context of climate-related international migration, these disparities may be further exacerbated, increasing the risk of maternal morbidity and adverse perinatal outcomes. While the intersections between climate change, migration, and health are increasingly acknowledged, literature specifically focused on international climate-related migrant women-particularly during the perinatal period-remains limited and dispersed. Thus, there is a growing need for research and synthesized data on climate change, population movements, and the perinatal health care needs of childbearing women. The aim of this study is to examine and describe the scope and nature of available evidence on maternal health and care for international climate-related migrant women, from pregnancy through the postpartum period. We will conduct a scoping review following the Joanna Briggs Institute methodology. A tailored search strategy using key terms related to climate change, migration, women, and perinatal health care will be applied to four databases-Embase, CINAHL, PsycINFO, and Ovid MEDLINE-without restriction on publication date. Relevant gray literature sources will also be searched and considered for inclusion. Only literature published in English, French, Portuguese, or Spanish will be included. Two reviewers will independently screen full-text records based on predefined inclusion criteria and extract the relevant data. A total of 741 studies were screened from 1113 records. Results summarizing perinatal health outcomes and needs, care experiences, barriers faced by international climate-related migrant women, and recommendations will be reported using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) 2020 flow diagram. We anticipate finalizing the manuscript for this work in 2026. Considering vulnerability factors related to migration status is essential to improving access to integrated perinatal health care and reducing health inequities among immigrant women. This review will provide valuable insights to tailor interventions to the social and cultural needs of climate-affected migrant women during the perinatal period.

22. Exploring the health-seeking journeys of individuals affected by leprosy: Lived experiences in selected urban rehabilitation centers in Ethiopia.

期刊: PLoS neglected tropical diseases 发表日期: 2026-Feb-17 链接: PubMed

摘要

Despite widely available and effective treatment, leprosy remains a major public health issue in Ethiopia. The disease is often misconstrued as a hereditary disease in origin, a curse, or a form of divine punishment for immoral behavior. In this study, we aim to explore how individuals affected by leprosy perceive the disease, recognize its early symptoms, and how these perceptions influence care-seeking behaviors. An exploratory qualitative study was conducted at selected leprosy treatment and rehabilitation centers located in Addis Ababa, Shashemene, and Jimma. In-depth interviews (key informant interview (KII)) and focus group discussion (FGD) were conducted. Interviews were transcribed verbatim in local languages, translated into English, and reviewed to identify key themes. Data were coded in MAXQDA 24 using pre-identified themes (perceived causes, stigma, social consequences, care-seeking) and open coding to include emerging themes. A total of 8 FGDs with 53 participants (25 females; mean age 52) and 11 KIIs (5 females) were conducted. Participants demonstrated limited knowledge of leprosy, often attributing it to supernatural causes or divine will, which delayed care-seeking and led to advanced disease stages. Misconceptions and stigma led to social isolation, discrimination, and inter-generational exclusion, with profound economic, social, and psychological impacts. Misdiagnosis or delayed diagnosis, and provider stigma were among the healthcare-related challenges. Despite this, there were individuals that demonstrated resilience by forming supportive social networks, including community-based associations that fostered mutual aid, inclusion, and dignity. In Ethiopia, leprosy is still a major public health issue. Affected individuals often suffer social exclusions, psychological distress, and diminished quality life. Stigma from health care providers was also reported. Collaborative efforts between the health system, religious leaders, and leprosy affected individuals and their associations are vital for elimination of the disease.

23. Prevalence and Impact of Lower Urinary Tract Symptoms among Women with Rheumatoid Arthritis: A Multicenter Cross-Sectional Study.

期刊: Medical principles and practice : international journal of the Kuwait University, Health Science Centre 发表日期: 2026-Feb-17 链接: PubMed

摘要

This study aimed to determine the prevalence of voiding dysfunction and its impact on quality of life among women diagnosed with rheumatoid arthritis, a chronic autoimmune condition known for joint inflammation and systemic manifestations. A cross-sectional observational design was employed at two tertiary care centers in Saudi Arabia. Over an 8-week period, 144 female patients with rheumatoid arthritis completed a self-administered online survey. The questionnaire included demographic data and the International Prostate Symptom Score (IPSS), a validated tool used to assess urinary symptoms and their effect on quality of life. Patients under 18 or with known urological disorders were excluded. Participants had a mean age of 47.2 years, and 72.9% were married. The average IPSS was 11.2, with 41.7% classified as moderately symptomatic, 40.4% mildly symptomatic, and 17.9% severely symptomatic. Only 16.7% discussed urinary issues with family or partners, and 15.3% with physicians. Notably, 35.4% planned to consult a specialist, and this intent was significantly associated with higher IPSS scores (p < 0.03). Voiding dysfunction is highly prevalent among women with rheumatoid arthritis and significantly affects quality of life. Despite moderate to severe symptoms, many patients do not seek medical help. Routine screening and increased awareness are recommended to improve management and outcomes for this population. Further research is needed to explore regional differences and incorporate objective diagnostic tools.

24. Vernacular memorial infrastructure after October 7: Commemorative stickers and connective memory in Israel.

期刊: Death studies 发表日期: 2026-Feb-17 链接: PubMed

摘要

After 7 October 2023, commemorative stickers proliferated across public and semipublic surfaces. This article examines how this vernacular memorial medium turns individual loss into shared memory. A qualitative visual content analysis with inductive typology building and morphological reading was conducted on 534 stickers from Israel, Hungary, and the Czech Republic. Individual stickers were coded as units. Dense installations were contrasted with nearby solitary placements, and language use and QR codes were recorded. The analysis yielded a five-part typology: heroic commemoration of uniformed personnel, civilian mourning iconography, collective commemoration, national-patriotic framing, and religious expression. Portrait-and-formula cores carry most of the semantic load, while national and religious layers stabilize interpretation. English appears on 39.7% of stickers inside installations and 62.2% outside. QR codes extend local remembrance to networked publics. These accumulations constitute a vernacular memorial infrastructure that can be maintained through light-touch stewardship rather than formal monuments.

25. Cardiovascular Risk and Prediction Model of Vascular Endothelial Growth Factor Tyrosine Kinase Inhibitors in Patients with Liver Cancer.

期刊: Cardiovascular toxicology 发表日期: 2026-Feb-17 链接: PubMed

摘要

Major adverse cardiovascular events (MACE) in patients with liver cancer receiving vascular endothelial growth factor tyrosine kinase inhibitors (VEGF-TKI) remain uncertain. This retrospective cohort study aimed to evaluate the association between VEGF-TKIs and MACE and develop a risk prediction score. Using the Taiwan Cancer Registry linked with the Taiwan National Insurance Claim Database, 11,960 VEGF-TKI users were matched to 11,960 non-users by age and sex. Cause-specific hazard ratios (HRs) were estimated using multivariable Cox models with competing risk of non-cardiovascular death; propensity score (PS)-adjusted or PS-matched models were additionally conducted. During follow-up, the incidence of MACE was 49.5 versus 28.3 per 1,000 person-years in VEGF-TKI users and non-users. VEGF-TKI use was associated with increased MACE risk in multivariable analysis (adjusted HR 1.31; 95% CI 1.14-1.50); however, PS-adjusted and PS-matched models show non-significant associations. Because proportional hazards assumptions were violated, a 60-day landmark analysis was conducted, in which the increased risk was again significant across analytic approaches, including multivariable adjusted (HR 1.92; 95% CI 1.63-2.27), PS-adjusted (HR 1.35; 95% CI 1.00-1.82) and PS-matched models (HR 1.30; 95% CI 1.03-1.63). A point-based score was developed using a multivariable sub-distribution hazard model and assessed by a time-dependent c-index. The score demonstrated good discrimination with c-indices of 79.9% (3 months) and 74.2% (6 months). VEGF-TKIs were associated with increased risk of MACE among liver cancer patients. Landmark analyses indicated a persistently elevated risk among patients surviving beyond early treatment. A risk score based on prior cardiovascular history may help identify high-risk patients.

26. Causal association between gut microbiota and osteonecrosis in European populations: a two-sample Mendelian randomization analysis.

期刊: Journal of bone and mineral metabolism 发表日期: 2026-Feb-17 链接: PubMed

摘要

Recent studies have linked gut microbiota composition to osteonecrosis, but the causal relationship remains unclear. Clarifying this relationship is clinically important because osteonecrosis currently lacks early biomarkers and etiology-targeted therapies; if causal, the gut microbiome would offer a readily modifiable intervention target. We conducted a two-sample Mendelian randomization analysis to explore this relationship. Exposure data were sourced from the MiBioGen consortium (N = 18,340), while outcome data on osteonecrosis were obtained from FinnGen (N = 392,580). The Inverse Variance Weighted method was used as the primary analytical approach, supplemented by comprehensive sensitivity analyses to assess the robustness of our findings. Our analysis screened 196 microbial taxa and identified seven taxa associated with osteonecrosis risk in European populations. Protective effects were noted for the genus Odoribacter (OR = 0.579; P = 0.027) and family Alcaligenaceae (OR = 0.703; P = 0.049). Conversely, increased risk was linked to the genus Eubacterium fissicatena group (OR = 1.272; P = 0.046), genus Bifidobacterium (OR = 1.372; P = 0.038), order Bifidobacteriales (OR = 1.412; P = 0.023), family Bifidobacteriaceae (OR = 1.412; P = 0.023) and phylum Actinobacteria (OR = 1.750; P = 0.001). Sensitivity analyses confirmed the robustness of these findings, with no evidence of pleiotropy or heterogeneity. This study establishes a causal link between gut microbiota composition and osteonecrosis, suggesting that gut microbiota may be a modifiable factor in its pathogenesis. Further research is needed to elucidate underlying mechanisms and evaluate microbiota-targeted interventions for prevention and treatment.

27. Process Evaluation of a Parish-Based Intervention to Reduce Mental Health-Related Stigma.

期刊: Community mental health journal 发表日期: 2026-Feb-17 链接: PubMed

摘要

Latino populations in the United States have high levels of unmet mental health (MH) needs and MH-related stigma. Collaborative, community-based programming with predominately Latino churches is a promising approach for reducing MH stigma and unmet MH need in Latino communities. Project AMEN implemented MH workshops, homilies and text messages with Latino Catholic parishes to test this approach. We examined reach, satisfaction, effectiveness and fidelity for the overall intervention and individual activities. We collected baseline and one-year post-intervention data from n = 579 people at seven parishes in southern California. Variables included participation in and satisfaction with activities, MH stigma, sociodemographic characteristics, faith-related characteristics, MH needs, and fidelity measures for workshops. We used bivariate and multivariate modeling to describe intervention reach, satisfaction and effectiveness and to identify differences across subgroups. We describe fidelity for the MH workshop. Overall, 71% of the sample participated in at least one intervention activity. Participants were on average 48 years old, female, married, had less than high school education, and attended the parish for more than five years; 24% reported MH needs. Reach and satisfaction were greater for married individuals and those with strong connections to the parish. Individuals with MH problems had more barriers to participation. Activities most often participated in were text messages (42%), the introductory MH workshop (20%) and MH homily (20%). We observed high workshop fidelity. The number of AMEN activities predicted reduction in four types of MH stigma. AMEN showed promising results with respect to reach, satisfaction and effectiveness at reducing MH stigmaf.

28. Delays in Seeking Health Care among Patients with Dengue Recruited in a Sentinel Surveillance System in Puerto Rico before and after the COVID-19 Pandemic.

期刊: The American journal of tropical medicine and hygiene 发表日期: 2026-Feb-17 链接: PubMed

摘要

We evaluated health care-seeking behavior among dengue patients in Puerto Rico (PR) before (January 1, 2014-March 31, 2020) and after (April 1, 2020-February 28, 2023) the COVID-19 outbreak declaration in PR (“after COVID-19”) and calculated age-adjusted odds ratios of illness duration at presentation and hospitalization rates. A total of 70 and 185 patients with dengue were identified before and after COVID-19 began respectively. Dengue virus 1 (DENV-1) was the most common dengue serotype (89%) identified in both periods. The median age of patients with dengue was higher after COVID-19 (18, interquartile range [IQR]: 12-32 years) than before (14, IQR: 7-22 years). A higher proportion of patients presented >3 days post illness onset after COVID-19 (66%, n = 123) in comparison with before (49%, n = 34) (OR = 1.16; 95% CI: 1.02-1.33). These findings indicate that the COVID-19 outbreak may have affected health care-seeking behavior among patients with dengue in PR, delaying care and potentially negatively affecting patient outcomes.

29. Exploring Strategies for a Digital Tool to Support Medication Adherence Among Adolescents and Young Adults Undergoing Hematopoietic Stem Cell Transplant and Their Care Partners: Qualitative Formative Study.

期刊: JMIR formative research 发表日期: 2026-Feb-17 链接: PubMed

摘要

Allogeneic hematopoietic stem cell transplant (HCT) is a complex but essential treatment for malignant and nonmalignant conditions, requiring strict posttransplant adherence to immunosuppressant medications to prevent complications such as graft-versus-host disease. Adolescents and young adults undergoing HCT face unique challenges, including balancing growing independence with ongoing reliance on care partners, often parents. Medication adherence in this group is often suboptimal, and few interventions address adolescent and young adult-care partner dyads. To address this gap, we aim to develop a mobile health (mHealth) app that engages both the patients and care partner to improve adherence. As formative research for early-stage intervention development, this study aimed to (1) explore current HCT medication adherence strategies and challenges; (2) understand attitudes toward digital technology, including dyadic perspectives on app use to support adherence; and (3) assess adolescent and young adult-care partner relationships, including views on care partner involvement. This process was intended to inform the design of a relevant, user-centered mHealth app. Eligible participants included adolescents and young adult patients aged 12-39 years and primary care partners, such as parents, involved in medication management. Participants were recruited from a large academic medical center through direct outreach and electronic health records. Data collection involved 2 focus groups (6 dyads and 2 additional adolescents and young adults), 4 individual interviews (2 patients and 2 care partners), and 6 dyadic interviews. Semistructured sessions (in person or virtual) gathered feedback on medication adherence practices and app design preferences. All sessions were audio recorded with consent and professionally transcribed. Qualitative data were analyzed systematically: transcripts were deidentified, coded using both inductive and deductive strategies, and themes were refined through team consensus. Patterns were organized into major themes, and representative quotations were selected to illustrate findings. Data management was facilitated by NVivo (version 13; Lumivero) software. We included 28 participants (15 adolescents and young adults and 13 care partners). The median age of adolescents and young adults was 18 (range 13-39) years and 53% (8/15) were female. Adolescents and young adults were 47% (7/15) White, 40% (6/15) Black, and 13% (2/15) mixed race. Care partners’ median age was 48 (range 36-72) years, with 92% (12/13) female and 77% (10/13) White. Three principal themes emerged: (1) existing reminders and organizational tools are often insufficient for consistent adherence; (2) adherence barriers are multifaceted, often involving autonomy vs care partner support; and (3) both adolescents and young adults and care partners showed strong interest in a dyadic digital health intervention to foster collaboration and support shared adherence goals. This formative study highlights the complex dynamics of medication adherence in adolescent and young adult-care partner dyads and supports the need for a dyadic mHealth app to enhance adherence, collaboration, and relationship quality.

30. DNA Methylation-based Risk Stratification and Classification of Pediatric Thyroid Carcinoma.

期刊: Clinical cancer research : an official journal of the American Association for Cancer Research 发表日期: 2026-Feb-17 链接: PubMed

摘要

Accurate assessment of invasiveness in pediatric thyroid carcinomas is essential to prevent unnecessary surgery and avoid surgery-associated complications. DNA methylation, a proven molecular biomarker for cancer classification, holds promise for stratifying thyroid cancer risk. The objectives were to determine the epigenetic hallmarks of pediatric thyroid carcinomas and to investigate whether DNA methylome profiling is a feasible approach for pre-operative risk stratification of this pediatric disease. We interrogated genome-wide DNA methylation profiles from two separately processed cohorts of pediatric thyroid carcinoma. The reference cohort included 100 samples, consisting of 87 well-differentiated primary tumors-77 papillary and 10 follicular thyroid carcinomas-and 13 matched lymph node metastases. To predict oncogenic drivers and tumor invasiveness, defined by the presence of nodal metastasis, we trained two classifiers on the reference cohort and then evaluated their performance on a second validation cohort of 84 samples, including 83 primary tumors and one lymph node metastasis. We identified distinct methylation patterns associated with tumor invasiveness and key driver mutations, including BRAF p.V600E, RAS-like mutations, kinase fusions, and DICER1 mutations. The differentially methylated regions reflect inflammatory stress, disrupted thyroid development and function, implicating AR, Hippo, and AP-1 signaling. Leveraging these epigenetic signatures, we developed and validated two methylation-based classifiers that accurately predict tumor invasiveness and oncogenic mutation subgroups. In pediatric thyroid carcinoma patients, DNA methylation assays accurately predict tumor invasiveness and driver mutations. Our findings highlight the clinical value of DNA methylation profiling for risk stratification and classification of pediatric thyroid cancers.

31. Establishing Reference Intervals for Fat-Soluble Vitamins in Healthy Chinese Adults: Study Protocol for a Cross-Sectional, Multicenter Study.

期刊: JMIR research protocols 发表日期: 2026-Feb-17 链接: PubMed

摘要

Fat-soluble vitamins (FSVs)-vitamins A, D, E, and K-are essential micronutrients involved in key physiological processes. Both deficiency and excess can influence nutritional assessment and disease risk. In China, clinical evaluation of FSVs often relies on reference intervals (RIs) derived from Western populations, and no large-scale study has comprehensively evaluated all 4 FSVs in healthy Chinese adults. The aim of this study is to establish population-specific RIs for vitamins A, D, E, and K in healthy Chinese adults, thereby supporting more accurate clinical assessment of vitamin status and the prevention of related diseases. This ongoing multicenter cross-sectional study aims to recruit 100,000 adults (≥18 y) from 20 hospitals across China. Participants undergo a standardized questionnaire, physical examination, and blood sample collection. FSV concentrations are quantified using liquid chromatography-tandem mass spectrometry. Group differences are assessed using the chi-square test or Fisher exact test. Nested ANOVA evaluates variation across subgroups. RIs will be established using parametric or nonparametric percentile methods following rigorous outlier removal to accurately determine the 2.5th and 97.5th percentile limits. As of October 2025, 13,545 adults have been enrolled, and 1690 participants have met the inclusion criteria. Recruitment began on 1 July 2024 and is expected to conclude by 30 June 2026. This study will generate the first large-scale, population-specific RIs for FSVs in healthy Chinese adults. The findings are expected to be published in 2027 and will provide an important evidence base for clinical nutrition assessment and disease prevention in China.

32. Effect of high-frequency radiofrequency (6 GHz) electromagnetic radiation on oxidative stress and kidney morphology.

期刊: Toxicology and industrial health 发表日期: 2026-Feb-17 链接: PubMed

摘要

This study aimed to investigate the effects of high-frequency (6 GHz) radiofrequency electromagnetic radiation (RF-EMR) exposure on oxidative stress markers and kidney morphology. Our study was designed with 3 groups, each containing 10 animals. These groups were: control, sham, and RF-EMR exposed group. No treatment was applied to the control group; the sham group was housed in the same room under the same conditions and for equal periods of time, except that the generator was turned off. The RF-EMR exposed group was exposed to 6 GHz RF-EMR emitted from the signal generator for 4 hours per day for 6 weeks. At the end of the experimental period, intracardiac blood was collected from animals and plasma oxidant (MDA), antioxidant (SOD, CAT and GSH) and cortisol markers were analyzed. After, the rats in all groups were sacrificed and kidney tissues were removed. Hematoxylin and eosin staining methods were applied histopathologically. Blood-plasma GSH, CAT, SOD and MDA levels (excluding cortisol) were lower in the RF-EMR exposed group compared to the control and sham groups (p < .001). No significant difference was observed in plasma levels GSH, CAT, SOD, MDA and cortisol activities between control and sham groups. In addition, we reported that the histological characteristics of kidney tissue were affected by RF-EMR. The results of our study indicated that 6 GHz RF-EMR can function as an environmental stress factor and can modulate oxidative stress in blood plasma and cause morphological changes in kidney tissue.

33. A Smartphone Sensing Platform Based on Multilanthanide Metal-Organic Framework Sensors for Portable Visual Quantitative Detection of Antibiotic Residues.

期刊: Inorganic chemistry 发表日期: 2026-Feb-17 链接: PubMed

摘要

Both enrofloxacin and tetracycline hydrochloride are widely used antibiotics, and the harm caused by their abuse affects the ecological balance and human health. In this study, La-MOFs based on polycarboxylate ligands were prepared and three functionalized multilanthanide metal-organic framework sensors were obtained by in situ doping of Eu3+ and Tb3+. Fluorescence experiments showed that the fluorescence intensity of MOFs had a good linear relationship with the detected antibiotics and a low detection limit, and the MOFs had good anti-interference performance. Subsequently, the detection effect of enrofloxacin and tetracycline hydrochloride in actual samples (tap water, milk, shrimp, and pork) was tested by a standard addition recovery experiment; the recovery rate was between 90.5 and 107.4%, and the RSD was less than 5%. The MOFs@PVDF film, combined with smartphone imaging technology and RGB recognition technology, can be successfully used for rapid and convenient visual quantitative detection of enrofloxacin and tetracycline hydrochloride. Finally, the fluorescence quenching mechanism of MOFs by FRET and IEF was revealed. The multilanthanide MOF sensors developed can achieve highly sensitive visual detection of antibiotics and provide a portable solution for environmental and food safety monitoring, and their low-cost characteristics are expected to promote the practical application of intelligent detection equipment.

34. Exploring the Influence of Digitalization on Multidisciplinary Poststroke Rehabilitation Practice: Qualitative Study.

期刊: JMIR rehabilitation and assistive technologies 发表日期: 2026-Feb-17 链接: PubMed

摘要

Leveraging digital technologies in health care is recognized as essential for effective and efficient services. However, significant challenges remain in implementing these technologies in stroke rehabilitation practice, and research on their influence is limited. This study aimed to explore the current influence of digital technologies on stroke rehabilitation practices and consider how these technologies could shape the future landscape of rehabilitation for multidisciplinary health care professionals in poststroke rehabilitation. A qualitative, exploratory design was used. Data were collected from 12 experienced multidisciplinary health care professionals at 2 Norwegian rehabilitation settings via semistructured interviews, and the data were analyzed using reflexive thematic analysis. Data analysis was guided by social practice theory. The 12 participants included experienced physiotherapists, occupational therapists, speech therapists, nurses, physicians, and social workers. The following three main themes were generated: (1) Outsourcing information about and to stroke survivors: coordination and continuity within and across services (subthemes on follow-up and interservice collaboration, and user-centered approaches); (2) Navigating the ambivalence of remaining human relations in digital psychosocial support conversations (highlighting multidisciplinary challenges in building relational depth and addressing sensitive topics); and (3) Enhancing digital supplements for assessment and engagement in motor rehabilitation (subthemes on progress monitoring and motor skills exercises). Overall, the use of digital technologies in specialized stroke rehabilitation practices was seen as an adjunct to practices. While digital technologies influenced rehabilitation practices, ambivalence and challenges were noted, particularly in digitalizing multidisciplinary psychological support and exercise programs. Systems for sharing medical records and goal-setting apps, which enhance coordination and involve stroke survivors, were emphasized as future digital technologies that can shape stroke rehabilitation. Health care professionals used various technologies in their daily specialist practices, as well as for the coordination and follow-up of stroke survivors after referral to community services. This study identified several organizational processes, roles, standards, and rules that can act as barriers or drivers to implementing digital technologies in practice. Viewing familiar digital technology as a supplement to existing practices, rather than as a singular solution for all areas of specialized stroke rehabilitation, offers significant potential for quality improvement. These findings provide valuable insights for technology developers, health care personnel, and user groups in specialized neurological rehabilitation settings.

35. Glucagon-Like Peptide 1 Receptor Agonists and Risk of Nonarteritic Anterior Ischemic Optic Neuropathy in Patients With Type 2 Diabetes.

期刊: Diabetes care 发表日期: 2026-Feb-17 链接: PubMed

摘要

To estimate the effect of initiating glucagon-like peptide 1 receptor agonists (GLP-1 RAs) versus dipeptidyl peptidase 4 (DPP-4) inhibitors on incident nonarteritic anterior ischemic optic neuropathy (NAION) among adults with type 2 diabetes. This active-comparator, new-user cohort emulated a pragmatic target trial using the U.K. Clinical Practice Research Datalink. Patients aged ≥18 years with a physician diagnosis of type 2 diabetes who newly initiated a GLP-1 RA or a DPP-4 inhibitor were included. DPP-4 inhibitors were selected as the comparator because they may be used as second-line treatment, like GLP-1 RAs, and have no established association with NAION. We estimated risks, risk differences (RDs), and risk ratios (RRs) of incident NAION, adjusted using propensity-score fine-stratification weighting. At 1 year, there were 14 NAION events among 106,858 GLP-1 RA initiators (18.5 per 100,000) and 53 among 416,369 DPP-4 inhibitor initiators (7.2 per 100,000). GLP-1 RAs were associated with an increased risk of NAION compared with DPP-4 inhibitors (RR 2.56; 95% CI 1.44-4.86; RD 11.3 per 100,000). The risk of NAION was higher during the first 6 months of use, diminishing with longer duration of use, and was higher in patients aged <50 years, men, ever-smokers, and those with ≥1% hemoglobin A1c reduction. GLP-1 RAs were associated with an increased 1-year risk of NAION compared with DPP-4 inhibitors among adults with type 2 diabetes, particularly in younger patients, men, ever-smokers, and patients with a marked hemoglobin A1c reduction.

36. Workforce Detachment in Persons with Chronic Kidney Disease.

期刊: Clinical journal of the American Society of Nephrology : CJASN 发表日期: 2026-Feb-17 链接: PubMed

摘要

Impaired kidney function is associated with mortality, cardiovascular events, and hospitalization as well as diminished functional capacity and health-related quality of life. We hypothesized that kidney function would be linked to employment status, which itself is closely linked to financial stability, physical and mental health, and personal identity. By use of weekly updated information of patients’ occupational status, combined with laboratory data and nationwide registries on hospitalizations and deaths, we estimated kidney function in a working age population (18-60 years) to examine the absolute risk of workforce detachment by chronic kidney disease (CKD) status and CKD stage using the Aalen-Johansen estimator accounting for competing risks of retirement, and death. We identified 12,704 individuals with CKD and 68,938 matched individuals without CKD in the workforce at index date. Persons with CKD had a higher absolute risk of workforce detachment (1-year absolute risk: 9% versus 5%, p<0.001); the absolute risk was higher with more advanced CKD: (1-year absolute risk: eGFR>60 ml/min/1.73m2 =5%; CKD stages G3a=8%, G3b=12%, G4=14%, and G5=20%). Older age, female sex, diabetes, and lower level of education were associated with higher likelihood of workforce detachment. Findings related to kidney function were persistent across all subgroups examined. Persons with CKD were significantly more likely to experience workforce detachment than persons with normal or near normal kidney function. These data highlight another, less well-documented burden of CKD, highlighting the urgency to develop and disseminate early detection and treatment interventions.

37. Occupational genotoxicity in nursing professionals: A systematic review.

期刊: Journal of oncology pharmacy practice : official publication of the International Society of Oncology Pharmacy Practitioners 发表日期: 2026-Feb-17 链接: PubMed

摘要

ObjectiveNursing professionals are frequently exposed to a variety of chemical agents in healthcare settings, including disinfectants, anesthetic gases, cytotoxic drugs and other hazardous substances, raising concerns about potential genotoxic effects. This systematic review investigates the genotoxicity associated with occupational exposure commonly encountered by nursing staff.MethodsA systematic search conducted in August 2025 across PubMed, SCOPUS, and Web of Science identified 16 relevant studies that evaluated DNA damage using biomarkers, such as the micronucleus assay, comet assay, and chromosomal aberration tests in human or mammalian cells.ResultsAll included studies consistently reported genotoxic effects linked to occupational exposure, including increased frequencies of micronuclei, DNA strand breaks, and chromosomal alterations. Quality assessment indicated that 15 (out of 16) studies were of moderate to strong methodological rigor, supporting the reliability of these results.ConclusionThese findings underscore the need for enhanced monitoring and protective measures for nursing professionals at risk of long-term genetic damage. The micronucleus assay emerges as a suitable assay for biomonitoring these professionals.

38. The Micronucleus Assay in Exfoliated Buccal Cells Induced by Lifestyle Factors: An Overview.

期刊: Mutagenesis 发表日期: 2026-Feb-17 链接: PubMed

摘要

We describe the impact of lifestyle related factors on the formation of micronuclei (MN) in buccal cells. It is known that consumption of alcohol and of other drugs including tobacco and other plants cause damage of the genetic material and leads to adverse health effects. Overall, 235 articles were evaluated in total. Tobacco smoking, i.e. consumption of cigarettes (75 publications), water pipes (OECD (2023) In Vitro Mammalian Cell Micronucleus Test. OECD, Paris) and crack smoking (Ravanat, J.L., Cadet, J., and Douki, T. (2012) Oxidatively generated DNA lesions as potential biomarkers of in vivo oxidative stress. Curr Mol Med, 12, 655-671) caused mainly positive effects, while negative results were obtained with pure marijuana (WHO (2025) Preventing cancer. WHO, Geneva). Chewing habits (smokeless tobacco (Wultsch, G., Nersesyan, A., Misik, M., Ferk, F., Schelch, K., Scharnagl, M., Grusch, M., and Knasmuller, S. (2025) The Micronucleus Assay in Exfoliated Buccal Cells for Occupational Exposure Studies: An Overview. Mutagenesis) and betel with and without tobacco (Fenech, M., Holland, N., Zeiger, E., Chang, P.W., Kirsch-Volders, M., Bolognesi, C., Stopper, H., Knudsen, L.E., Knasmueller, S., Nersesyan, A., Thomas, P., Dhillon, V., Deo, P., Franzke, B., Andreassi, M.G., Laffon, B., Wagner, K.H., Norppa, H., da Silva, J., Volpi, E.V., Wilkins, R., and Bonassi, S. (2024) Objectives and achievements of the HUMN project on its 26th anniversary. Mutat Res Rev Mutat Res, 794, 108511) caused induction of MN in cells from the oral cavity (numbers indicate the number of publications). A study concerning khat chewing yielded a positive finding while reduction of MN was seen in consumers of coca leaves. Investigations concerning the effects of alcohol (OECD (2023) In Vitro Mammalian Cell Micronucleus Test. OECD, Paris), meat consumption (Huang, R., and Zhou, P.K. (2021) DNA damage repair: historical perspectives, mechanistic pathways and clinical translation for targeted cancer therapy. Signal Transduct Target Ther, 6, 254) and studies concerning the impact of the body mass index and body fat (Mateuca, R.A., Decordier, I., and Kirsch-Volders, M. (2012) Cytogenetic methods in human biomonitoring: principles and uses. Methods Mol Biol, 817, 305-334) led to inconsistent results. No evidence of MN induction was observed in studies on continuous physical exercise (WHO (2025) Preventing cancer. WHO, Geneva). Furthermore, exhaustive sporting activities also showed no indications of chromosomal damage (WHO (2025) Preventing cancer. WHO, Geneva). A number of studies (in total 22) was realized to investigate the effects of mobile phone specific radiation. The exposure was not adequately assessed in these investigations with questionnaires, furthermore, frequently inadequate stains (DNA-unspecific) were used (OECD (2023) In Vitro Mammalian Cell Micronucleus Test. OECD, Paris). The findings are controversial, and a clear negative result was obtained in a recent controlled intervention study. Overall the results indicate that the MN assay with buccal cells can be used to monitor chromosomal damage caused by smoking and chewing habits and to predict adverse health effects in the respiratory system and on the upper gastrointestinal tract. To draw firm conclusions about the effects of nutrition, mobile phone use, physical exercise, and body weight, further well-controlled trials are needed.

39. Mitophagy and Ubiquitination Coordinate Context-Specific Mitochondrial Quality Control and EMT/MET Plasticity to Drive Cancer Cell Invasion.

期刊: Advanced science (Weinheim, Baden-Wurttemberg, Germany) 发表日期: 2026-Feb-17 链接: PubMed

摘要

Metastatic invasiveness emerges from coordinated intrinsic programs and microenvironmental cues that converge on mitochondrial quality control (MQC). Here, we use “context” to denote stage- and site-aware constellations of tumor-intrinsic states (e.g., mtROS tone, mtDNA integrity, epigenetic wiring, cellular stiffness, oncogenic mutations) and extrinsic landscapes (oxygen-nutrient availability, ECM mechanics, stromal/inflammatory signals). These axes jointly shape mitochondrial adaptation by tuning bioenergetics, redox balance, metabolic plasticity, fission-fusion dynamics, mechanosensitive hubs, and Ca2 + homeostasis. As pressures intensify, mitochondrial vulnerabilities-such as mtDNA compromise and mtUPR activation-signal the engagement of mitophagy to preserve organelle fitness under stress. Through these coupled changes in mitochondrial performance and stress responses, context governs EMT/MET plasticity and transitions across migratory, invasive, and proliferative states. Mechanistically, ubiquitin conjugation, via E3 ligases and deubiquitinases, serves as an integrating conduit that links mitochondrial remodeling and mitophagy to cytoskeletal reprogramming and invasive behavior. This ubiquitin-mitochondria interface therefore represents a coherent therapeutic entry point; translational strategies including PROTAC-enabled targeting and selective E3/DUB or mitophagy-pathway modulators may rebalance pathological ubiquitin signaling, restore mitochondrial homeostasis, and constrain tumor dissemination.

40. Computerized Cognitive Remediation Affects White Matter Microstructure in Relation to Improved Cognitive Function in Adults with Chronic Traumatic Brain Injury.

期刊: Journal of neurotrauma 发表日期: 2026-Feb-17 链接: PubMed

摘要

Traumatic brain injury (TBI) frequently results in long-term cognitive deficits due to traumatic axonal injury and disruption of structural brain connectivity. Computerized cognitive remediation (CCR) has shown promise for improving cognitive outcomes in chronic TBI; however, diffusion imaging studies evaluating its effectiveness have often relied on tensor-based metrics that are limited in their ability to detect subtle treatment-related changes. This study used correlational tractography, a diffusion magnetic resonance imaging (dMRI) connectometry method sensitive to localized, fiber-specific changes, to investigate the effects of CCR on white matter microstructure in adults with chronic TBI and to further examine the relationship between white matter changes and improvements in cognitive function. Seventeen adults with chronic mild to severe TBI were assigned to an experimental group (n = 10), who received 40 hours of CCR over 14 weeks, or a nonintervention control group (n = 7). All participants underwent dMRI scans and cognitive assessments at pre- and postintervention visits. Correlational tractography was used to assess differences in longitudinal change of normalized quantitative anisotropy (QA), a tensor-free metric associated with axonal density and plasticity, across whole-brain white matter between CCR and nonintervention control groups. Following the intervention period, increased QA was observed in the CCR group, relative to the nonintervention control group, and changes in QA in the CCR group were related to improvements on objective measures of processing speed, attention, and working memory. These results provide preliminary evidence that CCR may promote white matter plasticity in relation to improved cognitive function in individuals with chronic TBI. Furthermore, by leveraging QA and correlational tractography, we were able to detect regionally specific changes that may have been overlooked using traditional tensor-derived diffusion metrics or tract-averaged approaches. Overall, our findings support the potential of CCR as a scalable intervention to facilitate structural and functional plasticity in adults with chronic TBI.

41. Optimal integration of lignin nanoparticles and whey protein distinctively stabilizes high internal phase pickering emulsions for multiple environmental resistances.

期刊: Food chemistry 发表日期: 2026-Feb-16 链接: PubMed

摘要

High internal phase Pickering emulsions (HIPPEs) are increasingly explored for sustainable food industries, but they rely on advanced solid particles stabilizers. In this study, we constructed an optimal lignin nanoparticles-whey protein (LNPs-WP) complex system to stabilize Pickering emulsions by forming a viscoelastic membrane at the oil-water interface through electrostatic attraction. The HIPPEs stabilized by LNPs-WP at high ratios (6:8-8:8) exhibited smaller oil droplets (d4,3 < 20 μm), higher viscosity, stronger elastic moduli and better thixotropic recovery. Notably, the optimal LNPs-WP (8:8) nanocomplexes maintained the emulsions with exceptional storage stability for 90 days, high thermal resistance up to 90 °C and strong ionic resistance with 1000 mM NaCl. Furthermore, the HIPPEs with the optimal LNPs-WP enabled 78% curcumin retention after 96 h UV-irradiation. Therefore, this study has demonstrated a powerful and green strategy for evolving desirable Pickering emulsions stabilization by optimal integration of natural bioparticles, providing a broad application in functional foods, pharmaceuticals, cosmetics and beyond.

42. The cost of coping with infertility: Extending theory on stressor appraisal.

期刊: The Journal of applied psychology 发表日期: 2026-Feb-16 链接: PubMed

摘要

Despite research on the workplace challenges of pregnancy, there has been notable inattention toward those struggling to become pregnant-women experiencing infertility (one of the most stressful and life-altering experiences women endure that affects around 13% of women of childbearing age). From the perspective of transactional stress theory, a coping response that addresses the cause of infertility (assisted reproductive technology treatment, ART) should reduce anxiety. However, for millions of working women coping with infertility via treatment, their anxiety persists, with consequences for occupational prestige and income. This divergence between scholarly consensus on coping and the lived experience reflects a puzzle with theoretical, practical, and societal implications. To reconcile this, we explain that the consensus is misaligned with the fundamental tenets of transactional stress theory. We posit that the cost of treatment creates a context whereby its efficacy for coping is hindered-a phenomenon called financial toxicity. We hypothesize that insurance may detoxify infertility treatment and reduce anxiety as predicted. Across two studies (an Australian longitudinal panel data set [N = 2,728] and a cross-sectional U.S. survey [N = 192]), we triangulate tests of our hypotheses and find support for our arguments. We discuss implications for transactional stress theory and illustrate how scholars can expand their conceptualization of coping to consider its potential toxicity. We further call attention to the critical societal and public policy implications of our findings, and we provide a roadmap with clear and actionable solutions. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

43. Automated vs. manual segmentation for small renal mass imaging.

期刊: Canadian Urological Association journal = Journal de l’Association des urologues du Canada 发表日期: 2026-Feb-13 链接: PubMed

摘要

Automated segmentation using artificial intelligence (AI) has the potential to rapidly perform three-dimensional (3-D) segmentation of small renal masses (SRM). The objective of this study was to test for clinically and statistically significant differences in time spent segmenting, accuracy, and reliability when comparing manual and automated segmentation of computed tomography (CT) scans with SRM. Patients with a CT scan, SRM <4 cm, and renal neoplasm were identified through an institutional database. Of the 854 patients identified, 184 were excluded. Forty test cases were randomly selected. There were 630 cases for training (using nnU-Net) to which 488 cases from the KiTS23 open-source data set were added. Each of the test cases was segmented by a radiologist, a urologist, and the AI model. Time to segment and Dice coefficients were compared. Deidentified segmented CTs were provided to two independent radiologists who attempted to identify the segmentor and rated the acceptability of the segmented images on a five-point Likert scale. There were 39 cases with complete timing data. The median time for the AI model to segment was one third of the radiologist’s (152.4 s, interquartile range [IQR] 120.9-177.8 vs. 450 s, IQR 318.8-551.2) and about one-fifth of the urologist’s (800.0 s, IQR 492.0-1538.0) (p<0.001). There was a high degree of inter-rater reliability (median Dice coefficients 0.86-0.90, p=0.09). The scoring radiologists were able to correctly identify the true segmentor in 61.6% of cases (p <0.001). The AI segmentations were scored highest among the three segmentors (median score 4.1/5, standard deviation [SD] 1.0) compared to 3.8 (SD 0.7) for the radiologist, and 3.3 (SD 0.7) for the urologist. Automated segmentation of CT scans for patients with SRM was efficient, accurate, and acceptable in this study. This approach has the potential to greatly improve the clinical use of radiomics to assess medical images for these patients.

44. Sucrose elicitation enhances antiglycative activity in safflower (Carthamus tinctorius L.) sprouts via stimulated biosynthesis of luteolin-7-glucoside.

期刊: Food chemistry 发表日期: 2026-Feb-13 链接: PubMed

摘要

Safflower (Carthamus tinctorius L.) sprouts, consumed as nutrient-rich vegetable, are recognized for their health-promoting properties due to their abundance of bioactive compounds. These properties position them as a valuable addition to a balanced diet. The present study explored the antiglycative potential of safflower sprouts and identified luteolin-7-glucoside (cynaroside, L7G) as a key active component through antiglycative-activity guided screening and instrumental analyses. Additionally, quantitative analyses revealed that L7G was predominantly localized in the cotyledons. To optimize L7G production, various carbohydrate treatments were evaluated, with sucrose demonstrating the most remarkable stimulatory effect. Transcriptomic analysis further suggested that sucrose treatment enriched the starch and sucrose metabolism pathway, leading to significant upregulation of amylase activity. This indicated metabolic adaptations that facilitated L7G production under sucrose-induced abiotic stress. Collectively, these findings underscore the potential of sucrose treatment as a strategy to enhance the antiglycative properties of safflower sprouts, advancing their application in functional foods.

45. Ultrasound-assisted sodium alginate impregnation enhances chlorophyll stability in Undaria pinnatifida.

期刊: Food chemistry 发表日期: 2026-Feb-12 链接: PubMed

摘要

Chlorophyll (Chl) degradation during thermal processing significantly compromises the color and nutritional quality of seaweed products. To improve color in Undaria pinnatifida (UP), ultrasound-assisted polysaccharide impregnation was combined with thermal processing. Kinetics at 70-120 °C showed first-order Chl degradation (Ea = 21.84 kJ/mol) and zero-order color change (ΔE). Through single-factor and response surface optimization, Sodium Alginate (SA, 0.25%) performed better than κ-carrageenan (κC), lowering ΔE from 21.73 to 1.78 and increasing Chl retention 103-fold versus the control under optimal conditions (120 min, 120 W). SA also raised antioxidant activity (DPPH scavenging: 81.2% vs. 52.3%). Electronic nose and Gas Chromatography Ion Mobility Spectrometry(GC-IMS)showed SA-ultrasound treatment suppressed off-flavors (W1W signal decreased 64.3%) and enriched pleasant volatiles. This offers a scalable method to simultaneously enhance color, nutrition, and flavor in seaweed products.

46. Racial, Ethnic, and Sex Differences in Social Risks and Social Needs Concordance Among Veterans.

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

摘要

Social screening initiatives often prioritize identifying social risks before offering support. The extent to which the emphasis on social risks contribute to overscreening and/or underdetection of needs, overall and across demographic subgroups, remains underexplored. To examine the agreement between self-reported social risks and needs for support and variance in risk-need concordance across racial, ethnic, and sex subgroups. This cross-sectional study examined responses to an online or mailed survey fielded between March 2 and May 9, 2023, to Veterans Health Administration patients who visited their primary care practitioner in January or February 2023. Survey weights were used to adjust for sampling frame and nonresponse. The data were analyzed between April 6 and December 15, 2025. Intersection of race, ethnicity, and sex. Risk-need sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and concordance across 12 domains (paying for basics, obtaining adult caregiving, obtaining childcare, finding or keeping work, paying for food, finding or keeping housing, getting transportation, accessing the internet at home, feeling isolated, feeling lonely, getting legal assistance, and getting additional education or job training) were measured using age-adjusted relative risk ratios (ARRRs) of risk-need discordance (vs concordance), controlling for a family-wise error rate of .05. The analytic sample included 6596 respondents, representing 937 003 veterans after weighting (unweighted number [weighted percentage]: aged <65 years, 2992 [48.5%]; aged ≥65 years, 3604 [51.5%]; 1088 identifying as Black female [4.1%], 1140 as Black male [19.4%], 939 as Hispanic female [1.6%], 1279 as Hispanic male [11.3%], 802 as White female [5.3%], and 1348 as White male [58.4%] race or ethnicity and sex). Across domains, risk-need sensitivity ranged from 42% (95% CI, 34%-49%) for housing to 99% (95% CI, 98%-99%) for loneliness, and specificity ranged from 69% (95% CI, 66%-71%) for loneliness to 98% (95% CI, 97%-99%) for childcare. The PPV ranged from 27% (95% CI, 22%-33%) for housing to 69% (95% CI, 63%-75%) for legal issues, and NPV ranged from 93% (95% CI, 91%-94%) for housing to 99% (95% CI, 99%-99%) for both childcare and loneliness. In age-adjusted models, compared with White male veterans, Black male veterans had a significantly higher likelihood of need-without-risk discordance for paying for basics (ARRR, 3.95; 95% CI, 1.80-8.64), housing (ARRR, 2.67; 95% CI, 1.59-4.48), and adult caregiving (ARRR, 2.13; 95% CI, 1.30-3.48). Additionally, compared with White male veterans, the likelihood of need-without-risk discordance for loneliness was higher among White female (ARRR, 14.02; 95% CI, 2.85-68.95), Hispanic female (ARRR, 10.87; 95% CI 2.31-51.25), and Hispanic male (ARRR, 8.08; 95% CI, 2.47-26.39) veterans. Differences for risk-without-need discordance were not significant. This cross-sectional study of Veterans Health Administration patients found that social risk questions were better at identifying veterans without a social need than those who needed support and underdetected need for support among Black male veterans. Improved survey methods are essential to accurately detect needs in diverse populations.

47. Can generative artificial intelligence enhance evidence-based and personalized medicine?

期刊: PLoS medicine 发表日期: 2026-Feb 链接: PubMed

摘要

Should clinical applications of generative artificial intelligence (GAI) be designed to follow treatment guidelines rigidly, provide individualized recommendations, or be somewhere in-between? A recent study in PLOS Medicine comparing GAI versus physician treatment recommendations highlights the importance of context- and patient-specific circumstances in decision-making.

48. The effect of prenatal balanced energy and protein supplementation on small vulnerable newborn types in low- and middle-income countries: A systematic review and meta-analysis of individual participant data.

期刊: PLoS medicine 发表日期: 2026-Feb 链接: PubMed

摘要

Small vulnerable newborn (SVN) types, defined by combinations of being born too soon or too small, have distinct determinants, health consequences, and prevention strategies. The effects of prenatal balanced energy and protein (BEP) supplementation on SVN types remain unknown. We conducted a systematic review and meta-analysis of individual participant data from eight randomized controlled trials of prenatal BEP supplements (N = 10,252, with 5,164 in the BEP arm and 5,088 in the control arm) in low- and middle-income countries were used. The control arms varied across studies and included context-specific standards of care, iron and folic acid supplements, or multiple micronutrient supplements. Newborns were classified into 10 groups through the combinations of preterm birth, small for gestational age (SGA) birth, and low birthweight (LBW), such as term-appropriate-for-gestational-age (AGA)-nonLBW, preterm-SGA-LBW, preterm-large-for-gestational-age-LBW, term-SGA-LBW, preterm-AGA-nonLBW, and other permutations. Newborns were also analyzed using a four-group categorization that included term-nonSGA, preterm-nonSGA, term-SGA, and preterm-SGA. Log-binomial models were used to estimate study-specific risk ratios (RRs), which were pooled using meta-analyses. Subgroup analyses were conducted by maternal age, parity, gestational age at enrollment, early pregnancy body mass index, and maternal anemia status. In the 10-group categorization of SVNs, on average, prenatal BEP supplementation led to a 30% lower risk of preterm-SGA-LBW (RR: 0.70; 95% CI [0.53, 0.91]; P = 0.009), a 25% lower risk of preterm-AGA-LBW (RR: 0.75; 95% CI [0.60, 0.93]; P = 0.009), and a 20% lower risk of term-SGA-LBW (RR: 0.80; 95% CI [0.72, 0.90]; P < 0.001). In the four-group categorization, prenatal BEP supplementation led to a 31% lower risk of preterm-SGA (RR: 0.69; 95% CI [0.52, 0.91]; P = 0.008) and a 12% lower risk of term-SGA (RR: 0.88; 95% CI [0.81, 0.96]; P = 0.005). The protective effect of prenatal BEP supplementation on preterm-SGA was stronger among multiparous women and women without anemia. The protective effects on all three SVN types under the four-group categorization were stronger among women enrolled before 20 weeks of gestation. The main limitations of the study included the absence of some BEP trials and the small event numbers for some SVN types. Prenatal BEP supplementation reduces the risk of SVNs to varying extents. Further research is needed to determine the optimal targeting approach for providing BEP supplements to vulnerable pregnant women who are most likely to benefit from the supplementation.

49. Social Influences Across Vaping Trajectories of Female Tertiary Students.

期刊: Drug and alcohol review 发表日期: 2026-Feb 链接: PubMed

摘要

Vaping prevalence has risen rapidly among young people in Aotearoa New Zealand. This study aimed to explore social influences (e.g., norms and acceptability among peers), focusing on female university students, using a trajectory approach. This qualitative research was set in Canterbury, New Zealand; six friendship dyad interviews (semi-structured) were conducted with 12 female tertiary students aged between 18 and 24 who vaped at least daily. Data were thematically analysed. The young women in this study report finding ENDS attractive, and particularly noted social influences, flavours, device characteristics and mood management as important for both initiation and on-going vaping. Gendered findings were identified, including ‘pinkification’ and device modification. Influences shifted across trajectories as addiction and dependence developed, and harms were experienced, with participants identifying barriers to vaping cessation. Policy such as stronger restrictions on flavours and visual characteristics of ENDS should be considered to reduce the appeal of vaping to young women. There is a need for stigma reduction surrounding vaping addiction and dependence, and peer support may improve cessation engagement and efficacy for young women. This research explores trajectories of young women’s vaping from before first use, to experimenting, progressing to daily use and considering cessation. Throughout this trajectory, social influences form a significant influence on behaviour, emphasising the importance of considering social aspects in health promotion efforts. This study provides new insights on vaping in a tertiary education context and identifies gendered aspects of vaping through the focus on young women, which can then inform health promotion efforts.

50. Oral delivery of the systemic acaricide moxidectin to a confined Odocoileus virginianus (Artiodactyla: Cervidae) herd parasitized by Ixodes scapularis (Ixodida: Ixodidae).

期刊: Journal of medical entomology 发表日期: 2026-Jan-20 链接: PubMed

摘要

This study evaluated efficacy of oral delivery of the systemic acaricide moxidectin to a confined, wild, white-tailed deer (Odocoileus virginianus Zimmermann; WTD) herd in late fall, when adult blacklegged ticks (Ixodes scapularis Say) are known to actively seek hosts in the northeastern United States. Moxidectin-treated corn was dispensed using timed-release feeders at a fenced study site in Connecticut during fall 2021 and 2022. White-tailed deer were captured and sampled four times each year to measure moxidectin levels in sera and assess adult I. scapularis burdens. Results documented that oral moxidectin delivery achieved sufficient dosing for targeting I. scapularis. Mean moxidectin concentrations in sera samples (11.7 ppb when detected) were at or above minimum lethal threshold to kill parasitizing ticks (5-8 ppb) in 66% of captured deer (n = 33) when treated feed was available. Use of timed-release feeders purposefully reduced overall corn consumption by an average of 40% compared to traditional ad libitum 4-poster device strategy, presumably minimizing intraspecific competition from hierarchical feeding behaviors as well as non-target consumption and excessive caloric supplementation. This study demonstrates that fall deployment of moxidectin-treated corn using timed-release feeders can be an effective and efficient method for the systemic treatment of WTD contributing to integrated tick management strategies for reducing tick-borne disease risk while minimizing caloric input.

51. Irregular antibodies in pregnancy during the universal anti-RHD prophylaxis era: a survey of Spanish Hospitals.

期刊: Blood transfusion = Trasfusione del sangue 发表日期: 2026-Jan-19 链接: PubMed

摘要

Although great advances have been made in the prevention of hemolytic disease of the fetus and newborn, especially for anti-D, irregular antibodies still appear. In order to ascertain the situation in Spain, we conducted a survey among hospitals treating pregnant women. We sent a survey to Spanish public hospitals comprising demographical data (ethnicity, number of pregnancies, type of fertilization), characteristics of antibodies (specificity, number, antigenic compatibility), cause of alloimmunization and the clinical consequences (fetal death, icterus, anemia) between 2016 and 2021. We characterized the risk posed by antibodies and their clinical impact according to previously described criteria. During the study period, 574,140 children were born in the responding hospitals. Antibodies were detected in 1,055 women with 1,112 pregnancies, resulting in a 0.19% alloimmunization prevalence. The most common antibodies were anti-D (No.=393, 28.7%), anti-c (No.=204, 14.9%), anti-E (No.=199, 14.6%), anti-M (No.=129, 9.4%), and anti-Kell (No.=114, 8.3%). Incorrect prophylaxis administration in the current or past pregnancy accounted for 88.6% of anti-D, and 12 (6.5%) arose from an RhD-positive transfusion. When analyzing incompatible pregnancies (No.=424; 38%), 103 (24.3%) presented severe or very severe hemolytic disease, most of which (No.=92, 89%) were produced by high-risk antibodies, while only 11 cases were caused by medium-risk antibodies. The prevalence of irregular antibodies during pregnancy in Spain is lower than previously described for other Western countries. The most important antibodies are anti-D, anti-c and anti-K. More efforts to characterize antibodies should be made in order to reduce their prevalence and clinical impact.

52. Tools for municipal health promotion planning-A Group Delphi study to facilitate decision-making.

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

摘要

Health promotion at the local level requires coordinated action for the development of strategies to promote health and well-being. For structuring and implementing such processes, planning tools can help local coordinators. However, before starting the planning process, coordinators must navigate a broad range of available tools and identify those that best fit their local needs and conditions. Despite the availability of various planning tools for municipal health promotion, there is limited research on what kind of information can help health professionals choose the most suitable tool. To address this gap, the study investigates which specific attributes of planning tools are considered most relevant by municipal health promotion practitioners for informed decision-making. The study was conducted using the Group Delphi method, which involved experts in a participatory process to reach consensus on pre-defined statements. A total of 17 experts from intersectoral fields including municipalities, federal state and national institutions as well as academia took part. Quantitative and qualitative analysis of the Delphi results led to the identification of eleven categories. These findings provide a practical framework for describing planning tools in a way that meets the information needs of practitioners. By improving clarity and accessibility of tool descriptions, the results can support more targeted tool selection, enhance the efficiency of planning processes and ultimately contribute to a more effective municipal health promotion.

53. Predictors of 30-day hospitalization in patients with worsening heart failure receiving outpatient intravenous diuretics.

期刊: PloS one 发表日期: 2026 链接: PubMed

摘要

Outpatient intravenous (IV) diuretic treatment is an effective and safe strategy for worsening heart failure (WHF). Still, hospitalization cannot be avoided in a substantial portion of patients and potential predictors of HF hospitalization (HFH) are eagerly awaited. We aimed to identify predictors of HFH after outpatient IV diuretic treatment for WHF, in order to improve the selection of patients who qualify for successful outpatient IV diuretic treatment. We studied WHF patients receiving intravenous diuretics in an outpatient day-care setting in one of two Dutch hospitals. A total of 366 patients from hospital A were used to identify predictors of 30-day HF (re-)hospitalization (HFH), which occurred in 88 (24.0%). Mean age was 76 years, 57% were male and 49% had ejection fraction below 40%. Age, eGFR, NT-proBNP, sodium, and haemoglobin were identified as predictors of HFH. The multivariable logistic regression model containing these factors had acceptable calibration and discrimination (AUC 0.73). The performance of the model was less favorable in the 127 patients from hospital B (29 patients with 30-day HFH), with AUC 0.65 and suboptimal calibration, indicating overestimation of risk. Doubling of NT-proBNP plasma levels and higher ambulatory oral loop diuretic dosages were strong predictors of mortality and HFH at 6 months in hospital A. In patients with WHF receiving outpatient day-care intravenous diuretic treatment, age, eGFR, NT-proBNP, sodium and haemoglobin predicted 30-day HFH. These factors may guide decisions on day-care treatment versus hospitalization, but require further validation Fig 2.

54. Bladder cancer-induced CVD mortality: Role of CAPG protein.

期刊: PloS one 发表日期: 2026 链接: PubMed

摘要

Explore the causes and mechanisms of bladder cancer-induced Cardiovascular diseases (CVD) death. We acquired bladder cancer patient data from the SEER database to evaluate CVD death risk. Cross-WGCNA was employed to identify comorbidity genes linking bladder cancer and heart failure. Functional phenotypes of bladder cancer cell lines were analyzed using cell culture, transaction, CCK-8, and Transwell assays, while ELISA determined extracellular target protein concentrations. Myocardial cell function was assessed by examining cell proliferation, collagen I levels, and mitochondrial membrane potential. Our study, analyzing 140,760 bladder cancer patients from the SEER database, revealed that CVD is a major cause of death, increasing risk by 18%. Cross-WGCNA and Lasso regression identified SFRP1 and CAPG as key serum proteins linked to bladder cancer and heart failure. Regulating these proteins’ mRNA levels significantly impacts cancer proliferation, migration, and invasion. CAPG, in particular, suppresses myocardial cell function. We discovered SB525334 as a strong CAPG inhibitor in bladder cancer cells, potentially enhancing cisplatin’s effectiveness by targeting CAPG. Bladder cancer patients face an elevated CVD death risk due to high CAPG protein expression, which can raise serum CAPG levels and harm cardiomyocytes.

55. Local and global mortality experience: A novel hierarchical model for regional mortality risk.

期刊: PloS one 发表日期: 2026 链接: PubMed

摘要

Accurate mortality risk assessment is critical for decision-making in life insurance, healthcare, and public policy. Regional variability in mortality, driven by diverse local factors and inconsistent data availability, presents significant modeling challenges. This study introduces a novel hierarchical mortality risk model that integrates global and local data, enhancing regional mortality estimation across diverse regions. The proposed approach employs a two-stage process: first, a global Light Gradient Boosting Machine model is trained on globally shared features; second, region-specific models are developed to incorporate local characteristics. This framework outperforms both purely local models and standard imputation techniques, particularly in data-scarce regions, by leveraging global patterns to improve generalization. The model is computationally efficient, scalable, and robust in handling missing values, making it adaptable for other domains requiring integration of multi-regional data. This method enhances predictive accuracy across various regions and provides a more reliable approach for mortality risk estimation in data-scarce environments.

56. Elucidating key targets and mechanisms of diethyl phthalate-induced colorectal cancer through network toxicology and molecular docking.

期刊: PloS one 发表日期: 2026 链接: PubMed

摘要

Diethyl phthalate (DEP), a widely used plasticizer with endocrine-disrupting properties, has raised concerns regarding its potential carcinogenic effects. However, its precise role in colorectal cancer (CRC) development remains poorly understood. The chemical structure of DEP was obtained from the PubChem database. Potential targets of DEP were identified through ChEMBL and STITCH databases and intersected with known CRC-related genes to screen for candidate biomarkers. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analyses were performed to explore the biological functions and signaling pathways involved. Molecular docking was conducted to predict the binding affinities between DEP and core targets. Finally, 200-ns molecular dynamics (MD) simulations using GROMACS were employed to evaluate the binding stability and dynamic behavior of the DEP-target complexes. A total of 62 overlapping genes were identified between DEP targets and CRC-associated genes. GO and KEGG enrichment analyses indicated enrichment in epigenetic regulation, chromatin remodeling, and cancer-related signaling pathways, including Notch, TGF-β, and FoxO. Protein-protein interaction analysis identified EP300, EZH2, HDAC1, HDAC2, and KDM1A as key epigenetic regulators. Molecular docking predicted moderate binding affinities between DEP and these targets (-6.6 to -5.7 kcal·mol ⁻ ¹). Subsequent 200-ns MD simulations suggested that DEP formed stable complexes with HDAC1, KDM1A, and EZH2, moderate stability with EP300, and partial dissociation with HDAC2, consistent with hydrophobic and hydrogen-bonding interactions at the binding interfaces. This study provides a theoretical framework for exploring the molecular mechanisms through which DEP may contribute to CRC development, emphasizing the value of network toxicology in cancer research. These findings may inform future investigations into the risks of DEP exposure and support public health policy and the development of targeted therapeutic strategies.

57. Place susceptibility index mapping at local government scale from population-based survey for Sub-Saharan Africa.

期刊: PloS one 发表日期: 2026 链接: PubMed

摘要

The Place Susceptibility Index (PSI) has the potential to be a critical tool in effectively managing infectious disease outbreaks or natural disasters in Africa. However, PSI availability for the African continent is limited and often, when available, is only at the national or regional level. Thus, lacking the required details to support locally relevant decision-making to support such activities. Here, outlined the method for modeling PSI at the 3rd-order administrative level for selected African Countries. This method combined Bayesian spatial statistical modeling with the utilization of the Population-based HIV Impact Assessments (PHIA) data and geospatial covariates. Using the Jenks Classification, substantial variations in PSI classes across the countries were observed. Across the 10 countries, about 45% of the spatial units were categorized as the low and relatively low susceptibility classes, while around 31% belonged to the high and very high classes. Botswana had 17% of the spatial units classified as high or very high, while Zambia had as many as 58% of its spatial units in these classes. The analysis showcased wide variations in susceptibility across countries, thus highlighting heterogeneity often missed in national datasets. This thereby provides insight into regions and areas within each country with the potential for severe negative outcomes from disease outbreaks and natural or man-made disasters. The datasets presented here are publicly available as part of the INFORM Africa Research project, and provide an evidence base to inform strategic decision-making.

58. Comparing Low-density Lipoprotein Cholesterol Population Estimates Using Different Predictive Equations: National Health and Nutrition Examination Survey, 2015-2018.

期刊: National health statistics reports 发表日期: 2025-Dec-16 链接: PubMed

摘要

Since 1972, low-density lipoprotein cholesterol (LDL-C) has been calculated by the Friedewald equation, which estimates very low-density lipoprotein cholesterol as triglycerides divided by 5 and is accurate only for triglycerides <400 mg/dL. The Martin equation, published in 2013 (for triglycerides <400 mg/dL), replaced 5 with a factor varying over an array of non-high-density lipoprotein cholesterol and triglyceride levels. This array was extended in 2021 for triglycerides 400-<800 mg/dL. In 2020, the Sampson equation, accurate for triglycerides <800 mg/dL, was developed using multiple least squares regression. This report compares LDL-C as calculated by the Friedewald, Martin, and Sampson equations in a nationally representative sample of adults with triglycerides <400 mg/dL across the distribution of clinical cut points for LDL-C (<70 mg/dL, 70-<100 mg/dL, 100-<160 mg/dL, 160-<190 mg/dL, and ≥190 mg/dL) to assess the impact of equation choice on national estimates. Using data on 4,461 adults in the 2015-2018 National Health and Nutrition Examination Survey, classification agreement into the LDL-C categories used for clinical management across the three equations was assessed using kappa statistics for men and women overall and by demographic subgroups. A sensitivity analysis assessed classification agreement between the Martin and Sampson equations for adults with triglycerides <800 mg/dL. During 2015-2018, 9.8%-10.0% of adults age 20 and older had LDL-C levels <70 mg/dL (Friedewald: 10.0%, Martin: 9.8%, Sampson: 9.8%). Less than 3% had LDL-C >190 mg/dL (Friedewald: 2.3%, Martin: 2.4%, Sampson: 2.6%). Very good agreement between the equations was seen in all subgroups (kappa >0.8). The three equations for LDL-C produce similar U.S. population-level percent distributions for adults age 20 and older across LDL-C categories.

59. The Impact of Self-Care Practices on Resilience in Baccalaureate Nursing Faculty.

期刊: Nursing education perspectives 发表日期: 链接: PubMed

摘要

The study explored the relationship between self-care practices and resilience in baccalaureate nursing faculty before, during, and after the COVID-19 pandemic. There is limited research on self-care and resilience in nurse faculty, yet certain factors have been determined to negatively impact work-life balance. A cross-sectional research survey collected quantitative data on demographics, self-care practices, and resilience. Surveys were sent to nurse faculty within a large statewide system (n = 312). Before the pandemic, neither demographic characteristics nor self-care was significant predictors of resilience; during and after, however, there was a statistically significant relationship between self-care behaviors and resilience (p = .007, p = .018). Faculty reporting higher levels of self-care measured higher in resilience. Encouraging self-care practices in nurse faculty can enhance resilience and potentially improve overall well-being. Further research on factors of influence would be of benefit.

60. Health of Bi+ Dementia Caregivers: Moderation Effects of Minority and Caregiving Stress.

期刊: American journal of Alzheimer’s disease and other dementias 发表日期: 2026 链接: PubMed

摘要

Despite comprising the largest segment of the sexual minority population and experiencing unique stressors and health disparities, bi+ dementia caregivers remain underrepresented in health and caregiving research. This secondary analysis of cross-sectional survey data from LGBTQ+ dementia caregivers (bi+, n = 125; gay[g]/lesbian[l], n = 161) examined whether associations between minority and caregiving stressors and global health differed by caregiver group. Bi+ caregivers reported significantly higher minority stress and lower family quality of life but better health than g/l caregivers. Moderation analyses revealed: higher perceived stress predicted worse health for bi+ but better health for g/l; higher family quality of life predicted better health for both groups, with a stronger effect among bi+ caregivers; and more lifetime discrimination predicted worse health for both groups, with a stronger effect among bi+ caregivers. Results underscore the need for inclusive, affirming research and interventions addressing bi+ caregiver stress experiences.