公共卫生研究摘要 (2026-05-28)

共收录 57 篇研究文章

1. Evaluation of influenza vaccine effectiveness among older adults in Jiaxing, China, 2022-2025: A test negative design-based study.

期刊: Human vaccines & immunotherapeutics 发表日期: 2026-Dec-31 链接: PubMed

摘要

Influenza imposes a substantial burden on older adults, underscoring the need for annual evaluation of vaccine effectiveness (VE). Using a test-negative case-control design, this study assessed VE among patients aged ≥60 y with acute respiratory symptoms in Jiaxing, China, across three influenza seasons (2022-2025). Among 3,214 participants, vaccination provided moderate overall protection against laboratory-confirmed influenza, with adjusted VE of 42.5% (95% CI: 31.2-51.9). Protection was highest in the 2024-2025 season (47.2%) and against influenza A(H1N1) (42.4%). Notably, subgroup analyses revealed significantly higher VE among females, individuals without underlying disease (49.2%), those presenting with high fever (>39°C, 44.3%), and within 90 d post-vaccination (52.3%). These findings affirm the moderate protective effect of influenza vaccines in the older individuals and strongly support the critical importance of timely annual vaccination ahead of the influenza season to mitigate risk in this vulnerable population.

2. Access to Smoking Cessation Services in Rhode Island: Medication and Counseling Utilization.

期刊: Rhode Island medical journal (2013) 发表日期: 2026-Jun-01 链接: PubMed

摘要

3. In 2025, Attacks on LGBTQ+ People's Civil Rights and Access to Healthcare Reshaped the US and Medical Professions.

期刊: Rhode Island medical journal (2013) 发表日期: 2026-Jun-01 链接: PubMed

摘要

4. Strategies, Policies, and Practices to Support the Health of LGBTQ+ Youth in Rhode Island.

期刊: Rhode Island medical journal (2013) 发表日期: 2026-Jun-01 链接: PubMed

摘要

5. Restrictive Masculinity Norms and Behavioral Health Outcomes Among Rhode Island Sexual and Gender Minority Young Adults.

期刊: Rhode Island medical journal (2013) 发表日期: 2026-Jun-01 链接: PubMed

摘要

Restrictive masculinity norms (RMNs), characterized by emotional suppression, dominance, and risk-taking, have been linked to adverse health among cisgender heterosexual men. Little is known about how RMNs operate among sexual and gender minority (SGM) populations, particularly transgender young adults.  Methods: Data were from the 2024 Rhode Island Young Adult Survey, a cross-sectional, web-based survey of adults aged 18-25 years. Analyses were restricted to SGM participants (n=438), with sub-analyses among transgender young adults (n=100). RMNs were measured using a 12-item questionnaire. Outcomes include alcohol use disorder (AUD), cannabis use disorder (CUD), heroin use, intimate partner violence (IPV), problematic pornography use, and problem gambling. Modified Poisson regressions with robust standard errors were used to assess main effects after adjusting for sex assigned at birth, transgender identity, age, race/ethnicity, and social status. Among SGM young adults, a one-unit increase in RMNs score was associated with increased risk of all outcomes [AUD: 1.13 (95%CI 1.08, 1.18); CUD: 1.03 (95%CI 1.01, 1.06); heroin use: 1.22 (95%CI 1.13, 1.31); IPV: 1.04 (95%CI 1.02, 1.06); problematic pornography use: 1.05 (95%CI 1.02, 1.09); problem gambling: 1.11 (95%CI 1.07, 1.15)]. Associations were consistently stronger among transgender young adults, including a markedly elevated risk for heroin use [4.91 (95%CI 3.30, 7.31)], while the association with CUD was not statistically significant.  RMNs are associated with adverse behavioral health among SGM young adults and exert a disproportionate impact on transgender individuals. Addressing RMNs may represent an important, modifiable pathway for reducing behavioral health inequities during young adulthood.

6. Interpersonal Violence Victimization of Sexual and Gender Minority Youth: A Cross-Sectional Study of Risk and Protective Factors.

期刊: Rhode Island medical journal (2013) 发表日期: 2026-Jun-01 链接: PubMed

摘要

Little is known about risk and protective factors associated with distinct forms of violence victimization among lesbian, gay, bisexual, transgender, or questioning youth, or youth who define their sexual identity another way (LGBTQ+). This study sought to examine this in a statewide representative sample of Rhode Island high school students. Data were from the 2023 Rhode Island High School Youth Risk Behavior Survey-a biennial, voluntary, and anonymous survey designed to measure health-related behaviors and experiences among high school students. The sample comprised 1,932 high school students (weighted sample n = 46,603), of whom 28% identified as lesbian, gay, bisexual, transgender, questioning, or defined their sexual identity another way (“LGBTQ+” weighted sample n=11,891). The primary outcomes of interest were three types of victimization: bullying/discrimination, intimate partner violence (IPV), and sexual coercion/exploitation. Bivariate analysis explored differences in rates of victimization based on sexual orientation and gender identity. Weighted logistic and multinomial regression models focused on LGBTQ+ youth and examined the role of risk and protective factors in victimization. LGBTQ+ students who reported always having their basic needs met at home were less likely to experience IPV (Adjusted Odds Ratio [AOR]=0.53, 95% Confidence Interval [CI]= 0.31-0.88), sexual coercion/exploitation (AOR=0.38, 95% CI=0.17-0.85), and multiple types of victimization (AOR=0.32, 95% CI=0.18-0.57). Housing insecurity (AOR=3.36, 95% CI=1.73-6.50), ever living with someone with a drug/alcohol problem (AOR=2.56, 95% CI=1.63-4.04), and ever living with someone with mental illness (AOR=3.97, 95% CI=1.76-8.96) were associated with higher odds of sexual coercion/exploitation. Overall, findings contribute to the understanding of distinct types of victimization that LGBTQ+ youth face. Further research into the relationship between risk factors associated with unstable home environments and victimization would be valuable in identifying opportunities for prevention.

7. Decompression with or without Duraplasty for Chiari I and Syringomyelia.

期刊: The New England journal of medicine 发表日期: 2026-May-28 链接: PubMed

摘要

In children with Chiari type I malformation and syringomyelia, neurosurgical posterior fossa decompression (PFD) provides clinical improvement, but whether duraplasty (incising the dura and placing a dural graft) improves outcomes is unclear. We conducted a multicenter, cluster-randomized, controlled trial of PFD with duraplasty (PFD-D) as compared with PFD alone. Persons 21 years of age or younger with cerebellar tonsillar ectopia of at least 5 mm and a maximum syrinx diameter of 3.0 to 9.9 mm were enrolled at 38 centers. Centers were cluster-randomized: all the participants within each center underwent the same intervention. The primary outcome was surgical complications within 6 months. Secondary outcomes were clinical improvement, syrinx reduction, and repeat decompression at 10 to 24 months and the change in overall health-related quality of life at 6 to 24 months. A total of 162 participants were included in the trial, of whom 78 were assigned to undergo PFD-D and 84 to undergo PFD alone. The percentage of participants with complications within 6 months was 14% with PFD-D and 6% with PFD (adjusted odds ratio, 2.59; 95% confidence interval [CI], 0.86 to 7.84; P = 0.11). At 24 months, the percentage of participants with clinical improvement was 58% with PFD-D and 46% with PFD; the mean (±SD) syrinx reduction was 3.08±2.33 mm and 1.22±1.79 mm, respectively; and the percentage of participants with repeat decompression was 3% and 14%. Changes in health-related quality of life were similar in the two groups. The percentage of participants with surgical complications did not differ significantly between those who underwent PFD-D and and those who underwent PFD alone. Larger trials are needed to determine the relative benefits and risks of these two procedures. (Funded by the Patient-Centered Outcomes Research Institute and others; ClinicalTrials.gov number, NCT02669836.).

8. Global Epidemiological Insights: Temporal Trends and Disparities in Oral Cavity Cancer Mortality in the United States, 1999-2024.

期刊: International dental journal 发表日期: 2026-May-27 链接: PubMed

摘要

Oral cancer constitutes a significant public health burden globally and has long been associated with substantial socioeconomic, racial, and regional disparities worldwide. Population-level mortality surveillance in high-income countries such as the United States can provide crucial epidemiological evidence and methodological references for global cancer control and prevention strategies. However, national-level updated evidence on long-term trends, subgroup heterogeneity, and pre- and post-COVID-19 pandemic trends in oral cancer mortality in the United States remains limited. This study assesses the temporal trends and differences in oral cancer mortality in the United States from 1999 to 2024. Mortality data were extracted from the CDC WONDER Underlying Cause of Death database. Overall oral cavity cancer was defined using ICD-10 codes C00-C06, while subsite analyses focused on C02-C06. Adults aged 25 years and older were included. Joinpoint regression was used to analyse temporal trends in age-adjusted mortality rates (AAMRs, per 100,000 population) and to estimate annual percent change (APC) and average annual percent change (AAPC), with stratification by sex, region, and subsite. In addition, custom time intervals of 1999-2019 and 2020-2024 were specified to assess trend changes before and during the pandemic period. A supplementary age-stratified analysis comparing adults aged 25 to 44 years and those aged ≥45 years was also performed. Overall oral cavity cancer mortality exhibited one joinpoint in 2009. Mortality declined significantly from 1999 to 2009 (APC = -1.81%, 95% CI: -2.48% to -1.28%, P < .001), but increased significantly from 2009 to 2024 (APC=1.29%, 95% CI: 0.99% to 1.66%, P < .001), whereas the AAPC for the full study period was not statistically significant (0.04%, 95% CI:-0.11% to 0.19%, P = .624). Mortality rates were consistently higher in males than in females, and pairwise comparison showed that sex-specific trends were neither parallel nor coincident (parallelism P = .012; coincidence P = .001). All 4 U.S. Census regions demonstrated an initial decline followed by a later rebound, although only the Midwest showed a significant net increase over the full study period. Marked heterogeneity was observed across subsites: tongue cancer (C02) was the only subsite with a significantly increased AAPC over the full study period, whereas floor-of-mouth cancer (C04) and palate cancer (C05) showed sustained net declines. Custom interval analyses further demonstrated a declining trend before the pandemic (1999-2019; AAPC=-0.2709%, 95% CI:-0.4281 to -0.1087, P < .001) and an increasing trend during the pandemic period (2020-2024; AAPC=1.2879%, 95% CI: 0.9922 to 1.6558, P < .001). Significant sex-based differences were observed, with additional heterogeneity across regions and subsites. In supplementary age-stratified analyses, no significant joinpoint was identified among adults aged 25-44 years, whereas adults aged ≥45 years showed a significant reversal in mortality trend, suggesting that the overall mortality rebound was driven predominantly by the older age group. In the United States, oral cavity cancer mortality shifted from a declining trend to a sustained increase around 2009 and accelerated further during 2020-2024, indicating a biphasic rather than a simple linear pattern. Substantial heterogeneity was observed across sex, region, and subsite. Tongue cancer may have been a major contributor to the recent rebound in mortality, while the post-2020 trend reversal underscores the need to further examine the potential effects of diagnostic delay, disparities in healthcare access, and post-pandemic health system recovery on oral cavity cancer outcomes. Supplementary analyses further suggest that this mortality reversal was concentrated mainly in adults aged ≥45 years rather than in younger adults.

9. Tobacco retailer density and smoking prevalence following a hypothetical 500-meter buffer around schools in South Korea.

期刊: The International journal on drug policy 发表日期: 2026-May-27 链接: PubMed

摘要

To inform tobacco endgame policies, we aimed to assess the spatial distribution of tobacco retailers across districts and around schools in South Korea, and to estimate the potential impact of a simulated 500-meter school buffer zone policy on retailer density and adult smoking prevalence. A cross-sectional simulation study compared tobacco retailer exposure between status quo and simulated policy scenarios. District-level measures included retailer density and smoking prevalence; school-level measures included retailer counts within buffer zones and distance to the nearest retailer. The simulated policy removed all retailers within 500-meter circular buffers around schools. Changes in adult smoking prevalence were estimated using meta-analytic effect sizes. Results were stratified by urbanicity, income quartile, educational level, and institutional type. Simulated implementation of 500-meter school buffers was projected to reduce national retailer density by 66.6% (from 130,718 to 43,618 retailers), and lower adult smoking prevalence by 0.55 percentage points. At the district level, urban areas had higher baseline density and greater proportional reductions than rural areas. At the school level, approximately 70% of schools had at least one retailer within 200 m at baseline, and policy implementation increased mean distance to the nearest retailer from 221 m to 857 m. This simulation indicates that a 500-meter school buffer policy could substantially reduce tobacco retailer density and smoking prevalence in South Korea’s dense retail environment. Comprehensive implementation is recommended, and integration with other tobacco control measures will be essential to achieve tobacco endgame goals.

10. Movement, gender, and reproductive wellbeing: dance education as an informal health pathway for Chinese women.

期刊: African journal of reproductive health 发表日期: 2026-May-27 链接: PubMed

摘要

This study explores dance education as an informal health pathway linked to movement, gender, and reproductive wellbeing among Chinese women. A quantitative cross-sectional design surveyed women of reproductive age using a structured questionnaire measuring dance education participation, psychosocial mediators, and reproductive wellbeing. Data were analyzed with descriptive statistics, reliability analysis, correlation, regression, and mediation models. Results showed that higher levels of dance education participation were associated with greater reproductive wellbeing. Dance education also positively correlated with emotional regulation, body awareness, and social connection, and negatively with perceived stress. Mediation analysis confirmed that these psychosocial mechanisms partially explain the relationship between dance education and reproductive wellbeing. These findings position dance education as a cultural, gender-responsive, non-clinical intervention for women’s health promotion. The study provides empirical support for the proposed conceptual framework and aligns with Sustainable Development Goals 3 and 5, demonstrating how informal, community-based practices can support women’s reproductive wellbeing in China. Cette étude explore l’éducation à la danse en tant que voie de santé informelle liée au mouvement, au genre et au bien-être reproductif des femmes chinoises. Un design quantitatif transversal a interrogé des femmes en âge de procréer à l’aide d’un questionnaire structuré mesurant la participation à l’éducation à la danse, les médiateurs psychosociaux et le bien-être reproductif. Les données ont été analysées à l’aide de statistiques descriptives, d’analyse de fiabilité, de corrélation, de régression et de modèles de médiation. Les résultats ont montré que des niveaux plus élevés de participation à l’éducation à la danse étaient associés à un meilleur bien-être reproductif. L’éducation à la danse était également positivement corrélée à la régulation émotionnelle, la conscience corporelle et la connexion sociale, et négativement au stress perçu. L’analyse de médiation a confirmé que ces mécanismes psychosociaux expliquent partiellement la relation entre l’éducation à la danse et le bien-être reproductif. Ces résultats positionnent l’éducation à la danse comme une intervention culturelle, sensible au genre et non clinique pour la promotion de la santé des femmes. L’étude fournit un soutien empirique au cadre conceptuel proposé et s’aligne sur les Objectifs de Développement Durable 3 et 5, démontrant comment les pratiques informelles et communautaires peuvent soutenir le bien-être reproductif des femmes en Chine.

11. Evaluating the Effectiveness of an Enhanced Early Childhood Development Program Integrated Into Primary Health Care in China: Protocol for a Cluster Randomized Controlled Trial.

期刊: JMIR research protocols 发表日期: 2026-May-27 链接: PubMed

摘要

Early childhood development (ECD) programs refer to policies and programs aimed at protecting young children’s rights to achieve their full potential. Parenting interventions are effective at improving children’s cognitive development and overall well-being. However, there is limited evidence on how to effectively implement and integrate such programs into routine service delivery at scale. The Government of China launched the ECD program in 2013 and the ECD scale-up program in 2023. Our study aims to design, implement, and evaluate an enhanced ECD program embedded in the primary health care system in order to provide ECD policy recommendations for future national scale-up. This study involves a multicenter cluster randomized controlled superiority trial in 3 counties with different levels of socioeconomic development in China. Fifty-eight clusters will be randomly assigned in a 1:1 ratio to intervention and control groups, stratified by county. In each cluster, 18 families with children aged 6-23 months will be recruited. Our intervention aims to implement an enhanced ECD program in primary care facilities. Intervention group participants will receive usual care alongside enhanced ECD services, including improved facilities, capacity building, and improved ECD services (age-adapted clinical consultations on nutrition and stimulation, age-specific parenting group sessions, home visits, and referrals for children in need). Moreover, an electronic data platform will be used. Control group participants will receive usual care. Our primary outcome is children’s overall development, as measured by the Global Scale of Early Development combined form at 12 months of follow-up. Evaluation data will be collected in both arms. Additionally, a process evaluation and an incremental cost-effectiveness analysis will be conducted. Primary analysis will follow the intention-to-treat principle, and it will use generalized estimating equations to assess the population average intervention effect, with adjustment for corresponding baseline outcomes, selected individual variables, county, cluster variables, and variables differing at baseline. Qualitative data will be collected through semistructured interviews and focus groups, guided by the Capability, Opportunity, Motivation, and Behavior framework to explore implementation-related factors. Data will be transcribed for analysis using NVivo 14 (Lumivero). Ethical approval has been obtained from the Institutional Review Board of Shanghai Children’s Medical Center Affiliated to Shanghai Jiao Tong University School of Medicine. This study was funded in 2023 and registered in April 2024. The recruitment of 1044 participants was completed on September 14, 2024. Data collection was completed on January 31, 2026. We aim to design an enhanced ECD service delivery model that can be embedded into the routine primary health care system. The study findings will guide government policies and reforms for strengthening the health system to scale up ECD services. Furthermore, this project may provide policy evidence to support countries in establishing or expanding their ECD services.

12. AFRINA model: An innovative network-based strategy to prevent anemia and promote maternal well-being among brides-to-be.

期刊: African journal of reproductive health 发表日期: 2026-May-27 链接: PubMed

摘要

This study aimed to develop and evaluate the AFRINA Model (Anemia Free Integrative Network Approach) as a preventive strategy to reduce pregnancy and childbirth complications through increased awareness and education on anemia prevention among prospective brides. A cross-sectional design was used to identify determinants influencing anemia prevention in Bengkulu City. Variables included knowledge, attitudes, perceptions, beliefs, motivation, information exposure, facility access, family support, and health worker attitudes, along with sociodemographic factors such as age, education, occupation, income, and family history. Most participants (90.5%) were aged 21-30 years, with higher education (97.3%) and employment (85.1%). Factors significantly associated with anemia prevention (p < 0.05) were income, information exposure, attitude, perception, family support, facility availability, belief, health worker attitude, and motivation. Multivariate analysis identified motivation (OR 29.837), information exposure (OR 5.358), and family support (OR 5.045) as the strongest predictors. The AFRINA Model showed predictive accuracy between 79.9% and 93.4%, with an 86.6% accuracy rate in identifying at-risk individuals. Motivation, information exposure, and family support are key determinants of anemia prevention among prospective brides. The AFRINA Model demonstrates strong predictive validity and provides an effective framework for public health interventions addressing anemia prevention before marriage. Cette étude visait à développer et à évaluer le Modèle AFRINA (Approche Réseau Intégratif Sans Anémie) comme stratégie préventive pour réduire les complications liées à la grossesse et à l’accouchement par une sensibilisation accrue à la prévention de l’anémie chez les futures mariées. Une étude transversale a été menée afin d’identifier les déterminants influençant la prévention de l’anémie dans la ville de Bengkulu. Les variables étudiées comprenaient les connaissances, les attitudes, les perceptions, les croyances, la motivation, l’exposition à l’information, l’accès aux établissements de santé, le soutien familial et l’attitude des professionnels de santé, ainsi que des facteurs sociodémographiques tels que l’âge, le niveau d’études, la profession et le revenu. La majorité des participantes (90,5 %) étaient âgées de 21 à 30 ans, avec un niveau d’études supérieur (97,3 %) et un emploi (85,1 %). Les facteurs significativement associés à la prévention de l’anémie (p < 0,05) comprenaient le revenu, l’exposition à l’information, l’attitude, la perception, le soutien familial, la disponibilité des installations, les croyances, l’attitude des professionnels de santé et la motivation. L’analyse multivariée a identifié la motivation (OR 29,837), l’exposition à l’information (OR 5,358) et le soutien familial (OR 5,045) comme principaux prédicteurs. Le Modèle AFRINA a montré une précision prédictive de 79,9 % à 93,4 %, indiquant son potentiel pour orienter les interventions de santé publique dans la prévention de l’anémie avant le mariage.

13. Identifying barriers to essential newborn care practices: An assessment among healthcare providers in rural northern Tanzania.

期刊: African journal of reproductive health 发表日期: 2026-May-27 链接: PubMed

摘要

Neonatal mortality remains a major global health burden, with sub-Saharan Africa most affected. This study assessed the knowledge and practice of Essential Newborn Care (ENC) among healthcare providers in rural northern Tanzania and identified barriers to effective ENC. A cross-sectional survey was conducted using self-administered questionnaires among providers involved in obstetric or immediate neonatal care in Rorya district. Of the 67/68 respondents (98.5% response rate), 35/67 (52%) demonstrated satisfactory knowledge and 45/67 (67%) satisfactory practice. Being a clinical officer or untrained in ENC was significantly associated with unsatisfactory practice. Key deficiencies included improper suctioning during resuscitation, delayed cord clamping and bathing, untimely administration of medicines, and lack of skin-to-skin contact. Barriers to good ENC practice included inadequate provider training, supply shortages, and resistance from mothers. To improve neonatal outcomes in similar contexts, targeted ENC training, particularly for clinical officers and untrained staff in non-hospital settings, are urgently needed. La mortalité néonatale reste un problème de santé majeur à l’échelle mondiale, avec l’Afrique subsaharienne étant la région la plus touchée. Cette étude a évalué les connaissances et les pratiques en matière de soins essentiels aux nouveau-nés (ENC) chez les prestataires de soins de santé dans les zones rurales du nord de la Tanzanie et a identifié les obstacles à la mise en œuvre efficace des ENC. Une enquête transversale a été menée à l’aide de questionnaires auto-administrés auprès des prestataires impliqués dans les soins obstétricaux ou néonatals immédiats dans le district de Rorya. Sur les 67/68 répondants (taux de réponse de 98,5 %), 35/67 (52 %) ont démontré des connaissances satisfaisantes et 45/67 (67 %) des pratiques satisfaisantes. Le fait d’être agent clinique ou de ne pas avoir reçu de formation en matière de soins essentiels aux nouveau-nés était significativement associé à des pratiques insatisfaisantes. Les principales lacunes comprenaient une aspiration inadéquate pendant la réanimation, un clampage tardif du cordon ombilical et un bain tardif, une administration inopportune de médicaments et un manque de contact peau à peau. Les obstacles à une bonne pratique ENC comprenaient une formation inadéquate des prestataires, des pénuries d’approvisionnement et la résistance des mères. Afin d’améliorer les résultats néonatals dans des contextes similaires, une formation ENC ciblée, en particulier pour les agents cliniques et le personnel non formé dans les établissements non hospitaliers, est nécessaire de toute urgence.

14. [Mental Health Among Adolescents with a Migration Background: A Descriptive Study].

期刊: Acta medica portuguesa 发表日期: 2026-May-27 链接: PubMed

摘要

Migration may be associated with psychosocial challenges affecting adolescent mental health. This retrospective study described psychiatric hospitalizations of adolescents with a migration background in a child and adolescent psychiatry inpatient unit between December 2016 and June 2024. Forty-four adolescents were identified, accounting for 51 hospitalization episodes. Most patients were female (66%), with a mean age of 15.34 ± 1.47 years, and 91% were first-generation migrants. Suicidal ideation was the most frequent reason for admission (31.38%). Most admissions originated from the emergency department (84.32%), with a mean length of stay of 18.47 ± 10.62 days. At discharge, the most frequent diagnoses included depressive disorders (36.36%), trauma- and stressor-related disorders (22.73%), and schizophrenia spectrum and other psychotic disorders (13.64%). Most adolescents had no previous contact with mental health services (63.6%). These findings highlight the clinical relevance of this population and the need for early intervention strategies and improved coordination between healthcare, education and community services. A migração pode estar associada a desafios psicossociais com impacto na saúde mental durante a adolescência. Este estudo retrospetivo descreveu os internamentos psiquiátricos de adolescentes com antecedentes migratórios num serviço de pedopsiquiatria entre dezembro de 2016 e junho de 2024. Foram identificados 44 adolescentes, correspondendo a 51 episódios de internamento. A maioria era do sexo feminino (66%), com idade média de 15,34 ± 1,47 anos, e 91% eram migrantes de primeira geração. O motivo mais frequente de internamento foi a ideação suicida (31,38%). A maioria dos internamentos teve origem no serviço de urgência (84,32%), com um tempo médio de internamento de 18,47 ± 10,62 dias. À data da alta, os diagnósticos mais frequentes eram os de perturbações depressivas (36,36%), perturbações relacionadas com trauma e fatores de stress (22,73%) e perturbações do espetro da esquizofrenia e outras perturbações psicóticas (13,64%). A maioria dos adolescentes não havia tido contacto prévio com serviços de saúde mental (63,6%). Estes resultados destacam a relevância clínica desta população e a necessidade de estratégias de intervenção precoce e de articulação entre serviços de saúde, escola e comunidade.

15. Circulating biomarkers in older adults with and without sarcopenia: a systematic review and meta-analysis.

期刊: The journals of gerontology. Series A, Biological sciences and medical sciences 发表日期: 2026-May-27 链接: PubMed

摘要

Sarcopenia, the age-related loss of muscle mass and strength, poses a significant health and economic burden. This systematic review and meta-analysis evaluates circulating biomarkers (activin A, follistatin, growth differentiation factor (GDF-15), myostatin, growth hormone, insulin growth factor-1 (IGF-1), free and total testosterone) that may be associated with sarcopenia in community-dwelling older adults. Following PRISMA 2020 guidelines, we searched PubMed, Scopus, Web of Science, and Cochrane Library from inception to June 2025. Studies included adults without major comorbidities aged >60 years with sarcopenia defined by established consensus. Standardized mean differences (SMDs) were calculated using a random-effects model. Heterogeneity was assessed via I2 and meta-regressions, while Egger’s test was employed for publication bias. From 3488 records, 26 observational studies were included (n = 1345 adults with sarcopenia, 48.3% females, mean age 67.9-88.1 years). Adults with sarcopenia showed elevated GDF-15 (k = 5, SMD: 0.26, 95% confidence interval (95%CI): 0.03-0.50, I2 = 64%, P = 0.03) and reduced IGF-1 (k = 11, SMD: -0.40, 95%CI: -0.54 - -0.27, I2 = 36%, P < 0.01) compared to controls without sarcopenia. No significant differences were found between groups for the other circulating biomarkers. Elevated circulating IGF-1 and, to a lesser extent GDF-15, may be promising biomarkers for sarcopenia. Larger, longitudinal studies are needed to address heterogeneity and causality in this field.

16. Molecular Epidemiology, Antibiotic Susceptibility, and Virulence Profiling of Vibrio parahaemolyticus Isolated from Aquatic Foods in Shenzhen, China.

期刊: Foodborne pathogens and disease 发表日期: 2026-May-27 链接: PubMed

摘要

Vibrio parahaemolyticus is a common food-borne pathogen associated with aquatic foods, posing a major threat to human health worldwide. In this study, 22 isolates from aquatic foods were collected from 70 samples in Shenzhen, Guangdong, China (2023-2025). All isolates were subjected to antibiotic susceptibility testing, serotyping, and screening for antibiotic resistance genes and virulence factors. The results indicated that the most prevalent serotypes were O1 (45.4%), O14 (18.2%), while K -type exhibited greater genetic diversity. Multilocus sequence typing analysis divided the 22 isolates into 10 sequence types (STs), and the predominant ST was ST1823 (18.2%). Antimicrobial susceptibility tests showed that 18.2% of isolates (VP363, VP412, VP442, and VP452) were resistant to over five antibiotics. High resistance was observed to ampicillin (100%) and cefazolin (81.82%). A total of 15 antimicrobial resistance genes were identified. Among them, the tet(A) gene was detected in all isolates, while the blaCARB gene was found in the majority of isolates. Notably, the virulence genes tdh and trh were both absent in all strains. In addition, nearly all V. parahaemolyticus isolates in this study were found to harbor genes encoding the type III secretion system. These findings contribute to a better understanding of the characteristics of V. parahaemolyticus from aquatic products and provide fundamental data for ensuring food safety via the control of V. parahaemolyticus contamination.

17. Using the NASSS-Complexity Assessment Tool to Evaluate the Implementation of "Cadê O Kauê?": Chat-Story Intervention for Youth Participation in Mental Health Promotion in Brazil.

期刊: Journal of medical Internet research 发表日期: 2026-May-27 链接: PubMed

摘要

The global public health challenge of young people’s mental health is particularly evident in Brazil, which is considered the most anxious and the fifth most depressed country globally. In response to this, a digital intervention, that takes the form of a storytelling chatbot named “Cadê o Kauê?” (translation: “Where is Kauê?”), was coproduced by an interdisciplinary team of researchers, young people, and narrative designers as part of a project titled Engajadamente. The intervention was designed to strengthen Brazilian adolescents’ skills in promoting their peers’ mental health through direct support and collective action for mental health. The intervention was rolled out in select schools in Brazil and online via social media, but it encountered challenges during the initial implementation phase in school settings. This project’s primary objective is to evaluate the implementation of “Cadê o Kauê” in school settings in Brazil, assess current and potential complexities, and formulate recommendations to reduce or manage these complexities. The secondary objective of this project is to understand the current and potential sociotechnical change resulting from the implementation of the “Cadê o Kauê” in a real-world setting. The Non-adoption, Abandonment, Scale-up, Spread, Sustainability (NASSS) framework was selected as the theoretical framework to identify different areas of complexity across domains and further thinking of ways to reduce or manage these complexities. Data were gathered by conducting semistructured online interviews with the Engajadamente team members based in the United Kingdom and Brazil. The NASSS-Complexity Assessment Tool was used as a sensemaking device to facilitate a collective understanding of the implementation, and narratives were mapped onto specific NASSS domains. Key themes were identified across overarching domains using thematic analysis to meet the objectives of this evaluation. The results mapped onto the NASSS domains generated a narrative about the initial implementation of “Cadê o Kauê?” in schools. Existing and potential complexities across technology, organization, and wider system domains were characterized by interdependencies, unintended consequences, and uncertainties. The implementation of “Cadê o Kauê?” highlighted challenges related to internet dependency, infrastructure limitations, and varying levels of organizational readiness, teacher preparedness, and school culture. Addressing these through offline solutions, additional teacher training, whole-school engagement strategies, and a value-informed complexity approach can enhance accessibility, alignment with school priorities, and adaptability within Brazil’s dynamic sociopolitical context. Using the NASSS framework, the evaluation captured both current and emerging complexities in implementing “Cadê o Kauê?” in schools. By engaging with theory-informed approaches to technology implementation projects and deep-diving into discursive dynamic interactions between technology and its “context” of implementation, we have explored ways to manage these complexities and developed suitable recommendations to guide the Engadajamente team and support similar projects in the future.

18. Examination of Relationships Between 24-Hour Movement Behaviors and Mental Health Outcomes in Frontline Workers: Protocol for a Scoping Review.

期刊: JMIR research protocols 发表日期: 2026-May-27 链接: PubMed

摘要

Frontline workers across multiple occupations operate in high-stress, trauma-exposed environments characterized by chronic demands and irregular schedules, increasing risk of burnout, depression, and poor sleep. Emerging evidence highlights the role of 24-hour movement behaviors in relation to mental health. Despite growing attention, research remains fragmented and often focuses on individual behaviors rather than their combined influence. This protocol outlines a scoping review designed to map existing evidence and identify research gaps. The primary aim is to map research examining relationships between 24-hour movement behaviors and mental health outcomes in frontline workers. Objectives include examining measurement approaches, associations, and methodological gaps. This scoping review will follow the JBI methodology and the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) guidelines. Eligible studies include English-language research published between 2000 and 2025 involving adult frontline workers across multiple occupations and examining movement behaviors and mental health outcomes. A three-step search strategy will be conducted across multiple databases alongside targeted gray literature searches. Screening and data extraction will be performed independently by two reviewers. Findings will be synthesized using tabular summaries and narrative synthesis. Preliminary searches and pilot-testing were completed in October 2025. As of May 2026, updated database and supplementary searches have been completed, with 527 studies meeting the inclusion criteria for data charting. Data charting and synthesis are currently underway. Completion of the review and submission for publication are anticipated in July 2026. This review will provide a comprehensive overview of research linking 24-hour movement behaviors and mental health in frontline workers. Findings will highlight methodological, occupational, and research gaps to inform future research, policy, and practice.

19. Artificial Intelligence in Patient-Centered Care and Macro-, Meso-, and Micro-Level Determinants of Rehumanization and Dehumanization: Qualitative Interview Study.

期刊: Journal of medical Internet research 发表日期: 2026-May-27 链接: PubMed

摘要

Patient-centered care remains a foundational principle of modern health care. The digital transformation of health systems has accelerated the adoption of artificial intelligence (AI) across diagnostic, predictive, and communicative functions, with implications for efficiency and clinical workflows. At the same time, AI integration raises concerns regarding transparency, equity, accountability, and trust, positioning it as a potential driver of both rehumanizing and dehumanizing dynamics in health care practice. This study examines how the adoption of AI in health care may influence patient-centered care, exploring its potential to promote rehumanization or contribute to dehumanization. The objective is to identify the factors that shape these outcomes at the macrolevel (policy and infrastructure), mesolevel (institutional practices), and microlevel (individual behaviors and interactions). This study adopts an exploratory qualitative design informed by grounded theory principles, drawing on 20 semistructured interviews with health care leaders, clinicians, researchers, legal experts, and industry consultants who have substantial professional experience across European health care systems, with some participants also contributing experience from the US health care context. To enhance analytical rigor and transparency, the study applied the Gioia methodology, enabling inductive coding from first-order concepts to second-order themes and aggregate dimensions. This multistakeholder approach facilitated a nuanced examination of how AI integration is perceived and experienced across macro-, meso-, and microlevels of health care. The analysis identified key system-level factors shaping rehumanizing or dehumanizing outcomes of AI integration. At the macrolevel, 8 factors-including regulatory frameworks, policy priorities, and infrastructure-were identified as influencing whether efficiency pressures outweigh patient-centered values. At the mesolevel, 5 factors related to institutional strategies, workflows, and leadership shape how AI tools are embedded into care delivery. At the microlevel, 7 factors related to individual behaviors, trust, and doctor-patient interaction dynamics influence whether AI supports empathy and engagement or diminishes them. Rehumanizing potentials include reduced administrative burden, improved care pathways, clearer health communication, and enhanced decision-making, while risks include shorter consultations, reduced empathy, overreliance on automation, and erosion of professional identity. Without deliberate alignment with patient-centered principles, efficiency gains risk undermining the human dimensions of care. This study represents one of the first empirical examinations of how AI shapes health care practices through rehumanizing and dehumanizing dynamics. The findings demonstrate that outcomes depend not only on technical capabilities but also on regulatory frameworks, institutional strategies, and cultural adaptation. By systematically mapping influencing factors across macro-, meso-, and microlevels, the research provides actionable insights for decision-makers to ensure that efficiency gains remain aligned with patient-centered principles. Realizing AI’s promise requires coordinated action to preserve empathy, trust, and interpersonal connection, ensuring that innovation strengthens rather than weakens the human dimensions of care.

20. Three-Stage Evolution of China's Breakthrough Therapy Drug Policy: AI-Driven Quantitative Evidence and Global Implications.

期刊: The International journal of health planning and management 发表日期: 2026-May-27 链接: PubMed

摘要

Many countries have accelerated the approval of innovative drugs through breakthrough therapy policies to meet public health needs. China needs to optimise its policy system to narrow the gap with international practices. To identify shortcomings in China’s breakthrough therapy policies and formulate optimization strategies via quantitative analysis of their dynamic evolution and cross-jurisdictional comparisons. Adopting a quantitative design, this study employs AI technologies (LDA topic modelling + time-series deduction), combined with cross-jurisdictional policy element matrix comparison and typical drug case analysis, to systematically analyse the evolutionary path and implementation effects of China’s breakthrough therapy drug policies. Quantitative analysis of 59 policy texts (2020-2024) reveals that China’s policies have undergone a three-stage evolution: ‘approval-driven (2020-2022)-collaborative transition (2023-2024)-ecological construction (exploratory scenario deduction after 2024)’. The core topics focus on ‘drug review’, ‘industrial innovation’, and ‘medical services’, among which ‘drug review’ and ‘industrial innovation’ form a dual-dominant pattern. However, the persistently low intensity of the ‘medical services’ topic reflects an ecological imbalance of ‘accelerated approval-industrial innovation-lagging accessibility’. Cross-jurisdictional comparisons show gaps in early innovation incentives, international collaboration, and medical support. Based on the quantitative analysis of policy texts, this study proposes six optimization suggestions. These targeted strategies aim to address the imbalance of ‘fast approval but slow accessibility,’ support the ‘Healthy China 2030’ strategic goal, and provide references for developing countries in balancing resource allocation, accelerating research and development through the integration of artificial intelligence, and avoiding accessibility disparities via risk-sharing mechanisms.

21. Advanced cancer treatment decisions and their patient-facing financial burdens: A thematic analysis.

期刊: The oncologist 发表日期: 2026-May-27 链接: PubMed

摘要

Most research about the high costs of cancer care has focused on characterizing and mitigating the financial hardship patients and families experience after cancer-directed therapy. Few studies have examined how these costs prospectively influence treatment decision-making. Even fewer address how costs impact decisions about symptom-directed therapies. We aim to describe how patient-facing costs of care influence decisions about cancer-directed and symptom-directed therapies for advanced cancer. We analyzed semi-structured interviews with patients, care partners, clinicians, and health system leaders and clinical observations collected by investigators at 3 NCI-designated United States cancer centers between July 2019-May 2021. Two analysts conducted thematic analysis based on the Model of Financial Burden After Cancer Diagnosis. Analysis of 157 interviews and 92 observations identified 4 themes: (1) Insurance influenced treatment choice and location; (2) Medical costs influenced treatment choice, location, and timing; (3) Non-medical costs influenced treatment location and timing; and (4) Employment changes influenced treatment choice and timing. Patients and care partners emphasized costs of symptom-directed therapies; staff focused on costs of cancer-directed therapies. Patients and care partners described how employment influenced decisions about starting or continuing cancer-directed therapy, while staff noted how employment affected decisions about symptom-directed therapy. Patient-facing costs profoundly influence treatment decisions in advanced cancer care, but differences in perspective among patients, care partners, and clinicians can lead to oversights in treatment decision-making. Eliciting and incorporating patients’ varied priorities into treatment decisions can minimize these oversights, better align treatment with goals of care, and reduce financial hardship.

22. Self-Monitoring Risk Factors for Diabetic Foot Ulceration With the Feetchecker App: Mixed Methods Study.

期刊: JMIR formative research 发表日期: 2026-May-27 链接: PubMed

摘要

A prevalent and serious complication of diabetes mellitus is the development of diabetic foot ulcer (DFU). There is a need for effective solutions that help prevent DFU to support our increasingly stressed health care systems. The use of mobile health (mHealth) tools has been shown to improve awareness and effective self-care management skills in people at risk of developing diabetic foot ulceration. In this study, we aimed to investigate the perceived usefulness, engagement, and overall user experience of the Feetchecker app, a self-monitoring mHealth app for people at risk of DFU. A total of 24 patients (mean age 71, SD 8.6 years) with type 2 diabetes mellitus at risk of developing diabetic foot ulceration completed a 3-month evaluation period (70 recruited, 36 included, 12 dropped out) of a self-monitoring mobile app called Feetchecker app. A mixed methods approach was used to combine insights from app data with qualitative data from a pre- and postsurvey as well as interviews with patients and involved podiatrists. Data were analyzed using descriptive statistics and thematic analysis. We evaluated overall use of the app, patient engagement, and user experiences. Patients who fully completed the study conducted 393 feetchecks. In total, 7 patients sent in 9 pictures; all 7 were called for follow-up by a podiatrist. Overall, patients had a positive experience with the app and perceived the Feetchecker app as a valuable tool to monitor their feet for potential risk factors of DFU. Ease of use in performing a feetcheck and sending the podiatrist a picture was described as an important feature. Three main types of engagement with the Feetchecker app emerged: continuous, frequent, and no to little engagement. These patterns highlight enablers for self-monitoring such as ease-of-use, easy access to a podiatrist, and social support, as well as barriers such as digital skills and sustained engagement. Podiatrists highlighted the benefits of having patients report potential issues quicker and the ability to monitor their patients remotely. Challenges remain in integrating the promotion of the Feetchecker app into their consultations. The Feetchecker app supported patients in self-monitoring risk factors associated with DFU through routine checks and quick contact with a health care professional in case of a potential issue. Overall, patients described a positive user experience and considered the app helpful. While mHealth tools are not for everyone, user engagement for many patients was high and shows that such apps can offer support for people able to use them. Future research should focus on improving usability and engagement with the app as well as extend the way patients can communicate with health care professionals beyond a picture.

23. Differences Among Genomic Profiling Tests for Bone and Soft-Tissue Sarcomas in a Universal Health Insurance System.

期刊: The Journal of bone and joint surgery. American volume 发表日期: 2026-May-27 链接: PubMed

摘要

Accurate identification of gene fusions is critical for precision oncological approaches to sarcomas, where specific fusion genes are actionable targets of tyrosine kinase (TK) inhibitors. This study provides a descriptive overview of the real-world use, under a universal health insurance program, of 3 different comprehensive genomic profiling (CGP) panels within the Japanese national CGP system: GenMineTOP, which integrates DNA and RNA sequencing, and 2 DNA-based panels, FoundationOne CDx and the OncoGuide NCC Oncopanel System. We examined 2,633 sarcoma cases from the Center for Cancer Genomics and Advanced Therapeutics (C-CAT) database to identify potentially actionable alterations classified by the Cancer Knowledge Database (CKDB). The mean patient age was 51.1 years, and 45% were female. Detection rates of TK fusions (FGFR1-4, NTRK1-3, ALK, RET, ROS1, and BRAF) were compared descriptively. Additionally, 3 sarcoma cases with an NTRK fusion detected by GenMineTOP were functionally validated. Potentially actionable alterations (CKDB Levels A, B, and C) were identified in 566 patients (21.5%). Actionable TK fusions were detected in 3.1% (8 of 254) with GenMineTOP, 1.4% (31 of 2,211) with FoundationOne CDx, and 0.6% (1 of 168) with NCC Oncopanel. GenMineTOP identified rare NTRK fusions, including RBPMS::NTRK2, HTT::NTRK2, and EML4::NTRK3. Functional assays suggested their oncogenic potential and demonstrated responsiveness to the TK inhibitors larotrectinib and entrectinib. In this cohort, the DNA+RNA-based panel showed a higher detection rate for TK fusions, although the panels were applied to different patient groups and the sensitivity and specificity could not be determined. Future studies evaluating different test types on the same tumor specimens are warranted to clarify whether the dual-sequencing approaches can improve the identification of actionable genetic events. Diagnostic Level IV. See Instructions for Authors for a complete description of levels of evidence.

24. Tirzepatide data: safety always comes first!

期刊: Expert opinion on drug safety 发表日期: 2026-May-27 链接: PubMed

摘要

Tirzepatide, a dual GIP and GLP-1 receptor agonist, offers unprecedented efficacy for type 2 diabetes and obesity. Due to its rapid global adoption, understanding its complete safety spectrum is urgently needed to guide responsible prescribing and mitigate public health risks. A literature search was conducted using PubMed and other public databases available to evaluate current evidence on the efficacy, safety, and metabolic impact of tirzepatide. The research discussed encompasses clinical trials and real-world data detailing the glycemic and weight reduction benefits of the drug. We examine its overall tolerability, covering common gastrointestinal events, including its high comparative risk for severe gastrointestinal events and treatment discontinuation, rare risks such as gallbladder and thyroid disorders, and the complex impact of the drug on skeletal muscle mass. While tirzepatide represents a paradigm shift in metabolic therapy, clinical management must evolve toward precision phenotyping to individualize patient risk-benefit trajectories. Future research must prioritize long-term functional outcomes to ensure that disease-modifying benefits are not offset by treatment-induced sarcopenia.

25. Phlorizin activates BMP10 to attenuate atherosclerosis by inhibiting vascular endothelial senescence and inflammation in Apoe-/- mice.

期刊: International immunopharmacology 发表日期: 2026-May-27 链接: PubMed

摘要

Atherosclerosis is a chronic inflammatory vascular disease characterized by lipid deposition, endothelial dysfunction, and cellular senescence, posing a significant threat to the cardiovascular system. As demonstrated in previous studies, phlorizin has been shown to have anti-atherosclerotic effects. However, the precise molecular mechanisms by which this occurs remain to be elucidated. This study aimed to investigate the preventive effect of phlorizin on atherosclerosis and elucidate the molecular network mediated by bone morphogenetic protein 10 (BMP10). A total of 40 eight-week-old Apoe-/- mice were randomly divided into four groups (n = 10): control, model, phlorizin, and phlorizin+sh-BMP10 groups. Following a 12-week period of observation, phlorizin was found to have a significant impact on lipid metabolism disorders, whilst concomitantly inhibiting the formation of aortic sinus plaque. Furthermore, phlorizin was found to inhibit vascular endothelial cell senescence and inflammatory responses, whilst concomitantly modulating oxidative stress levels in mice. Transcriptome sequencing revealed that after phlorizin intervention, differentially expressed genes (DEGs) in mouse aortic tissue were significantly enriched in cellular senescence, cell-cell adhesion, and p53 signaling pathways. Among the phlorizin-regulated DEGs involved in atherosclerosis and cellular senescence, BMP10 emerged as a target for further investigation. Dual-luciferase reporter assay confirmed that phlorizin upregulates BMP10 by activating its promoter at the transcriptional level. In vitro experiments confirmed that phlorizin upregulates BMP10 expression, alleviates oxidative LDL-induced cellular senescence and lipid deposition, and enhances cellular angiogenic capacity and migratory function. The anti-AS effect of phlorizin depends on the Smad5 signaling pathway downstream of BMP10. Endothelial-specific BMP10 knockdown verified that the protective effect was specifically mediated by vascular endothelial cells. The efficacy of this approach was further validated through the use of sh-AAV-BMP10, which successfully induced BMP10 knockdown in mice. The knockdown efficiency of BMP10 at mRNA and protein levels was verified in aortic tissue. In addition, the in vitro interference of BMP10 expression in vascular endothelial cells using si-BMP10 further corroborated the anti-atherosclerotic effects of phlorizin, thereby confirming that BMP10 deficiency was entirely sufficient to reverse these effects. The results of molecular docking indicated stable interactions between phlorizin and both human and mouse BMP10. Mechanistically, phlorizin transcriptionally activates BMP10 and functions through the BMP10-Smad5 signaling axis to inhibit endothelial senescence, inflammation, and oxidative stress.

26. Redefining Photoinitiator Risk Prioritization by Bridging Environmental Fate and Human Internal Exposure.

期刊: Environmental science & technology 发表日期: 2026-May-27 链接: PubMed

摘要

This study integrates settled indoor dust measurements from multiple functional microenvironments with urinary biomonitoring of corresponding populations to characterize indoor exposure pathway, emission behavior, and internal burdens of photoinitiators (PIs). Total PI concentrations in settled dust exhibited pronounced differences across functional microenvironmental differences, decreasing in the order dormitories (geometric mean (GM): 617 ng/g) > offices (GM: 471 ng/g) ≈ residences (GM: 463 ng/g) ≫ background matrices (GM: 22.6 ng/g). Chamber emission experiments demonstrated that, despite substantial material-specific variability in gas-phase concentrations, adsorbed-phase PI levels converged across materials, suggesting that dust-associated adsorption effectively buffers. Human biomonitoring revealed compound-specific internal exposure patterns that were closely aligned with functional microenvironments. Benzil exhibited consistently elevated urinary concentrations (GM up to 1.50 × 103 ng/mL), whereas ethyl-4-dimethylaminobenzoate (EAB) predominantly characterized office- and dormitory-associated populations. Integration of environmental fate with human internal exposure enabled a dual-dimensional prioritization, identifying 2-ITX as the sole high-priority compound across all scenarios. Reliance on environmental data alone would underestimate the risk of Benzil due to its high internal burden, while overestimating the risk of PI-819, which shows high environmental prominence but negligible internal exposure. Collectively, these findings indicate that, for PIs widely used as green alternatives in UV-curable applications, health-relevant prioritization requires the joint consideration of external contamination and internal metabolic processes.

27. Progenitor Resilience and the Early Onset of Chronic Lung Diseases: NHLBI workshop report.

期刊: American journal of respiratory cell and molecular biology 发表日期: 2026-May-27 链接: PubMed

摘要

Lung function peaks in young adulthood and declines with age. Studies suggest that this trajectory may be modifiable, potentially enhancing lung health and resilience to prevent or delay the onset of chronic lung disease. Although significant progress has been made in identifying the lung stem/progenitor cell populations involved in lung repair and homeostasis, their regulation and potential for manipulation to promote respiratory health and resilience remain elusive. To explore these issues, the NHLBI organized a virtual workshop on November 7-8, 2024 that aimed to cover the current scientific landscape, address critical research gaps, and identify challenges, opportunities, and key research questions related to chronic lung disease, with a focus on lung stem/progenitor resilience and its applications in the early diagnosis, prevention, and treatment of chronic lung diseases. This report summarizes the scientific presentations, discussions, and recommendations from the workshop.

28. Effective alternative treatment regimens for syphilis: is doxycycline enough?

期刊: Sexually transmitted diseases 发表日期: 2026-May-27 链接: PubMed

摘要

29. An AI-Enabled Predictive Harm Response Management Algorithmic Tool to Reduce Adverse Events in Health Care Settings (PreHaRM): Protocol for a Three-Phase Model Development and Pilot-Testing Study.

期刊: JMIR research protocols 发表日期: 2026-May-27 链接: PubMed

摘要

Current data analysis and coordination methods do not effectively support nurses and midwives in risk reduction, as retrospective reporting does not allow real-time insights and precludes proactive, preventive care. Analysis of administrative data within Australia’s health care sector to predict risk may help address this shortcoming. Predictive analytics can transform these data into meaningful insights, identifying harm risk profiles that benefit the performance of Australian and international clinical programs. Importantly, these tools may support nurses and midwives in preventing adverse events and predicting high-risk situations. Researchers, in collaboration with local health network staff, will develop a proof-of-concept predictive risk algorithm. The “predictive harm response management algorithmic tool to reduce adverse events in healthcare settings” program (project DHCRC-0156) will provide real-time insights via an interactive dashboard, enabling nurses, midwives, and health administration to assess risks and optimize resources in health care settings. This protocol details the algorithm development activities for subproject 1a, predictive risk model development, which aims to develop and pilot-test a predictive harm algorithm across 2 South Australian local health networks. This study aims to identify the clinical harm outcome of interest and relevant data sources per site and build a suitable data solution to model predictors of harm risk and identify actionable clinical, workforce, and environmental factors that affect the harm outcome of interest. This study design includes three phases: (1) model generation, (2) model evaluation, and (3) prototype development. Data linkage by SA-NT DataLink can only proceed following approval from each of the following: the South Australia Department for Health and Wellbeing Human Research Ethics Committee, the University of South Australia Human Research Ethics Committee, and hospital governance committees. The clinical dataset will be split into a training set, a validation set, and a test set. Exploratory data analysis will be undertaken to ascertain features and classify outcomes from the raw dataset. Derived features will be computed, feature correlations will be estimated, and initial feature selection will be performed. Iterative model development will occur over 3 stages, and a dashboard to display these results will be developed. The study commenced on July 19, 2021, and will conclude on December 31, 2025. Finalized results are expected in December 2025. This research will conclude with the development of the algorithm for transferability to health care environments. Research activities will be detailed in publicly available reports and manuscripts prepared for peer-reviewed journals that will be drafted in accordance with existing and appropriate checklists. DERR1-10.2196/75474.

30. In Vitro Liver Models for Studying Pharmaceutical Metabolism in Fish - A Critical Analysis of Their Applications and Limitations.

期刊: Environmental science & technology 发表日期: 2026-May-27 链接: PubMed

摘要

Bioaccumulation studies performed as part of the environmental risk assessment of human pharmaceuticals are time- and resource-intensive, prompting interest in alternative nonanimal screening methods. For xenobiotics, including active pharmaceutical ingredients (APIs), biotransformation and metabolic clearance are key determinants of bioaccumulation and, consequently, effects in nontarget organisms like fish. Various in vitro liver models are available for studying pharmaceutical metabolism in fish, including microsomes, S9 fractions, and primary hepatocyte cultures maintained as suspensions, monolayers, or three-dimensional spheroids. However, broader application of these models is limited by a lack of robust in vitro-in vivo correlation data, as well as uncertainty regarding the most appropriate systems for different modeling purposes. This study critically evaluates in vitro liver models commonly used for assessing API clearance in fish, comparing their functionality, resource requirements, and informative value. Drawing on published data for selected APIs and on the strategies used to select suitable mammalian model systems, we propose the use of subcellular fractions for high-throughput screening of hepatic clearance (metabolic stability) and enzyme inhibition, hepatocyte suspensions for assessing intrinsic clearance while accounting for the impact of active drug transport, and hepatocyte monolayers or three-dimensional cultures for longer-term clearance and targeted effect studies. Key knowledge gaps are identified, and recommendations for future research are presented.

31. Barriers and Facilitators to Maintaining Physical Activity After an mHealth Intervention for People Poststroke or Transient Ischemic Attack: Reflexive Thematic Analysis.

期刊: JMIR cardio 发表日期: 2026-May-27 链接: PubMed

摘要

Regular physical activity is critical for preventing secondary stroke following a stroke or transient ischemic attack (TIA). Although mobile health (mHealth) interventions have shown promise for promoting short-term increases in physical activity, evidence on their long-term effects and the mechanisms that support sustained behavior change remains limited. In particular, little is known about how people poststroke or TIA integrate the skills, knowledge, and habits gained through mHealth interventions into their daily lives once structured intervention support ends. This study aimed to explore the perceived barriers and facilitators of maintaining physical activity among individuals poststroke or TIA after completing an mHealth intervention. A qualitative approach was used, involving a strategic sample of 12 participants recruited after they had completed a 6-month mHealth intervention for people poststroke or TIA. The intervention included supervised physical therapy with mHealth support for physical exercises and behavior change (eg, counseling, goal-setting, and self-monitoring), followed by a 6-month postintervention period with access to self-managed mHealth support. To enable richness and depth in participants’ accounts, the dataset consisted of 2 semistructured interviews conducted 3 months and 6 months after completing the intervention, along with participant-generated photographs. Between the interviews, participants took photos to reflect their experiences of maintaining physical activity after the intervention. These images served as prompts for dialog and reflection during the second interview. Data were analyzed using reflexive thematic analysis. We generated 3 themes: building experience and knowledge to maintain physical activity, staying physically active in a complex life situation, and the meaning of context for maintaining physical activity after the intervention. Barriers and facilitators were conceptually integrated into a comprehensive understanding of maintaining physical activity, symbolized by the metaphor of a soap bubble, which requires persistence and a supportive environment to stay afloat. The complexity of participants’ health and life situations created barriers to maintaining physical activity. To overcome these barriers, developing personal strategies within a supportive social and physical context was crucial. This development was facilitated by the mHealth intervention, which enabled knowledge acquisition of the principles of physical activity after stroke or TIA, along with increased awareness of its health benefits. mHealth interventions for people poststroke and TIA can serve as a catalyst for physical activity engagement and an enhancer of the knowledge and experience necessary to maintain physical activity after the intervention. Despite health-related and contextual barriers, participants may use personalized strategies, supported by their social and environmental context, to navigate these challenges. These insights highlight opportunities for future mHealth interventions to strengthen the interaction between individuals and their environment and empower tailored strategies for behavior change and long-term physical activity maintenance.

32. Periodic Molecular-Level Asymmetric Channels for Synergistical Purification of Iodide Wastewater and Osmotic Power Generation.

期刊: Journal of the American Chemical Society 发表日期: 2026-May-27 链接: PubMed

摘要

Heterogeneous structured nanofluidic membranes show an extraordinary potential for selective ion transport. In particular, heterogeneous membranes with periodically asymmetric nanofluidic channels are expected to exhibit optimal ion selectivity, yet have rarely been achieved to date. Herein, we designed a two-dimensional (2D) organic-inorganic superlattice-like membrane with periodically arranged molecular-level asymmetric channels that achieve high iodide-ion selectivity and permeability. The PDDA/Ti0.87O2 superlattice-like membranes (PDDA/Ti0.87O2 SLMs) were prepared from unilamellar Ti0.87O2 nanosheets with surface-modified poly(diallyldimethylammonium chloride) (PDDA) by a layer-by-layer assembly strategy, in which the PDDA layers and Ti0.87O2 nanosheets are alternatively stacked to form molecular-level asymmetric channels between the heterogeneous units periodically. Unlike conventional nonperiodic structures with discontinuous ion migration paths and high ion-diffusion resistance, superlattice-like membranes provide continuous, unobstructed transport channels, enabling I- ions to follow a periodic adsorption-repulsion synergistic transport mechanism, thereby forming nearly frictionless continuous ionic flow. As a result, the PDDA/Ti0.87O2 SLMs produce a record I-/SO42- selectivity of ∼680, which is the highest among all reported materials. When applied to osmotic energy generators with the artificial iodine wastewater, the PDDA/Ti0.87O2 SLMs can facilitate sustainable osmotic power generation and maintain operation for at least 160 h. In addition, the resulting iodine solution can be effectively utilized as a sterilizing agent with a high bactericidal effect of 99.5% for Escherichia coli within 30 min. This study establishes a new paradigm for periodic molecular-level asymmetric channels, presenting an approach for maximizing resource utilization from industrial iodine wastewater.

33. Development and institutional implementation of a prehospital emergency care protocol for individuals with autism spectrum disorder.

期刊: Prehospital emergency care 发表日期: 2026-May-27 链接: PubMed

摘要

Prehospital emergency environments are characterized by high sensory load, time pressure, and unpredictable dynamics - conditions that may exacerbate distress and behavioral dysregulation in individuals with Autism Spectrum Disorder (ASD). Despite increasing emergency service utilization among individuals with ASD, structured prehospital protocols tailored to their needs remain limited. To describe the development and institutional implementation of a prehospital emergency care protocol adapted for individuals with ASD within a state-level emergency medical service system. A structured, multi-stage protocol development process was conducted between September 2023 and October 2024. The process included (1) targeted literature review on ASD-specific emergency care, (2) interdisciplinary expert meetings involving a psychologist, physician, ASD researcher, and emergency medical services trained firefighter, and (3) iterative refinement of operational procedures adapted from existing institutional standard operating protocols. Consensus was reached through structured discussions until full agreement was achieved among panel members. The final protocol was formally approved and implemented by the Santa Catarina Military Fire Department (Brazil) as an official Standard Operating Procedure (No. 03/2024). The resulting protocol provides operational guidance across five stages of prehospital care: emergency call triage, approach to scene, on-scene primary and secondary assessment, in-ambulance management, and transfer of care. Key components include sensory load reduction strategies, structured communication guidance, caregiver involvement, behavioral crisis management considerations, and environmental adaptations during transport. Institutional adoption enabled integration into routine training activities and operational workflows. To our knowledge, this study presents the first institutionally implemented state-level prehospital protocol in Brazil specifically designed for individuals with ASD. The protocol offers a structured, operationally feasible framework to improve safety, reduce sensory distress, and support emergency responders in managing neurodivergent patients. Future research should evaluate its impact on responder confidence, care quality, and patient-centered outcomes.

34. Air pollution modifies clonal hematopoiesis-associated non-small cell lung cancer risk in non-smoking individuals.

期刊: Journal of the National Cancer Institute 发表日期: 2026-May-27 链接: PubMed

摘要

Small particulate matter air pollution (PM2.5) is a recognized driver of non-small cell lung cancer (NSCLC), including in non-smoking individuals. Inhaled PM2.5 recruits pro-inflammatory macrophages to the air-lung interface, which promotes malignant lung epithelial cell growth and progression to overt cancer. Smoking is recognized to potentiate this process, though no factors potentiating risk among non-smoking individuals have been identified. We sought to determine whether clonal hematopoiesis of indeterminate potential (CHIP), a common age-related condition characterized by hyperinflammatory macrophages, synergizes with PM2.5 to promote NSCLC in non-smoking individuals using genetic, environmental, and phenotypic data from over 650,000 people in the UK Biobank and All of Us cohorts. In meta-analysis, CHIP was associated with a greater risk of NSCLC in never-smoking participants (hazard ratio (HR)=1.76[1.07-2.89]). This risk is exacerbated in the setting of above-median PM2.5 levels (HR = 2.51[1.55 to 4.05]; p-interaction = 0.02). The CHIP x PM2.5 interaction also associated with elevated markers of systemic inflammation (CRP, IL-6, and IL-1β). Together, these results suggest CHIP and PM2.5 form a novel somatic gene × environment interaction promoting inflammation and NSCLC tumorigenesis in non-smoking individuals.

35. Global association between ambient air pollution and age-related macular degeneration: an ecological analysis across 203 countries.

期刊: Environmental science and pollution research international 发表日期: 2026-May-27 链接: PubMed

摘要

Age-related macular degeneration (AMD) is a leading cause of visual impairment worldwide, and both environmental and lifestyle factors have been implicated in its development; however, international-scale evidence regarding the impact of air pollution remains limited. We conducted a cross-sectional ecological study to evaluate national-level associations between AMD burden and environmental as well as lifestyle factors using data from the Global Burden of Disease study. Disability-adjusted life years (DALYs), age-standardized DALYs, and age-standardized prevalence of AMD from 1990 to 2020 were analyzed in relation to ambient air pollutants, including particulate matter ≤ 2.5 μm (PM2.5), PM ≤ 10 μm (PM10), nitrogen dioxide, sulfur dioxide, ozone, household air pollution from solid fuel use, and national smoking prevalence obtained from global databases. Between 1990 and 2020, global DALYs attributable to AMD increased by 26.7%, whereas age-standardized DALYs and age-standardized prevalence decreased by 19.2% and 3.4%, respectively. In 2020, age-standardized AMD prevalence showed significant positive correlations with PM2.5 (r = 0.65, p < 0.001), ozone (r = 0.55, p < 0.001), and household air pollution (r = 0.30, p < 0.001), and a significant negative correlation with smoking prevalence (r = -0.25, p < 0.001). Multivariable regression analyses identified PM2.5 (odds ratio [OR] 8.09, p < 0.001) and ozone (OR 5.42, p < 0.001) as independent predictors of AMD prevalence. These findings suggest that exposure to ambient air pollution, particularly fine particulate matter and ozone, may contribute to the global burden of AMD and represent potentially modifiable risk factors, underscoring the need for further research to clarify causal relationships and to inform public health and environmental policy interventions.

36. Microbiota-Derived Metabolites in Developmental Programming: Bridging Early-Life Gut Microbiota to Childhood Metabolic Disorders.

期刊: Current medical science 发表日期: 2026-May-27 链接: PubMed

摘要

The rising incidence of childhood metabolic disorders poses an increasingly serious public health challenge. The developmental programming of the gut microbiota during early life, shaped by perinatal and postnatal factors, establishes a functional trajectory that profoundly influences host metabolism, with microbiota-derived metabolites serving as critical bridging molecules that mechanistically link early-life exposures to metabolic outcomes in childhood. Key microbiota‒metabolite pathways underpin this process, including the fermentation of dietary fiber into short-chain fatty acids (SCFAs), the microbial metabolism of amino acids into both protective and detrimental products, the biotransformation of primary bile acids (BAs) into secondary BAs, and the generation of trimethylamine N-oxide (TMAO) from methylamine precursors. These metabolites exert their effects through diverse molecular mechanisms, spanning epigenetic regulation and receptor signaling (including farnesoid X receptor [FXR], G protein-coupled bile acid receptor 1 [TGR5], and other metabolite-sensing receptors). A deep understanding of these microbiota-derived metabolites in the context of developmental programming is therefore essential not only for advancing precise diagnosis and personalized treatment but also for informing early and targeted prevention strategies to reduce the burden of childhood metabolic diseases.

37. Risk prediction for individual patients and the pitfalls of selecting an optimal prediction model: do not judge a model by its c-statistic.

期刊: European journal of epidemiology 发表日期: 2026-May-27 链接: PubMed

摘要

Researchers often report the area under the curve (AUC/c-statistic), Brier-index (BI), and explained variation (R2) to assess risk prediction model performance. This may be inappropriate for scores to estimate individual patient risks because population characteristics like risk score distributions may influence these performance metrics. This study assessed performance values for a fully accurate risk score under different distributions. A risk score ranging 0-100% was simulated for 100,000 individuals with 1000 bootstraps under six distributions: normal, uniform, bimodal, extreme bimodal, uniform ascending and uniform descending. Outcomes were simulated with full accuracy: 1% of individuals with a score of 0.01 had an outcome, 2% with 0.02 etc. Values for the AUC, BI, BI scaled (BS), and R2 were calculated, and calibration plots made. Sensitivity analyses included narrowing risk score range and reducing score granularity. For a normally distributed score, performance indices did not exceed values generally considered poor (AUC = 0.67, BI = 0.23, BS = 0.08, R2 = 8%). Values were best for an extreme bimodal distribution (AUC = 0.93, BI = 0.10, BS = 0.61, R2 = 61%). Performance indices for the other distributions were moderate (AUC = 0.80-0.83, BI = 0.17-0.18, BS = 0.25-0.33, R2 = 25-33%). Calibration plots were perfect for all distributions. Values worsened with narrowing score ranges. Reducing granularity had marginal effects. Risk prediction model performance values depend strongly on risk distributions. They may not exceed values generally considered poor/moderate in many common risk distributions. When assessing patient risk prediction models, investigators and clinicians interested in the accuracy of risk estimations may prioritize calibration and net benefits over commonly used metrics like the AUC and BI.

38. Zinc as a central modulator of heat stress-induced intestinal and systemic dysfunction in poultry.

期刊: Journal of thermal biology 发表日期: 2026-May-25 链接: PubMed

摘要

Heat stress (HS) is a major environmental challenge in modern poultry production, where high metabolic heat output and intensive genetic selection increase vulnerability to thermal load. Beyond impairing thermoregulation and feed intake, HS disrupts intestinal barrier integrity, induces oxidative stress and inflammation, and promotes systemic metabolic dysregulation. The gastrointestinal tract has therefore emerged as a central target and amplifier of HS-induced pathology, highlighting the importance of gut-focused nutritional interventions. Zinc (Zn), an essential trace element with broad catalytic and regulatory functions, has gained attention as a key modulator of intestinal and systemic resilience under HS conditions. Accumulating evidence indicates that Zn not only supports antioxidant defenses and immune regulation but also preserves epithelial architecture by stabilizing tight junctions (TJ), modulating heat shock responses, suppressing inflammatory signaling, and promoting epithelial renewal. At the molecular level, Zn acts as a signaling ion through activation of the Zn-sensing receptor, G protein-coupled receptor 39 (GPR39) and downstream phosphatidylinositol 3-kinase (PI3K)/protein kinase B (AKT)/mammalian target of rapamycin (mTOR) and mitogen-activated protein kinase (MAPK) pathways, thereby facilitating epithelial repair and barrier restoration. Recent avian intestinal organoid studies provide direct mechanistic evidence that organic and moderately chelated Zn sources, such as Zn proteinate, more effectively alleviate HS-induced epithelial injury than inorganic forms. Complementary in vivo data further demonstrate HS-induced redistribution of Zn via coordinated regulation of Zn transporters and metallothionein, linking local intestinal protection with systemic Zn homeostasis. In conclusion, current evidence positions Zn as a central nutritional regulator of HS resilience and supports the development of precision Zn supplementation strategies for sustainable poultry production under increasing thermal stress.

39. Transcutaneous vagus nerve stimulation influences sleep quality and insomnia: A systematic review and meta-analysis.

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

摘要

Impairments in sleep quality, timing, or duration disrupt normal sleep patterns. This systematic review and meta-analysis investigated the effects of transcutaneous vagus nerve stimulation (tVNS) protocols on sleep outcomes. Thirteen randomized controlled trials with parallel or crossover designs that applied tVNS intervention and assessed sleep quality (Pittsburgh Sleep Quality Index) and insomnia severity (Athens Insomnia Scale and Insomnia Severity Index) were included. Effect sizes were calculated by comparing changes between the active tVNS and control groups. Moderator analyses examined whether stimulation of different targeted regions influences sleep outcomes. Meta-regression analyses examined potential relationships between the effects of tVNS protocols on sleep quality and demographic characteristics and multiple tVNS parameters, respectively. The random-effects meta-analysis indicated that tVNS protocols influenced better sleep quality and lower insomnia severity. Moderator variable analysis revealed that tVNS targeting the concha region induced better sleep quality. Meta-regression analysis revealed that better sleep quality was associated with lower ages of participants. These findings suggest that tVNS protocols, particularly those targeting the concha, were associated with favorable changes in sleep quality and insomnia severity, with age potentially moderating the treatment response.

40. Association between birth memory and postpartum psychological distress: The mediating role of sleep quality.

期刊: Midwifery 发表日期: 2026-May-21 链接: PubMed

摘要

Birth memory has been associated with postpartum psychological distress, particularly postpartum depression (PPD) and childbirth-related post-traumatic stress disorder (CB-PTSD). However, the mechanisms underlying this relationship remain poorly understood. Poor sleep quality has been associated with both negative autobiographical memories and increased risk of psychological distress, suggesting it may mediate this relationship. To investigate the mediating role of sleep quality in the relationship between birth memory and postpartum psychological distress. This cross-sectional study recruited primiparous women aged 18 to 49 years who had a vaginal birth and had a child aged 1 to 3 months from two tertiary-level public hospitals in China, between September and December 2024. A total of 420 women participated. Birth memory was measured using the 21-item Birth Memory and Recall Questionnaire. Postpartum psychological distress, operationally defined as the presence of PPD and/or CB-PTSD, was measured using the 10-item Edinburgh Postnatal Depression Scale and the 14-item Perinatal Posttraumatic Stress Disorder Questionnaire. Sleep quality was evaluated using the Pittsburgh Sleep Quality Index. Mediation analysis was used to estimate the total natural indirect effect (TNIE), pure natural direct effect, total effect, and proportion mediated. Sensitivity analyses were conducted to assess the robustness of TNIEs against unmeasured confounding. Five dimensions of birth memory: 1. emotional memory, 2. reliving, 3. centrality of memory, 4. sensory memory, and 5. involuntary recall indirectly increased the risk of postpartum psychological distress through impaired sleep quality, with TNIE odds ratios ranging from 1.09 to 1.12 (all P < 0.05). The proportion mediated ranged from 0.25 to 0.34 (all P < 0.05). Sensitivity analyses confirmed the robustness of the TNIEs with respect to the potential effects of unmeasured confounding. Coherence of memory did not show a significant TNIE on postpartum psychological distress through sleep quality (P = 0.441). Sleep quality partially mediates the relationship between specific dimensions of birth memories and postpartum psychological distress. These findings highlight the importance of sleep interventions in the postpartum period, particularly for women with negative birth experiences, as a potential strategy for preventing or alleviating postpartum psychological distress.

41. Age-Related Differences in Dietary Intake and Nutritional Status Among Older Adults in Croatia: Results from a National Food Consumption Survey.

期刊: Epidemiologia (Basel, Switzerland) 发表日期: 2026-May-21 链接: PubMed

摘要

Understanding nutrient intake and diet quality in older adults is essential for promoting healthy ageing and quality of life. The aim of the study was to assess dietary intake and nutritional status in two age groups of older adults in Croatia (65-74 years and ≥75 years). A total of 786 participants aged 65 and older were included in this cross-sectional study. Data from the National food consumption survey (OC/EFSA/DATA/2017/01), based on the EU Menu methodology, were used. Data collection included a general questionnaire, the International Physical Activity Questionnaire, two 24-h recalls or food diaries, and anthropometric measurements. The effects of body mass index and physical activity level on dietary intake were analysed using a general linear model. 21.5% of older adults in Croatia had a normal weight, while 78.5% of were classified as overweight or obese. Significant differences were recorded in energy and macronutrient intake between the two age groups. Body mass index was significantly associated with energy (kcal/day), fat intake (g/day), and intake of the meat, poultry, fish and eggs food group in the 65-74 year age group. In the ≥75 year age group, physical activity level showed an effect on energy, carbohydrates, and milk and dairy product intake. Intake of nutrient-dense foods and fluids was below recommendations in both observed groups. The study results, based on a representative sample, provide the first overview of the nutritional status of older adults in Croatia. These findings offer a foundation for public health initiatives and further research on the nutritional status of the older population in Croatia.

42. Evaluating the effect of Iron biofortification on nutraceutical and aromatic profiles of cereal grains: A case study of pearl millet.

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

摘要

Pearl millet is a nutrient-rich cereal that is an important food security crop in arid regions, supporting overall health and preventing chronic diseases. This study evaluated the impact of iron biofortification on the nutraceutical, volatile, and sensory profiles of pearl millet using HPLC, GC-MS, and UHPLC-Q-Orbitrap MS/MS. A total of 118 nutraceuticals, including flavonoids, phenolics, and amino acids, and 26 volatile compounds such as alcohols, aldehydes, and others, were identified across the pearl millet samples. Iron biofortification increased the total amino acids and volatile compounds by 22.67% and 41.73%, respectively, while reducing the total tannins by 15.73%. Sensory evaluation revealed enhanced aroma intensity, flavor, and overall acceptability in the biofortified variety. Multiplatform data fusion combined with PLS-DA effectively distinguished the millet types. This study provides the first in-depth evidence that iron biofortification enhances the nutritional and sensory qualities of pearl millet, thereby improving its dietary value and consumer appeal.

43. Cross-national differences in stroke management in the Baltic states: analysis within the Stroke Action Plan for Europe framework.

期刊: European stroke journal 发表日期: 2026-May-06 链接: PubMed

摘要

Although epidemiological studies often group the Baltic states together, they differ significantly in national stroke care legislation and infrastructure. Our study aimed to explore and compare the current state of stroke care in Lithuania, Latvia and Estonia. We analysed the Stroke Action Plan for Europe (SAP-E) Stroke Service Tracker data from 2022, including data from the respective National Health Insurance Funds and direct centre-level queries. Geographic Information System-based modelling assessed population access to stroke-ready hospitals within 1 h. Key metrics, including hospitalised stroke incidence, stroke unit admission, recanalisation therapy and in-hospital as well as 30-day mortality, were compared using Z-tests for proportions. The hospitalised stroke incidence per 100,000 inhabitants was similar in Lithuania (353) and Latvia (354), but lower in Estonia (246), despite similar population structures. Lithuania had the highest proportion of its population (94.0%) with access to a stroke-ready hospital within 1 h, followed by Latvia (87.1%) and Estonia (84.7%, P < .001). Estonia had the highest proportion of stroke unit admission rates and the lowest mortality rates-9.6% (in-hospital) and 15.0% (30-day) for ischaemic stroke. Endovascular treatment was most frequent in Lithuania (8.6% of all strokes, P < .001), while Estonia had the highest rate of intravenous thrombolysis (29.0%, P < .001). Despite broadly comparable populations and formal SAP-E alignment, the Baltic states exhibit marked differences in stroke access, treatment and outcomes. High stroke unit admissions and high recanalisation rates in Estonia may be associated with lower ischaemic stroke mortality, underscoring the importance of system design beyond geographic coverage alone.

44. Response to 'Impact of control selection strategies on GWAS results: a study of prostate cancer in the UK Biobank'.

期刊: Briefings in bioinformatics 发表日期: 2026-May-04 链接: PubMed

摘要

45. Inferring tumor absolute copy number and clonal substructure from single-cell chromatin accessibility.

期刊: Briefings in bioinformatics 发表日期: 2026-May-04 链接: PubMed

摘要

Accurate inference of absolute copy numbers beyond simple gains and losses from single-cell chromatin accessibility (scATAC-seq) data remains challenging, thereby obscuring the distinction between genetic and epigenetically driven oncogenic dependencies. Here, we present TeaCNV, a computational framework that reconstructs clonal absolute copy number profiles and tumor clonal architectures from scATAC-seq data without matched DNA baselines. Through validation both in silico and against bulk whole-genome sequencing in renal cell carcinomas, TeaCNV resolved subclonal absolute copy number profiles with less than 10% error and detected copy number variations (CNVs) with 98.6% accuracy, outperforming existing methods. Applied to six cancer types including renal, breast, pancreatic, head and neck, colorectal, and ovarian cancers, TeaCNV delineated polyclonal architectures and revealed distinct chromatin accessibility patterns driven by CNVs in key driver genes, including AKT2, ZNF217, and SOX2. By enabling absolute copy number profiling and clonal deconvolution from epigenomic assays, TeaCNV bridges critical gaps in studying oncogenic dependencies and genotype-phenotype relationships at single-cell resolution.

46. Pharmacological rhythm control strategy and outcomes in the oldest atrial fibrillation patients: an analysis of the nationwide Italian START registry.

期刊: Age and ageing 发表日期: 2026-May-03 链接: PubMed

摘要

Evidence on antiarrhythmic drugs (AADs) in the oldest atrial fibrillation (AF) patients is limited. We investigated clinical characteristics and outcomes associated with AADs use in this population. The oldest (age ≥ 80 years) AF patients from the nationwide START registry were included. Patients were divided into three groups: no AADs (n = 3573), class 1c-AADs (n = 207) and Amiodarone (n = 464). Factors associated with AADs were evaluated using multivariable logistic regression models. The associations between AADs and all-cause mortality were assessed using Cox proportional hazards models and cardiovascular events (CVEs) were analysed using Fine-Gray competing risk models. Among 4244 patients (54.9% women), the mean age was 84.8 ± 3.8 years. AADs were prescribed in 671 patients (15.8%), including amiodarone in 464 (10.9%) and 1c-AADs in 207 (4.9%). 1c-AADs use was associated with younger age and fewer comorbidities, including lower prevalence of diabetes, heart failure, chronic obstructive pulmonary disease/obstructive sleep apnoea and better functional and social status. Amiodarone use was associated with coronary artery disease and markers of frailty. Over a median follow-up of 502 (interquartile range 362-857) days, 492 deaths and 548 CVEs occurred. In unadjusted analyses, 1c-AADs were associated with lower all-cause mortality and CVEs; however, these associations were no longer significant after multivariable adjustment. Amiodarone use was not associated with clinical outcomes in either unadjusted or adjusted analyses. In the oldest AF patients, AADs use is influenced by comorbidity burden and frailty-related characteristics. AADs were not independently associated with mortality or CVEs, suggesting that pharmacological rhythm control may be reserved for selected cases in this population.

47. Inclusion of older adults in UK clinical research-the National Institute for Health and Care Research Year of Birth Project.

期刊: Age and ageing 发表日期: 2026-May-03 链接: PubMed

摘要

Inclusion of older adults in research ensures both equity and relevance. We used National Institute of Health and Care Research Year of Birth data to describe inclusion of older adults in contemporary UK clinical research. We worked with English research networks to collect individual participant level data on recruits into National Institute of Health and Care Research portfolio studies. We used data from 2022-2023 to 2023-2024 to assess participation. We described data in terms of geography, primary speciality managing the study and study characteristics. In subgroup analyses, we assessed inclusion of the ‘oldest old’ (aged over 85 years) and inclusion in research from three exemplars: heart failure, Parkinson’s disease and palliative care. In total, 455 734 participants were included in the analyses. The most common age group included in UK research was 65-74 years (15.5%). People aged over 85 years were 3.2% of all recruits, and this proportion decreased over time. There was modest geographical variation in participant age but marked variation by recruiting speciality. People aged over 85 years accounted for less than 5% of the total participants recruited in 9 of 14 specialities assessed. Older adults were less likely to be recruited into commercial studies. For three conditions of interest, recruitment did not match population epidemiology. This project has demonstrated feasibility of collecting participant age data at scale and provides important metrics for understanding study participation. While there is scope to improve older adult participation across all the study portfolio, there are major equity issues around inclusion in certain speciality areas and commercial research. To complement this abstract, a video abstract is available online.

48. HIV Infection: What Is New in Prevention and Treatment?

期刊: American family physician 发表日期: 2026-May 链接: PubMed

摘要

HIV remains a significant public health challenge despite highly effective prevention and treatment strategies. Screening for HIV infection is recommended for individuals ages 15 to 65 years. The status neutral approach to care includes preexposure prophylaxis for HIV-negative patients and antiretroviral therapy for patients with HIV. The preexposure prophylaxis options approved by the US Food and Drug Administration include oral and injectable formulations, which reduce HIV acquisition risk by 99% when taken consistently. Same-day antiretroviral therapy initiation is the standard of care for patients diagnosed with HIV infection, with integrase strand transfer inhibitor-based regimens preferred for treatment-naive patients. Key clinical considerations in primary care require modified management approaches for patients with HIV. All patients 40 to 75 years of age with HIV infection and 10-year atherosclerotic cardiovascular disease risk scores between 5% and less than 20% should be prescribed a moderate-intensity statin, and those with risk scores of 20% or greater should receive a high-intensity statin. In addition to standard age-appropriate vaccines, adults with HIV should receive hepatitis A and B (if not immune), meningococcal, pneumococcal, and herpes zoster vaccines. Cancer screening for patients with HIV includes lifelong cervical cancer screening. Anal cancer screening should start at age 35 for men who have sex with men and transgender women, and at age 45 for all other patients. Family physicians are uniquely positioned to deliver comprehensive care that addresses HIV-specific needs and whole person primary care.

49. Primary Platinum-Resistant Ovarian Cancer: Clinicopathologic Correlates and Outcomes From a Multicenter Prospective Indian Registry.

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

摘要

To identify clinicopathologic factors associated with primary platinum-resistant ovarian cancer and evaluate survival outcomes using data from a multicenter, prospectively maintained Indian cancer registry. Data were analyzed from a prospective database of Network of Oncology Clinical Trials in India registry from six tertiary care centers between January 2022 and December 2023. Primary platinum-resistant ovarian cancer was defined as progression during treatment or recurrence within 6 months of completing initial platinum-based chemotherapy. Demographic, clinical, and treatment variables along with survival outcomes were evaluated. Among 367 women with newly diagnosed epithelial ovarian cancer treated with platinum-based chemotherapy, 62 (16.9%) had primary platinum-resistant ovarian cancer. The cohort had a mean age of 54 ± 11.2 years, 79% were postmenopausal, and 53.2% had Eastern Cooperative Oncology Group performance score ≥2. High-grade serous carcinoma histology predominated (75.8%), 90.3% presented with stage III to IV disease, 74.2% had ascites, and 79.1% had peritoneal spread. Debulking surgery was performed in 24.2%, platinum-taxane doublet was used in 83.9%, and among those receiving curative intent treatment, 88.1% received chemotherapy in the neoadjuvant setting. Maintenance therapy was received by 6.5%; none entered clinical trials. Over a median follow-up of 10.32 months, median progression-free and overall survival were 4.75 (95% CI, 4 to 6) and 9.33 (95% CI, 6.2 to 16.3) months, respectively, from baseline at diagnosis. Primary platinum resistance was associated with poor performance status, ascites, advanced stage, omission of debulking surgery, neoadjuvant chemotherapy, and palliative-intent chemotherapy (P < .05). Primary platinum resistance affected 16.9% of Indian women with epithelial ovarian cancer and was linked to poor performance status, advanced stage, omission of debulking surgery, neoadjuvant chemotherapy, and dismal survival outcomes underscoring the urgent need for better predictive and therapeutic strategies.

50. A Policy Lens on Climate Vulnerability and Health Insurance.

期刊: JAMA network open 发表日期: 2026-May-01 链接: PubMed

摘要

51. Modifiable Risk Factors for Atrial Fibrillation/Flutter in the Association of Southeast Asian Nations: Global Burden of Disease 2021.

期刊: JACC. Advances 发表日期: 2026-Apr-28 链接: PubMed

摘要

Atrial fibrillation (AF) and atrial flutter (AFL) is increasingly contributing to cardiovascular mortality in Southeast Asia; however, region-specific data on modifiable risk factors remain limited. This study aimed to assess the burden of AF/AFL attributable to modifiable risk factors across the Association of Southeast Asian Nations (ASEAN) using Global Burden of Disease 2021 data. We analyzed the Global Burden of Disease 2021 data for all 10 ASEAN nations (1990-2021). The burden of AF/AFL attributable to metabolic, behavioral, and environmental risk factors was assessed, stratified by sex. The outcomes included age-standardized mortality rates (ASMRs), disability-adjusted life years (DALYs), and years lived with disability. Forecasts to 2035 were generated using validated time-series models. Between 1990 and 2021, the ASMRs for AF/AFL attributable to modifiable risk factors varied markedly across ASEAN countries. Metabolic risks rose from 1.30 (0.48-2.14) in 1990 to 1.78 (0.98-2.87) in 2021, followed by behavioral (0.42-0.45) and environmental (0.08-0.11) risks. Vietnam had the highest metabolic-attributable ASMR at 2.06 in 2021, whereas Singapore’s declined to 0.31 in the same year. Metabolic DALYs peaked in Indonesia at 52.29 in 2021 and were lowest in Singapore at 12.35. Males consistently showed higher ASMRs and DALYs than females, a gap projected to persist through 2035, reflecting persistent metabolic dominance and uneven progress across ASEAN. Metabolic risk factors remain the dominant contributors to AF/AFL mortality across ASEAN, with widening disparities across countries and sexes. Strengthening targeted prevention strategies is essential to reduce cardiovascular risk and achieve equitable progress by 2035.

52. Effects of social media sponsorship disclosure on adolescents' advertising literacy and purchase intention.

期刊: PloS one 发表日期: 2026 链接: PubMed

摘要

In the rapidly evolving digital age, adolescents have become a particularly vulnerable group impacted by social media marketing. This study aims to examine how different types of sponsorship disclosure (full, partial, and none) in social media affect adolescents’ ability to recognize advertising, their advertising literacy, and their purchase intentions. A self-administered questionnaire was used to assess the effects of three types of sponsorship disclosure in social media posts on adolescents. In 2022, a total of 3,149 high school students were recruited from 36 schools across Taiwan using a probability proportional to size sampling method. Adolescents were randomly assigned to one of three experimental groups and exposed to social media posts featuring varying levels of sponsorship disclosure. The study found that adolescents exposed to full sponsorship disclosure had significantly higher rates of advertisement recognition and greater conceptual advertising literacy compared to those in the partial or no disclosure conditions. The multivariate analysis revealed that advertisement recognition was associated with higher levels of both conceptual and attitudinal advertising literacy. Adolescents who could recognize advertisements demonstrated higher attitudinal advertising literacy, which was associated with lower purchase intentions. Clear sponsorship disclosure is crucial for raising advertising awareness among adolescents, enhancing their advertising literacy, and potentially protecting them from increased susceptibility to purchase intentions.

53. Beyond BMI: The musculoskeletal and metabolic consequences of normal weight obesity across the female lifespan.

期刊: Women’s health (London, England) 发表日期: 2026 链接: PubMed

摘要

Obesity is a global health concern linked to prediabetes, hypertension, sarcopenia, osteoporosis, and cardiovascular disease. However, body mass index (BMI) has limited sensitivity, misclassifying over half of individuals with excess adiposity as having normal weight. Growing evidence identifies a subgroup with normal BMI (18.5-24.9 kg/m2) but elevated body fat (>25% in men, >30% in women), termed normal weight obesity (NWO). Women are at a two-to six-fold higher risk of developing NWO compared to men. To investigate this, an expert review of the literature was conducted utilizing PubMed, Scopus, and Google Scholar to explore the impact of excess adiposity in the context of NWO, emphasizing female physiology across the lifespan and its influence on skeletal muscle and bone health. Many women with NWO remain unaware of underlying hormonal or menstrual dysregulation until challenges arise with fertility or during mid-life transitions. Metabolic disturbances during perimenopause occur independently of obesity but are likely worsened by excess adiposity despite a normal BMI. In postmenopause, the shift from estradiol to estrone and overall estrogen reduction accelerates bone resorption, leading to declines in bone density and strength, and increased fracture risk. Genetic variations in fat distribution, lean mass, and body proportions further modify disease risk among racial and ethnic groups. In women, increased adipose tissue often occurs in the hips and gluteal regions, predisposing to fatty acid infiltration within muscle (myosteatosis), which has been associated with reduced muscle quality outcomes (e.g. muscular strength) and increased falls in older adults. Increasing skeletal muscle mass may improve adiponectin levels, supporting metabolic health, while leptin dysregulation promotes lipid accumulation and inflammation. Higher adiposity, as seen in NWO, impairs bone microstructure and increases fragility through inflammatory pathways. In conclusion, NWO is an underrecognized yet clinically significant condition that elevates women’s risk for metabolic, hormonal, muscoskeletal dysfunction despite a normal BMI. A person can appear to have a “normal” body weight while still carrying too much body fat. This condition is called normal weight obesity (NWO). Because BMI only measures weight relative to height, it often misses excess fat, meaning many people with health risks are labeled as “healthy.” Women are especially affected and are two to six times more likely than men to develop NWO. This review explains how NWO impacts women’s health across the lifespan. Even with a normal BMI, higher body fat can disrupt hormones, menstrual cycles, and metabolism. Many women do not notice these issues until they experience problems with fertility or begin the mid-life transition into perimenopause. During this stage, metabolic shifts occur regardless of weight, but excess fat can make symptoms worse. After menopause, the natural decline in estrogen speeds up bone loss. In women with NWO, this bone loss is intensified, raising the risk of low bone density, weaker bone structure, and fractures. Muscle health is also affected. Women often store fat around the hips and glutes, and this can lead to fat infiltrating the muscles. This reduces muscle strength and increases the chance of falls, especially in older age. Hormones released by fat tissue contribute as well. When muscle mass is low, beneficial hormones like adiponectin decrease, while higher fat levels can disrupt leptin, increasing inflammation.In summary, normal weight obesity is a hidden but serious condition for women, raising the risk of metabolic problems, hormonal imbalances, weaker muscles, and fragile bones—even when BMI appears normal. Understanding NWO is essential for better health screening and prevention.

54. Nurses' Perceived Barriers to the Implementation and Sustainability of Best Patient Safety in Handover in the Clinical Setting: Cross-Sectional Survey Study.

期刊: Critical care nursing quarterly 发表日期: 链接: PubMed

摘要

Nursing clinical handover is a complex process used at the patient’s bedside to enhance communication and safety during shift changes. It is negatively influenced by environmental and other factors. This study aimed to explore nurses’ perceived barriers to the implementation and sustainability of safe patient handover in the clinical setting. From December 1, 2022, to January 31, 2023, 148 nurses from 2 medical wards, 3 intensive care units, and the emergency department of a university hospital participated in a cross-sectional survey study using a self-administered questionnaire. The most significant performance barriers reported by nurses were difficulty in recognizing which information is essential and the provision of irrelevant medical information during handover. The main environmental barriers were staff shortages and busy periods, followed by poor workforce planning and long working hours. The primary systemic barriers reported were a lack of training and overwhelmed staff. Handover is a complex process negatively influenced by the work environment. Organizational adjustments, such as workload reduction and dedicated handover training for staff, are necessary to improve handover procedures and enhance patient safety.

55. Vocational rehabilitation for people with multiple sclerosis: A systematic scoping review of international evidence.

期刊: PloS one 发表日期: 2026 链接: PubMed

摘要

People with multiple sclerosis (pwMS) may encounter challenges in their professional lives, due to a combination of environmental and individual factors. According to Escorpizo et al., 2011 framework, Vocational rehabilitation (VR) aims to optimise job participation, providing support in the job access, retention and in the return to work for people with disability. However, the corpus of research on VR for pwMS is poor. This scoping review aims to map the available literature on VR interventions for pwMS, summarising their characteristics, study designs, implementation features, feasibility, and stakeholders’ perspectives. Following the Joanna Briggs Institute (JBI) and the PRISMA-ScR guidelines, seven databases were searched up to October 2025: PubMed, SCOPUS, PsycInfo, CINAHL, Google Scholar, OT Seeker (University of Queensland), and the Physiotherapy Evidence Database (PEDro). Studies were eligible if they were related to VR interventions for pwMS, focused on job access, return, or retention and if they were primary articles. Data were extracted and synthesised following the Population-Concept-Context (PCC) framework. Out of 2,360 records, 28 articles describing 28 distinct VR interventions were included. Studies were published between 1996 and 2025, mostly from Western countries. Designs ranged from descriptive to randomized trials, with an increasing number of interventional and feasibility studies in recent years. The 61% of the interventions were multi-dimensional delivering a combination of rehabilitation, educational, and reasonable accommodation services. PwMS highlighted the importance of empathetic and individualized approaches, symptom management, and legal counselling as key elements in VR interventions, while logistical, personal and health issues were barriers to participation. Overall, interventions were considered feasible and acceptable. This is the first comprehensive overview of VR interventions for pwMS, outlining a progressive shift toward multidisciplinary and goal-oriented approaches over time. Despite promising feasibility and stakeholder satisfaction, further rigorous trials are needed to evaluate effectiveness and inform evidence-based implementation of VR programmes in diverse contexts.

56. Barriers and facilitators to implementing childcare in long-term care homes: A scoping review protocol and consultative exercise.

期刊: PloS one 发表日期: 2026 链接: PubMed

摘要

Long-term care (LTC) homes face persistent workforce recruitment and retention challenges, particularly among staff balancing professional responsibilities with childcare needs. Integrating childcare services within LTC homes has the potential to improve staff well-being, workforce stability, and resident experiences through intergenerational engagement. Despite this potential, the implementation literature remains fragmented, and no systematic synthesis of barriers, facilitators, or contextual determinants exists. To systematically map the literature on barriers and facilitators to implementing childcare services within LTC homes and identify gaps to inform research, policy, and practice. We will conduct a scoping review following the Arksey and O’Malley framework, enhanced by Levac et al., and report findings according to PRISMA-P and PRISMA-ScR guidelines. Literature searches will be conducted in MEDLINE, CINAHL, Embase, Scopus, and PsycINFO, supplemented by grey literature searches. Eligible studies include qualitative, quantitative, or mixed-methods research, program evaluations, and policy reports examining implementation of childcare services within or linked to LTC homes. Two reviewers will independently screen studies, extract data using a standardized form, and resolve discrepancies through discussion or a third reviewer. Extraction will capture study characteristics, childcare model details, reported barriers and facilitators, and outcomes. Findings will be synthesized narratively and organized thematically using the Consolidated Framework for Implementation Research (CFIR 2.0). Stakeholder engagement with LTC and early childhood centre staff will guide interpretation and knowledge translation. The review will identify key determinants of successful implementation, highlight gaps in the evidence, and provide actionable insights for LTC administrators, early childhood partners, and policymakers seeking to develop sustainable, equitable co-located childcare programs that benefit residents, children, and staff.

57. The long shadow of 9/11: Mental health outcomes in adult children of World Trade Center Responders with PTSD.

期刊: PLOS mental health 发表日期: 2026 链接: PubMed

摘要

Intergenerational transmission of trauma (ITT) has been documented among offspring of parents exposed to war, genocide, and interpersonal violence, yet little is known about ITT among families of World Trade Center responders (WTC-R). The aftermath of 9/11 terrorist attacks provides a unique naturalistic context for examining long-term psychological outcomes among now-adult offspring raised during periods of parental trauma exposure and recovery. The WTC-R cohort comprised traditional first responders (i.e., law enforcement officers) and nontraditional recovery workers, among whom those with PTSD were invited to complete an online survey and recruit their adult offspring. Parents and offspring completed standardized assessments of mental health, including depression, anxiety, PTSD, panic disorder, substance use, and lifetime traumatic experiences, as well as measures of social support, family relationships, and quality of life. Generalized Estimating Equations (GEE) models were used to examine associations between parental 9/11-related exposure, current parental psychopathology, and offspring mental health outcomes, with moderation by responder occupational category. Greater parental 9/11 exposure was associated with a higher likelihood of PTSD, anxiety, and panic symptoms among adult offspring. Current parental PTSD and depression were significantly associated with offspring PTSD and depression, respectively. Poor parent-offspring relationships were associated with offspring depression, PTSD, and alcohol use disorder. Several associations were moderated by occupational subgroup, suggesting differential vulnerability linked to the nature and context of exposure. These findings demonstrate enduring intergenerational mental health effects more than two decades after 9/11, highlighting how parental trauma exposure, ongoing psychopathology, and family relational functioning collectively shape outcomes in WTC-R offspring.