公共卫生研究摘要 (2026-05-14)

共收录 51 篇研究文章

1. Risk of Myasthenia Gravis Exacerbation During Pregnancy and Postpartum: A Nationwide Cohort Study.

期刊: Neurology 发表日期: 2026-Jun-23 链接: PubMed

摘要

The impact of pregnancy on the clinical course of myasthenia gravis (MG) remains uncertain, with existing evidence mainly derived from small case series. Using nationwide longitudinal register data, we aimed to assess the risk of MG exacerbation during pregnancy and up to 1 year postpartum. In this population-based cohort study, we included women with MG recorded in the Swedish National MG Register who had singleton pregnancies documented in the Medical Birth Register after MG diagnosis (1987-2019). The exposure was pregnancy, and the outcome was MG exacerbation. The primary outcome measure was hospital admissions with MG during pregnancy and the postpartum year, compared with the year preceding pregnancy. Cox proportional hazards models estimated hazard ratios (HRs), adjusting for disease duration and prior thymectomy. The secondary outcome measure was changes in immunosuppressive MG medications during pregnancy and postpartum. We identified 112 women with MG (median age 30 years) with 176 singleton pregnancies. During pregnancy, women were not more likely to be hospitalized for MG than in the prepregnancy year (HR 0.74, 95% CI 0.39-1.41), and there was no increased risk of longer hospital admissions (HR 0.83, 95% CI 0.36-1.88). The postpartum period was associated with an increased risk of prolonged MG admissions during the first 3 months (HR 5.02, 95% CI 1.66-15.24), with a similar risk observed throughout the first 12 months postpartum (HR 4.52, 95% CI 1.26-16.14). During pregnancy, immunosuppressive MG medications were reduced or discontinued in 13 pregnancies and increased in 6. Postpartum, medications were initiated or escalated in 10 pregnancies and reduced in none. The risk of prolonged MG admissions was higher in periods outside of pregnancy compared with the prepregnancy year (HR 2.95, 95% CI 0.84-10.43), suggesting that women conceive during periods of relative disease stability. Pregnancy was not associated with an increased risk of MG exacerbation. The postpartum period was linked to more severe or prolonged exacerbations in a minority of women, highlighting the importance of close monitoring after delivery. Milder exacerbations not requiring hospitalization or clear medication escalation may have been underestimated, underscoring the need for larger prospective international studies that include detailed clinical data.

2. Heat-Related Emergency Medical Services Activations in the United States, 2020-2024: Rates, Demographics, and Geographic Distribution.

期刊: American journal of public health 发表日期: 2026-Jun 链接: PubMed

摘要

Objectives. To examine the magnitude of heat-related emergency medical services (EMS) activations across the United States and identify factors that increase the risk of heat exposure illness. Methods. We extracted heat-related EMS activations from April through September for 2020 through 2024 from the National Emergency Medical Services Information System (NEMSIS) database. We linked information from the 2022 Centers for Disease Control and Prevention (CDC) Social Vulnerability Index with heat-related EMS activations using county of residence. Our analysis focused on heat-related illness by patient demographic, geographic, and EMS system factors. Results. Among the 79 077 804 EMS activations meeting study inclusion criteria, 261 687 (0.3%) were heat related. The rate of heat-related EMS activations was 16.46 per 100 000 population, with higher rates among older adults, males, African Americans, and Native Hawaiians/Pacific Islanders. Rates were higher in rural counties and in counties characterized by the CDC Social Vulnerability Index as having relatively worse socioeconomic or environmental conditions. Heat-related EMS activations were commonly reported in the afternoon and in indoor locations. Conclusions. The NEMSIS database provides novel information that improves our ability to monitor heat-related adverse health outcomes. Public Health Implications. The timely collection and sharing of data provide critical situational awareness to inform public health response efforts during a heat wave. (Am J Public Health. 2026;116(6):798-805. https://doi.org/10.2105/AJPH.2026.308513).

3. Climate Hazards and the Opioid Overdose Epidemic.

期刊: American journal of public health 发表日期: 2026-Jun 链接: PubMed

摘要

4. Trends in Meningococcal B Vaccine Uptake Among 16- and 17-Year-Old Adolescents in the United States: An Analysis of the National Immunization Survey-Teen, 2018-2023.

期刊: American journal of public health 发表日期: 2026-Jun 链接: PubMed

摘要

Objectives. To examine trends in meningococcal B (MenB) vaccination coverage among US adolescents aged 16 and 17 years. Methods. We conducted cross-sectional and longitudinal analyses of 2018 to 2023 National Immunization Survey-Teen data to calculate the annual percentage of eligible adolescents who received the MenB vaccine and to assess changes over time. Results. Only 19.8% of the 41 505 eligible adolescents initiated MenB vaccination between 2018 and 2023. A total of 24.5% (95% confidence interval [CI] = 22.5, 26.6) of adolescents received 1 or more MenB vaccinations in 2023, as compared with 13.2% (95% CI = 11.7, 14.6) in 2018. Among initiators, most received only 1 dose. Conclusions. MenB vaccination coverage among 16- and 17-year-old adolescents increased modestly between 2018 and 2023. As of 2023, approximately 3 out of 4 adolescents in this age group had not received the MenB vaccine. Public Health Implications. As of 2023, less than one quarter of 16- and 17-year-old adolescents had initiated MenB vaccination. Given that MenB has accounted for most meningococcal disease among adolescents and young adults since 2013, efforts to improve uptake are warranted. (Am J Public Health. 2026;116(6):851-854. https://doi.org/10.2105/AJPH.2026.308459).

5. In Memoriam: William "Bill" Foege, Visionary Leader.

期刊: American journal of public health 发表日期: 2026-Jun 链接: PubMed

摘要

6. Understudied Climate Change Attributes and Health Threats.

期刊: American journal of public health 发表日期: 2026-Jun 链接: PubMed

摘要

7. Food Security by Racial and Ethnic Identity Among Lower-Income Adults.

期刊: American journal of public health 发表日期: 2026-Jun 链接: PubMed

摘要

Objectives. To expand the understanding of food security among a racially and ethnically diverse sample of US adults living below 200% of the federal poverty line (FPL). Methods. I performed a cross-sectional analysis of the National Health Interview Survey (2019-2023) that included 37 748 respondents. I estimated unadjusted proportions and adjusted probabilities of food security for non-Hispanic White, Black, American Indian/Alaska Native (AIAN), Asian, and Hispanic adults living in severe (<  50% FPL), moderate (50% to < 100% FPL), and near poverty (100% to < 200% FPL). Results. The study reveals important nuances in food security by race and ethnicity. Non-Hispanic Asian adults in severe poverty experienced higher food security than their counterparts in less dire economic situations, non-Hispanic Whites and Hispanics were more similar than previously reported, and non-Hispanic AIAN adults reported extremely low probabilities of food security. Conclusions. Thoroughly documenting and expanding on these patterns of food security for lower-income adults could lead to better understanding of policy mechanisms that could alleviate food insecurity and reduce health disparities by racial and ethnic identity in the United States. (Am J Public Health. 2026;116(6):841-850. https://doi.org/10.2105/AJPH.2026.308508).

8. Returning Public Health to the National Conversation on Climate Change.

期刊: American journal of public health 发表日期: 2026-Jun 链接: PubMed

摘要

9. Solutions-Oriented Science: Combating Fatalism Regarding Climate Change and Health.

期刊: American journal of public health 发表日期: 2026-Jun 链接: PubMed

摘要

10. What if They Had Asked Us? Recommendations From Former CDC Noninfectious Disease Leaders.

期刊: American journal of public health 发表日期: 2026-Jun 链接: PubMed

摘要

11. The Need for Public Health Agencies to Collaborate and Innovate in an Era of Federal Instability: A View From the Northeast.

期刊: American journal of public health 发表日期: 2026-Jun 链接: PubMed

摘要

12. From Silos to Systems: Leveraging Technology to Bring Climate Health Insights to the Bedside and Back.

期刊: American journal of public health 发表日期: 2026-Jun 链接: PubMed

摘要

13. Endovascular Treatment of Medium-Vessel-Occlusion Strokes.

期刊: The New England journal of medicine 发表日期: 2026-May-14 链接: PubMed

摘要

Endovascular thrombectomy for acute ischemic stroke due to medium-vessel occlusion has had varying results across trials. Whether thrombectomy improves functional outcomes in patients with medium-vessel occlusion and moderate-to-severe deficits is unclear. We conducted an open-label, randomized trial with blinded outcome assessment at 48 centers in China. Eligible patients were adults who presented within 24 hours after the onset of a moderate-to-severe stroke (National Institutes of Health Stroke Scale [NIHSS] score, ≥6; scale, 0 to 42, with higher scores indicating greater neurologic deficits) due to occlusion of a medium vessel. Patients were assigned in a 1:1 ratio to thrombectomy plus medical management (thrombectomy group) or medical management alone (control group). The primary outcome was functional disability as measured by the shift in the modified Rankin scale score (scale, 0 [no disability] to 6 [death]) at 90 days. Violation of the proportional-odds assumption precluded the use of shift in the modified Rankin scale score, so as prespecified, functional independence (modified Rankin scale score of 0, 1, or 2) at 90 days was used as the primary outcome. Safety outcomes were symptomatic intracranial hemorrhage and 90-day mortality. Among 280 patients in the thrombectomy group and 283 in the control group, the median age was 71 years, the median NIHSS score was 10 (range, 3 to 36), and 42.8% were women; 36.6% received intravenous thrombolysis. Functional independence at 90 days was seen in 58.6% of the patients in the thrombectomy group and in 46.6% of those in the control group (adjusted rate ratio, 1.24; 95% confidence interval, 1.07 to 1.44; P = 0.004). The incidence of symptomatic intracranial hemorrhage was 4.7% in the thrombectomy group and 2.2% in the control group; 90-day mortality was 11.1% and 10.2%, respectively. Among patients with acute ischemic stroke due to medium-vessel occlusion and moderate-to-severe deficits, thrombectomy led to a greater likelihood of functional independence than medical management alone but also to a higher risk of symptomatic intracranial hemorrhage. (Funded by the National Natural Science Foundation of China and the Noncommunicable Chronic Diseases-National Science and Technology Major Project; ORIENTAL-MeVO ClinicalTrials.gov number, NCT06146790.).

14. Ensitrelvir for Covid-19 Postexposure Prophylaxis in Household Contacts.

期刊: The New England journal of medicine 发表日期: 2026-May-14 链接: PubMed

摘要

Ensitrelvir, an oral inhibitor of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) 3C-like protease, is approved in Japan for the treatment of mild-to-moderate coronavirus disease 2019 (Covid-19). Previously, no antiviral agents were approved for postexposure prophylaxis in household contacts of patients with Covid-19. In this double-blind, randomized, placebo-controlled trial, we randomly assigned persons who were SARS-CoV-2-negative on local diagnostic testing but were household contacts of a patient with Covid-19 (the index patient) to receive either ensitrelvir (375 mg on day 1 and 125 mg daily on days 2 through 5) or placebo within 72 hours after symptom onset in the index patient. The primary end point was Covid-19 (defined by a central laboratory-confirmed positive reverse-transcriptase-polymerase-chain-reaction assay and the presence of ≥1 of 14 prespecified Covid-19 symptoms lasting ≥48 hours) by day 10 in a household contact in the modified intention-to-treat population (all the participants who underwent randomization, had a central laboratory-confirmed negative RT-PCR test for SARS-CoV-2 at baseline, and received at least one dose of the trial drug or placebo). The modified intention-to-treat population included 1030 participants in the ensitrelvir group and 1011 in the placebo group. The mean age of the participants was 42.4 years; 71.1% had undergone randomization within 48 hours after symptom onset in the index patient, and 37.0% had at least one risk factor for severe Covid-19. The incidence of Covid-19 was lower in the ensitrelvir group than in the placebo group (2.9% vs. 9.0%; risk ratio, 0.33; 95% confidence interval [CI], 0.22 to 0.49; P<0.001). The incidence of adverse events during the trial was similar in the two groups (15.1% in the ensitrelvir group and 15.5% in the placebo group), as was the incidence of serious adverse events (0.2% in each group). No Covid-19-related hospitalizations or deaths were reported. Ensitrelvir administered to household contacts of a patient with Covid-19 within 72 hours after symptom onset in the index patient was effective in preventing Covid-19 in the contacts. (Funded by Shionogi; SCORPIO-PEP Japan Registry for Clinical Trials number, jRCT2031230124; ClinicalTrials.gov number, NCT05897541.).

15. Child Opportunity and Severity of Pediatric Acute Appendicitis: A Statewide Analysis.

期刊: The Journal of surgical research 发表日期: 2026-May-13 链接: PubMed

摘要

Socioeconomic disadvantage is associated with increased disease severity and worse clinical outcomes among children with acute appendicitis. We sought to evaluate the association between neighborhood-level child opportunity and complicated appendicitis (CA) among a retrospective pediatric cohort. We hypothesized that lower neighborhood-level opportunity, measured by the Child Opportunity Index (COI), is associated with higher incidence of CA and hospital length of stay (LOS). We performed a retrospective review of children (<18 y) with appendicitis in the North Carolina Discharge Database, from 2019 to 2021. Patients were categorized as having simple appendicitis or CA, based on the presence of perforation, gangrene, or abscess. Multivariate regression analysis was used to identify independent predictors of CA and LOS. A total of 876 children with acute appendicitis and available zip code data were identified. Most children had public (n = 463, 52.9%) health insurance coverage. Compared to children with simple appendicitis, those with CA were significantly younger (9.9 ± 4.4 versus 11.9 ± 3.8 y; P < 0.0001), and with a higher proportion from very low (15.3% versus 12.2%) and low (23.1% versus 15.9%) COI neighborhoods. Hospital LOS was significantly longer for children with CA (3.7 ± 5.2 versus 1.6 ± 2.1 d; P < 0.001). On multivariate regression analysis, COI was not independently associated with odds of CA (adjusted odds ratio: 1.003; 95% confidence interval: 1.00-1.01) or hospital LOS (adjusted relative risk: 0.001; 95% confidence interval: -0.001 to 0.003). In a statewide cohort of pediatric patients, COI was not independently associated with CA. Our findings suggest that high insurance coverage improves access to acute pediatric surgical care and may mitigate disparities linked to child neighborhood level opportunity.

16. Strategic consensus on the clinical translation of advanced therapies in paediatric rare neurological disorders.

期刊: Neurotherapeutics : the journal of the American Society for Experimental NeuroTherapeutics 发表日期: 2026-May-13 链接: PubMed

摘要

Advanced therapies (ATs), including gene and stem cell therapy, hold great potential for preventing and ameliorating many rare neurological disorders (RNDs) in children. These technologies are set to expand across modalities, potentially disrupting and augmenting conventional therapeutic pipelines, with the rapid pace of development highlighting data gaps and implementational challenges. We conducted a two-round modified Delphi study to co-develop a practice framework supporting the safe and effective application of advanced and/or experimental neurotherapeutics for children with rare neurological disorders within a public health ecosystem. The study generated 101 consensus recommendations encompassing criteria to 1) facilitate equitable and timely therapeutic access, 2) optimise transparent communication and shared decision making with families, 3) incorporate disease and patient level considerations for minimising risk and optimising safety within advanced therapeutic research, 4) strengthen resourcing of health systems to enable longitudinal evaluation of treatment effects and safety. Embedding this framework into practice will depend on enhancement of workforce training, establishment of digital infrastructure, fit-for-purpose clinical environments and education and engagement of patients, families and the broader community.

17. Leveraging Text Messaging and Behavior Theory to Improve Colorectal Cancer Screening in Federally Qualified Health Centers: Cohort Study.

期刊: Journal of medical Internet research 发表日期: 2026-May-13 链接: PubMed

摘要

Colorectal cancer (CRC) is the second leading cause of cancer-related deaths in the United States. Despite recommendations for screening to begin at the age of 45 years, significant disparities persist, particularly among medically underserved populations. This study examines the effectiveness of SMS text messaging reminders in improving CRC screening rates across 2 large federally qualified health centers (FQHCs) serving vulnerable populations. The study included 4822 adults aged ≥45 years, receiving care at 2 large FQHC networks in Texas and California. Participants were assigned to one of four groups: (1) control (no SMS text messages), (2) single-outreach SMS text overdue message, (3) three-week SMS overdue and reminder text messages, and (4) six-week SMS text messages that were informed by behavior theory. Data were collected from May 2023 to July 2024. The outcome measure was a binary indicator of whether the participant underwent 1 of 3 CRC tests, fecal immunochemical test, colonoscopy, and Cologuard, within 90 days of completing the SMS text messaging reminders. Independent variables included demographic, geographic, clinical, and primary care access variables. Multivariate logistic regression models were used to examine associations between CRC screening completion and the SMS text messaging reminder groups, adjusting for covariates. Adjusted odds ratios (aORs) and 95% CIs were reported. In the combined 3-test model, patients in the single-outreach SMS text message (aOR 1.22, 95% CI 1.00-1.47) and the 3-week SMS text message (aOR 1.27, 95% CI 1.05-1.53) groups had higher odds of completing the screening test compared to those in the control group. Within the fecal immunochemical test-only model, patients in the 3-week SMS text message group (aOR 1.25, 95% CI 1.00-1.56) were more likely to complete the screening test. Within the Cologuard-only model, patients in the 3-week SMS text message group (aOR 7.01, 95% CI 1.96-25.07) and the 6-week SMS text message group (aOR 5.75, 95% CI 1.53-21.61) had significantly higher odds of CRC screening completion. The findings highlight that moderate-frequency SMS text messaging reminders can effectively increase CRC screening rates in FQHCs; however, critical factors include the timing and frequency of these reminders. The 3-week intervention was associated with improved screening uptake, whereas the 6-week theory-informed intervention did not demonstrate a significant advantage over the control group, potentially reflecting a ceiling effect or message fatigue associated with more frequent messaging. Additionally, the study highlights unique screening patterns that contradict previous literature, underscoring the importance of a tailored approach for vulnerable communities.

18. Tracking the Night: Measuring Age and Sex Patterns in Sleep Duration Using Wearable Technology.

期刊: Sleep 发表日期: 2026-May-13 链接: PubMed

摘要

Sleep duration is a key component of overall sleep health, but prior population-level studies characterizing this have relied on brief self-report questions (often one item) or used different objective devices within the same study. We examined the normal variation of sleep duration in an adult population using a single consumer-grade wearable device with a unified algorithm. Retrospective cohort study conducted in the United States. Data were analyzed from 274,128 U.S.-based adults aged 20 to 69 who used a Samsung Galaxy Watch between February 2023 and April 2023; participants were included if they had ≥20 valid weekdays and ≥8 valid weekend days of data. Sleep duration was the primary outcome, defined as the longest continuous nighttime sleep period between 6:00 p.m. and 6:00 a.m. averaged over a three-month period. Sleep duration and weekday-weekend variability were examined across age groups and by sex using descriptive statistics and independent t-tests. Overall, average sleep duration was 7.57 hours, with a 10th-90th percentile range of 6.5 to 8.9 hours. Sleep duration was shortest in the 40-49 year old group (7.54 hours) and longest in the 60-69 year old group (7.75 hours; p < .001). Overall, 23.0% of adults slept less than 7 hours, more commonly among those aged 40-49 (25.1%) and 50-59 (24.7%). Across all age groups, weekend sleep was longer than weekday sleep by an average of 28 minutes, with the largest gap in the 40-49 year old group (34 minutes), and the smallest in the 60-69 year old group (20 minutes). Women consistently slept longer than men (+18 minutes on average), and exhibited greater between-subject variability in total sleep duration (SD = 1.61 hours for women vs. 1.54 hours for men). This study demonstrates considerable variability in objectively measured sleep duration across adulthood, spanning a broad range and differing by age groups and sex. These findings provide reference distributions that may inform clinical expectations and public health messaging regarding sleep duration.

19. A Digital Assistive System for Maintaining Nutrition and Mobility in Older Adults: Usability and Feasibility Findings From a Pilot Study.

期刊: JMIR formative research 发表日期: 2026-May-13 链接: PubMed

摘要

Due to demographic changes, the number of older people is increasing, often accompanied by limitations in mobility, nutrition, and independence. Preventive monitoring is rare, as care systems struggle with staff shortages and limited resources. Technical assistance systems can support older people in self-assessing their health and maintaining independence. We developed the AS-Tra system, which combines an application with a measurement and training station (MuTS), to enable early detection of nutrition and mobility-related deficits and risks. This paper presents the pilot study of the AS-Tra system with the aim of evaluating its usability and testing the feasibility of collecting health-related data from older adults (≥70 y) with early/mild deficiencies in nutritional state and mobility in preparation for a future randomized controlled trial. The system used in this 4-week pilot study was developed as a complex intervention in accordance with the Medical Research Council framework. Participants (target n=10) were recruited through a participant registry. They completed standardized mobility assessments (grip strength, Timed “Up and Go,” and 5-Time Chair Rise) at baseline and after 1, 2, and 4 weeks (T0, T1, and T2, respectively). Mini Nutritional Assessment-Short Form and short physical performance battery were recorded at baseline and at T2. Participants received a tablet app for regularly documenting nutrition and an activity sensor for 7 days of physical activity monitoring and performed weekly training starting at T0. At T2, the System Usability Scale (SUS) and feedback questionnaires (Evaluation Overall System [EOS] questionnaire-the evaluation of all subcomponents on a scale of 1-5, weekly Experience Report) were additionally collected. Data were analyzed descriptively using IBM SPSS Statistics, in which data were shown as total numbers, percentages, and means with SDs, and data from the activity sensor were displayed and analyzed using Python. A total of 9 older adults, with 1 dropout (mean 80, SD 5 y, 50% female), participated in this study. The SUS score was good (mean 79, SD 13.4 points). The MuTS devices had minor technical problems (in <17% of MuTS sessions), while 57% (17/30) of the users experienced instability issues with the food diary in the tablet app. The average overall system ratings were positive, with an EOS score of 2.01 (SD 0.99). The usability of the technical assistance system used in this study was rated as good. The data collection using questionnaires, sensors, and automated assessments proved feasible. The biggest challenge was the tablet-based food diary, which still needs improvement before the effectiveness of the AS-Tra system regarding mobility and nutritional status can be evaluated in a randomized controlled trial.

20. Experiences of professional public health advocacy in the UK health and social care system: a qualitative survey study [using the Theoretical Domains Framework].

期刊: Journal of public health (Oxford, England) 发表日期: 2026-May-13 链接: PubMed

摘要

Advocacy of public health principles (PHP) is crucial to tackling health inequities. Advocacy skills are therefore a core competency of Public Health speciality training in the UK. A survey of UK-trained specialist registrars found that the perceived ability to advocate for PHP varied significantly across work settings. This study explores barriers and enablers to PHP advocacy across workplaces, offering insights into how advocacy can be better supported in the UK public health landscape. An online survey was sent to UK-based public health specialty trainees, consultants, and public health practitioners on the portfolio route to consultant practice currently. Free-text survey responses were analysed using template analysis and the Theoretical Domains Framework. Sixty-four respondents completed the survey. This study found that role clarity, organizational support, and advocacy skills significantly affect public health specialists’ ability to advocate. Barriers included unclear responsibilities, fear of consequences, resource constraints, and inadequate training and mentorship. Supportive leadership and shared values facilitated success. To promote advocacy, the Faculty of Public Health should ensure specialists are positioned as autonomous experts, address biases in recruitment, and integrate advocacy skills further into training. Organizations must evaluate how their structure, culture, and leadership support public health advocacy.

21. Risk factors of ovarian cancer: a systematic review and meta-analysis of Mendelian randomiation studies.

期刊: Journal of public health (Oxford, England) 发表日期: 2026-May-13 链接: PubMed

摘要

Ovarian cancer (OC) remains a major global health issue, often diagnosed late and lacking effective screening. MR studies until 11 September 2023 were identified by a systematic search across nine databases. We complied with PRISMA guidelines and included different OC subtypes and all exposures studied, conducting meta-analyses where feasible to combine estimates from non-overlapping samples. We identified 120 articles examining genetic evidence for an association between 230 exposures and OC risk. Endometriosis, late age at menopause, and several adiposity measures were robustly associated with greater OC risk. In contrast, late age at menarche, higher adiponectin, and body fat without adverse metabolic profile were associated with lower risk (favourable adiposity: meta-analysis OR per SD 0.35, 95% CI 0.20-0.61). Meta-analyses on lipid-lowering drug target HMG-CoA reductase inhibitor (OR 0.66, 95% CI 0.53-0.82), serum vitamin D (OR 0.88, 95% CI 0.82-0.95), and dried fruit intake (HR 0.61, 95% CI 0.41-0.91) were supportive of protective associations. Genetic evidence confirms OC risks associated with endometriosis, and age at menarche and menopause. While greater overall adiposity increases the risk, fat without an adverse metabolic profile appears protective. Associations between vitamin D and HMG-CoA reductase inhibition with OC risk warrant further study.

22. [Healthcare resources and premature mortality from ischemic heart disease in Spain: An ecological analysis (2018-2023)].

期刊: Semergen 发表日期: 2026-May-13 链接: PubMed

摘要

To analyze the association between healthcare resources and premature mortality from ischemic heart disease in the Spanish autonomous communities between 2018 and 2023. An observational ecological study was conducted using aggregated data by autonomous community and year. The dependent variable was premature mortality from ischemic heart disease (< 75 years, adjusted for age). Independent variables included primary care physician density and per capita healthcare expenditure. Descriptive statistics, Pearson correlations, and multiple lineal regression were applied. The average premature mortality rate was 20.53/100,000 inhabitants (SD=4.59), being higher in men (34.21 vs. 7.66 in women) and in the Canary Islands, Asturias, and Andalusia. The rate remained stable over time (19.91-21.04/100,000). No significant associations were found between mortality and healthcare resources. However, healthcare expenditure correlated positively with the density of primary care physicians (r=0.307; P=.001). Although the availability of healthcare resources did not explain the differences in premature mortality, this study highlights the persistent territorial and sex-based heterogeneity in Spain and the need for comprehensive strategies that combine investment, prevention, and the reduction of inequalities. The findings provide useful evidence for planning cardiovascular health policies at the regional level.

23. Getting Serious about Tickborne Diseases - Shifting Research Priorities.

期刊: The New England journal of medicine 发表日期: 2026-May-13 链接: PubMed

摘要

24. The validity of selection assessments for medical specialty selection: examining prediction across different training outcomes.

期刊: Postgraduate medical journal 发表日期: 2026-May-13 链接: PubMed

摘要

The Multi-Specialty Recruitment Assessment (MSRA) is a proctored assessment, comprising a clinical problem-solving (CPS) test and a situational judgement test (SJT), often combined with selection interviews, for admission to multiple postgraduate medical specialty training programmes in the UK. The study examined the predictive validity of these selection assessments (i.e. the extent to which they effectively predicted later performance outcomes). Data were obtained from the UKMED dataset and analyzed for ten UK medical specialties (~13 000 unique applications) to explore relationships between selection data (CPS, SJT, and selection interview) and subsequent performance outcomes; Annual Review of Competence Progression (ARCP) and national professional examination scores, comprising Applied Knowledge Tests (AKTs) and Objective Structured Clinical Examinations (OSCEs). Results supported the predictive validity of the MSRA and interview scores with some evident trends across different criteria. For example, the CPS tended to be most predictive of the AKT performance, and the SJT (which assesses non-academic skills) tended to be more strongly predictive of OSCE than AKT performance. The predictive validity of the selection interviews beyond the MSRA varied by specialty. Results provide evidence of the predictive validity for both the MSRA and interviews across a range of specialties, providing insights into how best to design and combine different selection methods to balance key considerations such as reliability, validity, efficiency, and positive candidate feedback. The findings of this research also have implications for other healthcare selection settings. Key messages • What is already known on this topic - Previous research has already demonstrated that the MSRA shows predictive validity in the context of General Practice and Psychiatry selection, and has begun to explore the validity of the MSRA and interviews in further specialties. However, there is a lack of recent research exploring the predictive validity of MSRA in selection processes across other specialties, using a range of criterion measures and longitudinal performance outcomes, such as exam data. • What this study adds - The MSRA demonstrates validity with Annual Review of Competence Progression (ARCP) and national professional examination scores in postgraduate medical specialty training, across a range of different medical specialties. • How this study might affect research, practice, or policy - The results of this study can be used to inform future policy and decision making regarding the use of the MSRA alongside selection interviews and to enhance the reliability, validity, efficiency, and candidate experience for selection in future. Further, results provide valuable insights about the validity of such methods which may be informative to other settings internationally.

25. Association between twin birth and risk of anthropometric failure and morbidity outcomes among children in India, 2019-2021.

期刊: Journal of public health (Oxford, England) 发表日期: 2026-May-13 链接: PubMed

摘要

Twinning rates are increasing globally and in India, yet a comprehensive analysis of nutritional outcomes and growth patterns among twins in low-and middle income countries remains limited. This was a cross-sectional study utilizing data from India’s National Family Health Survey, 2019-2021. The final analytic sample comprised 224 177 children (0-59 months). We employed logistic regression models and Coarsened Exact Matching. The primary outcomes included anthropometric failure (stunting, wasting, underweight), anemia, diarrhea, and acute respiratory infection (ARI). Twins had a consistently higher prevalence for most adverse health outcomes. For instance, severe anemia prevalence was 4.29% (95% CI: 3.42, 5.16) in twins versus 2.09% (95% CI: 2.03, 2.15) in singletons, with 70% higher adjusted odds (aOR: 1.70; 95% CI: 1.28, 2.25). Nutritional disadvantages were most pronounced in the 0-5 months age group and attenuated with age. Disparities were greatest among the poorest groups, though the increased risk of severe anemia persisted across all wealth quintiles. Twins had lower prevalence and adjusted odds for ARI and diarrhea than singletons. Significant health disparities persist between twins and singletons in India, particularly in early childhood and among disadvantaged groups. These findings underscore the need for targeted, equity-focused public health interventions to improve nutritional and health outcomes for twins across India.

26. A necessary compromise: mainstreaming traditional birth attendants (Iya Abiye) into colonial maternal healthcare in Ibadan, c.1930 - c.1960.

期刊: Journal of the history of medicine and allied sciences 发表日期: 2026-May-13 链接: PubMed

摘要

The colonial project was both parasitic and extractive. Its resource extraction imperative depended on maintaining a reservoir of cheap labour, whose supply required that they encourage and sustain high birth rates in the colonies. Maternal healthcare was therefore key to this project. The period 1930 to 1960, which we examine, was also characterized by increased African political agitation and internationally, by deepening global liberalism. Advocates of the latter called for colonial reforms, including some political participation of the growing African middle class. This, plus political changes in Britain at the time, put British colonial officials in Africa under pressure to bring about some reforms, including healthcare services. In Nigeria’s Ibadan, the colonial regime initiated a training scheme for Africans to become midwives. They also recognized and mainstreamed in their medical service the institution of traditional birth attendants (known locally as Iya Abiye). We view this effort as a convenient response of the colonial officials to the shortage of medical personnel in Nigerian rural areas. These changes also reveal the rudimentary nature of health service delivery further away from urban areas. The introduction of Iya Abiye signals a shift in colonial health policy to an accommodative one due to the continued popularity of Iya Abiye in Yorubaland. By co-opting Iya Abiye into the mainstream maternal health system, colonial Nigeria officially became a medical pluralist society characterised by implementation challenges amidst some successes.

27. Who Are the Long-Term and Short-Term Users of Meals on Wheels Services in the 65+ US Population?

期刊: Journal of applied gerontology : the official journal of the Southern Gerontological Society 发表日期: 2026-May-13 链接: PubMed

摘要

This study identifies the long-term and short-term users of home-delivered meals, i.e., Meals on Wheels (MOW) services, and how they differ across socioeconomic and health status. The analysis relies on a nationally representative sample of 65+ Medicare beneficiaries from the 2013-2021 National Health and Aging Trends Study. A fixed effect multinomial logit model, with lagged indicators and complex survey design, predicts the probabilities of being a short-term (1 year or less) or long-term (2+ years) MOW client. Beneficiaries’ characteristics predictive of long-term MOW use include identifying as Black, being on Medicaid, pre-frail, and having 2+ IADL limitations. Medicaid enrollment is one of the few statistically significant predictors for short-term MOW use. These results reveal that long-term MOW users are more heterogeneous and vulnerable than short-term users. Understanding the reasons various individuals rely on MOW services for multiple years may inform policy on the social and care needs of older adults.

28. Kratom Use and Associations With Mental Health in the United States.

期刊: Journal of addiction medicine 发表日期: 2026-May-13 链接: PubMed

摘要

To assess the US lifetime and past-year prevalence of kratom Mitragyna speciosa use and its associations with mental health and DSM-5 substance use disorder (SUD). This study examined cross-sectional survey data collected from 169,408 non-institutionalized individuals aged 12 and older in US households between 2021 and 2024. Measures included kratom use, nonmedical use of cannabis, prescription drugs (opioids, sedatives/tranquilizers, stimulants), other drugs, mental health indicators (serious psychological distress, DSM-5 major depression, suicidal ideation), and DSM-5 SUD. Between 2021 and 2024, lifetime and past-year kratom use were highest among adults aged 21 to 34, 3.40% (95% CI: 3.17-3.65) and 1.01% (95% CI: 0.91-1.13), respectively. Among people who reported prior-to-past-year kratom use, most reported past-year cannabis (65.7%; 95% CI: 60.4-70.3) and had a past-year SUD (52.8%; 95% CI: 50.1-55.4), whereas an estimated 37.8% (95% CI: 37.2-47.3) experienced serious psychological distress. Similar results were observed for those who reported past-year kratom use. Multivariate logistic regression analysis revealed prior-to-past-year and past-year kratom use was associated with increased adjusted odds of past-year SUD (AOR: 4.36; 95% CI: 3.89-4.88 and AOR: 4.81; 95% CI: 3.99-5.80, respectively). Similar results were found for other substance use, DSM-5 major depression, and suicidal ideation. Over 5 million people in the United States used kratom in their lifetime, with the highest use at ages 21-34 years. Kratom use is increasing and strongly associated among individuals who use cannabis, have a DSM-5 SUD, and experience serious psychological distress. These findings reinforce a profile of individuals who use kratom, many with behavioral health symptoms, and need evidence-based treatment warranting consideration in clinical and policy efforts.

29. Illustration of Kleda concept in "common soil hypothesis" context.

期刊: Journal of Ayurveda and integrative medicine 发表日期: 2026-May-13 链接: PubMed

摘要

Kleda is one of the important but least explored concepts of Ayurveda. The term Kleda literally means ‘dampness/moisture’. Kleda plays an essential role in maintaining the physiology and manifesting diseases when imbalanced. It is the fundamental constituent in the pathogenesis of diseases associated with Pitta and Kapha Dosha. ‘Common soil hypothesis’ explains regarding the common prevailing substrate which is invariably involved in the manifestation of several Metabolic Disorders. There are several candidates for ‘common soil’, such as insulin resistance, vascular inflammation, and endothelial dysfunction, possessing oxidative stress and chronic inflammation as centrally participating mechanisms in all stages of diseases. This article presents a complete review on understanding Common soil hypothesis on the grounds of Kleda and Santarpanottha Vyadhi (diseases arising due to over nourishment). This review of the concept of Kleda has been outlined to foreground the necessity of a holistic approach in promotion of health, prevention, and management of variants of Metabolic disorders which sprout from the unified soil of Kleda.

30. Exposure to and Impact of a Mass Media Campaign Promoting Healthy Coping Strategies With Mental Health Challenges.

期刊: American journal of health promotion : AJHP 发表日期: 2026-May-13 链接: PubMed

摘要

PurposeTo evaluate the reach and short-term effectiveness of the Turn To social marketing campaign, which encourages healthy coping strategies for mental health challenges and promotes mental health communication in Texas.DesignA cross-sectional survey was conducted in March 2023, 3 months after the campaign launch.SettingData were collected online.SampleA sample of adult Texans (N = 1979).MeasuresMental health-related norms, efficacy, behaviors, and campaign awareness.AnalysisMultivariable linear regressions and multivariable logistic regressions were performed to assess the relationship between campaign awareness and potential campaign outcomes.ResultsExposure to the campaign was positively associated with higher levels of self-efficacy (B = .009, P < .001) and response efficacy (B = .042, P = .045) in stress management, stronger perceived norms of seeking (B = .088, P < .001) and providing (B = .088, P < .001) mental health support, and a greater likelihood of engaging in recommended behaviors-such as asking for help from one’s social network (OR = 2.126, P < .001).ConclusionsOur findings suggest that the campaign has achieved several indicators of early success. Social marketing campaigns may offer a feasible and promising approach to encouraging healthy coping strategies for mental health issues and fostering social connection through more open conversations about mental health challenges.

31. Impact of Ruminococcus torques Administration on Glucose Tolerance and Hepatic Selenoprotein Expression in Selenium-deficient Mature Female Mice.

期刊: Biological trace element research 发表日期: 2026-May-13 链接: PubMed

摘要

We previously found that dietary selenium (Se) deficiency and age increase the fecal abundance of Lachnospiraceae in aged telomere-humanized mice in a sexually dimorphic manner. Although Lachnospiraceae are key contributors of short-chain fatty acids to the host, different taxa within this family exert distinct effects on host physiology. Among them, Ruminococcus torques has been associated with type 2 diabetes. In the present study, we aimed to determine whether, and how, R. torques interacts with dietary Se to influence type 2 diabetes-like symptoms. Sixteen weaning female C57BL/6J mice were fed either a Se-adequate or Se-deficient diet for 26 weeks. From weeks 21 to 25, half of the mice in each dietary group received daily oral gavage of R. torques (2 × 10⁸ CFU in 0.2 mL). All mice were euthanized at week 26. Dietary Se deficiency induced glucose intolerance (13%) and insulin resistance (16%) (P < 0.05). While R. torques administration was associated with a reduction in glucose levels at 30 min post-injection in Se-deficient mice, it did not significantly alter the overall glucose area under the curve, insulin resistance, or fasting glucose levels. Se deficiency reduced the relative abundance of Lactobacillus spp., F. prausnitzii, and Roseburia spp./E. rectale in the cecal content, and these taxa were unaffected by R. torques treatment. In contrast, Se deficiency increased the relative abundance of R. torques and E. coli in cecal samples, with E. coli levels further elevated by R. torques gavage. Notably, R. torques oral gavage 1) decreased SELENOP and GPX1 protein levels in the liver, but not in skeletal muscle, of Se-adequate mice; 2) increased liver GPX1 protein levels in Se-deficient mice. Altogether, R. torques administration exerts a marginal effect on glucose excursion and increases both liver GPX1 protein levels and cecal E. coli abundance in Se-deficient mature female mice with diabetic symptoms.

32. Nationwide quality indicator survey on the current practice of esophageal cancer management in Japan: report from the guideline committee for the 6th edition of the Japanese Esophageal Cancer Practice Guidelines.

期刊: Esophagus : official journal of the Japan Esophageal Society 发表日期: 2026-May-13 链接: PubMed

摘要

To evaluate the dissemination and real-world implementation of recommendations from the 5th Edition of the Japanese Esophageal Cancer Practice Guidelines and to inform development of the upcoming 6th Edition, the Guideline Committee of the Japanese Esophageal Society conducted a nationwide Quality Indicator (QI) survey in Japan. A nationwide, cross-sectional, web-based questionnaire survey was distributed to 381 certified institutions participating in the 2023 National Registry of Esophageal Cancer in Japan. Conducted in November 2024, the survey covered six domains-epidemiology, surgery, endoscopy, chemotherapy, radiation therapy, and pathology-reflecting key recommendations of the 5th Edition. Responses were summarized descriptively at the institutional level. Valid responses were obtained from 190 institutions (49.9%). Smoking cessation guidance was implemented in more than 90% of institutions, and over 90% also provided guidance on alcohol abstinence or moderation, although complete alcohol abstinence was less uniformly recommended. Minimally invasive, including robot-assisted, esophagectomy was adopted by over 90% of institutions. The proportion of institutions performing prophylactic cervical lymph node dissection varied by tumor location and stage, reflecting contemporary staging concepts. The DCF regimen was the predominant neoadjuvant therapy for stage II/III disease (94.7%), and immune checkpoint inhibitor-based chemotherapy was widely used for unresectable or recurrent disease. Advanced endoscopic diagnostic modalities, including magnifying and image-enhanced endoscopy, were widely adopted. This nationwide QI survey demonstrates broad adherence to guideline-based multidisciplinary management of esophageal cancer in Japan and provides an evidence base for refining recommendations in the 6th Edition of the Japanese Esophageal Cancer Practice Guidelines.

33. Correction to: Efficacy and Safety of Oral Meclizine for Growth Promotion in Children with Achondroplasia: A Phase 2 Clinical Trial.

期刊: Calcified tissue international 发表日期: 2026-May-13 链接: PubMed

摘要

34. Instruments for Assessing Health-Related Quality of Life in People With Visual Impairment: Protocol for a Scoping Review.

期刊: JMIR research protocols 发表日期: 2026-May-13 链接: PubMed

摘要

Visual impairment affects approximately 2.2 billion people worldwide and has significant impacts on various aspects of life, including physical, social, economic, and emotional domains. Assessing the quality of life of these individuals is essential for identifying their needs and guiding health promotion strategies. However, no studies were found that systematically cataloged the instruments used for this evaluation specifically for people with visual impairment. This study aims to systematically map the scientific evidence regarding the instruments used to assess quality of life in individuals with visual impairment at any health care level. The population, concept, and context framework guided the development of the research question: What instruments are available in the scientific literature to assess the quality of life of people with visual impairment across health care levels? Data will be collected from major databases and gray literature, with duplicates managed in Mendeley and screening conducted independently by 2 reviewers using Rayyan. Full texts will be assessed based on eligibility criteria, and data will be synthesized in Microsoft Excel and reported using a flowchart and narrative summary, following PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) guidelines. This protocol was registered on the Open Science Framework platform on July 28, 2025. The results of this study will be disseminated through publication in a peer-reviewed scientific journal. It is expected that the findings will provide valuable support for the development and advancement of a broader research project. Identifying and evaluating instruments used to assess the quality of life in individuals with visual impairment are crucial to ensure the use of reliable and scientifically sound tools. This process not only advances scientific knowledge but also informs public health policies aimed at promoting equity, inclusion, and improved living conditions for this population.

35. Effectiveness and Safety of Early Rhythm Control in Patients With Atrial Fibrillation and Chronic Kidney Disease.

期刊: Journal of the American College of Cardiology 发表日期: 2026-May-13 链接: PubMed

摘要

Atrial fibrillation (AF) increases cardiovascular risk in patients with chronic kidney disease (CKD). The safety and efficacy of early rhythm control (ERC) in patients with CKD is not fully established. This predefined secondary analysis of the EAST-AFNET 4 trial assessed the effectiveness and safety of ERC in patients with CKD defined by estimated glomerular filtration rate (GFR). EAST-AFNET 4 randomized patients with recently diagnosed AF and comorbidities to ERC or usual care (UC). Key outcomes were analyzed by Kidney Disease Improving Global Outcomes defined CKD groups. The primary efficacy outcome combined cardiovascular death, stroke, hospitalization for worsening heart failure, or acute coronary syndrome. The safety outcome combined death, stroke, and serious rhythm control-related adverse events. Recurrent AF was a secondary outcome. Baseline creatinine was available in 2,742 of 2,789 (98.3%) patients. In this study, 23% had CKD (GFR: <60 mL/min/1.73 m2). Patients with CKD were older (CKD: 74 ± 7.4 years; no CKD: 69 ± 8.3 years; P < 0.001), had higher CHA2DS2-VASc scores (CKD: 4 ± 1.4; no CKD: 3.2 ± 1.2; P < 0.001), and more primary outcome events over 5.1 years of follow-up (HR: 0.98 per mL GFR decrease [95% CI: 0.97-0.99 per mL GFR decrease]). ERC reduced the primary outcome with and without CKD (no CKD: ERC: 3.4%/100 patient-years; UC: 4.1%/100 patient-years; HR: 0.84; P < 0.001; CKD: ERC: 5.8%/100 patient-years; UC: 8.5%/100 patient-years; HR: 0.67; P < 0.001; Pinteraction = 0.133). CKD increased safety outcomes without interaction with ERC (Pinteraction = 0.927). Patients with CKD experienced more AF recurrences with UC (Pinteraction = 0.036). ERC effectively and safely reduces cardiovascular events in patients with recently diagnosed AF and stroke risk factors with and without CKD. (Early Treatment of Atrial Fibrillation for Stroke Prevention Trial (EAST); NCT01288352).

36. Impact of Maternal, Infant, and Household Factors on Early-life Gut Microbiome Development in a Rural Setting.

期刊: The ISME journal 发表日期: 2026-May-13 链接: PubMed

摘要

Early-life gut microbiome development is influenced by host, microbial, environmental, and social factors. Rural infants typically exhibit greater microbial diversity than their urban counterparts, yet microbiome maturation patterns in less industrialized settings remain underexplored. Additionally, though microbial eukaryotes are integral to gut ecology, most studies to date have focused predominantly on bacterial communities. Using shallow shotgun metagenomics and 18S rRNA gene sequencing, we characterized eukaryotic and bacterial gut microbiomes in an intensively sampled longitudinal cohort of ten infants from a rural community in Morelos, Mexico, each followed monthly from the first to the 18th month, providing an unusually detailed view of early-life microbiome development in a low-resource setting. Although both bacterial and eukaryotic alpha diversity increased over time, they showed distinct colonization trajectories. Age, delivery mode, and environmental exposures, such as animal contact and household factors, influenced bacterial and eukaryotic community compositions, as well as bacterial metabolic composition. Inter-kingdom microbial networks varied with age, with a reduction in taxonomic diversity after the first year of life. Age and mode of birth also influenced changes in the overall community structure and connectivity of microbial co-occurrence patterns, but did not impact the associations among specific microbial taxa. Functional profiling revealed that bacterial metabolic potential diversified with age, whereas the mode of birth had a minimal impact on functional variation. These findings highlight the dynamic nature of bacterial and eukaryotic microbiota in early life and underscore the need to explore how rural environmental exposures shape microbial maturation, with potential implications for immune development and long-term health.

37. Fit testing of N95 respirators: A pilot study on respirator design and demographic factors.

期刊: Journal of occupational and environmental hygiene 发表日期: 2026-May-13 链接: PubMed

摘要

N95 filtering facepiece respirators (FFRs) approved by the National Institute for Occupational Safety and Health are widely used by healthcare workers to prevent the inhalation of hazardous airborne contaminants. Various nose-clip shapes and respirator styles in N95 FFRs are designed to eliminate gaps between the respirator and the wearer’s facial skin, ensuring adequate protection for the wearer. However, variations in facial dimensions across sexes and races may affect the fit and, consequently, the performance of these respirators. The primary objective of this study was to assess the effect of N95 FFR design, specifically the nose-clip shape and respirator style, on the fit factor (FF). The second aim was to assess how subject characteristics, specifically sex and race, affect the respirator fit. Additionally, the efficacy of N95 FFRs may degrade over prolonged use. The authors recently developed a portable device called the Exposure Protection Integrated Communicator (EPIC) that uses dual optical sensors to measure particle concentrations inside and outside the workplace and provide real-time monitoring of the workplace protection factor for FFRs. The EPIC’s performance was evaluated by comparing its results with the reference PortaCount fit tester. Two cup-shaped FFRs with different noseclip shapes and six N95 FFRs with various styles were tested. Twenty human subjects were recruited to perform the Occupational Safety and Health Administration approved quantitative fit test (QNFT) protocol by running both PortaCount and EPIC devices in triplicate with each respirator. Results indicated that respirator FF was significantly affected by respirator design and subject facial characteristics. Caucasian males generally achieved the best fit, while Hispanic or Latino females had the poorest fit, highlighting the need for design improvements that account for differences in sex and race. Additionally, the comparison between EPIC and PortaCount demonstrated a strong proportional bias, with EPIC tending to report higher fit factor values, particularly under conditions where the respirator achieved higher fit factors. These findings underscore the need for cautious interpretation and potential calibration before EPIC can be reliably used in occupational settings.

38. Occupational toxic inhalation injury to cleaning chemicals during the COVID-19 pandemic, including a case series for disinfectants aerosolized through spray and fog application.

期刊: Journal of occupational and environmental hygiene 发表日期: 2026-May-13 链接: PubMed

摘要

The occupational burden of injury caused by exposure to cleaning chemicals during the pandemic is not well described. The objective of this study was to determine whether the COVID-19 pandemic was associated with a change in the rate of toxic inhalation (TI) injuries following occupational exposure to cleaning chemicals. This retrospective study spanned from July 1, 2017, to June 30, 2022, with January 1, 2020, designated as the pandemic start. TI cases were identified among workers’ compensation claims filed in Washington State, USA using keyword text search and diagnostic and insurance codes. Qualitative claim data were reviewed to determine the frequency of cases with exposure to aerosolized disinfectants following spray or fog application. Rates of TI claims per full-time equivalent (FTE) workers were compared in the pre- and pandemic periods. Out of the 440 TI claims identified, 30% involved exposure to disinfectants and 13% had a diagnosis of work-related asthma. There was a decline in the overall rate of TI claims in the pre- vs. pandemic period (8.9/100,000 FTE vs. 7.4/100,000 FTE, respectively). However, the proportion of exposures to disinfectants increased during the pandemic period. Four industries, particularly “Transportation and Warehousing,” experienced an increase in TI injury rate. Fog or spray application of disinfectants was involved in 20 cases (including 14 in bus transportation) during the pandemic, compared to zero cases in the pre-pandemic period. In Washington State, the COVID-19 pandemic was associated with industry-specific increased TI injury rates due to cleaning chemicals, but not an overall increased rate. A case series emphasizes that aerosolized disinfectants are a toxic inhalation risk for workers. Studies to further characterize this practice and these injuries are warranted. Prevention efforts should utilize the hierarchy of controls as well as address hazard awareness, product over-application, and the need to estimate and uphold a safe re-occupation time after fog or spray application of disinfectants.

39. Effect of a Single-Session Therapeutic Patient Education Intervention on Physical Activity in Patients Initiating Cancer Therapy: A Randomized Controlled Trial.

期刊: JCO oncology practice 发表日期: 2026-May-13 链接: PubMed

摘要

Physical activity (PA) is recognized as a key supportive care intervention in oncology. However, encouraging patients to increase or maintain their PA level at the onset of their treatment is challenging. Therapeutic patient education may support PA during cancer treatments, but effective strategies remain to be determined. Adult patients were enrolled at the start of cancer therapy in a single-blind randomized controlled trial, in which patients and outcome assessors remained blinded to group allocation. The control group received a booklet with PA recommendations, resistance exercises, and a resistive elastic band. The experimental group received the same material plus a single 30-minute face-to-face educational session delivered by experienced physiotherapists. The primary outcome was variation in PA level between baseline and 6 months of follow-up, as measured with total global score of the International Physical Activity Questionnaire (IPAQ), analyzed on an intention-to-treat basis. Secondary outcomes included fatigue, health-related quality of life, and physical function. Ninety-eight patients were included. At 6 months, the IPAQ total global scores were maintained in both groups, with no significant between-group differences. There were no significant between-group differences in secondary outcomes, except for the IPAQ Transport subscale (P = .026) favoring the control group. The addition of a single-session educational intervention beyond the provision of educational material at the onset of cancer therapy did not significantly increase PA. However, PA levels were maintained in both groups. More iterative, tailored, or group-based interventions may be required to achieve measurable behavioral changes in PA.

40. Metabolic syndrome, cardiometabolic risk, and functional status in adults with early-stage spinal cord injury: A retrospective analysis.

期刊: The journal of spinal cord medicine 发表日期: 2026-May-13 链接: PubMed

摘要

Metabolic disturbances are well documented in chronic spinal cord injury (SCI), yet data regarding metabolic, inflammatory, and hemodynamic profiles during the subacute rehabilitation period remain limited. This study aimed to determine the prevalence of metabolic syndrome and to examine metabolic, inflammatory, hemodynamic, and functional characteristics of adults with subacute SCI during early inpatient rehabilitation. Retrospective observational study. Inpatient rehabilitation clinic. A total of 87 adults with traumatic or non-traumatic SCI more than six weeks post-injury. Participants underwent a structured inpatient rehabilitation program consisting of multidisciplinary therapy, including physical and occupational therapy. Sociodemographic and injury-related variables, American Spinal Injury Association (ASIA) Impairment Scale (AIS), laboratory parameters (fasting glucose, lipid profile, complete blood count), neutrophil-to-lymphocyte ratio (NLR), blood pressure, and Functional Ambulation Scale (FAS) scores at admission and discharge. Metabolic syndrome was defined using standard biochemical criteria. The mean age was 40.5 ± 19.6 years, and 78.2% of patients were male. Metabolic parameters remained within normal limits across AIS grades and lesion levels. Metabolic syndrome was present in 10.3% of patients. No statistically significant differences in NLR values were observed across AIS groups. Blood pressure remained stable across groups. Functional ambulation improved from a mean FAS score of 0.61 at admission to 1.06 at discharge. Structured inpatient rehabilitation in the subacute phase of SCI appears to support early improvements in ambulation while maintaining metabolic, inflammatory, and hemodynamic stability. Larger longitudinal studies are needed to clarify the long-term significance of these findings.

41. Cognitive fusion as a mediator between pain interference and depressive and anxiety symptoms among adults with spinal cord injury.

期刊: The journal of spinal cord medicine 发表日期: 2026-May-13 链接: PubMed

摘要

This study examined whether cognitive fusion statistically mediated the cross-sectional associations of pain interference with depressive and anxiety symptoms among individuals with spinal cord injury (SCI). Cross-sectional mediation models estimated using path analysis were used to test cognitive fusion as a mediator between pain interference and depressive or anxiety symptoms. Online survey completed by adults with SCI in the United States. 156 adults (51.3% female; mean age = 42.1 years) with traumatic (78.2%) or non-traumatic (21.8%) SCI. Pain interference was measured using the spinal cord injury - Quality of Life (SCI-QOL) Pain Interference Short Form. Cognitive fusion was assessed with the Cognitive Fusion Questionnaire-7. Depressive and anxiety symptoms were measured using the Patient Health Questionnaire-9 and Generalized Anxiety Disorder-7, respectively. Grief due to SCI, measured using the SCI-QOL Grief and Loss Short form, was retained as a covariate. Pain interference was significantly associated with higher cognitive fusion and greater depressive and anxiety symptoms. After controlling for SCI-related grief, cognitive fusion partially mediated these relationships, accounting for 45.4% of the total effect of pain interference on depressive symptoms and 42.3% of the total effect on anxiety. Cross-sectional path analyses supported an indirect statistical association between pain interference and depressive/anxiety symptoms through cognitive fusion. These findings highlight cognitive fusion as a critical, modifiable psychological mechanism underlying this relationship. Targeting cognitive fusion in interventions such as acceptance and commitment therapy may help mitigate the psychological impact of pain interference and improve mental health.

42. Epidemiological and clinicopathological factors associated with infection by multiple pathogens transmitted by Rhipicephalus sanguineus sensu lato in naturally infected dogs in the Semiarid area of Northeastern Brazil.

期刊: Comparative immunology, microbiology and infectious diseases 发表日期: 2026-May-12 链接: PubMed

摘要

Domestic dogs are frequently exposed to tick-borne pathogens such as Babesia vogeli, Hepatozoon canis, Anaplasma platys and Ehrlichia canis, which can cause a wide range of clinical manifestations, although little is known about the epidemiological and clinicopathological profiles of mono- and co-infections. This study aimed to characterize infection patterns and identify clinical and epidemiological factors associated with mono-infections, and co-infections with two or more pathogens in naturally infected dogs. We analyzed 181 dogs from a hospital population with suspected hemoparasitic infections, assessed hematocrit and platelet counts, and used statistical models (Chi-square, Fisher’s exact test, odds ratios, and multinomial logistic regression) to evaluate associations between infection types and clinical or epidemiological variables. This is the first comprehensive Brazilian study correlating infection type with clinical and epidemiological factors. Dogs with a history of tick infestation were 3.41 times more likely to be co-infected with two pathogens, and infections involving two (84.6%) or three or more pathogens (90.9%) were more frequent in dogs without the use of tick control medications. Male dogs and those presenting epistaxis, hyporexia or anorexia, dehydration, onychogryphosis, and ectoparasites were more likely to be co-infected with three or more pathogens. Thrombocytopenia was common in all groups, with dogs co-infected with three or more pathogens showing 16.3 times higher odds and dogs co-infected with two pathogens had increased odds of anemia (OR = 2.11). These results underscore the importance of tick control and comprehensive pathogen screening in endemic regions, especially in Brazil’s semi-arid northeast, to enhance diagnosis, management, and prevention strategies.

43. Mechanical aging of tire microplastics enhances the bioavailability of pre-adsorbed 17β‑estradiol in goldfish.

期刊: Journal of hazardous materials 发表日期: 2026-May-11 链接: PubMed

摘要

Tire microplastics (TMPs) are emerging contaminants in aquatic environments, posing ecological risks from both their ingredients and adsorbed pollutants. However, the transformation of TMPs by mechanical forces on wet-road surfaces and its effects on the carrier behavior of TMPs remain poorly understood. Here, we employed wet ball-milling to simulate mechanical TMP aging after rainfall by repeated TMP-road surface friction. The mechanical aging significantly increased the proportion of fine particles (1-10 μm) from 6.4% to 73.1%, accompanied by a change from dense, compact structures into loosely aggregated particles. In vitro desorption experiments showed that the aging enhanced the release of 14C-labeled 17β-estradiol (E2) pre-adsorbed onto the TMPs in simulated fish digestive fluids. This enhancement was likely due to shortened intraparticle diffusion pathways, leading to increased bioavailability. Goldfish exposure experiments revealed that the aged TMPs modulated the absorption, distribution, and clearance of E2 in vivo, promoting its intestinal release while delaying its hepatic accumulation, thereby altering the temporal response of the estrogen-responsive biomarker vitellogenin. Our findings indicate that mechanical aging under wet-road conditions not only refines TMP particles and alters their structure, but also increases their environmental risks as carriers of low-molecular-weight organic pollutants.

44. Association between functional autonomy and nutritional status in older adults: A scoping review.

期刊: Archives of gerontology and geriatrics 发表日期: 2026-May-11 链接: PubMed

摘要

Functional autonomy and nutritional status are critical for health and quality of life in community‑dwelling older adults. Evidence suggests a reciprocal association between these domains, yet findings remain fragmented due to heterogeneous study designs and assessment measures. Clarifying this link is essential for informing integrated strategies to prevent frailty and promote active ageing. A scoping review was conducted following Arksey and O’Malley’s framework and PRISMA-ScR guidelines. Searches in PubMed, Scopus and Web of Science identified studies in English or Spanish from the past five years. Eligible studies included older adults (≥60 years) living in the community and assessed both autonomy (BADL/IADL) and nutritional status. Data extraction covered design, tools, findings and contextual factors. A descriptive synthesis mapped concepts and gaps. Thirteen studies met criteria. Greater autonomy, especially in instrumental activities, was associated with better nutritional status, while functional dependence was associated with a higher risk of malnutrition. Declining autonomy was associated with subsequent nutritional deterioration. Depression and social isolation moderated outcomes. Common tools included the Barthel Index, Lawton-Brody Scale, Katz Index and the Mini Nutritional Assessment. This contribution may be relevant for community and primary care practice, where different health and social care professionals increasingly work together to address functional autonomy and nutrition as closely related aspects of active and healthy ageing.

45. Unveiling the mechanisms of oxidative stress-mediated multi-pathway programmed cell death in Ruditapes philippinarum exposed to butylated hydroxytoluene (BHT).

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

摘要

Synthetic phenolic antioxidants (SPAs), as representative emerging contaminants, have been widely detected across various environmental media and organisms, raising significant ecological and health concerns. However, the toxicological effects and underlying molecular mechanisms of SPAs in marine organisms remain poorly understood. By integrating transcriptomics, in silico simulations, and experimental validation, this study elucidates the “oxidative stress-macromolecular damage-cell death” mechanism in the Ruditapes philippinarum under BHT stress. Our results demonstrate that BHT exposure triggers significant ROS accumulation in the digestive glands. A time-dependent response was observed: an initial induction of antioxidant defenses (0-6 d) was followed by a late-stage (12-21 d) suppression of the NRF2-mediated pathway, culminating in compromised antioxidant capacity and severe macromolecular damage. Mechanistically, BHT-induced ROS disrupts the calcium pump, causing Ca2 + homeostasis imbalance and triggering the ER-mitochondria stress axis, which ultimately initiates apoptosis. Furthermore, BHT impairs iron homeostasis, causing Fe²⁺ overload, which drives ALOX5-mediated lipid peroxidation and may ultimately lead to ferroptosis. Simultaneously, activation of the NLRP3-CASPASE1 signaling cascade may also trigger pyroptosis. Collectively, this study provides comprehensive evidence of how BHT orchestrates oxidative stress-mediated multi-pathway programmed cell death (PCD) in aquatic invertebrates, offering crucial scientific insights for the ecological risk assessment of SPA pollution in marine ecosystems.

46. H3K18 lactylation-regulated ATG10 is involved in the acute respiratory distress syndrome induced by acute exposure to hydrogen sulfide through activation of autophagy in lung epithelial cells.

期刊: Journal of hazardous materials 发表日期: 2026-May-07 链接: PubMed

摘要

Hydrogen sulfide (H2S) is a colorless, toxic, asphyxiant gas. In recent years, industrial accidents involving H2S exposure have frequently resulted in fatalities and disabilities. Acute respiratory distress syndrome (ARDS) poses a substantial burden on healthcare systems worldwide. The syndrome’s heterogeneity and multifaceted pathogenesis, combined with a paucity of effective treatments, contribute to a persistently high mortality rate, which currently stands at 30-35%. The present study utilized metabolomics, transcriptomics, and CUT&Tag sequencing to explore ARDS pathogenesis, providing insights into its mechanisms and therapeutic targets for its treatment. Serum metabolomics for individuals with H2S-induced ARDS identified lactate accumulation as a pivotal metabolic event that mediates changes in H2S-induced ARDS biomarkers. Lactate, a potential biomarker of H2S-induced ARDS, is associated with a poor prognosis. However, whether elevated lactate directly promotes H2S-induced ARDS and the mechanisms underlying this effect remain unclear. Here, we demonstrate that lactate disrupts the alveolar epithelial barrier, thereby facilitating the development of ARDS. Mechanistically, lactate promotes histone H3K18 lactylation at the promoter for ATG10, a gene involved in the process of autophagy, driving its transcription and upregulating autophagy in alveolar epithelial cells, which results in disruption of the epithelial barrier. For rats, the reduction of lactate generation by a glycolytic inhibitor mitigates H2S-induced ARDS, as evidenced by attenuated pulmonary edema. Our results show that the lactate-autophagy axis mediates H2S-induced ARDS. Therefore, targeting the regulation of lactate production and/or autophagy is a therapeutic strategy for patients with H2S-induced ARDS.

47. Compliant bilayer vascular grafts with in situ heparin functionalization for small diameter vascular regeneration.

期刊: Biomaterials 发表日期: 2026-May-07 链接: PubMed

摘要

Given the scarcity of autologous graft donors, a substantial and pressing demand exists for small-diameter (<6 mm) vascular grafts (SDVGs) as viable alternatives in bypass and reconstructive surgeries for the treatment of cardiovascular diseases, including coronary artery disease and peripheral artery disease. However, the challenges of compliance mismatch, inadequate endothelialization, and insufficient anticoagulation of SDVGs generally lead to side effects like thrombosis, inflammation and intimal hyperplasia. To address these issues, this study proposes a biomimetic bilayer SDVG with heparin modification fabricated through dry-jet wet spinning. This comprises a reinforced outer layer for sufficient mechanical strength and a flexible inner layer for high compliance, effectively mimicking the mechanical properties of natural vessels. The one-step in-situ heparin coating strategy represents a significant simplification for fabrication, ensuring uniform heparin distribution to prevent platelet aggregation and thrombus formation, and enhancing endothelial cell (EC) adhesion, spreading, and proliferation. The in vivo evaluation of rabbit carotid artery demonstrates that the vascular graft achieves excellent long-term patency without apparent obstruction or thrombosis. Five months post-implantation, compositions similar to native blood vessels are formed, and immunofluorescence staining shows positive expression for ECs and smooth muscle cells and the persistent infiltration of M2-polarized macrophages on the inner surface. The proposed fabrication strategy provides a novel solution for vascular replacement and has potential applications in vascular bypass and reconstruction.

48. Molecular interactions between halogenated bisphenol compounds and GPER: Spectroscopic, molecular simulation, and DFT calculations.

期刊: Spectrochimica acta. Part A, Molecular and biomolecular spectroscopy 发表日期: 2026-May-07 链接: PubMed

摘要

Halogenated bisphenols (HBPs) are widely detected environmental contaminants present in water systems, soil, and biota. The incorporation of halogen substituents (Cl, Br) enhances their environmental persistence and potential toxicological effects. Understanding the cellular responses to HBPs exposure in living organisms is therefore essential for evaluating their human health implications. This study comprehensively characterizes the binding patterns and interaction mechanisms of HBPs with the G protein-coupled estrogen receptor (GPER) through an integrated approach combining multispectral analysis, molecular dynamics (MD) simulations, and quantum chemical calculations. Computational results reveal that hydrogen bonding and van der Waals interactions primarily mediate GPER-HBPs binding, with binding affinity modulated by both halogen atom count and the chemical nature of bridging groups between benzene rings. Binding of HBPs induces significant structural alterations in GPER, including conformational rearrangements, molecular compaction, enhanced hydrophobicity, and modifications to the microenvironment and secondary structure. Fourier-transform infrared (FT-IR) and three-dimensional fluorescence spectroscopy confirm secondary structure reorganization, particularly evidenced by reduced β-sheet content. Stern-Volmer analysis establishes static quenching as the dominant mechanism, correlated with specific HBPs binding modes and sites. Density functional theory (DFT) calculations identify hydrogen bonds, halogen bonds, and electrostatic interactions as key driving forces, supplemented by weaker intermolecular contributions. These insights advance the assessment of health risks associated with HBPs-type environmental pollutants.

49. Astrocyte reactivity across the AD continuum measured by [18F]SMBT-1 and its relationship with the Aβ burden.

期刊: European journal of nuclear medicine and molecular imaging 发表日期: 2026-May-06 链接: PubMed

摘要

Astrocytes colocalize with fibrillar amyloid-β (Aβ) plaques in postmortem Alzheimer’s disease (AD) brain tissue; however, their spatiotemporal dynamics in vivo remain poorly understood. This multicenter study aimed to investigate the progression of astrocyte reactivity across the AD continuum, including healthy controls (HC), mild cognitive impairment (MCI), and AD, using the novel monoamine oxidase B (MAO-B)-specific PET tracer [18F]SMBT-1, while exploring its association with cognitive performance and amyloid burden. A total of 91 participants (35 HC, 44 MCI, 12 AD) underwent [18F]SMBT-1 PET, amyloid PET, T1-weighted MRI, and standardized neuropsychological assessments. Standardized uptake value ratios (SUVRs) were calculated based on [18F]SMBT-1 PET data using four reference regions for subgroup comparisons stratified by Aβ status. [18F]SMBT-1 uptake was significantly elevated in amyloid-positive MCI (MCI+) and AD groups compared with amyloid-negative HC (HC-) in the frontal, temporal, and posterior cingulate regions. Notably, astrogliosis patterns distinguished MCI subtypes: MCI+ individuals exhibited a widespread AD-like pattern, whereas the MCI- group showed a distinct profile. Furthermore, the uptake in symptomatic MCI+ individuals was significantly higher than that in asymptomatic HC+ individuals. Regional SMBT-1 uptake also strongly correlated with greater Aβ burden and worse cognitive scores. This study demonstrates that [18F]SMBT-1 is a promising tool for characterizing the spatial pattern and magnitude of reactive astrogliosis across the Aβ-defined AD continuum. Our findings further suggest that astrogliosis may represent an important mechanistic link between amyloid pathology and cognitive impairment, supporting its potential relevance in therapeutic development. Japan Registry of Clinical Trials (jRCT) jRCTs031210602, registered Feb. 07, 2022. URL FOR THE TRIAL REGISTRY: https://jrct.mhlw.go.jp/en-latest-detail/jRCTs031210602 .

50. Digital SERS-lateral flow immunoassay platform for ultrasensitive and dosage-sensitive analysis of sibutramine.

期刊: Spectrochimica acta. Part A, Molecular and biomolecular spectroscopy 发表日期: 2026-May-03 链接: PubMed

摘要

Rapid detection techniques play a critical role in the field of food hazard factor analysis, as food safety constitutes a fundamental cornerstone of public health. However, the application of Surface-Enhanced Raman Scattering (SERS)-lateral flow immunoassay (LFIA) as a rapid detection method in this area still faces significant challenges. Consequently, traditional quantification methods that rely on average Raman signal intensity often prove inadequate for accurate measurement under such conditions. In response to these limitations, we developed a digital SERS-LFIA approach, which employs digital analytical techniques to process Raman spectral data for the ultrasensitive and quantitative analysis of sibutramine (SIB), a central appetite suppressant formerly used in obesity treatment that is now frequently illicitly added to foods such as weight-loss teas. Specifically, the method utilized core-shell Ag-coated Au nanoparticles functionalized with Raman reporter molecules as SERS tags. SERS-LFIA strips were prepared via antigen-antibody recognition for SIB detection. Rapid Raman mapping of the T-line region generated spatially resolved signal matrices, which were converted to binary values 0/1 by applying an intensity threshold at the reporter’s characteristic peak. Quantification was accomplished by correlating the positive signal frequency with SIB concentration, effectively mitigating the interference caused by signal heterogeneity and background signals on quantification. Compared with conventional Raman average intensity analysis, the digital SERS-LFIA achieved limits of detection of 0.28 ng/mL, demonstrating excellent quantitative detection capability. In summary, by incorporating digital SERS technology, this study extends the application of LFIA to enable ultrasensitive and efficient quantitative detection analytes in complex food samples.

51. Prenatal exposure to polycyclic aromatic hydrocarbons and birth outcomes in a pregnancy cohort in Nairobi, Kenya.

期刊: PloS one 发表日期: 2026 链接: PubMed

摘要

Prenatal exposure to polycyclic aromatic hydrocarbons (PAHs) has been linked to lower birth weight (BW) and shorter gestational age (GA) at delivery. Most research has focused on populations in high-income countries, leaving low- and middle-income countries (LMICs) understudied. We examined associations between pregnancy urinary PAH metabolites and birth outcomes in a prospective cohort in Nairobi, Kenya. The study population was drawn from women and their newborn babies enrolled in a pregnancy cohort. Third-trimester urinary mono-hydroxylated PAH metabolites (OH-PAH) were measured and infant BW and GA were ascertained using medical record abstraction and self-report; BW-for-GA z-scores were computed. Linear and modified Poisson regression models were used to estimate the effects of five OH-PAHs on birth outcomes; Weighted Quantile Sum regression was used to explore OH-PAH mixture effects. Among 353 mother-infant pairs, the median infant BW was 3.2 kg and 7.6% were born preterm. All OH-PAH metabolites were present in urine of >99% of mothers. Individual OH-PAH concentrations were not associated with BW or BW-for-GA z-scores. One metabolite, 2-hydroxyphenanthrene, was associated with shortened gestation (RR = -1.6 day per doubling in concentration, 95% confidence interval: -3.1, -0.1). This association was attenuated after adjusting for self-reported exposure to household fuel and outdoor combustion and was strengthened among female infants, but not male infants, in sex-stratified analyses. Other metabolites and the OH-PAH mixture were not associated with birth outcomes. Our findings suggest that exposure to 2-hydroxyphenanthrene may have a modest adverse effect on pregnancy duration, with potential sex-specific differences in association. No associations were observed for markers of fetal growth. These results highlight need for further studies on sex-specific vulnerabilities and the role of environmental co-exposures in impacting birth outcomes in LMICs.