公共卫生研究摘要 (2026-05-11)

共收录 61 篇研究文章

1. Endoscopic grading of gastric intestinal metaplasia and microvascular pattern for assessing gastric cancer risk: a prospective study.

期刊: Annals of medicine 发表日期: 2026-Dec 链接: PubMed

摘要

The endoscopic grading of gastric intestinal metaplasia (EGGIM) has not been comprehensively validated. Microvascular (MV) pattern abnormalities are critical for diagnosing gastric neoplastic transformation. The present study aims to validate the diagnostic accuracy of EGGIM for identifying high-risk GIM patients and to develop a modified EGGIM model incorporating microvascular pattern, evaluating its diagnostic performance for risk stratification of GC development in GIM patients. All patients underwent EGGIM scoring and microvascular pattern evaluation. Targeted or random biopsies were performed at the antrum, incisura, and corpus, followed by operative link on gastric intestinal metaplasia assessment (OLGIM). The sensitivity, specificity, positive likelihood ratios (PLR), and positive predictive values (PPV) of both EGGIM and the modified EGGIM model for assessing GC risk in GIM patients were validated. A total of 144 patients were enrolled. The area under curve (AUC) of the receiver operating characteristic of EGGIM for diagnosing OLGIM III-IV was 0.885 (95% CI 0.837-0.943). At the cutoff value ≥4, the sensitivity, specificity, PLR, and PPV were 90.90%, 73%, 3.36, and 50%, respectively. Altered microvascular pattern was identified as a risk factor for high-risk GC development in GIM (p < 0.001; odds ratio [OR] = 4.696; 95% CI 2.792-7.896). The modified EGGIM model achieved an AUC of 0.921 (95% CI 0.873-0.968) for identifying OLGIM III-IV; at the cutoff value ≥ 2.5, the sensitivity, specificity, PLR, and PPV were 97%, 66.70%, 2.91, and 46.4%, respectively. After incorporating MV, the AUC of the EGGIM score increased from 0.885 to 0.921, suggesting improved diagnostic performance. Microvascular pattern serves as a significant independent predictor for OLGIM III-IV. The modified EGGIM demonstrated good diagnostic performance for OLGIM III-IV, suggesting its potential as a non-invasive endoscopic tool for assessing the risk stratification of GC development.

2. A framework for oncology social work services scope of practice in Malaysia's public healthcare system: Insights from practitioners.

期刊: Journal of psychosocial oncology 发表日期: 2026-May-10 链接: PubMed

摘要

The rising incidence of cancer in Malaysia underscores the necessity for specialized oncology social work services. Implementing a localized plan for these services would strengthen medical social workers’ knowledge and skills, ultimately enhancing support for cancer patients and their families. A total of 171 medical social work officers in public health facilities participated in a self-report survey. Additionally, five medical social work officers who directly work with cancer patients participated in in-depth interviews, and 30 primary caregivers of cancer patients participated in a focus group discussion. These participants provided perspectives on the requirements for Oncology Social Work Services in government health facilities in Malaysia. The establishment of oncology social work services that incorporate the four scopes of practice defined by the Association of Oncology Social Work (AOSW) within Malaysia’s public health system is essential and creates opportunities for generalist medical social work officers to specialize in this critical field. Implementing a standardized oncology social work framework improve efficiency and enhancing clinical practice and discipline-specific responsibilities in psychosocial oncology.

3. [The historical development of Hungarian school health services, the cooperation of school doctors and health visitors, and today's challenges].

期刊: Orvosi hetilap 发表日期: 2026-May-10 链接: PubMed

摘要

Despite the fact that Hungarian school healthcare has a history dating back 140 years, no comprehensive study has yet been conducted to analyze the historical development and impact of system, particularly the institutionalization of the role of health visitors in educational institutions and the development of cooperation between school doctors and health visitors. 1) To explore the historical development of school health services and the takes of school doctors, 2) to analyze the involvement and role of public health visitors in school healthcare, 3) to examine the role of cooperating professionals (doctors, public health visitors, and other professionals present today), 4) to explore the challenges that determine current operations. We studied the relevant legislation, professional regulations, and literature through research, and carried out systematic and analytical work. The role of school doctors shifted from monitoring and epidemic control to preventive care and health promotion tasks. The development of school healthcare is linked to the name of József Fodor, who laid the foundations for the regular health monitoring of school-age children by introducing a public health approach. Health visitors gradually became involved in healthcare within the legal framework, and their role became increasingly important in the areas of prevention, care, and health education. Health visitors initially appeared as professionals supporting the work of doctors. Today, this cooperation extends to all areas of health visitors’ professional activities and plays a fundamental role in the effective functioning of school healthcare. The cooperation between school doctors and public health visitors is one of the cornerstones of Hungarian school healthcare and plays a key role in maintaining children’s health, prevention, and health promotion. Orv Hetil. 2026; 167(19): 753-764. Bevezetés: Annak ellenére, hogy a magyar iskola-egészségügyi ellátás 140 éves múltra tekint vissza, mindeddig nem készült átfogó tanulmány, amely a történeti fejlődést és annak hatását elemezve vizsgálta volna a rendszer kialakulásának folyamatát, különösen a védőnői szerep intézményesülését az oktatási intézményekben, valamint az iskolaorvos és a védőnő közötti együttműködés fejlődését. Célkitűzés: Az 1) iskola-egészségügyi szolgáltatás, az iskolaorvosok feladatainak történeti fejlődésének feltárása, 2) a védőnők iskola-egészségügyi ellátásba való bekapcsolódásának és szerepének elemzése, 3) az együttműködő szakemberek (orvos, védőnő, valamint a napjainkban jelen lévő szakemberek) szerepének vizsgálata, 4) a jelenkori működést meghatározó kihívások feltárása. Módszer: Szakirodalmi kutatómunkával tanulmányoztuk a témához kapcsolódó jogszabályokat, szakmai szabályozókat, szakirodalmi közleményeket, rendszerező, elemző munkát végeztünk. Eredmények: Az iskolaorvosok feladatköre az ellenőrző és járványügyi tevékenységektől a megelőző, gondozó és egészségfejlesztő feladatok felé mozdult. Az iskola-egészségügyi ellátás kialakulása Fodor József nevéhez fűződik, aki a közegészségügyi szemlélet meghonosításával megalapozta az iskoláskorú gyermekek rendszeres egészségügyi felügyeletét. A védőnők fokozatosan, jogszabályi keretek között kapcsolódtak be az ellátásba, és szerepük egyre hangsúlyosabbá vált a prevenció, a gondozás és az egészségnevelés területén. Megbeszélés: A védőnő kezdetben az orvos munkáját támogató szakemberként jelent meg. Napjainkban ez az együttműködés kiterjed a védőnő valamennyi szakmai tevékenységi területére, és alapvető szerepet játszik az iskola-egészségügyi ellátás hatékony működésében. Következtetés: Az iskolaorvos és a védőnő közötti együttműködés a magyar iskola-egészségügy egyik meghatározó pillére, és kulcsfontosságú a gyermekek egészségmegőrzésében, prevenciójában és egészségfejlesztésében. Orv Hetil. 2026; 167(19): 753–764.

4. [Disordered eating behaviors and eating disorders among athletes].

期刊: Orvosi hetilap 发表日期: 2026-May-10 链接: PubMed

摘要

Eating behavior and its disorders in sport are closely related to the development of sports nutrition and exercise physiology, as well as to performance and body ideal expectations placed on athletes. Since the late 1970s, eating disorders have received increasing public health attention, which has also extended to athletic populations. The aim of this phenomenon-centered, thematic narrative literature review is to illustrate the forms and consequences of disordered eating behaviors and eating disorders in athletic populations across different sport contexts, based on international literature published between 1980 and 2000. Based on the reviewed studies, disordered eating behaviors and eating disorders are multifactorial origin, with biological, psychological, sociocultural, and sport-specific factors all playing a role in their development. The concept of the female athlete triad proved to be a milestone; however, the involvement of male athletes has also been confirmed, particularly in weight-class and aesthetic sports. However, it should be emphasized that athlete status in itself does not uniformly imply an increased risk. Primary prevention, early detection, and multidisciplinary care are fundamentally important in preserving athletes’ health. Orv Hetil. 2026; 167(19): 746-752. A táplálkozási magatartás és annak zavarai a sport területén szoros összefüggésben állnak a sporttáplálkozás és sportfiziológia fejlődésével, valamint a sportolókkal szemben támasztott teljesítmény- és testideál-elvárásokkal. Az evészavarok az 1970-es évek végétől szélesebb közegészségügyi figyelmet kaptak, és a sportolói populációban is egyre inkább előtérbe kerültek. A jelenségközpontú, tematikus szempontú narratív szakirodalmi áttekintés célja a zavart táplálkozási magatartások és evészavarok sportolói populációban megjelenő formáinak és következményeinek bemutatása különböző sportági kontextusokban az 1980 és 2000 közötti nemzetközi szakirodalom alapján. Az áttekintett vizsgálatok alapján a zavart táplálkozási magatartások és evészavarok multifaktoriális eredetűek, kialakulásukban biológiai, pszichológiai, szociokulturális és sportági tényezők egyaránt szerepet játszanak. A női atlétatriász koncepciója mérföldkőnek bizonyult, ugyanakkor a férfi sportolók érintettsége is igazolt, különösen súlycsoportos és esztétikai sportágakban, miközben fontos hangsúlyozni, hogy a sportolói státusz önmagában nem jelent egységesen fokozott kockázatot. A primer prevenció, a korai felismerés és a multidiszciplináris ellátás alapvető jelentőségű a sportolók egészségének megőrzésében. Orv Hetil. 2026; 167(19): 746–752.

5. Digitoxin in heart failure with reduced ejection fraction according to atrial fibrillation status: the DIGIT-HF trial.

期刊: European heart journal 发表日期: 2026-May-10 链接: PubMed

摘要

6. Sharing in Caring: Perceptions of (In)Equality and Mental Health Among Siblings Caring for a Parent With Dementia.

期刊: Research on aging 发表日期: 2026-May-10 链接: PubMed

摘要

Care for a parent with dementia is often shared among multiple adult children, yet it is not always evenly distributed. Guided by the family stress process model, this study examined associations between perceptions of care equality, depressive symptoms, loneliness, and positive affect among 208 adult children caring for a parent with dementia within 110 families from the Siblings Caring for a Parent with Dementia Study (mean age = 58.36, SD = 9.38; 89% women), and mediating roles of caregiver burden and social support. When adult child caregivers perceived that they were contributing more to parental care than their sibling, they reported greater depressive symptoms than participants who reported equal care. Unequal care was linked to depressive symptoms, loneliness, and positive affect via caregiver burden but not social support. Perceptions of (un)equal divisions of care are associated with adult children’s mental health, representing potential caregiving intervention targets.

7. Commentary: Systemic Inequities in Japan's Technical Intern Training Program (TITP): Health, Labor, and Legal Vulnerabilities of Foreign Trainees.

期刊: Evaluation & the health professions 发表日期: 2026-May-10 链接: PubMed

摘要

Japan’s Technical Intern Training Program (TITP) has expanded into a major conduit for foreign labor, primarily from Vietnam, Indonesia, and the Philippines. While it was originally established to facilitate skill and technology transfer to developing nations, numerous reports indicate persistent issues of wage underpayment, excessive overtime, and limited access to healthcare. This commentary integrates evidence from legal, employment, and public health perspectives to illustrate systemic inequities affecting technical interns as they increasingly contribute to Japan’s health and long-term care sector. It also addresses gender-related vulnerabilities and enforcement challenges. In addition, the Employment for Skill Development (ESD) framework is discussed, with attention to how targeted policy refinements can improve worker protection without undermining its core goals of skill development and workforce stability, alongside the cultural barriers that may constrain their effectiveness. The commentary proposes directions to align Japan’s migrant labor systems with universal health coverage and labor law principles, emphasizing equitable protection and sustainable reform.

8. Immigrant mental health, safe work, discrimination, and state policies: From racism and xenophobia to health equity.

期刊: American journal of community psychology 发表日期: 2026-May-10 链接: PubMed

摘要

An ecological model was developed to examine the pathways linking immigration state policies to physically safe work conditions and work volition, interpersonal discrimination, and mental health distress. The ecological framework was tested among two subsamples totaling 529 Latinx immigrant participants: (1) immigrants who resided in states with anti-immigrant policies, and (2) immigrants who lived in states with greater health equity policies for immigrants. We used path analysis to assess the model’s goodness of fit and the strength and significance of the paths. The model fit well with both subsamples. For the anti-immigrant state subsample, greater health equity in state policies was associated with greater physically safe work and discrimination, but not work volition. For the pro-immigrant state policies subsample, more equitable policies were not linked to safer work conditions, work volition, or lower discrimination. Across both subsamples, safer work conditions were linked to lower discrimination, and higher discrimination was associated with mental health distress. We discuss implications for community research, interventions, employers, and policymakers in promoting migrant justice and responding to racist and xenophobic immigration policy climates.

9. Safety and Feasibility of the eLymTM System for Interstitial Decongestion in Acute Decompensated Heart Failure: Primary results of the DELTA-HF trial.

期刊: European journal of heart failure 发表日期: 2026-May-10 链接: PubMed

摘要

Persistent congestion at discharge is associated with worse outcomes in acute decompensated heart failure (ADHF), with impaired lymphatic function contributing to difficult-to-target tissue and organ congestion. The safety and effectiveness of the eLym System in ADHF was evaluated in the multicenter, single-arm DELTA-HF trial. A localized reduced-pressure zone at the venous angle was created in 40 patients using an endovenous axial pump to support lymph drainage through the thoracic duct. Forty patients with ADHF (32.5% female, 71±11 years) received therapy. Patients had a median of 2 hospitalizations in the prior 6 months. All were on home daily loop diuretic dose equivalent to ≥80 mg furosemide. Device deployment was successful in all cases (therapy time: 23.1±7.3 hours). Weight decreased by 3.6±2.4 kg during eLym therapy and by 6.8±3.4 kg at discharge. Median modified EVEREST Clinical Congestion Score improved from 5.0 (4.0-6.0) to 2.0 (1.0-4.0) after eLym treatment and to 0 (0-1.0) by discharge, remaining stable through 6 months (change from baseline p-values <0.0001). Serum creatinine remained stable acutely and through 6-months. Freedom from device- or procedure-related serious adverse events was 95%. One patient had a vascular complication causing mediastinal hematoma and death; another required inotropes due to hypotension. At 6 months, two patients experienced three HF hospitalizations and five patients died: four from cardiovascular causes; one from urosepsis. eLym therapy in ADHF appeared to be safe, with early data suggesting effective, durable decongestion and a low 6-month rehospitalization rate. Randomized controlled trials evaluating eLym therapy are warranted.

10. ZDHHC18-Mediated Palmitoylation of ORF3a Promotes SARS-CoV-2 Pathogenesis by Antagonizing TRIM16-Mediated Ubiquitination and Proteasomal Degradation.

期刊: Advanced science (Weinheim, Baden-Wurttemberg, Germany) 发表日期: 2026-May-10 链接: PubMed

摘要

SARS-CoV-2 accessory protein ORF3a contributes to viral pathogenesis through membrane remodeling, immune evasion, and inflammation induction. However, the molecular mechanisms underlying ORF3a-mediated pathogenesis remain poorly characterized, and no therapeutic strategies targeting ORF3a currently exist. Here, we demonstrate that palmitoylation, a post-translational modification, governs ORF3a-mediated viral pathogenesis. Specifically, ORF3a undergoes ZDHHC18-mediated palmitoylation at evolutionarily conserved Cys130/Cys133 residues, which stabilizes the protein by masking an intrinsic proteasomal degradation signal. This palmitoylation competitively inhibits tripartite motif-containing 16 (TRIM16)-dependent K27-linked polyubiquitination, thereby preventing ORF3a degradation and enhancing viral replication and inflammatory responses. A designed ORF3a-mimicking palmitoylation-inhibitory peptide (OPIP) blocked ORF3a palmitoylation, promoted its degradation, and significantly reduced SARS-CoV-2 pathogenicity. Collectively, these findings establish ZDHHC18-mediated palmitoylation as a central regulator of ORF3a stability and virulence, revealing a potentially druggable axis for disrupting SARS-CoV-2 pathogenesis.

11. Palatable-Food-Driven Top-Down Circuit Inhibits PVNCRF Activity to Mitigate Stress Via Peri-PVNCRFR1 Neurons.

期刊: Advanced science (Weinheim, Baden-Wurttemberg, Germany) 发表日期: 2026-May-10 链接: PubMed

摘要

Stress is a major precipitating factor for emotional disorders, including anxiety. To cope with stress, individuals frequently engage in hedonic behaviors, such as eating palatable food, which provide transient relief from psychological distress and may protect against the development of pathology. However, the neural mechanisms by which hedonic experience counteracts stress-induced anxiety remain poorly understood. Here, we identify a neural circuit functionally connecting the prefrontal cortex (PFC) to the paraventricular nucleus (PVN) of the hypothalamus that mediates stress mitigation through palatable food intake. Activation of this circuit suppresses stress-induced hyperactivity of PVN corticotropin-releasing factor (CRF) neurons and prevents the development of anxiety-like behaviors. This effect is driven by palatable-food-induced dopamine release in the PFC, which activates dopamine D1 receptor (D1R)-expressing neurons projecting to corticotropin-releasing factor receptor 1 (CRFR1)-expressing neurons in the PVN and peri-PVN. Notably, GABAergic CRFR1 neurons are enriched in the peri-PVN, with minimal presence within the PVN proper, suggesting that inhibition of PVNCRF neurons is mediated indirectly via peri-PVN GABAergic inputs. These findings define a previously uncharacterized PFC→peri-PVN→PVN circuit through which hedonic experience modulates stress responses and reveal a neural substrate for behavioral resilience, providing a potential avenue for anxiety intervention.

12. Culture-Negative Infective Endocarditis Presenting as ANCA-Positive Glomerulonephritis.

期刊: The American journal of case reports 发表日期: 2026-May-10 链接: PubMed

摘要

BACKGROUND Infective endocarditis is challenging to diagnose when blood cultures are negative, and its symptoms are nonspecific. Bartonella species are fastidious intracellular bacteria that can cause culture-negative endocarditis and immune-mediated complications such as glomerulonephritis, often mimicking ANCA-associated glomerulonephritis. CASE REPORT A 25-year-old man who underwent a Ross procedure for congenital aortic stenosis performed in childhood presented with 1 month of night sweats, abdominal pain, and intermittent nausea. Initial evaluation revealed elevated creatinine, pancytopenia, proteinuria, microscopic hematuria, and splenomegaly. Serologies showed positive c-ANCA and elevated PR3 antibodies. A presumed diagnosis of ANCA-associated glomerulonephritis led to initiation of high-dose steroids and planned rituximab. Kidney biopsy demonstrated crescentic glomerulonephritis with C3-dominant immune complex deposition, atypical for pauci-immune disease, prompting discontinuation of steroids. Further infectious workup revealed high Bartonella henselae IgM and IgG titers. The patient met the criteria for possible infective endocarditis under the 2023 Duke-ISCVID criteria. Transesophageal echocardiography showed valvular abnormalities without definite vegetations, although only a prior transthoracic echocardiogram was available for comparison. The patient was treated with doxycycline and rifampin for 12 weeks, resulting in clinical and laboratory improvement. CONCLUSIONS This case demonstrates that Bartonella endocarditis can closely mimic ANCA-associated glomerulonephritis and rapidly progressive glomerulonephritis. In patients with systemic symptoms, positive ANCA serologies, and negative cultures, occult infection must be a key consideration, especially in patients at high risk for infective endocarditis. A careful exposure history, including pets, travel, and dental procedures, can provide crucial diagnostic clues. Early recognition and targeted antimicrobial therapy are essential to prevent irreversible organ damage and avoid inappropriate immunosuppression.

13. Ziltivekimab in heart failure with preserved and mildly reduced ejection fraction: rationale and design of the ATHENA and HERMES trials.

期刊: European journal of heart failure 发表日期: 2026-May-10 链接: PubMed

摘要

For decades inflammation has been postulated to play a key pathophysiological role in heart failure (HF), particularly in HF with preserved ejection fraction (HFpEF). Previous attempts to target inflammation in HF have been unsuccessful, possibly due to the choice of therapeutic target or the characteristics of the patient population studied. We hypothesized that targeting interleukin-6 (IL-6)-a cytokine central to NLRP3 inflammasome activation that is associated with both the onset and progression of HF-may be beneficial in patients with HF and circulating evidence of cardiovascular inflammation, but without overtly reduced ejection fraction (EF). We describe the rationale and design of two clinical trials (ATHENA and HERMES) investigating ziltivekimab, a human monoclonal antibody directed against the IL-6 ligand, in patients with HF and mildly reduced or preserved EF (HFmrEF/HFpEF) and cardiovascular inflammation. ATHENA (n=673) and HERMES (n=4900) are international, multicenter, double-blind, placebo-controlled trials randomising adults with HFpEF/HFmrEF and cardiovascular inflammation (hsCRP ≥2mg/L) to ziltivekimab 15 mg or placebo, administered subcutaneously once-monthly on top of standard of care. Eligible participants have a left ventricular ejection fraction >40%, elevated NTproBNP and serum high sensitivity C reactive protein ≥2 mg/L. The primary endpoint in ATHENA is the change in Kansas City Cardiomyopathy Questionnaire-Clinical Summary Score at 12 months. The primary endpoint in HERMES is time to first composite of cardiovascular death, hospitalisation for HF or urgent HF visit. ATHENA has a fixed duration of 12 months whereas the HERMES trial is event-driven (approximately 845 adjudicated primary events) with a minimum exposure of 6 months from randomisation to last treatment visit. ATHENA and HERMES will investigate the effect of ziltivekimab in HFpEF/HFmrEF and cardiovascular inflammation. ATHENA will determine the effect of ziltivekimab on health status. HERMES will determine the efficacy and safety of ziltivekimab on morbidity and mortality.

14. Changes in Work Arrangements, Psychosocial Working Conditions, and Worker Well-Being Between 2018 and 2022: Evidence From the General Social Survey.

期刊: American journal of industrial medicine 发表日期: 2026-May-10 链接: PubMed

摘要

We used national-level data to compare worker demographic and socioeconomic characteristics, work arrangements, psychosocial working conditions, safety and health, job security, wages and benefits, and worker health and well-being before the COVID-19 pandemic, in 2018, and in the late stage of the pandemic, in 2022. Understanding these changes helps inform some of the potential ways these factors may shape the future of work. We analyzed self-reported and publicly available data from the 2018 and 2022 waves of the General Social Survey (GSS)-Quality of Worklife (QWL) module, focusing on adults working part-time or full-time. We describe differences in the broad categories of interest mentioned above, as well as subcategories within each. For example, we assessed changes in psychosocial working conditions by focusing on subcategories that included job demands, job control, role conflict, resource adequacy, job support, work flexibility, and work and family interface, that is, the boundaries between work and family life. We used Mann-Whitney tests to assess statistically significant changes, using weighted, nationally representative worker samples (N = 1473 in 2018; N = 2112 in 2022). Between 2018 and 2022, we observed two changes in work arrangements; the share of independent contractors increased (from 12.4% to 14.4%) while the share of those working full-time decreased (from 81.3% to 78.5%). Psychosocial conditions exhibited mixed trends; job demands and control showed marginal improvement, while role conflict, resource adequacy, and job support worsened. The share of workers who mainly worked at home increased (6.6%-17.2%), alongside those experiencing family-work conflict (from 26% to 32%). Health and well-being also worsened, with more workers reporting lower job satisfaction and very often feeling used up (from 13.1% to 16.0%). In addition, workers reported more days in poor mental health (from 3.6 to 4.4 days) and days with activity limitations (from 1.6 to 2.2) in the past 30 days. The quality of worklife in 2022 differed meaningfully from 2018, though not uniformly for better or worse. For example, increases in working at home and the share of independent contractor arrangements suggest different potential long-term consequences for worker well-being. Continued monitoring and more nuanced analyses are essential to understanding the evolving future of work.

15. Microporous Self-Assembled Pd(II) Tetrahedral Cages for Rapid and Reversible Multi-Phase Sequestration of Iodine and Methyl Iodide.

期刊: Small (Weinheim an der Bergstrasse, Germany) 发表日期: 2026-May-10 链接: PubMed

摘要

Industrial and medical iodine leaks create serious environmental and health risks, creating the need for materials capable of efficiently capturing radioactive iodine from air and water. Herein, we report a systematic study of four tetrahedral, microporous, self-assembled palladium-based coordination cages (C1-C4) incorporating high-affinity binding motifs, including naphthalene, tetrazine, benzothiadiazole, and benzene. Despite the absence of permanent porosity, these cages exhibit exceptional iodine uptake, reaching up to ~3.78 g g‒1 in the vapor phase at 75οC and ~3.52 g g‒1 in aqueous media, accompanied by fast kinetics surpassing state-of-the-art COFs and MOFs. Dynamic flow-through experiments further demonstrate their efficiency, with C4 achieving a record elution volume of 9.2 L g‒1 in a 0.5 mM I3 - solution. The cages enable efficient iodine removal under dynamic vapor-phase conditions (1.92 g g‒1), reduce iodine concentrations from ppm to ppb levels in real water samples, and exhibit strong affinity toward methyl iodide vapor (up to 1.44 g g‒1). DFT calculations indicate that the observed performance originates from cooperative π-iodine interactions and nucleophilic heteroatom binding. Combined with structural robustness, recyclability, and scalable synthesis, these coordination cages establish a new benchmark and represent the first example of dynamic vapor-phase iodine capture by coordination cages.

16. G3BP1 Succinylation at K413 is Critical for Cardiac Function by Modulating PI3K-AKT-mTOR Signal Axis.

期刊: Advanced science (Weinheim, Baden-Wurttemberg, Germany) 发表日期: 2026-May-10 链接: PubMed

摘要

G3BP1, GTPase activating protein (SH3 domain) binding protein 1, is a core component of stress granules. Homozygous null mutations in the G3bp1 gene result in embryonic lethality, underscoring its essential role in development. While various post-translational modifications regulate G3BP1 activity, here we first report that G3BP1 undergoes succinylation (Suc) at Lys (K)411 in mouse hearts (corresponding to human K413). G3BP1-Suc level was diminished in Myosin binding protein C3 (Mybpc3) knockout and transverse aortic constriction (TAC) operated mice, which developed heart failure (HF). Site-directed mutagenesis confirmed that the K413R mutation compromised the overall Suc level of G3BP1 in vitro. Mice injected with AAV9-G3BP1 (WT) developed typical phenotypes of dilated cardiomyopathy (DCM) and HF when compared to mice injected with AAV9-Ctrl and -G3BP1 (K411R) mice, suggesting a possible loss of functional effect of de-Suc at K411. Moreover, Homozygous knock-in G3bp1 (K411R) mice exhibited compromised cardiac parameters compared to WT littermates. De novo G3BP1 mutation (p.E411G) from a DCM patient disrupts Suc at K413. Mechanistically, G3BP1 de-Suc at K413 induced Rraga expression and impaired TSC1/2 and IDE binding, ultimately leading to excessive activation of the PI3K-AKT-mTOR signaling axis. We demonstrate a critical role for G3BP1 Suc at K413 in cardiac function by modulating the PI3K-AKT-mTOR pathway, providing new insights into the non-canonical function of G3BP1 in cardiomyopathy and HF pathogenesis.

17. Microbial desulfurization of low-grade Balochistan coal using Bacillus licheniformis and Bacillus pumilus.

期刊: Biodegradation 发表日期: 2026-May-10 链接: PubMed

摘要

Coal is an abundant source of energy; however, the use of Pakistani coal is limited due to its high sulfur content, which causes environmental and health issues. Hence, pre-combustion desulfurization of coal is imperative for quality enhancement. The present study investigates the microbial desulfurization of coal from the Balochistan mine by using local bacterial strains, Bacillus pumilus and Bacillus licheniformis, isolated from the same coal mine, for their sustainability, adaptability, and local availability. Batch incubation experiments with a coal particle size of 75 and 150 µm and incubation periods of 7 and 14 days were conducted to evaluate the effect of particle size and incubation period on the sulfur removal efficiency. Proximate analysis was conducted in accordance with ASTM D3173, ASTM D3174, and ASTM D3175 to determine the moisture content (MC), ash content (AC), and volatile matter (VM), while ultimate analysis was performed using a CHNS analyzer. Additionally, XRD was used to determine changes in composition and structure before and after treatment. The results showed that microbial treatment increased calorific value, specifically at smaller particle sizes and longer incubation periods. The maximum sulfur removal achieved by B. licheniformis was 32.73% and 41.06%, whereas B. pumilus exhibited a removal of 20.75% and 33.48% at a particle size of 75 µm after 7 and 14 days, respectively. These findings demonstrate that bio-desulfurization using indigenous microorganisms is an effective and environmentally sustainable approach for upgrading low-grade Pakistani coal for cleaner energy production.

18. Degradation dynamics: an insight into microbial interactions with explosive compounds.

期刊: Biodegradation 发表日期: 2026-May-10 链接: PubMed

摘要

Degradation dynamics is an essential aspect in the field of environmental science and is crucial in understanding the interaction between microbes and explosive compounds. Explosive compounds and their residues, such as nitramines, nitro-substituted aromatics, picric acid, TETRYL, and HEXYL), and aliphatic, RDX, etc.are highly persistent in the environment. These compounds are toxic to many life forms at high concentrations, specific microbial species have evolved resistance and degradation capabilities, though their growth can still be inhibited beyond certain thresholds, The results of microbial biodegradation can range from complete mineralization to only the biotransformation into less toxic or more resistant metabolites. Research using pure cultures of bacteria and fungi has provided insight into the degradation pathways of certain nitro-organic compounds, and some key enzymes (laccases and lignin peroxidases) have been identified and studied. This review mainly aims to provide an overview of the current state of research on the degradation dynamics of explosive compounds Recent advancements have pivoted toward ‘Bio-omics’ and synthetic biology tools, such as CRISPR/Cas systems, to engineer high-activity microbial strains.

19. Association between nursing work environment and decision fatigue in Chinese clinical nurses: A latent profile and mediation analysis.

期刊: Journal of health psychology 发表日期: 2026-May-10 链接: PubMed

摘要

This study examined latent subtypes of the nursing work environment and the mediating role of job stress in the association between environment type and decision fatigue among clinical nurses. A total of 812 clinical nurses were included from the four public tertiary hospitals between May 2023 and July 2023. A latent profile analysis was conducted to identify heterogeneity in the nursing work environment. Decision fatigue was predicted by frequent night shifts, extended overtime, and heavy patient load. Job stress partially mediated the link between exhausting-straining environment and decision fatigue and significantly mediated the stagnant-buffered environment decision fatigue association. Findings highlight that enhancing work conditions and reducing stress may mitigate decision fatigue and promote nurses’ effectiveness and occupational health.

20. Gender Justice in the Triple Planetary Crisis: A Scoping Review.

期刊: Journal of advanced nursing 发表日期: 2026-May-09 链接: PubMed

摘要

To identify and report how gender justice is conceptualised and discussed in contemporary health literature in relation to the Triple Planetary Crisis of climate change, pollution and biodiversity loss, with a particular focus on the experiences of women and gender-diverse populations, and the representation of nurses and other healthcare professionals dominated by women. Scoping review. Searches were conducted across MEDLINE (Ovid), Scopus, CINHAL, Embase and ProQuest, focusing on studies published from January 1 2000-23 September 2024. The review was conducted in accordance with the JBI methodology for scoping reviews and reported against the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines. Data were extracted according to a pre-specified extraction framework, developed a priori, encompassing components of gender justice and intersectionality. A total of 39 studies were included: 17 (43.6%) qualitative, 17 (43.6%) quantitative and 5 (12.8%) mixed methods. The focus of the studies included gendered experiences of climate change (30.8%), decision-making and governance (20.5%), health and wellbeing (17.9%), women’s economic participation (15.4%), cultural and spiritual connections to land (7.7%), and intersectionality and human rights (7.7%). Gender-diverse populations, nurses and other healthcare professions dominated by women were not represented in the literature. The literature reported that women experienced differentiated exposure to the Triple Planetary Crisis. The underrepresentation of gender diverse people and nurses in recent studies remains a significant barrier to advancing understanding of gender justice. Integrating gender justice into health systems is increasingly important to prevent women from being disproportionately impacted by the Triple Planetary Crisis. More attention to inclusion of frontline healthcare professionals, including nurses, in governance, policy discussions and leadership roles could strengthen the response to systemic environmental threats. No patient or public involvement.

21. Uptake of family planning methods among adults presenting with genital ulcers at community posts and public outpatient health facilities in central Uganda.

期刊: Contraception and reproductive medicine 发表日期: 2026-May-09 链接: PubMed

摘要

Genital ulcer disease (GUD), a common clinical presentation at health facilities in Uganda, is often caused by sexually transmitted infections (STIs) and increases the risk of HIV. Family planning (FP) methods are effective for preventing unintended pregnancies, while some methods, namely male and female condoms, also reduce the risk of STI transmission. However, little has been documented about FP use among individuals with GUD in Uganda. Patients with clinician-confirmed genital ulcers were enrolled for a GUD study at six sites across government clinics and community outreaches in Kampala, Wakiso, and Kalangala, Uganda, between July/2023 and June/2024. Demographic, behavioral, and family planning use data were collected in English and Luganda using prespecified questionnaires. Urine and genital swabs were collected for gonorrhea and chlamydia testing and blood for HIV and syphilis antibodies using rapid diagnostic tests (RDT). Pregnant women were excluded from the analysis. Associations with FP use were explored using rank sum tests, chi-square, and Fisher’s exact tests as appropriate. Of 104 participants with confirmed genital ulceration, 75(72.1%) were women, 12(16.0%) of whom were pregnant. Overall, of 92 non-pregnant participants, 36(39.1%) had a reactive HIV RDT; 10(27.8%) were new diagnoses. Nine (9.8%) had positive tests for gonorrhea, chlamydia, or syphilis. No men reported condom use. Of the 63 non-pregnant female participants analyzed, 29(46.0%) reported current FP use. Subdermal implants were the most used method in 15/29(51.7%). Twenty-one (33.3%) reported ≥ 2 sexual partners in the past 3 months. FP use was significantly associated with younger age, being married, transactional sex, ≥ 2 sexual partners in the past 3 months, and being sexually active in the past month. More than one-sixth of women with GUD were pregnant. The uptake of FP among individuals with GUD was low, and HIV/STI prevalence was high. Effective FP has a key role in preventing unintended pregnancies and mother-to-child transmission of STIs. These findings highlight the need for educational and policy strategies to increase sensitization on sexual health, including increasing uptake of FP and encouraging male condom use in a population at high risk of STIs.

22. Predictive and discriminant validity of the Impaired Control Scale - Cannabis (ICS-C): an intensive longitudinal study of daily cannabis use outcomes.

期刊: Journal of cannabis research 发表日期: 2026-May-09 链接: PubMed

摘要

Impaired control over substance use - difficulty adhering to limits on consumption - is a core feature of problematic use and addiction. Although extensively studied in alcohol research, impaired control over cannabis remains understudied. To advance research in this area, we evaluated the predictive and discriminant validity of the Impaired Control Scale-Cannabis (ICS-C) using an intensive longitudinal design. Young adults (N = 147; Mage = 22.07) who reported regular use of cannabis and alcohol completed three 21-day ecological momentary assessment (EMA) bursts spaced six months apart. The ICS-C was administered prior to each burst, followed by daily surveys assessing difficulty limiting use, substance consumption, and consequences. Three-level multilevel models examined whether ICS-C scores predicted cannabis outcomes observed on the daily surveys and whether daily reports of difficulty limiting cannabis use mediated these associations. The Perceived Impaired Control subscale demonstrated strong predictive validity: Within-person increases in perceived impaired control across bursts predicted greater difficulty limiting cannabis use in daily life, which in turn mediated associations with heavier cannabis consumption and use of multiple forms of cannabis. At the between-person level, the Attempted Control subscale predicted negative consequences through difficulty limiting cannabis use. The ICS-C also demonstrated discriminant validity, showing no significant associations with alcohol outcomes after controlling for cannabis use. The ICS-C, particularly the Perceived Impaired Control subscale, captures meaningful within-person fluctuations in self-regulatory capacity that predict real-world cannabis use patterns. Findings support the ICS-C as a valid tool for examining impaired control over cannabis across multiple temporal levels.

23. Innovation, respiration and drug paraphernalia policy: a mixed methods study of crack pipe practice and respiratory harm in England.

期刊: Harm reduction journal 发表日期: 2026-May-09 链接: PubMed

摘要

Provision of equipment for the purpose of stimulant inhalation is prohibited under UK law. Crack cocaine use is prevalent and rising in England, where the SIPP (safer inhalation pipe provision) study piloted and evaluated a crack equipment and workforce training intervention. We report mixed method findings from the baseline component of the study, prior to intervention implementation. The aim of this paper is to situate quantitative findings regarding respiratory risk through qualitative exploration of crack inhalation practice in a context of stimulant equipment prohibition. In this paper we report descriptive findings from baseline survey data (n = 727) with a focus on thematic analysis of interview data (n = 33). Participants were recruited through drug treatment services and peer networks in six geographical locations in England, with survey eligibility criteria including crack use (injecting or smoking) in the past 28 days. Of the 733 participants who completed the baseline questionnaire, 727 (99%) smoked crack in the past month and were included for further analysis. A minority reported crack injection (28%). Over half (55%) used crack daily in the past month. Many (60%) reported respiratory symptoms, with one third experiencing a respiratory-related hospitalisation. Qualitative data illustrate ingenuity of crack equipment practice, with participants fashioning pipes out of materials ranging from umbrella handles, through to tin cans and plastic inhaler cases. Ash and stainless-steel scourer were primarily used as suspension materials. Accounts of practice illustrate connections between materials used and respiratory harms, the latter exacerbated by poor living conditions and limited availability of supports. We evidence a high burden of respiratory harm among people who smoke crack in England. Stimulant inhalation equipment prohibition contributes to a constellation of respiratory risk, with use of unsafe materials and impoverished living environments exacerbating health harms among a highly marginalised population. There is a need to reorientate drug services to support safer crack inhalation practice and reduce respiratory risk. Legislative change can facilitate this process. ISRCTN12541454 https://doi.org/10.1186/ISRCTN12541454.

24. The impact of war on Primary Health Care in Ukraine: a cross-sectional survey and qualitative interviews with service providers.

期刊: BMC health services research 发表日期: 2026-May-09 链接: PubMed

摘要

Primary Health Care (PHC) is vital to supporting emergency preparedness and health care resilience. There is limited evidence of the impact of crises on PHC services and financing. We aimed to explore the impact of the full-scale invasion of Ukraine in February 2022 on PHC services in the country. We used a mixed-methods approach. Survey data were collected using an online questionnaire sent to a sample (n = 86) of PHC providers in Ukraine in January-February 2023. Fifteen providers were then randomly selected for semi-structured interviews from among those that reported an impact of war and from those areas most affected by conflict. Interviews took place in March 2023. 37% of PHC providers reported being affected by the full-scale invasion. Qualitative data revealed greater impacts at the beginning of the invasion, to which facilities adapted by the time of the survey. The most reported disruptions were electricity cuts (76%) and currency depreciation/price increases (72%). The most reported increased medical need was cardiovascular disease (CVD; 58%) (with qualitative data suggesting an increase in CVD among younger patients) followed by mental illnesses and disorders (55%). 59% of PHC providers reported an increase in remote consultations. Among those facilities that reported a change in revenues, the nature of the change depended on the type of ownership. For example, only 9% of private providers reported increased revenues from humanitarian aid, while 79% (n = 58) of public providers indicated an increase in these sources. To continue strengthening Ukraine’s PHC system, the benefit package must be aligned with clinical guidelines, particularly for CVD and mental health; increases in remote consultations should be closely monitored for quality; and payment systems must be adjusted to ensure equity of financing regardless of provider ownership. These findings offer insights for strengthening PHC and emergency-preparedness in other contexts.

25. A continuum of disconnection: the impacts of safer supply program closures on continuity of care, transition, and total loss of service access.

期刊: Harm reduction journal 发表日期: 2026-May-09 链接: PubMed

摘要

In March 2025, the expiration of federal pilot funding for Safer Supply Programs (SSPs), combined with restrictive provincial legislative changes to harm reduction service provision in Ontario, disrupted care for thousands of clients at risk of toxic drug poisoning. This study examines the impacts of these changes on client health, social stability, and overdose risk across a continuum of access. We conducted 30 semi-structured virtual interviews between September and November 2025 with clients who were enrolled in an SSP prior to March 31, 2025. Participants were recruited via purposive and snowball sampling. Data were analyzed using Braun and Clarke’s reflexive thematic analysis to explore experiences across three distinct groups: those who maintained continuity with their prescriber or SSP, those who transitioned to a new prescriber or SSP, and those who lost access entirely. Experiences of harm were directly proportional to the degree of service disconnection. Participants who maintained access (n = 10) retained clinical stability, but reported chronic anxiety and “survivor’s guilt” regarding peers who lost care. Participants who transitioned to an alternative prescriber (n = 13) experienced a “medicalization of harm reduction” characterized by increased surveillance (e.g., urine screens, monitored dosing), revoked take-home doses, and the loss of trusted relationships, which undermined their autonomy and stability. Those who lost access entirely (n = 7) experienced significant harms, such as the loss of an entire ecosystem of care (i.e., medication, primary care, and community), an immediate return to the unregulated fentanyl market, and engagement in survival strategies that can lead to criminalization. Notably, 100% (n = 5) of participants who reported an overdose following the policy changes belonged to this group. The loss of federal funding for SSPs in Ontario did not solely reduce medication availability; it severed the structural and relational network that supported participants’ reintegration into health care services that they previously felt uncomfortable accessing due to stigma, surveillance and mistreatment. Findings reveal a “continuum of disconnection” where the removal of wraparound supports and the reintroduction of punitive clinical practices function as forms of structural violence. Sustainable, low-barrier models are urgently needed to prevent further morbidity and mortality.

26. Exercise unveiled: an integrated model of motives, goals, affective states, and stress during the COVID-19 pandemic.

期刊: BMC psychology 发表日期: 2026-May-09 链接: PubMed

摘要

This study develops and tests an extended model to examine exercise behavior during the COVID-19 pandemic. In addition to exercise participation goals and regulatory styles, the model incorporates affective states and stress-related constructs, which are particularly relevant in the context of the pandemic. Data were collected from a sample of 283 participants during the pandemic, a period marked by heightened stress and disrupted routines. Structural equation modeling was employed to test the proposed relationships among exercise participation goals, behavioral regulation, affective states, stress, and exercise behavior. The results reveal that physical and psychological goals significantly predict exercise behavior. Regarding behavioral regulation, intrinsic and introjected regulation are positively associated with exercise behavior. Furthermore, negative affect and the ability to cope with stress show significant relationships with exercise behavior. The findings also indicate significant mediating effects of amotivation, introjected regulation, and intrinsic regulation on the relationship between participation goals and exercise behavior. Additionally, exercise participation goals mediate the effects of positive and negative affect, as well as the ability to cope with stress, on exercise behavior. These findings highlight the interplay of motivational, affective, and stress-related factors in shaping exercise behavior during the pandemic. The study provides practical implications for designing exercise promotion and intervention programs, particularly in contexts of public health crises.

27. Implementation of a Mental Health Literacy e-Curriculum (MHLeC) in Malawi Universities: a feasibility cluster randomised trial protocol.

期刊: Pilot and feasibility studies 发表日期: 2026-May-09 链接: PubMed

摘要

Mental health literacy (MHL) in Malawi is low. Mental illness is often attributed to substance abuse or spirit possession, resulting in stigma, maltreatment, and discrimination towards people with mental health problems. Inadequacies in Malawi’s mental health services and workforce increase limited treatment access, knowledge, and negative attitudes, causing an epidemic of substance use and suicides. MHL is foundational for mental health promotion, prevention of mental illness, and stigma reduction. Educational settings are ideal for implementing mental health promotion activities. We want to deliver a MHL e-curriculum (MHLeC) to first-year university students in Malawi to improve their MHL. The project aims to assess the feasibility of implementing MHLeC in four Malawian universities within a cluster randomised trial. In this pragmatic, cluster randomised feasibility trial, we will approach four to eight public and private tertiary institutions about study participation. Clusters will be participating universities allocated to the mandatory MHLeC or the voluntary MHLeC group using stratified randomisation on a 1:1 ratio. University type (e.g. public or private) will be used as the stratification factor for randomisation, with two levels ensuring two universities per stratum. This approach is appropriate for the four-cluster design. Specific feasibility objectives include (1) estimating likely participation rates of universities and students, (2) establishing potential attendance/retention rates during MHLeC delivery, (3) assessing acceptability of the MHLeC through qualitative feedback after intervention delivery, (4) assessing appropriateness of chosen questionnaires for measuring student outcomes. Data will be analysed descriptively. Outcomes from data collected will inform the feasibility of a future main trial including main trial design and recruitment strategies, sample size and power calculations for a full-scale cluster randomised trial. This trial will give us insights on how best to conduct the definitive trial. The intervention can be rolled out nationally within a full-scale trial in Malawi and tested in similar cohorts across Africa if positive results are obtained. More broadly, this research has the potential to significantly increase mental health awareness among young people in Malawi. This study is registered on the Pan African Clinical Trials Registry (PACTR) website https://pactr.samrc.ac.za/ (PACTR202308849574524). Registered 31st August 2023.

28. Effect of PM2.5 exposure on the risk of incident autoimmune diseases: a prospective cohort study in Taiwan.

期刊: Archives of public health = Archives belges de sante publique 发表日期: 2026-May-09 链接: PubMed

摘要

The interaction between fine particulate matter (PM2.5) and genetic factors is thought to play a significant role in the development of autoimmune diseases. However, the impact of PM2.5 exposure on the onset of these diseases remains unclear. This population-based cohort study investigated the effect of year-to-year variations in PM2.5 exposure levels on incident autoimmune disease risk in Taiwanese adults. In this longitudinal study, we followed-up 276,254 adults from the Taiwan MJ cohort (2005-2017) for 9.3 years to identify incident autoimmune diseases cases, ascertained from the patients’ clinical and laboratory reports. Autoimmune diseases were categorized as systemic and organ-specific. Data on residential address-specific annual PM2.5 concentrations were obtained from Taiwan Air Quality-Monitoring sites. A time-dependent Cox regression model, considering death as a competing risk, was used to assess the effect of year-to-year variations in PM2.5 exposure levels on autoimmune disease risk. During the 2,579,362 person-years of follow-up, new-onset autoimmune diseases were observed in 958 (0.35%) individuals, corresponding to an incident density of 37.14 per 100,000 person-years. Participants with high PM2.5 exposure levels (per 5-µg/m3 increase) had a significantly increased risk of incident autoimmune diseases (adjusted hazard ratio [aHR], 2.97; 95% confidence interval [CI], 2.84-3.11), particularly systemic lupus erythematosus (SLE) (aHR, 3.28; 95% CI, 2.99-3.59) and Sjögren’s syndrome (aHR, 2.82; 95% CI, 2.66-2.98). Proactive air pollution control strategies are crucial for the prevention of autoimmune diseases, particularly SLE and Sjögren’s syndrome.

29. Association between digital smart device use and depression among older adults: systematic review and meta-analysis.

期刊: BMC public health 发表日期: 2026-May-09 链接: PubMed

摘要

Depression among older adults is increasingly emerging as a global public health concern. With the rapid advancement of digital information technology, digital smart devices have profoundly reshaped the lifestyle of older adults and may influence their mental health. However, the association between digital smart device use and depression in this population remains unclear, with existing studies reporting inconsistent findings. This study employed a three-level meta-analytic approach to systematically explore the association between digital smart device use and depression among older adults. Systematic searches were conducted on six electronic databases including PubMed, Cochrane Library, Embase, Web of Science, MEDLINE, and PsycINFO from their inception to May 6, 2025. Original observational studies (cross-sectional or cohort) were included. Exclusion criteria comprised non-English publications, review articles, conference papers or abstracts, duplicate publications, and studies without available full text or required data. Two researchers independently performed literature screening, data extraction, and quality assessment. Three-level random-effects meta-analyses were conducted to estimate the pooled standardized beta coefficients (β) for continuous depression outcomes and odds ratios (OR) for binary depression outcomes. Risk of bias was assessed using the Newcastle-Ottawa Scale (NOS) for cohort studies and the AHRQ criteria for cross-sectional studies. Potential moderators were explored using three-level meta-regression, and potential publication bias was evaluated using funnel plots, modified Egger’s test, and trim-and-fill analysis. A total of 28 articles (23 cross-sectional, 5 cohort) published between 2014 and 2025 were included in the systematic review, with 24 eligible for meta-analysis. All included studies were deemed high quality (mean NOS score: 7.60; mean AHRQ score: 7.57). For continuous outcomes, digital smart device use was significantly associated with lower depression scores (β = -0.201, 95% CI: -0.324, -0.079, p < 0.01). For binary outcomes, device use was associated with a decreased risk of depression (OR = 0.676, 95% CI: 0.613, 0.745, p < 0.001). Moderator analyses indicated that the association was not significantly modified by age, study design, sample size, region, measurement tools, or publication year (p > 0.05). This study has certain limitations, including publication bias (p < 0.001). However, trim-and-fill analyses confirmed that the results remained statistically significant after imputing missing studies. This three-level meta-analysis provides robust evidence that digital device use is inversely associated with depression among older adults, supporting their potential role in mental health promotion. The study protocol was registered with the International Prospective Register of Systematic Reviews (PROSPERO) in 2024 (registration number: CRD42024616432).

30. Draft genome sequence of Priestia megaterium MHES4, a biofertilizer candidate isolated from tomato rhizosphere in Bangladesh.

期刊: BMC genomic data 发表日期: 2026-May-09 链接: PubMed

摘要

The genus Priestia has recently gained attention for its plant growth-promoting potential. To examine the genomic traits and biosafety profile for potential field application as a native, climate-smart bioinoculant, we sequenced, assembled and annotated the genome of Priestia megaterium strain MHES4, isolated from the rhizosphere of tomato plant grown in drought-prone ecosystem of Rajshahi, Bangladesh. Genome assembly data from the shotgun whole genome sequencing (WGS) of the P. megaterium MHES4 revealed 60 contigs with a total length of 5,267,048 bp, an N50 of 446,003 bp and 37.9% G + C content. The mean sequencing depth was 127.58×, with 100% breadth of coverage. Genome completeness assessed was 97.43% with 3.5% contamination, confirming high assembly quality. In total, 5,484 protein-coding genes were annotated. Additionally, 5,445 protein-coding sequences, 28 tRNAs, and 5 rRNAs were identified. Functional analysis identified gene clusters involved in the synthesis of secondary metabolites, such as phytoene synthase and alpha-amylase, and a Type I CRISPR-Cas system. Biosafety assessment using in silico tools detected no virulence factors or transmissible antibiotic resistance genes, indicating its potential safe use in agriculture. Overall, this genomic resource provides valuable insights into the genetic potential of P. megaterium MHES4 for nutrient cycling and adaptation to the rhizosphere environment.

31. The Influence of Oral Health Related Knowledge, Attitudes and Practices on Oral Health Risk-Related Behaviours of People in Custodial Settings: An Integrative Review.

期刊: Journal of advanced nursing 发表日期: 2026-May-09 链接: PubMed

摘要

To explore the influence of oral health-related knowledge, attitudes and practices on oral health risk-related behaviours of people in custodial settings. Integrative review. Scopus, ProQuest Central, Web of Science, Medline, CINAHL, Academic Search Complete, PsycINFO and Education Research Complete were searched in March 2024 and December 2025. Studies reporting on any individuals in custodial settings, at least one oral health-related knowledge, attitude or practice and at least one oral health risk-related behaviour (either smoking, alcohol, illicit substances or sugar consumption). Data related to custodial population’s oral health knowledge, attitudes, or practices and oral health risk-related behaviour were extracted, synthesised narratively and reported thematically. Findings from the 26 studies reveal that people in custodial settings had a general lack of oral health knowledge, and oral health risk-related behaviours were prevalent. The most common risk-related behaviours reported were tobacco use and free sugar consumption. Oral health knowledge, attitudes and practices of this population were influenced by custodial healthcare systems and attitudes of dental professionals. This review highlights the influence custodial healthcare and dental professionals have on the knowledge, attitudes, practices and risk-related behaviours of people in custodial settings. Oral health targeted interventions and strategies are required to improve oral health-related knowledge and attitudes thereby encouraging oral health practices among people in custodial settings. This review will inform targeted oral health promotion programs that can improve oral health outcomes and experiences of this population. People in custodial settings experience a disproportionate burden of oral diseases. This review underscores the need for proactive interventions and systemic reform to improve correctional healthcare experiences globally. Preferred Reporting Items for Systematic Reviews and Meta-Analysis, Extension for Scoping Reviews (PRISMA-ScR) 2018. No patient or public contribution. WHAT DOES THIS PAPER CONTRIBUTE TO THE WIDER GLOBAL CLINICAL COMMUNITY?: Synthesises evidence on influencing factors contributing to poor oral health among people in custodial settings. Highlights impact of healthcare staff and custodial healthcare systems on population health. Highlights the necessity of oral health promotion programs to improve oral health knowledge and to promote oral health protective behaviours.

32. Sedentary time during pregnancy and fetal malpresentation in the Japan Environment and Children's Study.

期刊: Communications medicine 发表日期: 2026-May-09 链接: PubMed

摘要

Fetal malpresentation, such as breech, transverse, and oblique presentations, is a frequent diagnosis in obstetrical practice. While several maternal factors have been studied, the potential relationship between maternal sedentary behavior and fetal malpresentation remains underexplored. This study aimed to examine the association between sedentary behavior during pregnancy and fetal malpresentation using data from a large longitudinal cohort study conducted in Japan. This prospective longitudinal cohort study recruited approximately 100,000 pregnant women from 15 Regional Centers in Japan. Participants completed self-administered questionnaires in the first and either the second or third trimester of pregnancy. Sedentary behavior was defined as the number of hours spent sitting or lying down per day. The fetal presentation at delivery was recorded from medical records. Logistic regression analyses were conducted to estimate the odds ratio of the association between sedentary time and the likelihood of fetal malpresentation. Here we show that among 73,813 eligible participants, the mean maternal age is 31.3 years, 27.4% deliver at ≥35, 3.0% experience fetal malpresentation, and 48.7% have female infant. The median sedentary time is 5 hours (interquartile range: 3-8). Women who report ≥12 hours sedentary time per day have higher odds for fetal malpresentation compared to those reporting <6 hours (adjusted odds ratio: 1.17; 95% confidence interval: 1.02-1.35). The findings emphasize the need to address sedentary behavior as a modifiable risk factor during pregnancy, which may implicate future interventions aimed at reducing the incidence of fetal malpresentation. Fetal malpresentation is a frequent diagnosis in pregnancy where the fetus is positioned incorrectly in the womb. We examined the association between time sitting or lying down during pregnancy and fetal malpresentation. Approximately 100,000 pregnant women completed self-administered questionnaires in the first and either the second or third trimester of pregnancy. The median sitting or lying time was 5 hours. Women who reported more than 12 hours per day had higher odds for fetal malpresentation compared to those reporting less than 6 hours. The findings emphasize the need to address sedentary behavior as a modifiable risk factor during pregnancy, which may improve treatments aimed at reducing the incidence of fetal malpresentation.

33. Design, synthesis, and quantitative structure-activity modeling of indole-3-pyrimidine hydrazone derivatives as novel antifungal agents.

期刊: Pest management science 发表日期: 2026-May-09 链接: PubMed

摘要

Fungicides remain the primary approach for preventing and controlling agricultural and forestry fungal diseases. However, the inevitable emergence of antifungal drug resistance in plant pathogenic fungi necessitates novel multi-target fungicides. A series of novel indole-3-pyrimidine hydrazones were designed and synthesized using pharmacophore fusion/fragment hybridization strategies, with ferimzone, PMDD-5Y, melatonin, and chloroinconazide as lead compounds. All synthesized compounds exhibited inhibitory effects against the tested seven agricultural and forestry pathogens. Notably, compound IPH-18 exhibits excellent broad-spectrum activity, with inhibition rates exceeding 90% against Cytospora chrysosperma, Magnaporthe oryzae, and Fusarium graminearum at 50 μg/mL (half-maximal effective concentration (EC50) = 6.98, 6.62, and 8.18 μg/mL, respectively), outperforming the positive control azoxystrobin. In vivo trials revealed that IPH-18 (20 and 50 μg/mL) effectively suppressed Sphaeropsis sapinea infection, demonstrating bioactivity comparable to the commercial fungicide carbendazim. Scanning electron microscopy (SEM) and transmission electron microscopy (TEM) confirmed that IPH-18 disrupts pathogenic fungi by damaging submicro- and ultra-structural components (cell wall and membrane). Quantitative structure-activity relationship (QSAR) modeling further revealed that introducing unsaturated substituents and electronegative atoms significantly enhanced antifungal potency. Molecular docking simulation results demonstrate that compound IPH-18 displays promising multi-target inhibitory activity. The calculated binding energies for glycogen synthase, enoyl-CoA hydratase, glutathione S-transferase, monopolar spindle kinase 1 (Mps-1), and laccase were -8.12, -8.56, -8.05, -7.80, and -7.92 kcal/mol, respectively. The QSAR analysis of 34 novel indole-3-pyrimidine hydrazones, combined with molecular docking simulations, established a crucial theoretical foundation for developing multi-target fungicides by enabling structural optimization and elucidating precise fungicidal mechanisms of action. © 2026 Society of Chemical Industry.

34. Sociodemographic determinants of contraceptive intention among young adult women (15-24) in Nigeria: the role of age at first sex and region of residence.

期刊: Contraception and reproductive medicine 发表日期: 2026-May-09 链接: PubMed

摘要

Young adult women represent a critical population in reproductive health due to their heightened risk of unintended pregnancy and limited socioeconomic opportunities. Contraceptive intention is a key determinant of future contraceptive use; however, limited evidence exists on the factors influencing contraceptive intention among young adult women in Nigeria. This study therefore examined the sociodemographic determinants of contraceptive intention among young adult women in Nigeria, with particular attention to age at first sex and region of residence. This cross-sectional study used data from the 2018 Nigeria Demographic and Health Survey (NDHS). A total of 14,210 women aged 15-24 years who reported their contraceptive intention were included, while current contraceptive users were excluded because the analysis focused specifically on contraceptive intention among women who were not currently using any contraceptive method. Descriptive statistics summarized sample characteristics, while bivariate and multivariable logistic regression analyses identified determinants of contraceptive intention. Results were presented as crude and adjusted odds ratios (CORs and AORs) with 95% confidence intervals (CIs), and statistical significance was set at p < 0.05. The prevalence of contraceptive intention among young adult women in Nigeria was 47%. Education showed a strong positive association, as women with tertiary education were more than three times as likely to intend to use contraception compared to those with no education (AOR = 3.51; 95% CI: 2.81-4.40; p < 0.001). Married women (AOR = 0.63; 95% CI: 0.54-0.74; p < 0.001) and Muslim women (AOR = 0.52; 95% CI: 0.45-0.60; p < 0.001) had significantly lower odds of intending to use contraception. Wealth status showed a positive gradient, while later sexual debut (≥ 20 years) was associated with higher intention (AOR = 1.35; 95% CI: 1.05-1.73; p = 0.02). Regional differences persisted: women in the North West had higher odds (AOR = 1.59; 95% CI: 1.39-1.83; p < 0.001), while those in the South East, South South, and South West had lower odds of contraceptive intention. Education, marital status, religion, wealth, age at first sex, and regional context are key determinants of contraceptive intention among young adult women in Nigeria. Addressing disparities through youth-centered and culturally sensitive family planning interventions that promote education, reproductive health awareness, and economic empowerment could improve contraceptive uptake and reduce unintended pregnancies. However, the cross-sectional nature of the data limits causal interpretation of the observed associations.

35. Risk factors for colonisation and infection with multidrug-resistant Pseudomonas aeruginosa in intensive care unit: a systematic review and meta-analysis.

期刊: Systematic reviews 发表日期: 2026-May-09 链接: PubMed

摘要

There are currently two opposing hypotheses regarding the risk factors for acquisition, colonisation and infection with multidrug-resistant Pseudomonas aeruginosa (MDR-PA) in the intensive care unit (ICU). Acquisition could be either endogenous or exogenous or both. It is of great interest to estimate pooled prevalence and describe individual and environmental factors associated with the colonisation and infection with MDR Pseudomonas aeruginosa in intensive care units. This systematic review was performed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The protocol of this review has been registered under CRD42021233832 in the International Prospective Register of Systematic Reviews (PROSPERO) and has been published on Systematic review on November 2022All types of studies carried out in intensive care units (ICUs) were included. MEDLINE (Pubmed), EMBASE (OVID), the Cochrane Library (Wiley), Web of Science, CINAHL (EBSCOHost), LILACS (BIREME), Google Scholar and Open Grey were searched from 1983 to 2023 and the results of electronic searches were uploaded to Rayyan software. The methodological quality of the studies was assessed using the National Heart, Lung, and Blood Institute Critical Appraisal Tools. The I2 test was performed to assess the statistical heterogeneity among the included studies. The publication bias was assessed by using the funnel plot and Egger’s test. Descriptive analysis and meta-analysis were performed. Fixed effect model were used to calculate the surveyed prevalence and odds ratio (OR) with their respective 95% confidence intervals (95% CI). A total of 10,791 articles were identified, of which 13 were retained for descriptive analysis and 8 for meta-analysis. The majority of these 13 studies were conducted in Western countries. Methods were heterogeneous and few studies addressed environmental factors. The pooled prevalence of MDR-PA in the ICU was 4% (95% CI: 0%-11%). Identified risk factors were: length of stay in ICU (> 8 days), mechanical ventilation with OR: 3.19; 95% CI: 2.25-4.53, use of invasive devices with OR: 2.97; 95% CI: 2.40-3.68 (use of central venous catheter with OR: 3.16 95% CI: 1.87-5.33, the use of urinary catheters with OR: 2.65; 95% CI: 2.05-3.44, the use of parenteral nutrition with OR: 2.43; 95% CI: 1.15-5.16 and the use of arterial catheters with OR: 7.00; 95% CI: 2.77-17.68) and the use of antibiotics with OR: 3.69; 95% CI: 3.16-4.27 (carbapenem with OR: 4.12; 95% CI: 3.29-5.16, quinolones with OR: 3.31; 95% CI: 2.45-4.47, bectalactam with OR: 3.58; 95% CI: 2.4-5.24, and aminoglycosides with OR: 3.32; 95% CI: 2.33-4.73) and environmental factors. All this suggest that acquisition or infection by MDR-PA in ICU could be due to endogenous and exogenous transmission. Due to the few numbers of studies analysed, further investigation with more studies is needed to draw definitive conclusions. The protocol of this review has been registered under CRD42021233832 in PROSPERO and has been published on Systematic review on November 2022. Eyebe et al. (Syst Rev 11:270, 2022).

36. An economic evaluation of the MultICath randomised controlled trial, comparing combined use of reusable and single-use intermittent catheters to single-use catheters only.

期刊: Cost effectiveness and resource allocation : C/E 发表日期: 2026-May-09 链接: PubMed

摘要

Widespread adoption of single-use intermittent catheters for bladder drainage has led to increased costs and environmental waste. Reusable catheters could reduce both. The MultICath study showed that combined reusable and single-use catheters (Mixed-use) was non-inferior to single-use catheters for urinary tract infection and quality of life, but the economic impact is unknown. We aim to determine whether Mixed-use is cost-effective compared to Single-use only. Cost-utility and cost-consequence analyses were conducted alongside MultICath. The analysis took the United Kingdom payer perspective, using individual patient-level data of the 578 randomised (1:1) trial participants over 12 months. Costs included catheter and cleaning costs, antibiotic costs, and health-related visit costs. Outcomes were measured in quality adjusted life years (QALYs), estimated from EQ-5D-5L data. Incremental, sensitivity, and scenario analyses were conducted. Mixed-use participants used on average 902 (95% CI 755.13; 1049.31) fewer single-use catheters per annum than Single-use participants. Mixed-use was cost-effective in all analyses. Base-case annual incremental cost savings were -£1348.82 (95% CI -1939.98; -757.65) whilst incremental QALYs were negligible (-0.001; [-0.026; 0.024]). These estimates produced a positive net monetary benefit of £1328.82 at a willingness-to-pay threshold of £20,000. The probability of Mixed-use being cost-effective was never below 96.6%. The primary limitation was differential withdrawal rates between groups, accounted for in sensitivity analyses. Mixed-use is cost-effective for the UK National Health Service, and provision of reusable catheters should be considered. These findings are also relevant for other health services worldwide with high single-use catheter costs.

37. Mechanistically informed circulating biomarkers are associated with acquired epilepsy after neonatal brain injury.

期刊: Journal of neuroinflammation 发表日期: 2026-May-09 链接: PubMed

摘要

Acute provoked neonatal seizures are a major risk factor for acquired epilepsy, yet clinicians lack reliable tools to identify neonates at highest risk. Preclinical data implicate innate immune activation and neuronal injury as key drivers of epileptogenesis, suggesting blood-based biomarkers could provide mechanistic insight and prognostic utility. We sought to identify biomarkers of epileptogenesis in neonates with acute provoked seizures after brain injury using multicenter cohorts. We conducted a prospective, multi-cohort analysis across two independent studies. NSR-RISE enrolled neonates with EEG-confirmed acute provoked seizures of diverse etiologies. The HEAL trial enrolled neonates with hypoxic-ischemic encephalopathy; analyses were limited to those with seizures. Plasma proteins were quantified 48-96 h after seizure onset. Associations with acquired epilepsy by 24-months were evaluated using log-link models with robust standard errors and false-discovery rate correction (FDR < 0.05). Significant proteins were added to models including established clinical predictors (≥ 3 days of EEG seizures and abnormal neurological examination at discharge). Exploratory pathway enrichment used KEGG databases. NSR-RISE participants also underwent plasma microRNA (miRNA) sequencing with integrative pathway analyses. Among 35 neonates in NSR-RISE, 7 (20%) developed epilepsy; among 40 neonates in HEAL, 6 (15%) developed epilepsy. Across both cohorts, neonates with epilepsy had higher concentrations of the pro-inflammatory cytokine IL-1β and the neuronal injury marker UCHL1 compared to those without epilepsy. Growth hormone (GH), measured only in NSR-RISE, was decreased in neonates with epilepsy. Incorporation of biomarkers improved prognostic accuracy for epilepsy beyond clinical features alone (Area under the precision-recall curve (AUPRC) 0.30 (95%CI, 0.28-0.32) versus 0.91 (95%CI, 0.89-0.92); p < 0.001). Pathway enrichment analyses implicated innate immune signaling, including TLR/IL1/NF-κB-related and MAPK-associated IL-17 signaling. miRNA profiling identified 11 species differentially expressed between neonates with and without epilepsy, including brain-enriched miRNAs. Network analysis identified a co-expression module enriched for let-7f-5p and miR-146a-5p targeting TLR/IL1/NF-κB, MAPK, and JAK/STAT pathways. Across two cohorts, mechanistically informed biomarkers were associated with acquired epilepsy after neonatal seizures. IL-1β, UCHL1, and GH reflect inflammation, neuronal injury, and impaired trophic signaling, while circulating miRNAs provide complementary mechanistic insight. Findings support a translational biomarker panel and highlight inflammation as a biologically plausible therapeutic target.

38. Differentiating the importance of workplace barriers for ICU nurse well-being and patient safety using AHP and FAHP methods.

期刊: Applied ergonomics 发表日期: 2026-May-09 链接: PubMed

摘要

High quality nursing in intensive care units (ICU) depends on supportive and efficient work systems. Using a sequential exploratory design, and the systems engineering initiative for patient safety (SEIPS) model as a framework, interviews were conducted with fourteen experienced ICU nurses working in Fars, Iran to identify workplace barriers. The transcribed codes were collated into eighteen barriers which were categorized into the five components of the SEIPS model. Two decision-making methods (the analytic hierarchical process (AHP) and the fuzzy analytic hierarchical process (FAHP)) were then applied to rank the workplace barriers by importance. These yielded the same order at the SEIPS component and the within-component levels. There were differences in overall ranking of workplace barriers that reflected differences in the underlying weightings of the two methods. The most important barrier using AHP was organisational culture, and using FAHP was task demand, difficulty and complexity. These outcomes are discussed in terms of tailoring interventions that address the complexities of the ICU work environment for nurses.

39. Lifestyle front offices in dutch hospitals: a cross-sectional survey on similarities, differences and future needs.

期刊: BMC health services research 发表日期: 2026-May-09 链接: PubMed

摘要

Since 2019, Dutch hospitals have been developing approaches aiming to bridge the gap between hospital care and community-based lifestyle support. This has led to the introduction of the so called ‘Lifestyle Front Office” (LFO) in 2022. The LFO enables healthcare professionals to refer patients for lifestyle and (psycho)social support adjacent to medical treatment in the context of specialist medical care. After a consultation at the LFO, patients are referred to the appropriate community-based lifestyle interventions. LFOs have been quickly adopted in Dutch hospitals, leading to conceptual differences. This study aimed to evaluate similarities, differences and future needs of LFOs in the Netherlands, striving for a more unified concept. A cross-sectional survey was sent out between December 2023 and September 2024 to all Dutch hospitals with an operational LFO (n = 17 hospitals). The survey focused on referral processes, patient eligibility criteria, departmental involvement, screening methods, consultation practices, follow-up procedures, financing, and capacity. The collected data were analyzed quantitatively and qualitatively to identify common practice, challenges, and opportunities for improvement. The survey response rate was 82% (14/17). Primary referral groups were patients with lifestyle-related conditions such as obesity, type 2 diabetes mellitus and cardiovascular diseases. Most LFOs conducted pre-visit screenings by using questionnaires, employed lifestyle care coordinators with diverse professional backgrounds, utilized structured tools during consultations and used the electronic patient records for screening and communication. Future needs included the need for (long-term) funding, which was only secured in 21% of the LFOs. Furthermore, inconsistent eligibility criteria, limited capacity, and follow-up procedures were seen as priorities for future attention. This study highlights the similarities, differences and future needs of LFOs in the Netherlands. To achieve a more unified concept, LFOs need to better align patient-related eligibility criteria, use of structured tools, referral to community-based support, follow-up strategies and long-term funding. While the LFO concept emphasizes strong inter-organizational collaboration, further research is needed to assess its impact by investigating success rate of referrals and (long-term) health outcomes after referral. Additionally, for maintaining LFOs in the Dutch healthcare system, additional research is required to better understand the barriers and facilitators regarding structural implementation.

40. Household livelihood vulnerability and child health in southwestern coastal Bangladesh: determinants and implications.

期刊: BMC public health 发表日期: 2026-May-09 链接: PubMed

摘要

Household livelihood vulnerability (HLV) remains a critical yet underexplored determinant of child health in climate-sensitive coastal regions of Bangladesh, where recurrent climate hazards disrupt livelihoods, reduce income stability, intensify food insecurity, and limit access to essential health services. Therefore, this study examines the extent and determinants of HLV and its implications for child health in southwestern coastal Bangladesh. Following the survey method, this community-based cross-sectional study was carried out in six villages of Dacope upazila in Khulna district of Bangladesh. Data were collected from 348 randomly selected caregivers of under-five children at the household level from July to October 2024. The findings demonstrated that the prevalence of HLV was 58.6% in the study area. HLV showed significant spatial and occupational variation, with the highest prevalence observed in Sutarkhali village and among households primarily dependent on Sundarbans-based natural resource extraction. Multivariate logistic regression analysis revealed that higher odds of livelihood vulnerability were examined among Muslim households, households with multiple dependents, food insecure households, those that had recently borrowed money from friends or relatives, and those relying on local government assistance. Conversely, household heads with primary, secondary, or higher education, monthly savings of BDT ≤ 1,000, and households with multiple income earners had lower odds of livelihood vulnerability. Furthermore, child health analysis revealed a significant relationship between household vulnerability and child undernutrition, indicating that children from vulnerable households were more likely to be severely underweight than peers from non-vulnerable households. This study highlights the need for integrated policy responses that simultaneously address livelihood insecurity and child health particularly, strengthening climate-resilient and diversified livelihoods, expanding education, vocational training, and financial inclusion programs (e.g., savings schemes and microcredit), and the integration of vulnerability assessments into child-nutrition programs through targeted cash transfers, supplementary feeding, growth monitoring, and nutrition counseling in coastal Bangladesh.

41. Association of active and passive smoking with adolescent asthma: a systematic review and meta-analysis.

期刊: BMC public health 发表日期: 2026-May-09 链接: PubMed

摘要

To synthesize evidence on the association of active or passive smoking with asthma in adolescents. A comprehensive search of Embase, PubMed, Scopus, and Web of Science were conducted from inception to January 2026. Only human studies published in English were included. Observational studies evaluating active or passive smoking in adolescents aged 10-19 years were eligible. Studies reporting odds ratio (OR), hazard ratio (HR), relative risk (RR), prevalence ratio (PR), incidence rate ratio (IRR), or prevalence odds ratio (POR) with 95% confidence interval (95% CI) were included. Two reviewers independently screened studies. Key study characteristics, including authors, year, setting, age range, design, sample size, exposure type, asthma outcome, adjusted covariates, and effect estimates, were independently extracted and cross-verified by two reviewers, with discrepancies resolved by consensus. Seventy-seven studies met inclusion criteria, with 72 contributing to meta-analysis. Active smoking (adjusted odds ratio [aOR] = 1.16; 95% CI: 1.13-1.20), cigarette use (aOR = 1.19; 95% CI: 1.13-1.26), e-cigarette use (aOR = 1.13; 95% CI: 1.10-1.16), and passive smoking (aOR = 1.23; 95% CI: 1.17-1.29) were all significantly associated with asthma. Parental smoking conferred elevated risk (aOR = 1.85; 95% CI: 1.33-2.36), and exposure from friends showed the strongest association (aOR = 3.70; 95% CI: 1.63-5.78). Both active and passive smoking significantly increase asthma risk in adolescents, with both cigarette use and e‑cigarette use showing adverse associations. Friend smoking represents the most potent passive exposure. According to the GRADE assessment, the certainty of evidence for these associations was rated as very low, reflecting limitations in study design, confounder adjustment, and exposure measurement. Future studies should incorporate longitudinal designs, validated biomarkers, and standardized outcome measures to better characterize dose-response patterns and underlying mechanisms.

42. Repeated opioid use during pregnancy in women with inflammatory bowel disease: prevalence and impact on birth outcomes in Denmark.

期刊: Journal of Crohn’s & colitis 发表日期: 2026-May-08 链接: PubMed

摘要

In women with IBD, there are few options to treat pain during pregnancy and prescribers sometimes rely on opioids. We investigated the prevalence of repeated opioid use during the pregnancy period as well as the impact on birth outcomes. Using the Danish national registries, we identified pregnancies of women with IBD from January 1, 1997, to June 1, 2023. We defined repeated opioid use as at least two opioid prescriptions with a minimum 30-day interval between them. We examined the prevalence in three separate time periods: (1) nine months before conception; (2) throughout pregnancy; and (3) nine months postpartum, and we calculated adverse birth outcomes. Of 10 904 women with IBD, 237 (2.2%) had repeated use of opioids prior to pregnancy, 220 (2.0%) during pregnancy and 359 (3.3%) postpartum. Women with repeated opioid use prior to pregnancy were significantly more likely to have repeated use during pregnancy (adjusted odds ratio (aOR): 231.50 (95% CI, 159.80-335.36)). Women who had repeated use during pregnancy were significantly more likely to have repeated use during the postpartum period (aOR: 74.98 (95% CI, 53.76-104.57)). Women with repeated use of opioids during pregnancy had statistically significant risks of preterm birth (aOR: 1.87 (95% CI, 1.28-2.74)) and of delivering a small for gestational age infant (aOR: 2.46 (95% CI, 1.41-4.32)). The proportions of women who used repeated opioids prior to pregnancy, during pregnancy, and in the postpartum period were low but consequences for neonates can be severe. Providers should screen for opioid use in this population.

43. Managing multidrug resistant Gram-negative bacteraemia in immunocompromised hosts.

期刊: Current opinion in infectious diseases 发表日期: 2026-May-07 链接: PubMed

摘要

Multidrug-resistant Gram-negative bloodstream infections (MDR-GNBSI) are increasingly frequent in immunocompromised hosts, particularly solid organ transplant (SOT) recipients and patients with haematological malignancy (HM) receiving intensive chemotherapy and/or cellular therapies. We summarize current evidence and practical approaches across empirical, quasi-targeted and targeted management. Contemporary cohorts show rising rates of MDR-GNBSI in both SOT and HM patients. Appropriate therapeutic management is key to ensure good clinical outcome while minimizing ecological impact. Risk-adapted empirical therapy usually incorporates prior colonization and local epidemiology plus individual risk factors, thus screening could play central role. Rapid diagnostic testing can reduce time to appropriate and proportionate therapy, but currently the majority of them provide genotypic resistance that in Gram negatives can be difficult to interpret, in addition off-target resistance mechanisms should be considered mainly in nonfermenter bacteria. Thus, machine-learning models and structured BSI bundles are emerging tools to support early decision-making and stewardship. For targeted therapy, novel β-lactam/β-lactamase inhibitor combinations and cefiderocol expand options for carbapenem-resistant strains; pharmacokinetics/pharmacodynamics (PK/PD) optimization may improve target attainment and mitigate resistance selection. Evidence supporting oral step-down and shorter courses is growing, whereas routine follow-up blood cultures remain controversial due to observational bias. MDR-GNBSI management in immunocompromised patients requires individualized, data-driven strategies integrating risk stratification, rapid microbiology, and PK/PD optimization. Pursuing antimicrobial stewardship principles in these populations remains a priority.

44. Biological Effects of Widely Consumed Psychoactive Substances in Adolescents: The Role of the Pediatrician in Prevention and Intervention.

期刊: The Journal of pediatrics 发表日期: 2026-May-07 链接: PubMed

摘要

This commentary, authored by members of the Working Group on Social Pediatrics of the European Pediatric Association, Union of National European Pediatric Societies and Associations, briefly discusses the biological impact of widely consumed psychoactive substances in adolescents and the pivotal role of pediatricians in prevention and intervention. Adolescence is a multifaceted, developmental stage marked by profound neurobiological, psychological, and behavioral change. During this transitional period, the brain undergoes extensive structural and functional remodeling, particularly in regions responsible for executive functioning, impulse control, and reward sensitivity. This phase constitutes a critical window of vulnerability, often accompanied by heightened risk-taking and experimentation with psychoactive substances, making it a pressing global public health issue1. Traditionally, both scientific debates and popular understanding have divided substances into “soft” and “hard” drugs, a distinction shaped more by sociocultural norms and legal classifications than by consistent pharmacological evidence. Current views, however, challenge the validity of this binary framework, especially in the context of adolescent development. Substances commonly labeled as “soft,” including alcohol, nicotine, and cannabis, can exert significant biological effects on the developing brain, with potential long-term consequences that may rival or even exceed those associated with so-called “hard” drugs.2 This persistent ambiguity in terminology suggests adoption of a more refined approach to substance use classification, one that accounts for the heightened neurobiological sensitivity of the adolescent brain. Although drugs such as heroin and cocaine are widely acknowledged for their acute toxicity and overdose risk, legally accessible substances like alcohol and nicotine warrant equal concern due to their widespread use and substantial impact on neurodevelopment. Cannabis, often perceived by young people as relatively benign, remains the most commonly used illicit substance worldwide. The increasing availability of high-potency formulations and emerging delivery methods, such as vaping, further complicate its risk profile3. Within this evolving landscape, pediatricians play a crucial role in early detection, prevention, and the delivery of evidence-based interventions4, positioning them at the forefront of efforts to mitigate substance-related harm during this vulnerable stage of life.

45. Facilitators and barriers to delayed medical-seeking in adults with pressure injuries: a qualitative study.

期刊: Journal of tissue viability 发表日期: 2026-May-05 链接: PubMed

摘要

This study aimed to: (1) explore factors associated with delayed medical consultation among patients with pressure injuries (PIs); and (2) provide a theoretical basis for formulating PI intervention strategies to curb injury progression and improve patients’ quality of life. This was a qualitative descriptive study. Patients with PIs who had delayed seeking medical treatment, or their caregivers (n = 18), were interviewed using a semi-structured interview guide. Interviews were audio-recorded, transcribed verbatim, and coded using NVivo. Four overarching themes were identified: (1) pressure injury awareness; (2) family support; (3) ability to seek medical care; and (4) medical resources. Barriers to timely care substantially outnumbered facilitators. The findings underscore the need for patient-centered, interprofessional education for PI prevention and management. Meaningful, needs-based interventions can improve health literacy and empower both patients and caregivers to engage in wound care. Increased investment in prevention and sustained public-awareness campaigns are essential to reduce delayed help-seeking and PI incidence. These results provide practical guidance for healthcare professionals and researchers seeking to enhance patient services and develop effective PI-prevention strategies.

46. [Interleukin-1 activity regulators in acute decompensated heart failure: dependence on obesity degree].

期刊: Terapevticheskii arkhiv 发表日期: 2026-May-02 链接: PubMed

摘要

To assess the circulating levels of IL-1 and its activity regulators, IL-1Ra and IL-1R2, in patients with acute decompensated heart failure (ADHF) depending on body mass index (BMI). The study included 159 patients hospitalized for ADHF. Depending on the BMI, the patients were assigned to 5 groups. The first group included 30 patients with healthy weight (BMI<25 kg/m2), the second - 50 overweight patients (25≤BMI<30 kg/m2), the third - 38 patients with class I obesity (30≤BMI<35 kg/m2), the fourth - 28 patients with class II obesity (35≤BMI<40 kg/m2), the fifth group - 13 patients with class III obesity (BMI≥40 kg/m2). With increasing BMI, IL-1 levels increased, while IL-1R2 levels, on the contrary, decreased, but no statistically significant differences were found. IL-1Ra concentrations changed ambiguously and had U-shaped dependence. IL-1Ra levels were lower in overweight patients than in normal weight and obese groups. At the same time, the increase in obesity was accompanied by higher IL-1Ra levels. The highest IL-1Ra value was observed at a BMI≥40 kg/m2. In ADHF an increase in obesity is accompanied by an increase in the inhibition of IL-1 activity, which may be one of the mechanisms by which adipose tissue exerts a protective effect. Цель. Оценить циркулирующие уровни интерлейкина (ИЛ)-1 и регуляторов его активности – антагониста рецептора ИЛ-1 (ИЛ-1Ра) и рецептора ИЛ-1 типа 2 (ИЛ-1Р2) – у пациентов с острой декомпенсацией сердечной недостаточности (ОДСН) в зависимости от индекса массы тела (ИМТ). Материалы и методы. В исследование включены 159 пациентов, госпитализированных в стационар по поводу ОДСН. В зависимости от ИМТ пациенты отнесены к 5 группам. В 1-ю группу вошли 30 пациентов с нормальной массой тела – ИМТ<25 кг/м2, во 2-ю – 50 пациентов с избыточной массой тела и ИМТ 25–29 кг/м2, в 3-ю – 38 пациентов с ожирением 1-й степени и ИМТ 30–34 кг/м2, в 4-ю – 28 пациентов с ожирением 2-й степени и ИМТ 34–39 кг/м2, в 5-ю группу – 13 пациентов с ожирением 3-й степени и ИМТ≥40 кг/м2. Результаты. При увеличении ИМТ уровни ИЛ-1 в крови повышались, а уровни ИЛ-1Р2, наоборот, понижались, однако статистической значимости различий не выявлено. Концентрации ИЛ-1Ра менялись неоднозначно и имели U-образную форму зависимости. У пациентов с избыточной массой тела уровни ИЛ-1Ра оказались ниже, чем у пациентов с нормальной массой тела и в группах с ожирением. При этом увеличение степени ожирения сопровождалось повышением уровней ИЛ-1Ра. Наибольшее значение ИЛ-1Ра отмечалось при ИМТ≥40 кг/м2. Заключение. Увеличение степени ожирения у пациентов с ОДСН сопровождается усилением ингибирования активности ИЛ-1, что может быть одним из механизмов защитного эффекта жировой ткани.

47. [Features of disorders of the gut microbiota in patients with urolithiasis, depending on the severity of symptoms of intestinal indigestion and indicators obtained in laboratory and instrumental assessment].

期刊: Terapevticheskii arkhiv 发表日期: 2026-May-02 链接: PubMed

摘要

The study examined the composition of the gut microbiota (GM) in patients with urolithiasis compared to healthy volunteers, based on laboratory, instrumental, and gastroenterological quality of life questionnaire (Gastrointestinal Symptom Rating Scale - GSRS) results. The composition of GM was studied using fecal samples obtained from 35 patients with urolithiasis and 31 healthy volunteers using gas chromatography-mass spectrometry. The GSRS questionnaire was used to assess gastrointestinal symptoms. In the group of patients with urolithiasis, the body mass index, serum creatinine concentration (with calculation of glomerular filtration rate), and serum uric acid concentration were analyzed, as well as the density of urinary stones using multispiral computed tomography (MSCT) in Hounsfield units (HU). Statistical analysis of the data revealed violations of the composition of the GM against the background of urolithiasis in comparison with healthy volunteers (control group): patients with urolithiasis had a statistically significant increase in the content of bacteria Corynebacterium spp., Peptostreptococcus anaerobius 18623, a decrease in the number of Clostridium propionicum (Anaerotignum propionicum), on average, 7 times, compared to the control group. When comparing the composition of the GM depending on the type of urinary stones, in the subgroup of patients with oxalate stones (n=18), an increase in the number of Clostridium perfringens was detected in the fecal samples, and in the subgroup of patients with uric acid stones (n=17), a decrease in the number of Prevotella bacteria was observed. In patients with urolithiasis, there was a negative correlation between the total GSRS score and the severity of dyspepsia syndrome, as well as the number of Propionibacterium spp. in the GM. The composition of the GM in patients with urolithiasis was significantly different from that of the GM in healthy volunteers. Statistically significant differences in the composition of the GM were found in patients with uric acid and oxalate stones. Цель. Изучение нарушений состава кишечной микробиоты (КМ) у пациентов с мочекаменной болезнью (МКБ) в сравнении со здоровыми добровольцами в зависимости от значений лабораторных, инструментальных показателей и результатов заполнения гастроэнтерологического опросника качества жизни (Gastrointestinal Symptom Rating Scale – GSRS). Материалы и методы. Проведено исследование состава КМ по образцам фекалий, полученных от 35 пациентов с МКБ и 31 здорового добровольца, при помощи метода газовой хроматографии-масс-спектрометрии. Для оценки симптомов со стороны желудочно-кишечного тракта использовали опросник GSRS. В группе пациентов с МКБ проведен анализ индекса массы тела, концентрации креатинина (с расчетом скорости клубочковой фильтрации) и мочевой кислоты в сыворотке крови, плотности мочевых камней с помощью мультиспиральной компьютерной томографии (МСКТ) в единицах Хаунсфилда (HU). Результаты. При статистическом анализе полученных данных выявлены нарушения состава КМ на фоне МКБ в сравнении со здоровыми добровольцами (группой контроля): у пациентов с МКБ наблюдались статистически значимое повышение содержания бактерий Corynebacterium spp., Peptostreptococcus anaerobius 18623, снижение количества Clostridium propionicum (Anaerotignum propionicum), в среднем в 7 раз, по сравнению с группой контроля. При сравнении состава КМ в зависимости от типа мочевых камней в подгруппе пациентов с оксалатными камнями (n=18) в образцах фекалий выявлено увеличение численности Clostridium perfringens, а в подгруппе пациентов с мочекислыми камнями (n=17) наблюдалось снижение численности бактерий рода Prevotella. У пациентов с МКБ установлена обратная связь как суммарного балла по GSRS, так и отдельно выраженности синдрома диспепсии с количеством Propionibacterium spp. в КМ. Заключение. КМ пациентов с МКБ достоверно отличалась по составу от КМ здоровых добровольцев. Установлены статистически значимые отличия состава КМ у пациентов с мочекислыми и оксалатными камнями.

48. [Forced oscillation technique in the diagnosis of fibrotic phenotype interstitial lung diseases].

期刊: Terapevticheskii arkhiv 发表日期: 2026-May-02 链接: PubMed

摘要

To identify functional features in patients with interstitial lung diseases (ILD), depending on disease phenotypes, using the forced oscillation technique. A single-center cross-sectional observational study was conducted on 68 patients with ILD (mean age 64 years, 70.6% women). The diagnoses were distributed as follows: idiopathic pulmonary fibrosis 17.7%, chronic hypersensitivity pneumonitis 44.1%, non-specific interstitial pneumonia 14.7%, unclassified ILD 23.5%. According to Tomographia Computata data, fibrotic changes were detected in 74.1% of patients. All patients underwent comprehensive pulmonary function testing, including spirometry, body plethysmography, measurement of diffusing capacity of the lungs, and oscillometry (forced oscillation technique). The ΔX5 parameter was statistically significantly higher in patients with a fibrotic phenotype than in those without fibrosis [0.92 (0.06- 1.63) hPa×s/L vs 0.19 (-0.05-0.43) hPa×s/L; p=0.016]. Patients with fibrosis also had significantly lower for diffusing capacity of the lungs (45.5% vs 52% predicted; p=0.027) and CO diffusion capacity - Kco (73% vs 81.5% predicted; p=0.037) values. Independent predictors of the fibrotic phenotype were ΔX5 (odds ratio 6.386, 95% confidence interval 1.479-27.564; p=0.013) and Kco (odds ratio 0.929, 95% confidence interval 0.867-0.997; p=0.040). ROC analysis showed that the combination of ΔX5 and Kco parameters has high diagnostic value for detecting fibrosis (AUC 0.817; p<0.001). The oscillometry parameter ΔX5 and the Kco index from diffusing capacity measurement are independent predictors of a fibrotic phenotype in patients with ILD. The combination of these functional parameters improves diagnostic capabilities for detecting fibrotic changes. The FOT method provides clinically important information in patients with ILD and restrictive impairment. Цель. Выявить функциональные особенности дыхательной системы у пациентов с интерстициальными заболеваниями легких (ИЗЛ) в зависимости от фенотипов заболевания с помощью комплексного функционального исследования легких, включающего метод форсированных осцилляций. Материалы и методы. Проведено одноцентровое поперечное обсервационное исследование 68 пациентов с ИЗЛ (средний возраст – 64 года, 70,6% – женщины). Диагнозы распределились следующим образом: идиопатический легочный фиброз – 12 (17,7%) пациентов, хронический гиперчувствительный пневмонит – 30 (44,1%) пациентов, неспецифическая интерстициальная пневмония – 10 (14,7%) пациентов, неклассифицируемое ИЗЛ – 16 (23,5%) пациентов. По данным компьютерной томографии фиброзные изменения выявлены у 50 (73,5%) пациентов. Всем пациентам проведено комплексное функциональное исследование легких, включающее спирометрию, бодиплетизмографию, диффузионный тест и осциллометрию (метод форсированных осцилляций). Результаты. У пациентов с фиброзным фенотипом показатель ΔX5 статистически значимо выше, чем у пациентов без фиброза [0,92 (0,06–1,63) гПа×с/л vs 0,19 (-0,05–0,43) гПа×с/л; p=0,016]. Также у пациентов с фиброзом значимо ниже показатели диффузионной способности легких (45,5% долж. vs 52% долж., p=0,027) и коэффициент диффузии (поглощения) CO – Kco (73% долж. vs 81,5% долж., p=0,037). Независимыми предикторами фиброзного фенотипа были такие показатели, как ΔX5 (гПа×с/л) (отношение шансов 6,386, 95% доверительный интервал 1,479–27,564; p=0,013) и Kco (% долж.) [отношение шансов 0,929, 95% доверительный интервал 0,867–0,997; p=0,040]. ROC-анализ показал, что комбинация параметров ΔX5 (гПа×с/л) и Kco (% долж.) обладает высокой диагностической ценностью для выявления фиброзного фенотипа при рестриктивных изменениях вентиляционной способности легких у больных ИЗЛ (AUC 0,817; p<0,001). Заключение. При рестриктивных нарушениях вентиляционной способности легких комбинация параметров осциллометрии (ΔX5, гПа×с/л) и диффузионного теста (Kco, % долж.) улучшает диагностику фиброзного фенотипа ИЗЛ.

49. [A "risk score scale" based on computed tomography angiography of the coronary arteries to assess the risk of cardiovascular events in the first year after acute coronary syndrome].

期刊: Terapevticheskii arkhiv 发表日期: 2026-May-02 链接: PubMed

摘要

Development of a “Risk Score Scale” (RSS) to assess the risk of Major Adverse Cardiovascular Events (MACE) based on computed tomographic angiography (CTА) of the coronary arteries in patients with acute coronary syndrome. The study included 249 pаtients with acute coronary syndrome (77.5% of men, age 58.2±10.7 years). Myocardial infarction occurred in 73.5% of patients, unstable angina - in 26.5%. After percutaneous coronary intervention CTA was performed by 320 - row CT scanner. 30 CTА characteristics were determined. During 39.1 [18.0; 57.4] months of follow-up, 28.5% patients had combined primary endpoint events (PEE) including nonfatal myocardial infarction, unstable angina, cardiac death, unplanned percutaneous coronary intervention, ischemic stroke. RSS was developed by ROC analysis of the significant CT predictors of PEE, which were determined using a univariate Cox model. The uncensored period was 305 days - 26 PEE. Using the Yuden method, cut-off values, AUC values, and other indicators were calculated for predictors. RSS included the following 8 most optimal predictors with their cut-off values and score values: “number of coronary arteries with plaques” >1.5 - 1.0 point; “maximum plaque length” >14.5 mm - 1.16 points; “total length of plaques” >22.5 mm - 1.17; “maximal coronary stenosis” >77.5% - 1.23; “number of plaques with ≥50% stenosis” >3,5 - 1.1; “minimum plaque density” <29.1 HU - 1.33; “number of plaques with spotty calcifications” >1.5 - 1.23; “number of low attenuation plaque <30 HU” >0.5 - 1.00. For the resulting RSS calculated threshold value was 3 points. A score of >3 points indicates a high risk of MACE: odds ratio 7.2, 95% CI 2.6-19.7 (p<0.0001). The use of RSS is a new and practically significant technique that makes it possible to improve the risk stratification of adverse outcomes. Цель. Разработка «Балльной шкалы рисков» (БШР) возникновения неблагоприятных сердечно-сосудистых событий по данным компьютерной томографической ангиографии (КТА) коронарных артерий у больных с острым коронарным синдромом (ОКС). Материалы и методы. Включены 249 больных с ОКС (77,5% мужчин, возраст – 58,2±10,7 года). Инфаркт миокарда выявлен у 73,5% больных, нестабильная стенокардия – у 26,5%. После чрескожного коронарного вмешательства выполняли КТА на КТ-томографе с 320 рядами детекторов. Определяли КТА-характеристики, всего – 30. Результаты. За 39,1 [18,0; 57,4] мес у 28,5% больных возникли события первичной конечной точки (ПКТ), включая нефатальный инфаркт миокарда, нестабильную стенокардию, кардиальную смерть, внеплановое чрескожное коронарное вмешательство, ишемический инсульт. БШР разработана благодаря Receiver Operating Characteristic (ROC)-анализу значимых (по однофакторной модели Кокса) КТА-предикторов ПКТ. Период без цензурирований составил 305 дней – 26 ПКТ. Вычислены отрезные значения предикторов по методу Юдена, площадь под кривой и другие показатели. БШР составили 8 наиболее оптимальных предикторов с их отрезными значениями и баллами: «количество артерий с атеросклеротическими бляшками (АСБ)» более 1,5 – 1,00 балл; «максимальная протяженность АСБ» более 14,5 мм – 1,16; «общая протяженность АСБ» более 22,5 мм – 1,17; «максимальный стеноз АСБ» более 77,5% – 1,23; «количество АСБ с обструктивным стенозом» более 3,5 – 1,1; «минимальная плотность АСБ» менее 29,1 HU – 1,33; «количество АСБ с пятнистыми кальцинатами» более 1,5 – 1,23; «количество АСБ с участком низкой плотности менее 30 HU» более 0,5 – 1,00. Для результирующей БШР пороговое значение составило 3 балла. Сумма баллов более 3 означает высокий риск достижения ПКТ: отношение шансов 7,2, 95% доверительный интервал 2,6–19,7 (p<0,0001). Заключение. Применение БШР является новой и практически значимой методикой, улучшающей стратификацию риска неблагоприятных исходов в первый год после ОКС.

50. Time-varying mediated effects of the nicotine patch on smoking before and after a quit attempt when it is added to varenicline and counseling.

期刊: Drug and alcohol dependence 发表日期: 2026-May-01 链接: PubMed

摘要

Even with evidence-based treatment, most people who try to quit smoking return to regular smoking within weeks. Mediation analyses simultaneously test hypotheses about how treatments affect possible smoking determinants and how these determinants may influence smoking risk. Such evidence may inform treatment enhancement. Conduct secondary analyses that assess the extent to which: a) active vs. placebo nicotine patch used in conjunction with varenicline and counseling affect candidate mediators in the peri-cession period, b) candidate mediators predict next-day smoking, and c) treatment effects on next-day smoking are mediated via candidate mediators. Time-varying mediation models (TVMM) were fit to ecological momentary assessment data collected nightly from 1202 adults motivated to quit smoking in the 2 weeks preceding and 2 weeks following the target date to quit smoking in a placebo-controlled, double-blinded randomized controlled trial of adjuvant nicotine patch therapy used with varenicline and individual counseling. Analyses confirmed the predictive value of hypothesized mediators (cravings to smoke, nicotine withdrawal symptoms, reduced positive affect, and low quitting confidence) on next-day smoking risk, but also found that only positive affect mediated active (vs. placebo) patch effects on next-day abstinence 3-9 days after a target quit day. Adding nicotine patches to varenicline and counseling improves positive affect in ways that predict lower next-day smoking risk in the first days of attempts to quit smoking but does not significantly improve withdrawal management or sustain confidence in quitting.

51. Multivariate Chemoprospecting of Five Ethnobotanically Important Himalayan Lichens Identifies Parmotrema austrosinense as a Promising Source of Phenolic Antioxidants.

期刊: Chemistry & biodiversity 发表日期: 2026-May 链接: PubMed

摘要

Lichens are an underexplored reservoir of nutritionally and pharmacologically relevant metabolites. This study provides one of the first comprehensive multivariate profiles of five ethnobotanically important lichen species (Lobaria retigera, Dirinaria consimilis, Parmotrema austrosinense, Ramalina conduplicans, and Usnea orientalis) from Uttarakhand, India, using an integrated screening approach to evaluate and rank their bioactive potential. A combined analysis of nutritional components (protein, carbohydrates, and essential minerals), phytochemicals (total phenolic and flavonoid content), preliminary antioxidant screening (2,2-diphenyl-1-picrylhydrazyl radical scavenging assay), and metabolite profiling (gas chromatography-mass spectrometry) was performed. Our results ranked and objectively identified P. austrosinense as the most promising lead species, exhibiting the highest total phenolic content (14.08 ± 2.53 mg gallic acid equivalents/g), flavonoid content (1.80 ± 0.23 mg catechin equivalents/g), protein content (24.36 ± 1.30 mg/g), and the most effective DPPH radical scavenging activity (83.05% inhibition). Although based solely on in vitro DPPH data, this screening establishes a prioritized ranking for further validation. Principal Component Analysis confirmed that these antioxidant traits were strongly intercorrelated. This integrated metabolomic screening approach establishes a robust chemotaxonomic and nutritional ranking, highlighting P. austrosinense as a prime candidate for subsequent in-depth investigations.

52. Comparative Efficacy of First-Line Immune Checkpoint Inhibitor-Based Combination Therapies in Patients With Sarcomatoid Renal Cell Carcinoma: A Japanese Multicenter Cohort Study.

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

摘要

Sarcomatoid renal cell carcinoma (sRCC) is an aggressive histological variant associated with a poor prognosis. While immune checkpoint inhibitor (ICI)-based combinations have become the standard of care, the optimal first-line regimen, specifically dual immunotherapy (IO-IO) vs. IO plus tyrosine kinase inhibitor (IO-TKI), remains controversial. We herein examined the real-world clinical outcomes of Japanese patients with sRCC. We conducted a retrospective multicenter study on 46 patients with advanced or metastatic sRCC receiving first-line ICI-based combination therapy between January 2018 and December 2024 (IO-IO: n = 18; IO-TKI: n = 28). In a comparative survival analysis, three favorable-risk patients in the IO-TKI group were excluded to align risk profiles, focusing on intermediate/poor-risk groups (n = 43). The primary endpoint was overall survival (OS). In the entire cohort (n = 46), the objective response rate was numerically higher in the IO-TKI group (64.3%) than in the IO-IO group (50.0%) (p = 0.37). In the comparative analysis of intermediate/poor-risk patients (n = 43), progression-free survival (PFS) was slightly longer (p = 0.071), and OS was significantly longer (p = 0.016) in the IO-TKI group than in the IO-IO group. A multivariable analysis adjusted for IMDC risk categories showed favorable survival with the IO-TKI regimen (HR 0.37, p = 0.061). The present study indicates that first-line IO-TKI combination therapy represents a promising treatment option with a potential survival advantage over IO-IO therapy for Japanese patients with sRCC. However, due to the retrospective design and small sample size, reliably determining the comparative efficacy of these regimens remains challenging, and further validation is warranted.

53. Anterior Fibromuscular Stroma-Preserving Anteroposterior Dissection HoLEP Reduces Day-1 Incontinence: A Retrospective Cohort Study.

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

摘要

To determine whether anterior fibromuscular stroma (AFS) preservation within an anteroposterior (AP) HoLEP platform independently reduces ultra-early postoperative incontinence. We retrospectively analyzed consecutive HoLEP cases (April 2019-June 2025) performed by a single surgeon. Of 719 procedures, 272 consecutive cases using a standardized AP platform were included and classified into conventional AP-HoLEP (CON, n = 60), mucosal incision-first AP-HoLEP (MI, n = 180), and AFS-preserving AP-HoLEP (AFS, n = 32). The primary endpoint was Day-1 incontinence, defined as any objective leakage (> 0 mL) within 24 h after catheter removal on Postoperative Day 2. Multivariable logistic regression was used to identify independent predictors. Day-1 incontinence occurred in 55% (33/60) of CON, 58% (104/180) of MI, and 25% (8/32) of AFS cases (p = 0.003). In multivariable analysis, AFS preservation was independently associated with lower odds of Day-1 incontinence versus CON (odds ratio [OR], 0.30; 95% confidence interval [CI], 0.11-0.80; p = 0.016), whereas MI was not (OR, 1.14; 95% CI, 0.62-2.11; p = 0.680). Perioperative safety outcomes were comparable, with low rates of Clavien-Dindo ≥ III events. Within an AP-HoLEP platform, AFS preservation was associated with improved Day-1 continence without compromising safety, supporting ventral-support preservation as a key lever for ultra-early continence recovery.

54. Olipudase alfa IgE-mediated anaphylaxis prevented by omalizumab and tailored desensitization in a child with acid sphingomyelinase deficiency.

期刊: Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology 发表日期: 2026-May 链接: PubMed

摘要

55. The Small Molecule H89 Facilitates Mesenchymal Stem Cell-derived Extracellular Vesicle Release and Optimizes Therapeutic Efficacy in Liver Regeneration.

期刊: Journal of extracellular vesicles 发表日期: 2026-May 链接: PubMed

摘要

The role of human umbilical cord mesenchymal stem cell-derived extracellular vesicles (hUCMSC-EVs) in liver regeneration is promising, yet their clinical translation is hampered by insufficient production. Current strategies targeting their secretion are inefficient and lack a clear mechanistic understanding. We isolated and characterized hUCMSC-EVs pretreated with the H89 and other mTORC1 inhibitors. Our findings revealed that H89 effectively enhances the secretion of hUCMSC-EVs across diverse cell types, demonstrating universal efficacy. Importantly, H89 upregulates GABARAPL1 expression, a key negative regulator of the PKA/mTORC1 pathway, to inhibit mTORC1 activity and promote the formation of amphisomes and SNARE-mediated hUCMSC-EVs release. Furthermore, EVs derived from H89-pretreated hUCMSCs (H-EVs) exhibited altered cargo composition, significantly increased proliferative activity, and potentiated liver regeneration via the RELA/miR-29a axis, which regulates the homeostasis of hepatic stellate cells. Our results highlight that H89 enhances hUCMSC-EV secretion through mTORC1 inhibition, with the resulting benefits for liver regeneration mediated by the RELA/miR-29a network. These findings demonstrate the great promise of H89 in EV-based liver regeneration, offering a promising platform for clinical translation.

56. Epidemiology of Rheumatoid Arthritis in the Asia-Pacific Region: A Systematic Analysis of the Global Burden of Disease Study 1990-2023 and Forecasts to 2025.

期刊: International journal of rheumatic diseases 发表日期: 2026-May 链接: PubMed

摘要

Updated, country-specific burden curves for rheumatoid arthritis (RA) across the Asia-Pacific region remain limited. We aimed to quantify long-term trends in RA prevalence, incidence, mortality, and disability-adjusted life-years (DALYs) from 1990 to 2023, and to project short-term burden to 2025. We extracted age-standardized rates (ASRs) and absolute counts for rheumatoid arthritis from the Global Burden of Disease (GBD) 2023 study for 27 Asia-Pacific countries and territories. Temporal trends were summarized using average annual percent change (AAPC) estimated from joinpoint regression, and short-term projections to 2025 were generated using Bayesian age-period-cohort models. Decomposition analysis quantified the relative contributions of population aging, population growth, and changes in age-specific rates to observed increases in prevalent cases. Between 1990 and 2023, the regional age-standardized prevalence rate of rheumatoid arthritis increased by approximately 16%, reaching 126 per 100 000 population in 2023, and is projected to rise further to 131 per 100 000 (95% uncertainty interval [UI] 124-138) by 2025. Age-standardized incidence increased from 10.0 to 11.6 per 100 000, with a projected rate of 12.1 per 100 000 (95% UI 11.2-13.0) in 2025. In contrast, age-standardized mortality declined by 43% (from 0.75 to 0.43 per 100 000), and DALY rates decreased modestly (from 45.3 to 41.8 per 100 000), although absolute DALYs increased due to demographic expansion. Decomposition analysis indicated that 84% of the net increase in prevalent RA cases was attributable to population aging and growth, with only 16% associated with rising age-specific prevalence rates. Female-to-male prevalence ratios remained stable at approximately 2.3-2.4 throughout the study period. The fastest relative increases were observed in lower-middle-income South-East Asian countries, while several high-income Western-Pacific countries showed stable or declining rates. The expanding burden of rheumatoid arthritis in the Asia-Pacific region is driven predominantly by demographic momentum rather than worsening per-capita risk. Although mortality and per-capita disability are declining, absolute health loss will continue to rise under population aging. Integrating early RA care with population-level prevention targeting modifiable risk factors may mitigate future burden growth.

57. Interpretable machine learning and deep learning model for discriminating pheochromocytoma from adrenocortical adenoma based on CT: A multicenter study.

期刊: European journal of radiology 发表日期: 2026-Apr-30 链接: PubMed

摘要

Differentiating pheochromocytoma (PHEO) from adrenocortical adenoma (ACA) is vital to avoid intraoperative hypertensive crises or redundant surgeries. To identify the optimal diagnostic strategy by benchmarking various machine learning (ML) and deep learning (DL) architectures for the preoperative differentiation of PHEO from ACA. We retrospectively enrolled 401 patients from two centers. Center 1 (n = 331) was divided into training (n = 232), validation (n = 49), and internal test (n = 50) sets; Center 2 (n = 70) served as an external validation cohort. From dual-phase CT, 1,781 radiomics features were extracted. We benchmarked eight ML classifiers against a SqueezeNet-based DL model. Performance was quantified using AUC and decision curve analysis. Shapley Additive Explanations (SHAP) were applied to interpret the best-performing model and construct a clinical nomogram. The Logistic Regression (LR)-based integrated model outperformed other classifiers and the DL baseline (AUC: 0.850, 95% CI: 0.838-0.869)), achieving an AUC of 0.917 (95% CI: 0.820-0.990) with an accuracy of 86.4% in the internal test set and 0.909 (95% CI: 0.7995-1.000) in external validation. Subgroup analysis showed high diagnostic stability, with an AUC of 0.933 (95% CI: 0.821-1.000) for tumors ≥ 4 cm. SHAP analysis identified dependence non-uniformity as a key diagnostic driver. The resulting nomogram provided personalized, transparent risk estimation. The SHAP-interpreted integrated LR model is a robust, non-invasive tool for distinguishing PHEO from ACA. By combining radiomic and clinical data, this transparent framework supports precise surgical planning and individualized management.

58. Risk Perception and Intention to Quit Smoking Among High-Risk Participants Enrolled in a European Lung Cancer Screening Trial in Spain.

期刊: Archivos de bronconeumologia 发表日期: 2026-Apr-26 链接: PubMed

摘要

59. Effectiveness of a day treatment program for negative symptoms in patients with schizophrenia.

期刊: Psychiatria polska 发表日期: 2026-Mar-30 链接: PubMed

摘要

To evaluate the effectiveness of a day treatment program in reducing primary negative symptoms in people with schizophrenia and to identify predictors of treatment response. This study was conducted at the Day Treatment and Rehabilitation Centre for people suffering from psychosis. Forty-three participants were assessed using PANSS, BNSS, CDSS, MOCA and FAB scales before and after 3 months of treatment. The therapeutic program included individual and group psychotherapy, social skills training, psychoeducation, music therapy, movement therapy, art therapy, occupational therapy, therapeutic community meetings, family sessions, and therapeutic excursions. Participants showed a significant decrease in negative symptoms and depressive symptoms following treatment. Improvement was observed in all five domains of negative symptoms. Regression analysis showed that intact motor programming skills were a significant predictor of improvement in negative symptoms. Improvement in insight correlated with better treatment outcomes. The day treatment program was effective in treating primary negative symptoms in all five domains. Further research with a larger sample size and a control group is needed.

60. Is there a relationship between insomnia, stress, and job burnout among health care workers?

期刊: Psychiatria polska 发表日期: 2026-Feb-28 链接: PubMed

摘要

The aim of the study was to search for the relationship between insomnia, stress, and occupational burnout and to identify factors influencing their severity among health care workers. This survey-based study was conducted among 216 health care workers. It was performed using the author questionnaire, the Perceived Stress Scale (PSS-10), the Athens Insomnia Scale (AIS), and the Maslach Burnout Inventory (MBI). Analysis of the effects of stress (PSS-10) and insomnia (AIS) on occupational burnout showed that stress correlated significantly (p ˂ 0.05) and positively (r ˃ 0) with all MBI subscales; that is, the more severe the stress, the higher the levels of emotional exhaustion, depersonalization, but also personal accomplishment. Insomnia correlated significantly (p ˂ 0.05) and positively (r ˃ 0) with all MBI subscales - the more severe the insomnia, the higher the levels of emotional exhaustion, depersonalization, but also personal accomplishment. (1) Age and work experience were the sociodemographic variables that determined the occurrence of insomnia among the surveyed participants. (2) The form of employment may be an important factor that determines the level of stress, insomnia, and job burnout. Those employed under permanent contracts had lower levels of stress and job burnout, more often suffered from insomnia, and had higher levels of personal accomplishment. (3) In the study group, stress and insomnia influenced all aspects of job burnout. As stress and insomnia increased, so did levels of depersonalization, emotional exhaustion, but also personal accomplishment.

61. Association of Neutrophil Percentage-To-Albumin Ratio With All-Cause and Cardiovascular Mortality in Chronic Kidney Disease.

期刊: Inquiry : a journal of medical care organization, provision and financing 发表日期: 2026 链接: PubMed

摘要

IntroductionThis research sought to understand the relationship of the neutrophil percentage-to-albumin ratio (NPAR) and mortality from cardiovascular (CVD) and all causes in populations with CKD.Methods7,553 CKD patients were included and grouped into quartiles based on NPAR. Kaplan-Meier curves were utilized for survival analysis, while a multivariate Cox proportional hazards model calculated the risk ratio of NPAR on CVD and all-cause mortality. The potential linear connection of NPAR with CVD/all-cause mortality was analyzed through restricted cubic spline (RCS) analysis, and receiver operating characteristic (ROC) analysis was used to assess predictive performance. Subgroup analysis was executed with stratification according to demographic characteristics.ResultsThe Kaplan-Meier curve indicated that a higher NPAR was linked to a greater risk of CVD/all-cause mortality (p < 0.0001). In fully adjusted models, a one-unit rise in NPAR correlated with a 185% rise in the likelihood of dying from CVD diseased (HR = 2.85, 95% CI 2.26-3.47) and a 154% rise in the likelihood of dying from any cause (HR = 2.54, 95% CI 2.22-2.91). A non-linear link for NPAR and CVD/all-cause mortality was validated through RCS analysis, with a P value <0.001. ROC analysis showed that NPAR had modest discriminative ability for predicting all-cause mortality (AUC = 0.601), with an optimal cutoff value of 1.48. Across different subgroups, NPAR reliably predicted CVD and all-cause mortality in CKD patients.ConclusionElevated NPAR were linked with a higher likelihood of CVD mortality and all-cause mortality in patients with CKD and could serve as an effective prognostic biomarker.