公共卫生研究摘要 (2026-05-02)

共收录 62 篇研究文章

1. Innovation, Evidence, Compassion, and Hope: Delivering Outcomes That Matter.

期刊: American Society of Clinical Oncology educational book. American Society of Clinical Oncology. Annual Meeting 发表日期: 2026-Jun 链接: PubMed

摘要

Over the past 50 years, advances in systemic therapy, radiotherapy, surgery, and supportive care have dramatically improved cancer outcomes. Yet, growing concern exists that in our race for biomedical innovation, the metrics used to evaluate progress have drifted away from the outcomes that matter most to people living with cancer. In addition, we have not built health care systems that adequately recognize the psychosocial, relational, and existential dimensions of illness. Many medical therapies approved through regulatory pathways in the past decade offer modest clinical benefit while imposing substantial burdens on patients and the sustainability of health systems globally. These patterns reflect the convergence of global structural forces-including clinical trial design, regulatory standards, practice guidelines, and reimbursement systems-that often prioritize innovation and access over greater certainty that therapies meaningfully improve clinically relevant outcomes. In this review, we examine how these interconnected forces influence patients’ experiences of cancer care worldwide. We argue that sustaining meaningful progress requires a reanchoring of oncology to outcomes that reflect what patients consistently value: longer survival, preserved function, improved quality of life, and timely access to high-value care.

2. A Phenomenological Pilot Study of the Experiences of Full-Time Physical Therapy Faculty and Clinical Practice.

期刊: The clinical teacher 发表日期: 2026-Jun 链接: PubMed

摘要

Research in nursing, occupational therapy and dental hygiene indicates that clinical practice engagement enhances academic faculty’s credibility with students and skill retention. However, common barriers include limited time, institutional constraints and unclear policies. Despite ongoing clinical involvement among physical therapy faculty, little is known about how these activities influence teaching performance and workload management. This study examined the experiences of full-time faculty members with clinical practice, focusing on the perceived benefits, barriers and institutional factors that affect their ability to sustain patient care while fulfilling academic duties. This phenomenological pilot study examined the lived experiences of seven full-time physical therapy faculty at a public land-grant institution. Data were collected through semistructured interviews and analysed using Colaizzi’s method with thematic coding. Research questions addressed experiences, perceived benefits and barriers and the influence of personal and institutional factors on clinical engagement. Four themes emerged: the experiences of engaging in physical therapist clinical practice, the perceived benefits of clinical practice, the perceived barriers to clinical practice and the impact of participant characteristics on experience. Clinical practice was viewed as essential for maintaining competence and enhancing teaching. Faculty valued it as a professional motivator, but institutional barriers often limited participation. Formalising clinical practice through policies, workload models and curricular integration may help sustain dual academic and clinical roles. These findings suggest that supporting faculty in maintaining clinical engagement benefits educators and students in physical therapy education.

3. The Effects of Body-Oriented Interventions on Cancer-Related Symptoms of Women Who Survived Breast Cancer: Protocol for a Systematic Review.

期刊: JMIR research protocols 发表日期: 2026-May-01 链接: PubMed

摘要

Breast cancer is one of the most prevalent cancers worldwide, with a 5-year survival rate exceeding 90%. Despite advances in treatment, survivors frequently experience persistent cancer- and treatment-related symptoms that negatively impact their quality of life. Body-oriented interventions (BOIs) have demonstrated effectiveness in symptom management; however, systematic reviews focused exclusively on BOIs for women who survived breast cancer (WSBC) remain limited. This systematic review protocol outlines the methodology for evaluating the scientific evidence on the effects of BOIs on cancer- and treatment-related symptoms in WSBC. The aim of this study is to examine the scientific evidence on the effects of BOIs on cancer- and treatment-related symptoms, well-being, and quality of life in WSBC. This protocol follows PRISMA-P (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols) guidelines. We will conduct searches in 6 electronic databases: PubMed, Cochrane, Web of Science, Scopus, APA PsycNet, and Portal Regional da BVS. Studies will be considered for inclusion if they are written in English, French, Portuguese, or Spanish, with no restrictions on publication date; they consist of WSBC (aged 18 to 64 years); they are randomized controlled trials, quasi-randomized controlled trials, and pilot studies focusing on BOIs; they include a control group receiving no intervention, standard care, or a non-BOI; and the primary outcomes of interest include preintervention and postintervention measures of cancer- and treatment-related symptoms, well-being, and quality of life. The methodological quality of the studies and the risk of bias will be assessed using the PEDro scale and version 2 of the Cochrane risk-of-bias tool, respectively. The synthesis of results will be measured through the Best Evidence Synthesis. Two experienced independent reviewers will conduct study selection, data extraction, methodological quality assessment, and scientific evidence assessment. Disagreements will be resolved by a third reviewer. This protocol describes the prespecified methodology for the systematic review. At the time of publication of this protocol, the corresponding full systematic review manuscript was under peer review. The outcomes will synthesize the scientific evidence on the effects of BOIs on cancer- and treatment-related symptoms in WSBC. It is anticipated that this systematic review will identify benefits and directions for future research to support the integration of BOIs tailored to this population. Considering that previous systematic reviews focused on the effects of BOIs in survivors of all cancer types, challenges related to study risk of bias such as heterogeneity in intervention types, study designs, and outcome measures are anticipated, potentially leading to some inconsistency and imprecision. To mitigate these issues, PRISMA guidelines will be followed, and methodological quality and best evidence strength will be rigorously assessed. This review will systematically synthesize the effects of BOIs on cancer- and treatment-related symptoms in WSBC. These findings will provide health professionals with reliable evidence and methodological guidance for further research. PROSPERO CRD42023452519; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=452519. DERR1-10.2196/76858.

4. Applicable Scenarios, Desired Features, and Risks of AI Psychotherapists in Depression Treatment From the Patient's Perspective: Exploratory Qualitative Study.

期刊: JMIR formative research 发表日期: 2026-May-01 链接: PubMed

摘要

Depression is a pervasive global mental health issue, yet access to trained professionals remains severely limited. With the rapid advancement of artificial intelligence (AI), digital tools are increasingly seen as a viable way to address this shortage. However, questions remain about how digital platforms for mental health care can be effectively designed. This study aimed to investigate, from an end user’s (patient’s) perspective, the potential use scenarios, desired features, and perceived risks of AI psychotherapists in depression treatment, providing design guidelines for their development. A grounded theory approach was applied to analyze qualitative responses from 452 individuals recruited via Amazon Mechanical Turk. Data were collected through a scenario-based online survey on AI-assisted depression treatment administered between March 2023 and May 2023. Participants responded to 3 open-ended questions regarding the potential use of AI in treating depression, the characteristics expected from an AI psychotherapist, and the associated perceived risks, along with demographic, control, and contextual measures. The open-ended responses were inductively coded into themes, with intercoder reliability established (Cohen κ=0.80). In addition, variations in themes were further examined across participant profiles, including social stigma, current depression severity, trust in an AI psychotherapist, and privacy awareness. Participants envisioned AI psychotherapists across 5 primary scenarios: diagnosis, treatment, consultation, self-management, and companionship. Key desired features include professionalism, warmth, precision care, empathy, remote services, active listener, personalization, flexible treatment options, patience, trustworthiness, and basic treatment alternative, while critical concerns include diagnostic inaccuracy, treatment errors, privacy breach, lack of human interaction, technical malfunctions, and lack of emotional engagement. Based on these findings, a general MoSCoW (must have, should have, could have, and won’t have) prioritization framework was proposed to serve as a conceptual starting point for future AI system design and empirical validation in mental health care. Notably, feature prioritization varied across user profiles: individuals with higher stigma placed greater emphasis on privacy protection, those with more severe depression prioritized precision care and timely access, low-trust users de-emphasized remote services, and privacy-sensitive individuals showed reduced preference for features requiring extensive data disclosure. These patterns highlight the need for context-sensitive design. This study provides a patient-centered framework for designing AI psychotherapists and complements the existing literature by highlighting the importance of balancing clinical effectiveness with relational considerations. The findings offer actionable guidelines for designing AI mental health care tools that are aligned with user expectations and sensitive to individual differences.

5. Virtual Reality-Based Social Musical Exergame Guided by Self-Determination Theory for Young Adults With Depression and Anxiety: Protocol for a Randomized Controlled Trial.

期刊: JMIR research protocols 发表日期: 2026-May-01 链接: PubMed

摘要

Depression and anxiety frequently emerge during late adolescence and young adulthood; however, many conventional and app-based interventions struggle to sustain engagement. Virtual reality (VR) exergaming, music-based activities, and social interaction each show promise for supporting young people’s mental health, but their combined therapeutic value remains insufficiently tested. This study aims to evaluate the effectiveness of a 6-week VR-based social musical exergame for reducing depressive and anxiety symptoms in young adults. The secondary objectives are to explore whether changes in basic psychological need satisfaction are associated with symptom change and to assess the effects on loneliness, presence, cardiorespiratory fitness, and in-game music-movement synchronization. This study is a 3-arm, parallel-group randomized controlled trial. A total of 110 participants aged 18 to 25 years with mild to moderate depression or anxiety will be recruited and randomized in a 1:1:1 ratio to (1) a VR social musical exergame, (2) a matched VR solo musical exergame active control, or (3) a waitlist control receiving standardized mental health guidance. Assessments will be completed at baseline, at the postintervention assessment (week 6), and at the 1-month follow-up assessment (week 10). The primary planned comparison is the experimental group vs the active control group. This study was approved by the ethics committee of Hunan Traditional Chinese Medical College on September 8, 2025 (YXLL202509006) and prospectively registered at ClinicalTrials.gov on March 15, 2026 (NCT07482852). Internal institutional funding had been secured. As of April 2026, the trial status was “not yet recruiting;” no participants had been enrolled, and no data analysis had been conducted. Recruitment is anticipated to begin in May 2026, with primary completion on March 1, 2028, study completion on May 1, 2028, and publication of the primary findings expected in late 2028. This protocol describes a self-determination theory-informed, multicomponent VR intervention designed to evaluate whether adding a bundled social layer to a matched solo exergame improves short-term mental health outcomes. The trial is expected to provide initial evidence on efficacy, safety, and potential mechanisms while generating hypotheses for future dismantling and longer-term trials. ClinicalTrials.gov NCT07482852; https://clinicaltrials.gov/ct2/show/NCT07482852. PRR1-10.2196/83737.

6. Examining Compassionate Workplace Interventions for Employees Navigating Serious Illness, Caregiving, Death, or Bereavement: Protocol for a Scoping Review.

期刊: JMIR research protocols 发表日期: 2026-May-01 链接: PubMed

摘要

Globally, researchers have documented an emergence of public health approaches within palliative care, leading to the development of compassionate communities, a movement that seeks to build community capacity to support individuals at the end of life and those affected by death and loss. Compassionate communities emphasize a social model of care that complements formal palliative services by reducing suffering, enhancing well-being, and empowering community members through collective action. The Compassionate City Charter broadens this scope to include civic institutions, outlining recommendations for adoption within workplaces and educational settings. However, empirical evidence examining the adoption of compassionate practices within workplace contexts remains limited. This study aims to systematically map and explore international evidence regarding compassionate workplace interventions for employees in a workplace or organizational setting who are experiencing serious illness or are affected by caregiving, death, or bereavement. The Joanna Briggs Institute (JBI) framework will guide this review to systematically search and locate published articles reporting primary research. The following five stages will be conducted: (1) research question and objectives development; (2) search strategy development; (3) study and gray literature search and selection across 7 databases, including CINAHL Ultimate (EBSCO), Scopus, PsycINFO (OVID), Web of Science, ABI/INFORM (ProQuest), Business Source Ultimate (EBSCO), and MEDLINE (ProQuest); (4) data extraction and charting; and (5) data analysis and presentation. The JBI 3-step strategy will be applied to determine the search method and article selection. Articles will be assessed for inclusion by two reviewers independently and included if they describe a compassionate approach to supporting employees navigating serious illness, caregiving, grief, or bereavement. The review will use the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) guidelines to present the results. Data collection for this scoping review was conducted between July and August 2025. The extracted data are currently being organized and analyzed, with submission of the final manuscript anticipated in May 2026. This protocol outlines a scoping review that will represent the first comprehensive review to explore the international evidence on compassionate workplace interventions for employees navigating serious illness, caregiving, death, or bereavement.

7. A Bilingual AI-Based Chatbot for Nutrition Education in a Food Is Medicine Intervention for High-Risk Pregnant Women: Design and Development Study.

期刊: JMIR formative research 发表日期: 2026-May-01 链接: PubMed

摘要

Conversational agents (artificial intelligence [AI]-based chatbots) offer a novel approach to health interventions by providing personalized, adaptive interactions that improve over time based on user engagement. In nutrition education, given the wide variation in knowledge, skills, and abilities across participants, AI-based chatbots have the potential to enhance accessibility, engagement, and behavior change. Food is Medicine (FIM) interventions, which aim to improve food security and diet quality among multicultural, at-risk populations, often face challenges related to sustained engagement and use. This paper describes the design, development, and iterative refinement of a bilingual AI-driven nutrition chatbot integrated into an FIM intervention for high-risk pregnant women receiving care at obstetric clinics in Houston, Texas. The chatbot was developed using an iterative process informed by behavioral theory, human-centered design (HCD), and plan-do-study-act (PDSA) quality improvement cycles. The conversational agent was embedded within an ongoing 2-arm randomized controlled trial (N=200) comparing standard FIM nutrition education to FIM plus AI-driven nutrition chatbot support. HCD activities took place prior to deployment and involved community advisory group members and implementation stakeholders. Postdeployment refinements were guided by 2 PDSA cycles and informal question-and-answer sessions conducted with intervention arm participants. Qualitative feedback was collected using structured scripts to identify facilitators of and barriers to chatbot engagement. The chatbot was developed using the GPT-3.5 Turbo application programming interface. An initial prototype built in Python using Gradio enabled rapid testing but lacked flexibility for modifications. To improve scalability and logging capabilities, the system was rebuilt using PHP, HTML, JavaScript, and SQL. To further understand usage patterns, participants who interacted with the chatbot at least once or not at all (classified as low users; n=32) were engaged in question-and-answer sessions. Of these participants, all were female (32/32, 100%), 88% (28/32) identified as Hispanic or Latino, and 90% (29/32) preferred Spanish. Two PDSA cycles guided iterative refinements. Cycle 1 identified low initial engagement, whereas cycle 2 focused on improving content clarity and cultural relevance through physical reminder prompts. Qualitative findings identified key barriers to engagement, including high cooking self-efficacy with perceived lack of need for support, low technology self-efficacy, and low urgency due to competing priorities. Embedding a bilingual AI-driven nutrition chatbot within an FIM intervention was feasible and featured critical design and implementation considerations for engaging high-risk pregnant populations. Findings show the importance of HCD and iterative refinement to address engagement barriers. This work provides actionable guidance for integrating conversational agents into FIM programs, with implications for future evaluation of clinical outcomes, long-term engagement, and scalability.

8. Subthalamic nucleus deep brain stimulation in Meige syndrome: mapping the optimal stimulation sites and network targets.

期刊: Journal of neurosurgery 发表日期: 2026-May-01 链接: PubMed

摘要

The aim of this study was to identify the optimal stimulation sites for subthalamic nucleus (STN) deep brain stimulation (DBS) in treating Meige syndrome using long-term follow-up data from a large sample cohort, evaluate the whole-brain functional connectivity patterns associated with favorable treatment responses, and validate these findings in an independent cohort. The authors retrospectively analyzed long-term outcomes in 65 patients with Meige syndrome who underwent bilateral STN-DBS in two centers. The local stimulation effects within the STN and the distributed functional connectivity associated with motor improvement were investigated using advanced imaging and modeling tools, including the Lead-Group Toolbox, DBS Sweet Spot Mapping Explorers, and DBS Network Mapping Explorers. To ensure the model’s reliability and generalizability, both internal validation through multiple cross-validation strategies and external validation using independent cohorts were conducted. STN-DBS yielded significant and sustained motor improvements in both cohorts, with mean Burke-Fahn-Marsden Dystonia Rating Scale (BFMDRS) movement score reductions of 63% in the training cohort (n = 50) and 56% in the validation cohort (n = 15) (p < 0.001). At the local level, the optimal stimulation sites were consistently located in the dorsolateral sensorimotor subregion of the STN, extending bilaterally toward the associative subregion and centered at MNI coordinates x = ±12, y = -13, z = -6. At the network level, favorable outcomes were primarily associated with positive functional connectivity to the cerebellum and negative connectivity to the somatosensory cortex. Both the sweet spot and connectivity models developed using the training cohort showed significant correlations with clinical outcomes in the independent validation cohort (R = 0.59, p = 0.020; R = 0.74, p = 0.002, respectively) and remained robust across different cross-validation strategies. The optimal therapeutic efficacy of STN-DBS for Meige syndrome depends on precise targeting within the dorsolateral STN and modulation of a distributed functional network involving the cerebellum and sensorimotor cortex. These findings may aid in developing personalized targeting strategies and adaptive programming paradigms, ultimately improving the therapeutic efficacy of DBS in this challenging disorder.

9. An Ecological Momentary Assessment Smartphone App for High-Risk HIV Populations: Development and Usability Study.

期刊: JMIR formative research 发表日期: 2026-May-01 链接: PubMed

摘要

HIV incidence has continued to increase among men who have sex with men (MSM) in Peru, despite intervention efforts. Addressing stigma, risky behaviors, and low medication adherence is key to reducing incidence rates. Ecological momentary assessment (EMA) allows for collection of discrete, real-time data on stigmatized, risky behaviors while reducing recall bias. The aim of this study was to develop and assess the usability of an EMA smartphone app among MSM with HIV in Peru, which tracks daily health risk behaviors to determine ease of use, usefulness, and satisfaction with the app. A mixed-method 3-phase study was conducted with 10 MSM with HIV, which included a usability test, 10-day field testing, and a debriefing focus group. Quantitative survey data and user analytics allowed for assessments of acceptability and user compliance. Qualitative interview and focus group data were thematically analyzed for in-depth assessments of user satisfaction. Acceptability of the EMA app was high, with a mean usability rating of 6.4 of 7.0 (SD 0.62), indicating high user satisfaction, ease of use, and usefulness. A 10-day field test demonstrated a high average compliance rate of 93% (93/100), which suggests high feasibility of the app for daily tracking of health risk behaviors among MSM with HIV. Interview and focus group findings indicated that the app was navigable, time-efficient, and holds promise for long-term use, particularly with the inclusion of daily reminders and incentives for prolonged use. EMA apps can provide valuable real-time data while protecting users’ privacy. This formative work lays the foundation for future larger-scale EMAs of substance use and sexual risk behaviors among high-risk HIV populations, and for the development of just-in-time interventions to address stigma, improve medication adherence, and reduce risky behaviors.

10. Enterovirus D68 and Acute Neurologic Outcomes: A Systematic Review and Meta-Analysis (2010-2025).

期刊: Reviews in medical virology 发表日期: 2026-May 链接: PubMed

摘要

Enterovirus D68 (EV-D68) has been implicated in clusters of acute flaccid myelitis (AFM) and severe respiratory illness; however, the magnitude and consistency of association across settings and over time remain uncertain. We quantified the association between EV-D68 detection and acute neurologic outcomes (particularly AFM) and explored design- and time-related heterogeneity. Following PRISMA 2020 and MOOSE guidance, we systematically identified observational studies reporting associations between EV-D68 detection and neurologic outcomes. Random effects meta-analysis was performed using REML with Knapp-Hartung adjustment; heterogeneity was summarised with τ2 and I2. Prespecified moderators were examined with meta-regression. Small-study effects were evaluated using contour-enhanced funnel plots, Egger and Peters tests, and PET-PEESE bias-adjusted models. PROSPERO registration: 1152300. Across 98 studies, the pooled odds ratio (OR) was 1.39 (95% CI 1.14-1.69), with high heterogeneity (I2 = 98.9%; prediction interval 0.24-8.15). By design, respiratory surveillance studies showed stronger association (OR 1.59, 95% CI 1.35-1.86, k = 78) whereas AFM case-control studies did not (OR 0.86, 95% CI 0.40-1.86, k = 20). In multivariable meta-regression, study design and calendar year explained about 47% of inter-study variance. Predicted ORs declined from 2014 to 2022 across regions. Funnel asymmetry and small-study effects were suggested; PET-PEESE bias-adjusted estimates remained above the null. The EV-D68 outcome association is context-dependent and time-varying. Surveillance datasets enriched during outbreak waves drive the pooled signal, while AFM case-control designs yield attenuated estimates after adjustment. Standardising diagnostics and integrating design-specific surveillance will improve risk estimation and AFM preparedness.

11. Dynamic safe nitrogen boundary for maintaining surface water quality in China.

期刊: Science advances 发表日期: 2026-May 链接: PubMed

摘要

Nitrogen plays a critical role in Earth’s biogeochemical cycles, acting as both an essential nutrient for life and an environmental pollutant. Managing nitrogen use within safe boundaries is crucial for achieving the Sustainable Development Goals, particularly under the pressures of a growing global population. Here, we quantified the temporal dynamics in the safe boundary for nitrogen input to the human-nature system in view of surface water quality in China, driven by changes in management practices and runoff over the period of 1980 to 2020. Insufficient nitrogen management in the human-nature system led to a reduction in the safe nitrogen boundary from 27 Tg N year-1 in 1980 to 17 Tg N year-1 in 2006. Subsequently, improvements in agricultural nitrogen use efficiency and urban waste management contributed to an expansion of this boundary, which reached 34 Tg N year-1 by 2020. Further integration of nitrogen management strategies spanning agriculture, urban waste, and human dietary patterns is needed to maintain nitrogen use within the established safe boundary by 2050, generating societal benefits of US$335 billion for ecosystems, human health, climate, and food supply, with associated implementation costs of US$106 billion. These findings demonstrate that improved nitrogen management practices can dynamically expand the safe operating space for higher nitrogen utilization to support human well-being while keeping nitrogen pollution within safe environmental limits.

12. Assessing Reliability of a Change in Survey Item Terminology from "Marijuana" to "Cannabis" Among a Sample of U.S. Adolescents and Young Adults.

期刊: Substance use & misuse 发表日期: 2026-May-01 链接: PubMed

摘要

Surveys of adolescents and young adults measuring self-reported marijuana use could use the term “cannabis” with minimal impact on reliability, thus contributing to continuity in reporting of prevalence and other survey estimates to inform cannabis policy.

13. Systems, Structures, and Support: Using a Socioecological Framework to Improve Health Equity for Children in Immigrant Families.

期刊: Pediatric annals 发表日期: 2026-May 链接: PubMed

摘要

Children in immigrant families (CIF) represent one in four children in the United States and face disproportionate health risks shaped by immigration policy, structural racism, trauma, and barriers to care. Using a socioecological framework, this article reviews the current state of pediatric immigrant health and outlines opportunities for pediatricians to advance equity at the individual, organizational, and structural levels. Clinicians can follow expert clinical care guidelines, practice trauma-informed care and safe documentation practices, and partner with qualified medical interpreters. Health systems can create safe spaces for immigrant families and collaborate with researchers to promote community-led cohort building while protecting patients from identification. Finally, pediatricians play a vital role in advocating for inclusive insurance coverage and equitable health policies. Advancing care for CIF requires coordinated efforts across all levels of influence to ensure that every child, regardless of birthplace or legal status, receives care grounded in dignity, trust, and justice.

14. Recognizing Housing Insecurity as a Critical Social Determinant of Healthy Aging.

期刊: JAMA network open 发表日期: 2026-May-01 链接: PubMed

摘要

15. International Availability and Price of Ultraexpensive Drugs in Medicare Part D.

期刊: JAMA network open 发表日期: 2026-May-01 链接: PubMed

摘要

This cohort study characterizes ultraexpensive drugs in Medicare Part D and examines their availability and relative prices across industrialized countries.

16. Health-Related Social Needs Screening Bias as a Health Equity Measurement Problem.

期刊: JAMA health forum 发表日期: 2026-May-01 链接: PubMed

摘要

17. Potential for Bias in Social Needs Data Collection and Screening Activities in Health Care Settings.

期刊: JAMA health forum 发表日期: 2026-May-01 链接: PubMed

摘要

Health-related social needs (HRSN) data are used in referral and treatment decisions, in population health management strategies, and in health services research. However, evidence suggests HRSN data are at risk for bias. To identify and classify sources of bias in HRSN data and the implications for usage for patient care and population health. In this qualitative study, key informant interviews with patients and health care professionals in Indiana and Florida (recruited using multiple recruitment methods and snowball sampling) were conducted from January to May 2025. Key informants in Indiana were primarily associated with a public safety-net system including federally qualified health centers, or a multihospital system with services statewide. In Florida, key informants were associated with a large academic medical center, with some dual-affiliated with a US Department of Veterans Affairs hospital. Health care professionals had the titles such as physician, social worker, and community health worker. Data collection occurred via video or telephone call. Interviews followed a semistructured interview guide grounded in a framework describing sources of potential bias in health data. Participants were asked about HRSN data collection practices and experiences, documentation practices, responses to HRSN data collection, and how, in their own words, they defined food insecurity, housing instability, financial strain, and transportation barriers. Thematic analysis followed a consensus coding approach. A total of 20 patients and 20 health care professionals were recruited (40 informants total; 22 aged 40-64 years [42.5%]; 27 female [67.5%]). Participants described variation in HRSN data collection and differing availability of organizational resources that contributed to sampling bias. Patients and professionals reported detection bias was possible because HRSNs could be intentionally sought during visits or not collected at all. Concerns about stigma or embarrassment, power distance, and privacy could result in nonresponse bias. Health care professionals and patients could all offer slightly different, or nuanced, definitions of different HRSNs. These more expansive or restrictive definitions could lead to misclassification bias. In this qualitative study, both patients and health care professionals described opportunities for bias in HRSN data collection and documentation. These findings suggest that, while HRSN data are potentially valuable to patient care, their fitness for use in organizational decision-making, research, and health policy may need improvement.

18. Beyond antimicrobial efficacy: Complex interactions of sodium benzoate, potassium sorbate, and citrate alter the rat gut microbiome.

期刊: Journal of the science of food and agriculture 发表日期: 2026-May-01 链接: PubMed

摘要

The gut microbiome is increasingly recognized as a target of dietary food additives. Sodium benzoate (SB), potassium sorbate (PS), and citric acid (Cit) are widely used preservatives, yet their combined effects on the intestinal microbiota remain poorly understood. This study investigated the individual and combinatorial impacts of these three compounds on key bacterial populations in the rat gut. Thirty-five adult male Sprague-Dawley rats received SB (500 mg kg-1 BW d-1), PS (300 mg kg-1 BW d-1), Cit (1200 mg kg-1 BW d-1), or their binary combinations in drinking water for 8 weeks. Fecal samples were analysed by selective culture and quantitative real-time polymerase chain reaction (PCR). All treatments significantly reduced Lactobacillus abundance (P < 0.05). Citrate alone and in combination with SB markedly increased Enterobacteriaceae (P < 0.01), with the Cit + SB group showing the highest levels. Enterococcus populations were elevated in most treatment groups, particularly after Cit + SB exposure. Staphylococcus responses were context-dependent: increased by SB or PS alone, but suppressed by citrate-containing combinations. Combination effects were often non-additive, with citrate frequently overriding the antimicrobial action of benzoate or sorbate. Chronic exposure to common preservatives at no-observed-adverse-effect level (NOAEL) induces significant, synergistic shifts in the gut microbiota, characterized by loss of beneficial Lactobacillus and expansion of potentially pro-inflammatory Enterobacteriaceae and Enterococcus. The unexpected promotion of Enterobacteriaceae by citrate reveals its role as an active ecological modulator. Our findings challenge the adequacy of single-additive safety assessments and support the inclusion of microbiome endpoints in regulatory toxicology. © 2026 Society of Chemical Industry.

19. FIB-4 fails to identify significant liver fibrosis in people with HIV: A large multinational screening study.

期刊: Hepatology (Baltimore, Md.) 发表日期: 2026-May-01 链接: PubMed

摘要

Steatotic liver disease (SLD) and liver fibrosis are major comorbidities in people with HIV (PWH). Guidelines recommend stepwise screening using the Fibrosis-4 (FIB-4) index followed by transient elastography (TE), yet its accuracy and the extent of FIB-4 misclassification in PWH remain uncertain. We evaluated the diagnostic performance of FIB-4 against TE, quantified missed fibrosis, and assessed whether metabolic and HIV-specific factors improve risk prediction. We conducted a multinational study of 4,917 PWH without viral hepatitis coinfection or hazardous alcohol intake undergoing TE screening across seven centers. SLD was defined by controlled attenuation parameter >275 dB/m and classified as metabolic dysfunction-associated SLD (MASLD) or metabolic dysfunction-associated alcohol-related liver disease (MetALD). Significant fibrosis (liver stiffness measurement [LSM] ≥8 kPa) was present in 12.6% of participants, advanced fibrosis (LSM ≥11 kPa) in 6.1%, and SLD in 21.7% (20.6% MASLD, 1.1% MetALD). FIB-4 showed modest accuracy for significant fibrosis (AUROC 0.69, 95% CI 0.67-0.72) and misclassified 36% of fibrosis cases as low risk (FIB-4 <1.3). Performance was poorer in MASLD than in non-MASLD (AUROC 0.60 vs 0.76; p<0.001). Participants with false-negative FIB-4 exhibited a more metabolic phenotype, including higher BMI and steatosis. Incorporating metabolic and HIV-specific factors improved discrimination and reclassification and enabled development of the FIB-HIV score, which outperformed FIB-4 (AUROC 0.78 vs 0.69; p<0.001). In PWH, liver fibrosis is common and frequently missed by FIB-4, particularly in MASLD. TE-centered screening strategies augmented by metabolic and HIV-specific indicators may improve early fibrosis detection and risk stratification.

20. Intensity-dependent corticospinal facilitation by repetitive peripheral magnetic stimulation: Evidence for a major contribution of group I afferents.

期刊: Journal of neurophysiology 发表日期: 2026-May-01 链接: PubMed

摘要

Repetitive peripheral magnetic stimulation (PMS) is increasingly used in neurorehabilitation, yet the optimal intensity for inducing corticospinal facilitation and underlying afferent mechanisms remain unclear. We investigated the intensity-dependent effects of PMS on corticospinal excitability and single motor unit responses, and tested the contribution of group I afferents. Healthy young adults received repetitive PMS over the extensor carpi radialis (ECR) in a crossover design at 0.9×motor threshold (MT), 1.2×MT, and high-intensity stimulation individually adjusted to induce maximal wrist dorsiflexion (mean: 1.8±0.3×MT). Motor-evoked potentials (MEPs) elicited by transcranial magnetic stimulation were recorded from the ECR and flexor carpi radialis (FCR) before and during the intervention (total 15 min). To examine group I afferent contribution, the same high-intensity protocol was applied during upper-arm ischemia after the ECR H-reflex was reduced to <10% of baseline. Sensory-motor input characteristics across stimulation intensities were compared using post-stimulus time histograms of ECR single motor unit firings. High-intensity PMS significantly increased ECR MEPs after 9-min, whereas PMS at 1.2×MT required 15-min. PMS at 0.9×MT did not induce significant MEP changes and FCR MEPs remained unaltered. ECR MEPs remained elevated for up to 30 min after 9-min of high-intensity PMS. This enhancement was abolished by ischemia, and suprathreshold PMS elicited a short-latency peak in firing probability, consistent with monosynaptic Ia excitation, whose amplitude increased with stimulation intensity. These findings suggest that repetitive PMS above MT facilitates corticospinal excitability in an intensity-dependent manner and depends on large-diameter group I afferent input, with additional evidence consistent with a substantial Ia component.

21. Association of monotherapy intervention with long-term outcomes in Spetzler-Martin grade I and II arteriovenous malformations: a nationwide multicenter observational prospective cohort study.

期刊: Journal of neurosurgery 发表日期: 2026-May-01 链接: PubMed

摘要

The aim of this study was to compare the long-term risk of hemorrhagic stroke and death between conservative management and monotherapy intervention in patients with Spetzler-Martin (SM) grade I and II brain arteriovenous malformations (AVMs). The authors included AVMs that underwent conservative management and monotherapy intervention between August 2011 and December 2021 from a nationwide multicenter prospective collaboration registry. Patients were categorized into unruptured and ruptured cohorts for comparison of long-term outcomes, with hemorrhagic stroke and death defined as primary outcomes and neurological status as a secondary outcome. The efficacy of various intervention strategies, including resection, embolization, and stereotactic radiosurgery (SRS), was also evaluated. Stratified analyses based on intervention strategies and different SM grade subtypes were conducted. Of 4286 AVMs in the registry, 1013 patients were eligible for inclusion (387 with unruptured AVMs and 626 with ruptured AVMs). Overall, the intervention group showed a lower incidence of long-term hemorrhagic stroke and death compared with the conservative management group (0.43 vs 0.88 per 100 patient-years; adjusted HR [aHR] 0.61 [95% CI 0.24-1.52]), although this difference did not reach statistical significance. The results were similar in the two subgroups: aHR 0.95 (95% CI 0.28-3.18) for unruptured AVMs and aHR 0.29 (95% CI 0.06-1.32) for ruptured AVMs. Stratified analyses based on different intervention strategies and different SM grade subtypes showed that resection might benefit both unruptured (0.00 vs 0.79 per 100 patient-years, p = 0.006) and ruptured (aHR 0.12 [95% CI 0.03-0.53], p = 0.033) AVMs, while SRS might only benefit ruptured AVMs (aHR 0.04 [95% CI 0.01-0.34], p = 0.163). Embolization and SRS might not be beneficial for unruptured low-grade AVMs. In this observational prospective cohort study, intervention demonstrated benefit over conservative management in preventing long-term hemorrhagic stroke or death in patients with SM grade I or II AVMs. Among specific monotherapy interventions, resection proved favorable for both unruptured and ruptured SM grade I and II AVMs, while SRS might serve as a reasonable alternative in ruptured cases.

22. Piezoelectric neuromodulation of the subthalamic nucleus ameliorates motor and nonmotor symptoms of Parkinson's disease.

期刊: Science advances 发表日期: 2026-May 链接: PubMed

摘要

Traditional deep-brain stimulation via implanted electrodes can effectively treat neurological disorders, but surgical injury limits its clinical application. Here, we developed ultrasound-responsive piezoelectric nanoparticles for minimal-invasive and wireless neuromodulation. In the 6-OHDA-induced Parkinson’s disease (PD) mouse model, these nanoparticles are injected into the subthalamic nucleus (STN) of the mouse brain. After ultrasound stimulation for several days, the motor behavior, particularly gait abnormalities and nonmotor symptoms such as pain and anxiety, in PD mice is alleviated without detectable toxicity. The piezoelectric nanoparticles can activate the STN area of the mouse after ultrasound stimulation. Our results demonstrate that piezoelectric-mediated neuromodulation of the STN reverses motor deficits in PD by modulating neural signals, thereby protecting dopaminergic neurons and enhancing levels of the neurotransmitter dopamine. This process can rescue and mitigate mitochondrial dysfunction and neuroinflammation in the nigrostriatal pathway. Our approach enables STN neuronal activation with minimal invasiveness, offering a promising strategy for treating neurodegenerative diseases.

23. Pediatric Oncology Knowledge Mobilization in Canada: Protocol for an Environmental Scan.

期刊: JMIR research protocols 发表日期: 2026-May-01 链接: PubMed

摘要

Nonprofit organizations that serve the pediatric oncology community play a crucial role in disseminating quality information that can inform and support people living with childhood cancer, those that work in the field, and others who make key decisions or policies. These registered organizations can be challenging to locate, as the internet is flux with information and resources of varying quality, misinformation, and disinformation. There remains limited understanding of the knowledge mobilization landscape of these organizations in Canada. This study will provide an overview of the pediatric oncology nonprofit organizational landscape and describe their knowledge mobilization efforts related to dissemination, highlighting existing strengths, gaps, and novel opportunities to strengthen and unite efforts. A novel environmental scan methodology will be employed to search government and nonprofit organizations’ databases. Independent reviewers will screen the websites of eligible organizations. Extracted data will be descriptively analyzed, geographically sorted, and presented in a tabular form with accompanying narrative. This project received funding in 2024. We anticipate that preliminary results will be available by summer 2025. The search strategy for this study will be completed in the spring of 2025. One key project milestone for this environmental scan includes sharing drafts of the results from this strategy through expert consultations in the spring of 2025. After this milestone, a full set of preliminary results will be available by summer 2025, and the final manuscript will be submitted in fall 2025. The environmental scan will explicate each step of our method to allow others the opportunity to garner understanding from our learnings. Findings will be disseminated to the broader community via social media, directly to the pediatric oncology network in Canada, and globally, through summaries, infographics, presentations, and traditional academic outputs. By doing so, the pediatric oncology community will have information pertinent to navigating these resources, and further steps can be devised to bolster the knowledge mobilization capacity in Canada. DERR1-10.2196/76787.

24. City-Level Nexus of Embodied Waste Carbon in China.

期刊: Environmental science & technology 发表日期: 2026-May-01 链接: PubMed

摘要

Waste management and carbon emission reduction, both central to the Sustainable Development Goals, are increasingly encouraged to be integrated due to the strong and inherent linkages between waste generation and greenhouse gas emissions. A system-wide understanding of this relationship across the entire supply chain, from production to final consumption, is fundamental for identifying leverage points for source reduction. This study provides a novel city-level assessment of the coupling coordination between waste and carbon emissions in China. The results reveal that, although megalopolises act as consumption hubs, benefiting from reduced local generation of hazardous waste, industrial solid waste, and carbon emissions through outsourced production, they still exhibit consistently high coupling coordination between carbon and waste emissions. Furthermore, demand-side strategies are equally critical because coupling coordination is 20.4-68.8% higher from the consumption perspective than from the production perspective, underscoring the decisive role of final demand in driving upstream environmental pressures. Between 2015 and 2019, the average coordination between hazardous waste and carbon emissions from a production perspective increased by 18.4%, whereas other coordination indicators remained relatively stable. The strengthening was particularly pronounced in medium and small cities, where increases in hazardous waste and carbon intensities were the primary drivers, outweighing the influence of sectoral output changes. These findings provide a foundation for integrated environmental governance to support both carbon neutrality and zero-waste development goals.

25. Catalases act as putative oral secretion effectors in Tuta absoluta, suppressing tomato oxidative defenses and providing safe RNAi targets for pest control.

期刊: Pest management science 发表日期: 2026-May-01 链接: PubMed

摘要

Tuta absoluta is a globally destructive invasive Solanaceae pest with widespread resistance to conventional insecticides, highlighting the urgent need for eco-friendly and sustainable control strategies. Catalase (CAT) is a key antioxidant enzyme that primarily scavenges intracellular hydrogen peroxide (H2O2) to maintain redox homeostasis. CATs have also been detected in the oral secretions (OSs) of some herbivorous insects, suggesting an additional extracellular role in manipulating plant defense during feeding making CATs innovative targets for pest management. Here, we systematically identified CATs in Tuta absoluta and evaluated their functions and suitability as RNA interference (RNAi) targets. Nine CATs were identified, with TaCAT1-TaCAT3 clustered phylogenetically with known insect OS-associated CATs. These genes showed high expression in larval heads and guts, induced by tomato feeding, indicating roles at the insect-plant interface. Silencing these CATs significantly impaired larval performance: individual double-stranded RNAs (dsRNAs) caused 69% mortality, while combined targeting (dsCAT-mix) achieved 80% mortality, accompanied by reduced pupation and smaller pupae. Functionally, CAT silencing induced tomato leaves H2O2 accumulation, and activated jasmonic acid pathway while suppressing salicylic acid signaling. These results demonstrate that CATs facilitate larval feeding by suppressing plant oxidative and hormonal defenses. Importantly, dsCAT treatments had no negative effects on predator Nesidiocoris tenuis, underscoring biosafety and specificity. These findings uncover a previously underappreciated role of CATs as putative OS effectors in a lepidopteran pest, validating them as effective, selective, and eco-friendly RNAi targets. This work provides mechanistic insight into insect-plant interactions and a practical foundation for sustainable RNAi-based strategies against Tuta absoluta. © 2026 Society of Chemical Industry.

26. Role of UAVs in precision pesticide spraying and environmental safety by combating pesticide resistance and safety of natural enemies.

期刊: Pest management science 发表日期: 2026-May-01 链接: PubMed

摘要

The use of unmanned aerial vehicles (UAVs) has emerged as a promising tool to maximize agricultural productivity and is useful in precision and sustainable insect pest control, with less impact on the environment and human health. In this review, we revealed how UAVs are valuable in dealing with pesticide resistance issues, reducing the ecological footprint of practices during pest management, and how they are safer for natural enemies. These UAVs have the ability to considerably reduce the overall dosage of insecticides with targeted delivery, which minimizes the risk of resistance development in insect pests against tested pesticides. Moreover, the addition of advanced technologies, such as computer vision systems, allows UAVs to optimize pesticide usage based on real-time data. The delivery of biological control agents by UAVs further supports ecological sustainability. However, a careful consideration is needed on the impact of UAV-applied chemicals on non-target organisms and ecosystems. To minimize drift, strategies such as optimized flight parameters, use of suitable nozzles, and integration of adjuvants should be adopted, which are important to ensure environmental safety. Future research on UAV technology, application methods, pesticide formulation, and natural enemy delivery is crucial to maximize the benefits of this innovative technique and ensure the safety of agroecosystems. © 2026 Society of Chemical Industry.

27. Engagement in Cancer Epidemiology Cohorts.

期刊: Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology 发表日期: 2026-May-01 链接: PubMed

摘要

Cancer epidemiology cohorts (CECs) provide key insights into genetic, environmental, lifestyle, and clinical factors influencing cancer development, progression and outcomes. Engaging communities impacted by research and participants in cohort studies is essential for building trust and ensuring the success of these studies. While the concept of engagement in cancer research is not new, the practice of engagement is evolving towards more rigorous, bidirectional relationships between researchers and communities. Here, we discuss some goals of engagement in CECs supported by the National Cancer Institute (NCI), Division of Cancer Control and Population Sciences (DCCPS), Epidemiology and Genomics Research Program (EGRP), which include: (1) involving community and participant voices in study design and implementation, (2) providing updates on study progress, (3) returning value to communities and participants, and (4) demonstrating appreciation to study participants. This paper also outlines opportunities to enhance engagement activities across cohorts such as expanding the use of digital technologies, continuing to share lessons learned, and supporting report back of findings. Additionally, strengthening evidence base on how to engage communities at all stages of research can foster more meaningful partnerships and ultimately lead to more impactful research and better health outcomes.

28. Consensus on factors critical to Augmentative and Alternative communication (AAC) use in Canada from multiple stakeholder perspectives: a Delphi study.

期刊: Disability and rehabilitation. Assistive technology 发表日期: 2026-May-01 链接: PubMed

摘要

Research evidence supports the benefits of AAC in enhancing social participation for people with communication disabilities, including in education and employment, however underutilisation and discontinued use of AAC systems remain unresolved issues. With this study, the research team aimed to gather consensus on factors important to AAC use and identify priorities based on the perspectives of key stakeholders in Canada. The perspectives considered included those of people who use AAC, family, caregivers, service providers, manufacturers, and technicians. A two-round modified Delphi study design was used. The research team developed 123 survey items, based on previous focus group studies, to be rated on a 9-point numeric rating scale with an online two-round Delphi survey. The result was consensus on 52 statements rated as important by at least 75% of participants. The statements related to several environmental and technological factors including characteristics of AAC systems, social interaction with AAC, AAC services, school, physical environment, and societal attitudes. The range of priorities identified as important for AAC pertain to the person who uses AAC, AAC system design, acquiring AAC systems, formal and informal support, and social context, highlighting where support is needed. Consensus on areas of importance based on the perspectives of different expert groups will help to inform future directions and priorities for research and practice, including recommendations for AAC service delivery guidelines in Canada. This study reports on consensus from lived experience and professional viewpoints on the factors that are most important to AAC use in CanadaFindings speak to the urgent need to enhance resources in many areas especially services, AAC training, and support at schools for AAC useThe results of the study highlight the importance of developing service delivery guidelines that aim to address priorities and support social participation of people who may benefit from AAC.

29. Paediatric Handbook: co-creation and user perceived satisfaction of a paediatric-specific knowledge translation resource for manual wheelchair skills training.

期刊: Disability and rehabilitation. Assistive technology 发表日期: 2026-May-01 链接: PubMed

摘要

The evidence-based Wheelchair Skills Training Program (WSTP) positively influences paediatric manual wheelchair users’ (PMWUs) mobility. Occupational therapists (OTs) raised a need for condensed knowledge translation resources supporting its uptake in paediatrics. This study aimed to: 1) co-create a condensed educational resource to support PMWU wheelchair skills training (Paediatric Handbook) with an international subcommittee of researchers and clinicians with expertise in paediatric mobility (WSP-Paediatric Subcommittee [WSP-PS]); and 2) explore WSP-PS’s and OTs’ overall satisfaction with the Paediatric Handbook, and perceptions regarding usability, content and relevance, and anticipated feasibility in paediatrics. The Paediatric Handbook was co-created in two steps (1): paediatric-specific synthesis of the WSTP content and novel considerations for PMWUs (2); co-creation of the format and presentation. Online focus groups and interviews explored the WSP-PS’s and OTs’ overall satisfaction with, and perceptions of, the Paediatric Handbook (usability, content and relevance, and anticipated feasibility). The framework method guided deductive thematic analyses. Eleven WSP-PS members co-created the Paediatric Handbook, comprising five sections (Safety, Motor Learning Principles, Skills Educational Sheets, Games, and Toolbox) in a format intended to be appealing and easy to navigate. Seventeen participants (eight WSP-PS members and nine OTs) found the Paediatric Handbook user-friendly (overall satisfaction), highlighting its visuals, clarity, and structure (usability). Participants perceived that it could support clinicians’ learning, particularly when integrated into hands-on training (content and relevance), and anticipated few barriers to its use in paediatric settings (anticipated feasibility). Overall satisfaction and perceptions suggest the Paediatric Handbook’s potential to support WSTP uptake in paediatrics. The Paediatric Handbook may support clinicians in delivering evidence-based manual wheelchair skills training to paediatric manual wheelchair users.Integrating the Paediatric Handbook into context-specific hands-on training and providing individualised support to clinicians may encourage uptake and implementation of the WSTP in paediatrics.

30. Maternal Heat Shock Protein as a Potential Biomarker of Adaptation to Heat Stress during Pregnancy and Its Relation to Preterm Birth.

期刊: Environmental science & technology 发表日期: 2026-May-01 链接: PubMed

摘要

We evaluated whether maternal HSP27 and HSP70 responded to heat stress during pregnancy and whether HSPs were associated with preterm birth in a secondary analysis of a prospective cohort with repeated biomarkers (N = 227 from MADRES). Serum HSPs were measured during early and late pregnancy using ELISA. Daily heat stress in the 30 days before HSP measurement was computed as Daily Maximum Heat Index (DMHI) and Wet Bulb Globe Temperature (WBGT). Distributed lag models identified sensitive windows of heat adaptation; logistic regression models assessed HSPs’ effects on preterm birth (<37 gestational weeks, n = 18 [7.9%]). Models were adjusted for sociodemographics, study design, and heat-exposure predictors. HSP27 and HSP70 concentrations decreased over pregnancy. Higher acute DMHI exposure was associated with higher HSP27 and HSP70 during early pregnancy (1-15 days lags; strongest effect per 1-SD increase: 0.6% [95% CI: 0.001-1.2%] for HSP27 at 9 days; 8.3% [2.6-14.5%] for HSP70 at 1 day) and higher HSP27 during late pregnancy. Mothers with larger HSP70 increases over pregnancy were associated with higher preterm birth risks (OR = 5.2, [1.5, 18.6]) versus those with stable/decreasing levels. HSPs may indicate acute heat stress during pregnancy, with increased HSP70 associated with preterm birth risks.

31. Development and Effectiveness Evaluation of an Integrated Multidisciplinary Radiation Protection Management Framework for Tertiary Hospitals.

期刊: Health physics 发表日期: 2026-May-01 链接: PubMed

摘要

Medical workers represent the largest occupationally exposed population to ionizing radiation, yet traditional radiation protection management often operates in departmental silos. This study aimed to develop and evaluate an integrated multidisciplinary management framework for enhancing radiation protection in tertiary hospitals. This retrospective study was conducted at a tertiary hospital in China from January 2020 to December 2024, including 510 radiation workers across diagnostic imaging, radiation therapy, interventional radiology, and cardiovascular departments. The study comprised three phases: baseline (2020), intervention (2021-2023), and evaluation (2024). An administrative multidisciplinary team incorporating Plan-Do-Check-Act cycle methodology was established to implement comprehensive radiation protection management. Following framework implementation, the average annual effective dose decreased from 0.54 mSv to 0.34 mSv, and the annual collective effective dose declined from 212.66 to 133.12 person-mSv. The proportion of workers receiving doses exceeding 1 mSv decreased from 6.27% to 3.33% (P<0.001). Implementation indicators also improved significantly: certification rate increased from 90.39% to 100%, annual training completion rate from 81.57% to 98.63%, and personal dosimetry monitoring rate from 92.75% to 100% (all P<0.001). The integrated multidisciplinary radiation protection management framework effectively reduced occupational radiation exposure and improved protection compliance across all departments, providing a replicable model for large general hospitals.

32. Cannabinoid hyperemesis syndrome prevalence and risk factors in the U.S․.

期刊: The International journal on drug policy 发表日期: 2026-Apr-30 链接: PubMed

摘要

Cannabinoid hyperemesis syndrome (CHS) is characterized by intense nausea, abdominal pain, and cyclical vomiting following heavy, chronic cannabis use. With increases in cannabis legalization in the United States (U.S.), CHS is an emerging concern for cannabis users, medical professionals, and policymakers. This study is the first to examine a large, nation-wide sample of cannabis users to estimate CHS prevalence and identify risk factors and at-risk populations. Survey data were collected in the U.S. by the International Cannabis Policy Study in 2023. The prevalence of past-year CHS was calculated among participants reporting cannabis use. Logistic multilevel modeling was used to test a-priori hypotheses for factors associated with CHS. 10,255 participants (45.82% female, Mage = 39.46 years) were included in this study. Approximately 6% reported past-year CHS. Participants who were younger, male, Hispanic, or two or more races were more likely to experience CHS. Older age of first cannabis use, more frequent use of cannabis edibles and concentrates, riskier cannabis use patterns, and past-year alcohol use were associated with higher risk. Those who grew their own cannabis, used cannabis to manage symptoms of headaches/migraines or nausea/vomiting, or experienced bipolar disorder or psychosis/dissociative identity disorder were also more likely to report CHS. Those who used cannabis for lack of appetite or experienced depression were less likely to report CHS. There was no significant effect of state-legal cannabis. Ongoing surveillance, standardized definitions, and identification of underlying risk factors are essential to enhance public health awareness and accurate diagnosis.

33. Unpacking the daily dynamics of parenting strain: A 15-day diary study of caregiving role overload, depressive symptoms, and parental burnout among parents of autistic children.

期刊: Research in developmental disabilities 发表日期: 2026-Apr-30 链接: PubMed

摘要

To explore the day-to-day dynamics between daily caregiving role overload and daily depressive symptoms among parents of autistic children, and to examine gender differences in these variables’ average levels and day-to-day dynamics, as well as whether such differences help explain parental burnout. We recruited parents of autistic children from autism intervention centers using convenience sampling (N = 210; 81.9% mothers) in mainland China. Parents completed a brief online diary survey each evening across 15 weekdays over three consecutive weeks to assess daily depressive symptoms and daily caregiving role overload. After the diary period, parents completed a post-diary questionnaire assessing parental burnout. Data were analyzed using dynamic structural equation modeling (DSEM). (1) At the within-person level, daily caregiving role overload and daily depressive symptoms showed reciprocal cross-day associations, forming a day-to-day feedback loop. (2) At the between-person level, mothers reported higher person-mean depressive symptoms than fathers, which in turn predicted higher parental burnout. (3) At the between-person level, mothers exhibited stronger day-to-day carryover of depressive symptoms than fathers, which in turn predicted higher parental burnout. The findings clarify processes through which parenting-related stressors contribute to day-to-day resource depletion and suggest gender-specific pathways and dynamic patterns in the development of parental burnout among mothers and fathers. These results have important implications for promoting parents’ mental health in families with high caregiving demands by informing early, sustained, and parent-tailored daily support to prevent resource depletion and reduce parental burnout.

34. Treatment interval in curative treatment of colon cancer and its impact on (cancer-free) survival in high-risk and non-high-risk patients.

期刊: Journal of geriatric oncology 发表日期: 2026-Apr-30 链接: PubMed

摘要

Implementation of prehabilitation for patients undergoing surgical treatment for colon cancer has proven effective in reducing the risk of postoperative complications. Currently the recommended maximal treatment interval has limited span for implementation of a prehabilitation program. The aim of the current study was to determine the association between advised treatment interval and (cancer-free) survival, while stratifying for the risk of postoperative complications. This retrospective multicenter study included patients who underwent elective surgical treatment for colon cancer between 2010 and 2016. Patients were stratified based on risk of postoperative complications (high-risk and non-high-risk). Treatment interval was defined as time between diagnosis and surgery, divided into three categories (≤35 days, 36-49 days, and > 49 days). Primary endpoints were overall survival and cancer-free survival, assessed by multivariate Cox proportional hazard regression analysis. A total of 3376 patients were included, of whom 60% were considered non-high-risk and 40% high-risk, with a median age of 72 years (IQR 64-78). Of the included patients, 862 (26%) had tumor stage I, 1353 (40%) had tumor stage II, and 1160 (34%) had tumor stage III colon cancer. Treatment interval was not associated with cancer-free survival (36-49 days [non-high-risk p = 0.77; high-risk p = 0.56] or > 49 days [non-high-risk p = 0.46; high-risk p = 0.13]). A treatment interval > 49 days was associated with poorer five-year overall survival in non-high-risk patients (HR = 1.35, p < 0.05), but not in high-risk patients (p = 0.69). A treatment interval of 36-49 days was not associated with five-year overall survival (non-high-risk p = 0.24; high-risk p = 0.98). Extending the treatment interval in curative treatment of colon cancer up to 49 days appears safe for both high-risk and non-high-risk patients. For high-risk patients, the expected benefits of longer treatment interval including prehabilitation should be balanced with the medical urgency to operate.

35. Evaluation of Artificial Intelligence versus Human-Authored Anesthesia Patient Education Materials: A Multi-Institution Survey Study.

期刊: Anesthesia and analgesia 发表日期: 2026-Apr-29 链接: PubMed

摘要

36. Effects of stress on brain activation changes: Recent developments.

期刊: Psychoneuroendocrinology 发表日期: 2026-Apr-29 链接: PubMed

摘要

Stress engages coordinated psychological, neuroendocrine, autonomic, and neural processes that enable adaptation to environmental demands but may contribute to vulnerability when stress is prolonged, uncontrollable, or socially evaluative. Functional neuroimaging has become central to psychoneuroendocrinology by enabling direct investigation of how acute stress shapes brain activation and connectivity and how these neural responses interact with hypothalamic-pituitary-adrenal axis regulation. This editorial introduces the Special Issue “Effects of stress on brain activation changes: Recent developments” and outlines key conceptual and methodological advances in the field. We highlight progress from endocrine-marker-based stress research toward brain-based models of stress, emphasizing evidence from scanner-based paradigms such as the Montreal Imaging Stress Task and ScanSTRESS, as well as emerging multimodal approaches including fNIRS, PET, EEG, and harmonized large-scale analyses. We discuss recent developments concerning exposure-time effects, network-level models of stress processing, and the importance of functional connectivity. We further emphasize the need to account for individual and contextual variability, including sex, gender, developmental stage, clinical vulnerability, and real-world stress relevance. This Special Issue invites contributions that use neuroimaging to advance mechanistic, translational, and reproducible models of stress-related brain function.

37. Assessing the value of measuring frailty in patients with chronic lymphocytic leukemia/small lymphocytic lymphoma.

期刊: Leukemia research 发表日期: 2026-Apr-28 链接: PubMed

摘要

Most patients with chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL) have comorbidities at diagnosis, which are associated with worse outcomes. Despite its clinical relevance, frailty is understudied in CLL/SLL. Our study examined the contributions of frailty, measured with Function-Related Indicators (FRIs), and comorbidity for assessing health status in patients with newly diagnosed CLL/SLL. Using Surveillance, Epidemiology, and End Results-Medicare data, we identified 30,880 older patients with CLL/SLL. FRI score and the National Cancer Institute (NCI) Comorbidity Index were calculated using claims in the year before diagnosis. Hazard ratios (HRs) for mortality and hospitalization were assessed with Cox hazards models. Frailty and comorbidity were common prior to diagnosis: 48.6% of patients had ≥ 1 FRI, 64.8% had ≥ 1 condition in the NCI Comorbidity Index, and 27.4% had prior or simultaneous cancer. People with more FRIs (i.e., frailer) were older, more likely to be female and unmarried, had more comorbidities, and were more likely to have been hospitalized in the 12-months prior to CLL/SLL diagnosis. The FRI remained predictive after adjusting for comorbidity and patients with higher baseline frailty had an increased risk of mortality (FRI ≥2 vs 0: adjusted HR = 1.37, 95% CI: 1.31-1.43) and hospitalization (FRI ≥2 vs 0: adjusted HR = 1.34, 95% CI: 1.29-1.40). Different aspects of health status were identified by the FRI and comorbidity. Assessing frailty at diagnosis, when many patients have not yet experienced extensive disease-related symptoms, adds independently to predicting patient outcomes beyond comorbidity alone.

38. Serum immunoglobulin G levels in patients with cirrhosis due to autoimmune hepatitis or other etiologies.

期刊: European journal of gastroenterology & hepatology 发表日期: 2026-Apr-28 链接: PubMed

摘要

Immunoglobulin G (IgG) elevation is a key laboratory finding of autoimmune hepatitis (AIH). However, the IgG elevation also occurs in patients with cirrhosis due to diverse etiologies. Therefore, we compared serum levels of globulin (GLB) and immunoglobulins among cirrhotic patients and optimized the IgG level to improve its diagnostic accuracy for AIH in the context of cirrhosis. In this cross-sectional study, we included age- and gender-matched patients with cirrhosis due to AIH and non-AIH etiologies. Demographic and key laboratory profiles were compared, focusing on the levels of GLB and immunoglobulins. Receiver operating characteristic curves were constructed. Bilateral P < 0.05 and area under receiver operating characteristic curves greater than 0.5 were considered statistically significant. A total of 60 AIH patients and 259 patients with cirrhosis of non-AIH etiologies were analyzed. The AIH group exhibited higher alanine aminotransferase and aspartate aminotransferase levels. Elevations of GLB (9.8-58.3%) and IgG (47.4-97.2%) levels were observed in all groups of cirrhosis, with the highest levels of IgG, immunoglobulin M, and immunoglobulin A occurring in the patients with cirrhosis due to AIH, primary biliary cholangitis, and alcoholic liver disease group, respectively. At a cutoff IgG level of 2000 mg/dl (1.25× upper limit of normal), the sensitivity and specificity for the diagnosis of AIH cirrhosis were 81.7% and 74.1%, respectively, with an area under receiver operating characteristic curves of 0.814 (P < 0.001). Hyperimmunoglobulinemia occurs in patients with cirrhosis due to different etiology. However, the different patterns of immunoglobulin subtype elevation may facilitate the differentiation of the underlying etiology of cirrhosis, with IgG level more than 2000 mg/dl (1.25× upper limit of normal) having a fair diagnostic performance for AIH-related cirrhosis.

39. Artificial Intelligence for histopathological diagnosis and grading of breast cancer in Ethiopia.

期刊: Pathology, research and practice 发表日期: 2026-Apr-24 链接: PubMed

摘要

Recent advances in computational pathology enables AI-assisted diagnosis and risk stratification of breast cancer. This advance in technology will reduce the inconsistent reporting of breast cancer grading using Nottingham Histologic grading system. This study evaluated the implementation of the DeepGrade model for breast cancer grading using H&E-stained slides from breast cancer patients in Ethiopia. To assess the accuracy, specificity, and sensitivity of the DeepGrade model in distinguishing between grade 1 and grade 3 tumours. Additionally, the study aimed to explore the model’s ability to further classify Nottingham Histologic Grade 2 tumours into two distinct risk categories. A retrospective analysis was conducted using data from 200 tumour samples from the Department of Pathology, Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia. The performance of the DeepGrade model was compared with three pathologists’ diagnosis using metrics such as specificity, sensitivity, area under the curve and agreement level. The DeepGrade model reached a 100% specificity for low-grade tumours and an 82.05% sensitivity for high-grade tumours, with an AUC of 0.914 and an agreement level of 86.79%. Our findings illustrated the model’s strong agreement with the pathologist, and a Kappa coefficient of 0.71 (95% CI: 0.51-0.90). The study showed the potential significance of DeepGrade model utilization in enhancing breast cancer grading practices in resource-limited settings. By adopting this model, a consistent and standardized grading system for breast cancer can be established, significantly enhancing the effectiveness of breast cancer management.

40. Ripples of resistance: Unveiling antimicrobial resistance dynamics along Switzerland's Aare river.

期刊: Water research 发表日期: 2026-Apr-23 链接: PubMed

摘要

The global spread of antimicrobial resistance (AMR) is a serious public health concern, driven by widespread antibiotic use and the global environmental circulation of antibiotic-resistant bacteria and resistance genes (ARGs). Wastewater treatment plants (WWTPs) are important sources of anthropogenic AMR entering large rivers, which serve as vital water resources but facilitate downstream dissemination. The drivers and dynamics of AMR propagation along river systems remain poorly understood. As Switzerland’s longest and one of its largest rivers, the Aare, situated in the upper Rhine watershed, plays a central role in the ‘water castle of Europe’. This study examines the impact of WWTP discharges, some receiving high loads of hospital effluent, on ARG distribution along the 288 km Aare river-continuum. Using quantitative PCR targeting 14 ARGs conferring resistance to eight antibiotic classes, combined with 16S rRNA gene amplicon sequencing, we conducted a high-resolution spatial survey to assess shifts in the riverine ARG content and microbiome. Concentrations of trace metals and nutrients were analyzed as tracers of anthropogenic inputs. Results revealed a progressive increase in ARG abundance downstream, driven by WWTP effluents enriched in ARGs. Effluents had 70-fold higher mean ARG concentrations than upstream waters, raising downstream levels up to 141-fold. Major tributaries such as the Reuss and Limmat sustained elevated ARG levels, while passage through lakes markedly reduced concentrations. This study provides the first detailed baseline for ARG prevalence along a large swiss river system, from pristine headwaters to pollution-affected lower reaches and insights into aquatic AMR dynamics and guidance for future monitoring.

41. Antiviral effect of lactoferrin against infectious bronchitis virus (IBV) are associated with alterations in the gastrointestinal microbiome.

期刊: Poultry science 发表日期: 2026-Apr-22 链接: PubMed

摘要

Coronaviruses (CoVs) are an enveloped, polymorphic, positive-sense single-stranded RNA viruses. Currently, both humans and animals are threatened by CoVs, making them a major public health concern. Among the four genera of the family Coronaviridae, infectious bronchitis virus (IBV), which belongs to the genus Gammacoronavirus, continues to cause substantial economic losses in the poultry industry. Nephropathogenic IBV strains, including the Taiwan-I (TW-I) and Taiwan-II (TW-II) serotypes, are the most prevalent IBVs in Taiwan and China and have continued to spread and generate variants through mutation and genetic recombination. Because IBV can replicate in the epithelial cells of the trachea, lung, kidney, and intestine, this study investigated the dysbiosis of the ileal microbiota caused by IBV TW-I and TW-II serotypes. The reduced weight gain of chickens infected with IBV TW-I or TW-II was improved by lactoferrin (LF). The antiviral effects of LF included a significant reduction in viral loads in the ileum of infected chickens. Furthermore, the villus shedding, decreased villus height, increased crypt depth, and reduced number of goblet cells induced by IBV infection were markedly attenuated by LF. Alterations in the ileal microbiome were also observed following LF treatment. Regarding cytokine responses, the IBV-induced upregulation of TGF-β and IL-10 and the elevated infiltration of CD3+ T cells in the ileum were reduced by LF, whereas the mRNA expression levels of IFN-γ, IL-2, and IL-4 were upregulated by LF. Moreover, the IBV-induced downregulation of MUC2, occludin, and ZO-1 in the ileum was reversed by LF. LF shifted the ileal microbiota toward homeostasis, regulated the immune response to facilitate viral clearance, and restored the intestinal barrier damaged by IBV TW-I and TW-II infection.

42. Vibrio vulnificus: A Highly Virulent Bacterium on the Rise.

期刊: Advanced emergency nursing journal 发表日期: 链接: PubMed

摘要

Vibrio vulnificus is a highly virulent gram-negative aquatic bacterium found in warm brackish waters and in molluscum shellfish worldwide that can cause sepsis after ingestion of raw oysters or undercooked molluscum shellfish as well as deadly skin and soft-tissue infections from immersion in contaminated seawater. Populations at a higher risk of infections are men older than 60 years with diabetes mellitus, liver cirrhosis, renal disease, or elevated iron levels and those who are immunocompromised. Three severe syndromes caused by V. vulnificus are gastroenteritis, primary septicemia, and wound infections. Gastroenteritis caused by ingestion is self-limited; however, sepsis can develop rapidly with a mean survival rate of 50%, and wound infections can progress to necrotizing skin and soft-tissue infections with 24 hours. Early identification, prevention of hypotension, initiation of antibiotics, and surgical debridement of necrotic wound tissue is paramount to survival. Public education and awareness of this deadly pathogen is necessary to prevent exposure and improve clinical outcomes, especially for high-risk populations.

43. The Complex Interplay between Botanical Supplements and the Human Gut Microbiome.

期刊: Journal of natural products 发表日期: 2026-May-01 链接: PubMed

摘要

Botanical supplements have been used for the prevention and treatment of human diseases since ancient times and remain important, widely consumed therapeutics. While they display promising efficacy across a broad spectrum of biological activities, poor oral bioavailability often limits their utility. Upon ingestion, these compounds may remain in the gastrointestinal tract prior to absorption, during which time they interact with gut microbiota. These interactions can significantly alter their bioavailability since microbial enzymes, known for their wide substrate specificity, are capable of readily transforming xenobiotics, often changing their biological activity as well as their bioavailability. Herein, we summarize the chemistry of microbial biotransformations of botanical supplements, highlighting key enzymatic transformations. The reciprocal interactions between four widely used botanical supplements and the human gut microbiome are outlined including green tea, açai, red wine, and mangosteen. Their microbial metabolism and modulation of human gut microbiota is discussed, highlighting the various enzymes and metabolites reported from relevant literature. Although the direct effect of microbiome bioconversion of botanical supplements is largely unexplored due to the complexity of both systems, this review provides a framework for research to determine the bidirectional effects of botanicals and gut microbiota on human health.

44. Noninvasive Screening for High-Risk Esophageal Varices in Cirrhosis: Current and Emerging Methods.

期刊: Journal of clinical gastroenterology 发表日期: 2026-May-01 链接: PubMed

摘要

The primary goal of variceal screening in patients with cirrhosis is to identify high-risk esophageal varices (HREV) and implement preventative measures. Historically, endoscopic screening was recommended for all patients with cirrhosis; however, this approach is increasingly recognized as neither cost-effective nor clinically necessary for all patients. As the prevalence of compensated advanced chronic liver disease (cACLD) continues to rise, there is increasing interest in noninvasive risk stratification methods to effectively tailor patient selection for endoscopic screening. Current clinical guidelines encourage the use of noninvasive predictive scores and algorithms to accurately identify patients at increased risk of having HREV and thereby reduce unnecessary screening endoscopies. In this review, we provide an evaluation of the various available noninvasive methods to predict HREV, including the Baveno criteria, platelet count:spleen diameter ratio, and the EVendo score. We review the performance, strengths, and limitations of these noninvasive methods-especially the machine learning-based EVendo score-and discuss future directions for optimizing risk stratification in patients with cirrhosis.

45. Children's Health-Related Quality of Life After Brachial Plexus Birth Injury.

期刊: JAMA network open 发表日期: 2026-May-01 链接: PubMed

摘要

This cross-sectional study assesses overall health-related quality of life among children in North America who have brachial plexus birth injury.

46. Harms of Framing Obesity as a Disease of Individuals.

期刊: JAMA health forum 发表日期: 2026-May-01 链接: PubMed

摘要

This Viewpoint examines how framing obesity as an individual disease that should be treated may impact addressing the larger systemic- and policy-driven roots of the problem that could be addressed to effectively prevent the disease.

47. Development and validation of matrix-validated LC-MS/MS method for simultaneous quantification of 21 neonicotinoids and their metabolites in human urine.

期刊: Environmental science and pollution research international 发表日期: 2026-May-01 链接: PubMed

摘要

Neonicotinoids (NEOs) are the most widely used class of insecticides worldwide. Consequently, human exposure occurs through multiple pathways, including dietary intake and environmental contact. Previous analytical methods have primarily focused on parent compounds, often excluding key metabolites due to matrix effects and poor quantification in complex biological samples. This gap severely limits the ability to accurately assess total NEO exposure and internal dose, highlighting the urgent need for more comprehensive and reliable biomonitoring approaches. This study developed a comprehensive LC-MS/MS method to quantify 21 NEOs and metabolites in human urine, uniquely including key transformation products such as clothianidin-n-desmethyl, clothianidin-urea, imidacloprid-urea, imidacloprid-olefin, 5-hydroxy-imidacloprid, thiamethoxam-urea, and thiamethoxam-n-desmethyl, thereby enabling a more thorough assessment of human exposure to NEOs. The method was validated using both synthetic and pooled human urine, providing a critical assessment of matrix-dependent variations in detection limits, accuracy, and precision. Method performance demonstrated high sensitivity, specificity, accuracy, and precision, with limits of quantification (LOQ) from 0.017 to 0.46 ng/mL and limits of detection (LOD) from 0.0050 to 0.14 ng/mL. The method was applied to urine samples from 246 pregnant women and 47 farmers in eastern Iowa to assess exposure levels. Results indicated widespread NEO exposure with detection frequencies of 99% of pregnant women and 100% in farmers, with 18 different NEOs and metabolites detected across both populations. Metabolite monitoring revealed that imidacloprid metabolites (IMI-O, 5-OH-IMI) were stronger predictors of total neonicotinoid burden than parent compounds alone (rs = 0.735 vs < 0.6 for parents), with some metabolites showing higher concentrations in pregnant women than farmers despite farmers having higher overall exposure. These findings demonstrate that parent-only biomonitoring substantially underestimates internal neonicotinoid exposure and fails to capture critical exposure pathways, particularly for vulnerable populations where metabolite patterns may differ significantly from occupational exposure profiles.

48. Esculetin inhibits PRV replication by suppressing activation of the PI3K-AKT/NF-κB pathway.

期刊: Veterinary microbiology 发表日期: 2026-Apr-28 链接: PubMed

摘要

Pseudorabies (PR), caused by pseudorabies virus (PRV), is an acute and highly contagious disease that results in substantial economic losses to the global swine industry. In recent years, the emergence of neurotropic PRV variants capable of escaping vaccine-induced immunity has highlighted the urgent need for safe and effective antiviral agents. In this study, we demonstrated that esculetin exhibits pronounced antiviral activity against PRV both in vitro and in vivo. Esculetin inhibited PRV replication in PK-15 cells in a dose-dependent manner, with a selectivity index (SI) of 15.85 and a maximal inhibition rate of 98.53%. In vivo, administration of esculetin at 0.2 g/kg increased the survival rate of PRV-infected mice to 28.5%. Viral loads in the brain, lungs, and kidneys were reduced in a dose-dependent manner, accompanied by marked attenuation of PRV-induced tissue damage. In addition, treatment with 0.2 g/kg esculetin significantly decreased serum levels of the pro-inflammatory cytokines IL-6, TNF-α, and IL-1β. Mechanistically, esculetin inhibited AKT phosphorylation, suppressed nuclear translocation of NF-κB P65, and downregulated the expression of inflammation-related genes and proteins, including IL-6, TNF-α, iNOS, and MCP-1. Collectively, these findings indicate that esculetin may exert its anti-PRV effects, at least in part, by modulating inflammatory responses, and highlight its potential as a promising antiviral candidate for the prevention and treatment of PRV infection.

49. Inflammaging: From Mechanisms to Clinical Implications and Targeted Interventions.

期刊: Aging and disease 发表日期: 2026-Apr-24 链接: PubMed

摘要

Inflammaging refers to the chronic, low-grade, sterile inflammatory state that emerges as a hallmark of biological aging and is increasingly recognized as a contributor to functional decline, frailty, and the progression of multiple age-associated diseases. While acute inflammation supports host defense and tissue repair, persistent and unresolved inflammatory signaling promotes tissue damage, metabolic dysregulation, and impaired immune homeostasis. Inflammaging reflects a dysregulated physiological state associated with elevated damage-associated molecular patterns (DAMPs), pro-inflammatory cytokines, altered immune cell composition, metabolic imbalance, and the accumulation of senescent cells exhibiting a senescence-associated secretory phenotype (SASP). Together, these processes impair immune surveillance, increase oxidative stress, and tissue vulnerability, potentially accelerating functional decline and amplifying disease trajectories that may originate earlier in life. Despite ongoing challenges in precisely defining and measuring inflammaging, evidence suggests that its development is shaped not only by chronological aging but also by behavioral, environmental, psychosocial, and genetic factors, highlighting its dynamic and potentially modifiable nature. In this review, we distinguish inflammaging from general chronic inflammation, synthesize current understanding of its biological origins and mechanistic drivers, and examine its role in clinical outcomes including sarcopenia, neurodegeneration, and cardiovascular disease. We propose a conceptual translational framework linking biological mechanisms of inflammaging to multilayer biomarker signatures, AI-based risk stratification, and precision interventions. Additionally, we discuss the opportunities and limitations of these approaches for identifying individuals at risk for chronic disease and informing multi-dimensional strategies to promote resilience and extend health-span.

50. Ecotoxicological assessment of UV-C/Oxidant processes for advanced treatment of aquaculture effluents.

期刊: Water research 发表日期: 2026-Apr-22 链接: PubMed

摘要

The growth of the aquaculture sector poses challenges in maintaining product quality, particularly regarding contamination, which risks aquatic organisms and human health. Advanced oxidation processes using UV-C radiation can remove persistent compounds and pathogens from aqueous matrices through the generation of reactive species. However, their chemical non-selectivity may produce toxic disinfection by-products (DBPs), which require cautious ecotoxicological assessment. This study aimed to evaluate the ecotoxicological effects of UV-C/oxidant processes on aquaculture effluents by employing survival assays with Daphnia magna (D. magna) and growth inhibition assays with Pseudokirchneriella subcapitata (P. subcapitata). UV-C treatment of synthetic and real aquaculture effluents was intensified by hydrogen peroxide (H2O2), peracetic acid (PAA), sodium hypochlorite (NaClO), potassium peroxymonosulfate (PMS), and sodium persulfate (PS). UV-C treatment combined with PAA, PMS, or PS showed promising reductions in toxicity and high D. magna survival rates, whereas treatments with H2O2 and NaClO resulted in significant adverse effects on its survival. This is likely due to residual oxidants and DBPs, as dark controls showed lower toxicity, and UV-C alone had a negligible effect. For P. subcapitata bioassays, UV-C/PMS and UV-C/PS were identified as the most suitable treatments. Our findings support the use of UV-C-based AOPs for aquaculture effluent treatment, with prudent selection and addition levels, while highlighting dilution via recirculation in recirculating aquaculture systems (RAS) as an intrinsic advantage for mitigating relevant ecotoxicological risks.

51. The Relationship between Ergothioneine, Allantoin and Neocortical Amyloid Load.

期刊: Aging and disease 发表日期: 2026-Apr-20 链接: PubMed

摘要

Alzheimer’s disease (AD) is characterised by hallmark pathology of amyloid beta (Aβ) plaques and hyperphosphorylated tau neurofibrillary tangles in the brain. Ergothioneine (ET) is a potent antioxidant, and anti-inflammatory compound that has shown potential as a therapeutic for neurodegenerative disease*. Cross-sectional analyses of cognitively normal individuals aged 65-90yrs from the Kerr Anglican Retirement Village Initiative in Ageing Health (KARVIAH) cohort were stratified by amyloid status (Aβ+, SUVR >1.35). Plasma ET, its metabolites and urinary allantoin, were quantified by liquid chromatography-mass spectrometry. Plasma Aβ1-40, Aβ1-42, GFAP, and NFL were measured by SIMOA and pTau181 and pTau231 were measured via ELISA. No differences in plasma ET or metabolites were observed between AB- (n=65) and AB+ (n=35) groups. Partial correlation analysis highlighted positive correlations between allantoin, and NFL (r = 0.40, pFDR < 0.01), pTau181 (r = 0.47, pFDR < 0.01) and GFAP (r = 0.31, pFDR = 0.01). Partial correlation by subgroup, revealed positive correlations between plasma ET (r = 0.48, pFDR = 0.05) with Aβ42/40 in the AB+ group only. Evidence indicates that ET may protect the brain from oxidative damage and neuroinflammation. Higher urinary allantoin levels were associated with higher plasma AD biomarkers. Further, plasma ET levels were higher in individuals with a higher AB42/40 ratio, within the AB+ group, suggestive that high ET may potentially have neuroprotective effects. More research will be imperative to validate the significance of ET as a therapeutic for prevention of cognitive decline.

52. A growing crisis of neonatal hyperosmolar-hypernatremic dehydration during heat waves: clinical insights from a semi-arid region.

期刊: Journal of tropical pediatrics 发表日期: 2026-Apr-11 链接: PubMed

摘要

Hyperosmolar-hypernatremic dehydration (HHND) is a life-threatening yet preventable neonatal condition, often due to inadequate breastfeeding. The recent North Indian heat wave heightened dehydration risks, necessitating an evaluation of extreme temperatures’ impact on neonatal hydration. This retrospective study analysed neonates admitted to a tertiary care level 3 neonatal intensive care unit (NICU) at AIIMS Jodhpur between April and June 2024. Case records were reviewed, and details on maternal age, feeding practices, presenting complaints, biochemical profile, and outcome were studied. The 2024 (April-May) heat wave led to a threefold increase in NICU admissions for HND compared to the previous 2 years, with cases rising from 2 to 3 per year to 10. Primigravida mothers accounted for 70% of the cases. The mean age of presentation was 6.7 days. Affected neonates experienced weight loss ranging from 11% to 33%, with serum sodium levels between 149 and 185 mEq/l and plasma osmolarity reaching 370-450 mOsm/l. Six neonates required peritoneal dialysis (PD) due to encephalopathy/anuria. One developed aortic thrombosis with lower limb gangrene, necessitating thrombolytic therapy. MRI abnormalities were observed in one case. Despite intensive management, one neonate succumbed to sepsis. Extreme environmental heat significantly heightens the risk of hyperosmolar-hypernatremic dehydration (HND) in neonates. Proactive neonatal monitoring, early breastfeeding support, and parental education are critical to preventing dehydration and its complications, especially in tropical and resource-limited settings, where extreme heat, early discharge, and limited lactation support increase neonatal vulnerability. Judicious fluid management targeting plasma osmolarity and timely intervention with PD in severe cases can optimize survival and neurological outcomes, underscoring the need for heightened vigilance during heat waves.

53. Pattern of smartphone use and its influence on psychosocial features among health professional course scholars: a cross-sectional study.

期刊: International journal of adolescent medicine and health 发表日期: 2026-Apr-01 链接: PubMed

摘要

Patterns of smartphone use vary across ages; however, adolescents and young adults may be at particular risk, with more behavioral addictions and adverse health effects. This study explored the prevalence of smartphone addictions among health adolescent professional students and examined how problematic smartphone usage interferes with their level of physical activity as well as health-related quality of life. A cross-sectional Analytical study based on self-perceived outcome measures such as the smartphone addiction scale-short version, the ‘International Physical Activity Questionnaire-short form’, and ‘Patient-Reported Outcomes Measurement Information System 29’-item profile was done with a sample of 400 participants. A total of 400 individuals (125 Males & 275 females) with mean age being 20.8 + 2.06 years recruited for the study. Smartphone addiction was most prevalent in dentistry students (43 %), followed by medicine (32 %) and allied health science (30.5 %), with no statistically significant differences in the addiction rate among the three programs. Compared with smartphone-addicted individuals, nonaddicted individuals had marginally greater physical function (mean difference =0.670, p<0.001), and those addicted to smartphones had significantly higher. anxiety (mean difference = 2.776, p<0.001), depression (mean difference =2.264, p< 0.001), and fatigue (mean difference =2.264, p<0.001). Physical activity was found to have no statistically significant difference between addicted and non-addicted individuals and except for sleep disturbance, none of the domains of PROMISE-29 showed any statistically significant correlation with physical activity. The findings highlight the need for recommendation for setting a time limit for the usage of smartphones for formal and informal academic activities, as well as policy measures to promote normal smartphone use.

54. Eligibility for dual pathway inhibition in patients with peripheral artery disease undergoing revascularization.

期刊: Journal of cardiovascular medicine (Hagerstown, Md.) 发表日期: 2026-Apr-01 链接: PubMed

摘要

Dual pathway inhibition (DPI) with low-dose rivaroxaban and aspirin offers superior ischemic protection compared with single-agent therapy in patients with peripheral artery disease (PAD). However, its real-world adoption remains limited. We aimed to determine the proportion of revascularized PAD patients eligible for DPI, and to explore reasons for ineligibility and associated clinical outcomes. Consecutive patients undergoing lower limb revascularization for PAD between May 2021 and May 2023 were prospectively enrolled in the RAPID (RivAroxaban for PerIpheral artery Disease) registry and followed up for a median time of 283 (interquartile range 142-445) days. VOYAGER PAD eligibility criteria were applied. The primary outcome was eligibility for DPI. Exploratory clinical outcomes included major adverse limb events (MALE) - defined as the composite of cardiovascular death, acute limb ischemia, or repeat limb revascularization - and major bleeding. A total of 196 patients were enrolled during the study period. Among them, 98 (50.0%) met DPI eligibility criteria; however, DPI was administered only to 4.1% of eligible patients. The most frequent exclusion factors were high bleeding risk (99.0%), low hemoglobin (48.8%), and age at least 75 years (36.7%). MALE occurred in 35 patients (28%), driven by recurrent revascularization (20%), while major bleeding occurred in nine patients (5%). DPI eligibility was associated with a lower risk of MALE (hazard ratio 0.42; 95% confidence interval 0.20-0.85), but this association faded out after statistical adjustment. Major bleeding did not differ between eligible and noneligible patients. In a contemporary population of PAD patients undergoing revascularization, only half met the VOYAGER PAD eligibility criteria. Bleeding-related exclusions prevailed, highlighting the need for systematic anemia correction and bleeding avoidance strategies to broaden eligibility for DPI and improve clinical outcomes.

55. Reconstructing Social Participation in Rural Communities: A Qualitative Study of Community Nursing Practice.

期刊: Cureus 发表日期: 2026-Mar 链接: PubMed

摘要

Introduction Participation is a central outcome in community-based rehabilitation, particularly in aging societies where social isolation among older adults is increasing. Community nurses have emerged as key facilitators of social participation in community settings. However, the mechanisms through which community nurses reconstruct participation in everyday practice remain insufficiently understood. This study aimed to clarify how community nurses reconstruct and facilitate participation in community-based rehabilitation. Methods This retrospective qualitative study analyzed activity logs and reflective practice records documented by three community nurses working in a rural Japanese community between January and December 2025. Thematic analysis following Braun and Clarke’s framework was conducted. Participation episodes were identified and analyzed to examine how participation emerged and was facilitated in everyday community practice. Identified activities were also interpreted with reference to the participation concept of the International Classification of Functioning, Disability and Health (ICF). Results A total of 134 participation episodes were identified across multiple participation domains, including community life, recreation and leisure, interpersonal relationships, and digital communication. Four themes were identified: (1) creating participation-ready environments, (2) facilitating reciprocal roles and resident empowerment, (3) reconstructing participation through personal narratives and identity, and (4) bridging participation barriers through relational and structural support. Participation emerged as a relational and dynamic process embedded in everyday community interactions. Conclusions Community nurses play a critical role in reconstructing participation in community-based rehabilitation by facilitating relational engagement, enabling meaningful social roles, and reducing participation barriers. These findings provide empirical insights into how participation can be operationalized in community practice and highlight the potential of participation-oriented approaches in aging societies.

56. Community Assets as Protective Factors Buffering Health Effects of Environmental Hazards: Framework and Considerations for Environmental Epidemiologists.

期刊: Environmental research, health : ERH 发表日期: 2026-Mar 链接: PubMed

摘要

Disparities in the adverse health effects due to ambient environmental exposures have long been documented in the environmental epidemiology literature. A growing body of environmental epidemiology literature has focused on how detrimental aspects of the physical environment (e.g., poor housing quality) and social environment (e.g., chronic social stressors) can exacerbate the adverse health effects of environmental exposures (e.g., air pollution, heat). However, the literature on protective factors which might mitigate adverse health effects of environmental exposure is more limited. We borrow from the climate resilience and disaster preparedness literature to discuss how protective community assets may be identified, operationalized, and understood in environmental epidemiologic research. We outline two major pathways through which community assets may protect environmental health: by reducing overall exposure (mediation) and by reducing susceptibility (effect modification). This framework can help environmental epidemiologists and other public health researchers select and understand appropriate community assets to test as effect modifiers or mediators of associations between environmental exposures and adverse health outcomes. We present examples of community assets organized into five domains and highlight pragmatic challenges that may arise when considering assets in large-scale epidemiologic research-for example, limitations on availability of publicly available data at meaningful spatial scales, and challenges interpreting available community asset data. Finally, we posit that research focused on community assets can inform scalable, impactful health-promoting interventions.

57. mHealth to support resistance training using outdoor gyms: the ecofit hybrid type 3 implementation-effectiveness trial.

期刊: Translational behavioral medicine 发表日期: 2026-Jan-07 链接: PubMed

摘要

There is a need to scale up effective physical activity interventions among the general population, particularly those incorporating resistance training. Ecofit is a community-based, multicomponent intervention promoting resistance and aerobic physical activity through smartphone technology, the outdoor built environment, and social support. This study aimed to scale up ecofit by comparing Low versus Moderate implementation support on the reach (outdoor gym use) of ecofit within two large regional municipalities. A hybrid type 3 implementation-effectiveness trial was conducted across two large municipalities in eastern Australia. Outdoor gyms (n = 18) were randomized to Low (ecofit app only) or Moderate [ecofit app, QR (quick response) codes on equipment, face-to-face workout sessions] implementation support. The primary outcome of “reach” was defined as the baseline-adjusted difference in the number of outdoor gym users (i.e. adults using outdoor gym equipment for resistance training) between groups. Reach was measured at baseline and 3-month follow-up using a modified System for Observing Play and Recreation in Communities tool, with blinded assessors observing community members perceived to be ≥18 years [categorized as Adults (aged 18-59) or Seniors (aged ≥60)]. Secondary outcomes included app uptake, dose received, implementation fidelity, and acceptability, feasibility, and dose-satisfaction regarding the app and guided sessions. There was no significant difference in people using outdoor gym equipment for resistance training between Low and Moderate support groups at 3-month follow-up [incidence rate ratio (IRR) = 1.68, 95% CI: 0.96-2.94]. Among adults (aged 18-59), the Moderate support group showed significantly higher outdoor gym use at follow-up (IRR = 1.83, 95% CI: 1.01-3.31) compared to the Low support group. Over 6 months, 1273 users registered for the app, completing 503 workouts, 62% of which occurred indoors. Ecofit shows promise for promoting resistance training, particularly among adults. Broader marketing and enhanced engagement strategies may be required to increase outdoor gym use and sustain participation over time. Outdoor gyms are increasingly installed in parks to encourage free, accessible exercise, yet they are often underused. We implemented the ecofit intervention, a free mobile app designed to help people use outdoor gyms for resistance and aerobic exercise, across two large regional municipalities in Australia. The app includes predesigned workouts, instructional videos, customizable options, and self-monitoring tools. We compared two levels of implementation support: nine gyms received Low support (ecofit app only), while another nine received Moderate support [ecofit app, QR (quick response) codes on equipment, and three cost-free group workouts led by an exercise professional]. The main aim was to compare the number of people using outdoor gyms receiving Low and Moderate support at baseline and 3 months. There was no significant difference in overall outdoor gym use between the Low and Moderate support groups. However, more adults under 60 used outdoor gyms with Moderate support compared to Low support at follow-up. Over 6 months, more than 1200 people registered for the app and completed 503 workouts. Users found the app easy to use and motivating, though many preferred private settings for exercise. Ecofit shows promise for promoting resistance training using outdoor gyms. Future studies should incorporate broader marketing and collaborate with municipal councils and local government agencies to improve engagement and accessibility.

58. The effect of maternal polyphenol intake on foetal neurodevelopment in rodent models: a narrative review.

期刊: Journal of nutritional science 发表日期: 2026 链接: PubMed

摘要

Maternal nutrition is critical for foetal brain development, and dietary polyphenolic compounds play an important role in mitigating oxidative stress, inflammation, and neurotoxic damage. This narrative review explored the potential promotion of brain development by polyphenols such as resveratrol, curcumin, quercetin, naringin, ferulic acid, genistein, and fisetin through their antioxidant, anti-inflammatory, and neurotrophic effects. The key molecular mechanisms are central to the advantageous actions of these polyphenols in the neurogenesis process. These compounds protect against neurodevelopmental challenges induced by maternal high-fat diet, immune activation, environmental toxins, and psychological stressors. However, their efficacy may depend on dosage, timing of administration, and maternal-foetal metabolic interactions, emphasising the need for personalised maternal nutrition strategies. Further research is needed to investigate the long-term effects and interactions of these compounds with other nutrients toward personalised maternal nutrition strategies. This narrative review presents the potential of polyphenols to support foetal brain health with an emphasis on their possible incorporation into maternal dietary interventions.

59. Protocol for the process evaluation of a mobile produce market intervention to increase fruit and vegetable consumption in lower-income communities: the Veggie Van Study.

期刊: Frontiers in public health 发表日期: 2026 链接: PubMed

摘要

Mobile produce markets have become increasingly prevalent throughout the United States, highlighting the need for evidence-based models for markets to follow. The Veggie Van (VV) model is a set of practices that have been found to be efficacious in increasing fruit and vegetable intake in underserved communities. The next step in determining the model’s effectiveness is evaluating the model when implemented on a broader scale under real-world conditions. As part of a multi-state randomized controlled effectiveness trial, the Veggie Van Study, an extensive process evaluation of the implementation of the VV model was conducted. Nine partner organizations agreed to implement the VV model at newly launched mobile markets over a 12-month period. Organizations received funding, training, and technical assistance to support implementation of the model. In addition to facilitating participant recruitment and data collection, partners agreed to participate in implementation-related data collection. Data collection methods include quantitative process measures surveys, qualitative interviews, and mobile market sales data. The main process outcomes are fidelity, dose delivered, penetration, maintenance of the VV model, and contextual factors related to implementation. This extensive mixed-methods process evaluation addresses a gap in the literature for transparent reporting of process evaluations; it also provides a model for similar community-based interventions to follow. Understanding the implementation process and the context surrounding implementation of the VV model is critical for interpreting effectiveness findings (i.e., dietary changes) and optimizing the intervention. https://clinicaltrials.gov/study/NCT04246593, NCT04246593.

60. Headaches, mental health disorders, and religiosity: analysis of the Saudi National Mental Health Survey.

期刊: Frontiers in public health 发表日期: 2026 链接: PubMed

摘要

Headaches have been consistently associated with mental health disorders. However, current prevalence of headaches in Arab populations is highly varied. Additionally, the potential role of religiosity in this relationship has not been studied. This study aimed to estimate the prevalence of headaches in Saudi Arabia, a highly religious Arab society, to examine their association with mental health disorders, and to explore whether religiosity modifies this relationship. This study used the Saudi National Mental Health Survey (SNMHS), a nationally representative, cross-sectional, community-based psychiatric epidemiological household survey. Trained interviewers assessed history of headaches, and common DSM-IV mental health disorders were diagnosed using the Composite International Diagnostic Interview (CIDI). Religiosity was measured using a validated culturally appropriate religiosity scale embedded within the survey. Headache prevalence was calculated as the proportion of respondents reporting headaches relative to the total sample. Survey-weighted logistic regression models were used to estimate adjusted association between headaches and mental health disorders. An interaction term was introduced to explore the role of religiosity. The overall lifetime prevalence of headaches among Saudis was 56% (95% CI: 53%-58%), with 28% reporting recent episode of headaches. In multivariable logistic regression models including sociodemographic factors, respondents with headaches were more likely to have mental health disorders (OR: 2.09, 95% CI: 1.50-2.91; p < 0.001). Religiosity did not modify the association between headaches and mental health disorders (interaction OR: 1.00, 95% CI: 0.98-1.02; p > 0.9). Headaches are highly prevalent in Saudi Arabia, with more than half of respondents reporting a lifetime history and nearly one-third experiencing recent episodes. Individuals with headaches are more likely to have mental health disorders. However, varying levels of religiosity do not appear to modify this relationship. These findings underscore the importance of screening for mental health disorders in individuals presenting with headaches, regardless of their religiosity, and highlight the potential value of collaborative models that integrate professional mental health support with religiously sensitive approaches.

61. An analysis of the bacterial and fungal diversity of the fecal material of gopher tortoises.

期刊: microPublication biology 发表日期: 2026 链接: PubMed

摘要

The gopher tortoise ( Gopherus polyphemus ) is listed in the State of Florida as a threatened species. It is well known that the microbiota of the host is imperative to health promotion and disease mitigation. The diversity of the gut microbiota of the tortoise has not been extensively surveyed.  In this study, we examined both the bacterial and fungal diversity in the fecal material of this animal using bacterial tag-encoded flexible-Titanium (FLX) amplicon pyrosequencing (bTEFAP) and fungal tag-encoded FLX amplicon pyrosequencing.  In the six samples, there were 16 total bacterial phyla identified with Bacillota (54.55 to 86.13%) as the most dominant and two fungal phyla identified with Ascomycota (79.64 to 97.32%) as the most predominant.  Interestingly, the pathogenic fungus Candida tropicalis was detected in all samples suggesting the tortoise could be a reservoir of zoonotic fungi.

62. Riding toward inclusion: the journey of adapted cycling.

期刊: Frontiers in sports and active living 发表日期: 2026 链接: PubMed

摘要

This study examined how adapted cycles, as a form of assistive technology, support participation in sports and recreational activities for people with disability. Although physical activity is widely recognised for its benefits to physical health, psychological wellbeing, and social connectedness, people with disability continue to face significant barriers to meaningful inclusion in sport and recreation. Adapted cycles offer a means of addressing some of these barriers by enabling individuals to engage in cycling in ways that are responsive to their functional abilities and support needs. Using a qualitative research approach, this study drew on in-depth interviews with six participants, including children and adults, who had experience using adapted cycles across a range of contexts. This diversity allowed for a nuanced exploration of individual experiences. Data were analysed thematically to identify patterns related to engagement, perceived benefits, and factors influencing successful use. Three key themes were identified: (1) navigating barriers and building pathways; (2) riding into wellbeing and inclusion; and (3) expanding horizons. Participants consistently reported improvements in physical health, including increased strength, endurance, and overall fitness. Many also described increased independence, noting that adapted cycles enabled them to access community spaces and engage in activities with reduced reliance on others. Importantly, these functional gains were valued for the ways in which they supported social inclusion. Participants described increased confidence and self efficacy, as well as a stronger sense of belonging when cycling with family members, friends, or within community groups. Adapted cycles were perceived as facilitating social interaction, increasing visibility in public spaces, and challenging assumptions about disability and capability. The study also identified several contextual factors that shaped inclusive outcomes. These included access to customised and well-maintained equipment, quality assessment and selection services, accessible environments, and strong social support from peers, families, and organisations. Persistent barriers such as inaccessible transport and environments were noted to constrain inclusion opportunities. Overall, the findings contribute to broader discussions on inclusive recreation and assistive technology by demonstrating that the value of adapted cycling lies not in participation itself, but in its capacity to foster meaningful social inclusion and enhance wellbeing.