公共卫生研究摘要 (2026-05-16)

共收录 59 篇研究文章

1. Neurobehavioral Profiles in Young Steroid-Naive Boys With Duchenne Muscular Dystrophy: A Baseline Data Analysis From the FOR-DMD Trial.

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

摘要

Duchenne muscular dystrophy (DMD) is the most common pediatric hereditary neuromuscular disorder. While interest in brain involvement in DMD is increasing, neurobehavioral data in steroid-naive children remain limited, often nonstandardized, and derived from small cohorts. The primary objective was to characterize the baseline neurobehavioral profile of young steroid-naive boys with DMD enrolled in a multinational clinical trial. Secondary objectives were to examine associations with developmental features (speech and learning difficulties), motor function, parent respondent type, brain dystrophin isoform, age, and country. We performed a baseline cross-sectional neurobehavioral analysis of steroid-naive boys recruited in the “Finding the Optimum Regimen for Duchenne Muscular Dystrophy” trial. Eligible participants were glucocorticoid-naive boys aged 4 to <8 years with genetically confirmed DMD; boys with severe behavioral problems affecting participation were excluded. Four parent-reported scales were analyzed: Strengths and Difficulties Questionnaire (SDQ), Personal Adjustment and Role Skills Scale (PARS-III), IOWA Conners-Parent Scale, and Revised Rutter Scale. Associations with age, respondent (i.e., the parent who completed the questionnaire), brain dystrophin isoforms, speech-learning difficulties, country, and motor function were explored. The cohort included 196 boys aged 4 to <8 years (mean 5.9 ± 1.0). Speech and learning difficulties were reported in approximately 40% and 25% of participants, respectively, with 20% presenting both. Scores across neurobehavioral scales were strongly correlated, with only 5%-10% of boys exceeding screening cutoffs. Speech and learning difficulties were associated with worse scores across all scales. Among boys with an above-threshold SDQ Impact score, the most frequently reported difficulty was classroom learning. No significant associations were observed with age, brain dystrophin isoforms, or country of origin. Weak correlations were identified between motor function and PARS-III scales, in particular between North Star Ambulatory Assessment total score and PARS-III Total, Peer Relations, and Productivity scores. Mothers more frequently reported inattentive-overactive behaviors than fathers. Although this was a selected cohort, young boys with DMD may experience social, emotional, and learning difficulties that can interfere with everyday life, including schoolwork, despite the absence of a formal neurobehavioral diagnosis. These findings stress the importance of routine early psychosocial screening and targeted interventions. ClinicalTrials.gov: NCT01603407. First submitted: April 3, 2012. First participant enrolled: January 30, 2013. clinicaltrials.gov/study/NCT01603407.

2. Changing the Child: The Impact of Novel Treatments on the Identity of Children With Monogenic Neurodevelopmental Disorders.

期刊: Bioethics 发表日期: 2026-Jun 链接: PubMed

摘要

Scientific advancements offer new possibilities for developing novel treatments for children with monogenic neurodevelopmental disorders (mNDDs), targeting the underlying effects of their condition. Although, in qualitative studies, parents of children with mNDDs have predominantly positive attitudes towards the development of novel treatments, a few parents express concerns about whether treatments could change who their child is. Existing literature on personal identity, including literature on how personal identity is affected by medical (neuro-)interventions, can assist in clarifying these concerns. This paper provides an analysis of interview data on perspectives of parents with children with mNDDs (STXBP1-Related Disorders and Kleefstra Syndrome) on the impact of novel treatments on their child’s identity. We identify four sets of concerns, about whether treatments (1) enable children to develop their self, (2) alienate children from their true self, (3) disrupt children’s relational identities, and (4) defy children’s horizontal identities. While parents hope that treatments will help children flourish, some worry that treatments may alienate children from their self or alter children’s personal characteristics which are meaningful to caregivers, thereby disrupting family dynamics. Others fear treatments may produce stigma by perpetuating the narrative that children need to be “fixed”. This analysis helps to understand the ambivalence some parents express when considering their child’s participation in clinical trials. For clinicians and researchers, it is essential to discuss parents’ concerns about impacts of treatments on their child’s identity (if present) when deciding on the child’s participation in clinical trials, and to monitor children for identity-related effects of novel treatments.

3. Translating patient-centered goals into 3D-printed assistive and prosthetic devices: A multidisciplinary clinical framework.

期刊: Prosthetics and orthotics international 发表日期: 2026-May-18 链接: PubMed

摘要

The use of 3-dimensional (3D) printing in the development of assistive adaptive devices (AADs) and prostheses has expanded rapidly, offering opportunities for patient-specific customization and iterative design. Despite this growth, there remains limited guidance on how 3D printing can be systematically integrated into routine clinical practice within a multidisciplinary rehabilitation framework. This case series presents a goal-oriented, multidisciplinary approach for the clinical implementation of 3D printing in the development of AAD and prostheses. Seven customized AAD or prosthetic devices were developed through collaboration between a rehabilitation physician, an occupational therapist, and a mechanical engineer. Device recommendation and design were guided by predefined patient-centered functional goals. Outcomes were evaluated using goal attainment scale, allowing individualized assessment relative to each patient’s baseline function and intended device purpose. Across the 7 cases, the fabricated devices achieved their predefined functional goals to varying degrees, reflecting the heterogeneity of impairments and individual priorities. The application of goal attainment scale enabled structured outcome evaluation while preserving patient-centered goal individualization. This study demonstrates the feasibility of implementing a multidisciplinary, goal-oriented framework that integrates 3D printing into clinical rehabilitation practice, supporting the translation of patient needs into functional assistive and prosthetic solutions.

4. Using Digital Phenotyping for Depression Screening in Community-Dwelling Older Adults: Bayesian Multilevel Hurdle Model Machine Learning Approach.

期刊: JMIR AI 发表日期: 2026-May-15 链接: PubMed

摘要

With the rapidly aging population, mental health among older adults has received growing attention. Although the likelihood of experiencing depressive symptoms is higher in late adulthood, older adults are more reluctant to visit a clinic due to the stigma surrounding mental health issues, and many remain undiagnosed and untreated. Digital phenotyping has emerged as a promising approach to mitigate this problem. Longitudinal monitoring via wearable devices can facilitate the timely identification of depressive symptoms in older adults. However, there has not been sufficient investigation to develop a machine learning approach that accounts for between-person and within-person characteristics. This study aimed to investigate the utility of active and passive digital phenotyping data collected via wearable devices for monitoring the probability and severity of depressive symptoms. Specifically, we applied multilevel hurdle modeling within a machine learning framework to enable efficient depression screening in the general population, with a focus on community-dwelling older adults. We analyzed 1011 cases reported by 147 older Korean adults for 2 years. Participants were asked to complete the 9-item Patient Health Questionnaire (PHQ-9) items in our mobile app during the last week of each month. In addition to the annual in-person data collection, we also collected active and passive sensing data from participants via smartphones and smartwatches. For dimensionality reduction on 44 features, parallel analysis and principal component analysis were used. With the extracted 6 principal components (PCs), a Bayesian multilevel hurdle model was used. When constructing PCs, the weekly stress rating from active data and sleep-related features from passive data were the top 5 contributing features. Among the 6 PCs, the PC consisting of low psychological distress and high social support was significantly associated with depressive symptoms in community-dwelling older adults. This Bayesian multilevel hurdle model showed good performance in screening for depressive symptom severity (R2=0.53) and in distinguishing between those with and without symptoms (area under the receiver operating characteristic curve=0.88 and F1-score=0.75) on the test data. The between-person variance was larger than the within-person variance, especially in explaining the probability of depressive symptoms. In mental health screening, active and passive digital phenotyping data can be used in conjunction with traditional clinical screening tools to monitor depressive symptoms among community-dwelling older adults. Dimensionality reduction via parallel analysis and principal component analysis can help identify latent risk profiles. Given the nested data structure and heterogeneity in depressive symptoms, a Bayesian multilevel hurdle model within a machine learning framework may be helpful for depression screening. Overall, digital phenotyping can be a useful tool for personalized, within-person health tracking, even after accounting for substantial between-person variance. We recommend future work to address data imbalance to further strengthen this approach.

5. Assessing the Use of Wearable Mobile-Monitoring Devices Among Individuals With Serious Mental Illness: Qualitative Acceptability and Feasibility Study.

期刊: Journal of medical Internet research 发表日期: 2026-May-15 链接: PubMed

摘要

Serious mental illness (SMI) is difficult to treat for various reasons, such as rapid changes in symptoms, comorbid health conditions, long gaps between provider visits, and additional societal barriers experienced by this population. Wearable mobile-sensing devices can be used to passively collect valuable patient-generated health data, such as daily step count, heart rate variability, sleep information, and other health-related behaviors, which could inform and improve treatment for individuals with SMI. Wearable health devices have become more economically accessible, providing promise for the possibility of their implementation in health care. However, more information regarding how individuals with SMI perceive and interact with these devices is needed. This study aimed to assess the acceptability and feasibility of using wearable mobile-sensing devices to improve treatment outcomes for Veterans with SMI. In addition, we were also interested in learning if privacy concerns would influence acceptability of devices, specifically surrounding location tracking and health information sharing, as well as assessing other barriers to device use. Qualitative interviews were conducted with participants who had been using a wearable health and fitness tracker for at least 2 weeks to explore their thoughts and perceptions of these devices. A total of 15 Veterans diagnosed with a SMI participated in interviews. Both thematic analysis and rapid qualitative analysis approaches were used to uncover findings in key domains and emergent themes. Wearable fitness trackers allowed participants to conveniently monitor various aspects of their physical and mental health, provided a greater understanding of their overall well-being, and motivated them to reach personal health goals. Individuals were open to sharing their personal health information collected from the devices with providers to improve their health care treatment and expressed no privacy concerns surrounding data tracking or the device’s global positioning system that monitors physical location. Participants experienced some technological challenges with using the fitness trackers, as well as the device’s accompanying cell phone app. Furthermore, participants expressed difficulties in understanding and interpreting the health data that was collected from the health and fitness trackers. Greater ongoing technological support, in addition to physical device adjustments to enhance comfort and usability, were suggested ways of improving overall user experience. Participants with SMI in this sample were accepting of wearable mobile-monitoring devices and believe it is feasible to incorporate these fitness trackers into their daily lives. Furthermore, participants in this sample expressed no privacy concerns regarding location tracking or the sharing of health information collected from these devices with providers. Patient-generated health data collected from these devices may offer valuable information that could be used to inform health care treatment for this population.

6. Feasibility of Establishing Community Living Labs (CoLLabs) to Improve Access to Prostate Health Resources, Education, Amenities, and Community Health: Protocol for a Pragmatic Clinical Trial.

期刊: JMIR research protocols 发表日期: 2026-May-15 链接: PubMed

摘要

In 2022, nearly 60,000 prostate cancer (CaP) cases were reported among Black men, who face an estimated lifetime risk of approximately 1 in 6, compared with 1 in 8 among White men. The disproportionate burden of CaP in Black men has been attributed to a combination of health-system factors, variations in care processes, and individual- or patient-level determinants. Addressing these multilevel contributors will require innovative strategies to advance prostate health equity. In this paper, we discuss the protocol for assessing the feasibility of establishing a Community Living Lab (CoLLab) Learning Health System in Black communities and the impact on facilitating access to prostate health Resources, Education, Amenities, and Community Health (REACH) services for Black men. The proposed research design for the study is a pragmatic clinical trial. The research setting is Northeast Florida, with the intervention based in 3 American Legion Posts (ALPs) and the control in one ALP. The development of the CoLLab REACH intervention was guided by the Intervention Mapping Framework, focusing on program design, adoption, implementation, and monitoring and evaluation plan. The intervention was cocreated with community members and is being provided by community health workers. The primary outcomes are improvement of Black men’s CaP awareness, knowledge, attitude, health beliefs, perceived control, intentions, cues to action, and clinical trials’ awareness. Generalized linear mixed regression approaches will be used to determine the differences between the study variables for the intervention and control groups. The CoLLab study was awarded in September 2023 and received institutional ethics committee approval on March 20, 2024. CoLLab REACH intervention includes the following services: (1) Wellness RX program, implemented to address financial health needs and grocery distribution to address food deserts of the communities around the posts; (2) social determinants of health Navigation Services that include food, housing, transportation, employment aid, legal aid, and financial support based on zip code; (3) educational resources and videos on CaP prevention, screening, detection, treatment, and survivorship; (4) The Clinical Trials Matching Services to match participants to Mayo Clinic clinical trials and biomedical research; and (5) CaP Advocacy training program. Baseline recruitment for the intervention arm was completed in June 2025, with 183 Black men enrolled at ALPs. By June 2025, 11 participants were enrolled at the control ALP, and recruitment for the control arm remains ongoing. Data analysis will be conducted upon completion of follow-up assessments at months 4, 8, and 12. We successfully co-designed the CoLLab REACH services at 3 ALPs. Using a longitudinal pretest-posttest design, we will assess the intervention’s impact at both the individual and community levels to evaluate the feasibility of this community-based, culturally informed approach. In addition, we will examine the feasibility of replicating the CoLLab Learning Health System in underserved communities nationwide.

7. A Novel Haptic Cardiac Simulator: Mixed Methods Pilot Evaluation in Medical Students and Educators.

期刊: JMIR formative research 发表日期: 2026-May-15 链接: PubMed

摘要

Cardiac auscultation is an essential component of clinical examination but is often challenging to achieve proficiency in. Self-contained, multisensory learning resources that incorporate simultaneous visual and haptic stimuli offer a unique approach to supporting learners in acquiring this core skill. This pilot study of both medical students and clinical educators evaluated the utility of a novel iPhone app, Haptic Heart, which generates haptic vibrations to simulate heart sounds and murmurs. We aimed to explore the perceptions of students and educators when using haptics as a learning resource and the underlying reasons behind these perceptions and to gather lessons that would inform future development of the resource. Clinical-year medical students from the Lincoln Medical School with access to an iPhone were invited to trial Haptic Heart between October 2023 and December 2024. Cardiology specialists involved in clinical education were also invited to take part. After using the app, participants were asked to complete a modified version of the 12-item Evaluation of Technology-Enhanced Learning Materials: Learner Perceptions questionnaire that included additional free-text items. Educators were also asked to comment on the resource’s authenticity and perceived usefulness. Quantitative responses were analyzed using descriptive statistics; free-text responses were analyzed for common themes. A total of 21 students and 18 educators completed the evaluation. Both cohorts returned positive responses across nearly all questionnaire items, with students showing near universal agreement that the app was of excellent quality (21/21, 100%), supported their learning needs (21/21, 100%), and would change their clinical practice (20/21, 95.2%). Educators similarly rated the resource highly for learning utility (16/18, 88.9%) and authenticity (13/18, 72.2%). Reported technical difficulties were minimal for students (1/21, 4.8%) and educators (2/18, 11.1%). Analysis of free-text responses suggested that learners valued the ability to “feel” murmurs and to vary heart rate. Educators highlighted the resource’s novelty and innovation, although some noted concerns about audio quality when using a stethoscope to auscultate haptic vibrations directly. This pilot evaluation demonstrates the potential of smartphone-based haptic technology as a tool for medical education. Haptic Heart was perceived by both students and educators as an innovative educational tool for cardiac auscultation. Further work should focus on expanding the range of haptic patterns provided and exploring the effectiveness of these resources on learning.

8. WhatsApp-Supported Teledentistry to Reinforce Oral Health Promotion Among Older Adults Residing in Rural and Urban Areas: Randomized Controlled Trial.

期刊: JMIR mHealth and uHealth 发表日期: 2026-May-15 链接: PubMed

摘要

Access to oral health promotion for older adults is globally limited, especially in rural, low- and middle-income settings. Digital research often lacks theoretical foundation and focuses primarily on younger cohorts, yielding few randomized trials evaluating accessible tools for oral health education in older adults. This study aimed to develop a telehealth reinforcement strategy for oral health promotion to improve knowledge, attitudes, and self-efficacy in community-dwelling older adults. A single-center, parallel-group randomized controlled trial was conducted in 4 municipalities (2 urban and 2 rural) in La Araucanía, Chile. Eligible participants were functionally independent adults aged ≥60 years with smartphone and internet access; those with cognitive impairment, complete edentulism, or inability to use WhatsApp were excluded. Participants were recruited from regional databases and assessed using the Geriatric Dental Specialties Tele-platform, a teledentistry tool for older adults. Participants were randomized (1:1) to face-to-face instruction (comparator) or the same instruction plus 2 weeks of social cognitive theory-informed telehealth reinforcement (4 validated videos via WhatsApp). Clinicians and statistical advisors were blinded. Primary outcomes (oral health knowledge, attitudes, and self-efficacy) were measured via telephone-administered questionnaires at baseline and 6 weeks post intervention. Secondary outcomes included acceptability and self-reported behaviors. Analyses included hypothesis testing, multiple correspondence analysis, and k-means clustering. A total of 120 older adults were randomized (comparator: n=59; telehealth: n=61), with 103 analyzed (comparator: n=51; telehealth: n=52). Both groups showed substantial within-group improvements in oral health knowledge (comparator: Cohen d=0.93, 95% CI 0.52-1.34; P<.001; telehealth: Cohen d=1.07, 95% CI 0.66-1.48; P<.001) and self-efficacy (comparator: r=0.59, 95% CI 0.38-0.74; P<.001; telehealth: r=0.62, 95% CI 0.43-0.77; P<.001). In per-protocol analysis, telehealth improved dental caries knowledge (P=.03) and attitudes (P=.004), with no between-group differences in other domains (P>.05). In intention-to-treat analysis, telehealth showed a significant between-group difference for attitudes only (adjusted mean difference=0.91, 95% CI 0.34-1.48; P=.002), with no differences for overall oral health knowledge (P=.11) or self-efficacy (P=.59). Exploratory analyses indicated only the rural telehealth subgroup showed significant gains in attitudes (P=.003) and flossing (P<.001). Clustering suggested greater improvements among participants with higher baseline needs, predominantly rural, with fewer teeth. Telehealth demonstrated acceptability across multiple indicators (>80% for most measures) with no clinical adverse events; minor video-access issues occurred. Telehealth reinforcement provided significant advantages in oral health attitudes compared with face-to-face instruction. The intervention was acceptable and showed benefits among older adults with higher preventive needs, commonly seen in rural settings. By integrating theory-informed strategies into a familiar digital platform, this study adds evidence from rural and urban contexts, extending prior work on mobile oral health. It offers insights to address service gaps in underserved areas and highlights potential for feasible, context-aligned implementation. Future research should evaluate long-term effects, adaptability, and cost-effectiveness. ClinicalTrials.gov NCT05917548; https://clinicaltrials.gov/study/NCT05917548.

9. Reducing Intrusive Trauma Memories Using a Brief Mental Imagery Competing Task Intervention: Case Series of Trauma-Exposed Women in Iceland.

期刊: JMIR formative research 发表日期: 2026-May-15 链接: PubMed

摘要

There is a need for scalable and simple interventions for trauma-exposed people. In this case series, we built on our previous case study and case series findings and further explored the use and potential effectiveness of a brief novel intervention to reduce the number of past intrusive memories of trauma. The imagery competing task intervention consists of a memory reminder and the visuospatial task Tetris played with mental rotation, targeting 1 intrusive memory at a time. Here, we test remote delivery of the intervention, including guidance from researchers without specialist mental health training, in a sample of women in Iceland with current intrusive memories from trauma. In a case series of trauma-exposed women, we aimed to explore whether this brief novel intervention reduces the number of established intrusive memories (primary outcome) and improves general functioning and symptom reduction in posttraumatic stress, depression, and anxiety (secondary outcomes). The acceptability of the intervention along with adaptations, that is, delivery by psychology students without specialist mental health training and digital delivery, was explored. Participants (N=8) monitored the number of intrusive memories from an index trauma (occurring 3-16 years previously) in a daily diary at baseline, during the intervention, and postintervention at 1-month and 3-month follow-ups. The intervention was delivered digitally with guidance from clinical psychologists or psychology students. A repeated AB design was used (“A”: preintervention baseline, “B”: intervention phase). Intrusions were targeted one by one, creating repetitions of an AB design (ie, length of baseline “A” and intervention “B” varied for each memory). The number of intrusive memories reduced for all participants from the baseline phase compared with the intervention phase, although the reduction was minimal for 2 participants (6.3%-93%). The number of intrusive memories continued to reduce for 6 out of 8 participants (58%-100% reduction at 1-month follow-up; 72%-100% reduction at 3-month follow-up). Symptoms of posttraumatic stress, depression, and anxiety were reduced for most participants postintervention and continued to decrease during the follow-up periods. Functioning was improved for 7 of the 8 participants from baseline to postintervention and continued to improve at the follow-up assessments for 3 participants. The intervention delivered digitally and partly by students was perceived to be an acceptable way to reduce the frequency of intrusive memories by all participants (mean rating 9.5 out of 10). Data from this case series of traumatized women provide preliminary evidence for the effectiveness of this novel brief intervention in reducing intrusive memories of trauma occurring several years ago and in improving functioning and reducing core symptom burden. This study will inform a randomized controlled trial of this novel intervention, which may have considerable implications for large-scale clinical management of traumatized populations.

10. Quality of reporting of systematic reviews with meta-analysis of diagnostic test accuracy of rapid antigen tests for SARS-CoV-2 according to PRISMA-DTA: A meta-epidemiological survey.

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

摘要

Systematic reviews are crucial for informing health decisions and supporting evidence-based policymaking. Reporting guidelines aim to reduce ambiguity and confusion while promoting clarity, completeness, and transparency in reporting. Our study aimed to assess the completeness of reporting of diagnostic test accuracy systematic reviews with meta-analysis on rapid antigen tests for SARS-CoV-2 deployed during the COVID-19 pandemic using the PRISMA-DTA guideline. We conducted a meta-epidemiological survey of systematic reviews with meta-analysis of rapid antigen tests for SARS-CoV-2. We searched MEDLINE/PubMed, EMBASE, L·OVE Covid-19, and Web of Science Clarivate, covering the period from inception to April 3, 2025, with no language restrictions. We included reviews that used explicit systematic review methodologies with summary estimates of test sensitivity and specificity. We assessed compliance with the 27 PRISMA-DTA items. After screening 5252 publications, we included 38 reviews. We found no PRISMA-DTA item with a low reporting frequency. Regarding the number of items reported, 23 (60%) of the included studies reported over 66%, and 15 (40%) reported between 33% and 66%, with none reporting fewer than 33%. None of the included reviews complied with the full PRISMA-DTA checklist. Our meta-epidemiological survey reveals persistent shortcomings in the reporting quality of systematic reviews evaluating rapid antigen test accuracy for SARS-CoV-2. While some items were consistently addressed, numerous critical domains requiring a deeper understanding of the specific diagnostic test accuracy assessment methods showed low reporting adherence. Las revisiones sistemáticas son fundamentales para fundamentar las decisiones en materia de salud y respaldar la formulación de políticas basadas en datos empíricos. Las directrices para la presentación de informes tienen por objeto reducir la ambigüedad y la confusión, al tiempo que promueven la claridad, la exhaustividad y la transparencia en la presentación de informes. El objetivo de este estudio fue evaluar la exhaustividad de la presentación de informes de revisiones sistemáticas sobre la precisión de las pruebas diagnósticas con metaanálisis de las pruebas rápidas de antígenos para el SARS-CoV-2 utilizadas durante la pandemia de COVID-19, utilizando la directriz PRISMA-DTA. Realizamos una encuesta metaepidemiológica de revisiones sistemáticas con metaanálisis de pruebas rápidas de antígenos para el SARS-CoV-2. Se realizaron búsquedas en MEDLINE/PubMed, EMBASE, L·OVE Covid-19 y Web of Science Clarivate, cubriendo el periodo desde el inicio hasta el 3 de abril de 2025, sin restricciones de idioma. Se incluyeron revisiones con metodologías de revisión sistemática explícitas con estimaciones resumidas de la sensibilidad y la especificidad de las pruebas. Se evaluó el cumplimiento de los 27 ítems de PRISMA-DTA. Tras examinar 5252 publicaciones, incluimos 38 revisiones. No encontramos ningún elemento PRISMA-DTA con una baja frecuencia de notificación. En cuanto al número de elementos notificados, 23 (60 %) de los estudios incluidos notificaron más del 66 %, y 15 (40 %) notificaron entre el 33 % y el 66 %, sin que ninguno notificara menos del 33 %. Ninguna de las revisiones incluidas cumplía con la lista de verificación completa de PRISMA-DTA. Nuestra encuesta metaepidemiológica revela deficiencias persistentes en la calidad de los informes de las revisiones sistemáticas que evalúan las pruebas rápidas de antígenos.

11. Who Leads, Who Treats, What Dose? European Paediatric DTC Practice - an EXPeRT survey.

期刊: European journal of endocrinology 发表日期: 2026-May-15 链接: PubMed

摘要

To map real-world management of paediatric differentiated thyroid carcinoma (DTC) across Europe and identify targets for harmonisation. Cross-sectional, web-based survey of centres providing paediatric DTC care. One consolidated response per centre was requested from a clinician overseeing paediatric DTC. The instrument covered centre profile/multidisciplinary tumour board organisation; staging and guideline use; risk stratification and dynamic response; diagnostics; surgery/lymph node management; radioiodine therapy (RAIT) policy and activity selection; Thyroid-Stimulating Hormone targets, follow-up, shared-care/transition. Analyses were descriptive at centre level. Forty-two centres from 18 countries participated. Among centres answering each item, university/academic hospitals ≈75%; paediatric age cut-off ≤18 y ≈70%; dedicated multidisciplinary tumour board (MDT) ≈60%. Staging systems varied and the primary guidance was mixed (∼30%), American Thyroid Association (ATA) 2015 (∼25-30%), national (∼20-25%), or European Thyroid Association (ETA) 2022 (∼10-15%). Dynamic response-to-therapy categories were commonly used. For unilateral presumed low-risk disease, hemithyroidectomy was the usual initial surgery in about two-thirds to three-quarters of centres, total thyroidectomy was less frequent. For low-risk patients, RAIT policy split between de-escalation (≈55%) and risk-adapted use (≈45%). When given, activity was determined by weight, dosimetry, or fixed empiric approaches. Country-level patterns were evident (ETA- vs ATA-leaning/national environments). Across Europe, centres broadly endorse risk-adapted care but diverge at key decision nodes-extent of surgery, formal risk framework, and RAIT in low-risk disease-reflecting guidance plurality and organisational context. Leveraging existing infrastructures offers pragmatic avenues to reduce unwarranted variation while generating paediatric-specific evidence to refine recommendations.

12. Engagement of Users in Digital Health Applications: Scoping Review.

期刊: JMIR mHealth and uHealth 发表日期: 2026-May-15 链接: PubMed

摘要

Mobile health (mHealth) uses mobile technology as a tool for prevention and health promotion. Research indicates that user engagement is crucial for effective mHealth interventions and improved health outcomes. However, many studies report low adoption rates, rapid decline after initial use, and a lack of acknowledgment of user implications in achieving outcomes. Thus, conceptualizing participation in mHealth is essential to identify key determinants for engaging users. This scoping review aims to identify and characterize the attributes and definitions of user engagement in mHealth, examine engagement methods, and analyze barriers and facilitators influencing participation. Following the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) guidelines, Scopus, Web of Science, and PubMed databases were searched for publications between 2000 and 2025 with a 2-stage selection process. Out of 2489 articles identified, 1416 were screened, and 52 met the inclusion criteria. Half were recently published in the last 5 years (2020-2025). Existing literature focused on digital interventions for specific populations and health topics. Analysis revealed four main perspectives on engagement in mHealth: (1) usage metrics, (2) subjective user experiences, (3) a hybrid approach that combines both, and (4) a goal-oriented perspective (behavior change or health outcomes). To understand the complexity and multifactorial nature of participation, it is relevant to conceptualize it as a dynamic mechanism enabling users to achieve their objectives. Both quantitative use and subjective user experience should be integrated to reach the optimal intervention dose. Recognizing users’ evolving needs, uniqueness, and their socioenvironmental context interdependence, it is essential to involve users in all stages (design, implementation, and iterative evaluation of mHealth). Findings will inform an e-Delphi study to establish consensus on engagement criteria.

13. Caloric restriction and aerobic exercise differentially counteract muscle-tendon dysfunction following diet-induced obesity in C57BL/6J mice.

期刊: The Journal of physiology 发表日期: 2026-May-15 链接: PubMed

摘要

Obesity profoundly impairs musculotendinous structure and function, but the extent to which these alterations can be reversed remains unclear. This study compared the effects of aerobic exercise (EX) and caloric restriction (CR) on the recovery of muscle-tendon structural integrity, contractile performance and passive mechanical properties in high-fat diet-induced obese mice. Male C57BL/6J mice were fed a high-fat diet for 28 weeks and remained on this diet during a subsequent 6 week intervention of either treadmill training (OBEX, 5 days week-1 at 45-65% V ̇ O 2 max $}{\mathrm{2}}}{\mathrm{max}}}}$ ) or 30% caloric restriction (OBCR), whereas controls received standard chow with (CNEX) or without exercise (CN). Muscle [soleus, extensor digitorum longus (EDL)] and Achilles tendon mechanical properties, morphology and composition were assessed alongside circulating and tissue-specific remodelling markers. OB had higher circulating transforming growth factor beta 1, periostin and advanced glycation end products, accompanied by higher muscle and tendon fibrosis. These molecular and structural alterations coincided with slower contraction-relaxation kinetics, lower specific force and increased tissue viscosity. EX but not CR increased tissue energy storage capacity. OBCR but not OBEX had lower muscle AGEs and muscle collagen fraction than OB. In CR, this was associated with significant improvements in muscle-specific force. However, tendon properties remained largely unaffected following CR. In summary, a 6 week CR decreased body mass, normalized glucose tolerance, reduced fibrosis and improved muscle contractility. By contrast, EX enhanced aerobic capacity and modestly improved tissue mechanical behaviour, but had limited effects on body mass, fibrosis, and muscle contractile function. These findings indicate that caloric restriction and exercise induce distinct, only partially overlapping adaptations, highlighting differential contributions of metabolic and mechanical pathways to the recovery of muscle-tendon function in obesity. KEY POINTS: Obesity is known to induce skeletal muscle dysfunction, but it is unclear to what extent this can be reversed by lifestyle interventions such as exercise or reduced food intake. Using a mouse model of diet induced obesity, we compared aerobic exercise with caloric restriction to assess recovery of muscle-tendon structure and function. Obesity caused excess connective tissue to accumulate in muscles and tendons, leading to lower specific force, slower contraction and relaxation, and a stiffer and more viscous muscle-tendon complex. Compared to exercise, caloric restriction more effectively restored muscle specific force and tissue composition than exercise, whereas tendon recovery remained limited. Caloric restriction and exercise elicit distinct, partly overlapping adaptations, suggesting that metabolic and mechanical pathways differentially drive muscle-tendon recovery following diet-induced obesity.

14. Ultraprocessed Foods and the Aging Brain: State of the Science.

期刊: Annual review of nutrition 发表日期: 2026-May-15 链接: PubMed

摘要

Ultraprocessed foods (UPFs), which feature reductions in naturally occurring food components (fiber, phytochemicals) as well as the addition of fat, sugar, salt, and artificial food components (colorings, preservatives) are consumed in large quantities globally. Although a growing body of research has suggested that higher levels of UPF consumption are associated with poorer cardiometabolic outcomes, literature synthesizing the evidence that UPF consumption has negative effects on the aging brain has been scarce. This review provides a comprehensive view of the evidence connecting UPF consumption to downstream consequences for the brain in aging, including proposed mechanisms of action, evidence supporting those mechanisms from basic science studies, and clinical evidence. We then survey current challenges and opportunities in the study of brain aging effects of UPF consumption and provide recommendations for researchers and policymakers.

15. The Role of Emotional Well-Being in Diabetes Prevention and Management.

期刊: Annual review of nutrition 发表日期: 2026-May-15 链接: PubMed

摘要

This article presents a nuanced analysis of current evidence regarding the role of emotions as understudied mediators of the effectiveness of type 2 diabetes (T2D) prevention and management programs. It reviews empirical literature on how indicators of poor mental health, as well as positive affective functioning, are relevant to health behaviors that contribute to T2D risk, such as compliance with recommended diets and improved nutrition. Addressing these emotional aspects of diabetes may be an effective means of improving uptake, and ultimately efficacy, of efforts to reduce the burden of T2D. This article also discusses examples of diabetes self-management efforts that aim to simultaneously address diabetes care and emotional health needs across clinical and community settings, including the collaborative care model, peer-led programs, and community health educators. Finally, this article considers what centering the emotional side of diabetes means for innovative health promotion efforts for people with T2D.

16. Effect of early mobilization in patients hospitalized for acute stroke with premorbid disability: a target trial emulation using instrumental variable analysis.

期刊: Disability and rehabilitation 发表日期: 2026-May-15 链接: PubMed

摘要

To evaluate the per-protocol effect of early mobilization on in-hospital adverse events among patients with acute stroke who had premorbid disability, using a target trial emulation framework. This retrospective observational study conducted at a single center in Japan included patients with acute stroke, all of whom had a premorbid disability. Early mobilization was defined as mobilization within 2 days of hospital admission. The primary outcome was the occurrence of any adverse event-such as death or neurological or non-neurological adverse events-between day 4 and day 30 following admission. Sunday to Thursday admission was used as an instrumental variable (IV) to estimate the causal effect of early mobilization, based on reduced rehabilitation staffing on weekends. A two-stage least squares regression model was applied, adjusting for relevant clinical covariates. Among 165 patients, 58% received early mobilization. Admission from Sunday to Thursday increased the probability of early mobilization by a mean of 0.53 points (F-statistic = 44.79). IV analysis indicated that early mobilization reduced the probability of adverse events by 28 percentage points (absolute risk difference) [95% confidence interval: -55 to -2 percentage points]. Early mobilization appeared to reduce adverse events in patients with acute stroke and premorbid disability. Early mobilization within 2 days of admission may reduce in-hospital adverse events in patients with acute stroke and premorbid disability.Rehabilitation services should minimize weekend-related delays in mobilization.An individualized, lower-dose and carefully titrated early mobilization strategy may represent a reasonable clinical approach for this population.

17. Mercury accumulation over the Holocene revealed from a Greenlandic ice core.

期刊: Science advances 发表日期: 2026-May-15 链接: PubMed

摘要

Mercury is a contaminant of global health concern, but anthropogenic impact on preindustrial mercury cycling remains poorly constrained. Here, we report a high-resolution Greenlandic ice core record of the mercury concentration and accumulation flux over the entire Holocene. We show that the Greenlandic mercury accumulation was shaped by volcanic eruptions, climate excursions, and anthropogenic activity in the past millennia. Mercury accumulation has increased remarkably since the 13th century and further intensified in the past two centuries, which closely mirrors estimated anthropogenic emissions. However, anthropogenic impact was evident long before that, as mercury accumulation entered multiple periods of continuous increase for almost two millennia following early anthropogenic mercury uses. Our result suggests that human activity might have started to impinge on Greenlandic mercury cycling earlier than previously thought and that assessing all-time anthropogenic mercury emissions needs to account for a longer period than the current estimates.

18. Natural history and impact of Giardia lamblia on child growth attainment and associated pathway-specific biomarkers in a Nicaraguan birth cohort.

期刊: PLoS neglected tropical diseases 发表日期: 2026-May-15 链接: PubMed

摘要

Giardia lamblia (Giardia) is one of the most common intestinal parasitic infections globally, with an estimated 280 million symptomatic infections annually. In children from low- and middle-income countries (LMICs), Giardia is highly prevalent and has been associated with loss of intestinal barrier function, nutrient-metabolic dysregulation, and linear growth impairment, but specific mechanisms linking Giardia to these outcomes remain poorly understood. We used data and samples from a subset of 76 children in a longitudinal birth cohort in Nicaragua to evaluate the natural history and geospatial distribution of Giardia infections, child growth outcomes (weight-for-age [WAZ] and length-for-age [LAZ] z scores), and relationships with established biomarkers of inflammation, intestinal damage, and growth-signaling. During the first 36 months of life, we tested 2,305 stools (1,903 surveillance stools and 402 diarrheal stools) for Giardia by qPCR. The incidence of Giardia-positive stools was 59.6 per 100 child-years. Any detection of Giardia was associated with a reduction in LAZ at 36 months of life (β:-0.16, P = 0.042). This effect increased when considering persistent or recurrent Giardia detections (β:-0.26, P=<0.001) as well as living in a high-density Giardia detection area (β:-0.44, P=<0.001). Among intestinal markers, Giardia was associated with lower median fecal neopterin (a marker of chronic intestinal T cell activation) at 24 and 36 months of age. Among serum systemic biomarkers measured at 24 months, Giardia detections were associated with indicators of intestinal epithelial cell damage (higher median Intestinal Fatty Acid Binding Protein (P = 0.002) and Anti-FliC IgA (P = 0.033), and reduced growth-signaling hormone (lower median Insulin-like Growth Factor (IGF-1) (P = 0.005). Giardia detection was negatively associated with linear growth in an exposure-dependent manner. Simultaneously, Giardia was associated with diminished serum growth-signaling hormones. Patterns of serum and fecal intestinal biomarkers suggest that Giardia-mediated epithelial disruption is dissociated from markers of intestinal inflammation.

19. Use of Toxicology Reports to Examine Substances Used in Poisoning-related Suicides among US Health Care Workers.

期刊: Journal of occupational and environmental medicine 发表日期: 2026-May-15 链接: PubMed

摘要

To assess the association between occupational access to drugs and poisoning-related suicides involving specific substances. Using National Violent Death Reporting System data, we compared poisoning-related suicides where selected substances were present versus absent. Occupational access to drugs was defined as working in occupations involving drugs. Adjusted odds ratios and 95% confidence intervals were estimated with sexstratified multivariable logistic regression. Male and female workers with occupational access to drugs had higher odds of poisoning-related suicides involving benzodiazepines and polysubstance use of benzodiazepines and opioids. Among female workers, access was also associated with suicides involving antidepressants, muscle relaxants, and opioids. Occupational access to drugs is linked to increased odds of poisoning-related suicides involving benzodiazepines. Prevention strategies, including lethal means counseling, may help reduce risk.

20. Spatial and seasonal changes in levels of perfluoroalkyl acids (PFAAs) in surface water and sediment from a typical paper-recycling area in Vietnam.

期刊: Environmental geochemistry and health 发表日期: 2026-May-15 链接: PubMed

摘要

Perfluoroalkyl acids (PFAAs) have been increasingly reported in the aquatic environment, but integrated evidence linking their occurrence in surface water and sediment in paper-recycling areas remains limited. This study outlined the levels, spatial and seasonal changes of selected PFAAs in surface water and sediment from Phong Khe, the largest paper-recycling area in Vietnam. Surface water (n = 40) and sediment (n = 25) samples were collected in dry and rainy seasons, extracted using solid-phase extraction (SPE), and analyzed for 12 PFAAs by liquid chromatography-tandem mass spectrometry (LC-MS/MS). Short-chain PFAAs (C6-C8) dominated in surface water, whereas long-chain homologues were more abundant in sediments. Concentrations of PFOS in more than 70% of surface water samples exceeded the European Union environmental quality standard. Total PFAA concentrations in surface water ranged up to 88.4 ng/L, and sediment concentrations ranged up to 6.32 ng/g, with the highest levels in drainage channels receiving paper-recycling effluents. The results showed a spatially consistent decrease in PFAA levels with increasing distance from the discharge sources, in the following order: drainage channels > Ngu Huyen Khe River > Cau River. Principal component analysis (PCA) of the five most frequently detected PFAAs revealed distinct patterns between drainage channels and rivers and indicated seasonal changes in the relative influence of local effluent inputs and riverine dilution. Finally, although ecological risks were generally within acceptable thresholds, some sensitive species, such as Chironomus plumosus, still showed low to moderate risk.

21. Mapping the impact of acute occupational stress on cognitive performance in firefighting contexts: a scoping review.

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

摘要

Firefighting combines intense physical exertion, heat, and psychological stress, creating high cognitive demands where errors have serious consequences. While physiological effects are well studied, cognitive impacts are less understood. This scoping review mapped research on how acute occupational stressors affect firefighters’ cognitive performance. Using PRISMA-ScR, we searched PubMed, PsycINFO, and Web of Science with no date limits, including English-language records only. Studies were included if they examined firefighting-relevant acute stressors and reported an objective cognitive outcome. Thirty-two studies were reviewed and synthesised quantitatively and thematically. Negative cognitive effects were most common, followed by positive and neutral outcomes. Complex tasks and combined heat and physical exertion were most likely to show impairment. Evidence is limited by task heterogeneity, predominantly male samples, English-only screening, and inclusion of grey literature. Findings highlight the need for stress-integrated training, defined recovery protocols, and studies testing moderators such as age and fitness. This scoping review examined how acute occupational stressors affect firefighters’ cognitive performance. Across 32 studies, impairment was most likely during complex tasks, especially with combined exertion and heat. Recovery varied, but 20 minutes may be a practical minimum threshold. Stress-integrated training may build resilience, though stronger intervention research is needed. More research is needed on sex, fitness, and age.

22. Associations between terminal device shape and prosthesis weight and key outcomes differ for body-powered and myoelectric prosthesis users: An observational study.

期刊: Prosthetics and orthotics international 发表日期: 2026-May-14 链接: PubMed

摘要

Anthropomorphic terminal device shape (shape) and prosthesis weight may affect key patient-centered outcomes. No studies have quantified these relationships or examined whether shape and weight affect body-powered and myoelectric prosthesis users differentially. Explore the associations between prosthesis weight, shape, and a variety of outcomes. Multisite observational study of 232 individuals with transradial and transhumeral amputation using upper limb prosthetic devices. Shape was classified as anthropomorphic (yes/no). Prosthesis weight was categorized as light (<1 kg), moderate (1-1.6 kg), and heavy (1.6+ kg). Primary outcomes included prosthesis satisfaction, hours of prosthesis use/day, self-reported disability, and health-related quality of life. Data were stratified by prosthesis type (body-powered (BP) and myoelectric) and bivariate comparisons examined outcomes by weight and shape. Separate multivariable linear and logistic regressions examined associations between shape and weight and outcomes, controlling for potential confounders. In BP users, after controlling for amputation level and other factors, heavy prostheses was associated with a 0.5 point decrease in TAPES satisfaction scores and greater odds of back (OR 25.7), neck (OR 6.4), residual limb (OR 4.2), and contralateral limb pain (OR 8.3) as compared with light prostheses. Anthropomorphic shape was associated with a 1.0 point decrease in TAPES satisfaction. In myoelectric device users, heavier weight was associated with greater odds of back pain (OR 9.9). Heavier prostheses are associated with negative outcomes and affect BP and myoelectric users differentially. Efforts to decrease prosthesis weight may improve satisfaction and decrease prevalence of painful conditions, particularly in body-powered prosthesis users.

23. Understanding the unheard voices: A study on the experiences and perceptions of women using external breast prosthesis in Gujarat, India.

期刊: Prosthetics and orthotics international 发表日期: 2026-May-13 链接: PubMed

摘要

Breast cancer is the most common cancer among women worldwide and an increasing concern in India, with incidence rates rising particularly among women under 50 years old. In India, delayed diagnosis and limited access to health care often lead to mastectomy, leaving many women to face complex physical, emotional, and social challenges afterward. External breast prostheses (EBPs) are a cost-effective option for post-mastectomy recovery, but there is limited research on the long-term experiences of Indian women using EBPs. This qualitative study employed a phenomenological approach to explore the lived experiences of 35 women in Gujarat who had undergone mastectomy and used EBPs for at least 5 years. Participants were purposively chosen and interviewed using a semi-structured guide that addressed satisfaction, challenges, user needs, and suggestions for improvement. Thematic analysis was performed to identify key patterns and insights. Most women reported high satisfaction with the adaptability, comfort, and positive impact of EBPs on self-confidence, especially when using silicone prostheses. However, challenges such as heat and perspiration, weight imbalance, durability concerns, limited product awareness, and affordability issues were noted. Participants suggested improvements including lighter, more breathable, and adjustable materials, longer warranties, enhanced counseling, and better financial access. Findings reveal both the psychosocial benefits and practical challenges of long-term EBP use among Indian women, aligning with global literature and emphasizing the need for patient-centered rehabilitation solutions. Although EBPs improve confidence and daily function, enhancements in design, cost, and awareness are needed. Addressing these could significantly improve life quality and rehabilitation for postmastectomy women in India.

24. Patients with lower limb discrepancies-Long-term follow-up, quality of life, and function while mobilizing with Extension-prosthesis.

期刊: Prosthetics and orthotics international 发表日期: 2026-May-13 链接: PubMed

摘要

When a child is born with or develops a lower limb discrepancy, a lifetime of functional limitations typically ensues. Lengthening surgery is commonly performed; occasionally nonsurgical treatment is chosen, i.e., the child will mobilize with a shoe lift or a personally fitted Extension-prosthesis. The literature on the long-term outcomes of surgical solutions is extensive, whereas there is only limited research describing the implications of nonsurgical alternatives. This presents a challenge when discussing the 2 options and their prognoses with newly diagnosed patients’ families. The aim of this study was to provide data on the long-term quality of life (QoL) and functional capabilities of adult Extension-prosthesis users. We reviewed medical records of patients aged 18 years and older Extension-prosthesis users between 2000-2020, including demographics and medical diagnoses. Telephone interviews were conducted on family status, education, employment, prosthetic use, mobility, pain, participation, and QoL. The interviews included validated questionnaires such as the SF-12, Prosthesis Evaluation Questionnaire-Mobility Scale, and Trinity Amputation and Prosthesis Experiences Scales-revised. Eighty-five patients met the inclusion criteria; 35 replied (41%) to the telephone survey. Twenty-five males (71%); mean age 51.4 (SD = 16.15). Twenty-three (66%) reported having pain. All participants live independently although some need assistance in dressing and bathing. Some are active in sports, and many attended some level of tertiary education, married, and work. Many participants reported that their psychological health was better (“very good”) than their physical health (“good”). Study results include data on the potential ramifications of Extension-prosthesis treatment, enabling the health care team to assist families in making informed decisions when navigating critical choices about their child’s future.

25. Pelvic Girdle Pain at 36 Weeks of Pregnancy and Two Years Postpartum: Associations With Biopsychosocial Factors.

期刊: Sexual & reproductive healthcare : official journal of the Swedish Association of Midwives 发表日期: 2026-May-12 链接: PubMed

摘要

To examine associations between biopsychosocial factors and pelvic girdle pain (PGP) at pregnancy week 36 and two years postpartum. In this longitudinal observational cohort study, data were drawn from the Swedish Pregnancy Panel and the Swedish Pregnancy Register. Multinomial logistic regression was used to examine predictors of PGP at both time points. Among 1,229 respondents, 34.0% reported PGP during pregnancy only, 11.9% at two years postpartum only, and 32.2% at both time points. Predictors of PGP during pregnancy included reduced physical activity (OR = 0.81, 95% CI 0.73-0.90), poorer sleep quality (OR = 0.69, 0.62-0.77), younger maternal age (OR = 0.89, 0.84-0.94), multiparity (OR = 0.40, 0.25-0.63), and higher birthweight (OR = 1.53, 1.06-2.19). Predictors of PGP two years postpartum included prior PGP during pregnancy (OR = 1.39, 1.06-1.82), ongoing worry (OR = 1.25, 1.09-1.42), poorer physical health (OR = 0.70, 0.54-0.91), and lower trust in healthcare (OR = 0.70, 0.55-0.90). Both physical and psychosocial factors were associated with PGP during pregnancy and at two years postpartum. PGP at two years postpartum was particularly associated with emotional distress and lower trust in healthcare, highlighting the importance of integrated, person-centred maternity care and relational continuity. Midwives may play a key role in early identification of women at risk and in strengthening trust and emotional support, which may contribute to reducing the risk of PGP at two years postpartum. BMI, body mass index; CI, confidence intervals; GDPR, the general data protection regulation; NPRS, numeric pain rating scale; OR, odds ratio; PGP, pelvic girdle pain; SD, standard deviation; SES, socio economic status; STROBE, the Strengthening the Reporting of Observational Studies in Epidemiology guidelines; SPP, the Swedish Pregnancy Panel; SPR, the Swedish Pregnancy Register; VAS, visual analogue scale.

26. The burden of premature births attributed to heat across 13 countries.

期刊: Environment international 发表日期: 2026-May-09 链接: PubMed

摘要

Climate change threatens global health, particularly among vulnerable populations such as pregnant individuals and their newborns. Evidence linking heat to premature birth is largely based on single-location studies or heterogeneous meta-analyses, leaving important gaps regarding underrepresented regions, preterm subgroups, and the role of maternal and infant characteristics. To quantify the association between heat and preterm birth (PTB) across multiple countries, assess gestational-age-specific effects, and identify maternal vulnerability factors. We analysed 36.6 million births occurring during the warm season from 250 locations in 13 countries to assess heat effects on PTB. Distributed lag non-linear models (DLNM) with quasi-Poisson regression estimated heat-PTB associations and the fraction of PTB attributable to heat. Gestational-age subcategories (extreme, very, late, and at-term) and socio-economic vulnerability profiles were also examined. Overall, 1.4% (95% CI: 1.3-1.5) of PTB were attributable to heat (855 PTB per million births), with national burdens from 628 to 1,347 PTB per million. Higher susceptibility was suggested for younger, single, non-primiparous, less-educated, and socio-economically deprived mothers, and among female fetuses. Late PTB showed the largest risk; at-term births also displayed a small but consistent heat-related increase. This large analysis of heat-related PTB using harmonized individual-level data indicates that heat increases PTB risk, with variations across countries and climates. It also shows that heat can trigger labour beyond the typical PTB window, affecting pregnancies not usually considered clinically vulnerable. Overall, these findings underscore the need for strategies to mitigate heat-related risks during pregnancy, particularly among socio-economically vulnerable populations.

27. Fecal Calprotectin as a Biomarker for Disease Activity in Microscopic Colitis.

期刊: Journal of clinical gastroenterology 发表日期: 链接: PubMed

摘要

Microscopic colitis (MC) is an intestinal inflammatory disorder. An objective biomarker to assess ongoing disease activity has not been previously examined. We aimed to examine the utility of fecal calprotectin (FC) measurement in symptomatic individuals with microscopic colitis. This cohort study included patients with a confirmed diagnosis of MC who had a calprotectin level measured in the setting of ongoing symptoms. We examined the frequency of elevation of FC in the setting of symptomatic microscopic colitis. Univariate and multivariate logistic regression models examined the independent predictors of elevated FC levels. Our study included a total of 166 subjects, yielding 234 independent instances of FC measurement during symptomatic MC. Of all 234 FC measurements, 68 (29.0%) levels were >150 mcg/g and 43 (18.4%) FC level>250 mcg/g. Those with elevated FC levels>150 mcg/g were older than those below this cutoff (54.7 vs. 61.5 y, P=0.011, respectively). A higher fraction of those with elevated FC (> 150 mcg/g) had nocturnal bowel movements (41.2 vs. 24.1%, P=0.009) and fecal incontinence (25.0 vs. 13.3%, P=0.029) compared with those with normal FC levels. This association was further evidenced on multivariate analysis. There was no difference in FC levels between those who were responsive or refractory to steroids (138 mcg/g vs. 249 mcg/g, P=0.45). Elevated calprotectin concentrations were noted in over a quarter of patients with symptomatic microscopic colitis and were associated with more severe symptoms. However, FC levels did not indicate the likelihood of treatment response.

28. Interactions Between ADIPOQ rs1501299 Polymorphism, Dietary Macronutrient Composition, and Gastric Cancer Risk: Evidence from a Korean Case-Control Study.

期刊: Journal of the American Nutrition Association 发表日期: 2026-May-15 链接: PubMed

摘要

The role of overall macronutrient balance in gastric cancer (GC) risk remains unclear. This study investigated the associations of the Ketogenic Ratio (KR) and Simplified Ketogenic Ratio (sKR), as composite indicators of macronutrient composition, with GC risk, and examined potential modification by the ADIPOQ rs1501299 genotype. A hospital-based case-control study was conducted among 376 GC cases and 752 controls. Dietary intake was assessed using a validated semi-quantitative food frequency questionnaire. Logistic regression models were used to estimate odds ratios (ORs) and 95% confidence intervals (CIs). Interactions between KR, sKR, the ADIPOQ rs1501299 polymorphism, and GC risk were evaluated using multiplicative terms in regression models. The ADIPOQ rs1501299 polymorphism alone was not associated with GC risk. Higher KR and sKR were significantly associated with reduced GC risk (KR: OR = 0.64; 95% CI = 0.44-0.93; sKR: OR = 0.59; 95% CI = 0.40-0.86). Notably, a significant gene-diet interaction was observed strictly for sKR, where this association was more pronounced among overweight/obese individuals carrying the ADIPOQ rs1501299 G/T or T/T genotypes (OR = 0.33, 95% CI: 0.16-0.66, P interaction = 0.038). In contrast, no significant interaction was found between KR and the ADIPOQ rs1501299 genotype. Higher KR and sKR are inversely associated with GC risk. The ADIPOQ rs1501299 genotype significantly modifies the association between sKR and GC risk, specifically among overweight/obese individuals. Future studies should focus on developing and validating standard measurements in nutritional epidemiology to elucidate biological pathways from gene-diet interactions.

29. Body representation and prosthetic adjustment in upper limb amputation: Implications for reintegration to normal living.

期刊: Prosthetics and orthotics international 发表日期: 2026-May-13 链接: PubMed

摘要

This study aimed to compare explicit and implicit aspects of body representation between upper limb amputees (ULA) and healthy controls, and to examine the relationships among body image, reintegration to normal living (RNL), and prosthetic adjustment in ULA. A total of 26 ULA and 26 healthy controls were included. Body image was evaluated using the Amputee Body Image Scale-Revised (ABIS-R), Multidimensional Body-Self Relations Questionnaire. The Reintegration to Normal Living Index (RNLI) was used to assess the level of RNL, and the Trinity Amputation and Prosthesis Experience Scales (TAPES) was used to assess the prosthetic adjustment. Laterality judgment and two-point discrimination (TPD) thresholds were assessed in both groups. Significant correlations in between ABIS-R and TAPES (for all p < 0.05); ABIS-R and RNLI (p < 0.05); and RNLI and TAPES (for all p < 0.01) were identified. In laterality judgment, the accuracy rates of the control group were higher than those of the amputee group (mean difference = 7.94; p = 0.002); the reaction times of the ULA was higher than the control group (mean difference = 661; p < 0.001). Regarding TPD thresholds, the ULA’s values were higher than the control group (mean difference = 2.24; p = 0.003); values on the ipsilateral side were higher than the contralateral side (mean difference = 1.51; p < 0.001). The present study highlights the multidimensional aspect of body representation in ULA and emphasizes the importance of considering both RNL and prosthetic adjustment in their life. Health care professionals may consider implementing measures that would facilitate a deeper relationship between amputees and their bodies, and increasing their social participation.

30. Effectiveness of telerehabilitation to improve motor capacity in patients with lower limb amputation: A systematic review.

期刊: Prosthetics and orthotics international 发表日期: 2026-May-12 链接: PubMed

摘要

Lower limb amputation affects mobility, balance, and independence, limiting quality of life. Although effective, traditional rehabilitation is often inaccessible because of geographic and financial barriers. Telerehabilitation offers a promising alternative by improving gait, strength, and patient engagement. However, variability in protocols and outcome measures hinders standardization, requiring further research to establish best practices and long-term efficacy. This systematic review followed PRISMA 2020 guidelines and was registered on PROSPERO (CRD42024593498). Studies were identified through PubMed, Scopus, Cochrane Library, and Google Scholar using a predefined Boolean search. Filters included full-text availability, human subjects, English language, and clinical trials published between 2014 and 2024. Eligible studies focused on exercise-based telerehabilitation for people with lower limb amputation (≥18 years). Four randomized controlled trials, including a total of 215 participants with lower limb amputation, were included. The primary outcome was walking capacity (2- or 6-minute walk test). Motor capacity was mainly assessed through walking-based outcomes, including walking distance and functional endurance, with some studies also assessing balance-related performance. Telerehabilitation shows comparable functional outcomes to conventional physiotherapy and consistent benefits in engagement and confidence in people with lower limb amputations, whereas uncertainty remains regarding superiority and long-term functional effectiveness.

31. Germline Pathogenic Variants in Breast Cancer-Predisposing Genes Among Early-Onset Female and Male Breast Cancer in Ethiopia.

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

摘要

Patients with breast cancer in Ethiopia are generally diagnosed with late-stage disease, and there is a high proportion of young female and male patients. The role of genetic predisposition is yet unknown in this setting. To increase the knowledge about hereditary breast cancer in Ethiopia, this study investigated germline pathogenic variants (PVs) in breast cancer-predisposing genes in a high-risk cohort of young women and men with breast cancer. One hundred women (age 18-39) and men (all ages) diagnosed with breast cancer at the Tikur Anbessa Specialized Hospital, Addis Ababa, were included. Basic patient and tumor characteristics, and family history were collected, and blood samples drawn. DNA was extracted locally before transport to Lund University, Sweden, for DNA analysis using next-generation sequencing. Type and frequency of PVs in breast cancer-related genes (ATM, BARD1, BRCA1, BRCA2, CDH1, CHEK2, PALB2, PTEN, RAD51C, RAD51D, STK11, and TP53) were analyzed. A high proportion of the 89 study participants with successful genetic analysis carried PVs in breast cancer susceptibility genes (23.6%; 95% CI 15.2 to 33.8). In total, 22 PVs were detected in BRCA1 (n = 7), BRCA2 (n = 8), PALB2 (n = 4), BARD1 (n = 1), PTEN (n = 1), and ATM (n = 1). Potential founder variants and two novel PVs were found (BRCA1 c.5278-864_5332+621del and PALB2 c.1169_1170del). Genetic predisposition plays an important role among young women and men in the study setting, with nearly one in four patients carrying a PV. The results call for further research and interventions targeting individuals at high risk, with the long-term potential of reduced morbidity and mortality.

32. Prevalence and Factors Associated With Financial Toxicity Among Patients With GI Cancer in Pakistan.

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

摘要

Financial toxicity (FT) affects cancer care in low- and middle-income countries (LMICs), affecting treatment adherence and quality of life. This study assesses FT prevalence and associated factors among patients with gastrointestinal cancer across distinct health care systems in Pakistan. A cross-sectional study was conducted across three tertiary care centers in Karachi: Aga Khan University Hospital (AKUH, private, fee-for-service), Jinnah Postgraduate Medical Centre (JPMC, public, free), and Cancer Foundation Hospital (CFH, private-philanthropy, subsidized). FT was assessed using the Urdu version of the Comprehensive Score for FT-Functional Assessment of Chronic Illness Therapy (COST-FACIT). Multivariable negative binomial regression identified factors linked to high FT. Of 375 patients, 44.5% were from AKUH, 33.6% from JPMC, and 21.9% from CFH. Mean age was 50.8 ± 14.4 years, with 62.4% males. Only 8.3% had health insurance, and median International Wealth Index was 79.9 (IQR, 57.1-95.1). Catastrophic health care expenditure affected 41.7%. Mean COST-FACIT score was 16.0 ± 7.4; 46.1% experienced mild FT (score: 14-26) and 41.9% moderate FT (score: ≤14). Delaying or forgoing care, borrowing money, selling assets, and cutting essentials were strongly associated with increased FT (P < .001). Patients at AKUH reported higher FT than JPMC (incidence rate ratio [IRR], 0.84 [95% CI, 0.74 to 0.97]). Younger patients (21-50 years; IRR, 0.66 [95% CI, 0.46 to 0.95]) and those receiving chemotherapy (IRR, 0.89 [95% CI, 0.81 to 0.98]) experienced higher FT. Females (IRR, 1.36 [95% CI, 1.17 to 1.58]) and higher socioeconomic status (IRR, 1.39 [95% CI, 1.06 to 1.83]) were associated with lower FT. Nearly 85% of patients with GI cancer faced FT. Younger age, male gender, lower socioeconomic status, and systemic therapy were associated with higher FT. Subsidized care, financial support, and institution-specific strategies are critical to mitigating FT in LMIC health care systems.

33. Partial Fluid-Air Exchange Enhances Submacular Injection of Retinal Sheets.

期刊: Ophthalmic surgery, lasers & imaging retina 发表日期: 2026-May 链接: PubMed

摘要

Subretinal therapeutics represent a growing area of research with diverse clinical applications. Inadvertent reflux of therapeutic into the vitreous after delivery represents a surgical challenge that leads to therapeutic loss. This study sought to evaluate a modified technique utilizing partial fluid-air exchange (pFAX) to reduce reflux. This single-center study included 18 eyes of nine live pigs. Human iPSC-derived retinal sheets (Sumitomo Pharma) were injected into the subretinal space utilizing pFAX. Retinal sheets were successfully delivered in all eyes. Incorporating pFAX reduced intraocular turbulence and reflux by maintaining (1) stable intraocular pressure, (2) self-sealing wound closure, and (3) subretinal bleb stability. When improper delivery or reflux of sheets did occur, reaspiration and reinjection was much easier with pFAX than with a fluid-filled eye. Incorporating pFAX reduced reflux during subretinal injection of retinal sheets. This technique may enhance current and future applications of subretinal surgery.

34. Mycetoma.

期刊: PLoS neglected tropical diseases 发表日期: 2026-May 链接: PubMed

摘要

The Neglected Tropical Disease mycetoma is a chronic, progressive infectious disease characterized by large tumor-like masses in subcutaneous tissues. It is endemic in rural areas of low- and middle-income countries, where it can lead to extensive health and socioeconomic burdens for the patient and their family. It is especially prevalent among male farmers. The disease can be caused by both bacteria and fungi, referred to as actinomycetoma and eumycetoma, respectively. Inoculation occurs when a skin breach allows the pathogen to enter the subcutaneous tissue. The pathogen can form grains, which make the disease more resistant to host defense and antimicrobial treatments. This review summarizes the current knowledge on the historical background and epidemiology of mycetoma, the characteristics of its causative agents, underlying pathophysiology, diagnostic approaches, available treatment strategies, preventive measures, and future prospects for disease management and research. Although the recognition of mycetoma as both a neglected tropical disease and a fungal priority pathogen has increased awareness and research interest, large knowledge gaps remain.

35. Nationwide trends in overall and abdominal obesity among Korean adults, 2007-2022: an age-period-cohort analysis.

期刊: International journal of epidemiology 发表日期: 2026-Apr-17 链接: PubMed

摘要

Overall and abdominal obesity are associated with increased risks of various chronic diseases. A comprehensive understanding of nationwide trends and contributing factors is necessary to reduce obesity burdens. We conducted hierarchical age-period-cohort analyses using cross-classified random-effects models on measured body mass index (BMI) and waist circumference (WC) data from a nationally representative sample of 86 806 Korean adults aged 19-79 years in the Korea National Health and Nutrition Examination Survey 2007-2022. In 2007-2022, there were overall increasing trends in age-standardized mean BMI and WC and prevalence of overall and abdominal obesity. When stratified by sex, the age-standardized mean BMI and WC increased among men (BMI: from 24.1 to 25.2 kg/m2; WC: from 84.6 to 88.6 cm), whereas only small changes were observed among women (BMI: from 23.1 to 23.2 kg/m2; WC: from 78.8 to 77.9 cm). Mean BMI and WC increased with age through middle adulthood in men and late adulthood in women. After controlling for age and period effects, mean BMI and WC were lowest among the birth cohorts of the late 1950s and 1970s and increased in more recent birth cohorts. Among men, mean BMI and WC were higher in higher socioeconomic subgroups (higher income, higher education, urban areas), but, among women, mean BMI and WC were higher in lower socioeconomic subgroups. To reduce obesity-related disease burdens in Korea, tailored interventions are needed to target the most vulnerable populations, such as younger generations, men of higher socioeconomic subgroups, and women of lower socioeconomic subgroups.

36. Austerity policies and falling life expectancy in disadvantaged areas in Scotland: a pre-pandemic decomposition analysis.

期刊: European journal of public health 发表日期: 2026-Apr-11 链接: PubMed

摘要

Previous decomposition analyses quantified the contribution of changes in age- and cause-specific mortality to the adverse changes in life expectancy observed in the UK since 2012. We extend those analyses by stratifying by socioeconomic deprivation. Between 2012-14 and 2017-19, changes in life expectancy were substantially worse in Scotland’s 20% most deprived areas. Negative impacts on life expectancy were found for most age groups and causes of death, reversing improvements between 2001-03 and 2012-14. This is consistent with the evidence of the role of UK Government ‘austerity’ policies in reversing previous health improvements among the UK’s poorest populations.

37. Adverse effects of atmospheric pollution on public health in Brazil: an integrative review.

期刊: Ciencia & saude coletiva 发表日期: 2026-Apr 链接: PubMed

摘要

Atmospheric contamination is closely linked to negative impacts on public health. Understanding the unique aspects of the Brazilian context is crucial for the implementation of public policies and health promotion. Thus, this article aims to evaluate the adverse effects of air pollution on public health in Brazil. This review was developed through a search in the LILACS, SciELO and PubMed/Medline databases, using the keywords “Air Pollution” AND (Health OR “Public Health”) AND “Adverse Effects” AND Brazil. After applying the inclusion criteria and removing duplicates, 19 references were used for this review. There is a significant correlation between respiratory diseases and the emission of atmospheric pollutants, highlighting an increase in hospitalizations due to respiratory illnesses. More studies are needed to address further information on atmospheric pollutants, as well as the effects on other systems of the human body. Even at levels considered acceptable, atmospheric pollutants still pose risks to public health. Therefore, specific public policies aimed at reducing emissions of these gases are mandatory.

38. Combination Guselkumab and Secukinumab for Plaque Psoriasis.

期刊: Cutis 发表日期: 2026-Mar 链接: PubMed

摘要

39. Effects of angiotensin converting enzyme inhibitors versus angiotensin receptor blockers on cognitive decline: A retrospective real-world database study.

期刊: Wiadomosci lekarskie (Warsaw, Poland : 1960) 发表日期: 2026 链接: PubMed

摘要

Aim: To compare 5-year cognitive outcomes in patients with HFrEF who receive angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs). Materials and Methods: Retrospective cohort study of: 1) 135,873 adults with HFrEF (International Classification of Diseases-10th Revision-Clinical Modification [ICD-10-CM] codes: I50.2 or I50.4) started on ACEI between Aug 1, 2019 and Aug 1, 2024; and 2) 135,873 propensity matched patients receiving ARBs during that time. Data were obtained from the TriNetX Research Network, encompassing 80 health care organizations in the United States. The primary endpoint was the composite of cognitive decline (ICD-10-CM: R41.8), dementia (ICD-10-CM: F01-F03), and Alzheimer’s disease (ICD-10- CM: G30). Results: At 5 years,17,679 patients on ACEI met the primary endpoint vs 16,345 patients on ARBs (5-year incidence: 30.71% vs 28.54%; HR: 1.153; 95% CI: 129-1.178; P < 0.001), with consistently higher rates of cognitive decline (24.94% vs 22.81%; HR: 1.146; 95% CI: 1.119-1.174; P < 0.001), dementia (15.63% vs 13.71%; HR:1.204; 95% CI: 1.168-1.241; P < 0.001), and Alzheimer’s disease (4.15% vs 3.51%; HR: 1.202; 95% CI: 1.131-1.277; P < 0.001) in the ACEI cohort. Conclusions: ACEI was associated with higher 5-year rates of neurocognitive disorders when compared to ARBs in patients with HFrEF.

40. Frontline decision autonomy under decentralization: Evidence from health sector reform.

期刊: PloS one 发表日期: 2026 链接: PubMed

摘要

Decentralization is designed to transfer autonomy from more central to more local actors, yet studies show differences in the autonomy realized under these reforms. Drawing on the case of health sector decentralization in Honduras, we utilize the decision space approach and original data for over 600 frontline health workers in a matched sample to explain facility-level autonomy. We find that reported decision autonomy in four functional areas is slightly reduced under decentralization, reductions are most pronounced where decentralization is led by municipal governments or associations, rather than NGOs, and differences across staff types are modest. Furthermore, capacity and resources are necessary for expanded autonomy, particularly in organizing service delivery, while supportive accountability allows for increased autonomy in human resources and finances. Our research shows the importance of including frontline staff in studies of decision autonomy under decentralization and considering the distribution of autonomy across levels in hierarchical service delivery systems.

41. Evaluating the effects of community-based programs on viral rebound and viral suppression among HIV-positive orphaned and vulnerable children receiving antiretroviral treatment: Findings from the ACHIEVE project in Tanzania.

期刊: PloS one 发表日期: 2026 链接: PubMed

摘要

Achieving and sustaining viral load suppression (VLS) among children living with HIV remains challenging despite the availability of antiretroviral therapy (ART), primarily due to adherence difficulties. This study evaluated the effects of three interventions under the ACHIEVE project on viral load outcomes (viral rebound and viral suppression) among HIV-positive orphaned and vulnerable children aged 0-17 years (hereafter referred to as CLHIV) receiving ART in Tanzania. This is a longitudinal analysis of 26,257 CLHIV who are beneficiaries of the ACHIEVE project in Tanzania, each with at least two viral load (VL) test results between 2021 and 2023. VL outcomes were assessed using two analytic groups: Group 1 included 21,448 CLHIV with undetectable VL (<50 copies/mL) at baseline, where those maintaining undetectable VL were compared with those experiencing viral rebound (VL ≥ 50 copies/mL) at follow-up. Group 2 comprised 4,809 CLHIV with detectable VL (≥50 copies/mL) at baseline, where those achieving undetectable VL at follow-up were compared with those who did not. The study used a multivariable logistic regression model and propensity score matching (PSM) to evaluate the effects of ACHIEVE project interventions-WORTH Yetu economic strengthening, linkage to teen/paediatric clubs, and health insurance-on viral rebound (Group 1), and the achievement of an undetectable viral load (Group 2). Overall, 13.1% (2,805/21,448) of Group 1 CLHIV experienced viral rebound at follow-up. CLHIV who received ACHIEVE interventions were 23.2% less likely to experience viral rebound compared to those who did not (aOR = 0.768, 95% CI 0.668-0.882, p < 0.001). In Group 2, 70.9% (3,411/4,809) achieved an undetectable viral load at follow-up, with those who received ACHIEVE interventions being 31.9% more likely to achieve an undetectable viral load compared to those who did not (aOR = 1.319, 95% CI 1.059-1.643, p = 0.014). These findings were confirmed in the PSM analysis (viral rebound: β = - 0.047, 95% CI -0.072 - -0.021, p < 0.001; achieving undetectable viral load: β = 0.10, 95% CI 0.04-0.16, p = 0.001). The ACHIEVE project interventions were significantly associated with a reduced likelihood of viral rebound, and an increased likelihood of achieving undetectable viral load among CLHIV, highlighting their potential to enhance ART outcomes. These findings suggest that expanding similar community-based interventions could further contribute to HIV treatment efficacy and support more children in achieving and maintaining an undetectable viral load, particularly those at risk of viral rebound or persistent high viral load. Future research should explore strategies for scaling these interventions and evaluating their long-term impact.

42. Genetic variants in the leptin-melanocortin pathway and their joint effects with physical activity and sleep duration on risk of childhood obesity.

期刊: PloS one 发表日期: 2026 链接: PubMed

摘要

This study aimed to investigate the associations between functional genetic variants in leptin-melanocortin pathway and risk of childhood obesity, as well as exploring gene-lifestyle interactions on obesity risk. A frequency-matched case-control study included 1123 children and adolescents with obesity and 1231 controls from Guangzhou, China. Twelve potentially functional genetic variants were genotyped. Multivariate logistic regression and classification and regression tree were applied to identify obesity-associated genetic variants. Unweighted and weighted genetic risk scores (GRSs) were constructed, and their interactions with physical activity and sleep were assessed using relative excess risk of interaction (RERI), attributable proportion of interaction (AP) and the interaction of odds ratio (IOR). We identified important genetic variants associated with obesity: MC4R rs17782313, rs12970134, LEPR rs1137101, and POMC rs6713532. High unweighted GRS was associated with a higher obesity risk than low GRS (OR = 1.40, 95% CI = 1.09-1.79), with similar results for the weighted GRS. High unweighted GRS combined with inadequate sleep or physical activity conferred increased risk of obesity compared to low/medium GRS with healthy lifestyle (OR = 1.70, 95% CI = 1.28-2.26; OR = 1.59, 95% CI = 1.17-2.17). However, the 95% CIs for all RERIs and APs contained 0, and for IORs contained 1, suggesting no significant interaction. Four genetic variants in the leptin-melanocortin pathway are associated with the risk of obesity, both individually and jointly. Furthermore, the joint effect of these genetic variants with inadequate sleep and physical activity may contribute to obesity development in children and adolescents.

43. The mediating roles of personal mastery and health-promoting behaviors in the relationship between self-regulatory fatigue and quality of life among patients with type 2 diabetes mellitus.

期刊: PloS one 发表日期: 2026 链接: PubMed

摘要

Quality of life (QoL) is a pivotal prognostic indicator for patients with Type 2 Diabetes Mellitus (T2DM). While the impact of various factors on QoL is recognized, the complex interplay between psychological and behavioral determinants remains underexplored. Understanding these pathways is essential for developing effective interventions. This study aimed to investigate the status of QoL and its associated factors among T2DM patients, and to examine the mediating effects of personal mastery (PM) and health-promoting behaviors (HPB) in the relationship between self-regulatory fatigue (SRF) and QoL by using structural equation modeling. The study adhered to the STROBE guidelines for cross-sectional reporting. From July 2025 to February 2026, 432 T2DM patients were recruited from three tertiary grade-A hospitals across two cities in China by using convenience sampling. Data were collected using the Demographic Characteristics Questionnaire, Self-Regulatory Fatigue Scale, Personal Mastery Scale, Diabetes Health Promotion Scale, and Diabetes-Specific Quality of Life Scale. Pearson’s correlation, multiple linear regression, and structural equation modeling were employed for data analysis. The mediating effects were tested using the bias-corrected (BC) bootstrap method with 5,000 resamples. The total scores for SRF, PM, HPB, and QoL were 38.63 ± 12.84, 26.12 ± 7.62, 97.69 ± 20.87, and 69.41 ± 20.89, respectively. Correlation analysis indicated that QoL was significantly positively correlated with SRF (r = 0.581, p < 0.01), and negatively correlated with PM (r = -0.557, p < 0.01) and HPB (r = -0.613, p < 0.01). Multiple linear regression analysis revealed that age, educational level, medical insurance payment method, smoking status, glycemic control status, number of comorbidities, self-care ability, self-regulatory fatigue, personal mastery, and health-promoting behaviors were independent predictors of QoL. Furthermore, the structural equation modeling demonstrated a significant total indirect effect of self-regulatory fatigue on QoL. The mediating effect of personal mastery accounted for 30.2% of the total indirect effect, while that of health-promoting behaviors explained 60.2%. The chain mediating pathway contributed 9.5% of the total indirect effect. This study suggests that SRF is statistically associated with directly and indirectly poorer QoL in T2DM patients, primarily by being associated with lower PM and fewer HPB. These findings highlight the importance of addressing psychological and behavioral mechanisms in diabetes care. From a nursing perspective, interventions targeting SRF, strengthening PM, and promoting HPB may be beneficial.

44. Engaging communities through participatory learning action for the control and prevention of diabetes: A protocol for the Process Evaluation of the EMPOWER-D trial in Pakistan and Afghanistan.

期刊: PloS one 发表日期: 2026 链接: PubMed

摘要

Type 2 diabetes is a growing challenge in low- and middle-income countries (LMIC), where health systems face major capacity gaps. Participatory learning and action (PLA) has shown effectiveness in preventing type 2 diabetes in Bangladesh, but little is known about its use in other LMICs for diabetes. The EMPOWER-D (Engagement of community through Participatory learning and action for cOntrol and prevention of type 2 diabetes) trial is testing PLA for diabetes prevention in communities in Pakistan and Afghanistan. This protocol describes the plans for the embedded process evaluation (PE). The PE will use a mixed-methods design across three sites, following the UK Medical Research Council framework for PE, examining implementation, mechanisms of impact and context. Implementation will be assessed using adaptation reports, fidelity checklists, attendance data and supervisor reports. Mechanisms of impact will be explored through interviews, focus group discussions and photovoice. Contextual factors will be examined through interviews with participants, community mobilisers, supervisors and key stakeholders. Quantitative data will be analysed descriptively, while qualitative data will undergo thematic analysis using a theory of change framework. Comparative analysis will identify common and context-specific influences. This is the first multi-country PE of a PLA intervention for diabetes prevention to our knowledge, and the first in Afghanistan and Pakistan. The study will provide insights into how the intervention was delivered, how and why it worked (or did not work) and the contextual factors shaping outcomes. Findings will inform the adaptation and scale-up of participatory approaches for non-communicable disease prevention in resource strained setting health systems. Trial registration: ClinicalTrials.gov: NCT06561126 (registered 23 August 2024); NCT06570057 (registered 26 August 2024).

45. Current performance as an indicator of the foreign students' KROK-2 license examination results.

期刊: Wiadomosci lekarskie (Warsaw, Poland : 1960) 发表日期: 2026 链接: PubMed

摘要

Aim: The aim of the work is to comprehensively assess the impact of indicators of current success of foreign students on the results of passing the licensing exam KROK-2 and its component - the subtest “Hygiene, Public Health”. Materials and Methods: A single-center retrospective quantitative study was conducted, during which a dataset of foreign students (n=70) with depersonalized records of current performance for the 3rd and 6th years, ECTS scales, traditional grades, the final result of KROK-2 and the subtest “Hygiene, Public Health” (2025) was analyzed. Data processing and modeling were carried out in the Python. Results: Current success in the 6th year is statistically related to the result of KROK-2, but explains a limited proportion of the variation in the result (R2≈0.13-0.21). Indicators of the 3rd year provide moderate incremental value; the most informative is PC_3% (independent association in the extended model). ECTS (6th year) acts as a suitable risk stratifier: categories D/E are associated with a decrease in the expected result from STEP-2 by approximately 11 percentage points compared to the reference C. Traditional assessments have a clear linear gradient: in the 6th year ≈+8.9 p.p./point, in the 3rd year - ≈+7.3 p.p./point. Conclusions: The Hygiene, Public health subtest is poorly predicted by overall grades in the 6th year of study, highlighting the need for subject-specific interventions. Multicollinearity between components of the 6th year current control is high; the use of robust and regularized approaches (HC3, PCA/PC1, Ridge, residualization) confirmed the robustness of key findings under alternative specifications.

46. Microbiology of dental decay and periodontal disease: A review.

期刊: Wiadomosci lekarskie (Warsaw, Poland : 1960) 发表日期: 2026 链接: PubMed

摘要

Aim: This review attempts to examine the microbiology, pathogenesis and current therapeutic approaches of dental caries and periodontal diseases with a special focus on the role of polymicrobial biofilms, the host-microbe interaction and the major pathogenic species involved in disease progression. Materials and Methods: A thorough literature review was performed using major scientific databases such as PubMed, Scopus, Web of Science and Google Scholar. Studies that were published between 2000 and 2025 were included. Relevant experimental, clinical and review articles that focused on the etiology, microbial composition, virulence mechanisms, host immune responses and therapeutic approaches of dental caries and periodontal disease were analyzed. Conclusions: The oral cavity harbors over 700-800 bacterial species, of which the primary cariogenic pathogen is Streptococcus mutans and Porphyromonas gingivalis has been implicated as a major cause of periodontal disease. Dental caries progression is mostly attributed to acid production and demineralization of enamel, whereas periodontal disease is a result of dysbiotic shift in the subgingival microbiome with destructive host inflammatory responses. The “red complex” (P. gingivalis, Treponema denticola and Tannerella forsythia) has a high degree of synergistic virulence in advanced periodontitis. Biofilm formation, production of extracellular polysaccharide (EPS) matrix, quorum sensing and immune components (neutrophils, macrophages and matrix metalloproteinases or MMPs) are all factors that contribute to disease formation. Prevention strategies include oral hygiene measures, fluoride exposure, dietary modification, and antimicrobial agents, whereas treatment measures include mechanical debridement, systemic antibiotics, antimicrobial peptides, probiotics, and photodynamic therapy. Dental caries and periodontal diseases are the result of complex interactions between polymicrobial biofilms and immune responses by the host. A better understanding of the microbial ecology, virulence pathways and host-pathogen interactions is crucial in the process of improving prevention and treatment. Advances in targeted antimicrobial therapies and innovative therapeutic approaches hold promise for enhancing global oral health outcomes.

47. Six-month effects of liraglutide and dapagliflozin on lipid profile, cardiovascular risk, and NT-proBNP levels in patients with metabolic dysfunction-associated steatotic liver disease.

期刊: Wiadomosci lekarskie (Warsaw, Poland : 1960) 发表日期: 2026 链接: PubMed

摘要

Aim: This study assessed and compared changes in lipid profile and cardiovascular risk in patients with metabolic dysfunction-associated steatotic liver disease after six months of liraglutide or dapagliflozin treatment. We also evaluated changes in N-terminal pro-B-type natriuretic peptide levels. Materials and Methods: This prospective, randomized, parallel-group study included 115 adult patients with metabolic dysfunction-associated steatotic liver disease. Participants were randomized into three groups: control (n = 36, lifestyle intervention only), dapagliflozin (n = 41, 10 milligrams daily), or liraglutide (n = 38, titrated to 1.8 milligrams daily). All patients adhered to a Mediterranean diet and moderate physical activity. Lipid profile and N-terminal pro-B-type natriuretic peptide levels were measured at baseline and six months. Cardiovascular risk was assessed using five validated scales: Globorisk, Framingham Risk Score, American College of Cardiology/American Heart Association atherosclerotic cardiovascular disease Risk Calculator, Prospective Cardiovascular Munster Score, and World Health Organization cardiovascular risk charts. Results: All groups showed significant within-group improvements in total cholesterol, low-density lipoprotein cholesterol, triglycerides, and high-density lipoprotein cholesterol (p < 0.001), with liraglutide showing greater lipid improvements intergroup (p < 0.05). Cardiovascular risk scores decreased significantly in all groups, with no differences between them. N-terminal pro-B-type natriuretic peptide levels increased significantly in the control and liraglutide groups, but remained unchanged in the dapagliflozin group. Conclusions: Liraglutide and dapagliflozin are effective in improving lipid profile and reducing cardiovascular risk. Liraglutide showed superior efficacy in lipid improvement. Changes in N-terminal pro-B-type natriuretic peptide require further investigation.

48. A curated dataset and lightweight deep learning framework for tea leaf disease classification.

期刊: PloS one 发表日期: 2026 链接: PubMed

摘要

Tea (Camellia sinensis) is the world’s second most consumed beverage, enjoyed daily by more than two billion people. In Bangladesh, it serves as a cornerstone agricultural export and a major sector of the domestic economy. However, commercial tea cultivation remains highly vulnerable to fungal and pest-related diseases such as Blight, Red Rust, and Helopeltis which severely reduce crop yield and compromise leaf quality. While early detection is critical to preventing widespread outbreaks, traditional manual inspection is slow, subjective, and highly error-prone. Deep learning provides a scalable alternative, yet single-branch networks often struggle to capture both minute disease lesions and broader structural degradation simultaneously. To address this, we propose a Hybrid Feature Fusion architecture that runs two highly efficient feature extractors in parallel: EfficientNetV2-Small to isolate fine-grained local textures, and MobileNetV3-Small to capture the global structural context of the leaf. The models were trained and evaluated on a real-world dataset of 2,000 annotated images, evenly distributed across the four target classes (Blight, Red Rust, Helopeltis, and Healthy). Before training, the images underwent a standardized preprocessing pipeline including resizing to 224 × 224 pixels and normalization, supplemented by a dynamic augmentation strategy featuring random rotations, horizontal flips, and brightness adjustments to improve model robustness. The proposed hybrid framework achieved an outstanding peak classification accuracy of 96.80% alongside a macro Area Under the Curve (AUC) of 0.9980. To rigorously validate its performance, the hybrid model was benchmarked against six diverse architectures: a Vision Transformer (ViT-B16 at 76.40%), a Custom CNN (89.60%), MobileNetV3 (94.40%), ResNet50 (95.60%), DenseNet121 (96.40%), and EfficientNetV2-B3 (97.60%). Although EfficientNetV2-B3 achieved a marginally higher raw accuracy, the proposed dual-branch framework delivered a superior precision-recall balance and faster convergence stability. These findings demonstrate that the proposed hybrid methodology is highly reliable and computationally balanced, making it an ideal candidate for integration into Internet of Things (IoT) edge devices for real-time disease monitoring in precision agriculture.

49. Effect of intra-dialytic pedaling exercise on dialysis adequacy: A randomized controlled trial.

期刊: PloS one 发表日期: 2026 链接: PubMed

摘要

In patients with chronic kidney disease undergoing hemodialysis, physical activity and rehabilitation are crucial for preventing declines in muscle strength and functional capacity. This study aimed to assess the impact of physical activity during hemodialysis on dialysis adequacy in patients undergoing hemodialysis. This randomized controlled trial (RCT) investigated the impact of pedaling exercise on dialysis effectiveness in 84 hemodialysis patients at hospitals in Bushehr. Participants were randomly assigned to either an experimental group (n = 42) that performed 30 minutes of pedaling exercise during their 4-hour dialysis sessions or a control group (n = 42) that received routine hemodialysis. Dialysis adequacy was assessed by comparing pre- and post-dialysis blood samples obtained from the arterial line. A conservative intradialytic exercise protocol, blood samples, and patient weight were measured using a calibrated digital scale. Data analysis was performed using SPSS version 24 software. The experimental and control groups were similar in demographic characteristics, except for age (X2 = -3.84, p = 0.001) and education levels (X2 = 10.100, p = 0.006). While there was no significant difference in weight between the groups before and after the intervention (t = 0.223, p = 0.82 before; t = 0.203, p = 0.84 after), both groups showed a substantial weight reduction overall (p < 0.0001). There were no statistically significant differences in weight change (t = 0.80, p = 0.25), BUN (t = 0.13, p = 1.52), or Kt/V (t = 1.62, p = 0.11) between the experimental and control groups. This study found that incorporating pedaling exercise during hemodialysis did not significantly improve dialysis effectiveness, as measured by weight change, BUN levels, or Kt/V. While both groups showed weight loss, there were no statistically significant differences between them. However, the study was limited by its small sample size and the specific exercise protocol employed. Further research with larger cohorts and a broader range of physical activities is needed to determine whether physical activity during hemodialysis can improve dialysis adequacy and overall patient outcomes. IRCT code number 20150529022466N15 and trial Code of Ethics IR.BPUMS.REC.1398.130E.

50. Evaluation of plasma anti-CS3 and anti-LTB IgG avidity among Zambian children vaccinated with ETVAX.

期刊: PloS one 发表日期: 2026 链接: PubMed

摘要

Enterotoxigenic Escherichia coli (ETEC) remains a major cause of diarrheal disease in low- and middle-income countries (LMICs). To curb ETEC related diarrhoea, several candidate vaccines are in development, with ETVAX® being the most advanced. Although immunogenicity studies have primarily focused on measuring antibody titres, assessing antibody avidity offers additional valuable insight into antibody quality and immune maturity. This study assessed anti-CS3 and anti-LTB IgG avidity in Zambian children to better understand vaccine-induced antibody responses in an endemic setting. Children aged 6-23 months (n = 60) received three quarter-doses of ETVAX® with dmLT adjuvant on days 1, 14, and 90. Plasma samples collected at baseline prior to the first vaccination (Day 1; V1), seven days after the second dose (Day 22; V5), and seven days after the third dose (Day 97; V7) were analysed by limiting antigen dilution ELISA to calculate avidity indices (AI). Naïve classification was performed using titre-based thresholds (20th percentile of baseline titres) and avidity-defined naivety (AI < 0.5). Receiver operating characteristic (ROC) analysis was used to evaluate the discriminatory performance of avidity indices against titre-defined naïve status. Baseline avidity was detectable for both CS3 and LTB, consistent with prior natural exposure. Mean CS3 IgG avidity decreased from 0.7 at baseline to 0.6 after the third dose (p < 0.001), while LTB IgG avidity showed transient decreases but no net gain. Naïve classification at baseline revealed that 9/60 children had titres but low avidity (functional naivety), and 6/60 had waned titres but high avidity. Only one child was naïve by both criteria for CS3, and none for LTB. ROC analysis demonstrated moderate discrimination for CS3 (AUC = 0.65; optimal cut-off AI = 0.36) but poor discrimination for LTB (AUC = 0.30). In this endemic population, ETVAX® induced strong antibody titres but minimal changes in avidity over time, with notable inter-individual variability. ROC analysis highlighted context-specific limitations in using avidity to discriminate immune maturity. Together, these findings suggest that while antibody avidity may provide complementary information on antibody quality, its interpretation should be cautious and considered alongside antibody titres in endemic settings.

51. Interest in long-acting injectable ART among adolescents with perinatally acquired HIV in Cameroon: Implications for implementation in developing countries.

期刊: PLOS global public health 发表日期: 2026 链接: PubMed

摘要

Long-acting injectable antiretroviral therapy (LAI-ART) has the potential to transform HIV treatment for adolescents with perinatal HIV infection (APHI). Given the existing knowledge gaps surrounding this recent strategy, we aimed to assess interest in LAI-ART among ART-experienced APHI in Cameroon. We conducted a cross-sectional study among ART-experienced APHI aged 10-19 years, across four paediatric HIV clinics in the Centre region of Cameroon. Data were collected from 4 to 30 November 2024 using structured questionnaires to assess sociodemographic characteristics, awareness of, and interest in LAI-ART. HIV-1 viral load (VL) and CD4 cell counts were measured during the same period. Logistic regression analysis was used to identify factors associated with interest in switching to LAI-ART. Of 248 participants (48.8% female; median [IQR] age 15 [13-17]), 40.0% lived with a guardian and 75.8% had partial/full HIV-disclosure; 3.2% reported stigma. Clinically, 77.5% were in multi-month ARV-dispensation (MDSD) and 28.2% had poor ART-adherence; fear of injection was none/moderate/high in 73.4%, 15.7% and 10.9%, respectively. Viral undetectability (VL < 50 copies/mL) and CD4 ≥ 500 cells/mm³ were 71.6% and 72.5%, respectively. Overall, 92.3% expressed interest in LAI-ART, motivated by reduced pill burden/fatigue (63.7%) and expected better adherence (74.2%); 30.2% reported prior LAI-ART awareness. In multivariable analysis, no prior awareness had 81% lower odds of interest (p = 0.036). Compared with no-fear, moderate-fear was associated with 46% lower odds (p = 0.393), while high-fear was associated with 78% lower odds (p = 0.017). Disparities in sex, education, residence, adherence, virological response, or treatment history did not influence interest in LAI-ART. Among all respondents, 77.1% said they would choose LAI-ART if available, whereas 20.2% preferred MDSD. In this Cameroonian APHI cohort, awareness of LAI-ART was low despite high-interest once adolescents were informed. Rollout in low/middle-income countries should prioritise targeted education, youth-friendly counselling to close knowledge gaps, reduce fear and ensure equitable uptake.

52. Health Literacy, Socioeconomic Status, and Health Behavior Adherence Among Young Adult Survivors With Cancer: A Cross-Sectional Study.

期刊: Cancer control : journal of the Moffitt Cancer Center 发表日期: 2026 链接: PubMed

摘要

IntroductionYoung adults (YAs) with cancer are at elevated risk for chronic conditions and late effects, making adherence to healthy eating and physical activity guidelines a key survivorship priority. Health literacy is theorized to support guideline-concordant behaviors, yet its role in YA oncology remains unclear, particularly in the context of socioeconomic and environmental influences. This study aimed to characterize health literacy among YA cancer survivors and examine its association with adherence to healthy eating and physical activity guidelines, after accounting for sociodemographic/clinical factors.Methods273 YAs (18-39 years) receiving care at an NCI-designated cancer center completed an anonymous online survey. Measures included the BRIEF Health Literacy Tool, the Rapid Eating Assessment for Participants-Short Version, the Rapid Assessment of Physical Activity, the Social Support and Eating Habits and Exercise Surveys, and self-reported sociodemographic and clinical variables. Analyses included descriptive statistics, bivariate correlations, and multiple regression models controlling for variables of interest.ResultsMost participants demonstrated adequate health literacy, and health literacy was positively associated with education and household income. However, health literacy was not significantly associated with adherence to healthy eating or physical activity guidelines. Higher BMI was associated with lower adherence to healthy eating, whereas having a college degree or higher and family participation in exercise were associated with adherence to healthy eating. For physical activity, friends’ discouragement of healthy eating and family participation in exercise were associated with better adherence.ConclusionsIn this relatively well-educated, higher-income YA oncology sample, health literacy was generally adequate and did not independently predict adherence to healthy eating or physical activity guidelines. These findings suggest that, in higher socioeconomic status settings, structural and social determinants may outweigh the influence of health literacy on lifestyle behaviors. Survivorship interventions should combine health literacy-sensitive communication with multilevel strategies targeting weight management, food/activity environments, and family/peer support.

53. Andean agriculture and hand tools: A qualitative approach of exploration of needs, barriers, and opportunities for innovation.

期刊: PloS one 发表日期: 2026 链接: PubMed

摘要

Peruvian Andean agriculture primarily consists of subsistence activities that rely on traditional methods. Rural farmers use locally made hand tools, often designed without technical or ergonomic considerations, increasing the risk of musculoskeletal disorders. This study examined farmers’ views, needs, barriers, and support in hand tool design, and how they assess satisfaction with tools during potato harvesting. A qualitative study using a phenomenological design was conducted using semi-structured interviews with 13 rural farmers from Yanaca, Apurímac, Peru. A total of 25 interviews were conducted, audio-recorded, transcribed verbatim, and analyzed via a mixed coding strategy. Data was organized using a thematic approach and triangulated to validate coding. The results from the first guide were organized into five themes: task, human, product, qualitative and environmental. Some aspects such as social and techniques aspects for adopting hand tools emerged as well as enablers like economic accessibility, similarity to traditional tools. Six themes emerged from second guide covering tools conditions for efficient use, pre-work preparation, evaluation of the tool, consequences of a deficient tool, accumulated experience and appropriation; and family and gender dynamics. We found that hand tools used in high-Andean agriculture are shaped by technical features such as weight and handle size, and external aspects like climate effect and cultural familiarity, while material limitations, rough handle surface or inadequate tool size can act as barriers. In addition, efficiency of tools during work, preparation like a sharpened tip, fit between components head and handle, local maintenance facilitates farmers’ satisfaction. These findings suggest that agricultural hand tool design should go beyond technical aspects to incorporate cultural and practical perspectives.

54. Protective factors against acute kidney injury in children exposed to diethylene glycol-contaminated medicines: A case-case-control analysis from The Gambia outbreak.

期刊: PLOS global public health 发表日期: 2026 链接: PubMed

摘要

During The Gambia’s 2022 diethylene glycol (DEG) outbreak, 82 children developed acute kidney injury (AKI) with 80% mortality. However, approximately 30% of children with documented DEG exposure did not develop AKI. Understanding protective factors could enable risk stratification and inform prophylactic interventions in future outbreaks. We conducted a case-case-control study among 321 children aged ≤8 years from six Gambian health regions. We compared exposed children who developed AKI (exposed-susceptible, n = 37) with exposed children who remained healthy (exposed-resistant, n = 16) and unexposed healthy children (n = 242). Multivariable logistic regression identified factors associated with AKI resistance among the 53 exposed children, adjusting for age, sex, and socioeconomic indicators. Sensitivity analyses included propensity score matching and stratification. Three factors were independently associated with reduced AKI risk: older age (adjusted OR=0.58 per year, 95% CI [0.36-0.92], p = .021), multivitamin supplementation (aOR=0.24, 95% CI [0.06-0.85], p = .028), and exposure to a single contaminated medicine (aOR=4.21 for ≥2 vs 1 medicine, 95% CI [1.12-16.85], p = .034). A dose-response relationship was observed, with AKI odds increasing 4-fold per additional contaminated medicine (p-trend = .018). Promethazine oral solution showed strongest toxicity (aOR=4.15, 95% CI [1.15-15.82]), consistent with highest DEG concentration (19.4 mg/mL). Multivitamin effects were strongest in children <18 months (aOR=0.15, 95% CI [0.02-0.81]). Findings remained robust across propensity score-matched analyses. Study limitations include small sample size of resistant children (n = 16), potential recall bias, wide confidence intervals, and possible residual confounding of multivitamin associations by socioeconomic and health literacy factors. Substantial heterogeneity exists in pediatric DEG susceptibility. Younger age, polypharmacy with multiple contaminated products, and absence of multivitamin supplementation were independently associated with increased AKI risk. These findings suggest potential targets for risk stratification and prophylactic strategies, though observed multivitamin associations require prospective validation with attention to confounding before clinical implementation.

55. The role of citizen science in mosquito-borne disease surveillance and control: A scoping review.

期刊: PloS one 发表日期: 2026 链接: PubMed

摘要

Mosquito-borne diseases (MBDs) pose substantial global health and economic burdens. Although conventional MBDs surveillance systems remain essential, they are often resource-intensive, uneven in coverage, and often insufficiently responsive to spatio-temporal variations in mosquito presence and risk. Citizen science, increasingly enabled by mobile and digital technologies, offers a scalable complement to expand surveillance reach and timeliness. However, existing reviews have not comprehensively integrated evidence across diverse dimensions of citizen science applied to MBDs surveillance and control. We conducted a systematic search of PubMed, MEDLINE, CINAHL, Scopus, and Web of Science from January 1, 2000, to October 17, 2025, to identify peer-reviewed studies examining citizen science applications in MBDs surveillance and control. Data were extracted and synthesized on study characteristics, participation objectives, recruitment strategies, citizen-generated data and technologies, validation mechanisms, effort-bias handling, analytical approaches, public health outputs, reported biases and methodological limitations, and ethical and governance practices. Of 3,734 records identified, 61 studies met inclusion criteria, with most published after 2017 (93.4%). Studies were conducted in Europe (44.3%) and the Americas (21.3%), with minimal representation from Asia (3.3%). Malaria-related surveillance was most common (23.0%), followed by dengue (13.1%), with other mosquito-borne diseases examined only sporadically, including West Nile virus (4.9%), Usutu virus (1.6%), La Crosse virus (1.6%), and California serogroup viruses (1.6%). Most studies were conducted in urban settings (47.5%), followed by mixed urban-rural contexts (36.1%), with relatively few exclusively in rural areas (18.0%). Mosquito Alert was the most frequently reported platform (23.0%), followed by GLOBE Observer (13.1%) and iNaturalist (11.5%). Commonly reported outputs included trend analyses (52.5%), risk-factor identification (44.3%), spatial predictions (42.6%), hotspot mapping (19.7%), and risk modeling (16.4%). Reporting of ethical and governance practices was inconsistent across studies. The growing body of evidence indicates that citizen science can enhance mosquito surveillance, particularly for monitoring invasive species and spatio-temporal trends. Nevertheless, gaps in methodological rigor, representativeness, and ethical transparency limit its broader operational use.

56. The library of isolated bacteria from gut microbiota in classical fish models: Zebrafish (Danio rerio), marine (Oryzias melastigma) and freshwater (Oryzias latipes) medaka.

期刊: PloS one 发表日期: 2026 链接: PubMed

摘要

Zebrafish (Danio rerio), Marine medaka (Oryzias melastigma), and freshwater medaka (Oryzias latipes) are three major animal species in evaluation of environmental pollutant toxicity and building of human disease models with conserved physiological and molecular pathways. Bacterial strains from gut microbiota should firstly be isolated for their functions’ exploration. In this study, we optimized a culture-based workflow under aerobic and anaerobic conditions to recover intestinal bacteria from adult zebrafish (ZF), marine medaka (MM), and freshwater medaka (OL) using both dissection-based and in vivo sampling. The isolates were then identified by Gram staining, 16S rRNA gene sequencing, phylogenetic analysis, and API 20E-based biochemical characterization. The culturable bacteria isolated from gut microbiota were identified belonged to 14 genera in ZF, 12 genera in MM, and 18 genera in OL. Comparative analysis showed clear differences in the composition of cultured gut bacteria among the three fish species. Overall, the library and the differences of gut bacteria in three key fish models provided the potential applications of bacterial strains as the probiotics, to against the fish pathogens and to increase the pollutant toxicity-resistant. Moreover, the bacterial library will support the deep researches combined with germ-free (GF) animals to clarify the relationships of intestinal microbiota to host health.

57. Knowledge, attitudes, and practices (KAP) regarding occupational protection among orthopedic theatre nurses using orthopedic power tools (OPTs): A cross-sectional study.

期刊: PloS one 发表日期: 2026 链接: PubMed

摘要

The objective of this study was to explore the factors associated with the knowledge, attitudes, and practices (KAP) of orthopedic theatre nurses with regard to occupational protection when orthopedic power tools (OPTs) are used to provide a reference for ensuring the occupational safety of nurses working in orthopedic surgery rooms. This cross-sectional survey involved 272 orthopedic theatre nurses across eight tertiary hospitals in Shanxi Province, China, between September and December 2024. An occupational protection assessment tool that was self-developed and included 3 dimensions (Knowledge, Attitude, and Practice), containing a total of 45 items, was utilized among operating theatre nurses with OPTs. The median as the cutoff, 52.9% (144/272) of respondents had an adequate Knowledge score, while 47.1% (128/272) had a good score; 54.0% (147/272) of the respondents had a positive Attitude score, and 46.0% (125/272) had a negative attitude; 53.7% (146/272) of the participants demonstrated good performance in the Practice score, whereas 46.3% (126/272) showed poor performance. Multivariable regression analysis revealed that the knowledge scores of those with a bachelor’s degree (aOR=7.040; 95% CI: 3.204-15.466; p < 0.001), senior professional title (aOR=5.216; 95% CI: 1.228-22.155; p = 0.025), occupational protection training frequency less than 6 months (aOR=10.085; 95% CI: 4.146-24.533; p < 0.001) or 6-12 months (aOR=6.550; 95% CI: 3.262-13.153; p < 0.001) and actively consulting the latest professional protection knowledge (aOR=2.652; 95% CI: 1.426-4.931; p = 0.002) were higher and statistically significant. Senior title (aOR=5.226; 95% CI: 1.409-19.387; p = 0.013), occupational exposure (aOR=2.770; 95% CI: 1.484-5.169; p = 0.001) and Knowledge scores (aOR=2.663; 95% CI: 1.581-4,448; p < 0.001) yielded attitude scores that were higher and statistically significant. Attitude scores (aOR=3.683; 95% CI: 2.106-6.441; p < 0.001), actively consulting the latest professional protection knowledge (aOR=2.962; 95% CI: 1.686-5.201; p = 0.001), and higher Knowledge scores (aOR=2.255; 95% CI: 1.294-3.930; p = 0.004) were independently associated with better practice scores. Nurses in the orthopedic operating room had a positive attitude toward the occupational protection of using power tools, but their knowledge was insufficient, and their practice behavior was poor. Normative guidelines for occupational protection in the workplace of an orthopedic theatre and a training and evaluation system should be developed. Moreover, future measures should focus on education and training for occupational protection. Additionally, developing and designing occupational protective equipment that is more convenient for orthopedic surgery is important. This research was designed as a cross-sectional survey study that was conducted in strict accordance with the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines.

58. Prevalence and determinants of suboptimal health status among outdoor labor workers in Chengdu, Southwest China: A cross-sectional study.

期刊: PloS one 发表日期: 2026 链接: PubMed

摘要

Suboptimal health status, termed sub-health, is a global public health problem. It is an intermediate health condition between health and disease. This study aimed to investigate the prevalence of chronic sub-health conditions among outdoor labor workers in Chengdu (a major city in Southwest China) and identify its associated risk factors. The Sub-Health Measurement Scale Version 1.0 (SHMS V1.0) was used to investigate the occurrence of sub-health conditions and their risk factors. Participants from four main outdoor occupations (drivers, construction workers, security guards, couriers) were surveyed to analyze the occurrence of sub-health and the associations between sub-health and other socio-demographic factors as well as exercise habits, using Pearson’s correlation analysis and the multifactorial binary logistic regression model. A total of 1030 questionnaires were distributed and 902 questionnaires were recovered (88% recovery rate). Excluding the invalid questionnaires due to omitted questions, multiple choices, etc., 705 questionnaires were retained (78% validity rate) and the prevalence of varying degrees of sub-health was 80.28%. Several significant correlating factors of the sub-health condition were identified, such as age, year of outdoor service, marital status, family size, monthly income, drinking habit, and regular participation in exercise. The incidence of subhealth was relatively high among outdoor workers, while no significant age-related difference was observed. The incidence also varies across the different occupations (i.e., drivers > security guards > construction workers > couriers). Future targeted measures to alleviate these contributing factors may improve the sub-health status of outdoor labor workers.

59. Midwifery and nursing students' occupational health hazards and safety competence perceptions: a cross-sectional study from Türkiye.

期刊: Revista da Escola de Enfermagem da U S P 发表日期: 2026 链接: PubMed

摘要

The study was aimed at investigating occupational health hazards that midwifery and nursing students are exposed to during their clinical practice and their perceptions of occupational safety competence. The study included 289 midwifery and 458 nursing students. Data were collected using the Student Information Form and Occupational Health and Safety Perceived Competency Scale. During their clinical practice, students were most frequently exposed to sharps injuries. Most students who experienced an occupational accident reported the incident to more than one authority. Multiple linear regression analysis indicated that the factors predicting occupational safety competence perceptions were department, choosing the department willingly, perceiving the training adequate, and being aware of the occupational health and safety measures. This study identified that midwifery and nursing students are most frequently exposed to sharps injuries during clinical practice, primarily due to inexperience and inattention. Students who received adequate occupational health and safety training, chose their department willingly, and were aware of preventive measures demonstrated higher perceived occupational safety competence. The findings confirm that both educational background and personal factors significantly affect students’ safety perceptions, highlighting the need for comprehensive and standardized occupational health and safety training in health education programs.