公共卫生研究摘要 (2026-05-06)

共收录 56 篇研究文章

1. Micro- and nanoplastics-mediated immunometabolic reprogramming: a systemic nexus for chronic inflammation and multi-organ disease risk.

期刊: Journal of immunotoxicology 发表日期: 2026-Dec 链接: PubMed

摘要

Micro- and nanoplastics (MNP) are ubiquitous environmental stressors increasingly detected in human tissues and directly linked to clinical cardiovascular events. This review proposes immunometabolic reprogramming as the central nexus through which MNP drive systemic immune dysregulation and chronic inflammation. Upon entering via multiple routes, MNP selectively sequester in immune organs, disrupting mitochondrial quality control via Drp1-mediated fission and activating the cGAS-STING pathway. Furthermore, MNP induce a pseudohypoxic state that stabilizes HIF-1a, driving a glycolytic “Warburg-like” shift that promotes pro-inflammatory macrophage polarization. These intracellular perturbations are further amplified by “lipid corona” formation and gut microbiota dysbiosis, which depletes anti-inflammatory short-chain fatty acids. Collectively, this systemic immunometabolic remodeling provides a mechanistic framework for understanding MNP-related risks for cardiovascular, metabolic, and neurodegenerative disorders.  This review emphasizes the necessity of integrating immunometabolic parameters into future environmental health risk assessment frameworks.

2. Evaluation of the Centers for Disease Control and Prevention-Harvard T.H. Chan School of Public Health Program Evaluation Practicum.

期刊: Journal of public health management and practice : JPHMP 发表日期: 2026-May-06 链接: PubMed

摘要

A Maternal and Child Health (MCH) workforce skilled in program evaluation is vital for program assessment and data-driven decision making. Collaborative evaluation capacity-building opportunities for state, tribal, local, and territorial (STLT) public health staff, partner organizations, and students are key strategies in building a skilled workforce, promoting program improvement, effectiveness, and sustainability to improve long-term MCH outcomes. We evaluated the Centers for Disease Control and Prevention and Harvard T.H. Chan School of Public Health Program Evaluation Practicum to determine if it contributed to STLT participants’ ability to implement evaluation plans responsive to their MCH programs and gather recommendations for Practicum improvement. Qualitative one-on-one interviews; data collected July-August 2023. Eighteen STLT public health staff, including Centers for Disease Control and Prevention Maternal and Child Health Epidemiology Program (MCHEP) field assignees, who participated in the Practicum between 2018 and 2022. Experiences of STLT MCH program staff and Centers for Disease Control and Prevention MCHEP field assignees. Six facilitator themes and 6 barrier themes for evaluating MCH programs were identified. Facilitators: an appreciation for evaluation from program partners and recipients; data availability; resources to support evaluation tasks; funding; internal program evaluation capacity; and organizational support. Barriers: data or systems access issues; staff turnover; shifting priorities; lack of evaluation readiness; limited evaluation capacity; and data collection issues. Four lessons-learned themes were identified: need for improved data collection tools; identification of future training needs; facilitation of programmatic decisions; and facilitation of evaluation buy-in. Five themes for recommendations on improving the Practicum were identified: collaborative learning and real-world examples; more evaluation support; modifying the Practicum structure; establishing appropriate Practicum teams; and helping programs determine evaluation readiness. Collaborative evaluation training like the Practicum can strengthen evaluation capacity within MCH programs and support program improvement. However, the Practicum may benefit from updated guidance, content, and structure to better assess participants’ evaluation readiness and meet participants’ needs.

3. A systematic review of radon concentrations and its lung cancer burden in Iran over two decades (2024-2000).

期刊: Reviews on environmental health 发表日期: 2026-May-06 链接: PubMed

摘要

The second most common cause of lung cancer after smoking is radon which is a naturally occurring radioactive gas. Although the levels of radon have been recorded in some parts of Iran, the general health effect of radon remains unclear. A systematic review that was conducted in this study determined the level of indoor radon in Iranian provinces and approximated the burden of lung cancer as a result of this exposure using an accepted risk assessment model. An extensive search in both national and international databases revealed that 263 records were found, 45 of which were included in the study based on the PRISMA guidelines. The data were taken out of 60 cities in 18 provinces organized into nine geographic zones. Systematic evaluation was done on key modifying factors which included season, building materials, floor level, ventilation, and building age. Data on radon exposure were augmented with provincial lung cancer disability-adjusted life years (DALYs) of the Global Burden of Disease (GBD) study. The uncertainty in exposure and the exposure-response coefficient was also taken into consideration using Monte Carlo simulations. The radon-attributable lung cancer morbidity was estimated to be approximately 19,400 DALYs/year, which was equivalent to the population attributable fraction (PAF) of 10.6 (95 % CI: 8.1-13.3 %). The provincial PAFs were between 0.9 % and 44.3 % with the greatest burden observed in Tehran, Mazandaran and Khorasan-e-Razavi. In some regions, radon was responsible for more than 25 % (95 % CI: 20.1-31.2 %) of the lung cancer burden. These findings point to the existence of serious regional differences and the necessity of the immediate attention to radon monitoring, mitigation, and Governmental policies to prevent cancers and improve the safety of buildings in Iran.

4. Estimating the healthcare costs of overweight and obesity amongst Australian children.

期刊: Internal medicine journal 发表日期: 2026-May-05 链接: PubMed

摘要

This study aimed to describe healthcare utilisation and costs associated with excess weight amongst Australian children (mean age 11 years). We analysed self-reported data from the Child Health CheckPoint study. From a healthcare provider perspective, children with overweight and obesity incurred annual excess costs of AUD +$140 and +$379 (+$117 and $328 adjusted) respectively compared to those in the healthy weight category. These findings suggest obesity is a significant driver of healthcare costs in children and support the economic argument for reducing childhood obesity.

5. "Optimizing Learning in Integrated Curriculum"-Comparative Effectiveness of Online and Face-to-Face Formative Assessments: Mixed Methods Study.

期刊: JMIR medical education 发表日期: 2026-May-05 链接: PubMed

摘要

Assessment is a critical component of teaching and learning and serves as the foundation for how learners demonstrate success in achieving learning objectives. Formative assessments (FAs) and timely feedback play a crucial role in integrated curricula, whereas basic and clinical sciences are taught in a coordinated manner. Feedback-based FA supports student learning, and teachers can determine learning gaps to monitor progress in learning. Based on existing evidence, limited literature compared the effect of online versus onsite FA on summative performance in a fully integrated curriculum. This study aimed to examine the effectiveness of online versus on-site FAs and feedback on summative assessment in the integrated medical curriculum. This study used an exploratory mixed methods approach to delving into students’ experiences with face-to-face versus online FA and feedback, and its effect on their summative performance in the integrated Bachelor of Medicine, Bachelor of Surgery program. This study was conducted at Fakeeh College for Medical Sciences in Jeddah, Saudi Arabia. A total of 143 consenting students were recruited into the study. The students in the study were distributed voluntarily into 2 groups regardless of age, sex, or academic performance. Group 1 (n=92) was assigned to receive online FAs and immediate online feedback throughout the module using the Speedwell system. However, Group 2 (n=51) was assigned to receive onsite FAs and face-to-face feedback throughout the module in the examination hall in the college. The quantitative part of the study involved analyzing student scores of summative assessments in 2 groups exposed to online and onsite FA and feedback. The qualitative part aimed to explore students’ perceptions of FA and feedback. The passing rate in summative examinations (quiz, midmodule, and final) was higher in the onsite group (61.2%, 51%, and 62.7%, respectively) compared with the online group (53.3%, 48.3%, and 45.7%, respectively). However, the difference was statistically significant only in the quiz examination. Four key themes were identified from the qualitative analyses regarding participants’ different experiences of FA and feedback: the accessibility of the examination format facilitates flexibility in learning; FA is a means of recognizing learning opportunities; FAs help shift student attitudes toward learning; and the last theme is opportunities for discussion and personalized feedback. This research sheds light on the intricate interplay between assessment modalities and student learning outcomes by demonstrating that onsite FA followed by onsite feedback is more effective than online FA and feedback in fostering student engagement and promoting deep understanding and improving students’ performance in summative examinations. Thereafter, this study contributes to the ongoing discourse surrounding effective assessment practices in contemporary educational settings.

6. Global Sentiment Toward Health AI at the Dawn of the ChatGPT Era: Empirical Analysis of Twitter (X) Discourse.

期刊: Journal of medical Internet research 发表日期: 2026-May-05 链接: PubMed

摘要

Artificial intelligence (AI) is increasingly proposed for use in health and health care systems. Beyond technical performance, public perceptions and affective responses influence whether AI technologies are accepted and adopted in real-world contexts. Social media platforms such as X (formerly Twitter) provide large-scale, real-time insight into public discourse surrounding emerging technologies, yet remain underused for examining how health AI is discussed, evaluated, and emotionally framed. This study aimed to develop and apply large language model (LLM)-based methods for exploratory social listening on health AI. This is the first study to map large-scale sentiment, emotional expressions, and confidence-related signals in online discussions of applications of AI to health. We collected 786,750 English-language posts from X (Twitter) published between January 1 and December 5, 2023, using health- and AI-related keywords. We benchmarked an LLM-based annotation framework by using OpenAI’s GPT-3.5-Turbo and GPT-4, comparing model classifications with trained human researchers. Annotations included overall sentiment and 6 evaluative domains frequently referenced in the literature surrounding attitudes toward health AI-usefulness, safety, privacy, ethics, quality, and trust. After cleaning, GPT-3.5-Turbo used the best-performing prompts to label 388,009 posts. A subset (n=268,347) was further analyzed using Emollama-7b, an open-source model fine-tuned from Meta’s LLaMA2-7B, for emotion detection, and latent Dirichlet allocation for thematic analysis. Comparisons were made across World Health Organization regions. Compared against human annotations, optimized prompts achieved weighted F1-scores above 0.60 across evaluative domains and sentiment classification. Global discourse about health AI was 65.26% (95% CI 65.11%-65.4%) positive and 83.62% (95% CI 83.48%-83.76%) emotionally optimistic, although substantial regional variation was observed in sentiment (P<.001). The Eastern Mediterranean and South-East Asia regions expressed significantly higher levels of positive sentiment and evaluative agreement in the studied features of health AI, alongside frequent discussion of the tech industry and commercial development. In comparison, the Western Pacific region expressed lower confidence and significantly more mentions of research topics (19.27%, 95% CI 18.5%-20.07%). Privacy was the most prominent global concern, with 33.31% (95% CI 32.98%-33.66%) of privacy-related posts expressing perceived risks. In the Region of the Americas, 18.19% (95% CI 17.92%-18.44%) of posts discussed algorithms and data governance, significantly higher than overall. This study offers the first systematic characterization of online health AI discourse at scale, mapping stances toward key features of AI, emotional tone, and discussion topics across regions. LLM-powered social listening is demonstrated as a feasible approach for identifying dominant narratives and regionally distinct concerns, capable of surfacing opinions absent from traditional media. This can extend to studying discourse on other evolving health technologies where public surveying is limited. While methodological refinement and multilingual expansion are needed, this framework can inform timely policy development, risk communication, and responsible health AI governance.

7. Emissions Reductions at Coal Power Plants Continue to Offer Routes to Meet New US PM2.5 Standards.

期刊: Environmental science & technology 发表日期: 2026-May-05 链接: PubMed

摘要

The 2024 revision of the National Ambient Air Quality Standard for particulate matter less than 2.5 μm diameter (PM2.5) to 9 μg/m3 by the US Environmental Protection Agency (EPA) has motivated an assessment of whether reducing Electric Generating Units (EGU) emissions is a potential strategy for bringing nonattainment counties into compliance. We assessed coal power plants’ contributions to PM2.5 using a chemical transport model. We identified the contribution of specific coal EGUs to PM2.5 concentrations using a reduced complexity air quality model and demonstrated health benefits of emissions reductions at facilities that would need to shutter to attain the new standard. In 2023, 9 nonattainment counties could have met the standard by eliminating SO2 emissions at 94 facilities (9% of US EGU capacity). Retiring these EGUs would avoid stack emissions of 500,000 tons of SO2, 304,000 tons of NOx, and 485 million tons of CO2, along with approximately 1,170 premature deaths per year (95% confidence interval: 1,060-1,280) among elderly people. Reducing coal power plant emissions continues to provide an avenue to meet U.S. air quality standards and improve public health.

8. Epidemiological Distribution Characteristics of Tuberculosis Among Older Adults in Chongqing (2020-2024): Spatial-Temporal Analysis.

期刊: JMIR public health and surveillance 发表日期: 2026-May-05 链接: PubMed

摘要

With global aging, the burden of tuberculosis (TB) among older adults escalates, yet spatial studies on this group are scarce. In Chongqing, where 18.87% of the population are aged 65 years and older and TB burden is high, controlling older adult TB remains a major challenge. This study analyzed the spatiotemporal patterns of TB among adults aged 65 years and older in Chongqing, China, to inform local prevention and control strategies. The study data were obtained from the Tuberculosis Information Management System of China. Global and local spatial autocorrelation analyses were conducted using ArcGIS (version 10.7) to identify high-risk spatial clusters and visualize their distribution. Spatiotemporal scan statistics were performed using SaTScan (version 10.3.2) to detect clusters of TB cases among the older adult population. Statistical significance was set at P<.05. The average annual incidence of TB among older adults in Chongqing was 69.59 per 100,000 population, with peaks occurring in spring and summer. The global Moran I ranged from 0.618 to 0.756 (P<.001 in all cases), indicating significant clustering. Persistent high-risk areas were identified in the northeastern and southeastern parts of Chongqing. Spatiotemporal scan statistics detected 1 most likely cluster (relative risk=3.52, 95% CI 3.37-3.68; log-likelihood ratio=1017.43; P<.001) and 3 secondary clusters. Significant seasonal patterns of TB among older adults were observed in Chongqing. High-risk areas were predominantly concentrated in the northeastern and southeastern parts of the municipality. More targeted public health interventions are imperative.

9. Anxiety and Depression Associated With the Dependent Use of Generative AI in Medical Students: Cross-Sectional Study.

期刊: JMIR formative research 发表日期: 2026-May-05 链接: PubMed

摘要

The growing integration of artificial intelligence (AI) in higher education has transformed learning processes but also raised concerns about potential mental health risks. Medical students represent a particularly vulnerable group due to high academic stress and increasing reliance on generative AI tools for study and decision-making tasks. Despite this, the relationship between AI dependence and psychological distress remains underexplored in Latin American contexts. This study aimed to evaluate the association between generative AI dependence and levels of stress, anxiety, and depression among medical students. A cross-sectional study was conducted with 187 human medicine students from a Peruvian university during the first academic semester of 2025. The Dependence on Artificial Intelligence Scale and the Depression, Anxiety, and Stress Scale-21 were applied. Negative binomial regression models, both crude and adjusted for sex, age, income, and year of study, were used to assess associations, reporting rate ratios (RRs) and 95% CIs. Participants had a median age of 22 (IQR 19-24) years, and 58.8% (110/187) were female. The median Dependence on Artificial Intelligence Scale score was 10 (IQR 7-14). Generative AI dependence showed significant correlations with anxiety (ρ=0.336, 95% CI 0.22-0.44) and depression (ρ=0.316, 95% CI 0.20-0.43) and a smaller correlation with stress (ρ=0.277, 95% CI 0.16-0.39). In the adjusted regression models, each 1-point increase in generative AI dependence was associated with a 5% higher expected anxiety score (RR 1.05, 95% CI 1.01-1.09; P=.01) and a 4% higher depression score (RR 1.04, 95% CI 1.01-1.08; P=.03), whereas the association with stress was positive but nonsignificant (RR 1.03, 95% CI 1.00-1.07; P=.08). Fifth-year students had significantly greater anxiety levels than their sixth-year peers (RR 1.82, 95% CI 1.09-3.01; P=.02). No significant effects were observed for sex, age, or income. This study empirically examined generative AI dependence as a distinct behavioral construct and its association with mental health symptoms in medical students. Unlike prior research, this study evaluated psychological dependence on generative AI and modeled its relationship with anxiety and depression using appropriate count-based regression techniques. By providing early evidence from a Latin American context, it contributes to the emerging field of digital mental health and medical education research. These findings underscore the need for universities to promote balanced and responsible AI use, integrate digital literacy with mental health support strategies, and develop preventive policies that mitigate potential maladaptive reliance on generative AI tools.

10. Giving and Receiving: A Study of Volunteering and Cardiometabolic Health Among Nonsmokers.

期刊: Journal of public health management and practice : JPHMP 发表日期: 2026-May-05 链接: PubMed

摘要

Poor cardiometabolic health contributes to the leading causes of death, including heart disease, stroke, and diabetes. This study examined the relationship between volunteering and cardiometabolic health among nonsmoking adults through an analysis of the Chicago Department of Public Health’s 2023 Healthy Chicago Survey (N = 4872). Cardiometabolic health was assessed through a 3-item summary score related to receiving a diagnosis of high blood pressure, high cholesterol, and diabetes. The analysis consisted of a Poisson regression and mediation models that incorporated demographic predictors and assessed mediation of physical activity, vegetable consumption, and belonging (feeling part of the neighborhood), 1 mediator at a time. Results show a significant relationship between volunteering in the past 12 months and cardiometabolic health and evidence that physical activity and belonging mediated this relationship. Urban health departments can promote cardiometabolic health as well as individual-level physical activity and a sense of belonging through assuring opportunities for volunteering.

11. Early Detection Intervals for Evaluating Event-Based Surveillance System: Reference Dataset Development Study.

期刊: JMIR public health and surveillance 发表日期: 2026-May-05 链接: PubMed

摘要

Early detection of health threats is an objective of public health surveillance, and event-based surveillance (EBS) using unstructured information from diverse sources has played an increasingly important role in achieving this objective. However, the evaluation of EBS systems has been hindered by the lack of reference data on outbreak onsets. We introduce the concept of an “early detection interval” and create a dataset of these intervals across multiple countries for the epidemic caused by the Omicron variant of SARS-CoV-2. We defined the early detection interval as the time between the date of introduction of an infectious agent to a country and the date at which an increase is detectable in traditional public health surveillance data. To determine the date of the introduction of the Omicron variant, we analyzed phylogenetic studies and genome databases. We estimated the end of the interval by applying Bayesian online change point detection to reported COVID-19 case counts. In addition to the early detection intervals, this dataset also contains variables indicating data quality. To further understand the variation in the lengths of the early detection intervals, stratified analysis and univariate Cox proportional hazards were implemented. This dataset contains early detection intervals for the Omicron variant in 117 countries. The intervals have a median length of 28 (IQR 18-44) days, with a median beginning date of November 27, 2021 (IQR November 17, 2021, to December 12, 2021), and a median ending date of January 2, 2022 (IQR December 19, 2021, to January 9, 2022). Countries with high sequencing availability tend to have earlier start dates with a maximum difference across data sources of only 15 (IQR 7-39) days and consequently a prolonged interval length with a median length of 29 (20-47) days. Countries with low incomes were underrepresented in this dataset, with only 12 (29.27%) out of 41 included, and they tended to have shorter intervals with a median duration of 16 (IQR 12-23) days. The univariate Cox proportional hazards ratio regression analysis confirmed prolonged interval length in countries with high sequencing availability (hazard ratio 0.59, 95% CI 0.38-0.92) and shortened interval length in low-income countries (hazard ratio 2.37, 95% CI 1.29-4.36). The dataset of early detection intervals created in this study can serve as reference data and facilitate the evaluation of the timeliness of alerts generated by EBS systems. Systematic and comprehensive evaluation of EBS is important to guide the development of EBS and motivate the integration of EBS into public health practice. Our study also highlights cross-country disparities in data quality, particularly for genomic evidence, and the need for data collection and sharing focused on low-resource settings.

12. A Method for Collaborative Storytelling: Supporting Public Health Transformation Through Practitioner-Driven Narrative.

期刊: Journal of public health management and practice : JPHMP 发表日期: 2026-May-05 链接: PubMed

摘要

We developed a collaborative storytelling model through the Kansas Health Institute’s Transforming Public Health for the 21st Century blog to surface, refine, and disseminate practitioner-driven narratives. Grounded in constructivist and interpretive qualitative traditions and informed by duoethnography, the model positions practitioners as cocreators rather than subjects. To ensure rigor and transparency, the approach is explicitly aligned with Tracy’s Big Tent Criteria for Excellent Qualitative Research, translating these principles into practical guidance for story selection, co-construction, analysis, and presentation. The model follows a structured yet flexible, step-by-step process that includes practitioner engagement, topic identification, semistructured interviews, iterative qualitative analysis, follow-up interviews, and narrative development. Tracy’s criteria, such as worthy topic, rich rigor, sincerity, credibility, resonance, and meaningful coherence, guide each stage of implementation. Final narratives are disseminated through a public-facing blog and national platforms, extending reach and relevance for practitioners and policy audiences. Model feasibility, acceptability, and analytic value are demonstrated through illustrative applications addressing multicounty governance, accreditation in small health departments, and organizational culture change. These examples show how the collaborative storytelling model supports analytic depth, practitioner authenticity, and field relevance across diverse public health contexts. Collaborative storytelling offers a practical strategy for public health transformation by fostering perspective change, practitioner thought leadership, and organizational learning. By embedding established qualitative quality criteria into an accessible, cocreative process, the model provides actionable guidance for leadership development, qualitative training, community health assessment, and capacity building in public health practice.

13. Developing a patient reported measure on out-of-pocket healthcare expenditure among Aboriginal patients: a formative study.

期刊: Health promotion international 发表日期: 2026-May-05 链接: PubMed

摘要

Healthcare costs not subsidized by the government and are covered by patients, are known as out-of-pocket healthcare expenditure (OOPHE). In Australia, OOPHE disproportionately impacts Aboriginal households, particularly in rural and remote regions. Currently no patient reported measures (PRM) to assess OOPHE exist, despite being an identified priority in Aboriginal communities. This study developed and psychometrically evaluated (validity and test-retest reliability) of an OOPHE PRM for Aboriginal households in outer regional to remote areas. This Aboriginal led study was governed by an Aboriginal Governance Group, which involved a 4-stage process: (i) identification of community-derived OOPHE themes; (ii) item development and expert judgment quantification; (iii) exploratory factor analysis (EFA) to determine factor structure through pilot testing with Aboriginal participants; and (iv) assessment of reliability and stability through test-retest methods. Stage 1 identified OOPHE themes (i.e. barriers, financial strain), informing development of a 15 item PRM in Stage 2. In Stage 3, 39 Aboriginal participants completed Test 1, with EFA revealing a two-factor model; Factor 1 (8 items, internal consistency = 0.91) and Factor 2 (6 items, internal consistency = 0.85). In Stage 4, 32 participants completed Test 2, with over 60% of items showing substantial to perfect agreement (κ = 0.61-0.87) and scale-level reliability as good to excellent (ICC = 0.75-0.92). Two items performed poorly and were removed, resulting in a final 13-item PRM. The OOPHE PRM demonstrates promising psychometric properties as a culturally grounded measure of OOPHE burden among Aboriginal families, supporting advocacy for equitable policy, funding, and health system reform.

14. Understanding Public Perceptions of Lung Cancer in China: Infodemiology Study of Baidu Index and Weibo Posts.

期刊: Journal of medical Internet research 发表日期: 2026-May-05 链接: PubMed

摘要

In China, lung cancer remains a major public health concern and accounts for a substantial proportion of cancer-related deaths nationwide. However, limited research has examined public perceptions of lung cancer in the digital sphere, where health-related information is increasingly disseminated and accessed. This study aims to systematically examine patterns of public attention and perceptions toward lung cancer in China by integrating search engine query data and social media content, thereby enhancing current understanding of web-based health information dynamics related to lung cancer. Data were collected from Baidu Index (BI) (2011-2025) and Sina Weibo (2010-2025) to represent web-based search behavior and social media discourse on lung cancer, respectively. Spatiotemporal patterns of BI, per capita Baidu Index (PBI), and Weibo posts were examined to capture temporal trends and spatial variations. Additionally, the spatial autocorrelation of PBI was assessed using global and local Moran I statistics. PBI-related explanatory variables were assessed using a spatial panel Durbin model. Topic modeling and lexicon-based sentiment analysis were applied to Weibo content to uncover thematic evolution and emotional polarity across years, sex/organization groups, and user types. Public attention toward lung cancer, as reflected by BI, increased initially, peaked in 2019, and subsequently declined, whereas Weibo discussions demonstrated a fluctuating but generally upward trend before stabilizing after 2022. Similar temporal patterns were observed across most provinces. Significant spatial heterogeneity was identified, with higher BI levels concentrated in eastern coastal regions and persistently lower levels in western and southwestern provinces. Spatial autocorrelation analysis revealed stable positive clustering over time, with low-low clusters particularly concentrated in southwestern regions such as Guangxi, and no significant high-high clusters were detected. Panel spatial regression analyses indicated that the provincial PBI was positively associated with gross domestic product (GDP) per capita and average years of education per capita, but negatively associated with the urbanization rate. Moreover, significant spatial spillover effects were observed, suggesting that socioeconomic factors were associated not only with local public attention but also with that of neighboring regions. Topic modeling revealed a clear thematic evolution over time. Although personal experiences initially dominated web-based discourse, discussions progressively shifted toward health care service-related issues, which became the most prominent theme by 2025. Sentiment analysis indicated an overall positive emotional tone throughout the study period, with “Good” and “Disgust” representing the predominant positive and negative emotions, respectively. Emotional expression varied across demographic groups and user types, with noticeable differences in both intensity and temporal trends. This study offers a comprehensive overview of public attention and discourse on lung cancer in China’s digital landscape, providing valuable evidence to inform targeted health communication and policy interventions.

15. Improving the Health of Governance: Identifying and Addressing Burnout Among Public Health Association Board Members.

期刊: Journal of public health management and practice : JPHMP 发表日期: 2026-May-05 链接: PubMed

摘要

The COVID-19 pandemic caused stress and burnout for governmental public health workers, negatively affecting workers’ desire to remain in their professional role. In October 2022, a board for a national association assessed their professional development needs, identified manifestations of burnout, and generated strategies to address burnout. Of 21 board members invited, 16 (76%) responded. Quantitative items were summarized using descriptive analysis. Open-ended responses were summarized with thematic analysis. Board members identified balance between private and professional lives to optimize well-being as a competency growth area. They selected group discussion (56%) as their top learning method. Burnout manifested as frustration, fatigue, disengagement, poor decision making, feeling overwhelmed, and illness. Six categories described strategies to address burnout: positive self-talk, protecting time, modeling, creativity/fun, “get-out-there,” and resources/support. To address burnout and support public health workers, associations can prioritize the development and well-being of board members who might not otherwise prioritize their development.

16. Identifying Priorities to Reverse a Statewide Relative Health Decline: Results From a Delphi Study in Kansas.

期刊: Journal of public health management and practice : JPHMP 发表日期: 2026-May-05 链接: PubMed

摘要

To identify and prioritize system-level factors contributing to Kansas’ long-term population health decline compared with the United States and demonstrate the application and value of the modified Delphi technique for complex, state-level health assessment. A modified Delphi study was conducted in Kansas to engage experts and leaders in Kansas’ health across sectors. Participants (n = 50 Round 1; n = 67 Round 2; n = 60 Round 3) provided qualitative input and completed quantitative prioritization across 3 Delphi rounds. Issue statements were developed from open-ended responses (Round 1), rated for importance (Round 2), and prioritized through a constant sum resource allocation exercise (Round 3). Participants identified 52 factors contributing to Kansas’ health decline. Of these, 4 emerged as the highest priorities: closure of rural hospitals and health care services, failure to expand Medicaid, limited mental health service availability, and low public health funding. Seven additional factors were identified as high priorities. The highest-ranked issues reflected system-level drivers rather than individual behaviors. Kansas’ declining health trajectory is primarily driven by structural system vulnerabilities, including policies and infrastructure gaps misaligned with what produces health. Addressing Kansas’ health decline will require targeted policy reforms that strengthen system capacity and align with evidence-based approaches used by higher-performing states.

17. 340B Drug Pricing Program: An Updated ASCO Policy Statement.

期刊: JCO oncology practice 发表日期: 2026-May-05 链接: PubMed

摘要

18. Characterizing Relationships Between Daily Pain, Opioid Use, and Mood in Patients With Advanced Cancer Using Ecological Momentary Assessments.

期刊: JCO oncology practice 发表日期: 2026-May-05 链接: PubMed

摘要

In advanced cancer, pain symptoms, opioid use, and cognitive-emotional processes fluctuate day to day and may mutually reinforce one another. We used 28-day ecological momentary assessments (EMAs) to quantify within-person associations between daily pain and (a) interference, (b) opioid use and perceived efficacy, and (c) mood, and to test whether variability in pain catastrophizing moderates these associations. Patients with advanced cancer receiving outpatient oncology care at a comprehensive cancer center completed once-daily EMAs for 28 days (N = 26 analyzed). Measures included worst/average/least pain, pain interference, short-acting opioid tablets (count) and perceived opioid efficacy, negative and positive affect, and daily catastrophizing. Multilevel models estimated same-day within-person associations, controlling for study day and between-person mean pain. Individuals’ standard deviation of daily catastrophizing changes (catastrophizing variability) was tested as a moderator. Across 477 daily assessments (median 21/28 per participant), higher-than-usual worst pain was consistently associated with worse pain interference, higher short-acting opioid use, lower perceived opioid efficacy, and higher negative affect (all P < .01); Average and least pain showed smaller or nonsignificant effects. Greater day-to-day variability in catastrophizing was associated with worse pain. Among individuals whose pain catastrophizing fluctuated more, there was a stronger relationship between pain severity and interference, affect, and perceived opioid efficacy (inverse; P ≤ .01). Greater day-to-day fluctuations in pain catastrophizing were associated with magnified correspondence of pain severity with interference, mood disruption, and perceived opioid inefficacy. Routine monitoring of pain severity combined with tracking catastrophizing variability may help identify high-risk days and inform in-the-moment support to better personalize pain management.

19. Integrating Community and Digital Support Through Social Prescribing to Improve Mental Health in Rural Older Adults in South Korea: Quasi-Experimental Study.

期刊: JMIR aging 发表日期: 2026-May-05 链接: PubMed

摘要

Mental health issues such as depression, loneliness, and cognitive decline are prevalent among older adults. They are particularly pronounced in rural areas due to socioeconomic disadvantages, limited health literacy, and social isolation. These challenges have been exacerbated by the COVID-19 pandemic, highlighting the urgent need for accessible, community-based mental health strategies. Social prescribing-linking individuals to nonmedical community resources-offers a promising model, especially when coupled with culturally relevant and digitally facilitated interventions. This study aimed to evaluate the effectiveness of a pilot social prescribing project for individuals aged 65 years and older residing in rural South Korea. Specifically, it examined the changes in social support, loneliness, depression, cognitive function, and life satisfaction among the older adults before and after the intervention and the relationships among these factors. A quasi-experimental, nonequivalent control group pretest-posttest design was conducted with 294 participants from Wonju City, Gangwon-do (n=148 in the experimental group, n=146 in the control group). The 8-week intervention featured a community-based music storytelling program incorporating local cultural elements and digital education. Statistical analyses, including t tests, difference-in-differences analysis, and structural equation modeling, were conducted to evaluate changes in scores and the effectiveness of the program intervention. The study confirmed that the social prescribing pilot project effectively reduced depression and increased social support and life satisfaction compared with the control group (P<.05, 95% CI). While cognitive function showed slight improvement, the change was not statistically significant. Social support emerged as a key mediating factor, positively influencing cognitive function and life satisfaction, and was negatively associated with depression. There was no statistically significant direct effect found between loneliness and cognitive function or social support. This pilot study supports the feasibility and mental health benefits of integrating community and digital support through culturally embedded social prescribing for rural older adults. The findings highlight the importance of leveraging local resources and social networks to address mental health disparities in underserved aging populations, offering valuable insights for policymakers and practitioners developing inclusive aging and health promotion strategies.

20. Cognitive behavioral therapy for menopausal insomnia in perimenopausal and postmenopausal women with insomnia and nocturnal hot flashes: a randomized-controlled pilot trial.

期刊: Menopause (New York, N.Y.) 发表日期: 2026-May-05 链接: PubMed

摘要

The objective of this randomized-controlled pilot trial was to develop and test a cognitive behavioral therapy intervention for both insomnia and vasomotor symptoms (VMS) in perimenopausal and postmenopausal women with insomnia disorder experiencing nocturnal vasomotor symptoms. Forty-three participants (mean age = 53.6 y) self-described as perimenopausal or postmenopausal who reported at minimum ≥ 1 nocturnal hot flash/night and met diagnostic criteria for insomnia disorder were randomized to cognitive behavioral therapy for menopausal insomnia (CBT-MI) or menopause education control (MEC). The CBT-I intervention was adapted for the study population by incorporating elements of CBT for menopausal symptoms. Primary outcomes measured at baseline, post-treatment measures, 1-month follow-up, and 3-month follow-up included: Insomnia Severity Index (ISI), Sleep Self-Efficacy Scale (SES), and Hot Flash Daily Interference Scale (HFDIS). CBT-MI compared with MEC significantly reduced ISI (CBT-MI vs. MEC: -10.2±1.15 vs. -6.2±0.99; P=0.007), HFDIS (CBT-MI vs. MEC: -1.3±0.29 vs. -0.5±0.17; P=0.01), and increased SES (10.2±1.46 vs. 5.9±1.24, P=0.03) post-treatment and 1-month after the end of treatment (ISI: CBT-MI vs. MEC, -10.9±1.19 vs. -6.5±0.98; P=0.003, HFRDIS: CBT-MI vs. MEC, -1.1±0.28 vs. -0.4±0.18, P=0.047, SES: CBT-MI vs. MEC, 11.9±2.06 vs. 5.6±1.25; P=0.003). Analysis of the ISI factors showed that CBT-MI significantly decreased night-time sleep symptoms and patient perception of insomnia at post-treatment and 1-month follow-up compared with MEC. Night-time sleep symptoms remained improved at 3-month follow-up compared with MEC. In this pilot study, a CBT intervention targeting both insomnia and VMS showed promising improvements in sleep and hot flash interference in midlife women.

21. Toward a new paradigm of adolescent sexual and reproductive health: Reproductive justice, equity, and wellbeing.

期刊: Current opinion in pediatrics 发表日期: 2026-May-05 链接: PubMed

摘要

Despite longstanding consensus that “sexual and reproductive health” are defined as more than merely the absence of disease, clinical care and research in adolescent sexual and reproductive health are generally framed in negative terms, with a focus on disease and risk rather than wellbeing, satisfaction, or other desired outcomes. Emphases on risk and risk mitigation have led to the promotion of practices and policies that undermine adolescent autonomy and the principles of reproductive justice. Sexual and reproductive health care and research are evolving toward more holistic, asset-based frameworks. Clinical practice guidelines, particularly around contraceptive care, increasingly call for person-centered care. Sexual and reproductive wellbeing has been proposed as a positive outcome intended to assess fulfillment related to sexuality and reproduction. The sexual and reproductive health equity framework considers structural factors that influence health and wellbeing and calls for upending practices, policies, and systems that perpetuate injustice. Adolescent sexual and reproductive health care and research must evolve to incorporate principles of reproductive justice. The concepts of sexual and reproductive health equity and sexual and reproductive wellbeing can inform our understanding of what to change and how to measure success. Pediatric clinicians should consider the unique developmental needs of adolescents as they strive to incorporate principles of justice, wellbeing, and equity into clinical care and research.

22. Heparanase (HPSE) genetic variants as prognostic indicators in ovarian cancer: evidence from discovery and validation cohorts.

期刊: Molecular biology reports 发表日期: 2026-May-05 链接: PubMed

摘要

Heparanase uniquely cleaves heparan sulfate, the main component of the outer layer of endothelial cell plasma membranes, promoting tumour invasion and dissemination. However, it can also enhance tumour immune surveillance and clearance. heparanase’s versatility extends to pro-thrombotic properties, such as the promotion of tissue factor release. Interestingly, elevated heparanase levels have been found in ovarian cancer (OC), which has a notably high incidence of venous thrombosis. Previously, single-nucleotide polymorphisms (SNPs) of HPSE were shown to modulate mRNA and protein levels, possibly predicting disease outcomes. Given the potential role of heparanase in OC, the implications of three SNPs - rs11099592, rs4364254 and rs4693608 - were investigated in OC patients. In the discovery cohort, rs11099592 TT genotype and rs4364254 C allele carriers showed lower survival time than their counterparts (log-rank test, p = 0.025 and p = 0.001, respectively). Validation cohort analysis confirmed the worse prognosis associated with the rs11099592 T allele and the rs4364254 C allele in non-serous (log-rank test, p = 0.016) and platinum-resistant (log-rank test, p = 0.044) OC patients, respectively. The rs4364254 C allele was associated with reduced HPSE expression in peripheral blood components (χ2 test, p = 0.005), suggesting a protective role for HPSE in OC patients. HPSE rs11099592 and rs4364254 showed prognostic value, with T and C allele carriers, respectively, displaying worse clinical outcomes. These results indicate that heparanase could enable a tumour microenvironment shift towards a less aggressive cancer behaviour, facilitating leukocyte migration and anti-tumour responses. Further research should explore the dual mechanisms of this protein to improve OC management.

23. Sleep-anxiety symptom networks and subgroup characterization in nasopharyngeal carcinoma patients undergoing chemoradiotherapy: A latent profile and network analysis.

期刊: Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer 发表日期: 2026-May-05 链接: PubMed

摘要

Patients with nasopharyngeal carcinoma often face sleep and anxiety problems during chemoradiotherapy. These two issues interact with each other, forming a vicious cycle that seriously affects the patients’ quality of life and treatment outcomes. In order to address the neglect of group heterogeneity in traditional studies, this study employs latent profile analysis and network analysis methods to explore patient subgroups and reveal the association patterns between symptoms, thereby providing a basis for precise nursing interventions. From September 2023 to March 2025, a convenience sampling method was used to select 513 patients with nasopharyngeal carcinoma who were receiving initial treatment in the Radiotherapy Department of a Grade A tertiary hospital in Nanning, Guangxi. General information questionnaires, the Pittsburgh Sleep Quality Index (PSQI), and the Anxiety Subscale of the Hospital Anxiety and Depression Scale (HADS-A) were used to assess the patients’ sleep quality and anxiety. Latent Profile All assessments were conducted at the mid-stage of concurrent chemoradiotherapy (2-4 weeks after the initiation of treatment), and the specific treatment phase of each participant was recorded and summarized. Latent Profile Analysis (LPA) was applied to identify potential patient subgroups with different “sleep-anxiety” characteristics. For different subgroups, symptom networks of sleep and anxiety were constructed respectively, and the core symptoms were identified and compared. The sleep quality and anxiety symptoms of nasopharyngeal carcinoma patients undergoing chemoradiotherapy can be divided into 4 latent profiles: low distress group (43.86%), emotional distress dominant group (21.25%), sleep problem dominant group (23.59%), and high anxiety-sleep disorder group (11.31%). Network analysis shows that in the low distress group network, the association between HADS1 and PSQI2 was the strongest, and PSQI2, PSQI3, and PSQI4 had the highest centrality. In the network of the emotional distress dominant group, the association between PSQI3 and PSQI4 was the strongest, and HADS4 also had relatively high centrality. In the sleep problem dominated group network, the association between HADS1 and PSQI2 was the strongest among all subtypes, and PSQI2, HADS1, and PSQI3 were the core symptoms in this network. In the network of the high anxiety-sleep disorder group, the association between HADS3 and PSQI3 was the strongest, and PSQI3, HADS3, and HADS2 were the core symptoms with high centrality. There is group heterogeneity in sleep-anxiety symptoms among patients with nasopharyngeal carcinoma undergoing chemoradiotherapy, which can be divided into four subgroups with different core symptom characteristics. The identified symptom associations provide hypothesis-generating insights for clinical intervention, and targeted strategies for core symptoms in each subgroup may help optimize symptom management in this population.

24. Equitable Learning Outcomes Among Community Health Workers Following a Modified Smoking Cessation Training: A Pre-Post Intervention Study.

期刊: American journal of health promotion : AJHP 发表日期: 2026-May-05 链接: PubMed

摘要

PurposeTo examine whether sociodemographic or professional characteristics predicted learning gains among community health workers (CHWs) immediately after completing a modified World Health Organization (WHO) smoking cessation training.DesignSecondary analysis of pre-post educational intervention conducted between October 2022 and June 2025 in Chicago, Illinois and San Joaquin Valley, California.Sample149 CHWs employed or in training, recruited through community-based organizations, public health agencies, and CHW certification programs in Chicago and San Joaquin Valley.InterventionA three-hour culturally adapted WHO 5A’s/5R’s training emphasizing motivational interviewing, structural determinants of health, and community-centered cessation support.MeasuresPre-post self-administered surveys assessed tobacco-related knowledge (10-item test), motivation, readiness, and confidence (10-point scales). Independent variables included age, gender, race/ethnicity, education, prior tobacco training/coursework, and time in position.AnalysisPaired-sample t-tests evaluated pre-post differences; multivariable linear regressions examined predictors of change using STATA 19.ResultsSignificant improvements were observed in knowledge (ΔM = 3.02, P < .001), motivation (ΔM = 0.90, P < .001), readiness (ΔM = 2.16, P < .001), and confidence (ΔM = 2.09, P < .001). Regression models showed no consistent sociodemographic predictors of change. Younger age (P = .024) and postgraduate education (P = .033) predicted greater readiness gains.ConclusionThe training produced substantial, equitable improvements across learning domains, indicating that culturally adapted, practice-oriented curricula can enhance CHW competence regardless of background. Findings support inclusive, community-responsive training as a mechanism of workforce equity.

25. A Time and a Place for Everything: Are Pullup Bars in Airports the Best Option to Promote Fitness.

期刊: American journal of health promotion : AJHP 发表日期: 2026-May-05 链接: PubMed

摘要

Previous work highlights issues surrounding stigma related to participation in physical activity, defined as a personal characteristic that is “deeply discrediting”. Through the lens of stigmatization, let us assess a new Federal initiative - placing pullup bars in airports. On the surface, 1 may conclude this is a positive step for the promotion of population health through increased opportunities for physical activity. Below the surface, this initiative may create a situation for stigmatization and deter individuals from considering a more physically active lifestyle, as the few with power and able to do pullups discredit the many who are unable.

26. Associations of crash, penalty, and demographic factors with hazard perception among Iranian professional drivers.

期刊: Traffic injury prevention 发表日期: 2026-May-05 链接: PubMed

摘要

Hazard perception plays a pivotal role in preventing road accidents. Despite control measures in developing countries, crash and injury rates remain high, indicating limitations in current strategies. Framed within Endsley’s Situational Awareness Theory, this study examined associations between crash history, traffic penalties, and demographic factors (age and education) with hazard perception among Iranian professional drivers. This cross-sectional study included 220 Iranian professional car drivers (age range: 23-75 years; M = 48.3, SD = 10.4). Participants completed a demographic questionnaire and the standardized Hazard Perception Test (HPT) validated for the Iranian context. Data were analyzed using univariate tests and a General Linear Model (GLM). The mean hazard perception score was remarkably low at 35.60 ± 15.68 (out of 100), with an average error rate of 3.68 ± 1.91 missed hazards. Drivers with no crash history in the past three years scored 11.68 points higher on average than those with crash involvement (p < 0.001). Higher penalty frequency was associated with lower hazard perception scores (p < 0.001). In the GLM, crash history (β = 11.68, 95% CI: 8.14-15.21, p < 0.001) and penalty frequency (β = -3.62, p < 0.001) remained significant predictors, while age, education, gender, and driving experience showed no independent association (all p > 0.05). This performance level is substantially lower than scores typically reported in high-income countries with mandatory HPT in licensing (often >50-60% among experienced drivers). Crash and penalty history were strongly linked to poorer hazard perception, highlighting behavioral factors as key risk markers. The HPT effectively distinguished high- from low-risk drivers, supporting its use as a screening tool for targeted interventions in settings with limited systemic protections. These findings extend Situational Awareness theory to low- and middle-income contexts and emphasize the need for context-specific training.

27. Closing the Gap to Interventions for Tuberous Sclerosis Complex-Associated Neuropsychiatric Disorders (TAND): Protocol for a Longitudinal Study of TAND Severity, Predictors, and Caregiver Well-Being (TANDem-2).

期刊: JMIR research protocols 发表日期: 2026-May-05 链接: PubMed

摘要

Tuberous sclerosis complex (TSC) is a rare genetic disorder caused by pathogenic variants in the TSC1 or TSC2 genes. Apart from multisystem physical manifestations, most individuals with TSC experience TSC-associated neuropsychiatric disorders (TAND). Little is known about how TAND severity changes over time and what factors may predict these changes. Preliminary data suggest the presence of differential TAND severity trajectories. Caregiver well-being may act as a mediator of TAND severity, and a well-being intervention designed for caregivers of children with developmental disabilities may improve caregiver well-being. The study aims are to (1) examine longitudinal trajectories of TAND severity in a large sample of individuals with TSC and to examine potential predictors of differential trajectories, (2) evaluate the association between caregiver well-being characteristics, TAND severity, and severity trajectories, and (3) adapt and evaluate the feasibility, acceptability, and potential efficacy of a brief, online group-based well-being intervention for family caregivers. For the first 2 aims, 500 individuals with TSC or their caregivers will be recruited in an accelerated longitudinal design to document TAND severity at 5 time points over 12 months via a web-based app. At each time point, participants will complete demographic, TSC characteristics, intervention, and well-being questionnaires. Data will be analyzed using latent class mixed and multinomial regression modeling (aim 1) and structural equation and mediation modeling (aim 2). Participatory methods will be used to adapt an existing caregiver well-being intervention for the TSC community (aim 3). Thirty caregivers will be invited to participate in the adapted group-based online well-being intervention. This study was funded from July 2024 (HT94252410790 and HT94252410791), and ethics approvals were obtained from the University of Cape Town (July 2024), Vrije Universiteit Brussel (November 2024), and the Department of Defense Office of Human Research Oversight (December 2024). The TAND Toolkit app was adapted for longitudinal data collection (aims 1 and 2). Recruitment started in December 2025 and will continue until 500 participants are enrolled (anticipated December 2026). Primary outputs are expected by July 2028. For aim 3, experiential and adaptation workshops were completed in June 2025, the pilot intervention was delivered in November 2025, and data collection will continue till May 2026. Outputs are expected by December 2026. Identification of differential longitudinal TAND trajectories and their correlates will stimulate research in TSC and generate evidence for the self-report quantified TAND checklist as a clinical outcome measure. Understanding the association between caregiver well-being and TAND severity will provide support for targeted well-being interventions. A successful pilot trial will provide preliminary data for larger-scale clinical trials, with the potential to support caregivers and improve TAND outcomes. Together, the findings from the study will help close the gap in interventions for TAND. ClinicalTrials.gov NCT06879665; https://clinicaltrials.gov/study/NCT06879665. DERR1-10.2196/91726.

28. The Centers for Disease Control and Prevention's Public Health Infrastructure Grant: Early Evidence of How It Bolsters Health Departments' Efforts to Recruit, Hire, and Retain Our Nation's Public Health Workforce.

期刊: Journal of public health management and practice : JPHMP 发表日期: 2026-May-05 链接: PubMed

摘要

The Centers for Disease Control and Prevention’s (CDC’s) Public Health Infrastructure Grant (PHIG) is a recent, large investment aimed at strengthening the nation’s public health infrastructure and addressing workforce gaps. To assess how PHIG supports health departments in recruiting, hiring, and retaining their workforce during early implementation. We conducted thematic coding and descriptive analyses of data submitted to CDC from 107 recipients, representing state, territorial, local, and freely associated state health departments. Work plan and progress report data were coded to generate themes, and descriptive analyses of the themes were conducted to aggregate recipient level results. We also conducted a descriptive analysis of the grant’s hiring data. Purposive sampling was used to generate a sample of evaluation results from health departments. Recruitment, hiring, and retention of the public health workforce. All recipients (n = 107, 100%) reported plans to recruit and hire staff by developing and publicizing job descriptions (n = 73, 68%) and establishing external partnerships (n = 52, 49%). Most (n = 94, 88%) reported plans to use PHIG funds to retain staff. By 18 months, 6255 positions were filled; 57% were in indirectly funded local health departments, mainly clinical roles. Recipients showed early signs of progress toward implementing system-level improvements, such as streamlined hiring processes, standardized recruitment systems, revised job classifications, and updated pay scales. PHIG is addressing immediate staffing needs, particularly in rural and smaller local communities where direct clinical services may be most needed. The grant is enabling health departments to pursue system-level improvements to recruit, hire, and retain staff. PHIG’s flexibility is key to supporting a workforce that meets local communities’ needs, and strengthening the infrastructure to build workforce capacity, enhancing the ability of health departments to respond to future public health threats.

29. A Promising Opportunity to Address Food Insecurity and Promote Equity: The Crucial Role of Federally Qualified Health Centers.

期刊: Journal of public health management and practice : JPHMP 发表日期: 2026-May-05 链接: PubMed

摘要

To explore how Federally Qualified Health Centers (FQHCs) are addressing food insecurity by understanding their existing and needed services, policies, and community partnerships using a social determinants of health perspective to promote health equity. A mixed-methods, exploratory case study research design consisting of two phases was conducted in 2023. Phase I involved a survey of FQHC leaders in Ohio. From these data, eight FQHC cases were identified for Phase II qualitative interviews of staff and patients. Ohio Federally Qualified Health Centers. Executives, Frontline Staff and Patient Board Members of Federally Qualified Health Centers. Policies, services, and community partnerships used by FQHCs to address food insecurity; FQHC screening staff and tools; resources to support food security; facilitators and barriers; FQHC methods to address health equity. The majority of survey respondents (54%) stated that nutrition counseling was the most popular FQHC service provided, followed by the National Diabetes Prevention Program, and National Hypertension Control Initiative each at 24%. Policies related to federal food programs were listed by most respondents (N = 18) for addressing food insecurity, followed by food assistance programs including food pantries and food banks (N = 14). Farmers markets (40.54%) and local health departments (21.62%) were listed most frequently as community partners for FQHCs. Equity-related responses included screening all patients for food insecurity and having the screening tool available in multiple languages. FQHCs provide services to underserved and at-risk patients. The top three diet-related chronic diseases addressed by FQHCs were diabetes, hypertension, and obesity. The most common social determinants of health concerns were food insecurity and transportation. Federally Qualified Health Centers staff and patient board members indicated that there should be an increased focus on equity.

30. Toxicity from asparaginase during acute lymphoblastic leukemia induction: A report from the Children's Oncology Group.

期刊: Blood advances 发表日期: 2026-May-05 链接: PubMed

摘要

Asparaginase-associated toxicities (AAT) often compromise therapy for acute lymphoblastic leukemia (ALL), impacting relapse risk and survival. There are conflicting data on the contributions of older age, obesity by body mass index (BMI), and/or large body surface area (BSA) to AAT. We examined the association of these risk factors with AAT and the impact of AAT on disease response. Induction data were examined from 4,925 patients ages 1-30 years enrolled in the Children’s Oncology Group ALL trials AALL0232 and AALL0434, which included a single dose of pegaspargase (2,500 IU/m2) without a maximum dose. The associations of age, BMI, and BSA with hyperbilirubinemia, elevated alanine aminotransferase (ALT), thrombosis, and pancreatitis were evaluated. The impact of AAT on minimal residual disease (MRD) positivity (≥0.01%) at the end of induction (EOI) was assessed. Increased risk for developing at least one AAT was observed in patients ≥10 years (p=0.002) and in those with obesity and high BSA (p<0.0001), but not with high BSA alone. Risks for hyperbilirubinemia, ALT elevations, and thrombosis were all increased in patients with obesity and high BSA (Odds ratio [OR] 3.5 [95% confidence interval [CI] 2.2-5.7], OR 3.3 [95%CI 1.7-6.6], and OR 3.1 [95%CI 1.5-6.5], respectively). AATs were not associated with EOI MRD positivity. To our knowledge, we report the largest dataset of AAT in children, adolescents, and young adults. Preventive strategies are indicated for older patients and for those with obesity and high BSA but not with high BSA alone. NCT00075725, NCT00408005.

31. Did Financial Incentives Increase 5-11-year-olds' COVID-19 Vaccination? Synthetic Control Method.

期刊: Journal of public health management and practice : JPHMP 发表日期: 2026-May-05 链接: PubMed

摘要

During 2020-2021, many states offered financial incentives for COVID-19 vaccinations. Systematic review evidence suggests that this was often effective among adults. We aimed to investigate whether incentives increased vaccination rates among 5-11-year-olds. The synthetic control method was used. Minnesota’s “Kids Deserve a Shot” policy. Data were drawn from the Centers for Disease Control and Prevention and the US Census Bureau. Relevant placebo and robustness tests were conducted. The offer of financial incentives for pediatric COVID-19 vaccinations. The number of fully vaccinated 5-11-year-olds in Minnesota. The synthetic control was well-matched with true Minnesota during the preintervention period. There was no difference between true Minnesota and the synthetic Minnesota during the postintervention period, indicating that the incentive policy had no effect. The robustness checks and placebo tests were all consistent with this result. Policymakers attempted various interventions to promote vaccine uptake, including financial incentives. Although this analysis did not find any differences between true Minnesota and synthetic Minnesota during the postintervention period, further research into which factors determine incentive effectiveness will strengthen interventions and protect communities in future public health crises.

32. Segmentation of Older People's Needs and Readiness for Smart Homes by Residentially Based Lifestyles in Spain: Survey Study.

期刊: JMIR aging 发表日期: 2026-May-05 链接: PubMed

摘要

Globally, the older population is increasing rapidly, becoming one of the most significant demographic trends of the 21st century. This growth poses important social, health, and technological challenges for societies that must adapt their environments and services to promote independent and healthy aging. In Spain, the population aged 65 years and older reached 18% of the total population in 2020, and projections indicate that this proportion will continue to rise in the coming decades. Within this context, smart homes have emerged as one of the most promising avenues to support aging in place and improve the quality of life. Smart homes encompass a wide variety of functions, including environmental control, safety monitoring, communication, and other assistive technologies, that may help older people stay healthy, safe, and independent in their own homes. However, older people are not a homogeneous group. Their lifestyles, health conditions, and technological experiences differ substantially, which means that, as with any assistive technology, smart home functions must match the real and perceived needs of the target users to ensure acceptance, adoption, and long-term use. In this study, as a step forward toward the adaptability of smart home technology, we present a method to analyze the practical needs of smart home functions for older people. Specifically, we aim to understand the Spanish older population’s readiness and needs for smart homes and to provide insights that can guide the design of more adaptive and user-centered solutions. We conducted an online survey focusing on residentially based lifestyles, health conditions, and preferences for smart home functions, targeting older adults living in Spain. The survey collected information about participants’ demographic profiles, daily activities, health self-assessment, and attitudes toward technology. A total of 102 valid responses were analyzed. We then classified the older adults according to their residentially based lifestyles using clustering techniques and analyzed the preferences and needs for smart home functions in each identified group. Four clusters emerged based on the information provided by the participants: (1) high quality of life and independent life, (2) poor quality of life, (3) social-centered life, and (4) creative and personal-centered hobbies at home. On the basis of this classification, we explored each group’s specific needs for smart homes and estimated their readiness to embrace different aspects of technology. As a result, the top-priority smart home functions for each group were identified and compared. This research contributes to understanding the practical user needs of smart homes as assistive technologies for older people. It provides a methodological approach to anticipate and prioritize functions according to user characteristics, supporting the development of personalized, adaptive, and more acceptable smart home solutions for aging populations.

33. Outdoor Secondhand Smoke Exposure Around a Public Smoking Area: Formative Field Study Using Passive Wi-Fi Packet Sensing.

期刊: JMIR formative research 发表日期: 2026-May-05 链接: PubMed

摘要

Outdoor secondhand smoke (SHS) remains a public health concern, particularly around designated outdoor smoking areas where nonsmokers may pass through or remain nearby. Although prior studies have quantified outdoor SHS concentrations, fewer have examined how many people may be present within a plausible exposure setting. Estimating the exposure-opportunity level requires methods that are feasible, scalable, and minimally intrusive. This study aimed to evaluate the feasibility of using passive Wi-Fi packet sensing, calibrated with brief on-site observation, to estimate the number of smokers and passersby within a plausible SHS exposure range at a public outdoor smoking area in Japan. We conducted a formative field study at a designated outdoor smoking area at the Asia Pacific Trade Center in Osaka, Japan. A passive Wi-Fi packet sensor collected timestamps, anonymized device identifiers, organizationally unique identifiers, and received signal strength indicator (RSSI) values from October 13 to 29, 2023. The main analysis focused on October 28, 2023, a high-footfall event day selected for direct calibration. Episodes were classified using empirically derived RSSI thresholds, and class-specific calibration ratios were applied to estimate day-level counts. Of 128,313 anonymized detections recorded on October 28, 90.3% (115,950/128,313) occurred during business hours. Among these, 8.6% (n=11,068) identifiers were detected more than once. Dwell time could be calculated for 1.4% (n=1817) of the identifiers, and 0.5% (n=659) eligible presence episodes remained after preprocessing. During a 30-minute validation window, smokers and passersby were counted manually within a 25-m radius. During the validation window, 6230 signal records formed 104 stays, with a mean stay duration of 9.89 (SD 7.89) minutes. During the validation window, direct observation recorded 14 smokers and 207 passersby within the 25-m radius. Applying the rule-based classification and calibration ratios to business hours data yielded estimated day totals of 262 smokers and 3907 passersby within the plausible SHS exposure range. Estimated smoker counts showed 2 peaks, around noon and 4 PM, whereas passerby volume peaked around midday. In an exploratory analysis, a random forest model using stay duration, mean RSSI, and RSSI variability achieved an accuracy of 0.95, sensitivity of 0.75, specificity of 0.97, and area under the receiver operating characteristic curve of 0.99. This formative field study suggests that passive Wi-Fi packet sensing, combined with brief on-site observation, can be used to estimate population-level exposure opportunity around an outdoor smoking area. The method identified substantial numbers of potentially exposed passersby in a high-footfall public setting. Although the findings are site specific and preliminary, they indicate that exposure-count metrics may complement concentration-based and survey-based SHS research. Further studies incorporating repeated validation, direct pollutant monitoring, and multiple sites are needed to refine the method and strengthen its usefulness for tobacco control and public health decision-making.

34. Molecular Evidence from FT-ICR MS and Bayesian Mixing Model Reveals Hillslope Soils as Dominant DOM Contributors during Rainfall.

期刊: Environmental science & technology 发表日期: 2026-May-05 链接: PubMed

摘要

Rainfall-driven migration of dissolved organic matter (DOM) from various sources regulates terrestrial carbon cycling and pollutant fate, yet its spatiotemporal source dynamics remains unresolved due to methodological limitations. Here, we conducted high-frequency runoff sampling across 15 rainfall events with potential DOM source samples including hillslope soil, riparian soil, groundwater, and rainwater. Fourier transform ion cyclotron resonance mass spectrometry (FT-ICR MS) was integrated with the Bayesian mixing model to quantify source-specific DOM contributions at high temporal resolution. Results showed significantly higher humic-like component proportions in soil and groundwater than in rainwater, whereas rainwater had the highest protein-like component. Furthermore, DOM aromaticity and unsaturated degree in runoff reached a maximum at peak discharge during rainfall, indicating the input of abundant terrestrial materials. The Bayesian mixing model revealed soils as the dominant source of runoff DOM (49.2% hillslope soil and 30.3% riparian soil), followed by groundwater (13.1%) and rainwater (7.5%). Specifically, the average contribution of hillslope soil to runoff DOM increased from 42.4% to 57.6% during rainfall events, and the highest average proportion of riparian soil (35.6%) was observed at the beginning of rainfall. Our finding that hillslope soil is a key contributor to runoff DOM during rainfall underscores the need to prioritize upland management in catchment strategies.

35. LIPID MAPS: Powering discovery in lipidomics.

期刊: Science signaling 发表日期: 2026-May-05 链接: PubMed

摘要

As lipidomics approaches its 25th anniversary, we explore how lipid research has matured over the years while highlighting emerging innovations that are expanding our ability to study these diverse, life-critical biomolecules. In particular, we showcase the community-driven, open-access databases, software, and educational resources made freely available through the ELIXIR Core Data Resource LIPID MAPS for the benefit of both established and new researchers.

36. Incognito Standardized Patients to Assess Physician Awareness and Capacity to Recognize Primary Syphilis Presentation in Chinese STI Clinics.

期刊: Sexually transmitted diseases 发表日期: 2026-May-05 链接: PubMed

摘要

Primary syphilis is frequently under-tested in clinical settings due to its protean presentation. China is experiencing a mass syphilis resurgence, but near elimination in the 1960s contributes to low medical community knowledge. This analysis assesses clinical performance of Chinese STI physicians using unannounced visits conducted by standardized “incognito” patients (SPs). Trained SPs presented standardized cases of classic post-primary syphilis to physicians who consented to receive visits but were not told when they would happen. SPs reported back key visit details including testing and physical exams performed by the physician. Logistic regression models identified predictors of performance metrics, adjusting for the HIV status and sexual orientation of the presented case. 123 visits were conducted with 41 physicians in 17 primary care centers. Syphilis testing was recommended in 84.5% of visits and in 31.7% of visits physicians performed at least 2 of 5 recommended clinical indicators. Physicians were less likely to offer syphilis testing to patients with HIV whether they presented as MSM (OR, 0.06; 95% CI, 0.01-0.57) or as straight men (OR, 013; 95% CI, 0.03-0.61). Those working >40 hours a week were less likely to offer testing (OR, 0.3; 95% CI, 0.09-1.01) and those older than the median age were less likely to perform a thorough exam (OR, 0.34; 95% CI, 0.14-0.83). Our analysis found that Chinese STI physicians frequently test patients for syphilis but are less likely to conduct thorough physical examinations. The under-testing of patients with HIV exposes missed opportunities to address the HIV/syphilis syndemic. Future trainings must emphasize the public health importance of dual screening and address physician concerns about occupational HIV exposure.

37. Teacher-student relationships and adult outcomes: Developmental cascades via childhood executive function and behavioral dysregulation.

期刊: Child development 发表日期: 2026-May-05 链接: PubMed

摘要

Longitudinal data were examined to test associations between teacher-student relationships and adult outcomes, as well as mechanisms underlying these associations. Results from the NICHD-SECCYD (N = 1,364; 52% male; 76% White; 13% Black; 6% Hispanic; 5% other; data collection took place in the United States beginning in 1991) revealed a complex set of findings. First, teacher-student conflict and closeness during early elementary school were associated with educational attainment, occupational prestige, arrest record, and risky behavior at age 26 (r = -.21-.17, ps < .01). Next, behavioral dysregulation during -middle elementary school, but not executive function, mediated associations between teacher-student conflict and age 26 -outcomes. Finally, behavioral dysregulation and end of high school functioning serially mediated associations between teacher-student conflict and adult outcomes. These findings showcase the relevance of teacher-student relationships for outcomes spanning two decades of development. Although previous research has shown the importance of early teacher–student relationships for children’s short-term development, the present study extends these associations to adulthood. Specifically, using data from the NICHD Study of Early Child Care and Youth Development (NICHD-SECCYD), we found that teacher–student closeness and conflict during early elementary school were related to children’s educational attainment, occupational prestige, arrest record, and risky behavior almost two decades later during adulthood. We also found that children’s behavioral dysregulation in middle elementary school and their academic and behavioral functioning at the end of high school linked teacher–student conflict to adult outcomes. These results shed light on the persistent association between teacher-student relationships and several important developmental outcomes across childhood, adolescence, and adulthood.

38. Cost-effectiveness of ongoing COVID-19 vaccination in the context of high population immunity: A structured review of international economic evidence.

期刊: Vaccine 发表日期: 2026-May-04 链接: PubMed

摘要

In the context of ongoing SARS-CoV-2 circulation and high population immunity, jurisdictions face decisions about which population groups should receive ongoing annual vaccination. Economic evaluations are increasingly central to these deliberations but the growing body of global cost-effectiveness evidence has not been synthesized. To summarize cost-effectiveness evidence for COVID-19 vaccination from 2023 onwards, organized by population groups of policy relevance. We conducted a structured literature search in December 2025 across MEDLINE, Embase, and EconLit, supplemented by grey literature searches of National Immunization Technical Advisory Group (NITAG) websites. From 644 screened references, 21 studies met inclusion criteria: economic evaluations of COVID-19 vaccination from 2023 onwards reporting cost-effectiveness of annual vaccination compared to no additional vaccination in quality-adjusted life years (QALYs) or disability-adjusted life years (DALYs). Results were synthesized by population group. Annual COVID-19 vaccination was economically favourable for older adults (≥60-65 years) across all 18 contributing studies spanning 12 countries and using diverse analytic approaches. For individuals with underlying conditions or comorbidities, results were more variable, with cost-effectiveness depending on age, specific conditions, and vaccine price. Vaccination of healthy working-age adults (3 of 4 studies) and children (2 of 3 studies) was generally unfavourable at standard cost-effectiveness thresholds. Limited evidence was identified for healthcare workers and no economic evaluations from 2023 onwards were identified for pregnancy. The evidence base was geographically concentrated in high-income countries, with approximately half of included studies reporting industry funding. Sequential US economic evaluations demonstrated progressive declines in cost-effectiveness as disease burden decreased over time. The economic evidence supports a risk-stratified approach to COVID-19 vaccination, with the strongest economic value observed for older adults and individuals with comorbidities. Cost-effectiveness is dynamic, sensitive to disease burden, vaccine price, and population characteristics, and should be reassessed regularly as epidemiological conditions evolve.

39. Can a DNA vaccine protect against Chagas disease? A systematic review of preclinical studies.

期刊: Vaccine 发表日期: 2026-May-04 链接: PubMed

摘要

Chagas disease, caused by Trypanosoma cruzi, remains a major neglected tropical disease with limited treatment options. DNA-based vaccination has been explored as a preventive strategy, but its overall efficacy and translational value remain uncertain. Despite encouraging preclinical findings, the evidence on DNA-based vaccines against T. cruzi remains heterogeneous and has not been systematically integrated across outcomes. A comprehensive review is therefore needed to contextualize the current knowledge and define the translational relevance of this platform. To systematically review preclinical in vivo evidence on the efficacy of DNA-based vaccination against T. cruzi, focusing on parasitological, immunological, histopathological, and cardiac outcomes. PubMed/MEDLINE, Scopus, Embase, and Web of Science were searched without date restrictions. Eligible studies were controlled in vivo experiments evaluating DNA vaccines against T. cruzi in animal models. Two reviewers performed study selection, data extraction, risk-of-bias (SYRCLE) and certainty of evidence (GRADE) assessment independently. Thirty preclinical studies were included. Murine models predominated, especially BALB/c, C57BL/6, and C3H/He mice, although canine studies added translational relevance. Naked plasmid DNA, Salmonella-delivered constructs, and adjuvanted DNA vaccines were the most common platforms. The principal antigens belonged to the trans-sialidase family and amastigote surface proteins. Overall, vaccination was associated with reduced parasitemia, improved survival in several murine models, Th1 immune responses characterized by increased IFN-γ, IgG2a, and CD8+ T-cell activation, as well as attenuation of inflammatory, histopathological, and cardiac damage. In canine models, vaccination also reduced parasite burden and myocardial inflammation, although protection remained incomplete. Confidence in the evidence was limited by substantial heterogeneity in animal background, antigen selection, parasite strain, inoculation route, dosing regimens, and follow-up duration. Frequent unclear risk of bias and incomplete reporting prevented meta-analysis and constrain causal inference. DNA-based vaccination against T. cruzi can induce Th1 immunity and reduce parasitological and tissue injury outcomes, but protection is often partial and rarely sterilizing.

40. System-level multi-omics uncover proteomic, peptidomic, and metabolic remodeling in Microcystin-LR exacerbated chronic kidney disease.

期刊: Ecotoxicology and environmental safety 发表日期: 2026-May-04 链接: PubMed

摘要

Chronic kidney disease (CKD) is increasingly linked to environmental toxins, including the cyanobacterial toxin microcystin-LR (MC-LR), particularly in populations with pre-existing renal injury. We have previously demonstrated that MC-LR promotes CKD, however the full underlying mechanism remains poorly understood. This study investigated how MC-LR exacerbates adenine-induced kidney disease in animal models using an integrative multi-omics approach. Male Sprague-Dawley rats were assigned to four groups: control, MC-LR, adenine, and adenine + MC-LR. Histopathology showed that MC-LR alone caused only mild, focal interstitial inflammation and fibrosis, whereas adenine alone induced granulomatous interstitial nephritis with tubular atrophy and acute tubular necrosis. The most severe lesions were in the co-exposure group, with widespread tubular injury, dense granulomatous inflammation, and extensive interstitial fibrosis. Proteomic analysis revealed distinct clustering and overexpression of Ctss, Wipf3, and Hmgcs2 in kidney tissue from the co-exposure group, together with enrichment of pathways related to DNA repair, p53 signaling, and integrin-HMGB1 complexes. Urinary metabolomics and peptidomics revealed metabolic and peptide signatures associated with CAMKK2 signaling, Farnesyl CoQ10, ferroptosis, and immune activation. Integrative multi-omics analysis demonstrated strong cross-omics correlations, highlighting coordinated oxidative stress, mitochondrial dysfunction, ferroptosis, altered mitophagy, and fibrotic remodeling as key mechanisms of MC-LR-enhanced nephrotoxicity. Together, these findings show that even sub-toxic, environmentally relevant MC-LR exposure can amplify kidney injury through tightly interconnected metabolic and inflammatory networks. This work provides mechanistic insight into cyanotoxin-associated kidney disease and supports the need for stricter monitoring and prevention strategies in regions affected by harmful algal blooms.

41. Parasitic interactions modulate the physiological responses of Gammarus fossarum to the herbicide metazachlor.

期刊: Ecotoxicology and environmental safety 发表日期: 2026-May-04 链接: PubMed

摘要

Parasites are ubiquitous in natural environments, yet their role in shaping host responses to chemical stressors remains largely underexplored in ecotoxicology. We investigated how natural infections by cystacanths of the acanthocephalan Polymorphus minutus and microsporidians modulate the toxicity of the chloroacetamide herbicide metazachlor (MTZ) in Gammarus fossarum during a high-exposure scenario. We exposed P. minutus- and/or microsporidia-infected and uninfected G. fossarum to 1 and 10 mg/L MTZ, assessing behavioral and physiological responses. We observed significantly higher mortality at 10 mg/L, with slightly lower values for P. minutus-infected individuals. Although locomotion was unaffected by MTZ or infection, both MTZ and parasites significantly influenced biochemical responses with significant interactions. We found distinct physiological response patterns associated with parasite infection and MTZ exposure. Two major infection-dependent response clusters were (i) coinfected (with P. minutus and microsporidians) and P. minutus-infected individuals, and (ii) uninfected and microsporidia-infected individuals, suggesting distinct physiological strategies for coping with parasites and MTZ. Coinfection and P. minutus appeared to elevate glutathione S-transferase (GST) and phenoloxidase (PO) activities compared to the other cluster at high MTZ and control, while catalase activity decreased. In contrast, microsporidia infection and the absence of parasites were associated with increased catalase activity at the highest MTZ treatment. Decreased GST activity across infection groups at high MTZ suggested reduced detoxification capacity, while MTZ induced depletion of glycogen and lipids indicated metabolic costs. The complex interactions observed between MTZ and parasites highlight the importance of considering multiple stressors when assessing the ecological impacts of environmental contaminants like MTZ.

42. Aortic aneurysm and dissection and its multidimensional impact on cognitive function: The pivotal role of PRDX6 in pathophysiological mechanisms.

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

摘要

This study aims to explore the relationship between aortic aneurysm and dissection (AAD) and cognitive impairment, with an emphasis on uncovering the potential biological mechanisms. Utilizing the UK Biobank database, a matched cohort study was performed to assess the association between AAD and the risk of Alzheimer’s disease. Cognitive function was evaluated in a β-aminopropionitrile (BAPN)-induced AAD mouse model through a series of behavioral assays. Drug-target Mendelian randomization analysis was conducted to identify candidate genes implicated in this association. Expression levels of PRDX6 were examined in brain tissues from Alzheimer’s disease patients using datasets from the Gene Expression Omnibus (GEO), as well as in aortic tissues and blood samples obtained from both AAD patients and AAD model mice. Correlative analyses between PRDX6 and pro-inflammatory cytokines (IL-1β and TNF-α) were performed in mouse hippocampal tissues of the mouse model. Additionally, in vitro experiments employing SH-SY5Y cells were carried out to investigate the functional role of PRDX6 in modulating synaptic protein expression and inflammatory responses. Competing risk regression analysis indicated that AAD is significantly associated with an increased incidence of cognitive impairment. Behavioral testing revealed that AAD model mice exhibited deficits in cognitive performance. Mendelian randomization prioritized PRDX6 was prioritized as a candidate gene of interest. Elevated PRDX6 expression was observed in brain tissues from Alzheimer’s disease patients. Both AAD patients and AAD model mice demonstrated markedly increased PRDX6 levels in aortic tissues and circulating blood; notably, PRDX6 expression was also upregulated in the hippocampus of AAD mice. In the hippocampus, PRDX6 expression positively correlated with levels of IL-1β and TNF-α expression in AAD mice. In SH-SY5Y cells, silencing of PRDX6 resulted in increased expression of synaptic proteins, reduced pro-inflammatory cytokine production, and decreased apoptosis, whereas overexpression of PRDX6 elicited inverse effects. The present findings establish a significant association between AAD and heightened risk of cognitive impairment. PRDX6 has been identified as a potential mediator in this relationship, and PRDX6-related neuroinflammation is proposed as a plausible mechanistic pathway linking AAD to cognitive dysfunction.

43. Seroprevalence of Neospora caninum in Camelids of the New and Old World: A Global Systematic Review and Meta-Analysis.

期刊: Veterinary medicine and science 发表日期: 2026-May 链接: PubMed

摘要

Neospora caninum (protozoa: Apicomplexa) is a major cause of economic losses in bovine production systems due to reproductive failure and abortion in cows. Although there is evidence of camelids being exposed to N. caninum, the importance of these animals in the parasite’s life cycle is unclear. Therefore, the present systematic review and meta-analysis was conducted for the first time to assess the seroprevalence of N. caninum in camels to improve understanding of the epidemiology of the disease and identify factors influencing its prevalence. Relevant scientific articles were retrieved from three databases (PubMed, Web of Science and Scopus) and the internet search engine Google Scholar without time limitations up to 1 August, 2025. Meta-analysis was performed using a random-effects model with 95% confidence intervals (CIs). Heterogeneity was assessed using Cochran’s Q and I2-statistic. Sources of heterogeneity were explored through subgroup and meta-regression analyses. A funnel plot, along with Begg’s and Egger’s tests, was used to detect publication bias. A total of 32 articles, including data on 12,749 camels, published between 1998 and 2025, met the final eligibility criteria. The pooled prevalence of N. caninum in camelids was 10% (95% CI: 7%-12%) with significant heterogeneity (I2 = 93.75%, p < 0.0001). The highest seroprevalence was detected in Old World camelids at 14% (95% CI: 10%-19%), indicating greater susceptibility to N. caninum exposure. Higher prevalence rates were observed in Europe (14%, 95% CI: 7%-26%) and Asia (12%, 95% CI: 8%-18%) than in Australia (2%, 95% CI: 0%-8%). No significant differences in N. caninum seroprevalence were found between age groups, genders, host species, or diagnostic methods. The funnel plot and Begg’s and Egger’s tests indicated no substantial publication bias (Egger’s test: p = 0.07). Despite the relatively low seroprevalence of N. caninum in camelids, the present results indicate a wide distribution of this parasite worldwide. Further research is warranted to investigate the role of camels in the life cycle of N. caninum.

44. Patulin Affects the Hydroxylation of Vitamin D by Downregulating 25-hydroxylase (CYP2R1) and 25-hydroxyvitamin D 1-alpha-hydroxylase (CYP27B1) Expression and Interfering Their Substrate Binding Sites.

期刊: Journal of biochemical and molecular toxicology 发表日期: 2026-May 链接: PubMed

摘要

Patulin (PAT) is a mycotoxin that grows on various fruits and grains, and its toxicity research mainly focuses on organ toxicity. However, the research on its impact on nutritional metabolism is still unclear. Vitamin D is an important nutrient and has been reported to have multiple physiological functions. Vitamin D deficiency has been reported to be associated with the risk of developing diseases such as fatal cancers, autoimmune disorders, cardiovascular disease, neurocognitive function impairment, and type 2 diabetes. However, vitamin D need to be converted into biologically active forms through two steps of hydroxylation in the liver or kidney by 25-hydroxylase (CYP2R1) and 25-hydroxyvitamin D 1-alpha-hydroxylase (CYP27B1). In this study, we found that PAT can cause liver and kidney injury, and affect the levels of activated vitamin D products 25(OH)D and 1,25(OH)2D. Specifically, we demonstrated that PAT affects the hydroxylation of vitamin D by downregulating 25-hydroxylase (CYP2R1) and 25-hydroxyvitamin D 1-alpha-hydroxylase (CYP27B1) expression and interfering their substrate binding sites. This study can provide a basis for a more comprehensive assessment of the impact of environmental pollution, food safety, and other issues on human health.

45. Immunization gaps and measles outbreaks in ASEAN (2015-2025): A systematic review and meta-analysis.

期刊: Journal of infection and public health 发表日期: 2026-Apr-29 链接: PubMed

摘要

Despite global elimination goals, measles remains a persistent regional health challenge in the Association of Southeast Asian Nations (ASEAN). This systematic review and meta-analysis characterized the distribution of cases and deaths during ASEAN measles outbreaks (2015-2025) and computed pooled proportions of cases stratified by age, vaccination history, migration status, and indigenous group membership. In this systematic review and meta-analysis (PROSPERO CRD420251149627), we searched Scopus, Medline, Embase, and Google Scholar through January 15, 2026, for studies on measles outbreaks in ASEAN (2015-2025) that stratified cases by age, vaccination history, or marginalized groups. A modified Joanna Briggs Institute/ROBINS-E tool was used to assess the risk of bias. Pooled proportions were calculated using random-effects generalized linear mixed models (GLMM). Heterogeneity and small-study effects were evaluated using I2 statistics and Luis Furuya-Kanamori (LFK) indices, respectively. Across 11 studies (15,679 cases), measles disproportionately affected children under five (n = 10,867). Vaccination history reporting was near-complete in children but negligible in adults (0·22%, 95% CI: 0·00-73·41%). Among cases with known history, 73·20% (95% CI: 59·37-83·61%) were unvaccinated. Age-ineligible infants (<9 months) comprised half the unvaccinated burden (49·98%, 95% CI: 24·85-75·13%). Among vaccinated cases, 74·84% (95% CI: 44·48-91·70%) were not fully vaccinated. Significant heterogeneity was observed throughout (I2 ≥ 89·0%). Risk of bias was generally low. Transmission was also documented among migrant and indigenous subpopulations. ASEAN measles outbreaks are driven by immunity gaps in unvaccinated children, partially vaccinated individuals, and age-ineligible infants. Achieving and sustaining regional measles elimination requires closing coverage gaps and addressing systemic drop-outs between doses. Future strategies must prioritize lifecycle immunity, including enforcement of the 2nd dose of measles containing vaccine (MCV2) and potential adult boosters, digitized vaccine registries, and cross-border collaboration.

46. Incidence, factors, and resultant management associated with small bowel diverticular perforation: A retrospective review.

期刊: American journal of surgery 发表日期: 2026-Apr-27 链接: PubMed

摘要

Small bowel diverticula are uncommon, often asymptomatic, and typically discovered incidentally. Small bowel diverticulitis with perforation is even more rare and potentially life-threatening. Given the paucity of literature and lack of management guidelines, a single-center retrospective study was conducted from 2015 to 2024 on patients diagnosed with small bowel diverticulitis. Of 32 patients with small bowel diverticulitis, 14 (44%) had perforation. Eight of these (57%) were managed operatively, including two initially treated non-operatively. All 32 patients received antibiotics with gram-negative and anaerobic coverage. Interestingly, about 34% of the patients in our sample were diagnosed in the year 2022 alone. Patients with perforated small bowel diverticulitis had a longer mean length of stay at 10.2 days in comparison to those without at 4.9 days (p = 0.056). All patients with small bowel diverticulitis without perforation did not need any surgical intervention and were managed nonoperatively (p = 0.0001). All patients who underwent surgery had abdominal pain and CT findings of contained perforation or extraluminal air/fluid. This is one of the largest single center studies in the US focusing on perforated small bowel diverticulitis. For patients without perforation, they were all managed non-operatively. The study highlights the rarity of the condition and offers insight into its presentation and management over nearly a decade.

47. Plasma metabolomic profiles associated with cardiovascular disease in type 2 diabetes from the Trans-Omics for Precision Medicine (TOPMed) program.

期刊: Atherosclerosis 发表日期: 2026-Apr-26 链接: PubMed

摘要

People with Type 2 diabetes (T2D) are twice as likely to develop cardiovascular disease (CVD), though not all excess risk has been fully elucidated. Plasma metabolomics profiles shared between these conditions may uncover molecular mechanisms linking T2D to CVD. We conducted a cross-sectional case-control analysis, comparing T2D individuals who had prevalent CVD to those without CVD at the time of metabolite measurement. Using untargeted liquid chromatography-mass spectrometry (LC-MS), we collected 522 metabolite abundances measured in 1374 participants with T2D (224 CVD cases) from the Trans-Omics for Precision Medicine (TOPMed) program. We used a mixed effects linear model to assess the association of CVD events with each metabolite abundance, adjusting for key covariates. Metabolites meeting a suggestive significance threshold were examined using metabolite set enrichment analysis and evaluated for replication in an independent cohort Atherosclerosis Risk in Communities (ARIC) (n = 1891; 214 CVD cases). We performed meta-analysis to combine both the discovery and replication associations, and assessed overall significance using an experiment-wide Bonferroni-corrected threshold. Metabolites meeting a suggestive threshold were enriched in metabolite sets linked to obesity and kidney disease. Meta-analysis identified eight metabolites reaching experiment-wide significance, confirming previously established associations of asymmetric dimethylarginine, phosphatidylcholines, and gluconic acid, while additionally identifying specific phosphatidylethanolamine species, N-acetyl-L-methionine, and allantoin associated with prevalent CVD among individuals with T2D. Our results established and replicated metabolite associations with prevalent CVD in people with T2D. These metabolites may help characterize metabolic alterations underlying cardiovascular complications that arise in T2D.

48. On the simultaneous inference of susceptibility distributions and intervention effects from epidemic curves.

期刊: Epidemics 发表日期: 2026-Apr-22 链接: PubMed

摘要

Susceptible-Exposed-Infectious-Recovered (SEIR) models with inter-individual variation in susceptibility or exposure to infection were proposed early in the COVID-19 pandemic as a potential element of the mathematical/statistical toolset available to policy development. In comparison with other models employed at the time, those designed to fully estimate the effects of such heterogeneity tended to predict small epidemic waves and hence require less containment to achieve the same outcomes. However, these models never made it to mainstream COVID-19 policy making due to lack of prior validation of their inference capabilities. Here we report the results of the first systematic investigation of this matter in idealized scenarios created with synthetic data. We simulate datasets using the model with strategically chosen parameter values, and then conduct maximum likelihood estimation to assess how well we can retrieve the assumed parameter values. Parameter uncertainties were found to markedly reduce when concurrently fitting multiple epidemics with shared parameters, suggesting a general methodological approach that can be further developed to tackle real-world questions.

49. The Aging World of Spinal Deformity Surgery: Epidemiological Trends Over A 12-Year Period.

期刊: Spine 发表日期: 2026-Apr-22 链接: PubMed

摘要

Retrospective cohort study. Assess epidemiological patterns in the rate and age distribution of surgically treated adult spinal deformity (ASD) over the last decade. Advances in patient selection, preoperative optimization, operative technique, and postoperative care have influenced trends in surgical management of ASD. However, nationwide epidemiological data of surgically treated ASD is lacking. Adults who underwent corrective ASD surgery between 2010-2022 were identified from a large insurance claims database. Age, sex, year, region, and insurance plan distribution were extracted. Yearly trends in case counts and mean age were assessed using linear regression. Incidence rate ratios were calculated to evaluate differences in case rates. Among 141,604 surgically treated ASD patients, incidence increased from 4.5 to 15.5cases per 100,000, an increase of 1.2cases per 100,000 every year over the study period (P<0.001). Mean age increased from 63.3 to 66.7years, an increase of 2.5years every 10 years over the study period (P<0.001). Incidence rates also increased with age, with a peak of 88.5cases per 100,000 in 65-69 year olds. Female incidence rate was 90.9cases per 100,000 and male incidence rate was 78.4cases per 100,000. Regionally, Midwest had the highest incidence rate, and Northeast had the lowest incidence rate. Most (63.8%) patients were covered by commercial insurance, but Medicare had higher incidence rates than commercial insurance (71.7 Medicare vs. 57.1 Commercial cases per 100,000). Medicare incidence rates increased from 1.5 to 4.6cases per 100,000 while Commercial insurance incidence rates increased from 2.9 to 9.8cases per 100,000 (P<0.001). Between 2010-2022, surgically treated ASD rates rose by nearly 250%, with the average age of the operative patients increasing by 3.4years. As surgical volume for ASD continues to grow, continued efforts to improve outcomes and payment models will be necessary for sustainability. IV.

50. Outpatient mastectomy: ERAS® and same-day discharge as a viable option in the elderly.

期刊: American journal of surgery 发表日期: 2026-Apr-21 链接: PubMed

摘要

Despite increases in same-day discharge after mastectomy, there are few studies assessing its implications in the elderly. Our institution initiated enhanced recovery after surgery (ERAS®) principles emphasizing outpatient mastectomy in 2017. This study assessed the effect of introducing outpatient mastectomy on outcomes in the elderly. A prospective database was retrospectively reviewed for patients ≥70 years old undergoing mastectomy with or without implant-based reconstruction from 2015 to 2023. Patients from 2015 to 2016 were pre-ERAS®, and 2017-2023 were post-ERAS®. Out of 139 patients, 85 were post-ERAS® and 54 were pre-ERAS®. Of the post-ERAS®, 65% were outpatient versus 17% of pre-ERAS® patients (p < 0.001). Complication rates were no different between groups (33% vs 33%, p = 0.88), even when separated by type of complication, including those requiring operative intervention (14% vs 13%, p = 0.85). Outpatient mastectomy can be implemented in the elderly without an increase in morbidity, making it safe and practical in this population.

51. Effects of China's Clean Heating Policy on respiratory symptoms and airway inflammation in adults: a quasi-experimental study in rural Beijing.

期刊: American journal of respiratory and critical care medicine 发表日期: 2026-Apr-21 链接: PubMed

摘要

Northern China’s Clean Heating Policy (CHP) aimed to reduce wintertime coal burning in rural homes by restricting coal use and providing subsidies for clean heating. The policy’s health impacts on respiratory outcomes have not been empirically evaluated. To estimate the impact of the CHP on respiratory symptoms and airway inflammation using a difference-in-differences design leveraging the policy’s staggered rollout across rural Beijing villages. We enrolled 1,003 adults aged ≥ 40 years from 50 rural villages reliant on coal heating at baseline (2018-19). Over four winters (2018-2022), 20 villages were enrolled into the CHP. During up to three winter waves of data collection, we measured respiratory symptoms by questionnaire and, in a subsample, measured fractional exhaled nitric oxide (FeNO). We estimated the policy’s effects using extended two-way fixed effects models, accounting for village-level clustering and potential time-varying confounders. Exposure to the CHP was associated with a 7.5 percentage point reduction (95% confidence interval (CI): -12.8, -2.3) in the prevalence of any respiratory symptom, primarily driven by reductions in reported difficulty breathing (-3.3 pp, 95% CI: -8.0, 1.3), shortness of breath (-3.5 pp, 95% CI: -9.3, 2.3), and cough (-2.8 pp, 95% CI: -7.3, 1.6). We observed no evidence of an effect of the CHP on FeNO (0.3 ppb, 95% CI: -2.2, 2.8). The CHP led to reductions in reported respiratory symptoms among Beijing adults. This study contributes to the limited empirical evidence that clean energy policies can yield health benefits.

52. Autumn European Testing Week 2021 in a Middle-income Country-Implications for Education of Females about Condom Use: A Cross-sectional Study.

期刊: Indian journal of public health 发表日期: 2026-Apr-18 链接: PubMed

摘要

Since 2002, Serbia has seen a rise in newly diagnosed HIV cases, especially among young adults. To examine condom use and interest in education about condoms among clients who came for voluntary and confidential counseling and testing (VCCT) for HIV during the autumn European testing week in Belgrade, Serbia. A cross-sectional study was conducted using anonymous questionnaires. VCCT for HIV was organized in 5 student dormitories in Belgrade, Serbia, in November 2021. Clients who presented for testing and counseling were invited to participate in this study. Descriptive statistics were used to present the study sample. The adjusted logistic regression model was used to test factors associated with having an interest in education about condom use. Slightly over one-half of sexually active study participants reported condom use at last sexual intercourse. Approximately 15% of participants expressed interest in education about condom use. The adjusted logistic regression model showed that being female was an independent predictor of having an interest in education about condom use. Being in a committed relationship, the perception that condom use reduces pleasure, and feeling that condom use causes discomfort during sexual intercourse were independent factors associated with less frequent condom use in the past year. Condom handling skills should be part of reproductive health education, particularly for young women.

53. Spirometry for Assessing Work Ability and Impairment: Navigating Scylla and Charybdis.

期刊: American journal of respiratory and critical care medicine 发表日期: 2026-Apr-09 链接: PubMed

摘要

54. Variation in mental health-related sickness absence duration: The role of occupational health professionals.

期刊: PloS one 发表日期: 2026 链接: PubMed

摘要

Mental health-related disorders are prevalent among the working population and account for a large proportion of sickness absence. Occupational health professionals (OHPs) play a key role in supporting employee recovery and reintegration, yet little is known about the extent to which individual OHPs affect return-to-work outcomes. Previous studies suggest that OHPs might influence absence duration, but comprehensive quantitative analyses examining variation between OHPs are lacking. In this study, we determine the variation in sickness absence duration attributable to OHPs in mental health-related cases. We analyze a large dataset of more than 30,000 sickness absence cases involving employees diagnosed with mental health-related disorders across multiple sectors. A cross-classified multilevel model was applied to estimate variance attributable to OHPs while controlling for other sources of variation. Our results show substantial variation in mental health-related sickness absence duration between OHPs ([Formula: see text]). This corresponds to marked differences in return-to-work outcomes: for high-performing OHPs, the median absence duration is 18 weeks or less, whereas for low-performing OHPs, the median duration is 28 weeks or more. Individual, organizational, and sectoral factors also contribute considerably to differences in sickness absence duration. Including OHP- and organization-level random effects reduced the estimated individual-level variance by about 50%, indicating that differences across providers and employers are relevant in reducing sickness absence duration. Based on this, we argue that OHPs and organizations should work in concert to reduce sickness absence durations. Future research should identify which specific OHP characteristics and practices are most helpful in accomplishing this.

55. The End of NIOSH's Hearing Loss Prevention Program: Setback or Opportunity?

期刊: Noise & health 发表日期: 链接: PubMed

摘要

The recent staff layoffs and defunding of the United States’ National Institute of Occupational Safety and Health’s Hearing Loss Prevention Program are perceived by many occupational hearing loss professionals and stakeholders as an unsettling setback. This Commentary explains how and why ending this federal governmental program’s research agenda-even if it is temporary-should not stop progress by the private sector toward secondary prevention of noise-induced hearing loss by leveraging the overabundance of under-utilized raw audiometric data already collected for compliance purposes. The resources needed to accomplish this objective include metrics and statistical methods that transform raw audiometric data into risk-based population analytics, optimization of program delivery, and selective prioritization of cost-effective technology and basic research. Integrating population-based audiometric database analysis into routine business practice will give employers the valuable business intelligence they need to continuously measure the actual effectiveness of and return on investment from their hearing conservation programs. Private sector stakeholders who stand the most to benefit-employers, insurers, and suppliers-can pragmatically implement this solution framework to more efficiently manage noise-related worker health risk for relatively little additional cost compared to what employers already pay to conduct audiometric testing and basic compliance reporting. Government agencies’ otherwise traditionally reactive enforcement role can concomitantly evolve into a proactive, risk-reducing resource that enhances their role in regulation and technical support.

56. Study on the Effectiveness of Combining Different Hearing Test Techniques in Aiding the Diagnosis of NIHL Using a Cross-sectional Survey.

期刊: Noise & health 发表日期: 链接: PubMed

摘要

Conventional audiometry (CA) has limitations in detecting early noise-induced hearing loss (NIHL). This study aims to assess the effectiveness of combining different hearing test techniques in aiding the diagnosis of NIHL by CA. This cross-sectional study enrolled 138 NIHL patients (diagnosed by CA) and 138 matched controls. The receiver operating characteristic (ROC) curve was used to assess the diagnostic performance of each supplementary diagnostic technique (e.g., extended high-frequency audiometry [EHF], distortion product otoacoustic emissions [DPOAE], the Dichotic Digits Test [DDT], or Bamford-Kowal-Bench Speech-in-Noise Test [BKB-SIN]). A parsimonious model was developed and validated. ROC curves were used to assess the improvement in CA’s diagnostic performance with the parsimonious model. The odds ratio (OR) for the parsimonious model was calculated among noise-exposed groups with normal CA. Significant differences were observed in four audiological measures (EHF, DPOAE, DDT, and BKB-SIN) between case and control groups ( P < 0.05). ROC analysis revealed distinct diagnostic performance among the four tests ( P < 0.05). Multivariate logistic regression identified EHF, DPOAE, and DDT as independent diagnostic factors ( P < 0.01). The parsimonious model (EHF+DPOAE+DDT) demonstrated a comparable goodness-of-fit to the full model (EHF+DPOAE+BKB-SIN+DDT) ( P > 0.05), while it significantly outperformed any single test alone ( P < 0.01). Bootstrap resampling validated its robust stability across subgroups (age, sex, and work experience). The Delong test showed improved diagnostic efficacy in the CA + parsimonious model group (AUC increased by 0.09, P < 0.01) and in CA-defined severity groups (AUC: 0.94-0.96). The multivariate logistic regression analysis showed that, among noise-exposed workers with normal CA, ORs of relevant indicators from the parsimonious model for early NIHL were 1.31 [95% Confidence Intervalat (CI): 1.21-1.47, P < 0.01]. A parsimonious combination of EHF, DPOAE, and DDT is effective for aiding CA in diagnosing early NIHL. More studies are needed for further validation.