公共卫生研究摘要 (2026-05-30)

共收录 55 篇研究文章

1. The Authors Respond.

期刊: Epidemiology (Cambridge, Mass.) 发表日期: 2026-Jul-01 链接: PubMed

摘要

2. Clinical Manifestations, Tumor Associations, and Long-Term Outcomes of Anti-KLHL11 Encephalitis.

期刊: Neurology(R) neuroimmunology & neuroinflammation 发表日期: 2026-Jul 链接: PubMed

摘要

Anti-Kelch-like protein 11 (KLHL11) encephalitis was discovered in middle-aged men with testicular seminoma and rhombencephalitis, defining a new type of paraneoplastic neurologic syndrome (PNS), but diagnostic criteria and treatment outcomes remain largely unclear. This study aimed to comprehensively describe the initial presentations and subsequent clinical courses, ancillary findings, treatments, and outcomes of patients with anti-KLHL11 encephalitis. We tested 1,361 patients with clinical features or tumors that could be associated with anti-KLHL11 encephalitis (1,164 CSF and 680 serum). The retrospective analysis included 458 serum and 288 CSF samples from 473 patients between January 2010 and July 2020, while prospective screening for anti-KLHL11 antibodies was regularly performed since July 2020. Anti-KLHL11-abs was screened using KLHL11 overexpression cell-based assay. Detailed clinical and paraclinical information was collected. Seventeen anti-KLHL11 encephalitis patients were identified. The median age of patients was 59 (IQR 48-72; range 28-76) years, and 12 individuals (n = 12, 71%) were male. Common phenotypes were cerebellar ataxia (n = 12, 71%), brainstem encephalitis (n = 12, 71%), opsoclonus-myoclonus syndrome (n = 8, 47%), and limbic encephalitis (n = 3, 18%). Meningitis was observed in one patient. Concurrent antibodies included those against N-methyl-D-aspartate receptor (n = 2), glial fibrillary acidic protein (n = 1), and contactin-associated protein-like 2 (n = 1). MRI was abnormal in 8 cases (47%), showing T2/FLAIR hyperintensity in the rhombencephalon (n = 3, 18%), limbic system (n = 4, 24%), or cerebellar atrophy (n = 2, 12%). Tumors were identified in 10 cases (59%), including seminoma (n = 5, 29%), ovarian teratoma (n = 1, 6%), urological (renal cell carcinoma and urothelial cell carcinoma, both n = 1, 12%), small-cell lung cancer, and carcinoma of unknown primary (all n = 1). Fifteen patients received first-line immunotherapies (88%), and 6 patients also received second-line immunotherapy (35%). Improvement or stabilization was achieved in 10 (7 and 3, respectively, 67%) patients. The median follow-up duration was 20 months (range 1.5-180). Six patients died within the first 12 months, related to encephalitis (n = 3, 18%) or cancer (n = 3, 18%). Anti-KLHL11 encephalitis mainly related to infratentorial encephalitis but can also present as limbic encephalitis and rarely as meningitis. Early diagnosis enables early oncological and immunologic treatment, hopefully improving outcomes.

3. The Illusion of the "Self-correcting" Nature of Science.

期刊: Epidemiology (Cambridge, Mass.) 发表日期: 2026-Jul-01 链接: PubMed

摘要

4. Latent Variation in Pathogen Strain-specific Effects Under Multiple-Versions-of-Treatment Theory.

期刊: Epidemiology (Cambridge, Mass.) 发表日期: 2026-Jul-01 链接: PubMed

摘要

Evidence-informed infectious disease policy requires estimates of the health effects of infections. However, pathogenic variation, whereby the risk of adverse outcomes depends on the strain-specific characteristics of the pathogen, might complicate the study of many infectious agents. Here, we consider the interpretation of epidemiologic studies of infectious diseases when there is such heterogeneity in strain-specific effects and when information on strain composition is unavailable. We use potential outcomes and causal inference theory for analyses in the presence of multiple versions of treatment to argue that oft-reported quantities in these studies have a causal interpretation that depends on population frequencies of infecting strains. Moreover, as in other contexts where the treatment-variation-irrelevance assumption might be violated, transportability requires additional considerations, beyond those needed for noncompound exposures. This discussion, considering potential heterogeneity in strain-specific effects, will facilitate the interpretation of epidemiologic studies and also highlight the value of pathogen subtype data.

5. Julianne Skarha, Winner of the 2026 Rothman Prize.

期刊: Epidemiology (Cambridge, Mass.) 发表日期: 2026-Jul-01 链接: PubMed

摘要

6. Microscopic gastritis and colitis: two tales of the same world.

期刊: European journal of gastroenterology & hepatology 发表日期: 2026-Jul-01 链接: PubMed

摘要

7. Diminished Performance and Learning of a Novel Visuomotor Skill in Children Born Preterm.

期刊: Developmental psychobiology 发表日期: 2026-Jul 链接: PubMed

摘要

Premature birth has long-term effects on sensory, motor, and cognitive development. Despite evidence of impaired motor function in young children born preterm, there is less known about motor learning and the characterization of the acquisition and retention of motor skills in this population. Furthermore, bimanual movements, important for performing everyday activities, may be preferentially affected in preterm children. In this study, we compared unimanual and bimanual motor skill learning in young children born preterm compared to children born at term age. Unimanual and bimanual de novo visuomotor learning tasks were implemented on a computerized tablet (Apple iPad). Fifty-five participants (N = 14 preterm), corrected age 5-8 years, completed three testing sessions: initial practice (72 practice attempts), 24-h retention (24 practice attempts), and 7-day retention (24 practice attempts). Speed (completion time) and accuracy (movement path length) characterized motor performance. Learning was determined by comparing performance at the end of initial practice to each retention test. Overall, preterm children exhibited reduced speed and accuracy on both tasks compared to term-born children. All children performed better on the unimanual version of the task. Retention was similar between groups and tasks. Biological age had a small, nonlinear relationship with performance. These results confirm that preterm children have impaired unimanual and bimanual skills but are capable of learning new visuomotor patterns, with potential differences in skill retention. This evidence provides insight into the varied trajectories of motor development of preterm children.

8. Use of High-Efficacy Therapy in Children With Multiple Sclerosis to Prevent Long-Term Disability.

期刊: Neurology 发表日期: 2026-Jun-23 链接: PubMed

摘要

Children with multiple sclerosis (MS) are increasingly treated with high-efficacy monoclonal antibody therapies; however, treatment approaches vary widely, largely because of regulatory restrictions that often delay access until adulthood. We hypothesized that initiating these therapies during childhood confers greater benefits than their initiation in adulthood. This study, therefore, evaluated long-term disability in patients with pediatric-onset MS treated with monoclonal antibodies before age 18 compared with those who initiated these therapies in adulthood. In this retrospective cohort study, patients younger than 18 years at the onset of MS symptoms were identified across 3 MS registries: MSBase, Observatoire Français de la Sclérose en Plaques, and the Italian MS Register. We categorized patients who commenced natalizumab, ocrelizumab, or rituximab between ages 12 and 17 into the pediatric high-efficacy therapy (HET) initiation group and those who began treatment between ages 20 and 22 into the adult HET initiation group. A landmark study design was used, with age 18 designated as the baseline and the outcome period spanning ages 23-27 years. The primary outcome was the change in Expanded Disability Status Scale (EDSS) scores, evaluated using a Bayesian weighted generalized linear mixed model. We included 277 patients (72% female), with a mean (SD) age at onset of MS symptoms of 14.97 (2.23) years. Of these, 108 initiated HET during childhood and 169 during adulthood. The postbaseline increase in EDSS scores was 0.53 steps lower in the pediatric HET initiation group compared with the adult group (β -0.53 [95% credible interval -0.87 to -0.19]). This benefit of pediatric HET initiation was most pronounced within the EDSS range of 4.5-6.0, with up to a 97% reduction in the odds of further disability worsening (odds ratio of EDSS score 5.0 over 4.5: 0.03 [95% credible interval 0.003-0.22]). Commencing high-efficacy monoclonal antibody therapy in childhood is associated with more favorable long-term disability outcomes than delayed initiation in adulthood. Early use of highly effective therapy is crucial for preserving neurologic function in children with MS. This study provides Class II evidence that, in children aged 12-17 years with MS, initiating therapy with monoclonal antibodies before age 18 (vs 20-22) is associated with less disability accrual between the ages of 23 and 27.

9. Physiological Responses to Occupational Heat Exposure Among Male Agricultural and Brick-Field Workers in Eastern India: A Biochemical Perspective.

期刊: American journal of human biology : the official journal of the Human Biology Council 发表日期: 2026-Jun 链接: PubMed

摘要

Occupational heat exposure is considered a major health concern for workers performing strenuous work during hot environmental conditions. This cross-sectional study aimed to assess the biochemical and physiological responses to occupational heat exposure among agricultural and brick-field workers working in hot environmental conditions in eastern India. A sub-sample of 20 agricultural workers and 20 brick-field workers was selected from the larger sample of 200 workers each to assess the physiological and biochemical responses to hot environmental conditions during the summer and winter seasons. Environmental heat exposure was measured using the time-weighted average Wet Bulb Globe Temperature (TWA-WBGT in °C). Venous blood samples were collected to measure the levels of sodium, potassium, and aldosterone. Active sweat gland responses were measured using the modified starch-iodine technique. Multivariate general linear models of repeated measures were used to measure the effect of the following factors: season, exposure day, and occupation. The multivariate analysis showed significant seasonal effects on serum potassium, sodium, and aldosterone levels, and that exposure day influenced only potassium, not occupation. The monitoring sessions showed normal physiological levels of electrolytes in both occupational groups. Sweat gland activation was also significantly higher during the summer season. TWA-WBGT values above 23°C-25°C are associated with a higher probability of hyponatremia, as revealed by the receiver operating characteristic (ROC) analysis. These findings highlight the physiological adjustments associated with occupational heat exposure and emphasize the importance of hydration and heat mitigation strategies for outdoor workers.

10. Data-driven personalized surgical treatment selection for metopic and sagittal craniosynostosis.

期刊: Journal of neurosurgery. Pediatrics 发表日期: 2026-May-29 链接: PubMed

摘要

Although the choice of surgical treatment for craniosynostosis is based on patient age and phenotypic severity, there are no tools to objectively identify optimal treatment approaches. The authors present a quantitative study of how age, sex, and phenotypic severity affect the surgical outcomes of patients with midline craniosynostosis to support treatment selection. The authors collected pre- and postsurgical 3D photograms of patients with nonsyndromic single sagittal (n = 280) or metopic (n = 69) craniosynostosis, which they grouped into endoscopic strip craniectomy (ESC) or cranial vault remodeling (CVR) cohorts. The authors compared their surgical outcomes using the Head Shape Anomaly (HSA) index, Craniosynostosis Risk Score (CRS), and a novel Craniosynostosis Severity Index (CSI) that provides improved sensitivity to local malformations. Then, the authors quantitatively modeled the effect of age, sex, and presurgical severity on treatment outcomes and used their findings to create a decision tool to support treatment selection. ESC and CVR improved all morphology metrics in patients with sagittal craniosynostosis (p < 0.001). In metopic craniosynostosis, ESC improved the CRS (p < 0.001) and CSI (p = 0.01), CVR improved the CRS (p = < 0.001) but not the CSI (p = 0.15), and neither ESC (p = 0.10) nor CVR (p = 0.83) improved the HSA index. The authors’ model showed that ESC outperforms CVR in metopic and sagittal craniosynostosis before 3 and 5 months of age, respectively, as well as in nonsevere phenotypes of sagittal craniosynostosis before 8 months of age. The authors’ quantitative results can support personalized surgical treatment selections for patients with midline craniosynostosis and constitute a needed step to reduce the variability in treatment approaches and outcomes.

11. Effects of Multicomponent Digital Health Interventions on Multidimensional Physical Activity in Older Adults: Systematic Review, Meta-Analysis, and Meta-Regression of Randomized Controlled Trials.

期刊: Journal of medical Internet research 发表日期: 2026-May-29 链接: PubMed

摘要

The comprehensive effects of multicomponent digital health interventions (DHIs) on multidimensional physical activity indicators and sedentary behavior (SB) remain controversial. This systematic review aimed to evaluate the impact of multicomponent DHIs on daily steps, moderate-to-vigorous physical activity (MVPA), light physical activity, total physical activity, and SB in older adults. PubMed, Web of Science, Embase, The Cochrane Library, and CINAHL were searched up to February 20, 2026. Randomized controlled trials concerning multicomponent DHIs for promoting exercise behavior in older adults were included. RoB 2.0 was used to evaluate study quality. Meta-analyses were performed using the Hartung-Knapp-Sidik-Jonkman random-effects model, and 95% prediction intervals (PIs) were calculated via Nagashima adjustment to evaluate effect dispersion. The GRADE (Grading of Recommendations, Assessment, Development, and Evaluation) system was used to evaluate evidence certainty. A total of 26 randomized controlled trials (n=4129) were included. The results showed that multicomponent DHIs significantly improved daily steps (mean difference [MD] 822.8, 95% CI 198.3 to 1447.3 steps/d; 95% PI -1452.4 to 3098.0) and MVPA (MD 45.9, 95% CI 23.9 to 67.9 min/wk; 95% PI -9.4 to 101.2). However, the improvements in SB (MD -283.7, 95% CI -610.8 to 43.5 min/wk; 95% PI -984.5 to 417.1), total physical activity (MD 104.4; 95% CI -109.2 to 318.0 min/wk; 95% PI -444.4 to 653.2), and light physical activity (MD 39.3, 95% CI -96.2 to 174.7 min/wk; 95% PI -227.6 to 306.2) did not reach statistical significance. As some included studies combined digital tools with human support, the independent contribution of digital technology remains uncertain. PIs indicated a certain degree of dispersion across different clinical contexts. Subgroup analysis showed higher effect sizes for standalone wearables, human-assisted interventions, and populations with chronic disease risks. Meta-regression showed that effect sizes remained stable across different ages and durations. The trim-and-fill method confirmed the robustness of MVPA results. GRADE assessment indicated “moderate” certainty for MVPA and “low” for daily steps and other indicators. This systematic review suggests that multicomponent DHIs may serve as an effective means for enhancing daily steps and MVPA in older adults. The innovation lies in evaluating the true effect distribution of multicomponent DHIs through Hartung-Knapp-Sidik-Jonkman random-effects models and Nagashima PIs. Compared with previous studies, this review identified the impact of population characteristics and control group differences on effect estimates using PI and subgroup models, confirming that advanced age did not significantly diminish the good adaptability of older adults to DHIs. Evidence limitations include high heterogeneity, lack of long-term follow-up, and differences between objective and subjective measurement tools. In practice, priority should be given to hardware carriers with simplified interaction and integrated human support, with tailored strategies developed for different risk subgroups.

12. Creation of an mHealth Infrastructure to Support the Development and Delivery of mHealth Interventions: Protocol for Demonstration Projects Addressing Smoking Cessation in Cancer Care.

期刊: JMIR research protocols 发表日期: 2026-May-29 链接: PubMed

摘要

Cancer remains a leading cause of morbidity worldwide. To reduce this burden, scalable, effective approaches are needed to address modifiable risk factors for cancer and support behavioral self-management. With smartphone ownership now nearly ubiquitous, mobile health (mHealth) interventions offer a powerful means to extend the reach, accessibility, and sustainability of evidence-based treatments for a variety of modifiable risk factors (eg, excessive alcohol use, physical inactivity, poor diet, and smoking). Moreover, the flexibility of mHealth platforms enables efficient delivery of novel interventions, supports innovative study designs, and facilitates real-time data collection to advance public health research. Despite the great potential of mHealth interventions, developing high-quality mHealth tools is complex, time-consuming, and resource-intensive. To address these challenges, we are developing a coordinated, accessible, research-grade infrastructure for mHealth app development, testing, and dissemination. The mHealth Florida infrastructure (mFLi) will provide a comprehensive, low-code software platform that enables researchers to build apps compatible with major mobile operating systems, namely, Apple iOS and Google Android. Through a modular interface, users will select from a menu of prebuilt features to tailor functionality to specific study needs. The platform will include 3 integrated environments (development, testing, and production), allowing researchers to prototype, evaluate, and deploy mHealth interventions. This infrastructure will be developed and maintained by a multidisciplinary team, ensuring that the platform is technically robust and usable and adheres to institutional and regulatory standards. To demonstrate the platform’s functionality, utility, and adaptability, a multisite study comprising three initial projects focused on smoking cessation among patients with cancer is being conducted: (1) participant screening and enrollment, (2) randomization and treatment delivery, and (3) data processing using machine learning methods with on-device and cloud-based approaches. This study was funded in May 2023, and ethics approval was obtained from all involved sites’ institutional review boards between February 2024 and October 2025. Recruitment began in March 2025 and enrollment is ongoing. As of January 2026, 41% (37/90) of the target sample have been enrolled and 21% (19/90) have completed their 6-month assessment. Data collection will be completed once the final participant completes their 6-month assessment (expected May 2027), with analyses commencing thereafter. Study findings are anticipated to be published in a peer-reviewed journal in 2027. Collectively, these projects will illustrate how mFLi can streamline app development, facilitate rapid translation of research into practice, and reduce barriers for researchers and developers. Ultimately, mFLi is designed to accelerate innovation in mHealth research, enhance access to behavioral interventions, and improve health outcomes among diverse populations. ClinicalTrials.gov NCT06909357; https://clinicaltrials.gov/study/NCT06909357. PRR1-10.2196/92288.

13. Sexual Health in Patients Admitted to Geriatric Psychiatry Wards in Flanders (Belgium).

期刊: Issues in mental health nursing 发表日期: 2026-May-29 链接: PubMed

摘要

Ageist stereotypes hinder sexual health and rights in late life. These challenges are amplified for geriatric psychiatry patients, who face dual stigmas around sexual and mental health in old age. With this paper, we aim to get a better insight into the sexual health characteristics of patients admitted to geriatric psychiatry wards. Between July 2019 and March 2020, 100 inpatients from three geriatric psychiatry wards in Flanders (Belgium) participated in structured face-to-face interviews. The participation rate was 58%. Over 30% were sexually active, while 78% of inactive patients experienced physical tenderness in the past 12 months. Among sexually active participants, 77% were satisfied with their sexual life, compared to 68% of sexually inactive patients. One participant identified as non-cisgender, and 18% as non-heterosexual. Male patients were more likely to be sexually active than female patients (p = 0.033). On average, participants exhibited less knowledge about and/or more negative attitudes towards sexuality in later life (p = 0.030). Participants provided positive feedback during the interviews. Sexual health remains important in patients admitted to geriatric psychiatry wards. Limitations include restricted geographical scope and sample size, exclusion of cognitively impaired patients, lack of data on psychopharmaceutical use, and potential selection and cultural bias. Training, communication tools, and tailored care procedures on sexual health are urgently needed for professionals in geriatric psychiatry.

14. Online Information Behavior Regarding COVID-19 Vaccination and Its Association With Vaccination Behavior Based on Cluster Analysis of User Groups: Cross-Sectional Study.

期刊: JMIR infodemiology 发表日期: 2026-May-29 链接: PubMed

摘要

The COVID-19 pandemic highlighted the importance of effective health communication and reliable information for crisis management, particularly following the introduction of vaccinations. Varied attitudes toward COVID-19 vaccination and an overwhelming amount of online information complicated communication and pandemic management. Previous studies have often focused on general vaccination behavior and its correlation with vaccination attitudes, establishing a link between information-seeking and vaccination decisions. However, there is insufficient analysis distinguishing specific user groups based on their actual online information behavior regarding COVID-19 vaccination and examining its correlation with vaccination behavior. This study aims to fill this research gap by identifying user groups based on their information behavior and investigating its influence on vaccination uptake. As part of the “Internetnutzung zur COVID-19-Impfung” (INCOVI) study, 1000 individuals in Germany were surveyed online (November 26 to December 8, 2021) regarding their internet usage related to COVID-19 vaccination. A hierarchical cluster analysis was conducted to identify user groups. Logistic regression analyses were then used to explore correlations among the user groups and their demographic characteristics, readiness to vaccinate, knowledge of vaccination, and health literacy. Additionally, a logistic regression analysis was performed to identify the influence of user groups and other factors on vaccination behavior. A total of 3 user groups were identified: frequent and critical information evaluators (454/778, 58.4%), who primarily relied on official information sources, exhibited a higher level of health literacy, and were older than the other groups; infrequent and passive recipients (222/778, 28.5%), who rarely sought information actively and were younger than the other groups; and frequent and multichannel, interaction-focused users (102/778, 13.1%), who actively searched across multiple channels and engaged in information exchange. Notably, the user groups did not significantly differ in knowledge or willingness to vaccinate. User group affiliation, knowledge, and health literacy did not significantly influence vaccination behavior. The strongest predictor of vaccination was preexisting willingness to vaccinate. Additionally, women were more likely to be vaccinated than men, and individuals with medium or higher education levels were 6-11 times more likely to be vaccinated compared to those with only a basic level of education. Segmenting the population into different user groups allows for more targeted communication tailored to the specific needs and beliefs of each group. Because these groups stem from observable usage patterns, they constitute a transferable framework for other health topics. For frequent and critical information evaluators, providing well-founded and detailed information on public channels is important. Infrequent and passive recipients benefit from straightforward formats, such as short explanatory videos, while frequent and multichannel, interaction-focused users are better reached through interactive offerings on social media. By specifically targeting these groups, informed decision-making about vaccinations can be supported.

15. Daily Stress and Heart Rate Variability Among Mindfulness Meditation Practitioners: mHealth Observational Study.

期刊: Journal of medical Internet research 发表日期: 2026-May-29 链接: PubMed

摘要

Mindfulness meditation has been reported to reduce stress and enhance well-being. However, its effects on heart rate variability (HRV)-a physiological marker of stress-remain underexplored. This study aimed to examine how meditation practice is associated with subjective stress, HRV, and their interaction, using mobile health technologies. This 3-week observational study included 90 participants-19 meditation practitioners (meditation group), 32 recreational runners as an active control group characterized by lower stress and higher HRV (running group), and 39 individuals without regular meditation or exercise habits (control group). HRV was continuously recorded using Garmin smartwatches. Subjective stress levels and activity states were assessed 3 times daily through a smartphone-based experience sampling method, yielding a total of 4557 responses (mean 50.6, SD 22.8 per participant). From the meditation group, start and end times of 632 daily meditation sessions (mean 33.3, SD 18.3 per participant) were also collected via the app. Standardized questionnaires on stress and related measures were administered at the end of the study period. The questionnaire survey confirmed that stress levels were significantly lower in both the meditation and running groups compared with controls (median Perceived Stress Scale scores: meditation 21, IQR 17-24; running 22, IQR 19-25; control 25, IQR 21-30; Kruskal-Wallis P=.02; adjusted Wilcoxon P=.05 and .04, respectively). Smartwatch-derived HRV (root-mean-square of successive differences [RMSSD]) was elevated in the running group relative to controls (median 47.0, IQR 44.0-54.2 and median 42.0, IQR 34.2-47.8, respectively; P<.001), whereas no significant difference was observed between the meditation and control groups (median 40.8, IQR 35.5-44.4 and median 42.0, IQR 34.2-47.8, respectively). Bayesian analysis of the experience sampling method data indicated that higher subjective stress levels were associated with a concurrent RMSSD reduction of -2.24 (95% credible interval -3.97 to -0.26) milliseconds. Although this pattern was consistent across groups, the steeper decline of -3.94 (95% CI -7.04 to -0.74) milliseconds was observed only in the running group, likely reflecting their elevated baseline HRV. Additionally, Bayesian modeling of 632 logged meditation sessions revealed an acute RMSSD increase of +4.68 (95% CI 2.96 to 6.38) milliseconds during meditation, with effects maintained for at least 30 minutes post practice. Although HRV among meditation practitioners did not appear elevated in overall daily life, the ability to increase HRV at arbitrary timings, along with the prolonged residual effect, may correlate with stress reduction. This hypothesis requires further exploration with adequate controls. Despite the preliminary nature of this study due to its limited sample size, our findings highlight the potential of mobile health-based methodologies to capture stress and HRV dynamics in real-world settings.

16. Moving Forward Together: A Protocol to Co-Adapt and Scale a Videoconference-Delivered Physical Activity Intervention for Children and Adolescents Diagnosed With Cancer or Blood Disorders in British Columbia, Ontario, and the Maritime Provinces.

期刊: JMIR research protocols 发表日期: 2026-May-29 链接: PubMed

摘要

Physical activity (PA) is safe and beneficial for children and adolescents diagnosed with cancer, yet most engage in low levels of PA. We developed IMPACT (IMplementation of Physical Activity for Children and adolescents on Treatment), a PA intervention delivered by videoconference to enhance PA among young people during treatment for cancer and blood disorder diagnoses. IMPACT is being evaluated in a type II hybrid effectiveness-implementation trial in Alberta, Canada. While referral rates are high and early visual analyses suggest IMPACT may enhance PA and aspects of quality of life and physical function, participation, retention, and adherence rates are low. Findings signal the positive effect of IMPACT for those who participate and underscore the necessity of implementation adaptations. On the basis of these early findings, a demonstrated desire, and funding for PA at sites across Canada, we must first reimagine IMPACT through active collaboration with research users-those who will refer to and/or use or benefit from the intervention. Over the next 5 years, our larger research program will (1) co-adapt IMPACT and prepare for scaling (phase 1) and (2) implement and evaluate co-adapted IMPACT across additional provinces in Canada (phase 2). Specific aims for phase 1 are detailed herein and include (1) identifying necessary IMPACT modifications, (2) examining site-specific factors influencing IMPACT implementation, and (3) developing an implementation research logic model to guide continued scaling. An integrated knowledge translation and patient-oriented research approach and pragmatic orientation have been adopted. A multiple-perspective mixed methods study is underway. Descriptive surveys and interviews, guided by the Consolidated Framework for Implementation Research 2.0, are being conducted with key research user groups, including children and adolescents diagnosed with cancer and blood disorders (on- and off-treatment), carers, health care providers, and support organization personnel. Data will be analyzed using descriptive statistics and framework analysis. An implementation research logic model will be developed with participants and IMPACT co-adaptation advisory board members and program partners and collaborators. Funding was secured, and initial ethics approval was granted on June 10, 2025. Additional administrative and full approvals were secured subsequently. Recruitment started in July 2025 in British Columbia and is commencing across sites in a staggered manner. Full results (ie, all site-specific modifications and implementation strategies and the final version of the implementation research logic model) are expected to be submitted for publication late 2026. Co-adaptation of IMPACT with research users will enhance the likelihood of relevance, acceptability, and uptake nationally. The resulting data will inform a model to guide continued scaling and a larger trial evaluating the co-adapted IMPACT intervention across British Columbia, Ontario, and the Maritime provinces. This work reimagines IMPACT for broader applicability across varied Canadian contexts.. DERR1-10.2196/92574.

17. Evaluating Oncologists' Communication Strategies Regarding Molecular Testing and Immunotherapy.

期刊: JCO oncology practice 发表日期: 2026-May-29 链接: PubMed

摘要

In metastatic colorectal cancer (mCRC), testing for mismatch repair deficiency (dMMR) can identify patients who will benefit from immune checkpoint inhibitors (ICIs). Communication regarding molecular testing and ICI is challenging, with studies demonstrating that oncologists have varied knowledge of genomic testing and frequently use technical jargon, and patient understanding is poor. We aimed to characterize discussions of molecular testing and ICIs to identify effective communication strategies. We conducted an observational qualitative study from 2022 to 2023. We recruited US medical oncologists who treat colon cancer. Oncologists participated in recorded telehealth encounters with standardized patients with dMMR mCRC who were referred to discuss treatment. NVivo QSR 14 was used for transcription and code identification via content analysis. The study included 107 oncologists at 42 institutions across 27 US states who were contacted via email, and 21 (20%) participated. The median age was 41 years, 43% were female, and 33% were non-White. Average encounter duration was 44 minutes 5 seconds. The conversation structure was similar, but descriptions differed. MMR was described using variable terms, most commonly mutation (8/21) and protein loss (8/21). Almost all (20/21) oncologists discussed ICI, and over half (11/20) explained the mechanism. A minority of oncologists (5/21) reported response rates to immunotherapy (30%-70%) and informed of severe side effects. Oncologists uncommonly discussed next-generation sequencing (6/21), while over half (13/21) discussed germline testing. This nationwide sample of oncologists used variable descriptions when discussing MMR and ICI, as evidenced by the use of technical jargon and inconsistent inclusion of key topics, including the likelihood of response and severe adverse events. The use of a structured framework could help oncologists communicate key information to patients more effectively.

18. Assessing the Success Rate and Costs of Common Recruitment Strategies for a Community-Based Environmental Health Study.

期刊: Journal of public health management and practice : JPHMP 发表日期: 2026-May-29 链接: PubMed

摘要

Recruitment is a vital component of public health research to produce generalizable findings and analytical power for subgroup differences in health outcomes. Recruitment strategies in population-based health studies vary widely with limited information on response rates and expected costs. To evaluate recruitment strategies to better inform future recruitment planning and practices based on response rates, implementation costs, and demographics of enrolled participants. We cross-sectionally examined recruitment data from the Colorado Study on Community Outcomes from Per- and polyfluoroalkyl Substances (PFAS) Exposure (CO SCOPE). Passive strategies included announcements and word-of-mouth referrals; active strategies included in-person outreach via door-to-door canvassing and/or tabling at community events, and phone or email contact to participants from a previous study. We calculated response rates per population reached by each strategy and estimated costs of materials and staff time. In 2021-2023, we recruited and enrolled participants from 4 communities in El Paso County, Colorado. This site was part of a national multisite study of exposure to per- and polyfluoroalkyl substances in drinking water and associated health effects. We enrolled 916 adult participants (92% of our goal). Overall participant response rate across all strategies was 0.5%. Response rates were lowest after announcements (0.1%), and highest from direct contact with previous study participants (32.3%). In-person outreach accrued the greatest number of enrolled participants but also at the highest estimated cost ($242/enrolled participant). Word-of-mouth referrals recruited the greatest proportions of young adults (aged 18-34) and people with a high school education or less. Ultimately, the enrolled study population over-represented older adults, women, and non-Hispanic White people compared with the target communities. Recruitment strategies differed substantially in response rates and cost effectiveness. Word-of-mouth referrals and in-person outreach were most successful in recruiting diverse populations.

19. Evaluation and control of formaldehyde exposures in a modern university anatomy laboratory.

期刊: Journal of occupational and environmental hygiene 发表日期: 2026-May-29 链接: PubMed

摘要

A functional understanding of human anatomy is fundamental for students studying health and medical sciences. Formalin, which is a formaldehyde-saturated solution, continues to be used for the preservation and disinfection of human specimens for teaching because other formalin substitutes are not readily available, practical, or preferred. The continued use of formalin exposes anatomy technicians who dissect human specimens to acute and chronic health effects, which has led to Australia’s national government policy agency, Safe Work Australia, to pursue lower permitted airborne formaldehyde workplace exposure limits (WEL). During this study, 14 personal airborne samples were collected to calculate the geometric mean and 95th percentile of the formaldehyde 8-hr time-weighted average (8-hr TWA) and short-term exposure limit (STEL) for comparison to the current Australian WES and proposed Australian formaldehyde WELs. Three participants were recruited for the study and participated in formaldehyde air sampling and completed a questionnaire after each monitoring session to report formaldehyde exposure symptoms. The calculated 8-hr TWA and STEL geometric means were 1.1 and 1.4 ppm respectively, and the 95th percentile of both the 8-hr TWA and STEL exceeded the current Australian WES and proposed WELs. Questionnaire responses identified participants had experienced formaldehyde exposure symptoms related to itching eyes, inflamed eyes, headaches, and discomfort during dissection. Lower formaldehyde concentrations were identified during dissection in a dedicated dissection room where a partially effective dissection table with downdraft local exhaust ventilation and a laboratory fume hood were utilized, compared to teaching rooms with no local exhaust ventilation system. Formalin use continues to remain an occupational hazard for anatomy technicians who perform dissection, and careful attention is required toward implementing effective control measures such as substituting formalin with other suitable solutions, reducing formalin concentrations in embalming solutions, installing local exhaust ventilation systems, and using suitable personal protective equipment.

20. Psychosocial Stress in the Chinese Community: Speech Analytics Through Linguistic and Acoustic Fusion Using Machine Learning.

期刊: JMIR biomedical engineering 发表日期: 2026-May-29 链接: PubMed

摘要

Family caregivers experience significant stress due to intensive caregiving activities, making them highly susceptible to adverse psychosocial health conditions. Early detection of this stress is crucial for timely interventions to prevent disease progression and long-term disability. This study aimed to develop and validate the Linguistic and Acoustic Speech Analytics Program, a novel machine learning approach capable of providing a fusion analysis of linguistic and acoustic speech features to enhance the effectiveness of psychosocial stress assessment. This quantitative study analyzed speech data collected from 100 Chinese family caregivers. Participants responded to 12 open-ended questions, and their voices were recorded for linguistic and acoustic feature extraction. Various machine learning classifiers, including support vector machine, were developed to process speech data. A key methodological step was the application of an orthogonalization procedure to decorrelate acoustic features from linguistic features before fusion analysis. The classifiers were then trained to evaluate psychosocial stress levels based on the processed and fused linguistic and acoustic speech features. Model performance was measured using receiver operating characteristic-area under the curve, F1-score, and accuracy. The linear support vector machine model emerged as the top performer, achieving a receiver operating characteristic-area under the curve of 78.28%, an F1-score of 75.27%, and an accuracy of 73%. These results demonstrate the model’s strong capability in identifying stressed participants based on their speech. Critically, the fusion of linguistic and acoustic features significantly outperformed models using either feature type alone. Furthermore, the orthogonalization procedure proved essential, as decorrelating features before fusion markedly enhanced classification accuracy compared to using non-orthogonalized features. This study demonstrates that fusion analysis of linguistic and acoustic features effectively identifies psychosocial stress among family caregivers. It also emphasizes the importance of proper feature processing when combining multiple features extracted from the same audio sample. These findings provide valuable insights for developing machine learning models for psychosocial stress assessment and addressing various psychosocial conditions in different contexts, supporting population mental health management.

21. Understanding mHealth Engagement Among Patients With 30-Day Hospital Revisits: Secondary Analysis of a Randomized Clinical Trial.

期刊: Journal of medical Internet research 发表日期: 2026-May-29 链接: PubMed

摘要

Reducing 30-day hospital readmissions has been a long-standing goal across health systems in the United States. While nurse-led phone outreach has been widely adopted to support transitional care, its reach is constrained by staffing and time limitations. Mobile health (mHealth) interventions, such as automated SMS text messaging and patient portals, offer scalable alternatives but have shown mixed effectiveness in reducing readmissions. Understanding how patients engage with mHealth after discharge may help optimize these tools for postdischarge care. This study aimed to characterize patients in an mHealth transitional care program who experienced hospital revisits within 30 days of discharge, comparing demographic and clinical characteristics, intervisit interactions, and revisit features between those who engaged with mHealth and those who did not. We conducted a secondary analysis of patients in the intervention arm of the Mobile Outreach to Reduce Emergencies-Primary Care randomized clinical trial. Participants received automated SMS text messages for 30 days after discharge alongside usual transitional care. We identified patients with a 30-day hospital revisit and conducted manual chart reviews to assess mHealth engagement and other forms of health care contact. We compared patient characteristics, intervisit interactions, and revisit features (time to revisit, relatedness to index hospitalization, and predictability of revisit) between mHealth users and nonusers. Among 496 patients with a 30-day revisit, 185 (37%) engaged with mHealth before their return. mHealth users were younger (n=47, 26% aged <50 years vs n=41, 14% among nonusers; P=.004) and more likely to have commercial insurance (n=43, 23% mHealth users vs n=35, 11% mHealth nonusers; P=.005). Revisits were more likely to be rated highly or somewhat predictable among mHealth users compared to nonusers (n=105, 56% vs n=152, 49%; P=.04), while relatedness to the index hospitalization was similar (n=98, 53% vs n=173, 55%; P=.09). mHealth users had a longer mean time to revisit than nonusers (15.2, SD 8.1 vs 11.3, SD 8.4 days; P<.001) and were more likely to contact their practices via telephone (n=100, 54% vs n=136, 44%; P=.03) or attend a clinic visit (n=112, 61% vs n=131, 42%; P<.001). Among patients enrolled in an mHealth postdischarge program who experienced hospital revisits, fewer than half engaged with mHealth prior to their return. Revisits among mHealth users occurred later and were more predictable, suggesting that engagement may enhance situational awareness but not necessarily prevent revisits. Future work should focus on strategies to increase engagement across groups and integrate mHealth with existing transitional care infrastructure.

22. Extreme Weather Events and Disruptions to Cancer Care: How the Oncology Community Can Prepare.

期刊: JCO oncology practice 发表日期: 2026-May-29 链接: PubMed

摘要

Extreme weather events are increasing in frequency and severity, disrupting health care services across the cancer care continuum. Oncology professionals and patients are directly affected by these events, yet preparedness and resilience planning specific to cancer care remain limited. This commentary synthesizes current knowledge on the impacts of extreme weather events on oncology care and draws on lessons from prior disasters to highlight opportunities for action. Three illustrative case studies regarding Hurricane Katrina, California wildfires, and Texas Winter Storm Uri highlight commonalities between different types of disasters and geographic locations, including patterns of disruption related to infrastructure damage, power outages, workforce strain, and challenges to continuity of care. Existing evidence-informed strategies to enhance resilience across clinical, institutional, and policy domains include integrating climate resilience into clinical training and practice, adapting infrastructure and operations, reviewing local climate vulnerabilities, and strengthening partnerships with community organizations. As extreme weather events increasingly threaten cancer care delivery and patient outcomes, proactive, coordinated efforts by oncology professionals and health systems are essential to maintain high-quality care in a changing environment.

23. Patient- and Physician-Identified Considerations for Clinical Implementation of a New Risk-Based Prediction Tool to Guide Surveillance Mammography in Breast Cancer Survivors.

期刊: JCO oncology practice 发表日期: 2026-May-29 链接: PubMed

摘要

Patient, tumor, and treatment factors can help predict the chance that a woman with a history of breast cancer diagnosis will be diagnosed with a second breast cancer within a year of a negative mammogram. This qualitative study elucidates breast cancer survivor and multispecialty physician perspectives on barriers/facilitators to clinical implementation of a risk-prediction tool to support surveillance decisions. We enrolled women who completed primary breast cancer treatment and physicians from November 2023 to April 2024. Participants were recruited through Breast Cancer Surveillance Consortium’s registries; patients participated in one of four focus groups and physicians participated in individual semistructured interviews. Participants were presented with information about an interval cancer risk prediction tool and were prompted to share perspectives on facilitators and barriers to using such a tool. To identify salient themes, thematic analysis was undertaken by three research team members. Participants included 40 physicians and 23 patients. Three themes emerged: (1) evidence needed for tool acceptance, (2) tool features to facilitate usage, and (3) barriers to tool adoption. Both cancer survivor and physician groups were accepting of risk prediction tool use for surveillance imaging when tool development information was available; they perceived the tool would fit within workflows, and data integrity could be verified. Both groups anticipated structural (time) and technological barriers (magnetic resonance imaging availability) could impede adoption. Qualitative findings from focus groups and interviews analyzed thematically suggest implementing a risk prediction tool for surveillance imaging requires evidence transparency, health record integration, data integrity protection, and system supports to promote ease of use in clinical settings while mitigating unintended consequences. All are important to consider during tool development and implementation planning.

24. Eczema Action Plans: Do They Improve Objective Disease Outcomes?

期刊: Clinical and experimental dermatology 发表日期: 2026-May-29 链接: PubMed

摘要

Eczema action plans have emerged as a management tool for eczema. Recent studies investigated the efficacy of the eczema action plans in improving quality of life and disease severity. This study aims to examine the effectiveness of eczema action plans in improving eczema. A search was conducted using MEDLINE, EMBASE, and SCOPUS databases for clinical trials evaluating eczema action plans in eczema management. Five studies (four randomized, one non-randomized) showed no objective improvement in atopic dermatitis severity or quality of life with eczema action plans. Eczema action plans improved patient knowledge, confidence, and satisfaction, but these did not translate to clinical outcomes, possibly due to complex regimens hindering adherence.

25. Intergenerational Differences in Cultural Capital and Food Promotion Perceptions: Evidence from Urban Indian Families.

期刊: Ecology of food and nutrition 发表日期: 2026-May-29 链接: PubMed

摘要

This study examines intergenerational differences in cultural capital and attitudes toward marketing of high-fat, sugar, and salt (HFSS) foods in urban, middle-class Indian households. A survey of parents (n = 218) and co-residing grandparents (n = 40) assessed values, food-related skills, and nutrition knowledge. The questionnaire incorporated validated multi-item scales measuring general human values, social beliefs, and nutrition-related competencies, thereby operationalizing cultural capital across embodied, institutionalized, and objectified dimensions. Parents scored higher on food information skills and sugar and protein knowledge, aligning with health discourse and media literacy. Grandparents relied on traditional caregiving and culinary practices. Drawing the forms of capital framework, findings revealed selective intergenerational contrasts in nutrition literacy and policy receptivity, while awareness of promotional environments remained largely convergent across cohorts, indicating that intergenerational negotiation occurs primarily at the level of interpretive evaluation rather than exposure itself.

26. Teeth Clenching Improves Selective Response and Shortens Reaction Time.

期刊: Journal of strength and conditioning research 发表日期: 2026-May-29 链接: PubMed

摘要

Sugai, N, Hirabayashi, R, Okada, Y, Yoshida, Y, Okouchi, T, Yokota, H, Ishigaki, T, Komiya, M, Sakamoto, K, and Edama, M. Teeth clenching improves selective response and shortens reaction time. J Strength Cond Res XX(X): 000-000, 2026-In sports, rapid decision making and quick reactions are vital for optimal performance. Enhancing reaction time in choice to respond, task-based tasks require efficient cognitive processing and motor output. This study examined the effects of teeth clenching and clenching balance on reaction time. Teeth clenching has been shown to boost muscle activity and cognitive function; however, imbalanced clenching between the left and right sides may negatively affect performance. Twenty-two right-handed subjects with normal occlusion and 28 or more teeth completed a forward stepping task under 3 clenching conditions: no clenching without dental contact (No-CL), moderate clenching (Moderate-CL), and maximal clenching (Max-CL). Reaction time was assessed through the soleus muscle (Sol) activity, including Sol reaction time, release time, and grounding time. Results showed significantly shorter Sol reaction, release, and grounding times under Moderate-CL and Max-CL conditions than under no-CL (p < 0.05). In subjects with balanced clenching, all 3 measures improved significantly under clenching conditions (p < 0.05). However, those with clenching imbalance showed improvement only in Sol reaction time (p < 0.05). Furthermore, a significant positive correlation was found between clenching imbalance and changes in reaction time, particularly for release time and overall reaction time under clenching conditions (r > 0.37, p < 0.05). These findings suggest that clenching can enhance spinal excitability and cognitive performance through activation of the locus coeruleus, potentially improving reaction ability in sports and daily life. However, clenching imbalance may limit these benefits, highlighting the importance of considering clenching balance in future research and performance strategies.

27. Health personality and health-related quality of life after temporary ileostomy closure in rectal cancer survivors: a comparative study of open and laparoscopic surgery groups.

期刊: Psychology, health & medicine 发表日期: 2026-May-29 链接: PubMed

摘要

Data on health personality and its association with outcomes of surgery have not been explored thus far. People with rectal cancer who underwent different surgical procedures might have distinctive perception of their health condition, because the open surgery scar is clearly visible as opposed to considerably smaller scarring after laparoscopic cancer removal. The purpose of this study was to examine the association of health personality traits with physical and mental quality of life in rectal cancer survivors after the end of the surgical treatment. This cross-sectional study included two groups of patients: one having had an open rectal cancer removal and another who had cancer removed laparoscopically from Jan 1, 2018 to Dec 31, 2021. Both groups had a temporary ileostomy, which was closed later on. Data collection was carried out from June 2022 to April 2023 by using the general questionnaire, Health Personality Assessment, SF-36 (mental and physical composite scores, MCS and PCS), Patient Health Questionnaire-2 and electronic medical records. A total of 81 patients who underwent open and 53 patients who underwent laparoscopic surgery were studied. They achieved a PHQ-2 score of 2 out of 6 in both study groups, thus below the depression threshold. In the open surgery group, lower Health Neuroticism and higher Health Agreeableness were associated with higher PCS and MCS. In the laparoscopic surgery group, lower Health Neuroticism was associated with better MCS. Also, higher Health Extraversion was associated with better PCS and MCS in the laparoscopic group. This research provides evidence that health personality could be a contributor to better physical and mental quality of life among rectal cancer survivors. Surgeons who manage patients with rectal cancer should be mindful of individual health personality traits. Through their support and responsiveness, surgeons are able to positively influence the physical and mental health of their patients.

28. Exploring Health Priorities in the Barbershop: A Modified Delphi Study of Barbers' and Clients' Views on What is Important and What is Feasible.

期刊: Journal of community health 发表日期: 2026-May-29 链接: PubMed

摘要

Barbershops are a place of cultural significance for many Black men and have been the site of successful health promotion programming; yet, efforts conducted in barbershops should recognize the contextual and organizational constraints of the site. The present study used a modified Delphi poll to identify health topics that were important among Black men and feasible to address in the barbershop according to barbers (Round 1) and clients (Round 2). A total of 63 individuals participated in this study (n = 29 barbers and n = 34 clients). Barbers were presented with 54 health topics and were asked to rate the importance and feasibility of addressing each health topic among Black men in the barbershop. Results were then plotted in a Go-Zone plot with four quadrants-(Go-Zone 1) high importance and feasibility;(Go-Zone2)low importance and high feasibility;(Go-Zone3) low importance and feasibility ;and(Go-Zone4)high importance and low feasibility. Results in Go-Zones 1, 2, and 4 were then presented to clients. Results were then plotted again and t-tests were performed to examine differences between barbers and clients. Final results visually display the importance/feasibility of each health concern according to barbers and clients. Additionally, t-test analyses indicate that barbers view health concerns as more important/feasible than their clients. The results of this study have important implications for the contextually-aligned design and implementation of health promotion programming in barbershops.

29. Forensic application of CAMP expression for the determination of wound vitality in human compressed neck skin.

期刊: International journal of legal medicine 发表日期: 2026-May-29 链接: PubMed

摘要

Determining whether ligature marks represent antemortem or postmortem injuries is a critical issue in forensic practice because this distinction directly influences the reconstruction of perimortem events. Consequently, assessing the vital reaction of neck skin plays an essential role in evaluating the viability of compression-related injuries. Cathelicidin antimicrobial peptide (CAMP), a multifunctional host-defense peptide involved in inflammation, immune cell recruitment, and wound repair, may serve as a reliable molecular marker for wound vitality. In this study, we examined CAMP expression in 40 ligature mark samples (32 samples of hanging and 8 samples of ligature/manual strangulation) obtained during forensic autopsies, along with matched intact skin controls, all with postmortem intervals of ≤ 3 days. Immunohistochemistry revealed strong CAMP expression in epidermal keratinocytes and moderate expression in dermal cells at compression sites, whereas control skin showed only faint or absent staining. Morphometric analysis demonstrated that the ratio of CAMP‑positive keratinocytes and the number of CAMP-positive dermal cells were significantly higher in compressed skin than in controls, independent of age, sex or postmortem interval. Moreover, neither ligature type nor mode of neck compression also had no influence on CAMP expression in the keratinocytes or dermal cells. These findings indicate that CAMP expression reflects a biological response to antemortem neck compression and may provide an objective molecular marker for assessing wound vitality in forensic pathology. Furthermore, combining CAMP with other established biomarkers may enhance diagnostic reliability when evaluating antemortem neck compression injuries.

30. Clinical practice guidelines for telesurgery, 2nd Edition : Committee for the Promotion of Remote Surgery Implementation, Japan Surgical Society.

期刊: Surgery today 发表日期: 2026-May-29 链接: PubMed

摘要

Recent advances in surgical robotic systems, high-speed communication networks, and information processing technologies have made the clinical implementation of remote surgery increasingly feasible. Although pilot clinical applications have been initiated worldwide, the safe, ethical, and sustainable adoption of remote surgery requires comprehensive guidance that addresses not only technical considerations, but also clinical practice, legal responsibility, and organizational frameworks. In response to these needs, the Japan Surgical Society has developed the second edition of the Clinical Practice Guidelines for Telesurgery through a multidisciplinary, consensus-based process involving multiple surgical societies. This updated edition builds on validation and verification studies conducted since the publication of the first edition and places particular emphasis on practical implementation in real-world clinical settings, including telesurgical support and telementoring. The guidelines provide expanded, implementation-oriented recommendations covering surgeon and support staff qualifications, institutional requirements, communication network performance and cybersecurity standards, registry-based governance, and structured approaches to remote surgical mentoring. In addition, legal and ethical considerations are strengthened through the inclusion of representative informed consent documents and contractual frameworks. To enhance international applicability, content that is broadly relevant across jurisdictions is presented separately from elements specific to the Japanese regulatory environment. These guidelines aim to support the responsible global dissemination of telesurgery by promoting safety, transparency, and clinical effectiveness.

31. Discovery of a Novel Potent and Orally Efficacious PGK1 Inhibitor C67-47 for the Treatment of Human Pancreatic Cancer.

期刊: Journal of medicinal chemistry 发表日期: 2026-May-29 链接: PubMed

摘要

Phosphoglycerate kinase 1 (PGK1), the first ATP-generating enzyme in glycolysis, is frequently overexpressed in a wide range of human malignancies. Beyond its canonical glycolytic function, PGK1 also functions as a protein kinase playing a critical role in tumorigenesis and cancer progression. Here, we report the identification of a novel and highly potent PGK1 inhibitor through structure-based high-throughput virtual screening, exemplified by compound 42 (C67-47). C67-47 binds strongly to PGK1 with a dissociation constant (Kd) of 63 nM and exhibits potent antiproliferative effects in pancreatic cancer cells. In preclinical studies, C67-47 demonstrated excellent oral pharmacokinetics in both mouse and rat models. Strikingly, a single oral dose of C67-47 resulted in up to 80% tumor growth inhibition in pancreatic cancer xenograft models with no observable toxicity. These findings establish C67-47 as a promising lead compound for the development of orally administered, PGK1-targeted therapies for pancreatic cancer.

32. Development and External Validation of a Machine Learning-Based Risk Classification Score for Prostate Cancer-Specific Cardiovascular Risk.

期刊: JCO oncology practice 发表日期: 2026-May-29 链接: PubMed

摘要

Patients with prostate cancer (PC) face elevated cardiovascular (CV) risk. Conventional CV risk scores are often poorly calibrated for PC and require laboratory tests that are not routinely available in PC clinics, limiting oncology use. The development cohort (DC) included men with PC (age ≥18 years) diagnosed in 2010-2014. Validation cohort 1 (V1) included men age 45 years and older within 1 year of PC diagnosis or near initiation of androgen deprivation therapy. Validation cohort 2 (V2) included men with PC diagnosed in 2006-2019. Outcomes were cardiovascular disease (CVD), atherosclerotic CVD (ASCVD), and heart failure (HF). Predictors were selected with XGBoost and LASSO, modeled with Fine-Gray and penalized Cox regression, and scaled to additive point scores (low/intermediate/high risk). Performance was assessed using time-dependent AUC (TDAUC), which quantifies the model’s ability to correctly rank patients by risk at each time point, and compared with conventional scores. The DC included 1,815 patients, and V1 and V2 included 4,022 and 1,729 patients, respectively (median follow-up 10.3 years). At 10 years, cumulative incidence was 15.0% for composite CVD, 9.4% for ASCVD, and 10.1% for HF. The composite CVD score (age, race, smoking history, high-risk Gleason score, and household members) achieved a 10-year TDAUC of 0.71 (95% CI, 0.64 to 0.78) in the DC and 0.59 (95% CI, 0.52 to 0.65) in V2, with a 2-year TDAUC of 0.66 (95% CI, 0.56 to 0.75) in V1. In the DC, ASCVD and HF scores achieved 10-year TDAUCs of 0.66 (95% CI, 0.58 to 0.75) and 0.70 (95% CI, 0.62 to 0.79), respectively, and retained discrimination in validation. To our knowledge, these are the first PC-specific CV risk scores derived from oncology-available variables, supporting pragmatic CV risk stratification in PC clinics and motivating further validation and implementation studies.

33. Global Trends and Research Hot Spots in Medication Regimen Simplification: Bibliometric Analysis.

期刊: JMIR aging 发表日期: 2026-May-29 链接: PubMed

摘要

Medication regimen simplification has gained increasing attention as a strategy to reduce treatment burden and improve medication use. However, the overall development, knowledge structure, and emerging themes of this field have not been systematically mapped, hindering efforts to identify clear research priorities and support strategies that facilitate the translation of simplified approaches into optimized medication management. This study aimed to examine global research trends, collaboration patterns, and research hot spots in medication regimen simplification. A bibliometric analysis was conducted to characterize the research landscape of medication regimen simplification. Publications from the Web of Science Core Collection (January 1, 2005, to December 31, 2025) were analyzed using Microsoft Excel 365, VOSviewer, CiteSpace, and Bibliometrix in R for publication trends, countries and regions, institutions, authors, cocited references, keyword co-occurrence, clustering, and thematic evolution. A total of 468 publications were included in this bibliometric analysis. Annual publication output showed an upward trend, although fluctuations occurred across years. The United States ranked first in publication output and total citations, and Monash University was the most productive institution. Collaboration was concentrated in a limited number of country, institutional, and author clusters, with the strongest international links between North America and Europe. Cocitation and keyword analyses showed that the field evolved from a focus on HIV-related regimen optimization and medication adherence to broader themes in chronic disease management, including type 2 diabetes, heart failure, long-term care, and medication regimen complexity. Research on medication regimen simplification has grown over time, but collaboration remains relatively concentrated. Current hot spots center on its use in specific disease settings and on medication complexity and adherence, whereas recent trends highlight real-world implementation. Future research should further examine the long-term impact and sustainability of simplification strategies.

34. Experiences and Perceptions Within a Co-Created Drone Transport Initiative With Rural First Nation and Non-First Nation Communities: Semistructured Interview Study.

期刊: Journal of participatory medicine 发表日期: 2026-May-29 链接: PubMed

摘要

People living in rural areas of British Columbia experience inequities in access to health care that impact health and well-being. Since time immemorial, Indigenous peoples have had a holistic understanding of health and wellness, and knowledge of healthful ways of living. However, in a rural context, Indigenous peoples contend not only with inequitable access to health care, but also with the historical and ongoing impacts of colonization. Virtual health innovations enable access to care closer to home, yet the need for diagnostic tests and essential medicines remains limited by supply chains. In this context, transport of medical supplies by drone offers a promising solution and has the potential to improve access to health care in rural and First Nations communities in British Columbia. The Drone Transport Initiative is a co-created health care innovation project between the Stellat’en First Nation, the Village of Fraser Lake, the University of British Columbia, and other health system partners that investigated the feasibility of drones to transport medical supplies in a rural British Columbian context. This analysis aimed to understand the experiences and perceptions of the Project Team, people directly involved in the Initiative. Twenty members of the Project Team, including representatives from the Steering Committee and Operational Team having diverse roles within the project, participated in semistructured interviews. Eleven interviews were conducted either individually (n=5), in pairs (n=5), or in a group of 5 (n=1). Interviews were audio-recorded, transcribed verbatim, and anonymized. A reflexive thematic analysis was conducted to understand the Project Team’s experiences and perceptions of the project. Initial results were shared with coauthors, including project cosponsors and community members, to interpret the findings and formulate discussion topics. Participants generally expressed positive experiences from being part of the Drone Transport Initiative, despite remarking on various challenges. Major themes derived from the analysis centered upon (1) building respectful and trusting relationships, (2) mutual benefits that enabled effective and engaged partnerships, (3) meaningful community engagement that facilitated community acceptance and ownership of the project, and (4) this project is “the first step of something big.” Themes were further divided into subthemes characterized as processes or outcomes. In this work, we highlight a health innovation project grounded in relational approaches and partnerships, where rural and First Nations communities are champions of advancing their development goals and co-creating solutions that address key social determinants of health. We contribute to the literature by emphasizing the relational foundation that is necessary at the cutting edge of innovation to co-create, implement, and sustain drone projects with rural and First Nations communities.

35. Bispecific MASP-2/3 Antibody Provides Superior Renoprotection Over Monotherapy in Pristane-Induced Lupus Nephritis.

期刊: Clinical and experimental immunology 发表日期: 2026-May-29 链接: PubMed

摘要

Lupus nephritis (LN) is a major cause of organ damage in systemic lupus erythematosus (SLE) and is driven in part by overactivation of the lectin pathway (LP) and alternative pathway (AP) of complement. Mannan-binding lectin-associated serine protease-2 (MASP-2) initiates LP through C4/C2 cleavage, whereas MASP-3 enables AP amplification by activating pro-factor D. We hypothesized that concurrent inhibition of both proteases would provide superior renoprotection compared with single-pathway blockade in established disease. Female BALB/c mice with pristane-induced LN received anti-MASP-2, anti–MASP-3, bispecific antibodies, or vehicle for 4 weeks. Bispecific MASP-2/3 inhibition produced greater improvements in albuminuria, renal activity index, and glomerular C3d and C5b-9 deposition than either monotherapy. Functional assays confirmed selective LP suppression with MASP-2 blockade and AP suppression with MASP-3 blockade, whereas dual inhibition maximally reduced both pathways and their downstream complement effectors. Kidney transcriptomics demonstrated broad down-regulation of complement, coagulation, and inflammatory gene networks. Together, these findings indicate that bispecific MASP-2/3 blockade provides robust complement-directed protection in established LN and may represent an effective therapeutic strategy for complement-mediated kidney disease.

36. A STAT1/ETC/GBP1 axis represents a potential therapeutic target for noncommunicable granulomatous skin disease.

期刊: Science advances 发表日期: 2026-May-29 链接: PubMed

摘要

Granuloma annulare (GA) and cutaneous sarcoidosis (cSAR) have an overlapping immunopathology, in which the aberrant activation of macrophages by IFN-γ constitutes a central driver. Nevertheless, the molecular understanding in GA and cSAR macrophages remains limited. We reanalyzed single-cell RNA sequencing data of GA and cSAR and performed in vitro experiments with primary human cells showing that oxidative phosphorylation (OXPHOS) is a dominant metabolic pathway in IFN-γ-activated macrophages. Furthermore, we identify an IFN-γ-induced response network in GA and cSAR macrophages, sensitive to electron transport chain (ETC) inhibitors. Guanylate-binding protein 1 (GBP1) was central in controlling IFN-γ-mediated macrophage activation. Meanwhile, inhibition of IFN-γ signaling, ETC complexes, and GBP1 reduced granuloma formation in a human in vitro model. Metformin, a clinically used ETC complex I inhibitor, suppressed IFN-γ activation of macrophages and in vitro granulomas. Together, we suggest that OXPHOS and GBP1 represent druggable targets in granulomatous diseases and that drug repurposing of metformin is a possible strategy.

37. DHX36 is a regulatory switch in the interferon-mediated antiviral response.

期刊: Science advances 发表日期: 2026-May-29 链接: PubMed

摘要

Innate immune and stress responses must be tightly regulated to prevent aberrant activation in the absence of pathogens. The RNA helicase DHX36 has been implicated in viral RNA sensing, but its role in immune regulation is not fully understood. Here, we show that DHX36 functions as a rheostat that restrains immune activation under homeostatic conditions while modulating antiviral signaling. Exposure to double-stranded RNA reduces DHX36 activity, enabling immune activation. In contrast, cells lacking DHX36 adopt a constitutively activated immune state characterized by accumulation of RNA G-quadruplex structures, protein kinase R (PKR)-dependent stress granule formation, and elevated interferon-stimulated gene expression. These cells also display enhanced responsiveness to the viral RNA sensor retinoic acid-inducible gene I (RIG-I) and more effectively suppress replication of a yellow fever virus replicon. Together, our findings position DHX36 as a key regulator of the type I interferon response, linking RNA structure surveillance to coordinated PKR- and RIG-I-dependent antiviral signaling and maintenance of immune homeostasis.

38. Advantages of vertebral coplanar alignment technique for restoring physiological thoracic kyphosis in hypokyphotic adolescent idiopathic scoliosis with < 10° of kyphosis.

期刊: Journal of neurosurgery. Spine 发表日期: 2026-May-29 链接: PubMed

摘要

Conventional segmental pedicle screw fixation for thoracic adolescent idiopathic scoliosis (AIS) often compromises the ability to restore physiological thoracic kyphosis (TK). The vertebral coplanar alignment (VCA) technique addresses 3D deformity correction on the convex side in thoracic scoliosis. In particular, it enhances sagittal plane correction by adding kyphotic contouring via the concave-side rod while preserving the ideal thoracic curvature, including the physiological TK apex location on the convex side. This multicenter cohort study aimed to analyze the surgical outcomes of the VCA technique and demonstrate its effectiveness in restoring physiological TK in hypokyphotic AIS patients with < 10° of kyphosis. Data from 127 consecutive patients who underwent corrective surgery using the VCA technique for hypokyphotic (TK < 10°) thoracic AIS at 13 institutions, with a minimum follow-up of 2 years, were retrospectively analyzed. Outcome measures included patient demographics, radiographic parameters, TK apex location, and Scoliosis Research Society (SRS)-22 scores assessed preoperatively and at 2 years postoperatively. The mean main thoracic Cobb angle improved significantly from 55.0° to 14.1° at 2 years postoperatively, with a mean correction rate of 74%. The mean TK (T5-12) increased significantly from 4.4° to 19.5°. The proportion of patients with the TK apex located at T6-8 significantly increased from 22% to 73%. The mean SRS-22 total score improved from 3.6 to 4.5 at 2 years postoperatively. This multicenter study highlights the advantages of VCA, particularly in restoring physiological TK in hypokyphotic (TK < 10°) thoracic AIS. The VCA procedure contributed to maintaining an ideal thoracic shape with the physiological TK apex on the convex side prior to rod placement and before performing various manipulations via the rod on the concave side.

39. A customized system for whole-body vibration measurement.

期刊: Journal of occupational and environmental hygiene 发表日期: 2026-May-29 链接: PubMed

摘要

This manuscript describes the technical components and performance of a custom whole-body vibration (WBV) instrumentation system designed for autonomous, prolonged field measurement. The study demonstrated the technical readiness of the system’s accelerometers. The system integrates a Teensy 4.1 microcontroller, triaxial microelectromechanical system accelerometers, force sensing resistors, global positioning system module, and microSD data storage. The accelerometers were validated against reference accelerometers commonly used in field-based WBV measurement using a motion simulator programmed with complex vibration input profiles specified in ISO 7096:2020 Earth-Moving Machinery-Laboratory Evaluation of Operator Seat Vibration for testing operator seat vibration in earth moving machinery. In the time domain, accelerometers in the custom WBV instrumentation system exhibited ≤ 2.21% error in root-mean-square (RMS) amplitude measurements and < 0.03 g sample-to-sample RMS deviation from the reference accelerometers. Frequency-domain analysis (1/3-octave band) suggested slight underestimation of signal power at low frequencies (≤10 Hz), but the differences were practically small at each 1/3-octave band. Ultimately, the system will enable WBV monitoring in settings in which operators are remote and/or the schedule of machine operation is variable (e.g., agriculture). Future work will focus on real-world validation and exploring use of the force sensing resistors to characterize operator posture, further enhancing the system’s utility in occupational WBV exposure monitoring.

40. Mathematical optimization of filters used in N95 filtering facepiece respirators.

期刊: Journal of occupational and environmental hygiene 发表日期: 2026-May-29 链接: PubMed

摘要

The filter used in an N95 filtering facepiece respirator (FFR) has a collection efficiency and pressure drop that are primarily influenced by filter depth and solidity, as well as the average diameter and electrostatic charge of its fibers. A sensitivity analysis was performed to determine the influence of each property on particle collection efficiency at the most penetrating particle size (MPPS) and pressure drop using previously verified N95 FFR filter performance models. Collection efficiency was most influenced by changes in filter solidity and least influenced by fiber charge. Likewise, pressure drop was most influenced by fiber diameter, least influenced by changes in filter depth, and was not affected by fiber charge. Given the competing desire for low pressure drop and high collection efficiency, the use of a quality factor demonstrated that increasing filter charge and fiber diameter had a nearly equal positive association with overall filter efficacy. A filter optimization process was also conducted that employed a non-linear optimization routine to first determine the filter depth required to obtain a collection efficiency criterion of ≥ 95% collection efficiency at the MPPS for sets of fiber diameter and filter solidity values, and to determine the pressure drop resulting from each combination of the three property values while holding fiber charge constant. This analysis demonstrated that filters with low solidity, high fiber diameter, and high depth produce the lowest pressure drop. However, all combinations of filter properties within the ranges analyzed produced acceptable pressure drops, indicating that an upper limit on filter depth can be applied based on N95 FFR design constraints and still maintain a reasonable pressure drop. To aid filter design efforts, linear regression models were developed to first predict the filter depth needed to meet the efficiency criterion given known fiber diameter and filter solidity, and then to predict the pressure drop from those three properties.

41. Mechanistic Insights into the Transient Reactions of Environmentally Persistent Free Radicals on Common Microplastics: An Important Role of Air Humidity.

期刊: Environmental science & technology 发表日期: 2026-May-29 链接: PubMed

摘要

The air relative humidity (RH) was reported to significantly influence the photoaging processes of microplastics (MPs), while few research studies have been conducted to obtain deep insights into the underlying mechanisms. In the present study, an in situ electron paramagnetic resonance (EPR) apparatus equipped with a humidity control system was developed to investigate the dynamics of environmentally persistent free radicals (EPFRs) during MP aging processes. The experimental results indicate that the lower RH tends to promote EPFR accumulation on MPs and inhibit their decay, particularly for polyvinyl chloride microplastics (PVC-MPs). Through theoretical computations, the mechanism involving water molecules in the alteration of EPFRs is interpreted. In addition, low RH conditions favor the generation of superoxide radical anions on both polystyrene MPs (PS-MPs) and PVC-MPs. As the RH level rises, the cytotoxicity of aged PS-MPs and aged PVC-MPs underwent decline and enhancement, respectively, in which superoxide radical anions and hydroxyls played the dominant role. In essence, this study presents new results for the formation of EPFRs on MP surfaces, which would provide a foundation for future research into the intricate aging mechanisms of MPs, e.g., discerning how various environmental parameters shape the aging process of MPs and, consequently, their environmental behaviors.

42. Effects and mechanisms of different organic manure on minimizing cadmium concentrations in rice grains.

期刊: International journal of phytoremediation 发表日期: 2026-May-29 链接: PubMed

摘要

Cadmium (Cd) contamination in agricultural soils represents a global issue for soil health and food safety. This study aimed to investigate the effects of organic fertilizers from different sources on Cd uptake and accumulation in rice plants, as well as the biochemical properties of Cd-contaminated soil. We performed high-throughput sequencing of 16S ribosomal RNA (16S rRNA) gene amplicons to characterize soil bacterial communities. The zeta potential of the soil colloids became more negative following the application of GM and EM. In terms of Cd fractionation, chicken manure (CM) amendment reduced the residual fraction of soil Cd, while GM and EM exerted an opposing effect. FT-IR spectroscopy demonstrated that organic fertilizers derived from different sources possessed distinct chemical structural features. At the phylum level, the relative abundance of soil bacteria was largely comparable among treatments receiving different manure application rates. Taxonomic analysis further revealed that Proteobacteria, Actinobacteria, Gemmatimonadetes, Bacteroidetes, and Acidobacteria were the five dominant bacterial phyla in the Cd-contaminated soil. Furthermore, GM and EM applications mitigated Cd uptake by rice plants at all growth stages and across all examined Cd concentration gradients. By contrast, excessive CM amendment amplified the risk of heavy metal bioaccumulation in rice tissues. Unlike previous studies that predominantly focus on single-factor effects (e.g., soil Cd speciation or microbial community changes), this work systematically integrates soil physicochemical properties (Cd speciation, zeta potential, functional groups via FT-IR), microbial ecology and rice agronomic traits to establish a holistic “organic manure-soil-microbe-rice” interaction network.

43. Asynchronous Broadcasting of Audiovisual Content as a Telerehabilitation Strategy for Patients in Rural Areas: Development and Usability Study.

期刊: JMIR rehabilitation and assistive technologies 发表日期: 2026-May-29 链接: PubMed

摘要

Geographical and economic barriers limit access to health care services in rural regions of Colombia. In San Vicente del Caguán, the lack of infrastructure and rehabilitation professionals forces patients to travel long distances. Asynchronous telerehabilitation using video broadcasting is a viable strategy to address these challenges. This study aims to design and validate a telerehabilitation model using asynchronous audiovisual content broadcasting for rural patients, evaluating functionality, usability, and clinical effectiveness. A 4-stage case study developed and validated the model in San Vicente del Caguán: (1) analysis of telemedicine experiences and video-based therapy; (2) solution design including telecommunications infrastructure (radio links and Wi-Fi), mobile app (HSRehabiAPP), and web platform (HSRehabiWEB); (3) fieldwork with 7 patients receiving physical, occupational, or speech therapy, evaluating functionality (11 criteria), usability (8 criteria), and content quality (5 criteria); and (4) results analysis. The infrastructure connected San Rafael Hospital with remote centers in Los Pozos and Tres Esquinas. Participants (aged 7-68 years) from urban and rural areas had conditions including stroke, shoulder injuries, knee pathologies, hypertension, and attention-deficit hyperactivity disorder. All 7 patients achieved 100% compliance across functional, usability, and audiovisual content criteria. Functional evaluation covered login, navigation, therapy access, session viewing, exercise execution, pain assessment, therapist communication, and satisfaction surveys. Usability assessment evaluated initial access, content location, navigation comfort, instructional guidance, session organization, video playback, instruction clarity, and interface intuitiveness. Content criteria included exercise clarity, step-by-step instructions, visual quality, audio quality, and correct posture demonstration. Patients reported high satisfaction, noting reduced travel costs and time, family convenience, and effective outcomes. Offline functionality proved essential in areas with limited internet connectivity. The asynchronous audiovisual telerehabilitation model is an effective solution for improving access to rehabilitation services in rural areas. It successfully addressed geographical barriers and infrastructure limitations while maintaining clinical effectiveness across therapies. Implementation requires adequate technological infrastructure, user-friendly platforms with offline capabilities, and quality therapeutic content. Future work demands inclusive health policies, professional training, and research with larger sample sizes to assess long-term sustainability in diverse rural contexts.

44. Passive Blood Flow Restriction Accelerates Muscle Recovery After Exercise-Induced Muscle Damage in Healthy, Recreationally Active Females.

期刊: Journal of strength and conditioning research 发表日期: 2026-May-28 链接: PubMed

摘要

Howard, MA, Lubiak, SM, Schmidt, JT, Stray-Gundersen, S, Hirsch, KR, Trevino, MA, Hammer, SM, Dinyer-McNeely, TK, Bergstrom, HC, Keller, JL, and Hill, EC. Passive blood flow restriction accelerates muscle recovery after exercise-induced muscle damage in healthy, recreationally active females. J Strength Cond Res XX(X): 000-000, 2026-The purpose of this investigation was to examine the effects of passive blood flow restriction (pBFR) on indices of exercise-induced muscle damage (EIMD) following a muscle-damaging protocol. Eighteen females completed 6 visits occurring at the same time of day (±2 hours). Muscle damage was elicited by performing 3 sets of 25 maximal, unilateral, isokinetic (60·s-1), concentric-eccentric leg extensions on each leg. Each leg was then randomly assigned to receive pBFR (80% of total arterial occlusion pressure) or sham (20 mmHg) at 0, 24, 48, 72, and 96 hours post-EIMD. Indices of EIMD (muscle soreness [0-10 visual analog scale], limb circumference, range of motion [ROM], pain pressure threshold, and maximal voluntary isometric contraction [MVIC] torque) were assessed before EIMD (baseline) and at 0, 24, 48, 72, and 96 hours. Separate 2 (Condition [pBFR and sham]) × 6 (Time [baseline, 0, 24, 48, 72, and 96 hours]), repeated-measures ANOVAs were performed. Collapsed across Condition, muscle soreness increased post-EIMD and partially recovered at 72 and 96 hours (change from baseline [Δ]; Δ2.3 ± 2.3 au and Δ1.4 ± 1.5 au, respectively). Limb circumference increased in both conditions post-EIMD and recovered by 24 hours (pBFR: Δ0.4 ± 1.8 cm; sham: Δ0.5 ± 2.2 cm). ROM recovered sooner for pBFR (24 hours; Δ-6.1 ± 8.9°) than sham (24 hours; Δ-9.2 ± 9.4°), and ROM was greater for pBFR than sham at 48 hours post-EIMD. Pain pressure threshold was greater, collapsed across Time, for pBFR (4.40 ± 1.62 kgf) than sham (4.12 ± 1.63 kgf). Like ROM, MVIC torque recovered sooner for pBFR (24 hours; Δ-14.9 ± 25.3 Nm) than sham (24 hours; Δ-33.9 ± 22.1 Nm). Applying pBFR after EIMD resulted in a faster rate of return for MVIC and ROM in females, suggesting that pBFR may serve as an effective strategy to facilitate recovery of muscle function.

45. Genetic Variants Associated With Nonpulmonary Vein Triggers of Atrial Fibrillation: A Genome-Wide Association Study.

期刊: JACC. Advances 发表日期: 2026-May-26 链接: PubMed

摘要

Atrial fibrillation (AF) originating from non-pulmonary vein (non-PV) foci is a major cause of postablation recurrence; however, its underlying mechanisms remain poorly understood. The purpose of this study was to identify genetic variants and electrophysiological features associated with AF originating from non-PV foci. We performed a genome-wide association study in 1,091 patients with paroxysmal AF undergoing first catheter ablation. AF triggers were classified into PV or non-PV groups based on standardized electrophysiological testing with isoproterenol provocation. AF originating from the posterior wall of the left atrium, including the PV antrum, was categorized into the PV group. Associations between genetic variants and non-PV AF triggers were assessed and validated in an independent cohort (n = 371). Non-PV AF triggers were documented in 126 of 1,010 patients (12.5%) in the discovery cohort and 37 of 346 patients (10.7%) in the replication cohort. The variant rs117203318 (T>C) showed the strongest association with non-PV AF triggers (P = 4.65 × 10-14; OR: 1.98; 95% CI: 1.49-2.62). This association was replicated under Firth’s penalized logistic regression adjusted for age and sex (OR: 3.31; 95% CI: 1.40-7.55; P = 0.007). Non-PV AF was associated with significantly longer intra-atrial conduction times, although rs117203318 showed no correlation with conduction parameters. The rs117203318 variant, near genes associated with myocardial fibrosis and cellular stress responses, is associated with AF originating from non-PV foci. These findings suggest that there may be distinct substrates for non-PV AF and this could inform strategies to improve ablation outcomes.

46. Optimizing ventilation in large-scale fulfillment centers: balancing indoor air quality, energy efficiency, and worker health.

期刊: Annals of work exposures and health 发表日期: 2026-May-12 链接: PubMed

摘要

Large-scale fulfillment centers present unique challenges in balancing indoor air quality with energy efficiency. This study evaluated reduced ventilation strategies in a 98,600 m2 UK fulfillment center using period-based compliance assessment. Twenty wireless sensors monitored CO2, PM2.5, and TVOCs across three ventilation scenarios over 12 days. Period-based compliance assessment across 57 shift periods showed 93.0% maintained full regulatory standards, with the optimized periodic ventilation scenario achieving 100% compliance. Periodic fresh air bursts (15-minute cycles every 4 hours) maintained air quality while achieving 70-75% energy reduction. Results suggest substantial energy savings may be achievable without compromising worker safety.

47. Benzene exposures during tank washing activities on crude oil tankers.

期刊: Annals of work exposures and health 发表日期: 2026-May-12 链接: PubMed

摘要

Personal benzene exposure data during tank washing aboard crude oil tankers are presented. The data are from 4 monitoring surveys conducted by a tanker ship company in the 1990s. Among 59 partial-shift samples for personnel on deck during tank washing, the sample mean was 0.49 ppm and 44% of the corresponding minimum 8-h time-weighted average (TWA) benzene exposure values exceeded 0.2 ppm (the European Union 8-h TWA benzene limit). Among 13 full-shift samples for personnel on deck, the equivalent 8-h TWA benzene exposure values had a sample mean of 0.44 ppm, and a parametrically estimated 85% exceeded 0.2 ppm. Among seven 15-min TWA benzene exposure values for personnel on deck who lowered portable wash machines into tanks and hoisted them out of tanks, the sample mean was 6.48 ppm and a parametrically estimated 52% exceeded 5 ppm (the US Occupational Safety and Health Administration 15-min TWA benzene limit). Among 13 partial-shift samples for personnel mucking inside a tank, the sample mean was 13.5 ppm, 100% of the minimum 8-h TWA benzene exposure levels exceeded 0.2 ppm, 92% exceeded 1 ppm (the U.S. 8-h TWA benzene limit), and 77% exceeded 5 ppm. Among 5 partial-shift samples for personnel assisting mucking from the deck, the sample mean was 1.03 ppm, and 60% of the minimum 8-h TWA benzene exposure levels exceeded 0.2 ppm. Because at present mucking may be seldom performed, and because portable wash machine use has substantially decreased, the associated exposures described here may be primarily of interest for epidemiological studies and questions of causation in the context of clinical evaluation.

48. Outcomes of simplified left atrial appendage occlusion using the WATCHMAN FLX device: the ROSE-FLX study.

期刊: Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology 发表日期: 2026-May-06 链接: PubMed

摘要

Conventional left atrial appendage occlusion (LAAO) procedures typically require transoesophageal echocardiography and general anaesthesia, which may limit feasibility in resource-limited settings. Simplified LAAO (sLAAO) guided exclusively by fluoroscopy offers a practical and efficient alternative. This study evaluated procedural safety, efficacy, and short-term outcomes of sLAAO using the WATCHMAN FLX device under exclusive fluoroscopic guidance in a real-world, multicentre setting. The ROSE-FLX study was a prospective, multicentre, single-arm registry including 400 patients with non-valvular atrial fibrillation at high thromboembolic and bleeding risk. All underwent sLAAO under local anaesthesia and exclusive fluoroscopic guidance. Procedural data, peri-procedural complications, and follow-up outcomes were analysed. Predictors of adverse events were determined using Cox regression. Procedural success was 100%, with low major complication rates: pericardial effusion (0.5%), access-site complications (1.3%), and major bleeding (0.8%). Over median follow-up of 194.5 days [interquartile range (IQR) 129.0-265.0], all-cause mortality occurred in three patients (0.8%), transient ischaemic attacks in 13 patients (3.3%), and device-related thrombosis in one patient (0.3%). In multivariable Cox regression, chronic obstructive pulmonary disease (HR 2.86, 95% CI 1.98-4.11, P < 0.001) and higher CHA2DS2-VASc scores (HR 4.69, 95% CI 1.90-11.57, P < 0.001) independently predicted adverse events. Exclusive fluoroscopy-guided sLAAO with the WATCHMAN FLX device is feasible, safe, and resource efficient, achieving high procedural success and low complication rates, suggesting that this approach may be considered in selected centres lacking advanced echocardiographic or anaesthetic support, pending confirmation from comparative studies.

49. Accessible Clinical Tool for Prognosis and Chemotherapy Prediction in Hormone Receptor-Positive/Human Epidermal Growth Factor Receptor 2-Negative Breast Cancer in Diverse and Low-Resource Settings.

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

摘要

Genomic assays are commonly used to predict breast cancer recurrence but remain inaccessible in low-resource settings, often leading to unnecessary chemotherapy. We previously optimized a LASSO-penalized regression model incorporating quantitative clinicopathologic features to predict genomic risk. Here, we present validation and clinical utility in an international cohort. We retrospectively analyzed patients with early-stage hormone receptor-positive/human epidermal growth factor receptor 2-negative breast cancer treated in Chicago and Rio de Janeiro. Model accuracy for predicting high Oncotype DX (ODX) scores was evaluated using area under the receiver operating characteristic curve (AUROC) in Chicago cohorts. Survival outcomes-disease-free interval (DFI), disease-free survival (DFS), and overall survival (OS)-were compared by Kaplan-Meier and Cox regression using a predefined threshold for high-risk disease. Adjusted models examined chemotherapy benefit by predicted risk. Estimated cost was compared between testing strategies and chemotherapy allocation in Brazil and the United States. The study was approved by the Brazilian Research Ethics Committee on October 24, 2024, under CAAE number 67993323.6.0000.5274. Due to the retrospective nature of the study, which involved only data collection from electronic medical records, the requirement for informed consent was waived by the Ethics Committee. Additionally, the study is covered under Institutional Review Board 22-0707 at the University of Chicago. We included 1,566 patients from Chicago and 296 from Rio de Janeiro. The estrogen receptor/progesterone receptor/Ki-67 model showed strong performance for ODX prediction (AUROC 0.81 and 0.91).Compared with high-risk patients, low-risk patients had superior 5-year DFI (98.0% v 81.6%, hazard ratio [HR], 11.89, P < .001), DFS (91.3% v 77.5%, HR, 3.41, P < .001), and OS (92.1% v 87.3%, HR, 2.47, P = .02). Chemotherapy provided no significant benefit in the low-risk group. Our model accurately predicted recurrence and outcomes across US and Brazilian cohorts, supporting treatment de-escalation in low-risk patients and promoting equitable care where genomic testing is limited.

50. Prevalence of PD-L1 Expression in Non-Small Cell Lung Cancer: A Real-World Analysis From Jordan.

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

摘要

Lung cancer remains the leading cause of cancer-related mortality worldwide. Immune checkpoint inhibitors (ICIs) targeting the PD-1/PD-L1 pathway have significantly improved survival outcomes in non-small cell lung cancer (NSCLC), and treatment selection is influenced by the degree of PD-L1 expression. Although ICI use began in 2017, there is a lack of data on PD-L1 expression in NSCLC among Jordanian patients. This study aimed to estimate the prevalence of PD-L1 expression and its association with demographic, clinical, and molecular characteristics, including EGFR mutation and ALK rearrangements. This retrospective observational study reviewed electronic medical records for all patients with lung cancer diagnosed at King Hussein Cancer Center from January 1, 2017, to April 1, 2024. Included patients had histologically confirmed NSCLC and were tested for PD-L1 expression. PD-L1 expression was considered positive if the tumor proportion score (TPS) was ≥1%. Descriptive statistics were performed to summarize patient characteristics. Comparisons between TPS 1%-49% and TPS ≥50% groups were performed using chi-square tests. Of the 1,872 screened patients, 1,508 met the inclusion criteria and were included in the analysis. In this sample, the majority of patients were male (79%), former smokers (70%), presented with advanced disease (stage III/IV, 86%), and had adenocarcinoma histology (71%). Approximately 25% presented with squamous cell carcinoma. The prevalence of PD-L1 positivity was 68% (n = 1,022). Among the PD-L1-positive patients, 59% had TPS 1%-49% and 41% had TPS ≥50%. Among patients tested for EGFR mutation and ALK fusion, alterations were identified in 16.6% and 8.4% of tested patients, respectively. In PD-L1-positive tumors, EGFR wild-type status was significantly associated with high PD-L1 expression (TPS ≥50%) compared with EGFR-mutated tumors (56% v 44%, P = .007). This first comprehensive analysis of PD-L1 prevalence in patients with NSCLC in Jordan demonstrates a relatively high prevalence of both PD-L1 positivity (≥1%) and high expression (≥50%) compared with reported data from other regions. Distinct molecular associations were observed, with higher PD-L1 expression in ALK-rearranged and EGFR wild-type tumors. These findings underscore the need for prospective and multicenter studies to further identify the biologic and clinical implications of PD-L1 expression in Jordanian patients with NSCLC.

51. Cancer Prevalence Trends in Kyrgyzstan (2020-2026): A Population-Based Epidemiologic Analysis.

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

摘要

Cancer represents a growing public health challenge in Kyrgyzstan, with increasing incidence and cumulative prevalence in recent years. This study aimed to evaluate national cancer prevalence and incidence trends in Kyrgyzstan between 2020 and 2026 and to assess epidemiologic patterns and public health implications. A population-based descriptive analysis was conducted using publicly available national oncology registry reports, Ministry of Health statistical publications, and international cancer databases. Annual incidence, prevalence, and crude incidence rates per 100,000 population were calculated using national demographic estimates. Temporal trends were evaluated using joinpoint regression modeling. Annual newly diagnosed cancer cases increased from approximately 5,471 in 2020 to 6,651 in 2024. Crude incidence rates rose from 83 per 100,000 population in 2020 to more than 92 per 100,000 in 2024. National registry estimates indicate that over 35,000 individuals will be living with a cancer diagnosis by 2025. Stomach, breast, lung, cervical, and colorectal cancers accounted for the largest proportion of cases. A temporary stabilization in incidence was observed between 2022 and 2023, followed by an increase again in 2024. Cancer burden in Kyrgyzstan increased steadily during the study period, with rising incidence and expanding national prevalence. These findings highlight the importance of strengthening national cancer surveillance systems, expanding screening programs, and improving oncology care infrastructure.

52. Prostate Cancer Treatment Patterns and Inequities Among Racial Groups in Brazil's Public Health System: Insights From a 16-Year Real-World Study.

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

摘要

The Brazilian Public Health System (BPHS) provides sole health coverage for approximately 77% of the population. Analyzing BPHS data enables nationwide assessment of epidemiology, treatment patterns, and costs for men with prostate cancer (PCa). We conducted a retrospective, population-based cohort study using linked administrative data from the BPHS Database DATASUS for patients with PCa treated in the BPHS from January 1, 2008, to March 31, 2023. Variables include demographics, clinical features, stage, treatments, and health care utilization. The primary objective was to evaluate the impact of race on stage at diagnosis, treatment delivery, and treatment costs. A total of 670,205 patients with PCa were treated during the study period; 277,030 (41.4%) were White and 393,175 (58.6%) non-White. Mean age at diagnosis was 72.9 years (40-99). Approximately 56% were diagnosed with stage I-III disease (56.1% v 55.5%), and 21% with metastatic disease (19.7% v 21.2%), with non-White men more frequently presenting with advanced stage (P < .001). White men more commonly received local therapy in stage I, whereas non-White men received local therapy more frequently in stage III (P < .001). Among 125,759 men with stage IV disease who received systemic therapy, only 22,393 (17.8%) received docetaxel, while use of first-generation antiandrogens and estrogens remained high (25%). Total PCa-directed expenditures reached In$ 1.83 billion, with mean costs 16.2% higher for White patients than for non-White patients. In the BPHS, race was associated with more advanced stages at diagnosis and differences in treatment delivery. High rates of de novo metastatic disease, underuse of docetaxel, and persistent use of agents without survival benefit highlight urgent gaps in PCa care. These findings may guide PCa policy in Brazil and other low- and middle-income countries.

53. Availability, appeal, and addictiveness by design: Tobacco and nicotine industry deliberate targeting of youth.

期刊: PLoS medicine 发表日期: 2026-May 链接: PubMed

摘要

Contemporary tobacco and nicotine products, particularly e-cigarettes, are deliberately designed, marketed, and distributed to maximize youth appeal, uptake, dependence, and use. Youth uptake is a predictable outcome of systems designed to maximize product availability, appeal, and addictiveness.

54. Key functions for the transferability of a French school-based health promotion intervention.

期刊: PloS one 发表日期: 2026 链接: PubMed

摘要

The “Alliance for Health” intervention is a French evidence-based initiative targeting teachers and after-school care staff, aimed at supporting the development of health-promoting environments for primary school pupils. Its initial implementation in 101 schools and 97 municipalities (randomly assigned to receive different levels of training and support) demonstrated promising outcomes. Yet, a critical question remains for broader implementation: under what conditions can the intervention achieve optimal transferability in new contexts? To address this issue, the key functions (i.e., intervention’s transferable components) were identified and distinguished from their forms (i.e., adaptable activities that can be tailored to specific contexts), as conceptualized within the FIC (Functions/Implementation/Context) model. The key functions were co-constructed through an iterative, collaborative process, based on qualitative data (semi-structured interviews conducted with intervention recipients and institutional actors involved in implementation) and on knowledge exchange between project leaders and researchers from various disciplines, following established methods. Seven key functions were identified, covering 4 main dimensions: institutional support (macro-level social influences on health determinants); empowerment of teachers and after-school care staff (inter-professional training and provision of support and resources, micro and meso levels), adaptation to institutional and recipients’ needs and constraints (micro level); and operational alignment and coherent coordination (meso and micro levels). These findings provide actionable recommendations to guide future implementation strategies, supporting the intervention’s replication or scale-up by clarifying which components must remain consistent and which can be adapted to maintain fidelity while enhancing transferability.

55. Spatial analysis of accessibility to healthcare-related facilities in Tokyo Metropolis using geographic information systems.

期刊: PloS one 发表日期: 2026 链接: PubMed

摘要

Geographic disparities in access to health services are a growing concern in Japan as population aging and decline increase care needs and as resources concentrate in dense urban cores. Focusing on Tokyo Metropolis as a large and internally heterogeneous urban region, we used geographic information systems to evaluate spatial proximity to healthcare-related facilities-pharmacies, hospitals, clinics, dental clinics, and elderly welfare facilities-together with public transportation infrastructure. For pedestrian access, we calculated population coverage from 400 m to 3200 m Euclidean buffers around each facility. For transportation-related proximity, we calculated the proportion of facilities located within 250 m to 3000 m buffers around public transportation features (bus stops, bus routes, and railway stations). Bus stop-based facility-transportation proximity was consistently high across facility types in both the 23 special wards and the Tama region, whereas railway-station proximity displayed larger spatial variation between areas. Interpreted as an indicator for walkable proximity rather than effective service access, these results highlight where transportation connectivity and facility locations align or diverge. These findings underscore the necessity for healthcare and urban planning strategies that integrate local characteristics with transportation infrastructure.