公共卫生研究摘要 (2026-05-19)

共收录 56 篇研究文章

1. Genomic diversity and the domestication history of cotton (Gossypium hirsutum).

期刊: Proceedings of the National Academy of Sciences of the United States of America 发表日期: 2026-May-26 链接: PubMed

摘要

Gossypium hirsutum is the leading fiber crop globally, but its origin as a domesticated plant and patterns of diversity in the wild remain to be elucidated. Here, we use extensive sampling of wild populations and comparative genome sequence data to illuminate the scope and patterning of wild cotton diversity across its native range. Analyses confirm the hypothesis that the Yucatán Peninsula (México) is the center of domestication, from which the original perennial forms and later modern annualized cultivars were derived. Population structure and phylogenomic analyses indicate that northwestern Yucatán harbors greater genetic diversity relative to smaller, geographically dispersed populations in northeastern Yucatán and the Caribbean basin. Genetic load and transposable element burden also are the lowest in northwestern Yucatán relative to other regions, consistent with its greater diversity and reflecting the effects of historical genetic bottlenecks in other populations. Populations from Florida and elsewhere in the Caribbean basin maintain unique pockets of diversity. Analyses of selection suggest that cotton domestication entailed long-term accumulation of mutations with relatively minor phenotypic effects, as opposed to a more punctuated process involving major domestication genes. Our study quantifies the scope and scale of genomic diversity in wild cotton, the origin of the cultivated gene pool, and the likely ecological and anthropogenic processes that shaped extant diversity and modern geographic patterning.

2. Multivalent mRNA vaccine platform with compatible antigens conferred broad-spectrum protection against orthoebolaviruses' exposure.

期刊: Proceedings of the National Academy of Sciences of the United States of America 发表日期: 2026-May-26 链接: PubMed

摘要

Several orthoebolaviruses have been established, including Orthoebolavirus zairense [for Ebola virus (EBOV)], Orthoebolavirus sudanense [for Sudan virus (SUDV)], and Orthoebolavirus bundibugyoense [for Bundibugyo virus (BDBV)]. Orthoebolaviruses are highly virulent pathogens that cause severe disease in humans. However, most existing vaccines primarily target EBOV, and fail to provide robust cross-protection against other lethal orthoebolaviruses. The development of a broad-spectrum vaccine has the potential to efficiently mitigate outbreaks caused by multiple orthoebolaviruses. In this study, we developed and evaluated a broad-spectrum mRNA vaccine, designated [GPs+NP]@LNP, formulated with a single lipid nanoparticle (LNP) platform to encapsulate a mixed mRNA payload encoding the glycoproteins (GPs) of EBOV, BDBV, and SUDV, along with the nucleoprotein (NP) of EBOV. This rational antigenic combination was designed to engage both humoral and cellular arms of the immune system. Consistent with this design, the compatibility of humoral immunity-driving GPs and cellular immune-dominating NPs supports complementary immune responses, which together are associated with broad and durable protection against EBOV, BDBV, and SUDV in animal models. Antigenic coordination within a single LNP formulation may therefore represent an effective strategy to optimize vaccine immunogenicity, protective effect, durability, and safety. Collectively, these findings highlight [GPs+NP]@LNP as a promising approach for the development of next-generation vaccines targeting multiple pathogenic orthoebolaviruses.

3. The role of reduced aerosol masking from air pollutant emission reductions in recent global warming acceleration (2013-2023).

期刊: Proceedings of the National Academy of Sciences of the United States of America 发表日期: 2026-May-26 链接: PubMed

摘要

In recent years, the Earth has likely experienced an accelerated warming trend, raising growing interest in the possible contributing factors. From 2013 to 2023, global anthropogenic air pollutant emissions declined significantly and brought enormous public health benefits, but the contribution of reduced aerosol masking of greenhouse warming to recent trends remains uncertain. Using two state-of-the-art global climate models, we show that global air pollutant emission reductions during 2013-2023 caused a global effective radiative forcing of 0.16 W/m2 (90% CI: 0.13 to 0.20), with international shipping, China, and other land regions contributing 0.05 W/m2 (0.00 to 0.09), 0.07 W/m2 (0.03 to 0.11), and 0.05 W/m2 (0.00 to 0.09), respectively. International shipping contributes disproportionately to radiative forcing relative to its emission reductions, highlighting its high forcing efficiency. The combined forcings are estimated to have contributed a warming of 0.044 °C (0.012 to 0.076) over 2013-2023, accounting for 52% (14 to 90%) of the observed warming acceleration (0.084 °C/decade) relative to the 1970-2012 trend. Especially strong reductions in aerosol-cloud interactions are found over the North Pacific, driven primarily by the downwind impacts of East Asian emission reductions. Aerosol unmasking contributes to the recent acceleration of warming and highlights the importance of accurately quantifying air pollutant emission changes for future climate projections.

4. Quantitative Ergonomic Assessment of Long Handle Farming Tools Among Women Farmers Using Camera-Based Analysis.

期刊: Journal of agricultural safety and health 发表日期: 2026-May-22 链接: PubMed

摘要

Moderate handle lift angles (27°-56°) and handle lift heights (545-1111 mm) reduce hip/shoulder flexion. Lighter tools (<2.0 kg) lower MSD risk; heavier ones boost leverage for taller users. D-grip handles with natural curves enhance wrist alignment and comfort (64% preference). Adjustable designs can accommodate diverse anthropometrics to mitigate physical strain. The design and characteristics of agricultural hand tools, including shovels and pitchforks, are essential for reducing physical strain and enhancing task efficiency among women farmers. This study investigates the ergonomic performance of conventional shovels and pitchforks in reducing physical strain among women farmers. A sample of seven female participants performed simulated farm tasks, scooping and throwing straw using 10 shovels and 8 pitchforks selected from an initial pool of 24 and 19, respectively. Tool mechanical parameters (weight, handle lift height, handle length, and handle lift angle) were measured with digital instruments, while user posture and biomechanical strain were assessed via 3D pose estimation using commercial AI-based ergonomic software (TuMeke). The software provided peak joint angles and calculated RULA and REBA scores as approximate indicators of musculoskeletal risk, and mechanical advantage was calculated using measured effort and resistance arm lengths. Two-way ANOVA analyses revealed statistically significant differences (p < 0.05) in hip and shoulder angles and mechanical advantage between tool types (shovels versus pitchforks) and handle grip designs (D-grip with natural inward curve versus straight handles). Results indicate that tools featuring moderate handle angles (27°-56°), handle lift heights aligning with typical standing elbow heights (545-1,111 mm), and lighter weights (<1.5-2.0 kg) effectively reduced awkward postures, as evidenced by lower peak hip and shoulder flexion angles and improved RULA/REBA scores. Conversely, heavier tools, while offering a higher mechanical advantage, imposed greater strain on the upper body. Additionally, approximately 64% of participants preferred D-grip handles with natural inward curves, which enhanced wrist alignment and overall comfort. This study highlights the importance of tool designs tailored to anthropometric variability. Tools with adjustable handle lift heights and moderate handle lift angles might improve health, reduce physical strain, and enhance productivity. Future research should explore broader anthropometric diversity, advanced analytical methods, and additional tool configurations to refine ergonomic recommendations.

5. How Big Is the "Gray Area"? Navigating Health-Threatening Previability Pregnancy Complications in States With Abortion Restrictions.

期刊: Annals of internal medicine 发表日期: 2026-May-19 链接: PubMed

摘要

6. Protecting the Integrity and Quality of the Medicare Advantage Program: A Position Paper From the American College of Physicians.

期刊: Annals of internal medicine 发表日期: 2026-May-19 链接: PubMed

摘要

Medicare Advantage (MA), the private plan option within Medicare, now enrolls more than half of all beneficiaries and is projected to keep expanding. The American College of Physicians (ACP) assesses the ethical and policy dimensions of this growth and its implications for the delivery of fair, high-quality, and fiscally responsible care to older adults and persons with disabilities. Payment and risk adjustment policies have created vulnerabilities to overpayment and favorable risk selection, whereas quality measurement remains fragmented and overly complex. Beneficiaries often face challenges in navigating plan choice, marketing practices, prior authorization, and access to clinicians and postacute services, with these barriers disproportionately affecting persons with low income, persons with several chronic conditions, or persons who live in rural communities. Limited transparency about ownership structures and relationships between insurers, “provider” networks, and investors complicates accountability and public oversight. ACP calls for reforms to ensure accurate payment, streamline and strengthen quality metrics, and protect enrollees from inappropriate utilization controls while supporting innovations that promote coordinated, patient-centered care. Collaborative engagement among policymakers, clinicians, health systems, insurers, and beneficiaries is essential to align MA with its original purpose and ensure that it complements traditional Medicare while providing accessible, affordable, and high-quality coverage for all who depend on it.

7. Subarachnoid hemorrhage from a basilar artery perforator pseudoaneurysm: a rare challenging lesion in the posterior circulation. Illustrative case.

期刊: Journal of neurosurgery. Case lessons 发表日期: 2026-May-18 链接: PubMed

摘要

Basilar artery perforator pseudoaneurysms are rare vascular lesions that present significant diagnostic and therapeutic challenges. Their management remains unstandardized, with limited evidence guiding treatment decisions. The authors report the case of a 74-year-old man with multiple comorbidities who presented with subarachnoid hemorrhage (SAH). Initial CT/CT angiography revealed diffuse SAH with intraventricular extension. Digital subtraction angiography demonstrated a pseudoaneurysm arising from a basilar perforator. The absence of an accessible inflow combined with the prohibitive procedural and surgical risks, neither endovascular embolization nor open surgery was attempted. Thus, conservative management was pursued, and repeat angiography on postoperative day 2 revealed spontaneous thrombosis of the pseudoaneurysm. Despite radiographic resolution, the patient’s course was complicated by vasospasm, infarction, and persistent coma, resulting in the patient’s death on day 21. Basilar perforator pseudoaneurysms are rare lesions that may be occult on initial imaging; repeat angiography is essential when posterior-circulation SAH lacks an identified source. Endovascular treatment risks perforator occlusion or require antiplatelets in an acute SAH setting. Open surgery also has its limitations with deep exposure, lack of proximal/distal control, and intraoperative rupture. Since neither route is safely feasible, conservative management with intensive neurocritical care and serial imaging is often the management approach. Unfortunately, radiographic thrombosis does not ensure recovery. https://thejns.org/doi/10.3171/CASE25779.

8. Impact of climate, air pollution, and urbanization on chronic respiratory infections.

期刊: Expert review of respiratory medicine 发表日期: 2026-May-18 链接: PubMed

摘要

chronic respiratory infections represent a significant source of global morbidity and mortality, especially among individuals with structural lung diseases or compromised defenses. Emerging evidence highlights the role of environmental factors - such as climate change, air pollution, and urbanization - in the epidemiology and progression of these infections. this review synthesizes current research on the interactions between climate conditions, pollution, and urbanization in bronchiectasis, cystic fibrosis, nontuberculous mycobacterial (NTM) pulmonary disease, and chronic pulmonary aspergillosis. A search of relevant medical literature in the English language was conducted in Medline/PubMed, EMBASE and Scopus up to January 2026. Increases in temperature, fluctuations in humidity, extreme weather events (e.g. heatwaves, floods, and cold spells), and elevated concentrations of particulate matter contribute to both pathogen proliferation and increased host susceptibility, which impact the severity and incidence of chronic respiratory infections, particularly those caused by environmental pathogens such as non-tuberculous mycobacteria and Aspergillus spp. respiratory infections. Higher urban density and changes in microbial ecosystems further enhance transmission and chronicity. Understanding the complex interactions between environmental stressors and respiratory health and incorporating environmental risk assessment into clinical practice and public health policy is crucial for reducing disease burden in the context of accelerating climate change.

9. Multimodal Personalized Mobile Health Just-in-Time Adaptive Intervention for Occupational Stress Management: Pilot Study.

期刊: JMIR mHealth and uHealth 发表日期: 2026-May-18 链接: PubMed

摘要

As digital health solutions gain traction, there is an urgent need for effective, person-centered stress management tools for employees. Advances in wearable stress monitoring and machine learning now enable the collection of high-resolution, real-time data and the delivery of personalized interventions with respect to both timing and content. Despite this technological progress, there remains a notable paucity of mobile health (mHealth) interventions that capitalize on these capabilities to implement just-in-time adaptive interventions (JITAIs). This pilot study aimed to examine the preliminary effects of the RELAX mHealth app, which uses a JITAI framework to reduce occupational stress, with a particular focus on initial indications of stress reduction, the influence of the app’s degree of personalization on these effects, and overall user experience. A 2-arm randomized trial was conducted with 46 employees across two phases of 3 weeks each. Participants used the RELAX mHealth app, which adapts intervention timing based on real-time stress data and tailors content according to users’ preferences. Stress was assessed via multiple heart rate variability (HRV) parameters measured with wearable sensors, alongside subjective questionnaires and ecological momentary assessment (EMA) questionnaires. Usability and user satisfaction were also evaluated. In the second phase, a group randomization was implemented, with two groups of different degrees of in-app personalization. The findings were mixed. While selected subjective stress indicators decreased from baseline to the end of the study, one physiological measure increased. Retrospective chronic stress (P=.048) and arousal related to the most recent stress event prior to EMA entry (P=.02) were reduced; however, the low frequency (LF)-to-high frequency (HF) ratio of HRV increased (P=.03). Other stress variables, such as work-related stress, valence of daily experiences, and momentary arousal, showed no change over the course of the study. No between-group differences were observed with respect to the assigned degree of personalization. Additionally, usability increased (P<.001), whereas satisfaction decreased at a trend level (P=.05). Although the results provide selective preliminary indications of stress reduction with app use, the variability of outcomes raises concerns about its current practical utility. The effects are also discussed with regard to the specific design of the prototype and the study setup. Technical issues and user discomfort were noted despite increasing usability over the study period, indicating areas for improvement in the developed prototype. Given the absence of a control group and the use of interventional arms only, no definitive conclusions about effects can be drawn. Nevertheless, this study highlights both the potential and the challenges of a personalized mHealth approach to occupational stress management. Further refinement of the app and more comprehensive evaluations are needed to fully understand the impact and functional usability of this JITAI-based approach in real-world settings.

10. Supervised and Self-Directed Technology-Based Dual-Task Exercise Training Program for Older Adults With a History of Falls: Mixed Methods Feasibility Study.

期刊: JMIR aging 发表日期: 2026-May-18 链接: PubMed

摘要

Older adults who have fallen are at an increased risk of future falls. Training cognitive and physical functions simultaneously, known as dual-task (DT) training, has been shown to improve mobility and reduce fall risks. With appropriate digital tools, such as smartphones and mobile apps, it is possible to deliver DT training in unsupervised, home-based settings, thereby increasing accessibility beyond the clinical environment. This study aimed to evaluate the feasibility and acceptability of a technology-based DT training program delivered through a blended model of supervised and self-directed sessions for older adults with a history of falls. Perspectives of health care professionals working in fall-prevention services were also explored. A single-arm, nonrandomized feasibility study was conducted with 45 community-dwelling adults aged 65 years or older with a history of falls. Participants were recruited through primary care practices, secondary care fall-prevention services, and community outreach. The 24-week DT program, which integrated balance and strength exercises with cognitive training using a mobile app, was delivered in two phases: (1) for12 weeks, weekly 50-minute physiotherapist-led group classes in the community, and 2 additional 50-minute self-directed sessions at home, and (2) for 12 weeks, 3 weekly 50-minute self-directed sessions at home. Feasibility and acceptability were assessed through recruitment and retention rates, adherence, app usage, and self-reported satisfaction. Qualitative data were obtained from focus groups with 28 participants who completed the program and 16 health care professionals. Quantitative data were analyzed descriptively, and qualitative data were analyzed thematically. We recruited 45 of the target 50 participants, with most participants (n=41) recruited through community pathways; 4 were recruited via National Health Service (NHS) pathways. Adherence was 64%, with higher adherence during phase 1 (81%) than phase 2 (50%). App usage was high (95%), and self-reported program satisfaction was moderate to high. Retention at 24 weeks was 76%, and no adverse events occurred. The qualitative findings supported the program’s feasibility and acceptability, emphasizing social connection and tailored exercises as key to adherence-especially in home-based sessions. Health care professionals identified community organizations and referral pathways as the most practical routes for implementation. A blended, technology-based DT training program is both feasible and acceptable for older adults at risk of falling and can be effectively delivered beyond clinical settings. Community-based recruitment outperformed NHS pathways, highlighting the value of community engagement. These findings support the feasibility and acceptability of a full-scale trial, with targeted refinements to recruitment, support structures, and delivery to maximize scalability and impact.

11. Communication between intensive care unit doctors and general practitioners: A sequential multiphase project to increase prevalence of communication.

期刊: Australian critical care : official journal of the Confederation of Australian Critical Care Nurses 发表日期: 2026-May-18 链接: PubMed

摘要

General practitioners (GPs) serve a pivotal role in the healthcare system and typically have substantial insights into their patients’ health. However, communication between intensive care unit (ICU) medical staff and GPs is infrequent. To explore communication between ICU medical staff and GPs, and codesign a strategy to increase communication. A sequential multiphase project comprising (i) a survey; (ii) development of a protocol to promote communication; and (iii) quantification of the effect of introducing the protocol. Participants were ICU medical staff from a single-hospital and GPs from 12 clinics. Outcomes were survey responses and ICU documentation of communication with a GP before (July-September 2023) and after (July-September 2024) the introduction of a communication protocol. Fifty-one ICU doctors and 47 GPs provided survey responses. Communication was reported to “rarely” or “never” occur by 30 (64%) GPs and 29 (57%) of ICU respondents. All but one respondent (1 GP) considered ICU-GP communication to be helpful. Most (100% ICU doctors, 85% GPs) preferred to communicate by telephone, and approximately half (53% ICU doctors, 57% GPs) thought this should occur only if ICU staff needed information rather than for all ICU admissions. A communication protocol was developed, encouraging ICU doctors to have a telephone call with the GP of patients with unplanned or ≥48-h ICU admissions. ICU doctors contacted GPs for 1.5% of admissions (12/784) before and 2.1% of admissions (17/801) after introduction of a communication protocol (P = 0.45). ICU medical staff members and GPs value communication about their patients who are critically ill. A strategy to increase prevalence of ICU medical staff calling GPs was not effective, and further research is required to improve this.

12. Heart failure and cardiomyopathies: epidemiology, mechanisms, and new therapeutic targets.

期刊: European heart journal 发表日期: 2026-May-18 链接: PubMed

摘要

13. "Empty Places…People Could Not See": Structural Barriers Faced by US-Based International Medical Graduates.

期刊: Teaching and learning in medicine 发表日期: 2026-May-18 链接: PubMed

摘要

Purpose: International medical graduates (IMGs) have long sustained the US healthcare system. In the US, 25% of practicing physicians are IMGs, who are pivotal for delivering primary and preventive care and for tending to first-generation immigrants. Despite their contributions, studies primarily have focused on individual challenges and difficulties of IMGs. In contrast, structural barriers-and their impact on IMGs’ private lives and emotional wellbeing-are rarely discussed. Using the example of Asian IMGs in the US, we explored structural barriers that complicate everyday thriving, including family wellbeing, work conditions, and emotional life. Method: We conducted a constructivist, qualitative interview study with 20 IMG physicians (60% female) in 2023. We purposefully sampled across multiple specialties, clinical settings, and geographic areas. The average time serving as an attending was 11.8 years. We recorded and transcribed semi-structured interviews, which lasted 45-60 minutes. With attention to IMGs’ positionality, we applied reflexive thematic analysis and Burgess-Proctor’s strategies for engaging with and empowering participants. We also drew on Ahmed’s theory of the politics of emotions to inform our interpretation. Results: IMGs described interconnected structural barriers rooted in the US visa system, including financial hardship, prolonged family separation, and sponsorship-dependent career precarity. Beyond these constraints, participants also encountered institutional selection bias and professional gatekeeping, including an invisible ceiling, tokenization, and limited recognition of IMG status within broader diversity discourse. While expressing gratitude for US career opportunities, participants reported a significant emotional toll characterized by guilt and shame tied to outsider positioning and pressures to justify their legitimacy in US training. Discussion: Structural barriers have a profound impact on IMGs’ relational and emotional lives. What might appear as a personal hardship-such as family separation-is in fact a consequence of structurally imposed constraints. Participants pointed to concrete areas where institutional practices could change, including formalized mentorship structures, stronger institutional accountability, more explicit inclusion practices, and policy advocacy. Addressing these inequities will require institutional engagement, with implications for sustaining the US physician workforce.

14. Cost-Effectiveness of Immune Checkpoint Inhibitor Therapy plus BCG for High-Risk Non-muscle Invasive Bladder Cancer: Analyses of CREST, POTOMAC, and ALBAN.

期刊: The Journal of urology 发表日期: 2026-May-18 链接: PubMed

摘要

Three recent trials evaluated immune checkpoint inhibitors (ICI)+BCG for treatment of high-risk non-muscle invasive bladder cancer (HR-NMIBC). Two of these trials (CREST, POTOMAC) demonstrated that ICI+BCG improved event-free survival compared with BCG alone but resulted in higher rates of treatment-related adverse events. Herein, we evaluated the cost-effectiveness of ICI+BCG compared with BCG alone. We then created a publicly available cost-effectiveness calculator to facilitate future NMIBC drug value comparisons. We used a Markov model to compare sansalimab+BCG to induction and maintenance BCG alone for BCG-naïve high-risk NMIBC. Efficacy and toxicity probabilities were extracted from the CREST trial. One-way and probabilistic sensitivity analyses were performed. Incremental cost-effectiveness ratios (ICERs) were compared using a willingness-to-pay threshold of $100,000/quality-adjusted life year (QALY). Analyses were repeated using POTOMAC and ALBAN data. From a U.S. Medicare payer’s perspective, the combination of sasanlimab+BCG resulted in 0.03 additional QALYs (6.12 vs 6.09) at an additional cost of $145,940 relative to BCG alone. Combination therapy was found not to be cost-effective over a lifetime horizon (ICER = $6,316,217/QALY). On one-way sensitivity analysis, the combination of sasanlimab+BCG became cost-effective only if the cost of sasanlimab was reduced by > 94% (to $1399/treatment). Similar findings were found from a U.K. perspective and with data from POTOMAC/ALBAN. ICI+BCG is not cost-effective as a combination therapy relative to BCG alone. Further efforts are needed to improve the efficacy/toxicity profile of novel therapies, while continued scrutiny of the health system cost implications of new agents remains warranted.

15. Frequency and persistence of post-acute symptoms after chikungunya, dengue, Zika, and malaria in travellers: a prospective multi-centre study.

期刊: Journal of travel medicine 发表日期: 2026-May-18 链接: PubMed

摘要

Long term follow-up data on the travel-associated burden of vector-borne diseases (VBDs) are scarce. A prospective multi-site observational study was conducted to delineate the longitudinal course, symptom patterns, physical and mental burden, and factors associated with prolonged illness in travellers after four VBDs. Patients with confirmed travel-associated acute chikungunya, dengue, Zika, or falciparum malaria were recruited at 15 GeoSentinel sites from 2016 to 2021. Persistent signs and symptoms were evaluated at one, three, six, 12 and 18 months (M) post-diagnosis, using a multi-modular study questionnaire with quality of life (QOL) evaluated by 12-item short-form health survey (SF-12). Demographic, premorbid, and acute disease characteristics were tested in multivariate analyses to determine factors associated with persistence of symptoms at M3. Missing data were imputed by rules and statistical methods. Among 273 patients enrolled, 35 (13%) had chikungunya, 110 (40%) dengue, 19 (7%) Zika, and 109 (40%) falciparum malaria. Median age was 38 years (interquartile range 30-49), 148/273 (54%) were men. At M3, 24/35 (69%) of chikungunya, 27/110 (25%) of dengue, 8/19 (42%) of Zika, and 12/109 (11%) of malaria patients had persistent symptoms. The proportion of symptomatic chikungunya patients was 18/35 (51%) at M6, mainly due to musculoskeletal symptoms including arthritis and stiffness. In dengue patients, fatigue and musculoskeletal symptoms without arthritis persisted until one year. Zika patients reported persisting headaches, musculoskeletal symptoms including arthritis, and fatigue. One month after malaria, fatigue was the main persisting symptom, which resolved almost completely at M3. At M12, 6/35 (17%) of chikungunya, 5/110 (5%) dengue, 3/19 (16%) Zika, and only 1/109 (1%) of malaria patients were still symptomatic.Impaired QOL was noted at M3 by 23/35 (66%) of patients with chikungunya, 20/110 (18%) with dengue, 6/19 (32%) with Zika, but only 4/109 (4%) with malaria. Female sex, Zika, chikungunya, and musculoskeletal symptoms during acute infection were associated with persistent M3 symptoms. Post-arboviral symptoms and impaired QOL persisted beyond six months after chikungunya, dengue and Zika. In contrast, post-malaria fatigue syndrome resolved within three months.

16. Development of the Japan College of Rheumatology guidance on musculoskeletal ultrasound scanning protocol in rheumatology practice (revised edition).

期刊: Modern rheumatology 发表日期: 2026-May-18 链接: PubMed

摘要

To describe the methodological framework and consensus-based decision rules that underpin the revised guidance on musculoskeletal ultrasound scanning protocols in rheumatology practice. A systematic literature search of musculoskeletal ultrasound imaging and assessment methods was conducted to extract candidate anatomical structures and the corresponding scanning techniques from the included articles. A Delphi survey of the Guidance Development Panel selected the sites for inclusion. Iterative consensus meetings defined standardised scanning procedures for each structure, including patient positioning, limb orientation, probe placement, scanning direction, and key anatomical landmarks to be captured on the ultrasound images. A total of 3 168 unique records were identified, of which 36 were included after screening. Based on the included articles and the first edition, a list of 159 candidate anatomical structures across the seven regions was compiled (including two structures added during the consensus process). Through the Delphi process, 50 structures were endorsed for inclusion in the guidance. An image atlas was produced presenting the standardised views used in routine practice and the scanning procedures for the recommended structures. This revised guidance provides standardised musculoskeletal ultrasound scanning methods for rheumatic diseases based on a systematic literature search and structured consensus process.

17. AI-Enabled Digital Health Promotion and Prevention: Computational Literature Review.

期刊: JMIR AI 发表日期: 2026-May-18 链接: PubMed

摘要

Health promotion aims to strengthen individuals’ and communities’ capacity to maintain health and well-being through behavior change, empowerment, and supportive environments. Achieving this requires interventions that are timely, personalized, and scalable-qualities increasingly supported by artificial intelligence (AI). However, research on AI-enabled health promotion remains fragmented, organized primarily around technological labels rather than the intervention purposes these tools serve, limiting the cumulative understanding of how AI techniques are applied across health promotion contexts. This study systematically maps peer-reviewed research on AI-enabled digital health promotion interventions to clarify how AI techniques are organized across intervention purposes, target users, and delivery contexts. We conducted a large-scale computational literature review of 6328 peer-reviewed journal articles using natural language processing and unsupervised machine learning. Topic modeling identified latent thematic structures, and scientometric analyses examined research clusters and application patterns across health promotion contexts. The analysis identified dominant application clusters organized into three broad intervention contexts: (1) AI-enabled digital technologies embedded in health promotion applications, (2) clinical and data-driven AI systems supporting preventive care and health promotion decision-making, and (3) population-level and policy-oriented applications of AI in public health promotion. This study provides a structured synthesis of how AI techniques are applied in digital health promotion interventions, organized by intervention context, target population, and health promotion purpose, facilitating comparison across applications beyond technological form alone. The findings support more purpose-sensitive design, evaluation, and governance of AI-enabled health promotion applications and offer a foundation for cumulative research in this rapidly expanding field.

18. Assessing the spatial clustering of climate change-related cardiovascular disease mortality in Iran: a spatiotemporal analysis approach.

期刊: International journal of biometeorology 发表日期: 2026-May-18 链接: PubMed

摘要

Cardiovascular diseases (CVD) are a major global health challenge, with rising prevalence, high mortality and disability rates, and significant economic costs. Emerging research suggests that climate change worsens these risks. This study aims to assess the impact of climate change on CVD mortality. This study analyzed validated national CVD mortality data from 2017 to 2019, with annual recorded deaths of 18,146; 21,945; and 24,352, respectively. These figures were aggregated to form the basis for subsequent analysis. We utilized advanced spatial statistical techniques, including Anselin Local Moran’s I and Hot Spot Analysis (Getis-Ord Gi), to assess CVD mortality patterns. Additionally, GIS were employed to identify and analyze climate change impacts at the township level, enabling a comprehensive spatial understanding of environmental and health-related factors. Following temperature, climate, and topographic assessments, an initial national zoning of these parameters was conducted. Analysis of spatial patterns revealed significant heterogeneity in CVD mortality across Iran’s diverse climate zones, which range from arid deserts to mountainous regions. Hotspot analysis (Getis-Ord Gi) identified significant high-risk clusters, particularly in the central arid regions, and low-risk clusters in other areas. The findings demonstrate a clear association between extreme climatic conditions, geographic features, and elevated cardiovascular mortality rates. Climate change and environmental factors significantly influence CVD mortality in Iran. Rising extreme heat events threaten cardiovascular health, especially among vulnerable groups. To combat this, targeted public health strategies and adaptive measures are needed to reduce heat-related risks nationwide.

19. Electroacupuncture Ameliorates Depressive-Like Behaviors by Enhancing Autophagy to Attenuate Hippocampal Neuroinflammation via the VEGF/AKT1/ERK Pathway in CUMS Rats.

期刊: Neurochemical research 发表日期: 2026-May-18 链接: PubMed

摘要

The high prevalence of depression and limitations of current antidepressants necessitate alternative therapies. Electroacupuncture (EA) shows promise, but its mechanisms remain unclear. Hippocampal impairment in depression involves neuroinflammation linked to defective autophagy. This study investigated whether EA alleviates depressive-like behaviors by enhancing autophagy via the VEGF/AKT1/ERK pathway to attenuate hippocampal neuroinflammation. Bioinformatic analysis of the GEO dataset GSE53987 was performed to identify autophagy- and neuroinflammation-related differentially expressed genes in depression. A chronic unpredictable mild stress (CUMS) rat model was used for validation. Rats were divided into control, CUMS, EA, EA + VEGFR2 inhibitor (SU5416) (EA+SU5416), EA + 3-methyladenine (3-MA), and FXL (fluoxetine) groups. Comprehensive assessments included behavioral tests, Nissl staining for histomorphology, transmission electron microscopy (TEM) for neuronal ultrastructure, immunofluorescence(IF), immunohistochemistry (IHC), Western blot (WB), enzyme-linked immunosorbent assay (ELISA), and reverse transcription quantitative polymerase chain reaction (RT-qPCR) to evaluate therapeutic effects and hippocampal alterations, focusing on VEGF/AKT1/ERK pathway expression and phosphorylation. AKT1 was identified as a key gene linking autophagy and inflammation. CUMS rats exhibited upregulation of hippocampal AKT1 transcription but decreased phosphorylation, along with enrichment of the VEGF pathway. EA at LI4/LR3 significantly ameliorated depressive-like behaviors and hippocampal damage in CUMS rats. Mechanistically, EA upregulated hippocampal VEGF expression and promoted synergistic phosphorylation of AKT1 and ERK. This was accompanied by enhanced autophagic activity (increased LC3-II/I ratio, decreased p62) and attenuated neuroinflammation (reduced IL-1β, TNF-α). Co-administration of the VEGFR2 inhibitor SU5416 largely abolished these therapeutic effects, including behavioral improvement, AKT1/ERK phosphorylation, autophagy enhancement, and anti-neuroinflammation. Furthermore, the autophagy inhibitor 3-MA also blocked EA’s benefits, indicating autophagy as the essential downstream executor. EA ameliorated depressive-like behaviors in CUMS rats, suggesting that the mechanism may involve the activation of the VEGF/AKT1/ERK pathway, leading to enhanced autophagy and attenuated hippocampal neuroinflammation.

20. Associations of sleep, outdoor activity, and sedentary time with depressive symptoms among secondary school students in Wuhan: an isotemporal substitution analysis.

期刊: European child & adolescent psychiatry 发表日期: 2026-May-18 链接: PubMed

摘要

To examine the associations between sleep,outdoor activity, sedentary time, and depressive symptoms among secondaryschool students in Wuhan, using an isotemporal substitution model. This prospective cohort study included 2,615 secondary school students in Wuhan. All participants were free of depressive symptoms at baseline in September 2023 and were followed up in September 2024. Sleep duration, outdoor activity time, and sedentary time were assessed using questionnaire surveys, and depressive symptoms were measured using the Center for Epidemiologic Studies Depression Scale (CES-D). Multivariate logistic regression models were applied to analyze the association between time-use behaviors and depression. Restricted cubic spline models were used to explore the dose-response relationship. Isotemporal substitution models were further employed to evaluate the impact of time reallocation between different behaviors on depression risk under the assumption of fixed total time. A total of 2,615 secondary school students were included in this study. After one year of follow-up, 456 students developed depression (17.4%). Sleep duration was inversely associated with incident depressive symptoms, while sedentary time was positively associated with depressive symptoms (P < 0.05). However, after adjustment for relevant confounders, the association between sedentary time and depressive symptoms was no longer statistically significant. Isotemporal substitution analysis revealed that, with total time spent in the assessed behaviors held constant, replacing 1 h of sedentary time (OR = 0.89, 95% CI: 0.81-0.97, P = 0.008) or 1 h of outdoor activity time (OR = 0.84, 95% CI: 0.73-0.97, P = 0.019) with 1 h of sleep was associated with a lower risk of incident depressive symptoms. Sufficient sleep was consistently associated with a lower risk of depressive symptoms among secondary school students, whereas sedentary time may be a potential risk factor that requires further investigation in future studies.

21. Alert fatigue measurement in clinical decision support: a systematic review.

期刊: Journal of the American Medical Informatics Association : JAMIA 发表日期: 2026-May-18 链接: PubMed

摘要

Alert fatigue is defined as alert dismissals due to excessive or irrelevant alerts and is frequently cited as a barrier to clinical decision support system use and impact. However, the criteria for determining the presence or absence of alert fatigue are poorly defined. The objective of this systematic review of systematic reviews was to identify operationalized definitions and measures of alert fatigue or alert-related metrics. Systematic reviews reporting at least one alert-related metric or measure/operationalization of alert fatigue for physician-directed electronic alerts were included. The Cochrane Library, Embase, and PubMed were searched from database start to 2024. The Revised Assessment of Multiple Systematic Reviews was used to assess study quality and risk of bias. Data were synthesized narratively and with descriptive statistics. A total of 22 studies were included in the review. Studies reported between 1 and 11 alert metrics. Studies were most often of medium quality. Reporting of primary study characteristics was frequently judged to be insufficient. Only one article reported an operational definition of alert fatigue. The most common alert metrics were quantity, override rate, and acceptance rate. Alert fatigue measurement methods are not clearly or consistently defined in systematic reviews related to alert fatigue in clinical decision support. Reporting of other primary study characteristics is often limited. We recommend that future efforts use a significant, sustained decrease in appropriate alert response rates from an established baseline as a measure of alert fatigue.

22. Inoculation of Bacillus velezensis SD24 enhancing the accumulation of tea catechin secondary metabolites.

期刊: Microbiology spectrum 发表日期: 2026-May-18 链接: PubMed

摘要

Tea (Camellia sinensis) is a globally significant economic crop, and its desirable quality and health benefits are largely credited to catechin derivatives. Plant growth-promoting rhizobacteria (PGPR), such as Bacillus velezensis, are well-known for enhancing the environmental fitness and disease resistance of plants. However, the regulation of their impact on tea catechin biosynthesis remains unclear. While previous studies have focused on PGPR-facilitated growth promotion in crops like tomatoes and rice, the physiological mechanisms by which microbes regulate secondary metabolism in tea-especially under co-inoculation conditions-remain largely underexplored. This study examined the effects of B. velezensis SD24, isolated from tea rhizosphere soil, on catechin derivative accumulation of tea leaves by altering gene expression and the rhizosphere microbiome. Strain SD24 exhibited broad-spectrum antimicrobial activity against various pathogens due to behaving antimicrobial gene clusters. Tea plants inoculated with SD24 showed significantly increased levels of catechin derivatives in their leaves. This was likely achieved by upregulation of leucoanthocyanidin reductase and anthocyanidin reductase within the phenylpropanoid pathway. Additionally, chlorophyll content was increased. Transcriptomic analysis revealed a notable enrichment in biosynthesis of secondary natural products among the tea genes activated by SD24 inoculation. Metagenomic analysis further demonstrated that SD24 inoculation led to a restructuring of the tea rhizosphere microbiome. Notably, co-inoculation with Piriformospora indica, a beneficial endophytic fungus, suppressed SD24-induced gene expression and catechin accumulation, underscoring its antagonism toward SD24. These findings suggest that B. velezensis SD24 enhances tea quality, probably by transcriptionally activating the synthesis of catechin derivatives, a process associated with the restructuring of the rhizosphere microbiome.IMPORTANCEThe mechanisms through which plant growth-promoting rhizobacteria (PGPR) influence secondary metabolism in perennial crops remain poorly understood. This study demonstrates that Bacillus velezensis SD24, a tea rhizosphere isolate, significantly enhances the accumulation of health-beneficial catechin derivatives in tea leaves. This quality improvement is associated with transcriptionally upregulating key biosynthetic genes (LAR and ANR) and concurrently restructuring the rhizosphere microbiome. Furthermore, we reveal a critical antagonistic interaction, where the beneficial fungus Piriformospora indica suppresses these SD24-induced effects. Our findings provide crucial insights into how specific PGPR strains may directly enhance tea quality by affecting host plant metabolism and the root microbiome, highlighting the complex and tailored microbial interactions that could be harnessed for sustainable agriculture.

23. Moyamoya disease presenting with repeated ruptures of a lateral posterior choroidal artery aneurysm: illustrative case.

期刊: Journal of neurosurgery. Case lessons 发表日期: 2026-May-18 链接: PubMed

摘要

Peripheral aneurysms may develop along collateral pathways in patients with moyamoya disease (MMD); however, their optimal management remains unclear. The authors report a case of a lateral posterior choroidal artery aneurysm associated with MMD that ruptured three times within a short period, along with a review of the literature. A 54-year-old woman with MMD, who had remained asymptomatic for 19 years, developed an intraventricular hemorrhage 1 month after periventricular aneurysm dilation was detected on annual imaging follow-up. Rebleeding occurred on days 7 and 10, and vertebral angiography revealed a 6-mm aneurysm in the distal segment of the left posterior choroidal artery. Transarterial embolization using liquid material achieved complete occlusion of the aneurysm; however, the patient developed right hemiparesis due to a left corona radiata infarction and was transferred to a rehabilitation hospital, with a modified Rankin Scale score of 5. Rebleeding from peripheral aneurysms associated with MMD is a predictor of poor prognosis, and spontaneous aneurysm regression during observational management or after bypass surgery requires several months. Accordingly, when such peripheral aneurysms are detected, early revascularization should be planned. However, in cases of rupture, prompt aneurysm-directed treatment, including endovascular or microsurgical intervention, is warranted to prevent clinical deterioration. https://thejns.org/doi/10.3171/CASE26167.

24. Global Disparities in Liver Transplantation Relative to the Burden of Cirrhosis and Other Chronic Liver Diseases (2000-2023).

期刊: Transplantation 发表日期: 2026-May-18 链接: PubMed

摘要

Global access to liver transplantation (LT) remains highly unequal. We analyzed worldwide patterns of LT activity, donor source, and their alignment with disease burden across sociodemographic strata. We combined country-level LT data from the Global Observatory on Donation and Transplantation (2000-2023) with prevalence and mortality estimates for cirrhosis and other chronic liver diseases from the Global Burden of Disease 2021 Study (2000-2021). LT rates and donor source were analyzed across Sociodemographic Index (SDI) categories. LT capacity was benchmarked against age-standardized prevalence rates and age-standardized mortality rates. Associations between LT intensity and the mortality-to-prevalence ratio were evaluated using pooled correlations, within-country analyses, and 2-way fixed-effects models adjusting for country-year and calendar year. From 2000 to 2023, LT activity was concentrated in high-SDI countries, whereas low-SDI countries relied almost exclusively on living donation but had extremely low overall LT rates. When benchmarked against age-standardized prevalence rates and age-standardized mortality rates, LT capacity showed a strong inverse gradient across SDI, with substantial heterogeneity among high- and middle-SDI countries. Within-country and 2-way fixed-effects models demonstrated a small but significant inverse association, indicating that higher LT activity was associated with lower mortality relative to disease prevalence at the population level. Global LT capacity remains poorly aligned with the burden of cirrhosis and other chronic liver diseases and is driven more by health system development than epidemiological need. Although prevention remains central, incremental expansion of equitable LT infrastructure may be associated with modest improvement in population-level mortality relative to disease prevalence.

25. Utilization and performance of a rapid treponemal antibody test for diagnosis of syphilis in a high-risk population at an urban county hospital.

期刊: Sexually transmitted diseases 发表日期: 2026-May-18 链接: PubMed

摘要

Rapid detection of syphilis infection enables timely antibiotic treatment to prevent long-term complications and further transmission. We implemented a treponemal rapid lateral flow immunochromatographic test that was performed by trained clinical laboratory personnel on a 24/7 basis in an urban county hospital. From March 2023 to February 2024, 461 rapid syphilis tests (RSTs) were performed on serum from 449 patients. Specimens were also tested by a conventional reverse algorithm beginning with an enzyme immunoassay (EIA), followed by a rapid plasma reagin (RPR) test, and when necessary, an additional treponemal test to resolve discordant results. Most patients (349, 77.7%) initially presented to the emergency department. The most common patient risk factors for syphilis were substance use disorder (51.9%) and unstable housing (42.8%). Compared to the reverse algorithm, RST sensitivity was 52.2%, specificity 98.2%, positive predictive value 83.7%, and negative predictive value 92.1%. After excluding 45 patients who had a documented prior history of syphilis, RST sensitivity was 83.3%, specificity 98.2%, positive predictive value 74.1%, and negative predictive value 99.0%. Nearly all of the 33 patients testing negative by the RST but positive by EIA were more likely to have been treated for a previous infection: 27 had a documented history of treatment and 30 had undetectable or low RPR titers (<1:2). The median RST turnaround time was 1.6 hours compared to 197.8 hours for reverse algorithm screening. RST is a useful option for high-risk patients in urban settings. Other testing methods are preferable for previously treated syphilis, and conventional follow-up testing is required to confirm results.

26. Congenital myopathies in adult patients: lived experiences and coping mechanisms.

期刊: Disability and rehabilitation 发表日期: 2026-May-18 链接: PubMed

摘要

To study the impact of congenital myopathies in adult patients’ lives and their coping mechanisms to live a fulfilling life, in an era with no treatments on the horizon. We conducted a qualitative study with semi-structured interviews among Dutch adult patients with congenital myopathies, exploring their experiences of living with the condition. Data from the interviews were analysed through open coding and thematic analysis using Atlas.ti version 24.0.0. Sixteen adult patients (50% females; age range of 26-72 years) were interviewed during January-April 2024. Six main themes were identified: disease management, self-management, personal development, social participation, support, and illness acceptance. Coping strategies were related to aspects of the disease, personal traits of patients and their social environment. This study provided a comprehensive perspective going beyond physical functioning, that also considered personal, social, and environmental factors that are crucial for coping with the disease and understanding its impact. These experiences offer valuable insights for clinicians, patients and family members, helping to support patients in finding fulfilment in life. We can learn from the specific experiences of patients who have lived their life with a congenital myopathy to help other (younger) patients with this condition.These experiences reflect a perspective that emphasises being alongside the person with a chronic medical condition, rather than solely focusing on the disease.Clinicians should be aware of the different coping strategies of patients to provide them effective support.

27. Direct Identification and Quantification of Nanoplastics in Aqueous Environments via Dual-Channel Electrothermal Vaporization-Microplasma-Based Point Discharge-Optical Emission Spectrometry (DC-ETV-μPD-OES).

期刊: Analytical chemistry 发表日期: 2026-May-18 链接: PubMed

摘要

A miniaturized analytical platform integrating dual-channel electrothermal vaporization-microplasma-based point discharge-optical emission spectrometry (DC-ETV-μPD-OES) has been developed for the direct identification and quantification of nanoplastics (NPs) in aqueous samples. Unlike conventional approaches that rely on time-consuming and potentially loss-inducing pretreatment steps like “filtration-drying”, this system introduces an innovative “evaporation-pyrolysis” dual-channel design, enabling direct introduction and analysis of liquid suspensions. By incorporating a three-way valve and a silica gel drying unit, the platform effectively redirects and removes water vapor, significantly improving plasma stability and analytical reproducibility. Under optimized conditions, the method delivered linear responses (R2 > 0.998) for polystyrene (PS) NPs, poly(methyl methacrylate) (PMMA) NPs, polylactic acid (PLA) NPs, and polyvinyl chloride (PVC) NPs across a concentration range of 5-227 mg C/L, with detection limits between 4.08 and 11.02 mg C/L. Machine-learning-assisted classification─particularly using the k-nearest neighbors (KNN) algorithm─achieved 100% accuracy in polymer discrimination based on spectral fingerprints. Analysis of spiked environmental water samples yielded recoveries (84.6-109.1%), confirming the method’s reliability for real-world applications. This work establishes a portable, low-energy-consumption alternative to conventional laboratory-based techniques, offering a practical and promising tool for on-site screening and quantification of NPs in aquatic environments.

28. Prediabetes and brain health: early signal or modest risk marker?

期刊: European journal of preventive cardiology 发表日期: 2026-May-18 链接: PubMed

摘要

29. The Data Science of Health in Space.

期刊: Annual review of biomedical data science 发表日期: 2026-May-18 链接: PubMed

摘要

Spaceflight exposes humans to unique stressors that remodel biology. Space health is emerging as a data science discipline grounded in multiomic atlases, harmonized biobanks, and open, findable, accessible, interoperable, and reusable (FAIR)-aligned infrastructures. We review this ecosystem, including the National Aeronautics and Space Administration (NASA)’s GeneLab; the Open Science Data Repository, European Space Agency, and Japan Aerospace Exploration Agency (JAXA) platforms; the Space Omics and Medical Atlas; and mission-specific repositories, and how it is used to integrate heterogeneous omics with clinical, environmental, and digital phenotypes. We highlight machine learning and causal inference approaches to identify conserved signatures of risk and resilience and to align astronaut datasets with large terrestrial cohorts and disease models. Spaceflight functions as an accelerated model of aging and systems-level stress, enabling discovery of biomarkers and countermeasures with reciprocal benefits for Earth-based medicine. Finally, we outline future directions, including countermeasure-prioritization pipelines; astronaut digital twins and virtual organs; operational analytics and wearables for personalized risk management; and federated, privacy-preserving data ecosystems that extend predictive, individualized space health to the operational edge.

30. Systematic review of health risk assessment in Africa's bushmeat trade: Are there any risks assessed?

期刊: PLoS neglected tropical diseases 发表日期: 2026-May-18 链接: PubMed

摘要

The bushmeat trade in tropical Africa represents a major route for zoonotic disease emergence. Yet, the extent to which health risks have been quantitatively assessed remains unclear. Therefore, our study aimed at systematically reviewing health risk assessments conducted in the African bushmeat trade, and identifying methodological patterns and research gaps. Following PRISMA guidelines, we searched Web of Science and Google Scholar (to November 2024) using multilingual Boolean queries. Eligible studies included any research assessing health, zoonotic, or food-borne risks in bushmeat value chains across Africa. Two co-authors independently cross-validated c. 23% of extracted data. Descriptive statistics and generalized linear models were used to explore publication patterns and predictors of research output. From 449 records finally identified, 129 met inclusion criteria. Ethnobiological and public health surveillance approaches dominated (41.1% each), while epidemiological studies were scarce. Most publications appeared after 2017, mainly from Cameroon, Nigeria, and the Democratic Republic of Congo, with epidemic occurrence significantly predicting national research output. Interviews were the most frequent method (44.8%), while pathogen detection occurred in 40.3% of studies, identifying 66 confirmed human pathogens (23 viruses, 19 bacteria, 24 parasites). More than 88% of studies did not report survey effort, and none implemented a formal quantitative health risk assessment. Quantitative health risk assessment in the African bushmeat trade remains unattainable due to scarce data on pathogen prevalence, exposure, and host-pathogen interactions. Only formal recognition and state-regulated management of the trade-incorporating molecular surveillance, host-pathogen ecological data, and supply-chain mapping within a One Health framework-will enable reliable risk quantification.

31. The Future of Survivorship in Critical Illness.

期刊: JAMA 发表日期: 2026-May-18 链接: PubMed

摘要

32. Decision-making for indoor residual spraying in the post-elimination phase of visceral leishmaniasis in Nepal.

期刊: PLoS neglected tropical diseases 发表日期: 2026-May-18 链接: PubMed

摘要

The effectiveness of indoor residual spraying (IRS) during the post elimination phase of visceral leishmaniasis (VL) and when to stop its application is uncertain. This study investigated the relationship between VL occurrence and frequency of IRS on vector density, infection rates, and insecticide susceptibility. Four villages in the Sarlahi district served as sentinel surveillance sites for sandfly density measurement and xeno-monitoring, selected based on VL endemicity levels of high, moderate, low and non-endemic (no reported cases in the past 10 years). A random sub-sample of households from each village was selected for sandfly surveillance. The sample size of 380 was determined to detect a 1% infection rate of sandflies with 95% confidence interval. Ecological and epidemiological data were collected and IRS activity data between 2012-2023 was analysed. Sandflies were collected using CDC light traps and mouth aspirators for 12 months from March 2023 to February 2024 and tested with PCR for kDNA of Leishmania donovani. Monthly density of female Phlebotomus argentipes sandflies varied across endemicity levels, with a peak in November, with fluctuations observed throughout the year. Village wise sandfly pools positivity with parasite DNA varied with level of endemicity (66.7% in high VL endemicity villages, 62.1% in moderate, 36.8% in low, and 26.3% in non-endemic villages). Overall, among the total 91 pools of sandflies tested, 50.5% were positive for parasite DNA. P. argentipes showed high susceptibility to insecticides alpha-cypermethrin, bendiocarb, deltamethrin, and malathion. There were differences in IRS applications with variations in coverage and frequency and programmatic factors across municipalities, with no IRS conducted in some villages. Occupational distribution varied across endemicity levels, and there were differences in sleeping habits during warm weather. Non-impregnated bed nets were available across all endemicity levels. IRS should be continued in the villages based on surveillance of sandfly density and reports of VL cases in the post elimination phase of VL.

33. Reduced physical activity during submarine deployment: health and performance consequences and feasible countermeasures - a narrative review.

期刊: Journal of occupational health 发表日期: 2026-May-18 链接: PubMed

摘要

Submarine environments pose unique challenges to maintaining physical activity due to space constraints, operational demands, and prolonged confinement. This review aims to synthesize existing literature on the health and performance consequences of reduced physical activity in submarine personnel and to examine feasible strategies to mitigate these effects during deployment. A narrative overview methodology was adopted, with peer-reviewed studies identified from PubMed, Scopus, and Google Scholar. Articles examining physical activity patterns, health outcomes, and exercise or movement-based interventions in submarine environments and comparable confined operational settings were included. Submarine deployments are consistently associated with reduced physical activity, low step counts, and limited opportunities for structured exercise. Prolonged inactivity during deployment may contribute to unfavorable changes in body composition, including increases in fat mass, potential reductions in muscle mass, and in some contexts, alterations in bone health. Collectively, these changes may increase longer-term cardiometabolic and musculoskeletal risk, particularly with repeated deployments. Practical, low-burden strategies such as increasing daily movement, no-load or bodyweight resistance exercise, and minimal-dose eccentric-focused training appear feasible within submarine constraints and may help preserve health and physical function. Maintaining physical health during submarine deployments requires proactive, context-specific approaches compatible with the operational environment. Low-resource exercise strategies that emphasize maintenance of activity, rather than performance optimization, may provide a practical means of mitigating health and performance declines during deployment. Further research is needed to determine the long-term effectiveness and implementation of these approaches in submarine populations.

34. Trauma in Health Care Settings: A Twelve-year Medico-legal Case Series and Comparative Analysis of Out-of-court Versus In-court Litigation.

期刊: Journal of patient safety 发表日期: 2026-May-18 链接: PubMed

摘要

Falls and traumas in the hospital setting represent one of the main categories of preventable adverse events, with significant clinical, medico-legal, and economic consequences. The phenomenon particularly affects the elderly population and is amplified by demographic aging, patient clinical complexity, and the structural characteristics of health care facilities. This retrospective study analyses traumatic claims received by the Claims Management Committee of the Policlinico San Martino Hospital in Genoa between 2013 and 2024. All traumatic events occurring within the hospital and related to care or work activities were included. For each case, the event dynamics, type of injury or death, medico-legal process, and amounts paid were analyzed. Extrahospital traumas, nontraumatic claims, and cases lacking adequate documentation were excluded. Out of 1796 total claims, 150 (8.35%) involved traumatic events. Cases showed a predominance of females (70.7%) with a mean age of 64 years. Structural risk was the most frequent (43.3%), followed by clinical risk (34.7%) and occupational risk (22.0%), highlighting the role of environmental hazards. Injuries were mostly fractures (79%), frequently affecting the lower limbs; cranial trauma accounted for the majority of deaths (8%). Seventy-six percent of disputes were resolved extrajudicially, while 20% proceeded to judicial settlement. The total expenditure amounted to €2,447,412.90 (≈$2,820,000), with significantly higher average costs in judicial cases. Hospital traumatic events have a significant clinical, medico-legal, and economic impact. Integrated preventive strategies and increased extrajudicial management are key elements to reduce traumatic events and related claims.

35. Intersectionality and health inequalities among minoritized groups in Europe: A cross-sectional MAIHDA study.

期刊: Social science & medicine (1982) 发表日期: 2026-May-15 链接: PubMed

摘要

Health inequalities in Europe are often examined using unidimensional socioeconomic variables, which can mask heterogeneity within minoritized populations. This study applies Multilevel Analysis of Individual Heterogeneity and Discriminatory Accuracy (MAIHDA) to examine how minority group, gender, age, and education jointly pattern self-rated health among migrants and native-born ethnic minorities in 28 European Union countries. We included 22,611 participants from the European Union Minorities and Discrimination Survey (EU-MIDIS II, 2016). The sample comprised immigrants from North Africa, Sub-Saharan Africa, South Asia, Turkey, and other parts of Asia; recent migrants; and two native-born minority groups (Roma and individuals of Russian background). We analyzed 64 strata defined by minority groups, age, gender, and education, with country random intercepts. Using multilevel logistic and linear models for self-rated health, we quantified general contextual effects (VPC), specific contextual effects, and discriminatory accuracy (AUC). The results reveal a multidimensional social gradient in self-rated health. Roma and individuals of Russian background reported the poorest health outcomes, while Asian and recent migrant groups had comparatively favourable profiles. A substantial portion of the total variability in self-rated health is structured by intersectional strata, indicating that health inequity among minoritized groups in Europe is not reducible to the independent contribution of each social dimension but reflects the convergence of ethnicity, sex, age, and socioeconomic position. These results show substantial heterogeneity within and between minoritized groups in Europe. Effective public health responses require intersectional policy frameworks that move beyond single-axis approaches to address the structural drivers of health inequity.

36. Health equity, consensual care and the work that survivors of violence do to navigate healthcare services.

期刊: Social science & medicine (1982) 发表日期: 2026-May-14 链接: PubMed

摘要

This article responds to the need for research examining the experiences of survivors of violence in navigating health care services in Canada. Backed by neoliberal government agendas and public sector shortages, responsibilities for healthcare provision have shifted from the state to individuals, including to those who provide and rely on care. This article focuses on the healthcare experiences of survivors of violence, as they navigate and negotiate their own care needs in relation to Canadian healthcare services. We extend previous research that, to date, focuses on how experiences of violence impact survivors’ short-term and long-term health, on what factors lead to survivors of violence seeking out healthcare, and on how the system can best address their needs. Drawing on qualitative findings from an online survey (N = 435) and semi-structured interviews (N = 71) with survivors based in Canada, our study makes three key contributions. First, we explicate inaccessible, inadequate or fragmented services, and the improper provision of care by workers who are themselves constrained. Second, we elaborate the ‘work’ that survivors themselves do to navigate their care, including to monitor changes in their health, access quality healthcare, advocate for their own needs, and educate themselves. Attending to this brings organizational relations and neoliberal logics of care into view. Third, we identify promising practices and organizational conditions to improve healthcare services, with insights that underscore the importance of consensual care and that offer a fuller conception of “health equity” that recognizes the importance of consent.

37. Migration status, discrimination, and recent sexually transmitted infection testing among South Asian gay, bisexual, and other queer men living in Canada.

期刊: Social science & medicine (1982) 发表日期: 2026-May-14 链接: PubMed

摘要

South Asian gay, bisexual, and queer men (SA GBQM) living in Canada report that racism and heterosexism negatively impact their sexual health. There is a paucity of research examining associations between these forms of stigma, migration status, and sexually transmitted infection (STI) testing for this population. We conducted a pooled analysis of Sex Now 2019 and 2021 - online, national, cross-sectional surveys of GBQM. We used modified Poisson regression models (adjusted for age, income, education, disability, and pre-exposure prophylaxis use for HIV) to examine the effects of migration status (born in Canada versus not) and past-year discrimination (racism and heterosexism) on recent STI testing. Using causal mediation decomposition, we estimated the pure direct, pure indirect, mediated interaction, and total effects. Among 197 SA GBQM, 59% were migrants and 62% were recently tested for STIs. Past-year experiences of racism and heterosexism were self-reported by 64% and 34% of participants, respectively. Recent STI testing was higher among non-migrants compared to migrants [unadjusted prevalence ratio: 1.65 (95% confidence interval: 1.10-2.49)]. Past-year racism was higher among migrants compared to non-migrants (1.32; 1.05-1.66). However, there was no statistically significant difference in experiencing past-year heterosexism between these two groups. Only the pure direct effect estimate for the multivariable racism models was statistically significant (1.80; 1.15-3.37), indicating non-migrant SA GBQM who did not experience racism were more likely to be recently tested than migrants. Addressing intersectional stigma and barriers to sexual health services experienced by migrant SA GBQM may improve testing over time.

38. Laser therapies as the adjunctive treatment of medication-related osteonecrosis of the jaw: Evidence synthesis and clinical recommendations. Official recommendations of the World Federation for Laser Dentistry (WFLD) and the Polish Society for Laser Dentistry (PTSL).

期刊: Dental and medical problems 发表日期: 2026-May-14 链接: PubMed

摘要

Medication-related osteonecrosis of the jaw (MRONJ) is a severe complication associated with antiresorptive and antiangiogenic therapies. Laser-based approaches, including photobiomodulation therapy (PBMT) and erbium laser-assisted surgery, have been proposed as adjunctive interventions to improve healing and clinical outcomes. This consensus-based review aimed to synthesize evidence from systematic reviews and meta-analyses evaluating laser-based therapies in the prevention and treatment of MRONJ, and to translate these findings into clinical recommendations developed by the World Federation for Laser Dentistry (WFLD) and the Polish Society for Laser Dentistry (PTSL).The review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 and Joanna Briggs Institute (JBI) guidance, and was prospectively registered in the International Prospective Register of Systematic Reviews (PROSPERO). An electronic search of the PubMed/MEDLINE, Embase, Scopus, and Cochrane Library databases was conducted for systematic reviews and meta-analyses published between January 2015 and October 2025. Study selection, data extraction and methodological assessment were performed independently by 3 reviewers.Eighty-five records were identified, and 14 reviews met the inclusion criteria. These included several hundred primary studies, mainly observational studies and case series. Laser-based interventions were primarily used as adjuncts to conventional MRONJ management. Photobiomodulation therapy was associated with pain reduction and improved soft tissue healing, while erbium-doped yttrium aluminum garnet (Er:YAG) laser-assisted surgery enabled the precise removal of necrotic bone. Combined protocols showed generally favorable trends. However, substantial heterogeneity in study design, laser parameters and outcome definitions precluded quantitative synthesis.Laser-based therapies may provide beneficial adjunctive effects in MRONJ management, particularly within multimodal treatment strategies. However, the strength of these conclusions is limited due to substantial heterogeneity in study design, laser protocols and outcome reporting.

39. Frailty, Sarcopenia, and Functional Decline After CAR-T Therapy: The Case for Structured Rehabilitation.

期刊: Cardiology in review 发表日期: 2026-May-14 链接: PubMed

摘要

Chimeric antigen receptor T-cell (CAR-T) therapy has revolutionized the treatment landscape of relapsed or refractory hematologic malignancies, offering unprecedented response rates and durable remissions in diseases such as B-cell acute lymphoblastic leukemia, diffuse large B-cell lymphoma, and multiple myeloma. By genetically engineering autologous T cells to recognize tumor-associated antigens, CAR-T therapy enables targeted immune-mediated cytotoxicity against malignant cells. Although early clinical experience has largely focused on acute toxicities including cytokine release syndrome and immune effector cell-associated neurotoxicity syndrome improving survival has shifted attention toward the long-term health status of survivors. As the population of CAR-T recipients grows, a broader survivorship framework that incorporates functional outcomes and quality of life has become increasingly important. Emerging evidence suggests that frailty, sarcopenia, and progressive functional decline represent underrecognized complications in patients recovering from CAR-T therapy. These impairments may result from multiple converging factors including systemic inflammation, prior intensive chemotherapy, prolonged hospitalization, corticosteroid exposure, and physical inactivity during treatment. Such changes may have important cardiovascular implications, including reduced cardiorespiratory fitness, impaired exercise tolerance, and increased vulnerability to cardiovascular morbidity. Despite these risks, structured rehabilitation programs remain poorly integrated into CAR-T survivorship care.

40. Associations of PFAS and phthalate/DINCH metabolites with metabolic regulation in teenagers from the HBM4EU aligned studies.

期刊: Environment international 发表日期: 2026-May-12 链接: PubMed

摘要

Exposure to per- and polyfluoroalkyl substances (PFAS) and phthalates is widespread during adolescence, a critical developmental period for metabolic regulation. To assess associations of serum PFAS and urinary phthalate/DINCH metabolites-individually and as mixtures-with a unified panel of metabolic biomarkers representing adipose-brain-liver cross-talk and oxidative stress in European teenagers. Serum PFAS and urinary phthalate/DINCH metabolites were measured in 1033 European teenagers (12-17 years) from the Human Biomonitoring Initiative for Europe (HBM4EU) Aligned Studies. Metabolic biomarkers representing adipose (HDL, LDL, cholesterol, and triglycerides)-brain (leptin, adiponectin, and kisspeptin)-liver (glucose, insulin) cross-talk and oxidative stress (8-hydroxy-2’-deoxyguanosine, 8OHdG) were measured. The Body Mass Index z-score (zBMI) was calculated. Single pollutant models, multivariate MANOVA, quantile g-computation, and BKMR models were fit, including interaction terms with sex. Single pollutant models showed positive associations of PFAS and phthalate/DINCH metabolites with 8OHdG. PFAS were associated with higher leptin, HDL, LDL, and cholesterol, while some phthalate/DINCH metabolites were associated with lower kisspeptin, HDL, triglycerides, cholesterol, zBMI, and higher adiponectin. We observed weak but statistically significant associations between PFAS and phthalate/DINCH metabolites with the entire set of metabolic biomarkers in the MANOVA. The PFAS mixture was associated with higher kisspeptin, LDL, HDL, cholesterol, and 8OHdG. The phthalate/DINCH mixture was associated with lower HDL. Exposure to these contaminants may be related to dyslipidemia in teenagers. PFAS and phthalate/DINCH metabolites may exert opposite associations on metabolism, with the exception of increasing oxidative stress. Given the cross‑sectional design and potential residual confounding, longitudinal studies are warranted.

41. Umbilical cord-derived mesenchymal stem cells synergize with biomimetic collagen scaffolds to drive structural cervical regeneration.

期刊: Biomaterials 发表日期: 2026-May-06 链接: PubMed

摘要

The regeneration of functional cervical tissue for congenital or acquired defects remains an unmet clinical challenge. While decellularized extracellular matrix scaffolds offer structural support, their regenerative capacity is inherently limited for critical-sized, full-thickness cervical defects. Here, we developed a composite graft by seeding human umbilical cord-derived mesenchymal stem cells (UC-MSCs) onto a biomimetic, bilayer collagen scaffold (CS). In a rabbit model of complete ectocervical excision, both the CS and UC-MSCs/CS construct promoted organized, full-thickness regeneration of epithelium, vascularized stroma, and smooth muscle layers. The regenerated cervix exhibited physiological hormone receptor expression and mucus production. Notably, compared with the scaffold alone, the composite yielded a smaller cervical diameter and denser morphology, and improved biomechanical strength over six months. These results demonstrate that UC-MSCs synergize with a decellularized collagen scaffold to support structural cervical regeneration, offering a clinically translatable, “off-the-shelf” strategy for reconstructing severe cervical defects.

42. Impact of Multicancer Screening on Late-Stage Cancer at Diagnosis in Breast Cancer Survivors: A Modeling Study.

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

摘要

Breast cancer survivors are at elevated risk of multiple new primary cancers compared with the general population. The impact of multicancer screening on late-stage cancer diagnosis is under clinical investigation in average-risk individuals, but it is unclear whether findings will generalize to breast cancer survivors. We adapted an existing multicancer natural history model for the average-risk US population to reflect increased risks of second primary cancers and all-cause mortality among female breast cancer survivors. We modeled 16 cancer types other than breast cancer and specified a range of natural history parameters and screening test sensitivities to reflect uncertainty in disease onset, progression, and detectability of target cancers. We evaluated annual multicancer screening over a lifetime horizon in simulated hormone receptor-positive (HR-positive) and hormone receptor-negative (HR-negative) cohorts of survivors age 50-74 years and in age-matched women without prior cancer (average-risk women). Outcomes included absolute and relative reductions in late-stage diagnoses compared with no multicancer screening. Across a range of natural histories and test sensitivities, multicancer screening was projected to reduce 35-99 late-stage diagnoses per 100,000 person-years (PY; 9%-25% reduction) among HR-positive survivors and 39-111 per 100,000 PY (9%-26% reduction) among HR-negative survivors, compared with 30-84 per 100,000 PY (7%-20% reduction) among average-risk women. Lung cancer contributed most to the reduction in late-stage diagnoses (34%-38%), followed by colorectal cancer (14%-16%) in all populations. Ovarian cancer accounted for greater reduction in HR-negative than HR-positive survivors (10%-11% v 6%). Model-based projections suggest that multicancer screening may reduce late-stage diagnoses among breast cancer survivors more than among average-risk women. This suggests a potential role in long-term surveillance for second primary cancers in this high-risk population.

43. Systematic Review: Prognostic Molecular Biomarkers in Wilms Tumors.

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

摘要

Molecular biomarkers are increasingly used for risk stratification, particularly in up-front surgery settings (Children’s Oncology Group trials), whereas in preoperative chemotherapy setting, the ongoing International Society of Pediatric Oncology (SIOP)-Renal Tumor Study Group-2016 UMBRELLA study aims to validate selected biomarkers for future risk-adapted treatment strategies. This systematic review summarizes all literature on the prognostic value of these biomarkers. A systematic literature review (PubMed and Embase; up to January 2025) included studies with ≥50 de novo Wilms tumors (WTs). Eligible biomarkers included copy number variations; 1q gain, 1p and/or 16q loss of heterozygosity (LOH)/loss, 12 gain, 14q loss, 22 loss, 11p15 LOH/loss of imprinting (LOI), and structural somatic variants (TP53 [and/or 17p loss], MYCN, FBXW7, WT1, WTX, SIX1/SIX2, DROSHA, DGCR8, AMER1, CTNNB1, GPC3, MLLT1, DICER1, DIS3L2). Outcome included relapse-free survival, event-free survival (EFS), and overall survival (OS). Risk of bias was assessed with quality in prognosis studies tool. Low-bias multivariable/stratified analyses identified 1q gain as worse EFS and 1p and/or 16q LOH/loss as worse EFS/OS prognostic factors, in up-front nephrectomy settings. Preoperative chemotherapy settings revealed similar trends with lacking significance. TP53 and MYCN were adverse prognostic in univariate analyses. No prognostic data were available for the remaining variants. 1q gain and 1p and/or 16q LOH/loss emerge as independent prognostic biomarkers in up-front nephrectomy settings. Evidence remains limited in preoperative chemotherapy settings, particularly when using SIOP-oriented treatment algorithms. Prognostic value of TP53, MYCN, and 11p15 LOH/LOI warrants further validation in both settings. This highlights the need for adequately powered prospective studies, specifically in the preoperative chemotherapy setting, to establish reliable molecular biomarkers.

44. Illicit Alcohol in Victorian Off-Licence Retailers: A Preliminary Observational Study.

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

摘要

Illicit alcohol sales account for 90% of the alcohol-related lost tax revenue in Australia (unrecorded alcohol); however, there is a paucity of research on this segment of the alcohol market. It is currently unclear if illicit alcohol is widely available in Australia and whether it is safe for human consumption. In this preliminary investigation, to establish immediate availability, we visited four licensed alcohol retailers in high socio-economic areas of Melbourne, Victoria, during June, July and September 2025. We found and purchased three suspected illicit alcohol products and one control product and submitted all four products for chemical testing. Three out of the four retailers we visited stocked suspected illicit alcohol products. These products were the cheapest products available in their category. Two of the products we tested contained both plasticizers and methanol at levels that far exceed food safety standards. Our study confirms that illicit alcohol products are in circulation in Australia, and stocked alongside licit alcohol products by licensed retailers, in contravention of food safety, liquor and tax regulations. Regulations such as those in place in the European Union that routinise sampling and testing of food products could potentially reduce the likelihood of products such as these being stocked in stores; however, it is unclear how widely spread this practice is. There is an urgent need for trans-disciplinary research into the prevalence, nature and magnitude of illicit alcohol in Australia, to inform and justify a proactive policy approach that could curtail this market. Suspected illicit alcohol products were found stocked by licensed retailers in high socio‐economic areas in Melbourne. Chemical testing of the suspected illicit alcohol products established and quantified the presence of plasticizers and methanol in two of the products. These early findings demonstrate the urgent need to establish the prevalence of illicit alcohol products in Australia and move towards a proactive policy approach to the safety of alcohol products.

45. "You Don't Want to See Your Kids Fail": The Role of Parents in Teaching Farm Safety to Adolescents.

期刊: Journal of agricultural safety and health 发表日期: 2026-Apr-29 链接: PubMed

摘要

Farm youth acquired safety knowledge through observing their parents, receiving formal training, and being supervised during new tasks. Parent-youth pairs perceived youth farm injury risk as low, expressing confidence in the effectiveness of their existing safety practices. Parent-youth pairs acknowledged inconsistent adherence to their farm safety measures. Youth remain at great risk for injuries and fatalities on farms, particularly on family farms where home and workplace blur together. While farming hazards are well-documented, less is known about youth interactions with these hazards and the most effective strategies for providing safety training, underscoring the need to better protect this vulnerable population. This qualitative study explored the strategies that adolescents and their parents on family farms use to protect working youth from serious farm injuries and assessed the perceived effectiveness of these safety strategies. Thirty semi-structured Zoom interviews were conducted separately with fifteen parent-youth dyads. All participants lived and worked on family farms in southeastern Iowa. Youth reported learning about farm safety through training, observing their parents, and being supervised while performing new tasks. Both parents and youth identified open communication as a key element of farm safety strategies. Participants perceived the risk of youth farm injuries occurring on their farm as low, attributing this to their confidence in the effectiveness of the safety measures they implemented (e.g., training, protective equipment). However, while most participants expressed confidence in their safety training and strategies, they also acknowledged inconsistent adherence to them. These findings contribute to the body of knowledge on youth safety in agriculture, particularly in understanding how family farms protect working youth from injury, how parents deliver farm safety guidance to youth, and how effective farm safety measures are perceived to be.

46. Interleukin-6 is a mediator of therapeutic efficacy in acute lung injury.

期刊: American journal of respiratory and critical care medicine 发表日期: 2026-Apr-28 链接: PubMed

摘要

Inflammation in acute respiratory distress syndrome (ARDS) and COVID-19 causes disruption of the alveolar-capillary barrier and tissue damage, which has been associated with increased mortality. Elevated pro-inflammatory plasma biomarkers (specifically interleukin-6) levels reflect the degree of systemic inflammation, and are linked to severity of lung injury. Understanding the causal pathway between inflammation, interventions, and patient outcomes could improve clinical care. To assess IL-6 as a mediator of effective interventions in ARDS and COVID-19. We leveraged individual patient data from five large randomized controlled trials. Interventions were imatinib, anakinra, low tidal volume ventilation, high positive end-expiratory pressure (PEEP), and simvastatin. We evaluated IL-6 as a mediator for the effectiveness of interventions on 28-day survival with joint modeling. Additionally, we analyzed the role of other pro-inflammatory markers (IL-8, TNFR1, and CRP). The association between IL-6 and mortality was meta-analyzed using a random effects model. For 2563 patients, IL-6 measures were available at baseline and at least one other timepoint. IL-6 mediated the effects of imatinib, anakinra, and low tidal volume on mortality. Higher PEEP and simvastatin did not alter IL-6 trajectories. In all studies, there were associations between higher IL-6 concentrations and increased mortality over 28 days (pooled HR for a log10 unit increase = 4·83, 95% CI: 3·50 to 6·66). . The mortality benefit by Anakinra and Imatinib in COVID-19 and low tidal volume ventilation in acute lung injury may operate through resolution of inflammation defined by a reduction in plasma IL-6 levels.

47. [Evaluation of the medical and social status of hundred-year centenarians in the Chelyabinsk region.].

期刊: Advances in gerontology = Uspekhi gerontologii 发表日期: 2026 链接: PubMed

摘要

The analysis of demographic trends reveals a sustained pattern of population aging. This process is associated with both declining fertility rates and increasing life expectancy. Despite these well-documented global demographic shifts, the health status of centenarians remains understudied. The aim of this research is to assess the medical and social status of centenarians in the Chelyabinsk Region. To investigate the health of centenarians, data extraction was performed for patients aged 100 years and older. The final database comprises 72 records detailing the health status and parameters of hundred-year centenarians in the Chelyabinsk Region. Each entry includes age, sex, diagnosis upon presentation, anthropometric measurements (height, weight, BMI), and a range of laboratory indicators from complete blood count and biochemical panels. The most prevalent conditions among the centenarian population of the Chelyabinsk Region belong to the following nosological groups: «I.67 Other cerebrovascular diseases» - recorded as either a primary or concomitant diagnosis in 65,27% of patients; «I.11 Hypertensive heart disease» - 51,39%; and «I.20 Angina pectoris» - 22,22%. These conditions were found in both the group of centenarians with disability and the group without this social status. In the group of patients without disability, the diagnosis «I.11 Hypertensive heart disease» as a primary diagnosis (46,5%) upon presentation to a healthcare facility is established statistically significantly more often than in the group of centenarians with the aforementioned social status (disability) (17,24%), p<0,05. A statistically significant difference exists in the number of clinical diagnoses between individuals with disability - 5 (4-6) and those without this status - 3 (2-3,5). This supports the assertion of a link between permanent loss of working capacity and polymorbidity (p<0,001). Venous blood glucose levels are statistically significantly higher in the group of hundred-year centenarians without disability (p<0,05). Анализ демографических трендов позволяет определить устойчивую тенденцию старения населения. Процесс связан как со снижением рождаемости, так и с увеличением ожидаемой продолжительности жизни. Несмотря на описанные глобальные демографические тренды, состояние здоровья столетних долгожителей малоизучено. Цель исследования — оценка медико-социального статуса столетних долгожителей Челябинской обл. Для изучения здоровья столетних долгожителей была проведена выкопировка данных о пациентах 100 лет и старше. В итоговой базе данных представлено 72 записи о состоянии и параметрах здоровья столетних долгожителей Челябинской обл., в каждой из которых даны возраст, пол, диагноз при обращении, антропометрические показатели (рост, масса тела, ИМТ) и ряд лабораторных показателей общего анализа крови и биохимических параметров. Наиболее распространены в популяции столетних долгожителей Челябинской обл. были следующие нозологические группы: I.67 Другие цереброваскулярные болезни — установлена в качестве основного или сопутствующего диагноза у 65,27% пациентов, I.11 Гипертензивная болезнь сердца — у 51,39%, I.20 Стенокардия — у 22,22% как в группе столетних долгожителей с инвалидностью, так и в группе без данного социального статуса. В группе пациентов без инвалидности диагноз I.11 Гипертензивная болезнь сердца в качестве основного (46,5%) при обращении в медицинскую организацию устанавливали статистически значимо чаще, чем в группе столетних с описанным социальным статусом (17,24%), p<0,05. Существует статистически значимое различие между числом клинических диагнозов у людей с инвалидностью — 5 (4–6) и без данного статуса — 3 (2–3,5), что подтверждает связь стойкой утраты трудоспособности и полиморбидности (p<0,001). Уровень глюкозы венозной крови статистически значимо выше в группе столетних долгожителей без инвалидности (p<0,05).

48. Osteoprotective effects of partially defatted house cricket (Acheta domesticus) powder in spontaneously hypertensive rats.

期刊: PloS one 发表日期: 2026 链接: PubMed

摘要

Clinical evidence suggests that essential hypertension is linked to oxidative stress and inflammatory infiltration, which can complicate osteoporosis. Edible house crickets (Acheta domesticus) are novel functional foods rich in proteins, fat, dietary fibers, and micronutrients. This research investigated the effects of a partially defatted house cricket powder (PDCP) on bone microarchitecture and strength in the spontaneously hypertensive rat (SHR) model. Fourteen female SHRs were divided into the experimental group receiving 300 mg/kg/day PDCP and the control group receiving the vehicle for 4 weeks. Blood pressure was determined by the CODA® non-invasive blood pressure system. Femoral bone microarchitecture and strength were determined by micro-computed tomography (µCT) and three-point bending, respectively. Immune cells were counted using an automated machine. Results showed that in the control group, systolic blood pressure (SBP) at baseline (166.6 ± 3.7 mmHg) increased to 182.4 ± 4.7 mmHg (P = 0.016). In contrast, the PDCP-treated group showed no significant change from baseline (168.1 ± 3.9 mmHg) to post-intervention (176.9 ± 5.6 mmHg) (P = 0.156). PDCP had no effects on bone microarchitecture but improved bone strength. The post-intervention yield load (a proxy for strength) of the control group was 77.55 ± 1.88 N, compared to the PDCP-treated group of 83.58 ± 1.26 N (P < 0.009). Similarly, post-intervention yield displacement was 307.72 ± 29.78 in the control vs. 395.93 ± 40.98 µm in the PDCP-treated group. White blood cell counts in the PDCP-treated group (7.91 ± 0.27 × 103/µL) were significantly higher than those in the control (6.91 ± 0.31 × 103/µL). Specifically, lymphocyte counts in the PDCP-treated group (6.66 ± 0.22 × 103/µL) were significantly higher than those in the control (5.75 ± 0.28 × 103/µL). In conclusion, the 4-week PDCP had osteoprotective effects, presumably mediated by dietary proteins and fibers that modulate immune-vascular homeostasis, thereby potentially mitigating immune system-related hypertension and bone mechanical impairment.

49. Supported storytelling through the 'Life Threads' approach for family members after traumatic brain injury: "We've been through all of this trauma, and you're giving me some string?".

期刊: PloS one 发表日期: 2026 链接: PubMed

摘要

Traumatic brain injury (TBI) brings inevitable and significant changes for family members, yet there is little to relieve their trauma, resolve their grief, or prevent ongoing suffering. The aim of this qualitative pre-feasibility study was to understand the clinical potential of storytelling for families after TBI using the ‘Life Threads’ approach (LTA). An in-depth inductive qualitative design was adopted within an interpretivist paradigm. Following informed consent, participants took part in an online focus group, then engaged with the LTA over four weeks before completing an unstructured, in-person interview. A final focus group explored participants’ reflections on the LTA. A purposive sample of 20 family members began the study, three withdrew after the first focus group leaving a final sample size of 17. The analytical approach used was Braun and Clarke’s reflexive thematic analysis. Eleven participants reported tangible benefits from engaging with the LTA, and thirteen described being able to tell their story in a way not possible through traditional methods. Four main themes were identified: ‘Scaling Cliffs with Broken Wings’ and ‘An Entanglement of Wellbeing’ illustrated the evolving and contextual needs of families post-TBI. ‘Hear Me, See Me: The Power of Story’ highlighted how the LTA facilitated voice, agency, and sense-making, while ‘Creating the Conditions for Stories to Be Told’ identified the enabling environment required for such benefits to emerge. The findings suggest that the LTA offers a meaningful way for family members to explore, express, and make sense of their experiences following TBI. It supports narrative reconstruction, fosters connection and agency, and provides a rare opportunity for self-reflection. However, implementation must be trauma-informed, paced, and supported by skilled facilitators capable of holding space for complex emotional responses.

50. Sports-based mental health promotion for adolescents in rural Nepal: A pilot cluster-randomised controlled trial.

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

摘要

Adolescent mental health disorders are a leading contributor to the global burden of disease, particularly in low- and middle-income countries where access to care is limited. Sport offers a promising platform for mental health promotion, but evidence from rigorous evaluations in these settings is lacking. In Nepal we tested the feasibility of a mental health promotion intervention comprising football, dance and martial arts coaching and community engagement through melas (community celebrations), home visits and consultation with community advisory groups. We conducted a parallel-group, two-arm superiority pilot cluster-randomised controlled trial with 1:1 allocation ratio. The study area was four community clusters (~1000 population per cluster). We conducted pre-intervention (n = 440) and post-intervention (n = 403) cross-sectional surveys of all adolescents aged 12-19 living in the clusters. The intervention was implemented for 10 months and open to all aged 12-19. Control was sport as usual. We collected data according to pre-specified progression criteria and compared trial arms post-intervention for wellbeing, depression, anxiety, self-esteem, self-efficacy, emotion regulation, social support and functional impairment. Among adolescents in intervention clusters 110/224 (49.11%) attended ≥5 sessions. Younger age and belonging to the least privileged caste group was associated with attendance. In 146/191 (76.44%) sessions, coaches demonstrated ≥75% of activities at satisfactory/superior level according to a fidelity checklist. We found only a small and uncertain difference in wellbeing between arms (effect size 0.05, 95% confidence interval -0.45 to 0.64) but moderate evidence towards improved depression (-0.32, -0.67 to 0.02), anxiety (-0.27, -0.61 to 0.06) and social support from a significant other (0.41, 0.05 to 0.77) in the intervention arm. The average implementation cost per session was $67.63 ($0.07 per adolescent in the community per session). Findings suggest the intervention is feasible and might help to reduce mental health inequities. Progression to a phase III trial is warranted.

51. Natural supplements in breast cancer therapy: translational evidence, clinical safety, and emerging challenges.

期刊: Frontiers in oncology 发表日期: 2026 链接: PubMed

摘要

The incidence and mortality rates of breast cancer are increasing, although improvements in traditional treatments, and it remains the most frequent cancer among women globally. The increasing demand for natural supplements and other forms of complementary and integrative medicine (CIM) shows that people are becoming increasingly intrigued by more comprehensive methods of health care that aim to improve people’s well-being as well as their ability to recover from illness. The objective of this review article is to focus on the clinical safety features supported by data and the translational utility of the natural supplements such as vitamins, minerals and phytochemicals against breast cancer. Anticancer activity by antioxidants, anti-inflammatory agents, apoptotic inductors, and hormonal modulators characterize the behaviour of such natural compounds as curcumin, withaferin A, luteolin, quercetin, and resveratrol. Preclinical and early-phase clinical studies suggest that certain natural supplements may modulate therapeutic response and influence treatment-related toxicity; however, robust clinical evidence remains limited, and definitive conclusions regarding efficacy require further well-designed randomized trials Indeed, the lack of bioavailability, standardization, and the risk of herb-drug interaction prevent these agents from becoming the prevailing therapy option. However, several well-functioning strategies that promote the development of nanotechnology-based formulations and corresponding optimal doses appear to be promising. Even though the regular administration of natural supplements can have significant potential within breast cancer management, the process should be consistent with the principles of evidence-based practice. At the same time, there is the need for clinical trials focused on the development of corresponding pharmacovigilance systems and closer interdisciplinary collaboration. Importantly, future studies are expected to make special emphasis on such factors as dosing personalization, standardization parameters, and their integration with precision oncology.

52. [The role of physical activity in the transition from pre‑frailty to frailty.].

期刊: Advances in gerontology = Uspekhi gerontologii 发表日期: 2026 链接: PubMed

摘要

The aim of the study was to assess the role of physical activity in the transition from pre-frailty to frailty in older adults under hypomobility conditions. The study included 143 elderly patients aged 65-74 years. A comprehensive geriatric assessment was performed using specialized software at baseline, after 1 month, and after 6 months. A decrease in physical activity, both short-term and prolonged, was associated with deterioration of muscle function in patients with pre-frailty. Significant positive correlations were found between handgrip strength dynamics and changes in the maximal torque of lower limb muscles (r from +0,763 to +0,902; p<0,05), indicating a systemic decline in muscle function. Patients with an unfavorable course demonstrated progressive worsening in SARC-F scores and the six-minute walk test. The heterogeneity of pre-frailty progression was established, with two main variants identified: stable and progressive, the latter leading to frailty development. Reduced physical activity was the most significant factor associated with progression, contributing to dynapenia and sarcopenia. The findings confirm the key role of physical activity in preventing the progression of pre-frailty and support the need for targeted interventions aimed at maintaining mobility in older adults. Цель исследования — оценка значения физической активности в процессе перехода старческой преастении в старческую астению в условиях гипомобильной среды. В исследование были включены 143 пациента пожилого возраста (65–74 года), которым проводили комплексную гериатрическая оценку с использованием специализированного программного обеспечения в начале наблюдения, через 1 и 6 мес. Показано, что краткосрочное и длительное ухудшение уровня физической активности приводит к снижению показателей мышечной функции у пациентов со старческой преастенией. Выявлены статистически значимые положительные корреляции динамики кистевой динамометрии и изменений максимального момента силы мышц нижних конечностей (r от +0,763 до +0,902; p<0,05), что свидетельствует о системном характере снижения мышечной функции. У пациентов с неблагоприятным течением отмечена отрицательная динамика показателей по шкале SARC-F и по тесту шестиминутной ходьбы. Установлена гетерогенность течения старческой преастении — выделены стабильный и прогрессирующий варианты, последний сопровождается переходом в старческую астению. Наиболее значимым фактором прогрессирования является снижение двигательной активности, ассоциированное с развитием динапении и саркопении. Полученные данные подтверждают ключевую роль физической активности в профилактике прогрессирования старческой преастении и обосновывают необходимость разработки мер по поддержанию двигательной активности у лиц пожилого возраста.

53. [Prevention of age-related decline in muscle mass and function: exercise, nutrition and medications.].

期刊: Advances in gerontology = Uspekhi gerontologii 发表日期: 2026 链接: PubMed

摘要

Due the increase life expectancy, sarcopenia, or age-related decline in skeletal muscle mass, strength, and performance, is becoming an increasingly common pathology. A decrease in the functional capabilities of skeletal muscles significantly reduces the quality of life of older people, increases their dependence on other people, and also worsens the course of other diseases, which leads to an increase in the frequency of hospitalizations. Therefore, much attention is paid to finding approaches for the prevention and treatment of age-related decline in skeletal muscle mass and functional capabilities, both through physical exercise and through combinations of various approaches. The review examines and summarizes the results of experimental studies, reviews and meta-analyses devoted to studying the effectiveness of various approaches aimed at preventing falls and restoring skeletal muscle mass and physical performance through various physical training, nutritional correction and pharmacological interventions. В связи с увеличением продолжительности жизни саркопения, или возрастное снижение массы, силы и работоспособности скелетных мышц, становится все более распространенной патологией. Снижение функциональных возможностей скелетных мышц значимо снижает качество жизни пожилых лиц, увеличивает их зависимость от других людей, а также ухудшает течение других заболеваний, что ведет к увеличению частоты госпитализаций. Поэтому большое внимание уделяется поиску методов профилактики и терапии возрастного снижения массы и функциональных возможностей скелетных мышц как с помощью физических упражнений, так и с помощью комбинаций различных подходов. В обзоре рассмотрены и обобщены результаты экспериментальных работ, обзоров и метаанализов, посвященных изучению эффективности различных подходов, направленных на профилактику падения и восстановление массы и работоспособности скелетных мышц с помощью различных физических тренировок, коррекции питания и фармакологических средств.

54. [Peptide bioregulation in the treatment of atherosclerosis and prevention of restenosis of the arteries of the lower extremities.].

期刊: Advances in gerontology = Uspekhi gerontologii 发表日期: 2026 链接: PubMed

摘要

Atherosclerosis is a chronic disease of the arterial wall, which involves both innate and adaptive immune mechanisms. With the development and progression of atherosclerosis, there is a violation of the process regulation the tone of the vascular wall. Regulatory peptides are substances that can restore the tone of the vascular bed and reduce the risks of atherosclerosis. The purpose of this review is to combine modern concepts of the effect of peptides on various components of the vascular wall. In addition, the potential for the use of regulatory peptides to reduce the risk of restenosis after interventions on the vessels of the lower extremities is discussed. Атеросклероз является хроническим заболеванием артериальной стенки, в котором участвуют как врожденные, так и адаптивные иммунные механизмы. При развитии и прогрессировании атеросклероза происходит нарушение процессов регуляции тонуса сосудистой стенки. Регуляторные пептиды — вещества, которые могут позволить восстановить тонус сосудистого русла и снизить риск развития атеросклероза. Цель обзора — объединение современных представлений о действии пептидов на различные компоненты сосудистой стенки. Кроме того, обсужден потенциал применения регуляторных пептидов для снижения риска рестеноза после вмешательств на сосудах нижних конечностей.

55. Factors influencing N95 respirator use among healthcare workers in a TB specialized hospital, Bangladesh.

期刊: PloS one 发表日期: 2026 链接: PubMed

摘要

Healthcare workers (HCWs) in public tertiary care hospitals, including chest diseases hospitals, experience a substantial tuberculosis (TB) burden, with 40-48% demonstrating baseline TB infection and incidence rates of 4.2-4.8 per 100 person-years, indicating occupational exposure in high TB-burden settings. TB infection prevention and control (IPC) guidelines recommend that HCWs wear N95 respirators in pulmonary TB patient areas. To ensure appropriate use of N95 respirators by HCWs, an understanding of the barriers and facilitators associated with respiratory protection is needed. This study explored factors influencing N95 respirator use and reuse among HCWs in a TB-specialized tertiary care hospital in Bangladesh. Between December 1, 2013, and June 05, 2014, a field team consisting of five social scientists conducted a qualitative study to explore the factors influencing N95 respirator use and reuse among HCWs in a TB-specialized, tertiary care hospital in Bangladesh. We initially conducted a day long training workshop with 28 HCWs (doctors, nurses and ancillary workers) working in two multi-drug resistant (MDR) TB inpatient wards on the proper use, reuse, and storage of respirators. Participants also underwent N95 respirator fit testing and received a two-month supply (60 days) of N95 respirators. We also conducted observations with 22 HCWs before and after the workshop to document use of N95 respirators and in-depth interviews with the 24 HCWs to explore TB risk perceptions, and the reported barriers and facilitators of N95 respirator uses. At baseline, N95 respirators use was high among nurses (8/9), whereas none of the doctors and ancillary workers used N95 respirators. Post-workshop observation findings showed that the use of N95 respirators remained highest among nurses (11/12) compared to doctors (1/5) and ancillary workers (2/5). Perception that N95 prevents germs from entering the body, the feeling of increased confidence when wearing them and concerns about MDR-TB were identified as key motivators for respirator use. In contrast, misperceptions that long-term exposure to TB confer immunity against infection, discomfort, lack of motivation from senior colleagues, pain, difficulties in accessing respirators, communication challenges, fogging of spectacles and cumbersome storage for reuse were identified as the main barriers to consistent N95 respirator use by HCWs. N95 respirator use among HCWs was feasible but varied substantially across professional groups, with consistently higher uptake among nurses. Persistent behavioral, structural, and institutional barriers limited consistent use. Addressing misconceptions, improving access and storage systems, strengthening leadership support, and reinforcing institutional policies may enhance adherence to respirator use in high TB-burden settings.

56. Disease burden of asbestos-related diseases in China (1990-2023) based on GBD estimates: A call for stronger labor protection laws.

期刊: PloS one 发表日期: 2026 链接: PubMed

摘要

Asbestos exposure remains a persistent occupational hazard in China, yet updated national estimates of asbestos-related diseases (ARDs) after 2019 are scarce. This study quantified long-term trends and demographic patterns of ARDs from 1990 to 2023 using Global Burden of Disease data and joinpoint regression. We analyzed incidence, prevalence, deaths, and disability-adjusted life years (DALYs) for asbestosis and asbestos-attributable cancers (mesothelioma, tracheal/bronchus/lung cancer, laryngeal cancer, and ovarian cancer). Absolute numbers and age-standardized rates were assessed overall and stratified by sex and age. joinpoint regression identified significant temporal inflection points. The absolute burden of ARDs increased continuously from 1990 to 2023. Age-standardized prevalence and incidence rates of asbestosis peaked in 2001, while mortality and DALY rates peaked in 2004. Major turning points for asbestos-attributable cancers occurred around 2010-2011, marking historical peaks followed by declines. A modeled increase in mortality and DALYs was observed from 2020 to 2022 across nearly all ARDs. Males consistently demonstrated higher burdens than females, and older adults (≥65 years) carried the greatest burden, with a secondary mesothelioma peak at 55-59 years in males. Although ARD indicators have declined from historical peaks, a statistically modeled increase was observed in 2020-2022, warranting continued public-health attention. These findings aim to provide evidence for clinicians, epidemiologists, and policymakers to strengthen occupational disease prevention, reinforce labor protection laws, and improve asbestos-control policies in China.