公共卫生研究摘要 (2026-05-26)

共收录 52 篇研究文章

1. Assessment of the relationship between maternal cardiometabolic health and fetal growth in pregnant women living with HIV on antiretroviral therapy in Mthatha, South Africa.

期刊: The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians 发表日期: 2026-Dec 链接: PubMed

摘要

The use of antiretroviral therapy (ART) during pregnancy among women living with human immunodeficiency virus (HIV) may adversely affect their cardiometabolic health, but its influence on fetal growth remains underexplored. This study aimed to investigate the relationship between maternal cardiometabolic health and fetal growth in pregnant women living with HIV receiving ART in Mthatha, South Africa. A pilot study included 21 HIV-positive and 53 HIV-negative pregnant women, measuring anthropometric parameters and blood pressure. Cardiometabolic risk factors were assessed, including dyslipidemia, glycemia, oxidative stress, endothelial function, and inflammatory markers. Noninvasive vascular function indicators, including uterine artery pulsatile index (UtA PI), flow-mediated slowing (FMS), carotid-femoral pulse wave velocity (cfPWV), and ankle-brachial index (ABI) were evaluated. Fetal growth parameters, including femur length (FL), biparietal diameter, head circumference (HC), abdominal circumference (AC), and estimated fetal weight, were recorded. Relationships between maternal health and fetal growth were analyzed with a significance threshold of p ≤ 0.05. Prehypertension was more common among pregnant women living with HIV (14.29% vs. 1.89%). Additionally, higher cfPWV, UtA, and LDL-C levels were noted in the HIV-positive group (p ≤ 0.05). A negative correlation (p ≤ 0.05) was found between maternal UtA PI and fetal growth parameters such as AC, FL and HC. Vascular dysfunction was observed in pregnant women living with HIV on ART coupled with an inverse association between maternal vascular function and fetal growth suggesting that impaired maternal vascular function may limit placental blood flow and potentially affect fetal growth.

2. An outbreak of measles linked to healthcare services in Far North Queensland, 2025.

期刊: Communicable diseases intelligence (2018) 发表日期: 2026-May-26 链接: PubMed

摘要

In September 2025, Cairns experienced its largest measles outbreak since 1997. An imported case from Indonesia subsequently transmitted to 11 secondary cases, including four hospital staff. No further transmission was identified despite identification of nearly 1,500 contacts. Most of the cases (11/12; 91.6%) reported or demonstrated prior vaccination or immunity. This outbreak demonstrates the continued potential for re-emergence of measles in a setting with validated elimination status; the outbreak resulted in disruption to healthcare staff and services. Australian healthcare services should consider use of measles serology and booster vaccination doses among susceptible healthcare workers to reduce the risk of future similar outbreaks.

3. ATAGI Targeted Review 2024: Immunisation strategies for prevention and control of respiratory syncytial virus disease in Australia.

期刊: Communicable diseases intelligence (2018) 发表日期: 2026-May-26 链接: PubMed

摘要

Respiratory syncytial virus (RSV) causes lower respiratory tract infection and severe disease, particularly in infants, and is increasingly recognised as a cause of major morbidity and mortality in the elderly. Several new vaccines aim to address the disease burden at both extremes of the age spectrum. Immunisation using a long-acting monoclonal antibody is also available for infants and young children. In 2025, a comprehensive RSV maternal and infant protection program commenced with a nationally coordinated maternal RSV vaccination in pregnancy on the National Immunisation Program and long-acting monoclonal antibody for infants and children funded by states and territories. This targeted review outlines the Australian Technical Advisory Group on Immunisation’s considerations and the evidence informing policy decisions on an RSV prevention strategy for Australia. Review of the burden of RSV disease in Australia indicates specific populations which would derive the most benefit from effective immunisation, including the very young; the elderly; First Nations people; and those with underlying medical risk factors. However, some data gaps exist in our understanding of RSV disease, particularly non-hospitalised disease and disease in adult age groups. The available evidence points to promising efficacy, against severe RSV disease, of three RSV vaccines in older adults, as well as the single available vaccine for use in pregnancy for protecting infants in the first six months of life. A long-acting RSV-specific monoclonal antibody, nirsevimab, has been highly effective in young infants in early assessments; however, there is a need to accumulate more information as these products expand in use. For RSV vaccines, there is a need to monitor duration of protection and safety, to inform the need for repeat vaccine doses in older adults and in subsequent pregnancies. As RSV immunisation involves new vaccines and monoclonal antibodies, it is important that a robust program monitoring and evaluation plan is put in place, to optimise assessment of vaccine uptake, patient acceptance and the impact of the interventions on RSV disease, with appropriate safety monitoring to facilitate public confidence in the immunisation program.

4. Infant respiratory syncytial virus (RSV) immunisation coverage in an Australian regional area, 1 May 2024 - 31 October 2025.

期刊: Communicable diseases intelligence (2018) 发表日期: 2026-May-26 链接: PubMed

摘要

The recent introduction in Australia of respiratory syncytial virus (RSV) immunisations - nirsevimab (neonatal) and Abrysvo (antenatal) - offers potential to reduce the RSV burden in infants. A retrospective cohort study included all infants born at Sunshine Coast University Hospital between 1 May 2024 and 31 October 2025. Of 5,116 infants, 71.7% (3,669/5,116) received valid RSV immunisation: 45.2% through nirsevimab only and 26.4% through antenatal Abrysvo only. During May-December 2024, RSV coverage was achieved exclusively through neonatal nirsevimab. Following Abrysvo’s introduction in January 2025, a progressive shift in immunisation composition occurred: among RSV-vaccinated infants, the proportion protected through nirsevimab alone fell from 100% in December 2024 to 13.5% by October 2025, while those protected by Abrysvo alone rose correspondingly from 0% to > 85.0%. Overall RSV coverage remained stable throughout the study period (66.2-77.9%) and throughout the transition period January-October 2025 (66.2-74.9%). Coverage was comparable to Australian and United States estimates but lagged European benchmarks. Abrysvo’s introduction maintained rather than improved population-level protection. These findings highlight the need to investigate barriers to RSV immunisation uptake to optimise infant protection.

5. 2024 Annual Australian Respiratory Surveillance Report.

期刊: Communicable diseases intelligence (2018) 发表日期: 2026-May-26 链接: PubMed

摘要

In 2024, coronavirus disease 2019 (COVID-19), influenza, and respiratory syncytial virus (RSV) were nationally notifiable in Australia. The states and territories reported 302,250 COVID-19, 365,589 influenza, and 175,918 RSV notifications to the National Notifiable Diseases Surveillance System. Influenza and RSV notifications increased between 2023 and 2024; however, COVID-19 notifications decreased. Trends in test positivity from sentinel laboratories were generally reflective of the trends in case notifications. The weekly proportion of new ‘fever and cough’ symptoms in the community remained stable between 2023 and 2024. In contrast, influenza-like-illness notification rates for consultations at sentinel general practice sites in 2024 were higher than in previous years, reflecting increased activity in case notifications. In 2024, there were fewer sentinel hospital admissions with COVID-19 or influenza than in 2023 or 2022, and the proportion of patients admitted directly to intensive care remained low and stable. In contrast, there were more sentinel intensive care admissions for severe acute respiratory infections overall in 2024 than in 2023; however, there were fewer intensive care admissions with COVID-19 than in previous years. In 2024, deaths involving influenza and RSV increased compared to 2023, whereas deaths involving COVID-19 decreased. However, COVID-19 remains the leading cause of acute respiratory infection mortality. All three acute respiratory infections are more likely to cause death in older age groups than in younger age groups. Overall, information from Australia’s national acute respiratory infection surveillance systems indicates there was high acute respiratory infection activity with moderate severity but a lower burden on health system utilisation in 2024.

6. Annual immunisation coverage report 2024.

期刊: Communicable diseases intelligence (2018) 发表日期: 2026-May-26 链接: PubMed

摘要

We analysed Australian Immunisation Register (AIR) data for children, adolescents and adults as at 2 February 2025, concentrating primarily on National Immunisation Program (NIP)-funded vaccines. Our focus was on the calendar year 2024 and trends from previous years. This report provides comprehensive analyses and interpretation of vaccination coverage data to inform immunisation policy and programs in Australia. Along with the results outlined below, the report also includes a range of other data for vaccines given across the lifespan, including data on timeliness and vaccination provider settings. Fully vaccinated coverage decreased between 2023 and 2024 at all three standard age milestones: 12 months (from 92.8% to 91.6%); 24 months (from 90.8% to 89.4%); and 60 months (from 93.3% to 92.7%). This follows the 1.2-2.0 percentage point decrease in vaccination coverage uptake at these three milestones between the 2020 and 2023 reports. A combination of acceptance and access factors have contributed to this ongoing decline. Coverage of a dose of HPV vaccine by the fifteenth birthday decreased in 2024 to 81.1% in girls and 77.9% boys; these values were 3.1 and 3.9 percentage points lower, respectively, than in 2023 and 5.5 and 7.0 percentage points lower than in 2020. In girls and boys turning 15 years of age in 2024, respectively 83.4% and 80.9% had received an adolescent dose of diphtheria-tetanus-pertussis vaccine by 31 December 2024. Overall, 68.5% of girls and 64.4% of boys turning 16 years of age in 2024 had received an adolescent dose of meningococcal ACWY vaccine by 31 December 2024. Zoster vaccination coverage (one dose of Zostavax or two doses of Shingrix given at least 4 weeks apart) was 45.9% for adults aged ≥ 65 years in 2024. Coverage of an adult dose of 13vPCV was 38.6% for adults turning 71 years of age in 2024, which was 1.0 percentage point higher than in 2023; and 41.5% for adults aged ≥ 70 years, which was 6.9 percentage points higher than in 2023. Influenza vaccination coverage decreased in 2024 across all adult age groups. Fully vaccinated coverage for Aboriginal and Torres Strait Islander children decreased between 2023 and 2024 at all three age milestones: 12 months (from 89.7% to 89.2%), 24 months (from 87.8% to 86.7%) and 60 months (from 95.0% to 94.4%), following a 2.0-3.4 percentage point decrease between the 2020 and 2023 reports. However, coverage of meningococcal B vaccine, which was introduced onto the NIP for all Aboriginal and Torres Strait Islander children in July 2020, was higher in 2024 than 2023: namely, 83.0% versus 81.0% for the first dose; 80.9% versus 80.0% for the second dose; and 75.0% versus 71.7% for the third dose. Coverage of a dose of HPV vaccine by the fifteenth birthday decreased in 2024 in Aboriginal and Torres Strait Islander adolescents to 76.7% for girls and 69.2% for boys; these values were 4.2 and 5.8 percentage points lower, respectively, than in 2023 and 11.1 and 13.8 percentage points lower than in 2020. In Aboriginal and Torres Strait Islander girls and boys turning 15 years of age in 2024, respectively 79.3% and 73.0% had received an adolescent dose of diphtheria-tetanus-pertussis vaccine by 31 December 2024. Coverage of an adolescent dose of meningococcal ACWY vaccine received by 31 December 2024 in Aboriginal and Torres Strait Islander adolescents turning 16 years of age in 2024 was 52.7% for girls and 47.1% for boys. Zoster vaccination coverage (one dose of Zostavax or two doses of Shingrix given at least 4 weeks apart) was 42.2% for Aboriginal and Torres Strait Islander adults aged ≥ 65 years in 2024. Coverage of an adult dose of 13vPCV was 48.7% for Aboriginal and Torres Strait Islander adults turning 71 years of age in 2024, which was 5.7 percentage points higher than in 2023, and 47.8% for those aged ≥ 70 years, which was 8.1 percentage points higher than in 2023. However, it was only 23.2% for those aged 50-69 years. Influenza vaccination coverage decreased in 2024 across all Aboriginal and Torres Strait Islander adult age groups. There have been concerning and persistent downward trends in childhood and adolescent vaccination coverage in Australia since 2020, with further declines in 2024. The picture for adult coverage is more mixed, but consistently suboptimal across all vaccines. National surveys of parents of young children and adults have identified a range of access and acceptance barriers that may be contributing to observed declines in coverage. More research is needed to delineate contributory factors, particularly among adolescents and Aboriginal and Torres Strait Islander peoples. This can then be used to inform evidence-based and culturally appropriate strategies to increase vaccine uptake and coverage equity. The National Immunisation Strategy for Australia 2025-2030 provides a comprehensive framework to guide such measures and improve coverage - and hence the protection provided by vaccine programs - against disease.

7. Identifying Meaningful Patient Savings on Generics: Direct-to-Consumer Prices Versus Commercial Insurance Cost Sharing.

期刊: Annals of internal medicine 发表日期: 2026-May-26 链接: PubMed

摘要

8. Regulatory Framework for Private Equity and Corporatization in Health Care: A Position Paper From the American College of Physicians.

期刊: Annals of internal medicine 发表日期: 2026-May-26 链接: PubMed

摘要

The growing involvement of private equity in the health care sector raises important questions about its effect on cost, quality, access, and the physician workforce. Private equity investment in health care is associated with increased costs and, in some settings, adverse effects on care delivery and outcomes. Rising costs, administrative burdens, workforce shortages, and declining reimbursement have made independent practice increasingly difficult, contributing to physician transitions to corporate ownership models. Physicians employed by private equity-owned health care organizations may also experience challenges due to the evolving dynamics of their work environment. State and federal regulators, as well as lawmakers, should consider implementing policy interventions to address these challenges. Although corporate investment may improve efficiency and, in limited instances, care delivery, private equity in this sector raises important questions about its role and effects. This American College of Physicians (ACP) position paper builds on the previous ACP position paper on financial profit in medicine, which explored the growing influence of corporate interests and private equity investment in the health care industry. This paper examines the effect of private equity investment on clinical autonomy, health care costs, quality, access, equity, and innovation. It emphasizes the need for more vigorous enforcement of regulatory measures and policy solutions to preserve the quality of patient care and protect the physician workforce. It also offers recommendations to strengthen oversight, transparency, and accountability related to private equity’s effects on clinical autonomy, care delivery, and organizational decision making. Finally, it discusses the potential opportunities and challenges associated with private equity investment in health care, including increased consolidation and corporatization.

9. ATAGI 2025 Annual Statement on Immunisation.

期刊: Communicable diseases intelligence (2018) 发表日期: 2026-May-26 链接: PubMed

摘要

The Australian Technical Advisory Group on Immunisation (ATAGI) 2025 Annual Statement on Immunisation is the fifth publication in this series. It highlights the key successes, trends and challenges in the use of vaccines and control of vaccine preventable diseases (VPDs) in Australia in 2024. It also signals ATAGI’s priority advice on actions to address key issues for 2025 and beyond.

10. ATAGI 2024 Annual Statement on Immunisation.

期刊: Communicable diseases intelligence (2018) 发表日期: 2026-May-26 链接: PubMed

摘要

The Australian Technical Advisory Group on Immunisation (ATAGI) 2024 Annual Statement on Immunisation is the fourth publication in this series. It highlights the key successes, trends and challenges in the use of vaccines and control of vaccine preventable diseases (VPDs) in Australia in 2023. It also signals ATAGI’s priority actions for addressing key issues for 2024 and beyond.

11. An In-Hospital Mortality Risk Model for Patients Undergoing Coronary Artery Bypass Grafting Based on Machine Learning: Cohort Study.

期刊: JMIR formative research 发表日期: 2026-May-25 链接: PubMed

摘要

Ischemic heart disease remains the leading cause of death worldwide. Coronary artery bypass grafting (CABG) remains the primary surgical treatment for ischemic heart disease. There is currently a lack of highly accurate and widely applicable models for assessing the risk of postoperative mortality following CABG. This study aimed to develop and validate an in-hospital mortality risk prediction system for patients undergoing coronary artery bypass grafting (CABG) by using machine learning algorithms and to compare its performance with the European System for Cardiac Operative Risk Evaluation II (EuroSCORE II) and Sino System for Coronary Operative Risk Evaluation (SinoSCORE). Between January 2017 and December 2020, 21,443 patients undergoing CABG in the Chinese Cardiac Surgery Registry were included. Patients were randomly divided into training (n=17,753) and test (n=3690) cohorts. We addressed class imbalance using the synthetic minority oversampling technique (SMOTE) and optimized hyperparameters via grid search. Fifteen machine learning algorithms were developed to predict in-hospital mortality. Performance was evaluated using the area under the receiver operating characteristic curve (AUC), calibration metrics (Brier score), and decision curve analysis, and was compared against EuroSCORE II and SinoSCORE. A total of 21,443 patients were included. Overall, in-hospital mortality was 2.1% (n=450). The Extreme Gradient Boosting (XGBoost) model achieved the best performance with an AUC of 0.850 in the training cohort and 0.782 in the independent test cohort (this cohort was independent and not involved in model construction). While EuroSCORE II showed an AUC of 0.722 and SinoSCORE showed an AUC of 0.726 in the test cohort, the XGBoost model demonstrated superior discrimination and calibration (P<.05). Our study developed and validated a machine learning-based risk prediction model for in-hospital mortality after CABG by using a large-scale Chinese multicenter registry. Among the algorithms tested, the XGBoost model demonstrated superior discrimination and calibration compared with the traditional EuroSCORE II and SinoSCORE, suggesting that locally calibrated models may better capture the risk profile of Chinese patients. The derived 7-variable web calculator may serve as an exploratory auxiliary tool to provide a preliminary reference for bedside risk stratification, though its direct impact on surgical decision-making requires further prospective validation. Future research should focus on independent test cohorts across diverse hospital tiers to ensure broad generalizability.

12. Aplastic or twig-like middle cerebral artery with the RNF213 variant: illustrative cases.

期刊: Journal of neurosurgery. Case lessons 发表日期: 2026-May-25 链接: PubMed

摘要

Aplastic or twig-like middle cerebral artery (Ap/T-MCA) is a rare cerebrovascular anomaly characterized by unilateral stenosis of the proximal middle cerebral artery (MCA) with a plexiform arterial network along the horizontal (M1) segment, requiring distinction from moyamoya disease. Genetically confirmed cases remain rare. We report the cases of 3 patients with Ap/T-MCA carrying the RNF213 (ring finger protein 213) variant. The first patient, a man in his 60s, presented with subarachnoid hemorrhage. The second patient, a woman in her 20s, developed involuntary movement of the left upper limb. The third patient, the older sister of the second patient, experienced transient left hemiparesis in her 40s. In all patients, MR angiography demonstrated unilateral MCA abnormalities, and digital subtraction angiography revealed M1 stenosis with a plexiform arterial network in the subarachnoid space. All patients were managed conservatively, and targeted sequencing confirmed the RNF213 p.R4810K variant in each case. Only 2 Ap/T-MCA patients with this variant have been previously reported. The presence of the RNF213 p.R4810K variant in all 3 patients supports a relationship between twig-like MCA and the RNF213 variant. These findings suggest that Ap/T-MCA may represent the RNF213-related vasculopathy spectrum, and the occurrence in two sisters indicates a hereditary predisposition. https://thejns.org/doi/10.3171/CASE26186.

13. Peer-Mentored Social Media Groups for Youth Vaping Cessation: Single-Arm Pilot Trial.

期刊: JMIR pediatrics and parenting 发表日期: 2026-May-25 链接: PubMed

摘要

Using social media to deliver e-cigarette cessation interventions to young people is a promising approach, but low participant engagement and retention may undermine intervention efficacy. Peer mentoring holds great potential to address these issues. This study aimed to understand the feasibility and acceptability of integrating peer mentoring into a social media-based intervention to help young people quit e-cigarette use. We conducted a single-arm pilot trial with 24 e-cigarette users (aged 16-21 years). Participants were assigned to 1 of 2 Instagram groups, where they received an existing vaping cessation intervention, Quit the Hit (QTH), in which a trained counselor posted 1 to 3 evidence-based vaping cessation messages on weekdays over 5 weeks. As an adjunct to QTH, each group included 2 peer mentors of similar age as participants who had successfully quit vaping. The mentors provided social support and shared their quitting experiences. Participants completed a baseline survey and a follow-up survey at the end of the intervention (week 5) and were invited to participate in postintervention focus groups. Participants’ mean age was 18.6 (SD 1.2) years, and 58.3% (14/24) were male. Most (20/24, 83.3%) identified as straight/heterosexual, 29.2% (7/24) identified as non-Hispanic White, and 45.8% (11/24) were high school students. On average, participants vaped e-cigarettes 5.1 (SD 1.7) days per week, and 33.3% (8/24) reported daily vaping. All participants (24/24, 100%) had made at least one quit attempt in the past year. Nearly all participants (23/24, 95.8%) engaged in the group by either posting or liking others’ comments at least once. Mean program engagement was 28.8 (SD 27.3) posts or likes over the 5 weeks. The study retention rate was 91.7% (22/24) at week 5. Using an intent-to-treat approach, 66.7% (16/24) of participants were abstinent (7-day point prevalence abstinence) at week 5. On a 5-point Likert scale, participants rated peer mentoring as highly useful (mean 4.6, SD 0.3) and reported high levels of satisfaction (mean 4.7, SD 0.3). All participants who completed the follow-up survey said they would recommend the program to others. Focus group findings supported these results, highlighting positive feedback on both the quality and usefulness of peer mentoring and the peer-mentored version of the QTH program. Suggestions for future improvements were also discussed. Integrating peer mentoring into social media-based e-cigarette cessation interventions for young people is feasible and acceptable. Participants engaged in the intervention and demonstrated strong retention. They rated both the peer mentoring and the overall program highly. Self-reported abstinence at 5 weeks was high. Larger trials are warranted to evaluate the efficacy of the peer-mentored intervention.

14. Association Between Wearable Device Adoption and Health-Related Lifestyle Behaviors: Retrospective Cohort Study.

期刊: Journal of medical Internet research 发表日期: 2026-May-25 链接: PubMed

摘要

Wearable devices are increasingly adopted for personal health monitoring, but evidence on their long-term associations with health-related lifestyle behaviors in real-world population settings remains limited. This study examined the longitudinal association between wearable device adoption and engagement in health-related lifestyle behaviors using a nationally representative panel dataset from South Korea. We analyzed data from the 2016 and 2022 waves of the Korea Media Panel survey. Health-related lifestyle behaviors in the physical, social, and cultural domains were operationalized as estimated annual activity counts based on self-reported frequency measures. We used a difference-in-differences framework with generalized estimating equations to compare changes in these behaviors between new wearable adopters and nonadopters adjusting for demographic and socioeconomic characteristics. Relative changes were estimated using Poisson models with a log link, and subgroup analyses were conducted to explore variation across sociodemographic groups. As a sensitivity analysis, inverse probability of treatment weighting was additionally applied to assess the robustness of the findings to observed baseline imbalance. Wearable device adoption was associated with greater increases in total, physical, and cultural health-related lifestyle activities over time. In the difference-in-differences model, adopters showed greater relative increases in total activity (rate ratio [RR] 1.24, 95% CI 1.08-1.35), physical activity (RR 1.36, 95% CI 1.12-1.64), and cultural activity (RR 1.78, 95% CI 1.31-2.42) than nonadopters. Subgroup analyses showed limited evidence of consistent heterogeneity and should be interpreted cautiously. Sensitivity analyses using inverse probability of treatment weighting showed overall patterns broadly similar to those of the primary analyses. In this nationally representative panel study, wearable device adoption was associated with greater increases in total, physical, and cultural health-related lifestyle activities over time, whereas no clear association was observed for social activity. These findings should be interpreted as associative rather than causal given the observational design and the inability to directly assess parallel trends.

15. Prevalence, Themes, and Partisan Differences in US State Legislator X Posts Mentioning Suicide: Content Analysis.

期刊: JMIR formative research 发表日期: 2026-May-25 链接: PubMed

摘要

Suicide is a leading cause of death in the United States, and state policies can be effective tools to prevent suicide. State legislators are increasingly active on social media, communicating about their legislative priorities and signaling information about their knowledge and attitudes about issues. This study aimed to characterize US state legislators’ social media posts mentioning suicide on X (formerly Twitter) and explore differences in how Democrat and Republican legislators communicate about suicide. We used Quorum, a public affairs database, to identify all state legislator X posts mentioning suicide (N=1049) between December 1, 2023, and November 30, 2024. We developed a codebook and used content analysis to characterize posts and document the frequency of communication about suicide and themes related to causes, solutions, and consequences of suicide. We assessed concordance between the social media post language used and guidelines for reporting about suicide. We conducted univariate analysis and chi-square tests to assess differences in the content of posts between Democrat and Republican legislators. Differences in the frequency of posts about suicide were analyzed using 2-tailed t tests. Of 1049 posts identified, 849 (80.9%) were included in the final sample. The annual suicide post rate per 10,000 posts was 13.2 (0.1% of all posts) among Democrats and 7.4 (0.1% of all posts) among Republicans (P=.09). Suicide related to a specific population was identified in 52.2% (443/849) of posts, with youth, veterans, firearm owners, and the LGBTQ+ (lesbian, gay, bisexual, transgender, queer, and more) population being identified most frequently. Causes of suicide were identified in 37.1% (315/849) of posts, with no significant difference between Democrats and Republicans. However, the types of causes identified varied, with Democrats more likely to identify lethal means (eg, firearms) as a cause of suicide than Republicans (115/573, 20.1% vs 20/172, 7.5%; P<.001). About two-thirds (558/849, 65.7%) of posts identified at least one solution to prevent suicide, with Democrats more likely to identify a solution than Republicans (443/573, 77.3% vs 114/268, 42.5%; P<.001). General awareness was the most frequent solution, while policy-specific solutions were present in only 23.3% (198/849) of posts. Collateral consequences of suicide were infrequently mentioned. This study found differences between Democrats and Republicans in their X posts about suicide and areas of misalignment with research evidence. When considered within the context of research on the epidemiology of suicide and evidence supporting suicide prevention policies, the study highlights the need to improve communication about suicide with state legislators and to encourage further collaboration with suicide prevention organizations and experts. Furthermore, given the differences observed, study findings suggest potential value in tailoring messages about suicide for legislators based on their political party.

16. Health Care Professionals' Perspectives on the Use of a Wearable Device for Early Detection and Continuous Vital Signs Monitoring of Acute Respiratory Infections in Nursing Homes: Qualitative Study.

期刊: JMIR nursing 发表日期: 2026-May-25 链接: PubMed

摘要

The growing aging population and staff shortages are placing pressure on Dutch nursing homes (NHs). These challenges have led to an increased interest in digital health technologies. Among these are wearable devices that allow for remote continuous monitoring of vital signs. An example is the Healthdot (smartQare), a wearable electronic device that continuously monitors heart rate, respiratory rate, and physical activity. In the context of acute respiratory infections (ARIs) in NHs, where initial symptoms can go unnoticed, continuous monitoring may aid in early recognition, timely intervention, and reduce staff workloads. However, little is known about how health care professionals perceive the use of continuous vital signs monitoring devices, such as the Healthdot, for this cause in NHs. This study aims to explore the perspectives of healthcare professionals on the use of the Healthdot for early detection and monitoring of ARIs in NHs, to inform potential future implementation. Semistructured interviews were conducted with 20 physicians, nurses, and certified nursing assistants from 4 NHs and 1 acute geriatric community hospital located in a NH. Interview transcripts were thematically analyzed to identify themes regarding their perspectives on the use of the Healthdot for monitoring ARIs in this setting. Five main themes were identified that related to the appropriate use of the Healthdot for NH clients and health care professionals: alignment of Healthdot use and NH clients’ treatment policies, balancing safety and freedom, impact of the Healthdot on work processes, supporting rather than replacing care, and possible use during pandemics and in the future. Additionally, several preconditions for the use of the Healthdot were identified, including its usability, a support base among care staff, adequate training and guidance, communication with NH clients and their relatives, and a clear policy regarding its use. Given the complexity of care in NHs, where clinical care is typically balanced against quality of life and a homelike environment, physicians generally expressed reserved attitudes toward the Healthdot, highlighting the need to consider multiple factors in its implementation. Care staff were generally positive about the device. Nevertheless, tailored assessment for each individual NH client remains essential, balancing treatment goals, safety, autonomy, and person-centered care. Additionally, clear communication and alignment between health care professionals in this setting are crucial, specifically regarding their expectations of the Healthdot’s role in care processes. This study offers practical guidance that may inform future implementation efforts of continuous vital sign monitoring devices in NHs.

17. Evaluating a Preventive Heart Health Program for Women at Midlife: Protocol for a Mixed Methods Pilot Study.

期刊: JMIR research protocols 发表日期: 2026-May-25 链接: PubMed

摘要

Cardiovascular disease (CVD) is the leading cause of death in women. Risk factors can be compounded by hormonal changes, especially during the menopause transition. Positive health promotion through a behavioral change strategy may be the most effective approach to reducing CVD mortality and morbidity. Health care providers are instrumental in identifying and managing CVD risk factors in women. This study aims to explore and assess the barriers and facilitators to implementing preventive heart health care in Singapore. A prospective mixed methods pilot study using both quantitative and qualitative research methods for program implementation and evaluation through an interrupted time series study design will be conducted with a sample of 100 women aged 45 to 65 years. An A-B-A reversal design of 6-month intervals (baseline [A]-participants’ healthy heart behaviors before the introduction of health coaching, intervention [B]-health coaching is introduced and participants’ behaviors are measured to observe for changes from baseline, and return to baseline [A]-health coaching is removed and there is a return to baseline) will be used to assess the feasibility and acceptability of behavioral change strategies to increase heart-healthy habits. Data collection will occur over 3 phases: the preimplementation phase, the implementation phase, and the postimplementation phase. Quantitative data collection will include structured surveys. Qualitative interviews will be conducted among a subset of patients and health care providers for the exploratory evaluation of this study. Purposive sampling will be used for the recruitment of interview participants. Primary outcomes will be the reach, effectiveness, adoption, and feasibility of the preventive heart health program. Secondary outcomes will include laboratory blood test results and CVD risk assessment. A segmented regression analysis of interrupted time series will be used to evaluate the impact of the behavioral change strategy intervention. Qualitative data will be analyzed using an inductive approach, and thematic synthesis will be used to identify patterns. Integrating quantitative and qualitative data will facilitate a nuanced understanding of the barriers and facilitators of implementing a preventive heart health program among midlife women. This study was funded in May 2022. Data collection started in April 2024 and is projected to end in April 2026. A total of 60 participants had been enrolled as of December 2025. Data analysis is expected to commence in June 2026 and expected results published in the autumn of 2026. Experiential knowledge arising from the adoption of personalized health coaching for midlife women can help ascertain the contextual challenges and effectiveness of service implementation in Singapore. Study findings can contribute to refining the framework of sex-specific, tailored CVD prevention care; enable upscaling of such services to other hospitals; and improve future preventive care for midlife women.

18. Spatio-temporal inequalities in vulvar cancer mortality in Spain, 1999-2023: a nationwide Bayesian analysis.

期刊: Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico 发表日期: 2026-May-25 链接: PubMed

摘要

To conduct the first nationwide spatio-temporal analysis of vulvar cancer mortality in Spain, identifying geographical inequalities and temporal trends over 25 years. A population-based ecological study analyzed mortality data (1999-2023) across 52 Spanish provinces and autonomous cities. Expected deaths were calculated via indirect standardization. Hierarchical Bayesian spatio-temporal models were implemented using Integrated Nested Laplace Approximation (INLA). Spatial heterogeneity accounted for 68.8% of the total posterior variance, whereas the national temporal trend explained only 8.2%. Nationally, mortality risk showed a modest downward trend, with the RR decreasing from 1.054 (95% CrI 0.981-1.133) in 1999 to 0.954 (95% CrI 0.890-1.022) in 2023. However, areas with a high posterior probability (PP(RR > 1) > 0.95) of excess mortality were consistently identified in southwestern Spain (Badajoz RR 1.25, Cádiz 1.21, Huelva 1.20, Sevilla 1.18) and Lugo (RR 1.16), while lower risks were observed in Madrid and Barcelona (RR 0.85). Vulvar cancer mortality in Spain shows persistent geographical disparities rather than a uniform national trend. These ecological findings do not allow causal interpretation, but they may reflect underlying contextual factors, such as socioeconomic inequalities, heterogeneous access to early diagnosis, variability in access to specialized gynecologic oncology services, and differences in the detection and management of precursor conditions. These results highlight the need for further research incorporating incidence, clinical stage, and healthcare access data, as well as public health strategies aimed at ensuring equitable access to multidisciplinary care and strengthening coordinated early detection pathways across regions.

19. Mindfulness-based cognitive-behavioral therapy improves sexual quality of life and reduces sexual distress in pregnant women.

期刊: Discover mental health 发表日期: 2026-May-25 链接: PubMed

摘要

Pregnancy is accompanied by numerous physical and psychological changes that can affect sexual quality of life and increase sexual distress in women. Identifying effective interventions to address these issues is essential. This study aimed to evaluate the effect of mindfulness-based cognitive-behavioral therapy on sexual distress and sexual quality of life in pregnant women. In this single-blind randomized clinical trial, 84 pregnant women (20-35 weeks of gestation) were randomly assigned to an intervention group (n = 40) or a control group (n = 41) using a block design. The intervention group participated in seven weekly sessions of mindfulness-based cognitive therapy. Data were collected using a demographic questionnaire, the Sexual Quality of Life-Female (SQOL-F) questionnaire, and the Female Sexual Distress Scale (FSDS). At baseline, there were no statistically significant differences between the two groups in demographic characteristics, sexual distress, or sexual quality of life. Repeated measures analysis showed significant improvements in the intervention group compared with the control group in overall sexual quality of life and its dimensions (psychosexual feelings, sexual and relationship satisfaction, self-worthlessness, and sexual repression). Sexual distress scores were also significantly reduced in the intervention group after the intervention and at follow-up. Mindfulness-based cognitive-behavioral therapy appears to be an effective approach for enhancing sexual quality of life and reducing sexual distress in pregnant women. Integrating this intervention into prenatal care services may help promote the overall well-being of expectant mothers. This study was approved by the Ethics Committee of Ahvaz Jundishapur University of Medical Sciences (IR.AJUMS.REC.1399.135) and registered in the Iranian Registry of Clinical Trials (IRCT20200901048581N1) on September 21, 2020.

20. Health Literacy in Latin America and the Caribbean: A Comprehensive Scoping Review of Research Developments.

期刊: Journal of prevention (2022) 发表日期: 2026-May-25 链接: PubMed

摘要

Health literacy is critical for reducing inequality and promoting effective implementation of health services and better health outcomes. The health literacy agenda is gaining momentum worldwide, including in Latin America and the Caribbean. However, a comprehensive overview of research developments in the region is lacking. This study aimed to explore the state of the art of health literacy research in Latin America and the Caribbean. A scoping review was conducted in January 2024 drawing upon data from the databases: La Referencia, BVS, PubMed, Web of Science, CINAHL, PsycINFO, and ERIC. The search results were reviewed in Rayyan by all co-authors. The title and abstracts were screened, based on inclusion and exclusion criteria followed by extraction, analysis and synthesis of data according to the research objectives. The search yielded 375 publications including 289 peer-reviewed articles and 86 dissertations and theses. The sample included quantitative (73.9%), qualitative (13.9%), mixed-methods (5.9%), and bibliographic (1.9%) studies and other types of scientific publications (4.5%). Two thirds of the countries published health literacy research. Most originated from Brazil, followed by Mexico, Chile, Peru, and Colombia. There was a marked increase in publications from 2017 onward, reaching a peak in 2022. The most frequently cited definitions were by Sørensen et al. (Sørensen et al in BMC Pub Health 12:80, 2012 and the WHO Health Promotion Glossary (World Health Organization (WHO). (1998). Health promotion glossary.). The prominent research topics included oral health literacy and non-communicable diseases. Other topics include e.g., general health literacy, communicable diseases, functional health literacy, and healthcare literacy. Health literacy was measured 312 times with a variety of established and newly developed instruments. This scoping review highlights progress and challenges concerning health literacy research in Latin America and the Caribbean. The active health literacy research community adopts multiple research strategies, themes and multidisciplinary approaches for adapting health literacy interventions to diverse populations. Brazil and its vibrant health literacy community can inspire the development of health literacy in the region. Ongoing research, policy innovation, and community-based action are needed to maximize health literacy’s potential for improving health services, public health, and wellbeing in the region.

21. To Reenvision and Redefine: Considering the Role of Lifestyle Interventions in the New Era of Second-Generation Obesity Management Medications.

期刊: Current atherosclerosis reports 发表日期: 2026-May-25 链接: PubMed

摘要

This narrative review examines lifestyle considerations before, during, and after second-generation obesity management medication (OMM) treatment. Second-generation OMMs, including semaglutide and tirzepatide, have demonstrated unprecedented weight losses of around 15-20% in recent trials, leading to their swift uptake in clinical care. With increased pharmacotherapy effectiveness, attention has shifted to the accompanying role of lifestyle interventions in optimizing health and wellbeing. Emerging literature raises concerns regarding treatment sustainability, lean mass loss, nutritional risks, and weight regain following pharmacotherapy discontinuation, highlighting persistent gaps in the role of lifestyle strategies during OMM treatment. Lifestyle modification remains the cornerstone of obesity treatment, yet barriers to implementation and long-term success underscore the need for more sustainable strategies. As novel OMMs redefine obesity care, lifestyle programs may be able to shift focus from weight reduction to overall health promotion. However, the optimal timing, frequency, and content of such interventions alongside OMMs remain unclear. Because obesity is chronic and OMMs are costly, pre-treatment programs may precede pharmacotherapy, though this can limit access and reinforce stigma. During treatment, lifestyle approaches can mitigate medication-related effects and enhance health beyond weight loss, addressing concerns such as inadequate nutrition or muscle loss through protein intake and physical activity and reducing gastrointestinal side effects via dietary strategies. After discontinuation, behavioral programs may help prevent weight regain and sustain health improvements. Tailoring lifestyle interventions to modern pharmacotherapy offers an opportunity for health-centered, patient-focused obesity care.

22. Early alcohol initiation is associated with higher lifetime Parkinson's disease risk after accounting for exposure latency.

期刊: Journal of Parkinson’s disease 发表日期: 2026-May-25 链接: PubMed

摘要

BackgroundObservational evidence linking alcohol consumption to Parkinson’s disease (PD) is inconsistent, potentially because conventional analyses do not account for the long latency between alcohol initiation and clinical onset or diagnosis.ObjectiveTo test whether latency-aware modeling changes alcohol-PD associations and whether earlier initiation increases lifetime risk.MethodsWe applied a latency-explicit semi-Markov framework in two longitudinal, community-based screening cohorts in Taiwan. The Keelung cohort (Community A; n = 23,475; aged ≥60 years; 2002-2005) was used for model development, and the Changhua cohort (Community B; n = 90,129; aged ≥50 years; 2005-2022) was used for external application. We compared conventional logistic regression with latency-adjusted relative rates, conducted smoking-stratified analyses, and benchmarked age-specific projections against an independent door-to-door PD survey.ResultsIn Community A, conventional regression suggested an inverse association (odds ratio 0.69; 95% confidence interval 0.53-0.91), whereas latency-adjusted modeling indicated higher PD risk among drinkers (relative rate 1.61; 95% confidence interval 1.32-1.95). Excess risk emerged ∼25, ∼35, and ∼45 years after initiation at ages 20, 30, and 40 years, respectively; alcohol-attributable risk by age 90 was 32.1%, 20.7%, and 4.9%. Smoking shortened estimated latency by 5 years. In Community B, PD incidence was higher among drinkers than non-drinkers, with wider separation at older ages (70-74 years: 58.6 vs 46.0 per 100,000).ConclusionAccounting for exposure timing and latency reversed the apparent protective signal and supported a higher modeled lifetime PD risk with alcohol use, particularly earlier initiation. Incorporating latency may strengthen etiologic inference and inform long-horizon prevention strategies. Because Parkinson’s disease develops slowly, early drinking may matter later in lifePlain language summaryParkinson’s disease (PD) develops slowly. Many people are diagnosed years after the brain changes that lead to PD have already begun. Because of this long delay, studies about alcohol and PD can give confusing results, especially if they do not consider when a person first started drinking.We used data from two large community health screening programs in Taiwan. We first examined one community to understand how PD risk might change over time after someone begins drinking. We then applied the same approach to a second community to see whether a similar pattern appeared. We also compared our age-based estimates with results from a separate door-to-door PD survey to understand how different ways of identifying PD cases might affect the numbers.When we used a simple approach that did not consider timing, alcohol use appeared to be linked to a lower chance of PD. When we took the long delay into account, alcohol use was linked to a higher longterm PD risk. The difference between drinkers and non-drinkers did not appear right away; it became clearer decades after alcohol use began. Starting alcohol use at a younger age was linked to a larger lifetime impact. Smoking often occurred together with drinking and was linked to a shorter time until PD appeared among people who drank, highlighting that health behaviors tend to cluster.This was an observational study, so it cannot prove that alcohol causes PD, and other unmeasured factors may contribute. Even so, our findings suggest that when alcohol use begins matters. Considering long delays may help explain why past studies disagreed and supports health-promotion efforts that delay early alcohol initiation and encourage healthier lifestyles across adulthood.

23. Changes to autonomous motivation and reductions in amotivation led to positive mental health in overweight male football fans: a causal mediation analysis of the European fans in training (EuroFIT) trial.

期刊: Psychology & health 发表日期: 2026-May-25 链接: PubMed

摘要

Do post-program motivational regulations mediate the intervention effect of the SDT-based European Fans in Training (EuroFIT) program on self-esteem, well-being and vitality at 12-months follow-up? A causal mediation analysis of data from the randomised controlled trial of the EuroFIT program that recruited 1113 overweight, male football fans in England, Norway, Portugal and the Netherlands. We found evidence of indirect effects of autonomous motivation on vitality (b=.487, 95% CI: .229, .767, p<.001) well-being (b=.063, 95% CI: .003, .131, p=.038) and self-esteem (b=.491, 95% CI: .278, .701, p<.001), but not controlled motivation, at 12-months follow-up in the EuroFIT trial. We also found that reductions in amotivation at post-program partly explained positive increases across outcomes at 12-months follow-up. When controlling for increases in outcome variables at post-program, only the mediating effect of autonomous motivation on self-esteem remained significant, whereas the indirect pathway through reductions in amotivation remained significant for all outcomes. None of the indirect effects were robust to potential mediator-outcome confounding. EuroFIT program produced small-to-moderate improvements in vitality, well-being, and self-esteem at 12-month follow-up that were partly explained by post-program increases in autonomous motivation and reductions in amotivation. All indirect effects estimates were sensitive to potential mediator-outcome confounding.

24. Determinants of midgut loop formation: Influence of midgut length, diameter, and location.

期刊: Developmental dynamics : an official publication of the American Association of Anatomists 发表日期: 2026-May-25 链接: PubMed

摘要

The midgut forms tertiary loops in the extraembryonic coelom, where biomechanical factors are thought to influence this process. The number of loops may stabilize once the midgut returns to the abdominal cavity. We therefore examined how midgut length and diameter affect the number of tertiary loops before and after intestinal return. Magnetic resonance images from 50 human embryo and fetus specimens and serial tissue sections from six fetuses were analyzed. The midgut was divided into four segments, and the length of each segment and the tube diameter at a representative central loop were measured and subjected to regression analysis. In the extraembryonic coelom, loop number increased linearly with midgut length, whereas diameter showed no independent association. In the abdominal cavity, greater length was associated with more loops, whereas greater diameter tended to be associated with fewer loops, particularly in Segment-2 and Segment-4. This pattern may be related to the apparent attenuation of further loop increase after return to the abdominal cavity during later fetal development. The effects of midgut length and diameter on tertiary loop formation differ between the extraembryonic coelom and the abdominal cavity, highlighting the importance of midgut position in loop formation.

25. Targeting inflammatory pathways in rheumatoid arthritis management using phytochemicals and mechanistic insights.

期刊: International immunopharmacology 发表日期: 2026-May-25 链接: PubMed

摘要

Rheumatoid arthritis (RA) is a long-term autoimmune disease marked by inflammation of the synovial membrane, gradual joint damage and systemic issues. Contemporary treatment, including non-steroidal anti-inflammatory drugs (NSAIDs), corticosteroids, disease-modifying anti-rheumatic drugs (DMARDs) and biologics, usually offers symptomatic relief and suppresses immunity but is often limited by side effects and does not prevent long-term structural damage. On the other hand, phytochemicals have attracted interest as multi-target therapeutic agents that can influence key disease pathways such as NF-κB, MAPK, JAK/STAT, Nrf2/Keap1 and NLRP3 inflammasome signaling pathways. RA is driven by activation of NF-κB, MAPK, and JAK/STAT pathways, leading to excessive pro-inflammatory cytokine production and synovial inflammation. The NLRP3 inflammasome further amplifies this response via IL-1β and IL-18 activation. Conversely, impaired Nrf2/Keap1 signaling reduces antioxidant defense, aggravating oxidative stress and joint damage. Bioactive compounds including polyphenols (like curcumin, resveratrol, quercetin and epigallocatechin gallate EGCG), terpenoids (such as boswellic acids) and alkaloids (like berberine and sinomenine) along with various flavonoids, demonstrated strong anti-inflammatory, antioxidant, immunomodulatory, chondroprotective and anti-resorptive effects in early and emerging clinical studies. However, incorporating these findings into clinical practice faces challenges primarily because of suboptimal pharmacokinetics, such as poor water solubility, low gut absorption and rapid metabolism, resulting in inadequate and inconsistent levels in plasma and synovial fluid. This review integrates mechanistic and pharmacokinetic evidence to critically evaluate the potential and limitations of phytochemicals for the management of RA, and highlights advanced formulations to improve bioavailability and targeted and personalized clinical use.

26. Dioscin alleviates allergic airway inflammation with IL-4R-associated modulation of epithelial-immune responses.

期刊: International immunopharmacology 发表日期: 2026-May-25 链接: PubMed

摘要

Allergic asthma is characterized by airway inflammation, epithelial barrier dysfunction, and dysregulated immune responses. While Th2 cytokines and IL-4 receptor (IL-4R) signaling are central to its pathogenesis, accumulating evidence underscores the involvement of epithelial-immune interactions, metabolic disturbances, and gut-lung axis dysregulation. Dioscin, a natural steroidal saponin, has demonstrated anti-inflammatory properties, but its role in airway inflammation remains insufficiently explored. We established an ovalbumin (OVA)-induced asthma model in BALB/c mice to assess the effects of dioscin on airway function, epithelial integrity, immune cell distribution, and mucosal inflammation. Lung metabolomics and 16S rRNA gene sequencing were conducted to evaluate metabolic and microbiota profiles. In vitro, two co-culture models were established: BMDCs-BEAS-2B to evaluate epithelial-immune crosstalk under IL-4R modulation, and BMDCs-RBL-2H3 to assess mast cell-associated immune responses under LPS/IL-4 stimulation with altered IL-4R expression. Dioscin administration was associated with reduced airway hyperresponsiveness, inflammatory infiltration, oxidative stress, and Th2/Th17-related cytokine levels. Lung metabolomics revealed that dioscin partially restored OVA-induced metabolic imbalances, particularly in glutathione and purine metabolism pathways. 16S rRNA sequencing showed a partial recovery of microbial diversity and composition. Immune profiling indicated a shift in CD86+/CD206+ immune-cell phenotype ratio and reduced eosinophil and CD4+IL-4+ T cell infiltration. In BEAS-2B co-cultures, IL-4R expression modulated epithelial responsiveness to inflammatory cues and dioscin. In addition, the RBL-2H3 system allowed the evaluation of mast cell degranulation and FcεRI-related signaling, which were also influenced by IL-4R levels. This study shows that dioscin alleviates allergic airway inflammation and is associated with improved epithelial integrity, reduced oxidative stress, and attenuated immune dysregulation. In vitro co-culture experiments suggest that IL-4R expression modulates the magnitude of epithelial-immune responses, but the current data do not establish a direct IL-4R-dependent mechanism in vivo; the metabolomic and microbiota findings should be interpreted as exploratory system-level associations rather than definitive mechanistic evidence. These findings provide insights into mucosal immunoregulation and natural compound-based interventions for allergic airway disease.

27. In search of PAH transformation pathways through air, water, sediment and bivalves in a coastal area of the Skagerrak Sea.

期刊: Chemosphere 发表日期: 2026-May-25 链接: PubMed

摘要

Polycyclic aromatic hydrocarbons (PAHs) and their derivatives constitute persistent contaminants in marine coastal environments, where their sources, fate, and potential ecological and human-health effects are of increasing concern. While much attention has been paid to parent PAHs, less is known concerning their oxygenated (Oxy-PAHs) and nitrogenated (N-PAHs) analogues, which may arise via atmospheric oxidation, photochemical aging, microbial transformation, or direct emissions (e.g., combustion or fossil-fuel usage). We studied a relatively unexploited coastal area of the Skagerrak Sea and a nearby harbour area. Sediments, terrestrial gyttja, water samples, and caged blue mussels (Mytilus edulis) and European flat oysters (Ostrea edulis) were analysed for 19 PAHs, 10 Oxy-PAHs and 4 N-PAHs. ΣPAHs in sediments ranged from 500 to 2000 ng g-1 dw, whereas water contained 1-3 ng L-1. Oxy-PAHs occurred at similar levels as PAHs in water but were an order of magnitude lower in sediments and bivalves. N-PAHs were undetectable in water but present in sediments, gyttja and bivalves, with highest levels in terrestrial gyttja. Each matrix represents a distinct environmental compartment and captures different aspects of pollutant behavior: sediments serve as long-term sinks that reflect historical deposition, water provides insight into ongoing inputs and dissolved-phase dynamics, and bivalves act as bioaccumulators integrating contaminant exposure over time. The use of the relationships between daughter and parent PAHs offered insights into sources and environmental pathways of both conventional and emerging PAH compounds. The combined study of five different matrices enhanced our ability to evaluate contaminant cycling.

28. Benzalkonium Chloride-Induced Nephrotoxicity in 2D Cultures and a Human Kidney-on-a-Chip System.

期刊: Environmental science & technology 发表日期: 2026-May-25 链接: PubMed

摘要

Benzalkonium chlorides (BACs) are antimicrobial compounds widely used across a variety of settings, and the COVID-19 pandemic has led to significantly increased usage of BAC-containing products. Previous studies in animals have shown that the kidney is the primary site of BAC accumulation, whereas the liver does not accumulate BACs, likely due to efficient hepatic cytochrome P450-mediated metabolism. Thus, we hypothesized that low BAC-metabolizing capacity contributes to the extent of BAC buildup in the kidney and promotes subsequent kidney injury. Using 2D-cultured proximal tubule epithelial cells (PTECs), we found that renal metabolism is insufficient to detoxify BACs. We then assessed BACs’ nephrotoxicity using a novel 3D “kidney-on-a-chip” microphysiological system (MPS). The MPS was exposed to C12- or C14-BAC at 100 nM for 1 week. Transcriptomic analysis of the 3D-cultured PTECs reveals several significantly altered biochemical pathways following BAC exposure, including focal adhesion and cholesterol biosynthesis. Additional studies utilizing orthogonal techniques validated the phenotypic changes associated with some of the significantly altered pathways using 2D-cultured PTECs. Together, these findings demonstrate that the poor BAC-metabolizing capacity of PTECs contributes to the nephrotoxicity of BACs.

29. The removal effects and mechanism of sulfate from acid mine drainage using fly ash and sunflower heads composite biochar.

期刊: Environmental geochemistry and health 发表日期: 2026-May-25 链接: PubMed

摘要

To address the persistent challenge of sulfate (SO42-) removal from acid mine drainage (AMD), a novel calcium-functionalized composite biochar (CaCl2-BC) was synthesized via the co-pyrolysis of sunflower heads, coal fly ash, and CaCl2. The composite prepared under optimal conditions (600 °C, 1:1 mass ratio) exhibited an exceptional SO42- removal capacity of 188.73 mg/g. The removal kinetics followed the pseudo-second-order model, while the equilibrium data fitted the Langmuir isotherm well. Crucially, microscopic characterizations and Density Functional Theory (DFT) calculations explicitly decoded a synergistic “adsorption-precipitation” mechanism. The fly-ash-derived Si-O groups acted as high-affinity anchors (- 174.3 kJ/mol) to initially capture and enrich SO42-, effectively overcoming electrostatic repulsion. Subsequently, the surface-loaded CaCl2·2H2O phase served as a reactive engine, driving the in-situ crystallization of stable gypsum (CaSO4·2H2O). Comparative system matrix evaluations demonstrated that this synergy far exceeded the simple sum of individual components. Furthermore, CaCl2-BC sustained a formidable capacity of 147.56 mg/g in complex real AMD, while leaching tests confirmed its environmental safety. This study establishes a rigorous theoretical framework for mineral-carbon synergy and provides a highly practical material for industrial AMD remediation.

30. Infection prevention in total knee arthroplasty: current concepts, controversies, and a clinical algorithm.

期刊: European journal of translational myology 发表日期: 2026-May-25 链接: PubMed

摘要

Periprosthetic Joint Infection (PJI) remains one of the most serious and challenging complications following Total Knee Arthroplasty (TKA), with a substantial impact on patient outcomes and healthcare systems. Despite advances in surgical techniques and perioperative management, the incidence of PJI has not significantly declined, highlighting the need for more effective preventive strategies. This review aims to provide a comprehensive and clinically oriented overview of current infection prevention strategies in TKA, with a particular focus on risk stratification, perioperative optimization, and the development of a practical clinical algorithm to guide decision-making. A narrative review of the literature was conducted using major medical databases to identify relevant studies on PJI prevention in TKA. Priority was given to recent systematic reviews, meta-analyses, and high-quality clinical studies addressing patient-related risk factors, intraoperative measures, and postoperative management. PJI is a multifactorial complication influenced by the interaction between patient-related, surgical, and postoperative factors. Modifiable risk factors such as obesity, diabetes, malnutrition, and smoking play a pivotal role and should be optimized preoperatively. Intraoperative strategies, including strict aseptic technique, appropriate antibiotic prophylaxis, and minimization of operative time, are essential to reduce contamination risk. Postoperative measures focusing on wound management, hematoma prevention, and early detection of complications further contribute to infection prevention. Several aspects remain controversial, including the role of laminar airflow systems, antibiotic-loaded bone cement in primary TKA, and optimal decolonization strategies for Staphylococcus aureus. Effective prevention of PJI requires a structured, multimodal approach integrating all phases of care. Risk stratification enables personalized preventive strategies and improved perioperative planning. The clinical algorithm proposed in this review provides a practical framework to support decision-making and may help standardize infection prevention pathways. Future research should focus on validating risk-based approaches and emerging technologies to further reduce the burden of PJI in TKA.

31. Epidemiological, Clinical, and Socioenvironmental Characteristics of Cutaneous Leishmaniasis Cases in the Xakriabá Indigenous Population, Brazil.

期刊: Acta parasitologica 发表日期: 2026-May-25 链接: PubMed

摘要

Cutaneous leishmaniasis (CL) remains a neglected tropical disease that disproportionately affects indigenous populations, where transmission is shaped by complex socioenvironmental conditions. Our objective is to describe and analyze the sociodemographic, environmental, clinical, and therapeutic characteristics of CL cases in the Xakriabá indigenous population, and to explore associations between these characteristics and clinical outcomes. An observational analytical study based on a case series was conducted using secondary data from the Brazilian Notifiable Diseases Information System (SINAN), covering the period from 2013 to 2024. Analyses were restricted to internal associations among reported cases, without inference of population-level risk. Sociodemographic, environmental, clinical, and therapeutic variables were analyzed using descriptive statistics and logistic regression models. A total of 259 CL cases were identified. Most cases occurred in males (63%) and individuals aged 20-39 years (38%), with nearly all cases residing in rural areas (99%). Associations were observed between clinical outcomes and variables such as occupational exposure (OR = 2.45; 95% CI 1.38-4.33) and proximity to vegetation (OR = 2.71; 95% CI 1.49-4.92). These findings represent associations within the case population and should not be interpreted as causal effects or population risk estimates. A high proportion of missing laboratory data was identified. Spatial distribution was described without inferential analysis. CL in the Xakriabá population is characterized by heterogeneous distribution and associations with socioenvironmental factors within reported cases. Given the study design, results should be interpreted cautiously, without causal inference. Strengthening diagnostic capacity, improving data quality, and implementing territorially adapted public health strategies are essential to improve disease management in indigenous contexts.

32. Cross-cultural adaptation and psychometric properties of a Spanish-language version of the Vestibular Disorders Activities of Daily Living Scale (VADL-ES).

期刊: Journal of vestibular research : equilibrium & orientation 发表日期: 2026-May-25 链接: PubMed

摘要

BackgroundVestibular disorders affect mobility, independence, and quality of life. Culturally adapted assessment tools are essential for accurate evaluation and effective treatment in diverse populations.ObjectivesTo translate, culturally adapt, and evaluate the psychometric properties of the Vestibular Disorders Activities of Daily Living Scale (VADL) into European Spanish (VADL-ES).MethodsThe VADL was adapted following international cross-cultural guidelines. Psychometric testing included internal consistency (Cronbach’s α), test-retest reliability (ICC), content validity (CVI), convergent validity with the Dizziness Handicap Inventory (DHI), and discriminant validity (ROC analysis, Youden index). Floor/ceiling effects, standard error of measurement (SEM), minimal detectable change (MDC95), and structural validity (exploratory and confirmatory factor analysis) were also assessed.ResultsThe VADL-ES showed excellent internal consistency (α = 0.978), test-retest reliability (ICC = 0.988), strong correlation with the DHI (ρ = 0.768), and high content validity (S-CVI = 0.93). ROC analysis yielded an AUC = 0.988 with 100% specificity. Factor analysis confirmed a three-factor structure explaining 72% of variance. No floor or ceiling effects were observed; MDC95 was 0.91.ConclusionsThe VADL-ES is a valid and reliable instrument for assessing functional limitations in Spanish-speaking patients with vestibular disorders, enabling standardized evaluation and longitudinal monitoring in clinical and research settings.

33. Individualized Virtual Angle Offset Training for Patients with Stroke.

期刊: Journal of motor behavior 发表日期: 2026-May-25 链接: PubMed

摘要

Stroke is a leading cause of long-term sensorimotor disability, with upper limb deficits often persisting into the chronic stage. For many patients with stroke, the active muscle control zone, i.e., the angular range of typical muscle activation patterns, is reduced, leading to abnormal patterns and spasticity. When the displayed angle in a virtual environment is smaller than the actual angle, participants may implicitly perceive that their arm remains within the control zone. This discrepancy between visual and proprioceptive information may promote visuo-proprioceptive recalibration and sensorimotor adaptation. The current study included two preliminary investigations, one with healthy participants and one with participants with stroke, each divided into two groups (offset, control). Twenty-one healthy participants underwent a 30-min training session, after which they were tested with the actual elbow angle. Twelve hospitalized individuals with sub-acute stroke underwent three 30-min training sessions over one week. In both studies motion duration of participants who trained with an offset differed from motion of controls who trained with actual feedback. However, Fugl-Meyer Assessment upper limb scores in participants with stroke increased similarly for both groups. Additional testing is required to examine whether the method may be a potential direction for individualized impairment-based intervention.

34. Evaluation of an Educational Intervention to Reduce Ageism and Enhance Inclusive Care Among Healthcare Providers: A Quasi-Experimental Study.

期刊: Journal of applied gerontology : the official journal of the Southern Gerontological Society 发表日期: 2026-May-25 链接: PubMed

摘要

BackgroundAgeism in healthcare is harmful. Theory-based approaches (e.g., Positive Education about Aging and Contact Experiences [PEACE] model), suggest that combining education and meaningful contact can reduce ageist attitudes.ObjectiveThe present study evaluated a half-day educational intervention using lectures and animated videos to reduce healthcare providers’ ageist attitudes.MethodsA single-group pre-post design used three lectures and three animated videos. Scores of Attitudes and Thoughts Toward Older People Scale (AT-TOPS) with pre-post changes were analyzed using paired t-tests with associated effect sizes to assess changes in age-related attitudes.ResultsHealthcare providers (n = 61) who completed the course showed significant improvements in AT-TOPS scores (t = 3.03, p = 0.004, d = 0.39). Item-level analyses indicated reduced ageist attitudes about older adults’ competence, productivity, family burden, and work suitability.ConclusionThe findings suggested that the intervention produced immediate reductions in institutional and interpersonal ageist attitudes, highlighting short-term attitudinal shifts consistent with PEACE-based mechanisms rather than enduring behavioral change.

35. Improving work outcomes in people with multiple sclerosis: A scoping review of non-pharmacological interventions.

期刊: Clinical rehabilitation 发表日期: 2026-May-25 链接: PubMed

摘要

ObjectiveTo evaluate the effectiveness of non-pharmacological intervention studies on work outcomes in people with multiple sclerosis (MS).Data sourcesWe searched three electronic databases (MEDLINE, PsycINFO, and Web of Science: Conference Proceeding Citation Index) and included studies reporting on having/returning to paid employment, work productivity, or factors related to work ability.Review methodsThe Cochrane Handbook for Systematic Reviews of Interventions and the PRISMA extension for scoping reviews checklist were followed. All steps were conducted by two reviewers.ResultsThe search (inception-April 2026) yielded 10449 articles. Sixteen studies were included: four vocational, seven psychological, one exercise, and four combining these intervention types. Reported work outcomes included employment status, work difficulties, workplace accommodations, promotions, impact on work and education, work productivity and impairment, and work and social adjustment. Eight studies aimed to improve work outcomes. Five interventions demonstrated significant improvement: two targeting fatigue with cognitive behavioral therapy (β = -0.34, 95% CI: -0.66 to -0.03; β = -3.68, 95% CI: -5.82 to -1.537), one on conscientiousness (effect size not reported), one on information processing speed (f2 = 0.04, p = 0.044), and one on job seeking (career goals and appraisal of potential work difficulties (t = -2.68, p = 0.009), self-esteem (t = 2.47, p = 0.016), relations (t = 2.44, p = 0.017), finances (t = 2.14, p = 0.036)).ConclusionFew non-pharmacological interventions evaluate work outcomes. Cognitive behavioral therapy targeting MS-related fatigue shows promise for improving work outcomes. The heterogeneity of MS and variability in work contexts add challenges, indicating that personalized interventions may ultimately prove more effective than generic approaches.

36. Validation and fidelity testing of a screening tool to identify patients' communication needs during mental capacity assessments: The Mental Capacity Assessment Support Toolkit Communication Screening Tool (MCAST CST).

期刊: Clinical rehabilitation 发表日期: 2026-May-25 链接: PubMed

摘要

ObjectiveTo establish the validity, reliability and fidelity of use of a screening tool for stroke survivors’ communication support needs during mental capacity assessments.DesignCross-sectional psychometric study and multiple methods case series.SettingParticipants’ homes and stroke units in north-west England.ParticipantsPsychometrics: 47 community-dwelling stroke survivors; 10 speech and language therapists experienced in stroke. Fidelity: four nurses and one occupational therapist working in stroke; eight inpatients diagnosed with stroke.Main measuresPsychometrics: Stroke survivors were tested using the new communication screening tool and subtests from the Western Aphasia Battery Revised and Comprehensive Aphasia Test to measure convergent and discriminant validity, test-retest and interrater reliability. Data were analysed using Kendall’s Tau, Goodman-Kruskal’s Gamma and Cohen’s Kappa.FidelityThe nurses and occupational therapist were videorecorded using the screening tool with inpatients. An observational checklist and semi-structured interviews were used to investigate adherence to predefined administration behaviours. Data were analysed using descriptive statistics and qualitative content analysis.ResultsPsychometrics: Screening tool subtests demonstrated moderate-to-strong convergent validity (τ = 0.41-0.72) but poor discriminant validity (τ = 0.27-0.58). Criterion validity was strong (κ = 0.77, 95%CI 0.57-0.98). Test-retest reliability ranged from substantial to near-perfect (κ = 0.68-0.95). Interrater agreement ranged from substantial to perfect (κ = 0.65-1.00).FidelityParticipants adhered to a mean of 85.79% (SD = 10.33) administration behaviours. User errors related to task instruction delivery and scoring. All participants found the tool easy to use and useful.ConclusionsThis unique screening tool for stroke survivors’ communication support needs during mental capacity assessments is valid and reliable. Minor refinements to administration training will improve fidelity of use.

37. Impact of night work on workers' sleep, mood and quality of life.

期刊: Work (Reading, Mass.) 发表日期: 2026-May-25 链接: PubMed

摘要

BackgroundNight work may be imposed in several work sectors, or chosen by companies because of its economic advantages. However, it may have negative effects on employees’ health.ObjectiveTo assess the repercussions of night work on sleep, mood and quality of life of employees concerned by night work.MethodsCross-sectional and descriptive study conducted in 2023 among night workers in two companies. Sleep disorders, mood disorders and quality of life were assessed by the Spiegel questionnaires, the HAD scale and the SF-12 questionnaire.ResultsA total of 199-night workers were included. Mean age was 36.1 ± 8 years. The median Spiegel score was 20 (IQR: 19-21). Sleep quality was pathological in 4.5% and disturbed in 93.5% of cases. The median HAD score was 16 (IQR: 13-20). Anxiety and depression were present in 10.6% and 32.2% of cases, respectively. The median SF-12 global score was 39 (IQR: 37-41). The overall quality of life was slightly impaired in 43.7% and, moderately impaired in 56.3% of cases. A positive correlation was found between quality of life and sleep quality (r: 0.164; p < 10-3). A negative correlation was found between quality of life and mood disorders (r: 0.164; p < 10-3) and also between sleep quality and mood disorders (r: 0.058; p = 0.001).ConclusionsOur study highlighted the harmful effects of night work on employees’ sleep quality, mood and quality of life. The mission of the occupational physician is to ensure better adaptation to night work, through an analysis of working conditions and an implementation of protective measures.

38. Developmental exposure to a PFAS mixture impairs the anamnestic response to influenza A virus infection in mice.

期刊: Toxicological sciences : an official journal of the Society of Toxicology 发表日期: 2026-May-23 链接: PubMed

摘要

Developmental exposure to per- and polyfluoroalkyl substances (PFAS) has been linked to reduced antibody responses to childhood vaccines, but the underlying mechanisms remain unclear. Antibody production relies on interactions between various immune cell types, and it is unknown which are affected by PFAS exposure during development. To investigate this in a human-health relevant system, an in vivo model was established to delineate effects of developmental exposure to a mixture of four PFAS commonly found in human serum: PFOA, PFOS, PFHxS, and PFNA. Pregnant mice consumed water containing these PFAS throughout gestation and lactation. PFAS were measured in both mothers and offspring, and an exposure that did not cause signs of overt toxicity was selected. The immune response to influenza A virus (IAV) infection was assessed in male and female offspring. Results showed that developmental PFAS exposure reduced IAV-specific antibody levels in both sexes. However, it diminished T follicular helper cells and germinal center B cells-critical for antibody production-in only female offspring. These findings highlight possible sex-specific immune effects and identify potential cellular mechanisms behind reduced antibody levels. Since these immune cells are essential for antibody production in humans, this study provides valuable insights into how PFAS exposure may impact human health.

39. A Bayesian Network Analysis of Gait Speed Change Upon Transition to Uneven Surfaces in Older Adults.

期刊: The journals of gerontology. Series A, Biological sciences and medical sciences 发表日期: 2026-May-23 链接: PubMed

摘要

Gait adaptability, defined as the ability to adjust walking performance to environmental challenges, likely reflects complex interactions among the central nervous system (CNS) and other physiological systems. However, the drivers of lower gait adaptability in older adults are poorly understood. We applied a Bayesian network framework to understand multisystem interactions contributing to percent change in gait speed (%GSC) on transition from even to uneven surface in 159 older adults. Neuroimaging measures include gray matter volume, white matter hyperintensities, striatal dopaminergic neurotransmission, and functional connectivity. Other measures were obtained for domains important for locomotor control: health history, lifestyle, psychological well-being, cognition, and musculoskeletal and peripheral nervous systems. The Bayesian network captured relationships among these variables as a network, quantifying their direct and indirect dependencies. The predictive accuracy of %GSC from the Bayesian network was compared with that of multivariate linear regression using 10-fold cross-validation. Participants exhibited slower gait on uneven compared to even surfaces (mean %GSC = -6.32%). The Bayesian network outperformed linear regression in predicting %GSC and identified four direct paths to %GSC from BMI, muscle strength, striato-cortical sensorimotor connectivity, and purpose in life. Indirect paths to %GSC showed interrelations among CNS and non-CNS variables, including striatal dopaminergic neurotransmission, total gray matter volume, medications, proprioception, and sex. Gait adaptability in older adults is influenced by interactions among functional connectivity, body composition, muscle strength, and psychological well-being. Strengthening both neural and physical systems through targeted interventions may mitigate declines in gait instability and preserve mobility with aging.

40. In Vitro Evaluation of the Potentiating Effects of Plant-Derived Molecules on Conventional Biocides.

期刊: Journal of visualized experiments : JoVE 发表日期: 2026-May-08 链接: PubMed

摘要

Developing innovative and efficient approaches to enhance the antimicrobial activity of conventional biocides is a promising strategy for improving microbial control for healthcare disinfection purposes. In this context, we describe a detailed protocol for evaluating the potentiating effects of plant-derived phytochemicals on synthetic biocides. These plant-based products are attractive candidates as biocide adjuvants due to their structural diversity, bioactivity, and often lower toxicity. The workflow here described allows for the determination of minimum bactericidal concentrations (MBCs) and the systematic generation of both dose-response and time-response curves for each product tested individually (biocides and phytochemicals) and for their dual or triple combinations. The resulting data allow for advanced mathematical modelling, including determining the fractional bactericidal concentration index (FBCI) and assessing the interactions between the tested products regarding synergistic, additive, or antagonistic effects using the software Combenefit. In that sense, it is possible to identify promising natural products as biocide enhancers, optimize antimicrobial efficacy, and design more sustainable and safer disinfection strategies that may reduce the concentrations required of synthetic biocides. This improves microbial control and minimizes environmental and public health risks associated with excessive biocide use.

41. Practices to Reduce Stigma and Discrimination Towards Older Transitional Housing Clients.

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

摘要

Homelessness remains an enduring social issue, in part, due to the stigmatization of and discrimination toward people experiencing homelessness, known as homeism. Despite extant research on the topic, little is known about how homeism, enacted through stigmatization and discrimination, may occur within transitional housing programs or among older people experiencing homelessness in these settings. We conducted a secondary analysis of qualitative interviews with providers and clients (n = 15) of a transitional housing program in Western Canada. Participants described ways in which clients self-stigmatize and are treated poorly by others, as well as the consequences of homeism among clients. Also described were program practices that served to reduce homeism toward people experiencing homelessness, including the use of a harm reduction approach, humanizing treatment, the provision of a stable address, and the use of arts-based and community-building activities. Study findings suggest several policies that housing programs can implement, which may support older adults to reduce their internalized stigma and improve community members’ perceptions of people experiencing homelessness. Future research should explicitly study the mechanisms by which harm reduction, humanizing treatment, providing a stable address, and arts-based and community-building activities shift perceptions of shame and stigma.

42. Predictive Value of Health Literacy on Health-Promoting and Protective Behaviours in Turkish Nurses and Allied Health Workers.

期刊: Nursing open 发表日期: 2026-May 链接: PubMed

摘要

This study aims to investigate the extent to which Turkish nurses and allied health workers’ levels of health literacy predict health-promoting and protective behaviours. A descriptive and cross-sectional study design was used. The study was conducted with 403 Turkish nurses and allied health workers working in different regions of Türkiye between January and May 2024. JASP 0.18.3.0, Jamovi 2.3.21, and SPSS 26 and AMOS26 programs were used for data analysis. Descriptive statistics and simple and multiple regression analysis were used in the analysis of the data. A positive, moderately significant relationship was found between health literacy and health-promoting and protective behaviours (r = 0.460, p < 0.001). Regression analysis results showed that health literacy explained 21.1% (R2 = 21.1) of the change in health-promoting and protective behaviours and was a significant predictor of health-promoting and protective behaviours. Understanding the predictive effect of health literacy and preventive health behaviours can guide practices and policies that will improve the level of health literacy and preventive health behaviours in healthcare workers. Improving their health literacy and preventive health behaviours can help patients and the general public increase their health literacy levels and gain positive health behaviours.

43. Factors associated to motor development in Down syndrome patients.

期刊: Boletin medico del Hospital Infantil de Mexico 发表日期: 2026 链接: PubMed

摘要

El síndrome de Down (SD) se caracteriza por dismorfias, retraso psicomotor y afectaciones sistémicas. Su prevalencia es de 1:700 nacidos vivos. Aproximadamente el 80% de los recién nacidos con SD presentan hipotonía, que es la principal causa de retraso motor grueso. El desarrollo motor se considera atípico, dado que se retrasa en comparación con niños de la población general. El objetivo de este trabajo es describir los factores asociados al desarrollo motor en pacientes con SD. Se realizó un estudio observacional, analítico, transversal y ambispectivo en el Servicio de Genética Médica del Hospital General de Zona No. 20, Puebla. Se analizaron: edad, sexo, mecanismo citogenético, prematurez, lactancia materna, nivel socioeconómico, cardiopatía congénita, función tiroidea y rehabilitación para el desarrollo motor. Se realizó análisis estadístico descriptivo e inferencial (chi cuadrada) para identificar las variables asociadas al desarrollo motor de pacientes con SD. Se analizaron 40 pacientes con SD, 22 (55%) de sexo masculino y 18 (45%) femenino; la mediana de edad fue 32.5 meses; 22 individuos (55%) presentaron trisomía 21 libre y 18 (45%) en mosaico; en 37 individuos (92.5%) se retrasó el desarrollo motor y solo 3 (7.5%) alcanzaron los hitos. Se encontró una diferencia estadísticamente significativa entre el presentar o no hipotiroidismo y el logro de los hitos (p = 0.046). En este estudio se comprobó que los pacientes con SD presentan retraso del desarrollo motor y que existe una diferencia estadísticamente significativa entre el hipotiroidismo y los hitos motores, destacando que el hipotiroidismo no limitó el desarrollo motor en los pacientes con SD que alcanzaron sus hitos motores. Down syndrome (DS) is characterized by dysmorphia, psychomotor delay, and systemic conditions, with a prevalence of 1:700 live births. Around 80% of newborns with DS exhibit hypotonia, which is the main cause of gross motor delay. In these children, motor milestones are considered atypical because it is delayed compared to children in the general population. The aim is to describe factors associated to motor development in patients with DS. An observational, analytical, cross-sectional, and ambispective study was conducted at the Medical Genetics Service of the General Hospital of Zone No. 20, Puebla. Age, sex, cytogenetic mechanism, prematurity, breastfeeding, socioeconomic level, congenital heart disease, thyroid function, and rehabilitation for motor development were analyzed. Descriptive and inferential statistical analysis was performed with the chi square test to identify variables associated with the motor development of patients with DS. Forty patients were analyzed, 22 (55%) male and 18 (45%) female, a median age of 32.5 months; 22 individuals (55%) had regular trisomy 21 and 18 (45%) mosaicism; 37 individuals (92.5%) presented developmental motor delay and 3 (7.5%) reached the milestones. A statistically significant difference was found between having or not having hypothyroidism and milestone achievement (p = 0.046). This study found that patients with DS have delayed motor development and that there is a statistically significant difference between hypothyroidism and motor milestones, highlighting that hypothyroidism did not limit motor development in patients with DS who reached their motor milestones.

44. Chronic pancytopenia, severe splenomegaly, and splenectomy: the importance of histopathology cases of suspected of pediatric visceral leishmaniasis.

期刊: Boletin medico del Hospital Infantil de Mexico 发表日期: 2026 链接: PubMed

摘要

In Latin America, the incidence of visceral leishmaniasis (VL) in children is unknown. In addition, there are very few pediatric reports from Central America and the Caribbean. In Costa Rica, the first pediatric case was published in 1999, although the patient was diagnosed in 1995. Since then, no other cases have been published. We describe the case of a 2-year-old female who presented with prolonged fever, pancytopenia, and massive splenomegaly, and who was diagnosed with VL incidentally after splenectomy. She was successfully treated with amphotericin B for 14 days. The evolution has been favorable, with no sequelae at 5 years follow-up. These clinical presentations are very uncommon. Even in non-endemic countries, VL should be considered as a cause of massive splenomegaly in tropical countries, and should be considered within the differential diagnosis of patients presenting with fever, splenomegaly, pancytopenia, hepatomegaly, and/or lymphadenopathy. En América Latina se desconoce la incidencia de leishmaniasis visceral en niños. Además existen muy pocos reportes pediátricos en Centroamérica y el Caribe. En Costa Rica, el primer reporte pediátrico se describió en 1999 de un paciente diagnosticado en 1995 y desde entonces no se han publicado otros casos. Se describe el caso de una niña de 2 años de edad que presentó fiebre prolongada, pancitopenia y esplenomegalia masiva, y que fue diagnosticada de leishmaniasis visceral de manera incidental después de una esplenectomía. La niña fue tratada con éxito con anfotericina B durante 14 días. La evolución ha sido favorable, sin secuelas a los cinco años de seguimiento. Las presentaciones clínicas como esta son muy poco frecuentes. Incluso en países no endémicos, la leishmaniasis visceral debe considerarse como causa de esplenomegalia masiva en países tropicales, y también dentro del diagnóstico diferencial de los pacientes que presentan fiebre, esplenomegalia, pancitopenia, hepatomegalia y/o linfadenopatías.

45. Incidence of delirium in children hospitalized with acute respiratory failure outside the intensive care unit.

期刊: Boletin medico del Hospital Infantil de Mexico 发表日期: 2026 链接: PubMed

摘要

La incidencia de delirium fuera de unidades de cuidados intensivos pediátricos (UCIP) es desconocida. Esta investigación buscó determinar la incidencia de delirium en niños con insuficiencia respiratoria aguda admitidos en salas de sostén respiratorio no invasivo (SRNI) fuera de UCIP. Se realizó un estudio observacional prospectivo en menores de 5 años hospitalizados y que requirieron SRNI fuera de UCIP. Se pesquisó delirium con la Escala de Cornell aplicada periódicamente durante los primeros cinco días de admisión. Cincuenta y cinco niños se incluyeron en el análisis final, de los cuales el 34% (n = 19) desarrollaron delirium durante la internación. El fenotipo hipoactivo fue el más prevalente (10/55; 52.63%). Uno de cada tres niños admitidos por insuficiencia respiratoria aguda y tratados con SRNI fuera de UCIP desarrollaron delirium, siendo el fenotipo hipoactivo el más frecuente. The incidence of delirium outside pediatric intensive care units (PICUs) is unknown. This research aimed to determine the incidence of delirium in children with acute respiratory failure (ARF) admitted to non-invasive respiratory support (NIRS) wards outside of PICUs. A prospective observational study was conducted on children under the age of five, who were hospitalized and required NIRS outside of PICUs. Delirium was screened using the Cornell Scale, applied periodically during the first five days since admission. Fifty-five children met inclusion criteria, from which 34% (n = 19) developed delirium during hospital admission. The hypoactive phenotype was the most prevalent (10/55; 52.63%). One in three children admitted for ARF and supported with NIRS outside of PICUs developed delirium, the hypoactive phenotype was the most frequent.

46. Obesity and dyslipidemia in patients with craniopharyngioma before and one year after surgical resection.

期刊: Boletin medico del Hospital Infantil de Mexico 发表日期: 2026 链接: PubMed

摘要

El craneofaringioma se caracteriza por manifestaciones clínicas derivadas de la compresión de estructuras del sistema nervioso central, deficiencias hormonales hipofisarias, así como obesidad. El objetivo fue identificar la frecuencia de obesidad y dislipidemia y sus factores de riesgo en pacientes pediátricos con craneofaringioma antes y después de la resección quirúrgica. Estudio de cohorte retrospectivo del año 2014 al 2023 en pacientes pediátricos craneofaringiomas evaluados antes de la cirugía y a los 12 meses posteriores. Se recopilaron datos antropométricos, perfil de lípidos y estudios. Las variables cualitativas se expresaron como frecuencias y porcentajes, y las cuantitativas como mediana. Se usaron pruebas estadísticas según el tipo de variable y regresiones logística y lineal para identificar factores asociados y cambios en el incremento (Δ) del índice de masa corporal estandarizado (zIMC, Z score del IMC). Se incluyeron 47 pacientes, mediana de edad 6 años, el 61.7% de sexo masculino. Al diagnóstico, el 27.7% tenía obesidad y el 10.6% sobrepeso. El diámetro tumoral fue de 3 cm. El zIMC aumentó significativamente (0.46 vs. 1.70; p < 0.001), con incremento de obesidad al 68.1%. La dislipidemia aumentó del 12.7 al 32.6%, principalmente la hipertrigliceridemia (25.5%). Inicialmente, el 66% no tenía deficiencias hormonales, pero a los 12 meses posquirúrgico el 95.7% ya tenían alguna deficiencia. El sexo masculino y presentar obesidad al inicio del seguimiento fueron los factores relacionados a presentar obesidad a los 12 meses posquirúrgico. La obesidad y dislipidemia aumentaron significativamente tras la cirugía, acompañadas de un incremento en las disfunciones hormonales. Craniopharyngioma is characterized by clinical manifestations resulting from the compression of central nervous system structures, pituitary hormonal deficiencies, and obesity. The aim was to identify the frequency of obesity and dyslipidemia and their risk factors in pediatric patients with craniopharyngioma before and after surgical resection. This was a retrospective cohort study conducted from 2014 to 2024 in pediatric patients with craniopharyngioma, evaluated before surgery and 12 months postoperatively. Anthropometric data, lipid profiles, and laboratory studies were collected. The Wilcoxon test was used for quantitative variables and the McNemar test for qualitative variables. A total of 47 patients were included, with a median age of 6 years; 61.7% were male. At diagnosis, 27.7% had obesity and 10.6% were overweight. The median tumor diameter was 3 cm. The body mass index Z score increased significantly (0.46 vs. 1.70; p < 0.001), with obesity rising to 68.1%. Dyslipidemia increased from 12.7 to 32.6%, mainly due to hypertriglyceridemia (25.5%). Initially, 66% had no hormonal deficiencies, but by 12 months post-surgery, 95.7% had developed at least one. Male sex and the presence of obesity at the beginning of follow-up were associated with obesity at 12 months post-surgery. Obesity and dyslipidemia significantly increased after surgery, accompanied by a rise in hormonal dysfunctions.

47. Changes in U.S. vaccination policies (2026) and their potential implications for Mexican pediatrics: a review by the Mexican Academy of Pediatrics.

期刊: Boletin medico del Hospital Infantil de Mexico 发表日期: 2026 链接: PubMed

摘要

En los últimos meses de 2025, EE. UU. ha experimentado cambios profundos y controversiales en sus políticas de vacunación. El Departamento de Salud y Servicios Humanos (HHS), bajo la dirección de Robert F. Kennedy Jr. y siguiendo un memorando presidencial de Donald Trump, ha modificado el calendario de vacunación de los Centros para el Control y la Prevención de Enfermedades (CDC). La medida principal consiste en reducir de 17 a 11 el número de enfermedades para las cuales se recomienda la vacunación sistemática y universal en niños. Numerosos especialistas en salud pública, junto con organizaciones como la American Academy of Pediatrics (AAP) y la American Public Health Association (APHA), han manifestado su preocupación ante estos cambios. En este documento se revisan los cambios en las políticas de vacunación en EE. UU. y sus posibles repercusiones en salud pública. Se presenta el esquema de vacunación incluido en la Cartilla Nacional de Vacunación en México y las principales características de las vacunas. Un análisis del comportamiento epidemiológico de las enfermedades prevenibles por vacunación de nuestro país permite plantear los riesgos de hacer modificaciones en el esquema y lograr un mayor convencimiento a los pediatras y a la población en general del impacto positivo de la vacunación, y continuar con el esquema de vacunación universal ya establecido. In the last months of 2025, the United States has experienced profound and controversial changes in its vaccination policies. The Department of Health and Human Services (HHS), under the leadership of Robert F. Kennedy Jr. and following a presidential memorandum issued by Donald Trump, has modified the vaccination schedule of the Centers for Disease Control and Prevention (CDC). The main measure involves reducing from 17 to 11 the number of diseases for which routine and universal vaccination in children is recommended. Numerous public health specialists, together with organizations such as the American Academy of Pediatrics (AAP) and the American Public Health Association (APHA), have expressed concern regarding these changes. This document reviews the changes in vaccination policies in the United States and their potential public health implications. We present the vaccination schedule included in Mexico’s National Vaccination Card and the main characteristics of the vaccines. An analysis of the epidemiological behavior of vaccine-preventable diseases in our country makes it possible to outline the risks of modifying the schedule and to recommend strengthening awareness among pediatricians and the general population about the positive impact of vaccination, as well as maintaining the already established universal vaccination schedule.

48. Hirschsprung's disease and Mowat-Wilson syndrome: should a pull-through be performed?

期刊: Boletin medico del Hospital Infantil de Mexico 发表日期: 2026 链接: PubMed

摘要

Hirschsprung’s disease (HSCR) is characterized by the absence of ganglion cells. Five percent of cases are associated with syndromic conditions, one of which is Mowat-Wilson syndrome (MWS), with an incidence rate of 50%. HSCR may be the first feature of this syndrome to be diagnosed. MWS is an autosomal dominant genetic disorder caused by a variant in the ZEB2 gene (ZFHX1B). OMIM #235730. It involves severe clinical manifestations such as ocular hypertelorism, intellectual disability, congenital heart defects, epilepsy, and HSCR. The association between MWS and HSCR is regarded as a serious condition with unpredictable post-operative outcomes, and many reported complications related to motility disorders are noted. We conducted a retrospective study and reviewed the medical records of patients with MWS treated at our center. We examined the relationship among HSCR, clinical features, molecular characteristics, surgical complications, and pre-operative and post-operative enterocolitis events. The study included four patients with MWS. Three (75%) were found to be associated with HSCR. Rectal biopsy confirmed HSCR in all patients. Two patients underwent a transanal pull-through Swenson procedure, and both experienced surgical complications. Both cases encountered multiple episodes of enterocolitis, and one of them required a permanent stoma. The third patient has not undergone surgical correction but has responded well to medical treatment (laxatives). The association between MWS and HSCR presents a severe condition with high morbidity. The outcome after the pull-through procedure is unpredictable. Further studies are necessary to gain a deeper understanding of this condition. We recommend evaluating these patients in a multidisciplinary consensus based on the existing literature and our findings. Those without recurrent enterocolitis or chronic motility disorders are suitable candidates for conservative management. La enfermedad de Hirschsprung es una entidad caracterizada por ausencia de células ganglionares; en el 5% de los casos llega a ser sindrómica. Uno de los síndromes más asociados (hasta 50%) es el síndrome de Mowat-Wilson, que es una enfermedad genética con variante en el gen ZEB2 (ZFHX1B), OMIM #235730. Localizada en el cromosoma 2 (2:144,384,081), esta asociación sindrómica se considera una condición grave con resultados poco predecibles y complicaciones posquirúrgicas graves hasta en el 80% de los pacientes. Se llevó a cabo una revisión retrospectiva de registros hospitalarios de pacientes con diagnóstico molecular de Mowat-Wilson tratados en nuestra institución. Se analizaron los siguientes datos: asociación con enfermedad de Hirschsprung, características clínicas, estudio molecular, complicaciones quirúrgicas y eventos de enterocolitis preoperatorios y postoperatorios. Se incluyeron cuatro pacientes con variantes patogénicas en ZEB2 con diagnóstico de Mowat-Wilson (tres de ellos [75%] asociados a enfermedad de Hirschsprung). Dos de los tres pacientes se detectaron en la etapa neonatal, cursando con eventos de enterocolitis; ambos se sometieron a descenso transanal tipo Swenson y ambos requirieron un redescenso transanal secundario a enterocolitis de repetición. El 100% cursó con complicaciones postoperatorias. La cuarta paciente ha cursado asintomática, sin tratamiento quirúrgico. La asociación de enfermedad de Hirschsprung con Mowat-Wilson es una condición grave con alta morbilidad, con evolución posterior al descenso transanal poco predecible. A pesar de que se necesitan más estudios en el futuro recomendamos que el abordaje de los pacientes con esta asociación sea de manera multidisciplinaria y aquellos sin episodios frecuentes de enterocolitis son buenos candidatos para tratamiento conservador.

49. The impact of kinesiophobia on physical activity levels in hemodialysis patients: a cross-sectional study.

期刊: Cirugia y cirujanos 发表日期: 2026 链接: PubMed

摘要

The aim of this study was to evaluate the relationship between kinesiophobia and physical activity levels in patients with end-stage kidney disease (ESKD) undergoing hemodialysis. This cross-sectional study involved 227 ESKD patients undergoing HD treatment. Patients were assessed using the Tampa Scale of Kinesiophobia (TSK), the International Physical Activity Questionnaire-short form, and Beck Depression and Anxiety scales. Our findings revealed a significant association between kinesiophobia and low physical activity levels in HD patients (r = 0.384, p < 0.001). Patients with high TSK scores were more likely to have reduced physical activity levels. In addition, age (odds ratio [OR] = -31.3, p < 0.001), dialysis duration (OR = -57.2, p = 0.003), and TSK score (OR = 49.9, p < 0.001) emerged as independent predictors of physical activity levels. Notably, older age and longer dialysis duration were associated. This study highlights the significant impact of kinesiophobia on physical activity levels in HD patients. More research is needed to figure out how these things work and help doctors decide how to treat ESKD patients so they can be more active. El objetivo de este estudio fue evaluar la relación entre la kinesiofobia y los niveles de actividad física en pacientes con enfermedad renal en fase terminal (ERFT) sometidos a hemodiálisis. Estudio transversal que incluyó 227 pacientes con ERFT en tratamiento con HD. Se evaluó a los pacientes utilizando la Tampa Scale of Kinesiophobia (TSK), el Cuestionario Internacional de Actividad Física (versión corta) y las escalas de depresión y ansiedad de Beck. Los resultados revelaron una asociación significativa entre la kinesiofobia y los bajos niveles de actividad física en los pacientes en HD (r = 0.384; p < 0.001). Los pacientes con puntuaciones elevadas en la TSK tenían más probabilidades de presentar niveles reducidos de actividad física. Además, la edad (OR: –31.3; p < 0.001), la duración de la diálisis (OR: –57.2; p = 0.003) y la puntuación en la TSK (OR: 49.9; p < 0.001) se revelaron como predictores independientes de los niveles de actividad física. En particular, la edad avanzada y la duración de la diálisis mostraron asociación. Este estudio pone de manifiesto el impacto significativo de la kinesiofobia en los niveles de actividad física de los pacientes con HD. Se necesitan más investigaciones para aclarar los mecanismos subyacentes y orientar las decisiones terapéuticas destinadas a reducir la inactividad física en los pacientes con ERFT.

50. Can a standardized blunt thoracic trauma score lead to lower length of stay and reduced intensive care unit admission for older patients?

期刊: Cirugia y cirujanos 发表日期: 2026 链接: PubMed

摘要

We implemented and evaluated a novel score called the blunt thoracic trauma score (BTTS) for the triage of chest wall injury (CWI) patients to optimize utilization of the intensive care unit (ICU). Patients who sustained rib fractures after a traumatic injury (2014-2020) were identified in our trauma registry. Demographics and clinical characteristics were summarized by cohorts pre- and post-BTTS implementation in 2017 and BTTS > 6 versus BTTS < 6 using median or frequency. Wilcoxon rank-sum test was used to compare continuous variables, and χ2 or Fisher’s exact test for categorical variables. Logistic/negative binomial regression models were used to find predictors for ICU admission and length of stay (LOS). Six hundred thirty-three patients were included; 407 pre-BTTS/226 post-BTTS. Pre-BTTShigher median ISS (p < 0.001), more rib fractures (p < 0.001). Post-BTTS older (p < 0.001), more comorbidities (coronary artery disease [p = 0.028], hyperlipidemia [p = 0.004], pulmonary disease [p = 0.038]). Post-BTTS cohort had lower rates of ICU admission (p = 0.008), shorter ICU-LOS (p < 0.001), and Hospital-LOS (p < 0.001). Post-BTTS cohort was associated with shorter Hospital-LOS after adjusting for other factors (p = 0.004). Implementation of a novel BTTS for triage of CWI was associated with decreased ICU admission rates and shorter ICU-LOS and Hospital-LOS. The decreased Hospital-LOS persisted even after controlling for other factors. Implementamos una nueva escala, denominada Blunt Thoracic Trauma Score (BTTS), para la clasificación de pacientes con lesiones de la pared torácica con el fin de optimizar la utilización de la unidad de cuidados intensivos (UCI). Identificamos pacientes con fracturas costales después de una lesión traumática (2014-2020). Las características demográficas y clínicas se resumieron por cohortes antes y después de la implementación de BTTS en 2017, y BTTS > 6 frente a BTTS ≤ 6. Se utilizó la prueba de suma de rangos de Wilcoxon para comparar las variables continuas y las pruebas de χ2 o exacta de Fisher para las variables categóricas. Se utilizaron modelos de regresión logística/binomial negativa para encontrar predictores de ingreso en la UCI y de la duración de la estancia. Se incluyeron 633 pacientes: 407 pre-BTTS y 226 post-BTTS. Grupo pre-BTTS mayor Injury Severity Score (p < 0.001), más fracturas costales (p < 0.001). Grupo post-BTTS: edad avanzada (p < 0.001), más comorbilidad (enfermedad arterial coronaria [p = 0.028], hiperlipidemia [p = 0.004], enfermedad pulmonar [p = 0.038]). El grupo post-BTTS tuvo tasas más bajas de ingreso en la UCI (p = 0.008), y duración de la estancia en la UCI (p < 0.001) y duración de la estancia hospitalaria (p < 0.001) más cortas. El grupo post-BTTS se asoció con una duración de la estancia hospitalaria más corta después de ajustar por otros factores (p = 0.004). La implementación del nuevo BTTS para la clasificación de lesiones de la pared torácica se asoció con menores tasas de ingreso a la UCI y con estancias en la UCI y hospitalarias más cortas. La disminución de la duración de la estancia hospitalaria persistió incluso después de controlar otros factores.

51. Zoonotic cutaneous leishmaniasis caused by Leishmania major: Do humans play a role in amplifying transmission?

期刊: Parasite (Paris, France) 发表日期: 2026 链接: PubMed

摘要

Zoonotic cutaneous leishmaniasis (ZCL) caused by Leishmania (L.) major is the most widespread form of CL worldwide, with hundreds of thousands of cases annually. It is associated with significant morbidity and economic burden, particularly in North Africa and the Middle East. For over a century, the zoonotic transmission of ZCL, involving wild gerbils (Muridae: Gerbillinae) as the reservoir and Phlebotomus (Ph.) papatasi as the vector, has been considered an established fact, with no contradictory debate. However, the pronounced endophilic and anthropophilic behaviors of Ph. papatasi, the exposure of multiple and large lesions, although with relatively limited persistence, to sandflies during their seasonal activity, and the simultaneous detection of human and L. major DNA within the vector, suggest a contribution of humans to the parasite cycle. Conversely, the high incidence of the disease in anthropized foci and the high prevalence of family cases highlight the role of humans in amplifying transmission. The experiments carried out by Adler and Theodor in the 1920s in Palestine and the more recent studies done by Fatemi et al. (2018) in Iran that identified L. major infectious metacyclic forms in Ph. papatasi fed on ZCL lesions reinforce this hypothesis. Additional xenodiagnoses-based approaches could provide definitive answers and lead to better management and control of ZCL, leading to a recommendation of updated preventive measures at the household level. This review aims to report on what is currently known about the zoonotic transmission of L. major, and to develop arguments supporting the hypothesis that humans play a potential role as “reservoir host” of the parasite, albeit a complementary one. Leishmaniose cutanée zoonotique due à Leishmania major : les humains jouent-t-ils un rôle dans l’amplification de la transmission ? La leishmaniose cutanée zoonotique (LCZ) due à Leishmania (L.) major est la forme de leishmaniose cutanée la plus répandue au monde, avec des centaines de milliers de cas par an. Elle est associée à une morbidité et un fardeau économique importants, notamment en Afrique du Nord et au Moyen-Orient. Pendant plus d’un siècle, la transmission zoonotique de la LCZ, impliquant la gerbille sauvage (Muridae : Gerbillinae) comme réservoir et Phlebotomus (Ph.) papatasi comme vecteur, a été considérée comme un fait établi, sans controverse. Cependant, les comportements endophiles et anthropophiles marqués de Ph. papatasi, l’exposition de lésions multiples et étendues, bien que de persistance relativement limitée, aux phlébotomes lors de leur activité saisonnière, et la détection simultanée d’ADN humain et de L. major chez le vecteur, suggèrent une contribution des humains au cycle parasitaire. D’autre part, la forte incidence de la maladie dans les foyers anthropisés et la prévalence élevée de cas familiaux soulignent le rôle des humains dans l’amplification de la transmission. Les expériences d’Adler et Theodor dans les années 1920 en Palestine et l’étude plus récente de Fatemi et al. (2018) en Iran, qui ont identifié des formes métacycliques infectieuses de L. major chez Ph. papatasi nourri de lésions de la LCZ, renforcent cette hypothèse. Des approches complémentaires basées sur le xénodiagnostic pourraient apporter des réponses définitives et permettre une meilleure prise en charge et un meilleur contrôle de la LCZ, ce qui pourrait conduire à recommander des mesures préventives actualisées au niveau des ménages. Cette revue vise à présenter l’état actuel des connaissances sur la transmission zoonotique de L. major et à développer des arguments suggérant que les humains pourrait jouer un rôle de réservoir pour le parasite, bien que complémentaire.

52. Prevalence and risk factors of human trichostrongylosis in Satun, southern Thailand.

期刊: Parasite (Paris, France) 发表日期: 2026 链接: PubMed

摘要

Trichostrongylus spp., zoonotic soil-transmitted nematodes, affect both livestock and humans globally. In Thailand, human trichostrongylosis has been reported, but no systematic study examining livestock and humans in the same locality has been conducted. This study aimed to address this gap in Satun Province, southern Thailand by characterizing the disease’s epidemiologic status among livestock, farmers, and the environment using both microscopic and molecular techniques. Human risk factors were assessed via questionnaires. Stool samples were collected from livestock farmers, their families, and herbivores in Nongkhai, Ratchaburi, and Satun Provinces. Vegetable samples were also obtained from households and local markets. Human and livestock feces were examined using the modified Kato-Katz method and a Mini Parasep® solvent-free fecal parasite concentrator. Total DNA was then extracted from fecal and vegetable sediments, and a 211 bp fragment of the ribosomal internal transcribed spacer 2 (ITS2) gene was amplified using a polymerase chain reaction (PCR). PCR products were digested with HinfI and analyzed via electrophoresis to identify Trichostrongylus species. In Satun, Trichostrongylus colubriformis monoinfection was found in 12 of 221 (5.4%) residents, while co-infection with T. colubriformis and T. axei occurred in 3 (1.4%). Herbivore feces and vegetable sediments from Satun also tested positive. No human cases were found in Nongkhai or Ratchaburi. Risk factors included education level, occupation, and outdoor toilet use. Most infected individuals in Satun were asymptomatic. Despite this, public health interventions should be implemented, targeting the human-livestock-environment interface to control the disease effectively. Prévalence et facteurs de risque de la trichostrongylose humaine à Satun, dans le sud de la Thaïlande. Trichostrongylus spp., des nématode zoonotique transmis par le sol, affectent le bétail et les humains à l’échelle mondiale. En Thaïlande, des cas de trichostrongylose humaine ont été rapportés, mais aucune étude systématique n’a été menée sur le bétail et les humains dans une même localité. Cette étude visait à combler cette lacune dans la province de Satun, dans le sud de la Thaïlande, en caractérisant le statut épidémiologique de la maladie chez le bétail, les agriculteurs et dans l’environnement à l’aide de techniques microscopiques et moléculaires. Les facteurs de risque humains ont été évalués par questionnaire. Des échantillons de selles ont été prélevés auprès d’éleveurs, de leurs familles et d’animaux herbivores dans les provinces de Nongkhai, Ratchaburi et Satun. Des échantillons de légumes ont également été obtenus auprès des ménages et sur les marchés locaux. Les selles humaines et animales ont été examinées à l’aide de la méthode de Kato-Katz modifiée et du concentrateur de parasites fécaux sans solvant Mini Parasep®. L’ADN total a ensuite été extrait des sédiments fécaux et végétaux, et un fragment de 211 pb du gène ITS2 (espaceur transcrit interne 2) de l’ARN ribosomique a été amplifié par PCR. Les produits de PCR ont été digérés par l’enzyme HinfI et analysés par électrophorèse pour identifier l’espèce de Trichostrongylus. À Satun, une mono-infection à Trichostrongylus colubriformis a été observée chez 12 des 221 résidents (5,4 %), tandis qu’une co-infection par T. colubriformis et T. axei a été constatée chez 3 d’entre eux (1 %). Les excréments d’herbivores et les sédiments végétaux de Satun se sont également révélés positifs. Aucun cas humain n’a été recensé à Nongkhai ni à Ratchaburi. Les facteurs de risque comprenaient le niveau d’instruction, la profession et l’utilisation de toilettes extérieures. La plupart des personnes infectées à Satun étaient asymptomatiques. Malgré cela, des interventions de santé publique, ciblant l’interface homme-bétail-environnement, devraient être mises en œuvre afin de contrôler efficacement la maladie.