公共卫生研究摘要 (2026-04-17)
共收录 61 篇研究文章
1. The Impact of an Intensive International Course on Advanced Practice Nurse (APN) Educators' Teaching Readiness and Competence in APN Programmes. A Pretest-Posttest Intervention Study.
期刊: Scandinavian journal of caring sciences 发表日期: 2026-Jun 链接: PubMed
摘要
Previous research has analysed advanced practice nursing education and nurse educators’ roles. However, limited attention has been paid, and a gap remains in understanding educators’ experiences delivering the APN programme and their readiness to focus on their teaching roles. To enhance our understanding of nurse educators’ experiences in becoming APN educators before and after participating in the APN educators’ intensive course and additionally describe how participants evaluated this course. A pretest-posttest intervention study. A total of 19 APN educators from the Nordic and Baltic countries completed both pre- and post-surveys. Fourteen respondents answered the course evaluation questionnaire. This intensive course intervention appeared to increase APN educators’ readiness and competence. Although the overall results were not statistically significant, the subgroup analyses highlighted that prior clinical experience, higher education and teaching experience influenced competency development. The course evaluation results indicate that the international intensive course was perceived as successful. This study provides new insights into the readiness and competencies of APN educators in the Nordic and Baltic countries. The research findings can contribute to understanding APN educators’ teaching readiness and competence and offer directions for future development in education for APN educators.
2. From evidence to action: Investment cases for strengthening sexual and reproductive health and rights financing in West and Central Africa.
期刊: African journal of reproductive health 发表日期: 2026-Apr-17 链接: PubMed
摘要
This article provides an overview of UNFPA’s investment case approach in West and Central Africa, drawing on national and subnational analyses from Chad, Ebonyi State (Nigeria), Gabon, Ghana, Guinea, Nigeria (federal level), and Sierra Leone. Across these settings, the investment cases quantify the costs, benefits, financing gaps, and fiscal space opportunities associated with scaling priority sexual and reproductive health and rights (SRHR) services. The evidence demonstrates consistently high economic returns and substantial long-term losses associated with inaction. It also highlights early policy traction through evidence-informed advocacy, including the creation of new budget lines, increased domestic allocations, and stronger stakeholder engagement around SRHR financing. Together, the findings provide a roadmap for integrating SRHR investment into national planning and public financial management systems, offering governments and development partners actionable strategies to advance sustainable and domestically financed SRHR programmes across West and Central Africa. Cet article présente un aperçu de l’approche du dossier d’investissement de l’UNFPA en Afrique de l’Ouest et du Centre, en s’appuyant sur des analyses nationales et sous-nationales réalisées au Tchad, dans l’État d’Ebonyi (Nigeria), au Gabon, au Ghana, en Guinée, au Nigeria (niveau fédéral) et en Sierra Leone. Dans ces différents contextes, les dossiers d’investissement quantifient les coûts, les bénéfices, les déficits de financement et les opportunités d’espace budgétaire associés à la mise à l’échelle des services de santé reproductive (SR) prioritaires. Les données démontrent des rendements économiques systématiquement élevés ainsi que des pertes substantielles à long terme liées à l’inaction. Elles soulignent également les premiers succès politiques obtenus grâce à un plaidoyer fondé sur des données probantes, notamment la création de nouvelles lignes budgétaires, l’augmentation des allocations nationales et un engagement accru des parties prenantes autour du financement de la SR. Ensemble, ces conclusions tracent une feuille de route pour l’intégration de l’investissement dans la SR au sein des systèmes de planification nationale et de gestion des finances publiques, offrant aux gouvernements et aux partenaires au développement des stratégies exploitables pour faire progresser des programmes de SR durables et financés au niveau national en Afrique de l’Ouest et du Centre.
3. NetMHCIIphosPan: A Machine Learning Tool for Predicting HLA Class II Antigen Presentation of Phosphorylated Peptides.
期刊: Journal of proteome research 发表日期: 2026-Apr-17 链接: PubMed
摘要
Phosphorylated peptides presented by human leukocyte antigen (HLA) class II molecules play pivotal roles in immune regulation, yet their characterization and prediction remain challenging due to data noise and limited HLA coverage. Here, we introduce NetMHCIIphosPan, a prediction method for HLA-II antigen presentation of phosphorylated peptides, developed using mass spectrometry (MS)-based immunopeptidomics data sets. Employing a refined peptide identification workflow, we reanalyzed earlier HLA-II phospholigand data sets and trained predictive models, achieving superior performance compared to models trained on the original data. Binding motif analysis revealed that HLA-specific preferences for phospholigands closely aligned with those of unmodified ligands. Incorporating unmodified ligands into training further enhanced predictive accuracy, particularly for HLA-DP and HLA-DQ molecules. NetMHCIIphosPan outperformed existing tools, such as NetMHCIIpan-4.3 and MixMHC2pred-1.3, for prediction of HLA antigen presentation of phosphorylated peptides, demonstrating robustness and utility. This work establishes NetMHCIIphosPan as a state-of-the-art tool for understanding the HLA-II phospholigandome, with potential applications in immunotherapy and vaccine design.
4. Comparative evaluation of ammonium chloride-modified and hospital-grade activated charcoal for paracetamol adsorption under simulated gastric (pepsin) and intestinal (pancreatin) fluid.
期刊: Clinical toxicology (Philadelphia, Pa.) 发表日期: 2026-Apr-17 链接: PubMed
摘要
Paracetamol overdose is a major cause of drug-induced toxicity, and activated charcoal is routinely used for gastrointestinal decontamination. This study compares the adsorption efficiency of ammonium chloride-modified activated charcoal, synthesized from Calligonum comosum wood, with hospital-grade activated charcoal in simulated gastric and intestinal fluid. Adsorption experiments were conducted using 20 mg of activated charcoal, in a paracetamol solution containing 2.5 mg of paracetamol (50 mg/L in 50 mL), corresponding to an adsorbent-to-drug ratio of 8:1 at 37 °C. Simulated gastric and intestinal fluid were prepared using pepsin and pancreatin, respectively. For isotherm analysis, paracetamol solutions were tested at charcoal-to-drug ratios ranging from 1:1 to 10:1 using a fixed 20 mg adsorbent dose. Kinetic modeling and the effects of ethanol and flavoring agents were also evaluated. Paracetamol adsorption efficiencies were 87 ± 0.5% and 85 ± 0.8% for modified activated charcoal in simulated gastric and intestinal fluid, respectively. Hospital-grade activated charcoal efficiencies were 47 ± 0.7% and 58 ± 0.6%. Maximum adsorption capacities were 574.93 and 566.71 mg/g for modified activated charcoal and 173.98 and 294.64 mg/g for hospital-grade activated charcoal. Adsorption data fitted the Freundlich isotherm for modified activated charcoal and the Langmuir model for hospital-grade activated charcoal. Exposure to ethanol reduced adsorption by approximately 14% and 32% for modified and hospital-grade activated charcoals, respectively. Flavoring agents reduced adsorption by about 5% and 10% for modified and hospital-grade activated charcoals, respectively. Kinetic analysis indicated a pseudo-second-order model for both materials. Modified activated charcoal showed higher paracetamol adsorption efficiency and capacity than hospital-grade activated charcoal under simulated gastric and intestinal conditions, with stable performance in enzyme and flavoring agent environments. These findings suggest modified activated charcoal may improve adsorption for gastrointestinal decontamination; however, comparative studies with multiple commercial medicinal charcoals and in vivo evaluation are needed to confirm clinical applicability.
5. Characteristics of Uveitis in European Tertiary Ophthalmology Centers: A Systematic Review and Meta-Analysis.
期刊: Ocular immunology and inflammation 发表日期: 2026-Apr-17 链接: PubMed
摘要
Uveitis is one of the leading causes of preventable visual impairment and shows marked heterogeneity in anatomical distribution, etiology, and management. Although numerous European cohorts have been published, pooled estimates are lacking. This systematic review and meta-analysis aims to contextualize characteristics of uveitis across European tertiary ophthalmology centers to provide a reference framework for clinical and research applications. A systematic search was conducted up to January 15, 2026, in accordance with PRISMA guidelines and a pre-registered protocol. Observational cohort and cross-sectional studies including ≥ 50 adult uveitis patients managed in European tertiary referral centers were eligible. Risk of bias was assessed using Newcastle-Ottawa Scale and Joanna Briggs Institute tools. Random-effects meta-analyses with logit transformation and restricted maximum likelihood estimation were performed for outcomes reported by at least five comparable studies. Twenty-seven studies including 30 471 patients were analyzed. Anterior uveitis was the most common anatomical subtype (pooled proportion 52.1%, 95% CI: 43.2-60.9%), followed by posterior uveitis (18.9%, 95% CI: 15.9-22.4%), panuveitis (14.4%, 95% CI: 10.7-19.1%), and intermediate uveitis (8.7%, 95% CI: 6.9-10.9%). Etiologically, non-infectious uveitis predominated (44.9%, 95% CI: 39.4-50.5%), followed by idiopathic (34.3%, 95% CI: 29.9-39.0%) and infectious uveitis (23.0%, 95% CI: 20.6-25.5%). All pooled estimates showed substantial heterogeneity (I2 > 90%). Treatment patterns and complication rates were inconsistently reported and are therefore summarized descriptively. This study provides the first pooled benchmark estimates of uveitis characteristics across European tertiary centers, revealing substantial heterogeneity. The results offer a reference framework for contextualizing single-center cohorts and identifying regional variation across Europe.
6. Stability analysis and optimal control of the fractional-order SEIQR epidemic model with logistic input.
期刊: Computer methods in biomechanics and biomedical engineering 发表日期: 2026-Apr-17 链接: PubMed
摘要
This article mainly investigates a fractional-order SEIQR model with a logistic input and a saturated incidence rate, and formulates a fractional optimal control problem (FOCP). The nonnegativity of solutions is analyzed, and the existence of disease-free and endemic equilibria is demonstrated by deriving a threshold R0. Sufficient conditions are established to guarantee local asymptotic stability of these equilibria. Considering infectious disease prevention and control strategies, we prove the existence of FOCP solutions and analyze the effects of the optimal control strategy. Furthermore, the effectiveness of the theoretical results is confirmed. Finally, the proposed model is applied to COVID-19 data.
7. Genetic and vaccination studies reveal feather viral load as a potential biomarker for individual and flock-level protection against Marek's disease in chicken.
期刊: Avian pathology : journal of the W.V.P.A 发表日期: 2026-Apr-17 链接: PubMed
摘要
Marek’s disease (MD) remains a major threat to poultry, despite control efforts through biosecurity, vaccination, and genetic selection. Marek’s disease virus (MDV), the causative agent, continues to persist and evolve to increased virulence, indicating that current measures are suboptimal. While vaccination-even with ‘leaky’ vaccines-has been shown to reduce MD symptoms and mortality at the flock level by decreasing virus shedding, it is unclear whether genetic resistance offers similar indirect protection. Using natural transmission experiments in inbred layer chickens, we compared the effects of vaccination and genetic resistance, defined by reduced tumour incidence and increased survival, on virus shedding and MD outcomes in both virus-inoculated shedder birds and unvaccinated MD susceptible contact birds. Shedder birds with genetic or vaccine-mediated resistance were less likely to develop disease and die, but only vaccinated shedders showed significantly reduced feather viral load (FVL). Nearly all contact birds became infected, suggesting that neither genetic resistance nor vaccination prevented transmission. However, significant reductions in symptomatic MD incidence and mortality were only observed in contacts exposed to vaccinated shedders. Exposure timing relative to shedders’ infection time also influenced contact outcomes. Process analyses and dose-response curves revealed that higher shedder or group mate FVL correlated strongly with MD incidence and mortality and shedding in contact birds. FVL emerged as a promising indicator for both individual and flock-level protection and could serve as a useful phenotype for future breeding and vaccination strategies aimed at reducing MDV transmission and limiting virulence evolution.
8. Vitellogenin Identified as a Novel Allergen in Tenebrio molitor: Evidence from an Occupational Asthma Case.
期刊: Journal of investigational allergology & clinical immunology 发表日期: 2026-Apr-17 链接: PubMed
摘要
9. Development of a DUX4-targeting antibody oligonucleotide conjugate as a therapy for FSHD.
期刊: Nucleic acids research 发表日期: 2026-Apr-13 链接: PubMed
摘要
Facioscapulohumeral muscular dystrophy (FSHD) is an autosomal dominant muscular disease in which genetic mutations activate DUX4 expression in skeletal muscle. Currently, there are no approved therapies for FSHD. We developed Delpacibart braxlosiran (del-brax, also known as AOC 1020), an antibody oligonucleotide conjugate (AOC), for the treatment of FSHD that is designed to specifically target and reduce DUX4 mRNA in skeletal muscle. AOC 1020 is composed of DUX4 mRNA-targeting small interfering RNA (siRNA), siDUX4.6, conjugated to a human transferrin receptor 1 (TfR1)-targeting monoclonal antibody to facilitate productive siRNA delivery to muscle. We demonstrate that siDUX4.6 reduces DUX4-regulated gene expression in FSHD patient-derived myotubes in vitro and in skeletal muscle of the ACTA1-MCM; FLExDUX4 FSHD mouse model in vivo. Single systemic intravenous treatment was sufficient to prevent DUX4-induced muscle weakness and fibrosis in this FSHD mouse model and reduce DUX4-regulated genes by ∼75% 8 weeks post-dose. The pharmacokinetic profiles of AOCs with siDUX4.6 were comparable in murine and non-human primate muscle. These data demonstrate the potential of AOC 1020 to treat the underlying cause of FSHD by suppressing DUX4 expression in muscles of patients with FSHD. The safety and efficacy of AOC 1020 is currently being investigated in clinical trials.
10. Measurement error-robust causal inference via constructed instrumental variables.
期刊: Biometrics 发表日期: 2026-Apr-09 链接: PubMed
摘要
Measurement error can often be harmful when estimating causal effects. Two scenarios in which this is the case are in the estimation of (a) the average treatment effect when confounders are measured with error, and (b) the natural indirect effect when the exposure and/or confounders are measured with error. Methods adjusting for measurement error typically require external data or knowledge about the measurement error distribution. Here, we propose methodology not requiring any such information. Instead, we show that when the outcome regression is linear in the error-prone variables, consistent estimation of these causal effects can be recovered using constructed instrumental variables (IVs) under certain conditions. These variables, which are functions of only the observed data, behave like IVs for the error-prone variables. Using data from a study of the effects of prenatal exposure to heavy metals on growth and neurodevelopment in Bangladeshi mother-infant pairs, we apply our methodology to estimate (a) the effect of lead exposure on birth length while controlling for maternal protein intake, and (b) lead exposure’s role in mediating the effect of maternal protein intake on birth length. Protein intake is calculated from food journal entries, and is suspected to be highly prone to measurement error.
11. Developing a Mortality Risk Score in Intensive Care Units of Referral Hospitals in Bahir Dar City, Ethiopia: A Prognostic Study.
期刊: Health science reports 发表日期: 2026-Apr 链接: PubMed
摘要
The aim of this study was to develop a mortality risk score in the intensive care units of referral hospitals in Bahir Dar City. The study included 852 participants who were admitted from January 1, 2019 to December 31, 2021. We used EpiData version 3.1 for data entry and R-software for analysis. The mortality rate among participants was 35.9%. Multivariable logistic regression was employed to identify the independent prognostic determinants. Using beta-coefficients, we developed and validated a prognostic model. Then a mortality risk score was determined based on the value of each prognostic determinant variable. Age, sex, health insurance user status, respiratory rate, temperature, mean arterial pressure, Glasgow Coma Scale, WBC count, sepsis, ARDS, organ-insufficiency, mechanical ventilation, and vasopressor were independent prognostic determinants. Based on the prognostic determinants, we developed an easily applicable mortality risk score model. The model had a discrimination performance of AUC 0.90 (95% confidence interval of 0.88-0.92) and a calibration p value of 0.69. The prognostic determinants identified in this study are easily accessible and easy to capture in routine clinical settings. As a result, the developed model has the potential to be effectively applied in low-income countries where resources may be limited. The model can help healthcare providers in low-income settings to identify high-risk patients and develop appropriate interventions to improve patient outcomes.
12. National Policies for Improving Micronutrient Intake in School Meals: A Global Cross-Sectional Study.
期刊: Health science reports 发表日期: 2026-Apr 链接: PubMed
摘要
Malnutrition, including overnutrition, undernutrition, and micronutrient deficiency, remains a major global public health challenge, closely linked to food insecurity. Among children, micronutrient deficiencies can impair cognitive development, making effective national policies vital to guide in-school micronutrient supplementation within school meal programs. This study aimed to assess how national policies on school feeding, nutrition, health, food safety, agriculture, and private sector engagement influence the implementation of micronutrient supplementation in school meal programs across countries. The study employed the Bayesian Mindsponge Framework, which combines the Granular Interaction Thinking Theory with Bayesian inference techniques. A dataset comprising responses from 126 government representatives (n = 126) responsible for large-scale school meal programs across 126 countries was analyzed to estimate the effects of various national policy domains on micronutrient supplementation outcomes. Findings revealed that school feeding policies have a small but positive effect on the implementation of micronutrient supplementation (β = 0.12, SD = 0.10). In contrast, nutrition policies exhibit a slight negative association (β = -0.12, SD = 0.10). Other policies, including those related to health, food safety, agriculture, and the private sector, demonstrated minimal or negligible influence. The study underscores the positive contribution of school feeding policies in promoting micronutrient supplementation within school meal programs. However, the negative association of nutrition policies suggests the need for critical policy reassessment to ensure coherence and effectiveness. Strengthening cross-sectoral linkages, particularly among health, food safety, agriculture, and private sector policies, may further enhance micronutrient intake and improve child health outcomes globally.
13. Unlocking the Potential of Health Technology Assessment (HTA) in Indonesian Midwifery: Challenges and Opportunities.
期刊: Health science reports 发表日期: 2026-Apr 链接: PubMed
摘要
Health Technology Assessment (HTA) supports evidence-based decision-making, resource allocation, and healthcare quality. Although Indonesia has established national HTA policies, their application in midwifery remains limited. Given ongoing efforts to reduce maternal mortality and advance health transformation, integrating HTA into midwifery is essential for safe, effective, and cost-efficient care. This paper critically examines HTA’s potential in Indonesian midwifery, identifying implementation gaps, challenges, and opportunities to improve maternal and child health outcomes. This study employed a narrative review and policy analysis, examining national health policies, HTA guidelines, institutional frameworks, and relevant scientific literature on HTA and midwifery in Indonesia. The analysis focused on identifying structural barriers, implementation challenges, and strategic opportunities for integrating HTA into community-based midwifery services. The analysis revealed that Indonesia possesses a foundational HTA policy framework supported by national health transformation strategies. However, a significant implementation gap exists between national HTA policies and frontline midwifery practice. HTA activities primarily focus on high-cost hospital technologies, while routine midwifery tools and digital health applications are often adopted without systematic evaluation. Key challenges include limited data availability, decentralized procurement systems, insufficient local HTA capacity, funding constraints, and inadequate knowledge translation mechanisms. Opportunities include strengthened stakeholder collaboration, digital health integration, capacity building for midwives, and development of standardized evaluation mechanisms tailored to midwifery technologies. Integrating HTA into Indonesian midwifery can enhance evidence-based practice, optimize resource allocation, and improve maternal and child healthcare quality. Addressing policy-practice gaps through capacity development, institutional coordination, and investment in data systems is essential. Strategic HTA implementation can support Indonesia’s health transformation agenda and contribute to improved maternal and newborn health outcomes.
14. Feasibility and Challenges of Telemedicine in Delivering Emergency Healthcare Among Digitally-Connected Populations in Yemen: A Cross-Sectional Study.
期刊: Health science reports 发表日期: 2026-Apr 链接: PubMed
摘要
Yemen’s healthcare system is severely weakened by prolonged conflict, limited resources, and workforce shortages, resulting in poor health outcomes. Telemedicine may offer solutions for emergency care provision in such fragile systems, yet its feasibility and adoption in Yemen remain unclear. This study aimed to assess the feasibility of telemedicine for emergency healthcare among digitally connected individuals in Yemen and to identify key barriers and predictors of adoption. A cross-sectional survey targeted adults aged 18-80 years with internet access across Yemen, conducted from November 2024 to December 2024. A self-administered, piloted questionnaire delivered via KoboToolbox collected data on demographics, telemedicine awareness and use, and perceived barriers. Main outcomes were telemedicine awareness, utilization for emergency care, and reported barriers. Descriptive statistics summarized participant characteristics and key measures; logistic regression identified predictors of telemedicine adoption. Among 263 respondents (mean age 33.8 years, SD 10.5; 71.1% male), 59.3% reported frequent digital device use and 57.4% had reliable internet. Only 21.3% were aware of telemedicine. Emergency telemedicine use was reported by 18.3%, mainly for pain management (62.5%) and pediatric emergencies (25.0%), while use for stroke, cardiac, trauma, and obstetric emergencies was less common. Adoption was higher among healthcare workers (45.7% vs. 20.9%; OR = 2.14, 95% CI: 1.27-3.61) and those with reliable internet (26.5% vs. 18.3%; OR = 1.85, 95% CI: 1.05-3.24). Major barriers included poor connectivity (73.0%), limited trust or awareness (49.0%), insufficient staff training (43.7%), and weak infrastructure (42.2%). Telemedicine is underutilized for emergency care among Yemen’s digitally connected population, mainly due to infrastructure, digital literacy, and trust barriers. Addressing these gaps through improved connectivity, provider training, local guidelines, and policy development is essential to advance emergency telemedicine in fragile health systems.
15. Landscape of Aging Policies in Bangladesh: A Perspective Study.
期刊: Health science reports 发表日期: 2026-Apr 链接: PubMed
摘要
Aging is currently a global concern, as there has been a massive transition in life expectancy and lower mortality rates because of advances in medical science. Bangladesh is experiencing a demographic transition with its elderly population, projected to reach 21% by 2050. This demographic shift raises significant social, economic, healthcare, and social inclusion challenges. This prospective study aimed to review the current landscape of aging policies in Bangladesh and assess their implementation, existing gaps, and opportunities. This study utilized a narrative review approach to search existing literature on aging policy in Bangladesh on PubMed, Google Scholar, Web of Science, and government and non-governmental policy documents. The analysis focused on essential objectives, including our demographic trends regarding the aging population, existing policies and programs, legal frameworks, and their implementation and gaps. The perspective was written based on the available information from literature and policy documents. Bangladesh already has some key policy and legal frameworks, such as the National Policy on Older Persons (2013), the National Social Security Strategy (2015), and the Old-Age Allowance Program, alongside legal measures like the Maintenance of Parents Act (2013). These frameworks showed a growing commitment to older people’s welfare and overall well-being. However, the actual impact of this policy is limited by insufficient funding, poor inter-ministerial coordination, inadequate healthcare infrastructure and facilities tailored to the needs of older adults. Additionally, persistent disparities, particularly along rural-urban and gender lines, further limit equitable access to these benefits and services. While Bangladesh has established some policy foundations and a legal framework for addressing aging, their effective implementation remains a significant challenge. Strengthening inter-ministerial coordination, expanding financial and healthcare support, improving legal enforcement, and developing robust data systems are essential to eradicate this problem. Political commitment and inclusive strategies are crucial to ensure dignity, equity, and well-being for the country’s growing older population.
16. Integrated Analysis of Gut Microbiota and Metabolome Profiling Reveals the Effects of Feeding Approaches on Infants' Gut Microenvironment.
期刊: Food science & nutrition 发表日期: 2026-Apr 链接: PubMed
摘要
Breast milk can improve infant health by exerting beneficial effects on the developing gut microbiota and metabolites. However, infant formula composition undergoes continual refinement to better approximate breast milk. This study aimed to timely monitor the evolving disparities in the gut microenvironment between breastfed (BF) and formula-fed (FF) infants. This prospective cohort study enrolled 44 healthy infants at 6 months of age, stratified by infant feeding modality into BF (n = 27) and FF (n = 17) groups. Fecal samples of all infants were collected and tested. Fecal microbiota was tested via full-length 16S rRNA sequencing, and fecal metabolites were tested via untargeted UPLC-MS/MS metabolomics. Associations between gut microbiota and metabolites were evaluated using Spearman’s rank correlation test. Bacterial full-length 16S rRNA gene sequencing analysis revealed that Escherichia, Staphylococcus, Haemophilus, and Rothia were more enriched in the BF group, but Enterococcus and Mediterraneibacter were more enriched in the FF group conversely (p < 0.05). UPLC-MS/MS metabolomic profiling revealed 600 dysregulated metabolites (p < 0.05) discriminating BF and FF infants, with 225 metabolites up-regulated and 375 metabolites down-regulated in the BF group. Further analysis of the significantly differential metabolites of the top 100 Variable Importance in Projection (VIP) revealed that 12 metabolites could be mapped onto Kyoto Encyclopedia of Genes and Genomes database (KEGG) pathways, in which the metabolites were mostly mapped onto Arachidonic acid (AA) metabolism and were down-regulated in the BF group, including Thromboxane B2 (TXB2), 5-hydroxyeicosatetraenoid acid (HETE), (15S)-Prostaglandin A2 (PGA2), and 11-dehydro-TXB2. Breastfeeding establishes a distinct ecological imprinting on the infant gut, promoting specific taxa and downregulating pro-inflammatory fecal AA metabolites. These disparities suggest breastfeeding uniquely modulates the microbial-metabolic axis to maintain a lower inflammatory tone, offering immunological advantages despite modern formula innovations.
17. Vision screening of Greenlandic children evaluating efficacy, coverage and future directions.
期刊: Acta ophthalmologica 发表日期: 2026-Apr 链接: PubMed
摘要
This thesis presents a comprehensive analysis of vision screening of children in Greenland, focusing on the efficacy of the current programme for six-year-old schoolchildren, the prevalence of vision impairment, amblyopia and refractive errors among six- and four-year-old children and the evaluation of a new screening method for preschool children. Additionally, it underscores the challenges of delivering consistent healthcare services in Greenland due to its vast and sparsely populated areas and the lack of prior research on vision health in Greenlandic children. The thesis involved three populations: two groups of six-year-old children, one with 2493 children from 2017 to 2022 and another with 517 children in 2017, and one group of 274 four-year-old children, all born in 2017. Key findings include an increase in screening coverage of schoolchildren from 43% to 61% from 2017 to 2022, although referral rates to ophthalmologists declined in the same period from 14% to 5% due to system inefficiencies. The prevalence of monocular amblyopia (≥0.3 logMAR) was 2% for both age groups, consistent with European and North American data. The prevalence of vision impairment was steady throughout the study period at 3% for the six-year-old children. Notably, Greenlandic children exhibit less severe vision impairment than in other regions, potentially due to genetic or environmental factors. However, they exhibited more hyperopia than African American and Chinese children but less than White American and Danish children. They also had higher myopia rates compared to Danish and indigenous Canadian children. The thesis highlights the importance of early detection and intervention for optimal visual development, emphasising a tailored approach for Greenlandic children. Improvements to the screening programme are suggested, including clear referral instructions, involvement of various healthcare professionals, such as optometrists, and enhanced parental awareness to increase coverage and ensure timely evaluations. It also suggests a new screening method incorporating a non-cycloplegic autorefraction to enhance the sensitivity and effectiveness of preschool children. Recommendations for screening methods and referral criteria for six- and four-year-olds are provided, along with an outline of the estimated costs of the new screening method. This thesis provides a basis for helping decision-makers in Greenland improve vision screening for Greenlandic children. Future research directions include assessing the quality of life of children with vision impairments, exploring the genetic and environmental determinants of myopia and leveraging technology to improve access to vision care for children in Greenland. Denne afhandling præsenterer en omfattende analyse af synsscreening for børn i Grønland, med fokus på effektiviteten af det nuværende program for seksårige skolebørn, prævalensen af synsnedsættelse, amblyopi og brydningsfejl blandt seks‐og fireårige børn, samt evalueringen af en ny screeningsmetode for førskolebørn. Derudover understreger den de udfordringer, der er forbundet med at levere kontinuerlige sundhedsydelser i Grønland, på grund af landets store og tyndt befolkede områder, samt manglen på tidligere forskning om synet blandt grønlandske børn. Afhandlingen involverede tre populationer: to grupper af seksårige børn, en med 2.493 børn fra 2017–2022 og en anden med 517 børn i 2017, samt en gruppe af 274 fireårige børn født i 2017. Vigtige fund inkluderer en stigning i screeningsdækningen af skolebørn fra 43% til 61% i perioden 2017–2022. Dog faldt henvisningsraterne til øjenlæger i samme periode fra 14% til 5% på grund af ineffektivitet i det grønlandske sundhedsvæsen. Prævalensen af monokulær amblyopi (≥0.3 logMAR) var. 2% for begge aldersgrupper, hvilket er i overensstemmelse med europæiske og nordamerikanske data. Prævalensen af synsnedsættelse var. stabil gennem hele studieperioden på 3% for de seksårige børn. Bemærkelsesværdigt udviser grønlandske børn mindre alvorlig synsnedsættelse sammenlignet med andre regioner, potentielt på grund af genetiske eller miljømæssige faktorer. Dog udviste de mere hyperopi (langsynethed) end afroamerikanske og kinesiske børn, men mindre end hvide amerikanske og danske børn. De havde også højere myopi (nærsynethed) forekomst sammenlignet med danske og indfødte canadiske børn. Afhandlingen fremhæver vigtigheden af tidlig identifikation og intervention for optimal synsudvikling, og understreger vigtigheden af en skræddersyet tilgang for grønlandske børn. Forbedringer til screeningsprogrammet foreslås, herunder klare henvisningsinstruktioner, involvering af forskellige sundhedsprofessionelle, såsom optometrister, og øget opmærksomhed om synsscreening hos forældrene for at øge dækningen og sikre rettidige evalueringer. Afhandlingen foreslår også en ny screeningsmetode, der inkluderer en non‐cykloplegisk brillestyrkemåling for at forbedre sensitiviteten og effektiviteten af screening af førskolebørn. Anbefalinger til screeningsmetoder og henvisningskriterier for seks‐og fireårige børn beskrives, sammen med en oversigt over de anslåede omkostninger ved den nye screeningsmetode. Denne afhandling giver et grundlag for at hjælpe beslutningstagere i Grønland med at forbedre synsscreeningen af grønlandske børn. Fremtidige forskning bør inkludere vurdering af livskvaliteten hos børn med synsnedsættelser, udforskning af de genetiske og miljømæssige årsager til myopiudvikling, og udnyttelse af teknologi til at forbedre adgangen til synsundersøgelse af børn i Grønland.
18. Corrigendum to "Prospective association between descriptive accelerometer-derived physical behaviour metrics and cardiometabolic risk indicators in Dutch children: The ABCD study" [J Exerc Sci Fitness 24 (2026) 200431].
期刊: Journal of exercise science and fitness 发表日期: 2026-Apr 链接: PubMed
摘要
[This corrects the article DOI: 10.1016/j.jesf.2025.200431.].
19. Maternal and Neonatal Outcomes Associated With Cesarean Versus Vaginal Delivery in the United States: A Population-Based Retrospective Cross-Sectional Analysis of CDC Natality Public Use Data (2017-2020).
期刊: Cureus 发表日期: 2026-Mar 链接: PubMed
摘要
Cesarean delivery is a common obstetric procedure in the United States, yet concerns remain regarding its association with maternal and neonatal outcomes at the population level. Understanding outcome patterns by mode of delivery is important for informing clinical practice and public health planning. To examine population-level associations between mode of delivery and severe maternal morbidity (blood transfusion, uterine rupture, unplanned hysterectomy, or maternal intensive care unit admission) and adverse neonatal outcomes (neonatal intensive care unit admission, assisted ventilation, or infant transfer) among live births in the United States. This retrospective cross-sectional study analyzed the Centers for Disease Control and Prevention (CDC) Natality public use microdata from 2017 to 2020, including all recorded live births during the study period. The mode of delivery was categorized as cesarean or vaginal. Severe maternal morbidity and adverse neonatal outcomes were defined using composite indicators derived from reported clinical variables. Multivariable logistic regression was used to estimate adjusted odds ratios (aORs) while controlling for maternal demographic characteristics, clinical comorbidities, obstetric factors, and year of delivery. Robust standard errors were applied. Among the 15,035,328 births included in the analysis, severe maternal morbidity occurred in 32,630 (0.32%) vaginal deliveries compared with 55,463 (1.16%) cesarean deliveries (p < 0.001). The composite adverse neonatal outcome was observed in 770,413 (7.52%) vaginal deliveries and 903,895 (18.88%) cesarean deliveries (p < 0.001). In multivariable analyses adjusting for maternal demographic characteristics, clinical comorbidities, obstetric factors, and year of delivery, cesarean delivery was associated with higher odds of severe maternal morbidity compared with vaginal delivery (aOR, 2.99; 95% CI, 2.94-3.04). Cesarean delivery was also associated with higher odds of adverse neonatal outcomes (aOR, 2.19; 95% CI, 2.19-2.20). Preterm birth demonstrated a strong association with adverse neonatal outcomes (aOR, 13.87; 95% CI, 13.81-13.93). Cesarean delivery was associated with higher maternal and neonatal morbidity in this national analysis. These associations likely reflect, in part, underlying obstetric complexity and high-risk clinical conditions that contribute both to the decision for cesarean delivery and to adverse outcomes. These findings emphasize the importance of careful clinical decision-making and continued efforts to improve maternal and neonatal care in high-risk pregnancies.
20. Bibliometric Analysis on Enamel Remineralization Agents.
期刊: Cureus 发表日期: 2026-Mar 链接: PubMed
摘要
Dental caries remains a major global oral health concern, affecting almost 2.5 billion people. While restorative treatments remain widely used, modern dentistry increasingly focuses on preventive and minimally invasive approaches that strengthen the natural process of enamel remineralization. A comprehensive literature search was conducted in PubMed for enamel remineralization agents from 2015 to 2025. Clinical trials, randomized controlled trials, systematic reviews, and meta-analyses published in English were included. After screening, 153 publications were retained. RStudio (Biblioshiny package for the Bibliometrix tool, Posit Software, Boston, MA) was used to evaluate publication trends, citation impact, keyword structure, and collaboration networks. A total of 153 publications from 68 sources were identified, contributed by 700 authors, with an average annual growth rate of 10.65% and a mean document age of 4.58 years. Two waves of research activity were observed, with fluoride and casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) dominating earlier years and biomimetic agents emerging more recently. This bibliometric mapping reveals enamel remineralization research as a field characterized by steady growth, global collaboration, and diversification of agent types. Fluoride and CPP-ACP continue to anchor the evidence base, while nanohydroxyapatite, bioactive glass, peptides, and natural products are emerging as promising contenders, driving the second wave of publications.
21. Effect of Trunk Rotation and Sex Differences on Lung Volume and Respiratory Muscle Strength in Healthy Young People.
期刊: Cureus 发表日期: 2026-Mar 链接: PubMed
摘要
Background Posture and trunk movements influence respiratory mechanics by altering rib cage mobility and thoracoabdominal motion. Trunk rotation frequently occurs during activities of daily living and may affect lung volumes and respiratory muscle function. Anatomical and physiological differences between males and females may also influence respiratory responses to posture. However, the combined effects of trunk rotation and biological sex on pulmonary function and respiratory muscle strength remain unclear. This study aimed to evaluate the effects of trunk rotation and sex differences on lung volume parameters and respiratory muscle strength in healthy young adults. Methodology A total of 20 healthy young adults (9 males and 11 females; mean age = 22 ± 1 years) participated in this study. Participants performed pulmonary function tests in the sitting position at the resting posture or in the sitting position with 30° trunk rotation. Lung function parameters, including vital capacity (VC), inspiratory capacity (IC), tidal volume (VT), expiratory reserve volume (ERV), inspiratory reserve volume (IRV), forced vital capacity (FVC), and forced expiratory volume in one second (FEV1.0), were measured using spirometry. Respiratory muscle strength was assessed using maximal inspiratory pressure (PImax) and maximal expiratory pressure (PEmax). Two-way repeated-measures analysis of variance was used to evaluate the effects of posture and sex. Results Significant main effects of sex were observed for several respiratory variables, including FVC, FEV1.0, VC, ERV, PImax, and PEmax, with males showing higher values than females. Significant main effects of posture were also observed for FVC, FEV1.0, VC, ERV, PImax, and PEmax, with lower values in the rotational posture than in the resting posture. A significant interaction between posture and sex was found for PEmax, with a greater decrease in males during trunk rotation. In contrast, PImax decreased significantly in the rotational posture only in females. Conclusions Trunk rotation in the sitting position reduces several lung volume parameters and respiratory muscle strength in healthy young adults, and the effects may differ between males and females. In particular, trunk rotation may affect forced expiration more in males and inspiratory muscle strength more in females. These findings provide fundamental data on the interaction between posture and sex in respiratory mechanics and may provide useful insights for respiratory assessment and rehabilitation strategies involving trunk movement.
22. Knowledge, Perceptions, and Job Satisfaction of National Emergency Medical Service Employees Regarding Performance Appraisals in Greece: A Comparison of Two Appraisal Systems.
期刊: Cureus 发表日期: 2026-Mar 链接: PubMed
摘要
This study examined the knowledge, perceptions, and job satisfaction of employees of the National Emergency Medical Service (NEMS/EKAB) in Greece regarding two successive performance appraisal systems (Law 4369/2016 and Law 4940/2022). A cross-sectional study was conducted across 11 regional branches of the National Emergency Medical Service using stratified proportional sampling. A total of 1,200 employees (paramedics and administrative staff) with at least one year of work experience participated. Data were collected through anonymous, self-administered questionnaires. Knowledge (range: 0-10), perceptions (range: 7-35), and satisfaction (range: 8-40) scores were calculated. Differences between the two appraisal systems were examined using paired statistical tests, while factors associated with knowledge, perceptions, and satisfaction were further explored using multivariable regression models. The mean knowledge score was significantly higher under the appraisal system of Law 4369/2016 (mean = 7.51, SD = 1.58) compared with Law 4940/2022 (mean = 5.80, SD = 1.90; p < 0.001). In contrast, perceptions were more positive under the newer system (mean = 21.43, SD = 7.38) than under the previous one (mean = 20.62, SD = 7.25; p < 0.001). Similarly, job satisfaction was higher under Law 4940/2022 (mean = 25.05, SD = 8.15) compared with Law 4369/2016 (mean = 23.76, SD = 8.07; p < 0.001). Younger employees and those with fewer years of service reported higher perception and satisfaction scores, whereas greater age and longer work experience were associated with higher knowledge levels but less positive attitudes. Involvement as an evaluator was associated with higher knowledge scores and more positive perceptions, particularly under the Law 4940/2022 system. Although the earlier appraisal system was better understood by employees, the newer system was perceived as more supportive and was associated with higher job satisfaction. Strengthening training, transparency, and employee participation appears to be critical for improving the acceptance and effectiveness of performance appraisal systems within the National Emergency Medical Service.
23. Correlation of Urinary Bisphenol A and Phthalates With Overweight and Obesity in Children.
期刊: Cureus 发表日期: 2026-Mar 链接: PubMed
摘要
Background Bisphenol A (BPA) and phthalates are endocrine-disrupting chemicals widely used in plastics, food packaging, and consumer goods. These compounds may contribute to childhood obesity by interfering with hormonal regulation and metabolic pathways. Objective This study aimed to evaluate urinary BPA and phthalate concentrations in normal-weight and overweight or obese children and to assess correlations with anthropometric measures. Methods A prospective observational study was conducted in the Department of Pediatrics, M. S. Ramaiah Medical College, Bangalore, India, from September 2023 to March 2025. Ninety children aged 2-18 years were enrolled: 45 overweight or obese (cases) and 45 age- and sex-matched normal-weight controls. Anthropometric parameters, including height, weight, body mass index, waist circumference, hip circumference, waist-to-hip ratio, and triceps skinfold thickness, were measured. Midstream urine samples were collected and analyzed for BPA and phthalates using a double-antibody sandwich enzyme-linked immunosorbent assay. Creatinine correction was performed. Statistical analysis included independent t-tests, chi-squared tests, and Pearson’s correlation coefficients. Results Mean urinary BPA levels were significantly higher in overweight or obese children (4.59 ± 1.23 ng/mL) compared with controls (1.57 ± 0.48 ng/mL; t = 13.6; p < 0.001). Mean urinary phthalates were also elevated in cases (230.90 ± 35.30 ng/mL) versus controls (100.30 ± 18.70 ng/mL; t = 19.4; p < 0.001). Raw urinary BPA and phthalate levels demonstrated positive correlations with body mass index, waist circumference, and triceps skinfold thickness. Interestingly, creatinine-corrected BPA and phthalate levels were higher in cases. Conclusion Urinary BPA and phthalate concentrations were significantly associated with overweight and obesity in Indian children. These findings support the role of endocrine-disrupting chemicals as potential obesogens and highlight the need for public health strategies to reduce pediatric exposure to plastics.
24. Outcomes After Laparoscopic Radical Prostatectomy Versus da Vinci Robot-Assisted Laparoscopic Radical Prostatectomy.
期刊: Cureus 发表日期: 2026-Mar 链接: PubMed
摘要
Purpose The study aimed to compare perioperative outcomes, early biochemical results, and recovery of urinary continence following laparoscopic radical prostatectomy (LRP) with da Vinci robot-assisted LRP (RALRP) in a group of men with favorable low- and intermediate-risk localized prostate cancer at a single hospital center. Materials and methods In this retrospective longitudinal study, we analyzed the clinical data of 48 patients with prostate cancer. Among them, 34 intervened with LRP and 14 with RALRP using the da Vinci system at Angeles del Carmen Hospital in Guadalajara, Mexico, from March 2023 to July 2025. The variables included were patient demographics and clinical and surgical data. Statistical analyses comprised both descriptive and parametric tests. Results Median age was 66 years. RALRP demonstrated longer operative time (198 min vs. 129 min, p≤0.001) and more blood loss (100-500 mL, 88% vs. 64% in RALRP, p=0.02). Continence recovery at 3 months was 70% after RALRP, compared with 65% after LRP and >90% at 12 months in both groups. At six-month follow-up, 95% had a prostate-specific antigen (PSA) level <0.2 ng/mL; no patient required salvage therapy. Conclusions In our study, both surgical techniques yielded good oncological results, with patients in both groups showing PSA levels indicating cure. However, continued follow-up of the population and an increased sample size are necessary.
25. Skin Barrier Modulation and Survival-Relevant Outcomes: A Systematic Review of Topical Emollients in Preterm Infants.
期刊: Cureus 发表日期: 2026-Mar 链接: PubMed
摘要
Preterm neonates have an immature skin barrier that predisposes them to excessive water loss, microbial colonization, and systemic infection. Topical emollient therapy has been proposed as a low-cost strategy to support barrier function. However, the extent to which clinical benefits reflect direct permeability changes versus downstream biological effects remains unclear. A systematic review was conducted in accordance with PRISMA 2020. PubMed, the Cochrane Library, and Google Scholar were searched from inception to January 31, 2025. Randomized or quasi-randomized controlled trials evaluating topical emollients in preterm neonates and reporting direct or proxy skin barrier-related outcomes were included. Due to substantial heterogeneity, results were synthesized narratively following the Synthesis Without Meta-analysis (SWiM) framework. Risk of bias was assessed using Risk of Bias Tool 2 (ROB-2), and certainty of evidence was evaluated using GRADE. Seven randomized studies met the inclusion criteria. Only one preterm trial directly measured transepidermal water loss (TEWL) and demonstrated a significant reduction with coconut oil. Three trials reported improved neonatal skin condition scores (NSCS) with emollient therapy. Proxy outcomes included reduced skin deterioration, altered microbial profiles, and lower rates of culture-proven sepsis. A reduction in neonatal mortality was observed in one large trial conducted in a low-resource hospital setting. Heterogeneity in populations, emollient formulations, and outcome measures precluded quantitative meta-analysis. Overall certainty of evidence ranged from low to moderate. Topical emollients are associated with improved skin condition and selected clinical outcomes in preterm neonates, despite limited direct evidence of barrier permeability modification. Observed clinical benefits appear context-dependent and are largely driven by a single large trial. Multidimensional trials integrating biophysical, microbiological, and clinical outcomes are needed to clarify mechanisms and guide targeted clinical application.
26. Antibiotic Exposure Patterns and Clinical Outcomes Preceding Clostridioides difficile Infection: A Retrospective Observational Study.
期刊: Cureus 发表日期: 2026-Mar 链接: PubMed
摘要
Background Clostridioides difficile infection (CDI) remains a major cause of healthcare-associated morbidity and mortality, with antibiotic exposure recognized as the principal modifiable risk factor. Variability in antibiotic class, duration, and overlap may influence CDI risk and clinical severity. Local audits of prescribing patterns are essential to inform antimicrobial stewardship strategies. Objective The objective of the study was to characterize antibiotic exposure patterns preceding laboratory-confirmed CDI and to describe associated clinical outcomes, including disease severity, recurrence, and CDI-attributable mortality in hospitalized patients. Methods This retrospective observational study was conducted at Kalinga Institute of Medical Sciences, Bhubaneswar, India, between January 2023 and December 2024. Adult inpatients (≥18 years) with glutamate dehydrogenase (GDH)- and toxin-positive CDI were included. Antibiotic exposure within the preceding 60 days was analyzed for class, duration, number of agents, overlap, and time to CDI. High-risk antibiotic classes were predefined. CDI severity was graded according to the Infectious Diseases Society of America (IDSA)/Society for Healthcare Epidemiology of America (SHEA) 2021 criteria. Outcomes assessed included recurrence and CDI-attributable mortality. Data were analyzed using descriptive statistics. Results Twenty-seven patients were included (mean age 54.26 ± 14.03 years; 59.3% male). The median cumulative antibiotic exposure was 41 days (Q1-Q3: 20.25-129), and 63.0% of patients had overlapping antibiotic therapy. The median interval from first antibiotic exposure to CDI diagnosis was 12 days (Q1-Q3: 8-30.25). Exposure to high-risk antibiotic classes ranged from zero to five, with 29.6% receiving two classes and 11.1% receiving four or more. Non-severe CDI was observed in 55.6% of patients, severe CDI in 37.0%, and fulminant CDI in 7.4%. No recurrence was documented. CDI-attributable mortality was 18.5%. Conclusion Prolonged and multi-class antibiotic exposure, including frequent use of high-risk agents and overlapping therapy, was common among hospitalized patients who developed CDI. The notable mortality observed underscores the importance of targeted antimicrobial stewardship interventions aimed at minimizing unnecessary broad-spectrum and concurrent antibiotic use.
27. Type 3c Diabetes Mellitus: Epidemiology, Diagnosis, Management, and Research Imperatives With Insights From the United Arab Emirates and Global Contexts.
期刊: Cureus 发表日期: 2026-Mar 链接: PubMed
摘要
Type 3c diabetes mellitus (T3cDM), also known as pancreatogenic diabetes, is a form of secondary diabetes resulting from pancreatic disease and is frequently misclassified as type 2 DM (type 2 DM). A narrative review of peer-reviewed literature from international databases was conducted, with emphasis on the epidemiology, clinical differences, diagnostic complexities, and management of T3cDM, with a specific focus on the United Arab Emirates (UAE) and global contexts. T3cDM accounts for a notable proportion of global diabetes cases, yet it is underreported due to a lack of dedicated registries and frequent misclassification as type 2 diabetes. The UAE has one of the highest diabetes prevalence rates worldwide, yet T3cDM remains undercaptured. Unlike type 1 DM (T1DM) and T2DM, T3cDM is characterized by both endocrine and exocrine pancreatic insufficiency (EPI). The diagnosis requires evidence of pancreatic pathology, absent autoimmunity, and exocrine dysfunction. Management includes insulin therapy, pancreatic enzyme replacement therapy (PERT), and nutritional supplementation; recent advances include the role of incretin therapies, improved enzyme preparations, and regenerative medicines. Emerging approaches also include metabolomics for prediction and fecal microbiota transplantation. Increasing awareness, dedicating regional registries, and implementing multidisciplinary management strategies are urgently needed in the UAE and globally.
28. Impact of Dedicated Nurse Time on Electronic Health Record (EHR)-Based Diabetes Quality Measures: A Pre-Post Observational Study.
期刊: Cureus 发表日期: 2026-Mar 链接: PubMed
摘要
Despite major advances in diabetes therapies, only about 60% of U.S. patients achieve recommended glycemic targets in primary care. Inconsistent electronic health records (EHR) complicate diabetes care delivery and highlight the need for strategies that support accurate documentation and patient engagement. The objective of this project is to have 50% of patients with diabetes meet six quality measures: hemoglobin A1c, blood pressure, statin use, aspirin use, tobacco status, and urine microalbumin. Methods: In April 2019, a registered nurse (RN) was tasked with overseeing these six diabetes quality measures among 477 patients with diabetes. Using electronic health record (EHR) reports, the RN identified patients not meeting measures and implemented interventions, including patient outreach, laboratory coordination, medication reconciliation, and documentation updates. The primary outcome was the proportion of patients meeting all six measures (“all-or-none compliance”). The clinic transitioned its electronic health record (EHR) from Cerner to Epic in October 2018, which affected quality reporting during the study period. All-or-none compliance was 40.0% during the pre-EHR transition phase, declined to 24.6% after EHR implementation (pre-RN phase), and increased to 40.6% during the RN intervention phase. At the start of the RN intervention, mean compliance was 35% and improved by an average of 45.7 patients (1.2%) per month through December 2019. RN review identified multiple deficiencies related to EHR documentation, including unreconciled medications, outdated tobacco status, missing external laboratory results, and patients no longer affiliated with the practice. Addressing these issues improved the accuracy of quality reporting and completion of required measures. Diabetes often carries a complex care plan, initiated and managed in most primary care settings. It requires a multidisciplinary approach with EHR facilitating quality measurement. Dedicating an RN to oversee the quality of measures of patients with diabetes may improve the accuracy and completeness of EHRs.
29. Melanoma Incidence, Mortality, and Dermatologist Availability Across Selected Urban and Rural Counties in Southwest Missouri.
期刊: Cureus 发表日期: 2026-Mar 链接: PubMed
摘要
Melanoma is the most lethal of the common skin cancers, and its incidence continues to rise in the United States. Access to dermatologic specialty care remains below recommended benchmarks, particularly in rural and nonmetropolitan regions. This descriptive, population-based analysis examined melanoma incidence and dermatologist availability across five selected counties in southwest Missouri, with limited county-level mortality reporting. Age-adjusted melanoma incidence data were obtained from the State Cancer Profiles database (National Cancer Institute and Centers for Disease Control and Prevention) and standardized to the 2000 U.S. population. Dermatologist availability was calculated using National Provider Identifier data and reported as dermatologists per 100,000 population. Nonmetropolitan counties demonstrated comparable or higher melanoma incidence rates alongside substantially lower dermatologist density; however, findings are descriptive and do not establish causal relationships. Melanoma mortality could not be meaningfully compared across counties, as data were suppressed in multiple counties due to low case counts. Greene County, designated as the urban reference county, had the highest dermatologist density and was the only county with non-suppressed mortality data. These findings highlight geographic variation in melanoma incidence and provider distribution while underscoring the challenges of interpreting melanoma burden in sparsely populated regions.
30. Navigating through HPV stigma: an intersectional lens on community engagement for vaccine acceptance in Pakistan.
期刊: The Lancet regional health. Southeast Asia 发表日期: 2026-Mar 链接: PubMed
摘要
Human papillomavirus (HPV) vaccination represents a significant milestone in global public health efforts to prevent cervical cancer. Yet its implementation in some countries such as Pakistan reveals complex sociocultural and geopolitical challenges. Since the staged introduction of the HPV vaccine in Pakistan in 2025, coverage did not fully reach the targeted 9-14-year-old girls-falling short of the national goal of 90% by 2027. This commentary critically examines the intersectional barriers shaping HPV vaccine uptake in Pakistan, arguing that mistrust, stigma, and inequity are rooted in historical, gendered, religious, and geopolitical power dynamics. Applying an intersectional lens, the analysis demonstrates how vaccine resistance is influenced by moral anxieties surrounding adolescent sexuality, diverse religious interpretations, socioeconomic disparities, weak health infrastructure, and digital disinformation. Comparative insights from the United Arab Emirates and Saudi Arabia challenge assumptions that Muslim-majority contexts inherently resist HPV vaccination, highlighting instead the importance of socioculturally responsive strategies. The commentary proposes three policy implications for Pakistan: localized communication tailored to socio-cultural context, investment in social infrastructure and community engagement, and equity-sensitive monitoring frameworks. Addressing hesitancy requires recognizing community concerns as rational responses to lived experience rather than ignorance, for achieving equitable immunization and safeguarding girls’ health rights in comparable settings.
31. Ten-Year Cardiovascular Disease Risk Among Employees Aged 40 Years and Older at the University of Sharjah: A Cross-Sectional Study.
期刊: Cureus 发表日期: 2026-Mar 链接: PubMed
摘要
Atherosclerotic cardiovascular diseases (ASCVDs) are a leading cause of mortality globally and in the United Arab Emirates. Despite regional studies on the ASCVD risk, no prior study has assessed the ASCVD risk within the academic community of the University of Sharjah. This study aimed to estimate the 10-year predicted ASCVD risk among university employees aged ≥40 years and to identify associated lifestyle risk factors. In this cross-sectional study, a stratified random sample of 124 employees aged 40 or older without a prior history of ASCVD was enrolled. The primary outcome was the 10-year ASCVD risk score calculated using the Mayo Clinic ASCVD risk calculator (Mayo Clinic, Rochester, MN). Data were analyzed using IBM Statistical Package for the Social Sciences Statistics version 22.0 (IBM Corp., Armonk, NY). Associations between ASCVD risk scores and lifestyle factors were assessed using Mann-Whitney U and Kruskal-Wallis tests, with statistical significance set at p < 0.05. Among the 124 participants included in the study (59.7% male and 40.3% female participants), the mean 10-year predicted ASCVD risk was classified as high at 37.16% (standard deviation ± 17.47). ASCVD risk scores were significantly higher among smokers compared with nonsmokers (48.6% vs. 32.7%, p < 0.001) and similarly elevated among participants with diabetes compared with nondiabetics (55.1% vs. 33.9%, p < 0.001). Physical activity level was also significantly associated with ASCVD risk (p = 0.009), while fruit and vegetable intake, saturated fat intake, daily sitting duration, and working hours showed no significant association (p > 0.05). Employees aged ≥40 years at the University of Sharjah demonstrate a markedly high predicted 10-year ASCVD risk. Smoking, diabetes, and physical inactivity were identified as key modifiable risk factors associated with higher predicted ASCVD risk. These findings underscore an urgent need for targeted workplace health promotion interventions to reduce cardiovascular risk in this population.
32. Clinical Impact of Macronutrients and Micronutrients: A Review of Nutritional Balance, Deficiency Disorders, and Therapeutic Applications.
期刊: Cureus 发表日期: 2026-Mar 链接: PubMed
摘要
Nutrition plays a fundamental role in maintaining human health and modulating disease risk across the life course. This narrative review synthesizes contemporary evidence on the clinical significance of macronutrients, including carbohydrates, proteins, and fats, and micronutrients, including vitamins and minerals, establishing nutritional balance as a central determinant of human health, disease susceptibility, and therapeutic efficacy. These nutrient categories function within an integrated metabolic network in which macronutrients provide energy and structural substrates, while micronutrients serve as essential cofactors and regulatory agents in enzymatic, hormonal, and cellular signalling processes. The synthesis demonstrates that nutritional imbalance, arising from either deficiency, such as iron-deficiency anaemia and vitamin D insufficiency, or excess, including high intakes of refined carbohydrates and saturated fats, constitutes a major contributor to global disease burden, particularly the phenomenon described as the double burden of malnutrition. In response to these challenges, the review highlights the role of evidence-based nutritional therapy, encompassing established dietary patterns such as the Mediterranean and Dietary Approaches to Stop Hypertension (DASH) diets, as well as the clinical implementation of medical nutrition therapy in chronic disease management. It further emphasizes a paradigmatic shift from population-level dietary recommendations toward precision nutrition, an emerging framework that integrates nutrigenomics, metabolomics, and gut microbiome profiling to inform personalized dietary interventions. By conceptualizing nutrition as a dynamic and interactive system, this review offers a comprehensive perspective that integrates biochemical mechanisms with individualized clinical care, positioning nutritional balance as a foundational component of contemporary preventive and therapeutic medicine.
33. Unusual Presentation of Pustular Psoriasis on the Face: A Case Report.
期刊: Cureus 发表日期: 2026-Mar 链接: PubMed
摘要
This case report describes an unusual presentation of pustular psoriasis on the face in a 36-year-old woman with a history of systemic lupus erythematosus (SLE). The patient presented with a rapidly worsening facial rash initially diagnosed as pustular psoriasis with superimposed bacterial impetiginization. Following ineffective initial treatment, she was started on spesolimab, a newly Food and Drug Administration (FDA)-approved monoclonal antibody targeting IL-36R, which led to rapid clinical improvement. The report highlights the clinical challenges of diagnosing pustular psoriasis, particularly in atypical cases, and underscores the importance of early intervention with targeted therapies to prevent disease progression.
34. Atypical Chest Pain: A Diagnostic Challenge for Takotsubo Cardiomyopathy.
期刊: Cureus 发表日期: 2026-Mar 链接: PubMed
摘要
Takotsubo cardiomyopathy (TTC) typically presents in post-menopausal females with chest pain, dyspnea, or palpitations and often mimics acute coronary syndrome. This case report describes a unique presentation of TTC in an elderly patient who exhibited gastrointestinal and musculoskeletal symptoms without cardiopulmonary complaints. This constellation of symptoms has not been previously described in the literature. The patient was ultimately diagnosed with TTC with evidence of ST-T wave abnormalities on ECG, elevated serum troponin levels, a reduced left ventricular ejection fraction, the absence of significant coronary artery disease on cardiac catheterization, and regional wall abnormalities on transthoracic ultrasound and left ventriculography. It contributes to our current understanding of the varied clinical presentation seen in TTC, which may help clinicians refine their differential diagnoses, provide earlier treatment, prevent misdiagnosis, and enhance patient care outcomes.
35. Primary Anal Squamous Cell Carcinoma With Metastasis to the Brain Presenting As Stroke-Like Symptoms in a 27-Year-Old Patient.
期刊: Cureus 发表日期: 2026-Mar 链接: PubMed
摘要
Metastatic squamous cell carcinoma (SCC) with spread to the brain is a rare entity in primary anal SCC. These findings are especially unusual in a young, HIV-negative patient. We present a case of a 27-year-old woman with metastatic SCC of the anus, previously treated with pelvic radiation and chemotherapy, who presented with acute right-sided weakness mimicking stroke-like symptoms. Neuroimaging revealed multifocal bilateral enhancing lesions consistent with metastatic brain disease. Symptoms resolved following treatment of the vasogenic edema secondary to brain metastasis. This case highlights the unique finding of primary anal SCC with metastasis to the brain in a young, HIV-negative, human papillomavirus type 16 (HPV 16)-positive patient. It further underscores the importance of preventative care with HPV vaccinations to prevent HPV 16 and 18, as well as brain imaging to rule out intracranial metastases in patients with malignancies presenting with new neurological deficits.
36. Young Adults With Acute Myocardial Infarction in Morocco: An Emerging Cardiovascular Challenge.
期刊: Cureus 发表日期: 2026-Mar 链接: PubMed
摘要
Acute myocardial infarction (AMI) in young adults - commonly defined as occurring before the age of 50 years - represents a distinct clinical entity with specific epidemiological and angiographic characteristics. Although its incidence is increasing worldwide, data from North African countries remain limited, and behavioral risk factors, particularly tobacco and cannabis use, appear to play a major role in premature coronary events. We conducted a retrospective single-center descriptive study including patients aged ≤49 years admitted with ST-segment elevation myocardial infarction (STEMI) between January and December 2025 at a tertiary university hospital in Morocco. A total of 62 patients were included, with a mean age of 41 ± 7 years and a predominance of males (77%). Smoking was the most prevalent cardiovascular risk factor (64.5%), followed by cannabis use (27.4%). Coronary angiography revealed predominantly single-vessel disease (77.4%), with the left anterior descending artery as the most frequent culprit vessel (64.7%). Myocardial infarction with non-obstructive coronary arteries (MINOCA) was identified in 9.7% of patients. Primary percutaneous coronary intervention was performed in 61.3% of cases, and successful reperfusion was achieved in 74.2%. In-hospital complications included left ventricular systolic dysfunction (23%) and cardiogenic shock (9.7%), while in-hospital mortality remained low (1.6%). AMI in young adults in Morocco is largely driven by modifiable behavioral risk factors and is characterized by predominantly single-vessel coronary disease with generally favorable short-term outcomes. These findings highlight the importance of targeted prevention strategies and optimized acute management to reduce the burden of premature myocardial infarction in this population.
37. Severe Babesiosis With Lyme Disease and Anaplasma Phagocytophilum Coinfection in a Dialysis-Dependent Patient Without Rash or Organomegaly.
期刊: Cureus 发表日期: 2026-Mar 链接: PubMed
摘要
Babesiosis is a tick-borne intraerythrocytic protozoal infection endemic to the northeastern United States. Coinfection with other Ixodes-transmitted pathogens may occur due to shared vector exposure, although confirmed triple infection remains uncommon. Severe babesiosis, defined by parasitemia ≥10% or evidence of organ dysfunction, may present atypically in immunocompromised individuals. A 73-year-old man with end-stage renal disease on hemodialysis presented with two weeks of cyclic fevers, chills, and weakness after hiking in upstate New York. Physical examination revealed asterixis without rash, jaundice, or organomegaly. Laboratory evaluation demonstrated hemoglobin 6.9 g/dL, platelet count 124 K/µL, lactate dehydrogenase 709 U/L, and 13% parasitemia on peripheral smear. Polymerase chain reaction confirmed Babesia microti. Serologic testing revealed positive Lyme IgG and IgM antibodies and elevated Anaplasma phagocytophilum IgG titers. The patient was treated with azithromycin, atovaquone, and doxycycline, resulting in parasitemia clearance by hospital day 7 without exchange transfusion. Severe babesiosis with Ixodes-borne coinfection may occur without classic findings such as rash or hepatosplenomegaly, particularly in dialysis-dependent patients. Persistent fever in endemic regions despite doxycycline therapy should prompt evaluation for babesiosis. Early recognition and individualized management may prevent invasive interventions.
38. Integrating Space Sexology Into Long-Duration Mission Architecture: A Five-Pillar Operational Framework.
期刊: Cureus 发表日期: 2026-Mar 链接: PubMed
摘要
The imminent transition from low Earth orbit operations to sustained deep-space exploration introduces significant demands upon crew health systems that extend well beyond the physiological and psychological domains traditionally addressed in aerospace medicine. Despite growing recognition that sexuality and reproductive health represent fundamental dimensions of human well-being, these domains have remained conspicuously absent from official mission planning, crew training curricula, and habitat design specifications. This narrative review was therefore undertaken to appraise and synthesize existing evidence on the biological, psychological, ethical, and technological dimensions of human sexuality relevant to long-duration spaceflight and to identify critical knowledge gaps and operational vulnerabilities. A structured literature search was performed across multiple academic repositories, including PubMed, PsycINFO, Web of Science, and Google Scholar, targeting English-language studies published from 1990 to 2026. The scope of the review comprised reproductive physiology within microgravity and high-radiation environments; the psychosocial and psychosexual dynamics of isolated, confined, and extreme settings; the intersection of habitat design, privacy, and ethical-regulatory frameworks; and the emergence of erotic technologies with potential aerospace applications. Eligible studies were thematically analyzed to construct a five-pillar operational framework. The narrative synthesis identified five operational pillars that require systematic integration into mission architecture. Reproductive risk assessment emerged as a foundational concern, encompassing radiation- and microgravity-induced impairment of gonadal function, gametogenesis, and embryonic development; however, the evidence base remains predominantly derived from animal models and in vitro studies. Psychosexual crew preparedness was identified as equally critical, necessitating the development of consent training, healthy intimacy education, and relationship management strategies. The review further highlighted the need for habitat design standards that incorporate spatial, acoustic, and hygiene requirements for intimate behavior in reduced-gravity environments. Regulatory and ethical governance represents an additional imperative, requiring the establishment of relationship policies, pregnancy contingency protocols, and sexual misconduct reporting mechanisms adapted to the jurisdictional complexities of extraterrestrial operations. Finally, a prioritized research agenda is proposed, targeting systematic reproductive health surveillance, analog-based psychosexual studies, stakeholder consultation, and erobotic technology evaluation. We conclude that the systematic neglect of sexuality and reproductive health in current mission planning may compromise crew well-being, interpersonal dynamics, and ultimately mission success as the duration and remoteness of human spaceflight increase. The proposed framework offers a structured conceptual roadmap for translating space sexology from academic discourse into actionable components of mission architecture but requires empirical validation through analog-based pilot studies and stakeholder engagement. This integration should be prioritized in parallel with the technological development of deep-space transportation systems.
39. Oropharyngeal cancer mortality in the United States, 1999-2023: a surveillance analysis using CDC WONDER.
期刊: Frontiers in oncology 发表日期: 2026 链接: PubMed
摘要
Oropharyngeal cancer (OPC) is a major head and neck cancer subtype with shifting U.S. epidemiology. We performed a surveillance-style analysis of OPC mortality trends and demographic/geographic disparities, 1999-2023. OPC mortality (1999-2023) was obtained from CDC WONDER. Age-adjusted mortality rates (AAMRs) were computed by category. Joinpoint regression estimated annual percent change (APC) and average annual percent change (AAPC). Pearson correlation assessed associations between AAMR and structural indicators. From 1999 to 2023, 51,719 OPC-related deaths were recorded. AAMR increased from 0.75 (1999) to 1.17 (2023), with a relatively stable pattern during 1999-2009 (APC = 0.42; 95% CI: -0.47 to 1.32) followed by an increase during 2009-2023 (APC = 3.02; 95% CI: 2.59 to 3.46); the AAPC for 1999-2023 was 1.93 (95% CI: 1.51 to 2.36; p < 0.001). Mortality was higher in males (AAMR = 1.44; 95% CI: 1.37 to 1.52) than in females (0.37; 95% CI: 0.34 to 0.41), with increases in both groups (AAPC: 2.16; p < 0.001 vs 1.13; p = 0.001). By race/ethnicity, overall AAMR was higher among non-Hispanic Black individuals (1.18; 95% CI: 1.03 to 1.32) but declined over time (AAPC = -1.12; p < 0.001; 95% CI: -1.76 to -0.47), whereas non-Hispanic White individuals increased (AAPC = 2.92; p < 0.001; 95% CI: 2.46 to 3.39) and exceeded non-Hispanic Black individuals in later years. AAMR increased across all U.S. census regions, with higher levels and/or faster increases in the Midwest and South. Nonmetropolitan areas increased faster than metropolitan areas (AAPC: 2.98; p < 0.001 vs 1.26; p < 0.001). State-level variation was observed; AAMR was inversely correlated with dentist density (r = -0.48, p = 0.010) and HPV vaccination coverage (r = -0.44, p = 0.018), while the correlation with poverty rate was positive but not statistically significant (r = 0.28, p = 0.152). OPC mortality increased in the United States from 1999 to 2023, with demographic and geographic disparities. These surveillance findings may support public health monitoring and provide a hypothesis-generating basis for future analytic studies.
40. Framework for evidence synthesis of traditional, complementary and integrative medicine systems incorporating context and complexity, illustrated by the example of homeopathy.
期刊: Frontiers in public health 发表日期: 2026 链接: PubMed
摘要
Evidence synthesis for whole medical systems, defined as complete systems of theory and practice that have evolved independently from biomedicine. is challenging. This paper provides a framework for evidence synthesis of Traditional, Complementary and Integrative Medicine (TCIM) systems incorporating context and complexity. A systematic review program on the effects of homeopathic preparations is used as a practical illustration of the proposed framework. A systems perspective considers the patient as a complex system of interconnected regulative subsystems embedded in a complex environment, and disease as a dysregulation of the dynamic adaptive state of the organism. Most TCIM systems, including homeopathy, aim to stimulate regulative systems and their functions to regain homeostasis. The consequences of these principles for the approach to evidence synthesis of TCIM systems are explored and explained. A systems perspective takes into account a plurality of evidence sources, including ‘real-world’ clinical data such as case reports, case series and cohort studies. The systematic review program focuses on comparative studies of homeopathy in various clinical indications and includes both non-randomized prospective studies of interventions (NRSIs) and randomized controlled trials (RCTs). For risk-of-bias assessments, use is made of respectively ROBINS-I and ROB2. Evidence certainty is graded transparently and rigorously based on the GRADE framework. An experienced patient advocate is involved in the research program and input from patient advisors who experienced the clinical indication under investigation is incorporated. RCT and NRSI evidence on homeopathic preparations for a range of clinical indications will be synthesised. A limitation, from a complex systems perspective, is that the implication of these findings will still need to be contextualized within the broader context of the existing state of knowledge. An ‘evidence eco-system’ that includes complementary sources of information will be required to inform decisions. Evidence synthesis of TCIM systems can move beyond conventional approaches by framing evidence within its complexity and context, together with real-world data and patient perspectives. This approach entails methodological challenges and will require gap analyses to guide future research and improve the applicability for public health and individualized patient care.
41. Community-based mental health centers in Ukraine - protocol for a mixed methods evaluation study using the RE-AIM framework.
期刊: Frontiers in public health 发表日期: 2026 链接: PubMed
摘要
Russia’s full-scale invasion of Ukraine has deepened the strain on an already fragile mental health system, long shaped by Soviet institutionalized psychiatry. In response, Ukraine has started a national reform to modernize mental health services by shifting from an institutional to a community-based mental health care model. Implementation of his transition is supported by the international technical project Mental Health for Ukraine (MH4U). To generate evidence-based evaluation of the community-based mental health centers as a basis for continued improvement and to guide national scale-up. We will conduct a mixed-methods evaluation guided by the RE-AIM framework. First, quantitative data will be collected through (a) questionnaires administered to patient’s prospective longitudinal cohort at baseline, three, and six months, (b) questionnaires from providers at the baseline and in the follow-up, and (c) administrative records. Second, qualitative data will be gathered through (a) interviews with subsample of participating patients and all the providers, and (b) focus groups with community stakeholders for each oblast (administrative region). Analyses will follow the RE-AIM framework. Adhering to a learning health systems (LHS) framework, we established continuous feedback loops and workshops to communicate study findings to MH4U implementers and stakeholders in Ukraine and Switzerland. Evaluation will provide unique evidence on not only whether the community-based Mental Health Center model works, but also how and why it works in real-world conditions. Findings will also inform national policy on mental health reform and offer lessons for global mental health systems operating under crisis conditions. https://www.isrctn.com/ISRCTN61471084, ISRCTN61471084.
42. Identifying age 26 as a threshold in psychosocial risks associated with child maltreatment among first-time mothers: a cross-sectional study in Japan.
期刊: Frontiers in public health 发表日期: 2026 链接: PubMed
摘要
Early pregnancy is associated with increased psychosocial vulnerability, which has been linked to factors associated with child maltreatment. However, previous research has predominantly focused on teenagers, and little is known about whether first-time mothers in their early-to-mid twenties also exhibit elevated psychosocial risks. This observational cross-sectional study aimed to determine whether psychosocial risk factors associated with child maltreatment are more prevalent among first-time mothers aged 17-25 years in Japan, compared with those aged 26 years and older. Routine administrative data were collected in July 2022 from 429 first-time pregnant women aged 17-43 years who submitted pregnancy notifications to their local municipal office in four municipalities in the Tokyo metropolitan area, Japan. A cumulative psychosocial risk score was calculated by summing six binary indicators: being unmarried, living alone, low household income, low educational attainment, poor mental well-being, and low perceived social support. A segmented regression analysis was used to identify the age at which the association with cumulative psychosocial risk changed. The association between maternal age and psychosocial risk factors associated with child maltreatment was most prominent up to age 26. A data-driven breakpoint at 25.9 years suggested that younger age was associated with greater psychosocial risk. Younger mothers (ages 17-25, n = 158) were more likely to be unmarried, live alone, have a low socioeconomic status, and have lower educational attainment compared with older mothers (ages 26-43, n = 271; p < 0.005). First-time pregnant women aged 17-25 years in Japan exhibited higher levels of psychosocial risk factors associated with child maltreatment compared with those aged 26 years and older. These findings suggest that, in addition to teenagers, women in their early-to-mid twenties should be recognized as a priority group for early preventive support within maternal and child health systems. Integrating age-informed approaches into public maternal health policy and antenatal care may help strengthen early prevention child maltreatment.
43. Micronutrient balance and brain function: neuropsychological, metabolic, and clinical interactions.
期刊: Frontiers in molecular biosciences 发表日期: 2026 链接: PubMed
摘要
Micronutrients, encompassing both vitamins and trace elements, play a central role in brain development, metabolic homeostasis, and cognitive performance from early life through old age. Rather than acting solely as enzyme cofactors or antioxidants, many of these nutrients influence transcriptional programs, shape synaptic signaling, and participate in neuroimmune and neuroendocrine crosstalk, and observational, interventional, and experimental studies now show that both deficiency and excess of specific micronutrients are linked to changes in memory, mood, attention, and executive function, as well as increased vulnerability to neurodevelopmental, neurodegenerative, and affective disorders. In this narrative review, we summarize mechanistic and clinical evidence on the contribution of key vitamins (A, D, E, C, B-complex, and choline) and minerals (iron, zinc, iodine, magnesium, selenium, copper, among others) to brain function, highlighting shared molecular pathways related to neuroplasticity, synaptic integrity, energy metabolism, oxidative balance, and neuroinflammation, and examining how micronutrient status interacts with aging, genetic variation, and lifestyle factors such as physical activity and diet. We also discuss the neurological and neuropsychological consequences of micronutrient imbalance and the potential of targeted, personalized nutritional strategies for brain health promotion and disease prevention in vulnerable groups and across diverse settings, arguing that clarifying these interactions provides a framework for integrating micronutrient assessment into multidomain approaches to preserve cognitive function and mental wellbeing throughout the lifespan.
44. A prospective observational study of lifestyle behaviors and biomarkers to promote cardiometabolic health in healthcare workers during the COVID-19 pandemic.
期刊: Frontiers in molecular biosciences 发表日期: 2026 链接: PubMed
摘要
Nutrition, physical activity, and sleep deficits contribute to diminished health status in healthcare workers (HCWs). The purpose of this study was to focus attention on HCWs by incorporating precision health approaches to address lifestyle behaviors believed to influence immune health, cardiometabolic status, and wellbeing. In this 1-year prospective observational study, a digital dashboard was created to post a health promotion video, targeted health messages, and personal health data accessible to each participant. Activity-sleep trackers were provided to capture actual step and sleep activity. Lifestyle questionnaires, serum biomarkers, body composition by bioelectrical impedance analysis, and blood pressure were obtained at four timepoints; gene expression was measured at three timepoints. Genes linking host immune response to key nutrients were isolated for correlational analyses with lifestyle behaviors. Participants received a comprehensive summary of their personal results at 12 months. Primary outcome was participant engagement. 104 HCWs enrolled between July and October 2021. At 12 months, 60% of participants were high adopters for device-wear time and daily step threshold. Daily steps declined by 831 (±3,441) steps per day, t statistic -1.742, p = 0.09 after 1 year. Insomnia Severity Index results suggested persistent subclinical insomnia with a mean score of 8.1 (±6.1) at 12 months. Thirteen genes had a moderate correlation with steps, r (49) = 0.29-37, sleep, r (56) = 0.27-0.37, distance, r (61) = 0.28, and Insomnia Severity Index, r (56) = 0.30-0.38, p = NS, after Benjamini-Hochberg adjustment. Participant engagement may have contributed to favorable behavior change in the first 6 months, but this was not sustained at 12 months. Novel strategies are needed to boost engagement for longer studies, promote HCW wellness to optimize immune and cardiometabolic health, and abate chronic disease progression.
45. Letrozole Reduces Ovulatory Responsiveness in In Vitro-Grown Mouse Follicles.
期刊: Reproductive medicine and biology 发表日期: 2026 链接: PubMed
摘要
This study aimed to determine whether continuous aromatase inhibition with letrozole reduces peri-ovulatory responsiveness to ovulatory stimulation in in vitro-grown mouse follicles. Early antral follicles were isolated from 21 to 24-day-old C57BL/6jjcl mice and cultured individually for 5 days with letrozole (0.01, 0.1, or 1 μM) or vehicle. Follicle survival and growth were assessed by measuring follicle diameter. Ovulatory responsiveness was evaluated by hCG/EGF stimulation. Expression of ovulation-related genes (Lhcgr, Ptgs2, and Runx1) and a luteinization-related gene (Foxo1) was analyzed using RT-qPCR. The effect of estradiol supplementation was also examined. Letrozole did not affect follicle survival or growth. However, ovulation rates were reduced in a dose-dependent manner (p < 0.0001). At 0.1 μM, letrozole significantly decreased mRNA levels of Lhcgr, Runx1, and Ptgs2 compared with vehicle-treated follicles. Estradiol supplementation restored the expression of these genes and partially rescued ovulatory capacity. In contrast, Foxo1 expression increased in letrozole-treated follicles and was attenuated by estradiol. Continuous letrozole exposure reduces ovulatory responsiveness in in vitro-grown mouse follicles and is associated with decreased Lhcgr expression after hCG stimulation, likely due to estrogen deficiency. These findings suggest that prolonged aromatase inhibition during follicular growth may impair acquisition of peri-ovulatory competence.
46. Nutrition and health canteen-based lifestyle intervention: association with weight management, lipid metabolism regulation, and inflammation alleviation in middle-aged adults.
期刊: Frontiers in nutrition 发表日期: 2026 链接: PubMed
摘要
Lifestyle interventions can prevent and manage non-communicable diseases (NCDs); however, they are not easy to implement in daily life. Nutrition policy-based interventions with both high impact and feasibility are needed for NCD prevention and control. This single-group before-after study was conducted for 12 weeks in a collective catering setting, where the construction of a nutrition and health canteen, proposed by the Reasonable Diet Action, is currently underway in China. The intervention for participants comprised a multifaceted approach featuring rich food diversity, a reduced supply of salt/sugar/oil, and structured health education on both diet and physical activity. The primary outcome was the change in body weight after the intervention. Demographic data, food frequency questionnaire results, and anthropometric data were also collected. Blood biochemical indicators and inflammatory biomarkers were also measured. A total of 97 participants (33 women) were included in this study. Of the 43 individuals (44.3%) who were overweight, 8 (8.4%) were obese. After the intervention, the body weight of participants significantly decreased [74.00 (61.05-81.6) kg vs. 72.35 (58.83-80.15) kg, p < 0.001]. The secondary outcomes also showed a trend toward benefit, including body mass index (BMI) and waist-to-hip ratio (p < 0.05). In particular, indicators of lipid metabolism, such as triglycerides [1.17 (0.78-1.70) mmol/L vs. 1.12 (0.74-1.87) mmol/L, p FDR = 0.047], low-density lipoprotein cholesterol (LDL-C, 2.76 ± 0.70 mmol/L vs. 2.58 ± 0.62 mmol/L, p FDR = 0.041), and apolipoprotein B (0.83 ± 0.20 g/L vs. 0.78 ± 0.18 g/L, p FDR = 0.045) slightly decreased, whereas HDL cholesterol (1.32 ± 0.33 mmol/L vs. 1.37 ± 0.34 mmol/L, p FDR = 0.044) increased. However, total cholesterol, blood pressure, insulin, glucose, and HOMA-IR did not differ after the intervention. Notably, the levels of inflammatory biomarkers, IL-6, IL-8, TNF-α, and hs-CRP decreased markedly after the intervention. The nutrition and health canteen strategy may be a feasible approach for implementing lifestyle interventions to promote body weight control, improve lipid metabolism, and reduce inflammation in middle-aged adults. Further studies, especially randomized controlled trials with longer terms, are warranted.
47. School-based screening for scoliosis and foot biomechanical abnormalities: a study of prevalence, plantar pressure, and gait among adolescents in Haidian District, Beijing.
期刊: Frontiers in pediatrics 发表日期: 2026 链接: PubMed
摘要
Adolescent idiopathic scoliosis (AIS) and foot biomechanical disorders are significant public health concerns, impacting physical function and quality of life. Despite national screening mandates, regional data remain sparse. We conducted a school-based screening study to investigate the prevalence of scoliosis and foot-related biomechanical abnormalities among adolescents in Haidian District, Beijing, China. A total of 1,419 participants (739 males and 680 female) from primary and middle schools underwent spinal and plantar health assessments using standardized protocols, including the Adams forward bend test with a scoliometer, Foot Posture Index-6 (FPI-6), and static/dynamic plantar pressure analysis. This cross-sectional study of 1,419 Beijing adolescents revealed a 2.04% prevalence of scoliosis (29 cases), showing significant female predominance (3.53% vs. 0.68%; χ 2 = 14.397, p < 0.001, φ = -0.101, Cramer’s V = 0.101). Scoliosis prevalence showed distinct developmental patterns, with a significant increasing trend across grades (p = 0.011). Clear peaks were observed in 6th (4.22%) and 9th (4.35%) grades, where cases significantly exceeded expected counts, though the reliability of estimates for upper grades (11th-12th) may be limited by smaller sample sizes (48 and 18 participants, respectively). In contrast, the detection rate of foot abnormalities was slightly higher among males (47.8% vs. 43.4%), this difference did not reach statistical significance (p = 0.098), and the effect size was negligible (Phi = 0.044). This indicates that foot abnormalities represent a common health concern affecting both sexes. Significant variation in foot abnormality prevalence was observed across grades [χ 2(11) = 36.98, p < 0.001], peaking sharply at school entry (62.7% in 1st grade) and then declining rapidly through elementary school. Prevalence stabilized during middle adolescence, with a non-significant apparent rebound in the small 12th-grade sample requiring cautious interpretation. Key findings highlight the need for early and targeted interventions within school health programs. A gender-stratified approach is recommended: implementing gender-sensitive screening for scoliosis, while adopting universal promotion measures for foot health. Specific priorities include increasing flatfoot screening frequency among 1st-2nd grade boys and enhancing posture-related health education for adolescent girls during key transitional growth phases. These strategies aim to mitigate long-term musculoskeletal complications.
48. Outcomes of older adult physical activity participation that matter to health care professionals.
期刊: Innovation in aging 发表日期: 2026 链接: PubMed
摘要
There is extensive heterogeneity in outcome domain selection and reporting in randomized controlled trials (RCTs) of physical activity interventions for older adults. Physical activity researchers need a core outcome set that recommends a minimum set of outcome domains to measure consistently, guided by input from health care professionals to ensure clinical relevance. This study aimed to identify the outcome domains related to older adults’ physical activity participation that are most important to health care professionals. Health care professionals completed an online survey in which they rated the importance of measuring 24 candidate outcome domains in future RCTs of physical activity interventions for older adults and ranked their top four. 225 health care professionals participated (72% female; mean [SD] age, 37.8 [11.2] years; 21 general practitioners, 99 physiotherapists, and 105 kinesiologists). The 5 outcome domains most frequently rated as “highly important” (6-7 of 7) were Falls (92.0%), Quality of Life (91.5%), Independence (87.9%), Balance (84.4%), and Mobility (82.7%). The 5 outcome domains that most frequently appeared in participants’ top 4 importance rankings were Quality of Life (67.1%), Independence (50.2%), Risk and Management of Chronic Disease (40.2%), Mobility (33.3%), and Falls (32.9%). Health care professionals prioritized Quality of Life, Independence, Falls, and Mobility as key outcome domains to measure in RCTs of physical activity interventions for older adults. These results will help align research with clinical priorities, support physical activity promotion, and guide the development of a core outcome set.
49. Sustainability of top-performance athletes' mental health and career retirement support services: European major sports organizations' perspective.
期刊: Frontiers in sports and active living 发表日期: 2026 链接: PubMed
摘要
The transition out of elite sports presents a complex array of psychological, financial, career, and social challenges requiring tailored and sustainable support services for elite athletes. Thus, this study explored policies, programs, and practices surrounding elite athletes’ mental health, career transitions, and retirement support services. A tailored semi-structured survey was administered to major sports organizations to assess typology, modality, funding, and perceived challenges of services delivery to elite athletes. Respondent organizations (n = 17, mostly National Olympic Committees) highlighted issues in ensuring athletes adequate support and a fragmented approach in services implementation and delivery. Services are offered mainly to medalists in international competitions. Access to external professionals (34%), awareness training (20%), and in-house psychologists (17%) resulted the most cited mental health support services. However, the sustainability and quality of services are affected by a lack of funding (41%) and different assessment methods. For career transitions and additional services, educational workshops (29%), career counselling (19%), nutrition (21%), financial (19%), social (19%), and travel/logistics (19%) support resulted the most cited, meeting athletes’ practical needs related to performance and well-being through internal organizational support networks (40%) and coach/staff referrals (33%). Results highlighted the absence of regulatory frameworks for career assistance and temporary initiatives/activities or informal support as the common practice. Multi-faceted programs and comprehensive, athlete-centered systems are needed to foster a sustainable and effective support for elite athletes.
50. Roles of Oxidative Phosphorylation and Fatty Acid Oxidation in Neuroinflammation Induced by Lipopolysaccharide in Hypothalamic Neuronal Cells.
期刊: International journal of inflammation 发表日期: 2026 链接: PubMed
摘要
Neuroinflammation is intricately associated with impaired neuronal function and is a contributing factor in the development of neurodegenerative diseases. Significant alterations in cellular metabolism often accompany these inflammatory changes. Although considerable research has focused on understanding these metabolic shifts in astrocytes and microglia, the precise mechanisms linking neuroinflammation and cellular metabolism in neurons remain poorly understood. This study explores the connection between neuroinflammation and neuronal cell metabolism through a lipopolysaccharide (LPS)-induced neuroinflammation model utilizing GT1-7 hypothalamic neuron cultures. Our findings indicate that LPS-induced neuroinflammation in GT1-7 hypothalamic neurons is marked by reduced oxidative phosphorylation (OXPHOS) and decreased endogenous fatty acid oxidation (FAO). In contrast, exogenous FAO increases, leading to elevated ATP production, while glycolysis remains unchanged. These metabolic changes are associated with increased inflammatory markers (IL-6, TNF-α) and oxidative stress indicators (ROS, NO), as well as decreased synaptic plasticity (as indicated by synaptophysin) and impaired cellular function, as evidenced by reduced gonadotropin-releasing hormone (GnRH) release. Our study highlights the intricate interplay between neuroinflammation and neuronal cell metabolism. These findings emphasize the significance of metabolic changes in neuroinflammatory processes, offering potential insights for therapeutic interventions in neurodegenerative diseases.
51. The relationship between green space and myopia in children and adolescents: a systematic review and meta-analysis.
期刊: Frontiers in public health 发表日期: 2026 链接: PubMed
摘要
To investigate the effect of green space exposure on the risk of myopia in children and adolescents. Studies on the relationship between green space and myopia in children and adolescents published before October 1, 2024, were retrieved from five electronic databases: web of Science Core Collection, PubMed, EBSCOhost, ScienceDirect and Cochrane Library. A systematic review was conducted to summarize the relevant articles, followed by a meta-analysis. A total of 11 studies were included in the systematic review, encompassing 2,224,332 participants aged 6-22 years. Of these, 6 studies were incorporated into the meta-analysis. Most studies indicated that increased green space is associated with a reduced risk of myopia. The Normalized Difference Vegetation Index (NDVI) showed a negative correlation with the prevalence of myopia in children and adolescents (cross-sectional studies: OR = 0.95, 95% CI: 0.94-0.96, I 2= 37.2%, P = 0.158; cohort studies: OR = 0.91, 95% CI: 0.91-0.91, I 2= 88.9%, P < 0.001). NDVI within school boundaries and a 500-meter buffer zone had a more significant effect on myopia prevention (within school boundaries: OR = 0.87, 95% CI: 0.77-0.99, P = 0.206; 500-meter buffer zone around schools: OR = 0.96, 95% CI: 0.94-0.97, P = 0.098; 1,000-meter buffer zone around schools: OR = 0.94, 95% CI: 0.92-0.97, P = 0.315) (within school boundaries: OR = 0.96, 95% CI: 0.94-0.98, P = 0.066; 500-meter buffer zone around schools: OR = 0.90, 95% CI: 0.90-0.91, P = 0.053). Increased exposure to green spaces has a beneficial effect on reducing the risk of myopia in children and adolescents. For every 0.1 increase in the NDVI, the prevalence of myopia decreases. Furthermore, the prevention and control of myopia are more effective within school boundaries and in the surrounding 500-meter buffer zone. Therefore, it is recommended that schools and relevant government authorities focus on enhancing vegetation coverage within school grounds and around areas where students frequently engage in activities, thereby providing stronger environmental support for myopia prevention in children and adolescents. However, potential publication bias cannot be excluded given the limited number of included studies; therefore, the pooled estimates should be interpreted with caution. https://www.crd.york.ac.uk/PROSPERO/view/CRD420251153654, PROSPERO: CRD420251153654.
52. Epidemiological characteristics and influencing factors of hand, foot and mouth disease reinfection cases in a large district of southern China.
期刊: Frontiers in public health 发表日期: 2026 链接: PubMed
摘要
To analyze the epidemiological characteristics of hand, foot and mouth disease (HFMD) reinfection cases in southern China and systematically evaluate key influencing factors from individual characteristics, epidemic cycles, and regional features, aiming to provide evidence for targeted prevention and control strategies. We extracted HFMD cases in a district of southern China from the China Information System for Disease Control and Prevention (2008-2024). Descriptive analysis was used to analyze the epidemiological characteristics of HFMD reinfection, and spatial autocorrelation analysis to identify geographic clusters of cases. Cox proportional hazards regression was used to evaluate reinfection risk factors. During the study period, 16,766 HFMD reinfection cases involving 8,210 individuals were reported in the district, with a reinfection rate of 6.41%. The interval between the two infections ranged from 0.06 to 9.92 years, and 77.42% of patients were reinfected within 2.5 years. There was a bimodal distribution in time (May-July and September-October). The spatial distribution of HFMD reinfections predominantly followed a random pattern, with cold spots clustered in a non-urban sub-district. Cox proportional hazards regression revealed significantly lower risks of HFMD reinfection among children aged >3 years, in early childhood education and care, students, and females. Individuals initially infected with prevalent strains of CV-A16, CV-A6, or other enteroviruses exhibited significantly higher risks of HFMD reinfection. Temporally, reinfection risks were significantly higher during epidemic years and peak transmission periods. Spatially, elevated HFMD reinfection risks were observed in urban areas, high population density regions, and areas with greater medical resource availability. HFMD reinfections in a district of southern China demonstrated distinct population heterogeneity, clustering temporally during epidemic peaks and spatially in urban centers with high population density and advanced medical resources. These findings underscore the need for a targeted early-warning system and enhanced control measures in high-risk transmission hotspots.
53. Understanding worldwide skin atopy across regions. Environmental, cultural, genetic, and lifestyle factors.
期刊: Frontiers in medicine 发表日期: 2026 链接: PubMed
摘要
Cutaneous atopy, which predominantly manifests as atopic dermatitis (AD), represents a significant global health concern due to its high prevalence and profound impact on patients’ quality of life. AD affects up to 20% of children and 10% of adults worldwide, with a rising incidence in both industrialized and developing regions. While genetic predisposition is a key determinant, most existing literature analyzes risk factors in isolation, limiting a comprehensive understanding of the disease. This article provides an integrative, regionally informed perspective on how environmental, cultural, genetic, and lifestyle factors may interact to shape the clinical expression of cutaneous atopy in diverse populations and regions. Drawing on published evidence and insights from an international expert panel, we highlight the complexity and multifactorial nature of the atopic environment, emphasizing the simultaneous disruption of the four key skin barriers-physical, chemical, immunological, and microbial-in AD. The article further addresses how regional differences in barrier function and the influence of urban versus rural living conditions can affect disease manifestation, underlining the need for personalized and holistic therapeutic strategies. This integrative perspective aims to offer healthcare professionals an updated framework for the management of AD, enabling more effective interventions tailored to the realities of diverse patient populations.
54. Association of Blood Arsenic Concentrations with Lipid Markers in Uruguayan Adolescents: Exploring Effect Modification by Body Mass Index and Sex.
期刊: Exposure and health 发表日期: 2026 链接: PubMed
摘要
Our study examined the association between blood As and total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), non-HDLC, and triglyceride (TGL) levels among Uruguayan adolescents and assessed the role of body mass index (BMI) and sex as potential effect modifiers. Adolescents, 9-20-year-old (n = 327 in complete-case and 337 in imputed dataset) in Uruguay had blood As measured two times (T1 and T2), a year apart, during 2021-2023. Serum lipid markers were measured at T2. Blood As was averaged and log transformed. Separate linear regressions were built for each lipid marker. Analyses were stratified by sex and at 85th percentile of BMI to assess effect modification. Median (range) blood As at T1 and T2 were 0.38 (0.18, 4.01) µg/L and 0.36 (0.14, 4.81) µg/L, respectively. 8%, 25%, and 24% adolescents had borderline or high levels of TGL (> 150 mg/dL), TC (> 170 mg/dL), and non-HDLC (> 120 mg/dL), respectively, and 31% had low levels of HDL-C (< 45 mg/dL). Blood As showed a positive association with TGL [β (95% CI): 12.2 (0.88, 23.5)], but not other lipids. Blood As was positively associated with TGL [β (95% CI): 30.3 (8.24, 52.4)] among those with BMI≥85th percentile and with TC [12.4 (2.13, 22.6)], non-HDLC [12.0 (2.81, 21.1)] and TGL [20.3 (5.17, 35.4)] among girls. Similar findings were seen in the complete case and imputed datasets. Our study showed that low-level blood As was associated with higher TGL levels among Uruguayan adolescents with evidence of an interaction with BMI and sex. The online version contains supplementary material available at 10.1007/s12403-026-00768-x.
55. Editorial: The role of birds in environmental transmission dynamics and impact on public health of zoonotic pathogens.
期刊: Frontiers in veterinary science 发表日期: 2026 链接: PubMed
摘要
56. Occupational exposure to inhalational anesthetics and the risk of spontaneous abortion: a systematic review and meta-analysis.
期刊: Frontiers in public health 发表日期: 2026 链接: PubMed
摘要
Healthcare professionals, particularly anesthesiologists, nurses, and dental staff, are routinely exposed to inhalational anesthetic agents such as nitrous oxide and halogenated gases. Although scavenging and ventilation systems have reduced ambient levels, concerns remain regarding reproductive risks associated with chronic exposure. Previous studies have yielded inconsistent results. A systematic review and meta-analysis of published observational studies was conducted to clarify the relationship, assessing reproductive outcomes among healthcare workers who were exposed. This systematic review and meta-analysis aimed to clarify the association between occupational exposure to anesthetic gases and the risk of spontaneous abortion among healthcare workers. A systematic search was performed in PubMed, Scopus, and Web of Science up from inception until the end of July 2025. Observational studies assessing spontaneous abortion among female healthcare workers exposed to inhalational anesthetics were included. Two reviewers independently screened and extracted data and assessed study quality using the Newcastle-Ottawa Scale (NOS). Pooled odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using a random-effects model. Heterogeneity was evaluated using the I2 statistic, and potential moderators were explored via subgroup and meta-regression analyses. Seventeen studies were included. The pooled analysis showed 1.29-fold higher odds of spontaneous abortion among exposed workers compared with unexposed controls (OR = 1.29; 95% CI: 0.96-1.75; I2 = 87%). Subgroup analyses indicated stronger associations in North American studies and among high-exposure occupations. Meta-regression analysis indicated that exposure duration is a significant predictor (p = 0.010), accounting for 73.6% of the heterogeneity. Sensitivity and Egger’s tests revealed robust findings without evidence of publication bias. Occupational exposure to anesthetic gases may increase the risk of spontaneous abortion, particularly in those who are at high exposure, emphasizing the need for stringent exposure control and improved workplace safety standards.
57. How digital mismatch leads to digital burnout among grassroots public servants in China: the moderating role of leadership care and organizational incentives.
期刊: Frontiers in public health 发表日期: 2026 链接: PubMed
摘要
Digital burnout is an increasingly prominent mental health issue in the modern digitalized workplace. As promoters, implementers, and experiencers of digital transformation, grassroots public servants face heightened occupational health risks in technology-driven environments. This study aims to explore the formative and buffering mechanisms of digital burnout among them, providing empirical evidence for maintaining the well-being of the public servant workforce and constructing a sustainable digital work environment. A questionnaire survey was conducted using convenience sampling and snowball sampling methods. A total of 656 valid questionnaires were collected from three cities in China (Shanghai, Wuhan, and Chengdu), representing the eastern, central, and western regions of the country, respectively. The data were analyzed using Confirmatory Factor Analysis, Structural Equation Modeling, and Regression Analysis to test the proposed hypotheses. Digital mismatch was identified as a critical antecedent to digital burnout. Specifically: (1) Digital suspension and digital overload positively predicted work stress, which in turn significantly exacerbated digital burnout; (2) Digital suspension and the digital divide had negative impact on technology identity, which effectively mitigated digital burnout; (3) Leadership care and organizational incentives played a significant negative moderating role in the relationship between digital overload and work stress, indicating that organizational support is a crucial buffering factor. The results indicate that digital mismatch affects digital burnout through dual mechanisms of “increased work stress” and “reduced technology identity,” while confirming the moderating effects of leadership care and organizational incentives in certain paths. These findings suggest that alleviating digital burnout among employees requires focused efforts on digital suspension, the digital divide, and digital overload, by establishing an occupational health protection system encompassing technological, organizational, and individual dimensions.
58. Occupational health, risk factors, and protection among unmanned aerial vehicle operator in the high-altitude region of China: an observational study.
期刊: Frontiers in public health 发表日期: 2026 链接: PubMed
摘要
Unmanned Combat aerial vehicles (UAVs) have evolved into assets of tactical-critical importance, thus safeguarding the occupational health of their operators is imperative. As UAV units of the Chinese are predominantly stationed in high-altitude regions, this study aimed to systematically assess the occupational health status and risk factors faced by these operators during their service, and to propose targeted protective measures. A cohort of 62 active-duty UAV operators stationed in high-altitude regions was recruited to complete a self-administered questionnaire. The investigation was conducted utilizing a comprehensive framework encompassing occupational health assessment, risk factor evaluation, and protective measures analysis. Statistical methodologies employed included descriptive statistical analysis, symptom co-occurrence network analysis, and clustering pattern analysis. UAV operators in high-altitude regions exhibited significantly higher prevalence of neurological (67.74%), musculoskeletal (64.52%), and psychological symptoms (46.77%) compared to their counterparts in plain areas, with additional manifestations of otorhinolaryngological (67.74%) and respiratory symptoms (64.52%). Symptom co-occurrence network analysis identified “musculoskeletal pain” and “memory impairment “as central hubs. Clustering analysis revealed distinct risk stratification, with high-, medium-, and low-risk subgroups constituting 20.97, 40.32, and 38.71% of the cohort, respectively. Among risk factors, “unreasonable work schedules” and “high-altitude hypoxia” received the two highest risk scores. Regarding protective measures, “health education,” (0.66) “scientific training protocols,” (0.62) and “rational shift scheduling” (0.60) demonstrated the highest comprehensive effectiveness scores. The UAV operator cohort in high-altitude regions demonstrated a notably poor occupational health status. “musculoskeletal pain” and “memory impairment “were identified as critical intervention targets. Given the prominent roles of “high-altitude hypoxia” and “unreasonable work-rest schedules” as dominant risk factors, occupational health strategies should be strategically redirected from over-reliance on personal protective equipment toward prioritized investment in efficient management systems. These include implementing “scientific training protocols,” enhancing “health education,” and establishing structured “work-rest rotation systems.” Simultaneously, essential oxygen supply and noise reduction equipment should be deployed at high-altitude workplaces.
59. Occupational exposure risk perception and its multilevel influencing factors among nurses in central sterile supply departments: a cross-sectional study based on the social ecological model.
期刊: Frontiers in public health 发表日期: 2026 链接: PubMed
摘要
Occupational exposure remains a critical issue in occupational safety management within healthcare institutions. Nurses working in central sterile supply departments (CSSDs) face a relatively high risk of occupational exposure due to the unique characteristics of their working environment. However, the multilevel mechanisms influencing occupational exposure risk perception among this population have not been systematically investigated. This study aimed to explore the level of occupational exposure risk perception and its multilevel influencing factors among CSSD nurses. A cross-sectional study design was employed. From June 2025 to January 2026, study preparation and site coordination were conducted. Following ethics approval in January 2026, an online questionnaire survey was administered among 580 CSSD nurses from 28 tertiary hospitals. Guided by the Social Ecological Model, variables were collected across individual, interpersonal, organizational, community, and policy levels. Stepwise multiple linear regression analysis was performed to identify factors associated with occupational exposure risk perception. The overall level of occupational exposure risk perception among CSSD nurses was moderate, tending to be above the midpoint of the scale. Multivariate analysis showed that self-efficacy, social support, participation in occupational exposure training, regular emergency drills, and supervisory protection were positively associated with occupational exposure risk perception, whereas occupational burnout was negatively associated with risk perception (all p < 0.05). Occupational exposure risk perception among CSSD nurses was associated with individual psychological resources and organizational support factors. Based on these findings, multilevel strategies may be considered and should be evaluated in future longitudinal or interventional studies, including strengthening psychological resource support, occupational safety training, and organizational safety culture, to inform capacity building in occupational protection and infection prevention and control.
60. Humoral immunity and infection status of PLWH following vaccination after the BA.5/BF.7 wave.
期刊: Frontiers in microbiology 发表日期: 2026 链接: PubMed
摘要
To ensure adequate preparedness of immunocompromised populations for future pandemic waves, it is crucial to assess the humoral immune response of people living with HIV (PLWH) to existing vaccination strategies and major Omicron sublineages following BA.5/BF.7 breakthrough infection (BTI). This study enrolled 232 PLWH who had received either the CoronaVac/BBIBP-CorV or ZF2001 vaccine and experienced the BA.5/BF.7 wave in China between January and April 2023. Serum samples from each individual were collected approximately 1-6 months after the last exposure. Immunoglobulin G (IgG) and total antibodies against SARS-CoV-2 were measured using a chemiluminescent immunoassay. Neutralizing antibodies (NAbs) against D614G, BA.5, and XBB.1.5 were detected using a pseudovirus-based neutralization assay. Meanwhile, an Enterprise WeChat link was created to allow PLWH to self-report severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections and clinical symptoms associated with coronavirus disease 2019 (COVID-19). The Omicron BA.5/BF.7 BTI rate among PLWH was 76.7%. The most commonly reported symptoms were fever, fatigue, and muscle ache. PLWH who experienced BA.5/BF.7 BTI after three doses of inactivated vaccines showed elevated levels of total antibodies, IgG, and NAb titers against D614G and BA.5. In contrast, those who experienced BTI after three doses of ZF2001 vaccines showed the highest NAb titers against D614G and BA.5. However, the neutralizing capacity of antibodies against XBB.1.5 was significantly reduced in both study cohorts. PLWH who had CD4 lymphocyte counts greater than 500 cells/μL demonstrated higher NAb titers against all tested variants and reported a lower incidence of symptoms. Hybrid immunity resulting from vaccination and BA.5/BF.7 BTI enhances humoral immune responses in PLWH, which may contribute to improved protection against COVID-19. However, this hybrid immunity offers limited protection against Omicron variant XBB.1.5. Regular monitoring of immune responses to new vaccines targeting emerging variants is crucial for optimizing COVID-19 prevention strategies in PLWH.
61. Microplastics in Urban Ambient Air: A Rapid Review of Active Sampling and Analytical Methods for Human Risk Assessment.
期刊: Environments (Basel, Switzerland) 发表日期: 2024-Nov 链接: PubMed
摘要
This study conducted a rapid review to evaluate active air sampling and analytical methods for characterizing outdoor air microplastics in urban areas. We synthesized information from 35 peer-reviewed journal articles. Studies utilizing active sampling methods were able to provide detailed data on inhalation concentrations and doses. The analytical techniques reviewed were categorized into microscopy, Fourier Transform Infrared (FTIR) spectroscopy, Raman spectroscopy, Scanning Electron Microscopy (SEM), and mass spectrometry, including Pyrolysis-Gas Chromatography (Py-GC). While conventional FTIR and Raman spectroscopy can identify microplastics in total suspended particles, advanced instruments such as μRaman and SEM are crucial for analyzing inhalable microplastics (e.g., particles smaller than 10 μm). Characterizing the shapes and colors of microplastics can provide qualitative estimates of their sources, with fibers and the color black being the most predominant. Establishing dose-response relationships for health effects requires quantitative analyses; thus, combining techniques like μRaman with Py-GC is essential for comprehensive human risk assessments. Future studies should focus on identifying and quantifying inhalable micro-plastic compounds that are relevant to human health.