公共卫生研究摘要 (2026-05-15)

共收录 50 篇研究文章

1. Postural health education in schools: teachers' perspectives on well-being, inequities, and institutional constraints.

期刊: International journal of qualitative studies on health and well-being 发表日期: 2026-Dec-31 链接: PubMed

摘要

Postural health remains an underexamined dimension of school-based health education, despite its relevance for students’ wellbeing and long-term musculoskeletal health. This study explores how Physical Education teachers conceptualise and implement postural health education, and which factors shape its enactment. A qualitative descriptive-interpretive design was adopted. Semi-structured interviews were conducted with 30 Physical Education teachers from primary and secondary schools in Spain. Data were audio-recorded, transcribed verbatim, and analysed using reflexive thematic analysis within a constructivist framework. Five interrelated themes captured a tension between teachers’ strong valuation of postural health and its marginal curricular status. These themes reflected (i) its recognised but limited curricular integration; (ii) fragmented conceptualisations and uneven pedagogical content knowledge; (iii) predominantly sporadic and unstructured implementation; (iv) insufficiently practice-oriented training; and (v) a strong demand for practical and institutional support. Conceptualisations ranged from hygiene-oriented approaches to more integrative understandings linked to motor control and physical literacy. Implementation was shaped by limited training, scarce resources, and low institutional prioritisation. Findings reveal a gap between the perceived importance of postural health and the structures supporting its implementation. Addressing this gap requires context-sensitive approaches that strengthen pedagogical support and curricular alignment.

2. Associations and Potential Biological Pathways Between Physical Frailty and Epilepsy Incidence: A Large-Scale Prospective Cohort Study.

期刊: Neurology 发表日期: 2026-Jun-09 链接: PubMed

摘要

Physical frailty has been longitudinally linked to multiple neurologic disorders but has not yet been extrapolated to epilepsy. The study aimed to investigate the prospective association between physical frailty and incident epilepsy and to explore potential biological processes associated with this relationship. This prospective cohort study included 421,383 UK Biobank participants free of epilepsy, Parkinson disease, dementia, stroke, or migraine at baseline. Physical frailty status was assessed using a modified Fried frailty phenotype model based on 5 components (weight loss, exhaustion, low physical activity, slow gait speed, and low grip strength) that categorized participants as nonfrail, prefrail, or frail. Incident epilepsy was ascertained through linked health records. Cox proportional hazard models were conducted to calculate hazard ratios (HRs) and 95% CIs for the association between physical frailty and incident epilepsy. Hypothesis-driven mediation analyses were used to investigate potential biological pathways associated with the frailty-epilepsy association. During a mean follow-up of 13.2 years, 2,752 incident epilepsy cases were identified. Compared with nonfrail individuals, the multivariable-adjusted HRs (95% CIs) for incident epilepsy among those with prefrailty and frailty were 1.29 (1.19-1.40) and 1.81 (1.54-2.13), respectively. Among the 5 frailty components, slow gait speed (HR 1.46; 95% CI 1.29-1.65), low grip strength (HR 1.19; 95% CI 1.08-1.32), exhaustion (HR 1.18; 95% CI 1.06-1.32), and weight loss (HR 1.17; 95% CI 1.06-1.29) were associated with higher hazards of incident epilepsy. Biomarker analyses observed that blood biomarkers reflecting liver and kidney function, immune-inflammatory response, endocrine activity, and hematologic profiles were associated with both frailty and incident epilepsy and may collectively explain approximately 18.57% (95% CI 13.18%-26.83%) of the frailty-epilepsy association. In addition, several metabolically related biomarkers, involving lipoprotein particle size, amino acids, ketone bodies, total lipids, and triglycerides, were identified as potential contributors. Physical frailty was associated with a higher incidence of epilepsy in this prospective cohort. Biomarker analyses provided preliminary insights into biological domains potentially related to this association, including organ function, inflammation, endocrine regulation, hematologic status, and metabolic homeostasis.

3. In Reply.

期刊: Obstetrics and gynecology 发表日期: 2026-Jun-01 链接: PubMed

摘要

4. Intervention Research to Reduce Disparities in Severe Maternal Morbidity and Mortality in the United States: A Scoping Review.

期刊: Obstetrics and gynecology 发表日期: 2026-Jun-01 链接: PubMed

摘要

Persistent inequities in severe maternal morbidity (SMM) and maternal mortality in the United States have received national attention over the past decade. This scoping review aimed to outline evidence-based interventions to decrease these inequities. We adapted a socioecologic framework of SMM and maternal mortality to integrate three equity approaches: 1) interventions across subpopulations, 2) analytic strategies, such as subanalyses or reporting outcomes among priority groups, and 3) assessing risk factors unique to priority groups. We conducted a structured search of peer-reviewed medical databases then assessed findings qualitatively. We included studies of SMM or its components, mortality, and postpartum rehospitalization that used an equity approach and focused on groups disproportionately affected by maternal mortality, such as Black, Indigenous, and rural populations and those with low income. Our findings revealed a lack of rigorous peer-reviewed interventions in many areas but identified key findings in multiple domains of our model, especially at the health system level. Although evidence is too nascent for firm conclusions on effective interventions, our review provides examples of best practices to guide future design and reporting of maternal health equity interventions.

5. Maternal Morbidity and Mortality Reduction: Ongoing Progress Requires Collective Commitment and Action.

期刊: Obstetrics and gynecology 发表日期: 2026-Jun-01 链接: PubMed

摘要

6. Fixational Microsaccades in Patients With Parkinson Disease.

期刊: Journal of neuro-ophthalmology : the official journal of the North American Neuro-Ophthalmology Society 发表日期: 2026-Jun-01 链接: PubMed

摘要

Fixational microsaccades (FM) encompass the involuntary, small-scale movements of the eye that occur as we attempt to fixate on a single point. These movements are crucial for maintaining a steady visual perception despite our gaze’s constant, subtle changes. FM is significant because it can serve as an indicator of central nervous system disorders; for example, altered FM correlated with multiple sclerosis disability levels and disease progression. This study aims to characterize FM in patients with Parkinson disease (PD). Fourteen older adults (age 71.0 ± 7.2 years, 6 females) with PD and 17 controls (age 73.4 ± 4.4 years, 15 females) were recruited. Retinal motion traces were recorded using a tracking scanning laser ophthalmoscope (TSLO, RetiTrack, C. Light Technologies, Cambridge, MA). The number of FM, saccade amplitude, velocity, peak velocity, and frequency were measured. All FM measurements were significantly different between PD and controls (P values < 0.05): the number of saccades (19.45 ± 7.40 vs 10.19 ± 6.69, P = 0.001), average amplitude (0.44 ± 0.15 vs 0.33 ± 0.10°, P = 0.027), average velocity (7.45 ± 1.44 vs 6.46 ± 0.96°/s, P = 0.037), average peak velocity (10.48 ± 2.99 vs 8.49 ± 2.03°/s, P = 0.044), and saccade frequency (1.95 ± 0.74 vs 1.07 ± 0.69 Hz, P = 0.002). Furthermore, the average amplitude strongly correlated with the Movement Disorders Society-sponsored Unified Parkinson Disease Rating Scale part III (MDS UPDRS III) motor subscale (r = 0.62, P = 0.02) and the Unified Parkinson Disease Rating Scale Hoehn and Yahr Stage (UPDRS HY Stage) (r = 0.62, P = 0.02). Similarly, average velocity and average peak velocity significantly correlated with both UPDRS III (r = 0.56, P = 0.04) and UPDRS HY Stage (r = 0.59, P = 0.03-0.04). These results indicated that PD patients had larger, more frequent, and quicker microsaccades, which were associated with disease severity. To our knowledge, this is the first study to characterize FM using TSLO in patients with PD. The tracking scanning laser ophthalmoscope appears to have high precision and sensitivity, offering detailed, real-time retinal imaging with minimal motion artifact. The results indicate that impaired fixational microsaccades in PD correlate with disease severity, suggesting that altered FM could serve as a biomarker for progression and treatment response.

7. Association Between Severe Perioperative Surgical Morbidity With Cesarean Delivery and Postpartum Readmission.

期刊: Obstetrics and gynecology 发表日期: 2026-May-15 链接: PubMed

摘要

To evaluate the association between severe perioperative surgical morbidity with cesarean delivery and postpartum readmission. This was a retrospective cross-sectional study using linked birth certificate and maternal discharge data for patients who underwent cesarean delivery in any California hospital between October 2015 and October 2021. Severe perioperative surgical morbidity is an index characterized by severe surgical complications occurring during hospitalization for cesarean delivery, identified using International Classification of Diseases, Tenth Revision diagnosis and procedure codes for severe surgical complications. The primary outcome was all-cause postpartum readmission within 42 days after hospital discharge. Readmission rates were quantified for patients with and without severe perioperative surgical morbidity, and generalized estimating equations were used to estimate adjusted relative risks (aRRs), adjusted risk differences (aRD), and 95% CIs, accounting for patient- and hospital-level factors. In secondary analysis, the association was assessed separately for prelabor and intrapartum cesarean deliveries. The study population included women who had undergone 703,079 cesarean deliveries. The readmission rate was higher among those with severe perioperative surgical morbidity compared with those without severe perioperative surgical morbidity (469.4/10,000 [95% CI, 428.0-511.0] vs 165.3/10,000 [95% CI, 162.3-168.3]). Severe perioperative surgical morbidity was associated with a twofold increased risk of readmission (aRR 2.22; 95% CI, 2.00-2.46). The aRD for patients with severe perioperative surgical morbidity was an excess of two readmissions (2.5; 95% CI, 2.1-3.0/100 cesarean deliveries) compared with patients without severe perioperative surgical morbidity. Wound infection was the most common diagnosis at readmission among patients with severe perioperative surgical morbidity (77/10,000; 95% CI, 60.5-95.3). The risk of readmission was similar among patients with severe perioperative surgical morbidity and without severe perioperative surgical morbidity who underwent intrapartum cesarean delivery (aRR 2.35; 95% CI, 2.09-2.65) and prelabor cesarean delivery (aRR 2.03; 95% CI, 1.72-2.40). Nearly 1 in 20 patients undergoing cesarean delivery who experience severe perioperative surgical morbidity undergoes postpartum readmission, with a twofold increased readmission risk at 42 days after discharge. Patients with severe perioperative surgical morbidity may benefit from targeted follow-up to reduce postpartum admission.

8. Breast cancer trends in China and its comparative analysis with group of 20 countries: Projections for 2022-2040.

期刊: Cancer 发表日期: 2026-May-15 链接: PubMed

摘要

Breast cancer is the most commonly diagnosed cancer among women worldwide. This study analyzed and compared breast cancer patterns in China and the Group of 20 (G20) countries and predicted future trends. Using data from the Global Burden of Disease 2021 study, the authors examined incidence, mortality, mortality-to-incidence ratio (MIR), age-standardized mortality rate (ASMR), age-standardized incidence rate (ASIR), and average annual percent change. Joinpoint regression was used to identify trend changes. Social demographics index associations were examined. Autoregressive integrated moving average was used to forecast trends to 2040. Between 1990 and 2021, breast cancer incidence in China increased by over 360%, with ASIR rising from 9.42 to 23.65 per 100,000, significantly higher than the G20 average (from 24.85 to 29.45). The most pronounced ASIR increases were observed among men 15-49 years old. Although G20 countries reduced their ASMR from 9.57 to 8.14 per 100,000, China’s ASMR increased slightly from 4.71 to 5.04 per 100,000. The MIR declined in both China and G20, especially in females 15-69 years old. Projections suggest continued ASIR growth in China, especially among those 50-69 years old, whereas ASMR is expected to stabilize or decline by 2040. Breast cancer incidence and mortality are increasing more rapidly in China than in G20 countries, driven by reproductive, lifestyle, and environmental factors. These trends highlight the urgent need for enhanced prevention, targeted screening-particularly for women 50-69 years old-and strengthened international collaboration to mitigate the growing disease burden. Breast cancer rates in China have risen sharply over the past 30 years, particularly among women aged 50–69 and older adults. Compared with the Group of 20 countries, China showed faster increases in both incidence and mortality. The study suggests strengthening early screening, improving public awareness, and expanding access to care—especially for older adults and rural populations.

9. Scientific highlights and perspectives from the International Inflammatory Breast Cancer Symposium 2025.

期刊: Cancer 发表日期: 2026-May-15 链接: PubMed

摘要

Inflammatory breast cancer (IBC) is a rare yet highly aggressive subtype of breast cancer, characterized by distinct clinical features, rapid progression, and complex biology. Despite decades of research, patient outcomes remain poor, underscoring the need for innovative approaches. The International IBC Symposium 2025 convened global experts to discuss advances in the field and to outline strategic priorities for research and clinical care. This report summarizes the key themes discussed. A major topic was IBC biology, with particular emphasis on tumor emboli formation and tumor microenvironment interactions, which shape the distinctive characteristics of the disease. Updates in molecular and immune profiling were presented, illustrating how these data may guide personalized therapeutic approaches. From a therapeutic standpoint, the importance of trimodal therapy in patients with nonmetastatic IBC was reinforced, while highlighting the need to investigate novel agents, rational drug combinations, and biologically informed strategies to improve outcomes. Additional sessions addressed optimization of locoregional management, even for selected patients with metastatic disease. Experts also discussed emerging technologies, including spatial transcriptomics, artificial intelligence tools, and liquid biopsy, as promising methods to advance disease characterization, facilitate earlier detection, and refine disease monitoring. Finally, a common theme across presentations was the critical importance of expanding awareness and education, as well as fostering global collaboration through the IBC International Consortium to standardize diagnosis, accelerate translational research, and ensure equitable access to care. Collectively, these efforts aim to redefine the clinical trajectory of IBC and move the field closer to achieving durable disease control and, ultimately, curative outcomes.

10. Association of maternal bisphenol exposure during pregnancy with spontaneous preterm birth and preliminary mechanistic exploration in a prospective cohort.

期刊: Ecotoxicology and environmental safety 发表日期: 2026-May-14 链接: PubMed

摘要

This study aimed to examine the associations between trimester-specific bisphenol exposure and preterm birth (PTB) and explore potential underlying mechanisms. Within the Tongji Precision Birth Cohort (TPBC), concentrations of ten bisphenols were quantified using high-performance liquid chromatography-tandem mass spectrometry (HPLC-MS/MS). Multivariable logistic regression models were employed to examine associations between trimester-specific urinary bisphenol exposure and spontaneous PTB (sPTB). Placental expressions of interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-α) were evaluated by immunohistochemistry. Median urinary concentrations of Bisphenol A (BPA) and BPF were used to guide in vitro assays. HTR8 and BeWo trophoblast cell lines were exposed to gradient BPA and BPF. RT-qPCR was used to measure mRNA levels of NF-κB pathway-related genes. Among the bisphenols analyzed, BPF emerged as the most common alternative to BPA. Placental BPA and urinary BPF showed associations with sPTB risk. Each standard deviation increase in placental BPA concentration was associated with a 38.1% increased risk of spontaneous preterm birth (95% CI: 1.023-1.866, p = 0.035). Placental expression of IL-6 and TNF-α was increased in sPTB. In trophoblast cells, low to middle concentrations of BPA and BPF might upregulate NF-κB pathway-related genes and selected inflammatory markers. Bisphenol exposure during pregnancy, particular BPA and BPF, may be associated with increased risk of sPTB. The findings further suggest the involvement of NF-κB pathway-related placental inflammatory signaling.

11. Risk of self-harm in first-diagnosed mental disorders: A 16-year territory-wide health-record database study in Hong Kong.

期刊: European neuropsychopharmacology : the journal of the European College of Neuropsychopharmacology 发表日期: 2026-May-14 链接: PubMed

摘要

Mental disorders (MDs) are established risk factors for self-harm, yet disorder-, age-, and sex-specific risk estimates in population-representative samples are rarely studied. We conducted a territory-wide, population-based cohort study using Hong-Kong medical record database covering public hospitals, specialist and general outpatient clinics, identifying 322,922 people with a first-recorded diagnosis of any MDs and 888,031 primary-care controls without MDs (proxy general population) between 1-January-2006 and 31-December-2021. Outcomes were incident self-harm events. Cox proportional-hazards models estimated hazard ratios (HRs) adjusting for sex, age-group, physical-comorbidity, and calendar-year; incidence rates (IRs) and HRs by each diagnostic-group, age-group and sex were generated. Over 3031,600.9 person-years, the MD cohort had an IR of 60.2 per 1000 person-years (95%CI 59.5-61.0), with HR 10.59(10.31-10.89). Elevated self-harm risk was observed across all fourteen diagnostic-groups, highest for substance use disorders (SUD, 22.86[21.47-24.34]), followed by alcohol use disorders (AUD,14.59[13.49-15.79]), personality disorders (PD,7.81[5.60-10.89]), major depressive disorder (7.48[7.14-7.85]), eating disorders (6.56[4.07-10.58]), bipolar disorder (6.43[5.71-7.24]), attention deficit/hyperactivity disorder (ADHD,6.09[5.51-6.73]), schizophrenia (5.00[4.63-5.40]), autism-spectrum disorders (ASD, 4.88[4.35-5.48]), post-traumatic stress disorders (PTSD, 3.64[2.83-4.68]), dysthymia (3.43[3.12-3.78]), obsessive compulsive disorder (3.74[3.27-4.27]), anxiety disorders (2.26[2.09-2.44]), and organic mental disorders (2.01[1.84-2.19]). Further analyses identified substantially elevated risk of SUD (with their high standalone and compounding risk). Subgroup analyses showed the highest self-harm risks in youths (≤24 years), and female predominance across most MDs, notably in PTSD, PD, AUD, ASD and ADHD. Taken together, this territory-wide electronic-health-record study maps the transdiagnostic nature of self-harm across first-diagnosed MDs, and further research to confirm the special vigilance for the at-risk subgroups/diagnostic groups.

12. Adding HE4 to the IOTA ADNEX model for differentiating adnexal masses: A Danish prospective, multicenter study.

期刊: Gynecologic oncology 发表日期: 2026-May-14 链接: PubMed

摘要

To assess the incremental value of incorporating human epididymis protein 4 (HE4) as an additional predictor in the International Ovarian Tumor Analysis (IOTA) Assessment of Different NEoplasias in the adneXa (ADNEX) model for differentiating benign from malignant adnexal masses. Prospective enrollment of 782 patients with adnexal masses was performed across 14 Danish gynecology units, including one tertiary center (2020-2023). ADNEX malignancy risk estimates with and without CA125 were calculated, and serum HE4 was incorporated. Patients were split into training and test subsets for internal validation. Model performance was evaluated using the area under the receiver operating characteristic curve (AUC), prediction error (Brier score), and predictive values at thresholds of 5-20%, stratified by center type. Malignancy was defined by histopathology or at least 12 months of follow-up. In the tertiary center, ADNEX models incorporating HE4 performed slightly better than the original models with and without CA125 (AUC 86.2-86.3% vs. 83.8% and 85.4%; Brier scores 14.7-14.8 vs. 15.5-16.4). A modest incremental effect of HE4 was observed at 10-15% thresholds (positive predictive values 46-55% vs. 43-47% and 43-53%), while negative predictive values remained comparable across models. In non-tertiary centers, model performance was similar across all models, with no improvement from incorporating HE4. Incorporating HE4 into the ADNEX model provided limited incremental value, with threshold-dependent performance changes, no improvement in non-tertiary centers, and only modest gains in the tertiary center. These findings do not support inclusion of HE4 in the ADNEX model.

13. All-Cause Mortality Among Working-Age Men in the United States, 2022-2023.

期刊: American journal of public health 发表日期: 2026-May-14 链接: PubMed

摘要

Objectives. To describe mortality rates by occupation among working-age men in the United States in 2022 and 2023. Methods. I obtained data on the occupation of decedents from death certificate data published by the National Center for Health Statistics for men aged 20 to 64 years. I calculated mortality rates and rate ratios for occupation groups. Results. Mortality rates were more than double for construction and extraction workers compared with all other workers. Mortality rates and rate ratios for workers in manual, blue-collar occupations were significantly higher than those for workers in other occupations. Conclusions. There were notably higher mortality rates for workers in manual, blue-collar occupations. Occupation groups with higher mortality rates also generally had a larger share of men in their workforce. Public Health Implications. Further research should examine work-related risk factors for occupational disparities in all-cause mortality. The workplace can be a convenient setting for interventions to prevent premature death among working-age men. Including occupation at the time of death in public health data can improve the validity and precision of future studies of the occupational causes of mortality. (Am J Public Health. Published online ahead of print May 14, 2026:e1-e4. https://doi.org/10.2105/AJPH.2026.308528).

14. Evaluating the Impact of Singapore's Nutri-Grade Beverage Labels on Prepackaged Beverage Purchases and Product Nutrient Composition: A Before-After Study, 2019-2024.

期刊: American journal of public health 发表日期: 2026-May-14 链接: PubMed

摘要

In December 2022, Singapore implemented mandatory Nutri-Grade front-of-pack labels for beverages. Using household scanner data (April 2019-March 2024), we evaluated changes in sugar purchases and product formulation. Households reduced sugar purchases by 3.1 grams per day (-18%), and purchases of unhealthy beverages fell 44%. Reformulation and reassortment lowered sugar content by 1.16 grams per 100 milliliters (-21%) but increased sweetener and lactose use. Higher-income and nutritionally literate households showed larger reductions. Findings support mandatory labeling but highlight equity concerns and supplier substitution risks. (Am J Public Health. Published online ahead of print May 14, 2026:e1-e5. https://doi.org/10.2105/AJPH.2026.308476).

15. The Long Arm of Incarceration: Incarceration History and Mortality Risk in a Nationally Representative Cohort of Older US Adults, 2012-2022.

期刊: American journal of public health 发表日期: 2026-May-14 链接: PubMed

摘要

Objectives. To evaluate whether incarceration history is associated with mortality risk among older adults in the United States. Methods. We used data from the 2012/2014-2022 Health and Retirement Study, a nationally representative longitudinal panel of US adults aged 51 years and older. We estimated mortality risk using Gompertz proportional hazards models and calculated average marginal effects to estimate predicted years of life lost. Additional models examined results for men and age groups. We used matched analyses to assess robustness. Results. Incarceration history was associated with an 88% higher hazard of death (hazard ratio = 1.88; 95% confidence interval [CI] = 1.51, 2.35) after adjusting for sex, race/ethnicity, and childhood health and socioeconomic factors. Marginal predictions reveal individuals with previous incarceration were estimated to die 5.8 years earlier on average (95% CI = -8.26, -2.51), with stronger associations observed for men and adults younger than 75 years. Conclusions. Incarceration history is a durable determinant of premature mortality in later life. Public Health Implications. Accounting for incarceration exposure in aging and mortality research is critical for addressing structural drivers of health inequality in the United States. (Am J Public Health. Published online ahead of print May 14, 2026:e1-e10. https://doi.org/10.2105/AJPH.2026.308449).

16. Vaccination-Related Applications and Health Care Professionals' Observed Changes in Human Papillomavirus Vaccine Hesitancy: Cross-Sectional Survey.

期刊: JMIR mHealth and uHealth 发表日期: 2026-May-14 链接: PubMed

摘要

Digital tools are known to promote public health interventions such as vaccine delivery. The recommendation that health care professionals (HCPs) use vaccination-related mobile apps or web-based applications has contributed to improving vaccine awareness and acceptance in the United States. The state of Texas, which has one of the lowest human papillomavirus (HPV) vaccination rates, has seen a significant increase in HPV vaccine hesitancy, particularly during the COVID-19 pandemic. This study aimed to examine the association between changes in HPV vaccine hesitancy observed by HCPs among patients in Texas and promotion of vaccination-related applications at the health care facilities where they practiced during the COVID-19 pandemic. A population-based cross-sectional survey was administered in 2021 by the MD Anderson Cancer Center to HCPs working in Texas using email addresses obtained from the LexisNexis Master Provider Referential Database. HCPs were asked if they assessed HPV vaccination status during every patient encounter. Those who responded “Often/Always” or “Sometimes” were subsequently asked whether they observed any change (“Decreased,” “No change,” “Increased,” or “Not sure”) in HPV vaccine hesitancy during the COVID-19 pandemic. Additionally, HCPs were asked whether their practice offers HPV vaccination. Those who responded “Yes” to this question were further asked whether vaccination-related applications are promoted at the facility where they practice, with response options being “Yes,” “No,” or “I don’t know.” Logistic regression analysis was performed to examine the association between changes in HPV vaccine hesitancy observed by HCPs and promotion of vaccination-related applications at the facility where they practice. A total of 1283 HCPs completed the survey. Of the 730 HCPs who observed changes in HPV vaccine hesitancy, 51 (7%) reported a decrease in their patients’ HPV vaccine hesitancy. Of these 730 HCPs, 578 (79.2%) responded to the questions regarding vaccination-related applications, of whom 104 (18%) reported that vaccination-related applications were promoted at their facilities. Compared to HCPs who reported not promoting vaccination-related applications, those who reported doing so at their facilities had significantly higher odds of observing a decrease in HPV vaccine hesitancy among patients (adjusted odds ratio [aOR] 2.48, 95% CI 1.10-5.55; P=.03). HCPs working at federally qualified health centers or city, county, or public health care facilities (aOR 4.02, 95% CI 1.33-12.14; P=.01) and HCPs who administered the HPV vaccine under standing orders at their facilities (aOR 2.91, 95% CI 1.11-7.63; P=.03) had significantly higher odds of observing a decrease in HPV vaccine hesitancy at their practices. Our findings suggest that promoting vaccination-related applications at health care facilities in areas with high HPV vaccine hesitancy such as Texas could further decrease HPV vaccine hesitancy in the population. This may be potentially applicable across diverse health care settings, particularly in the context of pandemic preparedness.

17. Intermittent Cobalt (II, III) Oxide Exposure Exacerbates Inflammatory Injury through Tumor Necrosis Factor-Alpha-Dependent Bone Marrow-Mediated Trained Immunity.

期刊: ACS nano 发表日期: 2026-May-14 链接: PubMed

摘要

Environmental nanoparticle exposure in real-world scenarios is often intermittent rather than continuous, yet its associated risks and mechanisms remain poorly understood. This study investigates whether such intermittent exposure induces maladaptive trained immunity within the bone marrow (BM) to drive inflammatory injury. We establish a physiologically relevant “prime-rest-rechallenge” mouse model of intermittent inhalation to cobalt (II, III) oxide (Co3O4) nanoparticles, a representative environmental stressor. Using this model, we provide in vivo evidence that intermittent Co3O4 exposure establishes a lasting, maladaptive immune memory in the BM─termed BM-mediated trained immunity. Primary Co3O4 exposure induces hematopoietic reprogramming toward a myeloid-biased phenotype, a state that is restored following a rest period. Upon secondary challenge, this reprogrammed state drives an augmented myelopoietic response, characterized by a 1.5-fold expansion of myeloid progenitors and a sustained output of mature myeloid cells. Integrated bioinformatics analysis and functional validation identify tumor necrosis factor-alpha (TNF-α), the highest-degree node (degree = 17) in the interaction network, as the central mediator orchestrating this BM-mediated trained immunity. In vivo TNF-α neutralization abrogates this trained myelopoietic phenotype. Furthermore, this Co3O4-induced, TNF-α-dependent trained immunity exacerbates inflammatory injury in distant organs, including the heart and brain. Our work establishes intermittent exposure as a critical yet overlooked risk paradigm, reveals trained immunity as a mechanistic link between nanoparticles and inflammatory disorders, and positions TNF-α as a potential therapeutic target to mitigate pollution-related risks.

18. Determinants of Willingness to Receive Health Information From Neighborhood Food and Beauty Establishments: Cross-Sectional Study.

期刊: JMIR public health and surveillance 发表日期: 2026-May-14 链接: PubMed

摘要

Although health care providers are the most trusted sources of health information, service establishments within communities represent important, yet underused, sources of health information. Specifically, food and beauty establishments can act as alternative settings for health communication, facilitating broader engagement with the general population. This study examined factors associated with willingness to receive health information from these non-health care service establishments among community-dwelling adults in Singapore. A cross-sectional survey was conducted among residents in 2 neighborhoods in central Singapore between November 2024 and April 2025. Data on sociodemographic characteristics, trust in information from health care and non-health care services, and willingness to receive health information were collected anonymously. The primary outcome was willingness to receive health information from non-health care services (yes or no), assessed among respondents with no prior exposure to health information from such services. Multivariable logistic regression was used to identify factors independently associated with willingness to receive health information from non-health care services. Among the 403 respondents, most were aged ≥50 years (n=223, 55.3%), female (n=219, 54.3%), Chinese (n=350, 86.9%), and highly educated (n=302, 74.9%). Of the 339 respondents without prior exposure to health information from non-health care services, approximately one-third (n=106, 31.3%) reported that they were willing to receive health information in the future. In adjusted analysis, greater trust in health information (adjusted odds ratio [AOR] 3.71, 95% CI 1.50-9.19) and high health information orientation (AOR 1.89, 95% CI 1.11-3.21) were associated with increased willingness to receive health information from non-health care services. Trust in health information was positively associated with willingness among those aged 21 to 34 years (AOR 4.96, 95% CI 1.35-18.30), those aged 35 to 49 years (AOR 8.02, 95% CI 2.62-24.59), and male respondents (AOR 6.22, 95% CI 2.79-13.89) to receive health information from these sources, but not among those aged ≥50 years (AOR 1.92, 95% CI 0.92-4.02) or female respondents (AOR 1.85, 95% CI 0.87-3.96). Nearly one-third of community-dwelling adults expressed willingness to receive health information from non-health care (food and beauty) services, highlighting the potential for leveraging these establishments as alternative health communication channels. Willingness was positively associated with higher health information orientation and greater trust. Additionally, trust in non-health care (food and beauty) services was associated with higher odds of willingness to receive health information among those aged 21 to 49 years and male respondents. This suggests the need for tailored trust-building strategies to strengthen engagement through such alternative channels.

19. Methodological Framework for the Design and Implementation of a US Latine-Hispanic Digital Brain Health Program: User-Centered Design Approach.

期刊: JMIR formative research 发表日期: 2026-May-14 链接: PubMed

摘要

US Latine and Hispanic communities face a 1.5 times greater risk of developing Alzheimer disease and related dementia (ADRD) with limited access to culturally and linguistically congruent primary prevention education. The COVID-19 pandemic exacerbated the digital divide, highlighting a need to focus on alternative digital methods for delivering brain health and ADRD primary prevention education. Social media emerged as a promising tool. The objective of this paper is two-fold. We first describe the development and pilot study of our social media-based Latine-Hispanic Digital Brain Health Program guided by evidence-based frameworks in ADRD. We then present the quantitative and qualitative results from the first 14 months of the program (October 2023-December 2024). We used human-centered design to develop the Digital Alzheimer Health Education Model, which was implemented via 3 social media platforms-Facebook, Instagram, and X (formerly known as Twitter). Our bilingual and bicultural team implemented the model by creating and disseminating tailored educational content in English and Spanish for the resulting Latine-Hispanic Digital Brain Health Program, emphasizing consistency and rapport, storytelling, cultural relevance, linguistic inclusivity, and visual representation. A mixed methods analysis (descriptive statistics and sentiment analysis) was conducted using social media data analytics and users’ comments to guide program evaluation and refinement. From October 2023 to December 2024, we retained 857 followers across our social media platforms (Instagram: n=534; Facebook: n=124; and X: n=199). Growth in follows, consistent reach and engagement, and positive sentiment were observed on Facebook and Instagram. X was not included in the analysis due to data access limitations. The development and pilot study of the Latine-Hispanic Digital Brain Health Program have demonstrated potential in leveraging social media to disseminate brain health and ADRD prevention education to the US Latine and Hispanic communities in English and Spanish. Our preliminary findings demonstrate that culturally and linguistically congruent social media-based approaches hold potential to improve engagement with brain health and ADRD primary prevention education among US Latine and Hispanic populations.

20. Estimation of the Attributable Fraction of Noncommunicable Diseases Related to Physical Inactivity, Morocco.

期刊: Preventing chronic disease 发表日期: 2026-May-14 链接: PubMed

摘要

Physical inactivity is a major risk factor for noncommunicable diseases (NCDs). With the growing prevalence of NCDs, quantifying the effects of physical inactivity is essential for informing public health policies. This study estimates the attributable fraction of NCDs related to physical inactivity in Morocco and examines differences by sex and physical activity level. We applied a population attributable fraction approach to estimate preventable cases of breast cancer, colorectal cancer, type 2 diabetes, ischemic heart disease, and ischemic stroke through increased physical activity. The analysis focused on adults aged 18 years or older, with a focus on ischemic conditions among those aged 35 or older. Data sources included the national World Health Organization (WHO) STEPwise approach to NCD risk factor surveillance (STEPS) survey (for inactivity prevalence), meta-analyses (for relative risks), the national cancer registry (for cancer incidence), and published studies (for disease prevalence). For breast cancer in women, physical inactivity accounted for 0.88% to 3.95% of cases. For colorectal cancer, the attributable fraction ranged from 2.72% (women) and 1.69% (men) at low activity levels to 6.49% (women) and 4.13% (men) at high activity levels. For type 2 diabetes, it ranged from 4.16% (women) and 2.60% (men) to 9.10% (women) and 5.84% (men). Among adults aged 35 years or older, physical inactivity accounted for up to 6.49% of ischemic heart disease cases and 7.08% of ischemic stroke cases in women and up to 5.16% and 5.64%, respectively, in men. Higher physical activity levels could significantly reduce NCD incidence. These findings underscore the preventive potential of physical activity and the need for sex-sensitive public health strategies to reduce NCD burden.

21. Using Facebook to Improve Participation in Colorectal Cancer Screening: Protocol for a Cluster Randomized Controlled Trial.

期刊: JMIR research protocols 发表日期: 2026-May-14 链接: PubMed

摘要

Colorectal cancer (CRC) screening participation in Canada is lower than the national target, and interventions designed to increase screening participation are generally expensive and have limited impact. Social media can be used as an innovative strategy to increase participation in cancer screening, particularly Facebook (FB), as it is the most popular social media platform for the population eligible for CRC screening. The aim of this study is to report on the protocol for a pragmatic cluster randomized controlled trial that will test the effectiveness of CRC social media advertisements on user engagement and screening intention. The trial will target FB users aged 45 to 64 years who reside in the province of Ontario, Canada. There are 521 forward sortation areas (FSAs) in Ontario, and the randomization will be done at this level using the first 3 digits of the postal code. Rural and urban FSAs will be randomly allocated to one of the 6 study arms. In 4 arms, FB users will all receive one of 4 social media advertisements developed in previous studies, while in the fifth arm, a tailored strategy by sex will be tested. In the final arm, FB users will not be shown any advertisements. If users click on any of the advertisements, they will be directed to a webpage with more information on screening and a place to pledge their intention to screen for CRC. The study’s primary outcome will be tested as a count measure, defined as the number of people per FSA who pledge their intention to screen for CRC. User engagement metrics, including impressions, link clicks, cost per link click, link click-through rate, and user comments, will be tracked across the 5 trial arms with advertisements shown. This cluster randomized controlled trial will provide evidence on the use of FB as a tool for delivering CRC screening messages and influencing screening intentions. The comparison of message types within a fixed campaign budget could identify which approaches promote user engagement in both urban and rural populations. This study has the potential to show that social media offers a cost-efficient, scalable approach to promote CRC screening. This approach is adaptable to other cancer screening programs and could provide evidence-based digital strategies for the promotion of cancer screening. ClinicalTrials.gov NCT04296630; https://tinyurl.com/5y5k7yjb. DERR1-10.2196/86829.

22. Adoption of Digital Mental Health Interventions in National Health Service England, Scotland, and Wales: Freedom of Information Questionnaire Study.

期刊: JMIR mental health 发表日期: 2026-May-14 链接: PubMed

摘要

Digital mental health interventions (DMHIs) have been widely promoted to improve access to mental health care within the UK National Health Service (NHS), particularly following the COVID-19 pandemic. In 2015, a total of 48 technologies were reportedly used in NHS services in England, but over the past decade, substantial changes to regulatory requirements, evidence standards, and procurement processes have reshaped the digital mental health landscape. There is limited clarity regarding which DMHIs are currently being formally procured and funded by NHS mental health services across the United Kingdom. This study aimed to identify and describe the DMHIs currently procured, contracted, or paid for by NHS mental health service providers in England, Scotland, and Wales for adult common mental health problems and to compare current procurement practices with findings reported in 2015. Freedom of Information requests were submitted to all NHS mental health trusts in England and all health boards in Scotland and Wales. Responses were collated and screened to provide an updated and extended record of which technologies are reportedly procured or paid for by services. In total, 19 different DMHIs were identified as being procured across mental health service providers for adult common mental health problems at the time of data collection. This demonstrates a substantial reduction in the number of technologies being adopted into practice compared to the 48 reported in England in 2015. The findings reveal several key insights, including that only 2 technologies have remained in use for a decade, and they shed light on the types of technologies being selected and the variations in procurement practices among the 3 national health services. Despite the expansion of the digital mental health marketplace, the number of DMHIs formally procured by NHS mental health services has markedly decreased over the past decade. This consolidation may reflect increased selectivity and the adoption of higher-quality products, driven by strengthened regulatory oversight, evidence standards, and national guidance. Although these developments may enhance safety and quality assurance, they also raise important questions about innovation, market sustainability, and equitable access to digital mental health care. Ongoing monitoring of procurement practices is needed to inform policy, service design, and the future development of DMHIs.

23. Mode Effects Between Mobile Web and Telephone Surveys on Patient Experience Scores in South Korea: Secondary Analysis of a Randomized Controlled Trial Under Various Missingness Scenarios.

期刊: Journal of medical Internet research 发表日期: 2026-May-14 链接: PubMed

摘要

Patient experience surveys are essential tools for assessing health care quality, yet the potential influence of survey mode on patient experience scores remains understudied. This study investigates the mode effects between mobile web and telephone surveys within South Korea’s Patient Experience Assessment. This study aimed to examine the presence and extent of the mode effects of mobile web versus telephone surveys on patient experience scores. The primary outcome was defined as the total score across all 21 survey items, rescaled to 0-100. This is a secondary analysis using experimental data from a parallel-group randomized controlled trial involving 3200 patients (adults aged ≥19 years, hospitalized >1 day, discharged 2-56 days before the survey) from 4 general hospitals between October and November 2022, equally allocated to telephone and mobile web survey modes. An independent survey company generated the random allocation sequence using computer-generated random numbers and assigned participants to the survey modes. Due to the nature of the intervention, blinding of participants, interviewers, and outcome assessors was not feasible after assignment. We calculated unadjusted score differences among respondents and estimated adjusted differences accounting for nonresponse using inverse probability weighting (IPW) and multiple imputation (MI) under the missing-at-random assumption. Sensitivity analyses, using the delta-adjustment method based on the missing-not-at-random assumption, assessed robustness to departures from the missing-at-random assumption. Subgroup analyses by sex, age group, and field of care were also conducted. Of 3200 patients randomized (1600 per mode), 878 completed the survey (520 mobile web and 358 telephone). Analyses included all randomized participants (n=3200), with nonresponse addressed through IPW and MI. No adverse events were reported in this survey-based study. The total patient experience score was significantly lower in the mobile web group (mean 81.5, SD 16.4) than in the telephone group (mean 84.9, SD 14.3; unadjusted difference -3.41 points, 95% CI -5.51 to -1.31; IPW-adjusted -4.11, 95% CI -6.17 to -2.04; MI-adjusted -4.59, 95% CI -7.45 to -1.73). Similar patterns were observed across most subdomains. Subgroup analyses revealed consistent mode effects across different demographic categories. Sensitivity analyses using the delta-adjustment method confirmed the robustness of these findings under various missing data scenarios. Mobile surveys may yield substantially lower patient experience scores than telephone surveys. Unlike previous studies, our study analyzes randomized experimental data under various missingness scenarios and provides evidence that this mode effect is unlikely to be attributable to analytical methods or heterogeneity in respondent characteristics between the 2 survey administration modes. Accordingly, caution is warranted when comparing patient experience scores obtained from traditional telephone surveys with those from mobile surveys. Methodologically, our sensitivity analysis approach provides a robust framework for assessing and addressing potential nonresponse bias in patient experience assessments.

24. Neighborhood Revitalization and Cardiovascular Disease Outcomes in Midlife and Older Adults Living in Low-Income Neighborhoods in the Bronx, New York: Protocol for a Natural Experiment and Multimethod Community-Based Study.

期刊: JMIR research protocols 发表日期: 2026-May-14 链接: PubMed

摘要

Neighborhood revitalization is a process through which land use rezoning and capital investment can spur new resources, such as access to healthful food and amenities for physical activity. While revitalization efforts may promote cardiovascular health, their benefits may not be distributed equally across sociodemographic groups. The objective of the study is to apply a socioecological framework that uses a multimethod approach incorporating quantitative data (longitudinal electronic health records and cross-sectional surveys) and qualitative data (longitudinal “walk-a-long” interviews) to examine the short-term effect of neighborhood land use rezoning and revitalization efforts on cardiovascular disease (CVD), CVD-related health behaviors, and access to and utilization of health care. System science methods, namely microsimulation modeling and system dynamics modeling, will be used to assess the long-term effects of land use rezoning policy and revitalization efforts on cardiovascular health and ways to sustain priority health equity goals in revitalized neighborhoods. We leverage a land use rezoning initiative in the Bronx, New York, where a largely commercial area is being rezoned along with capital investments to expand healthful neighborhood resources. Using electronic health records from a single hospital system, we will follow cohorts of midlife and older adults (≥50 y) residing in both the rezoned area and a comparison area. We will assess clinically measured incident CVD and other CVD risk factors to evaluate changes in cardiovascular health over time. In parallel, we will conduct a cross-sectional survey and a purposive sampling of patients for in-person “walk-a-long” qualitative interviews to understand how residents perceive neighborhood access to healthful resources after land use rezoning. To estimate long-term effects, we will use a validated microsimulation model to project CVD outcomes and costs. Finally, we will use system dynamics modeling to integrate quantitative and qualitative findings to inform future revitalization and public health strategies. Midlife and older adult patients (N=10,813) in the intervention area and the comparison area will be followed for approximately 7 years following land use rezoning and revitalization efforts to compare CVD risk between neighborhoods. The cross-sectional survey (n=300) and qualitative assessment (n=36) will increase understanding of perceptions of access to healthful resources and related health behaviors among residents. Systems science approaches will estimate long-term CVD risk and related costs associated with revitalization efforts. An advisory committee of clinical and community stakeholders will assist in interpreting results and developing dissemination strategies for their constituents. This study was funded from January 2023 until December 2026. This study uses a socioecological framework to provide a novel, transferable method for evaluating the impact of neighborhood revitalization efforts on cardiovascular health by combining methods to examine short- and long-term effects across individual, neighborhood, and structural (system) levels over time. Findings will inform policies aimed at reducing CVD through equitable urban revitalization.

25. How Health Systems 'Software' Factors Affect Frontline Health Workers' Humanitarian Response Efforts During Infectious Disease Outbreaks in the Rohingya Refugee Camps, Cox's Bazar, Bangladesh.

期刊: The International journal of health planning and management 发表日期: 2026-May-14 链接: PubMed

摘要

Humanitarian settings face a growing healthcare workforce crisis marked by staff shortages, unsafe working conditions, and limited professional development. Despite being critical intermediaries in outbreak responses, demands on health workers come at a substantial cost to their health and wellbeing. Research on health workers responding to the Rohingya refugee crisis in Cox’s Bazar, Bangladesh, is limited. Focussing on health systems “software” (relationships between people and structures), this study explores health workers’ interactions with different levels of governance structures, including humanitarian response governance, the health sector coordination leadership team, and their affiliated NGO management structures when responding to disease outbreaks in the camps, particularly during COVID-19. Qualitative research consisted of 33 interviews and 4 data validation workshops with frontline health workers, and 13 key informant interviews with humanitarian stakeholders. Health workers’ dependence on government camp authorities for their safety and public health enforcement produced complex relationships and sometimes compromised medical practices and professional support. Through the support of the health sector leadership team, infection prevention and control training was perceived as a key strength; however, health workers reported limited inclusion in decision-making and being professionally unprepared during outbreaks. These experiences compounded risks to their mental and physical health, and they reported receiving minimal organisational support. These relational and structural tensions undermined worker resilience and patient-provider trust. The findings underscore the need for outbreak preparedness and strategic reforms in humanitarian decision-making that prioritise health workers’ safety, promote inclusiveness in decision-making, and embed sustained professional support in humanitarian health systems for future outbreaks.

26. Understanding How a Digital Platform for Chronic Disease Management Can Enable and Limit Patient Self-Care: Qualitative Study.

期刊: Journal of medical Internet research 发表日期: 2026-May-14 链接: PubMed

摘要

A growing segment of the population requires ongoing care and support for managing their chronic diseases. Digital platforms for self-management are rapidly emerging to meet this need, but patients’ experiences with these platforms vary significantly. This may be due to the complexity and flexibility of digital platforms, where the wide array of available features can generate unexpected impacts. This study aims to explore how a digital platform can both enable and limit patients with a chronic disease in managing their own health. We conducted semistructured qualitative interviews with patients to better understand their experience of using a digital platform for self-managing their chronic diseases. Patients who had been using a digital platform (the Chronic Care Platform) for at least 1 month were invited to participate. Twenty-four patients were recruited and interviewed in person or by phone. The collected data were analyzed using template analysis, which is a type of thematic analysis that allows inductive identification of themes from data and deductive application of theory-informed themes. We leveraged Self-Care Theory to understand how patients’ motivation to use the platform and their subsequent use of its features generated perceived value and challenges in achieving this value. The platform was shown to support patients’ development of core self-care abilities (cognitive, psychosocial, and sociocultural abilities) and self-care behaviors (maintenance, monitoring, management), but it did not provide any support to the development of physiological abilities. Moreover, results indicate important limitations in the way in which the digital platform supported all self-care abilities and behaviors-in particular, self-care management. Hence, while the platform was viewed as valuable overall, patients reported several challenges in effectively using the Chronic Care Platform for self-care. Digital platforms for chronic disease management can enhance patient self-care by providing valuable resources and support for reinforcing desired behaviors. However, gaps in platform features can limit patients’ ability to comprehensively care for themselves. This study shows that relating platform features to specific dimensions of self-care can help identify missing features, providing a fine-grained understanding of how a given platform is generating positive impacts and how it may be improved to fully support self-care.

27. Evaluating the Methodological Quality of Artificial Intelligence-Assisted Systematic Reviews: Protocol for a Mixed Methods Meta-Research Study.

期刊: JMIR research protocols 发表日期: 2026-May-14 链接: PubMed

摘要

Artificial intelligence (AI), including large language models (LLMs), is increasingly integrated into systematic review (SR) workflows. AI tools may accelerate searching, screening, data extraction, and reporting, but their effects on methodological quality, reporting completeness, transparency, and reproducibility remain uncertain. Existing evaluations largely examine isolated tasks, and inconsistent disclosure of AI use limits reproducibility and oversight. This 4-phase mixed methods meta-research study will (1) compare the methodological quality of AI-assisted versus traditional SRs; (2) refine, finalize, and apply a preliminary AI Transparency and Disclosure Index (AITDI); (3) evaluate reproducibility by comparing outputs across repeated runs of the same AI model, across different AI models, and between AI models and human reviewers at multiple SR stages; and (4) explore knowledge user perspectives on rigor, transparency, and trust in AI-assisted SRs. We will conduct a matched cohort analysis of SRs published from 2023 to 2025 in biomedical journals. Each AI-assisted SR will be matched 1:2 with traditional SRs by publication year, clinical domain, review type, and meta-analysis status. Two independent reviewers will apply A Measurement Tool to Assess Systematic Reviews, version 2 (AMSTAR 2; methodological quality), PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) 2020 (reporting completeness), and, when applicable, Risk of Bias in SRs (ROBIS; risk-of-bias rigor). A preliminary AITDI will be refined and then applied to all AI-assisted SRs. Reproducibility will be assessed using SR-derived task sets to compare outputs across repeated runs of the same model, across different models, and between AI and human reviewers at key SR stages. Semistructured interviews with authors, editors, clinicians, policymakers, and patient partners will be analyzed using reflexive thematic analysis. As of December 2025, the study has been preregistered on the Open Science Framework (OSF; DOI: 10.17605/OSF.IO/Q5JRW), the search strategy has been finalized, and title/abstract screening has begun. Data extraction is planned for March-May 2026, followed by AITDI refinement and reproducibility testing from May 2026 to October 2026. Qualitative interviews are anticipated from October 2026 to February 2027, with final analyses by April 2027 and dissemination planned for mid-2027. This study will provide one of the first empirical comparisons of methodological quality, transparency, and reproducibility of AI-assisted versus traditional SRs in the LLM era. Findings will inform expectations for responsible AI integration and support refinement of reporting and methodological best practices, including future development of AI-specific reporting and appraisal extensions (eg, PRISMA-LLM [Preferred Reporting Items for Systematic Reviews and Meta-Analyses-large language model] and AMSTAR-LLM [A Measurement Tool to Assess Systematic Reviews-large language model]).

28. Hospital Twinning Partnership for Health System Strengthening in Rural China: A Mixed-Methods Implementation Study Using WHO Building Blocks and CFIR Framework.

期刊: Health policy and planning 发表日期: 2026-May-14 链接: PubMed

摘要

Hospital twinning partnerships have emerged as a strategy for health system strengthening, yet evidence on their implementation in domestic settings within low- and middle-income countries remains limited. This study examined a hospital twinning partnership between West China Hospital and Dafang County People’s Hospital in western China to identify partnership components and implementation determinants, complemented by assessment of implementation outcomes. A mixed-methods implementation study was conducted using the World Health Organization health system building blocks and the Consolidated Framework for Implementation Research (CFIR). Data were collected through semi-structured interviews (n = 10), structured surveys (n = 63), and administrative records. Partnership elements were mapped to the building blocks, while CFIR constructs were rated to identify facilitators and barriers. Qualitative and quantitative findings were integrated to provide a comprehensive understanding of implementation determinants. Partnership elements spanned all six building blocks, with particular emphasis on leadership and governance, service delivery, and health workforce development. Key facilitators included source credibility and reputation of the supporting hospital, government support, and a two-way partnership philosophy. Barriers included IT infrastructure limitations, inadequate external funding, intervention complexity, sustainability pressure, and cultural inertia toward change. Implementation outcomes showed improvements in service capacity, workforce development, and organizational culture, with observable changes extending to township health centers within the County Medical Consortium. The findings from this study suggest that structured domestic hospital twinning partnerships may serve as a promising approach to rural health systems. The comprehensive approach addressing multiple health system building blocks, combined with mechanisms for extending support to primary care facilities, offers a replicable model for health system strengthening in resource-limited settings.

29. HIV and Substance Use Reduction for Youth Experiencing Homelessness: Development and Usability Study.

期刊: JMIR formative research 发表日期: 2026-May-14 链接: PubMed

摘要

Youth experiencing homelessness face heightened vulnerability to HIV infection and substance use due to complex structural, psychosocial, and behavioral factors. Despite increased mobile phone access among youth experiencing homelessness, few mobile health interventions have been tailored to their unique needs, and even fewer have applied behavioral theory to inform message development. This study aimed to develop and refine theory-driven, tailored HIV prevention and substance use reduction messages for use in a just-in-time adaptive intervention app, MY-RIDE (Motivating Youth to Reduce Infections, Disconnections, and Emotional dysregulation), designed for youth experiencing homelessness aged 18 to 25 years. This study was conducted in 4 phases: prevention messages were developed and pilot-tested in 2018 (phase 1), revised and expanded using the experience and expertise of content experts and the study team (phase 2), reviewed for relevance and acceptability by youth experiencing homelessness in 2024 (phase 3), and supplemented with messages generated using an artificial intelligence (AI) tool (phase 4). Phase 1 resulted in the development of 386 intervention messages across 7 content categories: sex urge, drug and alcohol urge, stress, drug use, recent sexual activity, recent sexual assault, and general motivational messages. During phase 2, the study team expanded the message library to 888 messages across 10 categories. During phase 3, the youth working group liked 93% (803/864) of messages reviewed, which were categorized as acceptable for the intervention. Disliked messages were discarded and replaced with messages generated by an AI tool in phase 4. The finalized set of intervention messages was integrated into the MY-RIDE app to support personalized, real-time intervention delivery. Codeveloping messages with youth experiencing homelessness and leveraging AI tools proved feasible and effective for tailoring HIV prevention and substance use content. This approach supports scalable mobile health interventions for marginalized populations and informs future efforts to design engaging, theory-based digital health strategies. A randomized controlled trial of the MY-RIDE intervention is underway.

30. Disparities in mental health help-seeking and treatment utilization by race, ethnicity, and severity of mental health symptoms among college students.

期刊: Journal of American college health : J of ACH 发表日期: 2026-May-14 链接: PubMed

摘要

Disparities in mental health care among racial/ethnic minority college students persist. Severity of mental health symptoms may explain these disparities. N = 43,633 (weighted) college students from the Healthy Minds Study (2022-2023) with mental health symptoms. Mixed effects multinomial regression models investigated effects of race/ethnicity and severe mental health symptoms on mental health help-seeking and treatment utilization. Students with severe symptoms were more likely to seek formal treatment modalities (aRRR range: 2.36-3.37; 95% CI range: 1.82-4.37) across all racial/ethnic groups. The impact of severe symptoms on seeking both counseling and medication was larger in racial/ethnic minority students (e.g., non-Hispanic Black with severe symptoms (aRRR: 3.37, 95% CI: 2.60-4.37)) than in non-Hispanic White students with severe symptoms (aRRR: 2.36, 95% CI: 2.19-2.56). Colleges should prioritize pathways to care for racial/ethnic minority students with severe symptoms to ensure timely care.

31. Global survey of genetic testing methods for familial hypercholesterolemia. A study and recommendations from the EAS FHSC registry.

期刊: European journal of preventive cardiology 发表日期: 2026-May-14 链接: PubMed

摘要

Familial hypercholesterolemia (FH), primarily caused by pathogenic LDLR, APOB, or PCSK9 variants, results in elevated LDL-C and increased cardiovascular risk. Genetic testing offers the definitive diagnosis, yet global approaches to FH genetic testing remain unstandardized. We investigate current testing practices worldwide and provide relevant recommendations. A survey was distributed to national lead-investigators (NLIs) of 68 countries in the FH-Studies Collaboration, assessing referral criteria, assay methodologies, target genes, and pathogenicity interpretation methods. NLIs from centres in 55/68 countries (81%) responded, spanning Africa (N=2), Americas (N=6), Asia (N=20), Europe (N=26), and Oceania (N=1). DLCN scores were the most common reason for referral to genetic testing (adults:72%; children:57%). Simon Broome and MEDPED criteria were reported only by centres from high-income countries (adults: 7% and 2%; children: 12% and 2%). Methods for testing in index versus non-index cases were significantly different (p <0.001). Next-generation sequencing (NGS) was the predominant assay method for index cases (62%), while Sanger sequencing was favoured for non-index (71%). However, these testing techniques did not differ between centres from high- and non-high-income countries for index cases (p=0.74) and non-index cases (p=0.49). Copy-number variants (CNVs) were assessed by 65% of centres, with most integrating CNV analysis into NGS platforms (86%) and others (14%) using multiplex ligation-dependent probe-amplification (MLPA) or microarrays. Screening encompassed LDLR (100%), APOB (97%), PCSK9 (95%), and other genes. Most centres (96%) incorporated pathogenicity interpretation into their reports, adhering largely to American College of Medical Genetics and Genomics guidelines. FH genetic testing practices vary widely across countries surveyed, emphasizing the need for global standardization to enhance accuracy and comparability of FH diagnoses worldwide. We suggest that genetic testing should include the three FH-causing genes and ideally the five associated/phenocopy genes. This was a global survey from centres within 55 countries within the Familial Hypercholesterolemia Studies Collaboration (FHSC). The study evaluated the current practice of genetic testing for familial hypercholesterolemia (FH), an inherited condition characterized by high cholesterol levels and increased cardiovascular risk, since a definitive diagnosis is a key determinant of patient-centred care. The study found that while most centres screen for the three main FH genes and incorporate interpretation on whether a genetic change is disease-causing, notable differences existed in the reasons for referring for a test and laboratory testing techniques among and within centres from high and non-high income countries. Among testing techniques, next-generation sequencing was the predominant method for testing index cases, while Sanger sequencing was commonly used for relatives. The study also found that about one-third of centres did not test for other important genetic changes called copy-number variants (CNVs).To ensure patients receive accurate diagnoses regardless of where they live, the authors recommend creating a global standard where testing always includes the three primary genes responsible for the condition, ideally alongside five other associated genes.

32. Temporal Trends in Lung Cancer Cases Diagnosed at Early Stage.

期刊: JAMA oncology 发表日期: 2026-May-14 链接: PubMed

摘要

Since December 2013, the US Preventive Services Task Force has recommended lung cancer screening for adults at high risk of developing lung cancer because of their age and smoking history. Increased uptake in lung cancer screening may be reflected in changes in the stage at which lung cancer is diagnosed. To examine the percentage of lung cancer cases diagnosed at an early stage, visualizing temporal patterns with heat maps. This descriptive surveillance study used US Cancer Statistics incidence data to identify US adults who were diagnosed with malignant lung cancer from 2003 to 2022. Data were analyzed from November 14 to November 30, 2025. Percentage of lung cancers diagnosed at early stage, stratified by year of diagnosis, age at diagnosis, and state of residence. From 2003 to 2022, 4 363 687 new lung cancer cases were reported in the US. The percentage diagnosed at early stage increased slowly from 17.6% (95% CI, 17.5%-17.8%) in 2003 to 20.2% (95% CI, 20.0%-20.4%) in 2014, increased sharply from 21.4% (95% CI, 21.2%-21.6%) in 2015 to 24.6% (95% CI, 24.4%-24.8%) in 2016, then increased steadily to 30.1% (95% CI, 29.9%-30.3%) in 2022. The percentage diagnosed at early stage increased in all states, beginning around 2016 in most states. In 2003, the percentage diagnosed at early stage ranged from 11.2% (95% CI, 8.5%-14.6%) to 24.0% (95% CI, 22.7%-25.4%); by 2022, this range was 22.0% (95% CI, 18.9%-25.5%) to 40.2% (95% CI, 36.7%-43.9%). This descriptive surveillance study showed that since lung cancer screening was recommended in 2013, more people with lung cancer are being diagnosed early, when treatment is more effective and more treatment options are available. Population-based survey data indicate that fewer than 1 in 5 eligible persons reported being up to date with lung cancer screening in 2024. Strengthening awareness about the benefits of lung cancer screening and supporting uptake remain important strategies for cancer prevention and control.

33. Glucagon-Like Peptide-1 Receptor Agonists Inhibit the Initiation of Toxic Amyloid-β42 Aggregation.

期刊: Journal of the American Chemical Society 发表日期: 2026-May-14 链接: PubMed

摘要

The aggregation of the 42-residue form of the amyloid-β peptide (Aβ42) is important in Alzheimer’s disease (AD). Preclinical and clinical findings support that glucagon-like peptide-1 receptor agonists (GLP-1RAs) can protect against neuroinflammation and neurodegeneration with potential therapeutic relevance for AD, but studies of their direct effects on Aβ42 are limited. Herein, we investigated five FDA-approved GLP-1RAs, and show semaglutide, tirzepatide, and liraglutide inhibit Aβ42 aggregation. Semaglutide and tirzepatide delayed Aβ42 aggregation by targeting the primary nucleation microscopic step, with submicromolar IC50 values for primary nucleation (KIP). Liraglutide was highly effective at suppressing primary nucleation with a very low KIP value, and it demonstrated an additional modest inhibition of secondary nucleation. Consistent with a dominant effect on primary nucleation, Aβ42 formed β-sheet-rich fibrils in the presence of these GLP-1RAs. Aβ42 fibrils formed with semaglutide or tirzepatide had morphological properties and templating efficiencies that were similar to unmodified fibrils, while liraglutide significantly reduced fibril maturity, increased fibril tortuosity and length, and attenuated the ability of fibrils to passively self-replicate whether they were formed in the presence of liraglutide or exposed to this GLP-1RA after their formation. These results provide molecular-level insight into how specific GLP-1RAs can selectively target the fundamental steps governing toxic Aβ42 aggregation. Further studies are warranted to determine if current or next-generation anti-amyloid GLP-1RAs can delay or prevent AD through multifaceted protective mechanisms, including the direct inhibition of Aβ42 aggregation.

34. Maternal early-pregnancy and newborn biomarkers of prenatal exposure to Hg, Mn, Se and Zn and child neurobehavioral development in the first 24 months: A prospective cohort study.

期刊: Ecotoxicology and environmental safety 发表日期: 2026-May-14 链接: PubMed

摘要

There is limited information on the joint effect of multiple-metal(loid)s on infant development. This study aimed to investigate the joint impact of maternal early pregnancy and newborn exposures to mercury (Hg), selenium (Se), manganese (Mn) and zinc (Zn) on early child neurodevelopment. Included were 2771 mother-infant pairs from the Shanghai Birth Cohort who had maternal early pregnancy blood and newborn cord blood Hg, Mn, Se and Zn measured. Neurobehavior was assessed using the Ages and Stages Questionnaire (ASQ-3) instrument at age 6 months, and Bayley Scales of Infant & Toddler Development (BSID-III) at age 24 months. Linear regression was used to examine effect of metal(loid)s (in tertiles), and Bayesian kernel machine regression (BKMR) for exposures mixtures on child neurobehavior. The ASQ-3 communication score was 1.25 lower (95% CI: -2.11, -0.38) in the high tertile group of maternal Hg (> 2.09 μg/L), 1.36 lower (95% CI: -2.45, -0.246) in high cord blood Hg (> 2.64 μg/L), 1.61 lower ( 95% CI: -1.07, -0.15) in high maternal Mn, and 1.10 higher (95% CI: 0.04, 2.16) in high cord blood Se at age 6 months. High maternal Hg was also associated with 1.80 increased social-emotional (SE) scores (95%CI: 0.22, 3.37). At age 24 months, high maternal Zn (> 5.62 μg/L) was associated with 2.66 higher (95%CI 0.43, 4.89) cognition score. These associations were persistent with adjustment for the other metal(loid)s by using BKMR models. The overall effects of maternal blood and cord blood metal(loid) mixture were both adversely associated with communication score and SE at age 6 months, respectively. The early-pregnancy and newborn biomarkers of prenatal exposure to Hg show negative effect on early child development. The overall combined impact of maternal exposure to Hg, Mn, Se and Zn mixtures appear to be adverse in the first 24 months of life.

35. An Augmented Reality Audio-Motor Training Game for Improving Speech-in-Noise Perception: Single-Arm Pilot Feasibility Study.

期刊: JMIR formative research 发表日期: 2026-May-14 链接: PubMed

摘要

Difficulty understanding speech in noisy environments is a primary challenge of hearing impairment, inadequately addressed by hearing aids alone. While auditory training can enhance selective attention and speech perception, current digital programs face poor user adherence and lack realistic 3D spatial audio. This pilot study evaluated the feasibility, usability, and preliminary efficacy of ARIA (Augmented Reality Immersive Auditory training), a handheld mobile intervention that provides gamified at-home auditory training to middle-aged adults via earbud-delivered spatial audio. In this single-arm, pre-post-follow-up pilot study, 11 adults (mean age 53.0, SD 3.0 y) with functional hearing not requiring amplification completed a 4-week at-home training program using ARIA on provided devices (iPhone 14 Pro, AirPods Pro 2). Speech-in-noise perception was assessed via the Korean Matrix Sentence Test at baseline, 4 weeks, and 8 weeks at 3 signal-to-noise ratios (SNRs; 0 dB, -6 dB, and -9 dB, respectively). Feasibility, usability (System Usability Scale), user experience (Player Experience of Need Satisfaction), in-game performance, and qualitative feedback were collected. Protocol completion was 100% (11/11), demonstrating technical feasibility. Exploratory efficacy analyses revealed statistically significant speech-in-noise improvements posttraining across all conditions (0 dB: t10=3.43, P=.02; -6 dB: t10=5.34, P<.001; -9 dB: t10=4.34, P=.004). Gains were maintained at the 8-week follow-up. In-game localization improvements correlated significantly with speech perception gains at -6 dB SNR (ρ=0.639; P=.03) and -9 dB SNR (ρ=0.612; P=.045). User experience showed mixed results: the mean System Usability Scale score was 70.2 (SD 19.6; range 47.5-92.5), reflecting substantial individual differences in usability perception. While 72% (n=8) reported difficulties with the augmented reality (AR) environmental setup, 63% reported genuine mastery-driven engagement with core gameplay. Thematic analysis revealed a dissociation between peripheral usability challenges (setup friction, “homework” characterization due to protocol structure) and successful engagement with the training paradigm itself. This pilot demonstrated the feasibility of AR-based audio-motor training for at-home delivery and revealed encouraging preliminary efficacy signals, warranting progression to controlled efficacy trials. Formative findings identified specific usability refinements needed for broader implementation, particularly streamlining AR setup while preserving the core gameplay elements that successfully fostered competence and engagement. These insights provide clear guidance for platform optimization and randomized controlled trial design.

36. From mild-to-moderate to severe asthma: Risk factors and patient profiles from the NORDSTAR cohort.

期刊: American journal of respiratory and critical care medicine 发表日期: 2026-May-14 链接: PubMed

摘要

The progression from mild-to-moderate to severe asthma remains unclear. This study aimed to assess the risk of progression following the first asthma exacerbation in mild-to-moderate asthma and to identify risk factors and high-risk patient profiles. This was an observational cohort study based on Danish data from the NORdic Dataset for aSThmA Research (NORDSTAR) research collaboration platform. Adult patients with mild-to-moderate asthma experiencing their first asthma exacerbation were identified between 2000-2018 and followed prospectively for five years for the development of severe asthma according to ERS/ATS guidelines. Baseline risk factors for progression to severe asthma were assessed using multivariable logistic regression models and risk of progression was evaluated across specific patient profiles. Among 99,748 patients with mild-to-moderate asthma experiencing the first asthma exacerbation, 4.1% progressed to severe asthma within five years. Risk factors included baseline age 40-49 years [odds ratio (OR): 1.62 (95% CI: 1.49, 1.77), experiencing an exacerbation despite medium dose inhaled corticosteroid (ICS) use [OR: 3.72 (3.39, 4.09)], high use of short-acting beta agonist [OR: 1.76 (1.64, 1.90)], ≥2 respiratory infections [OR: 1.61 (1.49-1.73)], and blood eosinophil counts ≥ 0.6 × 109/L [OR: 1.97 (1.47-2.61)]. A 40-49-year-old patient with late-onset eosinophilic asthma, treated with medium-dose ICS and with recurrent respiratory infections, had a 30.4% five-year risk of progressing to severe asthma. In patients with mild-to-moderate asthma experiencing their first asthma exacerbation, few patients (4.1%) overall progressed to severe asthma within five years, but specific high-risk patient profiles faced risks of up to 30%. Whether early recognition can modify this risk warrants further investigation.

37. Climate-related health threats in Tanzania: a multi-level analysis of key policies, strategies and community response.

期刊: Health policy and planning 发表日期: 2026-May-14 链接: PubMed

摘要

Tanzania faces increasing climate-sensitive health threats, including vector-borne diseases, water-borne infections, and malnutrition. Effective preparedness at both national and community levels is critical for health system resilience and livelihood security. This study applied a multilevel mixed-methods approach to assess Tanzania’s policy structures and community-level experiences related to climate-health preparedness. Between January 2024 and May 2025, we conducted a concurrent mixed-methods study. At national level, we reviewed climate-health policy documents, mapped 30 key stakeholders, and conducted 15 semi-structured interviews with representatives from government ministries, research institutes, development partners and non-government organizations. At community level, we surveyed 388 adults and conducted eight focus group discussions in four councils in southern Tanzania. Data were analyzed and triangulated across all sources. Tanzania has developed several climate-health policies and community initiatives. However, gaps remain in cross-sectoral coordination, financing, and policy implementation. National stakeholders cited challenges in translating strategies into community-level action. Among community respondents, 77% acknowledged climate change and 97% reported exposure to hazards such as floods, drought, or extreme heat. Health impacts included malaria surges, diarrhoeal disease, and food scarcity. While 73.7% had received some government assistance, access to reliable health and climate information was limited. Households relied mainly on personal observations and informal networks. Communities and institutions jointly emphasized four priorities: strengthened risk communication, climate-smart agriculture, resilient health facilities, and inclusive early-warning systems. Strengthening multilevel governance, financing mechanisms, and community-driven adaptation planning is essential to improve Tanzania’s preparedness for climate-related health threats.

38. Rapid and Highly Selective Detection of the Tire Antioxidant 6PPD in Water Samples via Dual-Mode Fluorescent and Photoelectrochemical Sensing Based on Host-Guest Recognition.

期刊: Environmental science & technology 发表日期: 2026-May-14 链接: PubMed

摘要

The pervasive presence of the tire antioxidant N-(1,3-dimethylbutyl)-N’-phenyl-p-phenylenediamine (6PPD) in aquatic environments, and its role as the precursor of the acutely toxic transformation product 6PPD-quinone, has raised substantial concerns regarding tire-derived chemical pollution and its ecological impacts. Despite growing regulatory attention, selective and interference-resistant methods for the rapid and reliable determination of 6PPD in environmental waters remain limited, largely due to the lack of specific molecular recognition mechanisms. In this study, we report the identification and mechanistic elucidation of a host-guest interaction between β-cyclodextrin (βCD) and 6PPD, enabled by cavity-size complementarity and favorable hydrogen-bonding interactions. Isothermal titration calorimetry, NMR spectroscopy, and molecular docking collectively confirmed the formation of a stable βCD-6PPD inclusion complex (Kd = 2.11 μM). Leveraging this recognition, two βCD-based sensing platforms were developed: a fluorescence “turn-on” sensor (LOD = 4.13 nM) and a self-powered photoelectrochemical sensor with enhanced selectivity (LOD = 3.19 nM). Both sensors were successfully applied to the quantification of 6PPD in road runoff rainwater samples, yielding results in excellent agreement with those of HPLC-MS/MS analysis. This work establishes cyclodextrin host-guest chemistry as an effective recognition strategy for tire-derived contaminants and provides a practical foundation for the rapid, low-cost, and potentially field-deployable monitoring of 6PPD in environmental waters.

39. Implantable living materials autonomously deliver therapeutics using contained engineered bacteria.

期刊: Science (New York, N.Y.) 发表日期: 2026-May-14 链接: PubMed

摘要

Microbes are increasingly used as living therapeutics, yet their uncontrolled dissemination in the body has remained a clinical roadblock. Physical containment remains largely unattainable owing to eventual bacteria escape. In this work, we present an implantable material that encapsulates and confines bacteria, wherein synthetically engineered microbes produce therapeutic payloads from within. We developed a hydrogel scaffold with dual mechanical features: high stiffness to regulate bacterial proliferation and high toughness to resist material fracture under physiological stress. This design achieved complete bacterial containment for 6 months and withstood multiple forms of mechanical loading that otherwise caused catastrophic material failure. By genetically engineering embedded bacteria, we endowed the material with environmental sensing and on-demand therapeutic release capabilities and demonstrated autonomous treatment in a murine prosthetic joint infection model.

40. Influence of Different Duct Configurations on Flow Field Uniformity and Aerosol Distribution of Airborne Effluents in Nuclear Facilities: Experimental and CFD Simulation Study.

期刊: Health physics 发表日期: 2026-May-14 链接: PubMed

摘要

To ensure the accuracy of single-point sampling for airborne effluents in nuclear facilities, it is critical to clarify how stack and duct configurations regulate the flow field uniformity (velocity distribution) and aerosol distribution of the effluents. Taking the exhaust system of nuclear facilities as the research object, this study built a modular experimental platform covering seven duct configurations. Combined with experimental measurements and computational fluid dynamics (CFD) simulations, it systematically explored the impacts of duct configurations (including I, L, S, U types with smooth or right-angle transitions) and Reynolds numbers (Re = 5 × 104-1.5 × 105) on the coefficient of variation (COV) of velocity distribution and that of polydisperse aerosol distribution (average particle size: 5.2 μm). The CFD model established achieved excellent validation accuracy: over 93% of velocity data points showed a deviation between simulated and experimental values within ±15%, and the ratio of simulated to experimental aerosol concentration values followed a log-normal distribution with a mean (μ) of 1.13 and a standard deviation (σ) of 0.26. For flow field uniformity: long straight ducts lacked sufficient turbulence, resulting in a velocity COV >14% even at a length-to-hydraulic diameter ratio (L/D) of 20; elbows effectively reduced the velocity COV, with right angle transition elbows having a stronger turbulence effect than smooth-transition ones (e.g., L2 circular ducts reached a velocity COV <20% at L/D = 8, while L1 ducts required an L/D of 16 to achieve the same level); the S-type double-elbow ducts presented the highest flow field homogenization efficiency (S2 circular ducts achieved a velocity COV <20% at L/D = 7). For aerosol distribution: long straight ducts exhibited extremely poor aerosol mixing (COV >140% at L/D = 20); elbows promoted aerosol diffusion by enhancing vortex flow, with the right-angle transition S2 circular ducts performing the best (aerosol COV <20% at L/D = 4 and <10% at L/D = 20). When Re exceeded 104, further increasing the Re did not significantly improve flow velocity uniformity or aerosol mixing. The CFD method and regulatory requirements revealed in this study can provide technical support for optimizing sampling cross-sections in existing nuclear facilities and designing duct configurations for proposed ones.

41. Validated method for measuring airborne concentrations of tert-butylphenols for occupational exposure assessment.

期刊: Journal of occupational health 发表日期: 2026-May-14 链接: PubMed

摘要

This study aimed to develop a method for measuring airborne concentrations of tert-butylphenols (tert-BPs) to assess workers’ occupational exposure. Air samples were collected using an XAD-7 sorbent tube. Tert-BPs were desorbed from the sorbent with methanol, and their concentrations in the desorbed solutions were determined via high-performance liquid chromatography with fluorescence detection. Method validation included evaluation of retention efficiency, storage stability, method quantitation limit, and reproducibility. The retention efficiencies for 2-tert-BP, 3-tert-BP, and 4-tert-BP in the XAD-7 sorbent tube were 89%-97%, 93%-96%, and 95%-96%, respectively. Relative standard deviations, reflecting the overall reproducibility of the proposed method, ranged from 0.5% to 5.9% for all tert-BPs. Tert-BPs remained stable on the XAD-7 sorbent tube for at least 7 days at 4°C. The method quantitation limit was 0.118 μg/sample for each tert-BP. The developed method provides a robust and reproducible approach for assessing occupational exposure to airborne tert-BPs, enabling accurate determination within a concentration range of 0.8-160 ppb. This method can facilitate more precise risk assessments in occupational environments.

42. Association between participation in community activities and work engagement: a prospective cohort study.

期刊: Journal of occupational health 发表日期: 2026-May-14 链接: PubMed

摘要

It is well-established that participation in community activities is positively associated with mental and physical health and overall well-being. However, little is known about the effect of community activities on work. We investigated the association between work engagement (measured in 2023) and frequency of worker participation in two types of community activities: community contribution activities and hobby-learning activities (measured in 2022). We conducted a prospective cohort study comprising a baseline survey in 2022 and a follow-up survey in 2023. The sample comprised workers aged ≥20 years from different industries in Japan. Data for 14 526 participants aged 20-65 years were analyzed. Participants answered an online questionnaire to report the frequency of two types of community activities. Work engagement was assessed using the Japanese version of the nine-item Utrecht Work Engagement Scale. We used multiple regression analysis. The multivariate analysis showed that participation in community contribution activities was significantly associated with higher work engagement compared with no participation (B = 1.18, 95% confidence interval [CI]: 0.38-1.98 for ≥ once per week, B = 1.01, 95% CI: 0.38-1.64 for 1-3 times per month, and B = 0.46, 95% CI: 0.16-0.76 for several times per year). Participation in hobby-learning activities was significantly associated with higher work engagement compared with no participation (B = 0.69, 95% CI: 0.16-1.22 for ≥ once per week). Our findings suggest a potential association between participation in community activities and higher work engagement.

43. Lifecycle Implications of Poly(vinyl chloride) (PVC) Micro(nano)plastics (MNPs): Interactions with Coexposed Environmental Pollutants (EPs) and Impact on Their Toxicity and Bioavailability.

期刊: Environmental science & technology 发表日期: 2026-May-14 链接: PubMed

摘要

Sorption of environmental pollutants (EPs) on micro(nano)plastics (MNPs) across their lifecycle raises significant concerns regarding potential toxicological effects, but remains understudied. To address these knowledge gaps, we assessed the sorption of EPs, including toxic elements (arsenic (As), chromium (Cr), and lead(Pb)), and organic pollutants (boscalid and PFOS) on poly(vinyl chloride) (PVC) MNPs generated across their lifecycle by mechanical fragmentation/cryomilling, photo-oxidation, and incineration. The toxicological effects of EP-MNP coexposure were assessed using a small intestinal epithelium (SIE) model, coupled with a three-phase simulated GI digestion. Sorption of most EPs was MNP lifecycle-stage- and EP-specific, with aged-MNPs (cryomilled and UV photo-oxidized) having a higher EP affinity than unaged MNPs (cryomilled) and incinerated MNPs. While MNPs and EPs alone or combined did not produce cytotoxicity in the SIE, aged-MNPs and incinerated MNPs in the presence of EPs triggered oxidative stress, suggesting MNP lifecycle-stage and EP dependency. Importantly, MNP- and EP translocation across SIE were MNP concentration, MNP lifecycle-stage, and EP-dependent. Aged PVC (at 50 μg/mL) enhanced the translocation of Cr (78.8%), Pb (54.2%), boscalid (23.4%), and PFOS (56.9%), while incinerated PVC increased translocation of only boscalid (23.4%) and PFOS (56.9%) significantly when compared to EPs alone. EPs enhanced the translocation of aged PVC and incinerated PVC at 50 μg/mL by 102.2% and 54.0%, respectively, when compared to MNPs alone. Such reciprocal enhancement of the translocation of EPs and aged-MNPs, and of incinerated MNPs, correlated with the downregulation of cell junction genes, suggesting compromised cell junction integrity. Collectively, our findings offer significant toxicological insights into the lifecycle of ecologically relevant PVC MNPs, their interactions with EPs, and the consequent implications for the integrity of human intestinal epithelial structures.

44. Reliability of self-reported career histories reported by former professional association football players included in the health and ageing data iN the game of football (HEADING) study.

期刊: Annals of work exposures and health 发表日期: 2026-May-12 链接: PubMed

摘要

To assess the ability of former professional association football players in England to recall their playing careers. Self-reported data regarding playing careers were available from former professional football players participating in the Health and Ageing Data IN the Game of football (HEADING) study. We compared the self-reported data from 141 participants regarding the teams, positions, periods, and leagues they played for against the data available in publicly available records, compiled with the assistance of the English Professional Footballers’ Association. Self-reporting of career histories occurred a mean of 28.5 years since the players had their last competitive season. Overall, 20 discrepancies between self-reported and register-based data were observed in the career histories of 18 (12.8%) individual players. This is in line with data from earlier reliability studies on the self-reporting of occupational histories. The most common error observed was incorrect recording of years of play in certain clubs, occurring in 9 instances. Missing teams in self-reports were observed in another 8 cases. The results suggest that former professional association football players can provide plausible information over long periods regarding the general characteristics of their professional career. This information could form the basis for a reliable exposure assessment within epidemiological analyses. Further work is required to assess recall of the amount of heading and other head impacts during training and play.

45. Strategies to recruit and retain Black and Latina/x women and birthing people in a biospecimen research study.

期刊: Sexual & reproductive healthcare : official journal of the Swedish Association of Midwives 发表日期: 2026-May-04 链接: PubMed

摘要

The Supporting Our Ladies And Reducing Stress to prevent preterm birth (SOLARS) Feasibility Study utilized three strategies to recruit Black and Latina/x women in a biospecimen study: individual (warm hand-off from community partner); group (attend group sessions to discuss study), and tabling (setting up a table at a clinic or community event). Additionally, we combined individual + group and individual + group + tabling strategies. Using these strategies, 35 women were recruited, where 32 completed survey and biospecimen at two timepoints across their pregnancies. Findings from our study support that using a reproductive justice framework is an effective strategy to build trust and increase participation in biospecimen studies among communities of color.

46. Disentangling Positive Affect Heterogeneity in a Digital Physical Activity Intervention for Young Adult Cancer Survivors: A Group-Based Multi-Trajectory Modeling Approach.

期刊: Psycho-oncology 发表日期: 2026-May 链接: PubMed

摘要

As research on behavioral interventions for young adult cancer survivors (YACS) progresses, understanding heterogeneity in positive affect experienced with health behaviors is essential to enhancing intervention effectiveness and improving survivorship outcomes. Group-based multi-trajectory modeling was conducted on data from the 6-month intervention phase of the IMproving Physical Activity after Cancer Treatment (IMPACT) study to uncover trajectories of positive affect related to physical activity (PA) (PA enjoyment, mood after PA) among intervention participants (n = 140). Differences in baseline predictors were assessed using ANOVA and χ2, and moderate-to-vigorous physical activity (MVPA) measures were analyzed using multi-level linear mixed models. Three trajectories were identified: Low-Affect (n = 57), Mid-Affect (n = 58), and High-Affect (n = 22). Participants in Mid-Affect and High-Affect reported higher levels of being partnered and incomes > $60,000, while those in Low-Affect reported worse baseline psychosocial and health-related quality of life factors (p < 0.05). By 6 months, MVPA goal adherence for Low-Affect and Mid-Affect groups declined to 53% (SE = 13%) and 65% (SE = 13%), respectively, whereas participants in High-Affect achieved the intervention’s target of 150 MVPA min/week and sustained nearly 100% goal adherence. Increases in MVPA min/week over 6-months were largest among those in High-Affect (+32.3 [SE = 11.5]) compared to those in Low-Affect (+18.9 [SE = 7.6]) and Mid-Affect (+26.1 [SE = 7.3]), with no between-group differences (p > 0.05). These findings highlight variation in positive affect trajectories, their baseline predictors, and how they relate to MVPA goal adherence. Interventions that foster positive affect related to PA and offer support based on positive affect trajectory may improve MVPA and survivorship outcomes for YACS. ClinicalTrials.gov ID: NCT03569605, https://clinicaltrials.gov/study/NCT03569605.

47. Unravelling the composition, antioxidant, antimicrobial potential of Himalayan propolis and in vitro evaluation of its cytotoxicity against pancreatic PANC-1 cell lines.

期刊: Natural product research 发表日期: 2026-May 链接: PubMed

摘要

The present study aimed to investigate the bioactive constituents, antioxidant and cytotoxic activity as well as the susceptibility of the Escherichia coli and Candida albicans to ethanolic extracts of Himalayan propolis. Phenolic and flavonoid content were quantified using FC reagent and AlCl3 methods, respectively. Free-radical scavenging activity and bioactive constituents were assessed using the DPPH and LC-MS analysis, respectively. Cytotoxicity was evaluated by using MTT assay for PANC-1 cell lines. TFC and TPC for EEP were 14.246 ± 0.08 (mg/g) QE and 9.455 ± 0.14 (mg/g) GAE respectively. EEP inhibited the growth of microbes and showed effective action establishing a positive correlation between antimicrobial activity and flavonoid content. Propolis-treated PANC-1 cell lines suppressed cell proliferation in a dose-dependent manner and exhibited positive potential. Results revealed that the promising pharmacological potential of Himalayan propolis is due to the -bioactive compounds like pinocembrin and coumarin.

48. 3MDR Therapy Reduces Symptoms of PTSD and Related Conditions in Canadian Military Members and Veterans, Public Safety Personnel, and Clinical Personnel.

期刊: Brain and behavior 发表日期: 2026-May 链接: PubMed

摘要

Military Veterans, public safety personnel (police, fire fighters, paramedics, and others), and frontline healthcare workers are at elevated risk of posttraumatic stress disorder (PTSD) due to trauma exposure. Multimodal motion-assisted memory desensitization and reconsolidation (3MDR) therapy is an innovative therapy for PTSD and trauma-related mental health concerns, originally developed for military members and Veterans. The purpose of this study was to extend evidence for the effectiveness of 3MDR in Canadian military Veterans and to test it with public safety personnel and frontline healthcare workers. This study is a longitudinal mixed-methods clinical trial. We examined 48 participants with PTSD from Alberta, Canada. Twenty-two participants had treatment-resistant PTSD. Participants were active military members or Veterans (n = 17), public safety personnel (n = 21), and/or healthcare workers (n = 21). Participants received a 10- to 14-week course of 3MDR therapy. Quantitative data were collected pretreatment, at the end of treatment, and longitudinally at 3, 6, and 12 months after completion of 3MDR. Data from 48 participants were analyzed. Data collected pre- and post-3MDR therapy showed both statistically and clinically significant reductions in symptom scores for PTSD (CAPS-5 clinical interview: 46.4 ± 2.2 to 25.1 ± 3.4, mean ± standard error; PCL-5 questionnaire: 48.5 ± 2.2 to 32.2 ± 3.0), depression (PHQ-9: 14.3 ± 1.0 to 9.8 ± 1.0), anxiety (GAD-7: 12.2 ± 0.9 to 8.3 ± 0.9), and difficulties with life functioning (OQ-45: 92.0 ± 3.9 to 77.3 ± 4.4). These improvements were maintained through to 12 months follow-up. Resilience (CD-RISC-25), which was assessed pre- and post-3MDR but not at follow-up, also showed significant improvements over the course of 3MDR therapy. All results survived multiple comparison correction. These results support the growing body of literature illustrating 3MDR as an effective treatment for military-related PTSD as well as PTSD-related mental health conditions in public safety personnel and healthcare workers. These results also extend the period of post-3MDR follow-up to 12 months in a sample of Canadian 3MDR participants, from 6 months follow-up in earlier Canadian 3MDR studies. ISRCTN Registry 11264368; http://www.isrctn.com/ISRCTN11264368. International Registered Report Identifier (IRRID): DERR1-10.2196/20620.

49. Evaluating the reach, adoption, implementation, and effectiveness of a single occupational physiotherapy advice session for employees with low back pain: an RE-AIM evaluation.

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

摘要

While biopsychosocial interventions are effective for low back pain (LBP), implementing them in workplace settings remains challenging due to resource constraints. We adapted a comprehensive biopsychosocial approach into a single, brief, individualized advice session to enhance real-world feasibility. This study aimed to evaluate the reach, adoption, implementation, and preliminary effectiveness of this program using the RE-AIM (Reach, Adoption, Implementation, Effectiveness, and Maintenance) framework. A prospective pre-post quasi-experimental study was conducted in a Japanese insurance company. Employees with LBP were invited to a single 30-min occupational physiotherapy advice session. Outcomes were assessed at baseline and 3 months. Effectiveness was evaluated using mean changes in pain (numerical rating scale) and disability (Roland-Morris Disability Questionnaire), supplemented by a responder analysis based on minimal important change (MIC). Of 1201 eligible employees, 154 (12.8%) attended the session (Reach), and 68 (44.2%) provided completed the 3-month follow-up (Implementation). Regarding effectiveness, mean pain intensity showed no significant change (+0.12). However, the responder analysis revealed that 17.6% of participants achieved MIC in pain (≥2 points), and 35.3% were classified as meeting MIC in disability (≥2 points). Additionally, the proportion of participants perceiving LBP as the primary cause of productivity loss decreased from 58.8% to 16.2%. Between-group analyses showed no statistically significant differences. This quasi-experimental evaluation suggests that a single 30-min workplace physiotherapy advice session is feasible to implement. Effectiveness findings were exploratory: mean pain intensity changed little and between-group differences were not statistically significant, while some attendees who completed follow-up met the MIC threshold for disability. Low back pain is a common problem for office workers, but lengthy rehabilitation programs are often difficult to implement in busy workplaces. This study tested a “single-session” approach where a physiotherapist provides 30 min of individualized advice focusing on how to move and manage pain. We found that while this brief session did not immediately eliminate pain intensity, it helped many employees improve their daily functioning and reduce the duration of their symptoms. This suggests that even a short, well-designed advice session can be a valuable first step in corporate health programs to help employees stay active and productive.

50. Evaluating conflict-of-interest governance among Canadian medical societies using a novel assessment tool: A cross-sectional study.

期刊: PloS one 发表日期: 2026 链接: PubMed

摘要

Medical societies shape clinical standards, develop practice guidelines, and provide continuing education to physicians. Many receive funding from pharmaceutical and medical device companies, creating conflicts of interest (COI); however, organizational-level COI governance in medical societies remains largely unexamined. We developed what is, to our knowledge, the first comprehensive tool to assess medical society COI policies and applied it to Canadian medical societies. We identified 68 Canadian medical societies meeting our inclusion criteria and systematically searched the publicly accessible sections of their websites for COI policies. Two researchers independently analyzed policies using our 51-item tool covering nine domains: continuing medical education/continuing professional development (CME/CPD), leadership COI, clinical practice guidelines, industry relationships, research funding, external funding, annual general meetings, staff COI, and society journals. Only 33 societies (48.5%) had any publicly available COI policy, and those with policies addressed an average of only 1.85 domains (20.5% of possible domain coverage). The most frequently addressed domain was CME/CPD (22 societies, 32.4%), followed by leadership COI (12 societies, 17.6%). Within domains where policies existed, societies covered an average of only 32.5% of relevant items. The most common policy item was speakers’ declaration of COI in CME/CPD activities (16 societies, 23.5%). Policies addressing research funding, external funding, annual meetings, and staff COI were rare (1.5-5.9% of societies). Where present, policies were generally restrictive but narrow in scope. Most Canadian medical societies lack comprehensive COI governance, and existing policies are fragmented and reactive. More transparent, comprehensive, and enforceable frameworks are needed to protect institutional independence and public trust. The assessment tool may be adaptable for use in other jurisdictions to support international standardization and best-practice development.