公共卫生研究摘要 (2026-06-04)

共收录 61 篇研究文章

1. Mapping the scholarly landscape of Saudi Arabia-related folk medicine: a bibliometric study.

期刊: The Libyan journal of medicine 发表日期: 2026-Dec-31 链接: PubMed

摘要

Folk medicine remains an important component of health practices in Saudi Arabia and continues to attract growing scholarly attention. This study maps the scholarly landscape of folk medicine research related to Saudi Arabia by examining publication trends, author keywords, collaboration among institutions and countries, and the impact of authors and sources. Publications were retrieved from the Scopus and Web of Science databases using Saudi Arabia as the country affiliation. After PRISMA-guided identification, screening, deduplication, and eligibility assessment, 2527 publications published between 1989 and 2024 were retained for analysis. Bibliometrix was used for bibliometric computation and visualization, and VOSviewer was used to map country co-authorship and keyword co-occurrence networks. The results show sustained growth in publication output, strong participation by Saudi institutions, and broad international collaboration. The most prominent research themes were antioxidant activity, antimicrobial properties, herbal medicine, and traditional medicine. These findings provide a bibliometric overview of knowledge production in this area and may inform future systematic, clinical, and policy-oriented research on traditional medicine in Saudi Arabia.

2. Influence of Cardiometabolic and Alzheimer Disease Genetics on Cognitive-Related Outcomes in a Diverse Population.

期刊: Neurology 发表日期: 2026-Jul-14 链接: PubMed

摘要

Late-life dementia has a strong heritable component. While the APOE ɛ4 allele is the strongest genetic risk factor of Alzheimer disease (AD), polygenic risk factors also play a significant role. Cardiometabolic diseases (CMDs) and their risk factors predict dementia in many cohorts, but how genetic predictors of CMD influence dementia-related outcomes remains unclear. In this study, we examined the associations of polygenic risk scores (PRSs) for major CMDs and the established APOE risk alleles with dementia-related outcomes in the Reasons for Geographic and Racial Differences in Stroke (REGARDS) study, which is enriched for Black participants underrepresented in late-life dementia research. We constructed PRSs for AD and related dementias (ADRDs) and CMDs, including stroke, coronary artery disease, venous thromboembolism, type 2 diabetes, atrial fibrillation, blood pressure (systolic blood pressure, diastolic blood pressure, and pulse pressure), and circulating lipid levels (high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, and triglycerides), using lead genome-wide significant genetic variants from the latest genome-wide association studies. We evaluated the predictive performance of each PRS on their primary end point and tested their associations with incident cognitive impairment (ICI), assessed using the 6-item screener and enhanced cognitive battery, and dementia as a contributing cause of death (DCCD). In addition, we explored the impact of APOE variants and, based on previous reports, local genetic ancestry at the APOE locus on these dementia-related outcomes. Up to 8,818 participants were analyzed (mean age 63.7 years; 58.9% female; 83.3% Black). For CMD PRS, we identified a significant association between PRS for pulse pressure and DCCD (hazard ratio [HR] 1.16, 95% CI 1.06-1.28, p < 1.76 × 10-3). We observed that the PRS for ADRD was associated nominally with DCCD (HR 1.12, 95% CI 1.00-1.25), but not with ICI among REGARDS participants, suggesting heterogeneity in associations across different cognitive-related end points. Furthermore, we identified a nominally significant (p < 0.1) attenuated effect of APOE risk alleles on ICI among those with African ancestry at the APOE locus, similar to previous reports. Higher PRS for pulse pressure was associated with increased DCCD risk, supporting shared genetic underpinnings between CMD and dementia.

3. Kidney Transplantation in Two Highly Sensitized Candidates after CAR T-Cell Therapy.

期刊: The New England journal of medicine 发表日期: 2026-Jun-04 链接: PubMed

摘要

HLA sensitization poses a major challenge to kidney transplantation for patients with end-stage kidney disease, especially for highly sensitized candidates. Attempts at antibody elimination (desensitization) have had inconsistent efficacy and have often failed to produce sustained reductions in anti-HLA antibodies in patients with the highest level of sensitization (calculated panel-reactive antibody score, ≥99.9%). We now report the results for the safety run-in cohort of a multicenter phase 1 clinical study evaluating the safety and efficacy of combined CD19-targeted and B-cell maturation antigen (BCMA)-targeted chimeric antigen receptor (CAR) T cells in eliminating the cellular sources of preformed anti-HLA antibodies (ClinicalTrials.gov number, NCT06056102). Kidney transplantation was performed in two highly sensitized candidates after desensitization with the use of dual CAR T-cell therapy.

4. Global Stories, Shared Purpose: Evidence-Driven Advances in Global HIV Nursing.

期刊: The Journal of the Association of Nurses in AIDS Care : JANAC 发表日期: 2026-Jun-04 链接: PubMed

摘要

5. Human-AI Interaction in Low- and Middle-Income Countries: Qualitative Study of How Local Human Factors Influence AI Development and Deployment.

期刊: JMIR AI 发表日期: 2026-Jun-03 链接: PubMed

摘要

Artificial intelligence (AI) is rapidly transforming health care and health research, offering new opportunities for improving efficiency, accessibility, and equity. However, the ethical, societal, and regulatory challenges of AI development and deployment are particularly pronounced in low- and middle-income countries (LMICs). While existing literature often emphasizes high-level ethical principles or technical frameworks, there is a notable gap in empirical, qualitative research that centers on human involvement and sociocultural dynamics throughout the AI lifecycle in LMIC contexts. This study addresses this gap by exploring the role of human involvement across the AI lifecycle, examining how cultural, societal, and governance factors influence AI perceptions and expectations in LMICs. We conducted 21 qualitative online interviews with AI researchers and innovators across MENA (Middle East and North Africa), Africa, Latin America, and Asia. A semistructured interview guide informed by the KAP (knowledge, attitude, and practice) framework was used. A thematic analysis approach was used for coding and analyzing the transcripts. We identified five key themes: (1) the necessity of human oversight and the readiness required to support it, (2) the need for AI ethics training, (3) the importance of developing AI systems tailored to local realities, (4) the role of human-centered AI governance, and (5) the value of securing multidisciplinary teams. Findings highlight critical gaps in AI literacy, ethical governance, and interdisciplinary collaboration, emphasizing that AI solutions must be co-designed with local communities to be culturally and contextually relevant. This study underscores the urgent need for participatory AI development in LMICs and calls for investment in AI education, ethical oversight, and inclusive governance frameworks to ensure that AI serves as a tool for social equity rather than exclusion.

6. Opioid Agonist Treatment Use Among First Nation Peoples in Ontario, Canada: A Repeated Cross-sectional Study of Prevalence Trends From 2013 to 2023.

期刊: Journal of addiction medicine 发表日期: 2026-Jun-03 链接: PubMed

摘要

The opioid toxicity crisis has disproportionately harmed First Nation Peoples, prompting efforts to expand access to opioid agonist therapy (OAT). We described trends in OAT use among this population in Ontario, Canada. We conducted a population-based repeated cross-sectional study of registered (“Status”) First Nation Peoples aged 15 years or older dispensed OAT in Ontario, Canada, between January 1, 2013 and December 31, 2023. We reported quarterly proportions (%) of First Nation Peoples who were dispensed OAT, including methadone, buprenorphine/naloxone, or buprenorphine extended-release (BUP-ER), overall and by OAT formulation. In addition, we examined the annual prevalence of OAT dispensing, overall and by formulation, stratified by age, sex, and residence within/outside of First Nation communities in 2023. Between 2013 and 2023, quarterly OAT dispensed among First Nation Peoples doubled from 2.7% to 5.0%, plateauing at ∼5% in early 2020. Methadone dispensing remained steady, ranging from 2.0% to 2.6% of all First Nation Peoples, and was the most commonly prescribed OAT until mid-2018 when it was overtaken by buprenorphine-containing products (i.e., buprenorphine/naloxone, BUP-ER). Dispensing of buprenorphine-containing products among this population rose from 0.6% in Q1 of 2013 to 3.1% in Q4 of 2023; specifically, 2.8% buprenorphine/naloxone, 0.5% BUP-ER. In 2023, 6.1% (N = 8,518/140,615) First Nation Peoples accessed OAT, with higher rates among individuals aged 25-44 years and residing within First Nation communities. Information on changing trends in OAT use among First Nation Peoples may inform evolving approaches to delivering quality OUD treatment to this population that uphold their rights to dignity, autonomy, and culturally safe care.

7. Advancing Kratom Science and Regulation: A Comparative Framework With Cannabis.

期刊: Journal of addiction medicine 发表日期: 2026-Jun-03 链接: PubMed

摘要

Kratom (Mitragyna speciosa) is a psychoactive botanical with a long history of use in Southeast Asia and growing uptake in the United States for its analgesic, stimulant, and mood-altering properties. The evidence base remains limited, and retail products vary widely in composition and potency. This narrative review highlights what is known about kratom’s pharmacology and suggests a practical research and regulatory path toward evaluating its potential therapeutic applications within current regulatory frameworks, based on lessons from cannabis. A central distinction is between whole leaf products and those that are enriched in active constituents or that include semisynthetic derivatives. Because these categories differ in chemistry, pharmacology, and expected risk, they require different evidence standards. Priorities include development of chemically defined botanical preparations, validated analytical methods, and human studies that link exposure to effect through pharmacokinetic and pharmacodynamic modeling, abuse liability assessment, and cognitive and behavioral testing. The regulatory framework for kratom should consider a dual track. This includes enhanced standards for product quality, including composition, purity, labeling, and safety surveillance for botanical products, and conventional drug development pathways for enriched or semisynthetic constituents that include toxicology and human abuse potential studies. Coordinated federal support is urgently needed to align product standardization, early phase trials, and comparative evaluations across product classes. With this structure, kratom’s possible therapeutic applications can be examined while safeguarding public health.

8. ​EuroNet-PHL-LP1: Complete resection or low-dose chemo for pediatric low-risk nodular lymphocyte-predominant Hodgkin lymphoma.

期刊: Blood advances 发表日期: 2026-Jun-03 链接: PubMed

摘要

Children and adolescents with early-stage nodular lymphocyte-predominant Hodgkin lymphoma (nLPHL) have a 5-year event-free survival (EFS) of about 77% after complete lymph node resection and around 89% with anthracycline-containing chemotherapy. We investigated whether patients with early-stage nLPHL can be successfully treated with surgical resection alone or with low-intensity, anthracycline-free CVP chemotherapy for those with unresectable nodal disease. EuroNet-PHL-LP1 was a prospective phase III trial enrolling patients under 18 years with stage IA/IIA nLPHL. Completely resected lymph nodes led to active surveillance. Patients with unresectable disease received three cycles of CVP (cyclophosphamide, vinblastine, prednisone). In CVP-cohort-1, treatment cessation required a negative 18F -FDG-PET. An amendment in 2014 omitted PET for end-of-treatment response; CT and/or MRI alone defined response in CVP-cohort-2. The primary endpoint was 5-year EFS, with death, relapse, second malignancy and PET-positivity counting as events; for CVP-cohort-2, progression-free survival (PFS) was primary. Among 267 registered patients (2009-2018), 247 were evaluable. Seventy-eight underwent resection only; their 5-year EFS/PFS was 79.5%. Six of 18 patients who relapsed after surgical resection re-entered the CVP arm. In CVP-cohort-1, 51/82 (62%) achieved a complete metabolic response (CMR). 5-year EFS was 56.4%, while 5-year PFS in the CMR group was 91.3%. In contrast, PFS in 84 CVP-cohort-2 patients was 64.7%. During CVP, 68.3% of patients experienced grade 3-4 neutropenia. No treatment-related deaths were reported. Excellent outcomes were achieved after complete resection and with low-intensive, anthracycline-free chemotherapy if 18F-FDG-PET showed CMR after chemotherapy. This strategy now constitutes the EuroNet-PHL standard of care for early-stage nLPHL. The trial was registered under EudraCT-No.: 2007-004092-19.

9. Efficacy of Extended Time on Exams for College Students and Applicants With Attention-Deficit/Hyperactivity Disorder: Protocol for a Randomized, Counterbalanced Crossover and Within-Subject Trial.

期刊: JMIR research protocols 发表日期: 2026-Jun-03 链接: PubMed

摘要

Extended time on academic exams is one of the most frequently granted accommodations for students with attention-deficit/hyperactivity disorder. However, there is a lack of empirical evidence supporting its effectiveness, particularly in the college population. This study aimed to assess the efficacy and specificity of extended test time as an accommodation for college and college-prospective students with attention-deficit/hyperactivity disorder. This study will use a randomized, counterbalanced crossover and within-subject experimental design, using convenience sampling to recruit participants. All participants will undergo clinical and neuropsychological assessments to confirm their diagnostic status and cognitive performance. Following these assessments, participants will be randomized to sequentially complete 3 versions of a test modeled on the Brazilian National High School Exam under standard time conditions, with 25% extra time and with 50% extra time. The study was funded in February 2023. Data collection started in August 2023. As of March 2026, we have enrolled 103 participants. Data analysis was initiated in March 2026, and no projected timeline for the publication of results is currently available. The study will be the first of its kind outside the United States and one of the first to investigate the effectiveness of extended testing time at different dosages in the college population. Findings will provide insights into the impact of extended time accommodations in a distinct academic system, addressing gaps in previous research, such as different intervention doses and predictors of effectiveness. ClinicalTrials.gov NCT06063382; https://clinicaltrials.gov/study/NCT06063382. DERR1-10.2196/80271.

10. User Acceptance of Remote Care Assist, a Telecare System for Home Care Among Care and Nursing Staff: Cross-Sectional Pilot Study.

期刊: JMIR rehabilitation and assistive technologies 发表日期: 2026-Jun-03 链接: PubMed

摘要

Demographic and epidemiological changes are increasing pressure on health and long-term care systems, underscoring the need for digital innovations. Remote Care Assist is a digital system that enables home care staff to connect with care experts for exchange and support via real-time video calls. Although technology acceptance is crucial for successful implementation, little is known about how care staff’s expected benefits for care recipients influence acceptance in professional home care. This study examined predictors of user acceptance of the Remote Care Assist among home care staff, with a particular focus on the role of staff’s expectations of benefits for home care service users. Technology acceptance data were collected from staff in home care organizations in Austria and Luxembourg. Among 337 survey respondents, 139 participants who reported using Remote Care Assist at least once per month over a period of 5-6.5 months were included in the acceptance analysis (45 care experts and 94 on-site care staff). Partial least squares structural equation modeling was used to test a contextualized technology acceptance model. Technology acceptance was measured by “Behavioral Intention to Use” the Remote Care Assist. “Behavioral Intention to Use” was positively associated with “Expected Benefit for Home Care Service Users” (EBC; β=0.506, 95% CI 0.364 to 0.658; P<.001), “Perceived Usefulness (PU)” for care staff (β=0.314, 95% CI 0.151 to 0.460; P<.001), and “Perceived Ease of Use” (PEOU; β=0.130, 95% CI 0.038 to 0.231; P=.01). “EBC” (β=0.415, 95% CI 0.276 to 0.537; P<.001), “Perceived Efficiency” (β=0.396, 95% CI 0.267 to 0.531; P<.001), and “PEOU” (β=0.170, 95% CI 0.083 to 0.266; P=.001) were positively associated with “PU” for care staff. “PU” also positively mediated the associations of “EBC” (β=0.130, 95% CI 0.061 to 0.194; P=.001) and “PEOU” (β=0.053, 95% CI 0.017 to 0.101; P=.02) with “Behavioral Intention to Use.” “Reliable Functionality” was not significantly associated with “PU.” This study suggests that the technology acceptance of a digital system for enhancing professional exchange between different staff groups in home care is shaped not only by established predictors of acceptance, such as PU and PEOU, but also by a currently neglected predictor, namely care staff’s expectations that the technology will benefit home care service users, which plays an important role in technology acceptance. In addition to usability and workflow support, successful implementation strategies for digital technologies should clearly communicate the technology’s potential benefits for care staff, care service users, and the broader care ecosystem.

11. Moving From Keywords to Contextual Meaning: A Commentary on Hybrid Bibliometric Synthesis in Health Research.

期刊: Journal of medical Internet research 发表日期: 2026-Jun-03 链接: PubMed

摘要

The fast growth of social media mining in health research has contributed to an invaluable but quite fragmented body of literature. As the amount of unstructured patient-reported data grows, traditional bibliometric analyses face methodological limitations, particularly regarding synonym fragmentation and arbitrary parameter selection. In their recent publication, “Thematic Mapping and Evolution of Social Media Mining in Health Research: Hybrid Bibliometric Synthesis,” Yang and Bohnet-Joschko attempt to address these flaws by introducing a semantic-structural (hybrid) bibliometric framework. This commentary evaluates the methodological innovations of their study and its departure from traditional syntactic keyword-matching tools. By combining citation-informed transformers (SPECTER2) and biomedical language models (PubMedBERT) and dimensionality reduction and density-based clustering, the authors created a reproducible pipeline. In their architecture, they start with foundational machine learning (statistical validity) before transitioning into large language models for qualitative synthesis. I will attempt to explain how this transition from syntactic mapping to semantic vector representation solves known challenges in evidence synthesis, naturally grouping conceptual synonyms without artificially forcing boundaries on the literature. Furthermore, I examine the practical implications of their temporal findings. Such real-time social media mining applications can be very useful for retrospective reporting and evaluating targeted public health interventions. While this pipeline offers high generalizability across disciplines, it also introduces a computational literacy barrier to some, and this re-emphasizes the need for data literacy for health professions. Ultimately, the study provides a transparent approach to informatics because mathematically validated frameworks are foundational for the future of evidence-driven public health policy and clinical decision-making.

12. Association between long-term exposure to ambient air pollution and breast cancer risk in Mexico: a systematic review of observational studies.

期刊: Journal of environmental science and health. Part C, Toxicology and carcinogenesis 发表日期: 2026-Jun-03 链接: PubMed

摘要

Breast cancer remains a major public health concern in Mexico, and ambient air pollution has been proposed as a possible contributing factor. We conducted a PROSPERO-registered systematic review, following PRISMA guidance, to assess observational evidence on long-term exposure to PM2.5, PM10, NO2, SO2, O3, and polycyclic aromatic hydrocarbons (PAHs) in Mexican women. Searches of bibliographic databases and grey literature, including dissertations, institutional repositories, and scholarly networking sites, identified 35 records. Six studies met the inclusion criteria: four ecological or spatial studies and two retrospective clinical studies from Hermosillo, the Monterrey Metropolitan Area, Miguel Alemán, and Mexico City. Where pollutant concentrations were reported, PM2.5 and PM10 were directly assessed; other studies used residential proximity to industrial or emission sources as exposure indicators. Across studies, higher estimated exposure was consistently associated with greater breast cancer burden, less favorable prognosis, or more adverse tumor characteristics. Even so, the evidence base was limited by heterogeneity in design, indirect exposure assessment, and substantial risk of bias. Overall certainty of evidence was very low. These findings are best interpreted as preliminary and hypothesis-generating, underscoring the need for stronger, better-controlled studies before causal or policy conclusions are drawn.

13. For ultra-high dose rate carbon-ion irradiation, comparable beam parameters induce the equivalent cell sparing (FLASH) effect.

期刊: Journal of radiation research 发表日期: 2026-Jun-03 链接: PubMed

摘要

Recently, ultra-high dose rate (uHDR) irradiation has received attention for FLASH effect, a phenomenon in vivo that reduces normal-tissue damage without compromising antitumor efficacy compared to normal dose rate (NDR) irradiation. Such protective responses observed in vitro are referred to as cell-sparing effect. In previous studies, the cell-sparing effect was demonstrated using a carbon-ion beam scanning system. This study aimed to reproduce comparable irradiation conditions using a different machine at another facility and evaluate the cell-sparing effect. Comparable beam settings were adopted: physical dose 7 Gy, average dose rates (ADR) 100 Gy/s for uHDR and 1 Gy/s for NDR, dose-averaged linear energy transfer (LETd) 16.3 and 50 keV/μm, and identical scanning patterns. The same cell lines, Human salivary gland cell line (HSGc-C5), human dermal fibroblast (HDF), and human lung bronchial epithelial cell line (Nuli-1), were irradiated under normoxia. Colony formation assay and immunofluorescence staining of γH2AX were performed to assess cell survival and DNA damage. Comparable physical dose, ADR, and field flatness were verified by measurements. HDF and Nuli-1 showed the cell-sparing effects with increased surviving fractions and less DNA damage, which were enhanced at higher LET. In contrast, HSGc-C5 exhibited the smaller cell-sparing effect, being absent at low LET. These results were largely consistent with previous studies. To the best of current knowledge, this study is the first to indicate that the cell-sparing effect depends not on irradiation devices but on beam parameters, contributing to accelerating further FLASH research and clinical implementation of carbon-ion uHDR irradiation.

14. Dental Educators' Perceptions of Factors Contributing to Their Well-being-A Qualitative Study.

期刊: European journal of dental education : official journal of the Association for Dental Education in Europe 发表日期: 2026-Jun-03 链接: PubMed

摘要

Stress levels within academic institutions are high and have continued to rise over recent decades. This can have a detrimental impact on the well-being of dental educators and puts them at a risk of burnout. It is vital to explore the factors that affect the well-being of staff and identify solutions to inform the development of strategies for the promotion of well-being. Participants attending the ADEE annual conference were invited to participate in a qualitative study using focus group discussions to explore this topic. Prompts for the four focus group discussions were identified from quantitative data collected in an earlier study conducted by the research group. The transcribed data were coded and analysed by two of the researchers to identify emerging themes. Four key themes emerged from the data analysis: (1) Workload with an additional three subthemes of poor collegiality, poor uptake of well-being services and gender; (2) stigma associated with poor well-being; (3) workplace culture; and (4) proposed solutions for promotion of staff well-being. It is vital for educational institutions to build strong foundations of basic well-being and resilience within their workforce by providing an environment and culture that supports both good mental health and good understandings of mental health. This requires a change in workplace culture in terms of the value institutions hold on the benefits of having good well-being and sustainable resilience at all levels of the workforce.

15. Distribution of influenza A virus receptors in tissues of South American marine wildlife.

期刊: Veterinary research communications 发表日期: 2026-Jun-03 链接: PubMed

摘要

H5 clade 2.3.4.4b high pathogenicity avian influenza viruses (HPAIVs) have caused unprecedented mortality in marine wildlife. However, host determinants of susceptibility to influenza A virus (IAV) infection remain poorly understood. IAVs adapted to different hosts show distinct binding preferences for different kinds of sialic acid (Sia) receptors on cell surfaces. Human‑adapted IAVs preferentially bind Sia α2,6-linked glycans, while avian‑adapted viruses prefer Sia α2,3-linked glycans. We characterized the distribution of α2,6- and α2,3-linked Sia, and fucosylated or sulfated Siaα2,3 across respiratory, intestinal, and neural tissues from stranded marine animals, including two South American sea lions (Otaria flavescens), a Burmeister’s porpoise (Phocoena spinipinnis), and a Magellanic penguin (Spheniscus magellanicus). We also compared binding patterns of recombinant hemagglutinins (rHAs) derived from a classical H5 clade 1 virus and contemporary clade 2.3.4.4b viruses in the same tissues. We detected widespread expression of Sia receptors and H5 rHA binding in bronchial and alveolar epithelium (including air capillaries of the penguin) of the lung, enterocytes and goblet cells of intestinal villi, and the meninges and vascular endothelium of neural tissues, with species‑ and tissue‑specific patterns. These findings indicate that marine mammals and penguins possess receptor landscapes compatible with infection by both classical and contemporary H5 HPAIVs. Further investigation is necessary to determine how receptor distribution relates to productive replication, respiratory or fecal shedding, and cross-species transmission risk, particularly given the pronounced neurotropism and peracute disease course associated with clade 2.3.4.4b viruses.

16. PLD3-mediated Mitophagy Attenuates Neuronal Ferroptosis and Promotes Functional Recovery after Spinal Cord Injury.

期刊: Molecular neurobiology 发表日期: 2026-Jun-03 链接: PubMed

摘要

Ferroptosis is an important form of cell death following spinal cord injury (SCI), primarily caused by secondary microenvironmental alterations such as oxidative stress induced by local ischemia and hypoxia. Although Phospholipase D3 (PLD3) is known to contribute to neural homeostasis, its function in SCI and the associated mechanisms remain largely undefined. This study explores the role of PLD3 in the pathological process following SCI. In a mouse SCI model, proteomic analysis and biochemical assays revealed a marked reduction of PLD3 expression in injured spinal cord tissue, accompanied by elevated oxidative stress and ferroptosis markers. Adeno-associated virus-mediated overexpression of neuronal PLD3 significantly promoted spinal cord tissue repair and improved in vivo neurological function recovery. In an oxygen and glucose deprivation (OGD) model established using PC12 cells, PLD3 expression was significantly reduced, accompanied by mitochondrial dysfunction and increased oxidative stress and changes related to ferroptosis. PLD3 overexpression alleviated mitochondrial dysfunction, oxidative stress, and injury associated with ferroptosis in OGD-treated PC12 cells. Mechanistically, PLD3 overexpression was associated with activation of the PINK1/Parkin pathway, enhanced mitochondrial quality control responses related to mitophagy, and preservation of mitochondrial homeostasis. Complementary pharmacological experiments using Mdivi-1 and Cyclosporine A further supported an association between the protective effects of PLD3 overexpression, mitochondrial quality control, and injury related to ferroptosis. Collectively, these findings suggest that PLD3 overexpression helps maintain mitochondrial function and homeostasis in OGD-treated PC12 cells through mechanisms associated with PINK1/Parkin-related mitophagy. Together with the in vivo findings, these results provide new insight into secondary injury after SCI and support further investigation of PLD3 as a potential therapeutic target.

17. Posttraumatic stress disorder from early childhood to late adolescence: a resilience-oriented approach to prevention, diagnosis, and clinical management.

期刊: Discover mental health 发表日期: 2026-Jun-03 链接: PubMed

摘要

Posttraumatic stress disorder (PTSD) in children and adolescents remains underrecognized despite its significant developmental, relational, and public health impact. This narrative review synthesizes evidence on the prevention, diagnosis, and management of PTSD from early childhood through late adolescence, emphasizing a resilience-oriented and multisystemic framework. Developmentally informed assessment is essential to capture age-specific symptom patterns and to distinguish PTSD from complex PTSD, increasingly observed after chronic interpersonal trauma. Trauma-focused psychotherapies-particularly trauma-focused cognitive behavioral therapy (TF-CBT)-are the gold standard, with eye movement desensitization and reprocessing (EMDR) and narrative exposure therapy (KidNET) as effective alternatives. In the early post-trauma phase, single-session debriefing is discouraged, whereas selective multisession interventions such as the Child and Family Traumatic Stress Intervention (CFTSI) reduce acute distress and strengthen caregiver support. No pharmacological treatment is approved for pediatric PTSD; psychotherapy remains first-line, with selective serotonin reuptake inhibitors considered only for severe, persistent, or comorbid cases after shared decision-making. Recovery depends not only on symptom reduction but also on restoring safety, attachment, and agency through coordinated interventions involving family, peers, schools, and communities. Integrating resilience-building and social-support strategies across clinical, educational, and policy levels is key to sustainable recovery and long-term developmental health.

18. Barriers and facilitators for return-to-work following post-COVID-19 condition: A scoping review.

期刊: Work (Reading, Mass.) 发表日期: 2026-Jun-03 链接: PubMed

摘要

BackgroundSupporting workers with post-COVID condition in returning to work is critical. Qualitative evidence may provide insight into the complex factors shaping this process and inform intervention and policy development.ObjectiveTo identify and synthesize qualitative evidence on barriers and facilitators influencing return to work following post-COVID condition.MethodsWe conducted a scoping review using the Arksey and O’Malley framework, refined by Levac et al. MEDLINE, EMBASE, CINAHL, and Scopus were searched from inception to July 2025. Eligible qualitative and mixed-methods studies examined barriers and facilitators to returning to work among working-age adults with post-COVID condition or healthcare professionals involved in their care. Data were synthesized using critical interpretive synthesis, informed by the International Classification of Functioning, Disability and Health framework.ResultsTwenty-nine qualitative or mixed-methods studies (n=1902 participants) were included. Barriers and facilitators operated across domains within broader organizational and systemic contexts. Fluctuating, unpredictable symptoms were major barriers, while gradual rehabilitation and energy management facilitated return to work. Mismatches between work capacity and job demands limited work participation. Environmental barriers included stigma, inflexible policies, limited accommodations, and financial or compensation pressures, while facilitators included flexible work arrangements, supportive leadership, and collaborative planning. Guilt and fear of underperformance were personal barriers, while acceptance and motivation facilitated return to work. Specialists identified fragmented services and limitations of current care models as systemic concerns.ConclusionsPost-COVID condition necessitates flexible, multidisciplinary return-to-work models that accommodate symptom variability and address psychosocial needs. Improved coordination across healthcare, workplace, and social systems is essential for sustainable workforce participation.RegistrationThe review protocol was publicly registered on the Open Science Framework prior to screening and was approved by all team members (https://osf.io/nrbu5/).

19. Bisphenol TMC Impaired Mouse Oocyte Maturation by Disrupting Spindle Assembly via NEK3-Mediated Microtubule Acetylation.

期刊: Environmental science & technology 发表日期: 2026-Jun-03 链接: PubMed

摘要

Bisphenol TMC (BPTMC) is a novel substitute for bisphenol A (BPA) and is increasingly detected in the environment and in human tissues. Despite its potent estrogenic activity, BPTMC’s impact on mammalian oocyte quality remains poorly understood. In this study, we examined whether BPTMC exposure affected oocyte maturation in vitro by screening the first polar body and spindle morphology. The results showed that BPTMC significantly reduced the rate of polar body extrusion (MII oocytes) in a dose-dependent manner. Furthermore, BPTMC exposure disrupted cytoplasmic maturation, evidenced by abnormal mitochondrial distribution, elevated reactive oxygen species (ROS) accumulation, and increased apoptosis. These cytoplasmic defects correlated with lower fertilization ability and impaired embryonic development, indicated by reduced percentages of pronuclei and 2-cell embryo formation. Mechanistic analysis showed that BPTMC caused abnormal spindle assembly due to reduced microtubule acetylation, which was mediated by downregulation of the NEK3 protein. Collectively, our findings first demonstrated that BPTMC impaired oocyte maturation through oxidative stress and NEK3-dependent disruption of the cytoskeleton, providing important evidence for risk assessment of emerging bisphenol substitutes.

20. Early Deployment of an Integrated Digital Platform (shamiriOS) for Scalable Youth Mental Health Service Delivery in Kenya: Development and Usability Study.

期刊: JMIR human factors 发表日期: 2026-Jun-03 链接: PubMed

摘要

Scaling youth mental health services in low-resource settings requires digital infrastructure that supports not just clinical delivery but the full operational, supervisory, and engagement demands of community-based, task-shifted models. Existing platforms-whether commercial health systems, open-source medical records, or consumer-facing wellness apps-address fragments of this need, but none provide the integrated, offline-capable, and affordable architecture required for lay-provider delivery at scale. We introduce shamiriOS, an open-source, modular digital platform comprising 3 interlinked suites-the Shamiri Digital Hub (SDH) for operational management, Rafi for youth engagement, and the Shamiri Provider Platform (SPP) for clinical workflows-designed for scalable, stepped-care youth mental health delivery in Kenya. Our objectives were (1) to conduct an environmental scan of existing platforms and characterize their limitations, (2) to describe the user-centered design and development of shamiriOS, and (3) to report early deployment outcomes across centralized and decentralized settings between 2023 and 2024. We conducted a structured environmental scan of 6 case management platforms and 28 youth-facing mental health apps, assessing cost, usability, open-source availability, customizability, offline capability, and suitability for task-shifted delivery. Based on identified gaps, SDH was built as a browser-based operation platform, and Rafi was developed as a native mobile app (Android or iOS) with an offline-first architecture. The SPP was adapted from an existing electronic medical record system. Development followed a user-centered design process with community consultation, including cocreation workshops with 77 university-aged youths. Deployment was evaluated using use analytics, usability ratings, and Net Promoter Scores. No reviewed platform met the combined requirements for stepped-care delivery. SDH was deployed across 11 sites serving 76,344 youths via 1195 lay providers and 111 clinical supervisors by Q1 2024. Staff reported high satisfaction (usability: mean 8.36/10, SD 1.49; Net Promoter Score: mean 8.63/10, SD 1.46). Rafi achieved 74.7% (n=3737) registration at Mount Kenya University, with 50.4% (508/1008) booking therapy sessions, but sustained engagement with self-guided features declined to near 0 by 9 months. shamiriOS demonstrates the feasibility of building modular, open-source digital infrastructure for scalable, task-shifted youth mental health delivery. Its component-based architecture is designed for adaptation to other contexts, though extension would require participatory redesign. The most significant obstacles to impact lie not in platform design but in implementation readiness, incentive alignment, and institutional integration. Future priorities include SPP deployment, artificial intelligence-assisted supervision features (shamiriAI), and strengthening sustained engagement.

21. Mood Altering Waters: Multidimensional Profiling and Chiral Characterization of Antidepressants in Effluent-Impacted Waterways.

期刊: Environmental science & technology 发表日期: 2026-Jun-03 链接: PubMed

摘要

Antidepressants (ADs) and their metabolites are widely reported in wastewater effluent and effluent-impacted waterways due to incomplete removal during wastewater treatment. These chemicals have been known to influence the behavior and physiology of exposed organisms, raising concerns regarding the ecological impact of this contamination. However, although 28 ADs are approved by the United States Food and Drug Administration, environmental studies commonly target only a small fraction of these chemicals, as conventional analytical approaches are hindered by coeluting isomers and structural similarity. Here, we developed a multidimensional workflow integrating liquid chromatography, drift tube ion mobility spectrometry, mass spectrometry, and fragmentation analysis to enable high-confidence identification and targeted quantification of 26 parent and 8 AD metabolites in environmental samples, while also establishing a publicly available reference library to support future studies. Selected compounds were further characterized with chiral chromatography to assess enantiomeric ADs with differing biological activity. This workflow was applied to effluent-impacted waterways, enabling the identification and quantification of 17 AD chemicals across five sites. These findings highlight the prevalence of AD contamination and the need for improved monitoring and wastewater treatment strategies to mitigate ecological and human health risks.

22. Lethal effects of a hyperactive dGTP triphosphohydrolase in E. coli.

期刊: Genetics 发表日期: 2026-Jun-03 链接: PubMed

摘要

E. coli possesses a unique class of dNTPases, known as deoxyguanosine triphosphohydrolase (dGTPase), which hydrolyses the DNA precursor dGTP into deoxyguanosine and tripolyphosphate. The enzyme has a fidelity role, as deletion of the encoding dgt gene results in a mutator effect. The Dgt enzyme is a protein hexamer subject to allosteric regulation by dGTP substrate itself and by ssDNA. In the present work, we describe a dGTPase mutant carrying a Cys273Ser amino-acid substitution adjacent to the catalytically critical residue Tyr272. In vitro, the C273S enzyme was more active than wild type, its activity resembling the activated form. Cells harboring the mutant dgt-C273S gene as a single copy on the chromosome exhibited reduced viability. To further investigate this toxic effect, we expressed the mutant gene under controlled conditions from a plasmid in strain BL21-AI. Within one hour after induction, the number of viable cells began declining rapidly, and after 2.5 hours over 99.95% were dead. Microscopy showed that killing is associated with disruption of the bacterial nucleoid and eventual loss of chromosomal DNA. After maximal cell killing, the cultures were able to resume growth; however, this was due to the emergence of suppressor mutants that had lost the ability to express the mutant dGTPase. We infer that expression of the constitutively active dGTPase causes depletion of dGTP, which may lead to disrupted replication forks and eventual annihilation of the chromosome by nucleases. These studies highlight the critical importance of cellular dNTP control and support an additional mode of cell killing.

23. Heatstroke in a tropical environment: A series of 9 cases over 18 days in Guadeloupe.

期刊: Archives of environmental & occupational health 发表日期: 2026-Jun-03 链接: PubMed

摘要

In September 2023, a series of heatstroke cases across diverse exposure settings was observed at the University Hospital of Guadeloupe, a tropical region where published data on heatstroke are limited. The aim of this study was to describe the clinical features, environmental conditions, and outcomes of these cases. We conducted a retrospective single-center study including all adult patients admitted with heatstroke between September 1 and 30, 2023. Nine cases were identified over an 18-day period; all patients were male and local residents. Five (55.6%) had exertional heatstroke and four (44.4%) had classic heatstroke. Six patients (66.7%) developed multi-organ failure, of whom five died, with a median time to death of 2 days [1-3]. The median wet bulb globe temperature and heat index at the time of each case were 26.6°C [25.9-26.7] and 33.6°C [31.4-34.4], respectively.

24. Validity and reliability of the strain of care for delirium index in intensive care unit nurses: A psychometric testing study.

期刊: Contemporary nurse 发表日期: 2026-Jun-03 链接: PubMed

摘要

Background: Delirium poses a considerable clinical challenge in intensive care units (ICUs), imposing substantial burden on nurses caring for patients with delirium. The Strain of Care for Delirium Index (SCDI) measures nursing burden associated with delirium care.Objectives: This study aimed to translate the SCDI into Korean and evaluate the validity and reliability of the Korean version of the SCDI (K-SCDI).Design: Methodological study.Methods: This study translated and culturally adapted the SCDI into Korean in accordance with the World Health Organization guidelines. Six experts assessed content validity (average scale-level content validity index = 0.92). Data were collected from 234 ICU nurses at tertiary hospitals in Busan and Changwon, South Korea. Construct validity was assessed through confirmatory factor analysis, discriminant validity testing, and known-group validity examination. Reliability was evaluated using Cronbach’s α and intraclass correlation coefficients (ICCs).Results: Confirmatory factor analysis supported the original four-factor structure (hypoactive behavior, hypoalert behavior, fluctuating course and psychoneurotic behavior, and hyperactive/hyperalert behavior), achieving acceptable model fit indices (χ2/df = 2.25, Tucker-Lewis index = 0.93, comparative fit index = 0.94, root mean square error of approximation = 0.07). Similarly, discriminant validity was supported, with squared correlations between all factors lower than their respective average variance extracted values. Known-group validity was demonstrated in the hyperactive/hyperalert behavior domain, with nurses with and without delirium care education showing significant differences (t = -2.75, P<.05). Internal consistency reliability was excellent (Cronbach’s α = 0.91), and test-retest reliability was strong (ICC = 0.87).Conclusion: The K-SCDI is a valid reliable instrument for measuring strain in ICU nurses caring for patients with delirium. This tool can inform the development of nurse support programs, tailored educational interventions, and workplace improvements based on delirium behavioral subtypes.

25. Large language model exposure and precarious occupations: Unpacking relationships in the Canadian labor force.

期刊: Scandinavian journal of work, environment & health 发表日期: 2026-Jun-03 链接: PubMed

摘要

The adoption of digital technologies has historically impacted the most precarious occupations and contributed to widening labor market inequities. Large language models (LLM) may reshape this relationship. This study examines the association between occupational exposure to LLM and occupational precarity. Using Canada’s Labour Force Survey, occupational exposure to LLM and four dimensions of precarity (contractual instability, earnings inadequacy, schedule unpredictability, working-time mismatch) were examined. A multidimensional index was developed to summarize an occupation’s overall exposure to precarity. Four multivariate linear regression models with cluster-robust standard errors estimated the associations between LLM exposure and each dimension of precarity. A fifth multivariate model examined the relationship between LLM exposure and the multidimensional precarity index. Utilizing model coefficients, mean estimates of occupational LLM exposure were produced. Using the multidimensional precarity index, our analysis showed that occupations characterized by low exposure to precarity had a significantly higher mean LLM exposure [mean 0.386, 95% confidence interval (CI) 0.356-0.417] compared to occupations with medium (mean 0.258, 95% CI 0.221-0.295), high (mean 0.260, 95% CI 0.194-0.328) or very high precarity (mean 0.205, 95% CI 0.136-0.275). Apart from earning adequacy, LLM exposure was also lower among occupations using each separate dimension of precarity. Occupations most likely to be exposed to LLM are those where precariousness is lowest. These occupations have previously been sheltered from technological change. There is a need of examine the impacts of LLM on workers in job where the technology is prominent.

26. When Age Meets Perception: How Subjective and Chronological Age Shape Safety Motivation and Behaviour.

期刊: Psychological reports 发表日期: 2026-Jun-03 链接: PubMed

摘要

This study explores the dynamics of workplace safety, specifically examining how both objective and subjective age moderate the relationships between safety climate, safety motivation, and safety behaviors. It aims to understand how age-related perceptions shape safety attitudes and practices, highlighting the psychological and contextual factors involved in promoting safe behavior at work. A cross-sectional survey was conducted on 333 Italian employees from various occupational sectors. Data were collected through an online questionnaire including validated measures of safety climate, safety motivation, safety compliance, safety participation, chronological age, and subjective age. Moderated mediation analyses were conducted to examine the interplay between these variables. Findings indicate that a positive safety climate enhances safety motivation, which in turn predicts both safety compliance and participation. Safety motivation emerged as a key mediator in this relationship. Subjective age did not directly affect safety behaviors but significantly interacted with safety climate and motivation, indirectly shaping safety outcomes. Chronological age showed weaker effects compared to subjective age. By incorporating subjective age into safety research, this study provides novel insights into the psychological mechanisms underlying safety behavior. It emphasizes the need for age-aware interventions and highlights the importance of considering both motivational processes and age-related perceptions in promoting workplace safety, especially in an increasingly age-diverse workforce.

27. Emerging Era for Polymyalgia Rheumatica and GCA - Interleukin-17A Targeting.

期刊: The New England journal of medicine 发表日期: 2026-Jun-03 链接: PubMed

摘要

28. Targeted Supplementation and Nutritional Strategies for Healthy Aging: A Review of Physiological and Molecular Benefits.

期刊: Current nutrition reports 发表日期: 2026-Jun-03 链接: PubMed

摘要

Aging is marked by progressive physiological decline driven by chronic inflammation, mitochondrial dysfunction, and impaired metabolic and musculoskeletal resilience. As the global population ages, dietary supplements have gained attention as potential tools to support healthy longevity. This review summarizes current evidence on nutritional compounds that target aging-related pathways, focusing on interventions that influence mitochondrial health, cognitive performance, immune function, metabolic regulation, and maintenance of muscle mass in older adults. Thirty-two human studies were identified through PubMed, Scopus, and Web of Science. Evidence indicates that several targeted nutrients, including protein, probiotics, antioxidants, and emerging mitochondrial-support compounds, may contribute to healthy aging. Protein and collagen supplementation, particularly when paired with resistance training, consistently improve muscle mass and physical function. Antioxidants, glycine, N-acetylcysteine, and NAD⁺ precursors show potential benefits for mitochondrial efficiency, cellular stress responses, and cognitive performance; however, findings vary across populations and dosing strategies. Heterogeneity in study designs, supplement formulations, and biomarker endpoints underscores the need for individualized and context-specific application. A personalized, evidence-informed supplementation strategy integrated with exercise and balanced nutrition may help optimize physiological function in aging adults. Future research should refine dosing protocols, evaluate synergistic nutrient combinations, and clarify the roles of antioxidants and mitochondrial-targeted compounds across diverse older populations.

29. CT-defined orbital wall burden and early visual dysfunction in acute orbital.

期刊: Emergency radiology 发表日期: 2026-Jun-03 链接: PubMed

摘要

To evaluate whether computed tomography (CT)-defined orbital wall burden (OWB) is associated with early visual dysfunction in patients with acute orbital trauma and to assess the clinical relevance of CT-derived structural and focal imaging findings for early risk stratification. This retrospective cohort study included consecutive patients with CT-confirmed orbital trauma at a tertiary emergency referral center between January 1 and December 31, 2023. Visual dysfunction was defined as worst visual acuity (VA_worst) ≤ 0.8 during index hospitalization. OWB was categorized as 0, 1, or ≥ 2 fractured orbital walls. Additional imaging variables included intracranial involvement and retrobulbar hematoma. Univariable analyses, trend testing, and multivariable logistic regression were performed. A total of 328 patients were included, and visual dysfunction occurred in 88 (26.8%). Visual dysfunction increased across OWB categories (24.9% for OWB = 0, 38.1% for OWB = 1, and 60.0% for OWB ≥ 2; trend p < 0.001). In multivariable analysis, increasing age (adjusted OR 1.03, 95% CI 1.02-1.04; p < 0.001) and retrobulbar hematoma (adjusted OR 11.34, 95% CI 1.29-100.02; p = 0.029) were associated with visual dysfunction, although the latter estimate was imprecise due to limited event numbers. OWB and intracranial involvement were not independently associated with the outcome after adjustment. Model discrimination was moderate (AUC = 0.69). In acute orbital trauma, CT-derived structural findings demonstrate a graded association with early visual dysfunction at the crude level but do not independently predict outcome after adjustment. Instead, OWB appears to function as a marker of cumulative injury burden, whereas retrobulbar hematoma represents a focal, clinically critical imaging finding associated with visual compromise. These results support a radiology-oriented framework in which CT contributes to early risk stratification by differentiating overall injury severity from time-sensitive vision-threatening lesions.

30. Endocrine Disruption and Male Fertility.

期刊: Current environmental health reports 发表日期: 2026-Jun-03 链接: PubMed

摘要

Endocrine-disrupting chemicals affect nearly every human on the planet and are known to interfere with reproduction. Most studies have focused on gestational exposure effects in females. Emerging evidence indicates that preconception exposures in males can also impact pregnancy outcomes and offspring health. This review describes how several major endocrine disruptors impair key male fertility endpoints and their subsequent effects on downstream processes, including fertilization and the health of the next generation(s). Endocrine disrupting chemicals such as polychlorinated biphenyls, polybrominated diphenyl ethers, per- and polyfluoroalkyl substances, bisphenols, phthalates, and parabens can have widespread effects on male fertility by interfering with the hypothalamic-pituitary-gonadal axis and through direct effects on the male reproductive system. These effects include impaired semen quality (sperm count, morphology, motility), changes in the spermatogenic process, mitochondrial disruption, reactive oxygen species generation, skewed energy metabolism, germ cell apoptosis, and changes in the sperm epigenome (DNA methylation, histone modifications, noncoding RNAs). Studies continue to demonstrate that paternal endocrine disruptor exposure impacts the next generation and in some cases beyond, with studies in animal models showing disruption of fertility in the F1 and F2 generations, and studies of occupational exposures in humans showing increased risks of low birth weight and congenital heart disease for children born to exposed fathers. The hypothesis that preconception paternal exposures are consequential to future generations has slowly been gaining traction, but more research is needed to better understand the intergenerational and transgenerational health consequences of endocrine disruptor exposures, the underlying mechanisms, and, given the growing ubiquity of these chemicals in our food and environment, to develop and implement strategies for mitigation of these effects.

31. Integrated study of sediments and fish from Croatian rivers: potentially toxic elements and human health concerns.

期刊: Environmental geochemistry and health 发表日期: 2026-Jun-03 链接: PubMed

摘要

Aquatic ecosystems are highly vulnerable to contamination by potentially toxic elements (PTEs), with sediments acting as long-term sinks and fish serving as bioindicators of environmental pollution. This study evaluated PTE concentrations in river sediments and three Squalius chub species (S. cephalus, S. squalus, S. svallize) collected from Croatian rivers that belong to the Adriatic and Danube basins. Chemical analyses were performed using inductively coupled plasma-optical emission spectrometry (ICP-OES) and inductively coupled plasma-mass spectrometry (ICP-MS) following acid microwave-assisted digestion. Principal Component Analysis (PCA) biplot and Self-Organizing Maps (SOM) were applied to explore spatial patterns and associations among PTEs. Environmental implications were assessed using the contamination factor (CF) and ecological risk indices (Eri, RI), while human health risks (non-carcinogenic-HQ, HI and Carcinogenic Risk-CR, R) were estimated for fish consumers. Sediment analyses revealed that most PTE concentrations were below international guideline values, except for Cd, which frequently exceeded regulatory limits and represented the dominant ecological risk contributor. Moderate environmental risk (RI > 150) was observed in sediments from Vidak-Stubičke Toplice and Kupica-Brod na Kupi, both from Danube basin. Multivariate analyses highlighted a clear basin-dependent geochemical signature in sediments, while fishes are more complex with less basin-specific patterns, reflecting the combined influence of environmental exposure and biological processes. Cadmium was identified as the key sediment contaminant, while Pb and Cr in fish represented major food safety concerns. Health risk indices (HI > 1; CR > 1 × 10-6) show that long-term uncontrolled consumption of the analysed fish is not advisable. The integrated application of analytical and statistical approaches provides a robust framework for environmental monitoring and public health management in Croatia.

32. Perfection should not hinder progress towards occupational exposure limits for psychosocial hazard: A reply to Guseva Canu and van der Molen.

期刊: Scandinavian journal of work, environment & health 发表日期: 2026-Jun-03 链接: PubMed

摘要

We thank Guseva Canu and van der Molen for their thoughtful commentary (1) on our article advocating for the development of occupational exposure limits (OEL) for psychosocial hazards. We appreciate their careful consideration of both the conceptual and methodological challenges associated with transferring established approaches from the assessment of non-psychosocial (ie, chemical and physical) hazards to the psychosocial domain. We also welcome that the authors share the concerns raised in our original discussion paper (2) regarding uncertainties in existing operationalizations of psychosocial hazards. Nonetheless, psychosocial risk assessment has progressed substantially and is considerably more nuanced than suggested in the commentary. While our discussion paper was framed as a mapping of the current knowledge - explicitly titled around “what we know and what we do not know, yet” - we believe the commentary engages primarily with a narrowed reading of our argument, namely a proposal to immediately establish OEL, rather than the roadmap of conceptual and methodological requirements we presented. Considering recent methodological advances, we conclude that advancing toward OEL for psychosocial hazards is not a premature leap but a timely and necessary next step. From latent variable models to actionable items It is true that, for decades, influential work-stress theories have relied on latent variable models to operationalize psychological phenomena which, although not directly observable, have repeatedly been linked to employee health outcomes. Methodologically, manifestations of distinct individual aspects of the latent constructs are combined to operationalize the latent variable of interest. It should be noted, however, that eg, the latent variable job demands represents no more an observable hazard than generic categories like dust or metal represent identifiable hazardous substances. Accordingly, while the goal is to optimize job demands or job control, this can only be accomplished by addressing the distinct actionable items that constitute such latent constructs. Guseva Canu and van der Molen themselves use the example of bus drivers for whom efforts had been disentangled into 39 distinct actionable items. As an additional example, the Joint German Occupational Safety and Health Strategy (3) identifies more than 70 actionable items that constitute six latent domains of job stressors (work content, work organization, working time, social relations, work equipment, work environment) each representing a quantifiable presence or absence of hazards. The “fundamental paradigm shift […] toward more specific, measurable, and harmonized approaches”, as advocated by Guseva Canu and van der Molen, is thus already underway. Whether no-observed adverse effect level (NOAEL)/ lowest-observed-adverse effect level (LOAEL) are most usefully defined at the level of individual items, item composites, or aggregated constructs is itself an empirical question that future research should address. Subjective bias and social construction of hazards Guseva Canu and van der Molen argue that assessments of social support, decision authority, or emotional demands are inherently subjective or socially constructed. By referencing cultural norms and economic pressures, they highlight individual processes of perception, implying that actual exposure cannot be accurately quantified in terms of OEL. We believe that these phenomena can still serve as valid and meaningful decision aids for preventive action: Within occupational groups, employees show high within-group agreement in psychosocial risk assessments, and in addition, there is substantial agreement between employee evaluations and those conducted by occupational safety and health (OSH) committees for the same job activities (4). Moreover, methodological advances are improving our understanding of how subjective bias can be minimized. Stress measures frequently confounded exposure with appraisal as items often incorporate evaluations of job characteristics as stressful. To address this, it was recommended to operationalize job stress using condition-related, non-evaluative items (5, 6). Finally, advanced understanding of the psychometrics of psychosocial risk assessment, including activity-based rather than person-based item wordings combined with frequency rather than agreement response options, can further reduce subjective bias via personality traits on assessments (7). These developments demonstrate that, despite inherent subjectivity, psychosocial exposures can be reliably quantified when validated and carefully designed instruments are used. Concluding remarks As with chemical and physical hazards, decisions regarding psychosocial exposures should be guided as objectively as possible by evidence-based criteria, giving both employees and organizations the confidence that preventive measures - or the decision not to implement them - are justified rather than based on subjective judgments. We believe that, despite their construct-dependent ontological nature, OEL for psychosocial hazards can provide substantial support for preventive decision-making. We also share Guseva Canu’s and van der Molen’s emphasis on the political economy of the OEL setting, which our own call for institutionalized discussion forums (Essential 4) explicitly anticipates. With our proposal, we aimed to establish a framework for these decisions based on the current scientific state of the art. While its methodological foundations may not be perfect, we believe it represents a substantial improvement to harmonize research efforts and standardize reporting in a way that encourages researchers to tackle the remaining challenges. In other words, act on OEL where the evidence permits and continue to improve where gaps remain. References 1. Guseva Canu I, van der Molen HF. Occupational exposure limits for psychosocial hazards: A promising concept or a premature leap? Scand J Work Environ Health 2026 Mar. https://doi.org/10.5271/sjweh.4280. 2. Pauli R, Lang J, Müller A, Taibi Y, Kraus T, Metzler Y. Requirements for occupational exposure limits in psychosocial risk assessment: what we know, what we don’t know and what we can learn from other disciplines. Scand J Work Environ Health 2025 Nov;51(6):559-68. https://doi.org/10.5271/sjweh.4247. 3. Gemeinsame Deutsche Arbeitsschutzstrategie: Berücksichtigung psychischer Belastung in der Gefährdungsbeurteilung - Empfehlungen zur Umsetzung in der betrieblichen Praxis [Joint German Occupational Safety and Health Strategy. Consideration of psychological stress in risk assessments: Recommendations for implementation in operational practice] (4th fully revised edition; as of 15 June 2022, updated January 6, 2026). Federal Ministry of Labour and Social Affairs. 4. Schneider I, Mädler M, Lang J. Comparability of self- and observer-ratings in occupational psychosocial risk assessments - Is there agreement? BioMed Res Int 2019 Jun;2019:8382160. https://doi.org/10.1155/2019/8382160. 5. Rau R. Questioning or observation or both together? Which instruments should be used when psychic work load and strain have to be analyzed? Zentralbl Arbeitsmed Arbeitsschutz Ergon 2010;60(9):294-301. https://doi.org/10.1007/BF03344299. 6. Semmer NK, Grebner S, Elfering A. (2004). Beyond self report: Using observational physiological and situation based measures in research on occupational stress. In P. L. Perrewe & D. C. Ganster (Eds.), Research in occupational stress and well being, volume 3. Emotional and physiological processes and positive intervention strategies (1st ed., pp. 205-263). JAI. 7. Pauli R, Lang J. Survey Design Moderates Negativity Bias but not Positivity Bias in Self-Reported Job Stress. Eur J Psychol Assess 2024;41(5):357-66. https://doi.org/10.1027/1015-5759/a000806.

33. Association between intrinsic capacity and incident chronic kidney disease: The mediating role of metabolomic signatures.

期刊: Maturitas 发表日期: 2026-Jun-02 链接: PubMed

摘要

The relationship between intrinsic capacity and incident chronic kidney disease and its underlying mechanisms are unknown. This study investigated this relationship and assessed the potential role of metabolic mechanisms. We included 431,208 UK Biobank participants without baseline chronic kidney disease. An intrinsic capacity deficit score was computed from 7 factors across 4 intrinsic capacity domains. Cox proportional hazard regression was used to investigate the association between intrinsic capacity deficit score and incident chronic kidney disease. Elastic net regression determined the metabolic signature associated with intrinsic capacity deficit score. Mediation analysis assessed the mediating role of metabolic signature and specific metabolites. During a median follow-up of 13.9 years, 19,264 incident chronic kidney disease cases were identified. Compared with participants with an intrinsic capacity deficit score of 0, those with a score of 4+ exhibited a significantly elevated risk of chronic kidney disease (HR 1.49, 95% CI 1.40-1.59). We identified 43 metabolites related to intrinsic capacity deficit score (17 positively, 26 negatively). The metabolic signature partly mediated the association between intrinsic capacity deficit score and risk of chronic kidney disease (proportion of mediation effects 4.10%, 95% CI 2.67-5.92). Significant mediation effects were also observed for metabolites related to lipid metabolism, fatty acids, and amino acids, with PM% ranging from 0.13 to 1.78. Higher intrinsic capacity deficit score was associated with an elevated risk of chronic kidney disease. This relationship was partially mediated through perturbations in metabolic profiles-particularly those involving lipid-related metabolites, fatty acids, and amino acids.

34. Aging Biomarkers in Osteoporosis: A Systematic Review of Molecular Mechanisms, Biological Aging, and Population Evidence.

期刊: Aging and disease 发表日期: 2026-Jun-02 链接: PubMed

摘要

While chronological age is an important risk factor for osteoporosis, biological aging measures may better capture nuances in systemic and bone-tissue aging among same-age individuals. This review aims to summarize the associations between DNA methylation/telomere dysfunction (mainly telomere shortening) and bone health. We searched for human epidemiological studies that examined the associations between blood-based epigenetic aging clocks or leukocyte telomere length (LTL) and osteoporosis-related outcomes on PubMed and Embase. Five epigenetic aging-related studies and 14 LTL-related studies were eventually included, from which data on study design, population, bone health-related outcomes, and statistically significant effect estimates were extracted. Risk of bias was assessed using the Newcastle-Ottawa Scale for observational studies. Findings were summarized narratively due to heterogeneity in study design, biomarkers, and outcome definitions. This review concludes that while laboratory-based studies often provide evidence of aging biomarkers’ association with bone outcomes, population-level epidemiological studies provide inconclusive evidence, highlighting limited studies on epigenetic aging clocks and bone health, and inconsistent findings regarding the association between LTL and bone health. Challenges many of the human studies faced include small sample sizes, inadequate study designs, non-diverse cohorts, and heterogeneity in epigenetic clock selection and/or bone health outcomes. Future research should focus on conducting prospective studies with larger, independent cohort sizes and comprehensive adjustment for intervening factors to paint a clearer picture of the biological aging markers’ associations with osteoporosis and provide guidance on their potential clinical relevance in bone health.

35. Simultaneous determination of trimethylamine N-oxide (TMAO) and its 15 related metabolites by UPLC-MS/MS in human serum.

期刊: Journal of chromatography. B, Analytical technologies in the biomedical and life sciences 发表日期: 2026-Jun-01 链接: PubMed

摘要

Trimethylamine N-oxide (TMAO) is increasingly recognized for its role in the pathogenesis and progression of cardiovascular and metabolic diseases by disturbing fatty acid metabolism. Concurrently, the acylcarnitine profile serves as a critical indicator of associated mitochondrial dysfunction. However, present ultra-performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS) methodologies often focus on a few targets such as betaine, choline, TMAO, and trimethylamine and lack the integrated capability to monitor simultaneous changes in the acylcarnitine profile. This analytical gap restricts the depth of toxicological investigations into the effects of environmental pollutants as well as the thorough assessment of metabolic homeostasis. In this study, an optimized UPLC-MS/MS method was developed for the simultaneous measurement of TMAO and its 15 related metabolites in human serum. Serum samples underwent pretreatment through targeted ethyl bromoacetate-derivatization and protein precipitation. Using 4% bovine serum albumin as a surrogate matrix, matrix-matched calibration was performed to reduce matrix effects and ensure analytical accuracy. Using 10 mmol/L ammonium formate (pH 4.0) and acetonitrile containing 0.1% formic acid as mobile phases, chromatographic separation was achieved on a HILIC column within a 5.5 min runtime. Positive electrospray ionization and multiple reaction monitoring mode were used to monitor the target analytes. The assay demonstrated good linearity (R2 > 0.992) with limits of detection ranging from 0.012 to 5.2 μg/L. Spike recoveries in real samples were 84.5%-114.9%, with relative standard deviations below 10%. In conclusion, this study presents a rapid and validated UPLC-MS/MS method for simultaneous profiling of a targeted panel of TMAO, its precursors, and functionally related acylcarnitines in human serum. It may support studies investigating their associations with cardiometabolic disorders, chronic kidney disease, and metabolic dysfunction linked to gut microbial metabolism.

36. Communication With Clinicians and Relatives About Cascade Genetic Testing in Cancer Patients With Germline Pathogenic Variants.

期刊: JCO precision oncology 发表日期: 2026-Jun 链接: PubMed

摘要

Germline testing is underutilized and varies by cancer diagnosis. We hypothesized that patient and clinician involvement in cascade testing of relatives varies by the cancer susceptibility (breast v gastrointestinal [GI]) of the affected gene. All patients diagnosed with cancer in Georgia or California during 2018-2019 and reported to SEER registries, who were linked to a pathogenic variant (PV) result from testing laboratories, were surveyed 4.5 years postdiagnosis about (1) clinician involvement in result communication to relatives, (2) attitudes about result communication, (3) result communication to relatives, and (4) relatives’ testing. PVs were categorized by primary association with breast (BRCA1, BRCA2, ATM, BARD1, BRIP1, CDH1, CHEK2, PALB2, PTEN, RAD51C, RAD51D, STK11, TP53) or GI cancers (MLH1, MSH2, MSH6, PMS2, EPCAM, APC, BMPR1A, CDKN2A, GREM1, POLD1, POLE, SMAD4). A total of 4,080 patients were surveyed; 2,183 responded (53.5%). Most had PVs associated with breast (83.4%) versus GI cancers (16.6%). Most (85.0%) reported a genetic counseling visit. Genetic counselors were most involved in encouraging family communication (71.5%, v oncologists 33.4%, surgeons 19.4%), advising how to talk with relatives (55.0%, versus oncologists 18.0%, surgeons 9.1%), and talking directly with relatives (33.4%, v oncologists 12.6%, surgeons 7.0%). Most patients considered sharing results their responsibility (86.8%); they notified 86.8% of first-degree and 44.9% of second-degree relatives. Nearly one third (29.0%) of patients reported that no relative was tested, whereas 18.3% reported that four or more relatives were tested. Outcomes did not differ by affected gene or cancer type (P > .1). Patients with cancer are motivated to communicate PV results to relatives. However, few clinicians are involved and relatives’ testing remains low. Novel care delivery models are needed to advance cascade testing and precision risk reduction.

37. A snapshot of selected neglected tropical disease research using the World Health Organization International Clinical Trials Registry Platform database, 1999-2023.

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

摘要

Knowledge of clinical study methodology and location can inform researchers, clinicians, funders, and policymakers of the gaps which exist in a disease’s evidence landscape, thereby conferring guidance for appropriate resource allocation. This study summarises registered studies for selected neglected tropical diseases (NTDs) and identifies evidence gaps. The International Clinical Trials Registry Platform (ICTRP) was searched in September 2023 to extract 315 clinical study registrations submitted between January 1999 and September 2023 on Chagas disease, schistosomiasis, soil-transmitted helminthiases, and visceral leishmaniasis. Data were standardised before a descriptive analysis was performed on study location, inclusion age range, study design, phase, and population access to studies. Registered studies were partially aligned to the geographical distribution of disease burden; countries in which the highest number of studies were registered often face great burden, though there were several endemic countries with few or no studies. The number of registered studies increased over time in the period covered by the review, with 51-62% of studies across the 4 diseases conducted in 2014-23 period, as opposed to 42%-49% in the preceding 15 years. Only 12-17% of studies were multi-country studies across the 4 NTDs. 14% of Chagas disease studies included children under the age of 16 years (much lower than other NTDs) and only 2 studies (2%) exclusively studied under 16s. These findings highlight areas of research for these diseases which have been neglected between 1999-2023, indicating need for further research to fill these gaps and aid progress towards the World Health Organization’s roadmaps to elimination of NTDs by 2030.

38. Human neutrophilic cells express anti-inflammatory EBI3 in response to Neisseria meningitidis.

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

摘要

During bacterial infections of the central nervous system (CNS), the glia-neutrophil axis can drive a vicious cycle that results in lethal neuroinflammation. However, it is becoming apparent that glia can also be a significant source of immunosuppressive factors following bacterial challenge, presumably to mitigate inflammatory CNS damage. Similarly, neutrophils are known to express anti-inflammatory mediators following activation but their ability to produce them in response to clinically important neurotropic bacteria is poorly understood. In the present study, we have characterized the responses of a differentiated human neutrophil cell line to Neisseria meningitidis challenge by RNA Tag-Seq analysis and show marked enrichment in the expression of genes associated with Toll-like receptor-mediated NF-κB and AP-1 signaling, and inflammatory gene products. Interestingly, we also describe their upregulated expression of EBI3, a molecule that can exert immunosuppressive effects outside of its role as a component of IL-27 and IL-35. We have confirmed that these neutrophils produce and secrete EBI3 following N. meningitidis challenge, and we have begun to assess the functional ramifications of such production with the demonstration that EBI3 can significantly reduce the production of CXCL8 by infected primary human astrocytes. These results raise the possibility that neutrophils recruited to the CNS during N. meningitidis infection produce EBI3, thereby limiting inflammatory glial responses to this neurotropic bacterium.

39. Joint Modeling of Multivariate Longitudinal Measurements and Survival Data: Application to Hemodialysis Data.

期刊: Iranian journal of kidney diseases 发表日期: 2026-May-31 链接: PubMed

摘要

In studies involving hemodialysis patients, repeated laboratory measurements (longitudinal data) and survival outcomes are often analyzed separately, which can lead to biased results due to ignoring measurement errors and the intrinsic dependency between the two analyses. Joint modeling has emerged as a powerful approach to handle such data. This study aims to investigate the impact of six time-varying biochemical markers, along with baseline covariates, on the survival of hemodialysis patients using a multivariate joint model. A longitudinal cohort of 894 maintenance hemodialysis (MHD) patients, who had started dialysis between 2004 and 2023, were included. Baseline and follow-up clinical information and monthly laboratory measurements were analyzed. A multivariate linear mixed-effects model was jointly fitted with a Cox proportional hazards model to simultaneously assess the longitudinal biomarkers and time-to-event data. Analyses were performed using R software. The model indicated that older age (Hazard Ratio, HR = 1.02, P < .001), male gender (HR = 1.72, P < .001), diabetes mellitus (HR = 1.61, P < .001), walking disability at admission (HR = 1.78, P < .001), and catheter-based vascular access (HR = 1.71, P < .001) were significantly associated with an increased risk of mortality. Higher square root of phosphate levels (HR = 13.97, P < .001) were linked to increased, and higher square root of creatinine (HR = 0.32, P < .001), hemoglobin (HR = 0.75, P = .009) and albumin (HR = 0.31, P < .001) levels were associated with decreased mortality. Findings of the joint model confirm the importance of baseline clinical risk factors and modifiable biochemical markers on the survival outcomes of hemodialysis patients.

40. Post-traumatic stress disorder moderates the association between BrainAge acceleration and GrimAge acceleration.

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

摘要

Individuals with post-traumatic stress disorder (PTSD) are at higher risk for age-related physical comorbidities, such as cardiovascular disorders, and exhibit accelerated epigenetic and brain aging. The present study examined PTSD as a moderator of the association between DNA methylation (DNAm)-based systemic aging (GrimAge, PhenoAge) and brain aging, indexed by MRI-based and DNAm-derived BrainAge estimates, in 174 lifetime PTSD cases and 138 trauma-exposed controls from four cohorts. Peripheral DNAm assayed with the MethylationEPIC BeadChip was used to calculate epigenetic age acceleration (EAA), using multiple clocks (GrimAge, PC GrimAge, PC PhenoAge), and DNAm-based BrainAge acceleration. Neuroimaging-derived BrainAge estimates were calculated with T1-weighted MRI scans that were processed using FreeSurfer v5.3 and run on BrainageR. Meta-analysis of the four cohorts examined the interactions between lifetime PTSD and EAA on BrainAge acceleration. EAA measures were intercorrelated (0.43 < rmeta < 0.84), but MRI-based BrainAge acceleration was not correlated with any EAA estimate (rmeta = 0.03, p = 0.56). Lifetime PTSD moderated the association between PC GrimAge acceleration and DNAm-based BrainAge acceleration (Standardized Mean Difference [SMD] = 0.84 [95% CI: -1.51, -0.17], p = 0.01), and the association between GrimAge acceleration and MRI-based BrainAge acceleration (SMD = -0.40 [95% CI: -0.74, -0.07], p = 0.02). Stratified analyses confirmed that the positive associations between GrimAge acceleration and BrainAge acceleration were attenuated or absent in PTSD cases relative to trauma-exposed controls. Trauma-exposed individuals represent a vulnerable population who may benefit from personalized approaches guided by multi-modal measures of biological aging to prevent and manage modifiable medical disease processes.

41. Assessing age at natural menopause from self-reported data in a long-running population-based cohort study.

期刊: Maturitas 发表日期: 2026-May-29 链接: PubMed

摘要

To assess whether age at natural menopause could be determined through self-report, and evaluate consistency and reproducibility in self-reported age at natural menopause in a long-running population-based cohort study. We used longitudinal data from 3394 women participating in the Doetinchem Cohort Study (1987-2017), who reported menstrual status and age at menopause up to seven times over 30 years. We assessed the proportion of women for whom age at natural menopause could be determined, within-person variation across repeated reports, and reproducibility defined as agreement within one year across increasing recall intervals. Proportion determination of age at natural menopause, within-person variation across reports, and reproducibility defined as agreement within one year across increasing recall intervals. Age at natural menopause could be determined in 57% of women who reached menopause during follow-up; in the remaining women, this was mainly precluded by hormone use and gynecologic surgery. Among women who had experienced natural menopause, 60% reported age differences of ≤2 years and 17% ≥4 years across reports. Variation increased with longer recall intervals, with underreporting among women already postmenopausal at baseline. Agreement within one year declined from 62% at 5 years to 45% at 30 years. For a substantial proportion of women, age at natural menopause is difficult to determine and inconsistently reported, especially over longer recall periods. Accurate documentation of menopausal status, hormone use, and surgical history are therefore crucial for both research and clinical care. Clear definitions and careful prospective documentation of hormone use can improve reproducibility and data quality, enhancing comparability across studies and supporting appropriate female-specific health care.

42. Determinants of birth satisfaction in Australian public maternity care: A Cross-Sectional survey using the birth satisfaction scale-revised (BSS-R).

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

摘要

Birth satisfaction is an important indicator of maternity care quality and is associated with emotional wellbeing, care engagement, and future health-seeking behaviour. Although models of maternity care influence outcomes and experiences, most Australian studies using the Birth Satisfaction Scale-Revised (BSS-R) have focused on continuity-based or student-led cohorts, limiting generalisability to routine public services. To examine birth satisfaction among women receiving standard public maternity care in Australia and identify demographic, clinical, and psychosocial predictors. A cross-sectional survey of 396 women was conducted across three public hospitals in New South Wales, Queensland, and South Australia between 2022 and 2023. Birth satisfaction was measured using the UK version of the BSS-R and categorised as low (<20), moderate (20-25), or high (≥26). Differences across antenatal care models (hospital-based midwifery care, GP shared care, and public obstetric care) were examined using Kruskal-Wallis tests. Multinomial logistic regression identified independent predictors of satisfaction. Free-text responses were reviewed descriptively to provide contextual insight. The mean BSS-R score was 23.2 (SD 5.17), lower than scores reported in previous Australian studies involving continuity-based models. Satisfaction did not differ significantly across models of care. Independent predictors of low versus high satisfaction included higher EPDS scores (per-point OR 1.14, 95% CI 1.07-1.22), emergency caesarean (OR 4.8) or elective caesarean birth (OR 2.6), ongoing maternal complications (OR 3.8), parity of one prior birth (OR 3.4), and absence of a birth companion. Free-text responses highlighted the importance of respectful, emotionally supportive care and feeling listened to were, even within fragmented care pathways. This study provides new reference data on birth satisfaction among women receiving routine public maternity care in Australia. Satisfaction appeared more strongly associated with clinical events, psychosocial wellbeing, and relational aspects of care than with model-of-care labels alone, while free-text responses highlighted the importance of respectful and emotionally supportive care. Strengthening respectful, emotionally attuned care across maternity services may improve women’s birth experiences.

43. The intermediary role of resilience and psychological distress in the relationship between functional limitations and well-being among racial/ethnic minority persons with multiple sclerosis.

期刊: Multiple sclerosis and related disorders 发表日期: 2026-May-25 链接: PubMed

摘要

Racial/ethnic minorities with multiple sclerosis (MS) may face additional compounding stressors including access to care and cultural values. This study aimed to investigate the indirect role of resilience and psychological distress in the relationship between functional limitations and well-being in a sample of 224 racial/ethnic minorities with MS. Serial mediation analysis was conducted to examine the indirect effect of functional limitations on well-being through resilience and psychological distress. Our findings suggested that functional limitations were negatively associated with resilience and well-being, and were positively associated with psychological distress. Resilience was negatively associated with psychological distress and positively associated with well-being. Our serial mediation results provided preliminary support for resilience and psychological distress as partial mediators between the relationship of functional limitations and well-being. These findings may contribute to an understanding of the roles of resilience and psychological health in the relationship between functional limitations and well-being, which may be critical in addressing disparities in MS care and support.

44. Cost-effectiveness of Taurolidine as secondary prevention of recurrent catheter-related bloodstream infections in patients with chronic intestinal failure: Findings from a randomized controlled trial.

期刊: Clinical nutrition (Edinburgh, Scotland) 发表日期: 2026-May-22 链接: PubMed

摘要

Catheter-related bloodstream infections (CRBSIs) are a major complication in patients with chronic intestinal failure (CIF) dependent on home parenteral support (HPS), contributing substantially to morbidity, mortality, and costs. Taurolidine-containing catheter lock solutions reduce CRBSIs, but data on cost-effectiveness remain limited. This cost-effectiveness analysis used data from a double-blind, randomized controlled trial (2019-2022; ClinicalTrials.gov: NCT06660641) comparing 1.35% taurolidine with 0.9% saline as catheter lock solutions for secondary prevention of recurrent CRBSIs in 61 adults with CIF and a history of CRBSI. Economic analyses adopted a healthcare-provider perspective and included direct medical costs related to treatment and CRBSI management. Clinical outcomes were evaluated using recurrent-event methods, and costs were estimated using Diagnosis-Related Group (DRG) tariffs and a micro-costing approach (MCAP). Incremental cost-effectiveness ratios (ICERs) were calculated. Taurolidine significantly reduced recurrent CRBSIs (ratio: 0.23; 95% CI: 0.09-0.60; p = 0.0028) and associated CVC removals (ratio: 0.09; 95% CI: 0.02-0.41; p = 0.0019). The number needed to treat was 2.4 patients per year. Patients in the taurolidine group had fewer admission days (mean 3.3 vs 16.0; p = 0.015). Despite higher acquisition costs, taurolidine reduced the total hospital expenditures by 39% (DRG) to 64% (MCAP). Mean savings per patient at 24 months were €6395 (DRG; p = 0.016) and €15,434 (MCAP; p = 0.014). Taurolidine also reduced the probability of extreme high-cost CRBSI episodes. Incremental cost-effectiveness ratios (ICERs) indicated dominance, with 94.5-99.6% of bootstrap replications showing taurolidine to be more effective and less costly. In patients with CIF and prior CRBSI, 1.35% taurolidine is a clinically superior and cost-saving secondary prevention strategy that reduces recurrent CRBSIs, CVC removals, and hospital resource use. These findings support routine use in secondary prevention and highlight the need to evaluate taurolidine for primary prevention, where early risk stratification remains challenging.

45. Asthma in athletes: diagnostic challenges and management strategies.

期刊: Current opinion in allergy and clinical immunology 发表日期: 2026-May-18 链接: PubMed

摘要

Exercise-induced bronchoconstriction (EIB) and exercise-induced asthma (EIA) are common conditions among athletes and represent an important clinical issue with potential implications for both respiratory health and athletic performance. The prevalence of asthma in athletes is higher than in the general population, likely due to the combined effects of increased ventilatory demand and environmental exposures. The pathophysiology of EIB is multifactorial and involves osmotic and thermal mechanisms related to airway dehydration during exercise-induced hyperventilation. Although some athletes present a classical T2-high inflammatory phenotype associated with allergic sensitization, a considerable proportion develop EIB through non-T2 inflammatory pathways, including airway epithelial injury and autonomic dysregulation. Diagnosis requires objective assessment through pulmonary function testing and bronchial provocation tests. Biomarkers like fractional exhaled nitric oxide (FeNO) and blood eosinophil counts can support phenotypic characterization, but they do not replace functional testing. Management in athletes follows established asthma guidelines and includes inhaled corticosteroids as the cornerstone of therapy, combined with pharmacological and non-pharmacological strategies. Considering anti-doping regulations is also essential to ensure appropriate treatment and compliance.

46. Ultrasound detection of residual cervical cancer after conization, in a retrospective monocentric analysis: the URECA study.

期刊: International journal of gynecological cancer : official journal of the International Gynecological Cancer Society 发表日期: 2026-May-12 链接: PubMed

摘要

To assess the accuracy of ultrasound in identifying residual cervical tumors following conization, using histology as the gold standard. This retrospective, single-center study included patients with early-stage cervical cancer (International Federation of Gynecology and Obstetrics IA1-IB1 and early IB2) who underwent conization followed by secondary surgical treatment (re-conization, hysterectomy, or trachelectomy). Patients with locally advanced disease were excluded. All patients underwent trans-vaginal or trans-rectal ultrasound after conization and before definitive surgery between January 2015 and May 2025. Ultrasound findings were classified as follows: a) absence of residual tumor, b) presence of residual tumor, or c) uncertain (suggestive of either residual disease or post-conization artifacts). For statistical analysis, uncertain cases were conservatively considered positive for residual disease. Additionally, a secondary analysis was performed in which “uncertain” cases were classified as negative. Ultrasound results were compared with final histopathology, and diagnostic performance metrics with 95% confidence intervals were calculated. A total of 166 patients were included (mean age, 44.4 ± 9.2 years). Residual tumor was found at final histology in 75 patients (45.2%), while 91 (54.8%) had no residual disease. The median tumor diameter at conization was 9.8 ± 6.2 mm, and the mean interval between conization and ultrasound was 61.2 ± 45.5 days. Ultrasound correctly identified residual tumor in 40/75 cases (53.3%), while false-positive findings occurred in 16/91 patients (17.6%). Uncertain ultrasound findings were reported in 43 cases (25.9%), of which 16 (37.2%) had residual disease at histology. Residual tumors were predominantly hypoechoic and showed moderate (45.0%) or rich (35.0%) vascularization on color Doppler imaging. Ultrasound demonstrated a sensitivity of 74.7% (95% confidence interval 64.8 to 84.5), specificity of 52.7% (95% confidence interval 42.5 to 63.0), and overall accuracy of 62.7% (95% confidence interval 53.1 to 72.2). This study shows that ultrasound has sub-optimal performance in detecting residual tumor after conization for cervical cancer, indicating that optimal timing and accurate assessment of residual disease remain clinically relevant challenges.

47. Problematic pornography use: uncovering symptom importance and differences between women and men through Bayesian analysis of networks.

期刊: The journal of sexual medicine 发表日期: 2026-May-11 链接: PubMed

摘要

48. Paramedic Perspectives on Managing Agitation in Older Adults: A Descriptive Mixed-Methods Cross-Sectional Survey in Alberta, Canada.

期刊: The Journal of emergency medicine 发表日期: 2026-Apr-30 链接: PubMed

摘要

Undifferentiated agitation in older adults is common in the prehospital setting, and in transitions from emergency medical services (EMS) to emergency department care. Restraints are commonly used in the management of agitation, although there is little evidence to inform the development of best practices. To explore paramedic experiences and determine perceptions on issues when managing older adults with agitation and using restraints in EMS. We conducted a descriptive cross-sectional survey of paramedics in Alberta, Canada, with a mix of multiple choice and open-ended questions that were interpreted using descriptive statistics and a qualitative thematic analysis, respectively. Paramedics (n = 162) reported that older adults were commonly restrained due to risk of harm to self (81.5%) or others (76.5%), combative behavior (73.5%), or resistance to care (58.0%). Most paramedics believed that restraints were effective in facilitating care (76.9%) and had not resulted in adverse events (72.8%). Only 44.5% believed they had the necessary training to provide restraint alternatives, however, 93.6% agreed they have de-escalated situations without restraints, and 80.0% felt capable of using non-restraint-based agitation management strategies. Nearly half endorsed having suffered physical injury from patient agitation (48.1%). The mean total moral injury score was 20.9 ± 6.8 (range 9-35), indicating a relatively high level of moral injury. Restraints are frequently used by EMS for the management of agitation among older adults, especially when there was a perceived risk of harm. Physical and moral injury is high among paramedics, as well as insufficient training regarding restraint alternatives.

49. Analysis of Factors Influencing Vascular Calcification in Chronic Kidney Disease Patients Based on Oxidative Stress Response and Establishment of a Predictive Model.

期刊: Iranian journal of kidney diseases 发表日期: 2026-Apr-19 链接: PubMed

摘要

In this study, we compared the oxidative stress responses of patients with chronic kidney disease (CKD) and those with CKD-associated vascular calcification (CKD-VC), and established a risk predictive model for CKD-VC based on this comparison, providing a new approach for the clinical prevention and treatment of CKD-VC. We conducted several cross-sectional surveys involving 173 patients with chronic kidney disease (CKD) who were admitted between September 2023 and October 2024 admitted to Affiliated Hospital of Hebei University. Sixty-two patients had VC (CKD-VC group), while the 111 patients did not have VC (CKD group). The levels of superoxide dismutase (SOD), malondialdehyde (MDA), glutathione peroxidase (GSH-Px), and catalase (CAT) of the two groups were measured. Additionally, factors influencing CKD-VC were analyzed using Logistic regression, and a risk predictive model was established accordingly. The levels of SOD and GSH-Px were lower in the CKD-VC group than the CKD group, whereas the CAT and MDA level was higher (P < .05). Logistic regression analysis indicated that SOD, GSH-Px, CAT, MDA, serum calcium, serum phosphorus, age, hypersensitive C-reactive protein (hs-CRP), albumin (ALB), and urine acid (UA) were all independent factors affecting CKD-VC (P < .05). The risk predictive model established based on these factors had high diagnostic sensitivity and specificity for CKD-VC, reaching 100.00% and 87.39%, respectively, with an area under the curve (AUC) of 0.980. This study established a risk predictive model for CKD-VC based on oxidative stress response, which has high diagnostic efficacy. This model provides a new approach for the clinical prevention and treatment of CKD-VC in the future, helping to more accurately identify high-risk patients and take corresponding intervention measures to effectively ensure patient safety.

50. Genetic Associations Between Gastrointestinal Diseases and Chronic Kidney Disease: An Integrated Mendelian Randomization and Bioinformatics Analysis.

期刊: Iranian journal of kidney diseases 发表日期: 2026-Feb-25 链接: PubMed

摘要

Chronic  kidney  disease  (CKD)  is  a  progressive condition  with  complex  genetic  and  environmental  influences. This  study  aims  to  investigate  the  genetic  causal  relationships between  gastrointestinal  diseases  and  CKD  using  the  Mendelian Randomization (MR) approach and bioinformatics analysis. We  analyzed  genetic  associations  between  nineteen gastrointestinal diseases including celiac disease (CeD), inflammatory bowel  disease  (IBD),  intestinal  malabsorption,  and  CKD.  A  two- sample  MR  analysis  was  performed  using  publicly  available Genome-Wide  Association  Studies  (GWAS)  data  with  SingleNucleotide Polymorphisms (SNPs) as instrumental variables (IVs). The primary analysis employed the inverse variance weighted (IVW) method, with MR-Egger and weighted median as supplements. To explore potential biological mechanisms, Functional Mapping and Annotation (FUMA) analysis was used to map genes corresponding to IVs, followed by Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analyses. Significant genetic causal effects were observed for CeD (OR = 1.021, 95% CI = 1.002-1.041, P = .032), IBD (OR = 1.051, 95% CI = 1.014-1.089, P = .006), and intestinal malabsorption (OR = 1.031, 95% CI = 1.006-1.056, P = .013) on the risk of developing CKD. Other gastrointestinal  diseases  did  not  demonstrate  significant  causal effects  on  CKD.  Reverse  MR  analyses  did  not  reveal  significant causal  effects  of  CKD  on  CeD,  IBD,  or  intestinal  malabsorption, respectively. FUMA analysis identified 93 genes associated with CeD, 143  genes  with  IBD,  and  26  genes  with  intestinal  malabsorption. GO  and  KEGG  enrichment  analyses  highlighted  key  pathways, including  T-cell  receptor  signaling,  cytokine-cytokine  receptor interaction, chromatin regulation, and immune-related pathways. This  study  provides  genetic  and  bioinformatics evidence  linking  CeD,  IBD,  and  intestinal  malabsorption  to  an increased risk of CKD, highlighting the systemic impact of immune dysregulation and inflammation on kidney health.

51. The river meeting the sea: A qualitative exploration of the healthcare transition experiences of adolescents and young adults living with rare renal disorders and their parents.

期刊: PloS one 发表日期: 2026 链接: PubMed

摘要

Rare renal disorders are a group of complex conditions that can lead to progressive kidney failure and lifelong multi-system complications. Upon reaching young adulthood, adolescents and young adults must navigate the healthcare transition between paediatric and adult services. This process serves to bridge the gap between health services and provide adolescents and young adults with developmentally appropriate support to manage adult life with their condition. However, this process can prove challenging for adolescents and young adults with rare renal disorders, a research area that is currently under explored. To explore the experiences of adolescents and young adults and parents living with a rare renal disorder and undergoing healthcare transition. Qualitative descriptive study, using reflexive thematic analysis. Results reported according to the COnsolidated Criteria for REporting Qualitative research (COREQ) checklist. Twenty eight in-depth interviews were conducted, with 17 parents and 11 adolescents and young adults with rare renal disorders. Five themes were developed: 1. the complex and ever-changing nature of rare renal disorders, 2. preparing to move on, 3. understanding the person, 4. building support networks, and 5. care coordination, consistency, and communication. Adolescents and young adults and their parents recognised the need for individualised, collaborative, and holistic approaches to healthcare transition, emphasising the need for comprehensive support that acknowledges other areas of adolescents and young adults lives, including educational transitions, peer connection and psychological support. This study emphasises the dynamic interplay between health and social systems when planning healthcare transition. This study offers valuable insights into healthcare transition in rare renal disorders. Findings provide a foundation for future research and can inform practice, policy and the development of future healthcare transition interventions. Two adolescents and one parent from a rare-disease advisory group provided input on the study materials.

52. Physician behavior for "invisible" treatment; Korean herbal medicine doctor's treatment covered by auto insurance.

期刊: PloS one 发表日期: 2026 链接: PubMed

摘要

This study examines healthcare utilization patterns and provider behavior under auto insurance coverage in South Korea. We investigate whether the significant growth in insurance claims for Korean Herbal Medicine (KHM) is driven by clinical necessity or supply-side structural incentives, such as physician-induced demand. We analyze the utilization gap between Conventional Medicine (CM) and Korean Herbal Medicine (KHM) using cross-sectional secondary data from the Korea Health Panel (KHP). The decomposition method developed by Chernozhukov et al. (2013) allows for the decomposition of differences across the entire distribution of medical visits and length of stay (LOS), distinguishing between patient characteristics and provider-side factors. The results indicate that the higher utilization of KHM services is primarily attributable to structural factors rather than patient endowments. In the upper deciles of outpatient visits, structural effects accounted for over 100% of the observed difference, suggesting that provider-side incentives are the dominant driver of high-utilization outliers. Similarly, prolonged hospitalization in the KHM sector was largely unexplained by patient characteristics and remained robust after controlling for patient demographics. The observed disparities suggest that structural incentives within the KHM sector may influence provider behavior and utilization patterns differently than in the CM sector. While these findings are consistent with the theoretical framework of supply-side inducements, further research incorporating direct clinical severity measures is needed to establish definitive causal links. These results show the need for policy interventions targeting reimbursement structures to enhance the efficiency of auto insurance healthcare delivery.

53. A study of trends and projection of life expectancy and its association with socio-demographic index: Results from GBD study 2023.

期刊: PloS one 发表日期: 2026 链接: PubMed

摘要

Life expectancy (LE) serves as a central indicator of population health, reflecting the combined effects of social, economic, and demographic factors. Despite global improvements, substantial disparities persist across regions and development levels. This study aims to analyze temporal and spatial trends in life expectancy at birth (LEB) and assess its relationship with the Socio-Demographic Index (SDI) from 1960 to 2023, with projections to 2050. LE data for 190 countries from 1960 to 2023 were obtained from Our World in Data, while the SDI, reflecting overall social and economic development, was derived from GBD data. Joinpoint regression models were used to estimate annual and average annual percentage changes (APC, AAPC) across countries, regions, and SDI groups. Correlation analyses assessed the strength of association between LEB and SDI. Future trends were projected using a Bayesian Age-Period-Cohort (BAPC) model, generating estimates up to 2050 with 95% credible intervals. Global LE increased steadily from 1960 to 2023, with an overall AAPC of 0.58%. Despite this progress, large regional and socio-demographic gaps persist. Lower-SDI and low-income regions exhibited faster relative growth but greater fluctuations, whereas higher-SDI regions demonstrated slower yet stable improvement. The correlation between LEB and SDI remained strong throughout the study period (r = 0.82-0.90). Projections from the BAPC model indicate continued increases in LE, from 73.6 years in 2025 to 82.8 years in 2050, although uncertainty widens toward mid-century, reflecting potential divergence in global health trajectories. LE has improved globally but remains uneven across socio-demographic contexts. Strengthening social and economic systems, expanding equitable healthcare access, and integrating SDI-based evidence into policy frameworks are essential to sustain progress toward health equity and longevity through 2050 and beyond.

54. Online sexual health survey implementation: Practical lessons from a comparative, mixed-methods analysis of 30 countries.

期刊: PloS one 发表日期: 2026 链接: PubMed

摘要

Online surveys are potentially useful for sexual and reproductive health. However, there are many persistent problems related to online sexual and reproductive health surveys. This study aims to understand online recruitment, dissemination and implementation as part of the International Sexual Health And REproductive health (I-SHARE) consortium online sexual health survey. This study used a mixed-methods, cross-sectional, multi-country design. We used survey data from the I-SHARE study and organised a separate implementation survey completed by I-SHARE country leads. A total of 24,004 participants in 30 countries responded to the I-SHARE survey. All countries implemented the I-SHARE survey online and most (n = 27, 90%) used convenience sampling. Social media promotion (n = 27, 90%), and partner organisations sharing (n = 21, 70%) were the most common recruitment methods. Twenty-nine countries responded to the implementation survey. We identified three themes related to online survey implementation: (1) Adaptation and flexibility highlighted research teams’ responsiveness to rapidly changing contexts; (2) Better together: Partnerships illustrated the importance of multi-sectoral collaboration; and (3) Same but different: the heterogeneity of countries captured the ongoing tension between creating a standardised tool while honouring countries’ unique socio-health climates and responses to the unfolding pandemic. This data demonstrates the potential for using online sexual health surveys in diverse settings. Our study suggests the need for greater consideration of bias related to communication, especially the digital divide, when designing and implementing online surveys.

55. Effectiveness of a home-based exercise program for improving upper limb function in community-dwelling older people: A pragmatic randomized controlled trial.

期刊: PloS one 发表日期: 2026 链接: PubMed

摘要

Upper limb dysfunction, including shoulder pain, is a major health issue for older people. Exercise is commonly used to treat shoulder disorders. This study aimed to determine the effect of a home-based upper limb exercise program on upper limb function compared to a lower limb exercise program, among community-dwelling people aged 65 years + . A randomized controlled trial was conducted. One group received a home-based exercise program targeting upper limb (UL) strength, mobility and function. The other group received a home-based exercise program targeting lower limb (LL) balance and strength. Both exercise programs were taught at three group-based sessions in weeks 1, 4 and 12 post-randomization. Participants were requested to complete exercises three times per week for 12 months. The primary outcome was UL function, measured with the self-report Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire. Secondary outcomes included shoulder strength and range of motion (ROM), quality of life (QOL) and physical activity. 617 participants were randomly assigned to UL (n = 307) or LL (n = 310) groups. Mean age was 73 years, (SD 6.0) and 64% were female. No clinically important or statistically significant between-group difference was detected in UL function (measured by the DASH) at 12 months (mean difference (MD) = 0.99, 95% CI -0.82 to 2.79, p = 0.283, n = 462). There were no significant between-group differences in shoulder ROM, most measures of strength, physical activity (device-measured and self-report), QOL and UL function at three and six months. Participants performed the exercises twice per week, averaging 104 exercise sessions (SD 69, median 117, range 0-371) over the 12-month intervention period. People aged 65 + can successfully learn and adhere to a home-based exercise program for the UL with instruction provided in a group setting, however this program did not improve UL strength, mobility and function. Considering the increased rates of shoulder dysfunction in older age, more research is needed to determine the optimal exercise protocols for prevention of shoulder dysfunction.

56. A novel 3R-compliant ex vivo approach to assess ectoparasiticide repellency against Phlebotomus perniciosus in dogs.

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

摘要

Ectoparasiticides are essential for preventing insect bites and transmission of arthropod-borne pathogens such as Leishmania spp. Traditionally, their anti-feeding efficacy is evaluated in vivo using sedated dogs exposed to sand flies. To comply with 3R principles (replacement, reduction and refinement) and to avoid animal exposure, this study aimed to develop an ex vivo feeding model to assess the efficacy of a dinotefuran, permethrin, and pyriproxyfen (DPP) [Vectra®3D] combination against Phlebotomus perniciosus as an alternative to in vivo testing. Twelve dogs were assigned to either a DPP-treated group (n = 6) or an untreated control group (n = 6). On days -7, 1, 7, 14, 21, and 28, dogs were sedated and exposed for one hour to 50 (±5) female sand flies. In parallel, hair collected from each dog was used in an ex vivo artificial feeding system. After exposure, sand flies were assessed for feeding and survival rates. Anti-feeding efficacy was the primary criterion, while insecticidal efficacy was evaluated as a secondary outcome. In both models, control groups showed feeding and survival rates above 31% and 90%, confirming a reliable challenge. The treated group showed significantly lower feeding and survival rates than the control group (p < 0.05). In both models, DPP demonstrated a strong anti-feeding effect in dogs for one month, with efficacy above 80%. This first direct comparison of in vivo and ex vivo models confirms DPP’s fast and lasting protection against Ph. perniciosus and positions the ex vivo model as a promising 3R-aligned alternative for studying vector-borne disease prevention. Une nouvelle approche ex vivo conforme aux principes des 3R pour évaluer l’effet répulsif des antiparasitaires externes contre Phlebotomus perniciosus chez le chien. Les antiparasitaires externes sont essentiels pour prévenir les piqûres d’insectes et la transmission d’agents pathogènes transmis par les arthropodes, tels que Leishmania spp. Traditionnellement, leur efficacité anti-gorgement est évaluée in vivo sur des chiens anesthésiés exposés à des phlébotomes. Afin de respecter les principes des 3R (remplacement, réduction et raffinement) et d’éviter l’exposition des animaux, cette étude visait à développer un modèle de gorgement ex vivo pour évaluer l’efficacité d’une combinaison de dinotéfurane, de perméthrine et de pyriproxyfène (DPP) [Vectra®3D] contre Phlebotomus perniciosus, en alternative aux tests in vivo. Douze chiens ont été répartis en deux groupes : un groupe traité au DPP (n = 6) et un groupe témoin non traité (n = 6). Les jours -7, 1, 7, 14, 21 et 28, les chiens ont été sédatés et exposés pendant une heure à 50 (±5) phlébotomes femelles. Parallèlement, des poils prélevés sur chaque chien ont été utilisés dans un système d’alimentation artificielle ex vivo. Après l’exposition, les taux de gorgement et de survie des phlébotomes ont été évalués. L’efficacité répulsive (ou anti-gorgement) était le critère principal, tandis que l’efficacité insecticide était évaluée comme critère secondaire. Dans les deux modèles, les groupes témoins ont présenté des taux de gorgement et de survie supérieurs à 31 % et 90 %, respectivement, confirmant ainsi la fiabilité du modèle. Le groupe traité a présenté des taux de gorgement et de survie significativement inférieurs à ceux du groupe témoin (p < 0,05). Dans les deux modèles, le DPP a démontré un puissant effet anti-gorgement chez les chiens pendant un mois, avec une efficacité supérieure à 80 %. Cette première comparaison directe des modèles in vivo et ex vivo confirme la protection rapide et durable du DPP contre Ph. perniciosus et positionne le modèle ex vivo comme une alternative prometteuse, conforme aux principes des 3R, pour l’étude de la prévention des maladies vectorielles.

57. From Asia to Europe: epidemiology, genetic diversity, and One Health implications of Thelazia callipaeda.

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

摘要

Thelazia callipaeda, commonly known as the oriental eyeworm, is a vector-borne parasitic nematode that infects the ocular tissues of a wide range of mammalian hosts, including dogs, cats, wildlife, and humans. Historically confined to East and Southeast Asia, T. callipaeda has emerged over the past 2 decades as a significant zoonotic parasite in Europe, with an expanding geographic distribution driven by the spread of lachryphagous drosophilid fruit fly vectors of the genus Phortica. This review synthesizes current knowledge on the taxonomy, epidemiology, biology, genetic diversity, pathogenesis, and control of T. callipaeda, with particular emphasis on its One Health relevance. Molecular studies reveal low but structured genetic variability, characterised by a single predominant haplotype circulating in Europe and high haplotype diversity in Asian populations, reflecting long-term endemicity and distinct transmission dynamics. Clinically, infection can result in ocular irritation ranging from mild conjunctivitis to severe keratitis and corneal ulceration, with dogs acting as the primary domestic reservoir and wildlife sustaining sylvatic transmission cycles. Human infections, though underreported, are increasingly recognised and pose a growing public health concern. Effective management relies on mechanical worm removal, macrocyclic lactone treatment and prevention, and integrated surveillance of animal hosts and vectors. Given the influence of climate change, animal mobility, and environmental factors on vector ecology, coordinated One Health strategies are essential to mitigate the continued spread and zoonotic impact of this emerging eyeworm. De l’Asie à l’Europe : épidémiologie, diversité génétique et implications « Une Seule Santé » de Thelazia callipaeda. Thelazia callipaeda, communément appelé ver oculaire oriental, est un nématode parasite transmis par vecteur qui infecte les tissus oculaires d’une grande variété d’hôtes mammifères, notamment les chiens, les chats, la faune sauvage et les humains. Historiquement confiné à l’Asie de l’Est et du Sud-Est, T. callipaeda est devenu, au cours des deux dernières décennies, un parasite zoonotique important en Europe, avec une aire de répartition géographique en expansion, favorisée par la propagation des mouches des fruits lacryphages du genre Phortica. Cette revue synthétise les connaissances actuelles sur la taxonomie, l’épidémiologie, la biologie, la diversité génétique, la pathogénie et la lutte contre T. callipaeda, en mettant l’accent sur son importance dans le cadre de l’approche « Une Seule Santé ». Les études moléculaires révèlent une variabilité génétique faible mais structurée, caractérisée par un haplotype prédominant unique en Europe et une forte diversité d’haplotypes dans les populations asiatiques, témoignant d’une endémicité de longue date et de dynamiques de transmission distinctes. Cliniquement, l’infection peut provoquer une irritation oculaire allant d’une conjonctivite légère à une kératite sévère et à un ulcère cornéen. Les chiens constituent le principal réservoir domestique et la faune sauvage assure la transmission sylvatique. Bien que sous-déclarées, les infections humaines sont de plus en plus souvent diagnostiquées et représentent un problème de santé publique croissant. Une prise en charge efficace repose sur l’extraction mécanique des vers, le traitement et la prévention par lactones macrocycliques, ainsi que sur une surveillance intégrée des hôtes et vecteurs animaux. Compte tenu de l’influence du changement climatique, de la mobilité animale et des facteurs environnementaux sur l’écologie vectorielle, des stratégies « Une Seule Santé » coordonnées sont essentielles pour limiter la propagation continue et l’impact zoonotique de ce ver oculaire émergent.

58. Examining the Association between Oxidative Stress Markers and the Severity of Symptoms in Individuals with COVID-19 and Healthy Individuals.

期刊: Iranian journal of kidney diseases 发表日期: 2025-Nov-15 链接: PubMed

摘要

The association between inflammation and oxidative stress  in  COVID-19  patients  is  well  documented.  The  primary objective of the present study was to evaluate the levels of oxidative stress  markers  in  COVID-19  patients  compared  to  the  healthy individuals. In this case-control study, a comprehensive evaluation was conducted on 45 individuals, comprising 30 patients diagnosed with  COVID-19  and  15  in  a  healthy  control.  COVID-19  patients were divided into two groups: mild and severe, based on clinical severity. In addition to standard laboratory tests like ESR, serum levels of oxidative stress markers were measured, including total protein, total antioxidant capacity, total oxidant status, carbonylated protein content, glutathione reductase enzyme, and catalase activity. ESR levels were significantly elevated in the severe group compared to the mild group. However, no significant differences were  observed  in  the  levels  of  oxidative  stress  markers  between mild and severe COVID-19 patients. Compared to healthy controls, COVID-19 patients exhibited a significant decrease in total protein levels (P < .0001), and significant increases were observed in serum total antioxidant capacity (TAC) (P < .0001) and total oxidant status(TOS) (P = .002). Oxidative  stress  markers  exhibit  a  substantial  rise in  patients  with  COVID-19, suggesting  a  potential  role  in  the progression  of  the  disease.  Implementing  strategies  to prevent oxidative  stress  may  offer  clinical  advantageous  in  managing COVID-19 patients.

59. Efficacy and Safety of Oral Antidiabetic Drugs in People with Diabetes and Chronic Kidney Disease: A Systematic Review.

期刊: Iranian journal of kidney diseases 发表日期: 2025-Nov-15 链接: PubMed

摘要

This study is a systematic review assessing the efficacy and safety of oral antidiabetic drugs in managing type 2 diabetes mellitus in people with chronic kidney disease (CKD), focusing on their dosing and effects on renal function and glycemic control. A systematic search of online databases was conducted for published from  January  2023  to September  2024.  Studies  that  focused  on oral  antidiabetic  drugs  for  individuals  with  diabetes and  CKD, and  reported  outcomes  such  as  glycemic  control,  renal  function, and adverse events were included. A risk-of-bias assessment was performed to evaluate study quality. A  total  of  21  studies  that  met  the  criteria  were  included.  The evidences indicate that SGLT2 (Sodium-Glucose Cotransporter-2) inhibitors and GLP-1 (Glucagon-like peptide-1) receptor agonists provide renal protective benefits. SGLT2 inhibitors are more effective especially in early-stages of CKD. DPP-4 (Dipeptidyl peptidase 4) inhibitors are safe across various CKD stages and require minimal dose adjustments. Metformin remains a popular drug for glycemic control but should be monitored and even discontinued in advanced stages of CKD because of the risk of lactic acidosis. Sulfonylureas were related to hypoglycemia risk. Oral  antidiabetic  drugs,  especially  SGLT2  inhibitors  and  GLP-1 receptor  agonists,  are  suggested  in  managing  blood  glucose  in CKD  patients  owing  to  their  renal  and  cardiovascular  benefits. Individualized therapy is an important factor as drug safety and efficacy  are  influenced  by  CKD  stage,  comorbid  conditions,  and hypoglycemia risk. Individualized therapy helps maximize renal and cardiovascular protection while minimizing adverse outcomes. Regular monitoring of HbA1c (hemoglobin A1c), GFR (glomerular filtration rate), and albuminuria is recommended.

60. Quercetin Ameliorates Renal Fibrosis via SIRT5 in Diabetic Nephropathy.

期刊: Iranian journal of kidney diseases 发表日期: 2025-Aug-15 链接: PubMed

摘要

Renal fibrosis represents the principal pathological characteristic of diabetic nephropathy (DN). Quercetin, a well-known flavonoid with diverse pharmacological effects, has been studied for its link to preventing DN. Previous studies indicated that SIRT5 might have significant implications in fibrotic diseases. This study investigated whether the protective effects of quercetin on DN was related to SIRT5. Three doses of quercetin (30 mg/kg, 60 mg/kg, and 120 mg/kg) were orally administered to streptozotocin-induced diabetic rats over a period of four months. Colorimetric methods were used to measure blood urea nitrogen (BUN), serum creatinine (SCr) and urine creatinine (UCr). Enzyme-linked immunosorbent assay (ELISA) was used to quantify the level of urine microalbumin (Ualb). The ratio of urine microalbumin to urine creatinine (Ualb/UCr) was calculated. Periodic acid-Schiff (PAS) stain and Masson’s trichrome stain were used to observe glycogen deposition and collagen accumulation in the renal cortex, respectively. Western blot, ELISA, and immunohistochemical stain were performed to quantify the levels of SIRT5 protein in kidneys of rats. Diabetic rats exhibited increased levels of SCr, BUN, and Ualb/UCr, accompanied by significant glycogen deposition and collagen accumulation in renal cortex. These changes were associated with an increased level of SIRT5 protein. Following treatment of DN rats with varying doses of quercetin, all kidney function and pathology indices showed varying degrees of reversal, accompanied by a reduction in SIRT5 protein levels. Quercetin ameliorated renal fibrosis in DN rats via the inhibition of SIRT5, suggesting a novel mechanism of quercetin in the treatment of DN.

61. What Nephrologists Should Know About Infection Prevention Measures Before and During Eculizumab Administration in Children?

期刊: Iranian journal of kidney diseases 发表日期: 2025-Aug-15 链接: PubMed

摘要

Eculizumab is a recombinant humanized monoclonal antibody that acts as a terminal complement inhibitor. It works by binding to complement protein 5 and inhibiting its cleavage, thereby preventing the production of the complement terminal complex known as C5b-9. Eculizumab has been prescribed by physicians in Iran in both the adult and pediatric fields for the treatment of various diseases. Patients who receive this product are at an increased risk of life-threatening infections, with meningococcal disease being one of the most prevalent threats. Therefore, children receiving eculizumab, should receive meningococcal vaccine. Furthermore, the most effective method to prevent infection in these patients is a combination of vaccination and prophylactic antibiotic usage. Antibiotic prophylaxis should be initiated immediately after the initiation of eculizumab and continued for four weeks after discontinuation of the drug.  This review aims to address physicians’ questions particularly pediatric nephrologists regarding any necessary changes in routine vaccinations for children receiving eculizumab. Additionally, the article discusses infections that may occur more frequently in this population and emphasizes the importance of vaccination and preventive measures. The review also aims to introduce the most up- to- date recommendations for infection prevention before and during eculizumab treatment.