公共卫生研究摘要 (2026-05-24)

共收录 56 篇研究文章

1. Post-competition recovery in natural physique athletes: body composition, metabolic adaptation, and refeeding responses.

期刊: Journal of the International Society of Sports Nutrition 发表日期: 2026-Dec-31 链接: PubMed

摘要

Post-competition refeeding in physique athletes is poorly understood. We aimed to characterize physiological and psychological changes in natural physique athletes across contest preparation and a 12-week recovery period, and to explore the influence of post-competition refeeding strategies. Nineteen natural physique athletes (8 male, 11 female) were assessed at baseline (~21 weeks pre-competition; T0), 1-2 weeks pre-final competition (Tpre), and 2, 6, and 12 weeks post-competition (T2, T3, T4). Measures included body composition (DXA), resting metabolic rate (RMR), thyroid hormones (FSH, FT3, FT4), absolute strength (IMTP peak force), and psychometric questionnaires (POMS, ASSQ, EDE-QS). Body weight decreased from T0 to Tpre (-7.1 kg [-8.3, -5.9]), driven primarily by FM loss (-5.8 [-6.8, -4.8]), with modest FFM loss (-1.7 [-2.6, -0.9]). Both FM and FFM rebounded predominantly within the first 6 weeks post-competition (Tpre→T3: +3.4 [2.3, 4.4] and +2.7 [1.8, 3.6], respectively). By T4, FM was not clearly different from T0 (-0.8 [-1.8, 0.3], while FFM exceeded T0 (+1.6 [0.7, 2.5]). RMR·FFM-1 showed a small, uncertain reduction from T0 to Tpre (-0.9 kcal·kgFFM-1·day-1 [-2.7, 0.9]), followed by increases from Tpre to T4 (+2.4 [0.7, 4.1]). Thyroid hormones decreased from T0 to Tpre (FT3: -1.4 [-1.8, -0.9], FT4: -1.4 [-2.6, -0.2]) and returned within reference ranges by T4. Strength was broadly maintained, while mood and sleep worsened from T0 to Tpre, and improved by T4. Eating-disorder symptom severity was highest during preparation and declined across the recovery period. In exploratory Bayesian modelling, larger post-competition increases in energy intake were associated with greater recovery of adjusted RMR. Contest preparation was accompanied by fat loss, thyroid hormone suppression, and modest reductions in RMR, with recovery characterized by early increases in RMR and tissue restoration following competition. Larger post-competition increases in energy intake were associated with faster recovery of adjusted RMR, although FM regain occurred concurrently. Post-competition recovery should be treated as an active, structured phase, with refeeding individualized to athlete goals and psychological readiness and guided by multi-system monitoring rather than RMR alone. Athletes and coaches should plan ahead for this phase, with structured increases in food intake, realistic expectations around fat gain, and avoidance of unnecessarily prolonged restriction that may delay physiological recovery.

2. Development and Application of a UPLC-MS3 Platform for the Ultratrace Analysis of Clothianidin in Zebrafish.

期刊: Rapid communications in mass spectrometry : RCM 发表日期: 2026-Aug-30 链接: PubMed

摘要

Neonicotinoid insecticides like clothianidin pose significant ecological risks due to their environmental persistence and toxicity to nontarget organisms. Accurate monitoring of ultratrace residues in complex biological matrices is essential for risk assessment. This study aims to develop a highly selective analytical platform to overcome matrix interferences and sensitivity limitations inherent in traditional methods. A novel method was developed using ultrahigh performance liquid chromatography coupled with triple-stage mass spectrometry (UPLC-MS3) on a QTRAP 6500+ system. Clothianidin was extracted from zebrafish tissues via protein precipitation with acetonitrile. The MS3 transition (m/z 250.1 → 168.9 → 110.0) was optimized to enhance the signal-to-noise ratio compared with conventional multiple reaction monitoring (MRM). The UPLC-MS3 method provided a 13-fold improvement in signal-to-noise ratio (713.5) over MRM (54.5). The limit of quantification was 0.05 ng/mL across all tissues. Validation showed excellent linearity (r > 0.995), precision (CV < 8.4%), and recovery (90.64%-111.98%). Exposure studies revealed tissue-specific bioaccumulation, with the highest clothianidin concentrations found in muscle (6.06 ng/mg) and heart (5.42 ng/mg). The developed UPLC-MS3 platform offers unparalleled sensitivity and specificity for trace-level monitoring of clothianidin in complex biological systems. These findings provide a robust tool for investigating the environmental fate and toxicological mechanisms of neonicotinoids in vertebrates.

3. Heat-Related Mental Health Hospitalizations in Italy:A Global Sensitivity Analysis Approach to Evaluate Generalized Additive Model Assumptions.

期刊: Risk analysis : an official publication of the Society for Risk Analysis 发表日期: 2026-Jun 链接: PubMed

摘要

High temperatures are increasingly associated with adverse mental health outcomes, yet the influence of structural modeling assumptions on these estimates remains underexplored. This study examined the short-term association between high temperatures and mental health-related-hospitalizations in 21 major Italian cities from 2005 to 2023, using national hospital discharge data. Exposure-lag-response relationships were modeled through a Distributed Lag Nonlinear Model (DLNM) framework estimated within a Generalized Additive Model (GAM). Analyses focused on June-September and included hospitalizations with a primary diagnosis of mental disorders, considering the code 295-316 of the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM). A Global Sensitivity Analysis (GSA) assessed how structural decisions, such as the specification of temperature and lag splines, and the inclusion of September, affect risk estimates. A total of 210,310 hospitalizations were recorded. The cumulative exposure-response curve showed a marked nonlinear increase in risk, reaching relative risk values close to two at temperatures exceeding 40 ∘ C $^\circ\rm{C}$ . The GSA revealed that the number and placement of knots in the temperature dimension were the dominant contributors to output variability, with total-order sensitivity indices approaching one across most of the temperature range. Variations in the lag structure contributed minimally, while including or excluding September influenced model fit but only modestly affected risk estimates. Uncertainty quantified through GSA was substantially larger than that quantified by standard confidence intervals, indicating that structural assumptions meaningfully shape inference. Within the DLNM-GAM framework, high summer temperatures were consistently associated with increased psychiatric hospitalizations. Incorporating GSA clarified which modeling choices influence estimates, improving transparency and robustness in evaluating heat-related mental health impacts.

4. Direct Oral Anticoagulant Consumption and the Risk of Acute Interstitial Lung Diseases: A Case-Crossover Study Using Japanese Administrative Data.

期刊: Pharmacoepidemiology and drug safety 发表日期: 2026-Jun 链接: PubMed

摘要

Direct oral anticoagulants (DOACs) offer advantages over warfarin; however, concerns exist regarding their association with acute interstitial lung diseases (ILDs). This study investigated the risk of acute-onset ILDs associated with DOAC use. We conducted a case-crossover study to assess the risk of hospitalization for acute-onset ILDs following DOAC initiation using the JMDC database, a Japanese administrative claims database. Patients aged ≥ 18 years hospitalized for acute-onset ILDs (April 2011-February 2023) were included. DOAC exposure was defined as ≥ 14 days within predefined 30-day windows: 1-30 days before admission (exposure period) and 60-90 and 120-150 days before admission (reference periods). The primary outcome was hospitalizations for acute-onset ILD, identified using a validated algorithm. Conditional logistic regression estimated odds ratios (ORs). Sensitivity analyses included a bidirectional case-crossover design, a case-crossover analysis with warfarin as an active comparator, weighted case-crossover analysis, and a case-case-time-control design. A descriptive cohort analysis of new DOAC and warfarin users examined ILD frequency and prognosis. The main case-crossover analysis included 178 patients, showing an association between DOAC use and acute-onset ILDs (adjusted OR, 4.44 [95% CI, 1.58-12.5]). Sensitivity analyses demonstrated a consistent direction of association (adjusted ORs: 3.37-6.85). In descriptive cohort analysis (52 021 DOAC and 12 026 warfarin initiators), ILD incidence was low (0.24% vs. 0.20%), but 90-day mortality was higher in the DOAC group (21% vs. 0%). DOAC use was associated with an increased risk of hospitalization for acute-onset ILDs. Clinicians should monitor patients on DOACs for ILD symptoms. Direct oral anticoagulants (DOACs) are common medications used to prevent blood clots. This study investigated whether these drugs are linked to a rare but serious lung condition called acute interstitial lung disease (ILD). Using a large healthcare database in Japan, we conducted a case‐crossover study. Our analysis revealed an association between DOAC use and hospitalization for this lung disease (adjusted odds ratio: 4.44). While this adverse event is rare, our findings showed that the mortality rate was high (21% at 90 days) among those who developed it. This research highlights the importance of doctors being aware of potential respiratory symptoms, such as coughing or shortness of breath, in patients taking DOACs to ensure early detection.

5. Implementing Robson's classification to compare Cesarean section rates over time at a public tertiary care hospital in Pakistan: An eye-opener.

期刊: International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics 发表日期: 2026-May-23 链接: PubMed

摘要

The aim of the present study was to assess changes in cesarean section (CS) rates over 3 years at a public tertiary care hospital using the Robson Ten Group Classification System (RTGCS). The specific objectives were to compare population distribution across Robson groups, evaluate overall, group-specific, absolute and relative CS rates and assess data quality and completeness. This analytical cross-sectional study was conducted at a public tertiary care hospital in Rawalpindi, Pakistan and spanned over two phases. Phase 1: June 2019 to November 2019 and phase 2: August 2022 to January 2023. For analysis, RTGCS was applied. Robson’s report tables (RRTs) of two phases were generated to calculate and compare CS rates. Statistical analysis included the calculation of P values (considering <0.05 as significant) by chi-square and Fisher exact tests, odds ratios (ORs), relative risks (RRs) and 95% confidence intervals (CIs), using established online tools. The total number of women included in study during phase 1 were 5437, and in phase 2 were 3762. Overall CS rate increased from 31.06% (phase 1) to 40.09% (phase 2) (P < 0.001). In both phases, Robson group 3 was the largest (33% and 25.2% in phases 1 and 2, respectively) and group 9 was the smallest (<1%). The highest absolute contribution towards CS rate was made by group 5, followed by groups 10 and 2 in both phases. Combined contribution of groups 5, 10, and 2 was 70.5% in phase 1 and 64.9% in phase 2. Group 9 had the highest group-specific CS rate in both phases (93.7% and 100%). In phase 1, it was followed by groups 5 (80.4%), 6 (78.2%) and 7 (72%), while in phase 2 by groups 6 (89.6%), 5 (85.2%), and 8 (72.2%). In CS rate, a statistically significant increase was noted in Robson groups 1, 3, 5, 6, 8, and 10, while a decline was observed in group 4 only. The overall CS rate significantly increased over time. This rise was mainly due to a shift in the obstetric population in high-risk groups; 6, 8, 9, 10, and group 5. Conversely, the reduced CS rates in groups 2 and 4 suggest improved induction practices. The data quality was satisfactory.

6. Loss of Ribosomal Protein RPL22 Restricts African Swine Fever Virus Replication by Inducing PERK-Dependent ER Stress.

期刊: Emerging microbes & infections 发表日期: 2026-May-23 链接: PubMed

摘要

African swine fever virus (ASFV) is a large DNA virus that causes highly lethal disease in domestic pigs and wild boars, posing a significant threat to the global swine industry. The development of effective antivirals and vaccines is hindered by the complex structure of the virus and its sophisticated manipulation of host cellular processes. The inner envelope protein p54 is essential for multiple stages of the viral life cycle, including attachment, entry, and replication. In this study, we employed TurboID-based proximity labeling to systematically map the host protein interactome of ASFV p54. Our screen identified 257 potential host interacting partners. Among these, the interaction between p54 and the 60S ribosomal protein L22 (RPL22) was validated by co-immunoprecipitation and confocal microscopy. Functional studies using an RPL22-knockout (RPL22-KO) cell line revealed that RPL22 serves as a regulatory host factor for ASFV infection. Mechanistically, the loss of RPL22 significantly inhibited ASFV replication through the activation of the PERK signaling pathway, a key branch of the endoplasmic reticulum stress (ERS) response. This finding was further substantiated by pharmacological intervention; activation of the ERS/PERK pathway using thapsigargin (Tg) or CCT020312 suppressed viral replication, whereas its inhibition with 4-phenylbutyric acid (4-PBA) or AMG-PERK 44 promoted replication. In conclusion, this study presents the first systematic interactome of ASFV p54 and reveals a novel mechanism by which the host factor RPL22 modulates ASFV replication via the ERS-PERK pathway. These findings offer new insights into ASFV-host interactions and identify the ERS pathway as a promising therapeutic target for the development of anti-ASFV strategies.

7. Breastfeeding May Confer Long-Term Immunity Against Emerging Infectious Pathogens-Ecological Evidence over 2 Full Years of the COVID-19 Epidemic in Georgia, United States.

期刊: Breastfeeding medicine : the official journal of the Academy of Breastfeeding Medicine 发表日期: 2026-May-23 链接: PubMed

摘要

Long-term immunity acquired maternally against infectious pathogens has been reported in animal studies, but epidemiological evidence remains lacking. To assess long-term maternal immunity in humans against infectious pathogens, we examined COVID-19 disease burden in communities with varying breastfeeding practices. Using data from 159 counties in Georgia, the United States, from March 1, 2020, through February 28, 2022, we calculated the daily incidence, mortality, and fatality rates of COVID-19 and estimated rate ratios (RRs) in counties with low (<62%, n = 36) and moderate breastfeeding initiation rates (BFIRs) (62-79%, n = 81) compared to counties with high BFIRs (≥79%, n = 42) adjusted for counties’ sociodemographic and quantified indicators of public health interventions. More than 80% of 2 million cases involved individuals aged 18 or older. The daily incidence and mortality curves in the counties with high BFIRs lagged 2 weeks behind those in the counties with low BFIRs. Daily mortality reached 10 deaths per million during every major surge in low BFIR counties, but in high BFIR counties, this occurred only during the 2020-2021 winter spike. Compared to high BFIR counties, counties with low BFIRs had a daily incident RR of 2.95 (95% CI = 1.11, 6.00) in rural counties and 1.45 (1.03, 2.04) in urban counties on February 28, 2022, the cutoff date. A significantly higher COVID-19 incidence occurred in low BFIR counties compared to that in high BFIR counties. Breastfeeding may confer long-term immunity against emerging infectious pathogens by enhancing an individual’s biological immunity or strengthening the community’s social defense.

8. The COVID-19 Pandemic and the 2022 Formula Shortage: Associations with Breastfeeding Initiation over 5 Years in the State of Florida, United States.

期刊: Breastfeeding medicine : the official journal of the Academy of Breastfeeding Medicine 发表日期: 2026-May-23 链接: PubMed

摘要

To examine hospital breastfeeding initiation trends and their association with COVID-19 pandemic and the infant formula shortage. Using a multivariable logistic regression model, we examined associations between breastfeeding initiation and exposure to the COVID-19 pandemic and infant formula shortage, and the modifying roles of race/ethnicity, residence, and WIC participation in 1,060,057 individuals aged 15-49 years with institutional childbirths in Florida between January 1, 2018, and December 31, 2022. Overall, 922,922 (87.06%) initiated breastfeeding before hospital discharge. Initiation declined as COVID-19 progressed, but started increasing as the formula shortage hit and continued. The rates show a declining trend once the shortage was addressed. Compared with non-Hispanic White, the odds of breastfeeding initiation were higher for all groups except for non-Hispanic Black, and for urban than rural mothers. The odds increased with formula shortage onset for WIC beneficiaries across race/ethnicities and among urban WIC beneficiaries compared with nonbeneficiaries. The combined pressures of COVID-19 pandemic and formula scarcity increased breastfeeding initiation rates, especially in WIC beneficiaries. However, breastfeeding initiation rates returned to prepandemic levels as the formula shortage resolved.

9. Reply to: Re-Examining Sedative and Hypnotic Prescribing Following Hip Fracture.

期刊: Journal of the American Geriatrics Society 发表日期: 2026-May-23 链接: PubMed

摘要

10. A Practical Guide to Target Trial Emulation: Connecting Randomized Trials and Real-World Data in Cardiovascular Research.

期刊: European journal of preventive cardiology 发表日期: 2026-May-23 链接: PubMed

摘要

Randomized controlled trials (RCTs) remain the gold standard for causal inference in cardiovascular prevention but are often limited by cost, feasibility, and restricted generalizability. The rapid expansion of real-world data (RWD) offers new opportunities to address clinically relevant questions beyond the scope of RCTs, yet observational analyses remain highly susceptible to bias, particularly when study design is not aligned with the underlying causal question. Target trial emulation (TTE) is an increasingly adopted framework that improves the validity and interpretability of observational studies by explicitly specifying the protocol of the hypothetical randomized trial that would ideally answer the clinical question. This review provides a practical guide to TTE in cardiovascular prevention. We describe its conceptual foundations within the counterfactual framework, emphasizing the shift from a model-driven to a design-first approach, and outline the seven key components of the target trial protocol: eligibility criteria, treatment strategies, assignment procedures, time zero definition, outcomes, estimand, and statistical analysis plan. We clarify the role of analytical methods within TTE, including propensity score approaches, g-computation, and g-estimation, and provide guidance on selecting the appropriate method based on the estimand and treatment strategy. A step-by-step implementation framework is proposed, covering common pitfalls such as immortal time bias and prevalent user bias, the use of negative control analyses as diagnostic tools, and the handling of missing data. Illustrative examples from cardiovascular prevention demonstrate how TTE enhances causal interpretation across a range of clinical questions. TTE strengthens the credibility of real-world evidence by improving transparency, reducing avoidable design biases, and aligning analyses with clinically meaningful decisions. It does not eliminate residual confounding and should be viewed as complementary to, rather than a substitute for, randomized evidence.

11. Care Coordination and Optimization in Geriatric Surgery (COGS): A Pilot Program to Improve Surgical Outcomes in Older Adults.

期刊: Journal of the American Geriatrics Society 发表日期: 2026-May-23 链接: PubMed

摘要

Older adults undergoing surgery are at increased risk for complications, functional decline, and prolonged recovery due to frailty and other age-related vulnerabilities. To address these challenges, we developed the Care Coordination and Optimization in Geriatric Surgery (COGS) program, a pilot initiative integrating comprehensive geriatric assessment and targeted optimization into routine surgical care for Veterans. Using the Risk Analysis Index-Clinical (RAI-C) to identify higher-risk patients, the COGS team-comprising geriatric providers, nursing, and surgical staff-provides individualized evaluation and interventions focused on nutrition, mobility, medication safety, cognition, and social support. By embedding geriatric expertise directly into the surgical clinic, the program fosters collaboration among surgeons and geriatricians, improving communication and supporting shared decision-making about surgical readiness. Early experience demonstrates that COGS is both feasible and well-received, enhancing the coordination of care for older Veterans and aligning surgical decisions with patients’ goals and overall health status. Expansion of the program to additional surgical specialties and evaluation of short and long-term outcomes are underway. The COGS model demonstrates how integrating geriatrics principles within surgical care can promote safer, more goal-aligned surgery for older adults.

12. GLP-1 RAs May Prevent Metastatic Progression.

期刊: Cancer discovery 发表日期: 2026-May-23 链接: PubMed

摘要

New research suggests that starting a glucagon-like-peptide (GLP)-1 receptor agonist following a diagnosis of certain obesity-related cancers-namely stage I, II, or III lung, breast, colorectal, or liver cancers-may prevent them from advancing to stage IV. However, experts aren’t ready to prescribe them to patients with newly diagnosed earlier stage disease without additional research confirming their value.

13. Antibiotics for Delirium in Older Adults With No Clear Urinary Tract Infection: A Multicentre, Pragmatic, Randomized Trial-Vanguard Results.

期刊: Journal of the American Geriatrics Society 发表日期: 2026-May-23 链接: PubMed

摘要

It is unclear whether antibiotics improve outcomes for older adults with delirium who have pyuria or bacteriuria in the absence of other signs or symptoms of a urinary tract infection. Our study is a multicenter, parallel-group, single-blinded, non-inferiority pragmatic randomized trial. The trial included a vanguard phase of the first 30 participants, and herein we report the aggregate results from this phase. We included hospitalized adults aged 60 years and older who had delirium and pyuria and/or bacteriuria. We excluded patients with fever, upper or lower urinary tract symptoms, an indwelling foley for more than 72 h, more than 24 h of antibiotics at the time of eligibility, or another indication for antibiotics (e.g., pneumonia). The main outcomes of the vanguard phase were rates of participant recruitment, protocol adherence, and study withdrawal. Our initial goals were 4 patients randomized monthly per site, greater than 95% adherence to allocation, and less than 5% withdrawal rate. The median age was 86 years (interquartile range [IQR] 81-92), 68% were female, and most (79%) had either minor or major neurocognitive impairment. Of the participating sites that recruited at least one participant, the recruitment rates ranged from 0.05 to 1.8 participants per month. Adherence to allocation was 100%. Two participants (6.7%) withdrew. For participants randomized to receive antibiotics, the median duration was 5 days (IQR 5-7). By Day 7, delirium had resolved in 39% of the participants who remained hospitalized; 25% of participants were discharged, 32% had ongoing delirium, and 4% did not have a delirium assessment available. By Day 7, 1 (3.6%) developed C. difficile, 1 (3.6%) died, and 1 (3.6%) developed bacteremia. We completed our vanguard phase with 100% adherence to allocation and withdrawal was near the target of 5%. The recruitment rate varied widely and overall was lower than anticipated.

14. Anthropometric differences between twins at birth and their association with later cognitive performance.

期刊: Journal of child psychology and psychiatry, and allied disciplines 发表日期: 2026-May-23 链接: PubMed

摘要

Past studies indicate significant associations between birth anthropometrics, such as relative birthweight or head circumference, and later cognitive performance. Using twin data, we investigated whether these associations are confounded by genetic and environmental factors. Additionally, we determined whether the association of within twin differences in birth anthropometrics and cognitive performance is nonlinear or moderated by factors such as zygosity or age at assessment. Longitudinal data from over 2000 twin pairs from the German TwinLife study were analysed using the co-twin control method. Cognitive performance was assessed at two waves, with median ages of 12 and 18 years, with z-standardised scores based on wave and age. Differences between twins in birthweight and head circumference Z scores were calculated using Fenton’s size at birth chart, based on health records at birth. Within twin differences in relative birthweight were associated with differences in cognitive performance at Wave 1 (β = .08, p = .001) and did not differ by zygosity (β = .03, p = .560). However, this association was not significant when reducing the sample to twins with valid data at both waves (β = .05, p = .187). Testing for nonlinearity or for moderation by age at assessment did not improve model fit. Within twin differences in head circumference were not significantly associated with differences in cognitive performance in any analyses (smallest p = 0.365). After controlling for confounding due to genetics or the shared environment, conditions in the womb, as indexed by relative birthweight, is associated with later cognition. This association is not stronger in younger individuals.

15. Salivary Microbiota From a Periodontitis Donor Is Associated With Altered IgA-Related Immune Features in Germ-Free Mice.

期刊: Journal of clinical periodontology 发表日期: 2026-May-23 链接: PubMed

摘要

The oral microbiota has been implicated in mucosal immune regulation; however, its causal impact on salivary gland-associated immune features remains incompletely understood. In this proof-of-concept study, germ-free (GF) mice were colonised with salivary microbiota derived from either a periodontitis donor or a periodontally healthy donor, and IgA-associated immune readouts were evaluated across multiple compartments. GF mice were orally colonised with saliva-derived microbiota from a periodontitis patient or a periodontally healthy donor (or PBS). Total IgA in saliva, serum and faeces were quantified by ELISA. Cervical lymph nodes and blood were analysed by flow cytometry. Submandibular glands underwent histology and bulk RNA-seq. Mice receiving microbiota from a periodontitis donor exhibited altered IgA levels in saliva, serum and faeces, increased faecal lipocalin-2, changes in innate immune cell distributions and increased CD138+ cell signals and IgA immunoreactivity in the submandibular glands. Transcriptomic analysis revealed heterogeneous expression of individual IgA-related genes, with coordinated patterns observed at the level of IgA/mucosal defence-related gene sets. These findings indicate that salivary microbiota from a periodontitis donor are associated with altered IgA-related immune features under GF conditions. While limited by the use of a single donor per group, this study provides proof-of-concept evidence supporting a potential role of oral microbiota in shaping salivary gland-associated immune characteristics.

16. Analysing injuries to dancers working in the commercial dance industry.

期刊: Occupational medicine (Oxford, England) 发表日期: 2026-May-23 链接: PubMed

摘要

Commercial dancers work in live shows, films and other venues. They perform many dance genres and undergo substantial physical demands. This occupational community sustains many injuries but may not seek or have access to specialized medical services. To determine, in a sample of dancers in the commercial dance industry, the prevalence of musculoskeletal dance-related injuries, the dancers’ accessibility to medical consultation and the dancers’ healthcare-seeking tendencies over 5 years. An electronic questionnaire was distributed to commercial dancers via a commercial dance advocacy organization. One hundred twenty dancers (91 females, 29 males) in the commercial dance industry completed this retrospective study. Data were analysed via descriptive statistics. We hypothesized that the 5-year prevalence of injury would exceed 70%, and that healthcare resources are not widely available to the commercial dance community in relation to injury occurrence, body region of injuries and time loss due to injury. Ninety-one per cent of the participants reported at least one time-loss injury over the 5-year period. The knee, lower back, ankle and hip were injured most often. Ninety-three per cent of the respondents reported dancing with injury-related pain, and 73% visited a physiotherapist/physical therapist or occupational therapist for at least one injury. Forty-three per cent reported their primary reason for not seeking care was they ‘could not afford the care’. This study suggests that commercial dancers exhibit a high prevalence of injuries, often dance in pain and may be dissuaded from seeking care for their time-loss injuries by a lack of financial and medical resources.

17. Occupational health surveillance of compressed air workers: a scoping review.

期刊: Occupational medicine (Oxford, England) 发表日期: 2026-May-23 链接: PubMed

摘要

Compressed air is increasingly used in the underground construction of caissons and tunnels. New risks have been identified, suggesting the need to develop counter-measures. This scoping review aimed to provide insight into the health risks, prevention and surveillance measures, and adverse health effects related to compressed air work during tunnel construction. Health risks were assessed based on the Joanna Briggs Institute Reviewers’ Manual, the recommendations of Pollock and the PRISMA Scoping Reviews Checklist. The scoping review mapped and analysed studies of compressed air work over the past 50 years. Only 45 studies were deemed eligible for inclusion in this review. In the early days of mechanized tunnel construction, the incidence of decompression sickness was high, affecting up to 2032 individuals, with an incidence rate of the bends as high as 0.5%. Improvements in decompression tables and the use of mixed gases have reduced these rates to below 0.1%. New construction techniques have introduced new health risks, including silicosis. Because of traffic demands, especially in urban areas, newer tunnels have been built for operation at greater depths (up to 106 metres sea water). Relatively few studies in the past 50 years have analysed the effects of compressed air use for tunnel construction. Adverse health effects have decreased substantially over time, but several new health risks have been described. The registration of key information on health and safety risks and adverse health effects, in a highly accessible international repository is recommended.

18. Does health insurance increase health care utilization? evidence of ex-post moral hazard from the Social Security Scheme in Thailand.

期刊: Health policy and planning 发表日期: 2026-May-22 链接: PubMed

摘要

Expanding health insurance improves access to care, but it may also increase healthcare utilization and fiscal pressure on public systems. Using multiple waves of the Thailand Socio-Economic Survey, this study applies a difference-in-differences (DD) approach combined with propensity score matching to estimate the causal effect of Social Security Scheme (SSS) coverage. The results show that insurance coverage increases healthcare utilization, consistent with behavioral responses associated with ex-post moral hazard, although part of this increase reflects improved access to necessary care. The magnitude of the effects varies across types of medical expenditures, estimation methods, and study periods. These findings highlight the importance of balancing expanded healthcare access with the financial sustainability of the SSS. Policymakers may consider targeted cost-management measures, efficiency improvements, and strengthened preventive health policies while maintaining equitable access to healthcare services.

19. Capturing geographical inequalities in children's experience of dental health support using synthetic estimation technique and understanding their relationship with geographical inequalities in child dental health in England.

期刊: Community dental health 发表日期: 2026-May-22 链接: PubMed

摘要

This study aimed to estimate the proportion of families with five-to-fifteen-year-olds experiencing inadequate dental health support as a consequence of their parents’ socioeconomic conditions and deprivation in their neighbourhood across small geographies in England using synthetic estimation technique and explore its association with area-level proportion of children experiencing dental caries. Secondary analyses were performed using Children’s Dental Health Survey (CDHS) 2013, National Dental Epidemiological Programme (NDEP) 2018-2019, and Census 2011. Multilevel logistic regression using CDHS (five-to-fifteen-year-olds; n = 2177) derived odds of a child experiencing inadequate dental health support (child’s poor dental attendance, parents not accompanying a child to dental visits, not using sugar-free/dental chewing gum) based on parents’ family status, employment, and neighbourhood deprivation. These odds and census-informed population counts were used to derive the indicator of ‘estimated percentage of families with children experiencing inadequate dental health support in a census-based geography of ∼7500 people (n = 6791)’. Unadjusted linear regression was undertaken to examine the relationship between the indicator and NDEP-based percentage of five-year-olds experiencing dental caries in larger geographies (n = 397). Results indicated that inadequate child dental health support [CDHS mean = 8% (SD:0.27%)] was significantly associated with higher neighbourhood deprivation and an interaction effect from being both a lone and an unemployed parent. Increased area-level percentage of families with children experiencing inadequate dental health support (range:3.7%-15.2%) was associated with 1.59 (95%CI:1.14-2.04) rise in area-level percentage of five-year-olds experiencing dental caries. This study underscores the need for targeted support for lone and unemployed parents and families living in the most deprived areas to promote children’s dental health.

20. Inflammatory factors and hypertensive nephropathy: A bidirectional 2-sample Mendelian randomization study.

期刊: Medicine 发表日期: 2026-May-22 链接: PubMed

摘要

Hypertensive nephropathy (HTN) is a major public health concern worldwide. This study aims to investigate the potential causal relationships between inflammatory factors and HTN, as well as to identify possible underlying biological pathways. Using genome-wide association study data from large publicly available population cohorts, we applied a bidirectional 2-sample Mendelian randomization approach to investigate whether 91 inflammatory factors influence the risk of HTN. Additionally, we examined whether HTN has a potential causal effect on the levels of these inflammatory factors. Finally, we performed pathway enrichment analysis to explore the underlying biological pathways involved in these associations. Mendelian randomization results indicated that interleukin-20 receptor subunit alpha, caspase 8, CUB domain-containing protein 1, and stem cell factor were associated with a reduced HTN, while interleukin-18 receptor 1, leukemia inhibitory factor, oncostatin-M, and interferon-gamma were associated with an increased HTN. Pathway enrichment analysis further identified several biological pathways potentially involved in the development of HTN. This study provides evidence for causal relationships between multiple inflammatory factors and HTN, offering valuable insights that may inform disease management strategies and policy development related to HTN.

21. Effect of a Participatory Learning Capacity-Building Program on Knowledge, Perception, and Breastfeeding Skills Among Female Village Health Volunteers in Thailand.

期刊: Journal of human lactation : official journal of International Lactation Consultant Association 发表日期: 2026-May-22 链接: PubMed

摘要

Breastfeeding is a key strategy for improving maternal and infant health; however, Thailand continues to fall short of national and international breastfeeding targets. Village Health Volunteers (VHVs) play an essential role in community-based breastfeeding support, yet many lack structured training. This study examined the effectiveness of a participatory learning capacity-building program on breastfeeding knowledge, perception, and skills among female VHVs in Thailand. A quasi-experimental two-group, pretest-posttest design was implemented with 80 VHVs from Phra Ajarn Subdistrict, Ongkharak District. The experimental group received a participatory breastfeeding program consisting of experiential training, collaborative home visits, and follow-up evaluation. A validated assessment instrument measured breastfeeding knowledge, perception, and skills. Statistical analyses included paired-samples and independent-samples t-tests (α = .05). VHVs in the experimental group showed significant improvements in breastfeeding knowledge (M_pre = 7.48; M_post = 8.88; p < .001) and skills (M_pre = 7.98; M_post = 9.28; p < .001). Perceptions toward breastfeeding showed no significant change (p = .19). Post-intervention, the experimental group demonstrated significantly higher knowledge (p = .05) and skills (p < .001) than controls, with no group difference in perception (p = .17). Participatory learning enhanced VHVs’ breastfeeding knowledge and practical skills, supporting its use in community-level maternal-child health promotion. However, perceptions remained unchanged, suggesting that attitudinal shifts may require longer-term or culturally integrated strategies.

22. Breast Cancer Screening and Regional Inequalities: Effects of Pink October in Brazil.

期刊: Health education & behavior : the official publication of the Society for Public Health Education 发表日期: 2026-May-22 链接: PubMed

摘要

Breast cancer is the leading cause of cancer-related deaths among women in Brazil. Early detection through mammography is an effective strategy to reduce mortality; however, access remains unequal across regions. The Pink October campaign, promoted annually by Brazil’s Ministry of Health, aims to raise awareness and encourage breast cancer screening. This study evaluates the heterogeneous effects of the Pink October campaign across Brazil’s five regions using an interrupted time-series approach with data from 2015 to 2024. We analyzed monthly screening rates among women aged 50 to 69, the target population for biennial mammography. Results indicate a significant increase in screening rates during the campaign period, with notable variation across regions. The Northeast showed the highest relative increase (+57.42%), followed by the South (+29.73%). In contrast, the North and Central-West regions exhibited more modest gains. The regional disparities appear to be associated with differences in primary health care coverage, as the regions with the greatest increases also report higher Family Health Strategy coverage. These findings suggest that national awareness campaigns, while broadly effective, must be complemented by local capacity-building strategies to ensure equitable outcomes. Tailored implementation based on local health system strength can maximize the effectiveness of health promotion efforts and reduce persistent geographic inequalities in access to breast cancer prevention services.

23. The impact of peer support on college students' physical activity: The Parallel mediating role of task efficacy and barrier efficacy.

期刊: Journal of health psychology 发表日期: 2026-May-22 链接: PubMed

摘要

This study analyzes the mediating role of exercise tasks and barrier efficacy in the relationship between peer support and physical activity among college students. A cross-sectional questionnaire survey was conducted among 1047 college students using the Peer Support Scale, Exercise Self-Efficacy Scale, and Physical Activity Scale. Our analysis revealed that compared with female students, male students reported significantly higher in peer support, exercise self-efficacy, and physical activity. The data indicated that the model demonstrated good fit indices, with cmin/df = 7.763, CFI = 0.926, and RMSEA = 0.080, p < 0.001. Peer support not only directly and positively predicts college students’ physical activity but also indirectly promotes it through the dual mediating pathways of exercise task efficacy and barrier efficacy, with task efficacy exerting the predominant mediating effect. College administrators and sports practitioners should enhance task efficacy, integrate barrier training, and restructure peer support for better health interventions.

24. Outcomes of Patients With Hepatocellular Carcinoma Treated With Durvalumab Plus Tremelimumab in Real-World Clinical Practice Who Met or Did Not Meet the Inclusion Criteria for the Phase 3 HIMALAYA Trial.

期刊: Journal of gastroenterology and hepatology 发表日期: 2026-May-22 链接: PubMed

摘要

This study evaluated clinical outcomes in patients with hepatocellular carcinoma (HCC) treated with durvalumab plus tremelimumab (Dur/Tre) in routine practice, stratified by whether they fulfilled the eligibility criteria of the phase 3 HIMALAYA trial. A total of 412 patients with unresectable HCC receiving Dur/Tre at 30 Japanese institutions were enrolled. Of these, 92 fulfilled the HIMALAYA trial eligibility criteria (HIMALAYA group) and 320 did not (non-HIMALAYA group). Median progression-free survival (PFS) was 5.4 months in the HIMALAYA group and 3.0 months in the non-HIMALAYA group (p = 0.012). Multivariable analysis identified body mass index ≥ 25 kg/m2 (hazard ratio [HR], 0.780; 95% confidence interval [CI], 0.612-0.993; p = 0.044) and portal vein invasion (HR, 1.509; 95% CI, 1.049-2.170; p = 0.027) as independent predictors of PFS. Median overall survival (OS) was 19.4 months in the HIMALAYA group versus 15.4 months in the non-HIMALAYA group (p = 0.014). Multivariable analysis showed Eastern Cooperative Oncology Group performance status ≥ 1 (HR, 1.878; 95% CI, 1.253-2.814; p = 0.002) and albumin-bilirubin grade ≥ 2 (HR, 2.032; 95% CI, 1.319-3.318; p = 0.001) as independent determinants of OS. Any-grade endocrine dysfunction occurred in 13 (14.1%) and 21 (6.6%) patients (p = 0.030), with grade ≥ 3 events in 5 (5.4%) and 2 (0.6%), respectively (p = 0.007). Subgroup analysis suggested that non-HIMALAYA patients with ALBI grade 1 may have OS comparable to the HIMALAYA group. Patients fulfilling the HIMALAYA trial eligibility criteria and those who did not but had preserved hepatic function demonstrated favorable survival outcomes with Dur/Tre.

25. Implant therapy in older patients: Prosthetic considerations and biomechanical implications for frailty/aging.

期刊: Periodontology 2000 发表日期: 2026-May-22 链接: PubMed

摘要

Population aging is reshaping prosthodontic care for both partially and completely edentulous individuals. In older adults, conditions such as frailty, comorbidities, polypharmacy, and cognitive decline can have a direct impact on the biological and biomechanical demands of implant therapy, thereby influencing the success of implant treatment. This narrative review synthesizes evidence on implant therapy in older patients, integrating prosthetic and biomechanical considerations with patient-related factors. The literature search addressed implant survival, complications, prosthetic and material design, peri-implant soft tissue considerations, and treatment options such as shortened dental arch approaches, implant-assisted removable partial dentures (IARPDs), implant overdentures, and complete dentures, as well as maintenance strategies with patient and caregiver education. Implant survival in older patients remains high, and age alone should not be considered as a limiting factor for implant treatment. Hygiene-oriented prosthetic designs, including non-mucosa-contact intaglio surfaces and emergence angles less than 30°, were associated with reduced plaque accumulation and peri-implant bone loss in older adults. While limited keratinized mucosa correlated with greater plaque and recession, phenotype modification should be evaluated on a case-by-case basis, carefully weighing the benefits against the surgical burden for the older patient. Ceramic materials accumulate less plaque as compared with processed acrylic resin, and veneered zirconia remained more prone to chipping than monolithic zirconia. Alternative treatment options-such as overdentures to enhance bite force, a shortened dental arch when posterior implants are contraindicated, or IARPDs to improve stability-may be especially appropriate for older patients with functional limitations. Caregiver participation and structured maintenance significantly reduce peri-implantitis risk. Implant therapy in older patients, including individuals aged 75 years and above, is highly feasible when age-related risks are addressed, prostheses are designed for cleansability and retrievability, and maintenance includes structured follow-up and caregiver support. Clinicians should emphasize functional goals, hygiene-accessible designs, pragmatic treatment alternatives, selective peri-implant soft tissue management when indicated, and personalized maintenance supported by patient and caregiver education.

26. Pancreatitis-associated mortality in the United States: A population-based analysis of trends and disparities, 1999 to 2023.

期刊: Medicine 发表日期: 2026-May-22 链接: PubMed

摘要

Pancreatitis contributes substantially to gastrointestinal mortality, yet its population-level burden remains incompletely characterized. We conducted a retrospective, population-based study using the Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research Multiple Cause-of-Death database (1999-2023). Adults aged ≥45 years with pancreatitis (International Classification of Diseases, Tenth Revision: K85.x, K86.0-K86.1) listed anywhere on the death certificate were included. Age-adjusted mortality rates were calculated using the 2000 US standard population. Temporal trends were analyzed using Joinpoint regression to estimate annual percent change (APC) and average APC. The age-adjusted mortality rate declined from 6.30 to 4.63 per 100,000, with an overall decrease (average APC: -1.18%). Mortality declined through 2018, increased during 2018 to 2021, and declined thereafter. Higher mortality was observed among males, older adults, Black and American Indian/Alaska Native populations, and in the Southern United States. Alcoholic pancreatitis mortality increased, while chronic pancreatitis mortality remained stable. Pancreatitis-associated mortality declined over 2 decades but showed a temporary reversal from 2018 to 2021. Persistent disparities and rising alcohol-related mortality highlight the need for targeted prevention and equitable care strategies.

27. Procedural Rigor and Reproducibility in NMR Metabolomics: Community Practices and Challenges.

期刊: Critical reviews in analytical chemistry 发表日期: 2026-May-22 链接: PubMed

摘要

Nuclear magnetic resonance (NMR) spectroscopy is a fundamental tool of metabolomics, valued for its reproducibility, quantitative accuracy and broad applicability across biological, chemical and clinical sciences. However, methodological inconsistencies, insufficient protocol reporting and limited infrastructure continue to hinder reproducibility and data sharing. To assess the current state of NMR metabolomics practice, we developed a comprehensive questionnaire and distributed it worldwide to researchers engaged in NMR-based metabolomics. We received 75 responses from a diverse cohort of investigators from academia, clinics and core facilities. The survey focused on Quality Assurance (QA) and Quality Control (QC) practices and provides an overview of the current status of NMR metabolomics and its implementation. Results reveal that while 86% of laboratories have Standard Operating Procedures (SOPs), deviations from these protocols are common and often undocumented, undermining reproducibility. QC practices, including pooled samples and system suitability checks, are widely recognized, but their implementation is inconsistent. Data accessibility remains limited, with fewer than 10% of respondents routinely depositing raw or processed spectral data in public repositories. Formal regulatory oversight and dedicated QA personnel are uncommon. Training is largely informal, with substantial gaps in areas such as data analysis and statistics, raising concerns about knowledge transfer and methodological consistency. Our findings describe a technically skilled community that is constrained by variations in NMR infrastructure and inconsistent implementation of best practices. Addressing these issues through adaptive standardization, structured training programs, and stronger institutional support is critical for advancing transparency, reproducibility and impact of NMR in metabolomics.

28. Higher light at night exposure is associated with increased risk of diabetes mellitus: A cross-sectional study of the NHANES database.

期刊: Medicine 发表日期: 2026-May-22 链接: PubMed

摘要

While evidence links light at night (LAN) to metabolic disturbances, large-scale, population-based studies of objectively-measured LAN exposure remain limited. This study investigates the association between LAN and the risk of diabetes mellitus (DM) among US adults using data from the National Health and Nutrition Examination Survey. Cross-sectional data from the 2011 to 2014 National Health and Nutrition Examination Survey cycles were analyzed, focusing on participants with complete data on both LAN and DM. Participants were stratified by LAN level. Multivariable logistic regression analyses were employed to examine the association between LAN and DM. Multivariable linear regression analyses assessed relationships between LAN and diabetes risk markers, including hemoglobin A1c (HbA1c), fasting blood glucose, fasting serum insulin, and Homeostasis Model Assessment of Insulin Resistance (HOMA-IR). Subgroup and sensitivity analyses with multiple imputation tested robustness. A total of 4498 participants were enrolled. The prevalence of diabetes was higher in the high-LAN exposure group compared to the no-LAN group (21.01% vs 14.48%). Consistent with this, in the fully adjusted model, high-LAN exposure was independently associated with a significantly increased risk of DM (odds ratio [OR] = 1.39, 95% confidence interval [CI]: 1.00-1.92). High-LAN exposure was linked to elevated HbA1c and fasting blood glucose in initial models. However, these associations weakened and became nonsignificant after full adjustment for covariates. No significant associations were observed for fasting serum insulin or HOMA-IR. Subgroup analyses showed the association between LAN and DM was more pronounced in middle-aged adults (40-64 years), individuals with obesity, and those with dyslipidemia or hypertension. However, no significant effect modification was found across subgroups (all P for interaction > .05). Sensitivity analyses confirmed the robustness of these findings. This study uses objective actigraphy-based LAN measurement and shows its independent association with DM, especially in metabolically susceptible subgroups. These findings identify LAN as a modifiable environmental risk factor and support its relevance to DM prevention and public health strategy.

29. Effects of a psychological capital intervention on emergency nurses' work engagement and turnover intention: A randomized controlled trial.

期刊: Medicine 发表日期: 2026-May-22 链接: PubMed

摘要

Emergency nurses are exposed to high occupational stress, which leads to decreased psychological capital, reduced work engagement, and high turnover intention. Evidence on targeted psychological capital intervention (PCI) for this population remains limited. A parallel randomized controlled trial was conducted. A total of 122 emergency nurses from a tertiary hospital in Zhejiang Province were randomly assigned to the intervention group (6-week PCI, n = 61) or the control group (routine training, n = 61). Outcomes were measured at baseline (T0), post-intervention (T1), 1 month (T2), and 3 months (T3) using the Psychological Capital Questionnaire, Utrecht Work Engagement Scale, and Turnover Intention Scale. Baseline characteristics and outcome scores were comparable between groups (all P > .05). At T1 to T3, the intervention group had significantly higher Psychological Capital Questionnaire and Utrecht Work Engagement Scale scores and lower Turnover Intention Scale scores than the control group (all P < .001). Psychological capital was positively correlated with work engagement (R = 0.604, P < .001) and negatively correlated with turnover intention (r = -0.624, P < .001). This 6-week PCI program significantly improves psychological capital and work engagement, and reduces turnover intention among emergency nurses, with effects sustained for at least 3 months. These findings support the utility of PCI as a psychological management strategy for emergency nursing staff.

30. Occupational and lifestyle associations with mental health of healthcare workers.

期刊: Medicine 发表日期: 2026-May-22 链接: PubMed

摘要

Mental disorders are a leading cause of morbidity worldwide, and healthcare professionals are particularly vulnerable due to occupational stressors, a vulnerability intensified during the coronavirus disease 2019 pandemic. This study assessed the prevalence of mental health disorders among hospital workers and examined changes in their perceived mental health during the pandemic. A descriptive cross-sectional study was conducted with 215 employees attending the Health Surveillance Service of Virgen Macarena University Hospital (Seville) between January 2019 and December 2022. Data were collected from occupational health records and a telephone survey, including the General Health Questionnaire (12 items) questionnaire. The prevalence of diagnosed mental health disorders was 7.0%, with mixed anxiety-depressive disorder being the most frequent. Most affected workers required short-term temporary incapacity due to common contingencies, and 36.7% required job adaptations, mainly involving task modifications. During the pandemic, 68.1% of workers reported a perceived worsening in mental health, which was more common among alcohol users. Among those receiving treatment, 70.8% required medication adjustments, and 31.2% reported increased analgesic use. Although prevalence rates were lower than expected, likely due to underdiagnosis and prioritization of coronavirus disease 2019-sensitive evaluations, the profile of affected workers was consistent with previous literature, predominantly women around 50 years old, often Assistant Nursing Care Technicians. These findings highlight the crucial role of occupational health services in early detection, monitoring, and support of healthcare professionals. Identification of alcohol use, psychiatric medication adjustments, and increased analgesic intake as risk factors emphasize the need for proactive interventions to sustain the healthcare workforce.

31. Preliminary Comparative Analysis of Kenya's and South Africa's Digital Health Strategies in Relation to the WHO Global Digital Health Strategy.

期刊: Studies in health technology and informatics 发表日期: 2026-May-21 链接: PubMed

摘要

Digital transformation is increasingly central to health system strengthening in LMICs. This preliminary analysis compares Kenya’s and South Africa’s digital health strategies with the WHO Global Digital Health Strategy. Both show strong alignment (Kenya 30/35 components; South Africa 29/35), with gaps in equity, data anonymization, and cross-border interoperability. Findings suggest strong political commitment and advancing governance maturity. Further work will validate results through stakeholder input and implementation evidence.

32. Participatory Technology Assessment in AI Development for Sleep Medicine.

期刊: Studies in health technology and informatics 发表日期: 2026-May-21 链接: PubMed

摘要

This paper argues for the essential role of Participatory Technology Assessment (pTA) in the ethical development of Artificial Intelligence (AI) for sleep medicine. The involvement of stakeholders, particularly patients, is a socio-political and pragmatic necessity rooted in the moral claim to include diverse voices in decisions that affect them, leading to higher acceptance and resolution of value conflicts. AI development in sleep medicine, which is rapidly advancing through big data analysis, introduces complex ethical challenges, including patient privacy, data security, and the potential for algorithmic bias. Sleep data is inherently sensitive, and the risk of re-identification and data misuse by third parties is a major concern. pTA, informed by discourse ethics, provides a necessary framework to move AI development from a purely expert-driven model to a democratically legitimate and ethically informed one. By engaging patients on issues like consent and data control, pTA builds social trust, provides crucial policy insights, and ensures that AI innovation in sleep medicine serves the collective good.

33. Orchestration and Small World Governance in the European Health Data Space.

期刊: Studies in health technology and informatics 发表日期: 2026-May-21 链接: PubMed

摘要

The European Health Data Space (EHDS) introduces a legally binding framework for sharing health data across the EU. While the Regulation provides hard control through obligations, institutions and standards, its effectiveness will likely depend on soft coordination among Member States and stakeholders. This paper interprets the EHDS through orchestration theory and network science, proposing that its mandated governance forms an “orchestrated small world”. We argue that the EHDS represents a hybrid system combining legal authority and distributed agency, in which the European Commission orchestrates a networked ecosystem rather than managing a hierarchy. We map main bodies-the Commission, EHDS Board, Health Data Access Bodies (HDABs), Steering Groups and Stakeholder Forum-onto a multi-level network and hypothesise that intermediaries connect dense national or sectoral clusters, supporting diffusion and resilience. We foresee considering emerging ad-hoc structures such as the xShare Standards and Policy Hub (ESHIA in short). This paper adopts a conceptual-analytical approach and advances a conceptual mapping for applying network concepts such as clustering, path length, modularity and centrality as they offer a new analytical lens for EU digital-health governance. With this, it concludes by inviting quantitative validation by the biomedical-informatics community.

34. 'The stupid thing is, it's all about money': Clinician-Innovators' Perspectives on Financial Sustainability of Digital Health Innovations in a Large Dutch Hospital1.

期刊: Studies in health technology and informatics 发表日期: 2026-May-21 链接: PubMed

摘要

In the context of increasing healthcare digitalization, hospital-based clinicians are developing and implementing decentralized digital health innovations (DHIs) tailored to their patient and clinical needs. However, achieving financial sustainability remains one of their challenges. We explored clinician innovators’ perspectives on these challenges during the implementation and scale-up of their DHIs in a Dutch academic hospital using qualitative methods. Key challenges identified included funding gaps to cover transition costs, misaligned institutional financial incentives and reimbursement structures, short-term logics of funders overshadowing long-term value in DHI financing, and commercialization pressures. Findings provide insights into the financial and operational challenges faced by such context-driven internal innovations, highlighting the need for coordinated project-and institution-level strategies to support sustainable integration into routine care.

35. Metabolic Syndrome Surveillance Through Hospital Informatics in Northeastern Thailand.

期刊: Studies in health technology and informatics 发表日期: 2026-May-21 链接: PubMed

摘要

Metabolic syndrome (MetS) is an emerging occupational health challenge, particularly among healthcare personnel who face heavy workloads, shift duties, and limited self-care opportunities. This study aimed to determine the prevalence of MetS and its associated behavioral and perceptual factors using hospital informatics data. A descriptive cross-sectional study was conducted among 260 staff at Borabue Hospital, Maha Sarakham Province, Thailand. Clinical data were extracted from the hospital’s HOSxP electronic medical record (EMR) system, and behavioral data were collected using validated questionnaires based on the Health Belief Model (HBM) between 16 March and 31 May 2025. The prevalence of MetS was 46.5%. Health belief scores were high (mean 16.5 ± 2.0), while dietary (mean 34.1 ± 6.9) and exercise behaviors (mean 29.5 ± 7.6) were moderate. Dietary behavior and body mass index were significant predictors of MetS. Nearly half of hospital personnel were affected, highlighting occupational vulnerability. Integrating EMR data with behavioral informatics enables real-time risk detection, supports targeted wellness programs, and offers a sustainable model for digital surveillance and personalized health promotion among healthcare workers in Northeastern Thailand.

36. TrustInAging: Digital Tools for Healthy Aging.

期刊: Studies in health technology and informatics 发表日期: 2026-May-21 链接: PubMed

摘要

This poster presents the preliminary results of the TrustInAging project aimed at promoting healthy aging. An application was designed that comprehensively addresses prevention interventions for elderly people. The app addresses the motor, cognitive, social and nutritional areas. The app will be validated in a pilot study by elderly people living alone or in assisted residences.

37. Experts' Perception of AI-Generated Personalised Stories for Health Promotion.

期刊: Studies in health technology and informatics 发表日期: 2026-May-21 链接: PubMed

摘要

A qualitative study is presented aimed to explore how person-tailored stories generated by a storytelling system agent built on a combination of argumentation theory and large language models (LLM) can support a person in reflecting on activities promoting health and potential lifestyle changes. We conducted a formative evaluation with ten domain experts to explore perceived purposes, benefits and risks. They saw both potential opportunities, if applied with a clear purpose for their target groups, and risks in using LLM-based stories for health reflection if not carefully designed to adapt to an individual’s needs. The results will guide further design and implementation of the storytelling functionality, and studies involving older adults.

38. Determinants of the Acceptance of Health-Related Use of Artificial Intelligence in the General Population: A Cross-Sectional Study.

期刊: Studies in health technology and informatics 发表日期: 2026-May-21 链接: PubMed

摘要

The successful integration of artificial intelligence (AI) in healthcare hinges on user acceptance, which is influenced by cognitive, emotional, and contextual factors. This study investigates how general attitudes toward AI, e-health readiness (eHR), and technology anxiety (TA) relate to acceptance of AI applications in healthcare. A computer-assisted web survey of 1,108 Polish Internet users assessed acceptance of AI use in healthcare using a 9-item scale. eHR was measured with the seven-item e-Health Readiness Scale, general attitudes toward AI with a five-item Attitudes Towards AI Scale, and TA with the 11-item Technology Anxiety Scale. Multivariable linear regression, controlling for demographics, socioeconomic status, and health conditions, examined predictors of AI acceptance in healthcare. The model explained 43.3% of the variance in acceptance of health-related AI use (R=0.66, adjusted R2=0.42, F(19,1088)=43.76, p<0.001). Higher eHR (B=0.51, 95%CI=0.42-0.60) and general positive AI attitudes (B=0.85, 0.71-0.98) were strong positive predictors. TA showed a modest positive association (B = 0.16, 0.11-0.21), while AI fear was a negative predictor (B=-0.11, -0.19 to -0.02). Male gender and lower social media use also predicted greater acceptance. Digital readiness and positive attitudes drive AI acceptance, with smaller contributions from anxiety. These findings support tailored training to strengthen eHR in order to enhance the adoption of AI-driven health technologies.

39. Erased in Code: Uncovering Cultural Gaps in Clinical Terminologies.

期刊: Studies in health technology and informatics 发表日期: 2026-May-21 链接: PubMed

摘要

SNOMED CT, the most comprehensive multilingual clinical terminology, is essential for structuring global health data but reveals notable racial, ethnic, and cultural exclusions. Using the Diversity Minimal Item Set (DiMIS) framework, we examined whether socially and culturally relevant concepts-such as values and beliefs, geographical and environmental influences and social practices-are represented within the system. A structured search showed that many of these terms are either absent or insufficiently defined, impeding context-aware diagnostics and inclusive healthcare practices. For instance, while generic items like “scarf” exist, culturally specific terms like “hijab” are missing, and concepts such as consanguinity distinctions, or African Traditional Medicine remain unrepresented. These omissions reflect structural invisibilities that perpetuate healthcare inequities and limit the potential of data-driven, personalized medicine. Addressing these gaps requires inclusive, collaborative revisions of medical terminologies to ensure more equitable and socially responsive health systems.

40. Innovative Virtual Solutions to Address the Gap in Aged Care in Regional Australia: What Are the Critical Work-System Elements Required?

期刊: Studies in health technology and informatics 发表日期: 2026-May-21 链接: PubMed

摘要

Digital health tools such as video-telehealth offer a solution to address the critical gap in aged care health services in regional and remote Australia, however, the elements needed to deliver safe, good quality virtual care remain underexplored. This study aimed to scope the current use of telehealth, determine how individuals, tasks, technologies, tools, environmental and organisational factors interact when telehealth technologies are used in aged care settings, and identify the work-system elements required for successful video-telehealth delivery. Semi-structured interview data were collected from residential aged care staff, and residents, and primary health carers in regional and remote New South Wales (NSW), Australia. Participants were asked about their experiences of using telehealth, what works and does not work well, the level of support, and challenges, changes to work system and processes, and workarounds. A thematic analysis where we mapped data to the components of the Systems Engineering Initiative for Patient Safety (SEIPS) framework was conducted. Findings highlight the importance of a aligned workflow processes, clinical coordinator, flexibility, supportive staff, communication, targeted training and adequate infrastructure to support video-telehealth.

41. Convergence to Steady State in LLM-Generated Ontological Concepts.

期刊: Studies in health technology and informatics 发表日期: 2026-May-21 链接: PubMed

摘要

Large Language Models (LLMs) offer a scalable method to generate candidate concepts for ontology expansion. However, the outputs depend on LLMs’ sampling parameters such as “temperature.” A high temperature leads to increased hallucinations. We consider two hypotheses: (1) LLM outputs for higher temperatures should be supersets of corresponding outputs for lower temperatures; (2) Repeated LLM outputs for lower temperatures should converge to a steady state faster than for higher temperatures. A steady state is defined as k consecutive iterations with no new concepts generated (k-convergence). In this study, we analyzed Environmental Determinants of Health (EnDOH) concepts retrieved at sampling temperatures ranging from 0.1 to 1.0 using concept-structured prompting. Contrary to expectations, higher temperatures do not produce strict supersets of lower temperature outputs. To assess convergence towards a steady state we iteratively executed fixed prompts at different temperatures. Our results confirm that lower temperatures indeed lead to faster convergence.

42. Exploring User Perspectives on a Digital Preconception Care Risk Assessment Tool.

期刊: Studies in health technology and informatics 发表日期: 2026-May-21 链接: PubMed

摘要

Preconception care is considered essential for raising early awareness of health risks among women planning pregnancy, optimizing lifestyle factors, preventing potential perinatal complications, and supporting informed decision-making to improve both maternal and child health outcomes. The target group for preconception care is diverse, including women and men with varying backgrounds and health literacy levels. The digital tool ZwangerWijzer (Preparing for Pregnancy) has been validated and is designed to identify preconception risk factors while providing tailored information on topics such as lifestyle, chronic conditions, and hereditary diseases. This study evaluated the usability of ZwangerWijzer, employing the Think-Aloud method and semi-structured interviews with women (n=13). Results showed that users generally perceived the tool as intuitive, well-organized, and user-friendly. Users also identified room for improvement in content clarity, visual design, and the provision of interactive feedback. Recommendations are provided for further development to enhance accessibility and inclusivity in digital preconception care.

43. Developing a Roblox-Based Fire Drill Simulation for Safety Training in Occupational Health Education.

期刊: Studies in health technology and informatics 发表日期: 2026-May-21 链接: PubMed

摘要

Fire incidents remain a major occupational risk, yet conventional instruction often fails to reproduce the urgency and complexity of real emergencies. This study developed and evaluated a Roblox-based fire drill simulation to enhance fire-safety learning among Occupational Health and Safety (OHS) students. Seventy-one undergraduates at Mahasarakham University participated in a single-group pre-test/post-test intervention consisting of a short instructional video followed by interactive simulation. Outcomes were measured using five multiple-choice knowledge items and a five-point Likert satisfaction scale. Post-test performance improved across all domains, including fire classification (43.66% to 69.01%), extinguisher identification (45.07% to 98.59%), and response actions (62.91% to 90.61%). Participants also reported high satisfaction, emphasizing the simulation’s clarity, engagement, and practical relevance. These findings indicate that a Roblox-based approach can effectively support short-term cognitive and procedural gains in fire-safety education. Future research should examine long-term retention, behavioral transfer, and comparisons with alternative instructional formats.

44. Video-Based Learning to Improve Laboratory Safety Knowledge in Occupational Health Education.

期刊: Studies in health technology and informatics 发表日期: 2026-May-21 链接: PubMed

摘要

Laboratory safety is fundamental in Occupational Health and Safety (OHS) education, yet traditional lecture-based approaches may not adequately promote engagement or knowledge retention. This study developed and evaluated video-based instructional media to improve laboratory safety knowledge among OHS students at Mahasarakham University, Thailand. A total of 61 undergraduates participated in a single-group pre-test/post-test design. The video, structured according to the ESPReL framework, addressed fire safety, chemical spill response, laboratory conduct, personal protective attire, and chemical and equipment storage. Paired t-test analysis showed a significant improvement in knowledge following the intervention (p < 0.001). Mean scores increased from 16.77 ± 2.03 before viewing the video to 24.33 ± 0.90 afterward, indicating enhanced understanding of essential safety principles. Learner satisfaction was high across evaluated domains (M = 4.32-4.65), with particularly positive perceptions of time allocation and lesson organization. These findings support video-based learning as an effective and feasible approach for strengthening short-term cognitive outcomes in laboratory safety education. Future research should examine long-term retention and transfer of learning to practical environments.

45. Predicting COVID-19 Vaccination Decision-Making Profiles Among Dutch Adults: From Survey to National Administrative Data.

期刊: Studies in health technology and informatics 发表日期: 2026-May-21 链接: PubMed

摘要

Individual’s vaccination behaviors are influenced by factors such as values and beliefs. Applying latent class analysis (LCA) to such factors from the Longitudinal Internet Studies for the Social Sciences (LISS) panel[1], Matthijssen et al.[2] identified 12 distinct COVID-19 vaccination decision-making profiles in a sample of 2,567 Dutch adults. However, the extent to which membership in these profiles can be predicted using sociodemographic administrative data remains unknown. We assessed that by linking survey data to administrative records from the Statistics Netherlands (CBS) database and employing an Explainable Boosting Machine (EBM) model. The model showed substantial predictive performance and revealed the central role of income, interacting with other variables, in predicting profile membership.

46. Monitoring of Potential Malignant Oral Lesions and Oral Cancer; Touchpoints for Innovations to Improve Oral Healthcare.

期刊: Studies in health technology and informatics 发表日期: 2026-May-21 链接: PubMed

摘要

Oral potentially malignant disorders (OPMDs) have a high risk for malignant transformation. Currently the gold standard for monitoring of these lesions is through a biopsy. The aim of this study was to identify and explore potential touchpoints based on a service design perspective for improvement of the detection and monitoring of OPMDs and oral cancer. Interviews were conducted in 42 patients (oral leukoplakia (OL) and oral cancer (OC) patients), focusing on experiences within the diagnostic and monitoring process of their (pre)malignant lesions and analyzed through thematic analysis. The need for innovation was most evident in several critical phases: the initial stage of symptom recognition and referral to a specialist and the ongoing monitoring phase, at the specialist and at home. From a patients’ perspective for both OL and OC, touchpoints for innovations are perceived to be mostly needed in the detection phase. This underlines the need for the development of diagnostic tests to support more effective, patient-centered solutions.

47. Assessing Musculoskeletal Discomfort and Ergonomic Risks Among Healthcare Assistants at Operation Room: A Cross-Sectional Study in Thailand.

期刊: Studies in health technology and informatics 发表日期: 2026-May-21 链接: PubMed

摘要

Musculoskeletal disorders (MSDs) are prevalent among healthcare workers who perform physically demanding tasks in operation rooms. This study aimed to assess musculoskeletal discomfort and ergonomic risk, and to evaluate muscle activity associated with manual handling tasks among healthcare assistants at Mahasarakham Hospital, Thailand. A cross-sectional assessment was conducted among 20 participants using a musculoskeletal discomfort questionnaire, Rapid Entire Body Assessment (REBA), and surface electromyography (EMG) of four bilateral muscles: Biceps brachii, Triceps brachii, Trapezius pars descendens, and Erector spinae. The results indicated a high prevalence of discomfort, particularly in the lower back (100%), upper back (95%), and knees (90%). REBA assessment resulted in a score of 13, classified as very high ergonomic risk. EMG findings showed the highest muscle activation in the Erector spinae and Trapezius pars descendens during lifting and transferring tasks, reflecting substantial static and dynamic loading of the trunk and shoulders, while the Biceps and Triceps brachii exhibited moderate activity consistent with their supportive role. These findings demonstrate that repetitive lifting through a 90-cm-high window imposes substantial ergonomic strain. Ergonomic interventions, including workstation redesign, assistive lifting devices, and targeted training, are recommended to reduce musculoskeletal fatigue and improve occupational safety in operation rooms.

48. Microbial Life-History Strategies and Functional Gene Regulation Drive Soil Nitrogen and Phosphorus Bioavailability During Succession in an Arid Valley Ecosystem.

期刊: Molecular ecology 发表日期: 2026-May 链接: PubMed

摘要

Arid valley ecosystems are highly vulnerable to environmental change and face accelerating degradation due to climate warming and anthropogenic disturbance. Although soil microorganisms are known to drive nutrient cycling during succession, their adaptive strategies under persistent nutrient limitation remain poorly understood. This study integrated metagenomics, enzymatic stoichiometry and co-occurrence network analysis to investigate microbial community composition, life-history strategies, and nitrogen (N) and phosphorus (P) cycling functional genes along a successional gradient in an arid valley on the southeastern Tibetan Plateau. We found that microbial communities experienced consistent N limitation throughout succession, which shaped their functional potential and biogeochemical roles. Notably, during the transition from bare soil to biological soil crusts (BSCs), shifts in microbial life-history strategies towards resource acquisition (A-strategy) were accompanied by increased network complexity. Key functional genes, particularly those involved in nitrification (nxrB, amoC), dissimilatory nitrate reduction (nirB, nifH, nirD), inorganic P solubilization (gcd, ppk) and organic P mineralization (phnJ, phoA, phnM, phnI), were significantly upregulated during the BSCs stage. These genetic traits facilitated the transformation of organic and mineral nutrients into bioavailable forms, thereby supporting ecosystem development. This is manifested as a higher bioavailability of DON (+110%) and Bio-P (+97%) in the BSCs stage compared to bare land. Our results demonstrate that microbial communities adapt to resource constraints through trait-based strategies and functional gene regulation, highlighting the BSCs stage acts as a critical biogeochemical trigger in early succession. These insights advance our understanding of microbial-mediated nutrient cycling in arid ecosystems and inform restoration strategies under global change.

49. Prevalence and Clinical Implications of Aspergillus fumigatus Sensitisation in Chronic Obstructive Pulmonary Disease.

期刊: Mycoses 发表日期: 2026-May 链接: PubMed

摘要

Chronic obstructive pulmonary disease (COPD) is a chronic airway inflammatory disease characterised by airway obstruction. Aspergillus fumigatus sensitisation represents a distinct, clinically relevant endotype in COPD. In recent years, studies have shown that sensitised patients experience more frequent respiratory symptoms, exacerbations and a poorer prognosis, while the coexistence of allergic bronchopulmonary aspergillosis (ABPA) further increases morbidity and mortality. Recognising Aspergillus sensitisation (AS) as a potential treatable trait in COPD could provide new insights into disease heterogeneity and offer opportunities for personalised management. This review summarises the prevalence and clinical associations of AS among COPD patients.

50. Onset of Dementia and Changes in Electricity Consumption: A Case Report.

期刊: Geriatrics & gerontology international 发表日期: 2026-May 链接: PubMed

摘要

51. Macrophage piezo1 senses mechanical force to drive osteoclastogenesis via ZBP1: Implications for bone remodelling therapy.

期刊: Clinical and translational medicine 发表日期: 2026-May 链接: PubMed

摘要

The unpredictability of orthodontic tooth movement (OTM) and risks of root resorption stem from poorly understood mechanisms governing alveolar bone remodelling. Specifically, how macrophages transduce mechanical forces into osteoclastogenic signals remains elusive. Our integrated approach combined analyses at multiple levels: clinical analysis of human periodontal ligament (PDL) tissues via qPCR and immunofluorescence; in vivo functional assessment using murine OTM and fracture models with macrophage-specific knockouts (for Piezo1 and Z-DNA binding protein 1 (Zbp1), designated as Piezo1cko and Zbp1cko); and in vitro mechanistic investigation through RNA sequencing of murine bone marrow-derived macrophages (BMDMs) and pharmacological screening. This multi-faceted strategy was employed to dissect the pathway. Mechanical stress activated macrophage Piezo1, triggering Ca2+ influx and subsequent upregulation of ZBP1. This axis was essential for pro-inflammatory cytokine release and osteoclastogenesis. Macrophage-specific deletion of Piezo1 or Zbp1 significantly decelerated OTM and preserved alveolar bone mass. Notably, Zbp1 overexpression rescued the remodelling defects in Piezo1-deficient mice. Virtual screening identified JNJ-10311795 as a ZBP1 modulator; its administration effectively slowed OTM and, conversely, accelerated fracture healing by shifting the balance towards bone formation. The Piezo1-ZBP1 axis constitutes a novel mechano-immune switch converting physical stress into inflammation and bone resorption. Pharmacological targeting of this axis offers a bidirectional therapeutic strategy for controlling orthodontic movement and enhancing bone repair.

52. Emerging Dolutegravir Resistance Among Children on Antiretroviral Therapy With Virological Failure in Malawi: Results From a 2023 National Cross-Sectional Survey.

期刊: Journal of the International AIDS Society 发表日期: 2026-May 链接: PubMed

摘要

Malawi began transitioning children living with HIV (CLHIV) to dolutegravir-based regimens (DBRs) in 2020, and 99.9% were on a DBR by September 2023. With nearly universal use of DBR, surveillance of HIV drug resistance (HIVDR) to dolutegravir is essential. We describe the prevalence and patterns of HIVDR among CLHIV on DBR with confirmed virological failure (viral load [VL] twice ≥1000 copies/mL). We randomly selected 19 of the 25 highest-volume ART health facilities in Malawi for participant enrolment between July 2022 and February 2023. Enrolment criteria included CLHIV aged 2-14 years, on a DBR for ≥9 months and VL ≥1000 copies/mL. Sanger HIVDR genotyping was performed if a repeat VL result post-intensive adherence counselling was ≥1000 copies/mL. The Stanford University HIVDR Database was used for drug resistance interpretation. We present weighted HIVDR prevalence estimates with 95% confidence limits accounting for correlation within clinics. Of 302 CLHIV enrolled, 133 (44%) had confirmed virological failure. The weighted prevalence of dolutegravir resistance among CLHIV with confirmed virological failure was 15.6% (95% CI: 7.1-24.0%), with the presence of major dolutegravir drug resistance mutations (DRMs) in 14.2% (95% CI: 4.8-23.6). The most common dolutegravir DRMs were R263K (n = 11) and G118R (n = 4). Weighted prevalence rates of resistance to nucleoside reverse transcriptase inhibitors (NRTIs), non-nucleoside reverse transcriptase inhibitors (NNRTIs) and protease inhibitors were 42.2%, 65.5% and 5.0%, respectively. Three children had HIVDR to all four drug classes. Dolutegravir resistance was found in nearly one in six Malawian CLHIV with confirmed virological failure on DBRs. This raises concerns for treatment options in this vulnerable population, given the coexistence of high prevalence of resistance to NRTIs and NNRTIs. These results point to the need for regular HIVDR surveillance and further research to guide genotyping prioritization and next-line treatment strategies.

53. Climate Change Elevates the Risk of Antibiotic Resistance in Global Surface Ocean.

期刊: Global change biology 发表日期: 2026-May 链接: PubMed

摘要

Understanding how climate change affects antibiotic resistance genes (ARGs) and virulence factor genes (VFGs) in marine microbiomes is critical to safeguarding global health, yet a systematic, global-scale analysis of their responses and associated health risks remains lacking. Here, we analyzed 890 surface-ocean metagenomic samples, the largest dataset collected using a standardized sampling pipeline to date. Our analysis revealed distinct biogeographical patterns in the composition of ARGs and VFGs across spatial and temporal gradients. Using machine learning, we mapped global distributions of ARGs and VFGs across the surface ocean by leveraging their strong associations with climate-releated environmental factors, revealing clear differences between polar and low-latitude areas. We then quantified the community-level antibiotic resistance risk and identified global risk zones, finding that high-risk regions are the least extensive and occur primarily at low latitudes. Furthermore, we estimated how this risk would change under future climate scenarios, suggesting that anthropogenic climate change is projected to increase the antibiotic resistance risk index of the surface ocean by altering environmental factors, most notably carbonate concentrations. Under the SSP5-8.5 scenario, which respresents a high greenhouse gas emissions pathway, the risk index is projected to rise across 33.0% (95% CI: 32.2%-33.5%) of the surface ocean by 2100, mainly in low-latitude regions, driven by an increase in genes involved in antibiotic efflux, inactivation, and motility. In contrast, effective greenhouse-gas mitigation would limit this increase to 3.7% (95% CI: 3.4%-4.1%). This study advances our understanding of how climate shapes marine antibiotic resistome and underscores the urgency of climate mitigation.

54. Identifying Novel Biomarkers and Therapeutic Targets for Endometriosis: Integrative Analysis of the Plasma Proteome and Genome.

期刊: Mediators of inflammation 发表日期: 2026 链接: PubMed

摘要

There is currently no consensus on the etiology, pathogenesis, or treatment of endometriosis (EM). The discovery of disease-associated plasma proteins with causal genetic evidence provides an opportunity to identify new EM biomarkers and therapeutic targets. Protein quantitative trait loci (pQTLs) were derived from plasma proteomic associations in the UK Biobank Pharma Proteomics Project (UKB-PPP). Genetic associations with EM were obtained from the FinnGen cohort. The associations between proteins and the risk of EM were estimated by cis-Mendelian randomization (cis-MR) and validated using the GWAS catalog dataset of EM. Colocalization, protein-protein interaction (PPI) analysis, functional enrichment analysis, transcriptome differential expression gene (DEG) analysis and druggability evaluation were further performed to explore potential biomarkers and therapeutic targets for EM. Overall, genetically predicted levels of 23 plasma proteins were associated with EM risk, with five proteins validated via replication analysis (ALPI, KHK, HSPG2, STXBP1, and POLR2F). Lower levels of genetically predicted ALPI (odds ratio [OR]: 0.89, 95% confidence interval [CI] 0.83-0.95), HSPG2 (OR: 0.81, 95% CI 0.75-0.88), POLR2F (OR: 0.51, 95% CI 0.36-0.73), and STXBP1 (OR: 0.75, 95% CI 0.64-0.86) were associated with an increased risk of EM. Elevated levels of KHK (OR: 1.09, 95% CI 1.05-1.13) were associated with an increased risk of EM. We also identified ALPI, KHK, HSPG2, STXBP1, and POLR2F as potential drug targets and biomarkers for EM. A series of comprehensive analyses emphasized the potential role of ALPI, KHK, HSPG2, STXBP1, and POLR2F in EM and suggested that these genes could be developed into exact biomarkers and therapeutic targets for this condition in future research.

55. Clinical Factors Associated With Patterns of Medication Errors Among Pediatric Hospitalized Patients in Northwest Ethiopia: A Multicenter Prospective Observational Study.

期刊: BioMed research international 发表日期: 2026 链接: PubMed

摘要

Medication safety is an important public health challenge, especially in pediatrics. Medication errors (MEs) are often underreported in pediatrics and can lead to adverse outcomes such as frequent readmissions, increased total healthcare costs, prolonged hospitalization, and related morbidity and mortality. Thus, this study is aimed at assessing the magnitude and determinants of MEs among pediatric hospitalized patients at comprehensive specialized hospitals in Northwest Ethiopia. A multicenter prospective observational study involving pediatric hospitalized patients was conducted over 4 months, utilizing systematic random sampling for participant selection. Three clinical pharmacists, after a day of training, collected data under the supervision of an MSc health professional, with support from pediatricians in each hospital for reviewing MEs and adjusting treatment plans. Pediatric patients were followed prospectively during their hospital stay from admission to discharge. Data collection occurred via the Kobo Toolbox platform and was analyzed with STATA Version 17.0. Both bivariate and multivariable logistic regression analyses identified factors related to MEs, with statistical significance set at a p value < 0.05. Among 358 pediatric hospitalized patients, 53.63% experienced at least one ME, totaling 254 identified errors. The prescribing stage accounted for the highest percentage of errors (40.16%), followed by the administration stage (32.68%). The predominant types of MEs were dose errors (30.31%), frequency errors (14.96%), and omission errors (14.17%). Multivariable logistic regression analysis revealed that polypharmacy (≥ 5 medications) (AOR = 2.005, 95% CI: 1.269-3.168), male sex (AOR = 1.707, 95% CI: 1.097-2.656), and prolonged hospital stay (AOR = 1.673, 95% CI: 1.076-2.602) were significantly associated with the occurrence of MEs. This study found that MEs were prevalent in pediatric hospitalized patients. Polypharmacy, male patients, and the length of hospital stay were independent predictors of MEs. To reduce MEs, computer-based prescribing practice and clinical pharmacy services should be routine practices in the study settings.

56. Challenges and Strategies for Enhancing Nurse Managers' Financial Management Competencies: A Scoping Review.

期刊: Journal of nursing management 发表日期: 2026 链接: PubMed

摘要

As the financial responsibilities of nurse managers continue to grow in today’s rapidly changing healthcare landscape, there is a clear need to strengthen their financial management competencies. These competencies have historically received less emphasis in the managerial role description compared to other leadership skills. This scoping review aimed to identify factors that hinder nurse managers’ financial management and practical approaches to improve financial management for future implementation in nursing administration practice. We used Arksey and O’Malley’s five-stage framework to structure and guide the scoping review. A systematic search strategy was implemented using the databases PubMed, CINAHL, PsycINFO, and Scopus, with the literature search completed on November 22, 2024. Of the 2142 records retrieved, 14 studies were included in the review, with a total of 1518 participants across all study samples. Most of the studies (64.2%) were conducted in the USA. Thematic analysis identified three major challenges to effective financial management among nurse managers: (1) insufficient awareness, (2) limited authority, and (3) inadequate resources and systems. To overcome these challenges, three key strategic approaches to improve financial management were recognized: (1) practical experience, (2) professional credentials, and (3) targeted training and educational programs. The findings underscore the critical role of both institutional structures and tailored educational supports in enabling nurse managers to effectively carry out their financial duties. Specifically, strengthening competencies requires aligning managerial authority with responsibilities, improving access to systems and resources, and promoting experiential learning, credentialing, and targeted training. These insights offer practical and policy implications for strengthening competencies within nursing leadership. The findings suggest that healthcare organizations should prioritize policy and structural changes to support nurse managers’ financial roles, including expanding managerial authority and strengthening support systems. Such efforts may enhance leadership capacity and improve financial performance in healthcare.