公共卫生研究摘要 (2026-04-20)
共收录 62 篇研究文章
1. Metabolic syndrome in chronic schizophrenia: Cross-sectional hospital assessment of prolonged risperidone exposure.
期刊: Pakistan journal of pharmaceutical sciences 发表日期: 2026-Jun 链接: PubMed
摘要
Long-term use of antipsychotics like risperidone raises metabolic syndrome (MetS) risk, with evidence from Chinese populations being limited. This study compared MetS prevalence and metabolic profiles between chronic schizophrenia patients on long-term risperidone versus olanzapine. In this cross-sectional study, 80 risperidone-treated patients were compared to 80 olanzapine-treated controls. MetS [IDF (The International Diabetes Federation) criteria], glucose/lipid metabolism and anthropometric measures were assessed. Statistical analyses included t-tests and χ² tests. The prevalence of MetS was significantly lower in the risperidone group (30.0%) compared to the olanzapine group (48.8%, p = 0.015). Risperidone patients showed better glycemic control and lipid profiles (p < 0.05), though BMI (body mass index), waist circumference and blood pressure remained elevated compared to olanzapine patients. Long-term risperidone therapy is associated with a lower MetS risk than olanzapine. Regular metabolic monitoring and adjunctive interventions are recommended for high-risk patients.
2. Polypharmacy and cognitive outcomes in elderly inpatients with Alzheimer's disease: A three-year retrospective study.
期刊: Pakistan journal of pharmaceutical sciences 发表日期: 2026-Jun 链接: PubMed
摘要
Inpatient care for Alzheimer’s disease (AD), often complicated by comorbidities, frequently involves polypharmacy (≥5 medications). The profile and cognitive consequences of sustained polypharmacy in these elderly inpatients require further investigation. To investigate the status of polypharmacy in elderly inpatients with AD and its correlation with three-year cognitive outcomes, so as to provide a basis for clinical optimization of medication regimens. This study was a retrospective propensity score matching (PSM) cohort study. 300 AD inpatients who were hospitalized from March 2022 to March 2025 were included. Patients were stratified into polypharmacy and non-polypharmacy groups according to their polypharmacy status. The primary outcome was the incidence of cognitive decline (MMSE decline ≥3 points) at 3 years. Secondary outcomes were the association of CDR progression, rate of decline in MoCA, incidence of falls, all-cause rehospitalization, all-cause mortality and anticholinergic drug burden with cognitive outcomes. After PSM, baseline characteristics were balanced (p>0.05). At the 3-year follow-up, the polypharmacy group had a significantly higher incidence of cognitive decline than the non-polypharmacy group (64.0% vs. 38.0%; RR=1.68, 95% CI: 1.33-2.13, p<0.001). Polypharmacy was also associated with faster CDR progression, a greater annual rate of MoCA decline and increased risks of falls (RR=1.82, p<0.01) and all-cause rehospitalization (RR=1.67, p<0.001). A high anticholinergic burden (ACB score ≥3) was identified as an independent predictor of cognitive decline (OR=2.5, 95%CI: 1.7-3.7, p<0.001). Our findings highlight polypharmacy as a key, modifiable risk for cognitive decline in AD, calling for structured medication management to mitigate this risk.
3. Wu-Mei-Wan retards NAFLD progression by ameliorating obesity and regulating serum metabolites in high-fat diet-fed mice.
期刊: Pakistan journal of pharmaceutical sciences 发表日期: 2026-Jun 链接: PubMed
摘要
Non-alcoholic fatty liver disease (NAFLD), closely associated with obesity and metabolic syndrome, lacks universally effective therapies. Wu-Mei-Wan (WMW), a traditional Chinese medicine formula, has been used to treat metabolic disorders, but its efficacy and mechanism against NAFLD remain unclear. This study investigated the therapeutic potential of WMW in a high-fat diet (HFD)-induced NAFLD mouse model. After 24 weeks of HFD feeding, mice were allocated to control, model, low/middle/high-dose WMW (L-/M-/H-WMW), or metformin groups. Physiological parameters and liver pathology were assessed. Untargeted serum metabolomics was employed to identify altered metabolic pathways. H-WMW treatment significantly alleviated NAFLD phenotypes, reducing body weight, hepatic steatosis, dyslipidemia, and insulin resistance. Metabolomic analysis identified vitamin B6 metabolism as a key target, with H-WMW restoring levels of pyridoxal 5’-phosphate and 4-pyridoxic acid to near-normal. Mechanistically, WMW coordinately modulated interconnected purine and vitamin B6 metabolic networks. WMW demonstrates significant efficacy against NAFLD, likely through multi-target reprogramming of hepatic metabolism. These findings position WMW as a promising phytopharmaceutical candidate worthy of further clinical investigation.
4. Medic Training at Military-Civilian Partnerships-A Narrative Review.
期刊: Military medicine 发表日期: 2026-Apr-19 链接: PubMed
摘要
Military-Civilian Partnerships (MCP) were developed to mitigate degradation of combat medical readiness during peacetime. Although these programs have historically focused on sustaining surgical readiness and training military physicians, MCP increasingly augment training for Army Combat Medics, Navy Hospital Corpsmen, Air Force Aerospace Service Specialist, and other non-physician military medical personnel. The effectiveness, scalability, and alignment of MCP along with evolving operational requirements remain incompletely defined. We performed a review of available literature to assess and characterize the current state of medic training at MCP sites. A narrative review of the literature was conducted using PubMed, Embase, Scopus, and other grey literature (2000-2025). Studies describing MCP curricula, clinical exposure, and/or educational outcomes specific to combat medics were included. Data were qualitatively synthesized to characterize MCP models, training environments, assessment strategies, and reported outcomes. IRB review was not required. Nine studies met inclusion criteria. Eight publications detail MCP curricula and program sites. One publication outlining expert opinions, strategic prioritization, and consensus doctrine for MCP development was included. Across studies, MCP participation was associated with improved self-reported confidence; however, objective knowledge and skills gains were modest, inconsistently assessed, or absent. Training experiences were frequently observational, though level of clinical involvement was inconsistently reported. Medic-specific curricula and standardized assessment benchmarks were rarely described. Detailed programs were disproportionately concentrated at Level I trauma centers. Existing MCP provide perceived educational benefit to combat medics but incompletely address medic-specific readiness and scalability. Broad expansion of the MCP model, coupled with standardized curricula, interoperable training and educational standards for medics, and objective assessment tools may better optimize intended benefits. Training should align with future operational demands, which are constantly evolving. Iterative and agile curricula will benefit preparation and wartime needs. Diverse partnership offers profound opportunity to enhance both military and civilian contributions to the national trauma system.
5. Frailty and Steroid Treatment Outcomes in Patients with Sudden Sensorineural Hearing Loss.
期刊: The Annals of otology, rhinology, and laryngology 发表日期: 2026-Apr-19 链接: PubMed
摘要
To investigate the relationship between frailty and steroid treatment outcomes in patients with sudden sensorineural hearing loss (SSNHL). Retrospective cohort studySetting:Tertiary-care institution. 185 adult patients (≥19 years) with unilateral SSNHL presenting January 1, 2017 to May 24, 2023, stratified by 5-Factor Modified Frailty Index (mFI5). Oral prednisone and/or intratympanic dexamethasone. Post-treatment changes in pure-tone average (PTA), speech reception threshold (SRT), and word recognition scores (WRS). Female and younger patients were significantly less frail than male and older patients (P = .004, P < .001 respectively). Patients with higher frailty scores (≥2) were less likely to receive oral steroids (59.6% vs 82.8%, P = .004), though equally likely to receive intratympanic steroids (P = 1.000). However, patients classified as frail (≥1) were not more likely to receive intratympanic steroids alone compared to combination therapy (P = .220). Higher frailty scores were significantly associated with metabolic syndrome (P = .002), but specific treatment patterns in diabetic patients could not be delineated as treatment was individualized. Dizziness (P = .650) and vertigo (P = .200) did not correlate with frailty or treatment outcomes. The number of comorbidities increased with higher frailty scores (P < .001) but did not directly correlate with SSNHL outcomes. No significant differences were observed in audiometric outcomes (PTA/SRT/WRS) based on patient frailty scores across all comparisons (P’s > .05). While we found an association between frailty scores and treatment selection for SSNHL, we did not find a significant association between frailty scores and treatment outcomes. Therefore, treatment may be individualized in frail patients without compromising audiometric outcomes.
6. How to Use Quantum Computers for Biomolecular Free Energies.
期刊: Journal of chemical theory and computation 发表日期: 2026-Apr-19 链接: PubMed
摘要
Free energy calculations are at the heart of physics-based analyses of biochemical processes. They allow us to quantify molecular recognition mechanisms, which determine a wide range of biological phenomena, from how cells send and receive signals to how pharmaceutical compounds can be used to treat diseases. Quantitative and predictive free energy calculations require computational models that accurately capture both the varied and intricate electronic interactions between molecules as well as the entropic contributions from the motions of these molecules and their aqueous environment. However, accurate quantum-mechanical energies and forces can be obtained only for small atomistic models and not for large biomacromolecules. Here, we demonstrate how to consistently link accurate quantum-mechanical data obtained for substructures to the overall potential energy of biomolecular complexes using machine learning in an integrated algorithm. We do so using a two-fold quantum embedding strategy where the innermost quantum cores are treated at a very high level of accuracy. We demonstrate the viability of this approach for the molecular recognition of a ruthenium-based anticancer drug by its protein target by applying traditional quantum chemical methods. As such methods scale unfavorably with system size, we analyze the requirements for quantum computers to provide highly accurate energies that affect the resulting free energies. Once the requirements are met, our computational pipeline, FreeQuantum, is able to make efficient use of the quantum-computed energies, thereby enabling quantum computing-enhanced modeling of biochemical processes. This approach combines the exponential speedups of quantum computers for simulating interacting electrons with modern classical simulation techniques that incorporate machine learning to model large molecules.
7. Impact of leaving periodontal disease untreated on healthcare expenditures: A retrospective cohort study.
期刊: Journal of periodontology 发表日期: 2026-Apr-19 链接: PubMed
摘要
This study aimed to investigate whether healthcare expenditures (HCEs) differed depending on whether the patients left periodontal disease (PD) untreated, despite the need for treatment. This study used public PD screening data from a municipality in Japan to identify adults aged ≥ 40 years who were found to require treatment of PD by dentists at PD screening. The presence or absence of periodontal treatment was determined by a dental visit within 180 days after the date of PD screening based on medical claims data. Annual HCE were calculated from cumulative expenditures over 2 years from the date of the presence or absence of periodontal treatment. A generalized linear model with a gamma distribution and log link function was used to calculate the relative cost ratios (RCRs) and 95% confidence intervals (95% CI), and a two-part model was used to predict annual HCEs and the difference in predicted HCEs based on dental treatment. Among 652 people (mean age: 62.6 years [1 SD = 9.0], 65.5% women), 9.0% were untreated. After adjusting for the covariates, the RCR for medical, pharmaceutical, and dental costs in the untreated group compared with the treated group were 1.56 (95% CI: 1.02-2.38), 0.95 (95% CI: 0.53-1.70), and 0.14 (95% CI: 0.10-0.19), respectively. The differences in predicted HCEs were $593.5 (95% CI: -280.6, 1467.6) higher for medical, $79.9 (95% CI: -363.6, 523.4) higher for pharmaceutical, and $323.9 (95% CI: -397.3, -250.6) lower for dental. Leaving PD untreated was associated with increased HCEs, particularly medical expenditures. This study looked at whether people who were told by a dentist that they needed care for periodontal disease actually received treatment, and how this affected their healthcare costs. The research followed more than 600 adults in Japan for 2 years, comparing the cumulative healthcare costs of those who received dental care with those who did not. The results showed that people who did not treat their periodontal disease ended up spending more on medical care, even though they spent less on dental care. On average, untreated individuals had medical expenses that were around $600 higher than those who received treatment. This suggests that avoiding dental care for periodontal disease might lead to more serious health problems down the line, which can increase overall healthcare costs. Although skipping dental visits may seem like a way to save money, it could actually lead to higher medical bills in the future. These findings highlight the importance of early dental treatment not just for oral health, but also for managing overall healthcare costs and preventing other health complications.
8. Predictors and Outcomes of Pulmonary Embolism After Coronary Artery Bypass Grafting.
期刊: Angiology 发表日期: 2026-Apr-19 链接: PubMed
摘要
Pulmonary embolism (PE) can be a life-threatening complication following coronary artery bypass grafting (CABG). However, the impact of PE on short-term outcomes such as readmission and mortality remains poorly characterized. The Nationwide Readmission Database 2016 to 2021 was queried to identify patients with isolated CABG who were readmitted with PE within 30 days. International Classification of Diseases (ICD) 10th Revision Clinical Modification and Procedure Coding System codes were used to identify the cohort. Rates and patient characteristics were compared between post-CABG patients with and without PE. Multivariable logistic regression analysis was performed to identify risk factors for PE within 30 days of isolated CABG, as well as risk factors for mortality in these patients. Patients with PE had a higher prevalence of female sex (32.7% vs 30.7%, P = .04) and obesity (25.7% vs 22.3%, P < .001), but lower rates of hypertension and diabetes. Thirty-day mortality was higher in PE patients in univariable (Odds ratio (OR) 1.53, 95% confidence interval (CI) 1.16-2.05, P = .002) and multivariable analyses (OR 1.45, 95% CI 1.00-2.11, P = .04). PE following CABG is associated with increased 30-day readmission and mortality. These findings underscore the need for improved risk stratification, early detection, and targeted prevention strategies in the postoperative period.
9. Divergent Trends in Stroke Subtype Mortality Attributable to High Systolic Blood Pressure in China, 1990 to 2021: An Age-Period-Cohort Analysis and Projection.
期刊: Medical science monitor : international medical journal of experimental and clinical research 发表日期: 2026-Apr-19 链接: PubMed
摘要
BACKGROUND High systolic blood pressure (HSBP) is a major contributor to stroke mortality in China. This study analyzed trends in HSBP-attributable stroke mortality from 1990 to 2021 to elucidate the effects of age, period, and cohort and to project future trends for precision prevention. MATERIAL AND METHODS Using Global Burden of Disease 2021 estimates, temporal trends in age-standardized mortality rates were assessed by Joinpoint regression, age-period-cohort (APC) patterns were evaluated using APC modeling, and mortality trends were projected to 2030 within a Bayesian APC framework incorporating United Nations population projections. Uncertainty was summarized via 95% credible intervals. RESULTS From 1990 to 2021, HSBP-attributable stroke mortality declined overall (average annual percentage change [AAPC] -1.31%, 95% confidence interval [CI] -1.52 to -1.10), with pronounced subtype heterogeneity: ischemic stroke (IS) was relatively stable (AAPC -0.03%, 95% CI -0.29 to 0.24), whereas intracerebral hemorrhage (ICH) and subarachnoid hemorrhage (SAH) substantially declined (AAPC -1.75%, 95% CI -1.97 to -1.52; and -5.03%, 95% CI -5.29 to -4.76, respectively). IS trends diverged by sex, declining in women but increasing in men; mortality steeply increased according to age, with pronounced acceleration after 75 years. Cohort patterns suggested elevated risk in more recent birth cohorts. CONCLUSIONS Our analyses show that HSBP-attributable stroke mortality in China generally declined over the past 3 decades, but trends noticeably diverged among subtypes (ICH substantially declined and SAH most rapidly decreased, whereas IS remained relatively stable), underscoring the need for subtype- and population-specific prevention priorities, including sustained population-wide sodium reduction.
10. Physician-suggested strategies for deimplementing low-value care in Swedish primary care: a qualitative analysis across system levels.
期刊: Implementation science communications 发表日期: 2026-Apr-18 链接: PubMed
摘要
Low-value care (LVC) remains a persistent problem in primary healthcare. While various implementation strategies have been proposed and tested for deimplementation, there is limited knowledge about whether there are strategies uniquely suited to deimplementation. Furthermore, there is limited knowledge about system-level responsibilities for deimplementation. Given that implementation strategies are recommended to be tailored to the specific contextual factors surrounding LVC practices, involving primary care physicians in identifying contextually appropriate strategies holds promise. This study aimed to explore the strategies that primary care physicians suggest could facilitate the deimplementation of LVC and map them to the system levels responsible for initiating and deploying these strategies. This qualitative study was based on responses to an open-ended survey question asking physicians to suggest strategies that could facilitate the deimplementation of LVC practices within primary healthcare in Sweden. A national sample of 441 primary care physicians responded. Responses were analyzed via deductive content analysis categorized by the Expert Recommendations for Implementing Change (ERIC) compilation. Responses that could not be categorized via ERIC were analyzed inductively. The identified strategies were then mapped to the system levels (individual, group, leader, organization and overarching system) responsible for deploying these strategies. Strategies were identified across all nine original ERIC domains, representing 39 (53%) of the original ERIC strategies, and later additions for deimplementation. Additionally, a set of strategies categorized under a new domain, develop better evidence, was identified. Most strategies were suitable for deployment at the organizational (31 strategies) and overarching (31 strategies) levels. Sixteen strategies were best suited for the group level, thirteen for the leadership level, and two for the individual level. Primary care physicians proposed strategies across all nine ERIC domains, with additional strategies beyond those previously described, including develop better evidence. From the physicians’ perspective, deimplementation cannot rely solely on individuals but requires coordinated action across the organizational and system levels. Broader structural, policy, and cultural changes would support physicians and ensure that responsibility for deimplementation is shared across the healthcare system.
11. The structural roots of multimorbidity: social inequalities, health disparities, and systemic challenges in Southern Spain.
期刊: International journal for equity in health 发表日期: 2026-Apr-18 链接: PubMed
摘要
Multimorbidity-the co-occurrence of two or more chronic health conditions-has become a major public health challenge in ageing societies. However, most research continues to frame it as a clinical or epidemiological issue, overlooking the role of social determinants and healthcare system dynamics. This study investigates the patterns, experiences, and structural implications of multimorbidity in southern Spain, aiming to uncover how health inequalities shape disease profiles and care experiences in one of the most deprived regions of the country. We employed a mixed-methods sequential explanatory design. The quantitative phase was based on a cross-sectional telephone survey of 1,592 individuals aged 50 and over with multimorbidity. Latent Class Analysis (LCA) was used to identify multimorbidity patterns based on 33 chronic conditions. Associations with sociodemographic factors and healthcare utilisation were analysed using chi-square tests. The qualitative phase consisted of 18 semi-structured interviews with healthcare professionals and patients, analysed thematically to explore lived experiences, care trajectories, and institutional barriers. Five multimorbidity patterns were identified: unspecific, cardiometabolic, musculoskeletal, musculoskeletal-mental, and complex multimorbidity. These patterns showed clear social stratification: complex and musculoskeletal-mental profiles were more prevalent among low-income individuals, women, and residents in deprived areas. Healthcare utilisation also varied across patterns, with higher service use in more complex profiles. Qualitative findings revealed that multimorbidity was experienced as a cycle of physical decline, emotional vulnerability, and systemic neglect. Patients faced difficulties in treatment adherence, experienced long waiting times, and often relied on informal caregiving, predominantly by women. Healthcare professionals highlighted systemic fragmentation, lack of coordination, and the inadequacy of clinical guidelines for complex cases. Multimorbidity in this context is not merely a clinical challenge but a socially embedded condition shaped by structural inequality and institutional failures. Health systems must move beyond single-disease logic and adopt integrated, equity-oriented models of care that consider the syndemic nature of multimorbidity. This study highlights the need to incorporate social determinants into chronic care strategies and to prioritise the lived experiences of patients and caregivers in future health policy and planning.
12. Using co-design to develop actionable strategies to identify and follow-up on breast cancer survivors in primary care.
期刊: BMC health services research 发表日期: 2026-Apr-18 链接: PubMed
摘要
13. Clinical, social, and home-level factors associated with the quality of life of residents living with dementia in Canadian nursing homes: a cross-sectional, multi-province study.
期刊: Health and quality of life outcomes 发表日期: 2026-Apr-18 链接: PubMed
摘要
14. Mindfulness exercise and quality of life among nursing students: the mediating roles of self-control and internet addiction.
期刊: BMC nursing 发表日期: 2026-Apr-18 链接: PubMed
摘要
Internet addiction (IA) has become an increasingly prevalent behavioral health concern among university students, with previous studies reporting substantial levels of problematic internet use among nursing students, including a multicenter study in China that found a prevalence of 23.3%. Because problematic internet use may be associated with poorer quality of life (QL), QL represents an important well-being outcome in this population. Mindfulness exercise (ME), as a movement-based mindfulness practice, may serve as a protective factor associated with better self-regulation and healthier behavioral functioning. However, limited research has examined whether ME is associated with QL directly and indirectly through self-control (SC) and IA among nursing students. A cross-sectional survey was conducted among 480 nursing students using validated measures of mindfulness exercise, self-control, internet addiction, and quality of life. Data were analyzed using partial least squares structural equation modeling (PLS-SEM). Reliability, convergent validity, and discriminant validity of the measurement model were confirmed. Bootstrapping with 5,000 resamples was applied to examine direct and mediating effects among the study variables. The results showed that mindfulness exercise was positively associated with self-control (β = 0.435, p < 0.001) and quality of life (β = 0.181, p < 0.001). Self-control was negatively associated with internet addiction (β = -0.304, p < 0.001), and internet addiction was negatively associated with quality of life (β = -0.215, p < 0.001). In addition, self-control significantly mediated the association between mindfulness exercise and internet addiction (β = -0.132, p < 0.001), as well as the association between mindfulness exercise and quality of life (β = 0.163, p < 0.001). Furthermore, a significant sequential mediating effect of self-control and internet addiction was found in the association between mindfulness exercise and quality of life (β = 0.028, p = 0.001). Mindfulness exercise was associated with better quality of life among nursing students, both directly and indirectly through self-control and internet addiction. In particular, the findings support a sequential mediation pathway in which higher mindfulness exercise was associated with higher self-control, which in turn was associated with lower internet addiction and better quality of life. Given the cross-sectional design, these findings should be interpreted as associative rather than causal. Not applicable.
15. Evaluation and prioritization of food environment policies in Türkiye using the Healthy Food Environment Policy Index (Food-EPI).
期刊: BMC public health 发表日期: 2026-Apr-18 链接: PubMed
摘要
16. Factors impacting long-term care and retirement home populations' participation in immunity research: a qualitative study using the framework method.
期刊: BMC geriatrics 发表日期: 2026-Apr-18 链接: PubMed
摘要
17. Simultaneous point-of-care detection and virulence typing of Helicobacter pylori using multiplex recombinase polymerase amplification combined with lateral flow strip.
期刊: European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology 发表日期: 2026-Apr-18 链接: PubMed
摘要
18. Mapping multidomain assessment tools for home-visit nursing and rehabilitation: a scoping review.
期刊: BMC health services research 发表日期: 2026-Apr-18 链接: PubMed
摘要
19. Diagnostic accuracy of ovarian cancer using convolutional neural network: a systematic review and meta-analysis.
期刊: BMC medical informatics and decision making 发表日期: 2026-Apr-18 链接: PubMed
摘要
20. Causal cross-trait mapping at single-cell resolution identifies shared immunogenetic drivers of migraine and Meniere's disease.
期刊: The journal of headache and pain 发表日期: 2026-Apr-18 链接: PubMed
摘要
21. The CI plus model: a qualitative study of innovative community isolation and enhanced resilience in urban Thailand during the COVID-19 crisis.
期刊: BMC infectious diseases 发表日期: 2026-Apr-18 链接: PubMed
摘要
22. Structured digital health intervention for leprosy awareness: a case study of analyzing public engagement and sentiment in a Sri Lankan leprosy awareness campaign on Facebook.
期刊: BMC infectious diseases 发表日期: 2026-Apr-18 链接: PubMed
摘要
23. Correction: Post-Operative Safety Outcomes and 5-Year Healthcare Utilisation After Bariatric Surgery vs. Other Elective Types of Surgical Treatments - A Retrospective Observational Cohort Study.
期刊: Obesity surgery 发表日期: 2026-Apr-18 链接: PubMed
摘要
24. The Impact of Pain Coping Strategies on Chronic Pain Among Native Americans.
期刊: Journal of racial and ethnic health disparities 发表日期: 2026-Apr-18 链接: PubMed
摘要
25. Longitudinal Associations Between Sexual Regulatory Focus and Sexual Health and Well-Being.
期刊: Archives of sexual behavior 发表日期: 2026-Apr-18 链接: PubMed
摘要
Sexual health and well-being (SHWB) encompasses physical and emotional aspects beyond disease absence. Research has shown that sexual decisions and behaviors are informed by predominant motives for pleasure or safety, with some individuals prioritizing health protection and risk avoidance (i.e., predominant focus on prevention) and others sexual pleasure and rewards (i.e., predominant focus on promotion) with casual partners. This longitudinal study with individuals in Spain and Portugal explored how sexual regulatory focus was related to sexual responses, behaviors, and experiences with casual partners at baseline (T1, N = 811) and three months later (T2, N = 527). Results of a latent profile analysis revealed three distinct profiles. Participants predominantly focused on prevention reported higher sexual health outcomes at baseline (e.g., more sexual inhibition due to risk awareness; more condom use in different sexual activities) and three months later (e.g., enacted safer sexual activities) to the detriment of their sexual well-being (e.g., less sexual satisfaction). In contrast, participants predominantly focused on promotion reported higher sexual well-being outcomes at baseline (e.g., more sexual excitation; more sexual communal strength) and three months later (e.g., more sexual satisfaction; more autonomous reasons for having sex) potentially to the detriment of their sexual health (e.g., enacted riskier sexual activities; but were also more likely to have been tested for sexually transmitted infections). A third group of participants with a dual focus managed to protect their sexual health (e.g., enacted safer sexual activities later on) without compromising their sexual well-being (e.g., more sexual excitation; more sexual satisfaction later on). These findings show that sexual regulatory focus is a crucial aspect to consider in efforts aimed at fostering SHWB.
26. Factors influencing antibiotic-resistant bacteria colonization among community and hospitalized individuals in Chennai, India: an Antibiotic Resistance in Communities and Hospitals (ARCH) study.
期刊: Antimicrobial resistance and infection control 发表日期: 2026-Apr-18 链接: PubMed
摘要
Colonization with antibiotic-resistant bacteria (ARB) increases the risk for antibiotic-resistant infections. Our previous study documented a high level of colonization with ARBs in a suburban area of Chennai, a city in South India. Here, we aimed to identify potential risk factors for colonization with extended-spectrum cephalosporin-resistant Enterobacterales (ESCrE) and carbapenem-resistant Enterobacterales (CRE). Adult participants were enrolled in community and hospital surveys from November 2020 through March 2022, and ARB isolation was done from stool specimens. Multivariable logistic regression was used to calculate adjusted odds ratios (aOR) with 95% confidence intervals (CI). In the community, the adjusted odds of ESCrE colonization were lower among those reporting consumption of animal products (1-2 days a week, aOR: 0.51; 95% CI 0.27-0.96; > 2 days a week, aOR: 0.48; 95% CI 0.25-0.94). Among hospitalized patients, the adjusted odds of CRE colonization was higher among those with prior antibiotic use (aOR: 1.50; 95% CI 0.97-2.32) and who underwent invasive procedures (aOR: 1.80; 95% CI 0.95-3.39). No significant associations were identified for other risk factors among community or hospital participants and colonization outcomes. Drivers of ARB colonization may be difficult to ascertain in high-burden settings. However, healthcare-based strategies to reduce ARB transmission should continue to emphasize infection prevention and control as well as antibiotic stewardship. Additional studies are needed to understand community factors contributing to ARB colonization.
27. Eco-evolutionary dynamics of a shifting porcine parvoviruses (PPV1-PPV8) ecosystem reveal dichotomous selection pressures.
期刊: Veterinary research 发表日期: 2026-Apr-18 链接: PubMed
摘要
Porcine parvoviruses (PPVs) constitute a complex viral ecosystem. However, the genetic structure and evolutionary dynamics of currently circulating PPV populations remain poorly characterized. A large-scale genomic survey in China (1,055 genomes; 863 samples; 2021-2024) reveal a profound ecosystem shift, with PPVs detected in 212/863 samples (24.57%) Novel species (PPV7, 16.45%; PPV6, 9.62%; and PPV2, 8.82%) now dominate the niche previously occupied by classical PPV1 (3.13%). This new landscape is defined by pervasive multi-species co-infection (129/212, 60.85%), including 61 cases with ≥ 3 species and 7 pigs co-infected with ≥ 5 species, characterized by non-random associations, where even low-prevalence species such as PPV1 and PPV5 exhibit a high propensity for co-infection (permutation test: PPV1 p < 0.001; PPV5 p = 0.002). This high-transmission environment provides ample opportunities for frequent intra-species recombination, which powerfully accelerates variation within the primary antigenic region (ORF2). This study uncovered dichotomous evolutionary dynamics driven by contrasting immune pressure. The dominant naturally circulating species were constrained by strong purifying selection. In stark contrast, vaccine-targeted PPV1 followed a distinct path driven by strong positive selection of key surface epitopes (e.g., VP2 site 435), suggesting an adaptation to evade vaccine-induced immunity. Collectively, our work deconstructs how natural selection and vaccine filtering impose distinct selective regimes on the viral population, establishing a new framework for evolutionarily aware surveillance and rational design of next-generation vaccines.
28. Antibiotic resistance genes in companion animals and humans driven by the gut microbial communities: composition, distribution, and implications.
期刊: BMC veterinary research 发表日期: 2026-Apr-18 链接: PubMed
摘要
The widespread and inappropriate use of antibiotics in both human and veterinary medicine has accelerated the emergence and dissemination of antibiotic resistance genes (ARGs) in various environments. Companion animals, due to their close and prolonged interactions with humans, have increasingly been recognized as potential reservoirs and transmitters of ARGs. However, the extent remains largely unclear to which companion animals influence the diversity and distribution of ARGs in humans. Understanding these interactions is essential for assessing environmental pathways of antibiotic resistance transmission and for developing effective mitigation strategies within the One Health framework. We examined the profiles of ARGs and gut microbial communities among three groups: companion animals, pet owners, and non-pet owners. Quantitative polymerase chain reaction (qPCR) assays were applied to determine the abundance and diversity of representative ARGs, while 16S rRNA gene sequencing was used to characterize the composition and structure of microbial communities. Comparative and correlation analyses were conducted to evaluate the relationships between ARG distribution patterns and microbial community profiles across different host groups. Companion animals were found to possess the highest total abundance of ARGs (8.46 × 101⁰ copies/μL), while humans exhibited greater gut microbial diversity. ARGs ermB and tetQ displayed relatively high abundance in all three groups. In addition, intI-1 was significantly more abundant in pet owners than in non-pet owners. ARG profile of pet owners showed more similarity to that of their pets, assessed by the Jaccard similarity index. Age was associated with a limited subset of ARGs: sul2 and tetW decreased with age in companion animals, whereas aph(3’), cmlA, fexA and qnrS increased with age in humans. Notably, high correlation (r = -0.69/0.77) of oqxA-Megasphaera was identified, with negative correlation in animals and positive in pet owners, suggesting oqxA could be a potential key hub for ARGs dissemination. Our findings show that pet owners exhibit similar ARG profiles to those in companion animals, suggesting pet ownership may drive convergence in profiles of ARGs. Moreover, these findings provides evidence of potential resistome overlap at the human-animal interface and highlight the need to incorporate companion animals into antimicrobial control programs under a One Health framework.
29. Racial and Ethnic Variations in Dental Care Utilization and Expenditures: Associations with Usual Source of Care and Foreign-Born Status.
期刊: Journal of racial and ethnic health disparities 发表日期: 2026-Apr-18 链接: PubMed
摘要
30. Serum Manganese, Cobalt, Copper, Zinc, Selenium, and Iodine Levels, and the Incidence of Type 2 Diabetes: A Nested Case-control Study.
期刊: Biological trace element research 发表日期: 2026-Apr-18 链接: PubMed
摘要
31. Interpretable depressive symptoms screening via statistical reasoning-augmented large language models using wearable and environmental data.
期刊: Scientific reports 发表日期: 2026-Apr-18 链接: PubMed
摘要
Early assessment of depressive symptoms is essential for scalable and personalized mental health care. We developed a hybrid clinical decision support system (CDSS) that combines interpretable logistic regression with fine-tuned large language models (LLMs) to classify depressive symptom status using wearable-derived behavior, clinical features, and environmental exposures. This study aimed to develop a hybrid clinical decision support system by fine‑tuning a GPT‑based large language model with odds ratio-derived statistical reasoning to classify depressive symptom status from wearable‑derived behavioral metrics, clinical characteristics, and environmental exposures. We compared the diagnostic accuracy, interpretability, and operational efficiency of this OR‑based fine‑tuned model against both traditional nomogram‑based statistical models and label‑supervised fine‑tuned LLM approaches. We further evaluated the incremental predictive value of wearable‑derived behavioral features beyond readily available demographic and clinical variables using matched feature-set comparisons. We analyzed data from 2437 adults at Chonnam National University Hospital, South Korea (August 2021-January 2023) who wore wrist actigraphy devices continuously for 7 days. Depressive symptoms were assessed using PHQ-9, with a score ≥ 10 indicating higher symptom burden. We extracted temporal behavioral features including morning steps (06:00-12:00), non-daylight steps, and vigorous physical activity minutes, stratified by weekday/weekend. Meteorological data (temperature, precipitation) were integrated with behavioral metrics. Multivariable logistic regression identified significant predictors with odds ratios (ORs). Five LLMs (GPT-4o, o3-mini, Claude 3.5-sonnet, Gemini 2.0-flash, Llama 3.3) were evaluated under zero-shot conditions. The GPT-based model was selected for supervised fine-tuning using two strategies: label-based (binary outcome only) and OR-based (embedding statistical reasoning into prompts). The system was deployed as a chatbot interface. Among 2437 participants (mean age 60.2 years, 67.5% female), 317 (13.0%) were classified as having elevated depressive symptoms (PHQ-9 ≥ 10). Prespecified incremental-value analyses using matched feature sets (clinical-only, wearable-only, and combined) demonstrated that wearable-derived behavioral features provided additive predictive value beyond demographic and clinical variables. In the OR-based fine-tuned LLM framework, balanced accuracy increased from 0.635 (clinical-only) to 0.735 (wearable-only) to 0.787 (combined) on weekdays, and from 0.589 to 0.647 to 0.680 on weekends. In the nomogram framework, adding wearable features to the clinical model significantly improved risk reclassification (continuous NRI: 0.469, p < 0.001 on weekdays; 0.372, p = 0.002 on weekends) and integrated discrimination improvement (IDI: 0.037, p < 0.001 on weekdays; 0.018, p = 0.002 on weekends). The combined OR-based fine-tuned model achieved 90.3% accuracy and 94.5% specificity on weekdays and 88.8% accuracy and 96.4% specificity on weekends, outperforming both nomogram and label-based fine-tuned models. This hybrid framework demonstrates that odds ratio-anchored fine-tuning can improve classification performance while preserving predictor traceability for PHQ-9-defined elevated depressive symptoms. Wearable-derived behavioral features provided statistically significant incremental predictive value beyond demographic and clinical variables, with larger gains observed on weekdays than on weekends. Prospective external validation across diverse populations is required before clinical implementation.
32. Sources, seasonal trends and urban exposure to airborne particulate matter-bound pollutants.
期刊: Scientific reports 发表日期: 2026-Apr-18 链接: PubMed
摘要
Size-fractionated airborne particulate matter was collected over 1 year (2023-2024) at five urban pedestrian and cycling locations in Slovenia. PM10, PM2.5, PM0.1 were collected using a low-volume sampler with polytetrafluoroethylene filters, and PM<0.1 fraction was retained in ultrapure-water. Metal(loid)s and polycyclic aromatic hydrocarbons (PAHs) were determined to assess the potential health and environmental risks. Metal(loid) concentrations were the highest in PM10, with most elevated levels of Zn (7 ng m-3), Ba (4.5 ng m-3), Cu (2.8 ng m-3) and Cr (1.5 ng m-3). Significant enrichment in PM<0.1 was observed for Ba, Cu, Ni, Pb and Zn, with Ce-normalised values indicating a strong anthropogenic contribution. Tailpipe tracers were dominant in (ultra)fine PM fractions, while non-exhaust emission markers (Ba, Cu, Zn) strongly correlated with Ce and La in PM10. Among PAHs, BbF (0.05 ng m-3), BghiP and IP (0.04 ng m-3) exhibited the highest concentrations. BaP, BghiP and IP were enriched in ultra-fine particles, indicating fresh vehicular combustion emissions. Peak pollutant concentrations occurred during the heating period (HP) and in densely populated, high-traffic cities. Source apportionment revealed a dominance of pyrogenic sources, including: (i) vehicular exhaust emissions from diesel engines (5-6-ring PAHs, Ni, V and Pb), (ii) resuspended mineral dust and non-exhaust traffic particles (Ba, Cu, Zn), and (iii) coal and biomass combustion during HP (4-ring PAHs, Co, Mo, Tl). Incremental lifetime cancer risk for As (2 × 10-7), Co (1 × 10-6) and Cr (6 × 10-6) was minimal. Hazard quotient values were below 1. Children cycling during HP experienced the highest exposure levels. The European PM10 limit values for As (6 ng m-3), Cd (5 ng m-3), Pb (500 ng m-3), Ni (20 ng m-3) and BaP (1 ng m-3) were not exceeded.
33. Association of physical activity and rest-activity rhythm with sustained attention and melatonin among community-dwelling older adults.
期刊: European review of aging and physical activity : official journal of the European Group for Research into Elderly and Physical Activity 发表日期: 2026-Apr-18 链接: PubMed
摘要
34. A systematic review of sample size determination in Bayesian randomized clinical trials: full Bayesian methods are rarely used.
期刊: BMC medical research methodology 发表日期: 2026-Apr-18 链接: PubMed
摘要
35. Missing voices: Why ethnic minority representation in patient organisations is a priority in rheumatology.
期刊: Rheumatology (Oxford, England) 发表日期: 2026-Apr-17 链接: PubMed
摘要
36. Early-life liquefied petroleum gas cooking intervention and lung function in Guatemalan children: A randomized clinical trial.
期刊: Annals of the American Thoracic Society 发表日期: 2026-Apr-17 链接: PubMed
摘要
Household air pollution is a risk factor for obstructive lung diseases. We estimated the effect of an early-life liquefied petroleum gas cooking intervention on childhood lung function. The multi-country Household Air Pollution Intervention Network trial randomized 800 pregnant women (9-19 weeks gestation, 18-34 years) in Guatemala to receive a gas cookstove and free fuel intervention or continue cooking with biomass until the child is aged 1 year. The present analysis includes only Guatemalan children. At age 3 years, we measured lung function using oscillometry at 7-41 Hertz (Tremoflo C-100, Thorasys). Outcomes were resistance and reactance at 7 Hertz, area of reactance, resistance at 19 Hertz, resistance difference between 7 and 19 Hertz, and, as exploration, resistance across frequencies. Upper airway artifacts were removed using Tremoflo software. The effect of the intervention was estimated using linear regression models, unadjusted and adjusted (height, weight, age, sex). Children with respiratory infections during a 7-day recall period were excluded. Valid oscillometry was obtained from 525/750 (70%) 3-year-olds. Among the 225 missed oscillometry tests, 129/750 (17%) were due to the children not being willing to perform the measurements. We did not find evidence of an effect on prespecified oscillometry outcomes. Exploratory analysis suggested that resistance across the frequency spectrum was lower in intervention than control participants (adjusted difference: -0.31 cmH2O*S/L, 95% CI: -0.59, -0.03). Gas cooking compared to biomass cooking from mid-gestation through infancy was not associated with improved prespecified oscillometry outcomes in 3-year-old children. However, lowered resistance across all frequencies in the intervention arm suggests the intervention may have positively impacted airway caliber. Further studies are warranted, including exposure-response analysis and lung function trajectories.
37. Enhancing uptake of respiratory vaccinations in asthma and chronic obstructive pulmonary disease (COPD) patients: a systematic review.
期刊: Vaccine 发表日期: 2026-Apr-17 链接: PubMed
摘要
Despite influenza, pneumococcal and COVID vaccines being widely recommended for patients with chronic respiratory disease, vaccination rates in this cohort remain low. The aim of this systematic review is to identify interventions which are effective in increasing respiratory vaccination rates in adults with chronic obstructive pulmonary disease (COPD) or asthma. The inclusion and exclusion criteria for the study can be found in the PROSPERO protocol (PROSPERO registration no: CRD42025588565). A search was run across four databases (MEDLINE, Embase, CENTRAL and ClinicalTrials.gov) in February 2025, which returned 2537 studies. Eleven studies were deemed to meet the study inclusion/exclusion criteria and these were narratively synthesised: four randomised clinical trials (RCTs), six longitudinal studies and one observational cohort study. Risk of bias was assessed using the Cochrane’s Risk of Bias (RoB-V2) and ROBIN-I-V2 tools. Studies were categorised according to the COM-B model of behaviour change. All 11 studies consisted of COPD populations, with four studies also including asthma patients. Interventions focused on patient education, with/without involvement of a healthcare professional (HCP). Nine of the eleven studies showed a statistically significant improvement in influenza and/or pneumococcal vaccination rate with an intervention. No studies assessing COVID vaccine uptake in this population were suitable for inclusion. Most studies targeted patients’ capability to get vaccinated through improving patients’ and HCPs’ knowledge. Fewer studies focused on social opportunity (e.g. support from other patients/HCPs) or automatic motivation (e.g. reminders). The published literature in this area is currently limited. Most studies are non-randomised and are at high-risk of bias, making meta-analysis not possible. Further research should assess the practicalities (physical opportunity) of vaccination, especially in low-income economies (where most respiratory patients reside) and standardising research methods to allow for future meta-analysis. There is no funding for this review.
38. Health Risk-Driven Prioritization of Organic Contaminants in Aquaculture Products From Eastern China: Integrating Exposure and Toxicity Data to Inform Regulatory Frameworks.
期刊: Integrated environmental assessment and management 发表日期: 2026-Apr-17 链接: PubMed
摘要
Eastern China is a densely populated region with clustered industrial and agricultural complexes that discharge organic pollutants. These contaminants accumulate in the environment and aquaculture products. Since the residents in Eastern China have a dietary preference for specific foods (e.g., aquaculture products), region-specific priority chemicals based on health issues, as well as region-specific regulations for aquaculture production, should be updated. Firstly, the prevalence of neurological disorders, particularly autism spectrum disorder (ASD), was identified in Eastern China through a systematic data mining. Then, a hybrid AHP-Entropy-TOPSIS model was applied to rank the chemicals (n = 14), which might be positively associated with neurodevelopmental disorders, such as polycyclic aromatic hydrocarbons (PAHs), bisphenol A (BPA), organophosphate pesticides (OPPs), pyrethroids (PYRs), etc. Five parameters, which are odds ratios of pollutant-neurological disorder associations, urine or blood concentrations, intake via aquaculture products, publication quantities, and half-lives of the chemicals, were incorporated. The TOPSIS scores of PAHs, OPPs, BPA, PAEs, and PYRs were higher, suggesting a considerable health risk from consuming the aquaculture products in Eastern China. Finally, dietary contribution analysis confirmed aquaculture products as a significant source for PYRs (27.2%) and PAEs (11%), followed by PAHs (6.5%), OPPs (2.5%), and BPA (0.28%) in humans. It is necessary to monitor and regulate the use and incidental input of PYRs and PAEs during the culture period, coupled with public dietary advice to minimize the health risks. Regarding PAHs and OPPs, other exposure pathways could not be ignored. For BPA, predominant exposure pathways should be identified and regulated in the future. In summary, this study provided a scientific basis to screen for risk pollutants in aquaculture products in Eastern China, as well as delivering risk management advice for aquaculture production.
39. Prioritizing context-specific genetic risk mechanisms in 11 solid cancers.
期刊: Journal of the National Cancer Institute 发表日期: 2026-Apr-17 链接: PubMed
摘要
While genome-wide association studies (GWAS) have identified hundreds of cancer-associated genetic variants, the specific biological contexts where these variants exert their effects remain largely unknown. We aimed to prioritize context-specific genetic risk mechanisms for 11 solid cancers at both genome-wide and single-variant resolutions. We integrated cancer GWAS summary statistics from European ancestry samples (avg. n cases = 47,856) with 1,473 context-specific annotations representing candidate cis-regulatory elements. For genome-wide analysis, we applied CT-FM, a method that jointly models heritability enrichments across annotations to select likely disease-relevant biological contexts. Following functionally informed fine-mapping to identify high-confidence (PIP ≥ 0.5) causal SNPs, we used CT-FM-SNP to identify relevant contexts for individual variants. A combined SNP-to-gene framework was applied to construct putative {regulatory SNP-context-gene-cancer} quadruplets. Stratified LD score regression analysis identified 141 annotations showing significant heritability enrichment (FDR q ≤ 0.05). CT-FM prioritized four high-confidence (PIP ≥ 0.5) biological contexts mammary luminal epithelial cells for overall and estrogen receptor (ER)-positive breast cancer, a prostate cancer epithelial cell line (VCaP) for prostate cancer, and bulk tumor tissue contexts for colorectal and renal cancers. Variant-level analysis of hundreds of putatively causal SNPs aligned with these findings and identified additional high-confidence contexts for ER-negative breast, endometrial, lung, and bladder cancers. A total of 489 putative regulatory quadruplets were constructed, proposing specific molecular hypotheses underlying the observed GWAS signals. These findings advance our understanding of genetic susceptibility to different cancers. Future work in larger, more diverse GWAS, coupled with more comprehensive annotation atlases, is essential to expand upon and validate our results.
40. Distribution and risk assessment of organophosphorus pesticides in two suburban watersheds in Eastern China.
期刊: Environmental toxicology and chemistry 发表日期: 2026-Apr-17 链接: PubMed
摘要
The overuse of organophosphorus pesticides (OPPs) has adverse effects on the environment and human health in China. To fully understand the distribution of multiple OPPs in suburban watersheds and their potential ecological impacts, this study selected two watersheds in East China. A total of 41 OPPs were observed by the Hi-volume Solid Phase Extraction (SPE) technique. In general, the mean OPP concentrations in the two watersheds were higher in wet season (26.51 ng/L) than dry season (17.52 ng/L). Famphur, bromfenvinphos and chlorfenvinphos were the most common pollutants with their detection rates all above 83% in the study area. Among the 14 highly detected OPPs, famphur and parathion were the dominated compounds in dry season and wet season, respectively. The highest total concentrations of OPPs were observed around the farmlands and planting lands, which indicated that the distribution of OPPs were closely related to the use of pesticides. Parathion, parathion-methyl, fenthion and famphur were commonly detected in China, which were markedly different from those in other countries. According to the corresponding analysis, there was a strong correlation between formothion and dimethoate in dry season. Parathion and mevinphos had a strong relationship in wet season. The total risk quotient values of the parathion and fenitrothion were all above 1, which indicated that they might cause high ecological risks in the two watersheds. The average daily dose in wet season was nearly twice that of dry season both in the two watersheds, and methyl parathion, chlorfenvinphos and bromfenvinphos were the main contributors. The total HIs in the two watersheds (3.90 × 10-3 and 4.90 × 10-3) were both under an acceptable health risk.
41. Epigenetic Regulation in Hypertension: Mechanistic Insights and Environmental Influences.
期刊: American journal of hypertension 发表日期: 2026-Apr-17 链接: PubMed
摘要
Hypertension is a leading global cause of cardiovascular, renal, and cerebrovascular morbidity. Beyond classical genetic and environmental determinants, accumulating evidence highlights epigenetic regulation as a key contributor to blood pressure control and vascular pathology. Epigenetic mechanisms including DNA methylation, histone post-translational modifications, and non-coding RNAs govern gene expression without altering the underlying DNA sequence, thereby linking environmental and physiological stimuli to stable transcriptional changes. Aberrant epigenetic signatures have been identified in vascular, renal, and endocrine tissues integral to blood pressure regulation, influencing pathways that mediate vascular tone, sodium handling, oxidative stress, and inflammation. Among these, differential methylation and histone modification of renin angiotensin aldosterone system (RAAS) genes, including AGT, REN, ACE, and AT1R, have been shown to promote sustained activation of vasoconstrictive and sodium-retentive signaling cascades. Chronic exposure to a high-salt diet (HSD) represents a potent environmental modifier of this epigenetic landscape. Excess dietary sodium can alter CpG methylation patterns, histone acetylation states, and microRNA profiles across multiple tissues, leading to enhanced RAAS activity and vascular dysfunction. These HSD-induced alterations often persist despite subsequent sodium normalization, reflecting an enduring “epigenetic memory” of dietary stress that contributes to salt-sensitive hypertension. Understanding how HSD and other environmental factors reprogram RAAS-related gene networks through epigenetic mechanisms provides critical insight into the molecular basis of hypertension. Moreover, these findings open new avenues for therapeutic intervention utilizing DNA methyltransferase and histone deacetylase inhibitors, as well as RNA-based precision therapies aimed at reversing the maladaptive epigenetic imprint underlying chronic blood pressure elevation.
42. Exploring chronotype, sleep patterns, and health in petrochemical shift workers.
期刊: Atencion primaria 发表日期: 2026-Apr-17 链接: PubMed
摘要
Chronotype is a personal characteristic affecting an individual’s adaptability to shift work. The present study aimed to investigate the relationship between chronotype, shift work-related health disorders and sleep quality in shift workers in the petrochemical industry in southern Iran. This was a cross-sectional study. SITE: The study was conducted in a petrochemical complex located in southern Iran. 250 male shift workers with at least five years of shift work experience, no major physical or mental health issues, and no use of alcohol, drugs, or sleep medications. No interventions were applied, as this was an observational cross-sectional study. Data were collected using the Shift Work Impact on Health and Social Disorders (SOS) Questionnaire, the Pittsburgh Sleep Quality Index (PSQI), the Morningness-Eveningness Questionnaire (MEQ), and the Cognitive Failure Questionnaire. The prevalence of musculoskeletal, gastrointestinal, and cardiovascular disorders was significantly higher in morning types than evening types (p<0.05). Cognitive failures and sleep quality also differed significantly between the two groups (p<0.05). Evening-type individuals showed higher adaptability to shift work and lower vulnerability to negative consequences. Circadian typology should be considered when assigning workers to shifts, especially for sensitive jobs.
43. Risk of incident hematopoietic cancers in Danish male agricultural workers, 1968-2016.
期刊: Cancer epidemiology 发表日期: 2026-Apr-17 链接: PubMed
摘要
Modern agricultural workers may be exposed to a variety of agents that have the potential to cause hematopoietic cancers, including pesticides and viruses. Exposure levels may vary among different groups of agricultural workers and over time. However, epidemiologic studies examining different agricultural workers are lacking. The Danish Cancer Registry was used to identify men with selected hematopoietic cancers. A total of 9021 cases were included, and for each case, 50 cancer-free male controls were matched by year of birth. Both cases and controls were required to be born in Denmark and have an employment history, which was obtained from the Supplementary Pension Fund Register. Ever employment in “agriculture, overall” was associated with an increased risk of Hodgkin’s lymphoma (OR=1.39, 95% CI: 1.15-1.68) and myeloid leukemia (OR=1.42, 95% CI: 1.16-1.74). When focusing on ever employment in different agricultural industries, noteworthy increased risk estimates were observed for Hodgkin’s lymphoma and “agriculture, unspecified” (OR=1.90, 95% CI: 1.39-2.60) and “farming, livestock” (OR=1.51, 95% CI: 1.12-2.05); non-Hodgkin’s lymphoma and “horticulture” (OR=1.33, 95% CI: 1.01-1.74); and myeloid leukemia and “agricultural service” (OR=1.87, 95% CI: 1.17-2.98). Findings indicated an elevated risk of Hodgkin’s lymphoma and myeloid leukemia among Danish men employed in agriculture. Additionally, certain agricultural sectors were associated with a higher risk of specific hematopoietic cancers. Future studies should differentiate between agricultural sectors and include detailed exposure data to better understand the unique disease patterns among agricultural workers.
44. Prenatal exposure to 33 endocrine-disrupting chemicals and pubertal development at age 9 in Spain.
期刊: Environmental research 发表日期: 2026-Apr-16 链接: PubMed
摘要
Puberty relies on a hormone-regulated cascade of events initiated in fetal life and might be disrupted by exposure to endocrine-disrupting chemicals (EDCs), with alterations manifesting during pubertal development. However, studies addressing prenatal exposure to multiple EDCs remain scarce. This study explores the associations between prenatal exposure to 33 EDCs and early sex maturation in 386 Spanish mother-child pairs (girls: 49%; recruitment: 2003-2005). We measured seven organochlorine compounds (OCs) and four perfluoroalkyl substances (PFAS) in maternal blood, and seven phenols and 15 phthalates in maternal urine. Pubertal development was assessed at age 9 using Tanner staging for genital development (GD), breast development (BD), and pubic hair development (PH) alongside salivary sex hormones. Sex-specific analyses included single-chemical (robust Poisson/linear regression) and mixture (principal components /Bayesian kernel machine regression) analyses. In single-chemical models, higher prenatal p,p´-DDE and p,p´-DDT concentrations were associated with delayed BD and GD, respectively, while PCB-180 and parabens (ETPA, BUPA) were associated with earlier BD, and phthalates with earlier PH (girls: MEHP, MEHHP, MEOHP, MECPP; boys: MEP, MnBP). For sex hormones, β-HCH (both sexes), p,p´-DDE, PCB-180, PFOS (boys), and p,p´-DDT, OH-MPHP (girls) were positively associated with testosterone, and HCB was positively associated with estradiol (boys). Conversely, BUPA, OH-MPHP (boys), and BPA (girls) were negatively associated with testosterone. In mixture models, the first component of OCs was positively associated with male testosterone, but the results of other mixture analyses were unclear. Overall, prenatal exposure to some EDCs may impair fetal programming of puberty, yet the impact of chemical mixtures remains uncertain.
45. Short-term exposure to ambient air pollution, gut microbiota, and pro-atherosclerotic responses in healthy adults: A prospective panel study.
期刊: Environmental research 发表日期: 2026-Apr-16 链接: PubMed
摘要
Evidence shows that air pollution exposure is associated with an increased risk of cardiovascular diseases, and gut microbiota may server as biological intermediates. However, the underlying mechanisms and possible metabolic pathways remain unclear. A prospective panel study was conducted among 152 healthy young adults in Beijing, China, who were engaged in four rounds of follow-ups from September 21, 2019, to January 5, 2020. Gut microbiota, fecal metabolites, and serum biomarkers of pro-inflammatory (e.g., citrullinated histone-H3, interleukin-1β, neutrophil elastase, myeloperoxidase, and monocyte chemotactic protein-1) and pro-atherosclerotic responses (e.g., soluble intercellular adhesion molecule-1, vascular endothelial growth factor-A, lipoprotein-associated phospholipase-A2, matrix metalloproteinase-8, and P-selectin) were measured during follow-ups. Linear mixed-effects models were used to estimate the associations between air pollutants and health data. Mediation and functional analyses were performed to evaluate whether gut microbiota mediates the alterations in pro-inflammatory and pro-atherosclerotic biomarkers, and potential metabolic pathways. Interquartile range increases in ambient air pollutants, including fine particulate matter, black carbon, nitrogen dioxide, ozone, sulfur dioxide, and carbon monoxide at prior up to 24 hours were associated with 1.4% (95% CI: 0.05-2.8) to 248.0% (95% CI: 82.6-413.3) increases in biomarkers of pro-inflammatory and pro-atherosclerotic responses. Significant decreases in α-diversity (as measured by Shannon, Simpson, and Chao1) and alterations in the composition of gut microbiota were also observed in association with air pollution exposure. Specially, the abundance of several microbial species such as Anaerostipes hadrus, Laedolimicola ammoniilytica, and Ruminococcus callidus may act as potential mediators, accounting for an estimated 7.9% to 46.3% of the pro-inflammatory and pro-atherosclerotic effects of air pollution. Pathway enrichment analysis indicated that flavonoid biosynthesis, beta-Alanine metabolism, and xenobiotics metabolism by cytochrome P450 may be potentially involved in these mediating effects. This study provides observational evidence that gut microbiota may act as potential mediators in the detrimental subclinical cardiovascular effects of short-term air pollution exposure by modulating flavonoid biosynthesis, beta-Alanine metabolism, and xenobiotics metabolism.
46. Ferrocene-MOF derived nanoporous carbon for magnetic solid-phase extraction of p‑phenylenediamine antioxidants and quinone-derivatives in various environmental water samples.
期刊: Journal of hazardous materials 发表日期: 2026-Apr-14 链接: PubMed
摘要
p-Phenylenediamine antioxidants (PPDs) and their quinone derivatives (PPD-Qs), as emerging contaminants, have raised tremendous concerns regarding their hazardous risks and widespread occurrence in water bodies. Herein, we propose the first preparation of ferrocene-based MOF derived porous carbon (Fc-Fe@MPC) via high-temperature pyrolysis of Fc-Fe-MOF precursor for efficient magnetic solid-phase extraction (MSPE) of trace-level PPDs and PPD-Qs from various environmental waters before LC-MS/MS. This prepared composite maintained the highly distinctive ordered morphology from MOF precursor, while possessing extraordinary superparamagnetism thanks to the generation of FeC nanoparticles embedded in well-graphitized structure. Fc-Fe@MPC afforded the adsorption capacities of 34.78-67.92 mg/g toward PPDs and PPD-Qs, and the possible mechanism was elucidated by X-ray photoelectron spectroscopy and density functional theory. MSPE 100 mL of sample solution with 6 mg Fc-Fe@MPC in 3 min gave the enhancement factors of 841-1080. The established MSPE method using Fc-Fe@MPC prior to LC-MS/MS offered negligible matrix effects of 0.85-1.13, low detection limits of 0.005-0.045 ng/L, and satisfactory recoveries of 84.1%-108% in sea water, lake water and urban runoff. Besides, the regenerated Fc-Fe@MPC was stable enough for 20 extraction cycles without significant reduction of the recovery. This work was successfully applied for a rapid and sensitive monitoring of PPDs and PPD-Qs in various environmental water samples.
47. Assessing gallium arsenide health risk: critical insights for protecting workers and the environment.
期刊: Environment international 发表日期: 2026-Apr-12 链接: PubMed
摘要
Gallium arsenide (GaAs), a critical material in the rapidly expanding semiconductor industry, potentially poses a growing occupational and environmental health concern. Current occupational exposure limits (OELs) for GaAs are largely based on inorganic arsenic regulations, which fail to account for the unique toxicological profile and potential synergistic effects of its components. This study provides a rigorous human health risk assessment to inform decision-makers on the re-evaluation of existing regulatory standards. Benchmark dose modeling two-year inhalation study data from the United States National Toxicology Program identified chronic-active lung inflammation in male rats as the critical endpoint. We calculated a benchmark concentration lower 95% limit (BMCL5) of 8.0 × 10-4 mg GaAs/m3. Applying the Regional Deposited Dose Ratio model and an additional uncertainty factor of 30 for species extrapolation yielded a reference concentration of 1.71 × 10-5 mg GaAs/m3 and a recommended exposure limit of 1.26 × 10-4 mg GaAs/m3. A risk assessment using personal sampling data for exposed engineers, operators, and administrative staff found the minimum mean hazard quotient to be 61, dramatically exceeding the acceptable level of 1. These results demonstrate a substantial health risk under current occupational conditions, emphasizing the inadequacy of the existing OEL of 0.01 mg GaAs/m3. This study highlights an urgent need to revise occupational and environmental GaAs exposure guidelines to protect both workers and residents in this critical and rapidly growing industry.
48. Physical function in lung transplant recipients: Clinical implications and rehabilitation strategies.
期刊: Transplantation reviews (Orlando, Fla.) 发表日期: 2026-Apr-11 链接: PubMed
摘要
Lung transplantation (LTx) is an established procedure that provides benefits in health-related quality of life (HRQL) and survival for individuals with advanced lung disease. However, recovery of physical function after LTx can be variable. This narrative review summarizes key elements of physical function, including skeletal limb and respiratory muscle function, frailty, exercise capacity, and physical activity, and provides an overview of how these parameters are associated with clinical outcomes, and their response to rehabilitation. In the early post-LTx period (< 6 months), a number of physical function parameters recover but levels remain lower than age-sex matched healthy adults. While limb muscle strength, mobility, respiratory muscle function, and frailty demonstrate early recovery, persistent limitations remain in the first year post-LTx. Exercise capacity typically improves in the first 6 months, while physical activity levels remain lower than healthy adults. These post-LTx impairments are clinically important, as low muscle mass, frailty, and physical inactivity are associated with worse HRQL, greater hospital readmission rates, and increased mortality. Rehabilitation interventions can improve strength, exercise capacity, and HRQL, though participation for some LTx recipients remains limited due to individual and system level barriers. Emerging home-based and hybrid approaches with in-person rehabilitation show promise in improving access and engagement. Future research should identify optimal rehabilitation strategies focusing on supporting an active lifestyle post-LTx.
49. Perinatal outcomes and care patterns after centralisation of acute obstetric care in three Dutch regions: a retrospective cohort study.
期刊: European journal of obstetrics, gynecology, and reproductive biology 发表日期: 2026-Apr-07 链接: PubMed
摘要
To evaluate the impact of centralisation of acute obstetric care (AOC) on perinatal outcomes, care patterns, and obstetric interventions in three Dutch regions, while accounting for temporal trends. This retrospective cohort study used data from the Perined registry covering three regions that had closure of 24/7 obstetric units in 2018. Data were analysed for 1.5 years before and 1 year after centralisation. Perinatal outcomes included neonatal mortality, Apgar scores, prematurity, and postpartum haemorrhage. Care patterns and obstetric interventions comprised level of care, place of birth, mode of birth and induction of labour. Multivariable logistic regression analyses were performed, adjusting for ethnicity and time trends. We evaluated potential effect modification by time trends. The effects of centralisation varied across regions. Region 1 showed an increased odds of an Apgar score <7 at 5 min (aOR 2.11, 95% CI 1.02-4.36) after centralisation. In Region 2 lower rates of neonatal mortality were observed based on unadjusted analyses restricted by a small sample size. After centralisation several care patterns changed: Region 1 had higher rates of midwife-led care, Region 2 showed increases in obstetrician-led care and unplanned caesarean sections, while Region 3 demonstrated higher rates of obstetrician-led care at labour onset alongside fewer birth centre deliveries. Centralisation of AOC did not have consistent effects on perinatal outcomes, care patterns and obstetric interventions across Dutch regions. The heterogeneous findings suggest that local context and organisational responses substantially influence centralisation outcomes.
50. Impact of SARS-CoV-2 vaccination on CD4+ and CD8+ T lymphocyte profiles in an HIV-positive and HIV-negative female cohort.
期刊: Laboratory medicine 发表日期: 2026-Apr-03 链接: PubMed
摘要
The COVID-19 pandemic led to rapid global vaccine deployment, especially among high-risk groups, such as individuals living with HIV. Data are limited, however, on the immunologic effects of SARS-CoV-2 vaccination-specifically, on CD4+ and CD8+ T lymphocyte levels-in HIV-positive women in South Africa, a population with high HIV prevalence. This prospective cross-sectional study included 40 women (aged 14-42 years) admitted to a South African tertiary-care hospital, stratified by HIV and SARS-CoV-2 vaccination status. Flow cytometry (BD Multitest [BD Biosciences]) was used to determine absolute CD4+ and CD8+ T-cell counts. Data were analyzed with GraphPad Prism, version 8, software (GraphPad Software). The Mann-Whitney U test was used for comparisons between 2 independent groups. For comparisons across more than 2 groups, either a 1-way analysis of variance or the Kruskal-Wallis test was applied, with statistically significant results followed by the Dunn multiple comparisons test. Spearman correlation was used to assess relationships between variables. In all cases, statistical significance was defined as P < .05. Of the 40 participants, 27 (68%) were HIV positive and 20 (50%) were vaccinated. CD4+ T-cell counts were statistically significantly higher in HIV-negative women than in HIV-positive women (P = .01), while CD8+ levels did not differ significantly (P = .41). Vaccination status had no statistically significant impact on CD4+ or CD8+ counts. The CD4/CD8 ratio was statistically significantly higher in HIV-positive women (P = .01), especially among the unvaccinated subgroup (P = .002). SARS-CoV-2 vaccination did not substantially alter CD4+ or CD8+ T lymphocyte levels, regardless of HIV status.
51. Suspicious bands in serum and urine protein immunofixation electrophoresis tests in patients with and without a history of monoclonal gammopathies: a retrospective database study.
期刊: Laboratory medicine 发表日期: 2026-Apr-03 链接: PubMed
摘要
Electrophoresis tests are reported as negative, positive, or-rarely-as suspicious for monoclonal band (SfMB). This study aimed to determine the fate of patients with SfMB findings in long-term follow-up. Patients with SfMB results obtained in 2019 were retrospectively identified. These patients were examined for the presence of any control electrophoresis test until their most recent hospital visit in 2025. In 2019, electrophoresis tests were reported for a total of 1289 patients. In total, 115 patients with no prior electrophoresis test results were reported as positive (newly diagnosed patients) and 30 patients with no prior electrophoresis test results were reported as SfMB. Among the 30 SfMB cases, control electrophoresis tests had yielded a positive result in 2 patients and a negative result in 12 patients. In the remaining 16 patients, 7 were without control electrophoresis test results but had long clinical follow-up, whereas 9 were without a control electrophoresis test result and clinical follow-up. In 357 patients with a previously diagnosed monoclonal gammopathy, 18 were reported as SfMG. None of the patients initially reported as having an SfMB developed monoclonal gammopathy during their follow-up period. We recommend that cases reported as “suspicious” be managed separately in patients with and without a prior monoclonal gammopathy diagnosis, where the term “weak positive” may be more appropriate in patients with a known monoclonal gammopathy.
52. S1PR3 expression independently predicts the cumulative incidence of relapse in adult B-cell acute lymphoblastic leukemia: a single-center retrospective analysis.
期刊: American journal of clinical pathology 发表日期: 2026-Apr-03 链接: PubMed
摘要
This study aims to investigate the predictive value of S1PR3 for the 3-year cumulative incidence of relapse (CIR) in adult patients with B-cell acute lymphoblastic leukemia (B-ALL). This retrospective study enrolled 285 adult patients with B-ALL and 13 healthy controls from January 2019 through January 2022. S1PR3 expression was analyzed in leukemia cell lines and peripheral blood mononuclear cells (MCs) using reverse transcription-quantitative polymerase chain reaction (RT-qPCR) and Western blot. S1PR3 expression in bone marrow MCs was also measured by RT-qPCR. Predictive value was assessed using receiver operating characteristic curve analysis. Spearman correlation analysis was performed for correlation studies. Kaplan-Meier curves were employed for survival analysis. Cox regression was conducted for risk factor analysis. S1PR3 was upregulated in leukemia cell lines and B-ALL patient MCs compared with controls (P < .001). Relapsed patients demonstrated elevated S1PR3 levels compared with nonrelapsed patients (P < .001). S1PR3 expression predicted B-ALL relapse with an area under the curve of 0.887. Patients with high S1PR3 had a significantly higher relapse rate than those with low S1PR3 (P < .001). S1PR3 expression was closely associated with clinicopathologic characteristics. High S1PR3 expression was associated with a leftward shift in Kaplan-Meier curves and significantly increased CIR in patients (P < .001). High S1PR3 expression was an independent risk factor for relapse within 3 years in patients with B-ALL (P < .05). Elevated S1PR3 expression is an independent predictor of relapse in adult B-ALL, providing a novel biomarker to enhance risk stratification and guide potential targeted interventions.
53. The Impact of Nutritional Status on Lung Function Trajectories in Pediatric Patients With Primary Ciliary Dyskinesia.
期刊: Pediatric pulmonology 发表日期: 2026-Apr 链接: PubMed
摘要
Primary ciliary dyskinesia (PCD) is a phenotypically diverse disease; the impact of nutritional status on clinical trajectories in patients with PCD is not well defined. The aim of this study is to examine the impact of malnutrition on lung function in a pediatric cohort of patients with PCD. This was a retrospective cohort study of pediatric patients with a confirmed diagnosis of PCD at the Hospital for Sick Children in Toronto, Canada between 2000 and 2022. Undernutrition was defined as a BMI- or weight-for-age z-score < -1. Mixed effects linear regression models were used to assess the effect of undernutrition on FEV1 z-score (zFEV1) over time. Ninety-six patients with a median age at diagnosis of 7 years (IQR 3, 12) were included. Mean (SD) BMI-for-age z-score at first encounter was 0.15 (1.51), and weight-for-age z-score 0.00 (1.42). On a per visit basis, a BMIz or WFAz of < -1 was associated with a 0.21 lower zFEV1 (95% CI -0.35, -0.08; p = 0.002). Patients who had at least one encounter with undernutrition had a zFEV1 1.30 lower overall than patients who were consistently well-nourished (95% CI: -1.72, -0.88; p < 0.001). There was no significant difference in the rate of FEV1 decline or time to next exacerbation between the two groups. In pediatric patients with PCD, undernutrition was associated with a significantly lower FEV1, both at individual encounters and when compared to consistently well-nourished individuals. There was no significant difference in the rate of FEV1 decline in patients who were undernourished.
54. Therapeutic Remodeling of the Gut Microbiome as a Strategy to Restore Immune Tolerance in Autoimmunity.
期刊: MicrobiologyOpen 发表日期: 2026-Apr 链接: PubMed
摘要
Autoimmune diseases happen when the immune system, which is supposed to defend the body from infections and other harmful things, starts to attack the body’s own cells by mistake. In the last few years, they seem to be getting more public, and the reasons are quite complicated. It is usually not just one factor, but a mix of genes and environmental influences, such as diet, infections, or even stress. The gut microbiome, the vast community of bacteria and other tiny organisms living in our intestines, plays an important role in shaping how the immune system behaves. When this gut microbiota becomes unstable (a state called dysbiosis), it can be associated with the onset or worsening of various autoimmune diseases. In this review, we discuss the close relationship between the gut microbiome and autoimmune disorders and focus on how the microbiome can affect immune activation, immune tolerance, and inflammation at the molecular level. The general idea is that, if we understand these interactions better, we might be able in the future to design new ways to manage autoimmune diseases earlier and maybe in a more personalized way. In the end, the review suggests that if we understand better how the microbiome is involved in autoimmune diseases, it might be possible in the future to design more personalized therapies that change gut bacteria in a smart way and hopefully improve patient outcomes.
55. Associations of Neprilysin and Its Coding Gene Variation With Hypertension in Chinese Adults.
期刊: Journal of clinical hypertension (Greenwich, Conn.) 发表日期: 2026-Apr 链接: PubMed
摘要
Neprilysin (NEP) degrades several vasoactive peptides and may contribute to blood pressure maintenance. This study aims to examine the associations between serum NEP levels and variants at its coding gene and hypertension in a general Chinese population. Leveraging the baseline blood specimens of the Gusu cohort, serum NEP was assayed, and 14 single-nucleotide polymorphisms (SNPs) in the MME gene were genotyped (10 passed the Hardy-Weinberg equilibrium test) by MassArray for 2286 participants (mean age 52 years, 61.4% females). The associations of serum NEP and SNPs with hypertension were examined by logistic regression. Major conventional risk factors, including lifestyle and metabolic factors, were adjusted for. We found that participants with a higher level of serum NEP were more likely to have prevalent hypertension (OR = 1.07, 95%CI: 1.02-1.13, p = 0.006 for log2-transformed NEP). The SNP rs9864287 was associated with hypertension susceptibility (P < 0.05), but this association was not significant after correction for multiple comparisons. These results suggested that there was a weak association between serum NEP and hypertension in Chinese adults, independent of conventional risk factors. The role of NEP in hypertension remains to be elucidated.
56. Differential expression of Pparγ target genes in testis of rats under theinfluence of paternal trans fatty acid and vitamin-E.
期刊: Cell journal 发表日期: 2026-Feb-28 链接: PubMed
摘要
A paternal high-fat diet (HFD) has been shown to affect the expression of peroxisome proliferator-activated receptors (Ppars), particularly in offspring’s testicle regions. One of its isoforms, Pparγ, participates in spermatogenesis as a transcription factor regulating fatty acid metabolism genes. This study aimed to investigate how paternal dietary intake of trans fatty acids and/or vitamin E influences the expression of Pparγ target genes in the testes of their offspring, with the goal of elucidating potential mechanisms related to altered lipid metabolism and reproductive health. In this experimental study, adult male Wistar rats (F0) were fed for 60 days with one of the following four diets: control diets (C), control diets with trans fatty acids (CTH), diets containing vitamin E (E) and diets containing vitamin E and trans fatty acids (ETH). Then the male offspring (F1) were raised on standard chow, and their testicular tissue was later analyzed to assess the impact of paternal diet on gene expression, and the expression of the Pparγ target genes: Elovl2, Muc1, Fads2, Scd1, Glut2 and Lpl were measured quantitatively. The data revealed that paternal HFD can suppress the expression of Pparγ target genes in the testes of offspring. Fads2, Elovl2 were significantly upregulated in response to paternal vitamin E supplementation. The changes in Lpl gene expression were not statistically significant. Also, co-expression analysis and functional enrichment approach indicated that the genes involved in cellular response to fatty acid, fatty acid metabolic process, lipid storage, and fatty acid biosynthetic process were overexpressed in up/down regulated Pparγ target genes. Our findings demonstrate the metabolic impact of paternal diet on offspring’s, with focus on mechanisms related to altered lipid metabolism and reproductive health.
57. Clinical features and disease severity across immune status in pediatric patients with COVID-19.
期刊: Annals of Saudi medicine 发表日期: 2026 链接: PubMed
摘要
COVID-19 pandemic has caused a major global health disruption. Pediatric presentations vary widely, particularly among children with differing immune status. To compare the clinical presentation, disease course, and outcomes of immunocompetent versus immunocompromised pediatric patients with COVID-19 in a tertiary referral hospital in Jeddah, Saudi Arabia. Retrospective chart review. A tertiary center treating immunocompromised children including those with HIV, solid and hematologic malignancies, and solid organ or hematopoietic stem cell transplantation. Records of 123 pediatric patients (<15 years) with confirmed COVID-19 from March 2020 to March 2021 were reviewed. Demographic, clinical, laboratory, radiologic, and treatment variables were extracted and compared between immunocompetent and immunocompromised patients. Chi-square testing was used with significance set at P<.05. Immunocompromised status was defined as the presence of an underlying medical condition or treatment associated with clinically significant immune suppression. Differences in symptoms, severity, clinical progression, and outcomes between immunocompetent and immunocompromised children. 123 children. Most patients were immunocompetent (93, 75.6%). Immunocompromised children primarily included post-transplant or oncology patients on chemotherapy. Fever was the most common presenting symptom (69, 56.1%), significantly more common in immunocompetent children (P=.029). Immunocompromised children were more frequently admitted, mainly for non-COVID-related concerns (e.g., abnormal chest radiograph, febrile neutropenia, or hydration). Nearly all patients recovered without complications, and no significant difference in recovery rate was observed between groups (P=.568). COVID-19 severity and recovery appeared similar between immunocompetent and immunocompromised pediatric patients in this cohort. However, the higher hospitalization rate observed among immunocompromised children likely reflects precautionary admission practices rather than increased disease severity. Findings should be interpreted cautiously given the small immunocompromised subgroup and heterogeneity of underlying conditions. Interpretation of these findings is limited by the retrospective design and relatively small sample size. Larger multicenter studies are required to confirm these observations.
58. Morbidity and mortality of pediatric drowning in Qatar: an epidemiological analysis of submersion encounters at a level I pediatric trauma center.
期刊: Annals of Saudi medicine 发表日期: 2026 链接: PubMed
摘要
Pediatric drowning is a preventable cause of mortality and morbidity worldwide, yet detailed outcome data from the Gulf region remain scarce. To describe the epidemiology, clinical characteristics, neurological outcomes, and predictors of poor prognosis in pediatric drowning cases in Qatar. Retrospective observational study. Sidra Medicine, the only level I pediatric trauma and tertiary care center in Qatar. Records of all pediatric drowning cases (0-18 years old) over a 6.5-year period from May 2018 to November 2024 were reviewed. Data included demographics, incident details, prehospital interventions, clinical presentation, laboratory findings, and outcomes using the Pediatric Cerebral Performance Category Scale (PCPCS). Predictors of mortality were analyzed. Neurological status at discharge (PCPCS), mortality, and associations between clinical variables and outcome. 225 pediatric drowning cases. Median age was 3.0 years (IQR 2.0-6.0), and 65.3% were male. Incidents occurred in freshwater (76.4% [n=172]), predominantly residential pools (67.6% [n=152]). Mortality was 12.0% (n=27). Good neurological outcomes at discharge (PCPCS=1) occurred in 81.3% (n=183) of children, while 2.7% (n=6) survived with neurological disability (PCPCS 3-5). Prolonged submersion duration and lower initial arterial pH were independently associated with mortality. CPR duration and lactate were associated with mortality in univariate analysis but lost statistical significance after adjustment. Pediatric drowning in Qatar predominantly involves preschool-aged boys in residential pools. Mortality is strongly associated with prolonged submersion and severe acidosis at presentation. Prevention strategies should prioritize pool safety regulation, supervision, and early rescue to reduce hypoxic injury. Retrospective single-center design with incomplete prehospital details and no long-term follow-up.
59. Molecular characterization of Carbapenem-resistant Gram-negative bacilli associated with nosocomial infections in Hail, Saudi Arabia.
期刊: Annals of Saudi medicine 发表日期: 2026 链接: PubMed
摘要
Carbapenem-resistant Enterobacteriaceae (CRE) are listed as critical priority antibiotic-resistant pathogens by the World Health Organization. This study investigated the prevalence and the molecular mechanisms underlying carbapenem resistance among four clinically relevant Gram-negative bacterial species associated with nosocomial infections. Single-centre cross-sectional study. A tertiary hospital in Hail, Saudi Arabia. A total of 207 nosocomial gram-negative bacilli isolates were collected from December 2022 to July 2023. The isolates’ identification and antimicrobial susceptibility testing (AST) were done using BD Phoenix M50. Isolates that showed resistance to one or more Carbapenemes agents in the antibiotic susceptibility test (AST) profile were further tested by a molecular method using Polymerase Chain Reaction (PCR) (Xpert Carba-R assay) for the detection of five most common Carbapenemases [K. pneumoniae carbapenemase (KPC), imipenemase (IMP), Verona integron-encoded metallo-β-lactamase (VIM), the New Delhi metallo-β-lactamase (NDM) and oxacillinase (OXA-14)]. Identification of carbapenemase producers among Gram-negative bacteria associated with nosocomial infections. 207 Gram-negative bacilli isolates. Of 207 GNB isolates, 162 were carbapenem-resistant, with Klebsiella pneumoniae being the most prevalent isolates (n=59), followed by Acinetobacter baumannii (n=55), P. aeruginosa (n=34), and Proteus mirabilis (n=14). At least one carbapenemase gene was detected in 65 isolates, where K. pneumoniae has the highest rate with (n=43) followed by A. baumannii (n=9), P. aeruginosa (n=8), and P. mirabilis (n=5). The most predominant carbapenemase gene was blaOXA-48 with 70.8% (n=46), followed by blaNDM with 15.4% (n=10) and 13.8% (n=9) co-harboring blaOXA-48 and blaNDM. Carbapenemase-producing Gram-negative bacilli were prevalent among hospitalized patients in Hail, with blaOXA-48 and blaNDM detected primarily in K. pneumoniae. Whole genome sequencing (WGS) is recommended to identify dominant nosocomial clones in the region. The lack of sufficient funding has impeded the expansion of this study to perform WGS on all isolates.
60. Complications of silicone airway stents in malignant and benign central airway stenosis: timing of complications and survival outcomes.
期刊: Annals of Saudi medicine 发表日期: 2026 链接: PubMed
摘要
Silicone airway stents restore airway patency in central airway stenosis but may be complicated by migration, mucostasis, granulation tissue, and tumor overgrowth. To compare complication profiles, timing of complications, and survival outcomes after silicone airway stent placement in malignant versus benign central airway stenosis. Retrospective comparative cohort study. Single center, tertiary referral interventional bronchoscopy unit in Ankara, Türkiye. Consecutive adults who underwent silicone airway stent placement by rigid bronchoscopy between September 2012 and July 2017 were reviewed and analyzed. Complication distribution by etiology, time to first complication, complication-free survival, and stent survival. 80 patients (59 malignant, 21 benign). Complications occurred in 48% of benign and 30% of malignant cases, with significant differences in complication profiles between groups (P=.003). Migration was the most frequent complication in benign stenosis, whereas stent-edge granulation predominated in malignant stenosis. In benign stenosis, median time to migration, mucostasis, and granulation was 17 days (interquartile range, 6-50), 135.5 days (63-140.5), and 206 days (103.8-354.5), respectively. In malignant stenosis, the corresponding times were 25.5 (21.3-29.8), 22 (21.3-22.0), and 89 days (57.5-181.5), while stent-margin tumor overgrowth was 105 days (78.5-174.5). Median complication-free survival was 500 days (95% CI, 353-857), with no significant difference between benign (701 days) and malignant (410 days) groups (P=.5138). Median stent survival was 578 days (95% CI, 351-956), also comparable between groups (351 vs 578 days; P=.9688). Silicone airway stenting is associated with distinct complication patterns and timing in benign and malignant central airway stenosis. These findings support structured post-stent bronchoscopic surveillance. Retrospective single-center design, small benign subgroup, symptom-driven follow-up, and potential confounding and immortal-time bias in survival analyses.
61. Epidemiological patterns of acute respiratory illnesses in a tertiary center in Riyadh, Saudi Arabia.
期刊: Annals of Saudi medicine 发表日期: 2026 链接: PubMed
摘要
Acute respiratory illnesses (ARIs) are a major public health concern and are ranked by the World Health Organization among the leading causes of death worldwide. To determine the positivity proportion, clinical presentation, and risk factors associated with major respiratory viruses, including Influenza A, Influenza B, respiratory syncytial virus (RSV), and SARS-CoV-2. Retrospective study conducted between October 2022 and March 2023. Single center tertiary hospital in Riyadh, Saudi Arabia. Nasopharyngeal swabs (NPS) were collected from patients with ARI and tested for Influenza A/B, RSV, and SARS-CoV-2 using a multiplex polymerase chain reaction (PCR) panel, a molecular technique used to amplify DNA for detection and analysis. Patients were categorized into three groups based on the type of viral infection, and comparisons between groups were performed using chi-square or Fisher’s exact tests for categorical variables to assess associations among viral infections. Epidemiological and clinical characteristics of patients with positive PCR results. 4526 patients with ARI underwent NPS for viral PCR screening. Among study population, 537 (11.9%) patients tested positive for at least one of the targeted respiratory viruses. RSV was the predominant pathogen among pediatric patients (n=195, 62.2%), particularly in infants younger than six months. In adults, SARS-CoV-2 was most common (n=98, 44.1%), followed by Influenza A and B. RSV infection was significantly associated with lower respiratory tract involvement (P<.0001), whereas SARS-CoV-2 and Influenza were more frequently linked to upper respiratory tract symptoms. The overall recovery rate was 98.8% (n=531), with a mortality rate of 1.2% (n=6). RSV, Influenza, and SARS-CoV-2 remain significant causes of ARIs in Riyadh, Saudi Arabia, showing distinct age and seasonal patterns. The results underscore the importance of targeted vaccination and strengthened surveillance to protect high-risk groups. The study was limited by its single-center design and short six-month duration.
62. Epidemiology of pediatric invasive group A streptococcus infection in a Saudi tertiary care center.
期刊: Annals of Saudi medicine 发表日期: 2026 链接: PubMed
摘要
Invasive group A Streptococcus (iGAS) infections in children can cause severe illness and lead to high rates of complications and death. While recent global reports show a rise in pediatric iGAS after the COVID-19 pandemic, there is limited data from Saudi Arabia. Assess the clinical features, outcomes, and patterns of pediatric iGAS at a major tertiary center in Riyadh. Retrospective case series study. King Faisal Specialist Hospital and Research Centre (KFSHRC), Riyadh, Saudi Arabia. Pediatric patients aged 14 years or younger who had symptoms of iGAS confirmed by a positive culture from January 2018 to May 2025. Clinical features, outcomes, and patterns of pediatric iGAS. 32 children. Out of the 585 total infections recorded, 32 cases were classified as iGAS and included in the study. Most infections happened in winter and spring, with (433/585) 74% occurring from November to April. The highest rates of iGAS were seen during the COVID-19 pandemic years. The average age of patients was 4.1 years, and 94% (n=30) had other health problems, mainly congenital heart disease (n=9, 28%) and hematology/oncology (n=8, 25%). Bacteremia was the most common presentation (n=17, 53%), followed by cellulitis/necrotizing fasciitis (n=9, 28%) and pneumonia (n=8, 25%). Eleven children (34%) needed intensive care, and the overall death rate was 9% (3/32), with all deaths in patients who had bacteremia. In our center, pediatric iGAS infections carry a substantial comorbidity and disease severity burden, frequently presenting with complex and aggressive clinical manifestations. These findings underscore the urgent need for heightened vigilance in high-risk children, improved diagnostic precision, and strengthened local surveillance systems to enhance prevention and optimize management of these serious infections. Single-center, retrospective design and absence of rapid diagnostic testing.