公共卫生研究摘要 (2026-04-26)
共收录 60 篇研究文章
1. Do interracial friendships increase the odds of having an interracial romantic relationship later in adolescence?
期刊: Journal of research on adolescence : the official journal of the Society for Research on Adolescence 发表日期: 2026-Jun 链接: PubMed
摘要
Despite growing racial and ethnic diversity in North America, interracial romantic relationships remain rare among youth. This study tested whether forming an interracial friendship by the end of middle school predicted interracial romantic relationships by the end of high school, beyond opportunities provided by school demographics. Data were from a longitudinal study of 2418 students followed from grades 8 to 12 from 26 racially diverse California public schools. Of those in relationships, 32.6% had an interracial partner. Greater availability of cross-race peers in high school increased the odds of interracial romantic relationships, OR = 2.23, p < .001. Having at least one earlier interracial friendship 4 years earlier nearly doubled this likelihood, OR = 1.86, p < .001. Findings underscore the role of school diversity and continuity across close relationship types.
2. Empathy Subdomains and Nurse Burnout: Methodological Reflections on a Recent Meta-Analysis.
期刊: International nursing review 发表日期: 2026-Jun 链接: PubMed
摘要
This letter comments on the recent meta-analysis by Maximiano-Barreto et al. on empathy subdomains and burnout in nurses. The article makes a valuable contribution by showing that empathy is not uniformly protective: perspective taking may be associated with lower burnout, whereas personal distress and possibly fantasy may be associated with greater burnout. We suggest that three issues deserve further emphasis. First, pooling burnout syndrome with emotional exhaustion may obscure dimension-specific associations. Second, the predominance of cross-sectional studies and the substantial heterogeneity of empathy and burnout measures limit causal interpretation. Third, fantasy remains a conceptually debated subdomain and should be interpreted cautiously. Rather than asking whether empathy is protective or harmful in general, future research should specify which empathy components matter, for which burnout dimensions, and under which organizational conditions. This distinction has important implications for nursing education, staff support, and sustainable nursing policy.
3. Mitochondrial Transplantation as a New Therapeutic Approach Against Cardiac and Renal Consequences in Male Rats With Myocardial Infarction.
期刊: Acta physiologica (Oxford, England) 发表日期: 2026-Jun 链接: PubMed
摘要
Myocardial infarction (MI) is one of the leading causes of death worldwide. MI is associated with cardiac structural and functional alterations. Among these, cardiac fibrosis may be significantly influenced by mitochondrial dysfunction. We sought to evaluate whether the injection of functional mitochondria from healthy muscle could improve the detrimental consequences of MI. Male Wistar rats were submitted to MI through the ligature of the left anterior descending coronary artery. Animals subjected to a sham operation (the same surgical procedure without fastening of the suture that passes through the LAD) were included as a reference group (Sham). At the time of surgery, either vehicle (PBS) or isolated mitochondria (equivalent to 180 μg of mitochondrial protein in 75 μL of vehicle) were directly injected into the myocardium around the ligation to half of the animals in each group. Animals were sacrificed 4 weeks after both MI induction and the evaluation of cardiac and systolic functions. Cardiac mitochondrial transplantation was able to prevent the decrease in systolic function and the development of cardiac fibrosis in MI rats. These beneficial effects were accompanied by a reduction in cardiac hypertrophy, oxidative stress, endoplasmic reticulum stress activation, and inflammatory markers. We also evaluated the effects of mitochondrial transplantation by a proteomic analysis. In addition, cardiac mitochondrial transplantation was able to prevent the development of renal alterations observed in MI rats. The data reveal novel mechanisms of mitochondrial transplantation effects and emerge as a novel therapeutic strategy under chronic diseases such as MI.
4. SIRT1 Attenuates Host Resistance to Salmonella Infection by Negatively Regulating the Immune Responses.
期刊: FASEB journal : official publication of the Federation of American Societies for Experimental Biology 发表日期: 2026-May-15 链接: PubMed
摘要
Salmonella is a significant zoonotic foodborne pathogen that poses a serious threat to public health and the poultry industry. SIRT1 has been implicated in various biological processes, but its specific role in regulating immune responses during Salmonella infection remains inadequately defined. Our study shows that SIRT1 promotes Salmonella invasion of host cells, and its inhibition impairs intracellular bacterial survival in macrophages. SIRT1 suppresses the secretion of immune factors and attenuates the innate immune response of the host by regulating the NF-κB signaling pathway. Using RNA-Seq, we found that SIRT1 plays a crucial role in host immune responses by modulating pathogen-associated molecular pattern recognition via membrane-bound (TLR-like) and intracellular (NLR-like). Acetylomic analysis revealed that SIRT1 inhibition primarily affects acetylation within metabolic and transcriptional networks. Furthermore, inhibition of SIRT1 activity enhanced the resistance of chicks to Salmonella infection. In summary, our study indicates that SIRT1 promotes Salmonella infection of chicken macrophages and weakens host defense by negatively regulating NF-κB activation and the production of proinflammatory cytokines.
5. Beyond the Usual Suspects: Emerging Associations Between Epstein-Barr Virus Infection/Infectious Mononucleosis and Cancers.
期刊: Reviews in medical virology 发表日期: 2026-May 链接: PubMed
摘要
Epstein-Barr virus (EBV) is a ubiquitous herpesvirus and a causal factor for Burkitt Lymphoma (BL), Hodgkin Lymphoma (HL), gastric carcinoma (GC) and nasopharyngeal carcinoma (NPC). Whether EBV contributes to a wider spectrum of cancers remains uncertain. We reviewed MEDLINE, Embase and Web of Science on 30th July 2024 to identify observational studies that examined the association between EBV infection or EBV-infectious mononucleosis (IM) and cancers beyond BL, HL, GC and NPC. Evidence was appraised using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework. For cancers meeting minimum thresholds we assessed etiologic fractions (EFs), biological plausibility, epidemiological burden, latency after IM, and predictive biomarkers. Thirty-three eligible studies were identified, yielding 13 hypotheses (i.e., specific potential reported associations between EBV infection or IM and individual cancer types) that advanced through GRADE. Breast cancer and NHL had the greatest weight of biological plausibility, cervical and prostate the least. Despite an array of tests, testicular cancer studies provided limited evidence. EFs ranged between 12.3% (IM-breast) and 85.1% (EBV infection-NHL). Breast and prostate cancers had the highest global incidence. Only one study (for NHL) provided data on time from IM to cancer onset, and prostate-specific antigen was the only biomarker identified. In this review, we highlight eight cancers across six cancer groups (breast, cervical, leukaemia/other haematologic, NHL, prostate, testicular) with some evidence of EBV involvement. These results reinforce the potential long-term value of EBV vaccine development, while emphasising the need for high-quality prospective studies with robust methods of viral detection to establish causality.
6. Identification and Functional Characterization of Novel and Recurrent NTRK1 Variants in Chinese Families With Congenital Insensitivity to Pain With Anhidrosis: A Combined Clinical, Genetic, and Functional Study.
期刊: European journal of neurology 发表日期: 2026-May 链接: PubMed
摘要
Congenital insensitivity to pain with anhidrosis (CIPA) is an autosomal recessive disorder caused by variants in the NTRK1 gene (encoding TrkA). The identification and functional analysis of these variants are essential for elucidating the genetic basis of the disease and improving diagnostic efficiency. In this study, we investigated four unrelated Chinese families with CIPA. We employed next-generation sequencing to identify the causative genetic variants in 13 individuals (5 affected and 8 unaffected) from four unrelated Chinese families. A comprehensive bioinformatics and in vitro functional analyses were subsequently performed to assess the pathogenicity of the identified variants. We identified seven variants in the NTRK1 gene, including two novel variants (c.2285C > A and c.1990_1993delinsTGCT). Functional characterization of five variants (four missense: c.632 T > A, c.1942C > T, c.2122G > A and c.2285C > A; and one indel: c.1990_1993delinsTGCT) revealed that they disrupted distinct steps within the nerve growth factor (NGF)-TrkA pathway, including TrkA glycosylation and phosphorylation, NGF-TrkA binding, and downstream signaling pathway. Our findings expand the mutational spectrum of NTRK1 with two novel variants associated with CIPA and delineate the specific step(s) within the NGF-TrkA pathway affected by each variant, thereby establishing a link between genotype and the observed phenotypic severity. This study provides a crucial theoretical and experimental foundation for the future development of personalized therapies for CIPA patients.
7. Fluorogenic Peptide Aptamer Generated Using Bioorthogonal cDNA Display Technology for Cellular Imaging of Heat Shock Protein 90α.
期刊: Chembiochem : a European journal of chemical biology 发表日期: 2026-Apr-28 链接: PubMed
摘要
Fluorogenic probes are valuable tools for rapid detection and bioimaging of target molecules without requiring bound/free separation. Although antibody-based probes are widely used, their large size, reliance on secondary labeling, and limited accessibility to some intracellular regions can restrict their utility. In contrast, fluorogenic peptide aptamers-compact, chemically synthesizable, and self-reporting-offer a promising alternative. Here, we developed a method to prepare a fluorophore-conjugated peptide library using cDNA display and applied it to the selection of fluorogenic peptides targeting heat shock protein 90α (Hsp90α), a clinically relevant biomarker. As the solvatochromic reporter, we used an environmentally sensitive fluorophore, 4-N, N-dimethylamino-1,8-naphthalimide (4-DMN). One selected peptide, Peptide2, exhibited fluorescence enhancement in the presence of Hsp90α while remaining largely unresponsive to the homologous Hsp70. In fixed cells, Peptide2 produced intracellular fluorescence patterns that partially overlapped with those obtained using an anti-Hsp90α antibody, supporting its ability to detect intracellular Hsp90α-related signals. Peptide2 and the antibody also showed partially distinct staining distributions, suggesting differences in epitope accessibility and/or intracellular accessibility. These results establish a proof of concept for generating target-responsive, self-reporting peptide probes using bioorthogonal cDNA display.
8. First report of Culex flavivirus and its association with Wolbachia in Culex quinquefasciatus from Puducherry, India.
期刊: Transactions of the Royal Society of Tropical Medicine and Hygiene 发表日期: 2026-Apr-25 链接: PubMed
摘要
Symbiotic insect-specific viruses, such as Culex flavivirus (CxFV), are increasingly recognized for their ability to modulate arboviral replication in mosquitoes. However, the prevalence of CxFV in Culex quinquefasciatus mosquitoes from Puducherry, India-a region previously endemic for filariasis-and its interaction with the endosymbiotic bacterium Wolbachia pipientis, remain unexplored. Culex quinquefasciatus mosquitoes were collected from villages in and around Puducherry. A total of 150 pools were screened for CxFV by PCR targeting the NS-5 gene and the amplicons were sequenced. Further, 100 individual mosquitoes were tested for both CxFV and the relative density of Wolbachia. The study identified a CxFV prevalence of 3.73% (95% CI 2.27-5.46) among the mosquito pools by Bayesian estimation approach. Phylogenetic analysis classified the circulating strain as genotype 2 of CxFV. The median relative density of Wolbachia was observed to be 0.170 (IQR 0.009-0.683) in CxFV-positive mosquitoes and 0.132 (IQR 0.021-0.570) in CxFV-negative mosquitoes, with no statistically significant difference between the two groups. Thus, with the first report on the circulation of CxFV-infected mosquitoes in Puducherry, the study highlights a probable lack of association between the relative density of Wolbachia and CxFV. The raw sequence reads have been deposited in GenBank (https://www.ncbi.nlm.nih.gov/nuccore/) with the following accession numbers: PQ586414, PQ586415, PQ586416, PQ586417, PQ586418, PQ586419, PQ586420, PQ586421, PQ586422, PQ586423.
9. Game-based rehabilitation improves upper limb movement capacity compared to task-based training in people post-stroke: Kinematic analyses from the EnteRtain randomized clinical trial.
期刊: International journal of stroke : official journal of the International Stroke Society 发表日期: 2026-Apr-25 链接: PubMed
摘要
Although many gaming systems for early stroke rehabilitation capture kinematic data, studies on upper limb (UL) movement capacity analysis after virtual reality (VR)-based gaming interventions remain limited. This study is a secondary analysis of the EnteRtain randomized clinical trial and aims to examine the effects of gamified rehabilitation using a low-cost arm rehabilitation system compared to task-based training on UL movement capacity in individuals with acute or sub-acute stroke. This secondary analysis used data from a randomized, multicenter, single-blind clinical trial involving 120 participants (91 males) with unilateral stroke and an UL Brunnstrom motor recovery stage ≥ 1 to ≤ 5, recruited from four centers across India. Participants received either gamified training with the ArmAble™ device (experimental group; n = 64) or task-based training (control group; n = 56), alongside conventional therapy for two hours/day, six days/week, over two weeks, followed by four weeks of home-based UL rehabilitation. Movement capacity outcomes (reach distance, time, and movement velocity) were assessed by blinded evaluators at two and six weeks and analyzed using a linear mixed-effects regression model. At six weeks, the experimental group demonstrated significantly greater improvements compared to control group in movement velocity for reaches to both near [mean difference (95% CI): -2.8 (-5.0, -0.75); p = 0.008] and far targets [-2.7 (-4.9, -0.51); p = 0.016]. No significant differences were however observed at two weeks. Changes in reach distance and movement time were not statistically significant between the groups at any time point. Gamified rehabilitation with the ArmAble™ device enhanced UL movement velocity at six-week compared to task-based training in individuals recovering from acute/sub-acute stroke. These findings support the use of ArmAble™ both as an engaging therapeutic tool and as a quantitative assessment platform for evaluating UL function post-stroke.
10. Looking Beyond Dose: Identifying Responders and Non-Responders to RehaCom Computerized Cognitive Rehabilitation in Progressive MS-The CogEx Study.
期刊: Neurorehabilitation and neural repair 发表日期: 2026-Apr-25 链接: PubMed
摘要
BackgroundRehaCom, a computerized cognitive rehabilitation program for people with multiple sclerosis (PwMS), has been studied primarily in relation to treatment “dose” (duration, frequency, and adherence), with less focus on which training modules drive improvement or which participant factors predict responsiveness. This secondary analysis of the CogEx trial investigated whether progression within specific RehaCom modules was associated with processing speed improvement, measured by the SDMT, and whether baseline characteristics predicted response in participants with progressive MS.MethodsA total of 153 participants completed 12 weeks of RehaCom training across 5 attention-based modules. Cognition was assessed at baseline, 12 weeks, and 6 months using the SDMT. Correlation and regression analyses evaluated associations between module progression and cognitive outcomes.ResultsProgression correlated significantly with SDMT improvement in 4 modules, with the strongest effects for Attention/Concentration (r = .37, P < .001) and Divided Attention-2 (r = .36, P < .001). Higher baseline SDMT, higher premorbid IQ, older age, and greater module progression independently predicted better SDMT performance at12-weeks (adjusted R2 = .73). At 6 months, higher baseline SDMT, greater progression in Attention/Concentration and Divided Attention-2, older age, and female sex predicted better SDMT performance (adjusted R2 = .71).ConclusionProcessing speed gains in progressive MS were related to both module-specific progression and participant characteristics, supporting a precision approach to cognitive rehabilitation that tailors training content to individual cognitive profiles. This study is a secondary analysis of the CogEx trial (ClinicalTrials.gov Identifier: NCT03679468; https://clinicaltrials.gov/ct2/show/NCT03679468).
11. Updated hepatitis D seroprevalence among HBsAg-positive persons aged ≥6 years in the United States, National Health and Nutrition Examination Survey, 2007‒2018.
期刊: Clinical infectious diseases : an official publication of the Infectious Diseases Society of America 发表日期: 2026-Apr-25 链接: PubMed
摘要
To validate the accuracy of previously published US seroprevalence estimates for hepatitis D virus (HDV) antibody, we retested National Health and Nutrition Examination Survey samples from 2007‒2018 using a different assay. We found the HDV seroprevalence among hepatitis B surface antigen positive participants aged ≥6 years to be 1.26%.
12. Changes in Long-Term Survival After Stroke Between 2013 and 2020: A Nationwide Cohort Study from the Swedish Stroke Register.
期刊: International journal of stroke : official journal of the International Stroke Society 发表日期: 2026-Apr-25 链接: PubMed
摘要
IntroductionChanges in long-term survival after stroke at the population level are incompletely characterized, particularly using recent data and stratified by stroke type.Patients and MethodsThis nationwide, register-based cohort study used data from the Swedish Stroke Register (Riksstroke) and the Swedish Causes of Death Register. Adults (≥18 years) hospitalized with ischemic stroke or intracerebral hemorrhage in Sweden during either 2013 or 2020 were included. Patients were followed for 3 years after the index stroke. The primary outcome was difference in all-cause mortality within 3 years. Survival was assessed using Kaplan-Meier analyses and Cox proportional hazards regression, stratified by stroke type.ResultsThe study included 42 926 patients. Among patients with ischemic stroke, 3-year survival increased from 63.8% in 2013 to 69.3% in 2020, corresponding to an absolute difference of 5.5 percentage points, with survival differences increasing progressively during follow-up. Ischemic stroke in 2020 was associated with a lower risk of 3-year mortality compared with 2013 in both unadjusted (hazard ratio (HR), 0.83; 95% CI, 0.80-0.86) and multivariable analyses (adjusted HR, 0.92; 95% CI, 0.89-0.96). Survival improvements after ischemic stroke were most pronounced among patients aged 75 years or older. In contrast, long-term survival after intracerebral hemorrhage did not change between cohorts (3-year survival, 50.9% in both years; adjusted hazard ratio, 0.97; 95% CI, 0.89-1.05).ConclusionsIn this nationwide cohort study, 3-year survival after ischemic stroke improved between 2013 and 2020, particularly among patients aged 75 years or older, whereas long-term survival after intracerebral hemorrhage remained unchanged. These findings suggest a contemporary population-level improvement in long-term survival after ischemic stroke over a relatively short calendar period and indicate that survival differences between cohorts increased progressively over long-term follow-up.
13. Short-Course Low-Dose Primaquine for Radical Cure in G6PD-Normal Patients in the Pre-Elimination Context of Nepal.
期刊: Tropical medicine & international health : TM & IH 发表日期: 2026-Apr-25 链接: PubMed
摘要
Plasmodium vivax remains a challenge for malaria elimination in Nepal due to its ability to relapse. Radical cure with primaquine is effective but limited by poor adherence to the standard 14-day low-dose regimen. In 2022, the WHO recommended administering the same total dose (3.5 mg/kg) over 7 days to improve adherence. This study aimed to evaluate the 7-day low-dose primaquine regimen in G6PD-normal patients with uncomplicated P. vivax and/or P. falciparum malaria in the pre-elimination context of Nepal. A randomised study was conducted in south-west Nepal. Adult patients with microscopically confirmed P. vivax and/or P. falciparum malaria and glucose-6-phosphate dehydrogenase (G6PD) activity ≥ 30% were randomised 1:1 to receive either a 7-day low-dose primaquine regimen (0.5 mg/kg/day; total 3.5 mg/kg) or standard of care (14-day primaquine [0.25 mg/kg/day; total 3.5 mg/kg] for patients with P. vivax malaria and single-dose primaquine for P. falciparum malaria patients) in addition to their schizonticidal treatment. All treatment was directly observed, and patients were followed for 6 months. The primary outcome was the risk of P. vivax recurrence at 6 months. Safety outcomes included adverse events, gastrointestinal symptoms and haematological parameters. Of 5842 individuals screened, 27 eligible participants were enrolled. Among these, 21 had P. vivax, four had P. falciparum and two had mixed infections. Eleven participants had intermediate G6PD activity (≥ 30%-70% activity). At 6 months there were no recurrences in the 7-day primaquine arm (n = 14) and the risk of P. vivax recurrence in the standard primaquine arm (n = 13) was 9.1% (95% CI: 1.3-49.2). No participants vomited study drugs, and gastrointestinal symptoms were infrequent. Three participants experienced a ≥ 25% haemoglobin drop between baseline and Day 2, all of whom had baseline values > 15 g/dL. No presentations of haemoglobinuria, severe anaemia, serious adverse events, or deaths occurred during the study period. In this small study, the 7-day low-dose primaquine regimen was well tolerated, including among individuals with intermediate G6PD activity. Although the small sample size limits conclusions about efficacy, the findings support the feasibility and safety of this regimen in Nepal, offering potential programmatic advantages for radical cure delivery in a setting close to elimination. Clinicaltrials.gov: NCT04079621.
14. Independent and interactive effects of race and insurance on preterm birth risk.
期刊: International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics 发表日期: 2026-Apr-25 链接: PubMed
摘要
To assess racial and ethnic disparities in preterm delivery in the US and evaluate whether insurance type modifies these associations. We analyzed National Center for Health Statistics natality data (2018-2024) comprising 24,918,700 singleton live births. Preterm delivery was defined as birth before 37 completed weeks of gestation. Multivariable logistic regression with robust variance was used to estimate adjusted odds ratios, predicted probabilities, and absolute risk differences across race/ethnicity and insurance categories, adjusting for maternal sociodemographic, clinical, and obstetric factors. Overall, 2,134,329 of 24,918,700 singleton live births (8.6%) were preterm during the study period, with annual rates remaining stable between 8.23% and 8.75%. In multivariable-adjusted analyses, non-Hispanic Black women had the highest odds of preterm delivery (adjusted odds ratio [aOR], 1.40; 95% confidence interval [CI]: 1.39-1.40), compared with non-Hispanic White women. Racial and ethnic disparities persisted across all insurance strata; among uninsured women, non-Hispanic Black women had the largest absolute risk difference relative to non-Hispanic White women (5.74 percentage points; 95% CI: 5.52-5.96), which was attenuated but remained significant among Medicaid (2.38 percentage points; 95% CI: 2.33-2.43) and privately insured women (2.66 percentage points; 95% CI: 2.60-2.73). Insurance coverage attenuated but did not eliminate these disparities. Racial and ethnic disparities in preterm delivery persist in the US despite insurance coverage, underscoring the need for policies that address both healthcare access and structural determinants of maternal health.
15. Updated Epidemiology of Gastrointestinal Cancers in the Asia-Pacific: Evidence From GBD 2021 and GLOBOCAN 2022.
期刊: Journal of gastroenterology and hepatology 发表日期: 2026-Apr-25 链接: PubMed
摘要
Gastrointestinal (GI) cancer poses a significant burden in the Asia-Pacific region. Growing and aging populations, cancer prevention efforts, and treatment advances have all influenced GI cancer trends. This review provides an updated overview of GI cancer epidemiology in the region, using age-standardized incidence rates (ASIRs) and death rates (ASDRs) from the Global Burden of Disease 2021 and the Global Cancer Observatory 2022. Differences between the two datasets should be interpreted with consideration of variations in methodology, standard populations, and reporting years. Colorectal cancer ranks highest in all regions across both datasets for ASIR. However, ASDR is less uniform. There is geographic heterogeneity in GI cancer burden, with Mongolia disproportionately impacted by esophageal, gastric, and liver cancers, while Japan and Australia have a considerable burden of colorectal and pancreatic cancers, along with gastric cancer in Japan. Lower mortality-to-incidence ratios for colorectal and gastric cancers may reflect the effective implementation of screening programs, facilitating early detection and effective treatments. Conversely, esophageal, pancreatic, and gallbladder cancers have lower ASIRs but incidence-to-mortality ratio near one, likely reflecting lack of cost-effective screening and poor prognosis with late-stage diagnoses. Several South-East Asian and Pacific Island countries with lower socioeconomic status show markedly lower ASIRs and ASDRs, which may reflect differences in data availability, reporting, and healthcare access, highlighting the need to strengthen national cancer registry systems. Altogether, this review offers up-to-date GI cancer epidemiology insights to support healthcare providers and policymakers in developing targeted strategies to reduce the burden of GI cancer in the Asia-Pacific region.
16. Editorial: Epidemiology of IBD in Malaysia: a rare longitudinal lens in Asia.
期刊: Inflammatory bowel diseases 发表日期: 2026-Apr-25 链接: PubMed
摘要
17. Biallelic loss-of-function variants in PTGIS cause recurrent cervical internal carotid artery vasospasm.
期刊: International journal of stroke : official journal of the International Stroke Society 发表日期: 2026-Apr-25 链接: PubMed
摘要
Recurrent cervical internal carotid artery vasospasm (RCICAV) is a rare cause of ischemic stroke in young adults. However, its pathophysiology remains largely unknown. RCICAV is a life-threatening condition, sometimes accompanied by coronary spasmodic angina in addition to severe stroke, highlighting the need for further investigation of its etiology and therapeutic approaches. This study aimed to identify the genetic basis of Japanese families harboring RCICAV. Whole-exome and Sanger sequencing analyses were performed in five Japanese patients from four families (two affected siblings and three unrelated sporadic patients) and seven unaffected members from three families enrolled from October 2016 to May 2025. RCICAV was diagnosed using magnetic resonance angiography, which demonstrated vasospasm of the cervical portion of the internal carotid artery during the event and normalization during remission. In vitro and ex vivo analyses of the detected variants were performed to verify functional deficiencies. RCICAV was found to be an autosomal recessive disorder caused by biallelic loss-of-function variants in the PTGIS gene, which encodes the prostacyclin synthase. Three splice-site and nonsense variants, c. 1358+2 T>C, p.W39X, and p. E314X, were identified in five patients from four families in either homozygous or compound heterozygous states. The c.1358+2T>C variant caused exon 9 skipping (p.V403Ifs*24), which was confirmed by a minigene assay and reverse transcription polymerase chain reaction using RNA extracted from peripheral blood leukocytes of a homozygous patient. Human carotid artery endothelial cells expressing these truncated variants exhibited markedly reduced PTGIS protein and prostacyclin metabolite production. The results indicate that prostacyclin synthase deficiency is the core pathology of RCICAV. Given that prostacyclin is a potent vasodilator, impaired biosynthesis is consistent with the disease mechanism and may serve as a promising therapeutic target to prevent life-threatening events, including severe stroke and angina.
18. A Personalised Vaccination Program Based on Immune Reconstitution in Paediatric Cancer Survivors.
期刊: Acta paediatrica (Oslo, Norway : 1992) 发表日期: 2026-Apr-25 链接: PubMed
摘要
Paediatric cancer survivors often experience treatment-induced immunosuppression, requiring post-treatment revaccination. However, immune recovery timelines vary, and current revaccination guidelines, largely based on data of varied quality derived from studies on acute-lymphoblastic-leukaemia (ALL), may not be applicable across all paediatric malignancies. This study evaluated a personalised revaccination approach based on immune recovery. Immune recovery was evaluated using antibody titers to common childhood vaccines, immunoglobulin levels, B- and T-cell subpopulations, and T-cell receptor excision circles (TREC) and kappa-deleting recombination excision circles (KREC) markers. The recommended revaccination window was defined as 3-6 months post-treatment. Patients completing immune and serology testing within this window were categorised as the per-protocol-group (PPG), while others were categorised as the protocol-deviated-group (PDG). Among 19 PPG patients, 57.9% required major and 36.8% minor modifications to recommended revaccination guidelines, with major modifications more common among hematologic malignancies than solid tumours (83.3% vs. 46.2%, p < 0.0001). In the intention-to-treat (ITT) cohort (n = 52), 40.4% required major and 57.7% minor modifications; hematologic survivors again had higher rates of major modifications (52.9% vs. 34.3%, p = 0.008). Immune recovery following paediatric cancer therapy is highly variable, particularly among hematologic malignancies. Personalised revaccination strategies incorporating comprehensive immunological workups may optimise protection against vaccine-preventable diseases. Current revaccination guidelines for paediatric cancer survivors rely heavily on acute‐lymphoblastic‐leukaemia (ALL) based evidence and may not reflect the diversity of immune recovery across different malignancies. A large proportion of survivors, especially those with hematologic malignancies, experienced delayed or incomplete immune recovery, and therefore deviated from standard revaccination timelines of 3–6 months post treatment. Personalised revaccination strategies informed by comprehensive immune assessments may better ensure adequate protection against vaccine‐preventable diseases.
19. Fatty Acid Intake and Bladder Cancer Risk: A Multicenter Case-Control Study in Iran.
期刊: Nutrition and cancer 发表日期: 2026-Apr-25 链接: PubMed
摘要
Bladder cancer is a major public health concern worldwide. While smoking and occupational exposures are established risk factors, the role of dietary fatty acids (FAs) in bladder cancer risk remains unclear. Data were collected from 711 bladder cancer cases and 3,297 controls in the IROPICAN study (2017-2020) across ten Iranian provinces. Dietary intake was assessed using a validated food frequency questionnaire. Intakes of total fat, saturated FAs (SFAs), monounsaturated FAs (MUFAs), polyunsaturated FAs (PUFAs), and trans FAs (TFAs) were analyzed. Principal component analysis (PCA) identified fatty acid consumption patterns. Multivariable logistic regression estimated odds ratios (ORs) and 95% confidence intervals (CIs), adjusting for confounders. PCA suggested that balancing FA intake, specifically increasing omega-3 FAs, moderating omega-6, and reducing saturated fats, was associated with a favorable profile for bladder cancer risk. OR for stearic acid intake was 0.28 (95% CI: 0.12-0.67). Conversely, OR for high intake of palmitoleic acid, alpha-linolenic acid (ALA), and docosapentaenoic acid (DPA) was elevated. Sex-specific effects were found stearic acid was protective in men, while PUFAs were protective in women. No associations were observed for total fat or cholesterol. These results highlight the importance of FA subtypes, rather than total fat intake, in dietary recommendations.
20. Acute clinical events and trajectories of frailty after age 60: A population-based cohort study.
期刊: Journal of internal medicine 发表日期: 2026-Apr-25 链接: PubMed
摘要
We aimed to examine the relationship between acute events and frailty trajectories of community-dwelling adults aged 60 and older. We included 3146 participants, aged 60+, from the Swedish National Study on Aging and Care in Kungsholmen (SNAC-K). We considered all myocardial infarctions (MIs), lower respiratory tract infections (LRTIs) and falls that resulted in a hospitalization 5 years before to 12 years after SNAC-K baseline (2001-2004). Frailty was operationalized using a data-driven frailty index (FI), scored from 0 to 1. Linear quantile mixed models were used to examine the relationship between number and type of acute events and FI trajectories over a median follow-up of 11 years. Falls (n = 690) were most common, followed by LRTIs (n = 353) and MIs (n = 205). Those with more acute events showed significantly higher frailty levels over time from age 75 to 95. The greatest differences in frailty trajectories by event count were observed at age 80, with increases between zero to one, one to two and two to three or more events of 0.04 (95% confidence interval [CI] = 0.03-0.05), 0.08 (95% CI = 0.05-0.11) and 0.09 (95% CI = 0.05-0.13) FI units, respectively. Falls emerged as most deleterious, but there were also clear differences by MI and LRTI count after imputing frailty at death. Older adults who experience falls, LRTIs and MIs are more likely to sustain unfavourable frailty trajectories, with increasingly higher frailty levels with each additional acute event. Prevention, before age 75, should be optimized to avoid a vicious cycle of acute events and frailty progression as well as reduced lifespan.
21. Association between functional reach test scores and center of pressure measures in preschool-aged children.
期刊: Developmental neurorehabilitation 发表日期: 2026-Apr-25 链接: PubMed
摘要
Dynamic balance is a fundamental component of early motor development and is essential for functional movement and postural control in childhood. The Functional Reach Test (FRT) is widely used as a simple clinical measure of dynamic balance in pediatric populations; however, its relationship with objective postural control parameters, such as center of pressure (COP) displacement, remains unclear in preschool-aged children. The objective of this study was to examine the association between the FRT and forward COP displacement to explore the clinical utility of the FRT in healthy Japanese preschool-aged children. This cross-sectional study included 98 typically developing Japanese children aged 3-6 years. Each participant performed two FRT trials while standing on a force platform, during which COP data were recorded simultaneously. The mean values of the two trials were used for analysis. Correlation analyses were conducted to evaluate the association between FRT performance and forward COP displacement. Data normality was confirmed prior to statistical analysis. A moderate positive correlation was observed between FRT performance and forward COP displacement (r = 0.566, p < .001). In age-stratified analyses, significant associations were maintained in the 3-, 4-, and 6-year-old groups, while the association was not statistically significant in the 5-year-old group. Children with greater reach distances tended to exhibit larger anterior COP excursions during the reaching task, indicating a meaningful association between clinical FRT performance and objective postural control measures. These findings provide supportive evidence regarding the clinical utility of the Functional Reach Test as a simple and clinically practical measure of dynamic balance in preschool-aged children. The FRT may serve as a useful screening tool for assessing balance development in early childhood, particularly in settings where laboratory-based posturography is not available.
22. Wide-Awake Local Anaesthesia No Tourniquet Hand Surgery in Australia: An Analysis of Adoption, Perceptions and Implementation in a Global Context.
期刊: ANZ journal of surgery 发表日期: 2026-Apr-24 链接: PubMed
摘要
Wide-awake local anaesthesia no tourniquet (WALANT) is increasingly used globally for hand surgery, offering clinical and operational benefits. However, its adoption in Australia remains understudied. This study assessed current WALANT usage among Australian hand surgeons to identify key factors influencing its implementation. A national cross-sectional survey of all Australian Hand Surgery Society (AHSS) active members (n = 164) was conducted in 2024. The survey examined current WALANT use, perceived benefits and drawbacks, as well as facilitators and barriers of incorporation into practice. Quantitative data were analysed using descriptive and inferential statistics and qualitative data were analysed thematically. Sixty-eight surgeons responded (41% response rate). Seventy percent had performed WALANT at least once, and 50% incorporated it in practice. Current WALANT use was associated with hand surgery fellowship (OR = 8.7), prior WALANT exposure during training (OR = 6.1) and practice in university/teaching hospital (OR = 3.2). Respondents highlighted avoidance of general anaesthesia, shorter recovery, improved patient satisfaction and lower costs as benefits. Conversely, workflow inefficiencies, limited outpatient infrastructure, concerns over anaesthetist scheduling and remuneration and the absence of dedicated billing codes were the dominant barriers. Non-users viewed WALANT as more complex and remained wary of adrenaline safety, whereas users perceived more benefits and reported few technical concerns. WALANT is used by a substantial proportion of Australian hand surgeons, but broader adoption is limited by systemic and institutional barriers contributing to a perception gap. Training, infrastructure, policy reform, appropriate funding mechanisms and interprofessional collaboration may support wider integration of WALANT in Australia.
23. The relationship between self-awareness skills of healthcare workers and healthcare data quality: a cross-sectional study in Tanzanian regional referral hospitals.
期刊: BMC psychology 发表日期: 2026-Apr-24 链接: PubMed
摘要
Healthcare workers’ self-awareness skills have been shown to reduce burnout, stress, and turnover, while enhancing job satisfaction and engagement. By fostering metacognitive monitoring and error detection, self-awareness skills also underpin careful and reflective task performance. Yet its role in ensuring high-quality healthcare data, accuracy, completeness, timeliness, and consistency remains unexplored, especially within Monitoring & Evaluation systems. This study examines how core self-awareness skills (emotional awareness, accurate self-assessment, and self-confidence) influence data-management behaviors and outcomes among healthcare staff. A cross-sectional study was conducted across eight regional referral hospitals in Tanzania, involving 336 healthcare workers selected through multi-stage sampling. The study assessed three key self-awareness skills: emotional awareness, accurate self-assessment, and self-confidence and their relationship with four dimensions of healthcare data quality: accuracy (Regression A), completeness (Regression B), timeliness (Regression C), consistency (Regression D), and overall data quality (Regression E). Data were collected using self-administered questionnaires and analyzed using both descriptive and inferential statistics in SPSS version 27. The analysis showed that our regressions explained between 38.7% and 59.4% of the variance in data-quality dimensions, indicating moderate predictive accuracy (Regression E: R² = 0.594) but also leaving a substantial proportion of variance unexplained. Emotional awareness had a significant positive relationship with all five data-quality outcomes (β = 0.536 to 0.765, p < .001). In contrast, accurate self-assessment showed limited influence, significantly related to only the timeliness (regression C). Self-confidence had a significant negative relationship with all five data-quality outcomes (β = -0.168 to -0.308, p < .01). Emotional awareness was positively associated with healthcare data quality, while higher self-confidence was associated with lower data-quality scores; given the cross-sectional design, these associations warrant testing in longitudinal or experimental studies.
24. Using theory of change to better address social and economic needs in mental health services.
期刊: International journal of mental health systems 发表日期: 2026-Apr-24 链接: PubMed
摘要
Social and economic needs are greater in populations living with mental ill-health compared with the general population. However, these needs are often not routinely or adequately assessed in practice, and there is a lack of corresponding support available for a range of social and economic needs. A practical roadmap is required to work towards social and economic inclusion as a central component of mental health services. We used the participatory Theory of Change method to conduct two qualitative workshops with health care professionals, third-sector providers, academics and lived experience experts (Workshop 1, n = 16; Workshop 2, n = 14) in the area served by the South London and Maudsley NHS Trust. We co-developed a Theory of Change model which aimed to outline the key steps needed to put social inclusion at the centre of mental health care services in relation to the largest mental health Trust in the United Kingdom, yet with generalisable elements for mental health services in the United Kingdom more broadly. A shared goal for services was developed and agreed by participants of securing “a consistent mental health system that enables individuals to feel loved, valued, and capable of thriving beyond their basic needs”. To progress from the current context to this shared goal, six objective pathways were co-produced to act as a roadmap: (1) Provision of person-centred culturally appropriate care; (2) Advocacy for funding for effective social inclusion services in line with need; (3) Advocacy for funding and support of social and peer programmes; (4) Co-located and localised community-based support hubs; (5) A shared feedback system with social inclusion Key Performance Indicators (KPIs) with an ability to include positive outcomes and drive accountability; and (6) A collaborative community service network. This Theory of Change model offers a tangible framework to put social inclusion at the centre of mental health services. This model can be adapted and translated to other services and settings that are aiming to make social inclusion a core feature of their provision, beyond those in which it was developed.
25. GFAP degradation in TBI: linking novel modified products to astrocyte pathology and patient outcome.
期刊: Acta neuropathologica communications 发表日期: 2026-Apr-24 链接: PubMed
摘要
26. The ubiquitin ligase RNF115 is required for the clearance of damaged lysosomes.
期刊: FEBS letters 发表日期: 2026-Apr-24 链接: PubMed
摘要
Lysosomes play a critical role in the quality control of cellular organelles. However, lysosomal membranes can be damaged under a variety of conditions, leading to the onset of various diseases. Damaged lysosomes are selectively cleared via a ubiquitin-dependent mechanism, but the molecular mechanisms underlying this process have not been adequately elucidated. In this study, we found that RNF115 is a lysosomal damage-responsive ubiquitin ligase that undergoes massive translocation from the cytosol to the p62/SQSTM1-positive puncta around ruptured lysosomes. In accordance with the changes in its distribution, the depletion of RNF115 delayed the removal of Gal3 from damaged lysosomes during the restoration process following lysosomal damage. These observations suggest that RNF115 is responsible for the clearance of damaged lysosomes.
27. Relationship Between Daily Step Count, Biological Markers, and Clinical Outcomes in Patients With Sickle Cell Anemia: A Cross-Sectional Study.
期刊: European journal of haematology 发表日期: 2026-Apr-24 链接: PubMed
摘要
Sickle cell anemia (SCA) is characterized by recurrent pain, chronic hemolysis, autonomic imbalance, and progressive vascular dysfunction. In sub-Saharan Africa, where access to disease-modifying therapies remains limited, identifying modifiable behavioral determinants such as physical activity (PA) is of particular clinical relevance. This study examined the associations between objectively measured daily step count and clinical, biological, hemorheological, vascular, and autonomic parameters in adults with SCA. Ninety-eight adults with SCA were stratified into tertiles according to accelerometer-derived daily step count. Pain burden, renal indices (albuminuria and estimated glomerular filtration rate [eGFR]), hematological and hemorheological parameters, arterial stiffness (carotid-femoral pulse wave velocity), and heart rate variability were assessed. Higher daily step counts were associated with less frequent intense pain, reduced blood viscosity, and a higher hematocrit-to-viscosity ratio. More active participants also exhibited lower arterial stiffness and greater parasympathetic modulation. A graded, linear pattern was observed across tertiles for most outcomes. Although eGFR was positively associated with physical activity, this relationship was largely explained by age differences between groups. Greater daily physical activity is associated with a more favorable clinical and physiological profile in adults with SCA. While causality cannot be inferred, daily PA may represent both a marker of health status and a potential target for preventive strategies in this population. UMIN000042826.
28. Phase-dependent efficacy of intravenous amniotic mesenchymal stem cells in a rat spinal cord injury model.
期刊: Stem cell research & therapy 发表日期: 2026-Apr-24 链接: PubMed
摘要
Spinal cord injury results in profound neurological disability driven initially by primary mechanical damage and subsequently by secondary injury processes characterized by progressive neuroinflammation. Intravenous administration of human amniotic mesenchymal stem cells (MSC) has emerged as a promising therapeutic approach; however, the optimal timing of administration and its relationship to dynamic immune responses remain unclear. A rat contusion model of spinal cord injury was used to evaluate the effects of intravenous MSC administration at three post-injury time points: days 1, 3, and 7. Functional and histological assessments were performed for each group. Systemic inflammatory responses were evaluated through blood analysis of neutrophil and macrophage counts, systemic inflammation index (SII), and plasma proteomics. Local immune responses were assessed by quantifying infiltrating immune cells within the injured spinal cord. The most substantial improvement in locomotor function was observed in the day-1 treatment group, followed by the day-7 group, whereas the day-3 group showed minimal benefit. The day-3 group also demonstrated a trend toward greater lesion length and increased macrophage infiltration 28 days after injury. MSC administration reduced SII in the day-1 and day-7 groups but not in the day-3 group, which instead showed an increased systemic inflammatory response. Analysis of spinal cord tissue demonstrated that MSC treatment on day-1 effectively reduced neutrophil infiltration, which peaks at this time point, while day-7 administration reduced macrophage infiltration during its peak phase. In contrast, MSC administration on day-3 failed to attenuate either neutrophil or macrophage accumulation. Plasma proteomic profiling revealed enhanced complement and coagulation pathway activation specifically on day-3. The therapeutic efficacy of intravenously administered MSC is highly dependent on the timing of intervention. Optimal benefit is achieved when treatment coincides with peak activation of a dominant target immune cell population and avoids the peak of complement and coagulation signaling. These findings support a phase-matched therapeutic strategy to maximize MSC effectiveness following spinal cord injury.
29. Neurological management and outcome measures in Fabry disease: consensus statements from the Italian Fabry disease neurological working group.
期刊: Orphanet journal of rare diseases 发表日期: 2026-Apr-24 链接: PubMed
摘要
30. Induced membrane spontaneous osteogenesis leading to tibiofibular fusion: a study of case series and literature review.
期刊: BMC musculoskeletal disorders 发表日期: 2026-Apr-24 链接: PubMed
摘要
31. Editorial Commentary: Let's Continue the Debate of Hip Capsule Management: Periportal Capsulotomy Without Closure Can Lead to High Rates of Achieving Meaningful Clinical Outcomes.
期刊: Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association 发表日期: 2026-Apr-24 链接: PubMed
摘要
Adequate visualization for femoroacetabular impingement syndrome treated by hip arthroscopy is critical to avoid leaving residual structural disease. Proponents of access to the hip via interportal and T-capsulotomy argue that performing a larger capsulotomy allows for appropriate management of intra-articular pathology, with capsular closure required to prevent iatrogenic instability. However, advocates of smaller capsular incisions have recently published literature that suggests management of intra-articular hip pathology with periportal capsulotomy incision confers to high rates of patients achieving meaningful clinical outcomes at midterm follow-up with no need for revision arthroscopy or conversion to total hip arthroplasty. Some periportal capsulotomy proponents argue that superior postoperative outcomes can be achieved without capsular closure, implying that a minimalistic approach to capsular incision does not lead to hip instability if not closed. While the long-standing debate of how to best address capsular management continues on, there is promising evidence that periportal capsulotomy without closure can result in satisfactory outcomes for patients undergoing hip arthroscopy for treatment of femoroacetabular impingement syndrome.
32. Food Insecurity is Associated with COPD Prevalence and Mortality: Evidence from U.S. County-Level Data.
期刊: Annals of the American Thoracic Society 发表日期: 2026-Apr-24 链接: PubMed
摘要
Although unreliable access to healthy food has been linked to lower lung function, a higher burden of respiratory symptoms, and more frequent respiratory exacerbations in individuals with COPD, its association with COPD prevalence and mortality remains understudied. To determine the associations between food insecurity and COPD prevalence and COPD mortality at the county level in the United States. We obtained 2018 U.S. county-level data on food insecurity prevalence (FI%) and the Food Environment Index (FEI; lower values indicate worse food desert conditions) from County Health Rankings. We then queried the CDC’s National Environmental Public Health Tracking and WONDER databases for county-level COPD prevalence (2018) and COPD-related mortality (2018-2020), respectively. We constructed negative binomial regression models adjusted for demographic, socioeconomic, and health factors to examine the associations of FI% and FEI with COPD prevalence and mortality. The mortality model was additionally adjusted for county COPD prevalence. Counties with FI% at or above the median (13.2%) and those with FEI below the median (7.6) had lower median household income, lower primary care physician density, higher average daily PM2.5 concentration, and higher prevalence of poverty, uninsured status, rural residence and cigarette smoking (P < .001 for all analyses). In fully adjusted models, a 1% higher FI% was associated with a 1.62% higher COPD prevalence (95% CI 1.40-1.83%; P < .001), and a 1-unit lower FEI was associated with a 1.85% higher COPD prevalence (95% CI 1.17-2.54%; P < .001). A 1% higher FI% was independently associated with a 3.54% increase in COPD-related mortality (95% CI 2.86-4.22%; P < .001), and a 1-unit lower FEI with a 10.05% increase in COPD-related mortality (95% CI 7.82-12.27%; P < .001). Unreliable food access is associated with higher COPD prevalence and mortality at the county level. These results suggest that improving food access may be a target for improving population-level COPD outcomes.
33. Reassessing soil ecotoxicity of fluoride: Integrating species sensitivity distribution and organic matter correction with an expanded toxicity data set.
期刊: Integrated environmental assessment and management 发表日期: 2026-Apr-24 链接: PubMed
摘要
With the increasing complexity and diversity of environmentally hazardous chemicals, the availability of quantitative ecotoxicity data has become essential for soil risk management. Fluoride is widely used, and its aquatic toxicity is well understood, but quantitative soil ecotoxicity data remain scarce, limiting the establishment of soil protection values. To address this data gap, this study generated acute ecotoxicological data for fluoride using the soil alga Chlorococcum infusionum (primary producer) and the springtail Folsomia candida (decomposer), and compared species sensitivity distributions (SSD) with and without soil alga and springtail. Fluoride exposure reduced algal photosynthetic pigment concentrations for 6 days and survival of springtail for 14 days. Fluoride exposure significantly reduced algal photosynthetic pigments (6d-EC50 919.7 mg/kg for Chl-a, 943.7 mg/kg for Chl-b, and 988.3 mg/kg for carotenoid), and springtail survival (14d-LC50 539.3 mg/kg), with SSD-derived HC5 value 55 mg/kg (based on an organic matter content of 3.4%) considering four taxonomic groups. This finding indicates that the newly generated toxicity data for soil algae and springtail facilitates the establishment of a reliable SSD model. The results provide scientific evidence to support the development of soil health indicators and regulatory benchmarks for managing fluoride contamination in terrestrial ecosystems.
34. Dog bite injuries and armed conflict-related environmental stressors: a nationwide population-based time-series study.
期刊: Injury epidemiology 发表日期: 2026-Apr-24 链接: PubMed
摘要
Dog bite injuries pose a substantial public health burden worldwide. Environmental and acoustic stressors may contribute to dog behavioral dysregulation. However, there are as yet no population-level studies evaluating whether the incidence of dog bites increases during periods of armed conflict. The present study was conducted in Israel where the population is routinely exposed to an episodic pattern of high-intensity conflicts (escalation) alternating with periods of calm (de-escalation), providing a unique natural experiment to examine the effect of environmental stressors on population-level modifiers of injury risk. This nationwide retrospective observational study covered the decade from 2014 to 2025. Healthcare-encounter data were used to capture dog bite-related diagnoses in both hospital and community settings. Exposure to armed conflict-related environmental stress was operationalized using the number of civil defense sirens per month, categorized as none (0), low (< 500), or high (≥ 500) and aggregated by geographic region (North, Center, South). Monthly dog bite counts were modeled using negative binomial regression adjusted for region, seasonality, age group, sex, and socioeconomic status. Secondary outcomes were hospitalization within 7 days and surgical intervention within 30 days, reflecting injury severity. A total of 63,285 dog bite-related encounters were identified. Compared to months with no sirens, adjusted dog bite incidence increased by 15% during low-exposure months (incidence rate ratio [IRR] 1.15, 95% CI 1.13-1.18) and by 33% during high-exposure months (IRR 1.33, 95% CI 1.28-1.37), demonstrating a graded exposure-response association. High exposure was associated with increased odds of surgical intervention within 30 days (OR 1.09, 95% CI 1.02-1.16; P = 0.013). This study provides the first population-level evidence linking armed conflict-related environmental stressors to increased dog bite incidence, using a quantitative graded exposure measure rather than a binary conflict-period definition. Dog bite prevention and healthcare preparedness should be taken into consideration in civilian injury mitigation strategies during armed conflict.
35. Testing nature-based biopsychosocial resilience theory: a research programme protocol.
期刊: Archives of public health = Archives belges de sante publique 发表日期: 2026-Apr-24 链接: PubMed
摘要
36. Integrative bioinformatics, network toxicology, and molecular docking elucidate molecular mechanisms of ATBC-induced sarcoma progression with experimental validation.
期刊: BMC pharmacology & toxicology 发表日期: 2026-Apr-24 链接: PubMed
摘要
37. Occupation and urinary phthalate metabolite concentrations in a national survey of adults in Canada.
期刊: Environmental health : a global access science source 发表日期: 2026-Apr-24 链接: PubMed
摘要
38. Causal relationship between epigenetic markers and type 2 diabetes in West African populations: a Mendelian randomisation analysis.
期刊: Diabetologia 发表日期: 2026-Apr-24 链接: PubMed
摘要
Evidence for a causal role of DNA methylation sites (CpGs) in type 2 diabetes and glycaemic traits is limited due to the cross-sectional nature of many epigenome-wide association studies (EWAS). In addition, epigenetic studies in West African populations are particularly sparse, despite the high and rising burden of type 2 diabetes in these populations. Hence, we aimed to identify CpGs causally associated with type 2 diabetes among West Africans by leveraging Mendelian randomisation (MR) analysis and longitudinal data. We used the Illumina EPIC DNA methylation array to profile the methylation of DNA extracted from white blood cells collected from 879 Ghanaian individuals (the Research on Obesity and Diabetes among African Migrants [RODAM] study) and 332 Nigerian individuals (the Africa America Diabetes Mellitus [AADM] study) who were not on glucose-lowering medication. We carried forwards CpGs identified in EWAS for type 2 diabetes and meta-analysed EWAS for HbA1c and homeostatic model assessment estimates of insulin sensitivity (HOMA-S) as exposures to two-sample MR analysis. Independent cis methylation quantitative trait loci (meQTLs) were calculated using methylation data from blood and primary hepatocytes and subsequently used as instrumental variables (SNP-exposure associations). Genome-wide association analyses for type 2 diabetes on 4120 participants from the AADM study were used to derive the SNP-outcome associations. Longitudinal trait data (n=138) and RNA-seq data (n=77 blood, 49 adipose, 55 muscle) available for a subset of Nigerians were used for follow-up analyses. We identified 28 CpGs associated with type 2 diabetes, 26 with HbA1c and three with HOMA-S (total CpGs: 57), of which 49 had meQTLs in blood (AADM study data) and four had meQTLs in primary hepatocytes from African American individuals. MR analysis provided evidence for causality for cg00036588 and cg16759041 in type 2 diabetes using blood and hepatocyte meQTLs, respectively. Longitudinal analyses showed an association between baseline methylation of these CpGs with HbA1c at follow-up. RNA-seq data revealed a cis correlation of cg00036588 with FAM83C (false discovery rate [FDR]=3.3 × 10-4) and EIF6 (FDR=0.13) in skeletal muscle. Our study identified two epigenetic markers as likely to be causal for type 2 diabetes in West African populations. In addition to enhancing our understanding of disease mechanisms, these CpGs with evidence of causal associations could be prioritised as potential biomarkers for early detection of disease or as drug development targets.
39. An assessment of measurement error when using maternal urinary phthalates as proxies for placental tissue levels in the estimation of the association of prenatal phthalates and infant anogenital distance.
期刊: Journal of exposure science & environmental epidemiology 发表日期: 2026-Apr-24 链接: PubMed
摘要
Direct measurement of in utero phthalate exposure in placental and fetal tissues is generally not possible. Maternal urinary levels serve as proxies and may introduce measurement error, biasing health effect estimates. We adjusted for measurement error when using maternal urinary phthalates as proxies for placental-fetal exposure and to evaluate the impact of this correction on the association between prenatal phthalate exposure and anogenital distance (AGD). We biopsied and analyzed 68 placentas from the TIDES study (San Francisco site: n = 204, 2010-2012). Phthalate metabolite concentrations were measured in three placental tissue types: chorion smooth (CS), chorion frondosum (CF), and basal plate (BP). Phthalate concentrations were standardized to remove pre-processing variation. Regression calibration (RC) and multiple imputation for measurement error (MIME) were used for correction. Associations between phthalates and AGD were estimated by generalized linear models. Bias was quantified by calculating the percent change in the beta coefficient from the gold standard (placental phthalate) to the proxy (urinary phthalate), after correction for measurement error. Phthalate metabolites were detected in over 70% of placental tissues. Monoethylhexyl (MEHP) phthalate was the most abundant metabolite in CF and in CS. Phthalate concentrations were lowest in BP and varied across placental tissues. Weak associations were found between urinary and placental phthalates. MIME outperformed RC, reducing bias in the average phthalate effect on AGD in the male by 30% for AGD-penis and 69% for AGD-scrotum, and in the female by 32% for AGD-clitoris and 45% for AGD-fourchette. Placental phthalate concentrations varied by tissue type and showed poor correlation with maternal urinary levels. MIME outperformed RC in adjusting for measurement error in this setting. Findings suggest maternal and placental exposures are distinct constructs, highlighting the need for direct placental measurement in phthalate toxicity studies. Further research can improve phthalate exposure assessment and knowledge of maternal-placental-fetal transfer. This study highlights a key gap in environmental health research, where maternal urinary phthalates are often used as proxies for placental and fetal exposure. Using two correction methods, we found that maternal urinary and placental phthalates represent distinct exposure constructs and are not interchangeable.
40. Development of a farmworker soil exposure scenario to support the derivation of soil screening levels for per-and polyfluoroalkyl substances (PFAS).
期刊: Journal of exposure science & environmental epidemiology 发表日期: 2026-Apr-24 链接: PubMed
摘要
Soil screening levels (SSLs) are an important guidance tool for identifying sites where exposure to soil contaminants may pose health risks to people residing or working nearby; however, to date, no soil screening levels or default exposure scenario have been established specifically for farmworkers who have frequent, direct soil contact through their typical occupational tasks and behaviors. We developed an exposure scenario for a vegetable farmworker’s soil exposure. We apply this exposure scenario to derive and compare noncarcinogenic-based soil screening levels for four PFAS commonly detected in soil from farm fields with a history of land application of biosolids in Maine. We used existing EPA models for incidental soil ingestion and dermal contact, parameterizing model inputs with distributions drawn from the literature to be more representative for farmworkers. We developed an empirical model of the inhalation pathway using literature-reported exposure and time-activity data. We used Monte Carlo simulation to evaluate these models with toxicity values in the EPA Regional Screening Levels database to derive SSLs for the individual and combined pathways and compared these results to soil PFAS levels from a statewide testing program of biosolids-amended farmland. The 5th percentile values from the distribution of combined pathway SSLs were 26, 7.9, 790, and 0.5 ng/g for PFOS, PFOA, PFNA, and PFDA, respectively. Sensitivity analyses identified the incidental soil ingestion rate as the most influential parameter in deriving a SSL for our farmworker scenario. We found overlap for PFOS, PFOA, and PFDA in the distributions of plausible SSLs for a vegetable farmworker scenario and measured soil levels from a statewide testing program. Our comparison of these farmworker SSLs to more routinely evaluated adult exposure scenarios (residential, outdoor worker, construction worker) indicated that these other scenarios may not be protective of farmworkers. The farmworker exposure scenario and PFAS soil screening levels we developed are a novel and necessary public health tool for protecting farmworkers from exposure to contaminants in soils and informing risk management decisions for farms and fields amended with biosolids.
41. Incorporating a dermal absorption route into high throughput toxicokinetic modeling.
期刊: Journal of exposure science & environmental epidemiology 发表日期: 2026-Apr-24 链接: PubMed
摘要
Dermal absorption of chemicals represents an important route of exposure in pharmaceutical, occupational, and environmental settings. Thousands of chemicals with little toxicity or toxicokinetic (TK) data are in use. However, in many cases, in vitro bioactivity data are available. While it is not feasible to collect in vivo TK data, TK may be estimated using high-throughput methods. This study developed a generalized physiologically-based TK (PBTK) dermal exposure model for in vitro-in vivo extrapolation (IVIVE). This model estimates dermal exposures that result in systemic concentrations comparable to those associated with in vitro bioactivity. The PBTK model simulated dermal exposures for 22 unique exposure scenarios across 12 chemicals with published in vivo concentration time course TK data. Two different methods for estimating chemical- and vehicle-specific skin permeability were evaluated: Potts-Guy [1] and Surrey [2]. Root mean squared log10 errors (RMSLE) were calculated on a per-chemical and method basis. Given only 12 chemicals with in vivo TK data to permit evaluation, a single, optimal method for predicting dermal permeability could not be identified. IVIVE was performed separately using both permeability methods to calculate administered equivalent doses (AEDs) relevant to potential occupational exposure for 561 chemicals with in vitro bioactivity data. AEDs were defined here as parts per million (ppm) solution concentrations that would result in bioactive plasma concentrations after eight hours of submerged hands. The Potts-Guy method indicated that AED concentrations were not achievable for many chemicals. The new dermal PBTK model works with a pre-existing database of more than one thousand compounds including industrial chemicals and pesticides. Regardless of method, IVIVE indicated that dermal exposures can lead to bioactive plasma concentrations for only a small fraction of the chemicals with in vitro bioactivity data examined. Gloves might be recommended for handling those chemicals. Rapid estimation of risk posed by chemicals through dermal contact is an important need for occupational settings. A generic PBTK model was developed to characterize dermal absorption using chemical-specific in vitro data for metabolism and protein binding and physico-chemical properties. The model was evaluated using in vivo toxicokinetic data for multiple chemicals. The data were equivocal with respect to different dermal absorption assumptions. The new model allows for conversion of in vitro chemical bioactivity data from high-throughput toxicity screening to solution concentrations that would result in bioactive plasma concentrations in occupationally relevant conditions.
42. Polygenic Risk Scores in Healthcare Contexts: Expanding Roles, Redrawing Boundaries?
期刊: Genetics in medicine : official journal of the American College of Medical Genetics 发表日期: 2026-Apr-23 链接: PubMed
摘要
43. Plasma proteomic signatures of childhood adversity.
期刊: Protein & cell 发表日期: 2026-Apr-22 链接: PubMed
摘要
44. Factors Associated With Paradoxical Masseteric Bulging After Botulinum Toxin Injection for Masseter Hypertrophy: A Retrospective Analysis.
期刊: Journal of cosmetic dermatology 发表日期: 2026-Apr 链接: PubMed
摘要
Botulinum neurotoxin (BoNT) injection is the preferred minimally invasive treatment for masseter hypertrophy, but paradoxical masseteric bulging (PMB) is a distressing complication. How to clinically prevent and avoid the development of PMB remains a key concern for injecting physicians. This study collected ultrasound and injection data from 22 PMB masseter muscles and 66 non-PMB masseter muscles between September 2024 and January 2025. Univariate analysis was used to compare imaging and injection-related parameters between the two groups, including masseter prominence, masseter thickness, deep inferior tendon (DIT) type, DIT thickness, intraoperative tactile sensation, and injected agent. Univariate analysis showed significant intergroup differences in masseter prominence grade, DIT type, DIT thickness, masseter thickness, injection dosage, and intraoperative tactile sensation (all p < 0.05). The PMB group had greater masseter thickness (13.30 ± 0.171 mm vs. 10.32 ± 0.169 mm), thicker DIT (0.85 [0.348] mm vs. 0.60 [0.208] mm), and a higher incidence of fascial penetration sensation than the control group. Preoperative ultrasound assessment of masseter and DIT characteristics, combined with individualized layered injection and intraoperative tactile feedback, effectively mitigates PMB risk. Ultrasound-guided precise supplementary injection is the preferred intervention for PMB management.
45. Comparison of the Prognostic Value of Three Different Single HLA Based Antibody Detection Assays.
期刊: HLA 发表日期: 2026-Apr 链接: PubMed
摘要
Single antigen (SA) tests are indispensable for an accurate HLA antibody identification in sera of transplant patients. Three commercial tests using purified single antigens combined with microbead or microarray technology are currently available. This study aims to determine the prognostic value of these tests prior to kidney transplantation. Forty-nine pretransplant sera with donor-specific antibodies (DSA) from patients who underwent kidney transplantation from a living donor were selected from a previous multicentre study. All sera were tested by a new microspot SA test from BAG and bead array SA assays from Immucor/Werfen (IMM) and One Lambda/ThermoFisher (OLI). AMR-free survival within 6 months (AMR-S) and 10-year death-censored graft survival (10yGS) were compared to DSA-negative patients from the original study and evaluated according to (1) number of SA tests classifying the serum as DSA-positive (DSA+), and (2) number of SA tests detecting at least one identical DSA specificity. In part (1), the 22 patients classified as DSA-positive by all tests had lowest AMR-S and 10yGS. OLI was most sensitive and classified all sera as DSA-positive that were DSA-positive by BAG and/or IMM. However, the 14 patients who were DSA-negative by both BAG and IMM, had similar AMR-S and 10yGS like patients without any DSA. Overall, BAG and IMM had comparable sensitivities. In part (2), at least one identical DSA was detected by all tests in 18 patients, who had worse AMR-S and 10yGS. In 14 patients, the same DSA was detected by IMM and OLI, or by BAG and OLI, respectively. These patients had lower AMR-S, but no significant difference in 10yGS. In 17 sera, DSA were detectable by one or more tests, but no specificity was positive in more than one assay (in all sera DSA were detected by OLI, in one additionally another DSA by IMM and in two another DSA by BAG). AMR-S and 10yGS were similar to DSA-negative patients. Overall, all three SA assays were suitable for the reliable detection of strong DSA. OLI was shown to be the most sensitive assay, but also prone to possible false positive results defined by the lack of an association with impaired outcomes. Future studies are needed to determine how many OLI-only reactions are caused by very weak DSA and how many by reactions with denatured beads. While such reactions were rare for BAG and IMM assays, these tests missed some DSA associated with an increased risk for AMR.
46. Trailblazing Person-Centred Care: Lessons From a Hospital Cluster-Wide Retreat to Co-Design Approaches to Person-Centred Care in Singapore.
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
Person-centred care (PCC) is globally recognised as essential for quality healthcare, yet implementation remains inconsistent in Singapore due to hierarchical structures, time constraints, and fragmented understanding. SingHealth, Singapore’s largest public healthcare cluster, initiated a retreat to co-design a unified approach to PCC across its institutions. The retreat aimed to (1) align stakeholders on PCC’s importance; (2) co-develop a locally tailored PCC definition; (3) advance PCC through five workstreams (user experience, research, education, service innovation, strategic partnerships); and (4) provide experiential co-design learning. This qualitative case study employed reflexive thematic analysis to analyse data from a retreat designed using Goffman’s frame analysis. The retreat engaged 42 healthcare practitioners, 26 senior management, and 13 patient/caregiver experience experts in a three-phase co-design process. 1. Pre-design: Strategic stakeholder invitation and pre-reading to align perspectives. 2. Generative phase: Creative methods (‘Frozen’ metaphors, flip cube exercises and patient videos) to explore PCC’s ‘what’ and ‘why’, followed by live visual scribing, discussion and presentation. 3. Evaluative phase: Visioning exercises, debates on patient autonomy, and development of an implementation matrix. Four key themes emerged:. 1. Shared responsibility between patients and providers. 2. Communication skills as foundational to PCC. 3. Integration of PCC into systems and culture. 4. Actionable steps, including patient-reported experience measures and new models of care. Tangible outputs included a shared vision- ‘Empowering individuals. Everyone matters’ and a five-level implementation matrix operationalising PCC at institutional, departmental, and patient-provider levels. The retreat successfully fostered stakeholder alignment and co-designed actionable strategies for PCC. The co-design process successfully revealed nuanced tensions around shared responsibility while generating implementable strategies. This model demonstrates how structured stakeholder engagement can advance PCC in hierarchical healthcare systems. Experience experts (patients and caregivers), constituting 16% of retreat participants, were strategically recruited from established networks. They actively co-designed the PCC definition, participated in world café discussions, informed implementation strategies across five workstreams, co-created the vision statement and validated the final implementation matrix. Their lived experiences critically shaped key themes of this event. One experience expert co-authored this manuscript, reflecting sustained partnership.
47. The role of life-course socioeconomic position in cognitive change and mild cognitive impairment among middle-aged and older US Hispanic/Latinos.
期刊: Alzheimer’s & dementia : the journal of the Alzheimer’s Association 发表日期: 2026-Apr 链接: PubMed
摘要
The role of life-course socioeconomic position (SEP) in cognitive aging remains unclear. We assessed the association between life-course SEP with cognitive change and prevalent mild cognitive impairment (MCI). We used data from the Hispanic Community Health Study/Study of Latinos (2008 to 2011) and its Study of Latinos-Investigation of Neurocognitive Aging (SOL-INCA) ancillary study (2015 to 2018, n = 6351; aged ≥45 years). Weighted linear and logistic regression analyses estimated the association between childhood and adult SEP (low and high) and socioeconomic mobility (enduring high or low SEP, upward or downward mobility) with change in cognitive function and prevalent MCI, respectively. Childhood SEP was associated with greater adverse cognitive change but was not associated with prevalent MCI. Low adult SEP, downward mobility, and enduring low SEP were associated with greater adverse cognitive change. Enduring low SEP was additionally associated with higher odds of MCI. Life-course SEP is associated with changes in cognitive aging in middle-aged and older Hispanic/Latino adults.
48. Differential associations between traumatic brain injury severity and four dementia phenotypes in military veterans.
期刊: Alzheimer’s & dementia : the journal of the Alzheimer’s Association 发表日期: 2026-Apr 链接: PubMed
摘要
National Veterans Affairs electronic health records were used to examine the association between traumatic brain injury (TBI) severity and four dementia phenotypes ranging from narrow (strict AD) to broad (all-cause dementia). Veterans with TBI (n = 91,753) and a propensity score-matched comparison group of veterans without TBI (n = 183,506) were included. Four validated dementia phenotypes defined using International Classification of Diseases (ICD) codes were evaluated. The association between TBI severity and each dementia phenotype was examined using adjusted logistic regression. TBI severity was significantly associated with increased odds of developing dementia across the three broader dementia phenotypes in a dose-response manner (moderate/severe/penetrating TBI > mild TBI). Those with unclassified TBI had disease risk falling in between mild and more severe TBI. In contrast, TBI was associated with decreased risk of strict AD across all severity levels. Findings support a dose-response relationship between TBI severity and broader dementia risk but raise questions regarding the TBI-AD link.
49. A National Hypertension Awareness and Early Screening Initiative: "Act at 30 - It's Time for Heart Check".
期刊: Journal of clinical hypertension (Greenwich, Conn.) 发表日期: 2026-Apr 链接: PubMed
摘要
India is witnessing a growing burden of early-onset hypertension and cardiovascular disease, particularly among adults under the age of 40. Despite this trend, current national screening programs predominantly target individuals over 40, resulting in a significant gap in early detection and prevention efforts. This white paper addresses this gap by drawing on a mixed-methods approach that combines an extensive review of national and international literature, health surveys, and hypertension guidelines with qualitative insights from 25 expert consultations. These consultations included cardiologists, endocrinologists, and public health specialists, and were conducted through structured one-on-one interviews and focused group discussions. The findings revealed that nearly 25% of Indian adults aged 30-39 are already hypertensive or pre-hypertensive, with lifestyle-related risk factors such as chronic stress, unhealthy diets, physical inactivity, and obesity contributing to early cardiovascular risk. Experts unanimously emphasized the widespread underdiagnosis and lack of awareness in this age group, highlighting missed opportunities for early intervention. A strong consensus emerged around the urgent need to lower the current screening threshold to age 30 and introduce first-time cardiovascular assessments, including blood pressure, glucose, lipid profiles, and obesity metrics at this stage. The paper argues that implementing early screening through existing health infrastructure, workplace wellness initiatives, and digital health platforms is both epidemiologically sound and economically viable. A national policy shift in this direction could significantly improve early detection, reduce disease burden, and enhance long-term health outcomes for the Indian population.
50. Trends in Government-Subsidised Menopausal Hormone Therapy Dispensing in Australia Between 2014 and 2023.
期刊: The Australian & New Zealand journal of obstetrics & gynaecology 发表日期: 2026-Apr 链接: PubMed
摘要
Menopausal hormone therapy (MHT) is a mainstay treatment for menopausal symptoms. While international studies report rising MHT use, trends in Australia remain unclear. Using a 10% random sample of Pharmaceutical Benefits Scheme (PBS) data from 2014 to 2023, we analysed the prevalence of MHT dispensing among women aged 45-64. Overall prevalence of MHT dispensing remained stable (relative annual change: 0.42%, 95% CI -0.50 to 1.35). Use of transdermal and intrauterine device (IUD) MHT increased (5.89%, 95% CI 3.88-7.91 and 10.22%, 95% CI 9.48-10.95, respectively), and vaginal MHT decreased (-1.47%, 95% CI -2.30 to -0.63), while oral MHT appeared stable (0.66%, 95% CI -0.04 to 1.36). This study offers a clearer understanding of how MHT use in Australia has changed over the last decade.
51. The Role of Polyphenols in Regulating Skeletal Muscle Development and Homeostasis: Molecular Mechanisms and Potential Medical Applications.
期刊: Molecular nutrition & food research 发表日期: 2026-Apr 链接: PubMed
摘要
A healthy lifestyle, characterized by moderate physical activity, appropriate caloric intake, and a diet rich in fruits and vegetables, contributes to maintaining overall health and preventing several degenerative diseases. Within this context, the health of the muscular system also plays a pivotal role. Increasing evidence highlights the importance of a balanced diet, in combination with regular physical exercise, in preserving muscle function and integrity. Polyphenols, present in fruits, vegetables, and plant-derived foods, have emerged as key allies in counteracting oxidative stress and inflammation, processes that affect muscle cell health. These compounds are involved in the regulation of muscle cell development and differentiation, as well as in the regeneration processes following injury or excessive physical exertion. Through their ability to modulate reactive oxygen species levels, inflammation, and specific cellular pathways, polyphenols are capable of influencing muscle development and homeostasis. This review provides a comprehensive overview of current knowledge regarding the impact of polyphenols on skeletal muscle growth, development, and maintenance, with a focus on their mechanisms of action and therapeutic potential. Recent and innovative extraction and administration strategies, aimed at overcoming some limitations that normally characterize experimentation with bioactive molecules such as polyphenols, are considered and discussed in a prospective view.
52. Multi-Factorial and Multi-Component Fall Prevention Interventions Initiated From the Emergency Department: A Systemic Review and Meta-Analysis.
期刊: Academic emergency medicine : official journal of the Society for Academic Emergency Medicine 发表日期: 2026-Apr 链接: PubMed
摘要
Fall risk screening and prevention interventions initiated from the Emergency Department (ED) are endorsed by current national guidelines. We aimed to evaluate the effectiveness of ED-based multi-factorial and multi-component interventions to prevent falls. We conducted a systematic review and meta-analysis of interventions for fall prevention initiated in the ED for older patients (age ≥ 60 years). Multi-component and multi-factorial interventions were included. We excluded studies without a control or comparison group. The published literature was searched from 2019 to May 2024. Risk of bias was assessed with the Newcastle Ottawa tool for observation studies and the Cochrane Risk of Bias v2 for randomized trials. A meta-analysis was completed for the outcomes with multiple studies. The search resulted in 6312 abstracts with 2571 duplicates, for 3741 unique citations. A total of 18 studies were included in the systematic review; 5 were rated as high risk of bias/low quality. The articles were heterogenous in the intervention type (8 multi-factorial and 8 multi-component), setting (ED focused vs. outpatient), intervention components (i.e., nurses, physicians, therapists), and size (103-1435 participants). The interventions did not decrease risk of falls at 3 months (risk difference 0.05 95% CI [0.00; 0.09]), 6 months (0.07 [-0.04; 0.18]) or 12 months (-0.02 [-0.11; 0.07]). ED revisits at 1 month (-0.01 [-0.03; 0.00]), 3 months (-0.04 [-0.14; 0.06]), and 12 months (0.02 [-0.05; 0.25]) were also unchanged. Mortality and hospitalization rates were also unaffected. Improvement in functional status was noted in 4 of 5 studies reporting this outcome. Multi-factorial and multi-component fall prevention interventions initiated from the ED did not decrease falls or recurrent healthcare use. These interventions may improve functional status in older adults at fall risk. Comparisons are limited by the heterogeneity in types of interventions, intervention compliance, and timing of outcomes.
53. Polymorphisms in CLAUDIN1 and SPINK5 Influence Skin Absorption of Pyrene, Pyrimethanil, and Oxybenzone in Human Volunteers.
期刊: Environmental and molecular mutagenesis 发表日期: 2026-Mar 链接: PubMed
摘要
Absorption of chemicals through the skin affects occupational and environmental exposure to diverse compounds. We previously showed that loss-of-function (null) mutations and low-copy number variants (CNV) of Filaggrin (FLG), which encodes a key skin barrier protein, increased dermal chemical absorption; however, the FLG genotype did not explain all the observed variation. Here, we explore the effects of variation in genes encoding skin proteins that could affect chemical uptake. In a dermal exposure test, 23 null-FLG and 31 wild-type carriers were exposed to three common organic compounds: the polycyclic aromatic hydrocarbon pyrene, the fungicide pyrimethanil, and the ultraviolet-light absorber oxybenzone. Liquid chromatography-mass spectrometry was used to measure the concentrations of these chemicals or their metabolites in the subjects’ urine collected over a 40-h period following exposure. We genotyped the participants for 14 polymorphisms in seven skin function-related genes (Filaggrin 2 [FLG2], including a new method for assessing FLG2 CNV, claudin 1 [CLDN1], serine peptidase inhibitor kazal type 5 [SPINK5], S100 calcium binding protein A7 [S100A7], transmembrane protein 79 [TMEM79], laminin subunit alpha 3 [LAMA3], and involucrin [IVL]) and performed a population toxicokinetic analysis. While controlling for FLG genotype, the CLDN1 rs893051 minor allele was associated with increased absorption, faster absorption rate, and longer lag time, while the SPINK5 rs2303067 minor allele was associated with shorter lag time. However, the differences in total systemic absorption were minor compared with FLG variants. Thus, FLG remains the predominant genetic determinant of chemical uptake through the skin.
54. A Survey of DNA Damage in American Alligators (Alligator mississippiensis) in Florida.
期刊: Environmental and molecular mutagenesis 发表日期: 2026-Mar 链接: PubMed
摘要
The scientific concept of One Environmental Health is a research strategy focused on the study of toxicants, aiming to incorporate human, wildlife, and ecosystem health to establish a more comprehensive understanding of health. A One Environmental Health approach, studying the responses of American alligators (Alligator mississippiensis) that are considered apex sentinel organisms to environmental toxicants, is crucial. Due to their long-lived lifestyle on land and water, including a wide range of prey items in their diet and their ability to bioaccumulate metals, alligators serve as effective indicators of heavy metal pollution, which poses risks to aquatic ecosystems and human health. In this study, we examined DNA damage in American alligators from three locations in Florida using comet assay. We found alligators in Merritt Island National Wildlife Refuge had significantly higher DNA damage levels compared to those in Lake Apopka and Lake Woodruff. This trend was consistent across both sexes, with no observed sex differences. Similarly, DNA damage levels were significantly higher in both adult and juvenile alligators from Merritt Island compared to the other locations. Notably, juvenile alligators exhibited higher DNA damage than adults, with animals from Merritt Island exhibiting particularly elevated levels.
55. Global Seroprevalence (HSV-2 IgG), Risk Factors, and Outcomes of Genital Herpes Infection During Pregnancy: A Systematic Review and Meta-Analysis.
期刊: Journal of pregnancy 发表日期: 2026 链接: PubMed
摘要
Genital herpes (Herpes Simplex Virus Type 2) infection (HSV-2 IgG) is a common infection in adults. Given that the virus can indirectly affect fetal development, the infection is particularly important in pregnant women. The disease can remain latent for extended periods and, in addition to causing chronic and recurrent complications, can sometimes result in miscarriage. This study is aimed at investigating the global seroprevalence, risk factors, and outcomes of HSV-2 IgG during pregnancy through a systematic review and meta-analysis. In this study, the electronic databases, including PubMed, Scopus, Web of Science, Embase, ScienceDirect, and Google Scholar, were systematically searched to find studies reporting the seroprevalence of HSV-2 IgG until February 2025. A random-effects model was used for analysis. Heterogeneity between studies was assessed using the I2 index. Data analysis was performed using the software Comprehensive Meta-Analysis (Version 2). In the analysis of 15 studies with a sample size of 19,197 pregnant women, the global seroprevalence of HSV-2 IgG in pregnant women was reported as 23.4%. In examining the factors influencing the heterogeneity of the studies and the impact of sample size on this heterogeneity, it was reported that as sample size increased, the seroprevalence of HSV-2 IgG in pregnant women decreased (p < 0.05). Additionally, the findings suggested that with the increase in the year of study, the seroprevalence decreased (p < 0.05). In this study, a history of sexually transmitted diseases and having more than one sexual partner were also identified as factors associated with HSV-2 IgG in pregnancy. Given the seroprevalence (HSV-2 IgG), associated factors, and significant complications of contracting this infection during pregnancy, it is recommended that relevant authorities provide the necessary resources to increase awareness among the public and apply appropriate prevention and follow-up measures to minimize the risk of infection.
56. Socioeconomic Disparities in Multiple Myeloma Survival in New South Wales Australia: A Population-Based Cohort Study.
期刊: Cancer control : journal of the Moffitt Cancer Center 发表日期: 2026 链接: PubMed
摘要
IntroductionAustralia has one of the highest incidence rates of multiple myeloma (MM) globally, and this burden is projected to increase significantly in the coming decades. Survival has improved over time, but it is not clear how this differs by socioeconomic group. Here, we used population-based data to evaluate survival differences by socioeconomic group and other prognostic factors of individuals with MM in Australia.MethodsThis retrospective study included individuals diagnosed with primary MM between 2008 and 2019, as recorded in the New South Wales Cancer Registry, with survival follow-up to 2020. The identified individuals with primary MM were classified into 3 socioeconomic groups (low, medium, high) based on their residential location at diagnosis. Competing-risk modelling was used to estimate sub-hazard ratios (SHR) for socioeconomic group adjusting for potential prognostic factors, including age at diagnosis, sex, year of diagnosis, remoteness areas, autologous stem cell transplantation (ASCT) use, and hospital type.ResultsOverall, 6,030 individuals were included in the study. The 5-year cumulative incidence of death due to MM was higher (p<0.0001) in low and medium socioeconomic groups (0.42 and 0.39), compared with the high socioeconomic group (0.34). Individuals in the high socioeconomic group were more likely to receive ASCT and to receive care at public principal referral/private hospitals. Compared to the high socioeconomic group, the excess risk of dying was higher (p<0.0001) in low (SHR=1.27, 95% CI: 1.14-1.42) and medium (SHR=1.20, 95% CI: 1.08-1.33) socioeconomic groups, but not statistically different (p=0.13) when other prognostic factors were considered.ConclusionSurvival disparity by socioeconomic groups among individuals with MM in Australia is largely accounted for by known prognostic factors, especially ASCT receipt and hospital type. Existing disparities suggest that a comprehensive evaluation of access to and availability of MM treatment, including identification of potential barriers to treatment receipt, is urgently needed.
57. [Latent profile analysis of psychological capital and antenatal depression among pregnant women].
期刊: Zhong nan da xue xue bao. Yi xue ban = Journal of Central South University. Medical sciences 发表日期: 2025-Dec-28 链接: PubMed
摘要
Antenatal depression is an important public health issue affecting the physical and mental health of pregnant women and maternal-infant outcomes, with a global prevalence of 10% to 20%. Psychological capital, as a positive psychological resource of pregnant women, includes 4 core dimensions: Self-efficacy, hope, optimism, and resilience, and plays a critical role in coping with pregnancy-related stress and maintaining mental health. However, current research on antenatal depression and psychological capital remains insufficient, particularly with regard to exploration of their latent heterogeneous patterns. This study aims to identify latent joint profile types of psychological capital and antenatal depression among pregnant women using latent profile analysis (LPA), and to quantify the effects of social support, sleep quality, and exercise behavior on different types, so as to provide empirical evidence for the precision of psychological interventions during pregnancy. A cross-sectional survey design was adopted. From July to December 2023, an online survey platform was used to conduct investigations in tertiary hospitals in Hubei Province, Liaoning Province, and Guangdong Province (one hospital per province, 3 hospitals in total). A total of 772 valid questionnaires were obtained. Data were collected using the Chinese version of the Edinburgh Postnatal Depression Scale (EPDS), the 12-item short version of the Psychological Capital Questionnaire (PCQ-12), the Multidimensional Scale of Perceived Social Support (MSPSS) for perceived social support, the Pittsburgh Sleep Quality Index (PSQI), and a self-designed questionnaire. LPA was used to identify latent profile types of psychological capital and antenatal depression. The optimal fitting model was determined based on the Bayesian Information Criterion (BIC), entropy, and the Lo-Mendell-Rubin (LMR) adjusted likelihood ratio test results. Multinomial logistic regression was applied to evaluate the effects of various factors on different latent types. The three-class model was the optimal fitting model. The comprehensive deprivation group (3.50%) showed the lowest levels of psychological capital and the most severe depressive symptoms; the functionally restricted group (33.94%) showed moderate psychological capital and relatively high depressive symptoms; and the positive adjustment group (62.56%) showed high psychological capital and low depressive symptoms. Univariate analysis showed statistically significant differences among the 3 latent classes in occupation, educational level, monthly income, frequency of alcohol consumption during pregnancy, frequency of exercise during and before pregnancy, relationship with husband, perceived social support, and sleep quality (all P<0.05). After controlling for covariates, each 1-point increase in perceived social support increased the probability of pregnant women entering the positive adjustment group rather than the comprehensive deprivation group by 13.0% [odds ratio (OR)=1.130, 95% confidence interval (CI) 1.091 to 1.171, P<0.001]. Pregnant women who rarely exercised during pregnancy were more likely to enter the comprehensive deprivation group rather than the positive adjustment group (OR=0.107, 95% CI 0.012 to 0.962, P=0.046). Pregnant women with higher perceived social support scores were more likely to enter the positive adjustment group rather than the functionally limited group (OR=1.075, 95% CI 1.058 to 1.091, P<0.001), while pregnant women with poor sleep quality were more likely to enter the functionally limited group rather than the positive adjustment group (OR=0.902, 95% CI 0.848 to 0.959, P<0.001). Pregnant women with higher perceived social support scores were more likely to enter the functionally limited group rather than the comprehensive deprivation group (OR=1.052, 95% CI 1.017 to 1.087, P=0.003). Significant heterogeneity exists in psychological capital and antenatal depression among pregnant women, and 3 latent classes with clinical and intervention significance can be identified. Social support is a key protective factor in promoting psychological resilience and preventing antenatal depression, while regular physical activity and good sleep also have independent predictive value. It is recommended that positive psychological resources be incorporated into pregnancy mental health screening systems, promoting a shift in service models from “disease-oriented” to “resource-oriented” and implementing stratified intervention strategies based on class characteristics. For the positive adjustment group, participation in community peer support networks can be encouraged, and they can be cultivated as key opinion leaders for mental health promotion. For the functionally limited group, priority should be given to improving sleep disorders, increasing physical activity, and strengthening social connections to prevent progression to high-risk states. For the comprehensive deprivation group, inclusion in high-risk case management pathways in prenatal care clinics is required, with early identification and multidisciplinary collaborative interventions to effectively reduce the risk of adverse psychological and pregnancy outcomes and improve overall maternal and infant health. 目的: 产前抑郁是影响孕产妇身心健康和母婴结局的重要公共卫生问题，全球患病率为10%~20%。心理资本作为孕妇的一种积极心理资源，包括自我效能感、希望、韧性与乐观4个核心维度，可在应对孕期压力、维持心理健康中发挥关键作用。然而，目前关于产前抑郁和心理资本的研究仍不足，尤其缺乏对其潜在异质性模式的探索。本研究旨在通过潜在剖面分析(latent profile analysis，LPA)识别孕妇在心理资本与产前抑郁上的潜在联合剖面类型，并量化社会支持、睡眠质量与运动行为对不同类型的影响，为实现孕期心理干预的精准化提供实证依据。方法: 采用横断面调查设计，于2023年7至12月通过在线调查平台在湖北省、辽宁省和广东省的三级医院(每个省1家医院，共3家医院)开展调查，最终得到有效问卷772份。采用中文版爱丁堡产后抑郁量表(Edinburgh Postnatal Depression Scale，EPDS)、心理资本问卷12项简版(Psychological Capital Questionnaire-12，PCQ-12)、多维度领悟社会支持量表(Multidimensional Scale of Perceived Social Support，MSPSS)、匹兹堡睡眠质量指数(Pittsburgh Sleep Quality Index，PSQI)量表及自编问卷收集数据。通过LPA识别心理资本和产前抑郁的潜在剖面类型，依据贝叶斯信息准则、熵值及罗-门德尔-鲁宾(Lo-Mendell-Rubin，LMR)校正似然比检验结果等确定最优拟合模型，并采用多项Logistic回归评估各因素对不同潜在类型的影响。结果: 3类模型为最优拟合模型。3类模型中的全面匮乏组(占比为3.50%)心理资本水平最低、抑郁症状最严重，功能受限组(占比为33.94%)心理资本水平中等、抑郁症状偏高，积极调节组(占比为62.56%)心理资本水平高、抑郁症状低。单因素分析结果显示，3个潜在类别在职业、学历、家庭人均月收入、孕期伴侣的饮酒频率、孕前运动频率、孕期运动频率、与丈夫的关系、领悟社会支持、睡眠质量方面的差异均有统计学意义(均P<0.05)。在控制协变量后，MSPSS评分每增加1分，孕妇进入积极调节组而非全面匮乏组的概率提高13.0%[比值比(odds ratio，OR)=1.130，95%置信区间(confidence interval，CI) 1.091~1.171，P<0.001];孕期很少运动者更可能进入全面匮乏组而非积极调节组(OR=0.107，95% CI 0.012~0.962，P=0.046);MSPSS评分高的孕妇更可能进入积极调节组而非功能受限组(OR=1.075，95% CI 1.058~1.091，P<0.001)，PSQI评分高(睡眠质量差)的孕妇更可能进入功能受限组而非积极调节组(OR=0.902，95% CI 0.848~0.959，P<0.001);MSPSS评分高的孕妇更可能进入功能受限组而非全面匮乏组(OR=1.052，95% CI 1.017~1.087，P=0.003)。结论: 孕妇在心理资本与产前抑郁表现上存在显著异质性，可识别出具有临床与干预意义的3个潜在类别。社会支持是促进心理韧性、预防产前抑郁的关键保护因素，规律的运动与良好睡眠亦具有独立预测价值。建议将积极心理资源纳入孕期心理健康筛查体系，推动从“疾病导向”向“资源导向”的服务模式转型，并实施基于类别特征的分层干预策略:对积极调节组，可鼓励其参与社区同伴支持网络，培育为心理健康促进的关键意见领袖;对功能受限组，应重点改善睡眠障碍、增加身体活动、强化社会联结，阻断其向高危状态转化;对全面匮乏组，需纳入孕期保健门诊高危个案管理流程，开展早期识别与多学科协同干预，以有效降低不良心理及妊娠结局风险，提升母婴整体健康水平。.
58. Sex differences in association of mixed exposure to blood cadmium, lead, mercury, selenium, manganese with osteoporosis.
期刊: Zhong nan da xue xue bao. Yi xue ban = Journal of Central South University. Medical sciences 发表日期: 2025-Dec-28 链接: PubMed
摘要
Osteoporosis is a systemic metabolic disease characterized by decreased bone mass, deterioration of bone microstructure, and increased fracture risk. Its occurrence is closely related to sex, age, and lifestyle factors. Environmental exposure to heavy metals and metalloids may also influence its development, although existing findings remain inconsistent. The sex differences in the association between mixed metal exposure and osteoporosis are still unclear. This study aims to investigate whether sex differences exist in the associations between cadmium (Cd), lead (Pb), mercury (Hg), selenium (Se), manganese (Mn), and their mixtures and osteoporosis among men aged ≥50 years and postmenopausal women, and to analyze the potential moderating effect of dairy product consumption on these associations. Data from the National Health and Nutrition Examination Survey (NHANES) 2013-2014 and 2017-2018 cycles were used. In men and women separately, generalized linear regression models (univariate regression analysis and multivariate logistic regression) were applied to examine the relationships between single-metal exposure and osteoporosis at the femoral neck and vertebrae. A weighted quantile sum (WQS) model was used to construct a weighted index of mixed metal exposure to quantify the joint effects of multiple metals. Bayesian kernel machine regression (BKMR) was used to systematically evaluate the associations between blood Cd, Pb, Hg, Se, Mn, and their mixtures and osteoporosis at different skeletal sites, capturing potential nonlinear relationships and interactions among metals. Participants were further stratified into high dairy consumption (≥7 times/week) and low dairy consumption (<7 times/week) groups to explore the potential moderating effect of dairy consumption on the association between Cd exposure and osteoporosis. Multivariate logistic regression analysis showed that, in the fully adjusted model, Cd was positively associated with femoral neck osteoporosis in men aged ≥50 years [odds ratio (OR)=8.563, 95% confidence interval (CI) 1.888 to 38.845, P<0.05], whereas Se was negatively associated with femoral neck osteoporosis (OR<0.001, 95% CI 0 to 0.150, P<0.05). In postmenopausal women, Cd was positively associated with femoral neck osteoporosis risk (OR=2.148, 95% CI 1.038 to 4.443, P<0.05), while Se was negatively associated with femoral neck osteoporosis risk (OR=0.027, 95% CI 0.001 to 0.986, P<0.05). No significant association was observed between any metal and vertebral osteoporosis (all P>0.05). The WQS model indicated that mixed metal exposure was positively associated with vertebral osteoporosis in men (OR=1.452, 95% CI 0.277 to 2.626, P<0.05), whereas no significant association was observed in women. BKMR analysis showed that mixed metal exposure was positively associated with osteoporosis risk at the femoral neck and vertebrae in men, with Cd contributing most to osteoporosis risk, while no association was observed between mixed metal exposure and osteoporosis risk in women. The positive association between mixed blood metal exposure and osteoporosis risk might be partially offset by Se. In stratified analysis, the association between Cd exposure and osteoporosis was stronger in the high dairy consumption group (OR=1.19, 95% CI 0.51 to 2.78, P>0.05) than in the low dairy consumption group (OR=3.12, 95% CI 1.84 to 5.30, P<0.05), suggesting that frequent dairy consumption may attenuate the positive association between Cd exposure and femoral neck osteoporosis in women. In men aged ≥50 years, mixed metal exposure was positively associated with osteoporosis risk at different skeletal sites (femoral neck and vertebra), with Cd contributing most to the risk. In postmenopausal women, no association between mixed metal exposure and osteoporosis risk was observed, indicating clear sex differences. Selenium and dairy consumption may be potential protective factors for osteoporosis in women, whereas such protective effects were not observed in men. 目的: 骨质疏松症是一种以骨量减少、骨微观结构退化和骨折风险增加为特征的全身性代谢性疾病，其发生与性别、年龄、生活方式等因素密切相关，同时环境中重金属与类金属的暴露也可能影响其发展，但相关研究结果存在分歧。多种金属混合物与骨质疏松症之间关系的性别差异尚不清楚。本研究旨在探讨在50岁以上男性、绝经后女性中，血镉、铅、汞、硒、锰及其混合暴露与骨质疏松症的关联是否存在性别差异，并分析乳制品消费对上述关联的潜在调节效应。方法: 本研究采用2013—2014年、2017—2018年全国健康和营养检查调查(National Health and Nutrition Examination Survey，NHANES)的调查数据。分别在男性、女性中，应用广义线性回归模型(单因素回归分析和多因素逻辑回归)来明确单一金属暴露与股骨颈、椎体骨质疏松症的关系;采用加权分位数(weighted quantile sum，WQS)模型构建金属混合暴露加权指数，量化多种金属的联合作用;贝叶斯核机器回归(Bayesian kernel machine regression，BKMR)模型系统评估血镉(cadmium，Cd)、铅(lead，Pb)、汞(mercury，Hg)、硒(selenium，Se)、锰(manganese，Mn)及其混合暴露与不同部位骨质疏松症的关联，捕捉金属混合暴露与骨质疏松症之间可能存在的非线性关系及金属间的交互作用;同时，根据乳制品消费频率分为每周≥7次(高消费组)和每周<7次(低消费组)进行分层分析，探讨乳制品消费对Cd与骨质疏松症关联的可能调节效应。结果: 多因素逻辑回归分析显示，在完全调整模型中，Cd与50岁以上男性股骨颈骨质疏松症患病风险呈正相关[比值比(odds ratio，OR)=8.563, 95%置信区间(confidence interval，CI)1.888~38.845，P<0.05]，Se与股骨颈骨质疏松症患病风险呈负相关(OR<0.001，95% CI 0~0.150，P<0.05)，Cd与绝经后女性股骨颈骨质疏松症患病风险呈正相关(OR=2.148，95% CI 1.038~4.444，P<0.05)，Se与股骨颈骨质疏松症患病风险呈负相关(OR=0.027，95% CI 0.001~0.986，P<0.05)，未发现任一金属与椎体骨质疏松存在显著关联(均P>0.05)。WQS模型量化结果显示，金属混合暴露与男性椎体骨质疏松症呈正相关(OR=1.452，95% CI 0.277~2.626，P<0.05);而在女性中未观察到二者存在显著关联(P>0.05)。贝叶斯核机器回归分析结果显示，金属混合暴露与男性股骨颈及椎体骨质疏松症患病风险呈正相关，其中Cd对男性骨质疏松风险的贡献最大，未发现金属混合暴露与女性骨质疏松症风险存在关联。血液金属混合暴露对骨质疏松的正相关性可能部分被Se所抵消。乳制品低消费组(OR=3.12，95% CI 1.84~5.30，P<0.05)患者的Cd与骨质疏松症的关联高于高消费组(OR=1.19，95% CI 0.51~2.78，P>0.05)，这说明高频率的乳制品摄入可能削弱Cd与女性股骨颈骨质疏松症的正向关联。结论: 在50岁以上男性中，金属混合暴露与男性不同部位(股骨颈及椎体)骨质疏松症患病风险呈正相关，其中Cd对风险的贡献最大，而绝经后女性中未观察到金属混合暴露与骨质疏松症风险的关联，存在明显性别差异。硒和乳制品的摄入可能是女性骨质疏松症的潜在保护因素，而这种保护作用在男性身上并未观察到。.
59. [Association between daytime napping and depressive symptoms in older women: The chain mediating role of frailty and C-reactive protein].
期刊: Zhong nan da xue xue bao. Yi xue ban = Journal of Central South University. Medical sciences 发表日期: 2025-Dec-28 链接: PubMed
摘要
With the intensification of global population aging, the incidence of depressive symptoms among older women has increased year by year, affecting their quality of life and physical and mental health. Therefore, investigating the impact of daytime napping behavior on depressive symptoms in older women, particularly the regulatory effects of napping on frailty status and inflammatory response, is of important clinical and public health significance. This study aims to explore the relationship between daytime napping behavior and depressive symptoms in older women, with a focus on the chain mediating roles of frailty status and C-reactive protein (CRP) between napping and depressive symptoms. This study used 5 waves of data from the China Health and Retirement Longitudinal Study (CHARLS), including 3755 female participants aged ≥45 years. First, descriptive statistics and difference analyses were used to summarize baseline characteristics of the participants. Second, Cox proportional hazards regression models were used to analyze the effects of napping habits and nap duration on depressive symptoms. To explore the biological mechanisms linking napping and depressive symptoms, path analysis was further conducted to examine the chain mediating roles of frailty status and CRP in the effect of napping on depressive symptoms. To control for potential confounding factors, all analyses were adjusted for multiple covariates, including age, education level, marital status, smoking, drinking, social participation, and physical exercise. Finally, subgroup analyses were conducted to further verify the moderating effects of different lifestyles on the impact of napping. Napping behavior was significantly associated with a lower risk of depressive symptoms, particularly among women with nap durations of 5 to 30 minutes, who had the lowest risk of depressive symptoms. Specifically, individuals with nap durations of 5 to 30 minutes had a lower risk of depressive symptoms (HR=0.750, 95% CI 0.637 to 0.883, P<0.001), whereas those with naps longer than 60 minutes did not show a significant reduction in depressive symptom risk (HR=0.934, 95% CI 0.811 to 1.076, P=0.347). Further path analysis showed that there is a total indirect effect between napping and depressive symptoms (β=-0.0219, P<0.05), and there is an overall effect between the two (β=-0.081, P<0.05), indicating that napping could indirectly alleviate depressive symptoms by slowing frailty progression and reducing CRP levels. Subgroup analysis showed that the protective effect of napping on depressive symptoms was more pronounced among women who did not smoke or drink, exercised regularly, and participated in social activities, suggesting that the psychological protective effect of napping depends on an individual’s overall health behavior pattern. Daytime napping exerts a chain mediating effect on depressive symptoms in older women through frailty status and CRP levels. Moderate napping, especially short naps of 5 to 30 minutes, can effectively reduce the risk of depressive symptoms, and this effect may be achieved by improving physical function and alleviating frailty and inflammatory responses. 目的: 随着全球老龄化问题的加剧，老年女性抑郁症状的发病率逐年上升，影响其生活质量和身心健康。因此，研究午睡行为对老年女性抑郁症状的影响，特别是午睡对虚弱状态和炎症反应的调节作用，具有重要的临床和公共卫生意义。本研究旨在探讨午睡行为与老年女性抑郁症状的关系，重点分析虚弱状态和C反应蛋白(C-reactive protein，CRP)在午睡与抑郁症状之间的链式中介作用。方法: 采用中国健康与养老追踪调查(China Health and Retirement Longitudinal Study，CHARLS)的5期数据，涵盖3 755名年龄≥45岁的女性参与者。首先，通过描述性统计和差异性分析对参与者的基线特征进行整理。其次，采用Cox比例风险回归模型分析午睡习惯及午睡时长对抑郁症状的影响。为探讨午睡与抑郁症状之间的生物学机制，进一步使用路径分析方法，探索虚弱状态和CRP在午睡对抑郁症状影响中的链式中介作用。为排除潜在的混杂因素，所有分析均调整了年龄、教育程度、婚姻状况、吸烟、饮酒、社交、锻炼等多个协变量。最后，通过亚组分析进一步验证不同生活方式对午睡效应的调节作用。结果: 午睡习惯与较低的抑郁症状风险显著相关，尤其是午睡时长在5~30 min的女性群体，有抑郁症状的风险最低。具体而言，午睡时长为5~30 min的个体抑郁症状的风险较低(HR=0.750，95% CI 0.637~0.883，P<0.001)，而午睡超过60 min的个体未能显著降低抑郁症状的风险(HR=0.934，95% CI 0.811~1.076，P=0.347)。进一步的路径分析表明，午睡与抑郁症状之间存在总间接效应(β=-0.0219，P<0.05)，二者存在总体效应(β=-0.081，P<0.05)，表明午睡能够通过减缓虚弱状态和降低CRP水平间接减轻抑郁症状。亚组分析显示，午睡对抑郁症状的保护作用在不吸烟、不饮酒、积极锻炼和参与社交活动的女性群体中更加显著，这表明午睡行为的心理保护作用依赖于个体的整体健康行为模式。结论: 午睡行为通过虚弱状态和CRP水平在老年女性抑郁症状中起链式中介作用。适度午睡，尤其是5~30 min的短时午睡，能有效降低抑郁症状的风险，且这一效应通过改善身体功能、减缓虚弱状态和炎症反应实现。.
60. A Scoping Review of Breastfeeding Interventions Conducted in the Republic of Türkiye and the Turkish Republic of Northern Cyprus.
期刊: Turkish archives of pediatrics 发表日期: 2025-Nov-20 链接: PubMed
摘要
Breastfeeding (BF) is essential for maternal and child health, yet disparities persist in initiation, exclusivity, and duration. Despite cultural and policy support in Türkiye and the Turkish Republic of Northern Cyprus, challenges such as inconsistent hospital practices, early formula supplementation, and limited workplace accommodations hinder optimal BF outcomes. Understanding the effectiveness of BF interventions in these regions is key to improving maternal and infant health. This review is aimed to identify and synthesize BF interventions and their outcomes in Türkiye and the Turkish Republic of Northern Cyprus. A scoping review was conducted following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses)-ScR Guidelines, searching 14 electronic databases for English-language peer-reviewed studies published between 2010 and September 2024. Studies assessing individual-, community-, institutional-, and policy-level interventions were included. Twenty-nine studies met the inclusion criteria. Interventions fell into 4 categories: educational programs, hospital-based initiatives, digital BF support, and community-driven efforts. Most interventions led to increased exclusive BF rates, BF self-efficacy, early BF initiation, and improved maternal psychosocial well-being. However, challenges persisted in Baby-Friendly Hospital Initiative (BFHI) implementation, lactation support accessibility, and workplace accommodations. Multifaceted, context-specific interventions are most effective for sustaining BF practices, yet regional gaps and policy inconsistencies remain, particularly in the Turkish Republic of Northern Cyprus. Strengthening BFHI adherence, expanding digital lactation support, improving workplace policies, and addressing regional disparities can enhance BF outcomes and align with global health priorities.