公共卫生研究摘要 (2026-02-20)
共收录 55 篇研究文章
1. Contrast-Associated Acute Kidney Injury After Thrombectomy for Ischemic Stroke: Prognostic Impact and CAN-REST Predictive Score.
期刊: Neurology 发表日期: 2026-Mar-24 链接: PubMed
摘要
Contrast-associated acute kidney injury (CA-AKI) is a potentially preventable complication after exposure to iodinated contrast media. In patients undergoing endovascular thrombectomy (EVT) for acute ischemic stroke (AIS), the incidence and clinical impact are poorly characterized, and no validated prediction tool is currently available. The aim of this study was to assess the incidence and prognostic significance of CA-AKI in EVT-treated patients with AIS and to develop and validate a predictive score. A retrospective, multicenter cohort study was conducted involving EVT-treated patients across 73 centers in 16 countries (January-December 2023). Inclusion criteria were age ≥18 years, absence of dialysis, availability of preprocedural and 48-hour postprocedural creatinine levels, and available 90-day follow-up (modified Rankin Scale [mRS] score). The primary outcome was CA-AKI, defined by KDIGO (Kidney Disease: Improving Global Outcomes criteria;creatinine increase ≥0.3 mg/dL or ≥1.5 times baseline, within 48 hours). Secondary outcomes were (1) in-hospital mortality, (2) 90-day mRS score, and (3) 90-day severe disability or death (mRS score >3). Logistic models assessing associations with outcomes accounted for within-center clustering by applying robust standard errors. CA-AKI prediction models were developed across imputed data sets using univariable selection (p < 0.20), backward elimination (p < 0.05), and coefficient-based scoring after categorization of continuous predictors, with internal validation by bootstrap to obtain optimism-adjusted estimates. Among 6,638 patients (median age 74 years; 48.7% male), CA-AKI occurred in 326 (4.9%) and was independently associated with in-hospital mortality (adjusted odds ratio [aOR] 2.269; 95% CI 1.615-3.190), higher 90-day mRS scores (adjusted common odds ratio 1.584; 95% CI 1.110-2.258), and 90-day severe disability or death (aOR 1.530; 95% CI 1.057-2.216). A preprocedural risk model including 12 routine clinical variables-sex, ethnicity, arterial hypertension, dyslipidemia, chronic kidney disease, antiplatelet therapy, NIH Stroke Scale score at admission, serum glucose, estimated glomerular filtration rate, hemoglobin, mean arterial pressure, and IV thrombolysis-demonstrated acceptable discrimination (area under the receiver operating characteristic curve 0.710 [95% CI 0.682-0.738]; precision-recall area under the curve 0.13 [95% CI 0.10-0.16]), good calibration (slope 0.870 [95% CI 0.759-0.928]), good overall performance (Brier score 0.045 [95% CI 0.042-0.049]). A second model that included EVT-related variables (e.g., contrast volume) showed similar performances. In this large, international cohort, CA-AKI occurred in approximately 1 in 20 EVT-treated patients with AIS and was independently associated with poor outcomes. A simple preprocedural risk score enables early identification of high-risk individuals and may support preventive strategies.
2. Adjuvant Chemotherapy in Stage I Ovarian Clear Cell Carcinoma: A Systematic Review and Meta-analysis.
期刊: Obstetrics and gynecology 发表日期: 2026-Mar-01 链接: PubMed
摘要
To investigate the treatment effect of adjuvant chemotherapy for stage I ovarian clear cell carcinoma. We searched Cochrane, PubMed, International Standard Randomised Controlled Trial Number registry, ClinicalTrials.gov, the World Health Organization International Clinical Trials Registry Platform, and Ichushi-Web to January 22, 2025. We included randomized controlled trials (RCTs) and non-RCTs that included more than 50 patients with stage I ovarian clear cell carcinoma. The primary and secondary outcomes were disease-free survival and overall survival, respectively. We performed a meta-analysis of the stage-adjusted hazard ratios (HRs) of adjuvant chemotherapy compared with placebo or no intervention. The substage-related heterogeneity of effects was also assessed. A meta-analysis of proportions was also conducted to assess 5-year disease-free survival and 5-year overall survival. Risk of bias was assessed with the Risk of Bias in Non-randomized Studies of Interventions tool. Because no RCTs reported HRs for the ovarian clear cell carcinoma subgroup, data from nine non-RCTs were analyzed. The pooled substage-adjusted HR for disease-free survival associated with use of chemotherapy was 0.47 (95% CI, 0.29-0.74) and that for overall survival was 0.66 (95% CI,0.43-1.00). Heterogeneity in the effect by substage was not evident for either disease-free survival (P for subgroup difference=.91) or overall survival (P=.60). The pooled 5-year disease-free survival was 0.80 (95% CI, 0.65-0.89) for stage I overall, 0.95 (95% CI, 0.47-1.0) for stage IA, and 0.61 (95% CI, 0.47-0.74) for stage IC. The estimated number needed to treat was 10.2 (95% CI, 5.8-18.6) for stage I overall, 40.8 (95% CI, 3.9-infinity) for stage IA, and 5.2 (95% CI, 3.9-7.8) for stage IC. Adjuvant chemotherapy improves disease-free survival and may prolong overall survival in patients with stage I ovarian clear cell carcinoma. Available evidence suggests that recurrence is reduced by approximately 50%. Treatment decisions should consider the baseline recurrence risks and absolute benefits. PROSPERO, CRD42024562486.
3. Spatially resolved denitrification coupled with methane and arsenite oxidation at the millimeter-scale straw-soil interface.
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
Straw return reshapes the biogeochemical processes in paddy soils by driving microbial transformation of key elements. Despite growing awareness of these individual processes, the integration of these processes under millimeter-scale spatiotemporal heterogeneity remains unclear. Combining high-resolution geochemical profiling with multiomics, we revealed that straw addition altered the depth-dependent dynamics of arsenic, carbon, and nitrogen, establishing a sophisticated three-layer microbial stratification. We identified 1) an 18 mm organic matter (OM)-rich layer extending from the straw layer, which serves as a methanogenic epicenter co-occurring with active nitrogen fixation microbes; 2) an overlying layer dominated by aerobic methane oxidation and denitrification microbes; and 3) a deeper substraw layer dominated by anaerobic arsenite oxidation and denitrification microbes. Significantly positively correlated abundances of transcribed mcrA with nifH genes and pmoA or aioA/arxA with denitrification genes were identified. Corroboratively, intensified co-occurrence patterns of mcrA with nifH, pmoA with denitrification, and aioA/arxA with denitrification genes were observed in the OM-rich, upper, and lower layers, respectively. Moreover, the co-occurred mcrA-nifH and aioA-nirS/arxA-narG genes in different metagenome-assembled genomes presented 80.6 to 260.8- and 1.55 to 6.85-fold greater transcriptional activity in the OM-rich and lower layers than in the other layers, respectively. Our results demonstrated that straw incorporation established a dynamic soil redox zone, restructuring millimeter-scale microbial networks and promoting potentially coupled denitrification with arsenite or methane oxidation, as well as methanogenesis with nitrogen fixation. These findings provide a mechanistic basis for optimizing subsurface straw placement and nitrate application to enhance nutrient cycling and mitigate environmental risks.
4. Feasibility of a Noncontact Photoplethysmography-Based Mobile App for Noninvasive Hemoglobin Monitoring: Exploratory Observational Study.
期刊: JMIR formative research 发表日期: 2026-Feb-19 链接: PubMed
摘要
Anemia is a widespread global health issue. Hemoglobin (Hb) concentration measurement remains the most common method for anemia screening and diagnosis. In recent years, there has been growing interest in the development of noninvasive point-of-care technologies that eliminate the need for blood sampling. This pilot study explores the feasibility of using a noncontact photoplethysmography-based mobile app for Hb monitoring. Adult volunteers aged 18 years and older, of both sexes, were consecutively recruited. Participants were seated and allowed a 2-minute rest before measurements. During testing, they faced a smartphone running comestai.app, which used the front-facing camera to capture facial videos. Simultaneous readings were collected for Hb over approximately 90 seconds using the app. Ambient lighting was standardized for all remote photoplethysmography recordings. No medical decisions were made based on the app-generated data. A complete blood count, including Hb levels, was used as a reference for comparison with the data collected using comestai.app. A total of 555 (female: n=313, 56.4%; male: n=242, 43.6%) individuals participated in the study. The app achieved a mean absolute error of 1.46, a mean absolute percentage error of 11.26, a mean error of -0.67, and a root mean square error of 1.88. The Bland-Altman plot evaluated the agreement between the app-based and laboratory-based Hb measurements, with the mean difference between the 2 methods being -0.70 g/dL. The method demonstrated an overall accuracy of 75%. The area under the curve was 0.701 (95% CI 0.655-0.745). Comestai.app offers an innovative approach to wellness monitoring by providing noninvasive Hb estimation using the smartphone’s front-facing camera. Continued development, including algorithmic refinement and larger-scale validation in diverse populations, will be key to enhancing accuracy and broadening its utility. By leveraging the ubiquity of smartphones, comestai.app contributes meaningfully to the democratization of health monitoring and the promotion of proactive self-care.
5. Securing Federated Learning With Blockchain in the Medical Field: Systematic Literature Review.
期刊: Journal of medical Internet research 发表日期: 2026-Feb-19 链接: PubMed
摘要
The exponential growth of medical data and advancements in artificial intelligence (AI) have accelerated the development of data-driven health care. However, the secure and efficient sharing of sensitive medical data across institutions remains a major challenge due to privacy concerns, data silos, and regulatory restrictions. Traditional centralized systems are prone to data breaches and single points of failure, while existing privacy-preserving techniques face high computational and communication costs. This study aims to provide a comprehensive review of the recent advances in blockchain-based federated learning (BCFL) within the medical field. By exploring the synergistic integration of federated learning and blockchain, this review evaluates how BCFL enhances data security, supports privacy-preserving cross-institutional collaboration, and facilitates practical applications in health care, including medical data sharing, Internet of Medical Things, public health surveillance, and telemedicine. We conducted a systematic literature review using databases such as PubMed, IEEE Xplore, Web of Science, and Google Scholar. Boolean logic and domain-specific keywords were used to retrieve studies from 2018 to 2025. After automated deduplication and multistage manual screening, over 100 high-quality papers were included. These works cover BCFL’s theoretical foundations, system architectures, application domains, limitations, and future directions. BCFL frameworks combine the decentralized trust and auditability of blockchain with the privacy-preserving collaborative learning capabilities of federated learning. This integration mitigates risks such as model tampering, data leakage, and a lack of incentives in federated systems. Applications span across cross-institutional medical data sharing, Internet of Medical Things, epidemic forecasting, and telemedicine. Architectures including fully coupled, flexibly coupled, and loosely coupled models offer varying trade-offs between efficiency, scalability, and security. BCFL represents a transformative paradigm for secure, collaborative, and privacy-preserving medical AI. By combining decentralized trust, incentive-driven participation, and privacy-enhancing machine learning, BCFL paves the way for next-generation smart health care systems. Despite current technical and practical challenges, BCFL demonstrates strong potential to support precision medicine, global health data collaboration, and large-scale AI deployment in health care.
6. Experiences of Alert Fatigue and Its Contributing Factors in Hospitals: Qualitative Study.
期刊: Journal of medical Internet research 发表日期: 2026-Feb-19 链接: PubMed
摘要
Alerts, a key feature of electronic health record systems, intend to improve patient safety by providing timely information at the point of care. However, many electronic health record systems generate excessive alerts that are not immediately clinically relevant and that contribute to alert fatigue. Despite growing recognition of alert fatigue as a safety concern, clinicians’ experiences of alert fatigue and the broader system-level factors that contribute to it being experienced are not well understood. This study aims to use a human factors approach to (1) comprehensively explore how alert fatigue is experienced by junior doctors; (2) identify factors that contribute to experiences of alert fatigue; (3) identify perceived impacts of alert fatigue on employees, organizations, and patients; and (4) identify strategies to reduce alert fatigue in practice. Semistructured interviews were conducted with junior doctors working in hospitals across Australia. Data were thematically analyzed using a hybrid inductive and deductive approach, informed by the Systems Engineering Initiative for Patient Safety and an information processing model. A total of 20 junior doctors were interviewed. Alert fatigue was described to occur at different stages of information processing, including when alerts were not detected, were superficially processed using mental shortcuts, or required excessive cognitive effort to interpret. When alerts were not detected or thoroughly processed, participants more often perceived impacts on patient safety and care quality due to the potential to miss important information. Further, when alerts required excessive cognitive effort, participants frequently reported interruptions, frustration, and time and effort loss as impacts. Factors influencing experiences of alert fatigue were identified in all Systems Engineering Initiative for Patient Safety work system domains, including those related to people, tasks, the environment, tools and technologies, and the organization. Key contributors included the design and clinical relevance of alerts, institutional norms and expectations, and information overload from system alerts as well as other alerts and tasks. Alert fatigue was also described to be experienced differently depending on provider characteristics, such as experiences with and knowledge of alerts, mood, and personality, and organizational factors, including culture, shift type, and time of day. Alert fatigue is not a binary concept but is instead experienced on a continuum and influenced by interacting individual, technical, and contextual factors. Future research should incorporate clinician self-reports to evaluate experiences of alert fatigue in addition to objective measures. Addressing alert fatigue requires tailored interventions that target its different causes and outcomes. These could include technical and design improvements, changes to organizational practices, and individual customization to reduce experiences of fatigue and accommodate differences in clinicians’ needs.
7. Designing App Interfaces to Elicit Specific Emotional Responses and Improve Attention and Short-Term Memory in Patients With Insomnia Undergoing Brief Cognitive Behavioral Therapy: Within-Subject Eye-Tracking Experimental Pilot Study.
期刊: JMIR human factors 发表日期: 2026-Feb-19 链接: PubMed
摘要
Patients with insomnia have difficulty in both falling asleep and maintaining sleep. Individuals with long-term sleep deprivation are prone to poor concentration and impaired memory; however, these problems can be alleviated following brief behavioral treatment for insomnia (BBT-I). This study involved the design of an app called “Sleep Well” that enables individuals with insomnia to easily record their sleep behavior. The app guides users to recall and record sleep-related information, acquire sleep hygiene knowledge, and communicate with therapists online. This study examined how specific sleep diary interface design features in a brief cognitive behavioral therapy for insomnia (BBT-I) app influence users’ attention and short-term memory. Using a combination of objective eye-tracking measures and subjective attention assessments, the study compared 3 interface designs to determine how visual layout, input modality, and interaction style interact with insomnia symptoms to affect attentional performance, memory accuracy, and user preference. Three sleep diary interfaces were designed, varying background mode (day vs night), color scheme (blue vs green), box shape (circular, rounded rectangular, or rectangular), and input method (slide-in, tap, or type-in). A total of 33 participants completed standardized diary-entry tasks while eye movements were recorded using an eye tracker to capture gaze trajectories and visual attention patterns during app interaction. User experience, subjective attention, and interface preferences were assessed using structured questionnaires. Data were analyzed using descriptive statistics, nonparametric tests, Pearson correlation analysis, cross-tabulation analysis, and exploratory factor analysis to examine associations among interface design, attentional performance, memory accuracy, and user characteristics. A total of 33 participants (n=13, 39.4% male and n=20, 60.6% female) aged 20 to 64 years completed this study. Based on the Insomnia Severity Index, 6 of 33 (18.2%) participants had clinical insomnia and 13 of 33 (39.4%) reported insomnia symptoms. Most participants reported staying up late (22/33, 66.7%), and more than half of participants reported drinking tea (17/33, 51.5%). Interface design significantly influenced objective attentional performance, as measured by eye-tracking indicators of task efficiency and visual allocation. Sleep quality and insomnia symptoms were consistently associated with attentional and short-term memory outcomes, with memory accuracy varying across interfaces and showing particular sensitivity to sleep maintenance difficulties. Subjective attentional control was strongly associated with both eye-tracking metrics and memory performance, and interface preferences differed by insomnia status. Interface design significantly modulates attention and short-term memory performance in users with insomnia. Eye-tracking revealed that insomnia symptoms and sleep quality influence visual attention and task efficiency, whereas subjective attentional control showed stronger and more consistent associations with memory accuracy than physiological eye-movement indicators. These findings suggest that cognitive processing during sleep diary completion relies more on internal attentional states than on observable gaze behavior. Designing low-load, attention-supportive interfaces may therefore improve usability and data accuracy in digital BBT-I interventions.
8. Developing and Evaluating a WeChat-Based Applet Fluid Intake Reminder on Enhancing Fluid Adherence in Postoperative Patients With Urinary Calculi: Protocol for a Randomized Controlled Trial.
期刊: JMIR research protocols 发表日期: 2026-Feb-19 链接: PubMed
摘要
Urinary calculi (UC), affecting 1%-13% globally, pose a significant health burden due to high recurrence rates (up to 50% within 10 years) and substantial health care costs. Adequate fluid intake is a cornerstone of prevention; yet, its adherence remains poor due to forgetfulness, lifestyle barriers, and limited patient education. Existing mobile health interventions for UC prevention often lack medical oversight and clinical validation. WeChat-based digital therapeutic intervention may have a positive effect on fluid adherence in this patient group. Our objective is to develop a WeChat applet to improve hydration behavior and reduce stone recurrence among postoperative patients with UC. This is an open-label, 2-arm, parallel-group randomized controlled trial. We will recruit 148 participants from China’s tertiary hospital and randomly allocate them in a ratio of 1:1 to the intervention or control group. The intervention group received standard postoperative care supplemented by the WeChat-Based Applet Fluid Intake Reminder (WAFIR), which delivers personalized fluid intake reminders, urine color monitoring, 24-hour fluid intake and urine output tracking, and evidence-based educational content on hydration and urolithiasis management. The control group receives standard care of general discharge instructions from nurses. The primary outcome is the fluid adherence, measured by 24-hour fluid intake and urine volume; secondary outcome measures are the Wisconsin Stone Quality of Life Questionnaire, Patient Health Questionnaire-9, Electronic Health Literacy Scale, physical activity (International Physical Activity Questionnaire-Short Form), and recurrence rate of UC. Outcomes are measured before intervention (T0) and after a 1-month (T1) and 3-month (T2) follow-up period. Intention-to-treat analysis, 2-tailed t tests, and repeated measures ANOVA will be used to compare outcomes; statistical significance is set at a P<.05 significance threshold. The study was approved by the ethics review board in December 2024. The development of WAFIR, conducted in collaboration with stakeholders, was finalized in February 2025. Recruitment commenced on March 1, 2025; data collection was completed in September 2025, and data analysis was analyzed in December 2025. Dissemination of findings is planned through conferences and publications in 2026. This research evaluates the effectiveness of a nurse-led, evidence-based digital therapeutic intervention, WAFIR, in overcoming fluid adherence barriers among postoperative patients following urolithiasis surgery, aiming to increase daily fluid intake and urine output, reduce recurrence rates, enhance quality of life, and generate empirical evidence for its application in urology care, thereby optimizing postoperative management within clinical settings.
9. Maternal Screen-Related Behaviors, Toddler Screen Use, and Toddler BMI in Mexican American Families: Cross-Sectional Study.
期刊: JMIR pediatrics and parenting 发表日期: 2026-Feb-19 链接: PubMed
摘要
Parents, as the most proximal influence on young children, play an important role in shaping toddler behaviors. Yet, evidence on how parents shape toddler screen use is limited. Little is also known about the relationship between toddler screen use and BMI. Given existing disparities in screen use and early childhood obesity, a focus on Mexican American families with toddlers is warranted. This study aimed to evaluate the independent contributions of both maternal screen use and screen-related parenting practices with toddler screen use duration, for both TV viewing and mobile device use, and examine the relationship between toddler screen use duration and BMI. This cross-sectional study enrolled 384 Mexican American mother-toddler dyads recruited from safety net clinics. Enrolled mothers completed 7-day screen use diaries and surveys on screen-related parenting practices, and toddler anthropometrics were obtained. Negative binomial regression models estimated the relationships between screen-related parenting practices and maternal screen use (predictors) with child duration of daily TV use and mobile device use (outcomes). Spearman correlations were calculated to estimate the relationship between toddler screen use duration and age- and sex-specific BMI z scores. Maternal duration of daily TV and mobile device use were associated with toddler duration of daily TV (adjusted rate ratios [aRRs] 1.27-1.28; all P<.001) and mobile device use (aRRs 1.17-1.18; all P<.001), respectively, even after adjusting for maternal screen-related parenting practices. Specific parenting practices, including restriction of TV time (aRR=0.86; P=.01), restriction of mobile device time (aRR=0.80; P=.02), use of TV (aRR=1.27; P=.003) and mobile devices (aRR=1.78; P<.001) for child behavior regulation, and coviewing of mobile devices (aRR=1.51; P<.001), were associated with toddler duration of daily screen use, adjusted for maternal duration of daily screen use. Neither toddler duration of daily TV viewing nor daily mobile device use was correlated with toddler BMI z scores. Both the duration of maternal screen use and screen-related parenting practices, for both TV and mobile devices, should be considered when promoting healthy screen use in toddlers in Mexican American families. Interventionists should consider the family ecology when designing interventions promoting healthy screen use in early childhood.
10. The Role of Digital Tools in Meeting the Needs of Adults With Tourette Syndrome: A Human-Centered Design Approach.
期刊: JMIR formative research 发表日期: 2026-Feb-19 链接: PubMed
摘要
Individuals with tic disorders (TDs) have access to a small but growing number of digital tools (such as apps and websites) for tic management and support. While prior work has shown promise for these tools, they have traditionally been designed by researchers first and evaluated by members of the TD community after tool development is complete. A human-centered design process targeting this domain has the potential to reveal new insights relevant to the development of future tools. We seek to establish a preliminary understanding of how the TD community uses and perceives current resources for tic management and support as well as their overall concerns and needs in this area. This study aimed to explore the design potential of future digital tools for helping adults manage their tics by gathering an initial set of needs and requirements from adult members of the TD community in the United States. An online survey was distributed via TD community groups and also via TD clinicians and researchers in the United States. The survey contained a combination of dichotomous, multiple-choice, and open-ended questions, with opportunities for participants to specify how they currently receive support, rank their preferred features and requirements, and express their needs and concerns relevant to future work. Qualitative responses were analyzed with inductive thematic analysis. Most respondents typically sought answers from digital platforms first (124/158, 78.5%) when confronting a question about their tics. Even so, only 18.4% (29/158) reported having previously used a digital tool to help with their tics or any other aspect of their health. Simultaneously, 88.9% (136/153) indicated that they would be very (81/153, 52.9%) or somewhat (55/153, 35.9%) likely to use a digital tool designed for adults with tics. Of those listing concerns (42/158, 26.6%), common reported concerns included the tool being too time-consuming, difficult to use, or generally not meeting accessibility standards. When asked to rank the one feature of a digital tool that they believed to be most important, tic monitoring (66/154, 42.9%) and trigger monitoring (54/154, 35.1%) were among the most popular requested features as opposed to other options, such as information gathering, reminders to practice a therapeutic skill or take medicine, social support, or opportunities to share their story. While screen navigation was most preferred, results indicated that a multimodal design overall would support the most users. Our study participants reported a lack of useful technology for tic management and indicated a need for accessible tools to assist in tic and trigger monitoring in particular. Other concerns included that new tools would be difficult to use or learn due to tics. Findings suggest a cautious excitement for future digital tools in this area.
11. Adherence, Acceptability, and Sexual Health Outcomes of the Odeya App-Based Intervention for Sexual Distress in Women With Endometriosis: Randomized Controlled Mixed Methods Trial.
期刊: Journal of medical Internet research 发表日期: 2026-Feb-19 链接: PubMed
摘要
Evidence-based interventions effectively treat sexual dysfunctions. Up to 13.5% of women with gynecological conditions are affected, yet access to therapy is limited. Self-guided digital interventions may offer scalable, accessible first-line support. This randomized controlled mixed methods pilot trial evaluated adherence, acceptance, and safety of the Odeya app and changes in sexual and health outcomes among women with sexual dysfunctions and endometriosis. Following online and flyer-based recruitment, participants completed an online screening and were randomized to either an intervention group (IG) receiving 8 self-guided app modules targeting biopsychosocial aspects of sexuality or to a control group (CG) receiving routine care. Self-administered online questionnaires were completed at baseline (T0), midintervention (T1), postintervention (T2), and 6-month follow-up (T3). Standardized instruments assessed acceptance (Client Satisfaction Questionnaire-Internet [CSQ-I] and German mHealth App Usability Questionnaire [G-MAUQ]), safety (Inventory for the balanced assessment of Negative Effects of Psychotherapy-Online Intervention), sexual health (Female Sexual Distress Scale-Desire/Arousal/Orgasm [FSDS-DAO], Female Sexual Function Index-German version [FSFI-d], and Partnership Questionnaire), and overall health (Patient-Reported Outcome Measurement Information System-29-Item Profile, Beck Depression Inventory-II, and Generalized Anxiety Disorder-7). Adherence indicators included module completion, dropout rates, and symptom tracker use. Group differences were examined descriptively and using Cohen d. Qualitative data were collected through free-list questionnaires from dropouts (n=11) and interviews with completers (IG: n=3; CG: n=2). A total of 60 women (mean age 31.12, SD 6.67 years) with confirmed or suspected endometriosis and sexual distress (FSDS-DAO score >18) were randomized to the IG (n=29) or CG (n=31). IG participants completed on average 61.2% (4.9/8) of modules; the dropout rate was 65.5% (19/29). Emotional strain, time demands, and technical issues were key barriers causing dropout, while persona-based stories facilitated engagement. Participants wished for more professional interaction. IG completers (n=10, 34.5%) showed lower baseline depression and anxiety but higher sexual distress. Satisfaction was high (CSQ-I=26.60; G-MAUQ=5.38). Although some adverse health changes were reported, findings indicate safety. FSDS-DAO scores decreased in both groups, with mean reductions from baseline of -10.39, -12.61, and -14.98 in the IG and -3.68, -14.83, and -6.92 in the CG from T1 to T3, respectively. Moderate to large between-group effects favoring the IG were observed at T1 (d=-0.66) and T3 (d=-0.79). Sexual function (FSFI-d) improved only in the IG (T1-T3: d=0.16-1.00). Qualitative findings highlighted rediscovery of positive sexual experiences, improved communication, and increased openness. Both groups reported improvements in anxiety, depression, and physical functioning, with additional gains in emotion regulation, distress reduction, and body awareness reported in the IG. Women emphasized symptom complexity and a need for more professional guidance. The self-guided intervention was well accepted and showed preliminary improvements among completers. Adherence and sustained engagement seemed shaped by baseline psychosocial health, pointing to a need for tailored adaptations and larger confirmatory trials. German Clinical Trials Register DRKS00034351; https://drks.de/search/en/trial/DRKS00034351.
12. Stains in primary biliary cholangitis: Untangling promise from bias.
期刊: Hepatology (Baltimore, Md.) 发表日期: 2026-Feb-19 链接: PubMed
摘要
13. Analysis of Associated Factors and Construction of Risk Prediction Models for Frailty in Hospitalized Older Adults Living With HIV: Protocol for a Prospective Observational Study.
期刊: JMIR research protocols 发表日期: 2026-Feb-19 链接: PubMed
摘要
The aging trend of people living with HIV or AIDS in China is increasing day by day. Frailty is a common condition among older adults living with HIV or AIDS and represents a significant cause of poor prognosis, including falls, decreased quality of life, increased mortality, and potentially prolonged hospital stays. Consequently, early frailty screening in this population holds important clinical significance. This study aims to describe the theoretical basis, research objectives, and implementation plan of a prospective observational study. It will focus on investigating the current status of frailty syndrome in hospitalized older adults living with HIV or AIDS, while simultaneously exploring the development of a clinically applicable risk prediction model. This study is an ongoing single-center prospective observational study, with a plan to recruit at least 556 hospitalized older adults living with HIV or AIDS (n=445 for development and n=111 for validation). According to the theory of unpleasant symptoms, candidate predictors are categorized into physiological factors (including sociodemographic factors, disease-related influencing factors, sleep, nutrition, and neurocognitive function), psychological factors (including anxiety and depression status), and environmental factors (including social support status). Potential predictors are screened using univariate analysis and least absolute shrinkage and selection operator regression to identify variables for final model inclusion. Model construction and validation employ 3 standard machine learning algorithms: logistic regression, random forest, and support vector machine. Model performance will be evaluated by reporting accuracy, precision, sensitivity, specificity, and the area under the curve. This study is conducted at a designated infectious disease hospital in Changsha, Hunan Province, China. Participant recruitment commenced on December 22, 2024, and as of December 5, 2025, a total of 603 patients have been enrolled. The primary study findings are anticipated to be published in August 2026. The findings of this study are expected to provide clinicians in the department of infectious diseases with a convenient tool for frailty risk prediction, thereby enabling early intervention and ultimately improving the long-term health status and quality of life of people living with HIV.
14. Diabetic Dyslipidemia and Its Determinants Among People With Diabetes in South Africa: Protocol for a Systematic Review and Meta-Analysis.
期刊: JMIR research protocols 发表日期: 2026-Feb-19 链接: PubMed
摘要
Diabetic dyslipidemia (DD), characterized by a classical triad of abnormal lipid profiles among the diabetic population, presents a major public health concern in South Africa, particularly among Black South Africans. The increasing prevalence of DD significantly contributes to the development of atherosclerotic cardiovascular disease. With the incidence of diabetes rising from 4.5% in 2010 to 12.7% in 2021, urgent preventive measures and effective treatments are crucial to tackle the risk of premature mortality. This systematic review and meta-analysis protocol aims to examine the existing literature on DD, providing an understanding of its prevalence and associated predictors among the diabetic population in South Africa, with the intention of informing more effective clinical and public health interventions. The protocol is registered in PROSPERO (International Prospective Register of Systematic Reviews) and will adhere to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. The available literature on DD will be systematically searched in common scholarly databases and reviewed accordingly. All published and unpublished studies conducted in South Africa prior to 2024 and written in English will be included. Two members (MN and FA) of the review team will independently screen the studies identified through the database search and assess risk of bias using the revised JBI critical appraisal tools. The review will integrate both quantitative and qualitative data synthesis. Results from both qualitative and quantitative data synthesis will be presented through forest plots, subgroup forest plots, and summary tables, which will present findings on pooled prevalence, odds ratios for predictors, heterogeneity statistics, and sensitivity analyses. The protocol was finalized in January 2025. The literature search was conducted between October 2024 and March 2025. Title and abstract screening began in April 2025, and full-text review was completed by July 2025, with data extraction scheduled for completion by September 2025. The completion of statistical analyses is expected by October 2025. We anticipate submission of the completed systematic review and meta-analysis for publication in December 2025. The findings of the study protocol will inform the design of targeted interventions and policies aimed at advancing the management of DD and subsequently reducing the increased risk of atherosclerotic cardiovascular disease among the diabetic population.
15. Comparison of Characteristics and Outcomes of Patients With Metastatic Prostate Cancer With and Without Next-Generation Sequencing Testing.
期刊: JCO oncology practice 发表日期: 2026-Feb-19 链接: PubMed
摘要
Next-generation sequencing (NGS) is recommended for patients with metastatic prostate cancer (PC). Nationwide, testing rates are low. Whether PC disease characteristics and courses differ between those with and without NGS testing is unknown. We identified predictors of testing, explored likely reasons for lack of testing, and compared survival between those with and without testing. We retrospectively reviewed patients with metastatic PC initially seen between 2020 and 2022 at Johns Hopkins. Clinical data and reasons for nontesting were abstracted from the electronic medical record. We conducted a logistic regression assessing predictors of NGS testing, adjusting for age, Gleason grade, marital status, and metastatic diagnosis year. We used Cox regression to compare overall survival, defined from the time patients had both a metastatic diagnosis and a visit at our institution until death/last follow-up, between those tested and not tested. We adjusted for age, Gleason grade, initial metastasis (M) stage, comorbidities, and time from metastatic diagnosis to first visit. Of the 435 patients, 257 (59%) had NGS testing. Older patients were less likely to have testing (adjusted odds ratio [aOR], 0.96 [95% CI, 0.94 to 0.98]). Unmarried patients were less likely to have testing (aOR, 0.62 [95% CI, 0.38 to 1.01]). Patients with Gleason Grade Group 5 were more likely to undergo testing than patients with Groups 1-3 (aOR, 1.86 [95% CI, 1.14 to 3.04]). Among those without testing, 139 (78%) had at least one potential reason for lack of testing in the medical record. The most common reason for nontesting was patient/disease factors (37%). Older and unmarried men with metastatic PC were less likely to obtain NGS testing, whereas those with high Gleason grade were more likely. Interventions are needed to improve testing rates.
16. Internet Use and Self-Rated Health Among Older Adults: Scoping Review.
期刊: Interactive journal of medical research 发表日期: 2026-Feb-19 链接: PubMed
摘要
Self-rated health (SRH) is a robust predictor of morbidity, functional decline, and mortality in later life. As internet use becomes increasingly embedded in older adults’ daily routines, clarifying its association with SRH and the pathways through which it may operate is important for research, practice, and policy. This scoping review aimed to map and characterize the international evidence on the association between internet use and SRH among older adults, synthesize how potential mediators and moderators have been examined, and identify key methodological, theoretical, and population gaps in the literature. Guided by the Joanna Briggs Institute methodology and PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) reporting standards, we conducted a scoping review and searched 5 databases: PubMed, CINAHL, AgeLine, PsycINFO, and Web of Science. The final search was performed on February 5, 2024. Reference lists were screened, and Google Scholar searches were conducted as supplementary search methods. Database searches identified 4294 records; after removing 615 duplicates, 3679 records were screened, and 77 full texts were assessed, resulting in 27 included studies. All included studies were quantitative, and the evidence base was predominantly cross-sectional (25/27). Explicit theoretical frameworks were used in 6 out of 27 studies. Most studies were published between 2019 and 2024 (22/27) and were conducted most frequently in China (11/27) and the United States (7/27). All studies were conducted in high-income countries. SRH was typically assessed using a single-item measure, while internet use was operationalized as access/use (yes/no), frequency, and/or purpose/domain-specific measures. Most studies reported a statistically significant positive association between internet use and better SRH (24/27), with socially oriented uses (eg, communication and social participation) showing the most consistent associations. Mediating pathways were examined in 6 out of 27 studies, and most often suggested social mechanisms such as greater social support, higher social engagement, and lower loneliness. Subgroup heterogeneity was reported in 10 out of 27 studies, including differences by age, gender, residence, and marital status. Overall, internet use, particularly socially oriented use, was most consistently associated with better SRH among older adults. Policy efforts should support digital inclusion by improving access, skills, and ongoing assistance that enable meaningful use for social connection and service access. At the same time, nondigital options are essential to avoid excluding older adults who do not use the internet. In addition, evidence gaps, including limited use of theoretical frameworks and scarce data from low- and middle-income countries, underscore the need for theory-informed longitudinal and intervention studies to strengthen causal inference, expand knowledge on mediating and moderating factors, and assess generalizability across diverse contexts.
17. From Farms to Families: Perspectives on the Economic Ripple Effect of Nutrition Incentives.
期刊: American journal of health promotion : AJHP 发表日期: 2026-Feb-19 链接: PubMed
摘要
Background: Nutrition Incentive (NI) programs increase fruit and vegetable (FV) purchasing and consumption among Supplemental Nutrition Assistance Program (SNAP) participants by providing financial incentives at the point of sale. Through supported and sustained Farm Bill investment and bipartisan backing, NI programs operate in diverse retail settings. Discussion: Evidence indicates that NI programs generate benefits at multiple levels. At the individual and household level, they are associated with improved diet quality and enhanced food security. At the community and systems level, NI programs contribute to local economic activity by increasing FV sales in grocery and farm direct settings, supporting farmers, and reinforcing retailer participation in healthy food initiatives. This “triple-win” is dynamic, benefiting consumers, retailers, and producers and positions NI programs as a strategic mechanism for aligning public health and economic development goals. Conclusions: As a proven and scalable intervention, NI programs represent a cross-sector solution that advancas public health, strengthens local food systems, and promotes community resilience. Continued policy support and investment are critical to sustaining and expanding their impact nationwide.
18. Targeted screening for HTLV-1 infection in endemic and non-endemic regions: a global public health priority.
期刊: Expert review of anti-infective therapy 发表日期: 2026-Feb-19 链接: PubMed
摘要
Human T-cell lymphotropic virus type 1 (HTLV-1) is an oncogenic retrovirus responsible for adult T-cell leukemia/lymphoma and severe inflammatory diseases. Although at least several million individuals are infected worldwide, surveillance remains limited and the infection is frequently overlooked. Global migration has altered the epidemiology of HTLV-1, increasing the number of carriers in previously low-prevalence regions and creating hidden high-risk clusters. As universal population screening is not cost-effective, targeted testing of groups with elevated risk has become a critical public health priority. This review summarizes the changing global distribution of HTLV-1 and examines evidence supporting targeted screening strategies. A literature review was conducted focusing on epidemiological data, transmission dynamics, and policy initiatives in both endemic and non-endemic settings. Populations evaluated include migrants from endemic regions, family members of carriers, individuals with sexually transmitted infections, pregnant women, blood and organ donors, and patients with clinical conditions strongly associated with HTLV-1. Expanding targeted screening offers a practical approach to reduce transmission and enable earlier clinical intervention. Integration of HTLV-1 testing into antenatal care, sexual health services, and specialty clinics is feasible. Broader recognition of HTLV-1 will be essential to reducing the global burden of this neglected infection. What is HTLV-1 and why does it matter?Human T-cell lymphotropic virus type 1 (HTLV-1) is a virus that can cause serious illnesses, including a type of blood cancer and long-term nerve damage. Although millions of people around the world are infected, HTLV-1 receives far less attention than other viruses such as HIV. Many people who carry the virus do not know they are infected, which means it can be passed to others without being noticed.Why is screening important?HTLV-1 spreads through breastfeeding, sexual contact, blood transfusion, and organ transplantation. Because most countries do not screen the general population, many infections remain hidden. Recent global migration has brought HTLV-1 from traditionally high-risk regions (such as Japan, the Caribbean, and parts of South America and Africa) into large cities in Europe and North America. As a result, clusters of infection are now found even in places where the virus was once considered rare.What did this review examine?This article explains how the distribution of HTLV-1 is changing and identifies who is most likely to benefit from testing. These groups include migrants from endemic areas and their families, people with sexually transmitted infections, pregnant women, blood and organ donors, and patients with conditions known to be associated with HTLV-1.Why does this matter for public health?Targeted screening can help detect infections earlier, prevent mother-to-child and sexual transmission, and provide timely care to reduce the risk of severe complications. Increasing awareness among healthcare providers and integrating HTLV-1 testing into existing health programs could greatly improve prevention and patient outcomes worldwide.
19. CRISPR-Cas is beneficial in plasmid competition, but limited by competitor toxin-antitoxin activity when horizontally transferred.
期刊: PLoS biology 发表日期: 2026-Feb-19 链接: PubMed
摘要
Bacteria can encode dozens of different immune systems that protect them from infection by mobile genetic elements (MGEs). MGEs themselves may also carry immune systems, such as CRISPR-Cas, to target competitor MGEs. It is unclear when this is favored by natural selection, and whether toxin-antitoxin (TA) systems-common competitive mechanisms carried by plasmids-can alter their efficacy. Here, we develop and test novel theory to analyze the outcome of competition between plasmids when one carries a CRISPR-Cas system that targets the other plasmid. Our mathematical model and experiments using Escherichia coli and competing IncP plasmids reveal that plasmid-borne CRISPR-Cas is beneficial to the plasmid carrying it when the plasmid has not recently transferred to a new host. However, CRISPR-Cas is selected against when the plasmid carrying it transfers horizontally, if a resident competitor plasmid encodes a TA system that elicits post-segregational killing. Consistent with a TA barrier to plasmid-borne CRISPR-Cas, a bioinformatic analysis reveals that naturally occurring CRISPR-Cas-bearing plasmids avoid targeting other plasmids with TA systems across bacterial genera. Our work shows how the benefit of plasmid-borne CRISPR-Cas is severely reduced against TA-encoding competitor plasmids, but only when plasmid-borne CRISPR-Cas is horizontally transferred. These findings have key implications for the distribution of prokaryotic defenses and our understanding of their role in competition between MGEs, and the utility of CRISPR-Cas as a tool to remove plasmids from pathogenic bacteria.
20. Immune-focused RBD nanoparticles induce cross-reactive, RBS-directed responses capable of variant-resistant SARS-CoV-2 neutralization.
期刊: PLoS pathogens 发表日期: 2026-Feb-19 链接: PubMed
摘要
New SARS-CoV-2 variants pose an ongoing threat due to persistent immune escape of natural and vaccine-induced immunity. The emergence of BA.1 (Omicron) produced a large antigenic shift in the spike protein, rendering many antibodies ineffective with concomitant loss of Emergency Use Authorization (EUA) status. While strains have evolved far from BA.1, re-emergence of variants from branches closer to BA.1 are of recent concern. Here, we engineered a self-assembling nanoparticle displaying RBD 4mut g5.1, an immunogen developed using structure-guided design to focus antibody responses to the receptor binding site (RBS) epitope and promote cross-reactivity by inclusion of four rationally selected BA.1 mutations in the RBS. Unlike multi-component RBD approaches, we demonstrate a single, rationally designed component is sufficient for generating broad immunity. We demonstrate that in both naïve and antigen-experienced mice, RBD 4mut g5.1 nanoparticle induced cross-reactive and durable antibody responses capable of potent neutralization of ancestral SARS-CoV-2 and many Omicron variants. RBD 4mut g5.1 provided heterologous protection at a memory timepoint. By showcasing how subtle changes in an epitope can trigger a diversified antibody response, this study offers a promising new avenue for developing vaccines that can more effectively tackle the ever-evolving threat of immune escape, not only against SARS-CoV-2 but potentially against a range of variable pathogens.
21. Web-Based Application for Cognitive and Functional Assessments in Dementia Screening: Mixed Methods, User-Centered Development Approach.
期刊: JMIR human factors 发表日期: 2026-Feb-19 链接: PubMed
摘要
Digital health technologies offer new opportunities for cognitive screening and monitoring among older adults. In Thailand, where dementia prevalence is rising, accessible web-based cognitive tools remain limited despite their potential to facilitate early detection and community-based assessment. Understanding usability and validity is critical to ensure successful implementation in real-world contexts. This study aimed to develop and validate a web-based application, Healthy Brain Test, for cognitive and functional assessments in dementia screening among older Thai adults. Specific objectives were to (1) design user-centered cognitive modules covering key cognitive domains and (2) evaluate correlations between the web-based assessments and conventional clinical tools to determine diagnostic cutoffs for cognitive impairment. We designed Healthy Brain Test as a self-administered web application suitable for older users and their caregivers. The platform includes digital versions of the Thai Mental State Examination (e-TMSE), a clock drawing test, and a category verbal fluency test, along with electronic versions of the short form of the Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE-16) and cognitive instrumental activities of daily living (IADLs). Participants completed both web-based and paper-based assessments. Correlations between modalities were analyzed, and receiver operating characteristic (ROC) curves were generated to determine sensitivity and specificity. Data were analyzed using SPSS for Windows, version 30.0 (IBM Corp) and MedCalc Statistical Software (MedCalc Software Ltd). A total of 198 older adults participated (women: 137/198, 69.2%; median age 69.4 years), with 57.1% (113/198) having more than 6 years of education. Of the 198 participants, 44 were diagnosed with major neurocognitive disorder, 58 were diagnosed with mild neurocognitive disorder, and 96 were cognitively normal. The e-TMSE showed strong agreement with the traditional TMSE (r=0.837; P<.001). Category verbal fluency, IQCODE-16, and IADL modules also demonstrated significant correlations (P<.001). The e-TMSE achieved an area under the ROC curve of 0.84 (bootstrapped 95% CI 0.78-0.89); a cutoff ≤23 provided 88.6% sensitivity and 70.1% specificity for identifying major neurocognitive disorder. Participants reported high ease of use and engagement during pilot testing. Healthy Brain Test demonstrated strong validity and usability as a web-based cognitive and functional assessment platform for dementia screening. Its integration of established cognitive measures into a digital interface enables remote, accessible, and user-friendly evaluation for older adults and caregivers. Future research should assess long-term feasibility, user adherence, and integration with clinical workflows to support large-scale screening initiatives.
22. A hierarchical approach to the causality of shipyard accidents with integrated machine learning methods.
期刊: Work (Reading, Mass.) 发表日期: 2026-Feb-19 链接: PubMed
摘要
BackgroundThe number of shipyard accidents should be reduced by examining the effects of the various demographic and workplace factors on the severity of the accident.ObjectiveThe study examines shipyard accidents and various occupational-behavioral-environmental factors affecting these accidents to find minor accidents (or near-misses) that turned out to be major and to examine the effects of factors on the possible consequences of the accidents, to compare the predicted results with the actual results, and to investigate possible hidden reasons for the occurrence of accidents.MethodsThe study uses an accident causality model and conducts experiments with a multi-factor approach on accident causality in the shipbuilding industry through logistic regression and machine learning. It performs an association rules analysis to further enhance the causality model.ResultsMachine learning algorithm outputs yielded results that differed significantly from the apparent descriptive distribution of causes of major accidents. Lack of control and audit stands out as the most important accident factor in the occurrence of major accidents. Design errors and lack of training are also two important administrative factors in the occurrence of major accidents. 38.2% of major occupational accidents in shipyards are preventable or can be overcome with minor injury. In 87% of preventable major accidents, the employee had been involved in one or two previous minor incidents.ConclusionAdministrative deficiencies are prominent in major accidents. The main employer’s workers and managers are at higher risk in terms of major accident exposure. The effectiveness of safety training should be increased in accordance with the changing working environment and technological conditions.
23. Online self-help intervention for procrastination: a randomized controlled trial.
期刊: Psychology, health & medicine 发表日期: 2026-Feb-19 链接: PubMed
摘要
To explore the efficacy of online self-help procrastination intervention program (OPSI) in alleviating adult procrastination behaviors. A randomized controlled trial (RCT) design was adopted. Participants were randomly classified into the intervention group (n = 33) and the waitlist control group (n = 33). Three time points - baseline (t0), 6 weeks following the intervention (t1), and 12 weeks following the intervention (t2) - were assessed. The intervention adherence, adverse effects, and feasibility were assessed. Procrastination, perceived stress, depression, and anxiety were employed to measure the intervention effects. 66 Chinese adults diagnosed with procrastination were recruited, and age ranged from 20.25 to 47.06 years (M = 29.72). For participants in the experimental group, they got a 12-week online intervention. Compared with the control group, the procrastination of the intervention group was remarkably decreased. The group and time’s interaction greatly affected IPS scores (t (194) = 3.42, p < .001). The intervention group had a meaningful within-group difference between the post-intervention and baseline assessments (d = -1.43, 95% CI: -1.91; -0.95). There was a pronounced group-by-time interaction for PSS scores (t (194) = 2.82, p < .01). The perceived stress of intervention group was notably reduced between post-intervention and baseline (d = -1.06, 95% CI: -4.46; -2.33). The results provide empirical support for the use of scalable online self-help interventions as an accessible approach to procrastination management and adult mental health promotion.Trial Registration: ClinicalTrials.gov. Identifier: ChiCTR2200065752 (registered June 2022).
24. Activated partial thromboplastin time is a potential risk factor for prolonged chest drain placement following surgery for primary spontaneous pneumothorax: a case-control study.
期刊: General thoracic and cardiovascular surgery 发表日期: 2026-Feb-19 链接: PubMed
摘要
Primary spontaneous pneumothorax (PSP) is a condition that primarily affects young patients and has a high recurrence rate. While surgery is the treatment option associated with the lowest recurrence rate for PSP, some patients experience long-term chest drain placement due to prolonged air leak. Our study aimed to elucidate the relationship between coagulation abnormalities and prolonged postoperative air leak in PSP. Patients who underwent surgery for PSP were retrospectively reviewed. Patients were divided into the exploratory and the validation cohorts. From the exploratory cohort, patients with prolonged chest drain placement were identified as the air-leak prolonged (AL-P) group, and the Control group matched at a 1:4 ratio was selected using propensity score matching. In the exploratory cohort, 15 patients were assigned to the AL-P group and 60 to the control group. Among the coagulation markers including prothrombin time, activated partial thromboplastin time (APTT) and platelet count, univariate analysis revealed a significantly prolonged APTT in the AL-P group (median 33 vs. 31 s, odds ratio 1.26, p = 0.006). Multivariate analysis identified prolonged APTT as an independent risk factor for prolonged chest drain placement. Receiver operating characteristic curve of APTT values for predicting the incidence of prolonged chest drain placement showed a cutoff of 31.5 s. In the validation cohort, patients with an APTT ≥ 31.5 s showed significantly longer chest drain placement (p = 0.03). Our study suggests a potential association between prolonged APTT and prolonged postoperative chest drain placement in patients with PSP.
25. Differential Copy Number of Chromosomal blaCTX-M-14 in Escherichia coli Sequence Type ST38 from Companion Dogs and Cats.
期刊: Current microbiology 发表日期: 2026-Feb-19 链接: PubMed
摘要
26. Pilot-scale assessment of slag reactors for manganese removal from mine drainage.
期刊: Environmental geochemistry and health 发表日期: 2026-Feb-19 链接: PubMed
摘要
Manganese (Mn) is a common water contaminant in mining areas and one of the most challenging metals to treat. This study assessed Mn removal efficiencies of pilot-scale slag reactors using steelmaking slag mixed with limestone as the reactive material. Three different reactor configurations of baffle-type, weir-type, and vertical flow-type were installed and tested over a 316-day operational period with initial, middle, and final phases. Geochemical modeling indicated that most effluents were saturated with calcite (CaCO₃), rhodochrosite (MnCO₃), and manganite (MnOOH), suggesting that both carbonate and hydroxide precipitation contributed to Mn removal. As effluent pH increased, alkalinity decreased due to the consumption of carbonate ions (CO₃2⁻) during calcite precipitation. The potential formation of Mn carbonates may have contributed to the Mn removal efficiencies. X-ray photoelectron spectroscopy (XPS) analyses of the accumulated precipitates indicated that Mn(III, IV) oxides were the dominant phase. Although temperature, which influences Mn removal rate, decreased from middle to final phase, removal efficiencies and/or effluent concentrations of Mn exhibited increasing and decreasing trends, possibly due to the autocatalytic oxidation by the accumulated Mn(III, IV) oxides. These findings highlight the potential of slag reactors as a cost-effective and sustainable solution for treating Mn-contaminated mine drainage, groundwater, and industrial wastewater. Moreover, this approach contributes to reducing CO₂ emissions from lime production processes (e.g. calcination) while promoting the utilization of waste materials.
27. Multifunctional LepR⁺ skeletal stem/progenitor cells for bone and marrow homeostasis.
期刊: Journal of bone and mineral metabolism 发表日期: 2026-Feb-19 链接: PubMed
摘要
Bone is a multifunctional organ that provides structural support and hosts the bone marrow, a key site for hematopoiesis and systemic homeostasis. These dual features have long attracted the attention of both bone biologists and hematologists. Each field has pursued the identification of stem-like cells responsible for hard tissue formation and the regulatory microenvironment/niche that supports hematopoietic stem cells (HSCs), which give rise to all blood cell lineages. Converging advances in bone and hematopoietic biology have led to the identification of skeletal stem/progenitor cells (SSPCs), a multifunctional population that gives rise to osteolineage cells and serves as a principal component of the HSC niche. This landmark discovery was largely enabled by Cre/loxP-based genetic mouse models. Among them, the leptin receptor (LepR)-Cre system has become one of the most widely used tools in skeletal stem cell research worldwide. In this review, we summarize the historical background and recent advances in SSPC research, specifically LepR+ SSPCs, highlighting their function and lineage plasticity during development, adolescence, aging, and fracture healing. Advanced genetic labeling-based studies and single-cell transcriptomics unveiled the fate, dynamics and indispensible roles of LepR⁺ SSPCs under both homeostatic and pathological conditions.
28. Health Care Use and Health Care‒Amenable Mortality Among US Adults With and Without a Bachelor's Degree, 1996‒2023.
期刊: American journal of public health 发表日期: 2026-Feb-19 链接: PubMed
摘要
Objectives. To describe health care‒related educational divides in 2 dimensions-outpatient care utilization and medically preventable deaths-over the past 25 years. Methods. We examined education-based disparities in ambulatory care utilization by analyzing data on 476 277 respondents aged 25 years or older to the 1996-2022 US Medical Expenditure Panel Survey, and in deaths potentially preventable by medical care (defined by International Classification of Diseases, 10th Revision, code) from 26 092 720 death certificates of individuals aged 25 to 74 years in the United States from 2001 to 2023. Results. In 1996, the share of adults with zero provider visits was higher among those without (26.4%; 95% confidence interval [CI] = 25.3, 27.5) than with (20.2%; 95% CI = 18.5, 22.0) a bachelor’s degree, a gap that widened to a nearly 2-fold difference by 2022; the gap in the proportion with no doctor visit also widened. Disparities in health care use were larger after adjustment for health factors. Separately, we observed large and growing education-based gaps in age-adjusted health care‒amenable mortality. Conclusions. Education-based disparities in ambulatory health care utilization have grown since 1996, as have medically preventable deaths. Public Health Implications. Improved health care access for less-educated Americans might help address widening disparities in ambulatory health care use and, potentially, health outcomes. (Am J Public Health. Published online ahead of print February 19, 2026:e1-e10. https://doi.org/10.2105/AJPH.2025.308373).
29. Visualizing the Maternal Health Journey for Learning Health Systems: Mixed Methods Combined Experience Approach.
期刊: Journal of participatory medicine 发表日期: 2026-Feb-19 链接: PubMed
摘要
The United States faces a persistent maternal mortality crisis, with rates far higher than those in other high-income nations. The mortality rate among Black women is more than 3 times that among White women. Traditional data visualizations, such as bar and line charts, often emphasize aggregate outcomes, masking inequities and failing to reflect patient-level experiences. This study aimed to address the gaps by taking a systems view and developing a Visualized Combined Experience (VCE) diagram, which is an innovative tool that integrates persona-based storytelling with data visualization to provide a more comprehensive understanding of maternal health outcomes. Specifically, the following research questions were explored: (1) How can the VCE diagram approach be applied to illustrate maternal mortality disparities in the United States? (2) To what extent does this integrated visualization technique reveal connections between individual patient experiences and population-level health outcomes that traditional visualization methods do not? (3) How can the VCE diagram inform a learning health system (LHS)? This mixed methods study used publicly available quantitative data from the US Centers for Disease Control and Prevention and adapted qualitative data from the ProPublica award-winning investigative series “Lost Mothers” to construct the VCE diagram through a seven-step process involving the following elements: (1) composite persona derived from publicly available narratives, (2) journey map illustrating patient experiences and health system touchpoints, (3) emotive elements of the patient, (4) Sankey diagram of population-level maternal mortality outcomes, (5) “closer look” inset to unmask disparities obscured in aggregate data, (6) evaluation, and (7) data integration. The VCE diagram revealed critical connections between individual experiences and population-level disparities. When examining mortality rates per 1000 births, Black women had a high rate of 51.2, compared with 16.8 for White women, 14.3 for Hispanic women, and 10.2 for Asian women. The relationship between diagnostic delay and population-level mortality was revealed, with the “closer look” inset demonstrating how disparities can be obscured in aggregate data. The VCE diagram supported a more efficient and empathetic understanding of maternal health outcomes. The VCE diagram bridges micro-level patient experiences with macro-level population data, holding promise to enhance service evaluation, delivery, and design, and improve health care outcomes. The VCE diagram provides a replicable framework for data visualization that highlights systemic disparities often hidden in aggregate data. Moreover, the availability of structured human experience and service outcome data can provide robust context-specific and situational data to foster a culture of organizational learning and continuous improvement via an LHS. The LHS’s knowledge translation loops provide a conduit to improve patient experiences and reduce morbidity and mortality across populations and health systems. Future work will include usability testing across diverse audiences to assess interpretability and refine applications in LHSs.
30. Microbes can help protect corn against a fearsome pest.
期刊: Science (New York, N.Y.) 发表日期: 2026-Feb-19 链接: PubMed
摘要
Nontoxic approach bolsters plant’s own defenses.
31. An investigation on the respiratory deposition of respirable coal mine dust using Mobile Aerosol Lung Deposition Apparatus (MALDA).
期刊: Journal of occupational and environmental hygiene 发表日期: 2026-Feb-19 链接: PubMed
摘要
This study aims to improve the understanding of respirable coal mine dust (RCMD) particle deposition in the lungs to enhance health and safety measures in coal mining environments. Using the Mobile Aerosol Lung Deposition Apparatus (MALDA) and a wind tunnel, experiments were conducted under simulated mining conditions to evaluate how particle characteristics influence deposition patterns during airflow and activity similar to that of mine workers. The experimental results followed a trend similar to the conventional International Commission on Radiological Protection (ICRP) lung deposition curve but showed higher particle deposition in the gas exchange region, likely due to differences between moving and still air conditions. Irregular coal dust particle shapes may also contribute to the observed discrepancies. The study confirms that smaller particles tend to penetrate deeper into the alveolar region, increasing the risk of developing coal mine dust lung diseases (CMDLDs), including coal workers’ pneumoconiosis (CWP). These findings provide valuable insights into lung deposition dynamics under realistic mine-like airflow conditions.
32. Percutaneous Penetration of Quaternary Ammonium Compounds (QACs) Using in Vitro Three-Dimensional Human Skin Equivalents: Transport Mechanisms and Health Implications.
期刊: Environmental science & technology 发表日期: 2026-Feb-19 链接: PubMed
摘要
Quaternary ammonium compounds (QACs) are widely applied to antimicrobial textiles, yet their dermal exposure profiles and skin effects remain poorly understood. Using a three-dimensional human skin equivalent (3D-HSE), we quantified percutaneous penetration for benzylalkyldimethylammonium compounds (BACs), dialkyldimethylammonium compounds (DADMACs), and alkyltrimethylammonium compounds (ATMACs) with C8-C18 chains. Shorter-chain (C8-C10) BACs and ATMACs showed rapid uptake (>50% at 24 h; >70% at 48 h), whereas long-chain homologues (C16-C18) exhibited minimal permeation (<15%) and greater retention within the skin. The correlation between the octanol-water partition coefficient (log Kow) and molecular weight (MW), combined with molecular docking analysis, revealed that both passive and active transport were involved in the skin exposure of QACs. By integrating sweat leaching and 3D-HSE data, estimated daily intakes (EDIs) of total QACs were 1.82 ng/kg bw/d for dry clothing, increasing to 96.9 ng/kg bw/d for sweaty clothing, while these values reached 51.3 and 1960 ng/kg bw/d in the high-exposure scenario, respectively. Finally, transcriptomics and lipidomics showed downregulation of keratinization and epidermal genes and broad depletion of structural and signaling lipids, consistent with impaired skin integrity and immune activation. These results identify textiles as a significant sweat-mediated exposure source and demonstrate chain-length-dependent dermal kinetics and toxicity of QACs.
33. Concentration-Dependent Kinetics of Micropollutant Oxidation: Revealing the Hidden Role of Long-Lived Reactive Species.
期刊: Environmental science & technology 发表日期: 2026-Feb-19 链接: PubMed
摘要
Micropollutants (MPs) are ubiquitously present in aquatic environments at nanomolar (nM) concentrations or lower, yet they pose substantial risks to both ecosystems and human health. However, laboratory studies often examine MP transformation at micromolar (μM) levels due to analytical constraints, potentially overlooking certain MP behaviors under environmentally relevant concentrations. This study investigated the oxidation kinetics (kobs) of model MPs across a wide range of initial concentration (C0), with particular emphasis on the distinct roles of short- and long-lived reactive species (SLRS and LLRS) formed in irradiated dissolved organic matter (DOM) solutions. A generalized kinetic framework was developed and revealed that SLRS, such as triplet-state DOM, dominated MP oxidation at higher C0 (≥μM), while LLRS, primarily DOM radicals, drove MP degradation at sub-μM levels. Laser flash photolysis confirmed that LLRS exhibits much longer lifetimes (∼ms) than SLRS (∼μs), enabling elevated LLRS concentrations under trace MP conditions and significantly enhancing MP oxidation. The observed kobs-C0 relationship features a characteristic “three-platform” behavior governed by RS formation rates, reactivities, and lifetimes. These findings advance our understanding of MP fate under real-world conditions and underscore the critical yet often overlooked role of LLRS in aquatic systems.
34. Potential human exposure to systemic insecticides via alcoholic beverages: first report on Japanese sakes.
期刊: Food additives & contaminants. Part A, Chemistry, analysis, control, exposure & risk assessment 发表日期: 2026-Feb-19 链接: PubMed
摘要
Hydrophilic systemic insecticides that translocate within plant tissues have created emerging dietary exposure pathways via alcoholic beverages produced from treated crops. While such insecticides have been detected in wines and beers, their occurrence in sake, a traditional Japanese rice-based beverage, remains unexamined. This study analysed 52 sake samples from five prefectures in Japan for seven neonicotinoids and six metabolites, chlorantraniliprole, ethiprole, sulfoxaflor, and triflumezopyrim using a liquid chromatography-tandem mass spectrometry (LC-MS/MS). Risk assessments were evaluated by comparing detected concentrations with red wine data and regulatory limits, and by calculating hazard quotient (HQ) and hazard index (HI) values based on maximum daily intake (MDI) and acceptable daily intake (ADI) implemented in Japan. Systemic insecticides occurred in 88% of samples (maximum 68.2 μg/L), with dinotefuran as the most frequently detected compound. Contamination levels were comparable to Asian red wines but exceeded those reported for EU red wines, which are subject to stricter regulations. Although concentrations were below Japan’s tap water limits and contributed <0.2% of Japanese ADIs (HQs, HIs < 1), 81% of samples and eight compounds exceeded EU drinking water thresholds. Given the potential cumulative and synergistic effects, strengthened regulation and monitoring of systemic insecticides in alcoholic beverages including sake are suggested.
35. The Substitution of Bisulfite by Water on the Hydrated Iron(III) Center: A Mechanistic Study.
期刊: The journal of physical chemistry. A 发表日期: 2026-Feb-19 链接: PubMed
摘要
The formation of sulfate, a major component of fine particles posing significant threats to human health, is closely linked to the speciation of Fe(III) complexes with S(IV) at the air-water interface, a crucial yet underexplored aspect of atmospheric sulfur cycling. The speciation of Fe(III)-sulfito complexes at the interface remains poorly understood and thus hinders the understanding of the oxidizing properties of transition metals in atmospheric aerosol. Here, we reveal the coordination preference of the active reaction center (Fe(III)-sulfito complex) and the ligand substitution mechanism between Fe(III)-sulfito complexes and H2O at the air-water interface. Our results demonstrate that the Fe(III) complexes coordinated by HSO3- undergo a rapid and spontaneous transformation from S-coordination to O-coordination within picoseconds. Furthermore, the substitution reaction of HSO3- in [Fe(H2O)4(OH)(HSO3)]+/[Fe(H2O)3(OH)2(HSO3)] by the H2O nucleophile proceeds via both a kinetically and thermodynamically favorable pathway, characterized by free energy barriers of ∼6.39/3.81 kcal/mol. These findings further demonstrate that HSO3- preferentially occupies the second hydration shell of hydrolyzed Fe(III) complexes. The dynamic equilibrium between competing coordination forms provides molecular-scale insights into interfacial metal-sulfur chemistry, where distinct Fe(III) complexes govern the catalytic behavior of the system, thereby bridging coordination chemistry and atmospheric science.
36. Risk-benefit ranking of nitrification and urease inhibitors applied to agricultural soils using the PROMETHEE method.
期刊: Integrated environmental assessment and management 发表日期: 2026-Feb-19 链接: PubMed
摘要
Nitrification and urease inhibitors (NUIs) are chemical compounds that can reduce nitrogen (N) loss and potentially enhance fertiliser nitrogen use efficiency (NUE) when combined appropriately with N fertilisers. Many studies have highlighted their agricultural and environmental benefits, including improving crop yields, reducing nitrate leaching, and lowering nitrous oxide emissions. However, their unintended presence in the environment (e.g.,, surface water) and the food chain has raised concerns. Individual inhibitors exhibit different levels of risks and benefits that need to be evaluated separately. In this study, a risk-benefit ranking was conducted to prioritise 10 NUIs based on environmental exposure, toxicity, and benefit through the preference ranking organization method for enrichment evaluation (PROMETHEE). In general, the urease inhibitor N-(n-butyl) thiophosphoric triamide (NBPT) was identified as the most preferred with a net flow value (φ) of 0.11 in the risk-benefit ranking of all NUIs due to its significant agricultural and environmental benefits with low risk from its short half-life. This assessment was supported by the fact that sometimes NIs can increase ammonia emissions, reducing their overall effectiveness in improving NUE compared to UIs. Our results also illustrated that the nitrification inhibitor dicyandiamide (DCD) was a recommended alternative (φ: 0.08) among evaluated NIs. This study assists stakeholders to balance the benefits and potential risks regarding the environment and human health issues associated with the application of NUIs in agriculture.
37. Ergonomic risks and musculoskeletal disorders: A descriptive study on nurses.
期刊: Work (Reading, Mass.) 发表日期: 2026-Feb-19 链接: PubMed
摘要
BackgroundWorkplaces can present ergonomic hazards, leading to musculoskeletal problems.ObjectiveThis study focused on ergonomic risks and musculoskeletal disorders experienced by nurses.MethodsThis was a descriptive study. The research was conducted between January and May 2023. The sample consisted of 537 nurses. Data were collected face-to-face using a personal information form, the Questionnaire Survey of Ergonomic Risks Among Nursing Workers-TR (ErgoEnf-TR), and the Nordic Musculoskeletal Questionnaire (NMQ).ResultsParticipants had a mean ErgoEnf-TR “biomechanical factors,” “environmental factors/workplace,” and “organizational and psychosocial factors” subscale score of 71.89 ± 22.48, 56.74 ± 28.33, and 67.10 ± 25.48, respectively. Participants working night and day/night shifts had a significantly higher mean ErgoEnf-TR score than those working day shifts. Participants who could not take breaks had a significantly higher mean ErgoEnf-TR score than those who could. Participants who did not adhere to the principles of body mechanics had a significantly higher mean ErgoEnf-TR score than those who did. Participants who did not exercise regularly had a significantly higher mean ErgoEnf-TR score than those who did. The ergonomic risks included musculoskeletal disorders in the lower back, back, neck, and shoulders. Furthermore, ergonomic risk increased by one unit in the presence of biomechanical, environmental, organizational, and psychosocial factors.ConclusionIndividual characteristics and workplace factors put nurses at an increased risk for musculoskeletal problems. Working style, rest status, work stress, compliance with the principles of body mechanics, regular exercise, and pain status affect nurses’ ergonomic risk scores.
38. What american mahjong taught me about work.
期刊: Work (Reading, Mass.) 发表日期: 2026-Feb-19 链接: PubMed
摘要
39. Who determines clinical placement capacity? Understanding the historical, social, and political context using Foucault's critical discourse analysis.
期刊: Advances in health sciences education : theory and practice 发表日期: 2026-Feb-19 链接: PubMed
摘要
40. Ultra-processed food intake and cognitive decline in older adults.
期刊: European journal of nutrition 发表日期: 2026-Feb-19 链接: PubMed
摘要
41. Socio-demographic and occupational determinants of poor self-perceived health among seasonal migrant farmworkers: A cross-sectional analysis.
期刊: Public health 发表日期: 2026-Feb-18 链接: PubMed
摘要
This study analyzes the self-perceived health of seasonal migrant farmworkers in Spain and identifies its associations with socio-demographic and occupational factors. Cross-sectional multicenter study. A total of 616 seasonal migrant farmworkers of African origin were recruited in 2021-2022 from four Spanish provinces. Self-perceived health was assessed using a validated questionnaire and dichotomized as poor (regular/bad/very bad) vs good (good/very good). Multivariate logistic regression and decision tree analysis were conducted to identify associated factors. The model was evaluated using AUC and Hosmer-Lemeshow tests. Poor self-perceived health was reported by 23.1% of participants. Women (OR = 2.10), older adults (OR = 8.36 for ≥45 years), individuals without residence permits (OR = 2.10), alcohol users (OR = 2.02), and residents in southern regions (OR = 2.29) had significantly higher odds of reporting poor health. Specific conditions such as respiratory, circulatory, musculoskeletal, and mental health problems were also associated with poor health perception. Gender and geographic origin defined risk patterns. Our findings show that seasonal migrant farmworkers in Spain, particularly women and those without legal documentation or living in southern regions, experience worse health outcomes. Addressing and transforming the social and occupational conditions in which these migrant workers live and work requires structural interventions through governmental policies.
42. How multidisciplinary teams matter in public health expertise: A case study on the 2023 French infectious disease prioritization exercise.
期刊: Public health 发表日期: 2026-Feb-18 链接: PubMed
摘要
Infectious disease prioritization exercises have been part of national and international health surveillance. They typically use multi-criteria approaches and generally involve expert groups composed of physicians and public health specialists from various disciplines. However, little is known about the impact of multidisciplinarity composition itself. This paper builds on the 2023 infectious disease prioritization exercise conducted by the French High Council of Public health (HCSP) which employed a Multi-Criteria Decision-Making (MCDM) method; a model-based re-analysis of the initial prioritization is provided. Using multilevel modelling methods, we evaluated the impact of the contributions of non-infectious diseases physicians by testing two hypotheses: i) significant differences exist in risks ratings across specialties for several criteria; ii) these differences impact the final disease ranking. Using pediatricians as a case study and comparing them to infectious disease specialists (IDS), we found that pediatricians’ ratings differed significantly for six out of eight criteria. Counterfactual analyses demonstrated that excluding pediatricians’ responses or simulating a panel composed entirely of pediatricians altered the final disease classification. Our findings underscore that a multidisciplinary approach to disease risk assessment facilitates a broader -and likely more accurate- consideration of population needs.
43. Workflow-based Information Management: a nimble, abstracted framework for information management in multicenter research studies.
期刊: Online journal of public health informatics 发表日期: 2026-Feb-18 链接: PubMed
摘要
Biological and health research is becoming more data-driven. Institutions, including commercial and research laboratories, generate data faster now than ever before. The increasing rate of data generation, along with the lessons learned from the COVID-19 pandemic, necessitates a nimble and dependable data infrastructure for organizations to be able to quickly execute research studies and provide insights to inform public health policy and practice. In this manuscript, we describe our Workflow-based Information Management (WIM) framework, a research information management system built on the open-source and freely available R programming language and the associated ecosystem of community-developed packages. We demonstrate that the framework can be readily adapted to a wide range of epidemiology studies and research projects.
44. Maternal Immunization.
期刊: Obstetrics and gynecology 发表日期: 2026-Feb-18 链接: PubMed
摘要
Vaccines administered to women during pregnancy can provide protection against serious infectious diseases for the mother, the child, or both. Maternal immunization boosts the concentration of maternal antibodies that can be transferred across the placenta to directly protect children too young to be immunized. In addition, indirect protection through prevention of maternal infection and breast-milk antibodies can be achieved through maternal immunization. In general, inactivated vaccines are considered safe for pregnant women and fetuses, whereas live attenuated vaccines are avoided due to the theoretical potential risk of infection to the fetus. However, the potential risks of vaccines need to be weighed against the risk of the disease itself and the benefits of vaccination in terms of protection of the mother and child against infectious disease. Tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap); influenza; coronavirus disease 2019 (COVID-19); and respiratory syncytial virus (RSV) vaccines are routinely recommended for all pregnant women in the United States. Maternal immunization has the potential to improve the health of mothers and young children; therefore, other diseases of relevance during this period are now targets of active research and vaccine development, including group B streptococcus (GBS). Similarly, several vaccines can be administered during pregnancy in special circumstances when maternal health, travel, or other special situations arise. This article reviews the current recommendations for vaccination of women during pregnancy.
45. Metabolic Dysfunction-Associated Steatotic Liver Disease in Pregnancy: A Review.
期刊: Obstetrical & gynecological survey 发表日期: 2026-Feb-01 链接: PubMed
摘要
Metabolic dysfunction-associated steatotic liver disease (MASLD), formerly known as nonalcoholic fatty liver disease, is characterized by fatty deposits in the liver, with histologic features like alcohol-induced liver injury, without associated alcohol misuse. This condition is associated with other metabolic comorbidities, particularly obesity and insulin resistance. MASLD is also associated with the development of pregnancy-related complications such as gestational diabetes mellitus and hypertensive disorders of pregnancy. MASLD is one of the most common liver diseases today, with a prevalence of 14% in pregnant individuals. The goal of this review was to explore the topic of MASLD with a discussion of its pathophysiology, diagnosis, clinical management, and complications related to pregnancy. A literature search was conducted utilizing Rayyan to review 180 articles published between 2000 and 2024 for inclusion or exclusion in the review. MASLD is an increasingly prevalent disease process likely underdiagnosed in pregnancy. Evidence suggests a synergistic pathway between obesity and the physiological changes of pregnancy, which can initiate or exacerbate liver steatosis. MASLD is associated with adverse outcomes in pregnancy and in the offspring of affected pregnancies. Further research is needed to demonstrate optimal screening, diagnosis, and management in pregnancy. If detected early, early diabetes screening and low-dose aspirin may be appropriate, given the significant association with gestational diabetes and gestational hypertensive disorders. Patients should be counseled on the increased risk of maternal morbidity, preterm birth, miscarriage, macrosomia, pregnancy-induced hypertension, cesarean delivery, gestational diabetes, and metabolic disease in the offspring.
46. Metabolic modeling reveals determinants of prebiotic and probiotic treatment efficacy across multiple human intervention trials.
期刊: PLoS biology 发表日期: 2026-Feb 链接: PubMed
摘要
Prebiotic, probiotic, and combined (synbiotic) interventions often show variable outcomes across individuals, driven by complex interactions between introduced biotics, the endogenous microbiota, and the host diet. Predicting individual-specific success or failure of probiotic and prebiotic therapies remains a major challenge. Here, we leverage microbial community-scale metabolic models (MCMMs) to predict probiotic engraftment and microbiota-mediated short-chain fatty acid (SCFA) production in response to probiotic and prebiotic interventions. Using data from two human clinical trial cohorts, testing a five-strain probiotic combined with the prebiotic inulin designed to improve metabolic health and an eight-strain probiotic designed to treat recurrent Clostridioides difficile infections, respectively, we show that MCMM-predicted engraftment largely agrees with measurements, achieving 75%-80% accuracy. Engraftment probabilities varied across taxa. MCMMs captured treatment-driven shifts in predicted SCFA production, and higher model-predicted growth rates of Akkermansia muciniphila were negatively associated with glucose area under the curve (AUC) in the first trial, providing clues about the mechanisms underlying treatment efficacy. Extending these models to a third human cohort undergoing a healthy diet and lifestyle intervention revealed substantial inter-individual variability in predicted responses to increasing dietary fiber, which were significantly associated with baseline-to-follow-up changes in cardiometabolic health markers. Finally, our simulation results suggested that personalized prebiotic selection may further enhance probiotic efficacy. Together, these findings demonstrate the potential of metabolic modeling to guide personalized microbiome-mediated interventions.
47. Research on the path of social psychological collaborative education in colleges and universities driven by the dynamic reward and punishment mechanism of the government.
期刊: PloS one 发表日期: 2026 链接: PubMed
摘要
This study addresses the prevalent issues of “coordination failure” and “cooperative inertia” in the collaborative education of mental health between universities and society. Utilizing evolutionary game theory, it systematically constructs and analyzes four models that combine government rewards and punishments. The findings indicate that while the traditional static reward and punishment mechanism offers basic incentives, its rigid design results in the system’s path dependence on government subsidies, thereby hindering the development of sustainable endogenous motivation. In order to address this governance dilemma, this paper first put forward the idea of combining “performance-based grant-reputation incentive” linkage system, this mechanism has prompted the external incentives to the internal incentives transformation effect under the joint governance of short-term fiscal policy and long-term reputation asset through the dynamic adjustment of incentive coefficient and reputation incentive resources are put into use. Numerical simulation results show that the “dynamic reward - static punishment” hybrid model of the two has the best policy effect. In the initial stage of cooperative relationship, government funding helps to break the situation of cooperation cannot be broken; In the later stage of the cooperation, the pursuit of reputation capital has become the motive for cooperating in deeper. It can be learned from relevant studies that reasonably allocating more incentive resources to universities that take the initiative can significantly enhance the efficiency of the system evolving into the state of deep cooperation and open sharing. Both theoretical and empirical evidence confirms that the proposed dynamic linkage mechanism markedly outperforms the traditional static model in terms of policy adaptability, incentive sustainability, and institutional robustness. This finding not only enriches the understanding of the evolutionary dynamics of the psychological healthy education system but also provides a theoretical foundation and practical pathway for establishing an incentivized, compatible, and sustainable governance system for mental health education.
48. Rapid bacteriophage quantification with a particle size analyzer combined with polarization intensity differential scattering (PIDS) detector.
期刊: PloS one 发表日期: 2026 链接: PubMed
摘要
The study of bacteriophages (phages) and effects on their microenvironments expanded exponentially within the last decade. While there are multiple described methods for phage quantitation, there is still a need for a rapid, label-free method. To this end, we established a procedure for rapid phage quantitation through novel use of a particle size analyzer with Polarization Intensity Differential (PIDS) technology and eliminated the need for labels or knowledge of bacterial host. We validated the procedure and analysis method, termed PhageFOTO (Fast Optical Tallying of Objects) using several physiologically different phages ranging from ~6 nm capsid width (Inoviridae) to ~90 nm capsid width (Caudoviricetes). PhageFOTO demonstrated 89 ± 4.3%, 98 ± 1.7%, and 94 ± 2.7% accuracy for quantitating PhiX, M13, and T4 phages/mL respectively as compared to the gold standard plaque assay with limit of detection for particle concentration occurring around 107 phages/mL. PhageFOTO proved to be a novel, rapid, label free method for phage counting that does not rely on knowledge of the bacterial host presenting unique capability for quantitation of phage samples.
49. Effectiveness of Non-Pharmacological Interventions for Hormone Therapy-Induced Hand Arthralgia in Breast Cancer Patients: A Systematic Review.
期刊: Journal of evidence-based integrative medicine 发表日期: 2026 链接: PubMed
摘要
BackgroundAromatase inhibitor-induced arthralgia (AIA) is a frequent adverse effect of endocrine therapy in breast cancer survivors, often leading to treatment modification or discontinuation. Non-pharmacological interventions have been proposed to manage AIA, but evidence remains fragmented.ObjectiveTo synthesize recent randomized controlled trials (RCTs) evaluating the efficacy of non-pharmacological interventions for AIA.MethodsA systematic search of PubMed, Scopus, and Web of Science identified RCTs published between 2010 and 2025 assessing non-pharmacological strategies for AIA. Two reviewers independently performed study selection, data extraction, and quality appraisal using standardized criteria.ResultsEight RCTs met inclusion criteria, encompassing interventions such as acupuncture, structured exercise (aerobic, resistance, and Pilates), progressive relaxation, and neuromuscular taping. Acupuncture produced clinically meaningful reductions in pain intensity (mean differences 0.9-1.1 points on the Brief Pain Inventory), while exercise programs yielded moderate improvements in pain, function, and quality of life. Relaxation and taping interventions demonstrated smaller or less consistent effects. No eligible trials evaluated occupational therapy-based interventions.ConclusionsAcupuncture and structured exercise show the strongest evidence of benefit for managing AIA, though overall methodological quality remains moderate. Further well-designed trals with standardized outcomes and longer follow-up are needed to guide clinical implementation and to explore underrepresented approaches such as occupational therapy.
50. Family History and ASCVD Risk Among Different Age Groups: Cohort Study in China and the United Kingdom.
期刊: JACC. Asia 发表日期: 2025-Dec-30 链接: PubMed
摘要
Evidence on the association between family history and atherosclerotic cardiovascular disease (ASCVD) across age groups remains limited. This study aimed to evaluate the relations of family history of ASCVD (FHA) with incident ASCVD and its predictive value across age groups in China-PAR (Prediction for Atherosclerotic Cardiovascular Disease Risk in China) and UK Biobank. A total of 117,640 Chinese and 457,781 UK adults were included from 2 population-based cohorts, with family history assured by face-to-face interviews with standardized questionnaires. During median follow-ups of 6.0 (Q1-Q3: 5.7-11.4) years (China-PAR) and 11.8 (Q1-Q3: 11.0-12.5) years (UK Biobank), 4,681 and 26,913 ASCVD cases occurred. Generally, FHA was consistently associated with higher ASCVD risk, but the association weakened with age (Pinteraction < 0.001). The strongest effect was in adults <45 years, with HRs of 1.48 (95% CI: 1.11-1.96) in China-PAR and 1.47 (95% CI: 1.23-1.76) in UK Biobank, which was transformed to 6.75 and 5.33 years ASCVD-free years lost at the index of 20 years, and this gap decreased to 3.40 and 1.42 years at the index of 80 years, respectively. Notably, sibling history conferred greater risk than parental history (Pheterogeneity < 0.001). In both populations, FHA is a key indicator for identifying high ASCVD risk, especially in younger individuals, with a stronger impact driven by sibling history. These findings highlight the importance of tailoring recommendations for identifying high-risk individuals based on family history, with consideration of different age groups.
51. Burden of Cardiovascular Disease in Asian Countries, 1990-2021.
期刊: JACC. Asia 发表日期: 2025-Dec-04 链接: PubMed
摘要
Cardiovascular diseases (CVDs) account for a large and increasing health burden worldwide, as shown in the Global Burden of Disease Study 2021. However, there has been no comprehensive assessment of CVDs in Asia, which bears the largest population globally. This study sought to evaluate the burden of CVD in Asia from 1990 to 2021. Mortality, prevalence, and disability-adjusted life years (DALYs) along with their age-standardized rates (ASRs) per 100,000 population from 1990 to 2021 were used to measure the CVDs burden. Further subanalyses were conducted based on age group and sex. In 2021, CVDs caused an estimated 11.9 million deaths (95% uncertainty interval [UI]: 10.9-12.9 million deaths), 340.4 million prevalent cases (95% UI: 315.1-366.9 million prevalent cases), and 270.4 million DALYs (95% UI: 251.6-290.2 million DALYs). Although the ASR of prevalence slightly increased from 1990 to 2021 with a percentage change of 5.7% (95% UI: 3.9%-8.1%), the ASRs of death and DALYs were significantly decreased, with percentage changes of -28.2% (95% UI: -42.2% to -12.5%) and -37.8% (95% UI: -50.5% to -24.3%), respectively. The Asian burden of CVDs was higher in males and the elderly. The primary contributors to DALYs across Asia were ischemic heart disease, stroke, and hypertensive heart disease. Burden of CVDs in Asia remains substantial. Certain populations, including males and the elderly, experienced a heavier burden of CVDs.
52. [Not Available].
期刊: La Tunisie medicale 发表日期: 2025-May-05 链接: PubMed
摘要
Recently, special attention has been paid to the relationship between health professionals and the pharmaceutical industry, which could influence medical prescriptions. The aim of this work was to evaluate the attitude of Tunisian endocrinologists towards pharmaceutical promotion. It was a cross-sectional study based on an anonymous 9-item survey about the attitudes and behaviors of physicians towards the pharmaceutical promotion. The study included 120 residents and endocrinology specialists. One-third of the physicians did not complete the survey. We analyzed 75 responses of 32 residents and 43 specialists. The inexpensive gifts were appreciated by most participants. Costly gifts were judged less frequently appropriate. However, these expensive gifts were received or desired by many participants. Among residents, 9.4% thought that their prescriptions would be very influenced by the promotion while they estimated that 15.6% of their colleagues would be (p=ns). This difference was significant among the specialists: respectively 4.7% and 35.3% (p=0.002). Training about conflict of interest is insufficient according to 96.8% of residents and 97.6% of specialists (p=ns). Contact between learners and medical visitors should be prohibited according to 9.4% of residents and 36.6% of specialists (p=0.007). Most participants confirmed that they had links of interest with the pharmaceutical industry, but they thought that this had no influence on their prescriptions. Many studies have shown that gifts, even small ones, are very effective in subtly influencing doctors’ therapeutic attitudes. Awareness is needed to ensure an independent medical prescription.
53. Quality improvement in hemodialysis: A systematic review.
期刊: La Tunisie medicale 发表日期: 2025-May-05 链接: PubMed
摘要
The predominant modality of renal replacement therapy, hemodialysis (HD), is a specialized area associated with a heightened susceptibility to infections, partly due to patients’ vulnerability, the invasiveness of procedures necessitating vascular access, and the cyclical nature of the treatment. These factors, along with a notable incidence of infections, present a significant public health challenge owing to their implications on both human health and economic resources. Mortality rates in dialysis patients are markedly elevated, typically ranging from 10 to 20%, primarily linked to cardiovascular (40%) and infectious (10%) etiologies. Enhancing the caliber of care, patient safety, and clinical outcomes represents a pivotal focal point for healthcare systems globally. Nevertheless, could the adherence to universally acknowledged and validated benchmarks engender variability in outcomes within hemodialysis environments? Can interventions aim at improving quality lead to positive outcomes by reducing infections and improving results for patients undergoing hemodialysis? To respond to these inquiries, a systematic review based on the PRISMA guidelines was carried out over 14 years across various databases, identifying cases of quality improvement initiatives and detailing their effectiveness in infection prevention and quality-centred approaches to risk management. Multiple forms of interventions aimed at enhancing quality have been outlined and considered relevant, including (i) integrating the PDCA (Plan-Do-Check-Act) cycle with oversight of risk factors, (ii) utilizing the Failure Mode, Effects, and Criticality Analysis (FMECA) framework, (iii) applying LEAN management principles, and (iv) strictly following the guidelines established by the Centers for Disease Control and Prevention (CDC) and the kidney disease: Improving Global Outcomes (KDIGO). Adopting these quality approaches has significantly reduced infection rates in hemodialysis contexts. However, these quality improvement interventions are elementary and not comprehensive, with limited long-term effectiveness. A comprehensive management initiative must therefore bring together successful improvement practices, pertinent methodologies, and current quality standards to establish an integral management system based on quality control, quality assurance, and continuous improvement.
54. Epidemiological study on nasopharyngeal cancer in Morocco: Case of the University Hospital Center Mohammed VI in Marrakech.
期刊: La Tunisie medicale 发表日期: 2025-May-05 链接: PubMed
摘要
Globally, nasopharyngeal cancer has a varied geographic distribution, occurring more frequently in certain areas and less often in others (1). This article presents the epidemiological situation of this cancer in the Marrakech-Safi region, Morocco. Our retrospective study analyzed the epidemiological profile of nasopharyngeal cancer in the Marrakech-Safi region (Morocco) based on 226 cases evaluated at the University Hospital Center MOHAMMED VI of Marrakech from 2014 to 2018. We used descriptive and analytical statistics to create this profile. Results: The cases studied were 61.9% male (140 cases), and 38.1% female (86 cases), with a mean age of 47.95 ± 16.54 years and a sex ratio of 1.62 (p <0.001). The majority, 76.5%, were married, 16.4% single, 5.8% widowed and 1.3% divorced. The Medical Assistance Plan (RAMED) was the most widespread medical coverage (86.73%). The provinces most affected were Marrakech (42.92%), Safi (10.62%) and El Kelaa (9.73%). These cases were without profession (55.31%), housewives (13.72%), farmers (7.08%), and workers (3.98%). This may be due to the multifactorial etiology of the disease, including occupational exposure to chemical carcinogens. The study reveals the incidence of nasopharyngeal cancer and identifies the age group most affected in the region studied, highlighting a link with formaldehyde. Further studies are recommended to determine the probable risk factors for this cancer.
55. Management of Spinal Cord Injury in Tunisia: 2024 landscape and challenges.
期刊: La Tunisie medicale 发表日期: 2025-Apr-05 链接: PubMed
摘要
Spinal Cord Injury (SCI) is a pressing global health issue, with a notable increase in incidence in Tunisia primarily attributed to traffic accidents. The repercussions of SCI extend beyond physical impairments, significantly affecting patient mental health and quality of life, and pose substantial economic challenges. This study aims to provide an in-depth analysis of the current landscape of SCI management in Tunisia, identifying key challenges faced by patients and healthcare providers while offering actionable recommendations for improvement. A comprehensive review of existing literature was conducted to assess the SCI management framework in Tunisia. The study focused on evaluating the rehabilitation system, healthcare provider training, and the implementation of disability rights in the country, while identifying barriers to effective care. Findings indicate a critical shortage of specialized rehabilitation facilities, with only 13 out of 24 governorates of the country providing adequate services. Additionally, there is a significant lack of trained healthcare professionals and inconsistent application of disability rights. Social stigmas further complicate the situation, hindering access to comprehensive care for SCI patients. To enhance SCI care in Tunisia, it is essential to expand rehabilitation services, improve healthcare providers training in disability management, and strengthen disability support systems. Implementing policy reforms, increasing data collection efforts, promoting research and peer support programs are vital steps toward addressing the multifaceted challenges of SCI management and improving the quality of life for affected individuals.