公共卫生研究摘要 (2026-05-25)

共收录 61 篇研究文章

1. Combining Treatment of Acute Malnutrition With Integrated Community Case Management: A Cluster-Randomised Controlled Trial (SETiPlus).

期刊: Maternal & child nutrition 发表日期: 2026-Jul 链接: PubMed

摘要

Achieving good treatment coverage and outcomes for acutely malnourished children is challenging in resource limited and remote settings. Inclusion of treatment within integrated community case management (iCCM) programmes has shown promise, but evidence is limited. We conducted a cluster randomised controlled trial in rural villages within the districts of Hargeisa, Gabiley, and Faraweyne in Somaliland. We compared treatment coverage and outcomes between 18 villages implementing iCCM, where cases of malnutrition (mid-upper arm circumference (MUAC) < 12.5 cm and/or oedema) were referred to MCH clinics, and 19 villages implementing iCCM +, where malnutrition treatment was provided by family health workers (FHW) at village level. Coverage was measured in a closed household cohort at baseline and after 6 months of intervention. Treatment outcomes were determined in an open cohort of cases that were identified by the iCCM FHW and followed up on each month. The prevalence of acute malnutrition diagnosed using MUAC was four-fold lower compared to that diagnosed using weight-for-height z-scores (WHZ) (3% vs. 13%). This larger than expected difference resulted in the study being underpowered. Treatment coverage was 27% and 23% in the control and intervention arms at baseline and increased sharply in the intervention arm with an adjusted difference of 20 percentage points. However, the improvement was not statistically significant (adjusted OR 2.55 (95% CI 0.4, 18.8) p = 0.344). Cases were more likely to start treatment in the intervention arm (difference 71.9% (95% CI 58.1, 85.7) p < 0.001), but relapse and non-response were more frequent (p = 0.041 & p = 0.004). Over diagnosis of acute malnutrition by FHW was high, with 67.4% and 77.4% of cases being misdiagnosed in the control and intervention arm, respectively. While the integration of malnutrition treatment with iCCM shows potential for improving treatment coverage in some contexts, careful consideration should be given to the level of training and supervision required. TRIAL REGISTRATION: ISRCTN31437934. Registered 3/10/2023.

2. Maternal blood lead level and its association with birthweight and preterm birth in Adjara, Georgia: An inverse probability of selection weighting analysis of a population-based cohort study.

期刊: International journal of hygiene and environmental health 发表日期: 2026-May-24 链接: PubMed

摘要

Lead exposure poses significant health risks, particularly during pregnancy, as lead affects fetal development. This study aimed to evaluate the association between maternal blood lead levels (BLL), birthweight and preterm birth in Adjara, Georgia. Using the nationwide Georgian Birth Registry, we included data on all singleton births in Adjara between 1stJuly 2021 and December 2023 (n = 13,911) among women who attended antenatal care. Propensity scores and inverse probability of selection (IPS) weights were calculated to balance the characteristics of women with BLL test (n = 7076) and without (n = 6835). IPS-weighed multivariable linear regression model was used to assess the association between maternal BLLs and birthweight, while IPS-weighted multivariable logistic regression models were used to assess associations between maternal BLLs and low birth weight (LBW, <2500 g), and preterm birth (<37 weeks of gestation). Each 1 μg/dL increase in maternal BLL was associated with a mean reduction of 5g in birthweight (β = -5.02, 95% CI: [-9.05 to -0.99]). No association was observed between BLLs and LBW or preterm birth. Higher maternal BLLs were associated with lower birthweight. However, no significant relationship was observed between maternal BLLs, LBW and preterm birth.

3. Mental disorders related to work: distribution, data completeness, and temporal trends in Brazil, 2007-2023.

期刊: Revista brasileira de psiquiatria (Sao Paulo, Brazil : 1999) 发表日期: 2026-May-24 链接: PubMed

摘要

To characterize the distribution, data completeness, and temporal trends of notifications of Work-Related Mental Disorders (WRMD) in Brazil from 2007 to 2023. Cross-sectional and time-series study analyzing 22,378 notifications recorded in the Notifiable Diseases Information System (SINAN). Notifications were characterized according to demographic and clinical variables. Temporal trends were evaluated using the Joinpoint Regression Mode. WRMD notifications increased from 0.13 per 100,000 employed working-age individuals in 2007 to 3.51 in 2023, with an average annual percent change of 18.24%, and peaks in 2009, 2017, and 2021. Most notifications involved women (64.86%), predominantly aged 35-49 years (49.27%). The Southeast and Northeast accounted for most cases, and anxiety and mood disorders were the most frequent diagnoses. Data completeness was excellent for sex and age group, fair for race/skin color and education, and insufficient for clinical variables related to substance use Temporary disability was reported in 56.38% of cases. WRMD notifications increased substantially over the study period, particularly after 2021. Notifications predominated among women and workers aged 35-49 years, were concentrated in the Southeast and Northeast, and most frequently involved anxiety, stress-related, and somatoform disorders and mood disorders, with temporary disability reported in over half of cases.

4. Second regulatory workshop on utilising in silico models to expedite vaccine development, testing, and lifecycle management - an expert meeting report.

期刊: Vaccine 发表日期: 2026-May-24 链接: PubMed

摘要

The Inno4Vac consortium, funded under the Innovative Medicines Initiative 2 Joint Undertaking, was launched in September 2021. Among its four key objectives is the development of an open-source, in silico simulation platform designed to support the design, scale-up, operation, and technology transfer of vaccine manufacturing processes, including stability testing. A workshop was held on May 27, 2025, in Brussels, Belgium, which provided an opportunity for modellers to show the progress made, and have an open dialogue with regulatory health authorities’ representatives. Regulators are increasingly open to advanced kinetic modelling and other modelling approaches for predicting vaccine stability and shelf-life, provided they are transparent, scientifically justified, and validated with real-time data. Initial claims can rely on accelerated studies and modelling simulating worst-case scenarios, with extensions supported by additional data. In urgent contexts, extrapolation from similar products or processes may be accepted if scientifically sound. Platform-based extrapolation requires strong similarity, but product-specific data remain critical, as small formulation changes can alter stability. Simulation studies that demonstrate robustness and predictive accuracy enhance confidence. Projects like Inno4Vac highlight Bayesian methods for formulation design, though formal guidance is limited. Regulatory scrutiny depends on model risk, with low-risk models probably still requiring justification. Transparent data practices, including justified handling of outliers, are essential. Collaboration between regulators, industry, and academia remains key to advancing science-based innovation while ensuring product quality.

5. Response to "Epidemiology of IBD in Malaysia: a rare longitudinal lens in Asia".

期刊: Inflammatory bowel diseases 发表日期: 2026-May-24 链接: PubMed

摘要

6. Availability of Caregiver-Friendly Workplace Policies: A Follow-Up International Scoping Review Study.

期刊: Journal of aging & social policy 发表日期: 2026-May-24 链接: PubMed

摘要

Caregiver-employees provide unpaid adult care while simultaneously managing employment. The negative health and employment impacts incurred by caregiver-employees have drawn attention to caregiver-friendly workplace policies internationally, which is the focus of this research. Aging populations and changing workforce demographics present challenges for work-life balance. Using PRISMAs methodological guidelines, a comprehensive search strategy to explore the availability of carer-friendly workplace policies was implemented using 17 databases, as developed in consultation with a health science (SS) and a commerce (IP) librarian. Articles included in the review were published between May 1, 2019, and May 31, 2023, written or translated to English, and specifically discussed the provision of unpaid adult care. A total of 45 articles were included in the review, with 53 unique workplaces identified. Using descriptive statistics and content analysis, this study specifically names organizations, their location, and the carer-inclusive policies currently being offered. Workplaces in the finance, technology and healthcare industry/sectors offered the most caregiver-friendly accommodations. Web/App based supports are emerging rapidly among workplaces. Organizational culture change was found to be the most prominent transformative support. The results of this study can inform international policy in response to adapting labor markets to increasing demands of unpaid care.

7. Graduated exposure to traumatic events decreases distress during prolonged exposure therapy for posttraumatic stress disorder.

期刊: Journal of behavioral medicine 发表日期: 2026-May-24 链接: PubMed

摘要

Prolonged exposure (PE) is an evidence-based treatment for PTSD. However, the imaginal exposure portion of PE can be distressing for patients, and despite many service members reporting multiple traumatic events, traditional PE focuses solely on the most distressing event. This article evaluates a modified version of PE that considers the need for distress-reduction in trauma-focused treatments. We compared distress during two methods of imaginal exposure: (1) standard exposure, where participants focused on their most distressing event; and (2) graduated exposure, where participants focused on their top three most distressing events, from third most distressing to most distressing. Mean peak subjective units of distress scores (SUDS) were compared across groups. Participants were 199 active duty personnel and veterans (79.9% men; mean age 38.5 years). There was a significant overall effect of group on peak SUDS, F(3,359) = 12.46, p < .001. Participants receiving standard exposure reported an average peak SUDS of 88.1/100 (SD = 13.4), compared to 75.2 (SD = 22.5) for graduated imaginal exposure participant’s most distressing event. Participants in the graduated group also reported significantly lower peak SUDS for their second (M = 72.23, SD = 20.6; t(183) = 5.49, p < .001, d = .81) and third most distressing events (M = 74.63, SD = 21.1; t(183) = 466, p < .001, d = .69) compared to mean SUDS rating for the standard exposure group. Incorporating a graduated approach appears to mitigate average peak distress from participating in the imaginal exposure component of PE.Trial registration These data were collected as part of a larger, randomized clinical trial that was registered with ClinicalTrials.gov (Identifier NCT03529435).

8. Bimanual asymmetric exercises reduce pathological mirror movements after stroke: a case report with disconnectome mapping.

期刊: Neurocase 发表日期: 2026-May-24 链接: PubMed

摘要

Involuntary mirror movements (MMs) may occur in the nonparetic hand after stroke events, accompanying voluntary movements of the paretic hand. These can interfere with unimanual dexterity and bimanual coordination, potentially impacting the performance of activities of daily living (ADLs). However, neither the changes in such MMs over time nor effective interventions for them have been sufficiently established. We recently treated a patient with right putaminal hemorrhage following a stroke, who presented with difficulties performing bimanual tasks (e.g. typing and washing hair) because of prominent MMs in the nonparetic hand accompanying movements in the paretic hand, despite mild upper-limb motor paralysis and ADL independence. To facilitate voluntary paretic hand movement while targeting independent control of both hands, we implemented a bimanual asymmetric exercises (BAEs), wherein the patient performed different motor tasks with each hand concurrently. This reduced the patient’s MMs while improving bimanual coordination. Even when paretic upper-limb impairment is mild, and patients can perform ADLs independently, evaluations and interventions should be conducted, while remaining mindful that MMs in the nonparetic hand can reduce overall upper-limb performance. BAEs may represent an effective approach for reducing MMs.

9. Efficacy of residual acaricides against Tyrophagus putrescentiae (Sarcoptiformes: Acaridae), a serious pest of high-value stored products.

期刊: Journal of economic entomology 发表日期: 2026-May-24 链接: PubMed

摘要

Methyl bromide is no longer available as a commodity or structural fumigant in many countries, except for quarantine and other critical uses, due to its atmospheric ozone layer-depleting properties. There is a need to find alternatives to methyl bromide to protect dry-cured hams from mold mites, Tyrophagus putrescentiae (Schrank). Residual acaricides may be a means to manage this pest in ham aging rooms, but minimal research has been conducted in this area. Therefore, the objective of this study was to assess some commercially available acaricides and insecticides that could serve as a potential protective barrier in a dry-cured ham aging room. The toxicity of twelve acaricides was evaluated in laboratory studies. Four of these acaricides were effective as residual treatments on surfaces. Twenty mites were transferred to vials treated with different concentrations of these chemicals for 24 h. The persistence of these four chemicals was further assessed over an 8-week period by applying the recommended rate to three different surfaces: metal, concrete, and wood. Results indicated that acequinocyl and amitraz were very persistent and effective at killing mites throughout the experiment period. Amitraz was effective at controlling mold mites for 4 to 6 weeks on metal and 6 to 8 weeks on concrete and wood. Further work needs to be studied on a larger scale, simulating a ham aging room, to evaluate the effectiveness of amitraz and acequinocyl in commercial applications.

10. Children's Everyday Actions After Disaster: Cultural Meaning, Developmental Timing, and Moral Agency in Post-disaster Japan.

期刊: Culture, medicine and psychiatry 发表日期: 2026-May-24 链接: PubMed

摘要

Following the 2011 Great East Japan Earthquake, children in affected regions exhibited everyday behaviors that challenge conventional psychological interpretations. Drawing on ethnographic field observations conducted in schools, shelters, and temporary housing in Miyagi Prefecture between March 2011 and March 2012, with follow-up observations from 2012 to 2013, this study examines five vignettes of children’s post-disaster behaviors: hiding shoes, experiencing perceived scarcity related to school lunches, impulsive spending, giving away sweets and supplies, and engaging in silent play in communal spaces. The study aims to explore how these behaviors function as culturally and developmentally meaningful adaptations to disaster rather than as indicators of psychopathology. Analytically, these behaviors are interpreted through Japanese cultural frameworks-particularly group harmony (wa), reciprocal obligation (giri), and tacit social negotiation-alongside developmental theories of moral and cognitive growth in middle childhood. The findings suggest that these behaviors represent symbolic efforts by children to reassert moral agency, reconstruct temporal coherence, and restore social belonging in disrupted environments. The study concludes that culturally grounded, interpretive approaches are essential for understanding children’s post-disaster responses and for developing psychosocial interventions that recognize children as active agents in communal recovery.

11. Advances in machine learning for cardiac event prediction: where can we still improve?

期刊: Expert review of cardiovascular therapy 发表日期: 2026-May-24 链接: PubMed

摘要

Artificial intelligence (AI) is playing a transformative role in cardiovascular care by enabling more precise prediction of adverse clinical events across prevention, imaging, electrophysiology, and interventional practice. AI models integrate high-dimensional clinical data and imaging-derived phenotypes to improve risk stratification beyond traditional scoring systems, identifying patients who may benefit from earlier, targeted interventions. This review examines recent advances in AI-based cardiovascular event prediction, focusing on coronary artery disease, heart failure, cardiac arrhythmias, and valvular heart disease. In these domains, AI transcends conventional markers - such as ejection fraction and stenosis severity - to extract prognostically relevant insights from complex data streams. Despite this potential, clinical translation remains limited. Many models are retrospective, rely heavily on discrimination metrics, and lack consistent validation across diverse health systems and patient subgroups. Furthermore, risk estimates are rarely linked to explicit management pathways. rigorous external and prospective validation with a focus on calibration and fairness; coupling predictions with actionable care algorithms; and developing interpretable, workflow-integrated tools. Overcoming these barriers is essential to establishing AI-based risk prediction as a reliable clinical standard.

12. Temporal Trends and Future Projections of P ulmonary Embolism and Top Contributing Causes of death in the United States, 1968-2040: insights from the CDC WONDER database.

期刊: Journal of thrombosis and thrombolysis 发表日期: 2026-May-24 链接: PubMed

摘要

Pulmonary embolism (PE) is a preventable yet often deadly cardiovascular event. We aimed to investigate PE mortality trends from 1968-2023 and forecast rates through 2040 in the U.S. We analyzed CDC WONDER death certificates for adults ≥ 25 years. Age-adjusted mortality rates (AAMRs), annual percent changes (APCs) were used to analyse trends and Auto-ARIMA/Prophet forecasting models were used for future projections, all stratified by sex, age, race, and contributing cause of death. From 1968-2023, 516,187 PE deaths occurred, with a mean AAMR of 6.06 per 100,000 (AAPC -1.85). Mean AAMRs were 6.76 in men and 5.57 in women. By age, rates averaged 0.98 for adults 25-44 years, 3.96 for 45-64 years, and 21.73 for ≥ 65 years. Black adults had a mean AAMR of 10.87 versus 5.76 in White adults. From 1999-2023, PE death linked to Coronary Artery Disease, COPD, infection, and diabetes declined, while PE death linked to hypertension rose and heart failure related PE plateaued. Forecasts project an overall AAMR of 3.63 by 2040 (2.32 in men, 3.25 in women), with the highest predicted rate of 9.24 among adults ≥ 65 years. Projected racial AAMRs are 3.70 in White and 7.71 in Black individuals. Hypertension and heart failure linked rates are expected to rise further. Despite a sustained decline in PE death since 1968, persistent racial gaps, aging populations, and rising hypertension and heart-failure related PE threaten progress, highlighting the need for targeted prevention and equitable cardiovascular risk management.

13. Two decades of pulmonary vascular disease and ischemic heart disease mortality in the united states: A longitudinal analysis using CDC WONDER (1999-2020).

期刊: Journal of thrombosis and thrombolysis 发表日期: 2026-May-24 链接: PubMed

摘要

Pulmonary vascular disease (PVD) and ischemic heart disease (IHD) are major contributors to cardiovascular mortality in U.S. adults. This retrospective study aims to examine mortality trends and demographic disparities between 1999 and 2020. However, both diseases have been studied individually, but their combined temporal trends remain unexplored. The CDC WONDER database was used to obtain data for adults aged ≥ 45 years. AAMRs per 100,000 population and APC were calculated using Joinpoint regression, stratified by demographic, geographic, and urbanization categories. PVD and IHD together reported a total of 184,780 deaths. The overall AAMR increased from 6.9 to 8.9 per 100,000 between 1999 and 2020. Mortality rates were higher in men (8.8) compared to females (6.0) throughout the study period. Black or African American individuals had the highest AAMR (8.9), demonstrating a current surge in 2018. Similarly, non-metropolitan areas consistently experienced greater AAMR (8.5) than metropolitan areas (6.9), with a steep rise after 2018 (APC = 14.72%). Furthermore, mortality was greatest in the South; however, the Midwest region reported the highest AAMRs (8). Additionally, individuals aged 85 + had the highest CMR (44.6). Lastly, Vermont had the highest AMMRs (13.6) among other states. PVD- and IHD-related mortality depicted a recent steep increase despite an initial decline, with considerable differences across demographic and regional groups. This highlights the importance of a direct call to action by expanding preventive care, spreading awareness, and early diagnosis with management to address these inequities and decrease the growing burden.

14. Exploratory gut microbiota-host interaction in parkinson's disease: integrative multi-omics analysis of metabolic and epigenetic pathways.

期刊: AMB Express 发表日期: 2026-May-24 链接: PubMed

摘要

Mounting evidence has associated gut microbial composition and systemic metabolic profiles with Parkinson’s disease (PD), yet causal pathways and molecular mechanisms remain unclear. We employed a systematic two-stage analytical framework integrating multiple Mendelian randomization (MR) approaches, transcriptome and epigenome-wide regulatory analyses, and colocalization analysis to genetically dissect the microbiota-host regulatory network implicated in PD susceptibility. Initially, two-sample MR was performed using gut microbiota data from the MiBioGen consortium, followed by an independent replication MR analysis using mbQTL data from the Dutch Microbiome Project (DMP). The two-step MR approach was employed to identify potential mediation of blood metabolites. Summary data-based MR (SMR) methods were also used to pinpoint key blood metabolic genes and regulatory regions associated with PD risk, with the combination of PD GWAS data, blood expression quantitative trait loci (eQTLs), and DNA methylation quantitative trait loci (mQTLs). Colocalization analyses were performed to explore interactions between host metabolic gene expression and the gut microbiota using blood expression quantitative trait loci (eQTLs) and fecal microbial quantitative trait loci (mbQTLs). Our multi-stage analyses identified five microbial taxa with nominal positive associations with Parkinson’s disease (PD), including class Clostridia, order Bacillales, and genera Clostridium sensu stricto 1, Dorea, and Lachnospiraceae UCG001. By contrast, three additional microbial genera (Butyricimonas, Defluviitaleaceae UCG011 and Marvinbryantia) exhibited nominal protective correlations with PD. Cross-cohort analyses further indicated a shared correlation pattern along the Clostridia-Clostridiales-Clostridiaceae/Lachnospiraceae taxonomics potentially linking to PD risk across both discovery and validation cohorts. Mediation analyses indicated that betaine may mediate the Lachnospiraceae UCG001-PD associations, while androstenediol monosulfate may serve as a mediator linking Clostridium sensu stricto 1 to PD. SMR analysis highlights genes like SH2B1, JUP, as key host metabolic genes with potential causal relevance to PD, with colocalization indicating genetic overlaps supporting their potential involvement in gene-microbiota interactions. These findings deepen our understanding of gut-brain axis dysregulation in PD and may provide novel insights for future mechanistic validation and targeted preventive or therapeutic investigations.

15. Association of age-related macular degeneration with exposome related metabolomics.

期刊: Metabolomics : Official journal of the Metabolomic Society 发表日期: 2026-May-24 链接: PubMed

摘要

Age-related macular degeneration (AMD) is a multifactorial disease, but it remains unclear how external exposures - the exposome - promote its development. Metabolomics can provide insights to better understand AMD pathophysiology. Previous work to date has focused primarily on associations between endogenous metabolites and AMD. This study aimed for the first time to investigate associations of exogenous metabolites in plasma and urine and AMD. Cross-sectional study including patients with AMD and a control group (> 50 years) from Boston, US and Coimbra, Portugal (PT). Color fundus photographs (CFP) of all participants were used for AMD staging. Fasting plasma and urine samples were used for metabolomic profiling using Ultrahigh Performance Liquid Chromatography - Mass Spectrometry (Metabolon, Inc). Multivariate and ordinal logistic mixed-effect regression models were computed for each cohort and then combined by meta-analysis. Primary outcome was association of metabolites with AMD (vs. no AMD). False discovery rate (FDR) was used to account for multiple comparisons and significant q-values are reported. We included 1023 eyes (823 from the US and 580 from PT). Meta-analysis revealed significant associations of tartronate, thioproline and 2-methoxyhydroquinone sulfate levels with both presence and staging of AMD (q < 0.005 for all). Similar trends were seen in urine. To the best of our knowledge, this is the first study to identify associations between exogenous metabolites and AMD. These findings are crucial for identifying possible targets for preventive strategies for this blinding disease.

16. Causal relationships between insomnia and blood metabolome: a Mendelian randomization study with mouse experimental validation.

期刊: Metabolomics : Official journal of the Metabolomic Society 发表日期: 2026-May-24 链接: PubMed

摘要

The two-way relationship between metabolites and insomnia is not yet fully understood. We investigated the bidirectional relationship between metabolites and insomnia using human genome-wide association study and mouse models to identify potential biomarkers. We analyzed data from two large genome-wide association studies: one on insomnia (336,965 participants) and one on metabolites (7,824 participants). Genetic variants related to metabolites and insomnia were examined. In the animal study, 12 mice were divided into control and chronic sleep deprivation groups (n = 6 each). After 32 days, blood and fecal metabolites were analyzed. Higher oleate levels were linked to lower insomnia risk (β: -5.99, p = 0.01), but insomnia did not alter oleate levels. Insomnia increased glucose (β: 0.18, p = 0.002), mannose (β: 0.11, p = 0.02), and influenced six lipids and four amino acids. In mice, sleep deprivation lowered corticosterone (p = 0.03), raised glucose and mannose (p = 0.001), and reduced blood (p = 0.007) and fecal oleate (p = 0.05). Fecal 4-aminobutyric acid also decreased (p = 0.01). Insomnia and metabolites exhibited a bidirectional relationship, with notable metabolic and hormonal changes in the animal model. Improving sleep hygiene and regular assessments may help mitigate insomnia-related metabolic disruptions.

17. Reduced Childhood Outdoor Exposure Raises Pediatric Multiple Sclerosis (PedMS) Risk.

期刊: Neurology and therapy 发表日期: 2026-May-24 链接: PubMed

摘要

Sun exposure may influence MS susceptibility, but evidence in pediatric-onset MS (PedMS) is limited. We examined whether reduced early-childhood outdoor time (a proxy for lower sun exposure) is associated with PedMS risk. In the Italian multicenter PEDIGREE Study, environmental data were collected using the PEQ-IT questionnaire. We enrolled individuals < 18 years with PedMS and disease duration ≤ 5 years and controls without CNS inflammatory disorders. Outdoor time was reported by season and age (0-1, 1-2, 3-5 years); reduced activity was defined as < 60 min/week. We included 114 PedMS cases and 121 controls. Cases were 77.2% female; mean (SD) age 16.8 (2.7) years; mean (SD) age at onset 14.2 (2.6) years; median EDSS 1.0 (range 0-4.0). Associations were strongest in winter: reduced outdoor time was associated with higher odds of PedMS in the first year (adjOR 3.02, 95%CI 1.50-6.08), ages 1-2 (adjOR 2.72, 95%CI 1.45-5.09), and ages 3-5 (adjOR 2.66, 95%CI 1.40-5.07). Across ages 0-5, low winter outdoor activity remained strongly associated (adjOR 4.30, 95%CI 1.82-10.17). Other seasons showed weaker but overall significant trends. Limited early-childhood outdoor activity may be associated with increased PedMS risk; larger longitudinal studies are needed.

18. Integrated GC-MS and UHPLC-HRMS/MS profiling of bioactive compounds from Streptomyces sp. BPA-6 isolated from bees-collected pollen.

期刊: Metabolomics : Official journal of the Metabolomic Society 发表日期: 2026-May-24 链接: PubMed

摘要

Antimicrobial resistance is one of the most current global health challenges, due to the increasing ineffectiveness of antibiotics and the increasing difficulty in treating infections. Approximately two-thirds of microbial antibiotics are produced by actinomycetes, of which approximately 74% come from the genus Streptomyces. In this study, a novel actinomycete strain, Streptomyces sp. BPA-6, isolated from pollen collected by Algerian bees, was investigated for its antimicrobial potential and chemical composition by GC-MS and HPLC-MS analyses. The strain showed strong antimicrobial activity against Staphylococcus aureus, Bacillus subtilis, and Candida albicans, with minimum inhibitory concentrations (MICs) ranging from 62.5 to 250 µg/mL. Molecular identification using 16S rRNA gene sequencing and scanning electron microscopy confirmed the affiliation of the isolate to the genus Streptomyces. GC-MS analysis of the ethyl acetate extract revealed a complex mixture of volatile organic compounds, including fatty acid methyl esters, long-chain hydrocarbons, and sesquiterpenes, many of which are associated with antimicrobial, antioxidant, or anti-inflammatory properties. Complementary HPLC-MS profiling identified more than 40 nonvolatile bioactive compounds, including macrolides (erythromycin), polyethers (nigericin), aminoglycosides (netilmicin), polyketides (cytosporone C), and various sugar and lipid derivatives. The chemical diversity of the extract highlights the rich biosynthetic capacity of BPA-6 and its potential as a source of novel natural products.

19. Luxury at a Cost: Portable XRF-Based Bioaccessible Chromium in Sweat Predicts Dermal Exposure Risk to Chromate in Leather Products.

期刊: Environmental science & technology 发表日期: 2026-May-24 链接: PubMed

摘要

Extensive use of chromium (Cr) in leather tanning poses a potential dermal exposure risk to consumers from carcinogenic chromate (CrVI) in leather products. To enable rapid screening, we analyzed 470 commercial genuine leather products from 7 countries using a calibrated portable X-ray fluorescence spectrometer (pXRF). Measurements revealed exceptionally high total Cr, with 93% of samples exceeding 10,000 mg kg-1 and the highest being 60,200 mg kg-1. A positive correlation was found between product price and total Cr content (R2 = 0.65), indicating higher Cr levels in luxury full-grain leathers. To assess potential risk to humans, we quantified bioaccessible Cr in artificial sweat extracts using pXRF (474-4460 mg kg-1), achieving excellent agreement with ICP-OES data. Critically, the bioaccessible Cr pool showed a strong correlation with the CrVI content based on ICP-MS (R2 = 0.77). Leveraging this correlation, we established a pXRF-based risk threshold of 1000 mg kg-1 of bioaccessible Cr in sweat extract. This threshold can be used as a proxy for identifying leather products likely exceeding the regulatory limit of 3 mg kg-1 CrVI. This work transforms pXRF into a validated tool for rapid, risk-based screening of leather products, helping to monitor and mitigate Cr exposure from global leather consumer market.

20. Prevalence of late presentation of HIV among older adults in Asia: a systematic review and meta-analysis protocol.

期刊: Systematic reviews 发表日期: 2026-May-23 链接: PubMed

摘要

Late presentation of HIV among older adults challenges the “End AIDS by 2030” target, posing devastating consequences of individual health outcomes and increasing the burden on social health systems. While Asia faces the double burden of HIV aging and population aging, evidence on late presentation remains fragmented and lacks contextual relevance. We aim to summarize the prevalence of late presentation of HIV and its associated factors in older people living with HIV in Asia. The protocol will follow the 2015 Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols. We will search six international databases and three Chinese language databases. Observational studies reporting the prevalence of late presentation of HIV in older adults in Asia will be included. Study quality will be assessed using the Joanna Briggs Institute Critical Appraisal tools. Data will be analyzed using Stata 18, with meta-analysis, meta-regression and subgroup analyses conducted as appropriate. This study will synthesize evidence on the prevalence of late presentation among older people living with HIV in Asia. Our findings will clarify the status and risk factors of late presentation in older people living with HIV in Asia, offering insights to guide targeted strategies and policy response. PROSPERO CRD42024618152.

21. "Healthy bodies, healthy minds": barriers and solutions to implementing a menstrual hygiene management program in South Sudan.

期刊: Reproductive health 发表日期: 2026-May-23 链接: PubMed

摘要

Menstrual hygiene management (MHM) can be challenging for women and girls living in conflict-affected low- and middle-income countries, where access to menstrual products, soap, water, and private sanitation facilities is often limited. In response to these challenges, the Canadian Red Cross, in partnership with the South Sudan Red Crescent and the South Sudanese Government, implemented the Healthy Bodies Healthy Minds (HBHM) program from 2020-2023 to support MHM in South Sudan. Despite growing attention to MHM needs, few studies have examined the on-the-ground realities of implementing MHM programming in fragile settings. To address this gap, this study aimed to (i) describe the implementation of HBHM, (ii) identify barriers faced during implementation, (iii) identify potential solutions to overcome barriers, and (iv) understand the impact of the COVID-19 pandemic on program delivery. Data was collected through key informant interviews with individuals involved in program design and implementation and were analyzed via thematic analysis. A total of 14 respondents were interviewed. Respondents identified several interrelated and compounding barriers, including resource constraints, logistical challenges, competing stakeholder interests/priorities, ongoing conflict, and climate change. To mitigate these barriers and improve the delivery of MHM programs, respondents recommended solutions and strategies such as extending implementation timelines, planning program activities around anticipated climate events, and strengthening inter-organizational collaboration. The COVID-19 pandemic introduced additional barriers, particularly by restricting the movement of people and goods. However, it also yielded unexpected benefits, notably expanding the project’s reach beyond the target group of girls to the broader community. Implementation of the HBHM program was impacted by several interrelated and compounding factors including resource constraints and logistical challenges, protracted conflict, climate change, and COVID-19, however, collaboration between implementing partners and agility in the approach to program rollout supported enhanced program reach. International partnerships enabled community-level implementation, which proved especially effective for continued program implementation. Additionally, the shift to a more community-based model resulted in benefits to the broader community, offering another key insight that should be considered in the design of future MHM programs in South Sudan and similar contexts.

22. Processes and challenges of integrating nutrition assessment, counselling, and support into health systems in Uganda: a case study of Tororo district.

期刊: BMC nutrition 发表日期: 2026-May-23 链接: PubMed

摘要

Nutrition assessment, counselling and support is a holistic strategy designed to combat malnutrition and enhance health outcomes. Uganda has been implementing this strategy for a decade; however, a comprehensive documentation of the processes and experiences of integrating nutrition assessment, counselling and support in health systems remains scarce. This study aimed at describing the processes and experiences associated with integrating nutrition assessment, counselling, and support into the health system. A phenomenological approach employing a purposive sampling technique was used to document the process and experiences of health workers in integrating nutrition assessment, counselling and support into the health system. The study utilised four focus group discussions, 24 key informant interviews and 22 in-depth interviews to gather insights from the health workers. The interviews were recorded, transcribed verbatim and analysed thematically using ATLAS. ti version 22. Four themes emerged from the study: service delivery and quality for nutrition assessment, counselling and support; challenges and barriers associated with integrating nutrition assessment, counselling and support; community involvement and client empowerment; and capacity building and sustainability. From these themes, the processes and experiences included structured mentorship, performance reviews, supervision, training of health workers, male involvement and community sensitisation on the utilisation of locally available foods. The challenges included staff shortages, inadequate continuous training, a lack of essential equipment, difficulties in managing nutritional assessment data and heavy reliance on donor support. The effective integration of nutrition assessment, counselling, and support programs into the health system requires a structured and well-supported approach at all levels of service delivery. By addressing these challenges and leveraging the lessons learned, a more robust and effective nutrition service delivery system can be achieved.

23. Climate change and the global spread of antimicrobial resistance in livestock systems: a comprehensive review.

期刊: One health outlook 发表日期: 2026-May-23 链接: PubMed

摘要

Climate change and antimicrobial resistance (AMR) are converging threats to livestock systems, food security, and public health. This review synthesizes mechanistic evidence linking climate variables to the proliferation of AMR in livestock and proposes integrated mitigation strategies. Elevated temperatures compromise livestock immunity, increase disease susceptibility, and drive antimicrobial use, while enhancing horizontal gene transfer (HGT) through increased plasmid stability, integrase activity, and bacterial stress responses. Altered precipitation and humidity influence biofilm formation, pathogen survival, and the mobilization of resistant bacteria and antimicrobial residues from manure into soil and water. Floods and droughts further concentrate or disperse resistance determinants across environmental reservoirs, creating transmission bridges between livestock, wildlife, and humans. Key evidence gaps include understudied climate variables (humidity, soil temperature), geographic blind spots (Sub-Saharan Africa, South Asia, Southeast Asia), and a scarcity of field data validating laboratory-based HGT mechanisms. Addressing these challenges requires climate-smart livestock practices (improved housing, adaptive breeding), enhanced antimicrobial stewardship (vaccination, probiotics, biosecurity), and sustainable waste management (anaerobic digestion, composting). Global coordination under a One Health framework, supported by robust policy mechanisms and targeted research funding, is essential to safeguard animal and public health from AMR in a changing climate.

24. A scoping review of COVID-19 modelling studies in Belgium 2020-2024: incorporation of behaviour and lessons learned.

期刊: Archives of public health = Archives belges de sante publique 发表日期: 2026-May-23 链接: PubMed

摘要

The COVID-19 pandemic underscored the importance of integrating human behaviour in infectious disease modelling approaches, yet an in-depth assessment of how behavioural components are incorporated remains limited. We conducted a scoping review of COVID-19 models applied to Belgian data to examine how behavioural dynamics, both voluntary and policy-driven, were represented within model structures. Our aim was to identify current practices, highlight methodological gaps, and provide recommendations for the development of behaviourally integrated epidemiological models. Using Scopus and PubMed, we identified 98 studies published between March 2020 and October 2024, describing 105 models in total. Models were classified by model class (mathematical, statistical, or ensemble), objectives, approaches used to incorporate behavioural factors, and types of behaviour data employed. Behavioural integration was confined to specific modelling contexts, with only half of the 105 models incorporating behavioural components. Mechanistic models, particularly compartmental models, were the most likely to include behavioural features, especially in studies assessing non-pharmaceutical interventions or conducting long-term forecasts and scenario analyses. Behavioural change was most commonly represented through modifications to transmission parameters or contact matrices. These adjustments were frequently informed by social contact surveys or mobility data derived from various sources. In contrast to previous reviews that focused exclusively on behavioural models, this study evaluates the full landscape of Belgian COVID-19 models, offering a comprehensive perspective on how behavioural representation varies across modelling approaches. Our findings recommend that effective behavioural integration relies on timely, routine, and disaggregated surveillance and behaviour data, alongside the use of flexible mechanistic models.

25. Health outcomes of victim-survivors accessing specialist domestic abuse services: the role of abuse experience, vulnerabilities and sociodemographic characteristics.

期刊: BMC women’s health 发表日期: 2026-May-23 链接: PubMed

摘要

Domestic abuse (DA) is a public health problem with wide-ranging impacts for victim-survivors and services responding to it. The purpose of the current study was to explore relationships between victim-survivors’ experiences of abuse, additional needs/vulnerabilities and sociodemographic characteristics, and physical and mental health outcomes and health care help-seeking behaviours following DA. Secondary analysis was conducted using Women’s Aid Federation of England’s (Women’s Aid) case management and outcomes measurement system, On Track, the largest national dataset on DA. To understand the relationship between abuse types (physical, sexual, emotional, financial, coercive control, technology-facilitated abuse (tech abuse) and threats to kill), needs/vulnerabilities (disability; offending, drug and alcohol-related support needs; pregnancy, recourse to public funds and accessing by-and-for services) and health outcomes (perpetrator caused harm to or loss of unborn child, attempted strangulation, self-harm (disclosed), feeling depressed or suicidal, injury requiring GP treatment and injury requiring Accident and Emergency (A&E) treatment), we used a series of logistic regression models, controlling for potentially confounding variables (including accommodation status, sexual orientation and ethnicity). Stakeholders from Women’s Aid and five other third sector organisations input into the study design and interpretation of results. Ninety-six percent of victim-survivors accessing DA services (n = 77,785) were female. Almost half (41.24%) had felt depressed/suicidal, while 5.59% disclosed having self-harmed. Almost one quarter (23.41%) had suffered a strangulation attempt, and 2.54% had suffered harm to or loss of their unborn child caused by the perpetrator. Just under 10% had an injury requiring A&E treatment and slightly less (7.33%) had an injury requiring GP treatment. Associations with the type of abuse varied by health outcome, for example physical abuse followed by threats to kill were most strongly associated with attempted strangulation and injuries requiring GP and A&E treatment, whilst tech abuse was most strongly associated with self-harm and feeling depressed/suicidal. Vulnerabilities/needs were more consistently associated with health outcomes, with those with a disability; drug, alcohol or offending support needs, or living in temporary/unstable accommodation more likely to experience negative outcomes across the board, and almost all needs/vulnerabilities being associated with adverse mental health outcomes (with the exception of pregnancy and accessing specialist by-and-for services, which appeared to have a protective effect). Our findings highlight the almost inevitable harms to mental health for victim-survivors of DA, the dangers of non-physical types of abuse such as threats to kill and tech abuse and the heightened risk of attempted strangulation. These findings have particularly important and timely implications for the training of health care professionals. Alongside improvements in health care settings, health care professionals, specialist support workers, researchers and policymakers must continue to explore more integrative and collaborative ways of working to further improve the response to DA and intervene before irreversible damage is done.

26. Structural tensions between health policy and medical ethics: a qualitative study of physicians' experiences under Türkiye's health transformation programme.

期刊: BMC medical ethics 发表日期: 2026-May-23 链接: PubMed

摘要

Türkiye’s Health Transformation Programme (HTP), launched in 2003, reorganised the country’s healthcare system through interlocking mechanisms: a Performance-Based Revolving Fund (PBRF) - a pay-for-performance scheme - linking physician income to procedure volume; a Central Appointment System (CAPS) imposing daily patient quotas; and a General Health Insurance (GHI) scheme conditioning coverage on premium payment. No integrated qualitative analysis has examined the cumulative impact of multiple HTP mechanisms across all four principles of the Beauchamp and Childress framework using practice-level physician accounts. An interpretive, constructivist qualitative design employing reflexive thematic analysis was used. Twenty-two specialist physicians participated across two phases: seven in a pilot phase for scenario development (not in the analytical dataset) and fifteen in the main interview phase, of whom twelve were retained for analysis after consensus review (n = 12 analytical sample; mean seniority approximately 25 years; criterion-based purposive sampling across five districts of Muğla, Türkiye). Data were collected via semi-structured interviews structured around four researcher-developed hypothetical scenarios. Primary coding was undertaken by the researcher and progressively validated through consensus discussion with the academic supervisor and a professor of medical ethics on the doctoral thesis monitoring committee. Transcripts were returned to participants for review (COREQ item 23). Four primary themes and one cross-cutting pattern emerged. Participants described the PBRF as eroding beneficence and non-maleficence through patient-poaching, defensive clinical decision-making, and progressive normalisation of ethical violations. The hospital enterprise model was described as subordinating patient welfare to revenue priorities. Participants reported that CAPS quotas render genuine informed consent structurally difficult to achieve, while complaint mechanisms deepen perceived autonomy deficits. The GHI’s premium-debt exclusion was described as transferring institutional injustice onto individual physicians. A cross-cutting theme captured participants’ accounts of the transformation of professional identity from patient stewardship to a shift-completion mentality - consistent with the trajectory from moral distress toward moral injury described in the international literature. Physicians in this study perceive HTP policies as creating cumulative tensions with the four-principle framework. These perceptions mirror patterns documented in neoliberal reform contexts across Australia, France, Iran, Botswana, and Canada. They constitute interpretive accounts drawn from a small purposive sample of senior practitioners in a single province, rather than structural diagnoses of the system. Findings argue for integrating practice-level physician accounts into health-policy ethical evaluation alongside efficiency metrics; the scenario methodology offers a replicable approach for practice-informed policy-ethics research rather than a direct structural diagnosis of the system.

27. Substance use and treatment utilization patterns of working-age American men who were not in employment, education, or training (NEET) during the COVID-19 pandemic.

期刊: Substance abuse treatment, prevention, and policy 发表日期: 2026-May-23 链接: PubMed

摘要

A growing population of working-aged men are not in employment, education, or training (NEET). The COVID-19 pandemic has been associated with changes in rates of substance use disorders (SUDs) and treatment seeking in the general population, but COVID-era substance use patterns among NEET men are unknown. We estimated the prevalence and correlates of NEET status among working-aged (18-64) men using data from the 2022 National Survey on Drug Use and Health, a nationally representative survey of non-institutionalized individuals in the United States. We developed logistic regression models to examine associations between NEET status and substance use behaviors and treatment engagement, adjusted for sociodemographic factors. An estimated 11.1% of working-aged men were NEET in 2022 representing 10.6 million individuals. Compared to non-NEET men, NEET men were significantly overrepresented among older age groups, lower income brackets, unmarried individuals, those with lower educational attainment, and Non-Hispanic Black men. After adjusting for sociodemographic factors, NEET status was significantly associated with higher odds of prescription tranquilizer/sedative use disorder (aOR = 3.54, 95% CI: 1.97-6.37), methamphetamine use disorder (aOR = 3.10, 95% CI: 1.82-5.28), and prescription pain‑reliever use disorder (aOR = 2.88, 95% CI: 1.82-4.53), while being inversely associated with alcohol use disorder (aOR = 0.68, 95% CI: 0.54-0.85). More than 1 in 10 working-aged men were NEET in 2022. Adjusted models showed higher odds of past-year SUDs but lower odds of alcohol use disorder. Targeted interventions should include age-appropriate, culturally tailored, and substance-specific treatment programs to improve public health.

28. Practical Qualitative Research Strategies: An Introduction to Data Analysis and Rigorous Coding Practices.

期刊: Journal of nutrition education and behavior 发表日期: 2026-May-23 链接: PubMed

摘要

The increased emphasis on qualitative research in nutrition education and behavior underscores the need for structured processes that enhance analytical rigor and transparency. A 5-phase qualitative analysis process was developed to guide research teams through a structured coding and theming process, while promoting intercoder consistency, critical reflection, iterative refinement, and replication. This process supports novice and experienced analysts alike and is adaptable to diverse study designs. By enhancing the trustworthiness of findings, implementing the 5-phase process can improve program development, evaluation, and adaptation, and inform context-specific, evidence-based policies in nutrition education and health promotion settings.

29. "There is a light that our wives had not seen before": community perspectives on a gender-responsive maternal health intervention in Western Kenya.

期刊: Reproductive health 发表日期: 2026-May-23 链接: PubMed

摘要

The Chamas for Change (Chamas) program is an innovative three-year community-based gender-responsive intervention in Western Kenya. During this period, the program provides peer support, microfinance initiatives, and health education to pregnant women. A randomized control trial demonstrated significant improvements in maternal and child health outcomes for program participants. This qualitative study explored community perceptions of the program. We conducted 9 focus group discussions and 4 key informant interviews between November 2017 and June 2019. Participants (n = 75) were recruited from four sub-counties in Trans Nzoia County representing diverse rural, peri-urban, and urban settings. They included 26 pregnant women (pre-intervention), 19 Chamas women, 10 spouses, 16 CHPs, and 4 county public health nurses (post-intervention). We used purposive sampling to ensure representation across all four sub-counties where the intervention was deployed. We recruited women aged 18-45 years who had experienced pregnancy within the previous two years from each sub-county in Trans Nzoia County, capturing experiences across rural, peri-urban, and urban settings. This sampling strategy ensured comprehensive geographic representation within the intervention catchment area to understand how pregnancy experiences and gender dynamics varied across different community contexts. CHP and local leaders in each sub-county facilitated recruitment. Pre-intervention FGDs explored pregnancy experiences, gender-related barriers to care, and social support needs. Post-intervention, we examined Chamas program components, implementation, cultural acceptability, and perceived effects across individual, interpersonal, and community levels using the socio-ecological model (SEM). Data were analyzed thematically with ATLAS.ti® version 23.4, organizing findings by SEM levels and participant type. Pre-intervention participants described deep-rooted gender inequities and structural barriers to care that shaped pregnancy experiences. Our analysis revealed four key themes: (1) The “heaviness” and isolation of pregnancy shaped by gender roles, (2) Building individual skills and knowledge for pregnant and parenting women and their children, (3) Enhancing interpersonal support and family dynamics, and (4) Community-wide effects and challenges of implementing a gender-responsive program. Participants reported increased self-reliance, health knowledge, and financial skills at the individual level. Interpersonally, the program fostered improved family dynamics, communication, and shifts in gender roles. At the community level, it enhanced social cohesion and collective action, gaining widespread acceptance due to its cultural relevance. The program’s microfinance component created participation barriers for the poorest women. The Chamas program’s integrated approach was viewed favorably across SEM levels showing benefits for individuals and communities. Results show benefits for individuals and communities. Multiple participant perspectives provided comprehensive understanding of the program’s effect. Future research should examine modified microfinance models to enhance accessibility for the poorest women and explore program application in similar settings. Women in rural Kenya face isolation and challenges during pregnancy due to gender inequalities and limited healthcare access. The Chamas for Change program brings pregnant women together in groups that combine health promotion, financial savings, and peer support over three years. Researchers asked different community members - including pregnant women, their husbands, health workers, and program participants - to share their views about the program and its effects.The program empowered women in several important ways. Women gained valuable knowledge about pregnancy and childcare, learned to manage money, and developed self-reliance. The program transformed family relationships - husbands and wives communicated better, and men took more active roles in pregnancy and childcare, shifting away from traditional gender roles. Women built stronger social connections in their communities and worked together to solve problems.Community members welcomed the program and found it respected their cultural values. However, the requirement to contribute money to savings groups prevented the poorest women from participating. The researchers recommend future versions of the program should include these women and suggest testing similar programs in other communities that face similar challenges. This study demonstrates how combining health education, financial skills, and peer support helps address gender inequalities in maternal healthcare while respecting local culture. The Chamas for Change program shows how community-based approaches can improve maternal health outcomes and promote gender equity.

30. Advancing global mental health through social media engagement: lessons from an international professional organization (IACAPAP).

期刊: Child and adolescent psychiatry and mental health 发表日期: 2026-May-23 链接: PubMed

摘要

Since the emergence of social media in 2004, it has become an increasingly influential medium for communication, education, and advocacy within healthcare. For child and adolescent mental health, it offers unique opportunities to engage a diverse global audience, promote mental health literacy, galvanize partners in advocating for children’s mental health and counter misinformation and stigma. At the same time, the use of social media by professional medical organizations raises important questions related to ethics, governance, credibility, and responsible engagement, particularly when working with vulnerable populations such as children and adolescents. Despite the widespread adoption of social media by health professionals and organizations, there is limited guidance on how international professional bodies can strategically and ethically navigate this evolving digital landscape. Here, we draw on our experience managing the social media platforms of the International Association for Child and Adolescent Psychiatry and Allied Professions (IACAPAP), a global organization representing mental health professionals across disciplines and regions. We describe the objectives and scope of IACAPAP’s social media activities, including mental health promotion, professional education, and advocacy, and outline key strategies used and challenges encountered to tailor content across platforms. Based on these experiences, we propose the “ABLE-GA” framework to support responsible social media engagement by professional medical organizations. ABLE-GA stands for Alignment, Boundaries, Language, Ethics, Governance and Adaptation. By sharing lessons learned from IACAPAP’s experience, this commentary aims to contribute to the emerging discourse on the role of social media in child and adolescent mental health and to offer practical insights for professional organizations seeking to use digital platforms effectively and ethically.

31. Ghana's 2025 physical activity report card: children, adolescents and CAWD.

期刊: BMC public health 发表日期: 2026-May-23 链接: PubMed

摘要

Regular physical activity in childhood and adolescence supports cardiometabolic health, mental wellbeing, and learning, yet many countries lack routine surveillance and actionable, benchmark-linked accountability tools. The Active Healthy Kids Global Alliance (AHKGA) “Report Card” approach synthesizes the best available national evidence to grade physical activity behaviours and their determinants, enabling cross-country comparisons and policy dialogue. Ghana last published a Report Card in 2018; since then, new evidence and policy developments warrant an updated appraisal, including attention to children and adolescents with disabilities and/or chronic conditions (CAWD). We compiled and synthesized Ghana-specific evidence used for the 2025 Ghana Report Card within the AHKGA Global Matrix 5.0 framework. Ten common indicators were graded for the regular population (ages 5-17 years) using the Global Matrix 5.0 rubric bands (A + to F; INC for insufficient evidence). Data sources included national school-based surveillance (Global School-based Student Health Survey (GSHS) 2012 fact sheets/microdata), peer-reviewed studies (2009-2022), theses, policy documents, and program-based budgets. When multiple eligible estimates were available, we applied transparent synthesis rules (e.g., unweighted means for Active Transportation). CAWD grades were assigned only when disability-relevant, benchmark-aligned evidence or defensible structured consensus supported grading. Ghana’s highest grades were Sedentary Behaviour (B+) and Active Transportation (B), while Overall Physical Activity was graded D-. Key benchmark-linked estimates included: 25.0% meeting an MVPA proxy guideline (Overall Physical Activity), 27.6% participating in sport ≥ 3 times/week (Organized Sport), 73% active travel to/from school (Active Transportation; unweighted mean), and 78.4% below the “high sedentary time” threshold (Sedentary Behaviour). Physical Fitness was graded C- (mean percentile ~ 40-42 across three field tests). School (D) and Community & Environment (D-) reflected low effective PE delivery and limited access to acceptable, publicly accessible spaces in an Accra-based audit proxy. Government was graded B based on rubric-aligned policy, implementation, and funding/accountability scoring (mean score 67%). For CAWD, 7/10 indicators were INC; assignable grades were Family & Peers (C-), Community & Environment (F), and Government (D+). Ghana’s 2025 Report Card highlights persistently low physical activity levels alongside gaps in school delivery, community environments, and surveillance systems. The CAWD results are dominated by evidence insufficiency, underscoring an urgent need for disability-disaggregated surveillance and inclusive infrastructure, alongside strengthened PE implementation and safer active travel systems.

32. Effects of exergames on depression, anxiety, and sleep in adolescents with subthreshold depression: a randomized controlled trial.

期刊: Scientific reports 发表日期: 2026-May-23 链接: PubMed

摘要

Subthreshold depression (SD) is highly prevalent among adolescents and increases the risk of developing major depressive disorder. Exergaming, an interactive form of digital physical activity, may enhance engagement and improve adherence compared with traditional exercise, making it a promising approach for adolescent mental-health promotion. This randomized controlled trial investigated the effects of an eight-week exergame intervention on depressive symptoms, anxiety, and sleep quality among adolescents with SD. A total of 51 students were randomly assigned to an exergame group (n = 26) or a control group (n = 25). Participants in the exergame group completed moderate-intensity exergaming for 40 min, two to three times per week, while the control group continued routine school activities. Mental-health outcomes were assessed before and after the intervention using validated self-report questionnaires, including the Self-Rating Depression Scale (SDS), the Self-Rating Anxiety Scale (SAS), and the Pittsburgh Sleep Quality Index (PSQI) for subjective sleep quality. After the 8-week intervention, the exergame group showed significantly greater improvements than the control group in depressive symptoms, anxiety, and sleep quality (all p < 0.05). These findings indicate that exergames are an engaging, feasible, and effective school-based strategy for improving mental health in adolescents with SD. As a low-threshold and scalable digital exercise modality, exergaming may offer meaningful benefits for early intervention and mental-health promotion in youth populations.

33. Maternal and cord-blood inflammatory markers and BDNF in diabetic vs. non-diabetic pregnancies.

期刊: Scientific reports 发表日期: 2026-May-23 链接: PubMed

摘要

Maternal diabetes is associated with increased systemic inflammation and has been linked to adverse neonatal outcomes, including developmental delays that persist into early childhood. In this study we sought to characterize and compare the maternal levels and fetal cord-blood levels of the inflammatory markers C-reactive protein (CRP) and IL-6, as well as the neurotrophin brain-derived neurotrophic factor (BDNF) between mothers with pre-gestational Type-1 diabetes (T1DM) or Type-2 diabetes (T2DM), and non-diabetic controls (nonDM).A prospective cohort design was employed, analyzing biomarker concentrations during the third trimester in 98 pregnant women ages 18-40 years of age including 16 participants with T1DM, 49 participants with T2DM and 33 control participants matched for gestational age and body mass index (BMI) to control for confounding factors such as obesity. Plasma samples were collected at 28-30 weeks, 34-36 weeks, delivery, and from cord blood. The biomarkers CRP, IL-6, and BDNF were measured using standardized assays, and concentrations were compared among groups using ANOVA.In T2DM mothers, CRP levels were 2x higher in the third trimester as compared to nonDM controls. In T1DM mothers, IL6 levels were 3x lower than nonDM controls and 3.4x lower than T2DM. While not reaching statistical significance, cord-blood levels of IL6 were higher in T2DMs than other groups (p = 0.052). When examining BDNF levels, no differences were observed between groups.This study emphasizes the importance of addressing inflammation-related risks in pregnancies affected by diabetes. Targeted interventions may mitigate adverse neonatal outcomes and improve health trajectories. Future research should explore direct pathways linking maternal inflammation to fetal neural function to inform clinical strategies.

34. Carbapenem-resistant Gram-negative bacilli infections in Japanese patients with cancer.

期刊: Scientific reports 发表日期: 2026-May-23 链接: PubMed

摘要

Carbapenem-resistant bacteria represent a significant challenge for patients with cancer; however, the characteristics and prognoses of carbapenem-resistant Gram-negative bacilli (CRGNB) infections in Japanese patients with cancer remain unclear. Therefore, we aimed to investigate the features and outcomes of CRGNB infections in this population. This multicenter prospective observational cohort study prospectively enrolled 167 patients with CRGNB infections, with or without cancer from April 2019 to March 2022. The 30-day mortality rate was numerically higher, although not significantly (18.2% vs. 14.0%, p = 0.45), in the cancer group than in the non-cancer group. The average length of hospital stay was similar (44.6 days vs. 51.0 days, p = 0.55). Similarly, the incidence of the composite outcome-defined as the 30-day mortality or events associated with worsening clinical course-was also not significantly different (56.1% vs. 43.6%, p = 0.12). Propensity score analysis using inverse probability weighting showed no significant difference in the 30-day mortality and average length of hospital stay (p = 0.25 and 0.66). However, the incidence of the composite outcome was significantly higher in the cancer group (odds ratio, 2.36; p = 0.02). Patients with cancer and CRGNB infection experienced worse composite outcomes than those without cancer, highlighting the need for preventive measures for CRGNB infections in this population.

35. Avian coronaviruses induce inflammatory responses by activating p38/MAPK signaling and NLRP3/caspase-1 inflammasomes through sphingosine-1-phosphate receptor 1.

期刊: Veterinary research 发表日期: 2026-May-23 链接: PubMed

摘要

Infectious bronchitis virus (IBV), a member of the γ-coronavirus genus within the Coronaviridae family, is a major pathogenic threat to the global poultry industry. Most IBV infections induce severe renal pathological lesions in chickens, yet the renal metabolic perturbations triggered by IBV infection remain largely elusive. Herein, we applied a metabolomic approach to characterize the metabolic profiles of kidney tissues from IBV-infected specific-pathogen-free (SPF) chickens. IBV infection caused profound alterations in the renal metabolome, encompassing amino acids and their derivatives, energy metabolites, and lipid molecules. Most amino acids and their derivatives were significantly downregulated at 7 days post-infection (dpi), indicating that IBV usurps host amino acid pools to support its own replication in SPF chickens. In addition, the levels of L-glutamine, D-mannose 1-phosphate, and D-galacturonate were markedly elevated post-infection, implying their potential roles in mediating host energy utilization and facilitating viral replication during IBV infection. Subsequently, sphingosine-1-phosphate (S1P)-a key bioactive lipid molecule-was identified as a prominently upregulated metabolite in IBV-infected kidney tissues. Follow-up functional experiments revealed that IBV infection upregulates the S1P-S1PR1 signaling axis, and concomitantly activates the p38/JNK/MAPK pathway as well as the NLRP3/caspase-1 inflammasome. Notably, S1PR1 was found to modulate the p38/MAPK signaling pathway and NLRP3/caspase-1 inflammasome, thereby regulating the expression of the proinflammatory cytokines IL-1β and IL-18. Collectively, our study delineates the comprehensive renal metabolic landscape of chickens in response to IBV infection and identifies S1PR1 as a pivotal regulatory target of IBV-induced renal inflammation. These findings provide novel mechanistic insights for the development of preventive and therapeutic strategies targeting metabolic signaling pathways against IBV infection.

36. Traveling with HIV.

期刊: Tropical diseases, travel medicine and vaccines 发表日期: 2026-May-23 链接: PubMed

摘要

International travel is increasingly common, and it remains a clinical context in which preventable morbidity may occur if not adequately addressed through a comprehensive pre-travel consultation. This article provides a structured, evidence-informed framework for counseling people living with human immunodeficiency virus (HIV) who travel internationally, emphasizing the need for individualized assessment and proactive risk mitigation. We outline key domains relevant to travel health in people living with HIV, including legal and structural barriers, general health evaluation, vaccination planning, malaria prevention, sexual health, and strategies for managing expected and unexpected events during travel. Persistent HIV-related entry, stay, and residence restrictions in some countries may influence itinerary planning, disclosure, and access to healthcare abroad. From a clinical perspective, the cornerstone of safe travel is sustained viral suppression on antiretroviral therapy, with careful planning to ensure uninterrupted medication supply, adherence across time zones, and preparedness for loss or theft of medications. Drug-drug interactions are an important consideration, particularly when prescribing malaria chemoprophylaxis or antibiotics. Vaccination strategies should include routine and travel-specific immunizations, with attention to immune status, and the possibility of reduced immunogenicity requiring serological assessment or additional vaccine doses to obtain optimal response. Travel may increase sexual risk-taking and exposure to sexually transmitted infections (STIs), warranting targeted counseling on prevention, post-exposure strategies, and access to testing and treatment. Destination-specific precautions, such as malaria prevention, must combine rigorous mosquito avoidance measures with appropriate chemoprophylaxis compatible with antiretroviral therapy (ART) regimens. Overall, HIV-informed travel counseling should be considered a standard component of comprehensive HIV care, integrating medical, pharmacological, behavioral, and structural considerations to support safe travel and reduce avoidable complications.

37. Future Pharmacists in the Age of Artificial Intelligence: A Mixed-Methods Study of First-Year Students in Vietnam.

期刊: BMC medical education 发表日期: 2026-May-23 链接: PubMed

摘要

To assess AI readiness, perceptions, and usage patterns among first-year pharmacy students, and to identify factors associated with AI engagement. A mixed-methods study was conducted among 220 first-year pharmacy students. Quantitative data were collected using a structured questionnaire assessing AI readiness (cognition, ability, vision, ethics), perceptions, and usage, followed by multivariable regression analyses. Qualitative insights were obtained through semi-structured interviews with a purposive subsample and analyzed thematically. Students showed moderate overall AI readiness, with higher cognition and ability than vision and ethics. AI use was common, primarily for academic tasks, with ChatGPT as the most frequently used tool. Positive perceptions of AI in education predominated, alongside concerns about academic integrity and over-reliance. Higher digital literacy and urban residence were associated with greater AI readiness and more favorable perceptions. Qualitative findings revealed strong interest in structured, pharmacy-specific AI education emphasizing practical application and ethical guidance. First-year pharmacy students demonstrate positive attitudes but uneven preparedness for AI. Early, structured integration of AI training that combines technical foundations with ethical and future-oriented perspectives is needed to support responsible AI adoption in pharmacy education.

38. ZNF831 suppresses triple-negative breast cancer progression through NLRP3-associated pyroptotic signaling and M1-like macrophage phenotypic remodeling.

期刊: Breast cancer research : BCR 发表日期: 2026-May-23 链接: PubMed

摘要

Triple-negative breast cancer (TNBC) remains difficult to treat because of poor immunogenicity and an immunosuppressive tumor microenvironment (TME). Pyroptotic signaling can enhance antitumor immunity through inflammatory cytokine release, but upstream regulators linking this process to macrophage phenotypic remodeling in TNBC remain incompletely understood. We investigated whether zinc finger protein 831 (ZNF831) restrains TNBC progression in association with enhanced NLR family pyrin domain containing 3 (NLRP3)-related pyroptotic signaling and macrophage phenotypic remodeling. We integrated The Cancer Genome Atlas (TCGA-BRCA), Gene Expression Omnibus bulk datasets (GSE103091, GSE176078), and breast cancer single-cell RNA-sequencing datasets from Tumor Immune Single-cell Hub 2 (BRCA_GSE114727_inDrop, BRCA_GSE148673, BRCA_GSE150660, and BRCA_GSE161529) to evaluate ZNF831 expression, prognosis, pathway enrichment, and macrophage-related immune features. ZNF831 was overexpressed or silenced in MDA-MB-231 and 4T1-luc cells to assess macrophage recruitment, macrophage phenotypic changes, NLRP3-associated pyroptotic signaling, and IL-1β/IL-18 release. Chromatin immunoprecipitation (ChIP)-qPCR, actinomycin D chase assays, and RNA immunoprecipitation (RIP)-qPCR were performed primarily in MDA-MB-231 cells to evaluate promoter association, mRNA stability, and transcript interaction. In vivo efficacy was assessed in 6-week-old female BALB/c mice bearing orthotopic 4T1-luc tumors treated intratumorally with MCC950 or PBS. Across cohorts, higher ZNF831 expression was associated with favorable outcome, an M1-skewed macrophage signature, and enrichment of pyroptosis-related pathways. In vitro, ZNF831 overexpression enhanced macrophage recruitment, shifted macrophage phenotypes toward a more pro-inflammatory M1-like state while suppressing M2-like features, promoted NLRP3-associated pyroptotic signaling, and increased IL-1β and IL-18 release, whereas ZNF831 knockdown produced opposite trends. Mechanistically, ZNF831 showed association with the NLRP3 promoter and selective enrichment of NLRP3 mRNA, consistent with multi-level regulation of NLRP3 expression. In vivo, pharmacologic inhibition with MCC950 attenuated the antitumor effects and macrophage-related changes associated with ZNF831 overexpression. These findings support a role for the ZNF831-NLRP3 axis in shaping a more inflammatory TNBC microenvironment and suggest that ZNF831 may contribute to macrophage M1-like phenotypic remodeling through NLRP3-associated pyroptotic signaling.

39. Microbial systems for azo dye biodegradation: enzymatic mechanisms, microbial consortia, and emerging biotechnological strategies.

期刊: Microbial cell factories 发表日期: 2026-May-23 链接: PubMed

摘要

Azo dyes are the most widely used class of synthetic colorants in textile and related industries; however, their discharge into natural ecosystems poses severe environmental and human-health concerns due to their xenobiotic structure, toxicity, and resistance to degradation. Traditional physicochemical remediation strategies are often costly and may result in incomplete mineralization and secondary pollution. Microbial systems provide an ecologically compatible and economically viable solution through efficient enzymatic reduction and subsequent mineralization of azo dyes and their degradation intermediates. This review synthesizes current advances in microbial bioremediation, with particular emphasis on the enzymatic mechanisms and metabolic processes involved in azo dye degradation, including the roles of key enzymes such as azoreductases, laccases, and peroxidases. The synergistic performance of microbial consortia, optimization of environmental and nutritional parameters, and the integration of bioelectrochemical systems are also discussed. Recent innovations-including genetic engineering, advanced immobilized biocatalysts, nanobiotechnology, high-performance bioreactors, and artificial-intelligence-driven process optimization-are evaluated for their potential to enhance biodegradation efficiency and operational stability. Finally, the major challenges and future perspectives for developing robust microbial systems capable of efficient detoxification and mineralization of azo dyes in industrial wastewater are highlighted. Overall, this review emphasizes the potential of microbial systems and emerging biotechnological strategies as sustainable solutions for azo dye remediation and environmentally responsible wastewater management.

40. Climate vulnerability factors for temperature-related respiratory mortality: a nationwide two-stage time-series study from 2008 to 2021.

期刊: Environmental health : a global access science source 发表日期: 2026-May-23 链接: PubMed

摘要

Taiwan is one of the fastest-warming regions globally. As climate change intensifies, understanding how vulnerability influences health outcomes critical. This study aimed to identify regional vulnerability factors for temperature-related respiratory mortality and effective region-specific adaptation policies. A two-stage time-series study was conducted using daily respiratory mortality counts aggregated by county and day. This study employed a distributed lag non-linear model to estimate the temperature-attributable mortality burden from respiratory diseases across all counties and cities in Taiwan. A two-stage meta-analysis was conducted to estimate temperature-mortality associations and quantify cold- and heat-related mortality burdens by county. Meta-regression was used to identify regional vulnerability factors modifying temperature-related mortality risk, and geographically weighted regression (GWR) was applied to characterize the spatial heterogeneity of these effects across counties. Cold exposure was linked to a higher burden of respiratory disease mortality (attributable fraction [AF]: 2.03%, 95% CI: 1.10-2.95) than heat exposure (AF: 1.02%, 95% CI: 0.65-1.40). For cold-related AFs, higher proportions of Indigenous populations (3.27, 0.79-5.75), low-income populations (2.11, 0.67-3.55), greater population density (2.21, 0.46-3.96), and children (0.98, 0.35-1.61) were significantly associated with increased risk, suggesting vulnerability factors. GWR further showed that hospital bed availability had statistically significant protective effects against cold-related AF in 10 of 19 counties (β = - 5.24 to - 6.78), most pronounced in remote mountainous counties (Hualien, Taitung, Kaohsiung). Higher proportions of Indigenous populations, low-income population, and children amplify cold-related respiratory mortality. Hospital bed availability confers the strongest protection against cold-related mortality in remote, mountainous counties. Climate adaptation policies for cold-related respiratory health should therefore be tailored to local vulnerability profiles, prioritizing healthcare expansion in geographically remote counties rather than applying uniform investment across all regions.

41. Knowledge and perceptions of climate change and diarrhea prevention practices in Nepal.

期刊: BMC public health 发表日期: 2026-May-23 链接: PubMed

摘要

Despite growing awareness of the health risks associated with climate change, how Nepalese people perceive these threats and their links to diarrheal diseases remains insufficiently understood in Nepal. This study examines and compares knowledge of climate change and diarrheal prevention practices among communities in four districts in Koshi and Karnali provinces. We conducted a cross-sectional study from February 12 to June 28, 2023, surveying 882 households using a structured questionnaire. Data were collected on socio-demographic characteristics, climate change knowledge, perception of climate change and its impact on diarrhea, and practices for diarrhea prevention. Statistical comparisons between Koshi and Karnali provinces were performed to identify potential drivers of differences, and multiple logistic regression analyses were used to examine associations between socio-demographic factors and study outcomes, including climate knowledge and diarrheal prevention practices. Of the 882 participants, 70% were aware of climate change; among them, 66.1% strongly believed climate change increases diarrheal risk, with higher agreement in Koshi (P = 0.029); 60.9% linked rising temperatures to more diarrheal cases (P = 0.046), while only 24% associated it with increased precipitation. Regarding diarrheal prevention, 94.3% reported access to safe drinking water and 84.1% used improved sanitation facilities (P = 0.001). Only 11.3% of participants were vaccinated against rotavirus; 36.6% did not purify their water and 37.2% used cloth-filtered water. Despite access to care, 70.1% delayed treatment for diarrheal illness, varying by province (P < 0.001). In the multivariate analysis, females had significantly higher odds of lacking knowledge of climate change compared with males (AOR: 1.51; 95% CI: 1.14-2.08). A similar pattern was observed among participants engaged in agriculture (AOR: 6.16; 95% CI: 1.42-26.50) and labor occupations (AOR: 9.48; 95% CI: 1.81-49.71), indicating lower knowledge levels in these groups. Residents of the Karnali Province (AOR: 2.59; 95% CI: 1.83-3.66) had higher odds of not immediately visiting a health institution for diarrheal illness, indicating delayed healthcare-seeking behavior. Although two-thirds of participants recognized the impact of climate change on diarrheal disease, our study identified low rotavirus vaccination coverage, suboptimal household water treatment practices, delayed care seeking, and limited recognition of rainfall as a risk factor. These findings highlight the need to strengthen education on climate-related risk factors, promote safe water and sanitation practices, and encourage timely healthcare seeking in the study districts to combat diarrhea in the context of climate change.

42. Comprehensive evaluation of surface water quality: heavy metals, speciation, and human health risks in an industrial region of West Bengal, India.

期刊: Environmental monitoring and assessment 发表日期: 2026-May-23 链接: PubMed

摘要

This study evaluates the hydrogeochemical characteristics, heavy metal (HM) contamination, irrigation suitability, and associated human health risks of surface water in an industrial area affected by dye-manufacturing activities in West Bengal, India. A total of 30 surface water collected in triplicate were analysed. Major ions were determined using standard American Public Health Association (APHA)  methods, HMs were quantified using atomic absorption spectrometry (AAS), and aqueous speciation was modelled using Visual MINTEQ. The water was slightly alkaline, with pH values ranging from 7.18 to 8.92 (mean 7.79±0.41). Extremely high salinity was observed, as electrical conductivity ranged from 2500 to 21,000 μS cm⁻¹ (mean 11,300±4272 μS/cm), while total dissolved solids varied between 1500 and 12,600 mg/L (mean 6780 ± 2563 mg/L), exceeding World Health Organization (WHO) guideline values. Major cations followed the order Ca²⁺ > Mg²⁺ > Na⁺ > K⁺, whereas dominant anions were HCO3⁻ > Cl⁻ > SO42⁻, reflecting combined geogenic and anthropogenic influences. Mean concentrations of heavy metals were elevated, with values of Cr (0.97 mg/L), Pb (0.23 mg/L), Ni (0.19 mg/L), Cu (0.06 mg/L), and Cd (0.004 mg/L). Except for Cu, all metals exceeded WHO permissible limits, indicating substantial contamination. Pollution indices (Pi) confirmed severe degradation, with Pi > 1 for Pb, Ni, Cr, and Cd. High average values of Cd (48.89), Heavy Metal Evaluation Index (HEI), 53.65, and Heavy Metal Pollution Index (HPI), 338.73, indicated high to extreme pollution, while Water Pollution Index (WPI) values (1.51-5.27) classified all samples as severely polluted. Speciation modelling showed Cd predominantly occurred as Cd2+ (52.35%) and CdCl+ (32.10%), suggesting high mobility. Lead (Pb) was predominantly present as PbCO3(aq) (39.47%) and PbHCO3+ (31.31%), Ni largely as Ni2+ (63.15%), and Cr(VI) mainly as CrO42⁻. Copper was largely present as CuCO3(aq) (67.94%). Irrigation indices indicated suitability, although overall water quality remained poor. Human health risk assessment identified Pb and Cr as posing non-carcinogenic risks, while Cr presenting the highest carcinogenic risk, particularly for children (CR > 1 × 10⁻4). Overall, the findings highlight severe surface water degradation and underscore the urgent need for remediation measures and stricter regulatory intervention.

43. Game-based and gamification-enhanced telerehabilitation for physical therapy in people with multiple sclerosis: a scoping review.

期刊: Biomedical engineering online 发表日期: 2026-May-23 链接: PubMed

摘要

People with multiple sclerosis (MS) commonly experience balance, gait, and upper-limb impairments that require long-term physical therapy (PT). Home-based telerehabilitation can improve access to therapy, and game-enhanced interventions (serious games/exergaming) and gamification elements may enhance engagement and adherence. This scoping review examined the current evidence and explored the implementation considerations of gamification-based telerehabilitation (GBT) systems designed to deliver home-based PT for people with MS. Following PRISMA-ScR guidance, the databases OVID Medline, OVID EMBASE, CINAHL, and EBSCO were systematically searched between January 2010 and November 2024. Fifteen studies satisfied the inclusion criteria. Study quality was appraised using the Downs and Black checklist, and evidence levels were classified according to a modified Sackett scale. The majority of the 15 studies were of fair-to-good methodological quality, and all used a quantitative design with small sample sizes. The included studies mainly focused on whole-body physical rehabilitation. Eleven studies used commercial games, while others developed customized hardware or software modules. No serious adverse events were reported. High levels of participant satisfaction and adherence in home settings supported feasibility. The effectiveness of GBT for people with MS is still uncertain because the results are mixed. Across controlled trials, balance and postural control outcomes showed the most consistent improvements, whereas fatigue, QoL, and participation outcomes were mixed and often not significant between the groups. GBT solutions may serve as a therapeutic alternative to conventional therapy, particularly when access to traditional services is limited or when individuals with MS experience reduced motivation to maintain their exercise routines. More research is needed to find out which measures respond best, which subgroups benefit most, and to provide stronger evidence through the use of both within-group and between-group comparisons.

44. Exploring perspectives on structured academic debates as a learning strategy in speech-language pathology graduate education: a qualitative descriptive study.

期刊: Disability and rehabilitation 发表日期: 2026-May-23 链接: PubMed

摘要

Rehabilitation professionals require strong critical thinking, teamwork, and communication skills that can be developed through active learning methods such as debates. Debates have been used to develop these skills in fields such as occupational therapy, medicine, and nursing, but have not been studied in speech-language pathology (SLP). Across health disciplines, there is limited research on how debates compare to other learning methods and how students and faculty perceive their utility. We conducted a qualitative descriptive study of SLP graduate students and faculty who engaged in debates on a range of controversial SLP topics. Data were collected using surveys and focus groups and were analyzed using inductive content analysis. Across 18 participant responses, debates developed unique skills (e.g., evidence-based practice, communication and collaboration, cognitive flexibility/clinical reasoning, personal skills) and had unique disadvantages (e.g., challenges navigating controversial topics, risks of incorrect information, missing opportunities for multimodality, student stress). Participants also provided recommendations for rehabilitation educators delivering debates in the future. Many of the skills developed and disadvantages of debates in our study align with existing literature on debates in health professional education. The results of our study may be valuable for health professional educators, including SLP educators, as they design curricula. Education programs for rehabilitation professionals (e.g., speech-language pathology, occupational therapy, physiotherapy) use various active learning methods to develop critical thinking and clinical reasoning skills.Academic debates have been shown to develop critical thinking skills in other health disciplines but are yet to be studied in speech-language pathology.Educators can implement academic debates to equip learners for real-world clinical discussions, enabling students to share their opinions on controversial topics and evaluate new evidence using their clinical reasoning.

45. Radioprotection maturity in nuclear medicine: A structured KPI assessment framework.

期刊: Journal of medical imaging and radiation sciences 发表日期: 2026-May-23 链接: PubMed

摘要

Nuclear medicine uses unsealed radioactive sources, creating radioprotection challenges that span governance, patient optimisation, occupational monitoring, contamination control, and radioactive waste/public protection. A structured questionnaire-based KPI approach can support systematic assessment of radioprotection maturity across these domains. We developed a structured questionnaire-based KPI assessment framework for nuclear medicine radioprotection. The framework was operationalised into a predefined KPI dictionary covering governance and training, patient protection and optimisation, occupational protection, contamination control, waste/public protection, and incident learning/improvement. Questionnaire items were designed to capture binary, categorical, and continuous indicators using consistent definitions and reference periods. The questionnaire structure suggested variability in management maturity, with stronger emphasis on role designation and basic radiation protection arrangements than on formalised quality management systems. Training and induction items indicated moderate but uneven maturity, suggesting that workforce preparation may require clearer standardisation. Patient optimisation appeared comparatively well represented, particularly through administered-activity benchmarking, although pregnancy and breastfeeding screening remained an important gatekeeping area requiring more consistent formalisation. Therapy-related questionnaire items suggested stronger attention to post-therapy instructions than to fully documented release procedures. Occupational protection responses indicated generally established dosimetry arrangements, with technologists appearing as the staff group most exposed by workflow proximity, while extremity and eye monitoring remained less consistently incorporated. Incident learning emerged as the least mature domain, with limited formal reporting structures, weak external learning participation, and slower corrective-action feedback loops. Overall, the qualitative pattern indicates that routine technical controls were better represented than structured governance, documentation, and learning-system maturity. A structured questionnaire-based KPI framework can help nuclear medicine services review core infrastructure, patient optimisation, gatekeeping protocols, occupational monitoring, contamination control, waste/public protection, and incident learning. The framework provides a practical basis for generating measurable safety-system improvement plans aligned with international radiological protection expectations. Nuclear medicine uses small amounts of radioactive materials for diagnosis and treatment, which requires careful safety measures. This study developed a structured checklist to review how well nuclear medicine services manage safety across areas like staff protection, patient care, and waste handling. This study found that basic safety practices were generally in place, but systems for management, documentation, training, and learning from incidents were less developed. This matters because clearer standards and stronger safety systems can help protect patients, staff, and the public more effectively.

46. Shelf Acetabuloplasty Restores Native Rotational Motion in a Cadaveric Acetabular Dysplasia Model.

期刊: Journal of ISAKOS : joint disorders & orthopaedic sports medicine 发表日期: 2026-May-22 链接: PubMed

摘要

Developmental dysplasia of the hip is associated with inferior clinical outcomes when treating concomitant intra-articular pathologies. Shelf Acetabuloplasty has been proposed as a less invasive alternative to periacetabular osteotomy for developmental dysplasia of the hip; however, there is a lack of biomechanical studies regarding its efficacy. We hypothesized that a cadaveric dysplasia model would cause increased range of motion and lateral femoral head translation compared to native, and that shelf acetabuloplasty would restore native biomechanics. Ten cadaveric hips were dissected down to the capsule and mounted to a 6-degrees of freedom robotic arm. Each specimen was tested sequentially in 4 states: 1) Native, 2) Capsular repair, 3) Acetabular dysplasia model created by acetabular rim resection to achieve a lateral center-edge angle (LCEA) of 15-20° under fluoroscopic guidance, and 4) Shelf acetabuloplasty restoring LCEA of 35-40° utilizing a bone graft harvested from the iliac crest. Robotic testing included: 1) 5- Newton Meter (Nm) abduction, 2) 5-Nm internal rotation (IR) at 75° flexion, 3) 5-Nm flexion, and 4) 88-N Lateral Drawer. Range of motion under standardized torque was used as a surrogate measure of rotational stability. The effect of specimen state was determined using analysis of variance, and post hoc pairwise comparisons were made using Tukey’s method. Capsular repair did not statistically significantly differ from native state. Compared to native, the acetabular dysplasia model showed increased abduction (+2.3°, p=0.004) and IR at 75° flexion (+0.9°, p=0.017) without statistically significant changes in flexion or lateral translation. Shelf acetabuloplasty restored native abduction and IR at 75° flexion but reduced hip flexion (-1.7°, p=0.003). This study demonstrated that acetabular rim resection increased rotational motion under applied torque, while shelf acetabuloplasty restored rotational motion to native levels. However, shelf acetabuloplasty resulted in a statistically significant reduction in hip flexion (-1.7°, p=0.003), suggesting potential over-constraint depending on graft positioning. Not Applicable, Controlled Laboratory Study.

47. RIFM fragrance ingredient safety assessment, 1-(1,2,3,4,5,6,7,8-octahydro-2,3,8,8-tetramethyl-2-naphthalenyl)ethanone, CAS Registry Number 54464-57-2.

期刊: Food and chemical toxicology : an international journal published for the British Industrial Biological Research Association 发表日期: 2026-May-22 链接: PubMed

摘要

48. PFAS associated with dysglycemia and glucose trajectories: A prospective cohort study from the Isomers of C8 Health Project in China.

期刊: Environmental pollution (Barking, Essex : 1987) 发表日期: 2026-May-22 链接: PubMed

摘要

The longitudinal relationship between per- and polyfluoroalkyl substances (PFAS) exposure and dysglycemia in adults is not well understood. This study aimed to investigate this association in a prospective cohort of 741 adults (2015-2020). Serum concentrations of nine PFAS congeners were measured, and FBG levels were assessed annually. Linear mixed models (LMM) assessed individual PFAS associations with FBG changes, while quantile g-computation (qg-comp) and advanced bayesian kernel machine regression (A-BKMR) evaluated mixture effects. A Group-based trajectory model (GBTM) identified four FBG trajectories: normal-low, normal, at-risk for high-FBG, and persistent-increasing. Multinomial logistic regression, qg-comp and A-BKMR were further applied to estimate the associations between PFAS exposure and FBG trajectories. LMM, qg-comp and A-BKMR analyses indicated positive associations between PFAS exposure and longitudinal FBG levels. Longitudinal analysis indicated that perfluorooctane sulfonate (PFOS) and perfluoro-n-tridecanoic acid (PFTrDA) were associated with increases in FBG from 2015 to 2020. In multinomial logistic regression, two PFAS congeners PFOS and PFTrDA were associated with a higher probability of belonging to the persistent-increasing trajectory group. In the longitudinal qg-comp and A-BKMR models, higher PFAS mixture concentrations were associated with increased odds of belonging to the persistent-increasing trajectory group, compared with the normal-low trajectory. Higher PFAS mixture concentrations were also significantly associated with prediabetes (HR = 2.09, 95% CI: 1.03-4.23). PFTrDA and PFOS emerged as potential key contributors to the observed associations. Overall, these findings suggest that PFAS exposure may contribute to persistently increasing FBG levels in adults.

49. Network structure of artificial intelligence anxiety among nursing students and educational implications: A multicenter network analysis.

期刊: Nurse education today 发表日期: 2026-May-20 链接: PubMed

摘要

While artificial intelligence (AI) transforms nursing practice, nursing students experience profession-specific AI anxiety. This study examines the network structure of such anxiety and its association with learning needs. This study aims to describe the network structure of AI anxiety among nursing students, compare anxiety network differences between students with associate degree or below and those with bachelor’s degree or higher, and explore the association between anxiety and learning needs. A multi-center cross-sectional survey using stratified convenience sampling. Schools of nursing within 93 medical universities from 13 provinces across China’s five major geographic regions (North, South, East, Western, and Central China), representing diverse nursing education environments. 1253 nursing students were recruited from May to June 2025. The study used a general information survey, the Artificial Intelligence Anxiety Scale (AIAS; 21 items, 4 dimensions), and a learning needs assessment. Gaussian graphical network and bridge centrality analysis identified core symptoms and cross-dimensional pathways. Group comparisons used permutation-based network invariance testing. This study collected 1113 valid questionnaires. Nursing students’ AI anxiety exhibited a complex network structure (21 nodes, 103 edges, density = 49.05%), with learning interaction anxiety (node strength = 1.746) and concerns about AI misuse (bridge strength = 1.808) as core symptoms. Learning AI technology and specific functions showed the highest predictability (R2 = 0.925). Students with associate degrees or lower demonstrated stronger cross-dimensional anxiety connections (e.g., fear of robot autonomy → job displacement, P = 0.022), while fear of job displacement was positively correlated with learning motivation (edge weight = 0.29). The network displayed excellent stability (CS coefficient = 0.75). AI anxiety among nursing students forms a stable and interconnected network, with profession-specific hubs. Targeted interventions should prioritize procedural learning anxiety and ethical misuse concerns, while using occupational threats as a catalyst for learning. Curriculum reform must address the higher susceptibility of associate degree or below education students to anxiety spillover effects.

50. MMIP-assisted selective molecular depletion of icaritin-type aglycones for causality-guided metabolite identification in fermented Epimedium.

期刊: Journal of chromatography. A 发表日期: 2026-May-19 链接: PubMed

摘要

Establishing causal relationships between individual metabolites and biological activity in complex natural product systems remains a significant analytical challenge, as conventional chromatographic profiling is largely limited to correlation-based interpretation. In this study, a chromatography-guided analytical intervention strategy was developed based on a magnetic molecularly imprinted polymer (MMIP) to enable selective and quantitative manipulation of target metabolites in fermented Epimedium flavonoids. Time-resolved UPLC-MS/MS profiling revealed rapid microbial deglycosylation of prenylated flavonoid glycosides, accompanied by the accumulation of icaritin-type aglycones, particularly icaritin and desmethylicaritin. An icaritin-imprinted MMIP was synthesized and systematically characterized, exhibiting high binding capacity (58.14 mg g⁻¹), favorable adsorption kinetics, and selective recognition toward target aglycones. Under optimized conditions, the MMIP enabled controlled depletion of icaritin from fermented matrices, and residual levels were accurately quantified by a validated HPLC-UV method, achieving a removal efficiency of 84.5 %. Selective removal of aglycones resulted in a pronounced attenuation of cartilage-promoting effects in zebrafish models, and the magnitude of functional loss was quantitatively correlated with the degree of depletion, providing direct evidence of metabolite-activity causality. Compared with conventional fractionation approaches, the proposed strategy enables selective chromatographic modulation of target analytes with minimal disturbance to the surrounding chemical matrix, extending chromatographic analysis from passive profiling to active molecular intervention and providing a generalizable framework for causality-oriented metabolite identification in complex systems.

51. Social phenotype of early-onset Parkinson's disease: occupational loss, marital disruption, and caregiver inversion.

期刊: Parkinsonism & related disorders 发表日期: 2026-May-19 链接: PubMed

摘要

52. Long-term Outcomes of Low-Energy Open Tibial Shaft Fractures: A 10-Year Follow-up Study of Infection Rates.

期刊: West African journal of medicine 发表日期: 2026-Apr-30 链接: PubMed

摘要

Low-energy open tibial shaft fractures present a clinical challenge, particularly in resource-limited settings. While high-energy injuries have been widely studied, the long-term outcomes of low-energy mechanisms remain underreported. This study assessed the clinical outcomes and long-term complications of cast immobilization following surgical debridement in patients with low-energy open tibial shaft fractures. A prospective study was conducted over ten years at UNIOSUN Teaching Hospital, Osogbo, Nigeria. Sixty-six patients with Gustilo-Anderson type I or II open tibial shaft fractures caused by low-energy mechanisms were enrolled. Data were collected on demographics, injury characteristics, treatment timelines, and outcomes. Follow-up assessments were performed at 1, 5, and 10 years post-treatment to evaluate bone union, joint stiffness, and chronic osteomyelitis. The majority of patients were male (77.3%) and young adults (57.6%). Most injuries were due to road traffic accidents (78.8%). All patients were managed by surgical debridement followed by plaster cast immobilization. Primary wound closure was delayed in 59.1% of cases. Bone union complications were observed in 16.7% of patients at 1 year, decreasing to 10.6% at 5 years, and 6.1% at 10 years. Joint stiffness was reported in 3.0% at 1 year but resolved by year 5. Chronic osteomyelitis occurred in 7.6% at 1 year and declined to 4.5% at 10 years. Overall, the majority of patients achieved satisfactory wound healing and functional outcomes. Cast immobilization following timely debridement remains a viable treatment for low-energy open tibial shaft fractures in low-resource settings, with a low rate of long-term complications. Early intervention and adequate follow-up are critical to optimizing outcomes. Les fractures ouvertes de la diaphyse tibiale à faible énergie représentent un défi clinique, en particulier dans les environnements à ressources limitées. Alors que les traumatismes à haute énergie ont été largement étudiés, les résultats à long terme des mécanismes à faible énergie restent peu rapportés. Cette étude a évalué les résultats cliniques et les complications à long terme de l’immobilisation plâtrée après débridement chirurgical chez des patients présentant des fractures ouvertes de la diaphyse tibiale à faible énergie. Une étude prospective a été menée sur dix ans à l’hôpital universitaire UNIOSUN, Osogbo, Nigeria. Soixante-six patients présentant des fractures ouvertes de type I ou II selon Gustilo-Anderson, causées par des mécanismes à faible énergie, ont été inclus. Les données recueillies concernaient la démographie, les caractéristiques des blessures, les délais de traitement et les résultats. Les évaluations de suivi ont été réalisées à 1, 5 et 10 ans après traitement afin d’évaluer la consolidation osseuse, la raideur articulaire et l’ostéomyélite chronique. La majorité des patients étaient des hommes (77,3 %) et de jeunes adultes (57,6 %). La plupart des blessures étaient dues à des accidents de la route (78,8 %). Tous les patients ont été pris en charge par débridement chirurgical suivi d’une immobilisation plâtrée. La fermeture primaire de la plaie a été différée dans 59,1 % des cas. Des complications de consolidation osseuse ont été observées chez 16,7 % des patients à 1 an, diminuant à 10,6 % à 5 ans et 6,1 % à 10 ans. Une raideur articulaire a été signalée chez 3,0 % à 1 an mais avait disparu à 5 ans. L’ostéomyélite chronique est survenue chez 7,6 % à 1 an et a diminué à 4,5 % à 10 ans. Globalement, la majorité des patients ont obtenu une cicatrisation satisfaisante et de bons résultats fonctionnels. L’immobilisation plâtrée après un débridement réalisé en temps opportun demeure une option thérapeutique viable pour les fractures ouvertes de la diaphyse tibiale à faible énergie dans les contextes à faibles ressources, avec un faible taux de complications à long terme. Une intervention précoce et un suivi adéquat sont essentiels pour optimiser les résultats. Fracture ouverte du tibia, Immobilisation plâtrée, Traumatisme à faible énergie, Résultats à long terme, Pseudarthrose, Ostéomyélite, Nigeria.

53. The Ibadan Chronic Heart Failure Project: Baseline Clinical Profile, Management, and Six-Month Outcomes of the First 1,290 Participants.

期刊: West African journal of medicine 发表日期: 2026-Apr-30 链接: PubMed

摘要

Chronic heart failure is an increasing cause of morbidity and mortality across sub-Saharan Africa, yet contemporary data from large African cohorts remain limited. To characterise the clinical profile, management, and short-term outcomes of patients with chronic HF enrolled in the Ibadan Heart Failure Project. The Ibadan Heart Failure Project is a real-life, pragmatic, prospective, hospital-based cohort of adults with chronic heart failure being conducted at University College Hospital, Ibadan, Nigeria. The present report is based on participants recruited between September 1, 2016, and December 31, 2022. Baseline sociodemographic, clinical, and echocardiographic data were obtained, and participants were followed for six months. The primary outcomes were all-cause mortality and hospital readmission. Among 1,290 patients (mean age 56.7 ± 15.4 years; 55.8% men), hypertensive heart disease was the leading cause, followed by dilated cardiomyopathy and rheumatic heart disease. Women were younger and more likely to have preserved or mildly reduced ejection fraction. The use of sodium-glucose cotransporter-2 inhibitors (3.3%) was low. The cumulative incidence of readmission, death, and a composite of these events at six months was 4.9%, 12.9%, and 17.8%, respectively. The use of beta blockers was associated with 43% reduction in the risk of readmission (HR-0.57, 95%CI-0.33-0.97), while the use of renin -angiotensin-aldosterone axis inhibitors was associated with 62% and 46% reduction in the risk of death and composite of readmission and death, respectively. A unit increase in serum creatinine is associated with 11% and 32% increase in readmission and death, respectively (HR-1.11, 95%CI-1.00-1.23 and HR-1.32, 95% CI-1.21-1.45, respectively) In addition, a unit increase in tricuspid annular plane systolic excursion is associated 64% and 53% lower risk of death and composite of readmission and death, respectively. (HR-0.36, 95%CI-0.22-0.60, HR-0.47, 95%CI-0.30-0.73 respectively). No significant sex or age-related differences were observed in adjusted risks of hospitalization or death. Hypertensive heart disease remains the predominant cause of chronic heart failure in Nigeria. Despite similar short-term outcomes across sexes, suboptimal use of newer evidence-based therapies underscores the need for system-level interventions to improve HF care in sub-Saharan Africa. L’insuffisance cardiaque chronique est une cause croissante de morbidité et de mortalité en Afrique subsaharienne, mais les données contemporaines issues de grandes cohortes africaines restent limitées. Décrire le profil clinique, la prise en charge et les résultats à court terme des patients atteints d’insuffisance cardiaque chronique inclus dans le projet Ibadan Heart Failure. Le projet Ibadan Heart Failure est une cohorte pragmatique, prospective et hospitalière, en conditions réelles, portant sur des adultes atteints d’insuffisance cardiaque chronique, menée au University College Hospital, Ibadan, Nigeria. Le présent rapport est basé sur les participants recrutés entre le 1er septembre 2016 et le 31 décembre 2022. Les données sociodémographiques, cliniques et échocardiographiques de base ont été recueillies, et les participants ont été suivis pendant six mois. Les critères de jugement principaux étaient la mortalité toutes causes confondues et la réhospitalisation. Parmi les 1 290 patients (âge moyen 56,7 ± 15,4 ans ; 55,8 % d’hommes), la cardiopathie hypertensive était la cause principale, suivie de la cardiomyopathie dilatée et de la maladie cardiaque rhumatismale. Les femmes étaient plus jeunes et plus susceptibles de présenter une fraction d’éjection préservée ou légèrement réduite. L’utilisation des inhibiteurs du cotransporteur sodium-glucose de type 2 était faible (3,3 %). L’incidence cumulée de la réhospitalisation, du décès et du critère composite à six mois était respectivement de 4,9 %, 12,9 % et 17,8 %. L’utilisation des bêtabloquants était associée à une réduction de 43 % du risque de réhospitalisation (HR 0,57 ; IC 95 % : 0,33–0,97), tandis que l’utilisation des inhibiteurs du système rénine–angiotensine–aldostérone était associée à une réduction de 62 % du risque de décès et de 46 % du risque composite de réhospitalisation et décès. Une augmentation d’une unité de la créatinine sérique était associée à une augmentation de 11 % et 32 % du risque de réhospitalisation et de décès, respectivement (HR 1,11 ; IC 95 % : 1,00–1,23 et HR 1,32 ; IC 95 % : 1,21–1,45). De plus, une augmentation d’une unité de l’excursion systolique de l’anneau tricuspide était associée à une réduction de 64 % et 53 % du risque de décès et du critère composite, respectivement (HR 0,36 ; IC 95 % : 0,22–0,60 et HR 0,47 ; IC 95 % : 0,30–0,73). Aucune différence significative liée au sexe ou à l’âge n’a été observée dans les risques ajustés d’hospitalisation ou de décès. La cardiopathie hypertensive demeure la cause prédominante de l’insuffisance cardiaque chronique au Nigeria. Malgré des résultats à court terme similaires entre les sexes, l’utilisation sous-optimale des thérapies récentes fondées sur les preuves souligne la nécessité d’interventions systémiques pour améliorer la prise en charge de l’insuffisance cardiaque en Afrique subsaharienne. Insuffisance cardiaque chronique, Insuffisance cardiaque, Registre hospitalier, Étude de cohorte, Pronosti.

54. Whispers from a Hollow Place: Caregiver Experiences Following Childhood Cancer Survival in Lagos State: A Qualitative Study.

期刊: West African journal of medicine 发表日期: 2026-Apr-30 链接: PubMed

摘要

As childhood cancer survival improves globally, increasing attention is directed toward the emotional and social challenges faced by families, especially caregivers. However, in low- and middle-income countries such as Nigeria, caregivers’ coping experiences remain underexplored despite extensive documentation in high-income settings. To explore the psychosocial and health-related experiences of caregivers of childhood cancer survivors after treatment completion in Lagos, Nigeria, focusing on their coping strategies, emotional responses, and perceived family impact. A qualitative descriptive design was employed, with 15 caregivers of childhood cancer survivors recruited through purposive sampling. Data collection combined semi-structured focus group discussions with standardized assessments, including the Hospital Anxiety and Depression Scale (HADS), the PTSD Checklist for DSM-5 (PCL-5), and the Connor-Davidson Resilience Scale (CD-RISC). Discussions were audio-recorded, transcribed verbatim, and thematically analyzed using Braun and Clarke’s six-phase framework. The analysis revealed three key themes: (1) Physical Consequences, including loss of employment, reduced work efficiency, and financial hardship; (2) Emotional Strain, marked by symptoms of PTSD, feelings of helplessness, and anxiety about potential relapses; and (3) Social Adjustments, such as improved health-seeking behaviours and stronger family relationships. Among participants, 60% demonstrated high levels of resilience, while 73% showed signs of anxiety, and the same proportion exhibited PTSD-related symptoms. All three male caregivers reported experiencing PTSD symptoms. Caregivers of childhood cancer survivors in Lagos experience notable physical and emotional strain, including symptoms of anxiety and PTSD. Despite minimal formal support, many adapt through strengthened family ties, improved health practices, and spiritual traditions. These results suggest a need for culturally sensitive, caregiver-focused support within survivorship care. Further research should guide the development of targeted interventions in low-resource settings. Caregivers of childhood cancer survivors in Lagos continue to experience significant psychosocial burdens beyond active treatment. There is an urgent need for structured psychosocial support integrated into survivorship care plans, especially in LMIC contexts. Alors que la survie au cancer de l’enfant s’améliore à l’échelle mondiale, une attention croissante est portée aux défis émotionnels et sociaux rencontrés par les familles, en particulier les aidants. Cependant, dans les pays à revenu faible et intermédiaire comme le Nigeria, les expériences de coping des aidants restent peu explorées malgré une documentation abondante dans les pays à revenu élevé. Explorer les expériences psychosociales et liées à la santé des aidants d’enfants survivants du cancer après la fin du traitement à Lagos, Nigeria, en mettant l’accent sur leurs stratégies d’adaptation, leurs réponses émotionnelles et l’impact perçu sur la famille. Un devis qualitatif descriptif a été utilisé, avec 15 aidants recrutés par échantillonnage raisonné. La collecte de données a combiné des discussions de groupe semi-structurées avec des évaluations standardisées, incluant l’échelle HADS (Hospital Anxiety and Depression Scale), la liste de vérification du PTSD pour le DSM-5 (PCL-5) et l’échelle de résilience Connor–Davidson (CD-RISC). Les discussions ont été enregistrées, transcrites mot à mot et analysées thématiquement selon le cadre en six phases de Braun et Clarke. L’analyse a révélé trois thèmes principaux: Conséquences physiques : perte d’emploi, baisse d’efficacité au travail et difficultés financières. Tension émotionnelle : symptômes de PTSD, sentiment d’impuissance et anxiété face aux rechutes possibles. Ajustements sociaux : amélioration des comportements de recours aux soins et renforcement des relations familiales. Parmi les participants, 60 % ont montré un haut niveau de résilience, tandis que 73 % présentaient des signes d’anxiété et la même proportion des symptômes liés au PTSD. Tous les aidants masculins ont rapporté des symptômes de PTSD. Les aidants d’enfants survivants du cancer à Lagos subissent une charge physique et émotionnelle notable, incluant l’anxiété et le PTSD. Malgré un soutien formel limité, beaucoup s’adaptent grâce à des liens familiaux renforcés, de meilleures pratiques de santé et des traditions spirituelles. Ces résultats soulignent la nécessité d’un soutien culturellement adapté, centré sur les aidants, dans les soins de survie. Des recherches supplémentaires devraient guider le développement d’interventions ciblées dans les contextes à faibles ressources. Les aidants d’enfants survivants du cancer à Lagos continuent de subir des charges psychosociales significatives au-delà du traitement actif. Il est urgent d’intégrer un soutien psychosocial structuré dans les plans de soins de survie, en particulier dans les pays à revenu faible et intermédiaire. Aidants, Néoplasmes, Survivants, Recherche qualitative, Adaptation psychologique, Nigeria.

55. Effect of an Mhealth Intervention on Sexual and Reproductive Health Literacy and Service Utilisation among University Students in Southwest Nigeria.

期刊: West African journal of medicine 发表日期: 2026-Apr-30 链接: PubMed

摘要

Sexual and Reproductive Health (SRH) literacy influences young people’s health behaviours and outcomes. Mobile health (mHealth) technologies are potential tools for the delivery of health education and services, but evidence on their effectiveness in strengthening SRH literacy is limited in the study setting. This study assessed the effect of an mHealth intervention on SRH literacy and service utilisation among in-school young people in Osun State, Nigeria. A quasi-experimental design was employed among undergraduate students aged 18 - 24 years in two tertiary institutions in Osun State. Participants were allocated by institution into intervention (n = 60) and control (n = 60) groups. The intervention group received a six-week mHealth SRH literacy programme delivered through a mobile application. Data was collected at baseline and post-intervention. Paired t-tests, analysis of covariance and regression analyses were done. Post-intervention, the intervention group demonstrated a significant increase in mean SRH literacy scores compared with baseline (p = 0.018). The post-test SRH literacy scores were significantly higher in the intervention group than in the control group (p = 0.002), with a large effect size (partial η² = 0.84). The mHealth intervention independently increased the odds of good SRH literacy (AOR = 3.69; 95% CI: 1.54 - 8.86), SRH service utilisation (AOR = 6.25; 95% CI: 1.29-30.16), and the intention to use SRH services in the future (AOR = 2.86; 95% CI: 1.03 - 7.95). The mHealth-based intervention significantly improved SRH literacy and service utilisation among young people. The deployment of mHealth interventions to strengthen health literacy competencies in the study setting should be considered. La littératie en santé sexuelle et reproductive (SSR) influence les comportements et les résultats de santé des jeunes. Les technologies de santé mobile (mHealth) sont des outils potentiels pour la diffusion de l’éducation et des services de santé, mais les preuves de leur efficacité dans le renforcement de la littératie en SSR restent limitées dans le contexte étudié. Cette étude a évalué l’effet d’une intervention mHealth sur la littératie en SSR et l’utilisation des services parmi les jeunes scolarisés dans l’État d’Osun, Nigéria. Un devis quasi-expérimental a été utilisé auprès d’étudiants de premier cycle âgés de 18 à 24 ans dans deux établissements d’enseignement supérieur de l’État d’Osun. Les participants ont été répartis par institution en groupe d’intervention (n = 60) et groupe témoin (n = 60). Le groupe d’intervention a bénéficié d’un programme de littératie en SSR via une application mobile pendant six semaines. Les données ont été recueillies au départ et après l’intervention. Des tests t appariés, une analyse de covariance et des analyses de régression ont été réalisés. Après l’intervention, le groupe d’intervention a montré une augmentation significative des scores moyens de littératie en SSR par rapport au départ (p = 0,018). Les scores post-test de littératie en SSR étaient significativement plus élevés dans le groupe d’intervention que dans le groupe témoin (p = 0,002), avec une taille d’effet importante (η² partiel = 0,84). L’intervention mHealth a indépendamment augmenté les chances d’une bonne littératie en SSR (OR ajusté = 3,69 ; IC 95 % : 1,54 – 8,86), de l’utilisation des services de SSR (OR ajusté = 6,25 ; IC 95 % : 1,29 – 30,16), ainsi que de l’intention d’utiliser les services de SSR à l’avenir (OR ajusté = 2,86 ; IC 95 % : 1,03 – 7,95). L’intervention basée sur mHealth a significativement amélioré la littératie en SSR et l’utilisation des services chez les jeunes. Le déploiement d’interventions mHealth pour renforcer les compétences en littératie en santé dans le contexte étudié devrait être envisagé. Santé sexuelle et reproductive, Littératie en santé, mHealth, jeunes, Utilisation des services, Nigéria.

56. Optimising Asthma Control in a Sub-Saharan African Population: Assessing Agreement among Five Standardized Questionnaires.

期刊: West African journal of medicine 发表日期: 2026-Apr-30 链接: PubMed

摘要

Asthma management prioritises symptom control, typically assessed using standardized questionnaires. However, comparative data on their performance and agreement remain scarce in Sub-Saharan Africa. In a cross-sectional study of 100 adults [79% females, mean age 38.1±14.6 years] with physician-diagnosed asthma at a Nigerian tertiary hospital, asthma control was evaluated using Global Initiative for Asthma (GINA), Asthma Control Test (ACT), Asthma Control Questionnaire (ACQ-7), Royal Society of Physicians 3 Questions (RCP-3Qs) and Asthma Therapy Assessment Questionnaire (ATAQ). Agreement was measured with Cohen’s kappa statistics. Diagnostic accuracy for GINA-defined well-controlled asthma was analysed using ROC-derived thresholds, with GINA serving as the reference standard to assess the performance of ACT, ACQ, RCP-3Qs, and ATAQ. The level of controlled asthma ranged from 73% to 83% across tools. Agreement among control tools was low; GINA showed slight agreement with others (κ = 0.018-0.107), while ACT and ACQ had moderate agreement (κ = 0.546). ACT, ACQ, and RCP-3Qs demonstrated strong diagnostic accuracy for identifying GINA-defined well-controlled asthma (AUC 0.90; 95% CI: ACT 0.76-0.95; ACQ 0.75-0.94; RCP-3Qs 0.78-0.92), whereas ATAQ performed poorly (AUC 0.5; 95% CI: 0.29-0.59). At pre-specified thresholds of >20, ≤1.57, ≤1 and 0.5, the specificity of ACT, ACQ, RCP-3Qs, and ATAQ was 92.6%, 70.4%, 70.4%, and 85.2%, respectively; while sensitivity was 73.7%, 94.7%, 100%, and 26.3%. ACT, ACQ, and RCP-3Q effectively identified GINA-defined well-controlled asthma, while ATAQ showed poor diagnostic value. Low agreement among the tools suggests they are not interchangeable for assessing asthma control. La prise en charge de l’asthme privilégie le contrôle des symptômes, généralement évalué à l’aide de questionnaires standardisés. Cependant, les données comparatives sur leur performance et leur concordance restent limitées en Afrique subsaharienne. Dans une étude transversale menée auprès de 100 adultes [79 % de femmes, âge moyen 38,1 ± 14,6 ans] atteints d’asthme diagnostiqué par un médecin dans un hôpital tertiaire nigérian, le contrôle de l’asthme a été évalué à l’aide de: l’Initiative mondiale pour l’asthme (GINA), le test de contrôle de l’asthme (ACT), le questionnaire de contrôle de l’asthme (ACQ-7), les trois questions de la Royal Society of Physicians (RCP-3Qs), et le questionnaire d’évaluation de la thérapie de l’asthme (ATAQ). L’accord a été mesuré par les statistiques kappa de Cohen. La précision diagnostique pour l’asthme bien contrôlé selon GINA a été analysée à l’aide de seuils dérivés des courbes ROC, GINA servant de référence pour évaluer la performance de l’ACT, de l’ACQ, des RCP-3Qs et de l’ATAQ. Le niveau d’asthme contrôlé variait de 73 % à 83 % selon les outils. L’accord entre les outils de contrôle était faible ; GINA présentait un faible accord avec les autres (κ = 0,018–0,107), tandis que l’ACT et l’ACQ montraient un accord modéré (κ = 0,546). L’ACT, l’ACQ et les RCP-3Qs ont démontré une forte précision diagnostique pour identifier l’asthme bien contrôlé défini par GINA (AUC 0,90 ; IC 95 % : ACT 0,76–0,95 ; ACQ 0,75–0,94 ; RCP-3Qs 0,78–0,92), alors que l’ATAQ a montré de faibles performances (AUC 0,5 ; IC 95 % : 0,29–0,59). Aux seuils prédéfinis de >20, ≤1,57, ≤1 et 0,5, la spécificité de l’ACT, de l’ACQ, des RCP-3Qs et de l’ATAQ était respectivement de 92,6 %, 70,4 %, 70,4 % et 85,2 % ; tandis que la sensibilité était de 73,7 %, 94,7 %, 100 % et 26,3 %. L’ACT, l’ACQ et les RCP-3Qs identifient efficacement l’asthme bien contrôlé selon GINA, tandis que l’ATAQ présente une faible valeur diagnostique. Le faible accord entre les outils suggère qu’ils ne sont pas interchangeables pour l’évaluation du contrôle de l’asthme. Asthme, Contrôle de l’asthme, Questionnaires sur l’asthme, Initiative mondiale pour l’asthme, Courbe ROC.

57. Patients' Satisfaction with Healthcare Services in a Tertiary Healthcare Facility, North-Central, Nigeria.

期刊: West African journal of medicine 发表日期: 2026-Apr-30 链接: PubMed

摘要

Patient satisfaction is the extent to which a healthcare facility fulfils patients’ expectations. It is a critical and integral part of patient-oriented healthcare, serving as a key indicator for measuring the quality of care provided to patients. Assessing patients’ satisfaction with care is a way of obtaining feedback from patients, which can be a measure of the effectiveness of healthcare services. This study aimed to assess the level of patient satisfaction with services received at the Bingham University Teaching Hospital in Jos, Plateau State, to improve healthcare services. The study was a descriptive, cross-sectional study conducted in the Bingham University Teaching Hospital (BHUTH). The BHUTH is a private tertiary hospital located in Plateau State’s capital city of Jos, the North-central region of Nigeria. Participants were selected conveniently from the outpatient clinics and wards. The data was collected using the Long-form Patient Satisfaction Questionnaire (PSQ-III) and included the participants’ sociodemographic characteristics. There are seven domains in the PSQ-III, namely General satisfaction, Technical quality, Interpersonal care, Communication, Financial aspects, Time spent with the doctor, and Access/availability/convenience. Data collected was analyzed using IBM SPSS Statistics for Windows, version 27. There were 236 respondents. A little more than half (51.7%) of the patients were in the 18 - 39 years age group, and more (59.7%) were females. A majority (62.7%) of the responders had attained a tertiary level of education. The overall patient satisfaction rate was 67.6%. Only 52.5% of patients reported having a high general satisfaction, 56.4% were highly satisfied with the financial aspects of healthcare services, and 86.0% had high satisfaction with the communication. This study has revealed an overall average patient satisfaction. Among the domains of satisfaction assessed, communication had the highest rate of satisfaction, and the financial aspect of healthcare services was among the lowest rates of patient satisfaction. These findings can help prioritize strategies for improving healthcare services. La satisfaction des patients correspond au degré auquel un établissement de santé répond aux attentes des patients. Elle constitue une composante essentielle des soins centrés sur le patient et un indicateur clé de la qualité des soins dispensés. Évaluer la satisfaction des patients est une manière d’obtenir un retour d’information, pouvant servir de mesure de l’efficacité des services de santé. Cette étude visait à évaluer le niveau de satisfaction des patients concernant les services reçus au Bingham University Teaching Hospital de Jos, État du Plateau, afin d’améliorer les prestations de soins. Il s’agissait d’une étude descriptive transversale menée au Bingham University Teaching Hospital (BHUTH), un hôpital privé tertiaire situé dans la capitale de l’État du Plateau, Jos, dans la région Nord-Centre du Nigeria. Les participants ont été sélectionnés de manière commode dans les consultations externes et les services d’hospitalisation. Les données ont été recueillies à l’aide du questionnaire de satisfaction des patients PSQ-III (version longue), incluant les caractéristiques sociodémographiques des participants. Le PSQ-III comporte sept domaines : satisfaction générale, qualité technique, soins interpersonnels, communication, aspects financiers, temps passé avec le médecin, et accessibilité/disponibilité/convenience. Les données ont été analysées avec IBM SPSS Statistics for Windows, version 27. Un total de 236 patients ont participé. Un peu plus de la moitié (51,7 %) étaient âgés de 18 à 39 ans, et la majorité (59,7 %) étaient des femmes. La plupart (62,7 %) avaient atteint un niveau d’éducation tertiaire. Le taux global de satisfaction des patients était de 67,6 %. Seuls 52,5 % ont rapporté une satisfaction générale élevée, 56,4 % étaient très satisfaits des aspects financiers des services de santé, et 86,0 % ont exprimé une grande satisfaction concernant la communication. Cette étude a révélé une satisfaction globale moyenne des patients. Parmi les domaines évalués, la communication a obtenu le taux de satisfaction le plus élevé, tandis que l’aspect financier des services de santé figurait parmi les plus faibles. Ces résultats peuvent aider à hiérarchiser les stratégies d’amélioration des services de santé. Satisfaction des patients, Services de santé, Établissement de soins tertiaries, Nigeria.

58. Risk Factors for Paediatric Intensive Care Unit Admission and In-hospital Mortality among Paediatric Emergencies in Nigeria: A Single Centre Study.

期刊: West African journal of medicine 发表日期: 2026-Apr-30 链接: PubMed

摘要

In Nigeria, the burden of critical illness and risk factors for mortality remains poorly described. This study describes the epidemiology of patients admitted at the children’s emergency ward (EW) and risk factors for Paediatric intensive care unit (PICU) admission and in-hospital mortality (IHM). This was a retrospective study of patients admitted to the Children’s EW of the University College Hospital, Ibadan, Nigeria, from 1st December 2022 to 30th November 2023. Patient’s demographics, presenting clinical features and diagnosis at admission were extracted. The primary outcome was PICU admission. Secondary outcomes were duration of hospital stay and IHM. There were 649 patients; 421(64.9%) were <5 years old. Median age was 2.3 (interquartile range 0.8-7.0) years. Most common presenting features were dyspnoea [269 (41.4%)], vomiting [182 (28%)] and hypoxaemia [188 (29%)]. At presentation, 51 (7.9%) and 63 (10.3%) had altered mental status and seizures, respectively, while the most common diagnoses were sepsis [250 (39%)], malaria [192 (30%)], and pneumonia [165(26%)]. At presentation, 217 (33.5%), 110 (16.9%), 48 (7.4%), and 32 (4.9%) required oxygen, blood transfusion, fluid bolus, and inotropes, respectively. Twenty (3.1%) patients required cardiopulmonary resuscitation (CPR), and 101 (15.6%) required PICU admission. Median duration of hospital stay was 5 (interquartile range 3-9) days, while IHM was 74 (6.6%) patients. On bivariate analysis, gender, dehydration, breathlessness, dyspnoea, cyanosis, cold extremities, thready pulses and altered mental state were associated with mortality, while breathlessness, hypoxaemia, dyspnoea, dehydration, cyanosis, thready pulses, cold extremities, convulsion and altered mental status were associated with PICU admission. Shock state and hypoxaemia were associated with poor outcomes in paediatric emergencies. The introduction of basic critical care services will reduce the burden of adverse outcomes. Au Nigéria, la charge des maladies critiques et les facteurs de risque de mortalité restent peu décrits. Cette étude décrit l’épidémiologie des patients admis au service des urgences pédiatriques (EU) et les facteurs de risque d’admission en unité de soins intensifs pédiatriques (USIP) et de mortalité hospitalière (MH). Il s’agit d’une étude rétrospective menée auprès des patients admis au service des urgences pédiatriques de l’University College Hospital, Ibadan, Nigéria, du 1er décembre 2022 au 30 novembre 2023. Les données démographiques des patients, les caractéristiques cliniques à la présentation et le diagnostic à l’admission ont été extraits. Le critère principal était l’admission en USIP. Les critères secondaires étaient la durée d’hospitalisation et la MH. Au total, 649 patients ont été inclus ; 421 (64,9 %) avaient moins de 5 ans. L’âge médian était de 2,3 ans (intervalle interquartile 0,8–7,0). Les symptômes les plus fréquents étaient la dyspnée [269 (41,4 %)], les vomissements [182 (28 %)] et l’hypoxémie [188 (29 %)]. À la présentation, 51 (7,9 %) et 63 (10,3 %) présentaient un état mental altéré et des convulsions, respectivement. Les diagnostics les plus fréquents étaient la septicémie [250 (39 %)], le paludisme [192 (30 %)] et la pneumonie [165 (26 %)]. À l’admission, 217 (33,5 %), 110 (16,9 %), 48 (7,4 %) et 32 (4,9 %) ont nécessité respectivement de l’oxygène, une transfusion sanguine, un bolus de fluides et des inotropes. Vingt patients (3,1 %) ont nécessité une réanimation cardio-pulmonaire (RCP), et 101 (15,6 %) ont été admis en USIP. La durée médiane d’hospitalisation était de 5 jours (intervalle interquartile 3–9), tandis que la MH concernait 74 patients (6,6 %). L’analyse bivariée a montré que le sexe, la déshydratation, la gêne respiratoire, la dyspnée, la cyanose, les extrémités froides, les pouls filants et l’état mental altéré étaient associés à la mortalité, tandis que la gêne respiratoire, l’hypoxémie, la dyspnée, la déshydratation, la cyanose, les pouls filants, les extrémités froides, les convulsions et l’état mental altéré étaient associés à l’admission en USIP. L’état de choc et l’hypoxémie étaient associés à de mauvais résultats dans les urgences pédiatriques. L’introduction de services de soins critiques de base réduira la charge des issues défavorables. Maladie critique; Pédiatrie; Unités de soins intensifs, Pédiatrique, Mortalité hospitalière, Facteurs de risque.

59. Posterior Urethral Valves at the University College Hospital Ibadan: A Seven-Year Review.

期刊: West African journal of medicine 发表日期: 2026-Apr-30 链接: PubMed

摘要

Posterior urethral valve (PUV) is the most common severe obstructive uropathy in boys. We reviewed patients with PUV in our hospital to provide an update on the presentation, management and outcome of PUV in our setting. A retrospective study of patients with PUV admitted in our hospital between January 1, 2016 - December 31, 2022. Fifty-one patients were included, seven (median age 6.4 IQR 2.3, 10.8 years) had undergone valve ablation before presentation, while 44 (median age 1.3 IQR 0.1, 2.9 years) had not. Among the 44, four (9.1%) had abnormal features on antenatal ultrasound. 15.9% and 56.9% presented in the neonatal period and after one year of age respectively. The main complaints were voiding symptoms (45.5%), abdominal swelling (40.9%) and history of fever (38.6%). Wasting occurred in 43.9%. Serum creatinine ranged from 0.2-25.5 (median 1.4, IQR 0.8-3.0) mg/dl. Thiry seven children underwent valve ablation. Additionally, four of the 51 patients underwent repeat valve ablation. End-stage kidney disease (ESKD) occurred in five (9.8%). Dialysis was carried out in six patients (11.7%) including two patients with acute kidney injury. None underwent kidney transplantation. Mortality occurred in 10 (19.6%) and was due to sepsis (n=5) and ESKD (n= 4). Posterior urethral valve is an important cause of morbidity and mortality in low resource settings and has 19.6% mortality in our centre over a 7-year period. Enhanced access to antenatal detection, early diagnosis and treatment, and kidney transplantation have the potential to improve outcomes. La valve urétrale postérieure (VUP) est la forme la plus fréquente d’uropathie obstructive sévère chez les garçons. Nous avons analysé les cas de patients atteints de VUP admis dans notre hôpital afin de fournir une mise à jour sur la présentation, la prise en charge et les résultats de la VUP dans notre contexte. Étude rétrospective des patients atteints de VUP admis dans notre hôpital entre le 1er janvier 2016 et le 31 décembre 2022. Cinquante et un patients ont été inclus. Sept d’entre eux (âgés de 0,1 à 12,5 ans, médiane de 6,4 ans, IQR 2,3-10,8) avaient déjà subi une ablation de la valve avant leur présentation, tandis que 44 (âgés de 0,0 à 10,43 ans, médiane de 1,3 ans, IQR 0,1-2,9) ne l’avaient pas. Parmi les 44, quatre présentaient des anomalies à l’échographie anténatale. 15,9 % ont été diagnostiqués en période néonatale et 56,9 % après l’âge d’un an. Les plaintes principales étaient les troubles de la miction (45,5 %), l’abdomen distendu (40,9 %) et les antécédents de fièvre (38,6 %). Un état de cachexie était observé chez 43,9 %. Le taux de créatinine sérique allait de 0,2 à 25,5 mg/dl (médiane 1,4, IQR 0,8-3,0). Une hydrouretère bilatérale à l’échographie et un reflux vésico-urétéral à la cysto-urétrographie mictionnelle étaient retrouvés respectivement chez 72,1 % et 27 %. Trente-sept enfants ont bénéficié d’une ablation de la valve, dont 34 (91,9 %) selon la technique de Mohan. En outre, quatre des 51 patients ont subi une deuxième ablation, toutes réalisées par voie endoscopique. Une insuffisance rénale terminale (IRT) est survenue chez cinq patients (9,8 %). La dialyse a été pratiquée chez six patients (11,7 %). Aucun patient n’a bénéficié d’une transplantation rénale. La mortalité a concerné 10 patients (19,6 %) due à une septicémie (n=5) et à une IRT (n=4). La VUP est une cause majeure de morbidité et de mortalité dans les environnements à faibles ressources. Il est nécessaire de renforcer la sensibilisation et le soutien pour améliorer la détection anténatale, l’intervention précoce, la prise en charge vésicale et l’accès à la transplantation rénale. Valves de l’urètre postérieur, Urosepsis, Pédiatrie, Ablation valvulaire, Anomalies congénitales des reins et des voies urinaires, Insuffisance rénale terminal.

60. Associations of ambient temperature exposure with embryonic and early fetal development.

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

摘要

Exposure to heat and cold are associated with adverse birth outcomes, but whether ambient temperature affects embryonic and early fetal development remains unclear. We aimed to examine the association between ambient temperature exposure during early pregnancy and crown-rump length (CRL). Data from the Generation R Next Study (2017-2021) were analysed, with findings replicated in the Generation R Study (2002-2006), both population-based cohorts based in Rotterdam, The Netherlands. Weekly mean temperatures were modeled from the last menstrual period onward at a spatial resolution of 100 × 100 m by using the UrbClim™ model. The CRL was measured via 2D ultrasound at approximately 8, 10, and 12 weeks’ gestation in pregnancies with regular menstrual cycles. Distributed lag nonlinear models were applied. In Generation R Next (N = 1378; mean maternal age 31.9 years), higher temperatures during the first 9 weeks were associated with a smaller CRL at 12 weeks {e.g. -7.2 mm [95% confidence interval (CI) -12.0, -2.3] at 19.2 vs 9.0°C during weeks 1-6}. Colder exposures during the first 11 weeks were also associated with a smaller CRL [-7.6 mm (95% CI -11.9, -3.3) at 3.6 vs 9.0°C during weeks 1-11]. No associations were observed for CRL at 8 or 10 weeks. Similar associations with cold, but not heat, were observed in the replication cohort (N = 1520). Moderate cold and heat exposure during early pregnancy may affect fetal development as early as the first trimester. These findings indicate that early gestational development may be sensitive to ambient temperature and, as environmental conditions shift, may have potential clinical implications for birth outcomes and long-term health.

61. Cohort Profile Update: The 1982 Pelotas (Brazil) Birth Cohort follow-up at 40 years.

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

摘要