公共卫生研究摘要 (2026-06-02)

共收录 56 篇研究文章

1. Longitudinal Change in Blood-Based Biomarkers and the Association With MRI-Measured Neurodegeneration in Cognitively Unimpaired Individuals.

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

摘要

Blood-based biomarkers are reliable indicators of Alzheimer disease (AD)-related pathology in cognitively normal individuals. However, it remains unclear how changes in these biomarkers relate to emerging brain atrophy. We aimed to investigate longitudinal associations between blood-based biomarkers and brain atrophy, and the temporal sequence of these processes. In the prospective observational Subjective Cognitive Impairment Cohort based in Amsterdam, individuals with subjective cognitive decline recruited from a memory clinic underwent repeated blood sampling (484 samples, follow-up 5 ± 3 years) and MRI scans (457 scans, follow-up 5 ± 3 years). We measured blood-based biomarkers (Aβ42/40 ratio [Aβ42/40], phosphorylated tau [pTau217], glial fibrillary acidic protein [GFAP], and neurofilament light [NfL]) using the SIMOA platform. AD-signature brain volumes (5 temporal, 4 parietal, and 2 frontal regions) were determined using the FreeSurfer pipeline. We used linear mixed models to examine associations between baseline or slope of biomarker and brain volume changes. In an exploratory analysis, extrapolated pTau217 trajectories were compared with hippocampal volume trajectories to estimate the temporal gap between these changes. A total of 167 individuals were included (49 amyloid-positive and 118 amyloid-negative), with amyloid-positive individuals being older (age: 66 ± 8 years, 57.1% female) than amyloid-negative individuals (61 ± 8 years, 33.9% female). Baseline levels and longitudinal increases in GFAP showed associations with higher rates of atrophy across nearly all AD-signature regions (β range -0.02 to -0.00, 95% CI range -0.04 to -0.00, pFDR < 0.05). Baseline pTau217 was associated with atrophy across several medial temporal regions (β range -0.03 to -0.01, 95% CI range -0.04 to -0.00, pFDR < 0.05), whereas increases in pTau217 were only associated with atrophy primarily in temporal regions (β range -0.02 to -0.01, 95% CI range -0.02 to -0.00), although the latter associations were only trend-level after FDR correction (pFDR = 0.077). Baseline concentrations, but not increases in NfL, showed associations with temporal regions (β range -0.02 to -0.01, 95% CI range -0.04 to -0.00, pFDR < 0.05). By contrast, baseline Aβ42/40 showed only associations with hippocampal atrophy (0.01 [0.00-0.03]), but not after FDR correction. Using baseline and (extrapolated) trajectories over time, we estimated that changes in pTau217 preceded hippocampal atrophy by 19.8 (10.7-43.7) years. Blood-based biomarkers capture distinct aspects of brain atrophy, with pTau217 primarily indicating atrophy in medial temporal regions and GFAP more widespread neurodegeneration. This supports the complementary use of both markers for early identification and monitoring in preventive trials and clinical care.

2. HLA micropolymorphisms confine neoantigen conformational adaptability and guide T cell receptor selectivity.

期刊: Proceedings of the National Academy of Sciences of the United States of America 发表日期: 2026-Jun-09 链接: PubMed

摘要

T cell receptor (TCR) restriction by highly polymorphic major histocompatibility complex (MHC) proteins is a foundation of cellular immunity. Although the effects of MHC polymorphisms on peptide binding and selection are well established, how micropolymorphisms within MHC supertypes impact immune recognition is poorly understood. Here, we identified a mechanism through which the micropolymorphisms in two closely related HLA-A3 superfamily members govern TCR specificity. We previously showed that TCRs specific for a public neoantigen arising from a PIK3CA oncogenic hotspot mutation restricted by HLA-A03:01 were unable to recognize the same epitope in the context of HLA-A03:02 despite equivalent processing and presentation by both alleles. We found here that the two micropolymorphisms distinguishing A03:02 from A03:01 prevent TCR binding not by altering peptide binding or static structures, but by altering the conformational ensemble of the neoantigen, preventing it from adopting a binding-permissive state. The effect is rooted in how the two polymorphic sites interact with other covarying, evolutionarily coupled polymorphisms, reflecting a cross-groove network of interactions that controls the conformational adaptability of the peptide/HLA complex. We suggest polymorphism-dependent adaptability reflects an evolved feature of class I MHC proteins, further diversifying epitopes and contributing to how TCRs and other immunoreceptors differentiate between antigens. Beyond this mechanistic insight, our findings emphasize the need for high-resolution HLA typing in efforts across immunology, including antigen-specific immunotherapy.

3. Coordinated expression and assembly of BiP, p58IPK, and ER chaperone complexes maximize proinsulin folding in pancreatic β cells.

期刊: Proceedings of the National Academy of Sciences of the United States of America 发表日期: 2026-Jun-09 链接: PubMed

摘要

Proper proinsulin folding in the endoplasmic reticulum (ER) is prerequisite to producing bioactive insulin, and proinsulin misfolding causing β cell ER stress accompanies pancreatic β cell dysfunction in type 2 diabetes (T2D). How (and which) ER chaperones coordinate to prevent proinsulin misfolding is largely unknown other than an unspecified dependence on the hsp70 member, BiP. A genetically engineered mouse enables efficient, specific pulldown of endogenous islet β cell BiP (GRP78, the major HSP70 ER chaperone) in complexes with client proteins. We demonstrate that BiP assembles in various protein complexes (including cochaperones p58IPK, GRP170, ERdj3, and oxidoreductases PDIA1 and PDIA6) that specifically bind to nonnative proinsulin. BiP requires p58IPK for productive proinsulin folding, whereas nonstoichiometric BiP excess actually hinders proinsulin folding. Coordinated and dyscoordinated BiP/cochaperone assembly in response to demand for proinsulin highlights physiologic and pathophysiologic conditions, respectively, offering a potential check point for therapeutic intervention.

4. Resetting population mobility responses under repeated nonpharmaceutical interventions: Implications for hypothesized pandemic fatigue.

期刊: Proceedings of the National Academy of Sciences of the United States of America 发表日期: 2026-Jun-09 链接: PubMed

摘要

Nonpharmaceutical interventions (NPIs) are essential for controlling infectious diseases during prevaccine periods, yet their success hinges on sustained population behavioral responses to restrictions. This study investigates how mobility responses to tiered restriction systems evolved over time during COVID-19 in six geographical regions across Europe, North America, Africa, and South America. Using daily mobility data and linear-mixed models, we characterized three temporal dimensions shaping these responses: cumulative exposure to restrictions, time spent under a given tier, and repeated reintroduction of the same tier. Time spent under a given tier caused the most rapid attenuation of mobility reduction, producing effects within days that cumulative exposure, required months of restrictions to achieve. Iterative application of shorter NPIs, interspersed with temporary relaxation, was associated with a restoration of mobility responses when restrictions were reintroduced, mitigating attenuation and sometimes even strengthening responses. These patterns are consistent with mechanisms discussed under the umbrella of pandemic fatigue, whereby temporary relaxation may provide psychological relief and a sense of regained autonomy that can renew public willingness to respond to restrictions when reintroduced, while remaining compatible with behavioral adjustment and structural constraints. However, they are also compatible with alternative explanations, including behavioral adaptation, structural constraints on mobility, or evolving interpretations of restrictions. These findings emphasize the dual benefits of short, strategic NPIs for epidemic control and public resilience, offering actionable insights for designing more sustainable pandemic interventions.

5. Rethinking energy transition strategies for the European Union amid rising energy prices.

期刊: Proceedings of the National Academy of Sciences of the United States of America 发表日期: 2026-Jun-09 链接: PubMed

摘要

Geopolitical tensions and the disruption of major energy imports have sharply elevated energy prices across the European Union (EU), creating a persistent energy supply gap and posing long-term challenges for energy security. Here, we introduce a comprehensive framework integrating the advanced Greenhouse Gas and Air Pollution Interactions and Synergies (GAINS) model with a system dynamic WILIAM (“Within limits”) Integrated Assessment Model to systematically evaluate strategies for closing this energy gap. We find that measures to close the energy gap in the short term exacerbate either economic or public health burdens, highlighting the need for more sustainable solutions in the long term. Our further analysis shows that long-term strategies focused on renewable energy transitions not only close the energy gap but also bring net benefits equivalent to ~3% of projected GDP for 2050. Moreover, we find that rising energy prices substantially influence the cost-effectiveness of accelerated energy transitions. Under current high energy price levels, the benefits from achieving energy targets set for 2050 by 5 to 20 y in advance could outweigh the additional costs. The consideration of dynamic trends in the levelized cost of electricity (LCOE), particularly under rapid renewables expansion, is critical for avoiding overly optimistic estimations of green transition benefits. Our findings suggest that a timely transition to renewable energy benefits the EU in the face of the energy crisis, and policies proactively adjusting energy prices could facilitate a greener, more sustainable future.

6. Cryptosporidiosis outbreak associated with recreational water exposure in a central park.

期刊: Enfermedades infecciosas y microbiologia clinica (English ed.) 发表日期: 2026-Jun-01 链接: PubMed

摘要

Cryptosporidiosis is a gastrointestinal disease transmitted via the faecal-oral route, associated with waterborne outbreaks, particularly in summer. In 2023, an unusual increase in cases was detected in Spain, with particular impact in the Valencian Community. A retrospective descriptive study (June-November 2023) was conducted in the Valencia-Doctor Peset Health Department (population 288,583), including cases with Cryptosporidium detection in stool samples by modified Ziehl-Neelsen staining and/or immunochromatographic testing. A total of 163 confirmed cases were identified (cumulative incidence 56.5/100,000), compared with 3 during the same period in 2022; 93.9% (95% CI: 89.3-96.8) were under 11 years of age. The outbreak, declared by Public Health authorities, was linked to ornamental water features in an urban public park, which was temporarily closed. Diarrhoea (median duration 4 days) was the predominant symptom; 5 patients were immunocompromised, 3 required hospitalisation, and no deaths were recorded. Early identification of the source enabled effective outbreak control.

7. Updating Indonesia's adolescent mental health governance: From stand-alone legislation to integrated school-community implementation.

期刊: Asian journal of psychiatry 发表日期: 2026-Jun-01 链接: PubMed

摘要

8. Beyond predictive performance: Indonesia as a critical implementation case for digital mental health and machine learning.

期刊: Asian journal of psychiatry 发表日期: 2026-Jun-01 链接: PubMed

摘要

9. Violence against women and survivors' experiences in Brazilian health services: a qualitative systematic review.

期刊: Public health 发表日期: 2026-Jun-01 链接: PubMed

摘要

Violence against women is a global scourge. Yet, the care offered within health services has mostly been explored from the perspective of healthcare professionals, with limited attention to survivors’ voices. This qualitative systematic review investigates how women experiencing violence perceive the care provided by primary healthcare services, focusing on both its benefits and challenges. The study incorporated a qualitative systematic review. A search was conducted in the Scopus and Web of Science databases, identifying 589 articles and reference checking identifying 10. Seven met the inclusion criteria and were analyzed. Survivors’ accounts revealed three overarching themes: the benefits, challenges, and ambivalences of healthcare services. Influential factors included onboarding procedures, the performance of multidisciplinary teams, availability of human resources and training, adequacy of physical infrastructure, awareness of women’s rights, and the presence of support networks. Women identified health services as a primary access point for support and emphasized the importance of empathetic, welcoming care in their recovery. However, they also reported significant challenges, particularly the lack of professional training and poor coordination among services. These shortcomings can contribute to institutional violence, worsen health outcomes, especially mental health, and reinforce gender inequalities.

10. Standardized workflow enables reproducibility of drug synergism detection: Results from a multi-center in vitro ring test on complex drug combinations in pancreatic cancer models.

期刊: Biomedicine & pharmacotherapy = Biomedecine & pharmacotherapie 发表日期: 2026-Jun-01 链接: PubMed

摘要

In the framework of REMEDi4ALL’s mission to strengthen reproducibility in drug repurposing, we conducted a multicenter ring study to evaluate the reproducibility and translational value of combining histone deacetylase inhibitors (HDACi) with simvastatin (SIM) in pancreatic ductal adenocarcinoma (PDAC) cells. Initial inconsistencies due to misaligned protocols were resolved through harmonized SOPs across three European laboratories (INT-NA, ITMP, KI), enabling robust and comparable results. Under standardized procedures, valproic acid (VPA) and SIM emerged as the most synergistic combination, confirming our previous findings. The reproducible enhancement of antitumor activity when VPA/SIM was added to the standard chemotherapy (gemcitabine+nab-paclitaxel) further supports its translational relevance. Beyond validating this drug combination, the resulting open dataset enables systematic evaluation of technical confounders affecting drug sensitivity and provides a reference for data harmonization across heterogeneous assay platforms. All centers independently delivered high-quality data, demonstrating their readiness for future REMEDi4ALL repurposing efforts with enhanced rigor, robustness and interoperability.

11. Racial disparities in the survival outcomes of craniopharyngioma: a 17-year population-based analysis.

期刊: Neurosurgical focus 发表日期: 2026-Jun-01 链接: PubMed

摘要

Craniopharyngioma is a rare epithelial tumor of the sellar and suprasellar regions that, despite benign histology, causes substantial morbidity due to proximity to critical structures. Racial disparities have been recognized in other CNS tumors, but the impact on craniopharyngioma outcomes remains poorly defined. This study evaluated racial differences in survival and treatment patterns in a contemporary, population-based cohort. Patients with craniopharyngioma from 2004 to 2020 were identified from the SEER (Surveillance, Epidemiology, and End Results) 17 registries. Race was categorized as White, Black, or other. Hispanic ethnicity was analyzed separately. Overall survival (OS) was assessed using Kaplan-Meier estimates and restricted mean survival time (RMST) at 5 and 10 years. Sequential Cox models assessed the contribution of demographics, tumor, and treatment variables. Adjusted probabilities of gross-total resection (GTR) and radiation therapy (RT) were estimated using regression with marginal standardization. A total of 2651 patients met inclusion criteria (White, n = 1891; Black, n = 441; other, n = 319). Black patients more often resided in lower-income and urban areas. OS differed significantly by race (log-rank, p < 0.0001): the 5-year OS was 78.4% for Black, 85.2% for White, and 82.1% for other-race patients. RMST analysis demonstrated a survival deficit for Black versus White patients (-5.6 months at 5 years, -17.9 months at 10 years). In multivariable models, including adjustment for county-level median household income, Black race remained independently associated with worse OS (HR 2.28, 95% CI 1.87-2.78; p < 0.001), while other race was protective (HR 0.71, 95% CI 0.51-0.99; p = 0.05). Adjusted probabilities of GTR and RT did not differ significantly across races. Black patients with craniopharyngioma had significantly worse long-term survival despite comparable rates of surgery and RT. These disparities were not explained by treatment patterns, suggesting that unmeasured variables such as differences in posttreatment care, social determinants of health, or systemic inequities may underlie outcome gaps. Further investigation into survivorship access and longitudinal care pathways is warranted to advance equity in neuro-oncology outcomes.

12. Racial and socioeconomic disparities in long-term survival in craniopharyngioma: a SEER database analysis.

期刊: Neurosurgical focus 发表日期: 2026-Jun-01 链接: PubMed

摘要

The aim of this study was to characterize sociodemographic disparities in long-term survival outcomes among adults and children with craniopharyngioma and evaluate their impact on surgical approach and radiation therapy (RT). Using the Surveillance, Epidemiology, and End Results database (2000-2022), the authors retrospectively identified adult (age ≥ 18 years) and pediatric patients with craniopharyngioma who had undergone resection. Log-rank tests and multivariable Cox proportional hazards regression were used to assess the impact of race/ethnicity, county-level median household income, extent of resection, and RT on overall survival. Separate analyses were performed for pediatric and adult cohorts. The cohort consisted of 3132 patients with craniopharyngioma, including 832 pediatric and 2300 adult patients. Racial disparities were identified, with non-Hispanic Black patients demonstrating 15-year survival of 39.8% in adults and 75.7% in children compared with 52.5% and 88.6% for White patients, respectively. After multivariable adjustment, Black race remained an adverse prognostic factor in both pediatric (HR 2.9, 95% CI 1.56-5.56, p < 0.001) and adult (HR 1.67, 95% CI 1.39-2.15, p < 0.001) cohorts. Among adults, both Hispanic (HR 0.78, 95% CI 0.62-0.98, p = 0.003) and Asian/Pacific Islander (HR 0.654, 95% CI 0.472-0.905, p = 0.01) races were independently protective compared with White race. There were significant income-based disparities (p = 0.0029) concentrated among adults undergoing subtotal resection (STR), where lower-income patients demonstrated 15-year survival of 42.1% compared with 63.5% for higher-income patients; outcomes after gross-total resection (GTR) were comparable based on income strata (57.3% vs 57.7%, respectively). Among adults, STR with RT led to a 15-year survival of 63.7%-not significantly different from GTR with RT (58.2%)-whereas STR alone showed inferior outcomes (49.7%). Among pediatric patients, extent of resection did not independently predict survival, whereas RT was protective (HR 0.55, 95% CI 0.301-0.994, p = 0.048). Substantial racial and socioeconomic disparities in survival persist in craniopharyngioma, even after adjusting for tumor characteristics and treatment received. Non-Hispanic Black patients in both age groups experienced inferior outcomes. Income-based disparities were concentrated among adults who had undergone conservative surgical approaches, suggesting differential access to adjuvant RT. Selection bias limited direct treatment comparisons; however, conservative resection without adjuvant RT was associated with significantly inferior outcomes. Ensuring equitable access to multimodal treatment and addressing structural barriers to specialized care may help reduce these disparities.

13. An Exploration of "Near-Miss" Events in Non-Operating Room Anesthesia Locations.

期刊: Anesthesia and analgesia 发表日期: 2026-Jun-01 链接: PubMed

摘要

The Non-Operating Room Anesthesia (NORA) Safety Project is an exploratory prospective cohort study examining the incidence of near-miss events in NORA settings. While adverse events are typically well captured because of quality improvement programs that exist in most major health settings, near-miss events are often not documented, and safety standards are not well established. We present the results of a dedicated forum for near-miss reporting, including the incidence and type of near-miss events, as a first step toward understanding NORA near misses. By providing granular data from a highly engaged audience, we aimed to highlight evidence-backed opportunities for improving safety culture in the procedural landscape. We surveyed all in-hospital NORA cases excluding pediatrics, those performed in the intensive care unit, or the peri-partum areas. The day of data collection was rotated weekly. Providers surveyed included anesthesiologists, nurse anesthetists, and anesthesiology residents. REDCap survey was sent via secure e-mail. If a near-miss event occurred, respondents were asked to classify their events in the following categories: patient, provider, and/or environment. Over a 42-week period, 1383 completed surveys were received in which 90 near-miss events were reported. Filtering for near misses reported on study data collection days and removing voluntary near misses from our total survey responses, our incidence rate was 3.22% (43/1336). The top near-miss locations were the magnetic resonance imaging suite (21/90 [23.3%]) and both neuro and body interventional radiology suites (15/90 [16.7%] and 11/90 [12.2%], respectively). The top near-miss category was environmental concerns (75/90 [83.3%]), and top subcategory was poor group dynamics (31/90 [34.4%]). Significant characteristics in the near-miss patients included older age (mean [±standard deviation {SD}] 60.8 [±16.9] vs 56.8 [±17.3] years [P = .03]), male (52/90, 57.8% vs 586/1293, 45.3% [P = .03]), higher American Society of Anesthesiologists (ASA) physical status (III and IV 65/90, 72.2% [P < .001]), longer procedure (119.8 ± 108.9 minutes vs 63.1 ± 72.2 minutes [P < .001]), emergent procedures (28/90, 31.1% vs 159/1293, 12.3% [P < .001]), and involvement of resident providers (36/90, 40.0% vs 234/1293, 18.1% [P < .001]). A Least Absolute Shrinkage and Selection Operator (LASSO) logistic regression model confirmed a statistically significant relationship between the presence of a resident provider and near-miss events (odds ratio: 2.38 [P = .02]). The NORA landscape is often remote in location, not as well-staffed or well-resourced, and with variable setups. With a systematic survey, we were able to capture near-miss events which would otherwise have been lost. These near-miss events cannot be evaluated in isolation. Future direction should focus on a systems-wide approach in safety surveillance that facilitates multidisciplinary collaboration and reporting. Our findings demonstrate near misses as an opportunity-to improve in-hospital access to care, promote quality assurance, and ultimately, make NORA a safer place.

14. Diversity Science in Perioperative Medicine: Key Concepts and Guidance for Publishing and Reviewing.

期刊: Anesthesia and analgesia 发表日期: 2026-Jun-01 链接: PubMed

摘要

15. Smartphone Keystroke Biomarkers as Predictors of Adverse Neuropsychiatric Sequelae After Trauma in Trauma Survivors: Prospective Observational Cohort Study.

期刊: Journal of medical Internet research 发表日期: 2026-Jun-01 链接: PubMed

摘要

Adverse posttraumatic neuropsychiatric sequelae are common after trauma. Early identification of individuals at risk for these outcomes could enable the deployment of preventive interventions to survivors at greatest risk. Smartphone keystroke biomarkers show promise in identifying individuals with neuropsychiatric symptoms; however, to our knowledge, no research has examined whether they can be used to identify symptoms in the aftermath of trauma. This study evaluates whether passively collected keystroke data from smartphone use in daily life could identify individuals with high symptom levels, as well as worsening or recovery of symptoms, after trauma exposure. Data from a diverse cohort of individuals presenting to 27 emergency departments after trauma were analyzed. Inclusion criteria were presenting to the emergency department within 72 hours of trauma, age 18-75, and the ability to speak and read English. Exclusion criteria were solid organ injury, significant hemorrhage, operative intervention, or likely admission for over 72 hours. Participants installed an app that passively collected keystroke data during use of any app on their smartphone, beginning in the emergency department. Participants also completed serial symptom assessments over 8 weeks after trauma exposure. A total of 3445 patients met study criteria, provided informed consent, and completed assessments in the emergency department. Of these, 1072 (mean age 40, SD 13; 616/1072, 57.46%, women; 565/1072, 52.71% non-Hispanic Black) installed the app on their Android smartphone and completed the 8-week assessment and were therefore included in analyses. Keystroke biomarkers related to typing speed, identified using bivariate linear mixed models controlling for false discovery rates, were associated with elevated pain, reexperiencing, and mental fatigue (absolute values of rs=0.22-0.25, Ps=.02). Separate change-of-operation and scrolling keystroke biomarkers were associated with increased reexperiencing symptoms (r=0.18, P=.047) and mental fatigue (rs=0.18-0.19, Ps=.031-.047). Further, changes in specific keystroke biomarkers were associated with worsening or recovery of pain (rs=0.07-0.10, Ps=.02), somatic symptoms (rs=0.02, Ps=.02), mental fatigue (rs=0.02-0.04, Ps=.02), sleep disturbance (absolute rs=0.07-0.09, Ps=.02), reexperiencing (rs=0.02-0.04, Ps=.02), and hyperarousal (rs=0.02-0.04, Ps=.02). In general, slower typing and scrolling speeds were associated with higher symptom levels, with small to medium effect sizes. Keystroke data passively collected via smartphone use may help identify individuals with significant or changing posttraumatic symptoms. Future research should continue to explore these keystroke biomarkers and whether they can be leveraged to connect vulnerable trauma survivors to appropriate services. Overall, these results add to the literature, indicating that passively collected keystroke data may help identify individuals with neuropsychiatric symptoms or changes and are, to our knowledge, the first to test whether keystroke biomarkers are useful in the aftermath of trauma. This represents a critical period during which preventive interventions could be deployed to reduce the long-term burden of trauma-related sequelae.

16. Personalized Digital Health Solutions to Increasing Diabetes-Related Knowledge and Behavioral Outcomes: Results From a Randomized Controlled Trial.

期刊: JMIR diabetes 发表日期: 2026-Jun-01 链接: PubMed

摘要

The prevalence of diabetes in the United States necessitates investigations into how to better enable adults with type 2 diabetes mellitus (T2DM) to manage their health using easy-to-access and personally adaptable technologies. The ubiquity of digital content further justifies the need to consider the impact of different digital intervention modalities in diabetes self-care activities. This study aimed to compare the impact of 2 digital diabetes self-care education programs delivered separately and in combination to adults with T2DM across various settings in Texas. We conducted a randomized controlled trial in Texas with 188 adults with T2DM to assess whether 2 different interventions alone (Virtual Making Moves with Diabetes or Technology-Based Education and Support) or in combination (Virtual Making Moves with Diabetes followed by Technology-Based Education and Support) improved multiple outcomes associated with diabetes self-management. We used several estimation techniques, including generalized estimating equations, to account for multiple factors simultaneously. All 3 digital intervention modalities led to statistically significant improvements in diabetes-related confidence, distress, and self-care behaviors, with significance from baseline through 6 months and supported by moderate to strong effect sizes (Cohen d) ranging from 0.446 to 0.827 at 3-month follow-up versus baseline and from 0.538 to 0.888 at 6-month follow-up versus baseline. No statistically significant superiority was observed among the intervention modalities. Higher self-care behaviors were significantly associated with higher baseline confidence and lower distress. Those in the most disadvantaged positions (less education, less financial stability, and no health insurance) showed significantly larger improvement in self-care behaviors. Given the benefits associated with this study’s interventions, we suggest future work to further develop digital content that can be tailored to individuals with T2DM to help them manage their chronic conditions in a cost-effective manner.

17. Beyond Training: Systems Framework for Sustainable Health Informatics Investment in Africa.

期刊: JMIR public health and surveillance 发表日期: 2026-Jun-01 链接: PubMed

摘要

Across Africa, substantial investment has built national health information systems (HISs), including the surveillance platforms, reporting tools, and digital infrastructure through which health data flow. However, the health informatics capacity needed to sustain those systems remains fragile: trained health informaticians leave for better-resourced organizations, platforms fall into disrepair when donor funding ends, and data systems multiply without connecting. Health informatics is the discipline that designs, governs, and sustains HISs; the two are inseparable, and investment that builds one while neglecting the other cannot produce durable results. This viewpoint, grounded in the authors’ direct implementation experience across sub-Saharan Africa and informed by published literature, argues that the cause is a structurally misaligned investment logic: resources concentrate on training health informaticians while the institutional, governance, and infrastructure conditions that determine whether those informaticians can perform are chronically underfunded. We propose that sustainable health informatics capacity requires a functioning HIS ecosystem and that this ecosystem rests on four interdependent pillars: (1) workforce development beyond training; (2) institutional strengthening; (3) governance and data standards; and (4) interoperable infrastructure, including the national HIS platforms, such as the District Health Information Software 2, through which health informatics practice operates. The pillars are interdependent: weakness in any one undermines the others in specific, predictable ways. The framework makes 3 contributions beyond existing World Health Organization (WHO) and Africa Centers for Disease Control and Prevention frameworks: it shows how weakness in one pillar actively undermines the others; it focuses specifically on health informatics and national HISs as the primary investment domain rather than as components of a broader digital health agenda; and it treats the enabling environment, specifically civil service structures, domestic financing, data sovereignty, and artificial intelligence governance, as core investment requirements rather than background conditions. Drawing on illustrative experiences from Ethiopia, Kenya, and Sierra Leone, we show how health informatics capacity succeeds or fails depending on the strength of all 4 conditions. A practical readiness checklist and audience-specific policy recommendations are provided for national health ministries, national public health institutes, regional bodies, and development partners.

18. Real-time evaluation of workplace protection factors from powered air-purifying respirators.

期刊: Journal of occupational and environmental hygiene 发表日期: 2026-Jun-01 链接: PubMed

摘要

Loose-fitting powered air-purifying respirators (PAPRs) are widely used by healthcare workers to protect against inhalation hazards, as they require no fit testing. However, incorrect use can compromise their efficacy, which may progressively deteriorate over time. Therefore, there is a critical need for real-time monitoring of PAPR performance during occupational activities. In this study, a portable device called the Exposure Protection Integrated Communicator (EPIC) was developed, which uses optical particle sensors to evaluate the workplace protection provided by PAPRs. EPIC monitors concentrations inside and outside a respirator using two sensors to quantitatively calculate the protection factor (PF), defined as the ratio of particle concentrations outside to inside the respirator. The system applied algorithms to correct sensor readings and alert wearers if respirator protection was compromised. The prototype EPIC was evaluated using a manikin headform connected to a breathing recording and simulation system (BRSS) to simulate a sinusoidal breathing pattern. A PortaCount fit tester based on a single-condensation-nuclei-counter principle served as the reference measurement device during parallel tests. The results were expressed as PFs for comparison between the EPIC system and the reference method. The prototype EPIC demonstrated to be an effective tool for quantifying the real-time performance of PAPRs, particularly in environments with particle concentrations of 40,000 to 70,000 particles/L. Data collected from both the EPIC and PortaCount were compared, revealing that the EPIC could measure PFs ranging from 10 to 10,000. The EPIC showed a strong correlation with the reference PortaCount (R2 = 0.84), despite the two systems using different measurement principles and detection limits. The study results confirmed the effectiveness of EPIC in quantitatively assessing respirator particle ingress.

19. Private Equity Acquisitions of Home Health Care Agencies.

期刊: Journal of the American Geriatrics Society 发表日期: 2026-Jun-01 链接: PubMed

摘要

20. Not enough time.

期刊: Health affairs (Project Hope) 发表日期: 2026-Jun 链接: PubMed

摘要

21. Third-Party Convener Firms And The Rise Of Geographically Dispersed, High-Earning Medicare ACOs.

期刊: Health affairs (Project Hope) 发表日期: 2026-Jun 链接: PubMed

摘要

Accountable care organizations (ACOs), Medicare’s flagship reform to slow cost growth, were envisioned as local, clinically integrated networks of clinicians and hospitals caring for shared patients. Increasingly, third-party firms known as conveners have recruited clinicians into Medicare Shared Savings Program (MSSP) ACOs. Conveners provide capital and analytic infrastructure, but they may also strategically aggregate low-cost clinicians across large, geographically dispersed networks. Using national MSSP data from the period 2012-21, we found that the share of beneficiaries in convener-led ACOs grew from 11 percent to 23 percent. The share of beneficiaries in dispersed ACOs increased over time, rising sharply from 13 percent to 42 percent among convener ACOs. Dispersed convener ACOs earned the highest shared-savings payments ($171 per beneficiary per year), whereas local convener ACOs earned the lowest ($95), without evidence of higher-quality performance. These findings suggest that third-party conveners are reshaping the structure of the MSSP. Policy makers should strengthen the disclosure of convener relationships and consider network definition rules to promote coordinated care in the MSSP.

22. Medicare's Hospital Wage Index Exceptions Grew By Nearly 60% From 2016 To 2024.

期刊: Health affairs (Project Hope) 发表日期: 2026-Jun 链接: PubMed

摘要

The hospital wage index standardizes Medicare hospital payments for labor cost differences, paying otherwise equivalent hospitals more when they operate in areas with higher labor costs than in areas with lower labor costs. However, because of a plethora of exceptions, labor costs are commonly disconnected from the originally assigned wage index, and policy makers have expressed concerns that exceptions are not justified. Using publicly available wage index and Centers for Medicare and Medicaid Services impact files, we found that wage index exceptions increased by nearly 60 percent from 2016 to 2024 and were highly prevalent, with more than 70 percent of hospitals receiving exceptions by 2024 (compared with 46 percent in 2016). Growth was disproportionate across states and hospital types. Two exceptions-geographic reclassifications and rural floor adjustments-increased annual hospital revenues by an average of $650,000 and $930,000, respectively. Growth in costly exceptions distorts wage index accuracy and impedes the policy’s intended goal of calibrating payments to actual labor costs.

23. Dual-Functional Rhizobium dioscoreae Q9a for Glyphosate Biodegradation and Plant Growth Promotion: Insights into the Degradation Kinetics, Catabolic Pathways, Beneficial Properties, and Underlying Enzymatic Mechanisms.

期刊: Journal of agricultural and food chemistry 发表日期: 2026-Jun-01 链接: PubMed

摘要

The extensive and persistent application of glyphosate has led to its accumulation in agricultural soils, creating potential ecological and health risks. In this study, a novel glyphosate-degrading bacterium, Rhizobium dioscoreae Q9a, was isolated and characterized. Strain Q9a effectively degraded glyphosate (50 mg/L) within 9 d in liquid culture. In addition to its degradative ability, strain Q9a exhibited multiple plant growth-promoting traits, including solubilization of up to 150 mg/L insoluble phosphate, production of 45 μg/mL indole-3-acetic acid, and siderophore secretion. Genome sequencing revealed multiple candidate genes potentially responsible for glyphosate metabolism, and heterologous expression validated the glyphosate oxidoreductase function of the key enzyme GoxD encoded by an oxidoreductase gene. Further, molecular docking and site-directed mutagenesis confirmed that Ser38 serves as the critical active site in GoxD for catalyzing glyphosate. These findings highlight the potential of strain Q9a as a promising bioinoculant for the bioremediation of glyphosate-contaminated environments and for enhancing crop growth.

24. Mixed Methods Evaluation of a Community-Based Weight Management Program for Latino Children.

期刊: American journal of health promotion : AJHP 发表日期: 2026-Jun-01 链接: PubMed

摘要

PurposeTo describe acceptability, feasibility, and preliminary effectiveness of a community-based weight management program for overweight/obese Latino children in immigrant families.DesignMixed methods evaluation of an exploratory single-arm pragmatic intervention trial.SettingCommunity sites in Maryland and Colorado.SampleLatino immigrant families with 5-12-year-old overweight/obese children with 93 participants (39 index children, their parents and siblings).InterventionCommunity Active and Healthy Families, an adaptation of an evidence- and behavioral-theory based, culturally tailored weight management program delivered in Spanish.Measures(1) Height and weight; (2) Surveys of sociodemographics, diet, and physical activity (PA) and (3) Parent/child interviews.Analysis(1) Pre and post means, standard deviations, differences in means and the P-value of the difference. (2) Thematic analysis of interviews.ResultsMean index child age was 9.8 years. Mean change in %BMIp95 was -2.24 (7.49), P = 0.12. Families attended a mean of 4.5/8 program sessions. Interviews with 15 parents and 5 children demonstrated program content was acceptable, and both parent/child respondents reported liking the hands-on learning activities and child PA time. Parents reported making some recommended dietary changes and increased physical activity via family outings. Barriers to change included fresh food costs, child diet preferences and time.ConclusionOur evaluation demonstrated a preliminary signal of effectiveness, acceptability and feasibility of Community Active and Healthy Families demonstrating readiness for a larger-scale implementation and effectiveness trial.

25. First things first: Provision of basic needs is a critical foundation for health-promoting campuses.

期刊: Journal of American college health : J of ACH 发表日期: 2026-Jun-01 链接: PubMed

摘要

Universities that have adopted the Okanagan Charter and title of “health-promoting campus” have committed to supporting the health and wellbeing of their campus communities. The provision of basic needs, including access to food, housing, healthcare and employment opportunities, is paramount to fulfilling this commitment.1Objective: This study sought to understand barriers and opportunities that marginalized community members of a large, land-grant university experience in meeting their basic needs for health and wellbeing, and to galvanize action by universities toward meeting the basic needs of their students. Participants:n = 37 faculty, staff, and students participated in this study. Methods: Operating within an Indigenous Research Framework, this study employed Photovoice sessions and individual interviews to shed light on participants’ experiences and illuminate opportunities to increase campus health and wellbeing. Results: Financial insecurity, lack of safe and affordable housing, challenges with accessing healthcare, inability to maintain work-life balance, and limited physical accessibility on campus emerged as major barriers to health and wellbeing. Recommendations: Support programs for student-parents, job placement, physical accessibility accommodations and access to on-campus housing for students unable to safely return to their homes during school breaks should be primary areas of focus for institutions committed to promoting the health and wellbeing of their campus populations.

26. Factors affecting detection and quantification of Schistosoma haematobium eggs in pooled urine samples.

期刊: PLoS neglected tropical diseases 发表日期: 2026-Jun-01 链接: PubMed

摘要

Building on our previous work showing that pooled urine testing can rapidly detect Schistosoma haematobium infections but has limited sensitivity in low-intensity settings or with large pool sizes, this study evaluated how urine volume, pool size, infection intensity, and diagnostic method affect the detection and quantification of S. haematobium eggs in pooled samples. Between July 2022 and April 2023, 2,134 urine samples from school-age children living in three regional states of Ethiopia were individually examined by deploying urine filtration microscopy (UFM). Subsequently, 5, 10, 20 and 40 individual samples were strategically pooled and examined by deploying UFM and Fluke Catcher (FC) and varying volumes of urine (10, 20 and 30 mL). UFM was significantly more sensitive than FC for detecting S. haematobium eggs in pooled urine samples ([Formula: see text] =0.83, p < 0.001). There were significant interactions between the mean log of urine egg count (UEC) and volume of urine ([Formula: see text] =0.01, p = 0.021) or pool size ([Formula: see text] =-0.02, p = 0.007) for detecting S. haematobium eggs in pooled samples. The odds of detecting eggs in pooled samples in which the mean UEC of individual samples equaled 10 eggs/mL were 0.78 (95% CI:0.67-0.90) and 0.60 (95% CI:0.51-0.76) times lower when 10 mL rather than 20 mL and 30 mL was examined, respectively. There was a moderate or strong positive correlation between the mean egg count of pooled samples and the average egg count of the individual samples making the pools when pool sizes were 5, 10 or 20 (r ≥ 0.5). The diagnostic sensitivity of pooled testing for diagnosing S. haematobium infection is affected by a complex interplay between the pool size, the volume of urine examined, the mean UEC and the diagnostic method. The sensitivity of the pooled testing strategy may increase with larger urine volumes, higher infection intensity, and when UFM (rather than FC) is used for testing. However, sensitivity could decrease as the pool size increases. Use of UFM, larger urine volumes and smaller to moderate pool sizes could improve detection of S. haematobium infection in surveillance and mass deworming programs in low-intensity settings.

27. Factors Associated With Intention to Undergo Colonoscopy Reexamination Based on Pender's Health Promotion Model: A Cross-Sectional Study.

期刊: Gastroenterology nursing : the official journal of the Society of Gastroenterology Nurses and Associates 发表日期: 2026-Jun-01 链接: PubMed

摘要

This study aimed to identify factors influencing intention to undergo colonoscopy reexamination regardless of the colonoscopy results based on Pender’s Health Promotion Model. The study included 152 individuals who had undergone colonoscopy at Chonnam National University Hospital in Gwangju City, South Korea. Data using structured self-administered questionnaires were collected from participants who were alert after the completion of the procedure. The factors associated with the intention to undergo colonoscopy reexamination were perceived benefits (β = 0.33, p < .001, 95% CI = 0.10 to 0.30), perceived self-efficacy (β = 0.19, p = .021, 95% CI = 0.02 to 0.18), employment status (β = 0.18, p = .010, 95% CI = 0.25 to ~1.83), and marital status (β = 0.16, p = .018, 95% CI = -1.87 to -0.17). These variables explained 33.9% of the variance in the intention to reexamine. The study revealed that individuals who perceived benefits and had high self-efficacy related to colonoscopy were more likely to have an intention to undergo colonoscopy reexamination. It is essential to emphasize the benefits of colonoscopy and to encourage and support examinees’ confidence in undergoing colonoscopy, thereby increasing the intention and actual rate of colonoscopy reexamination every 5-10 years.

28. Exposure to high doses of tyre antioxidant 6PPD causes senescence to induce unexplained miscarriage by suppressing BAZ1B-mediated ubiquitination degradation of P21.

期刊: EBioMedicine 发表日期: 2026-Jun-01 链接: PubMed

摘要

Unexplained miscarriage (UM) highly occurs and largely limits human reproduction. Cellular senescence is a ubiquitous process that is associated with many human diseases. Increasing global usage and wear of tyres result in worldwide pollution of 6PPD (an antioxidant in tyres) in various environments and even in pregnant women’s bodies. Importantly, whether 6PPD exposure might cause senescence to induce unexplained miscarriage is largely unknown and should be urgently explored. We combined case-control study using a UM case-control group and in vitro functional assays using mouse model and human trophoblast HTR-8/SVneo cells. The associations between environmental exposure to 6PPD and cell senescence were explored. Trophoblast cell senescence and the BAZ1B-mediated ubiquitination degradation of P21 were also investigated. Higher urinary 6PPD levels are closely associated with villous tissue senescence and miscarriage (n = 50). 6PPD-exposed mouse model further confirms that exposure to high doses of 6PPD causes placental senescence (≥12 mg/kg/d) to induce mouse miscarriage (≥36 mg/kg/d). In cellular mechanisms, 6PPD exposure down-regulates BAZ1B expression levels, suppresses BAZ1B-mediated ubiquitination degradation of P21, and thus up-regulates P21 protein levels. Subsequently, the up-regulated P21 results in cell senescence, which further induces miscarriage. The mechanisms in 6PPD-exposed trophoblast cells are consistent with those in 6PPD-exposed mouse placental tissues and in UM vs HC women villous tissues. Therapeutic down-regulation of p21, supplement with murine Baz1b, or direct suppression of senescence could effectively reduce placental senescence and suppress mouse miscarriage in the 6PPD-exposed mouse models. This study not only discovers new health risks of 6PPD exposure on miscarriage, explores potential pathogenesis and biological mechanisms in 6PPD-induced miscarriage, but also provides potential biological targets for treatment against miscarriage, providing a new example about the crosstalk among environmental 6PPD exposure, cellular senescence, and female reproductive health. This work was supported by Natural Science Foundation of China (NSFC No. 82373602), Shenzhen Medical Research Fund (No. B2303002), the National Key R&D Program of China (No. 2025YFC2708402), Guangdong Basic and Applied Basic Research Foundation (2023B1515120054 and 2023A1515110497), Shenzhen Science and Technology Program (No. JCYJ20241202152800001, JCYJ20250604142511015, JCYJ20230807111401002, JCYJ20230807111401002, JCYJ20250604142519025), China Postdoctoral Science Foundation (No. 2025M780729), Shanxi Province Higher Education “BillionProject” Science and Technology Guidance Project; MOE Key Laboratory of Coal Environmental Pathogenicity and Prevention, Futian Healthcare Research Project (No. FTWS011).

29. Knowledge, Attitudes, and Practices on Fecal-Oral Disease Prevention and Social Acceptability of Compost Latrines in Nyamugo Health Area, Bukavu, Democratic Republic of the Congo: Mixed Methods Formative Study.

期刊: JMIR formative research 发表日期: 2026-Jun-01 链接: PubMed

摘要

Fecal-oral diseases remain a major public health challenge in sub-Saharan Africa, where sanitation infrastructure is limited and cultural barriers hinder improved practices. Compost latrines are promoted as ecological solutions, but their acceptability is uncertain. This study assessed household knowledge, attitudes, and practices regarding fecal-oral disease prevention in Nyamugo, Democratic Republic of the Congo, and explored perceptions of compost latrine acceptability. The aim was to identify enabling factors and barriers, including cultural and economic determinants, to inform integrated interventions. A mixed methods cross-sectional design was used. Quantitative data were collected from 432 households through structured questionnaires, and qualitative insights were obtained via focus groups and key informant interviews. Chi-square and logistic regression analyses examined associations between knowledge, attitudes, and practices indicators and sociodemographic variables. Both significant and nonsignificant results were reported for transparency. Households demonstrated partial knowledge of fecal-oral diseases. Cholera was widely recognized (367/412, 88.9%), while hookworm and poliomyelitis were rarely mentioned. Preventive methods such as sanitation (285/412, 69.2%) and hand hygiene (224/412, 54.4%) were the most frequently cited, with education significantly increasing the odds of sanitation knowledge (odds ratio [OR] 2.1, 95% CI 1.4-3.2). Attitudes revealed strong recognition of fecal hazard prevention (397/422, 94.2%), yet compost latrine acceptability remained low (178/422, 42.2%). Regression confirmed that higher education increased favorable attitudes (OR 1.9, 95% CI 1.2-3.0). Qualitative findings highlighted persistent cultural taboos, with latrines described as “impure” or “shameful.” Practices were inconsistent. Although 88% (380/432) of the households owned latrines, only 30.3% (115/380) maintained them hygienically, and open defecation persisted in 31.7% (137/432). Larger household size predicted open defecation (OR 1.8, 95% CI 1.2-2.7), while education was associated with improved hygiene (OR 2.3, 95% CI 1.4-3.6). Compost latrines were not used. Diarrheal episodes in children younger than 5 years were reported in 38.7% (167/432) of the households, with unimproved water sources significantly increasing risk (OR 2.4, 95% CI 1.5-3.8). Qualitative testimonies reinforced these findings, emphasizing poverty, lack of infrastructure, and cultural resistance as barriers. This study confirms a persistent gap between knowledge and practice in fecal-oral disease prevention. Cultural taboos and economic constraints limit compost latrine adoption, even among educated households. Nevertheless, participants expressed openness to adoption if external support-through subsidies, training, and sensitization-was provided. Public health interventions should integrate financial support, cultural dialogue, and infrastructure strengthening to sustainably reduce diarrheal disease burden. Future research should assess the long-term impacts of compost latrine adoption, explore cost-effectiveness, and evaluate behavior change strategies.

30. Service Ready Ambulance Surfaces and Emergency Medical Services Clinicians are Routinely Contaminated with Clinically Important Pathogens.

期刊: Prehospital emergency care 发表日期: 2026-Jun-01 链接: PubMed

摘要

To characterize contamination of ambulances and emergency medical services (EMS) clinicians with clinically important pathogens (CIPs) before and after a shift. Prospective observational study of 20 ambulances from two EMS agencies (10 nonemergency transport, 10 emergency 9-1-1) from September 2021 to March 2022. Samples were collected from patient-facing and clinician-facing surfaces, EMS uniforms, and right nostril before a shift and after a shift but prior to post-shift cleaning. Ambulance surfaces were disinfected by study staff after pre-shift sampling to establish a near-zero reference. The CIPs included methicillin-resistant and methicillin-sensitive Staphylococcus aureus (MRSA, MSSA), vancomycin-resistant Enterococcus (VRE), and Clostridioides difficile. The EMS clinicians completed surveys on hygiene behaviors and beliefs. Primary outcome was presence of ≥1 CIP at an individual sampling site. Across 20 ambulances and 27 EMS clinicians, 941 samples were collected. Overall, 18.5% harbored ≥1 CIP. MSSA was most common (12.8%), followed by MRSA (4.6%) and VRE (3.0%). Clostridioides difficile was rare (0.1%). When deemed service ready, 63.1% of EMS clinicians and 60% of ambulances had ≥1 CIP. Post-shift contamination remained similar (EMS clinicians 67.6%, ambulances 60%). Emergency 9-1-1 ambulances had higher contamination than nonemergency ambulances. EMS clinicians reported high awareness of the importance of clean uniforms and vehicles. EMS clinicians and ambulances harbor CIPs when deemed service ready and contamination accumulates during shifts. Pre-shift uniform contamination suggests clinicians may be sources of medical transport setting contamination. Improved uniform hygiene, rigorous terminal cleaning, and targeted interventions are needed to reduce medical transport-associated infection risk.

31. Environmental mechanics shape segmental trunk control in moderate-to-late preterm infants: A longitudinal analysis examining predictions of the environmental-sensorimotor cascade.

期刊: Infant behavior & development 发表日期: 2026-Jun-01 链接: PubMed

摘要

Segmental trunk control is central to upright motor development in preterm infants, yet evidence linking specific home environment attributes to condition-specific control in late infancy remains limited. This study aims to examine the associations between characteristics of commercial baby containers-defined as restricting equipment or furniture such as playpens and cots-and segmental trunk control during the standing-walking window. Additionally, age-related usage patterns of these containers from 8 to 13 months corrected age were described. In a prospective longitudinal study of 76 moderate-to-late preterm infants, caregivers provided monthly reports on container usage, specifically categorizing attributes of size, rail height, and floor surface compliance. Segmental trunk control was assessed monthly using the Segmental Assessment of Trunk Control (SATCo) under static, active, and reactive conditions. Results indicated that trunk control improved with age across all conditions, although reactive control initially developed more slowly than static and active control before converging at full proficiency by 13 months. Larger container size was consistently linked to better trunk control across static, active, and reactive conditions. Floor surface compliance also played a significant role; soft floors were associated with better static and active control but did not influence reactive control. Conversely, the height of the container rails showed no independent relationship with trunk control performance. Usage patterns shifted over time toward larger spaces and firmer surfaces. These findings suggest that in late infancy, expanded physical space consistently supports segmental trunk control, while surface compliance specifically benefits steady-state and anticipatory control. The results support low-cost, home-based guidance that encourages expanding safe play areas and selecting appropriately compliant surfaces to foster motor development in preterm infants.

32. Sustained and controlled release of natural volatile organic compounds from hydrophilic-lipophilic balance-optimized phytoncide emulsion-zeolite composites for indoor application.

期刊: Journal of hazardous materials 发表日期: 2026-Jun-01 链接: PubMed

摘要

Existing approaches for applying essential oils to indoor environments remain limited by their temporary effects and insufficient control over release behavior. This study develops a sustained natural volatile organic compounds (NVOC) release system using a hydrophilic-lipophilic balance (HLB)-optimized phytoncide emulsion-zeolite composite. Phytoncide oil and hydrosol were emulsified with nonionic surfactants (Tween 80 and Span 80) across various HLB values and loaded into zeolite. High-HLB emulsions (HLB 14) showed enhanced stability, generating small and uniform droplets (∼170 nm, polydispersity index ∼0.13). It was confirmed that NVOC was adsorbed into zeolite pores without significant morphological or structural deterioration of the zeolite. The optimized composite achieved a loading capacity of up to 47%, surpassing previously reported zeolite-based carriers through finer droplets and more uniform adsorption. Short- and long-term release behavior followed the Weibull model (R² ≥ 0.99), with release exponents consistent with Fickian diffusion-influenced transport. The optimized emulsion-zeolite composite markedly improved release persistence, reducing the cumulative release after 14 days by approximately 55% compared with pure phytoncide oil. Quantitative analysis of VOC emissions emitted from the composite revealed that twenty-five NVOC species were detected-mainly cymene, limonene, and valencene. To provide a regulation-relevant context for indoor use, the measured VOC concentrations were evaluated against health-based indoor guideline values, confirming that hazardous VOCs and major terpenes remained below the most stringent guideline under the test conditions. Overall, the composite shows potential as a bio-based controlled-release material for moderating NVOC emission intensity and extending release persistence under indoor-use conditions.

33. Occupational Exposure to Chemical Solvents and Heavy Metals and Oxidative Stress-Related Sperm Dysfunction in Textile Workers.

期刊: Journal of biochemical and molecular toxicology 发表日期: 2026-Jun 链接: PubMed

摘要

Occupational exposure to chemical solvents and heavy metals among workers in textile-related industries has emerged as a significant risk factor for male reproductive dysfunction; however, the underlying biological mechanisms remain incompletely understood. Oxidative stress has been proposed as a key mediator linking occupational exposure to impaired sperm morphology and function. This study aimed to evaluate the association between occupational exposure to chemical solvents and toxic metals and alterations in sperm function, with particular emphasis on oxidative stress-mediated pathways. In this case-control study, semen samples were collected from teratozoospermic men occupationally exposed to chemical solvents and heavy metals (n = 60) and from age-matched normozoospermic controls without known occupational exposure (n = 30). Standard seminal parameters were assessed according to WHO guidelines. Oxidative stress status was evaluated by measuring reactive oxygen species (ROS) and malondialdehyde (MDA) levels, along with antioxidant defense markers, including superoxide dismutase (SOD), catalase, and reduced glutathione (GSH). Sperm functional integrity was assessed through acrosome integrity assays and sperm DNA fragmentation (SDF), evaluated using the comet assay and flow cytometry. Levels of toxic metals (cadmium, lead, and chromium) were quantified using atomic absorption spectrophotometry. Occupationally exposed teratozoospermic men exhibited significantly elevated oxidative stress markers, with increased ROS levels (32.0 ± 9.0 vs. 15.0 ± 5.0) and MDA concentrations (4.8 ± 1.1 vs. 2.1 ± 0.6 nmol/mL), accompanied by a marked reduction in antioxidant defense markers (SOD, catalase, and GSH; p < 0.05) compared with controls. The proportion of acrosome-intact spermatozoa was significantly lower in exposed men (38.3% ± 9.2% vs. 62.4% ± 10.1%). Both comet assay and flow cytometric analyses demonstrated significantly higher levels of sperm DNA fragmentation in the exposed group. Furthermore, quantitative analysis revealed significantly elevated body burdens of cadmium, lead, and chromium among occupationally exposed individuals. These findings indicate that oxidative stress represents a central pathophysiological mechanism linking occupational exposure to chemical solvents and heavy metals with sperm functional impairment and teratozoospermia. The results underscore the importance of routine reproductive health surveillance and oxidative stress monitoring among workers in high-risk occupational settings.

34. Associated Factors of Burnout and Psycho-Physical Distress Among Private Security Personnel in Türkiye.

期刊: The International journal of social psychiatry 发表日期: 2026-Jun-01 链接: PubMed

摘要

This study aimed to examine the prevalence of excessive working hours, burnout, fatigue, and mental and sleep disorders among private security personnel in Turkey. It also assessed their quality of life and self-reported perceptions regarding remuneration. We do agree with the reviewer and we have re-stated in that a cross-sectional survey was conducted using multistage cluster sampling method. Over 3,000 private security company /agency contacted sample of 4,475 private security workers and from those randomly selected only 3,846 participated and completed the survey (response rate: 85%). Univariate and multivariate stepwise regression analyses were performed. Significant gender differences were found in educational attainment, income, smoking habits, working hours, shift rotation, work experience, and subcontracted employment. Somatic symptom severity, assessed via the Patient Health Questionnaire-15, was significantly associated with age, sex, education, occupation, smoking, working hours, shift patterns, experience, and subcontracting status. Depression prevalence was significantly higher among males, who also reported greater somatic symptomatology, anxiety, stress, and daytime sleepiness (all p ⩽ .031). Males showed higher scores of Burnout and related Emotional Exhaustion (EE), Depersonalization (DP), as well as lower Personal Accomplishment (PA; all p ⩽ .015). Burnout, EE, DP, and reduced PA were present in 28.5%, 35.8%, 52.3%, and 39.5% of all participants, respectively. EE and low PA were significantly associated with sleep disorders. Independent predictors of burnout included unexpected phone calls, workload, daily working hours, musculoskeletal pain, smoking, lower education, anxiety, and income (all p ⩽ .007), and were also linked to reduced self-esteem, pessimism, and fatigue (all p ⩽ .035), controlling for age and gender. These findings underscore the psychosocial and occupational vulnerability of private security personnel, with burnout shaped by multiple work-related and demographic factors.

35. Utilization of Non-pharmacological Interventions in Rett Syndrome: A Systematic Review of the Literature on Supportive Care Management.

期刊: Neurology and therapy 发表日期: 2026-Jun-01 链接: PubMed

摘要

Rett syndrome (RTT) is a rare neurodevelopmental disorder characterized by early childhood loss of mobility, reduced verbal communication, and behavioral impairment. Although non-pharmacological supportive interventions are widely used, there is a need to better understand their role in RTT care globally. Following PRISMA guidelines and a PICOST framework, a systematic review of white (PubMed, Embase, Cochrane) and gray literature was conducted. Non‑pharmacological interventions examined in the United States (US) and outside the US (OUS) settings included ancillary services (e.g., physical therapy [PT]), assistive devices (e.g., wheelchairs), surgical procedures (e.g., scoliosis correction), and assisted interventions (e.g., enteral feeding). Across 28 eligible studies, patient ages ranged from 1 to 66 years, and 71.4% focused exclusively on female patients with RTT. Approximately 25.0% of the studies were conducted in the US, while 75.0% were conducted in OUS. Six studies examined ancillary service use, where PT utilization ranged from 24.4% to 100.0% and occupational therapy (OT) ranged from 11.5% to 91.7%. Pediatric patients demonstrated a two- to fourfold higher utilization of PT and OT services compared to adults. Among six studies evaluating assistive devices, wheelchair use was reported in up to 90.0% of patients. Nine studies reported surgical procedures, with 1.2%-50.0% of patients requiring scoliosis surgery. Eighteen studies examined assisted interventions, showing enteral feeding utilization rates from 2.0% to 52.0%. Despite the universal clinical reliance on non-pharmacological interventions in RTT, the evidence base quantifying their real-world utilization remains sparse. The wide variability in reported rates might be due to differences in data sources, geographic settings, and patient populations which underscores the need for standardized, prospective, longitudinal research. Age-related declines in ancillary service use and geographic gaps highlight systemic disparities that warrant further investigation. These findings provide a foundational evidence base to inform health resource planning and future research priorities in RTT.

36. Social support as the protector of mental health during the COVID-19 pandemic: Population-based longitudinal evidence across pre- and post-vaccine phases.

期刊: Social psychiatry and psychiatric epidemiology 发表日期: 2026-Jun-01 链接: PubMed

摘要

This longitudinal study examined how perceived social and emotional support was associated with symptoms of depression and anxiety during the COVID-19 pandemic in a sample of a general adult population of Wisconsin, before and after the availability of vaccines. Using a statewide population-based longitudinal household cohort data from two critical pandemic phases (January-March 2021 and June-August 2021), a series of regression analyses were performed to explicitly test associations across distinct phases of the pandemic, using generalized estimating equations (GEE), adjusting for age, gender, race and ethnicity, education, and income. Before vaccines were available, participants with inadequate social support significantly had a higher prevalence of symptoms of depression (PR = 2.10; 95% CI = 1.85, 2.38; p<0.001) and anxiety (PR = 1.64; 95% CI = 1.48, 1.83; p < 0.001), compared to those with adequate social support. Although the overall prevalence of depressive and anxiety symptoms decreased over time, the association between social support and mental health was stronger after the vaccines were widely distributed. Longitudinal findings of this study emphasize the critical role social and emotional support plays as a social determinant of common psychiatric symptoms. It highlights that the role of social and emotional support on mental health is not static but rather, it varies over time, in response to changing conditions in the society that are closely tied to public health policies. This study offers implications for population-level preparedness in future public-health emergencies. Future research on both perceived and received social support with longer longitudinal assessments is warranted.

37. Comparison of functional and anatomical parameters in patients with nasal obstruction: peak nasal inspiratory flow and computed tomography-based internal nasal valve angle.

期刊: European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery 发表日期: 2026-Jun-01 链接: PubMed

摘要

The internal nasal valve (INV) is the narrowest segment of the nasal airway and plays a key role in nasal airflow resistance. This study aimed to evaluate the relationship between peak nasal inspiratory flow (PNIF), bilateral INV angles measured on computed tomography (CT), and nasal examination findings in patients presenting with nasal obstruction. This retrospective cross-sectional study included 94 patients who presented with nasal obstruction to the otorhinolaryngology outpatient clinic between January 2024 and September 2025. All patients underwent detailed nasal examination and septal deviation was classified according to the Baumann classification. Bilateral INV angles were measured on coronal paranasal sinus CT images. PNIF values were obtained from medical records. Statistical analyses were performed to assess correlations and group differences. The mean PNIF value was 68.1 ± 24.7 L/min, and the mean bilateral INV angle was 11.2 ± 3.2°. A moderate, significant positive correlation was observed between PNIF values and bilateral INV angles (rho = 0.290, p = 0.005). Patients with a bilateral INV angle below 9° had significantly lower PNIF values compared with those with angles ≥ 9° (p = 0.011). No significant differences in PNIF values or INV angles were found among different Baumann septal deviation subtypes. Narrower INV angles are associated with reduced functional nasal airflow as measured by PNIF. Assessment of the INV provides additional functional insight beyond septal deviation classification alone. PNIF represents a practical, noninvasive tool for functional evaluation of nasal obstruction and may support clinical decision-making and surgical planning.

38. Resistome risks of biological wastewater treatment communities: A global dataset of activated sludge, anaerobic digestion, and anammox.

期刊: Journal of hazardous materials 发表日期: 2026-May-30 链接: PubMed

摘要

Activated sludge (AS), anaerobic digestion (AD), and anammox (AMX) systems are widely used for wastewater treatment. Their microbial communities harbor resistomes, including but not limited to antibiotic resistance genes (ARGs) and metal resistance genes (MRGs), which may pose potential risks to human and ecological health if they are mobilized or transferred to pathogenic hosts. However, cross-process comparisons of resistome risks are limited at a global scale. This study analyzed 225 metagenomic datasets (210 public: 70 each for AS, AD, AMX; plus 15 in-house AMX) to assess resistome risks and identified key influential factors. Overall, within the constraints of current data availability, North America, Europe and Asia systems exhibited comparable risk levels. AD systems exhibited more than 2-fold higher human health resistome risks (potentials for human pathogens of acute resistance concern to acquire ARGs) than AS and AMX systems. Mesophilic and co-digestion AD systems posed 30-90% higher risks than thermophilic and mono-digestion systems with higher abundance of pathogens, ARGs, and MRGs. AMX systems, otherwise, showed higher ecological resistome risks (overall mobility of ARGs/MRGs and potentials for pathogen acquisition) than AS and AD. The conservative AMX communities contained core taxa that harbor 19.8% more ARGs/MRGs per genome and exhibit 31.4% higher horizontal gene transfer potential than non-core taxa. Key operating factors influencing resistome risks included temperature for AD, and organic loading, influent antibiotics and heavy metals for AMX. These findings provide insights into future wastewater treatment towards improved efficacy and reduced resistome risks.

39. Factors associated with histological outcomes of MRI-guided biopsy in the lumpectomy bed.

期刊: Clinical imaging 发表日期: 2026-May-28 链接: PubMed

摘要

To evaluate the association between clinical and MRI characteristics and histological outcomes of MRI-guided vacuum-assisted biopsies (MVAB) performed in the lumpectomy bed after malignant breast-conserving surgery (BCT). This retrospective study analyzed all MVABs performed in malignant lumpectomy beds between 2016 and 2022, evaluating the relationship between demographic and imaging characteristics and pathological outcomes (benign vs. malignant) using appropriate statistical methods. Malignancy was diagnosed in 14 of 72 biopsies (19%), most commonly invasive ductal carcinoma (50%). Fat necrosis was the predominant benign finding (38%). On univariate analysis, benign outcomes were more frequent in younger patients (median 60 vs. 69 years), those with prior radiation therapy (90% vs. 69%, P = 0.048), lesions adjacent to a postoperative cavity (28% vs. 7%, P = 0.1), and when coarse calcifications were present on mammography (43% vs. 0%, P = 0.011). Benign results were also more common for biopsies performed within one year or beyond six years after lumpectomy (97%, P = 0.087). No MRI morphological or kinetic features reliably distinguished benign from malignant lesions. MVAB of lumpectomy bed lesions yielded a 19% malignancy rate, with benign outcomes often associated with specific clinical and imaging features. Larger studies are warranted to validate these findings and refine patient selection.

40. The opportunities and experiences of interprofessional education for undergraduate nursing students on professional experience placement: An integrative literature review.

期刊: Nurse education today 发表日期: 2026-May-28 链接: PubMed

摘要

This Integrative review aimed to identify the interprofessional education opportunities for undergraduate nursing students on clinical placement and to understand their experiences of undertaking them. This study used an Integrative Review design following the process outlined by Whittemore and Knafl (2005). Five electronic databases were searched: CINAHL Complete, MEDLINE Complete, ERIC, Web of Science Core Collection and ProQuest Health and Medicine Collection. The PRISMA principles were used for reporting the review. Quality assessment was undertaken using an adapted version of the Mixed Methods Appraisal Tool (MMAT). Braun and Clarke’s (2020) six-step reflexive thematic analysis approach was adopted to interpret the study characteristics and main themes. A total of 32 articles were included in the review. Interprofessional education in clinical placement has variability in lengths of placement, placement settings, and interprofessional education activities. The length of placement and activities were linked to a lack of placement availability and the financial impact on a facility. The three main settings for interprofessional placements were primary health care, residential aged care and rehabilitation wards. Most articles reported the creation of temporary multidisciplinary placements for interprofessional education research. Five main themes were classified during data analysis including: ‘authentic and valuable learning experience’; ‘communication and collaboration’; ‘constraints and challenges’; ‘professional hierarchies’; and ‘professional identity’. Student nurses value interprofessional education opportunities and believe they support the development of communication and collaboration skills, their own role perceptions and perceptions of other professions, although professional hierarchies remain a concern. Opportunities for interprofessional education are mainly artificially created for research projects. Research is lacking on actual opportunities or experiences for nursing students in standard clinical placements. Further research is needed on Interprofessional education focusing on the acute setting and the length of time required to support interprofessional education in practice.

41. Lipid droplets are potentially involved in bovine alphaherpesvirus 1 productive infection partially via stabilization of virion-associated proteins.

期刊: Veterinary microbiology 发表日期: 2026-May-28 链接: PubMed

摘要

Bovine alphaherpesvirus 1 (BoAHV-1) is one of the most important viruses that infects cattle and leads to significant economic losses to cattle industry. We have recently reported that both carnitine palmitoyl-transferase 1 A (CPT1A), a rate-limiting enzyme of mitochondrial fatty acid β-oxidation, and the lipogenic enzyme fatty acid synthase (FASN) are involved in viral productive infection. Excessive fatty acids are typically re-esterified into triacylglycerol (TAG), which are then deposited into lipid droplets (LDs), the primary form of lipid storage in cells. TAG acyltransferase 1 (DGAT1) and DGAT2 are key enzymes involved in TAG synthesis, while adipose triglyceride lipase (ATGL) is a key enzyme involved in breakdown of TAG stored in LDs. To further reveal the roles of fatty acid played in BoAHV-1 life cycles, we investigated the interplay between LDs and viral infection both in vivo and in vitro. Here, we found that the viral lytic infection in bovine trigeminal ganglia (TG) neurons increased perilipin 2 (PLIN2) protein levels, indicative of an increase in LDs. Similarly, viral productive infection in bovine kidney (MDBK) cells increased LD accumulation, as determined using the lipophilic dye BODIPY493/503. Although viral infection differentially altered the expression of ATGL, DGAT1, and DGAT2, the consistently reduced expression of ATGL both in vivo and in vitro would be expected to decreased lipolysis and consequently the decreased LD degradation. Interestingly, we observed that a proportion of LDs co-localize well with virion-associated proteins, such as viral protein gD, and chemical inhibition of LD accumulation reduced viral productive infection in MDBK cells, which was partially attributed to the reduced levels of virion-associated proteins. Taken together, we provide an evidence that LDs may facilitate BoAHV-1 productive infection both in vivo and in vitro.

42. New insights in tumor-on-a-chip models for studying cancer drug resistance.

期刊: Pathology, research and practice 发表日期: 2026-May-27 链接: PubMed

摘要

Cancer presents significant challenges due to its high incidence, frequent recurrence, elevated mortality, and generally poor prognosis, making it a serious threat to human life and an obstacle to societal progress. A major difficulty in cancer treatment is the development of drug resistance, which undermines the effectiveness of therapies and limits patient survival, creating a substantial challenge for clinical oncology. In-vitro models, such as two-dimensional (2D) and three-dimensional (3D) cell cultures, have historically been used to study cancer cells responses to antitumor drugs and treatments. However, these models have faced limitations in reproducibility and scalability. Animal models, while commonly used, also fall short in accurately forecasting treatment outcomes in patients and casting doubts on their utility in fundamental research. Moreover, tumors at different stages of differentiation present varying levels of complexity, making it increasingly difficult to assess treatment resistance using traditional 2D/3D culturing and animal models. Hence, there remains a critical need for the creation of a novel platform that possesses the ability to manipulate cancer cells and tumor microenvironment in a scalable and reliable manner. In this review, we explore emerging microfluidic technologies and advanced tumor-chip systems that efficiently offer dynamic assessment of drug resistance.

43. Combined periodontitis GWAS identifies LINC01541 as a regulator of innate immunity in the oral mucosa.

期刊: Human molecular genetics 发表日期: 2026-May-26 链接: PubMed

摘要

Periodontitis is a complex inflammatory disease in which chronic immune activation drives destruction of periodontal soft tissues and alveolar bone. Although early-onset forms show high heritability, much genetic risk remains unresolved. To identify shared genetic signals across early- and later-onset periodontitis, we combined two European genome-wide association study datasets (3183 cases, 10 326 controls) and applied Fisher’s combined probability test (FCOMB) and effect-size-based genome-wide association meta-analysis (GWAMA) across > 7 million variants to capture shared signals with either heterogeneous or more concordant effect sizes. We confirmed known associations at SIGLEC5 and DEFA1A3 and identified several additional suggestive loci. Among these, FCOMB highlighted the strongest signal at the long non-coding RNA LINC01541 (rs11876034, P = 1.7 × 10-6). We evaluated the biological relevance of LINC01541 by repressing it in gingival fibroblasts using CRISPR interference. Knockdown led to significant downregulation of inflammatory mediators, including CSF2 and CSF3, regulators of neutrophil recruitment, members of the interleukin (IL) family (IL1B, IL36B, IL36RN), and chemokines (CXCL5, CXCL8, CCL20). Six of the top ten differentially expressed genes belonged to an epithelial keratinization expression cluster. Gene-set enrichment analyses following linc01541 knockdown demonstrated repression of cytokine signaling, with IL-10 signaling most affected (padj = 5.3 × 10-14; AUC = 0.81), alongside activation of cell-cycle pathways (padj = 3.3 × 10-24; AUC = 0.73). We demonstrated the utility of aggregating heterogeneous samples to detect modest but biologically meaningful genetic effects. The convergence of the genetic association at LINC01541 with functional evidence suggests that this lncRNA modulates an upstream mucosal inflammatory axis relevant to periodontal pathogenesis.

44. The causal association between sleep traits and osteoarthritis traits: evidence from bidirectional mendelian randomization.

期刊: Human molecular genetics 发表日期: 2026-May-26 链接: PubMed

摘要

Sleep disorder is associated with risk of osteoarthritis, yet their causal association has not been fully understood. This study aims to evaluate the causal association between sleep traits and osteoarthritis, by performing two sample Mendelian randomization (MR) leveraging the currently largest genome-wide association study (GWAS) summary statistics for sleep traits and osteoarthritis traits. We demonstrate that insomnia has a risk-increasing causal effect on osteoarthritis at any site, hip osteoarthritis, and hip and/or knee osteoarthritis, corresponding to approximately 60%, 100%, and 50% higher odds of disease, respectively, with the strongest effect observed for hip osteoarthritis. Conversely, genetic predisposition to osteoarthritis at any site was associated with a modest 4% increase in the odds of insomnia. These findings reveal a bidirectional causal relationship between insomnia and osteoarthritis-related traits, underscoring the critical interplay between sleep health and joint disease, and suggesting opportunities for preventive and therapeutic strategies that align with the body’s intrinsic timing systems.

45. Determinants of ultra-processed food purchases: Evidence of between- and within-household variation in France.

期刊: Social science & medicine (1982) 发表日期: 2026-May-22 链接: PubMed

摘要

Ultra-processed food consumption is associated with obesity and chronic diseases, but its determinants are not well documented. This understanding is essential to inform policies aimed at improving public health. To this end, we construct a unique longitudinal dataset of French households’ food purchases from 2004 to 2015, which we merge with nutritional and food processing data. Using panel data econometric analysis, we identify the determinants of ultra-processed food purchases by exploiting variation between and within households and capturing the persistence of purchasing behavior over time. Moreover, we combine this analysis with an instrumental variable approach to obtain price elasticities. Demographics explain differences between households. Higher ultra-processed food purchases correlates with obesity, younger cohorts, poverty, rural areas, and Paris and northern region of France. Within a household, the purchase of ultra-processed food is influenced by income constraints. Time constraints, such as those imposed by having young children or being a one-adult household, also play a role, highlighting the link between ultra-processed food consumption and convenience, as well as limited time for food preparation. Nevertheless, a tax policy could effectively reduce ultra-processed food purchases. A 20% price increase would reduce ultra-processed food purchases by 19.5% within a year, with even larger declines in the long run, around 32%, due to persistent purchasing patterns. We show how different groups react differently to taxes, which has important consequences for designing effective policies aimed decreasing ultra-processed food consumption.

46. Relationship between long-term exposure to sources of particulate matter, ambient air pollution and cognitive function in older adults.

期刊: Social science & medicine (1982) 发表日期: 2026-May-20 链接: PubMed

摘要

Long-term exposure to particulate matter with a diameter of less than 2.5 μm (PM2.5) is associated with cognitive decline, but it is not clear whether the potential effects of PM2.5 from different emission sources vary. This study aims to assess the association between PM2.5 from different emission sources and cognitive function in older adults in Northern Ireland. Using data of the Northern Ireland Cohort of Longitudinal Ageing from wave 1 (n = 3440) and wave 2 (n = 5408). Long-term exposure to PM2.5 (5-year and 10-year average) was estimated using the UK Pollution Mapping approach within the 1-km residential circular buffers, while PM2.5 source fraction was calculated using the atmospheric chemistry-transport model. Cognitive function was assessed using the Mini-Mental State Examination (MMSE) scores. The association between PM2.5 and MMSE scores was estimated using multilevel linear regression models, and the Quantile-based g-computation approach was employed to decompose the potential effect of different emission sources of PM2.5. The 5-year average PM2.5 levels were negatively associated with MMSE scores (coef. = -0.07; SE = 0.02), with no evidence of association with 10-year average levels (coef. = -0.05; SE = 0.02). Furthermore, 5-year average PM2.5 from agriculture, wildfires and road traffic were negatively associated with MMSE scores, while 10-year average PM2.5 from agriculture was also negatively associated with MMSE outcomes. Moreover, industry and agricultural sources provide the greatest contributions to the potential effect of PM2.5. Long-term exposure to PM2.5, especially from agricultural, road traffic, and wildfire, may be harmful to cognition. Therefore, policy should aim to regulate emissions from high-risk sources.

47. Financial, housing, food, and healthcare insecurities and their independent and joint associations with depressive symptoms and stress in a U.S. cohort of adults with and without HIV.

期刊: Social science & medicine (1982) 发表日期: 2026-May-14 链接: PubMed

摘要

Financial, housing, food, and healthcare insecurities are prevalent forms of material-need insecurity (MNI) in the U.S. that often co-occur, with significant consequences for health. We investigated how these MNIs overlap and relate jointly and independently to mental health among people with and without HIV enrolled in the MACS/WIHS Combined Cohort Study (MWCCS). Confirmatory bifactor analyses were used to examine how much unique variability remained in subfactors for financial, housing, food, and healthcare insecurities after accounting for common, underlying material hardship, described herein as overall MNI severity (n = 2433). Structural equation models tested how overall and specific MNI severity relate independently to depressive symptoms, as measured by the Center for Epidemiologic Studies Depression scale, and perceived stress, as measured by the Perceived Stress Scale, adjusting for income and other socioeconomic covariates. Most of the variance in financial (76.2%), housing (88.7%), food (55.7%), and healthcare insecurity (64.4%) was explained by overall MNI severity, which was strongly related to depressive symptoms (standardized β: 0.508, SE: 0.028, p < 0.001) and perceived stress (standardized β: 0.538, SE: 0.026, p < 0.001). Independently of overall MNI severity and each other, the specific subfactors had additive associations with depressive symptoms and stress. In summary, financial, housing, food, and healthcare insecurities were strongly interrelated, and both their overlapping and distinct characteristics related independently and additively to depressive symptoms and perceived stress. These findings highlight the value of moving beyond studying MNIs in isolation to examining the health consequences of co-occurring MNIs and developing interventions and policies that improve multiple forms of MNIs simultaneously.

48. Effectiveness of agricultural interventions to minimise the health impacts of air pollution: a synopsis from a mixed method study.

期刊: Public health research (Southampton, England) 发表日期: 2026-May 链接: PubMed

摘要

Agriculture dominates United Kingdom ammonia emissions, from livestock manure exposed to the atmosphere via livestock housing, storage, land and grazing. Ammonia significantly contributes to the formation of PM2.5 (particles with diameter of 2.5 μm or less) concentrations in Europe which are associated with adverse human health outcomes. Ammonia emissions contribute to nitrogen deposition, whereby reactive compounds of nitrogen are deposited into the biosphere, potentially resulting in biodiversity loss. Recent research has not found sufficient evidence for effectiveness of interventions to reduce ammonia emissions and little evidence on the cost-effectiveness of interventions. The current study aimed to address this knowledge gap. The study aimed to assess effectiveness and cost-effectiveness of two agricultural interventions to mitigate ammonia emissions - improved housing for farmed animals and improved manure application. Emission measurements were made at five farms (dairy, pig, poultry). Information on uptake of mitigation measures, barriers and enablers for implementation were determined through an online survey and focus groups with farmers, supplemented by stakeholder interviews. Chemical transport and dispersion modelling estimated population exposures to air pollution at local and national levels under three scenarios (low, medium, high intervention uptake). A health impact assessment estimated health effects associated with the scenarios, and data on self-reported health issues were collected via an online survey of rural residents. Economic evaluation methods estimated cost-benefits of the scenarios and impact on ecosystems. Farmers favour mitigation measures which are cheaper, and build on existing practices, such as amending diet or extending the grazing season. However, these are less effective in decreasing ammonia emissions. Scenarios based on realistic current, and future, uptake levels of measures showed little impact on air quality, partly due to the ammonia-rich United Kingdom atmosphere minimising conversion of ammonia emissions to particulate matter. Consequently, minimal impact of mitigation measures was evident on health outcomes and costs. There was no evidence that self-reported health symptoms from rural residents were related to living near a farm, type of farm or seasonality of farm activities, consistent with results of local dispersion modelling which estimated that most emissions from animal housing dispersed within 1 km. Impacts of COVID-19 and the United Kingdom’s withdrawal from the European Union on the agricultural industry affected the recruitment and availability of farms and farmers, resulting in fewer field measurements than planned. A lower response to the farmers’ survey was mitigated by the quality of data provided by participants and the successful series of focus groups. The study highlights the need for enhanced communication with the farming community to encourage implementation of more effective mitigation measures, such as air scrubbers, or those relating to slurry storage, currently perceived to be too expensive and complex. Greater clarity on benefits is essential so that farmers understand not only what they need to do but also how and why. Further investigation of the health impacts of ammonia emission should focus on those exposed on the farm, or resident nearby animal houses. Further modelling development of key atmospheric processes is also indicated to minimise uncertainties associated with the regional modelling. This synopsis presents independent research funded by the National Institute for Health and Care Research (NIHR) Public Health Research programme as award number NIHR129449. Air pollution damages lung and heart health, contributing to premature death and hospital admissions. These health effects are associated with exposure to very small particles, including from reactions of ammonia emitted from farming, the main United Kingdom producer of ammonia, principally from animal manure in livestock housing, fertilisation of fields and animal grazing. Recently, other United Kingdom sources of particles have decreased, but ammonia levels have not. This study aimed to assess the effectiveness of improved cattle housing and manure storage and application, at reducing emissions of gases and particles. We measured ammonia emissions from five farms and used surveys, focus groups and interviews with farmers and stakeholders to understand views on ammonia reduction measures. Computer models were used to estimate the impact of emissions reduction on exposure and related health issues of people near farms and the wider United Kingdom population. We calculated savings in National Health Service costs. We also surveyed people living near farms about their health. The study found that the measures that farmers were currently prepared to consider implementing reduced ammonia emissions by up to 13%, but the overall reduction in air pollution particles was limited (around 1%). Improvements in health and cost-savings were also small, and surveys of rural residents did not show health problems were related to farming. The study also showed that emissions from farms almost entirely dispersed into the background air within 1 km. Farmers were interested in reducing their environmental impact and favoured cheaper interventions building on existing practices, which also tended to be less effective in reducing ammonia emissions. Barriers to using these interventions were costs and lack of knowledge. To reduce ammonia emissions, future policies should address the barriers and clearly communicate benefits to the environment and to farmers. It would be useful to study more effective farming interventions to reduce air pollution.

49. Estimating Small Area Statistics and Developing a Novel Mapping Tool to Display Them Using a User-Centered Design Process.

期刊: JCO clinical cancer informatics 发表日期: 2026-Apr 链接: PubMed

摘要

Cancer registries are often asked to present cancer data for small geographic areas to inform and facilitate targeted interventions and prevention programs. However, it is challenging to compute and visualize reliable cancer estimates for areas with small case counts and populations to support cancer control planning. Leveraging a user-centered design process, we developed a visual analytics platform and interactive graphics to display modeled cancer risk estimates for small areas. Development of our visual analytics platform was informed by cancer registry and public health professionals through focus groups and surveys. The reliable cancer risk estimates for small areas that we displayed on this platform were created using a Bayesian hierarchical model that borrows strength from neighboring areas and over time to produce cancer estimates for small areas. The Cancer Analytics and Maps for Small Areas tool (CAMSA) provided age-adjusted cancer incidence and mortality rates and risk probabilities for eight cancers at the county and ZIP-code tabulation area levels. It allowed the user to identify areas of high cancer incidence, including among subgroups defined by sex and race/ethnicity. Potential end users were enthusiastic about the opportunity to implement CAMSA within their practice, emphasizing the tool’s potential for increased collaborative opportunities at local and state levels. Suggestions for improvement included adding map overlays such as additional cancer risk variables and incorporating functionalities such as exportable data tables. CAMSA presented cancer rate and risk estimates for small geographic areas where they may have previously been suppressed. Through our user-centered design process, we developed statistical models and data visualizations to support the needs of an array of potential end users.

50. Facility staff perspectives on the implementation of Maternal and Perinatal Death Surveillance and Response in six health facilities in Kigoma, Tanzania.

期刊: PloS one 发表日期: 2026 链接: PubMed

摘要

Maternal and Perinatal Death Surveillance and Response (MPDSR) is an important accountability mechanism for preventing avoidable deaths and addressing gaps in care. Health facilities in resource constrained settings often face barriers to implementing and sustaining MPDSR. The purpose of this study was to identify factors that may influence MPDSR implementation outcomes in health facilities in Tanzania. Semi-structured, in-depth interviews (IDIs) were conducted in January 2024 with 17 delivery care providers (e.g., doctors, midwives, anesthesiologists) and 5 health administrators who oversaw or facilitated the facility’s MPDSR process. The implementation outcomes framework and the Practical, Robust, Implementation and Sustainability Model (PRISM) were used to guide the study, the development of interview guides, and analysis. We analyzed transcripts using a multistage approach and the constant comparative method. We identified several factors that may have impacted MPDSR implementation outcomes, which we grouped into three primary themes: (1) organizational and staff perspectives on MPDSR, (2) characteristics of the implementation setting, and (3) implementation and sustainability infrastructure. Subthemes included more specific barriers and facilitators that were related to MPDSR implementation outcomes. Prominent facilitators included positive perspectives of MPDSR, ongoing training and mentorship, and community engagement. Major barriers included lack of organizational readiness, resource, financial and other constraints, and blame culture. Identifying factors that influence MPDSR implementation outcomes is important for understanding barriers and facilitators to implementation. Fostering safe environments (i.e., no blaming), addressing barriers to staff participation and motivation, and implementing monitoring systems for MPDSR recommendations may help strengthen implementation outcomes and, ultimately, sustainability.

51. Health issues and needs among adolescents in Ethiopia: A cross-sectional study.

期刊: PLOS global public health 发表日期: 2026 链接: PubMed

摘要

Adolescence, which is a critical foundation for lifelong health, comes with distinct health challenges and needs. Understanding these is crucial for timely and effective measures. This study therefore examines adolescent health issues and needs and identifies unmet health information and service needs, including differences by sex, grade level, and school type, to inform tailored and effective interventions. The study employed a cross-sectional design involving school adolescents. Respondents were randomly selected after stratification by sex at grade level. Data were collected using a self-administered questionnaire that was informed by qualitative findings. Descriptive statistics were used to summarize the data, and Pearson’s chi-square tests evaluated differences by sex, grade level, and school type, in SPSS 27.0. Of the 722 adolescents participated in this study, 27.6% reported recent health problems related to mental health, reproductive health, and other issues. Respondents identified risky sexual behaviors, substance use, mental health issues, and social media addiction as major health concerns among adolescents, with sex-based differences in perceived priorities. About 73% of the respondents reported seeking health information and services for various reasons, with females were more likely to do so than males (p = 0.025). They reported often consulting parents, friends, the Internet, and health professionals, in that order, while seeking health information, with variations by school type and grade level. However, they trusted health professionals most, followed by the Internet, television/radio, and family. Only 32.7% of the respondents reported that they could access health service when needed. Adolescents from private schools were significantly more likely than those from public schools to do so (p < 0.001). Overall, the study shows that adolescent health challenges and needs are multifaceted, demanding tailored interventions, including effective multichannel health communication, promotion of health literacy, strong parental and community involvement, and accessible adolescent-friendly health services.

52. Higher internal locus of control is associated with higher performance in a workplace walking intervention, Global Corporate Challenge®.

期刊: PloS one 发表日期: 2026 链接: PubMed

摘要

Given the increasing reliance on self-regulation in modern work environments, understanding how psychological characteristics influence physical activity participation can help inform more effective health promotion strategies. This study examines whether individuals with different Locus of Control (LOC) orientations show varying levels of engagement and performance in a workplace pedometer program. We conducted a secondary analysis of 426 office workers in Melbourne, Australia who participated in the 2008 Global Corporate Challenge® (GCC®), a four-month team-based pedometer program encouraging 10,000 steps per day. Internal LOC (ILOC) was assessed at baseline, four months, and 12 months using the Duttweiler Internal Control Index. Baseline ILOC was the primary exposure. Program performance was operationalized as average daily step counts and achievement of the 10,000-step daily goal. Linear regression and logistic regression, adjusted for workplace clustering and covariates, were used to examine associations between ILOC and outcomes. Paired t-tests and descriptive comparisons were used to assess changes in ILOC over time. Participants with higher baseline ILOC were older (p < 0.001), more likely to have previously completed the GCC® (p = 0.039), more health-motivated (p = 0.015), met fruit (p = 0.040) and vegetable (p = 0.003) intake guidelines, and reported higher wellbeing and mental health-related quality of life (both p < 0.001). During the program, higher ILOC was associated with higher average daily step counts (β = 46.97, 95% CI [24.62, 69.33]; p = 0.001) and greater likelihood of achieving the 10,000-step goal (OR = 1.02, 95% CI [1.01, 1.03]; p = 0.001). ILOC showed no significant net change overall, but a clear regression-to-the-mean pattern was observed across baseline quartiles. Higher ILOC was associated with better performance in the pedometer program, though this did not translate into sustained additional health gains.

53. Incremental impact of community-delivered HPV self-sampling on screening uptake within an active outreach system: A quasi-experimental implementation study in rural Thailand.

期刊: PloS one 发表日期: 2026 链接: PubMed

摘要

Thailand has still not achieved the cervical cancer screening coverage target set by the World Health Organization (WHO). Although HPV self-sampling has been introduced to reduce access barriers, delivery remains largely facility-based, requiring women to attend primary care units during working hours. Community-delivered approaches have been proposed as an alternative; however, evidence comparing strategies within the same service context remains limited. This study aimed to assess the incremental benefit of a community-delivered approach, incorporating structured workshops and same-day sample return, within an already active outreach system, compared with a facility-based approach with similar outreach support, on screening uptake; secondary outcomes included operational feasibility and acceptability. We conducted a quasi-experimental comparative study in a rural subdistrict of Thailand. Eligible women aged 30-60 years were recruited from two villages and allocated at the village level to either a community-delivered approach (CD group) or a facility-based approach with active outreach (FB group). Screening uptake was defined as the return of a completed self-sampling kit and is presented using proportions and 95% confidence intervals. Feasibility and acceptability were also assessed descriptively using process indicators and participant-reported experiences. A total of 108 participants were enrolled, with 106 included in the primary analysis. Screening uptake was 52% (28/54; 95% CI: 42% to 61%) in the CD group and 35% (18/52; 95% CI: 26% to 45%) in the FB group. The observed absolute difference was 17% (95% CI: -1% to 34%). All returned samples were adequate for HPV testing. Participant-reported confidence, usability, and overall experience with self-sampling were favorable and similar across groups. HPV self-sampling was operationally feasible and acceptable under both delivery approaches in this rural Thai setting. Screening uptake was numerically higher in the community-delivered group; however, the confidence interval included no difference, indicating uncertainty in the direction and magnitude of effect. These findings are suggestive but inconclusive evidence. Further adequately powered studies with rigorous implementation evaluation are needed, particularly to optimize service delivery, including increasing flexibility in scheduling, strengthening implementation fidelity, and evaluating workforce and cost implications, to better determine effectiveness and scalability. Trials Registration: Thai Clinical Trials Registry (TCTR): TCTR20241231010.

54. Unveiling the Potential of Drug Delivery Systems for Tyrosine Kinase Inhibitors in the Treatment of Neovascular Eye Diseases.

期刊: Critical reviews in therapeutic drug carrier systems 发表日期: 2026 链接: PubMed

摘要

Tyrosine kinase inhibitors (TKIs) represent a promising category of therapeutic agents for managing edema and neovascular eye diseases (NEDs) such as corneal neovascularization, proliferative diabetic retinopathy and neovascular age-related macular degeneration. By impeding the phosphorylation of receptor tyrosine kinases, TKIs prevent the activation of angiogenic signaling pathways that are vital for cell growth and proliferation. However, the TKIs delivery in ophthalmology presents significant challenges such as toxicity and poor bioavailability. This review discusses emerging TKIs for NEDs, their physicochemical properties, and delivery systems, highlighting strategies such as sustained-release ocular implants, hydrogels, particulate and composite systems. Amid each category, we explore groundbreaking research approaches with a focus on preclinical and clinical studies, providing an in-depth look at the latest advancements in TKI-based delivery systems. Numerous TKI formulations currently under investigation (AXPAXLI, DURAVYU, CLS-AX and D-4517.2) hold the potential to improve therapeutic outcomes and enhance patient adherence, transforming the treatment landscape of NEDs. Advanced TKI delivery platforms, integrated with artificial intelligence-driven tools and minimally invasive technologies may enable more effective and personalized treatment options in the field of eye care.

55. Food purchase patterns in Nairobi before, during, and after the COVID-19 pandemic lockdown measures.

期刊: PLOS global public health 发表日期: 2026 链接: PubMed

摘要

The nationwide lockdown measures implemented during the coronavirus disease 2019 (COVID-19) pandemic disrupted food supply systems, potentially altering consumer purchasing behaviour. There is limited evidence quantifying these changes in low- and middle-income settings. This study aimed to examine the impact of COVID-19 on grocery purchase patterns among consumers in Nairobi. Using generalized least squares (GLS), we conducted an interrupted time series (ITS) analysis of weekly food purchase data from 2018 to 2023. The analysis considered three periods: pre-COVID (12th January 2018-26th March 2020), COVID (27th March 2020-21st October 2021), and post-COVID (22nd October 2021-31st December 2023). A total of 11,105,974 transactions from two supermarkets in Nairobi were classified using the NOVA food classification and linked with nutrient composition data. Compared to the pre-COVID period, characterized by declining purchases of processed culinary, unprocessed/minimally processed foods, and increasing ultra-processed food (UPF) purchases, the COVID period was associated with a short-term change toward healthier purchasing patterns, including reduced UPF, with increased processed and unprocessed/minimally processed food purchases. Nutritionally, pre-COVID trends of rising energy and carbohydrate purchases and declining proteins, calcium, iron, magnesium, potassium, and sodium, were contrasted by short-term increases during COVID in fibre, iron, magnesium, phosphorus, potassium, and sodium, alongside a long-term decline in carbohydrates. Proteins showed consistent short- and long-term increases, while calcium rose sharply at COVID onset but declined over time. In comparison, the post-COVID period reflected a reversal of these changes. While processed food purchases increased briefly before declining, longer-term trends showed increases in calcium, sodium, and carbohydrate purchases and decreases in energy and fat. These findings shed light on how populations adapt their food purchasing behaviors during and after global crises, offering insights that can inform future policies aimed at curbing unhealthy food purchases and strengthening food security.

56. Pain catastrophizing is associated with higher pain intensity following carpal tunnel release: a prospective observational study.

期刊: Scandinavian journal of pain 发表日期: 2026-Jan-01 链接: PubMed

摘要

This study aims to examine preoperative sociodemographic, clinical, and psychological factors associated with acute worst pain intensity following open carpal tunnel release (CTR). This prospective observational study included 83 patients between 18 and 79 years undergoing primary outpatient CTR. All patients filled in consent forms and a questionnaire that assessed demographics, comorbidities, pain and function, sleep quality and pain catastrophizing. The primary outcome was worst pain intensity during the first three postoperative days. Linear regression analyses were done to estimate associations between age, sex, education, comorbidity, pain catastrophizing and sleep quality, and worst postoperative pain intensity. The patients mean age was 60 years and most were women (64 %). Patients rated their worst preoperative pain to 4.5 on a scale from 0 to 10, and worst pain intensity of 5.3 during the first three postoperative days. Postoperatively, 47 % of the patients experienced moderate pain and 32, 5 % reported severe pain in the three first days. In the univariable analyses, poorer sleep quality, more pain catastrophizing, more PRWHE hand pain and disability, and higher preoperative pain were associated with more severe postoperative pain. In the multivariable analysis, only higher level of pain catastrophizing remained associated with more severe postoperative pain. Higher preoperative pain catastrophizing was independently associated with higher postoperative pain intensity after CTR. This factor may be useful as part of preoperative screening to identify patients at higher risk for more severe postoperative pain. REC approval # 2018/1562.