公共卫生研究摘要 (2026-05-03)

共收录 56 篇研究文章

1. Saccharomyces boulardii CNCM I-745 synergizes with the small intestinal microbiota to boost AhR signaling in celiac disease.

期刊: Gut microbes 发表日期: 2026-Dec-31 链接: PubMed

摘要

Celiac disease (CeD) is an immune-mediated condition that leads to small intestinal villous atrophy and is driven by dietary gluten in individuals carrying HLA-DQ2 and DQ8. Microbial factors have been implicated in both the onset of CeD and persistent symptoms (non-responsive CeD) after the gluten-free diet (GFD), through mechanisms including impaired tryptophan metabolism and aryl hydrocarbon receptor (AhR) pathway activation. Although probiotics have been shown to be safe in CeD, there are currently no clinical recommendations for strains that target disease-related mechanisms. We here demonstrate that S. boulardii activated the AhR pathway in gluten-sensitized mice expressing HLA-DQ8, improving gluten-immunopathology. Mechanistically, S. boulardii enhanced the CeD patients’ microbiota capacity for AhR activation when duodenal indole-producing commensals, such as Lactobacillus reuteri, were present. Our study provides preclinical evidence that S. boulardii CNCM I-745 targets a microbial deficiency previously described in CeD through modulation of microbial tryptophan metabolism. The findings encourage clinical testing of S. boulardii in CeD to prevent or better treat non-responsive cases.

2. Intestinal epithelial Syndecan-1 maintains mucosal homeostasis in inflammatory bowel disease by enhancing Faecalibacterium prausnitzii biofilm formation.

期刊: Gut microbes 发表日期: 2026-Dec-31 链接: PubMed

摘要

Despite the rising global incidence of inflammatory bowel disease (IBD), curative therapies remain unavailable. While our previous work implicated the intestinal proteoglycan Syndecan-1 (SDC1) in IBD-associated barrier dysfunction and inflammation, the underlying mechanism was unclear. This study aimed to elucidate how SDC1 maintains intestinal barrier integrity through interactions with the gut microbiome. In DSS-induced colitis, global knockout of Sdc1 (Sdc1-/-) exhibited exacerbated inflammatory infiltration and greater impairment of barrier structure and function than wild-type (WT). Formation of intestinal organoids was independent of genotype, indicating that Sdc1-/- does not impair barrier function via disrupting epithelial development. The heightened colitis susceptibility in Sdc1-/- mice was abolished in the antibiotic-treated pseudo-germ-free models, and transmissible to WT mice via fecal microbiota transplantation. Similar results were reproduced in a germ-free mouse model. Metagenomic sequencing identified Faecalibacterium prausnitzii as the most significantly depleted species upon Sdc1 knockout. In vitro, SDC1-attached glycosaminoglycans (heparan sulfate (HS) and chondroitin sulfate (CS)) but not the SDC1 core protein promoted F. prausnitzii growth. Prokaryotic transcriptome profiling indicated that HS/CS induces cobalamin biosynthesis in F. prausnitzii. The critical role of cobalamin as a mediator was confirmed, as its synthetic inhibition significantly diminished the growth-promoting effect of HS/CS. Mechanism studies showed that HS/CS enhanced biofilm formation in F. prausnitzii, thereby facilitating cobalamin biosynthesis. Oral administration of HS ameliorated DSS-induced colitis and promoted mucosal colonization of F. prausnitzii, independent of the host genotype. Finally, human IBD biopsies revealed a positive correlation between epithelial SDC1 and mucosal F. prausnitzii, as well as an inverse correlation with bacterial translocation and the number of LPS‑positive cells. Our study elucidates a novel mechanism in which the glycosaminoglycan chains of SDC1 promote F. prausnitzii colonization and growth through enhanced biofilm formation and cobalamin synthesis, thereby highlighting the therapeutic potential of HS for IBD and offering a new basis for host-directed microbiota regulation.

3. Child maltreatment and young adult depressive symptoms and metabolic risk: The moderating role of social support.

期刊: Journal of research on adolescence : the official journal of the Society for Research on Adolescence 发表日期: 2026-Jun 链接: PubMed

摘要

Child maltreatment is a significant risk factor for mental and metabolic health, with negative effects that can persist into adulthood. Using data from a U.S.-nationwide study, the National Longitudinal Study of Adolescent to Adult Health (Add Health), this study examined the associations between child maltreatment, specifically childhood threat (i.e., harm or threat of harm) and deprivation (i.e., absence of expected environmental inputs), and young adult mental (i.e., depressive symptoms) and metabolic health (i.e., metabolic risk). The moderating effect of social support was also examined, focusing on both quality of different types of support (i.e., from teachers, friends, and other adults) and variety of support sources. Results showed that young adults who experienced more threat during childhood exhibited higher levels of depressive symptoms in young adulthood, and those exposed to more deprivation reported elevated levels of metabolic risk. This study also highlighted the protective-stabilizing role of quality of teacher support in buffering the impact of deprivation on depressive symptoms, and the protective-stabilizing role of high-quality other adult support in the link between childhood deprivation and metabolic risk, such that the benefits of social support remained stable across increasing levels of deprivation. Additionally, the variety of social support showed a protective-reactive pattern in moderating the link between deprivation and metabolic risk, wherein the benefits of variety of social support were released under low deprivation but not high deprivation conditions for metabolic risk. These findings underscore the importance of eliminating child maltreatment experiences and highlight potential interventions, such as enhancing teacher-student relationships and broadening adolescents’ access to diverse support networks, to buffer the long-term mental and metabolic health consequences associated with early experiences of threat and deprivation.

4. Support Strategies and Policy Recommendations to Manage the Aftermath of an Emergency or Traumatic Situation.

期刊: The Nursing clinics of North America 发表日期: 2026-Jun 链接: PubMed

摘要

Nurses in all practice areas are often thrust into emergency situations, requiring them to act swiftly to protect the health and safety of their clients. Once the emergency is over, they seamlessly return to their regular duties, driven by the belief that the work never stops, that nursing is a 24 hour job, and that selflessness is a nursing virtue. Occupational exposure to traumatic events can lead to adverse outcomes like posttraumatic stress disorder and secondary traumatic stress, which impact nurse well-being, patient safety, and workforce stability. This article presents a framework for managing the aftermath of such events.

5. Microfluidic Assembly of NIR-II AIE Nanoparticles for Enhanced Photothermal Ablation of Breast Tumors.

期刊: Advanced healthcare materials 发表日期: 2026-May-02 链接: PubMed

摘要

Aggregation-induced emission (AIE) luminogens with strong near-infrared absorption and excellent photostability are emerging as powerful photothermal agents; however, achieving nanoscale formulations with controlled size, high stability, and near-infrared-II (NIR-II) emission remains challenging. Here, we report an NIR-II emissive AIE small molecule that can be rapidly assembled into monodisperse nanoparticles (NDA-MEPA NPs, ∼40 nm) using a microfluidic strategy that ensures reproducible control over particle size and uniformity. Surface encapsulation with DSPE-PEG2K confers excellent colloidal stability, biocompatibility, and enhanced tumor accumulation. The resulting NDA-MEPA NPs exhibit efficient photothermal conversion under 808 nm irradiation, along with dose- and time-dependent cellular uptake, and induce robust photothermal cytotoxicity in vitro. In vivo evaluations demonstrated that NDA-MEPA NPs enable high-contrast NIR-II fluorescence imaging and effective photothermal tumor ablation with minimal systemic toxicity. This work establishes a programmable microfluidic approach for constructing NIR-II AIE nanomaterials and highlights a biocompatible photothermal platform with strong potential for translational cancer therapy.

6. Traumatic Brain Injury in Female Intimate Partner Violence Survivors: Incidence, Sociodemographic Disparities, and Clinical Outcomes.

期刊: Journal of interpersonal violence 发表日期: 2026-May-02 链接: PubMed

摘要

Intimate partner violence (IPV) represents a public health crisis in the United States. Experiencing IPV is associated with various adverse health outcomes and injuries, including traumatic brain injury (TBI). Improving screening and care for individuals affected by concurrent IPV and traumatic brain injury (IPV-TBI) requires understanding its incidence, sociodemographics, risk factors, and clinical outcomes. Using standardized multicenter data from the US National Trauma Data Bank years 2018 to 2022, this study aimed to answer the following questions: (a) What is the incidence of IPV-TBI among female patients treated for TBI at US trauma facilities? (b) Are there sociodemographic and clinical differences between female IPV-TBI and female non-IPV-TBI patients? (c) What hospital outcomes (length of stay [LOS], emergency department discharge disposition, hospital discharge disposition) are associated with IPV-TBI, based on TBI severity. Statistical differences were examined using Welch’s t-test and analysis of variance, Pearson’s chi-squared test with post hoc Bonferroni-corrected z-tests, and multivariate logistic and linear regressions. Our findings indicate that most female trauma center patients with assault-related TBI experienced IPV (76.8%), often inflicted by male partners (97.9%). Compared to those with non-IPV TBI, IPV survivors who experienced TBI were younger (mean 37.9 ± 12.5 years vs. non-IPV: 48.0 ± 12.4; p < .001) and more commonly insured by Medicaid (47.0% vs. 36.5%, p < .001). IPV-TBI was associated with significantly higher odds of discharge to home in female patients (aOR = 1.31 [95% CI: 1.01, 1.69]), and IPV-TBI patients were likely to have shorter hospital LOS than those with TBI from non-IPV assault (4.3 ± 6.8 days vs. 5.9 ± 9.8; p < .001). Our findings underscore the critical importance of screening TBI patients for IPV, given that the social and medicolegal contexts surrounding their injury and recovery may be substantially different from TBI patients without IPV, and being discharged home may present significant safety risks.

7. Association between pemphigus and subsequent malignancy: A nationwide population-based study in Taiwan.

期刊: Clinical and experimental dermatology 发表日期: 2026-May-02 链接: PubMed

摘要

Pemphigus is a rare autoimmune vesiculobullous disorder caused by autoantibodies targeting desmosomes. While paraneoplastic pemphigus is known to be associated with malignancy, the cancer risk in non-paraneoplastic pemphigus remains unclear, particularly in Asian populations. This study aims to assess the risk of subsequent malignancies in pemphigus patients compared to matched controls in Taiwan. Using Taiwan’s National Health Insurance Research Database, a retrospective cohort study was conducted and included 357 pemphigus patients and 1,428 matched controls from 2000 to 2015. Covariates including age and sex, were adjusted using multivariable Cox regression. Adjusted hazard ratios (HRs) were calculated after controlling for age, sex, and comorbidity. Comorbidities were assessed using the revised Charlson Comorbidity Index, with higher scores indicating greater comorbidity burden. Risks of different subsequent cancers were estimated between patients with pemphigus and the control group. Overall cancer risk was not significantly elevated in the pemphigus group (aHR 1.103; p = 0.342). In the sex-stratified analysis, male patients had a higher risk of malignancy compared with female patients (aHR 1.703; p = 0.039). However, after adjusting for covariates in the multivariable Cox regression model, sex was not an independent risk factor for subsequent malignancy (aHR 1.129; p = 0.321 and aHR 1.074; p = 0.367, respectively). Lymphatic and haematopoietic malignancies were correlated with the highest risk in pemphigus patients (aHR 2.903; p < 0.001). Median follow-up durations were 6.37 years in the pemphigus cohort and 6.45 years in the control cohort, yielding an overall median follow-up duration of 6.4 years. Pemphigus was not associated with an overall increased risk of subsequent malignancy. Sex was not an independent risk factor; however, males exhibited a higher cancer risk compared with females. Among specific cancer types, lymphatic and haematopoietic malignancies showed the strongest association with pemphigus.

8. Epidemiology and disparities of mortality in comorbid cardiovascular disease and osteoporosis: A 25-year nationwide study in the United States.

期刊: Journal of investigative medicine : the official publication of the American Federation for Clinical Research 发表日期: 2026-May-02 链接: PubMed

摘要

Cardiovascular disease (CVD) and osteoporosis are highly prevalent age-related conditions that frequently coexist, yet their joint epidemiology and mortality burden remain poorly characterized in middle-aged and elderly adults. This retrospective cross-sectional study analyzed mortality data from the CDC WONDER database between 1999 and 2023. Cases were identified using ICD-10 codes for CVD (I00-I99) and osteoporosis (M80-M81). Age-adjusted mortality rates (AAMR) were calculated, and Joinpoint regression was applied to assess temporal trends across subgroups defined by age, sex, race/ethnicity, region, and urbanization. A total of 188,152 deaths were attributed to CVD with coexisting osteoporosis. The AAMR declined significantly from 9.28 per 100,000 in 1999 to 3.79 in 2023 (average annual percent change -3.73, p < 0.001). Women accounted for 88% of deaths, with consistently higher AAMR than men. Non-Hispanic Whites exhibited the highest mortality burden, while non-Hispanic Blacks had the lowest. Mortality increased markedly with age, particularly among those ≥85 years. Medium/small metropolitan and rural residents consistently demonstrated higher mortality rates compared with large metropolitan areas. Geographic variation persisted, with the Midwest and West showing the greatest burden. Mortality from comorbid CVD and osteoporosis has declined substantially over the past two decades in middle-aged and elderly adults, yet striking sex, racial, age, and geographic disparities persist. These findings underscore the need for integrated, tailored prevention and management strategies targeting high-risk populations.

9. Development and Psychometric Properties of the BOT-3 Movement Fundamentals Score.

期刊: Perceptual and motor skills 发表日期: 2026-May-02 链接: PubMed

摘要

This study describes the development and psychometric properties of the BOT-3 Movement Fundamentals Score (BOT-3-MFS). A nationally representative sample of individuals aged 4:0-24:11 (n = 1,360) were administered the BOT-3-MFS. Scores were analyzed to confirm that they followed expected developmental patterns and to evaluate internal consistency reliability. Test-retest stability and internal consistency were examined to establish reliability of the BOT-3-MFS. BOT-3-MFS scores in three clinical groups: developmental delay in the motor domain (n = 31), developmental coordination disorder (n = 31), and autism spectrum disorder (n = 39) were used to evaluate internal consistency in clinical populations, as well as explore known-group validity using matched control samples without motor impairments to test hypothesis-based group differences in performance on the BOT-3-MFS. The BOT-3-MFS demonstrated expected developmental patterns in the nationally representative sample of individuals aged 4:0-24:11. Internal consistency reliability ranged from .74-.84 in the normative sample and .82-.91 in the clinical groups. Test-retest stability was .84. All three clinical groups had significantly lower BOT-3-MFS compared to controls (p < .001). The standard difference in scores between clinical groups and controls ranged from moderate to large, with the largest standard difference in the developmental coordination disorder group (1.44). These findings suggest that the BOT-3-MFS score is a theoretically and research-based measure of fundamental movement skills that demonstrates expected developmental patterns in a normative sample, acceptable internal consistency reliability, high test-retest stability, and can be used to differentiate individuals with motor impairments from those without motor impairments.

10. 'Becoming a Nurse': A Lifelong Journey Beyond the Transition to Professional Practice-An Analytical Discursive Paper.

期刊: Journal of advanced nursing 发表日期: 2026-May-02 链接: PubMed

摘要

To reconceptualise becoming a nurse as a lifelong developmental journey that extends beyond the traditional focus on new graduate transition, and to inform policies and practices supporting recruitment, retention and career sustainability. The global nursing shortage persists, exacerbated by high attrition rates among new graduates and an aging workforce. While existing literature predominantly examines the transition from student to professional practice, we propose that ‘becoming a nurse’ begins earlier and extends beyond clinical roles into retirement. An analytical discursive paper. Key theoretical frameworks (Schlossberg’s Transition Model, Kennedy’s Integrated Transition Model, Benner’s Novice-to-Expert framework and Duchscher’s Stages of Transition Model) were integrated with empirical literature (1974-2025) on nursing career trajectories, clinical expertise development and professional identity across the lifespan, with emphasis on contemporary evidence from 2015 to 2025. Becoming a nurse is reconceptualised as a continuous, lifelong transition encompassing four interrelated phases: (1) early career interest, where nursing aspirations emerge during childhood and adolescence; (2) non-traditional entry, involving second-career entrants who undergo profound identity reconstruction as novices; (3) middle-career transition, characterised by sustained development from competence through proficiency toward expertise and clinical wisdom; and (4) late-career transition, where professional identity and contribution continue beyond retirement. Each phase presents distinct developmental demands requiring tailored educational, organisational and workforce responses. Together, these phases form a Lifespan Transition Framework that advances the field by proposing transition as a recursive developmental mechanism, where adaptive capacities built at each phase become foundational resources for subsequent phases, rather than separate, time-limited events. Understanding becoming a nurse as a lifelong transition provides a unifying conceptual foundation for more coherent, stage-sensitive workforce strategies. This perspective shifts policy and practice beyond short-term graduate retention toward lifespan-oriented workforce systems that strengthen recruitment, sustain expertise and preserve professional wisdom across the whole nursing career lifespan.

11. SGK1 inhibition supports neuroprotection in spinal cord injury by suppressing oxidative stress and AIM2 activation via FoxO1 mediated mitophagy.

期刊: Journal of neuroinflammation 发表日期: 2026-May-02 链接: PubMed

摘要

Spinal cord injury (SCI) is accompanied by a significant microglia-associated inflammatory response that is associated with secondary tissue damage and poorer functional outcomes. Serum and glucocorticoid-regulated kinase 1 (SGK1) has been implicated in the regulation of cell survival and neuronal excitability in various diseases. However, the role and cell-specific mechanism of SGK1 in SCI remain to be elucidated. In this study, we observed that SGK1 was predominantly expressed in microglia located at the lesion margin during the early phase of SCI in a mouse contusion model. Inhibition of SGK1 by GSK650394 has been shown to promote neural repair while simultaneously suppressing neuroinflammation and mitochondrial oxidative stress. Mechanistically, the inhibition of SGK1 results in a reduction of FoxO1 phosphorylation and the promotion of nuclear import, consequently inducing microglial mitophagy and promoting mitochondrial homeostasis, leading to the suppression of absent in melanoma 2 (AIM2) related pyroptosis and the conversion of microglia into a neuroprotective M2 phenotype. In particular, AIM2 overexpression or deletion effectively interfered with the influence of SGK1-FoxO1 on the modulation of SCI. In conclusion, the present findings provide a potential therapeutic strategy for the treatment of SCI.

12. Prognostic Modeling Based on Post-Endovascular Thrombectomy Systolic Blood Pressure Trajectories Using Explainable Artificial Intelligence: A Secondary Analysis of the OPTIMAL-BP Trial.

期刊: Journal of medical systems 发表日期: 2026-May-02 链接: PubMed

摘要

Blood pressure (BP) management following successful reperfusion after endovascular thrombectomy (EVT) is critical in achieving favorable clinical outcomes. Individualized BP management using predictive modeling by machine learning may further improve prediction of functional outcomes. This study was a retrospective analysis of data from the Outcome in Patients Treated with Intra-Arterial Thrombectomy-Optimal Blood Pressure Control (OPTIMAL-BP) trial, a randomized controlled trial comparing between intensive and conventional BP management during the 24 h after successful recanalization by EVT from June 18, 2020, to November 28, 2022. The trial was conducted across 19 centers in South Korea. Machine learning models were developed to predict functional independence (90-day modified Rankin Scale 0 to 2). Model performance was compared between clinical variables only and systolic blood pressure (SBP) metrics in addition to clinical variables. In addition, the Shapley additive explanations (SHAP) analysis was performed to provide model explanation and understand the importance of SBP metrics. A total of 288 patients (61.1% men, median age 75 years [interquartile range, 65-81]) were included. Among the six algorithms, the deep neural network model incorporating SBP metrics performed best on validation, achieving an area under the curve of 0.86 (95% confidence interval, 0.76-0.92) which was significantly better than the model using only clinical variables (area under the curve 0.80 [95% confidence interval, 0.69-0.88], P = .037). Among SBP metrics, SHAP analysis identified time rate of SBP and minimum SBP as important features, with time rate showing greater influence in the intensive group and minimum SBP in the conventional group. Integrating SBP metrics with clinical variables significantly improved machine learning performance in predicting functional outcomes after successful EVT. Explainable artificial intelligence (AI) identified time rate and minimum SBP as key predictors of outcome. Trial Registration Information: ClinicalTrials.gov (NCT04205305; registered December 17, 2019).

13. Effects of vaccines targeting interleukin-1 receptor, type I on atrial and ventricular function after myocardial infarction.

期刊: British journal of pharmacology 发表日期: 2026-May-02 链接: PubMed

摘要

The strong relationship between myocardial infarction (MI) and inflammation has been supported by numerous observations; targeting inflammatory signalling pathways represents a crucial approach to rescue cardiac function after MI. Our team has designed and developed therapeutic vaccines, ILRQβ-007 and ILRQβ-008, which target interleukin-1 receptor, type I (IL-1R1). The aim of this study is to investigate the effect of the vaccines on short-term and long-term MI animal models. The ILRQβ-007 and ILRQβ-008 vaccines were prepared and then used to immunize C57BL/6J (C57) mice with MI and observed their effects at 7 and 28 days, respectively. Cardiac ultrasound and histological staining were used to assess cardiac function and remodelling after MI in C57 mice. Flow cytometry and molecular biology tests were used to evaluate the systemic inflammatory infiltrate. While transesophageal catheter pacing was used to assess susceptibility to atrial fibrillation in mice. The vaccines produced high titres of antibodies and reduced IL-1R1 expression levels in the heart after MI. They significantly reduced myocardial infarct size and systemic inflammation following short-term MI, as well as protecting cardiac function and reducing cardiac fibrosis following long-term MI. Moreover, the susceptibility to atrial fibrillation was reduced in both the short and long-term models. Further, the vaccines improved mitochondrial dynamics and thus maintained mitochondrial homeostasis protecting the heart. This study demonstrates that vaccines targeting IL-1R1 can be applied to the prevention and treatment of MI, providing a new direction for MI research.

14. Effects of different numbers of micro-osteoperforations on acceleration of orthodontic tooth movement and alveolar bone remodeling in rats.

期刊: BMC oral health 发表日期: 2026-May-02 链接: PubMed

摘要

‌BACKGROUND: Micro-osteoperforations (MOPs) have been confirmed to accelerate orthodontic tooth movement (OTM). However, the optimal number of perforations and the associated changes in alveolar bone structure, composition, and biomechanical properties under different numbers of perforations remain unclear. Seventy-two Sprague-Dawley rats undergoing OTM were divided into four groups: OTM (0 MOPs), 2MOP, 3MOP, or 4MOP. Rats were euthanized on Days 3, 7, or 14, and maxillary samples were analyzed using micro-CT, Raman spectroscopy, and nanoindentation to assess bone morphology, composition, and biomechanical properties. MOPs accelerated OTM, with 3MOP and 4MOP showing superior efficacy to 2MOP. Alveolar bone in 3MOP and 4MOP groups exhibited initial resorption followed by regeneration from Days 3-14. Mineral-to-matrix ratios decreased then increased from Days 3-14 across all groups, while carbonate substitution levels showed the opposite trend. Elastic modulus and hardness followed a similar decreasing-increasing pattern. No consistent pattern of intergroup differences was observed in bone microstructure, chemical composition, or biomechanical properties. MOPs can accelerate OTM, with three MOPs potentially offering a more effective balance between therapeutic efficacy and surgical intervention. No additional acceleration effect was observed in the four-perforation group. Under higher trauma levels (≥3 MOPs), alveolar bone demonstrated a time-dependent transition (initial resorption followed by regeneration) across microstructural, compositional, and biomechanical parameters.

15. Assessment of Early Nephrotoxicity in Workers Exposed to Trichloroethylene Using NGAL and KIM-1 Biomarkers.

期刊: Journal of applied toxicology : JAT 发表日期: 2026-May-02 链接: PubMed

摘要

This study evaluated early renal effects of chronic occupational exposure to mixed organic solvents among automotive spray painters by integrating urinary trichloroacetic acid (TCA) as an internal exposure marker with serum neutrophil gelatinase-associated lipocalin (NGAL) and kidney injury molecule-1 (KIM-1) as early tubular injury biomarkers. In this cross-sectional comparison of exposed workers and controls, urinary TCA was quantified as a surrogate of trichloroethylene metabolism, and serum NGAL and KIM-1 were measured alongside routine biochemical indices, creatinine, and estimated glomerular filtration rate (eGFR). Exposed workers showed significantly elevated NGAL and KIM-1 despite within limits creatinine and eGFR. TCA demonstrated strong linear associations with NGAL and KIM-1, while other solvent metabolites showed weaker relationships. Findings indicate that chronic solvent exposure produces measurable subclinical tubular injury, underscoring the limitations of creatinine-based monitoring and supporting the incorporation of NGAL and KIM-1 into occupational health surveillance.

16. Intimate partner violence during pregnancy in sub-Saharan Africa: a systematic review and meta-analysis.

期刊: Reproductive health 发表日期: 2026-May-02 链接: PubMed

摘要

Intimate partner violence (IPV) has health and human rights implications for its victim-survivors. During pregnancy, IPV can be associated with several morbidities, injuries, and mortality among women and their foetuses. Identifying the prevalence and factors associated with IPV during pregnancy is crucial towards developing preventive strategies to curb its occurrence. This review aims to estimate the prevalence of IPV during pregnancy and its associated factors in sub-Saharan Africa. This review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. A literature search was conducted in PubMed, Scopus, Web of Science, PsycINFO, Embase, and CINAHL for articles published on IPV experienced during pregnancy in sub-Saharan Africa from January 01, 2011, to May 30, 2025. Grey literature search was also conducted to complement the articles retrieved from the six databases. All the published articles that met the inclusion criteria were included in the final analysis. Stata 18.0 was used for data analysis. Microsoft Excel was utilised for synthesising the factors influencing IPV during pregnancy. A total of 3988 records were retrieved from the six databases and sixteen from grey literature, of which 65 articles were finally included in the study. The pooled prevalence of IPV was 38.1% [95%CI = 33.3-42.9]. The prevalence of physical, sexual, and emotional violence was 15.7% [95%CI = 13.2-18.3], 18.0% [95%CI = 14.6-21.5], and 27.7% [95%CI = 23.6-31.9], respectively. The risk factors for IPV during pregnancy were substance use, unplanned pregnancy, justification of violence against women, exposure to violence during childhood, experience of controlling behaviour, past experience of IPV and marital conflicts, rural residency, and polygyny. Women’s empowerment, social support, and education were identified as key factors that reduce women’s likelihood of experiencing IPV during pregnancy. Our study highlights the prevalence of IPV during pregnancy in sub-Saharan Africa, emphasising the need for targeted strategies that address key risk factors. It advocates for promoting women’s empowerment, improving girls’ education, and strengthening legal frameworks to effectively prevent IPV. Ministries of Health across sub-Saharan African countries could integrate routine, confidential IPV screening into antenatal care and ensure immediate access to evidence-based interventions with clear referral pathways to supportive services to prevent further violence.

17. In utero and childhood exposure to organochlorines and perfluorinated chemicals in relation to sperm aneuploidy in adulthood.

期刊: Environmental health : a global access science source 发表日期: 2026-May-02 链接: PubMed

摘要

Sperm chromosomal abnormalities are linked to infertility and may be caused by endocrine disrupting chemical exposures during development. We examined whether exposure to organochlorine compounds (OC), including polychlorinated compounds (PCBs), and perfluorinated compounds (PFASs) measured repeatedly since birth predicted sperm chromosomal abnormalities in young adulthood. Aneuploidy was determined in semen samples obtained from 96 Faroese young men aged 22-24 years who were members of a birth cohort created in 1986-1987. Their current and previous serum as well as cord blood were analyzed for DDE, major PCB congeners (118, 138, 153, and 180), and PFAS (PFOA, PFOS, PFNA, PFDA, and PFHxS). Incidence rate ratios between the exposures and the risk of an extra sex chromosome in adult sperm were assessed as indication of meiotic errors. The mixture effect for overall exposures (PCBs and/or PFASs) was estimated as the change in the percentage of each type of disomy for a doubling of the exposures for two individuals within the same smoking status and abstinence time group. Higher concentrations of organochlorines in cord blood and in serum at ages 7, 14 years and 22 years were associated with increased proportions of chromosomal disomies. The PCB concentration in cord blood was associated mainly with having an extra Y chromosome (p-value: 0.006), while PFAS concentrations at adulthood were consistently associated with XX18 and YY18 disomies (p-values < 0.05). These findings provide new evidence that fetal and subsequent chemical exposures can have enduring influence into adulthood on the formation of male germ cells.

18. Neonatal mortality following referral from peripheral facilities to Kanifing General Hospital, The Gambia (2022-2024): a survival analysis approach.

期刊: BMC pediatrics 发表日期: 2026-May-02 链接: PubMed

摘要

Neonatal mortality remains a critical public health challenge in Sub-Saharan Africa, with The Gambia reporting one of the highest rates in the region. Despite global progress, the neonatal mortality rate has shown limited decline, and context-specific data on delivery setting-related risk factors remain needed to inform health system strengthening in The Gambia. We aimed to identify risk factors for neonatal mortality at Kanifing General Hospital (KGH), and examine the association between place of delivery and survival outcomes. We conducted a retrospective cohort study of 1,354 neonates admitted to KGH between January 2022 and December 2024. The primary outcome was neonatal death during admission. Kaplan-Meier survival analysis and Cox proportional hazards regression with robust standard errors clustered by facility were used to identify risk factors. During the study period, 137 deaths occurred (10.1% mortality; 95% CI: 8.6-11.9). Median follow-up was 96 h. Overall, survival at 7 days was 87.8%, but differed substantially between neonates delivered at KGH Labour Ward (91.3%) versus peripheral facilities (78.9%; log-rank p < 0.001). In multivariable analysis, delivery at KGH Labour Ward was strongly protective (adjusted hazard ratio [aHR] 0.41; 95% CI: 0.28-0.58; p < 0.001), representing a 59% reduction in mortality risk. Higher birth weight was protective (aHR 0.58 per kg; 95% CI: 0.37-0.90; p = 0.016), while birth asphyxia increased mortality risk (aHR 1.30; 95% CI: 1.11-1.53; p = 0.001). The model demonstrated acceptable discrimination (C-statistic = 0.713). E-value sensitivity analysis indicated robustness to unmeasured confounding (E-value = 4.36 for facility effect). Study limitations include the retrospective design and single-center setting. Neonates referred from peripheral facilities experienced substantially higher mortality compared to those delivered at the referral hospital. Birth weight and birth asphyxia were independently associated with survival. These findings highlight the critical importance of strengthening referral hospital capacity and improving quality of care at peripheral facilities to reduce neonatal mortality in The Gambia.

19. Impact of Weight Bias, Stigma and Discrimination on Physical, Mental, and Quality of Life Outcomes of Metabolic and Bariatric Surgery: A Systematic Review.

期刊: Obesity surgery 发表日期: 2026-May-02 链接: PubMed

摘要

Weight-related bias, stigma, and discrimination significantly affect quality of life and health in persons with obesity. Their influence on post-operative outcomes following metabolic surgery and bariatric remains underexplored. This systematic review aimed to evaluate any impact of pre- and post-operative weight bias, stigma, and discrimination on post-metabolic and bariatric surgery outcomes, specifically physical health and mental health, including quality of life. This review was conducted in accordance with the PRISMA 2020 guidelines, with the protocol registered on PROSPERO. Comprehensive searches were performed across MEDLINE, PsycINFO, Embase, Web of Science, PEDro, CINAHL, ISRCTN, and CENTRA. Eligible studies included randomized controlled trials, clinical trials, longitudinal studies, cross-sectional studies, and qualitative research involving patients who underwent metabolic and bariatric surgery. Risk of bias was assessed using validated tools tailored to study design. Eleven studies met the inclusion criteria, examining the influence of weight bias, stigma, and discrimination on post-surgical outcomes. Physical health outcomes included weight loss and BMI. Mental health outcomes included depressive symptoms, disordered eating behaviours, and quality of life domains such as social interactions, occupational settings, sexual health, educational experiences, and post-surgical health management. Findings suggest that weight bias negatively influences mental health and quality of life, associating with depressive symptoms, problematic eating, and lower adherence to nutritional instructions and exercise, potentially impeding optimal physical outcomes. Despite some studies suggesting its negative impact on postoperative outcomes, current evidence on the impact of weight bias, stigma, and discrimination on post-metabolic and bariatric surgery outcomes is limited. Critical gaps remain in understanding how these psychosocial factors affect long-term disease management, self-care, and overall quality of life.

20. Risk Profiles in Hospitalized Adults Based on Functional Capacity, Pressure Injury Risk, and Fall Risk: A Cluster and Multiple Correspondence Analysis.

期刊: Journal of nursing scholarship : an official publication of Sigma Theta Tau International Honor Society of Nursing 发表日期: 2026-May 链接: PubMed

摘要

Patient safety is a global priority, as adverse events represent the 14th leading cause of morbidity and mortality worldwide. Among the most common complications in hospitalized adults are functional decline, pressure injuries, and falls, all of which increase hospital stays, healthcare costs, and mortality. Although these risks are typically assessed independently, their interaction has been scarcely explored, and the identification of integrated patient risk profiles could better guide nursing care. To establish profiles of adult inpatients based simultaneously on their level of functional capacity, risk of pressure injuries, and risk of falls. Cross-sectional observational study. A total of 2.666 patients were admitted to adult inpatient units in a Spanish hospital. Data from the Barthel, Braden, and Downton scales collected within 24 h of admission were analyzed. A hierarchical cluster analysis followed by the k-means method was used to classify patients. Relationship between profiles and clinical variables were explored through multiple correspondence analysis, and predictors for each profile were identified using multinomial logistic regression. Three patient profiles were identified: profile 1 (low risk), minor dependency, low risk of pressure injuries and falls (68.5%); profile 2 (moderate risk), moderate dependency and intermediate risk (15.4%); and profile 3 (high risk), severe dependency with high risk of pressure injuries and falls (16.1%). Older age, female sex, and higher comorbidity were significantly associated with higher-risk profiles (p < 0.001). Hospitalized adults can be reliably classified into risk profiles based on functional capacity and the risk of pressure injuries and falls. The identification of combined risk profiles may potentially guide nursing strategies to enhance patient safety, support individualized care planning, and contribute to optimizing resource distribution in hospital settings. Loss of functional capacity, pressure injuries, and falls are key nursing-sensitive indicators of care quality. Profile-based stratification offers a new framework for personalized, data-driven, and safety-oriented nursing care. The identification of integrated risk profiles based on functional capacity, pressure injury risk, and fall risk may support more comprehensive nursing assessment in hospitalized adults. These profiles may help inform care prioritization, facilitate early identification of vulnerable patients, and contribute to more efficient allocation of nursing resources. Incorporating multidimensional risk stratification into clinical practice may enhance coordinated and patient-centered care planning.

21. Toward Health System Reform: Unveiling the Relationship Between Nurses' Psychological Empowerment and Job Embeddedness Under the Umbrella of the New Universal Health Insurance System.

期刊: Journal of nursing scholarship : an official publication of Sigma Theta Tau International Honor Society of Nursing 发表日期: 2026-May 链接: PubMed

摘要

The new Universal Health Insurance (UHI) reforms aim to improve equity and quality of healthcare delivery; however, their sustainability depends on engagement and retention of the nursing workforce. Psychological empowerment has been identified as a key factor influencing nurses’ attitudes and work-related behaviors, yet the evidence on how it relates to job embeddedness among nurses working in the early phase of UHI implementation in Egypt remains underexplored. This study aimed to assess the association between psychological empowerment and job embeddedness among nurses under the umbrella of the new Universal Health Insurance in Egypt. A descriptive cross-sectional design was employed from August 2025 to November 2025. A total of 213 nurses working at Aswan Specialized Hospital, affiliated with the UHI system in Upper Egypt, were recruited. Data were collected using a demographic questionnaire, and psychological empowerment was measured using the Psychological Empowerment Scale, and job embeddedness was assessed using the Global Job Embeddedness Scale. Descriptive statistics, Pearson correlation analysis, and hierarchical linear regression were used for data analysis. Among 213 nurses, the mean score of psychological empowerment was reported at high overall levels of 5.75 (SD = 0.77), particularly in the dimensions of competence and meaning, alongside moderately high levels of job embeddedness, with a mean score of 4.76 (SD = 0.89). Psychological empowerment showed a significant positive correlation with job embeddedness (r = 0.512, p < 0.001). In hierarchical regression analysis adjusting for demographic and professional covariates, psychological empowerment emerged as a strong and independent predictor of job embeddedness (β = 0.55, 95% CI: 0.398-0.701, p < 0.001), explaining an additional 16.5% of the variance after controlling for covariates (ΔR2 = 0.165). In adjusted analyses, the covariates were not independently associated with job embeddedness. Psychological empowerment was positively associated with nurses’ job embeddedness in the UHI implementation setting. Higher levels of empowerment-related factors were positively associated with greater embeddedness, suggesting their relevance to workforce engagement and retention during health system reform. Our study findings highlight that psychological empowerment plays a crucial role in fostering nurses’ job embeddedness, which is critical for sustaining workforce retention and stability. Enhancing supportive leadership and nurses’ involvement in decision-making is critical, especially during the early phase implementation of the universal health insurance system reform.

22. Fiducial Confidence Intervals for Agreement Measures Among Raters Under a Generalized Linear Mixed Effects Model.

期刊: Statistics in medicine 发表日期: 2026-May 链接: PubMed

摘要

A generalization of the classical concordance correlation coefficient (CCC) is considered under a three-level design where multiple raters rate every subject over time, and each rater is rating every subject multiple times at each measuring time point. The ratings can be discrete or continuous. A methodology is developed for the interval estimation of the CCC based on a suitable linearization of the model along with an adaptation of the fiducial inference approach. The resulting confidence intervals have satisfactory coverage probabilities and shorter expected widths compared to the interval based on Fisher’s Z-transformation, even under moderate sample sizes. Two real applications available in the literature are discussed. The first application is based on a clinical trial to determine if various treatments are more effective than a placebo for treating knee pain associated with osteoarthritis. The CCC was used to assess agreement among the manual measurements of the joint space widths on plain radiographs by two raters, and the computer-generated measurements of digitalized radiographs. The second example is on a corticospinal tractography and the CCC was once again applied in order to evaluate the agreement between a well-trained technologist and a neuroradiologist regarding the measurements of fiber number in both the right and left corticospinal tracts. Other relevant applications of our general approach are highlighted in many areas including artificial intelligence.

23. Evaluation of c26:0-Lyso-Phosphatidylcholine Levels in X-Linked Adrenoleukodystrophy: Diagnosis and Biochemical Monitoring.

期刊: International journal of developmental neuroscience : the official journal of the International Society for Developmental Neuroscience 发表日期: 2026-May 链接: PubMed

摘要

X-linked adrenoleukodystrophy (X-ALD) is the most common peroxisomal disorder, caused by ABCD1 mutations that impair very long-chain fatty acid (VLCFA) degradation, leading to progressive neurological damage and adrenal insufficiency. C26:0-Lysophosphatidylcholine (C26:0-Lyso-PC) has emerged as a robust biomarker for X-ALD and a candidate for newborn screening programs. The objective of this study is to standardize and validate C26:0-Lyso-PC quantification by liquid chromatography-tandem mass spectrometry (LC-MS/MS) and evaluate its diagnostic accuracy in high-risk populations. Reference values were established from 25 healthy controls and compared with five confirmed X-ALD cases (one cerebral childhood form, three heterozygous women and one asymptomatic male). Additionally, 64 DBS samples from individuals at high risk for inborn errors of metabolism (IEM) were tested. Plasma VLCFA were quantified by gas chromatography-mass spectrometry (GC/MS). Control C26:0-Lyso-PC values ranged from 0.13 to 0.25 μg/mL (mean = 0.19 μg/mL). All X-ALD patients exhibited elevated concentrations (0.377-0.787 μg/mL). Among samples from patients at high risk for disease, four were abnormal-two consistent with X-ALD and two with other peroxisomal disorders. Strong correlations were observed between C26:0-Lyso-PC and plasma C26:0 (r = 0.952, p < 0.001) and the C26:0/C22:0 ratio (r = 0.801, p < 0.05). The method demonstrated high reproducibility (intra-assay CV = 8.6% and interassay CV = 12.8%). C26:0-Lyso-PC measurement in DBS by LC-MS/MS is a rapid, sensitive and reproducible alternative to plasma VLCFA analysis, enabling reliable discrimination of X-ALD and other peroxisomal disorders. These findings support its integration into targeted and population-based screening to allow presymptomatic diagnosis, early intervention and genetic counselling.

24. Extraction of Acoustic Features via Empirical Wavelet Transform to Determine Stenosis Degree of the Left Anterior Descending Artery Based on the Diastolic Heart Sounds of 75 Participants.

期刊: Annals of noninvasive electrocardiology : the official journal of the International Society for Holter and Noninvasive Electrocardiology, Inc 发表日期: 2026-May 链接: PubMed

摘要

This study aimed to develop a method for extracting acoustic features to assess left anterior descending artery (LAD) stenosis severity. Heart sound data were collected from 75 participants (10 diastoles per participant) using a high-signal-to-noise ratio micro-electro-mechanical systems stethoscope. The diastolic signals were preprocessed, and empirical wavelet transform was applied to decompose their power spectra into three modes (0-150, 150-500, and > 500 Hz). The spectral energies (e(1), e(2), e(3)) of these modes were analyzed, and support vector machine (SVM) and extreme gradient boosting (XGBoost) machine learning algorithms were used to classify LAD stenosis into mild (< 50%), moderate (50%-75%), and severe (> 75%). Spectral energies e(2) and e(3) significantly increased with stenosis severity, and XGBoost outperformed SVM, achieving a test accuracy of 0.8133 and areas under the curve of 0.9358, 0.9644, and 0.9580 for mild, moderate, and severe stenosis, respectively. Empirical wavelet transform-extracted spectral energies of e(2) and e(3), combined with XGBoost, effectively determine LAD stenosis degree, offering a non-invasive screening tool.

25. The Separate and Joint Associations of Own and Spousal Depression with Mortality in Couples.

期刊: Epidemiology (Cambridge, Mass.) 发表日期: 2026-May-01 链接: PubMed

摘要

Depression causes a substantial burden on a person’s health and well-being. However, evidence is limited regarding whether depression of one person in a marital relationship may affect the other partner’s health. We assessed whether depression in one partner within a married couple might contribute to the other partner’s mortality hazard, also considering whether only one or both partners have depression. We examined a nationally representative sample comprising 8,442 older US adults within 4,225 couples from the Health and Retirement Study. Using the Center for Epidemiologic Studies Depression Scale, we characterized depression status as follows: i) no depression in either partner, ii) depression in respondent only, iii) depression in spouse only, and iv) depression in respondent and their spouse. Associations between couples’ depression status on individuals’ mortality hazards over 11 years were estimated using Cox proportional hazards models adjusted for 27 characteristics of the individual, their spouse, and their household. We observed a higher mortality hazard when only the respondent had depression (hazard ratio (HR): 1.44 [95% confidence interval (CI): 1.26, 1.66]), as well as a modestly elevated hazard when only their spouse exhibited depression (HR: 1.18 [95% CI: 1.01, 1.39]). When both partners had depression, we observed a jointly elevated mortality hazard (HR: 1.53 [95% CI: 1.26, 1.86]). Results suggest the harmful effects of depression could extend beyond the individual to spouses’ physical health. Future studies on health effects of depression should incorporate familial contexts.

26. Predicting Prognosis for Gastric Cancer Patients Receiving Neoadjuvant Treatment With Body Composition-Based Deep Learning.

期刊: Cancer medicine 发表日期: 2026-May 链接: PubMed

摘要

This study sought to develop an innovative body composition (BC)-based deep learning (DL) model to precisely evaluate survival in gastric cancer (GC) patients undergoing neoadjuvant treatment (NT). This retrospective study included GC patients undergoing NT from two centers. CT images both pre-NT and post-NT were preprocessed, focusing on the automatic segmentation of subcutaneous fat, visceral fat, and skeletal muscle regions using TotalSegmentator. Delta Radiomics features were extracted using Pyradiomics. After feature fusion and selection, the optimal model is Naive Bayes (Rad model). A hybrid DL model was developed by combining ResNet18 and Transformer networks for feature extraction. The Clinic_Rad_DL model was constructed by combining clinical features, radiomic signatures, and DL signatures. The ExtraTree classifier was used for the Clinic_Rad_DL model, while a separate Cox regression model was developed for survival analysis using the same features. A total of 356 patients (mean age, 59 ± 10 years; 264 males [74.2%]) were enrolled and divided into training, validation, and test sets in a 7:2:1 ratio. The DL model outperformed the Rad model. The Clinic_Rad_DL model outperformed both Rad model and DL model, with AUC of 0.915, 0.890, and 0.890 in training, validation, and test sets, respectively. The Cox proportional hazards model showed C-index of 0.806, 0.803, and 0.819, effectively stratifying patients into high- and low-risk groups with significant survival differences. The study developed and validated a BC-based DL model to predict survival in GC patients undergoing NT, offering potential for personalized treatment strategies in clinical practice.

27. Treatment Dose Increase Versus Co-Medication in Allergic Rhinitis: Systematic Review With Dose-Response Network Meta-Analysis.

期刊: Allergy 发表日期: 2026-May-01 链接: PubMed

摘要

To achieve adequate symptom control, patients with allergic rhinitis (AR) often need to increase their medication dose or add other treatments (co-medication). We aimed to perform a systematic review to compare the efficacy and safety of AR medications for increased dose versus co-medication. We searched four bibliographic databases and three trial databases for randomised controlled trials assessing the effect of intranasal and/or oral medications in patients of all ages with seasonal or perennial AR. We performed pairwise meta-analysis based on direct evidence to compare (i) non-standard versus standard treatment doses, and (ii) co-medication strategies versus monotherapy using standard doses. Furthermore, we fitted dose-response network meta-analysis (NMA) to obtain projected estimates for comparisons involving two times the standard dose of AR medications in monotherapy versus co-medication with the standard dose of the same medications. We assessed the certainty of evidence using GRADE for NMA. We included 262 studies. Co-medication schemes involving oral antihistamines (OAH) + intranasal corticosteroids (INCS) resulted in higher improvements of nasal symptoms and quality of life than doubling the dose of OAH. However, doubling the dose of intranasal medications led to better results than having intranasal medications + OAH. Doubling the dose of INCS was associated with higher efficacy than adding intranasal antihistamines (INAH). No relevant safety differences were found between treatment strategies. Results favoured (i) doubling the dose of intranasal medications versus adding OAH, and (ii) adding INCS to OAH over doubling the dose of OAH. This study will inform the ARIA-EAACI 2024-2025 guidelines.

28. Diagnostic Impact of Two-Dimensional Shear Wave Elastography for Liver Fibrosis: A Multicenter Retrospective Study.

期刊: Hepatology research : the official journal of the Japan Society of Hepatology 发表日期: 2026-May-01 链接: PubMed

摘要

Two-dimensional shear wave elastography (2D-SWE) is a non-invasive technique for assessing liver fibrosis. However, its clinical utility has not been fully established. This study evaluated the diagnostic accuracy of 2D-SWE using magnetic resonance elastography (MRE) as the reference standard in a retrospective, multicenter, large-scale cohort. A total of 744 patients with chronic liver disease were included in the analysis. The association between 2D-SWE measurements and fibrosis stages determined by MRE was assessed. The correlation between 2D-SWE and MRE values was analyzed, and the diagnostic performance of 2D-SWE was evaluated using receiver operating characteristic (ROC) curve analysis. As 2D-SWE and MRE values were not normally distributed, they were log-transformed (Log-2D-SWE and Log-MRE) for analysis. A strong correlation was observed between Log-2D-SWE and Log-MRE values, with a correlation coefficient of 0.764 (p < 0.001). When 2D-SWE values were stratified according to the histological stages of liver fibrosis (F0-F4), based on MRE data, the corresponding median values were 4.61, 5.63, 6.18, 7.44, and 11.64 kPa, respectively (p < 0.001, Jonckheere-Terpstra test). The areas under the ROC curve (AUROCs) and cutoff values for 2D-SWE were 0.872 and 5.47 kPa for ≥ F1 (n = 285), 0.894 and 5.88 kPa for ≥ F2 (n = 217), 0.931 and 6.48 kPa for ≥ F3 (n = 137), and 0.937 and 7.39 kPa for F4 (n = 81), respectively. In subgroup analyses, AUROCs for detecting ≥ F2, ≥F3, and F4 exceeded 0.78, even among patients with elevated body mass index or advanced hepatic steatosis. 2D-SWE represents a highly useful and reliable non-invasive modality for assessing of liver fibrosis.

29. Extent of Pelvic Lymph Node Dissection at Partial Cystectomy: Effect on Cancer-Specific Mortality.

期刊: International journal of urology : official journal of the Japanese Urological Association 发表日期: 2026-May 链接: PubMed

摘要

We assessed the extent of pelvic lymph node dissection (PLND) at partial cystectomy (PC) according to PC eligibility (≤cT2 stage, tumor ≤ 3 cm and segmental resection possible) and tested its effect on cancer-specific mortality (CSM). Within the SEER database (2004-2021), we identified PC patients undergoing PLND and tabulated the number of lymph nodes (LNs) removed according to PC eligibility. Multivariable Cox-regression models tested the effect of PLND extent on CSM after adjusting for age, sex, T stage, N stage, and chemotherapy. Of 1017 PC patients undergoing PLND, 197 (19.4%) were eligible vs. 820 (80.6%) ineligible according to PC eligibility criteria. Median number of LNs removed at PLND was 6 (IQR: 3-11) in eligible versus 7 (IQR: 3-14) in ineligible patients (p = 0.09). Mean numbers of LNs removed at PLND increased over the study period, from 7 to 16 (p = 0.007) in PC-eligible and from 8 to 13 (p = 0.001) in PC-ineligible patients. In 1017 patients regardless of PC eligibility, 5-year CSM-free survival rate was 65.6%, and PLND extent predicted lower CSM (multivariable hazard ratio [mHR]: 0.99, p = 0.036). In 197 PC-eligible patients, 5-year CSM-free survival rate was 84.2%, and the PLND extent was not associated with CSM (mHR: 0.96, p = 0.2). Conversely, in 820 PC-ineligible patients, 5-year CSM-free survival rate was 61.1%, and PLND extent predicted lower CSM (mHR: 0.99, p = 0.043). In all PC patients regardless of eligibility status, more extensive PLND was associated with improved cancer-specific survival.

30. Developing and Applying a Typology of 'Better for You' Claims on Alcohol Products.

期刊: Drug and alcohol review 发表日期: 2026-May 链接: PubMed

摘要

To appeal to health-conscious consumers, alcohol producers are marketing products with a range of ‘better for you’ claims. This study aims to: (i) develop a typology of text-based ‘better for you’ claims used on alcohol products; (ii) assess the prevalence of these claims in the Australian market overall and by alcohol category; and (iii) identify the extent to which products display multiple claims. Between March and November 2024, images of 5982 unique alcohol products were captured in-store from three retailers in Australia. The products were coded for presence and type of ‘better for you’ claims, with each claim classified into an emergent typology of categories. Descriptive analyses were conducted overall and by alcohol category. Eight major categories of claims were identified: nutrient content, energy content, absence of ingredient, low alcohol, fruit/botanical references, natural, processing and vegan claims. Across the sample, 35% of products displayed at least one claim (range: 1-9 claims), and one in eight displayed multiple claims. Cider (91%) and premix (75%) categories contained the highest proportion of products featuring at least one claim. The use of claims across the Australian alcohol market appears to be quite common, particularly on premix and cider products. Limited regulation of claims allows companies to portray products as ‘better for you’, potentially misleading consumers and taking advantage of their efforts to be health-conscious. Future work in Australia should prioritise developing policies that restrict the use of claims on alcohol products, particularly those shown to be misleading.

31. Decommodifying and Humanizing Health Care: Revisiting Pellegrino's Ethical Imperative.

期刊: The Milbank quarterly 发表日期: 2026-May-01 链接: PubMed

摘要

Policy Points A quarter of a century since bioethicist Edmund Pellegrino warned about the commodification of health and health care, the problem has significantly worsened. Commodification of health and health care objectifies and dehumanizes people and undermines core concepts of holistic person-centered health, much less core human rights, including fulfillment of human potential and comprehensive health care. Multilevel sustained strategies and multisector coalitions are required to decommodify and humanize health and health care based on mental models, national and state policies, practices, resource flow, power dynamics, and relationships and connections. Edmund Pellegrino warned about the growing commodification of health and health care in the United States. After twenty-five years, it is worth revisiting Pellegrino’s critique and examining this critique in the current era. We conducted a targeted review of the literature to revisit the state of commodification in health and health care as defined by Pellegrino, examined its relationship to dehumanization, and explored prospects for addressing commodification. The commodification of health and health care substantially worsened in the US, characterized by increased health care corporatization and consolidation, biomedical lobbying, and unaffordable costs. Commodification and dehumanization reinforce each other, undermining rights to health and health care, the provision of holistic person-centered health, and the fulfillment of human potential. Decommodifying and humanizing health and health care requires a paradigm shift towards whole-person definitions of health; the acknowledgement of human relationships as a foundation; the recognition of health as a social good; and the need for society and healthcare to partner to optimize health, including providing health care to all. This paradigm shift will require collective, cross-sectoral advocacy and mobilization not only by diverse health care professional organizations but also by organizations outside health care that are committed to improving health for all.

32. The Effects of Recent Polarized Elections on Mental Health.

期刊: The Milbank quarterly 发表日期: 2026-May-01 链接: PubMed

摘要

Policy Points Researchers investigate how recent elections in the United States have influenced mental health, especially among political- and policy-based election losers. The previous two presidential elections worsened the self-reported mental health of Americans on average. Likely partisan election losers and those who had the most to lose in terms of health policy were even more likely to have their mental health affected by the results of elections. As American politics has become increasingly polarized and the perceived stakes of elections have loomed larger in recent years, elections have become a source of worsening mental health for Americans. Politics is increasingly important to many Americans. Yet little is known about how the increasing centrality of politics affects Americans’ mental health. This work aimed to evaluate how recent polarized elections have influenced Americans’ mental health. To investigate this question, we compared online search interest in politically related mental health issues and self-reported mental health data. Analyses explored changes before and after election days in 2020 and 2024. The two outcome variables were aggregate Google search interest in politics-related mental health issues and individual responses to the following item from the Behavioral Risk Factor Surveillance System (BRFSS): ‘‘Now thinking about your mental health, which includes stress, depression, and problems with emotions, for how many days during the past 30 days was your mental health not good? With BRFSS, we compared differential changes for likely Democrats and Republicans using multiple proxy measures and for those with health policy interest in the election. The 2020 and 2024 presidential elections substantially increased interest in politics-related mental health issues online. The 2020 election led to just under 0.2 additional days of poor mental health (P < .05), and the 2024 election led to just under 0.5 additional days of poorer mental health (P < .05). Likely losing partisans and those who stood to lose out from Trump’s reelection in terms of health policy were found to drive most of this relationship, with just under 1 full additional day of poorer mental health for each group. The stakes of elections in this polarized era of American politics are worsening the mental health of Americans. Additional resources may be necessary to allow therapists and clinicians to navigate additional care-seeking surrounding and following elections.

33. Comparing the quality of dying for patients with hematological malignancy and solid tumors: A bereavement study in Japan.

期刊: Cancer 发表日期: 2026-May-01 链接: PubMed

摘要

Although research on palliative care in hematological malignancies has increased, research examining quality of death (QOD) and quality of care (QOC) in this population remains limited. This study compared QOD and QOC between patients with hematological malignancies and those with solid tumors. The authors conducted a secondary analysis of a nationwide mortality follow-up survey of bereaved family members in Japan (2017-2018). The study included 3575 decedents with hematological malignancies and 50,592 with solid tumors. Propensity score matching was performed to adjust for demographic and clinical characteristics. QOD and QOC were assessed using the Good Death Inventory (GDI) and the Care Evaluation Scale 2.0 (CES). Bivariate analyses compared the matched groups. Overall, QOD and QOC were comparable between groups. However, among the GDI subdomains, patients with hematological malignancies had slightly lower scores for “good relationships with family” (mean difference, 0.2; 95% confidence interval [CI], 0.03-0.3) and “preparation for death” (mean difference, 0.2; 95% CI, 0.04-0.3). In addition, patients with hematological malignancies were less likely to die in palliative care units than those with solid tumors (mean difference, 3.9%; 95% CI, 0.4%-7.4%). Although overall quality measures were similar, specific QOD domains related to family relationships and preparation for death were slightly lower among patients with hematological malignancies. These findings may reflect limited opportunities for end-of-life discussions due to the unpredictable and rapidly progressive course of hematological malignancies. Enhancing communication about prognosis and goals of care and early integration of palliative care may improve end-of-life experiences.

34. A body shape index trajectories and cognitive function among older hypertensive patients: a national cohort study.

期刊: Archives of public health = Archives belges de sante publique 发表日期: 2026-May-01 链接: PubMed

摘要

While several cross-sectional studies have suggested an association between a body shape index (ABSI) and cognitive decline, the relationship between longitudinal ABSI patterns and cognitive outcomes among older hypertensive patients remains unclear. This study aimed to investigate the association between ABSI trajectories and cognitive outcomes in this population using a longitudinal cohort design. Data were obtained from the China Health and Retirement Longitudinal Study (CHARLS), with ABSI measurements collected in 2011, 2013, and 2015. Group-based trajectory modeling (GBTM) was used to identify the distinct ABSI trajectories. Cox proportional hazards models and linear mixed-effects models were applied to evaluate the association between ABSI trajectories and cognitive function among older hypertensive patients. A total of 1,065 older hypertensive participants were included in the study (572 males, 53.7%; 493 females, 46.3%). Three ABSI trajectory groups were identified: moderate-stable (n = 602, 56.5%), low-rapid-rising (n = 144, 13.5%), and high-slightly-increasing (n = 319, 30.0%). After adjusting for potential confounders, there was borderline evidence of effect modification by sex for incident low cognitive performance defined by a Z-score cutoff (P for interaction = 0.046). Compared with low-rapid-rising trajectory group, hazard ratio point estimates were higher in women (moderate-stable trajectory group: HR = 1.57, 95% CI 0.81-3.03; high-slightly-increasing trajectory group: HR = 1.83, 95% CI 0.94-3.58) but lower in men (moderate-stable trajectory group: HR = 0.78, 95% CI 0.48-1.27; high-slightly-increasing trajectory group: HR = 0.63, 95% CI 0.36-1.09), although sex-stratified estimates were imprecise, with confidence intervals crossing the null. In mixed-effects models of global cognitive Z-scores, baseline cognition was similar across groups; moderate-stable trajectory group showed a less steep decline than low-rapid-rising trajectory group (moderate-stable trajectory group×time: β = 0.05, 95% CI: 0.00-0.10), whereas high-slightly-increasing trajectory group was similar, with no evidence of sex modification of slopes. Long-term ABSI trajectories showed heterogeneous associations with cognitive outcomes in older hypertensive patients, with potential sex-related heterogeneity for incident low cognitive performance. Defining incident events by first crossing a Z-score cutoff may capture earlier cognitive vulnerability before clinically diagnosed impairment, offering a prevention-relevant perspective on longitudinal changes in ABSI among older adults with hypertension. However, sex-specific estimates were imprecise, and replication in larger, independent cohorts is warranted.

35. Do caregiver cooking skills boost adolescent resilience and prosocial behavior? Results from a population-based longitudinal study in Japan.

期刊: BMC psychology 发表日期: 2026-May-01 链接: PubMed

摘要

Promoting positive mental health in adolescence is important for life-course well-being. We sought to examine whether caregivers’ cooking skills are associated with the promotion of adolescents’ resilience and prosocial behavior in Japan. We used longitudinal data from 2018 to 2020 from the Adachi Child Health Impact of Living Difficulty (A-CHILD) study. The baseline survey was administered to all fourth-grade elementary school students (9-10 years old) and their caregivers, and a follow-up survey was administered 2 years later (n = 3,641, follow-up rate = 87%). Caregiver cooking skills were assessed at baseline using a cooking skills scale modified for use in Japan. Child resilience and prosocial behavior in fourth and sixth grade were assessed by caregivers using the Children’s Resilient Coping Scale and the Strength and Difficulties Questionnaire, respectively, and scores were rescaled to a 0-100 metric to facilitate interpretation. Multivariable linear regression models were used to examine associations between caregiver cooking skills and child outcomes after adjustment for potential confounders. Mediation analyses estimated indirect effects through food-related household routines, caregiver-child interactions, and family cohesion. In multivariable linear regression analyses, higher baseline caregiver cooking skills were associated with higher resilience and prosocial behavior scores at follow-up. Compared with children in the lowest quartile, those in the highest quartile had resilience scores that were 8.75 points higher (95% CI: 7.38 to 10.1) and prosocial behavior scores that were 9.51 points higher (95% CI: 7.68 to 11.3) in the model adjusted for potential confounders. These associations were partially mediated by food-related household routines, caregiver-child interactions, and family cohesion. For early adolescents in Japan, caregivers’ cooking skills were associated with children’s positive mental health. An educational program that allows caregivers to learn cooking skills may be important in promoting adolescent positive mental health.

36. Animal Models of Hunner-Type Interstitial Cystitis.

期刊: International journal of urology : official journal of the Japanese Urological Association 发表日期: 2026-May 链接: PubMed

摘要

Animal models are crucial for mechanistic studies and therapeutic development of human diseases. At present, the etiology of interstitial cystitis/bladder pain syndrome (IC/BPS), a chronic disease of the urinary bladder, remains undefined. Therefore, numerous theories of pathogenesis have been proposed, and various animal models have been developed based on these theories. This enigmatic human disease can be categorized into two subtypes: Hunner-type IC (HIC) and bladder pain syndrome (BPS). These two subtypes of IC/BPS have different pathological mechanisms, but their clinical symptoms overlap. Recent evidence indicates that HIC is an immune-mediated inflammatory disease of the urinary bladder, while BPS is a minimally inflamed bladder condition comprising various clinical phenotypes. Furthermore, increasing evidence suggests that autoimmunity may play a significant role in IC/BPS, particularly in HIC. Today, the rodent models of experimental autoimmune cystitis (EAC) are being used in HIC research. This article provides an overview of immune-mediated inflammation and autoimmunity in IC/BPS, as well as EAC models that can be used for HIC research, with a focus on the URO-OVA model, a novel transgenic EAC model that effectively mimics HIC. The URO-OVA model develops chronic bladder inflammation, pelvic/bladder pain, and voiding dysfunction seen in human HIC patients. It responds to treatment with dimethyl sulfoxide (DMSO) and specific inhibitors, such as Toll-like receptor (TLR)4, mitogen-activated protein (MAP) kinase, and interferon (IFN)-γ inhibitors. The URO-OVA model is stable and reproducible, providing a unique EAC model for HIC research that incorporates immune/autoimmune components in its pathophysiology.

37. What Diet Trials Can and Can't Tell Us - Mitigating Misinformation in Nutrition Science.

期刊: American journal of health promotion : AJHP 发表日期: 2026-May-01 链接: PubMed

摘要

38. Adherence to 24-hour movement guidelines and health-related quality of life from childhood to late adolescence: a prospective cohort study of Australian youth.

期刊: BMC public health 发表日期: 2026-May-01 链接: PubMed

摘要

Adherence to integrated 24-hour movement guidelines (moderate-to-vigorous physical activity, recreational screen time, and sleep) is low among young people but has been linked tolinked to better health-related quality of life (HRQoL). However, the evidence is largely cross-sectional and may not adequately capture factors that change over time. This study examined whether adherence across childhood and mid-adolescence is associated with HRQoL in late adolescence, whether adherence predicts HRQoL at subsequent wave, and whether these associations differ by sex. Data from the Longitudinal Study of Australian Children (LSAC; Kindergarten cohort), Waves 2-7 (n = 4,463 at age 6-7 years, followed to 16-17 years) were analysed. Adherence to all three guideline components was derived from time-use diaries at each wave. HRQoL (physical, psychosocial and total; 0-100) was measured using the Pediatric Quality of Life Inventory (PedsQL). We used structural nested mean models fitted via g-estimation to estimate (i) the cumulative association per additional wave of adherence from ages 6-15 with HRQoL at ages 16-17, and (ii) lead-lag associations between adherence at wave t and HRQoL at wave t + 1, adjusting for baseline and time-varying covariates. Sex-stratified analyses were also conducted. Adherence declined from 24.5% at ages 6-7 to 7.2% at ages 14-15. Each additional wave of adherence was associated with higher total HRQoL at ages 16-17 (mean difference 0.81 PedsQL points; Bonferroni-adjusted 95% confidence interval (CI) 0.10 to 1.51). In lead-lag analyses, adherence predicted higher HRQoL at the subsequent wave for physical functioning (1.73; 0.90 to 2.53), psychosocial functioning (1.33; 0.58 to 2.08) and overall HRQoL (1.37; 0.68 to 2.06). In sex-stratified analyses, significant next-wave associations were observed for psychosocial functioning (1.10; 0.12 to 2.06) and overall HRQoL (1.22; 0.28 to 2.06) in boys, and for physical functioning (2.33; 1.02 to 3.56), psychosocial functioning (1.60; 0.63 to 2.64) and overall HRQoL (1.54; 0.57 to 2.53) in girls; in boys, each additional wave of adherence was also associated with higher overall HRQoL at ages 16-17 (1.15; 0.28 to 2.07). Given the low and declining prevalence of adherence, these findings suggest that the 24-h movement guidelines may be relevant to public health, health promotion, and preventive care efforts aimed at supporting HRQoL across childhood and adolescence.

39. Cluster analysis of heart rate variability reveals subgroups with preserved and early-impaired autonomic regulation in amyotrophic lateral sclerosis.

期刊: BMC neurology 发表日期: 2026-May-01 链接: PubMed

摘要

Patients with amyotrophic lateral sclerosis (ALS) occasionally exhibit autonomic nervous system dysregulation. We examined whether autonomic regulation differed across patients with ALS with varying severity and progression. A total of 45 patients with ALS were enrolled and classified into three subgroups using cluster analysis. Heart rate variability was assessed using the maximum entropy method. The low-frequency (LF) and high-frequency (HF) components, LF/HF ratio (LF/HF), and heart rate (HR) were measured. Temporal changes in each parameter during rest, mental tasks, and post-task rest were evaluated. The values for all patients and subgroups were compared with those of 11 healthy control subjects. Between-group differences were evaluated at rest and using the Task/Rest and After/Task ratios, and within-group changes across the three phases were also analyzed, with non-parametric statistical tests applied. Cluster analysis classified the patients into three groups: “Group 1: early-preserved group”, “Group 2: late-preserved group”, and “Group 3: late-impaired group”. Overall, the patients showed lower HF and higher LF/HF at rest than the controls, indicating parasympathetic hypoactivity and sympathetic predominance. Abnormalities were more prominent in Groups 1 and 3 than in Group 2. The former two groups showed blunted HF, LF/HF and HR responses during the tasks. The late-preserved group (Group 2) showed no difference in the Task/Rest ratios of HF, LF/HF and HR compared with the controls. Autonomic regulatory functions differ depending on the severity and progression of ALS. The presence of HRV abnormalities in early-preserved patients suggests that autonomic dysregulation in ALS may not be limited to a late-stage secondary complication but may also be present earlier stages. Recognizing HRV abnormalities from early stages may help identify patients at risk of faster progression. Future longitudinal studies in larger cohorts are needed to establish the pathophysiological significance of HRV abnormalities.

40. The Hippo tumor suppressor pathway triggers non-cell autonomous tumorigenesis in Drosophila.

期刊: EMBO reports 发表日期: 2026-May-01 链接: PubMed

摘要

The Hippo pathway is a tumor suppressor pathway, and most related studies have indicated that its inhibition leads to tumorigenesis. However, recent studies have suggested that the activated Hippo pathway can promote tumorigenesis in certain contexts. Here, we demonstrate that the activated Hippo pathway induces non-cell-autonomous tumorigenesis, characterized by tumor markers in the Drosophila wing epithelium. This suggests that Hippo-activated cells behave similarly to “oncogenic niche cells.” We find that Hippo-activated cells induce Dronc-Wingless/Spitz signaling in the hinge/ventral notum region, which causes tumorigenesis. Moreover, we identify the amino acid transporters Sat1/2, which are implicated in amino acid incorporation and function redundantly with the growth factors Wingless and Spitz to facilitate non-cell-autonomous tumorigenesis.

41. The Clinical Benefits of Nutritional Supplementation Across the Chemotherapy Journey in Cancer Patients: A Multicenter Prospective Cohort Study.

期刊: Cancer medicine 发表日期: 2026-May 链接: PubMed

摘要

This study aimed to explore the clinical benefits of receiving nutritional supplementation (NS) throughout the whole course of chemotherapy. This multicenter prospective cohort study totally included 251 cancer patients requiring nutritional support and scheduled for chemotherapy. Primary outcomes included energy intake (EI), protein intake (PI), body mass index (BMI), NRS 2002 and PG-SGA scores. Short-term efficacy was the secondary outcome. Among the study participants, 168 received NS, whereas 83 opted for dietary advice (DA) alone. In the NS group, EI and PI demonstrated a gradual upward trend across the six cycles of chemotherapy, with no significant changes in the DA group. The BMI remained stable in both groups. The proportion of patients with or at risk of malnutrition showed a declining trend in the NS group but an increasing trend in the DA group. The generalized estimating equation results indicated that NS significantly improved PI (coefficient = 0.19, 95% CI: 0.11 to 0.27, p < 0.001), NRS 2002 (coefficient = -0.13, 95% CI: -0.23 to -0.03, p = 0.005), and PG-SGA (coefficient = -0.18, 95% CI: -0.28 to -0.08, p < 0.001). The improvements in PI, NRS 2002, and PG-SGA scores occurred from cycle 1, cycle 3, and cycle 2, respectively. Multivariate logistic analysis confirmed NS as a favorable factor associated with higher disease control rate (OR = 4.65, 95% CI: [1.88, 12.01], p = 0.001). The incorporation of NS yielded several clinical benefits beyond adequate EI and stable weight. It contributes to higher protein intake and good nutritional status in patients with cancer throughout the whole course of chemotherapy, ultimately improving treatment efficacy. Patient-Reported Outcome Management Including Surveillance and Intervention in Nutritional Group (PROMISING) Study (registration number: ChiCTR2100047535).

42. Biocontrol of Wheat Blast by Seed-Associated Bacillus Strains: Three-Year Field Evaluation and Comparison with Chemical Fungicide for Disease Control and Yield Optimization.

期刊: Plant disease 发表日期: 2026-May-01 链接: PubMed

摘要

Wheat blast, caused by Magnaporthe oryzae pathotype Triticum (MoT), poses a major, escalating threat to global wheat production, particularly in South Asia. This study systematically evaluated the biocontrol and yield-enhancing potential of three seed-associated Bacillus strains, Bacillus subtilis BTS-3, B. velezensis BTS-4, and BTLK6A, against MoT under both greenhouse (seed priming, preventive and curative foliar application) and field conditions (seed priming and foliar spray), Seed priming with BTS-4 demonstrated significant disease suppression, reducing leaf blast severity by up-to 89.88 %. Synergistic seed priming treatment further enhanced protection, with the BTS-3 + BTS-4 consortium achieving 93.38 % reduction of the disease in the seedling assay. Notably, preventive foliar application of BTS-4 also resulted in complete leaf blast suppression (0% severity), demonstrating its prophylactic efficacy, whereas curative treatments were comparatively less effective. Three years of rigorous field trial data confirmed the high efficacy of the Bacillus treatments, with BTS-4 and the bacterial consortium consistently reducing blast severity by more than 50% compared to the negative control. More importantly, the biocontrol treatments significantly improved yield attributes, with the consortium achieving the highest grain yield. These results clearly demonstrated that biological control treatments, alone or combined with fungicide, outperformed the negative control by 86.2% and the standard chemical fungicide (Nativo®) treatment by 47.3%, respectively. These findings highlight the strong potential of these Bacillus strains, particularly the BTS-4 and consortium treatments, as sustainable, superior biocontrol agents that for the integrated management of wheat blast and field-scale crop productivity enhancement.

43. Association between Internet addiction and mental health problems among Chinese adolescents in the post-COVID-19 pandemic era: a propensity score matching study.

期刊: BMC psychology 发表日期: 2026-May-01 链接: PubMed

摘要

Improving adolescent mental health is a priority for public health, with Internet addiction (IA) being notably linked to these problems. In the post-pandemic era, increased screen time and social isolation persist, albeit in a more normalized form, potentially continuing to affect adolescent mental health. The current study aims to examine the relationship between IA and mental health problems among Chinese adolescents in the post-COVID-19 pandemic era. A cross-sectional survey was conducted in two cities of Henan Province, China, between April and May 2023. A total of 8176 junior high school students were recruited from 6 schools using a stratified random cluster sampling method. The associations between IA and mental health problems were assessed using ordinary least squares model and propensity score matching, specifically employing 1:1 nearest neighbor matching, radius matching, and kernel matching. The average treatment effect on the treated (ATT) was reported. The detection rate of IA was 19.37% (1584/8176) in this study . Before matching, IA was correlated with elevated levels of depression (β = 2.766, p < 0.001) and anxiety (β = 2.338, p < 0.001), after adjusting for other variables. After matching, participants exhibiting IA were more likely to experience depression and anxiety compared to those who were not addicted. Nearest Neighbor Matching: ATT for depression and anxiety was 3.026 (95% CI: 2.609 ~ 3.443) and 2.472 (95% CI: 2.096 ~ 2.848); Kernel Matching: ATT for depression and anxiety was 2.980 (95% CI: 2.654 ~ 3.396) and 2.448 (95% CI: 2.072 ~ 2.824); Radius Matching: ATT for depression and anxiety was 2.886 (95% CI: 2.470 ~ 3.302) and 2.349 (95% CI: 1.973 ~ 2.725). IA was associated with depression and anxiety among Chinese adolescents in the context of the post-COVID-19 pandemic era. Policymakers, parents, and school personnel should prioritize addressing IA to decrease mental health problems in this population.

44. B vitamins and cardiovascular health: mechanisms, clinical evidence, and precision prevention strategies.

期刊: Nutrition & metabolism 发表日期: 2026-May-01 链接: PubMed

摘要

Cardiovascular diseases is the most common cause of mortality in the world. B vitamins (B₁-B₁₂) control how mitochondria make energy, how nitric oxide is made, how one-carbon is used, and how genes work. A deficiency leads to hyperhomocysteinemia, oxidative stress, and endothelial dysfunction, all of which are important to vascular disease. Observational studies consistently associate low B-vitamin levels with an elevated risk of cardiovascular diseases; nevertheless, randomized supplementation trials have demonstrated only modest reductions in significant events. This narrative review summarizes molecular, epidemiological, and clinical evidence on the role of B vitamins in cardiovascular health. Special focus was paid to functional biomarkers and gene-nutrient interactions that affect how well a therapy works. The literature was identified through targeted searches of PubMed, Scopus, and Google Scholar. Priority was given to high-quality evidence, including mechanistic studies, observational cohorts, randomized controlled trials, meta-analyses, and major review articles relevant to cardiovascular outcomes. Functional indicators, such as methylmalonic acid and holotranscobalamin, offer superior accuracy compared to blood levels in assessing vitamin status. Nutrigenetic interactions, particularly the effects of folate and riboflavin on methylenetetrahydrofolate reductase polymorphisms, exhibit blood pressure-lowering and stroke-preventive advantages. The clinical efficacy of B-vitamin supplementation is highly dependent on baseline nutritional status and regional food fortification policies. For example, folic acid supplementation significantly reduces stroke incidence in populations who lack mandatory folate fortification, whereas trials conducted in folate-sufficient cohorts generally demonstrated no added cardiovascular benefit. Recognizing this population-specific variability helps explain the historical discrepancy between the strong mechanistic potential of B-vitamins and the mixed results observed in large-scale clinical trials. While adequate B-vitamin status remains mechanistically essential for cardiovascular homeostasis, the clinical benefits of routine supplementation are nuanced and highly population-dependent. Consequently, ubiquitous supplementation is unlikely to produce extensive advantages. A precision strategy that combines biomarkers, genotype stratification, and population context can help find their therapeutic potential. Future methods should integrate diet with precision cardiology to enhance vascular prevention.

45. Single intake of matcha increases brown adipose tissue activity in young women with low thermogenesis.

期刊: Physiological reports 发表日期: 2026-May 链接: PubMed

摘要

Matcha contains several bioactive compounds that contribute to the facilitation of thermogenesis. However, the effects of a single intake of matcha on brown adipose tissue (BAT) activity remain to be elucidated. This study aimed to evaluate the association between matcha intake and BAT activity. Healthy young women (n = 30) were enrolled in a randomized single-blind crossover trial. Participants consumed 3 g of matcha powder or a placebo and then received the alternate condition in a subsequent trial. BAT activity was analyzed using thermography with cold exposure. A stratified analysis was performed based on tertiles of maximal changes in BAT activity. BAT activity was increased for all participants following cold exposure; however, no significant difference in the increased levels was found between the matcha and placebo trials. Stratified analysis showed that BAT activity was significantly different in the placebo trial across the low, middle, and high tertile groups; however, this was not found in the matcha trial. Differences in maximal BAT activity between the matcha and placebo trials were significantly higher in the low activity group than in the other groups. These results suggest that matcha powder has beneficial effects on BAT thermogenesis in young women with lower BAT activity.

46. Low Free Testosterone Is Independently Associated With Long-Term Mortality in Men With Chronic Spinal Cord Injury.

期刊: Andrology 发表日期: 2026-May-01 链接: PubMed

摘要

Testosterone deficiency is highly prevalent in men with chronic spinal cord injury (SCI) and is associated with obesity, sarcopenia, systemic inflammation, and metabolic dysfunction. However, the independent prognostic role of low testosterone in long-term mortality in this population remains unclear. To investigate whether baseline calculated free testosterone (cFT) independently predicts all-cause mortality in men with chronic SCI. We conducted a retrospective cohort study including 152 men with chronic SCI admitted to a rehabilitation center between 2017 and 2023. Participants were followed until death or December 2024 (median follow-up 62 months). Severe hypogonadism was defined according to European Male Ageing Study criteria. Cox proportional hazards models were used to assess the association between testosterone and mortality. Fully adjusted models included age, comorbidities, inflammatory status, functional independence, injury duration, age at injury, autonomic dysreflexia, body mass index (BMI), HDL, and testosterone-binding factors, including albumin. Prespecified parsimonious models (age + CCI or albumin) were also tested. Kaplan-Meier curves were compared by log-rank test and model discrimination was evaluated using Harrell’s C-index. Twenty-four deaths (15.8%) occurred. Deceased patients had significantly lower cFT (48.9 vs. 85.4 pg/mL; p < 0.001) and lower serum albumin levels. In fully adjusted Cox models, lower cFT independently predicted mortality (HR 0.97 per pg/mL increase; 95% CI 0.95-0.98; p = 0.0139). Serum albumin was also strongly associated with mortality in multivariable models, confirming its role as a marker of nutritional and clinical frailty. The association between cFT and mortality remained robust in parsimonious models (HR 0.82 per 10 pg/mL increase; p = 0.001), including those adjusted for albumin. The age-cFT-CCI model showed good discrimination (Harrell’s C-index 0.85). ROC analysis identified an internally derived threshold of 59.55 pg/mL (AUC 0.839), with significantly lower survival in men below this threshold (log-rank p < 0.0001). Low cFT independently predicts all-cause mortality in men with chronic SCI. These findings suggest that cFT may represent an integrative biomarker of systemic frailty beyond markers of nutritional and clinical status in this high-risk population and warrant confirmation in prospective multicenter studies.

47. Whole-genome sequencing of MDR K. pneumoniae circulating in Moroccan river ecosystems: a comprehensive genomic analysis of environmental isolates.

期刊: BMC genomics 发表日期: 2026-May-01 链接: PubMed

摘要

Klebsiella pneumoniae is a major opportunistic pathogen and a recognized contributor to the global burden of antimicrobial resistance (AMR). Although traditionally associated with healthcare settings, it is increasingly detected in environmental compartments influenced by anthropogenic activities. Aquatic ecosystems may act as reservoirs and dissemination hubs for multidrug-resistant (MDR) lineages and resistance genes. However, genomic data on environmental K. pneumoniae in Morocco remain scarce. This pilot study aimed to characterize a targeted subset of MDR K. pneumoniae isolates recovered from Moroccan rivers using whole-genome sequencing (WGS), with a focus on resistance determinants, virulence-associated loci, plasmid content, and phylogenetic relationships. The main findings revealed marked genetic heterogeneity among the environmental K. pneumoniae isolates. Of the 44 isolates recovered from six Moroccan rivers, 11 MDR isolates were selected for WGS and belonged to nine distinct sequence types, including the high-risk clones ST147 and ST307. Resistance to extended-spectrum β-lactams was mainly associated with ESBL genes, particularly blaCTX-M-15, whereas carbapenem resistance was linked to blaOXA-48 and blaNDM-14 in a subset of isolates. The genomes also carried multiple determinants associated with resistance to other major antimicrobial classes. In addition, the isolates showed diverse plasmid backgrounds, heterogeneous virulence-associated loci, and substantial capsular diversity. Phylogenetic and pangenome analyses further indicated high intraspecific variability and extensive genome plasticity across the collection. This pilot study provides the first whole-genome-based characterization of river-derived MDR K. pneumoniae in Morocco. It demonstrates that aquatic ecosystems harbor genetically diverse lineages carrying clinically relevant resistance and virulence determinants. These findings underscore the imperative of integrating environmental surveillance into national AMR monitoring strategies within a One Health framework.

48. Molecular detection of Cyclospora cayetanensis in fresh produce and irrigation water in peri-urban settings: a cross-sectional study of the environmental-agricultural interface.

期刊: BMC microbiology 发表日期: 2026-May-01 链接: PubMed

摘要

Cyclospora cayetanensis is an important foodborne parasite worldwide, with fresh produce and contaminated irrigation water as major transmission vehicles. In South Asia, environmental surveillance data remain limited. We investigated the occurrence of C. cayetanensis DNA in fresh produce and irrigation water across peri-urban areas of Khyber Pakhtunkhwa, Pakistan, and assessed environmental and farm-level factors associated with contamination. A cross-sectional study was conducted in Peshawar and Kohat districts from April to September 2025. A total of 420 samples were collected, including 300 fresh produce samples (six commonly consumed vegetables and herbs) and 120 irrigation water samples from canal, tube-well, and mixed sources. Samples were processed using concentration techniques, and detection was performed by nested PCR targeting the 18 S rRNA gene. Structured field questionnaires were used to capture farm-level practices, and logistic regression was applied to identify risk factors. We detected C. cayetanensis DNA in 6.0% of produce (18/300) and 12.5% of irrigation water (15/120; p = 0.028). Canal water (20.0%) was more frequently contaminated than tube-well water (5.0%; OR 4.75; 95% CI: 1.01-22.3). Leafy vegetables and herbs had higher contamination than smooth-surfaced produce (8.0% vs. 2.0%; p = 0.009). In multivariable analysis, canal irrigation (aOR 3.41), proximity to drainage channels ≤ 50 m (aOR 3.98), and use of untreated rinsing water (aOR 2.91) remained independently associated with contamination (all p < 0.05). This study provides among the first molecular evidence of C. cayetanensis contamination at the produce-water interface in peri-urban Khyber Pakhtunkhwa, Pakistan, identifying surface irrigation and poor water management as key risk factors. However, because PCR detects DNA rather than viable organisms, these findings indicate environmental contamination and potential exposure pathways rather than direct infection risk. Sequencing confirmation is needed to exclude cross-amplification of related coccidia.

49. Physical activity in infancy is associated with body composition at age three.

期刊: BMC public health 发表日期: 2026-May-01 链接: PubMed

摘要

The prevalence of obesity in the pediatric population is increasing, driven by a multifactorial etiology that includes genetic predisposition as well as both prenatal and postnatal influences. We aimed to explore associations between child physical activity (PA) at ages one and three years and body composition at age three. Furthermore, we investigated associations between maternal PA during pregnancy and child body composition at age three. Mother-child pairs (n = 68) from a pregnancy PA intervention study were included. Children’s PA was assessed at one- and three-year follow-ups using 7-day accelerometry and categorized into 24-hour PA and daytime PA (6 a.m. - 8 p.m.). Child body composition was measured by Dual-energy X-ray absorptiometry and expressed as fat-free mass (FFM) and body fat percentage (BF%). Maternal moderate-to-vigorous intensity PA (MVPA) was measured using a commercial activity tracker. Associations between maternal and child PA and child body composition were examined using linear regression. Variables used for model adjustment included maternal pre-pregnancy body mass index, gestational weight gain, maternal educational level at baseline, parity, maternal age at baseline, child walking status at age one, child sex, and child age at the three-year follow-up. We found a positive association between daytime PA at age one and child FFM at age three. Daytime PA at age three was positively associated with FFM, and 24-hour PA at age three was negatively associated with BF% and positively associated with FFM. A 10% increase in 24-hour PA was associated with approximately 400 g higher FFM. Maternal MVPA during pregnancy showed no association with child body composition at age three. More daytime PA at ages one and three was associated with higher FFM at age three in children. These findings highlight the importance of research focusing on early PA habits to support healthy body composition in young children.

50. Allied health services availability and human milk nutrition among preterm infants.

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

摘要

Structural inequities in neonatal care may influence human milk (HM) feeding outcomes. We examined whether allied health service (AHS) availability differs between safety-net (sn) and non-snNICUs and its association with HM use at discharge among very low birth weight (VLBW) infants. Population-based cohort study of California Perinatal Quality Care Collaborative (CPQCC) data (2022-2023) for infants born <29 weeks’ gestation or <1500 g birth weight (BW). Multivariable models assessed associations between AHS availability (lactation, occupational/physical therapy, social work, psychology) and HM use at discharge, adjusting for infant, maternal, and hospital factors. Among 138 NICUs, 35% were snNICUs; 64% of VLBW infants were discharged home. AHS availability did not differ between sn and non-snNICUs. Individual AHS availability was not associated with increased HM use, while greater cumulative AHS availability was associated with lower HM use. HM use at discharge was higher in non-snNICUs (70.2% vs. 63.1%, p < 0.001). Higher infant gestation, BW, Apgar score, maternal Asian race, absence of infection and prenatal care were positive predictors; maternal Black and Hispanic race were negative predictors. Cumulative NICU AHS availability was not associated with higher HM use. Structural presence of AHS alone may not reflect integration into effective feeding practices. This statewide analysis examined relationships between allied health service (AHS) availability and human milk (HM) nutrition among preterm infants in California NICUs. Contrary to expectations, AHS availability did not differ between safety-net and non-safety-net hospitals. Individual AHS availability showed no association with HM use at discharge, while greater cumulative AHS availability correlated with lower HM use. Findings challenge assumptions that more AHS automatically improves HM outcomes and highlight the need to evaluate how allied health resources are integrated, coordinated, and aligned with family-centered lactation support in the NICU.

51. Dr. Yamaguchi et al reply.

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

摘要

52. Urethral complications after gender-affirming genital surgery: prevention and reconstructive management.

期刊: Current opinion in urology 发表日期: 2026-Apr-30 链接: PubMed

摘要

Urethral complications remain a major source of morbidity following gender-affirming genital surgery, particularly in the setting of masculinizing procedures requiring urethral lengthening. This review summarizes recent advances in the epidemiology, prevention, and reconstructive management of urethral complications, with a focus on principles relevant to reconstructive urologists. Urethral complications are uncommon after feminizing genital surgery but occur frequently following masculinizing surgery, with pooled rates of strictures and fistulae approaching 50% after phalloplasty. Recent studies emphasize the heterogeneity of these complications, highlighting the importance of timing, anatomical location, and surgical technique. Improved classification systems, such as the Montréal classification, aim to standardize reporting. Preventive strategies - including careful patient selection, expectation management, hair removal protocols, optimized flap design, tissue interposition, and staged reconstruction - are increasingly recognized as critical but remain underreported. Reconstructive management must be individualized, as outcomes are influenced by tissue vascularity and prior interventions. Staged urethroplasty appears to offer the most durable results for complex strictures, while prolonged urinary diversion may allow conservative resolution of selected fistulae. Urethral complications after masculinizing gender-affirming genital surgery are common and complex. Emphasis on prevention, standardized reporting, and individualized reconstructive strategies is essential to improve long-term urinary outcomes.

53. Ten years on: An updated scoping review of relative motion orthoses for managing various hand conditions.

期刊: Journal of hand therapy : official journal of the American Society of Hand Therapists 发表日期: 2026-Apr-30 链接: PubMed

摘要

In the decade since the landmark Relative Motion (RM) scoping review was published, literature volume has tripled, alongside expanded applications across three categories: protective, exercise and adaptive. To provide an overview of published evidence since 2016 relating to RM orthoses and integrate these findings with the 2016 review. Scoping review. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews guided this study. Four databases were searched: CINAHL, Embase, MEDLINE and PubMed. Studies investigating RM use in adults with hand conditions were included. Data extracted included demographic, intervention and outcome details. Quantitative and qualitative studies were appraised using the Structured Effectiveness Quality Evaluation Scale and Standards for Reporting Qualitative Research respectively. The Template for Intervention Description and Replication checklist evaluated intervention reporting, informing a narrative synthesis. Twenty-two studies involving 386 participants met inclusion criteria. Quantitative studies were categorized as protective (n = 19 studies, 346 participants) and exercise-based (n = 1 study, 20 participants). Qualitative studies explored adaptive use (n = 1 study, four participants) or combined protective and exercise applications (n = 2 studies, 16 participants). Study designs included randomized control trials (n = 6), retrospective case series (n = 6), prospective case series (n = 1), clinical audit (n = 1), case reports (n = 4), qualitative studies (n = 2) and mixed-methods (n = 1). Three studies comparing RM extension with alternative approaches for zones V-VI extensor tendon repairs reported equivalent or superior outcomes. Randomized control trials found no significant difference between RM and metacarpophalangeal blocking orthoses for trigger finger management. Multiple randomized control trials support RM orthoses without a wrist component to adequately protect extensor tenorrhaphy in zones V-VI. Since 2016, RM literature has expanded to include a broader range of hand conditions. Further research is required to evaluate the orthosis’ use in flexor tendon injuries, boutonniere deformity and sagittal band injuries.

54. Body Composition Tools in Young Children: A Spanner in the Works?

期刊: The Journal of pediatrics 发表日期: 2026-Apr-29 链接: PubMed

摘要

55. Accidents of occupational exposure to ionizing radiation in radiology departments: risks, prevention, and management.

期刊: Presse medicale (Paris, France : 1983) 发表日期: 2026-Apr-29 链接: PubMed

摘要

Occupational exposure to ionizing radiation in radiology departments is a rare but important concern, given the potential long-term health effects and the regulatory framework surrounding radioprotection. This review analyzes the main risks associated with exposure to X-rays, including cancer, cataracts, radiodermatitis, pregnancy risks, and reduced fertility, as well as the specific contexts in which accidents occur. The majority of significant exposure incidents are reported in interventional radiology, where proximity to the radiation source and prolonged fluoroscopy times increase operator exposure. Causes include human error, lack of training, inadequate protective equipment, or technical malfunctions. Radioprotection measures are detailed, including zoning, collective and personal protective equipment, dosimetric monitoring, and medical surveillance. The management of significant radioprotection events (ESR) is described, with emphasis on immediate site actions, medical care of exposed staff, reporting obligations, and corrective measures. The review highlights the role of key stakeholders including the Radiation Protection Officer (CRP), the Nuclear Safety and Radioprotection Authority (ASNR), and the Institute for Radiological Protection and Nuclear Safety (IRSN). Despite the low incidence of accidents, continuous training, rigorous adherence to protocols, and optimal use of protective measures remain essential. Recent reports confirm the rarity of exposures exceeding regulatory limits but underscore the necessity of vigilance in interventional settings.

56. Persistent pelvic pain in tertiary multidisciplinary pain clinics: a comparative study with non-pelvic pain patients using registry data.

期刊: Scandinavian journal of pain 发表日期: 2026-Jan-01 链接: PubMed

摘要

Persistent pelvic pain (PPP) is often regarded as multifactorial and complex. There is limited knowledge on how patients with PPP resemble and differ from those with persistent non-pelvic pain (PNPP). The specific aims of this study were to compare self-reported background and pain characteristics, affective symptoms, and quality of life at baseline between patients with PPP and those with PNPP at three multidisciplinary pain clinics in Norway, and to explore differences between men and women with PPP. This is a cross-sectional study, using registry data from three tertiary, multidisciplinary pain clinics. Patients ≥17 years answered web-based questionnaires on background, baseline pain symptoms, mental health, and quality of life. We used t-tests, chi square, and multivariable logistic regression. Of 934 consenting patients (71 % of those attending), 30 had missing diagnoses, and 127 (13.6 %) were diagnosed with PPP. PPP patients less often reported widespread pain than PNPP patients (adjusted odds ratio (AOR) 0.2, 95 % confidence interval (CI) 0.2-0.4). We found high prevalence of fatigue, insomnia, and anxiety among all the pain patients, but PPP patients were more likely to report depression (AOR 1.6, 95 % CI 1.0-2.6) and pain catastrophizing (AOR 1.8, 95 % CI 1.2-2.8). All the pain patients had a low health-related quality of life. Women with PPP had higher prevalence of severe fatigue than men with PPP. This study confirms that pain clinic patients generally experience high levels of emotional distress and poor health-related quality of life. PPP patients tend to exhibit higher rates of pain catastrophizing, yet less widespread pain. Understanding the specific symptom profile of PPP patients is crucial for effective treatment in pain clinics. The potential underutilization of pain clinics in the treatment of PPP patients warrants further investigation.