公共卫生研究摘要 (2026-04-21)
共收录 57 篇研究文章
1. Optimizing healthcare through alignment and nurturing across cultures (OHANA).
期刊: MethodsX 发表日期: 2026-Jun 链接: PubMed
摘要
The increasing cultural diversity of healthcare systems requires strategies that support effective communication and equitable care for patients from diverse cultural and linguistic backgrounds. Cultural concordance refers to situations in which patients and healthcare professionals share relevant cultural or linguistic characteristics that may facilitate communication and mutual understanding. In some healthcare organizations, this concept has been operationalized through organizational strategies aimed at aligning patients with healthcare professionals who share similar cultural or linguistic backgrounds. However, limited research has explored how these initiatives are experienced in clinical practice. The OHANA (Optimizing Healthcare through Alignment and Nurturing Across cultures) protocol was developed to investigate experiences of culturally concordant care within healthcare organizations that have implemented cultural concordance systems. This multicenter qualitative study, coordinated by the Fondazione Policlinico Universitario A. Gemelli IRCCS in Rome in collaboration with several Italian hospitals, will explore the perspectives of both healthcare professionals and patients. Data will be collected through semi-structured interviews and analyzed using inductive qualitative content analysis to identify themes related to communication, perceived benefits, and challenges associated with culturally concordant care. The findings are expected to inform strategies to support culturally responsive healthcare. Key points:▪Multicenter qualitative study protocol exploring experiences of culturally concordant care in hospital settings.▪Investigation of perspectives from both healthcare professionals and patients involved in cultural concordance systems.▪Use of semi-structured interviews and inductive qualitative content analysis to examine how culturally concordant care is experienced in clinical practice.
2. The role of community pharmacies in the provision of human papillomavirus (HPV) self-testing: A range of delivery models and proof-of-concept study.
期刊: Exploratory research in clinical and social pharmacy 发表日期: 2026-Jun 链接: PubMed
摘要
Cervical cancer persists in Aotearoa New Zealand, mainly due to under-screening. Longstanding disparities in screening and cancer rates remain for Māori, Pacific and people not regularly screened. Community pharmacies are an important and accessible part of primary care. To outline and provide potential models of pharmacy involvement in the provision of HPV self-testing. Of the three potential models proposed, our proof-of-concept study trialled two models: 1) promotion of human papillomavirus (HPV) self-testing by pharmacy staff, with mailed test kits from the centralised co-ordination team, and 2) on-site provision of at-home self-test kits by study nurses, both with telehealth support and results follow-up from the study team to expand self-test access. Six Auckland community pharmacies with high proportions of female Māori and Pacific customers (based on dispensing data) participated in the study for 6 weeks from May to July 2024. All pharmacies participated in the promotion model and one participated in the on-site provision model. Although our numbers were small (n = 45 participants), our sample return uptake was 69%, showing that pharmacy involvement can engage people with HPV self-testing. Self-tested participants (n = 31) included 29% who were Māori (19%) or Pacific (10%), and 32% who were overdue for screening by ≥2 years. All surveyed pharmacy staff (n = 16) supported pharmacy involvement in providing HPV self-tests. Community pharmacies, supported by a centralised co-ordination team, appropriate infrastructure and resources, may be an additional setting for further research to increase access to HPV self-testing for Māori, Pacific, under-screened people, and those not enrolled with a primary care provider.
3. The effects of supervised exercise and pain neuroscience education on muscle strength and power in patients with chronic pain after total knee arthroplasty: An exploratory analysis from the NEPNEP trial.
期刊: Osteoarthritis and cartilage open 发表日期: 2026-Jun 链接: PubMed
摘要
This study investigated the effects of neuromuscular exercises and pain neuroscience education (PNE) compared with PNE alone on muscle strength and power in patients with chronic pain after total knee arthroplasty (TKA). Secondary analysis of a randomized controlled trial. Patients with chronic pain for >1-year after TKA were randomized to supervised neuromuscular exercises with PNE or PNE alone. The neuromuscular exercise group underwent 24 sessions over 12-weeks. The PNE was delivered in two 1-h group sessions, identical in the two groups. Outcomes included maximum voluntary isometric contractions for knee extensors and flexors, peak leg extension power and the Knee injury and Osteoarthritis Outcome Score (KOOS). Outcomes were measured at baseline, 3, 6, and 12-months. Analysis was conducted using repeated measures mixed models. Multivariable linear regression, with groups collapsed into one, was conducted to evaluate associations. Sixty-nine participants were enrolled, 36 in the exercise and PNE group and 33 in the PNE alone group. No significant between-group differences were found in changes from baseline to 12-months for muscle strength or leg extension power. The exercise and PNE group showed significant within-group improvements in leg extension power (26.3 W, p = 0.019) and knee flexor strength (19.7 N, p = 0.001), which was not observed in the PNE alone group. No significant associations were found between changes in muscle strength or power and changes in KOOS. Neuromuscular exercises and PNE do not seem to provide superior improvements in muscle strength or power compared to PNE alone in patients with chronic pain after TKA. The trial was pre-registered at ClinicalTrials.gov (NCT03886259).
4. Early Mobilization Outcomes With Tenecteplase Treatment in Acute Ischemic Stroke (EMOTE-TNK) Study: Safety and Tolerability.
期刊: Mayo Clinic proceedings. Innovations, quality & outcomes 发表日期: 2026-Jun 链接: PubMed
摘要
To evaluate the safety and tolerability of early mobilization among patients with acute ischemic stroke (AIS) receiving intravenous (IV) tenecteplase (TNK). We hypothesized that physical therapy and occupational therapy would be relatively safe and tolerable when mobilization was attempted shortly after thrombolysis. In this single-center, single-arm retrospective cohort study, we included adults with AIS treated with IV TNK who underwent first physical therapy or occupational therapy screening and mobilization 13 hours or more but less than 24 hours after thrombolysis. The primary outcome was mobilization-associated adverse events (AEs; screening through the immediate recovery period). Tolerability was defined by whether patients could continue mobilization after screening. We used health record data to determine stroke severity (National Institutes of Health Stroke Scale score, modified Rankin scale score), vital signs, AE type, and symptomatic intracranial hemorrhage occurring after thrombolysis but before mobilization. Of 180 patients, 159 (88.3%) underwent early mobilization without any AE. Twenty-one patients (11.6%) had an AE (orthostasis, dizziness, pain, heart rate >120/min, or systolic blood pressure >180 mm Hg); all were mild, transient, and not life threatening. Adverse events were significantly associated with baseline mean arterial pressure (P<.01). Moreover, AE type (pain vs autonomic; P=.01) and initial National Institutes of Health Stroke Scale score (P=.04) were associated with successful mobilization. Three patients had symptomatic intracranial hemorrhage. Early mobilization (<24 hours after IV TNK) was relatively safe and well tolerated. Our findings suggest that screening-based early mobilization strategies can be integrated into standardized protocols for select patients with AIS receiving TNK.
5. Enhanced Home-Based Wart Treatment Protocol: Optimizing Debridement and Occlusion Therapy for Improved Outcomes.
期刊: Advances in skin & wound care 发表日期: 2026-May-01 链接: PubMed
摘要
Verruca vulgaris remains a prevalent dermatologic condition, affecting ∼10% of the population, with a higher incidence in children and immunocompromised individuals. Although professional interventions such as cryotherapy, excision, and laser therapy demonstrate success rates of 60% to 90%, financial limitations and restricted health care access underscore the need for structured, home-based alternatives. The proposed research presents an evidence-based treatment protocol that integrates systematic mechanical debridement with occlusion therapy to enhance wart clearance. The methodology emphasizes precise debridement using fine-grade sandpaper or single-edge razors after hydration, followed by occlusion with duct or electrical tape and adjunctive salicylic acid application. Debridement to the level of pinpoint bleeding improves therapeutic penetration and immune activation, while maintaining safety through strict endpoint recognition and single-use tool precautions. A stepwise algorithm and representative case example illustrate the protocol’s feasibility, with observable wart softening, size reduction, and skin line restoration within 6 to 12 weeks. Safety monitoring, hygiene practices, and patient education are emphasized to prevent complications such as infection or nerve injury. This structured approach offers clinicians and patients a reproducible, low-cost, and accessible alternative to conventional in-office procedures, bridging evidence-based dermatologic care with home-based treatment practicality. JOURNAL/aswca/04.03/00129334-202605000-00004/figure1/v/2026-04-14T095130Z/r/image-jpegGENERAL PURPOSE: To demonstrate knowledge of an evidence- and home-based debridement and occlusion treatment protocol to enhance clearance of common warts (verruca vulgaris).TARGET AUDIENCE: This continuing education activity is intended for physicians, physician assistants, nurse practitioners, and registered nurses with an interest in skin and wound care.LEARNING OBJECTIVES/OUTCOMES: After participating in this educational activity, the participant will:Identify patients who are appropriate candidates for a home-based wart treatment protocol.Apply evidence-supported methods for implementing a home-based wart treatment protocol.Apply management strategies to address complications or treatment failure associated with a home-based debridement and occlusion protocol for common warts.
6. The Role of the cGAS-STING Signaling Pathway in Oral Mucosal Diseases: Mechanisms and Therapeutic Implications.
期刊: FASEB journal : official publication of the Federation of American Societies for Experimental Biology 发表日期: 2026-Apr-30 链接: PubMed
摘要
The oral mucosa maintains a delicate immunological equilibrium amidst constant microbial and environmental challenges. Within this unique microenvironment, the cytosolic DNA-sensing cGAS-STING signaling pathway has emerged as a central innate immune hub characterized by critical duality across a spectrum of pathologies. While transient STING activation is vital for protective anti-microbial defenses and driving anti-tumor immunity in oral squamous cell carcinoma, chronic, maladaptive signaling-often driven by self-DNA accumulation-fuels pathology in autoimmune and inflammatory conditions. Consequently, emerging therapeutic strategies targeting this pathway involve dichotomous applications, utilizing STING agonists for malignancies versus inhibitors for inflammatory disorders. Safely harnessing the significant therapeutic potential of the cGAS-STING pathway for managing recalcitrant oral diseases urgently requires precise, localized modulation strategies.
7. A Potential Novel Molecular Interaction in Bronchiolitis Obliterans Syndrome in Lung Transplantation Patients: The Role of SERPINA3 and Osteoprotegerin.
期刊: FASEB journal : official publication of the Federation of American Societies for Experimental Biology 发表日期: 2026-Apr-30 链接: PubMed
摘要
Chronic lung allograft dysfunction significantly limits survival after lung transplantation. The obstructive phenotype bronchiolitis obliterans syndrome (BOS) is characterized by the abnormal activation of airways epithelium, fibrotic changes with excessive extracellular matrix deposition, and airway obliteration. Mast cells, through mediators such as tryptase and chymase, play a role in lung fibrosis. The proteins osteoprotegerin (OPG) and SERPIN family member A 3 (SERPINA3) have been associated with lung fibrosis progression. Tryptase-mast cells can produce OPG, while chymase interacts with SERPINA3. This study aimed to investigate if and how SERPINA3, OPG, and tryptase/chymase-positive mast cells are related to fibrotic airway obliteration and potentially show an association with BOS severity. Serum SERPINA3 levels in BOS and non-BOS were examined using ELISA. In BOS lung tissue, non-cartilaginous airways were classified into normal, partially obstructed, and completely obstructed airways. Immunohistochemistry detected SERPINA3, OPG, chymase, and tryptase. Colocalization of and interactions between SERPINA3, OPG, and tryptase were assessed by immunofluorescence, proximity ligation assay, and AlphaFold modeling. SERPINA3 serum levels in BOS patients were higher compared to non-BOS patients. A low percentage of SERPINA3 and OPG was detected in partially and completely obstructed airways. Cells positive for OPG and SERPINA3 colocalized with tryptase-mast cells in airways. OPG colocalized with SERPINA3, and they positively correlated in partially obstructed airways. In completely obstructed airways, OPG, SERPINA3, and tryptase all positively correlated with each other. These findings suggest mast cells express SERPINA3 and OPG, and these proteins potentially form a complex in lung tissue, possibly contributing to airway remodeling in BOS.
8. Ensuring the future of Atlantic bluefin tuna.
期刊: Proceedings of the National Academy of Sciences of the United States of America 发表日期: 2026-Apr-28 链接: PubMed
摘要
Atlantic bluefin tuna (ABT) are a highly migratory fish that have been exploited by fishers for more than two millennia. This lucrative fishery is managed by the International Commission for Conservation of Atlantic Tunas (ICCAT), formed by 55 contracting parties. Implementation by ICCAT of an ABT recovery plan and decades of conservation efforts have led to significant progress and the species is rebounding throughout its range. Here, we combine and report on three decades of ABT electronic tag data from five nations that provide fisheries-independent biological information and spatially explicit track data vital to understanding the species’ life history. Tag data, state-space modeling, and spawning ground assignments enable estimations of fisheries area utilization, population overlap, and natural mortality that improve the accuracy of management models. We also examine the distribution of ABT fisheries impact over 70 years by assessing ICCAT catch reporting by fleet, gear type, and region. We hypothesize that, under the historical two-stock management paradigm, escapement of eastern juveniles and subadults from the Mediterranean Sea to the lower fishing mortality of the North Atlantic has contributed to the recovery of the eastern stock, with the 45°W meridian acting as an indirect conservation measure for migrating ABT in the West Atlantic. Although recent Management Strategy Evaluation modeling in ICCAT partly incorporates this migration behavior into catch composition estimates and recognizes the contribution provided by eastern migrants to western Atlantic biomass, these complex trans-Atlantic migratory behaviors need to be accounted for in future stock assessments and management. Tag data and development of genomic technology for dockside catch origin assignments can support improvements of stock assessments that will ensure the sustainability of ABT.
9. Journal of Health Communication: 2025 Year in Review.
期刊: Journal of health communication 发表日期: 2026-Apr-20 链接: PubMed
摘要
This annual review provides an overview of the Journal of Health Communication in 2025. The journal published scholarship that engages the social, political, and economic conditions shaping health communication, with contributions addressing changing information environments, institutional trust, social media, health and medical conditions, and health promotion. The volume also marked the journal’s thirtieth year and included articles on the milestone and included one supplement. This review summarizes the journal’s editorial leadership and editorial board, and acknowledgment of peer review contributions, and highlights selected articles and readership trends. By providing this overview, this article offers insight into the journal’s operations and recognizes the collective efforts of authors, reviewers, and editors who contribute to advancing global health communication scholarship in the journal.
10. Obesity subtypes and longitudinal trajectories of function over 7-years of follow-up: data from the Multicenter Osteoarthritis Study.
期刊: Arthritis care & research 发表日期: 2026-Apr-20 链接: PubMed
摘要
Obesity, defined by BMI ≥30kg/m2, is a risk factor for functional limitations in people with knee osteoarthritis (OA). However, function varies among such individuals. Our objective was to evaluate the implications of obesity subtypes on longitudinal patterns of physical functioning in people with or at risk for knee OA. We included participants from the Multicenter Osteoarthritis (MOST) Study with a BMI ≥30 kg/m2 and DXA-measured body composition. Three obesity subtypes were defined: 1) obesity with low muscle mass (OLM) and high fat mass; 2) obesity with cardiometabolic comorbidities (OCC) but without low muscle mass; and 3) uncomplicated obesity (UO), i.e., neither OLM nor OCC. We examined the relation of these 3 obesity subtypes to self-reported WOMAC physical function at baseline, and 7-years, using linear regression at both timepoints, and to their longitudinal functional trajectory patterns using multinomial logistic regression. Of the baseline sample (N=1211 individuals, 63% female, mean age 61.2±7.6 years, BMI 35.0±4.5 kg/m2), 49.1% were UO, 34.4% OLM, and 16.5% OCC. Compared to UO, the OLM and OCC groups had worse physical function at baseline. Five distinct trajectories of functioning were identified over 7-years, with 23%, 38.5%, 26%, 4.5%, and 8% of the sample in groups 1-5, respectively. Compared to UO, OLM and OCC groups had higher odds of being in the persistent poorest functioning trajectory [OR 1.9, 2.6, respectively]. Individuals with obesity and concurrent low muscle or cardiometabolic comorbidities have persistent worse functioning over a 7-year period compared to those with obesity alone. Distinguishing obesity subtypes may enable personalized interventions to delay or avoid extended mobility disability.
11. Intravenous 3-Dimensional Digital Subtraction Angiography: A Noninvasive, High-Quality Alternative to Cerebral Catheter Angiography.
期刊: Operative neurosurgery (Hagerstown, Md.) 发表日期: 2026-Apr-20 链接: PubMed
摘要
Arterial angiography remains the gold standard for the assessment of cerebrovascular anatomy and pathology. However, when arterial access is higher risk (patients with extreme tortuosity, type 4 Ehlers Danlos Syndrome, or the young pediatric population), and for long-term follow-up or intraoperative scenarios, intravenous 3-dimensional digital subtraction angiography (IV 3D-DSA) is an acceptable substitute. We assessed our experience in consecutive IV 3D-DSA procedures. Five hundred twenty-eight adult and 21 pediatric IV 3D-DSAs were performed at our institution on 2 state-of-the-art systems from January 2019 to March 2025. Imaging obtained on older angiography systems are not included. The cone-beam computed tomography (CBCT) data were reconstructed and displayed as 3D-DSA, CBCT without contrast, and CBCT angiography. Data were analyzed for indication, conversion to intra-arterial angiography, use of anesthesia, radiation dose, and complications. The primary indication in 408/528 adult and 9/21 pediatric patients was aneurysm evaluation, initial, postoperative, or follow-up. Other indications included vascular malformations, postoperative after revascularization surgeries, and other pathologies such as extracranial carotid disease and intracranial atherosclerotic disease. Seven of the 528 adult cases were significantly limited by motion artifact (1.3%), but only 3 of these were considered nondiagnostic (0.6%). Seventy-one adult and 2 pediatric acquisitions were performed intraoperatively in the hybrid operating room. 20/21 pediatric cases required general anesthesia. Eighty-six adult cases were performed under anesthesia, although most of these were performed intraoperatively under the same anesthetic as the index operation. There were no significant complications reported. With the newer, higher resolution, semirobotic biplane systems, IV 3D-DSA has become a tool in the angiography suite for rapid vascular assessment. It offers increased spatial resolution when compared with multidetector computed tomography, making it well suited to evaluate vasculature and endovascular devices, is noninvasive compared with catheter angiography, and can be used for intraoperative assessment of treatment.
12. Ethnic Differences in Foreign Body Ingestion: Insights Into Social and Epidemiological Aspects.
期刊: Acta paediatrica (Oslo, Norway : 1992) 发表日期: 2026-Apr-20 链接: PubMed
摘要
Foreign body ingestion (FBI) in children is a worldwide health concern, yet little research has examined the influence of ethnicity and socioeconomic background. This study compared the epidemiology of FBI among Jewish and Bedouin children in southern Israel, two populations with distinct social and economic profiles. A retrospective review was conducted of children presenting with FBI to the emergency department at Saban Children’s Hospital between 2022 and 2023. A total of 479 children were identified, 53.9% males, with a median age of 6.1 years; 66% were Bedouin. The overall prevalence of FBI was 0.15 per 100 children, with higher rates among Bedouins than Jews (0.19 vs. 0.10 per 100, p < 0.005). Uniquely, Bedouin females presented more often than males. Blunt objects accounted for most ingestions (48.5%), followed by sharp objects (26.7%). Bedouin children ingested sharp objects more frequently than Jews (33.5% vs. 13.5%), while magnet ingestion was more common among Jews (16.6% vs. 3.5%). Hospitalisation was also higher in Bedouins (52.2% vs. 35.6%). Bedouin children experienced higher rates of FBI and hospitalisation, likely reflecting socioeconomic disadvantage. Cultural practices, such as hijab pin use, may explain the predominance among Bedouin girls. Targeted education could reduce this burden.
13. Coronavirus infectious bronchitis virus spike protein inhibits FUNDC1-mediated mitophagy to prevent nucleocapsid protein degradation.
期刊: Journal of virology 发表日期: 2026-Apr-20 链接: PubMed
摘要
Autophagy is involved in various stages of the viral life cycle and modulates viral replication. Coronaviruses have developed several strategies to exploit autophagy for their benefit. Nevertheless, the exact mechanisms through which the infectious bronchitis virus (IBV) influences autophagy remain inadequately understood. Here, we demonstrate that IBV infection of chicken embryonic kidney (CEK) cells activates the AKT-mTOR signaling pathway to suppress autophagosome formation and mitophagy. Further investigation reveals that the viral spike protein (S) inhibits cellular autophagy by interacting with the mitophagy receptor FUNDC1. However, FUNDC1-mediated mitophagy promotes degradation of the viral nucleocapsid (N) protein and restricts IBV replication. To counteract this host defense mechanism, the S protein competitively binds to the LC3-interacting region (LIR) motif of FUNDC1, thereby disrupting its interaction with LC3 and ultimately suppressing mitophagy. Molecular docking analysis revealed that a conserved asparagine residue at position 240 (N240) in the S1 subunit of the IBV S protein is essential for binding to FUNDC1. Furthermore, reverse genetics demonstrated that an IBV mutant with an N240A substitution exhibited reduced pathogenicity in the kidneys, trachea, and lungs of specific-pathogen-free (SPF) chickens compared to the wild-type virus. Collectively, these findings unveil a novel mechanism by which IBV antagonizes host mitophagy and provide new insights into the host-virus interplay within the context of autophagic regulation.IMPORTANCEIBV has evolved a mechanism to counteract the host’s antiviral defense. Specifically, the viral spike (S) protein blocks a form of autophagy called mitophagy by binding to the mitochondrial receptor FUNDC1. Normally, FUNDC1 helps cells eliminate damaged mitochondria and restricts IBV replication by promoting the degradation of the viral nucleocapsid protein. By interfering with this process, the S protein enhances viral survival. We further identified a single conserved amino acid in the S protein that is critical for this function, and mutation of this residue weakened IBV in chickens. These findings reveal how IBV manipulates host defenses and suggest new strategies for controlling coronavirus infections.
14. Pan-genomic insights into resistance, virulence, and stress adaptation in Clostridium perfringens from the Tibetan Plateau.
期刊: mSphere 发表日期: 2026-Apr-20 链接: PubMed
摘要
Clostridium perfringens is a ubiquitous foodborne and zoonotic pathogen responsible for necrotizing enteritis, food poisoning, and gas gangrene in humans and livestock, with mortality reaching 100% in specific subtypes. The Qinghai-Tibetan Plateau, with its high altitude, hypoxia, large temperature fluctuations, and strong UV radiation, imposes a strong selective regime that drives distinctive, plateau-specific microbial evolution. We isolated and sequenced eight C. perfringens isolates from yaks and Tibetan pigs and analyzed them with 129 public genomes. Multilocus sequence typing (MLST) revealed extensive genetic heterogeneity, with 35 novel alleles and 18 novel sequence types (STs), all plateau isolates carrying novel alleles or STs. Toxinotyping identified six toxinotypes, dominated by A (43.0%) and F (42.3%), with virulence gene repertoires matching toxinotype assignments. Sixteen antimicrobial resistance (AMR) genes across eight drug classes were detected, with vancomycin- and defensin-like genes present in >96.0% of isolates; four were linked to mobile genetic elements (MGEs) or type IV secretion systems (T4SS). Environmental tolerance assays showed that three plateau isolates maintained growth at pH 7.5 under anaerobic conditions, while the growth of all isolates was inhibited at pH 7.0. Pan-genomic association analysis identified a 146-node, 3,390-edge network, with IS family transposases (ISCbt3/ISCpe4), sigma factors (sigL and sigA), and DNA polymerase I (polA) as central hubs potentially mediating stress adaptation. Genomic epidemiology of C. perfringens from the Tibetan Plateau reveals marked genetic diversity, broad resistance, toxinotype-defined virulence, and genetic signatures of high-altitude adaptation, underpinning evidence-based control in plateau ecosystems.IMPORTANCEClostridium perfringens is a widespread pathogen, but its adaptation to extreme environments like high-altitude plateaus remains a mystery. Our integrated genomic analysis of 137 strains, including 8 newly sequenced from the plateau, uncovers a startling reality: this region harbors a highly diverse population with near-universal resistance to critical antibiotics. We identified new sequence types (STs) and genetic “hubs” that may drive this adaptation. These findings have profound implications for One Health as they highlight an environmental niche where resistance can evolve and potentially spread, underscoring the urgent need for surveillance in unique ecosystems.
15. Exploring How Cannabis Use Featured in the Mental Health Experiences and Daily Lives of Queer, Non-Binary, and Trans Youth in the Early Phases of the COVID-19 Pandemic: A Mixed-Methods Study in Canada.
期刊: Journal of homosexuality 发表日期: 2026-Apr-20 链接: PubMed
摘要
While the COVID-19 pandemic has exacerbated mental health and substance use inequities among youth, less is known about how queer, non-binary and transgender (QNT) youth in Canada experienced changes in cannabis use and mental health during the pandemic. This mixed-methods study explored the relationship between cannabis use, mental health, and experiences with the COVID-19-related public health measures among QNT youth. Between July 2020 and June 2021, we surveyed 178 QNT youth (18-30) across Canada and interviewed 30 QNT youth from British Columbia to examine their experiences with cannabis use and mental health. Descriptive analyses showed that 63.6% of the survey participants increased cannabis use during the pandemic. This subgroup was more likely to experience negative physical and mental health challenges (feeling tired, anxious) and used cannabis for mixed purposes. Thematic analysis of interviews revealed that while participants used cannabis to cope with stress and boredom, they also carefully balanced its harms and benefits, as COVID-19 disrupted their daily lives. Our findings illustrate how QNT youth adapted their cannabis use in response to pandemic-related changes. Future research should explore how youth intentionally adapt their cannabis use to address mental health and other broader emotional needs (e.g. disconnecting from work). Queer, non-binary and trans youth used cannabis to mitigate effects of the pandemicCannabis was used as a coping tool to manage stress and boredom during the pandemicCannabis was also used for enhancing productivity and creativity in isolationYouth balanced cannabis harms and benefits as the pandemic changed their daily lives.
16. Development and Pilot Testing of a Novel Methodology to Examine the Food, Waste, and Packaging in Australian Schoolchildren's Lunchboxes.
期刊: Health promotion practice 发表日期: 2026-Apr-20 链接: PubMed
摘要
Most children in Australia bring a packed lunch from home for consumption at school, yet few studies have explored the environmental outcomes of lunchbox contents. This study presents a novel audit methodology that combines food photography with a custom-designed survey developed in REDCap, supported by a detailed coding guide, to assess lunchbox contents, including food, estimated waste, and packaging types. To pilot test the audit tool, two school sites in high socioeconomic regions in South Australia participated. Lunchbox photographs were captured at two time points on a single day (before and after consumption) by the student researcher at the preschool and by a class teacher at the primary school. Independent coding was completed by two researchers, with inter-coder reliability assessed. Among the 40 lunchboxes sampled, the average contents included one vegetable, one to two fruits, one to three grain or cereal items, one dairy product, and one to two snack items. Intraclass correlation coefficient estimates indicated excellent agreement between coders. Food photography on-site, combined with subsequent coding off-site, offers a practical and objective method for assessing food, waste, and packaging in school lunchboxes, while placing minimal burden on participants. Lunchboxes are essential to the nutrition of school-aged children and have sustainability implications. This dual-focus methodology lays the groundwork for future research with larger sample sizes, aiming to inform the development of interventions that improve both the quality of foods in lunchboxes and their environmental impact.
17. Objective Assessment of Financial Decision-Making With a Simulated Online Money Management Task in Older Adults: Protocol for a Prospective Observational Study.
期刊: JMIR research protocols 发表日期: 2026-Apr-20 链接: PubMed
摘要
Technology-enabled tasks to conduct financial transactions are ubiquitous around the world. In a recent survey, about 75% of the respondents endorsed the use of technology to perform financial activities such as reviewing bank statements and keeping track of money spent. However, assessment of financial decision-making (FDM) is limited by tasks that use traditional paper-and-pencil methods or by relying on self or informant reports. Furthermore, such tools have weak psychometric properties, are prone to biases, and are at times limited in scope. Thus, there is an urgent need to develop modern, technology-based tools that have strong psychometric properties and that can assess FDM comprehensively and accurately. This study aimed to develop and establish the psychometric properties of a novel, simulated Online Money Management (OMM) credit card task. Based on existing gaps identified in the literature, this task relied on objective measurement, assessed multiple dimensions within a single task, and mimicked a real-world task to bridge the gap between a controlled, clinical setting and real-world functioning. This was a prospective cohort study that enrolled cognitively healthy older adults. This study was funded by the National Institutes of Health. Various recruitment sites were involved, which allowed for the recruitment of older adults across the United States. The OMM task was developed in collaboration with an interdisciplinary team of computer scientists, economists, psychologists, and geriatricians. The tasks consist of both online and offline components, with subcomponents examining the ability to navigate, basic and complex credit card literacy, and statement monitoring. Data about participants’ perception of their financial abilities and a self-report survey on financial exploitation were collected. The test battery consisted of an array of cognitive, financial, and psychosocial tasks. Participants provided written informed consent, and all procedures received institutional review board approval. Data collection began in September 2019, and enrollment stopped in July 2025. A total of 272 participants completed the baseline visit, while 147 completed the longitudinal follow-up visit. Data analysis is underway as of August 2025, and results are expected to be published in 2026. Rigorous standards have been deployed for developing this novel OMM credit card task. If the measurement properties of the task are found adequate, the OMM task can be used to assess FDM in clinical evaluations for early detection and prevention or mitigation of financial mismanagement.
18. Hypernatremic Dehydration in Breastfed Neonates: Clinical Findings and Risk Factors.
期刊: Journal of human lactation : official journal of International Lactation Consultant Association 发表日期: 2026-Apr-20 链接: PubMed
摘要
Neonatal hypernatremic dehydration (NHD) is a dangerous disease that can lead to hospitalization of the infant, serious complications, and death. Despite the significant advantages of breast milk for both the mother and the baby, some neonates who are exclusively breastfed experience malnutrition in the first few days. This study aims to evaluate the clinical presentations, maternal and neonatal risk factors, and preventive strategies for hypernatremic dehydration in term and late-preterm infants who were exclusively breastfed. In this study, neonates who were hospitalised with the diagnosis of hypernatremic dehydration in the Neonatal Intensive Care Unit of Mardin Training and Research Hospital between 2019 and 2023, who were exclusively breastfed after birth, whose gestational age was 35 weeks and above, and whose serum sodium concentration was measured ≥150 mEq/L were retrospectively evaluated. Statistical analyses were performed using SPSS 25.0 software. A total of 141 newborns diagnosed with hypernatremic dehydration were included in the study. The mean age at presentation was 4 (1-20) days, and 53% of the patients were male. The mean birth weight was 3248.16±491.05 g, while the mean admission weight was 2885.67±477.61 g, indicating a significant weight loss of 11.33±7.46%. The mean maternal age was 28.95±6.22 years, and 41% of deliveries were by caesarean section. Transcranial ultrasonography was normal in 97.2% of the patients, while 2.8% had signs of haemorrhage or oedema. The most common presenting complaint was malnutrition (46.8%), followed by jaundice (41.1%). Awareness of NHD among both mothers and healthcare personnel is the most important factor. Calling babies for early postnatal check-ups, close monitoring of neonatal weight loss, and encouraging successful breastfeeding techniques may reduce hospitalization rates.
19. Observational study of nailfold capillaroscopy features in hypertension, diabetes Mellitus, stroke, and chronic kidney disease: Associations and potential for early detection in cardiovascular and metabolic disorders.
期刊: Clinical hemorheology and microcirculation 发表日期: 2026-Apr-20 链接: PubMed
摘要
ObjectivesTo assess nailfold capillary (NFC) features in hypertension, diabetes mellitus (DM), stroke, and chronic kidney disease (CKD) versus healthy controls, and explore relationships between abnormalities.MethodsObservational study of 162 participants (69 M/93F, mean age 39.7 ± 13.16y). NFC evaluated vessel clarity, tubular collateral number/length, input/output tab diameters, apex diameter/width, granular flow rate, blood color ratio, perfused capillary density (PCD) in five groups.ResultsSignificant differences found vs. controls: DM group had reduced tubular collateral length and input tab diameter; Stroke group had reduced tubular collateral length and apex width, plus altered blood color distribution; CKD group had reduced vessel clarity; The PCD was significantly reduced in the hypertension, diabetes mellitus, and stroke groups(P < 0.01). Well-point sites had fewer tubular collaterals than non-well-point sites.ConclusionsSpecific NFC parameters (capillary length, width, blood color, clarity) provide reference values for assessing these cardiovascular/metabolic disorders. Well-point NFC may aid early detection/prevention.
20. Particulate Matter and Innate Airway Immunity: Mechanisms of Disruption and Impact on Respiratory Infections.
期刊: Immunological investigations 发表日期: 2026-Apr-20 链接: PubMed
摘要
Air pollution is a major global public health challenge, with particulate matter (PM) as a leading environmental risk factor for increased morbidity and premature mortality worldwide. The respiratory tract is the primary interface for PM exposure, where airway epithelial cells and innate immune systems coordinate frontline host defense. Chronic PM-exposure disrupts this system, impairing airway immune homeostasis and increasing susceptibility to respiratory infections. This review aims to integrate current molecular and cellular evidence describing how PM affects airway innate immunity, focusing on its impact on host defense mechanisms and its role in increasing susceptibility to respiratory infections. A comprehensive literature review was conducted focusing on PM interactions with the respiratory tract and their effects on airway epithelial and innate immune functions, emphasizing mechanisms of immune dysregulation. PM-exposure induces innate immune dysregulation characterized by oxidative imbalance, altered cytokine and chemokine signaling, reduced phagocytic capacity, and decreased production of host defense peptides, resulting in impaired epithelial barrier integrity, persistent inflammation, defective pathogen clearance, and increased susceptibility and severity of respiratory infections, including tuberculosis, bacterial pneumonia, and viral respiratory diseases such as COVID-19. PM is a key driver of airway innate immune dysfunction and increased susceptibility to respiratory infections by disrupting epithelial and immune defense pathways, weakening host resistance, and exacerbating disease burden. Further studies are needed to elucidate PM-immune interactions and support the development of preventive and therapeutic strategies. Air pollution is one of the world´s biggest health threats, and tiny air particles known as particulate matter (PM) are among its most harmful components. These particles can travel deep into the lungs, where they trigger inflammation as part of the body´s natural defense system. While short-term inflammation can help fight harmful agents, long-term exposure to PM can damage lung tissue, disrupt immune defenses, and even affect other organs.PM weakens the respiratory system´s ability to fight infections by reducing protective molecules called host defense peptides and impairing phagocytosis (the process by which immune cells destroy harmful microbes). As a result, people become more susceptible to respiratory diseases such as tuberculosis, pneumonia and COVID-19.This review brings together recent scientific evidence showing how PM affects lung cells, disrupts immune balance, and increases infection risk. Understanding these mechanisms is key to developing effective health strategies, reducing exposure, and protecting vulnerable communities living in areas with poor air quality.
21. Management of latent tuberculosis infection in patients with kidney disease.
期刊: Clinical microbiology reviews 发表日期: 2026-Apr-20 链接: PubMed
摘要
SUMMARYLatent tuberculosis infection (LTBI) is common and preventable among patients with chronic kidney disease (CKD), where uremia and iatrogenic immunosuppression heighten reactivation risk. This narrative review synthesizes evidence across pre-dialysis CKD, dialysis, and kidney transplantation to propose a pragmatic care pathway. In advanced CKD, the tuberculin skin test performs poorly, whereas interferon-γ release assays (IGRAs) are preferred. Screening should be risk-targeted in pre-dialysis CKD, systematic at dialysis initiation, and mandatory pre-transplant for candidates and living donors. Following a positive test, clinicians must exclude active tuberculosis via clinical assessment and chest imaging before starting preventive therapy. Short-course rifamycin-based regimens (4 months of daily rifampin [4R], 3 months of once‑weekly isoniazid plus rifapentine [3HP], or 3 months of daily isoniazid plus rifampin [3HR]) enhance completion rates compared with 9 months of daily isoniazid (9H). In transplant recipients, rifamycin interactions with calcineurin and Mammalian target of rapamycin (mTOR) inhibitors typically favor 9H; rifamycins demand expert multidisciplinary management with intensive therapeutic drug monitoring. Programmatic data from dialysis units show high completion with tolerable toxicity, affirming routine feasibility. We integrate IGRA-based screening at critical transitions with tailored regimen selection, pyridoxine coadministration for isoniazid, and structured safety monitoring. Priorities include validating novel Mycobacterium tuberculosis antigen-based skin tests in CKD and developing implementation strategies to standardize renal care. We delineate setting-specific approaches for high- versus low-burden countries, addressing subclinical and incipient TB challenges in high-burden contexts. Adopting this framework can curb active TB progression, safeguard grafts, and enhance patient outcomes.
22. Catching our breath: development of interventions and therapies for respiratory syncytial virus.
期刊: Microbiology and molecular biology reviews : MMBR 发表日期: 2026-Apr-20 链接: PubMed
摘要
SUMMARYRespiratory syncytial virus (RSV) continues to be a significant global health concern, particularly affecting infants, young children, and older adults. Although the virus was discovered decades ago, a complete cure remains elusive. RSV is a leading cause of lower respiratory tract infections, contributing to significant illness and mortality around the world. Recent scientific advances have brought promising developments in the fight against RSV. Progress in vaccine technology has led to the approval and distribution of preventative vaccines, particularly for high-risk groups. Monoclonal antibodies, designed to target and neutralize the virus, are used both to prevent and treat infections. Antiviral treatments, though still limited, are also showing potential in reducing disease severity and duration. Advanced animal and controlled human infection models have bolstered preclinical and clinical research, allowing for the testing and refinement of therapeutic candidates in more physiologically relevant systems. These models are playing a crucial role in understanding disease mechanisms and evaluating the efficacy of new interventions. As the field rapidly evolves, it is essential to pause and assess our current standing in the fight against RSV. In many ways, we are finally catching our breath-equipped with better tools and a deeper understanding, yet still facing the challenges of a persistent and complex virus. Continued innovation, investment, and global collaboration will be essential to translate these developments into widespread therapy for those most vulnerable to RSV.
23. Persistence of azole-resistant Aspergillus fumigatus in a southeastern United States environmental hotspot: a prospective genomic study.
期刊: mSphere 发表日期: 2026-Apr-20 链接: PubMed
摘要
Aspergillus fumigatus is a globally distributed fungal pathogen that can infect humans and is commonly found in the environment. Azole antifungals are the primary treatment for A. fumigatus infections; however, the emergence of azole resistance has become an important public health issue. This resistance is often linked to the use of agricultural fungicides and is primarily caused by tandem repeats (TRs) in the cyp51A promoter, along with mutations in the coding region, leading to pan-azole resistance. Azole-resistant A. fumigatus has been identified in patients across the United States and has been found in environmental soil samples from 38 states. A previous study conducted in the southeastern United States detected azole-resistant A. fumigatus in the environment. To further investigate the persistence of these resistant strains, soil samples were collected over three time periods. Whole genome sequencing was performed on isolates from each sampling date, and results were compared to publicly available isolates using phylogenetic, principal component, and ADMIXTURE analyses. These findings demonstrated that the same strains of TR-based azole-resistant A. fumigatus persisted in the same environmental hotspot over time. Additionally, we observed high levels of recombination between different clades, which may contribute to the ongoing presence of A. fumigatus in the United States. These findings highlight the environmental persistence of azole-resistant strains and underscore the need for monitoring antifungal resistance in environmental settings to better understand its potential clinical implications.IMPORTANCEAspergillus fumigatus is a fungal pathogen that poses a substantial threat to humans, particularly in high-risk populations, with mortality rates reaching 90%. It is also a saprophyte that is commonly found in agricultural settings. Azoles are the primary antifungal treatment for A. fumigatus infections; however, azole-resistant strains have emerged, particularly in Europe and Asia, over the past two decades. Recently, such strains have also been isolated from clinical cases in the United States and identified in environmental soil samples from 38 states. In this study, azole-resistant A. fumigatus was isolated with three different variants of tandem repeat mutations in the cyp51A promoter region from southeastern U.S. soil samples collected over three time periods. These findings demonstrate that resistant strains can persist in the environment for at least 12 months, suggesting that established environmental hotspots can serve as ongoing reservoirs for resistant strains.
24. Lysine benzoylation of fatty acid β-oxidation core enzyme FoxA regulates the aflatoxin biosynthesis by benzoyltransferase EsaA in the pathogenic fungus Aspergillus flavus.
期刊: mBio 发表日期: 2026-Apr-20 链接: PubMed
摘要
Lysine benzoylation (Kbz) is a newly identified post-translational modification, which participates in the regulation of a variety of cellular processes. However, the function of Kbz in pathogenic fungi remains unclear. Here, we first identified that FoxA is a benzoylated protein with two benzoylated sites at lysines 425 and 433. Mutations of Kbz sites in FoxA significantly reduced long-chain fatty acid (LCFA) utilization activity and exhibited a phenotype similar to that of foxA gene deletion mutant, including decreased conidiation and aflatoxin production, reduced seed colonization, and increased sclerotia formation. Metabolomic analyses indicated that the deletion of FoxA or interference with its benzoylation could disrupt peroxisomal β-oxidation, resulting in the accumulation of LCFAs. This disruption may inhibit conidiation and aflatoxin production by modulating the synthesis of 15d-PGJ(2)-G. Furthermore, we found that EsaA has benzoyltransferase activity in vitro and in vivo, and its expression influences the Kbz of FoxA and LCFA utilization activity. Notably, mutants at the acetylated sites exhibited phenotypes similar to those of the benzoylated site mutants, suggesting that acetylation also plays a significant role in FoxA protein. Our study uncovers a previously unknown mechanism by which benzoylation and acetylation regulate FoxA activity to affect the development, secondary metabolism, and pathogenicity of A. flavus.IMPORTANCEAs a predominantly plant-pathogenic fungus, Aspergillus flavus not only causes severe crop diseases and economic losses but also poses a global food safety threat due to its production of aflatoxins. Furthermore, under certain conditions, it can act as an opportunistic pathogen, endangering the health of both humans and animals. Numerous studies have shown that protein post-translational modifications, such as acetylation, succinylation, and benzylation, were involved in aflatoxin production; however, the exact mechanism was still unclear. This study reveals, for the first time, the molecular mechanism by which benzoylation regulates the functional execution of multifunctional β-oxidation hydratase/dehydrogenase FoxA proteins and further influences the development and aflatoxin synthesis in Aspergillus flavus. This discovery not only provides new insights for the prevention and control of aflatoxin contamination but also provides theoretical support for the study of secondary metabolism regulation mechanisms of other fungi.
25. Evaluation of ultraviolet irradiation at 254 nm and 222 nm in inactivating human noroviruses on surfaces.
期刊: Applied and environmental microbiology 发表日期: 2026-Apr-20 链接: PubMed
摘要
Human norovirus (hNoV) presents significant public health challenges due to its low infectious dose and environmental persistence. This study compared the inactivation efficacy of ultraviolet C irradiation at 254 nm (UV 254) and far-UVC radiation at 222 nm (UV 222) against four hNoV GII strains and two surrogate viruses, Tulane virus (TV) and bacteriophage MS2. A symptom scoring assay was developed to assess hNoV infectivity following microinjection into zebrafish embryos, being used in combination with reverse transcriptase quantitative PCR (RT-qPCR), long-range RT-qPCR, and RNase-treated RT-qPCR. With a general laboratory setup of viruses being suspended in deionized water droplets in Petri dish, UV 222 irradiated at 7 and 70 mJ/cm2 was demonstrated with comparable, if not superior, performance in reducing hNoV infectivity and RNA integrity and was significantly more effective than UV 254 in damaging viral capsids. MS2 exhibited inactivation patterns similar to hNoVs, whereas TV was markedly more resistant to UV 222. The performance of UV 222 was consistent in inactivating hydrated viruses on both stainless steel and porcine skin surfaces. However, the efficacy of UV 222 was substantially more reduced when virus inocula were dried or mixed with simulated vomitus containing high levels of organic matter, compared with UV 254. No evidence of viral adaptation or persistent genomic diversification was detected by RNA sequencing and variant calling after six rounds of repeated sublethal UV exposures. Taken together, UV 222 can be regarded as a promising technology in surface disinfection for hNoV control while keeping safe for human exposure. We recommend it to be applied after surface cleaning and ideally on moist surfaces. Human norovirus (hNoV), the main cause of foodborne illness and non-bacterial gastroenteritis, can be transmitted through human-to-human contact. Indirectly, food or food-related surfaces are readily contaminated by hNoV, completing the transmission route. So far, no standard cultivation tool is available for detecting viable hNoV, resulting in the challenges of evaluating inactivation effectiveness of various disinfection technologies, including UV 222 treatments. The significance of our study lies in attempts to quantify hNoV infectivity loss of four strains using zebrafish model during UV 222 and UV 254 treatments, together with the underlying antiviral mechanisms indicated by three different types of reverse transcription qPCR methods. In addition, the concerns over the possible emergence of variants were subdued by genome-wide sequencing results after consecutive UV exposures and passaging in vivo zebrafish model.
26. Survival of NASA-cleanroom microbial isolates under simulated space and Martian conditions.
期刊: Applied and environmental microbiology 发表日期: 2026-Apr-20 链接: PubMed
摘要
Planetary protection hinges on understanding microbial survival following reduction procedures, the stressors of space travel, and exposure to extraterrestrial environmental conditions. This study identified 23 fungal strains isolated from NASA spacecraft assembly cleanrooms, capable of surviving ultraviolet radiation exposure. Using experimental simulation facilities, we conducted a comprehensive assessment of microbial survivability and morphology on the most resilient spacecraft-associated microorganisms. Aspergillus calidoustus demonstrated remarkable survival under simulated Martian conditions, withstanding up to 1,440 min of Martian solar irradiation, Mars atmospheric pressure and composition, and the presence of Martian regolith. Lethality only occurred under combined irradiation and cooling to -60°C (the mean Mars surface temperature), emphasizing the synergistic effect of these conditions. Furthermore, A. calidoustus survived long-duration neutron radiation exposure (replicating ionizing space radiation doses) and dry-heat microbial reduction technique (typically used for spacecraft components). This is the first study to perform an end-to-end evaluation of eukaryotic microbial survival across conditions that occur during preparation for, travel to, and robotic exploration of Mars. The experimental facilities and chronic exposure methods utilized offer a biologically meaningful model for understanding microbial risks during long-duration space missions. The capacity for fungal conidia to survive multiple space-relevant conditions suggests their potential as forward contaminants, capable of being transported to and persisting on Mars. As current spacecraft microbial reduction protocols prioritize bacterial spores, this research highlights a critical gap in planetary protection strategies. In addition to offering novel insights into microbial survival, these findings have broader implications for biocontamination within the food, pharmaceutical, and medical sectors.IMPORTANCEThis study reveals that conidia of the fungus Aspergillus calidoustus, which was isolated from spacecraft assembly cleanrooms, can survive simulated space-relevant stressors like ultraviolet irradiation, Martian cold atmospheric pressure, regolith exposure, ionizing radiation, and specific doses of recommended dry-heat microbial reduction method for spacecraft. Such fungal resistance demonstrates that the species can survive certain space and Mars conditions previously thought to be sterilizing, highlighting a need to revise current spacecraft decontamination standards that focus mainly on bacterial spores. This study also emphasizes the need for continued microbial monitoring of spacecraft during transit from Earth to other planets, not only to achieve goals of planetary protection but also to maintain healthy closed systems for human missions. Moreover, fungal species are highlighted as biocontamination risks for food, medical, and pharmaceutical industries, which may require the need for new standards of sterilization approaches transferable to space exploration.
27. Targeted metatranscriptomic detection of viruses from floors for simultaneous evaluation of respiratory disease burden and viral variant identification.
期刊: mSphere 发表日期: 2026-Apr-20 链接: PubMed
摘要
Built environment surveillance is a proven approach for tracking disease burden of some viruses within hospitals and long-term care facilities. However, studies in clinical settings are lacking for simultaneously surveying targets in a built environment using targeted metatranscriptomics. We swabbed six discrete floor locations within an acute care center’s emergency department (ED) in Ottawa, Canada, and sequenced cDNA using a 132 viral taxa panel, identifying viral burden across sampling locations and time. The determined SARS-CoV-2 variant profile across time was matched to provincial variant prevalence. The correlation between metatranscriptomic read abundances and reported cases of influenza A, SARS-CoV-2, and RSV was assessed. We quantified these via qPCR and assessed the correlation of Cq versus metatranscriptomic reads for these viruses. We sequenced a median of 1,302,882 reads per sample from 38 floor swabs collected during peak respiratory viral season (November 2022-February 2023). Diversity of viral communities varied significantly across locations in the ED. SARS-CoV-2 variant abundance shifts matched the changing infection landscape concurrently reported in Ontario. Relationships between targeted metatranscriptomic read ratios and clinical burden were not statistically significant, although we found modest correspondence between qPCR signal and read depth for RSV and SARS-CoV-2. This approach characterized the viral communities and the within-species diversity within an ED. Correlating sequencing-derived data with disease burden for three key respiratory viruses was inconsistent, with the exception of significant correlation between metatranscriptomic reads and Cq data for SARS-CoV-2. We were able to recover the distribution of clinically reported SARS-CoV-2 variants from the floor swab data. Environmental surveillance is useful for estimating the disease burden for certain viruses. qPCR is commonly used for surveillance of wastewater and built environments, including during the COVID-19 pandemic, but single, multiplexed reaction targets are limited. Targeted metagenomic or metatranscriptomic approaches can accurately quantify microbial populations of interest in an environment, reduce off-target sequencing, and evaluate a broader number of targets than qPCR assays. Here, we assessed the capacity of a targeted viral metatranscriptomic panel to correlate viral abundance in the hospital built environment with key pathogens of interest, including influenza A, RSV, and SARS-CoV-2. Our results suggest that targeted metatranscriptomics may identify viral communities in healthcare facilities, including strain-level detection capability. However, this approach must be validated for its effectiveness in viral surveillance that accurately reflects disease burden. This work contributes to a growing toolkit for pathogen surveillance, a critical endeavor to safeguard against outbreaks of known and emerging pathogens.
28. Gadolinium-Enhanced Bismuth Cathode for High-Performance CO2-to-Formate Conversion Across Electrochemical and Bioelectrochemical Energy Systems.
期刊: Small methods 发表日期: 2026-Apr-20 链接: PubMed
摘要
Electrocatalytic CO2 conversion to formate represents a crucial pathway for carbon cycling and renewable energy storage, yet catalysts exhibiting high activity, selectivity, and stability remain elusive. This study employs a rare-earth-regulated strategy to construct a carbon-encapsulated gadolinium-doped bismuth catalyst (Gd-Bi@C) via a one-step hydrothermal process. In a flow cell, this catalyst achieved a formate Faradaic efficiency of 95.58% at -1.1 V versus RHE and operated stably for over 170 h at current densities exceeding 400 mA cm-2. In situ characterization confirmed that gadolinium doping optimized the electronic structure of bismuth, promoting the formation of the *OCHO intermediate while suppressing hydrogen evolution. Furthermore, Gd-Bi@C demonstrates exceptional cross-system applicability: achieving a peak power density of 2.166 mW cm-2 in a Zn-CO2 battery and sustaining a current density of 12.40 ± 2.20 A m-2 in a microbial electrolysis coupled CO2 reduction system (MEC-CO2). This work bridges electrochemical and bioelectrochemical CO2 conversion systems using a single rare-earth-modified catalyst, providing an integrated material platform for multi-scenario carbon utilization and energy storage.
29. Insights into complementary exposomic targeted analysis and suspect screening approaches: a case study examining human serum for chemicals with LC-IMS-MS.
期刊: Environmental science. Advances 发表日期: 2026-Apr-17 链接: PubMed
摘要
Although PFAS exposure is widespread in the general population, concern is heightened for individuals with unique occupational exposure scenarios. Accordingly, the PROject for Military Exposures and Toxin History Evaluation in US service members (PROMETHEUS) study is evaluating whether serum chemical exposure profiles correlate with cancer incidence in large cohorts (typically hundreds of samples per analysis) among military service members who may experience distinct occupational and environmental exposures. Here we describe analytical workflow development and results from a pilot subset (n = 36) of human serum samples using an integrated targeted and suspect-screening LC-IMS-MS platform. Serum (50 µL) was extracted by acid-assisted protein precipitation with isotopically labeled internal standards, concentrated, and analyzed by LC coupled to an Agilent 6560 IM-QTOF. Targeted PFAS quantitation was performed using matrix-matched calibration curves and was benchmarked against NIST SRM 1957 to assess method accuracy. Across the samples, the targeted panel captured predominantly legacy PFAS as anticipated noting their prevalence in prior studies (e.g., PFOS, PFOA, 8 : 2 FTS, N-MeFOSAA, etc.). Ultra-short-chain PFAS presented class-specific analytical challenges; trifluoromethanesulfonic acid (TFMS) was observed, whereas trifluoroacetic acid (TFA) eluted near the void volume and exhibited pronounced clustering in the ion mobility dimension, precluding reliable quantitation. In parallel, CCS-based mobility filtering supported suspect screening against an exposomic library (∼1100 entries) to expand detectable chemical space beyond targeted PFAS. Suspect screening yielded 49 non-PFAS candidates meeting accurate mass and CCS agreement criteria, and correlation analysis recapitulated expected co-exposure groupings among legacy PFCAs/PFSAs and structurally related suspect analytes. Collectively, these results establish a scalable, CCS-informed LC-IM-MS workflow for integrated targeted PFAS quantitation and exposomic suspect screening, enabling higher-powered association testing in the full set of PROMETHEUS samples and other large-scale human biomonitoring studies.
30. Machine Learning Algorithms-based Methods for Monitoring Performance and Aging in Electric Vehicle Batteries.
期刊: Journal of visualized experiments : JoVE 发表日期: 2026-Apr-03 链接: PubMed
摘要
This protocol describes the Artificial Intelligence-Powered Lifelong Estimation Learning Framework (AI-PLELF) for adaptive battery monitoring and management in electric vehicle battery systems. The framework integrates real-time battery sensor data, including current, voltage, and temperature, with historical usage information and environmental parameters to support structured state estimation and charging strategy evaluation within a Battery Management System (BMS). The protocol outlines sequential procedures for sensor data acquisition, preprocessing, feature organization, machine learning-based prediction of State of Charge (SOC) and State of Health (SOH), and formulation of adaptive control responses. The workflow is implemented in a controlled computational environment using publicly available real-world driving cycle datasets. Data are partitioned into training, validation, and testing subsets to evaluate prediction stability and generalization under varying operating conditions. Simulation-based trials are conducted across different cycling and environmental scenarios to assess the consistency of SOC and SOH estimations and corresponding control suggestions. The described methodology provides a reproducible framework for developing and evaluating AI-assisted battery monitoring strategies. Although the present study focuses on simulation-based validation, the protocol establishes a structured foundation that may be extended to laboratory and hardware-integrated testing in future applications.
31. Mutational epidemiology: achievements and expectations on enhancing our understanding of the causes of cancer.
期刊: Journal of the National Cancer Institute. Monographs 发表日期: 2026-Apr-01 链接: PubMed
摘要
Mutational epidemiology integrates genomic techniques with large-scale population studies to uncover new causes of cancer. This approach goes beyond traditional epidemiology by analyzing the patterns of somatic mutations in cancer cells to identify specific mutational signatures that serve as a historical record of an individual’s past mutagenic exposures. The field is also expanding to study mutational landscapes in normal tissues and precancerous lesions to understand the earliest stages of carcinogenesis. Initial studies are exploring how factors like certain mutagenic bacteria and air pollution can act as mutagens or promoters, influencing the selection and expansion of preexisting mutated clones. Ultimately, the goal is to use this evidence to uncover new and potentially preventive causes of cancer, understand differences and over time changes in incidence of certain cancers and develop tailored prevention strategies and public health policies.
32. Evaluating Patient and Public Involvement and Engagement Activity Within the 3DPiPPIn Trial: A Qualitative Exploration of Contributors' Perspectives on Their Impact.
期刊: Health expectations : an international journal of public participation in health care and health policy 发表日期: 2026-Apr 链接: PubMed
摘要
Patient and Public Involvement and Engagement (PPIE) is now considered essential to the delivery of high-quality, patient-centred and translational research. However, despite widespread recognition of this, PPIE remains poorly understood, inconsistently utilised and inadequately reported. This study aimed to report, discuss and analyse the PPIE activities undertaken within 3DPiPPIn-a randomised control trial investigating the feasibility of using 3D printing to develop customised masks for patients receiving positive airway pressure (PAP) therapy. Emphasis was placed on analysing the wider impacts of these activities, including the impact on Patient Advisory Group (PAG) members. Data were collected from PAG members via 1:1 semi-structured interviews, which took place either face-to-face or online as per members’ preference. Interviews were recorded, transcribed verbatim and analysed in NVivo using Braun and Clarke’s Six-Phase Reflexive Thematic Analysis. Three PAG members were interviewed; two were conducted remotely via Microsoft Teams, while the third took place face-to-face. Analysis resulted in the identification of three themes: ‘Disparate perceptions of PPIE influence in research’, ‘Empowered and enriched through PPIE’ and ‘Navigating the evolving experience and hurdles of PPIE’. PAG members described their influence on the trial as variable, feeling their involvement was impactful in some instances and insignificant in others. Despite this, they unanimously agreed that PAG involvement had a positive personal impact and that their experiences of PPIE were diverse and dynamic. Within the subtheme ‘Supports and stumbling blocks for PPIE’, members reflected on facilitators and barriers to PPIE. For example, the relaxed environment created by the Principal Investigator was seen to have promoted open discussion, while personal challenges sometimes diverted their focus from their role as a PAG member. This Reflexive Thematic Analysis explored the impact of PPIE on the 3DPiPPIn trial from the perspective of its PAG members. It exemplifies PPIE best practice and highlights areas for improvement to other researchers, advocating for meaningful rather than tokenistic PPIE. By encouraging excellence in PPIE, this report could enhance public engagement in research and, by demonstrating the impact and importance of quality PPIE, could inspire funders to ensure the provision of adequate PPIE resources. Embedded within the 3DPiPPIn trial (ISRCTN 74082423).
33. Clinical Characteristics and Risk Factors of Immune Checkpoint Inhibitor-Related Myocarditis: A Real World Observational Study.
期刊: Clinical cardiology 发表日期: 2026-Apr 链接: PubMed
摘要
Rare occurrence, immune checkpoint inhibitors (ICI)-related myocarditis are poorly documented in the literature. We conducted a retrospective review of patients who had ICI until June 2023. Patient follow-up was extended until death or on May 2024. The primary outcome was the incidence of suspected ICI-related myocarditis. Logistic regression was used to investigate the associations between clinical characteristics and suspected ICI-related myocarditis. Among the included 8199 patients, 1638 (19.98%) patients developed suspected ICI-related myocarditis. Logistic regression revealed that thymomas and thymic carcinomas (OR 2.242; [95% CI, 1.132-4.440], p = 0.021), lung cancer (OR 1.259; [95% CI, 1.119-1.416], p < 0.001), older patients (OR 1.021; [95% CI, 1.016-1.026], p < 0.001), male (OR 1.213; [95% CI, 1.061-1.388], p = 0.005), block two or more immune checkpoints (OR = 1.391 [95% CI 1.058-1.828], p = 0.018), combined with hypertension (OR = 1.326 [95% CI 1.162-1.513], p < 0.001), or hyperlipidemia (OR = 1.656 [95% CI 1.302-2.107], p < 0.001) were associated with higher risk of suspected ICI-related myocarditis. This large, real-world cohort demonstrates that the incidence of suspected ICI-related myocarditis may be underestimated in previous literature. Routine cardiac surveillance is needed in high-risk patients receiving ICI therapy. Registered at https://www.chictr.org.cn (identifier: ChiCTR2300075974).
34. Predicting Dietary Impact on Multiple Sclerosis-Related Symptoms With the Gut Microbiome: A Pilot Study Using Unsupervised Machine Learning.
期刊: Brain and behavior 发表日期: 2026-Apr 链接: PubMed
摘要
Multiple sclerosis (MS) is a neurodegenerative disease where dietary intervention has emerged as a potential adjunct treatment. Recently, the modified Paleolithic elimination (MPE) diet, also known as the Wahls diet, and the low-saturated fat (LSF) diet, also known as the Swank diet, were linked to reduced fatigue and improved quality of life (QoL) in the WAVES study (NCT02914964). However, how diet impacts these outcomes remains unclear. As diet impacts gut microbiota, we investigated whether the baseline gut microbiota can predict response to diet in people with MS (pwMS). We performed fecal 16s rRNA sequencing to profile the microbiome changes associated with pwMS receiving the MPE (n = 11) and LSF diet (n = 12). Next, we utilized topic modeling, a machine learning technique, to determine whether baseline microbiome features predicted diet response in the combined MPE + LSF dietary cohort (n = 23). Specific genera significantly differed over time on both diets. On the MPE diet, Hungateiclostridiaceae, Ruminiclostridium, and Shuttleworthia decreased, while Coriobacteriaceae Collinsella decreased on LSF. Predictive machine-learning analysis associated a baseline microbiome enriched with Akkermansia, Bacteroides, and Barnesiella with fatigue response in the combined MPE + LSF cohort. For a non-response in Mental QoL improvement in the combined MPE + LSF cohort, our analysis associated an enrichment of Faecalibacterium and Alistipes at the start of the diet. Utilizing topic modeling, this pilot study identified baseline microbiota communities linked to improvements in fatigue and Mental QoL in pwMS on dietary intervention. These findings highlight the microbiota’s role in dietary response and the potential for personalized nutrition. Given the small cohort and exploratory design, the results are hypothesis-generating and require validation in larger mechanistic studies.
35. Hypophosphatasia with Coexisting Endocrinopathies: A Diagnostic Dilemma.
期刊: EJIFCC 发表日期: 2026-Mar 链接: PubMed
摘要
Adult-onset hypophosphatasia presents a diagnostic challenge due to confounding clinical and analytical factors. Although rare, the consequence of missed diagnosis is significant, as it can potentiate skeletal mineralization defects. Despite the recent development of diagnostic criteria, integration into routine clinical practice remains limited, partly due to the variable course of disease progression. Effective management often requires a multidisciplinary team, including rheumatologists, orthopedic surgeons, endocrinologists, medical geneticists, dentists, physical and occupational therapists, pain specialists and clinical biochemists. Here, we present a case of adult-onset autosomal dominant hypophosphatasia, where diagnosis was complicated by coexisting endocrine disorders, Addison’s disease and primary hypothyroidism. Persistently decreased alkaline phosphatase activity had been observed for over a decade and were initially attributed to hypothyroidism. However, an endocrinologist’s clinical suspicion led to genetic testing, confirming hypophosphatasia. Although the patient exhibited no additional symptoms such as premature tooth loss, osteopenia, or osteoporosis, this incidental finding prompted a referral to medical genetics, carrier screening to support family planning, and cascade testing for family members.
36. Changes in women's subjective health perceptions through online balance ball lessons: a qualitative study.
期刊: Journal of rural medicine : JRM 发表日期: 2026-Feb 链接: PubMed
摘要
Objective: The balance ball is an exercise suitable for beginners; it incorporates diverse elements such as aerobic and anaerobic exercise, stretching, and balance training, with easily adjustable intensity and difficulty. Under instructor guidance, it can be practiced safely and effectively within a short period. Furthermore, online formats allow participation from home, making them suitable for busy women to establish exercise habits. Previous research on the effects of balance ball lessons has primarily focused on improvements in physical and cognitive functions, with little attention paid to the holistic effects. This study aimed to clarify the impact of online balance ball lessons on women’s subjective health perceptions. Participants and Methods: This study involved 21 working women aged 31-67 years who participated in online lessons conducted by a balance ball instructor. Semi-structured interviews were conducted in groups of 3-6 participants, each lasting approximately 60 minutes, and utilized SNS chat functions. The collected data were analyzed using qualitative content analysis. Results: Regarding physical health, participants found that “anyone can continue” with the balance ball once they learn the “basic posture”. Continuation led to a sense of “maintaining weight and body shape” and “improved physical fitness”, contributing to health management. Psychologically, “changes in awareness of body shape” were observed. The refreshing effect provided “mental healing” and enhanced “subjective well-being”. Socially, the online lessons facilitated the building of “new connections” outside work. Conclusion: Online balance ball lessons holistically enhanced the subjective health perceptions of the participating women from physical, psychological, and social perspectives. This could be a new option for holistic health promotion in future community health support and health promotion initiatives.
37. Regional and temporal patterns of partisan polarization during the COVID-19 pandemic in the United States and Canada.
期刊: PloS one 发表日期: 2026 链接: PubMed
摘要
During the COVID-19 pandemic, public health measures emerged as highly polarizing topics in online discourse, with debates intensifying around specific policy implementations and events. This study introduces a novel computational approach to measure subnational and event-driven variation in partisan polarization and explores these dynamics across the United States and Canada. Analyzing over 50 million tweets from late 2020-a critical period of polarizing discourse during the pandemic’s early phase-we examine regional variations in discussions surrounding three key health interventions: lockdowns, masks, and vaccines. Our analysis reveals that politically conservative regions exhibited significantly higher levels of partisan polarization in both countries, with this effect particularly pronounced in the United States. We demonstrate a strong negative correlation between regional vaccination rates and the degree of polarization in vaccine-related discussions in the U.S., suggesting tangible public health implications of online partisan division. This relationship was notably weaker in Canada, pointing to important cross-national differences in how political polarization manifests and impacts health behaviors. By tracking the temporal evolution of polarization, we identify distinct spikes linked to specific political events and policy announcements. These polarization surges typically lasted only a few days, revealing the dynamic nature of online partisan discourse. The geographic heterogeneity in polarization patterns-with certain conservative states showing unexpectedly low polarization and some liberal states displaying high polarization-highlights the complex interplay between political ideology, policy implementation, and public response during health crises. While our polarization index reflects the discourse of politically engaged Twitter users, it nevertheless captures key dynamics of online debate that influence public narratives and align with observable regional outcomes. Our findings suggest that online discussions both reflect and potentially drive rapid changes in public opinion, with measurable consequences for regional public health outcomes. This computational framework for quantifying polarization provides a valuable tool for researchers and policymakers to understand, monitor, and potentially address partisan divisions during public health emergencies and beyond.
38. Beyond Bleeding: Underrecognized Thrombotic Complications in Acute Promyelocytic Leukemia - A Single-Center Experience from the GCC Region.
期刊: Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis 发表日期: 2026 链接: PubMed
摘要
BackgroundThrombosis remains a clinically important complication of acute promyelocytic leukemia (APL), coexisting with the prototypical hemorrhagic diathesis. Data from Gulf Cooperation Council (GCC) populations are limited in addition to data specifically about thrombosis, which is heterogenous in general.ObjectivesTo describe the incidence, clinical characteristics, treatment, and outcomes of thrombotic events in patients with APL treated at a tertiary center in the GCC.MethodsWe conducted a retrospective cohort study of 75 consecutive patients with newly diagnosed APL managed at a single tertiary center. Baseline demographic variables (age, sex, regional background), hematologic parameters (hemoglobin, leukocyte, platelet counts), and coagulation indices (fibrinogen, activated partial thromboplastin time, prothrombin time, international normalized ratio, and D-dimer) were compared between patients with and without thrombosis. Thrombotic event type, timing, antithrombotic management, bleeding complications, and mortality (including early mortality within 30 days) were recorded.ResultsEleven of 75 patients (14.7%) developed thrombosis. Baseline demographic characteristics, hemoglobin level, leukocyte count, platelet count, fibrinogen, and activated partial thromboplastin time were comparable between patients with and without thrombosis, whereas prothrombin time, international normalized ratio, and D-dimer levels were numerically higher in patients who developed thrombosis. Most thrombotic events (73%) occurred during active therapy, and the majority were venous (55%). Pulmonary embolism accounted for 36% of all thrombotic episodes, and catheter-associated thromboses represented a clinically relevant subset. Anticoagulation was initiated in 45% of patients with thrombosis and antiplatelet therapy in 18%. Bleeding episodes occurred in 36% of patients who experienced thrombosis. Thrombosis was associated with a 27% all-cause mortality.ConclusionsIn this GCC APL cohort, thrombosis, though less frequent than bleeding, emerged as a serious and clinically significant manifestation associated with substantial morbidity and mortality. These findings underscore the need for vigilant thrombo-hemorrhagic assessment and individualized antithrombotic strategies, particularly during induction and early consolidation therapy.
39. Prevalence and correlates of active transportation to campus among Canadian post-secondary students: evidence from the Canadian Campus Wellbeing Survey.
期刊: Frontiers in sports and active living 发表日期: 2026 链接: PubMed
摘要
Active transportation to campus may be an important source of physical activity while contributing to broader benefits to the environment. Currently, little is known about the transportation behaviour of post-secondary students. The aims of the current study were (a) to examine the prevalence of active transportation to campus in a national sample of post-secondary students, and (b) to examine the sociodemographic, contextual and lifestyle characteristics associated with those transportation behaviours. This large-sample cross-sectional analysis used self-reported data from the Canadian Campus Wellbeing Survey across three deployment time periods. Descriptive analyses were conducted to characterize the sample, mental health indicators, and prevalence of active transportation. Binary logistic regression was used to examine associations between sociodemographic, contextual, and mental health factors and transportation mode (active vs. not active). Results were reported as adjusted odds ratios with 95% confidence intervals. In total, 41,553 respondents were included in the sample from 56 post-secondary institutions (33 universities, 15 colleges, and 8 institutes). Overall, 16.4% of respondents reported using an active mode of transportation to campus. Active transportation prevalence was highest among respondents aged 20-24 (20.6%; aOR = 1.37, 95% CI: 1.14-1.63, vs. under 20) and those who identified as a man (17.9%; aOR = 1.20, 95% CI: 1.07-1.35) or non-binary or Two-Spirit (19.7%; aOR = 1.44, 95% CI: 1.18-1.75), relative to women. Students from Ontario (22.1%) and Nova Scotia (23.6%) had the highest prevalence of active transportation; compared with Ontario, odds were lower in Alberta (aOR = 0.31, 95% CI: 0.17-0.56) and British Columbia (aOR = 0.29, 95% CI: 0.15-0.54). Commute time showed the strongest association: prevalence was 27.7% for 0-30 min, and odds were substantially lower for 31-60 min (aOR = 0.08, 95% CI: 0.06-0.12) and over 60 min (aOR = 0.01, 95% CI: 0.01-0.03), compared with 0-30 min. Students who met the Canadian physical activity guidelines (18.3%) reported higher prevalence of active transportation; not meeting guidelines was associated with lower odds (aOR = 0.62, 95% CI: 0.54-0.71). Most Canadian post-secondary students travel to their institution by transit or car. Correlates of active transportation were consistent with existing research. Students using active transportation were more likely to be younger, male and of higher SES. Active transportation was more likely to occur in larger, urban settings. They were also more likely to report meeting the Canadian physical activity guidelines. Future policy and practice should focus on how to support more students living within a reasonable distance from their campus to walk or cycle.
40. REMOTE-Neuro: co-produced recommendations to optimise remote neurology.
期刊: BMJ neurology open 发表日期: 2026 链接: PubMed
摘要
To examine stakeholder experiences of remote neurology outpatient care and to co-produce an evidence-based framework to support safe, equitable and sustainable service delivery. We undertook an inductive thematic analysis of free-text responses from three national surveys: a patient and carer survey conducted by the Neurological Alliance (2021; n=2463) and two surveys of neurologists conducted by the Association of British Neurologists (2020 and 2021; n=593). Findings were validated through co-production workshops and interviews with patients, carers and healthcare professionals in 2024 (n=43). Themes were triangulated and refined to generate stakeholder-endorsed recommendations. Participants valued flexible choice in consultation modality, recognising the accessibility and convenience of remote care, but expressed concerns about clinical quality, privacy and equity. Both patients and clinicians viewed remote care as a distinct skill set requiring tailored training and stronger digital infrastructure. Importantly, some participants perceived remote appointments as less legitimate than in-person consultations, a novel and under-recognised challenge with implications for engagement and health equity. Five domains aligned with National Health Service (NHS) transformation principles were identified: (1) patient-centred care, (2) neurology and specialist area considerations, (3) clinical safety and quality, (4) capacity and sustainability and (5) operational efficiency. These findings informed the REcommendations for optimising Modality, Operational efficiency, Training and Equity in NEUROlogy (REMOTE-Neuro) framework. Remote care continues to offer significant benefits to both patients and clinicians. However, several years postpandemic, there are still unresolved issues which limit its effective integration with face-to-face care. REMOTE-Neuro provides a co-produced set of recommendations to optimise remote neurology practice. Grounded in over 3000 stakeholder perspectives and aligned with NHS transformation priorities, it offers a practical roadmap for implementation in neurology and a transferable model for other specialties.
41. Prospective Evaluation of the Neurology Same Day Emergency Care (NeuroSDEC) Model in Secondary Care: data from 931 patients over the first 12 months.
期刊: BMJ neurology open 发表日期: 2026 链接: PubMed
摘要
Acute neurological presentations are common in emergency settings. These are managed with a high rate of misdiagnosis in about one-third of cases. This is the first description of a consultant-led model within an existing same day emergency care service. As part of service evaluations, we prospectively collected data from 931 acute neurological presentations, over the first year since establishing the neurology same day emergency care (NeuroSDEC) embedded within the emergency department (ED) at University College London Hospital. The service was evaluated in terms of diagnostic accuracy, cost-saving and efficiency. 60.8% were female, mostly between 25 years and 40 years old. Most referrals were from ED, with the most common presenting symptom of headaches (343 cases, 36.8%).NeuroSDEC reduced lack of diagnosis in over 27% of cases, prevented admissions in over one-third of cases seen, saw same-day cases on average within 1 hour, reduced intended outpatient neurology referrals from 36.4% to 4.8%, cut stroke and transient ischaemic attack clinic referrals in half, completed the care of more than a third of cases (36.1%) exclusively in NeuroSDEC, aborted unnecessary acute brain imaging in 9.7% and cut intended lumbar punctures by 40% (49 reduced to 29). Acute neurology presentations challenge acute physicians in distinguishing benign from serious neurological conditions in real time. Our NeuroSDEC model provides a successful example of a transformative healthcare model, safely reducing unnecessary investigations, outpatient referrals, admissions and misdiagnosis rates. A conservative estimate for potential cost savings was £660 000 in admission prevention alone, more than the excess staff cost of £363 000.
42. Inclusive approaches to research and healthcare for nitrous oxide users: lessons from a longitudinal study.
期刊: BMJ neurology open 发表日期: 2026 链接: PubMed
摘要
Recreational use of nitrous oxide (N2O) has risen markedly over the past decade; typically, users are young adults, often from ethnic minority backgrounds and not in full-time employment. Prolonged or intense N2O use can inactivate vitamin B12, leading to subacute combined degeneration of the spinal cord, which may result in significant neurological disability. Understanding N2O-related health and social harms remains challenging due to limited patient engagement with research and healthcare. Drawing on our experience of conducting a longitudinal study and existing literature, we offer practical recommendations for researchers and clinicians. Inclusive research practices that incorporate lived experience perspectives are essential to enhance relevance and accessibility. Offering compensation, psychological support resources and flexible delivery models may improve recruitment and retention. Confidentiality limits must be clearly communicated, particularly when illegal activity may be disclosed. Strengthening engagement in research will inform evidence-based practice within healthcare systems. Additionally, we advocate for better training on N2O-related harms and multidisciplinary collaboration to enhance healthcare provision. Trial registration number NCT05714917.
43. Advancing Lipid Management in Europe: Insights from the WHF Regional Roundtable Series and Country Case Studies.
期刊: Global heart 发表日期: 2026 链接: PubMed
摘要
Elevated cholesterol remains a major modifiable risk factor for atherosclerotic cardiovascular disease (ASCVD), yet lipid targets are unmet in many high- and very-high-risk individuals across Europe. This gap persists despite strong evidence, established guidelines, and effective therapies. To address this, the World Heart Federation (WHF) convened a Regional Europe Roundtable Series, bringing together clinicians, policymakers, researchers, and patient representatives. This review synthesises insights from meetings held in July and August 2025, alongside country case studies. Key barriers include low awareness, statin misinformation, fragmented care pathways, limited data systems, inequitable access to therapies, and inconsistent policies for familial hypercholesterolaemia detection and management. Despite these challenges, scalable solutions exist, including national strategies, screening programmes, digital referral systems, and integrated prevention initiatives. Strengthening policies, data systems, primary care capacity, public education, and equitable access to therapies will be essential to close the implementation gap in lipid management across Europe. Summary of challenges and solutions for lipid management in Europe, including unmet targets, fragmented care, limited data, and inequitable access, alongside proposed actions such as national strategies, screening programmes, digital tools, and improved therapy access.
44. Impact of air pollution on life expectancy in Asian developing countries: Does renewable energy adoption matter?
期刊: Frontiers in public health 发表日期: 2026 链接: PubMed
摘要
Air pollution (AIRP) remains a critical public health and environmental challenge in developing Asia, where rapid industrialization and fossil fuel dependence continue to undermine population health and longevity. This study examines the impact of AIRP on life expectancy (LIFE) and investigates whether renewable energy adoption moderates this relationship. AIRP is proxied by carbon dioxide (CO₂) and nitrous oxide (N₂O) emissions, which capture pollution-intensive energy systems, industrial activity, and agricultural practices that jointly generate health-damaging co-pollutants, particularly in contexts where consistent long-term data on ambient pollutants such as PM₂.₅ are unavailable. Using balanced panel data for 30 developing Asian countries from 2000 to 2023, we apply fixed effects, system GMM, and Lewbel IV-2SLS estimators to address unobserved heterogeneity, endogeneity, and persistence in health outcomes, while accounting for key socioeconomic and healthcare-related confounders. The results indicate that higher CO₂ and N₂O emissions significantly reduce LIFE, with CO₂ exerting a relatively stronger adverse effect. Importantly, greater renewable energy adoption weakens the negative association between emissions and LIFE, suggesting a mitigating role of clean energy transitions. While acknowledging that LIFE is influenced by multiple structural factors beyond AIRP, the findings provide robust evidence that renewable energy expansion can contribute to improved environmental quality and long-term health outcomes. These results highlight the potential co-benefits of clean energy policies for environmental sustainability and public health, offering cautious and policy-relevant insights aligned with SDG 3, SDG 7, and SDG 13.
45. Beyond birth rates: a theoretical framework for women's reproductive autonomy and quality childbearing.
期刊: Frontiers in public health 发表日期: 2026 链接: PubMed
摘要
Global birth rates have been in steady decline and are projected to continue this trajectory in the coming decades. While existing literature provides important insights into the demographic and socioeconomic dimensions of this trend, there remains a critical gap in theoretical frameworks that engage with the broader implications of declining fertility. Current family planning programs often concentrate on pregnancy and postnatal care but tend to overlook the preconception period, particularly the need to equip women with the resources and autonomy required to make informed decisions about reproduction. Such omissions may have unintended consequences for women’s reproductive choices and broader fertility patterns. Meanwhile, rather than centering policy efforts solely on increasing birth rates, it is imperative to shift the focus toward improving the quality of births which emphasizes the long-term comprehensive benefits to individuals, families and society. This approach necessitates the provision of comprehensive support covering the entire reproductive cycle for women, supported by robust engagement from the global health community. This study seeks to explore the multifaceted factors that shape women’s capacity and inclination to bear children under conditions conducive to positive maternal and infant outcomes. It introduces a holistic framework designed to inform the policies and practices of health and governmental institutions, with the aim of promoting women’s overall well-being and effective and sustainable fertility outcomes.
46. How to promote orderly access to medical care: an empirical analysis based on the Chinese experience.
期刊: Frontiers in public health 发表日期: 2026 链接: PubMed
摘要
This study focuses on the implementation of China’s hierarchical diagnosis and treatment system, conducting an in-depth analysis from three dimensions-healthcare service framework, policy experimentation, and service utilization patterns-aiming to provide valuable insights for the construction and improvement of an orderly medical order in other countries of the world. Utilizing data from the China Health Statistics Yearbook and China National Health Service Survey Reports, this study proposes a three-dimensional framework for China’s hierarchical diagnosis and treatment system, categorizes medical institutions into three distinct levels, and systematically analyzes structural variations in outpatient and inpatient service provision across different medical institutional tiers from 2007 to 2022. The analysis reveals notable shifts in healthcare-seeking patterns in China: regarding first-contact care, the proportion of urban/rural residents initiating care at primary healthcare institutions demonstrates overall contraction, while secondary hospitals show increased first-contact shares, and tertiary hospitals maintaining stable utilization around 8.0%. In outpatient services, primary institutions retain the highest annual visit volumes, yet tertiary hospitals exhibit the strongest average annual growth rate. Structural variation analysis shows both tiers are primary contributors to system-wide changes-primary institutions demonstrate pre-dominantly negative VSV (Value of Structural Variation) trends, contrasted by tertiary hospitals’ consistently positive VSV. For inpatient care, tertiary hospitals display the most rapid service expansion, with sustained positive VSV since 2010 and structural contribution rates exceeding 35%. This trajectory has positioned tertiary institutions as the primary inpatient service providers. (1) China has established clear functional roles for different medical institutions across distinct tiers of care, thereby laying a solid foundation for orderly patient referrals; (2) The evolving distribution of healthcare services across different tiers of medical institutions in China suggests that gaps remain between the current patient referral patterns and the intended objectives of the hierarchical medical system, particularly for inpatient services; (3) China’s policies to promote the hierarchical diagnosis and treatment system exhibit distinct regional characteristics, highlighting the need to further expand the implementation scope of these policies to promote the formation of an orderly healthcare-seeking pattern; (4) The role of tertiary hospitals in China’s hierarchical diagnosis and treatment system requires further optimization; (5) Developing integrated healthcare delivery systems with vertically coordinated services and horizontally regulated competition among medical institutions at all levels should be a critical future direction for China’s health system reform.
47. Bridging perception and reality: understanding Chinese women's behavioral intentions toward robot-assisted gynecologic surgery.
期刊: Frontiers in public health 发表日期: 2026 链接: PubMed
摘要
Robot-assisted gynecological surgery (RAGS) represents a major advancement in minimally invasive care with demonstrated clinical benefits. Yet, its adoption depends on individual acceptance shaped by complex psychosocial factors, particularly salient in China due to healthcare disparities and information asymmetry. Prior studies on health technology acceptance have seldom examined discrepancies between individual expectations and actual clinical outcomes. This study investigates Chinese women’s acceptance of RAGS, introducing the concept of perceived postoperative difference to capture the perception-reality gap and its influence on behavioral intention. A cross-sectional survey was conducted among Chinese women using convenience sampling, yielding 546 valid responses. An extended UTAUT framework incorporating trust, perceived risk, and perceived postoperative difference (PPD) was applied. The perception-reality gap was quantified by matching participants’ perceived postoperative outcomes with objective clinical data. Structural Equation Modeling (SEM) tested the framework, and multi-group SEM examined behavioral differences across gap-defined groups. Analysis of variance and chi-square tests were used to assess demographic variations among these groups. The model showed good fit. Analyses indicated that effort expectancy was the strongest predictor of behavioral intention, followed by perceived postoperative difference and performance expectancy. Facilitating conditions enhanced both behavioral intention and performance expectancy, while trust increased both and reduced perceived risk. Multi-group analysis revealed notable heterogeneity. In the overestimation group, behavioral intention mainly depended on effort expectancy, while social influence and perceived risk reduced intention. In the alignment group, facilitating conditions and trust improved performance expectancy. In the underestimation group, behavioral intention was primarily shaped by performance expectancy and social influence. Higher education and technical jobs characterized the overestimation group, whereas lower education and unstable employment defined the underestimation group. This study reveals that the perception-reality gap reconfigures women’s decision pathways, demonstrating that adoption mechanisms are highly heterogeneous across perceptual groups. These gaps reflect underlying socioeconomic and structural factors, highlighting the necessity of targeted patient education and communication strategies. This research expands the boundaries of traditional technology adoption models in high-risk medical contexts, refines user acceptance theory, and provides valuable empirical evidence for formulating personalized communication strategies and optimizing the promotion of novel medical technologies.
48. Threat, efficacy, and the ambivalent role of COVID-19 news: an EPPM analysis of health discrimination and preventive behaviors.
期刊: Frontiers in public health 发表日期: 2026 链接: PubMed
摘要
During global public health crises, news media play a crucial role in disseminating information about prevention, treatment, and recovery. This study aims to investigate the social and psychological impact of news during the prevention and control process of COVID-19 in China. We collected data from 598 participants and employed the Extended Parallel Process Model (EPPM) to analyze the influence of different combinations of perceived threat and perceived efficacy in news on fear, compliance with preventive measures, and health discrimination. The findings reveal significant associations between perceived threat and various outcomes: increased fear, enhanced compliance with preventive measures, and heightened health discrimination. In this process, perceived efficacy has a significant moderating effect: under high perceived efficacy conditions, fear’s promotion of health discrimination is suppressed, and its encouragement of preventive measures is enhanced. This study highlights that balanced health communication in media, conveying both threats and efficacy, is crucial for mitigating health discrimination and sustaining public motivation for preventive behaviors.
49. The Prevalence of Tic Disorders in Poland: Regional and Sex Differences.
期刊: Tremor and other hyperkinetic movements (New York, N.Y.) 发表日期: 2026 链接: PubMed
摘要
Primary tic disorders, including provisional tic disorder, chronic tic disorders and Tourette syndrome (TS), are common childhood-onset neurodevelopmental conditions. Epidemiological data from Central and Eastern Europe remain limited. This nationwide registry-based study provides the first population-level overview of tic disorders in Poland over a 14-year period. We analysed anonymised National Health Fund data from 2010-2024, identifying individuals diagnosed with tic disorders (ICD-10 F95), including provisional tic disorder (F95.0), chronic motor or phonic tic disorder (F95.1), and TS (F95.2). Comorbid ADHD (F90) and OCD (F42) were examined. Prevalence was stratified by age, sex, and region. Age at first diagnosis and healthcare utilisation were assessed. Healthcare utilisation was defined as the number of inpatient and outpatient encounters in which tic disorders were recorded as either a primary or comorbid diagnosis. Recorded prevalence increased across all tic disorders. Prevalence was higher in males than females (p < 0.001), with male-to-female ratios ranging from 2:1 for provisional tics to 5-6:1 for TS in children. First diagnoses peaked between 6-12 years, with females diagnosed later than males (p < 0.001). Marked regional variation was observed, with higher prevalence in southern and southeastern regions (p < 0.001). ADHD and OCD were common, particularly in TS, and were associated with increased healthcare utilisation (p < 0.001). While total visits increased, visits per patient declined. Tic disorder prevalence has risen in Poland, with persistent regional disparities, highlighting the need for improved specialist access, earlier recognition, and integrated management of comorbidities.
50. The Effectiveness of a Self-Management-Based Nutritional Promotion Program on Food Consumption Knowledge, Behaviors, and Quality of Life of Patients Undergoing Hemodialysis.
期刊: Journal of multidisciplinary healthcare 发表日期: 2026 链接: PubMed
摘要
Patients undergoing hemodialysis (HD) often experience food consumption and nutritional challenges that affect their health outcomes and quality of life (QoL). Traditional nutritional education alone may be insufficient to promote sustainable behavioral change. The self-management concept, which emphasizes patients’ active involvement in managing their health, has been insufficiently applied among HD patients in Thailand. This study evaluated the effectiveness of a nutritional promotion program in improving the QoL of HD patients, based on the self-management concept of Creer (2000). A quasi-experimental design was employed with 110 HD patients recruited from two dialysis centers in Sakon Nakhon Province, Thailand. Participants were equally allocated to experimental (n = 55) and control (n = 55) groups. The experimental group received a 12-week nutritional promotion program based on the self-management concept of Creer (2000), which consisted of individual face-to-face education, group-based educational content via the LINE application, individualized tele-counseling, and group discussions, while the control group received standard care. Data were collected using the Kidney Disease Quality of Life-Short Form (KDQOL-SF™), version 1.3, and analyzed using descriptive statistics and repeated measures ANOVA. The results indicated no significant differences in demographic characteristics or baseline mean QoL scores between groups. The experimental group showed significant improvements in food consumption knowledge, food consumption behaviors, and QoL (p < 0.05) across time points compared with the control group. The nutritional promotion program grounded in Creer’s (2000) self-management framework, integrating individualized education, structured group-based LINE content, individualized tele-counseling, and group discussions, effectively improved food consumption knowledge, food consumption behaviors, and QoL in HD patients. The program strengthened patients’ capacity for self-regulation of food consumption behaviors and enhanced their overall well-being. These findings underscore the potential of hybrid, self-management-based nutritional interventions as a patient-centered approach to improving key outcomes in HD care.
51. Sexual harassment, stress and suicide attempt among international college students in the USA.
期刊: BMJ public health 发表日期: 2026 链接: PubMed
摘要
Sexual harassment is a significant public health concern on US college campuses, yet limited research has examined its prevalence and correlates among international students. This study investigates the prevalence of sexual harassment among international college students and examines associations with stress and suicide attempts. A cross-sectional secondary data analysis was conducted using the 2022 American College Health Association-National College Health Assessment . The analytic sample included 13 242 international students. Sexual harassment in the past 12 months served as the primary outcome. Predictor variables included stress level, suicide attempt in the past year, number of sexual partners, academic level and sex assigned at birth. Descriptive statistics, univariate logistic regression and a final multivariate logistic regression model were used to examine associations. Among 13 242 international college students, 6.1% (n=799) reported sexual harassment in the past 12 months. In the adjusted logistic regression model, moderate to high stress was associated with higher odds of sexual harassment (adjusted odds ratio (AOR) =1.800, 95% CI 1.470 to 2.205), and past-year suicide attempt was associated with higher odds of reporting sexual harassment (AOR=4.112, 95% CI 3.035 to 5.570). The study underscores the need for targeted interventions and policies that account for gender-specific and population-specific vulnerabilities. International students face unique stressors, underscoring the need for comprehensive support systems at multiple levels. Limitations include self-reported data and a cross-sectional design. Future research should employ longitudinal designs and diverse samples to deepen understanding and strengthen support mechanisms, thereby fostering safer educational environments.
52. Glycemic Control and Adherence to Treatment According to Personality, Self-Esteem, and Perceived Stress in Type 1 Diabetes Mellitus.
期刊: Nursing research and practice 发表日期: 2026 链接: PubMed
摘要
The aim of this study was to assess whether personality traits, self-esteem, and perceived stress are associated with glycemic control and adherence to treatment in adults with Type 1 diabetes mellitus (T1DM). We conducted a cross-sectional study in 107 T1DM patients and measured psychological variables (self-esteem, perceived stress, and personality traits) and clinical markers. More than 90% of patients had good or very good adherence to treatment. In addition, patients with poor adherence had higher HbA1c levels. Regarding personality traits, adherence to treatment correlated significantly with agreeableness and conscientiousness and negatively with neuroticism. Patients with high self-esteem had greater adherence to treatment. Finally, a significant positive correlation was observed between perceived stress and HbA1c. We concluded that some personality traits and self-esteem are associated with treatment adherence, and perceived stress is associated with poorer glycemic control in T1DM.
53. The path mechanism of occupational burnout affecting the health of emergency nurses: a moderated mediation model of work-family behavior role conflict and the work environment.
期刊: Frontiers in public health 发表日期: 2026 链接: PubMed
摘要
The purpose of this study is to discover how occupational burnout influences the health status of emergency nurses and to investigate the mediation effect of work-family behavior role conflict. A multi-center cross-sectional study. A questionnaire survey of 1,540 emergency nurses from 30 tertiary hospitals in China was conducted between December 26, 2023, and January 18, 2024. Using an online questionnaire, we performed a cross-sectional survey to collect demographic data and information about occupational burnout, work environment, work-family behavior, role conflict, and emergency nurses’ health status. The PROCESS macro for SPSS 26.0 was used to analyze the moderated mediation model, and the bootstrap approach was used to investigate the mediating effects. The findings revealed that 57.3% of the nurses had experienced occupational burnout. A substantial positive association was identified between professional burnout, work-family behavior role conflict, and somatic symptoms (r = 0.493, 0.534; p < 0.001). Occupational burnout was found to be a significant predictor of somatic symptoms, with work-family conflict serving as a mediator (β = 0.616, t = 13.295, R 2 = 0.488, p < 0.01). Our research found that nurses’ work environment mediated the association between burnout and work-family behavior role conflict (β = 0.007, t = 3.647, p < 0.01), indicating that a positive work environment may reduce the impact of burnout on family role conflict. Work-family behavioral role conflict and the nursing work environment were found to partially mediate the association between occupational burnout and the health outcomes of emergency nurses. These findings suggest that, while interventions aimed at mitigating work-family role conflict and improving the work environment are essential, they may not be sufficient on their own to safeguard nurses’ health. Additional strategies are needed to comprehensively address the health risks associated with occupational burnout. Moreover, the interplay among burnout, work-family conflict, and environmental factors underscores the necessity of integrated and multifaceted intervention approaches to alleviate the health burden experienced by emergency nurses effectively.
54. Injury prevalence and characteristics among tennis coaches in the Netherlands: a cross-sectional survey.
期刊: BMJ open sport & exercise medicine 发表日期: 2026 链接: PubMed
摘要
To describe the prevalence and characteristics of injuries among tennis coaches in the Netherlands and examine associations with individual and occupational factors. In this cross-sectional survey, all 1902 licensed tennis coaches in the Netherlands were invited to complete an online questionnaire. Data were collected on injuries during a 2-year recall period, as well as mental health problems, pain-medication use, healthcare utilisation and work-related characteristics. 900 coaches (74.8% men) completed the survey and 37% reported at least one injury in the previous 2 years. Injuries most frequently affected the lower back (19.5%), shoulder (12.0%), knee (11.6%), neck (7.4%) and elbow (6.2%), with overuse injuries accounting for the largest proportion. Injury prevalence did not differ significantly between male and female coaches. Coaches reporting injuries were taller and had a higher body mass index than uninjured coaches, although differences were small. Approximately one-third of coaches reported that injuries interfered with their ability to teach or play tennis. Pain medication use during tennis instruction was reported by 23% of coaches. Among coaches with health problems, 35% consulted a physiotherapist, 35% a general practitioner and 9% attended an emergency department. Musculoskeletal injuries are common among tennis coaches and most frequently affect the lower back and lower extremities. Many coaches continue teaching despite ongoing injuries and functional complaints, often accompanied by substantial healthcare utilisation and pain medication use. These findings provide insight into the musculoskeletal health burden associated with tennis coaching and highlight the need to include coaches in tennis injury prevention initiatives.
55. Persistent health inequality in the global burden of digestive diseases attributable to risk factors: a systematic analysis for the Global Burden of Disease Study 2021.
期刊: BMJ public health 发表日期: 2026 链接: PubMed
摘要
Digestive diseases are a major cause of health burden globally. Understanding the relative contribution of various risk factors to this burden is essential for developing effective reduction strategies. However, there is a gap in knowledge regarding the global burden of digestive diseases attributable to risk factors. This study aimed to assess the global burden of digestive diseases attributable to risk factors from 1990 to 2021. We analysed data from the Global Burden of Diseases 2021, covering 12 digestive diseases and 10 risk factors across 204 countries and territories. Age-standardised rates of disability-adjusted life-years (DALYs) were estimated. The estimated annual percentage change determined annual percent change. In 2021, there were 3.30 million deaths and 116.73 million DALYs from digestive diseases globally, accounting for 43.3% and 45.9% of all digestive disease deaths and DALYs, respectively. Males accounted for 74.42 million digestive disease DALYs attributable to risk factors, representing 49.1% of total DALYs in males, whereas females accounted for 42.31 million DALYs, representing 41.1%. Unsafe water, sanitation, and handwashing was the leading risk factor in both males and females (26.95 million and 17.8% in males; 24.67 million and 24.0% in females). The age-standardised DALY rates of digestive diseases attributable to environmental and occupational risks and behavioural risks decreased, while that attributable to metabolic risks increased. The risk factors highly associated with economic and social development caused a substantial digestive disease burden. The highest burdens of environmental and occupational and behavioural risks were concentrated in countries in sub-Saharan Africa. More global cooperation is needed in the field of digestive diseases to promote health equity and achieve the Sustainable Development Goals.
56. Heat-related challenges and interventions in hospitals: A future-oriented, qualitative approach to improve nurses' working conditions.
期刊: The journal of climate change and health 发表日期: 2026 链接: PubMed
摘要
This study explores organizational interventions aimed at mitigating heat-related challenges and stress for nurses in acute care settings, with a focus on adapting to the intensifying climate crisis. Six trans- and interdisciplinary participants participated in the workshop. The one-day workshop was based on the methodology of ‘Zukunftswerkstatt’ (Futures Workshop) and ‘design thinking’ principles. Participants analyzed challenges related to heat waves and developed actionable, future-oriented interventions based on scenarios and tools. Data collection involved photographs of handwritten workshop activities and researchers’ notes. Data analysis followed three main steps to abstract and synthesize results: discussing results using the collected data, participants’ feedback on the workshop documentation, and final synthesis. The study identified several key interventions to manage heat-related stress, including the development of a comprehensive Heat Health Action Plan (HHAP), modular training programs, and a mobile staff app for real-time communication. Interventions were categorized into four phases: prevention, preparation, response, and recovery, with organizational strategies outweighing individual-level interventions. Participants highlighted the need for leadership commitment, adequate resource allocation, cross-sector collaboration, and clear communication. Successful implementation of HHAP was viewed as dependent on engagement from middle management and its integration into hospital governance and strategic planning. This study highlights the complexity of heat adaptation in hospitals. Findings underscore the importance of successful heat adaptation for hospital employees. Strengthening institutional commitment and integrating staff-driven approaches are essential for developing robust, future-ready heat preparedness in hospitals.
57. Income, employment, and clinical outcomes in Parkinson's disease.
期刊: Clinical parkinsonism & related disorders 发表日期: 2026 链接: PubMed
摘要
Socioeconomic factors such as employment status and household income may influence clinical outcomes in Parkinson’s disease, yet their associations with both motor and non-motor symptoms are not well characterized. This study examined whether employment status and income are associated with cognitive complaints, depressive symptoms, health-related quality of life, and motor severity among individuals with Parkinson’s disease. Data were obtained from FoxInsight, and online longitudinal cohort study. Participants aged 40 years and older with Parkinson’s disease who completed self-report questionnaires were included (n = 29,826). Multilevel models examined associations between employment status and household income with cognitive complaints, depressive symptoms, health-related quality of life, and motor severity across up to three annual assessments. Employment status was significantly associated with all outcomes. Compared with full-time employment, unemployment and retirement were associated with more cognitive complaints, greater depressive symptoms, poorer health-related quality of life, and greater motor severity (all p < 0.05). Part-time employment was generally associated with fewer depressive symptoms and did not significantly differ from full-time employment on several outcomes. Lower household income was significantly associated with greater depressive symptoms, poorer health-related quality of life, and greater motor severity (all p < 0.05), but was not associated with cognitive complaints. Employment status and household income are important social determinants of both motor and non-motor outcomes in Parkinson’s disease. These findings highlight the potential clinical relevance of socioeconomic factors shaping disease experience and emphasize the need for interventions that address economic and occupational vulnerability.