公共卫生研究摘要 (2026-06-06)

共收录 57 篇研究文章

1. Neoplastic CD3⁺ B cells remodel the DLBCL tumor microenvironment via single-cell and spatial transcriptomics.

期刊: Cancer biology & therapy 发表日期: 2026-Dec-31 链接: PubMed

摘要

This study constructs a high-resolution multi-omics map of Diffuse Large B-Cell Lymphoma (DLBCL) by integrating single-cell, single-nucleus, and spatial transcriptomics. We identified a previously unrecognized, recurrent subset of malignant B cells that unexpectedly express CD3, a protein typically found only on T cells. This unusual CD3⁺ B cell population appears to be driven by a specific genetic circuit involving five key regulatory genes: BCLAF1, CHURC1, FLI1, NFATC2, and ELF2. Spatial and functional analyses revealed that these cells are associated with macrophage enrichment and M2 polarization, potentially involving TGF-β signaling and contributing to an immunosuppressive tumor microenvironment. Clinically, the abundance of CD3⁺ B cells was associated with advanced disease stage, poor treatment response, and reduced survival. Our findings support the presence of a CD3⁺ B cell subset with T cell-like features that is associated with tumor microenvironment remodeling and adverse clinical outcomes, highlighting molecular determinants like FLI1 and the TGF-β axis as potential therapeutic targets.

2. Does Age Matter in Migraine-Stroke Risk?

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

摘要

3. Migraine and Stroke Risk in Postmenopausal Women in the Women's Health Initiative.

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

摘要

Migraine is a known risk factor for stroke in women of reproductive age, although its relationship with stroke among postmenopausal women remains unclear. We assessed the association between migraine history and incident stroke in a sample of postmenopausal women. We included women enrolled in the Women’s Health Initiative, a large US longitudinal cohort study of postmenopausal women, and excluded those with previous stroke or those with missing data on key variables. The primary exposure was self-reported, physician-diagnosed migraine at baseline, and the primary outcome was incident stroke (total, ischemic, or hemorrhagic). Multivariable Cox proportional hazards models were used to test the cause-specific hazard ratios (HRs) between migraine history and total, ischemic (overall and by subtype), and hemorrhagic stroke, sequentially adjusted for age, traditional cardiovascular risk factors, and female-specific risk factors (age at menopause, age at menarche, menstrual irregularity, presence of vasomotor symptoms, parity, breastfeeding, and use of menopausal hormone therapy). We then quantified the association between a history of migraine and total stroke by age at baseline (in 5-year age groups) using multivariable models. Data on the presence of aura and migraine frequency were not available. Participants (N = 130,277) had a median age of 63 years (interquartile range [IQR] 57-69). A total of 5,743 incident stroke events occurred over a median follow-up period of 19.9 years (IQR 9.1-25). In multivariable models, there was no significant association between migraine history and total stroke (HR 1.07, 95% CI 0.99-1.17), but there was a significant association between migraine history and ischemic stroke (HR 1.12, 95% CI 1.02-1.23). In planned secondary analysis of ischemic subtypes, the associations were most pronounced in the cardioembolic (HR 1.17, 95% CI 0.98-1.39) and undetermined (HR 1.14, 95% CI 0.98-1.33) categories. Migraine was not associated with hemorrhagic stroke (HR 0.85, 95% CI 0.67-1.09). Risk did not differ significantly by age group. Over 20 years of follow-up, postmenopausal women with a history of migraine had a higher risk of ischemic stroke, but not total or hemorrhagic stroke. Along with other factors, a history of migraine should be considered a risk marker when assessing ischemic stroke risk after menopause.

4. Drivers of Rising Prevalence in Major Motor Neurodegenerative Diseases: Temporal Trends in Sweden and France (2003-2022).

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

摘要

The prevalence of Parkinson disease (PD), multiple sclerosis (MS), and motor neuron diseases (MNDs) is rising globally. However, it is unclear to what degree this is related to an increase in incidence or to improved survival after diagnosis. We performed 2 nationwide, population-based, retrospective cohort studies, including all individuals living in Sweden between 2001 and 2016 and living in France between 2009 and 2022, respectively. Pooled mixed-effects regression models, with country as a random effect, were used to determine temporal trends in prevalence, crude and age-standardized and sex-standardized incidence, and age and life expectancy at diagnosis. Annualized prevalence of PD, MS, and MNDs increased significantly between 2003 and 2022 in the pooled model (PD: prevalence ratio [PR] per year = 1.014, p < 0.001; MS: PR = 1.029, p < 0.001; MND: PR = 1.028, p < 0.001). While the crude incidence of both PD and MS remained nearly stable over time (PD: incidence rate ratio [IRR] per year = 0.998, p < 0.001; MS: IRR = 0.992, p < 0.001), the standardized incidence showed a more marked decrease for PD (IRR = 0.986, p < 0.001) while remaining almost unchanged for MS (IRR = 0.995, p < 0.001). For MNDs, both the crude and standardized incidence increased over time (crude IRR = 1.018, p < 0.001; standardized IRR = 1.008, p < 0.001). Life expectancy at diagnosis of PD increased between 2003 and 2013 (+0.95 months per calendar year, p < 0.001) and then decreased between 2013 and 2022 (-1.20 months, p = 0.002), while it increased significantly over the entire study period for MS (+2.35 months, p < 0.001) and MNDs (+0.34 months, p = 0.01). These findings indicate that the rising MS prevalence is largely survival-driven and the rising MND prevalence reflects a true increase in incidence, whereas PD prevalence grows modestly, largely independent of incidence. Depending on the mechanism that drives prevalence, whether increased incidence reflecting changing risk factor exposures, improved survival due to therapeutic advances, or demographic aging of the population, inferences about underlying causes differ substantially between PD, MS, and MNDs, with direct implications for health care planning and etiologic research.

5. High-throughput protein target mapping enables accelerated bioactivity discovery for ToxCast and PFAS compounds.

期刊: Proceedings of the National Academy of Sciences of the United States of America 发表日期: 2026-Jun-23 链接: PubMed

摘要

Chemical pollution is a global threat to human health, yet the toxicity mechanisms of most contaminants remains unknown. Here, we applied an ultrahigh-throughput affinity selection-mass spectrometry (AS-MS) platform to systematically identify protein targets of prioritized chemical contaminants. After benchmarking the platform, we screened 50 human proteins against 481 prioritized chemicals, including 446 ToxCast chemicals and 35 per- and polyfluoroalkyl substances (PFAS). Among 24,050 interactions assessed, we discovered 35 interactions involving 13 proteins, with fatty acid-binding proteins (FABPs) emerging as the most ligandable protein family. Given this, we selected FABPs for further validation, which revealed a distinct PFAS binding pattern: legacy PFAS selectively bound to FABP1, whereas replacement compounds, perfluoroether carboxylic acids, unexpectedly interacted with all FABPs. X-ray crystallography further revealed that the ether group enhances the molecular flexibility of alternative PFAS to accommodate the binding pockets of FABPs. Our findings demonstrate that AS-MS is a robust platform for the discovery of protein targets beyond the scope of ToxCast and highlight the broader protein-binding spectrum of alternative PFAS as potential regrettable substitutes.

6. Enhanced recovery after surgery (ERAS®) society guidelines for gynecologic oncology: 2026 update.

期刊: Gynecologic oncology 发表日期: 2026-Jun-05 链接: PubMed

摘要

This is the third updated enhanced recovery after surgery (ERAS®) society guideline presenting a consensus for optimal perioperative care in gynecologic oncology surgery. A database search of publications using Embase and PubMed was performed (2018-2025). Studies for key elements within the ERAS gynecologic oncology protocol were selected with emphasis on meta-analyses, randomized controlled trials, and large prospective cohort studies. These studies were then reviewed and graded according to the grading of recommendations, assessment, development and evaluation (GRADE) system. All recommendations on ERAS protocol items are based on best available evidence. The level of evidence for each item is presented accordingly. The updated evidence base and recommendation for items within the ERAS gynecologic oncology perioperative care pathway are presented by the ERAS® society in this consensus review. Gynecologic surgeons may consider incorporating these recommendations into perioperative pathway design, with efforts to achieve consensus within their practice where feasible.

7. Is lower-limb length discrepancy a risk factor for curve progression in adolescent idiopathic scoliosis? A systematic review.

期刊: Rehabilitacion 发表日期: 2026-Jun-05 链接: PubMed

摘要

We evaluated whether lower-limb length discrepancy (LLLD) is a risk factor for curve progression in adolescent idiopathic scoliosis (AIS). A systematic review of observational studies was conducted. On April 18, 2025, two independent reviewers searched Medline (PubMed and Ovid), Embase, PsycINFO, BIREME, PEDro, and Google Scholar using a PECO framework: population (AIS), exposure (LLLD), comparator (AIS without LLLD), and outcome (Cobb angle progression). The search identified 730 records; after removing 75 duplicates, 655 titles and abstracts were screened. Of these, 644 were excluded, and 11 full-text articles were assessed for eligibility. Eight were excluded for not meeting inclusion criteria, leaving three studies that partially met eligibility requirements. Because of the small number of included studies and the absence of appropriate control groups, meta-analysis and formal assessment of publication bias were not feasible. Current evidence is insufficient to determine whether LLLD is a risk factor for curve progression in AIS.

8. Assessing income heterogeneity of female sex as risk factor for long COVID: a meta-analytic investigation.

期刊: Biodemography and social biology 发表日期: 2026-Jun-05 链接: PubMed

摘要

Women have a higher risk of Long COVID, defined as symptoms persisting for three or more months after SARS-CoV-2 infection. This study examines whether the elevated risk of Long COVID among women varies across income subgroups in a nationally representative sample of the U.S. population. Using data from the 2023 Behavioral Risk Factor Surveillance System (BRFSS), we estimated adjusted odds ratios for Long COVID associated with female sex, stratified by four age categories and 11 income groups. We conducted random-effects meta-analyses of income subgroup estimates within each age category and assessed heterogeneity using Cochran’s Q, I2 statistics, prediction intervals, and Galbraith plots. Among younger age groups (18-34, 35-49, and 50-64 years), Cochran’s Q ranged from 7.70 to 10.98 (p > 0.10), and I2 was 0.00%, indicating no significant heterogeneity across income groups. In the ≥65 age group, Cochran’s Q was 18.35 (p = 0.0494), and I2 was 21.96%, suggesting modest heterogeneity. The 95% prediction interval for the ≥65 group (1.121-1.978) was wider than those for younger groups: 1.437-1.975 (18-34 years), 1.551-2.019 (35-49 years), and 1.355-1.766 (50-64 years).

9. Screen-Free Time With Friends to Promote Face-to-Face Peer Interaction and Reduce Recreational Screen Use Among Children Aged 9-11 Years: Protocol for a Cluster Randomized Controlled Trial.

期刊: JMIR research protocols 发表日期: 2026-Jun-05 链接: PubMed

摘要

Children’s leisure time has changed in recent decades-with more time spent on screen media and less time face-to-face with peers-potentially affecting their physical and mental well-being. This protocol outlines a cluster randomized controlled trial evaluating the Screen-Free Time With Friends intervention, which aims to promote face-to-face peer interaction and reduce recreational screen media use among children aged 9-11 years. The study is conducted as a cluster randomized controlled trial involving 9-11-year-old children and their parents from 18 schools in Denmark. Schools are randomized (1:1) to either a control or an intervention group. The intervention includes five core components: (1) curricular activities, (2) two family meetings, (3) a brief parent exercise, (4) a development program for after-school clubs, and (5) two community workshops. It is designed to allow local adaptation while maintaining fidelity to the core components. Primary and key secondary outcomes, including face-to-face peer interaction across leisure domains and solitary screen time, are assessed at baseline, 6-10 months, and 13-15 months follow-up. Additional exploratory outcomes (e.g., leisure activities, social relations, and well-being) are measured at baseline and follow-up. Time spent in face-to-face interactions with peers was assessed using a short SMS-based questionnaire sent to registered parents. The instrument has not been formally validated but was tested in a feasibility study. A comprehensive process evaluation explores implementation, context, and mechanisms of change. The project was funded in July 2020. Schools were recruited from July 2023 to January 2024, while children and parents were recruited from November 2023 to April 2024. At baseline, 685 children were enrolled at the participating schools, with 343 (50%) having at least one parent enrolled in the questionnaire. The primary outcome is therefore assessed among a subset of participants, which may affect the effective sample size. Baseline data were collected from December 2023 to June 2024, and follow-up data from March to August 2025. As of March 2026, data analysis has not yet commenced, and no study results are currently available. Findings are expected to be published by the end of 2026. Regardless of the findings, this study will generate important knowledge about the intervention’s potential effectiveness, complemented by insights into its implementation, context, and mechanisms of change. These insights can assist municipalities, schools, after-school clubs, community stakeholders, and parents in shaping everyday environments that foster children’s face-to-face interaction and encourage balanced screen use. The findings may inform policy decisions, guide the development of new national and local initiatives, and inspire future research into feasible, real-world interventions that support meaningful and enriching leisure experiences for children.

10. Using the Machine Learning Algorithm XGBoost to Understand the Correlates of Wearing Hearing Protection in Central States' Agricultural Producers.

期刊: American journal of audiology 发表日期: 2026-Jun-05 链接: PubMed

摘要

Hearing loss is a common work-related condition. Estimates suggest that 46%-86% of agricultural workers have hearing loss. Agricultural safety programs have been working to increase the use of personal protective equipment (PPE) to protect against noise, respiratory, and chemical exposures, but PPE use remains sporadic. The purpose of this study was to assess factors that might explain the use of hearing protection in agricultural operators working in seven states in the Central United States. The Farm and Ranch Health and Safety Survey data collected in 2018, 2020, and 2023 were used for this study. We examined 24 potential correlates of wearing hearing protection. Bivariate analyses were conducted using a Wilcoxon two-sample test based on dichotomizing the frequency of hearing protection use at the median of 10%. We used XGBoost with training and testing data sets to identify the most important factors that explain wearing hearing protection. The strongest predictors of wearing hearing protection was wearing respiratory and chemical PPE, followed by age. Noise exposure was low in importance. The use of hearing, respiratory, and chemical PPE followed a similar pattern over the age spectrum with chemical PPE use showing the most frequent use. Younger operators more frequently wore PPE. Wearing hearing PPE is more likely to be related to personality traits related to risk perception and less likely due to noise exposures. This is an important consideration when designing hearing loss prevention programs because messaging needs to address safety motivation and unrealistic optimism. https://doi.org/10.23641/asha.32513328.

11. Chaotic and Stochastic Components in an Influenza Surveillance Series: Nonlinear Dynamics and Predictive Modeling Study.

期刊: JMIRx med 发表日期: 2026-Jun-05 链接: PubMed

摘要

Chaotic dynamics has been the subject of both theoretical and empirical research in epidemiology, with the most recent research strongly focusing on SARS-CoV-2. However, few empirical studies have been undertaken with respect to influenza, even though evidence of chaos has also been found in influenza surveillance data. Furthermore, empirical studies on chaos are focused on reconstructing hidden attractors in epidemiological time series to filter out noise; however, dynamical noise affecting chaotic dynamics can have relevant epidemiological features that are, in this way, left unresearched and that can be used for epidemiological surveillance and risk analysis by capturing the main underlying nonlinear processes associated with epidemiological dynamics. This study aimed to reinforce empirical research on chaotic dynamics in influenza surveillance and the study of the dynamical noise affecting that chaotic dynamics, addressing the consequences for epidemiological risk analysis and surveillance. Working with the weekly share of positive influenza tests for the Northern Hemisphere from January 2009 to March 2025 compiled by Our World in Data using FluNet data from the World Health Organization, we applied a recent method based on topological data analysis for reconstructing underlying attractors from time series and decomposing the dynamics down to independent and identically distributed noise. We adapted the method to the epidemiological context so that it can be used for predictive decomposition with direct application to epidemiological risk analysis and surveillance. We found evidence of a low-dimensional chaotic attractor in the researched surveillance data, with a fractal dimension between 1 and 2, and a positive statistically significant largest Lyapunov exponent. The chaotic dynamics had power law scaling associated with long-wave influenza outbreaks, and it is affected by a stochastic component that is nonstationary in variance, leading to turbulent bursts in the outbreak dynamics. Testing different machine learning algorithms using the attractor as input for prediction and a 10-week rolling window, we found the following largest R2 scores for the prediction of the target series: 92.11% (1 week ahead), 85.95% (2 weeks ahead), 81.75% (3 weeks ahead), 77.59% (4 weeks ahead), and 73.35% (5 weeks ahead). The main results reinforce previous theoretical and empirical studies on chaos in epidemiology. Our findings showed that there is a 2-dimensional chaotic attractor that can support up to a 1-month prediction of the target surveillance series with high prediction scores and that the attractor plus noise can be modeled in a way that supports uncertainty quantification and epidemiological risk analysis.

12. Evaluation of a Digital Intervention to Improve the Health Outcomes of Older Adults: Secondary Data Analysis.

期刊: Journal of participatory medicine 发表日期: 2026-Jun-05 链接: PubMed

摘要

The health of aging populations is among the top challenges facing global health systems. The use of mobile health (mHealth) approaches has been found to be effective in prompting changes and has been identified as a potentially valuable tool to enhance health behaviors among older adults. This study sought to explore the efficacy and acceptability of a personalized mHealth app for older adults, focusing on well-being, mental and physical health, and relationship with food. This secondary data analysis examined outcomes of real-world Holly Health users who enrolled between August 2022 and January 2023. Results showed that, after the intervention, self-confidence, energy, mindfulness, health mindset, and short- and long-term mindset all improved. Furthermore, the personalized mHealth app showed a good level of acceptability among the participants. Engaging with this digital health intervention improved several aspects of physical and mental health, adding to existing evidence that effective and accessible tools are needed to promote healthy aging.

13. Knowledge, Attitudes, Practices, Barriers, and Promotional Strategies Related to Clinical Data Interchange Standards Consortium Adoption Among Clinical Data Management Professionals: Semiqualitative Interview Study.

期刊: JMIR medical informatics 发表日期: 2026-Jun-05 链接: PubMed

摘要

National Medical Products Administration of China has actively encouraged organizations to adopt the Clinical Data Interchange Standards Consortium (CDISC) for clinical data submission since 2020. This study aimed to explore the knowledge, attitudes, practices, and barriers to using the CDISC among data managers and to propose strategies for promoting CDISC use in China. A total of 38 participants as leaders or experts of data management departments and teams were recruited from 38 organizations in China from April to August 2022. Data on knowledge, attitude, practice, and barriers to the CDISC, as well as strategies for its dissemination, were collected using a semiqualitative interview guide. For textual data, thematic analysis was conducted using a hybrid approach integrating constructivist and deductive logic, involving iterative coding and theme saturation checks. Of the 38 participants, 36 (94.7%) mentioned that the National Medical Products Administration of China specifying CDISC standards used in submitting data is important for clinical trials, 32 (84.2%) supported this policy, and 29 (76.3%) had experience with CDISC-compliant submissions. The primary barriers to CDISC implementation included high costs, shortage of specialized expertise and training resources, inadequate localization support, inherent complexity of CDISC standards, incomplete standard specifications, lack of detailed regulatory guidelines, low overall proficiency in clinical research, heterogeneity among enterprises and institutions, and challenges related to organizational survival. Corresponding promotional strategies included cost reduction, strengthened publicity and training, adoption of the CDISC from clinical study design, development of supporting tools, integration of traditional Chinese medicine terminology into the CDISC, refinement of CDISC standards, formulation of detailed regulatory guidelines, establishment of a review system, and promotion of collaboration among enterprises and institutions. The CDISC has been recognized, adopted, and supported by most data management experts in China. However, key barriers to its widespread implementation continue to include cost burdens, expertise shortages, and inadequate technological, social, and policy support. Strategies to advance CDISC dissemination should prioritize improving cost-effectiveness, strengthening outreach and training, and refining regulatory frameworks. These findings provide valuable references for international regulators and sponsors in advancing the global adoption of the CDISC.

14. Evaluating an Abbreviated Version of Mindfulness-Based Cognitive Therapy Delivered via Telephone or Videoconferencing Compared to Enhanced Usual Care-Treatment for Migraine and Mood (TEAM-M) Study: Protocol for a Three-Arm Multisite Randomized Controlled Feasibility Trial.

期刊: JMIR research protocols 发表日期: 2026-Jun-05 链接: PubMed

摘要

Migraine ranks among the leading causes of disability worldwide. Comorbid depressive symptoms are highly prevalent in patients with migraine and are associated with worsened pain severity, greater migraine-related disability, and poorer migraine prognosis. Despite this burdensome comorbidity, the treatment of these co-occurring disorders has rarely been studied. While mindfulness-based cognitive therapy (MBCT) shows promise for addressing both migraine-related disability and depressive symptoms, its traditional format-8 weekly 2-hour sessions in person-creates substantial access barriers, particularly for patients who experience frequent debilitating migraine and mood symptoms. The objective of the Treatment for Migraine and Mood (TEAM-M) trial is to evaluate the feasibility of an abbreviated MBCT intervention (MBCT-Brief) delivered via telephone or videoconferencing in adults with migraine and elevated depressive symptoms. TEAM-M is a 3-site trial with a goal sample size of 145 adults with episodic migraine and elevated depressive symptoms randomized to MBCT-Brief telephone, MBCT-Brief videoconferencing, or enhanced usual care (EUC). To be eligible, participants must meet the criteria for migraine as defined by the International Classification of Headache Disorders 3rd edition, have ≥1 year of migraine history, and have mild to moderate depressive symptoms (scores 5-19 on the Patient Health Questionnaire-9). Our primary outcomes include treatment feasibility, acceptability, and fidelity. Our secondary outcomes include headache disability, migraine-specific quality of life, and depressive symptoms. This trial was funded in May 2021. We began recruitment in November 2023 and completed enrollment in January 2026. As of May 2026, we have randomized 145 participants, of which 104 have completed the intervention and provided data for our primary outcomes. Data analysis is currently in progress, and primary outcome results are expected to be submitted for publication in spring 2027. The TEAM-M trial addresses a gap in clinical care by evaluating an abbreviated version of MBCT that has scalability and accessibility advantages over full-length MBCT and the potential to address both migraine and depressive symptoms. By reducing the time commitment while maintaining the core MBCT components, MBCT-Brief can potentially address significant access barriers that often prevent patients from receiving evidence-based health care for comorbid physical and mental health symptoms. The remote delivery model offers enhanced scalability. This trial will also yield information about potential differences in telephone versus videoconferencing delivery, which will inform optimal integration into existing primary care and mental health clinic workflows, allowing for improved access to specialized care for mental health and migraine across diverse health care settings.

15. Impact of the COVID-19 pandemic on pediatric hemolytic uremic syndrome: Epidemiology, complications, and outcomes.

期刊: Advances in clinical and experimental medicine : official organ Wroclaw Medical University 发表日期: 2026-Jun-05 链接: PubMed

摘要

Hemolytic-uremic syndrome (HUS) is a thrombotic microangiopathy that is most commonly caused by infection with Shiga toxin-producing Escherichia coli (STEC-HUS). Atypical HUS (aHUS) is associated with inappropriate activation of the alternative complement pathway caused by infections, including SARS-CoV-2, malignancies, medications, or other triggering factors in genetically predisposed individuals. Assessment of the impact of the COVID-19 pandemic on epidemiology, course, complications, and outcome of HUS in children in a single tertiary nephrological center in Poland. It is a retrospective study, in which a total number of 74 pediatric patients with HUS were analyzed, including 16 cases in 5-year period before the outbreak of the COVID-19 pandemic (HUS-5) and 58 cases in 5-year period after the outbreak of the pandemic (HUS+5). A more than 3.6-fold increase in HUS cases and a 7-fold higher incidence of STEC-HUS were reported in the HUS+5 population. Strokes and persistent neurological complications were observed only in this group. 91.9% of patients presented with abnormal renal ultrasound (USG) findings at admission, and these findings improved significantly more frequently in the HUS-5 (68.75% vs 25.9%, p = 0.002) group. Mortality did not differ significantly between the 2 analyzed groups and was 6.8% for the entire population. The COVID-19 pandemic has had a significant impact on the incidence of HUS in the pediatric population. SARS-CoV-2 infection most markedly increases the risk of neurological complications but does not affect overall mortality.

16. Molecular Epidemiology to Decipher the Transmission Networks of MPOX in an Outbreak Scenario: Applications in Thailand during the 2023 Global Health Emergency.

期刊: The Journal of infectious diseases 发表日期: 2026-Jun-05 链接: PubMed

摘要

The 2022 global health emergency highlighted the necessity for rapid diagnostic measures in response to Mpox clade IIb outbreaks. This study investigates the Mpox lineages identified in Thailand during this period and explores the transmission dynamics of dominant lineages. Using targeted next-generation sequencing from 162 Mpox-infected individuals, we created a transmission network map by linking high-similarity sequences through molecular-temporal distance matrices. Our findings reveal that the study population aligns with global trends of transmission almost exclusively within the MSM community, and a majority of cases resulting from lineage C viruses as well as eight additional sub-lineages. Within the observed substitutions, a majority of mutations were either G→A (289, 49.74%) or C→T (221, 38.04%) indicating APOBEC-3-driven deaminase activity. We also present a global transmission network for lineage C Mpox genomes, illustrating both domestic and international spread. This research underscores the significance of whole-genome sequencing in diagnostics during outbreaks and the importance of sharing genomic data to enhance our understanding of disease transmission on a global scale.

17. Racial and ethnic differences in opioid fills following cancer-directed surgery among older and younger Medicare beneficiaries.

期刊: Journal of the National Cancer Institute 发表日期: 2026-Jun-05 链接: PubMed

摘要

Opioid receipt differs by race and ethnicity across multiple settings, yet few studies have examined disparities after cancer-directed surgery. Using fee-for-service Medicare claims, we identified cancer-directed surgeries between 2012 to 2021. Multivariable linear regression models estimated racial and ethnic differences in postoperative opioid fills and doses within 30-days, adjusting for demographic and clinical factors. We ran separate models among older (age ≥ 65) and younger (age < 65) Medicare beneficiaries (who typically qualify based on disability), and further models by preoperative opioid use (opioid-naïve vs not). We identified 958,593 surgical episodes. Overall 84.9% were non-Hispanic White (White), 8.1% non-Hispanic Black (Black), 4.4% Hispanic, and 2.2% Asian. Among older beneficiaries, Black and Hispanic patients were 4.7 [95%CI : 4.3,5.1] and 3.1 [95%CI : 2.6,3.6] percentage points more likely to fill ≥1 opioid than White patients. Mean 30day doses were similar between Black and White patients; whereas Hispanic and Asian patients filled modestly lower doses (-22 MME [95%CI:-27,-16], -53 MME [95%CI:-61,-46]). Among younger beneficiaries, opioid fill rates were relatively similar across racial and ethnic groups. However, mean 30-day doses were substantially lower among Black (-135 MME [95%CI:-154,-115]), Hispanic (-167 MME [95%CI:-198,-136]), and Asian (-259 MME [95%CI:-327,-191]) vs White patients, particularly those with prior opioid use. We observed modest racial and ethnic differences in opioid fills following cancer-directed surgeries among older Medicare beneficiaries. However, among younger beneficiaries, Black, Hispanic, and Asian patients filled substantially lower 30-day doses than White patients, primarily among those with prior opioid use. Cancer pain equity efforts should target populations experiencing meaningful disparities.

18. Developing and Testing a Brief Mindfulness Just-in-Time Adaptive Intervention to Reduce Stress Among Caregivers of People With Dementia: Quasi-Experimental Study.

期刊: JMIR aging 发表日期: 2026-Jun-05 链接: PubMed

摘要

Dementia caregiving entails chronic, fluctuating stress with downstream risks to caregivers’ mental health and quality of care. Mindfulness-based interventions can reduce caregiver stress; however, moment-to-moment fluctuations in stress may limit receptivity to practice at any given time. We developed a brief mindfulness just-in-time adaptive intervention (JITAI) that aims to deliver support at the right moment by using machine learning algorithms to optimize notification timing based on receptivity to engage in brief mindfulness practices. This study aims to evaluate the feasibility, acceptability, and effectiveness of a brief mindfulness JITAI for caregivers of people with dementia on stress, depressive symptoms, caregiver burden, sleep, quality of life, and trait mindfulness. A single-arm, pretest or posttest design was adopted. A total of 120 community-dwelling caregivers were recruited to participate in the 18-day intervention, which included 4 days of psychoeducation delivered via videos and phone coaching, alongside an in-app brief, low-dose mindfulness-based stress reduction component. From days 5 to 11, prompts were delivered either by a static machine learning model trained on prior pilot data or at random times, with equal probability. From days 12 to 18, three delivery models were used with equal probability, namely static, random, and adaptive models, which updated per participant using accumulating receptivity data. Feasibility and acceptability were assessed post intervention. Standardized measures of stress, depressive symptoms, caregiver burden, positive aspects of caregiving, sleep, quality of life, and trait mindfulness were collected via phone interviews at baseline and post intervention. Retention was 100%. Most participants (111/120, 92.5%) found the app easy to use, 81.7% (98/120) perceived it as helpful for stress management, and 80% (96/120) would recommend it to other caregivers. Pre-post analyses indicated significant reductions in perceived stress (P<.001), depressive symptoms (P<.001), and caregiver burden (P=.003), as well as a significant increase in positive aspects of caregiving (P<.001) and subjective sleep quality (P=.02). Health-related quality of life and trait mindfulness did not change significantly. A brief, smartphone-delivered mindfulness JITAI for caregivers of people with dementia was feasible and acceptable, with high retention and positive user evaluations. Pre-post findings suggest reductions in perceived stress, depressive symptoms, and caregiving burden, alongside increased positive aspects of caregiving and improved sleep, supporting the potential of adaptive, technology-enabled interventions to provide timely support to caregivers.

19. Health literacy, media literacy, and the digital divide: A conceptual framework for public health.

期刊: Advances in clinical and experimental medicine : official organ Wroclaw Medical University 发表日期: 2026-Jun-05 链接: PubMed

摘要

The increasing digitalization of health systems has transformed the ways in which individuals and communities interact with information, health services, and decisions related to their wellbeing. In this context, health literacy, media health literacy, and the digital divide in health have emerged as critical determinants of informed and equitable participation in digital environments. The aim of this conceptual review is to examine the interconnections between health literacy, media health literacy, and the digital divide, and to propose an integrated conceptual framework to inform equitable public health practice, policy, and research in the digital era. The article provides a critical and integrated analysis of these constructs, highlighting their conceptual relationships, key methodological challenges, and implications for clinical practice, health policy development, and public health research. The findings indicate that approaches focused exclusively on individual skill development are insufficient to address digital health inequities. Without attention to structural and organizational determinants, the expansion of health technologies may reproduce or exacerbate pre-existing social and health inequalities. Accordingly, the review underscores the need for multilevel approaches that align literacy development, digital inclusion, and health system design to strengthen equity in the digital era.

20. Methodological and reporting quality, risk of bias, and associated factors in systematic reviews of clinical pharmacy services: a meta-research study protocol.

期刊: The International journal of pharmacy practice 发表日期: 2026-Jun-05 链接: PubMed

摘要

To assess the methodological quality, reporting quality, and risk of bias of systematic reviews (SRs) on clinical pharmacy services and to identify factors associated with these outcomes. This meta-research study will include SRs, with or without meta-analysis, focused on pharmacist-led clinical services: medication review, medication therapy management, medication reconciliation, pharmacotherapeutic follow-up, disease management, drug monitoring, management of minor illness, and health education. A preliminary search was conducted in PubMed, Embase, Scopus, Web of Science, Latin American and Caribbean Health Sciences Literature (LILACS), and the Cochrane Library from inception to 6 August 2025, without language or date restrictions. Searches will be rerun and updated after protocol publication. Two reviewers will independently perform study selection and data extraction. Methodological quality will be assessed using A MeaSurement Tool to Assess SRs 2, risk of bias using the Risk of Bias in Systematic Reviews tool, and reporting quality using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 (PRISMA 2020) and PRISMA for Abstracts checklists. Analyses will summarize results and explore associations between study characteristics and quality indicators. The preliminary searches retrieved 4947 records after deduplication. This protocol has been registered with the Open Science Framework: osf.io/mg89h. This study is expected to provide a comprehensive overview of methodological rigor, reporting practices, and bias levels among SRs of clinical pharmacy services, identifying patterns and predictors of quality. The study may guide improvements in transparency, reproducibility, and methodological standards, ultimately supporting higher-quality evidence to inform pharmaceutical care and policy.

21. Understanding HPV Mitigation Content in Highly Engaged YouTube Videos: A Mixed-Method Topic Modeling and Sentiment Analysis of Videos and Related Comments Study.

期刊: Journal of health communication 发表日期: 2026-Jun-05 链接: PubMed

摘要

As the most common sexually transmitted infection and leading cause of several cancers, the human papillomavirus (HPV) warrants careful attention in how it is portrayed and discussed on social media platforms such as YouTube. This study examines highly commented YouTube videos about HPV to analyze how different content creators frame health information and behaviors, and how audiences respond. We applied the Health Belief Model to evaluate how different creators portrayed health information, performed sentiment analysis to assess comments’ emotions, and conducted topic modeling to identify key themes emerging from the comments. Medical professionals contributed most of the videos (n = 15, 75%) and were protagonists (n = 15, 75%). However, those videos received lower viewer engagement and fewer positive interactions. The most frequently mentioned health behavior was vaccination (n = 12, 60%), followed by medical screening (n = 10, 50%), treatment (n = 8, 40%), consulting healthcare providers (n = 6, 30%), practicing safe sex (n = 5, 25%), and lifestyle change (n = 3, 15%). Constructs of perceived severity, perceived susceptibility to HPV, and perceived benefits of health behaviors were present in over 80% of videos, whereas self-efficacy was mentioned in only 45%. Topic modeling of comments identified four major themes: knowledge (43.36%), screening and treatment (27.67%), vaccination (16.58%), and alternative treatment (12.38%). These findings highlight that medical professionals were the primary creators and figures in HPV-related YouTube communication. Health behaviors received limited emphasis. Comments revealed notable disagreement and skepticism toward recommended health behaviors and frequent promotion of alternative treatments, highlighting the need for more engaging, trust-building, and behaviorally focused HPV communication on social media.

22. Interventions to improve adolescents' sense of coherence and social support on quality of life and gingivitis: a cluster-randomised clinical trial.

期刊: Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation 发表日期: 2026-Jun-05 链接: PubMed

摘要

to evaluate two interventions to improve sense of coherence (SOC) and social support on oral health-related quality of life (ORHQoL), health-related quality of life (HRQoL), dental biofilm and bleeding on probing (BOP) among adolescents. A cluster-randomised school-based clinical trial was conducted with 254 adolescents aged 15-16 years from four secondary schools in Brazil. The SOC intervention group (SOC-G) included seven 60-minute sessions aimed at developing and empowering positive attitudes, personal skills and coping strategies. The SOC plus social support intervention group (SOC/SS-G) comprised face-to-face and online meetings between participants and high school students to enhance social support, along with the SOC intervention. Mixed-effects models revealed significant effects of SOC-G and SOC/SS-G on SOC, social support, self-esteem, dental biofilm, BOP, OHRQoL and HRQoL at three-month follow-up. Structural equation modelling showed direct effects of interventions on dental biofilm and HRQoL. Interventions indirectly predicted ORHQoL via SOC change. Social support change mediated the effect of the interventions on BOP. The present findings suggest that interventions aiming to enhance SOC and social support can positively impact quality of life and periodontal clinical outcomes among adolescents. Identifier: RBR-3rxj6y6. Adolescents living in deprived areas often face challenges that affect their oral health and quality of life. Improving their ability to cope with stress and strengthening social support may help improve both their quality of life and oral health. This study evaluated whether interventions that build coping skills and social support can improve adolescents’ oral health and quality of life. The study tested two school-based programs: One focused on coping skills, and another combining coping skills with individual peer support to see if they improve quality of life and oral health in teenagers. Both programmes led to better coping, more social support, higher self-esteem, and improvements in oral health (less dental plaque and gum bleeding). These changes also improved how teens felt about their health and well-being. The results suggest that helping teens build resilience and social connections can lead to real health benefits to their oral health and quality of life.

23. Clinical associations and related factors of metabolic syndrome in systemic sclerosis: results from an observational multicenter study of GIRRCS (Gruppo Italiano di Ricerca in Reumatologia Clinica e Sperimentale).

期刊: Rheumatology international 发表日期: 2026-Jun-05 链接: PubMed

摘要

Metabolic syndrome (MetS) has been increasingly recognised as a relevant comorbidity in systemic autoimmune diseases; however, data on its prevalence and clinical associations in systemic sclerosis (SSc) remain limited and heterogeneous. This study aimed to evaluate the prevalence of MetS in a large Italian SSc cohort and to explore its clinical, functional, and vascular associations. A cross-sectional multicenter study enrolled 613 SSc patients from 11 tertiary Rheumatology centres across Italy, fulfilling ACR/EULAR 2013 criteria. MetS was defined according to the International Harmonised 2009 Joint Interim Statement criteria. Clinical, laboratory, functional, and imaging data were collected. Comparisons were performed between MetS+ve and MetS-ve patients. Logistic regression analysis was performed to identify factors associated with MetS. Among 570 patients with complete data, MetS was identified in 8.4% (48/570). MetS+ve patients were older and more frequently had active disease according to the EScSG index (45.2% vs. 17.7%, p = 0.0001). They more commonly exhibited mild restrictive lung impairment, with a higher proportion showing FVC 70-79% (21.6% vs. 7%, p = 0.008), as well as moderately reduced DLCO. Cardiovascular involvement was more prevalent in MetS+ve patients, particularly left ventricular diastolic dysfunction (54.3% vs. 25.8%, p = 0.0001) and clinically diagnosed PAH (27.3% vs. 12.6%, p = 0.007). Moreover, advanced microvascular damage, reflected by a higher frequency of late nailfold videocapillaroscopy (NVC) pattern (38.5% vs. 23.1%, p = 0.031), was more common among MetS+ve patients. In multivariable analysis adjusted \for age and sex, active disease (OR 4.79, 95% CI 2.09-10.98; p < 0.0001) and mild lung restriction (FVC 70-79%) (OR 4.54, 95% CI 1.62-12.69; p = 0.004) remained independently associated with MetS. Systemic arterial hypertension was the most frequent component of MetS (77.1%). In this large Italian SSc cohort, MetS, although relatively infrequent, identified a distinct clinical phenotype characterised by increased disease activity, mild lung functional impairment, and more advanced microvascular damage. These findings support the clinical relevance of cardiometabolic comorbidity in SSc and highlight the importance of comprehensive metabolic assessment in routine care. Prospective studies are needed to clarify temporal relationships and underlying mechanisms.

24. Validation of the Game Addiction Scale in Adolescents (GASA short version): adaptation for Mexican children.

期刊: Psicologia, reflexao e critica : revista semestral do Departamento de Psicologia da UFRGS 发表日期: 2026-Jun-05 链接: PubMed

摘要

The objective of this study was to evaluate the psychometric quality of the Game Addiction Scale for Adolescents (GASA shortened version) in its adapted version for Mexican children. The instrument was administered to 289 primary school students using a non-probability quota sampling method. The average age of the participants was 10.47 years, with a standard deviation of 1.003 years, with 55% being boys and 45% being girls. Descriptive statistics were obtained from the seven items which make(made) up the scale to proceed with the confirmatory factor analysis (CFA), which was carried out using the robust estimation method Satorra-Bentler and the fit indices RMSEA (Root-mean square error of approximation), CFI (Comparative fit index), and SRMR (Standardized root mean square residual), as well as the X2/df ratio. Likewise Nevertheless, an analysis of the invariance of the factorial structure according to the sex of the participants was performed. Finally, reliability was determined by subscales using the McDonald’s omega coefficient. The CFA shows a good adjustment data for the uni-factorial proposed model (X2/df = 1.26, p = .223; CFI = 0.992; RMSEA = 0.030, CI 90: 0.000 - 0.068; SRMR = 0.029). The Hoelter’s statistic was around 388. CONCLUSIóN: The post-COVID-19 context has created profitable conditions for the use or abuse of video games. The identification of addiction symptoms allows the strategies design of promotion and health intervention in vulnerable populations, such as the development of healthy games.

25. Health Care Use and Recurrence Rate in Hemolytic Disease of the Fetus and Newborn: Retrospective Cohort Study.

期刊: JMIR pediatrics and parenting 发表日期: 2026-Jun-05 链接: PubMed

摘要

Hemolytic disease of the fetus and newborn (HDFN) is a life-threatening condition resulting from maternal-fetal erythrocyte antigen incompatibility. Although anti-Rhesus D (RhD) prophylaxis has reduced RhD-associated cases, HDFN persists due to non-RhD antibodies and gaps in prevention. Population-based data on maternal and neonatal outcomes and recurrence patterns are limited. This study aimed to characterize maternal and neonatal outcomes, health care use patterns, and recurrence rates of HDFN across pregnancies. We conducted a retrospective cohort study of 464,711 pregnancies within the Kaiser Permanente Southern California system from January 1, 2008, to June 30, 2022. HDFN diagnoses were confirmed using validated natural language processing-assisted manual chart review and followed through 2023. Maternal characteristics, neonatal outcomes, and health care use were compared by HDFN status, and recurrence patterns were evaluated among individuals with ≥2 pregnancies. Chi-square tests and Wilcoxon rank-sum tests were used to compare characteristics between HDFN and non-HDFN pregnancies. Statistical significance was defined as P<.05. Among all pregnancies, 139 of 464,711 (0.03%) were diagnosed with HDFN. Women with HDFN were more likely than those without HDFN to be older (aged ≥35 years; n=42, 30.2% vs n=97,146, 20.9%) and multiparous (n=121, 87.1% vs n=264,766, 57%). Infants affected by HDFN had higher rates of preterm birth (n=40, 28.4% vs n=42,240, 9.5%), low birth weight (<2500 g; n=22, 15.6% vs n=31,740, 7.1%), and neonatal jaundice (n=92, 65.2% vs n=162,465, 36.4%) than non-HDFN infants. Delivery hospitalizations (median 5.0, IQR 2.0-7.5 days vs median 2.0, IQR 1.0-2.0 days) and neonatal intensive care unit stays (median 4.0, IQR 0.0-7.0 days vs median 0.0, IQR 0.0-0.0 days) were longer, and maternal nondelivery hospitalizations were more frequent (n=27, 19.4% vs n=23,228, 5%) among pregnancies complicated by HDFN. Among women with a prior HDFN-affected pregnancy, 83.3% (n=25) experienced recurrence in a subsequent pregnancy. Of these recurrent cases, 32% (n=8) were severe, and 75% (n=6) involved fetal anemia requiring at least 1 intrauterine transfusion. HDFN was rare but was associated with substantial maternal and neonatal morbidity, including higher rates of preterm birth, increased neonatal intensive care unit admissions, and greater health care use. Recurrence was frequent and clinically significant, underscoring the importance of early surveillance and proactive management strategies.

26. A Novel Therapy With a One-Month Ultrashort Regimen to Halt Progression From Latent Infection to Active Tuberculosis Among Close Contacts (The TB‑YOUTH Study): Protocol for a Cluster Randomized Controlled Trial.

期刊: JMIR research protocols 发表日期: 2026-Jun-05 链接: PubMed

摘要

Close contacts of individuals with active pulmonary tuberculosis (TB) face an elevated risk of TB acquisition, necessitating systematic screening for latent TB infection and subsequent TB preventive treatment (TPT). Major TPT regimens require ≥3 months of drug exposure and demonstrate suboptimal safety profiles, significantly compromising treatment completion rates. Therefore, the development of shorter, safer chemoprophylaxis strategies represents a critical need in global TB control. Among close contacts, school-aged children and adolescents constitute the most vulnerable demographic subgroup, warranting prioritized intervention efforts. The primary objective of this study is to demonstrate noninferiority of an ultrashort, 1-month TPT regimen of isoniazid plus rifapentine, administered 3 times a week (1H3P3) compared with the standard 3-month daily isoniazid plus rifampicin (3HR) regimen in preventing active TB, as measured by the 24-month cumulative incidence of active TB following randomization. An investigator-initiated, prospective, multicenter, open-label, noninferiority, cluster-randomized controlled clinical trial is being implemented under the auspices of the national TB control program in China. Close contacts of school pulmonary TB index cases, regardless of diagnostic type, are actively screened for symptoms using interferon-gamma release assays, chest imaging, and sputum molecular diagnostic testing to detect TB infection and exclude active TB. Eligible latent TB infection cases will be randomized in a 1:1 cluster ratio to receive either the standard 3HR regimen or the novel ultrashort 1H3P3 regimen for TPT, with subsequent follow-up for up to 2 years to assess disease progression. The primary composite end point includes microbiologically confirmed TB (sputum culture or molecular diagnostic testing) or clinically diagnosed TB. With 80% power to detect noninferiority (20% margin), the study requires 1760 participants per arm, accounting for cluster design effects. Recruitment started in September 2023. By the end of December 2025, a total of 2478 participants, comprising 627 index cases, had been enrolled, and recruitment is estimated to continue until September 2026. Data analysis will commence after the 2-year follow-up period, and the results are expected to be published by March 2029. This cluster randomized controlled trial aims to establish the noninferiority of a novel, ultrashort 1H3P3 regimen compared to the standard 3-month 3HR regimen for preventing active TB in infected school contacts. If successful, this well-tolerated 1-month regimen could significantly improve treatment completion and optimize preventive therapy delivery in high-transmission congregate settings, thereby contributing substantively to global TB control efforts.

27. Exploring Factors Influencing Nursing Task Prioritization for Supportive Information System Design: Qualitative Study With Thematic Analysis.

期刊: JMIR human factors 发表日期: 2026-Jun-05 链接: PubMed

摘要

Nurses are required to perform multiple tasks concurrently, which leads to multitasking situations, and they have to continuously determine which tasks should be prioritized. This is particularly challenging for novice nurses. Although IT-based systems supporting prioritization have begun to emerge, research on the types of information required when prioritization is processed computationally is scant. Despite the clear need for a supportive information system to assist nursing task prioritization, such systems are not yet sufficiently developed. This study aimed to explore the appropriate granularity and structure of information that should be provided to computational systems to support decision-making based on the influencing factors of nursing task prioritization. Semistructured interviews were conducted with 10 nurses working in general wards to examine the factors they consider when determining task prioritization during clinical practice. Data were analyzed using an inductive, semantic approach based on a thematic analysis framework. Three themes and nine categories including (1) medical condition assessment factors (signs of acute physiological changes and indicators of clinical status and conditions), (2) patient-related nursing care factors (physical status, psychological condition, and personal characteristics; care needs during hospitalization; and treatment goals and care preferences), and (3) organizational and operational work factors (temporally structured tasks, requiring collaboration partners for task execution, environmental factors affecting task performance, and institutional- and ward-level policies) were identified. Analysis of computational tractability of the identified factors indicated that medical condition assessment factors are relatively quantifiable. In contrast, patient-centered care and organizational and operational work factors rely on contextual and experiential judgment, limiting standardization and formalization. Regarding such ambiguous and context-dependent elements, flexible information-processing approaches, such as large language models, in addition to conventional rule-based methods, may be effective. Furthermore, the appropriate level of information granularity should be determined by the nature of the prioritization outputs required in actual nursing practice rather than the degree of abstraction itself.

28. Evaluating an Abbreviated Internet-Delivered Stress Recovery Intervention for Health Care Workers: Pre-Post Feasibility Study of Outcomes, Usability, and Acceptability.

期刊: JMIR formative research 发表日期: 2026-Jun-05 链接: PubMed

摘要

Health care workers face numerous occupational stressors that place them at heightened risk for burnout and poor mental health. Internet-delivered interventions have shown promise in reducing stress and related symptoms, yet adherence is often low, and users do not complete programs. Abbreviated interventions may help address engagement barriers such as high workload, limited time, and varying user preferences. There is a need to evaluate brief, accessible formats of internet-delivered programs for this population. This study aimed to examine the initial outcomes, usability, and acceptability of a 4-week abbreviated internet-delivered stress recovery intervention for health care workers. Specifically, it evaluated changes in stress recovery, perceived stress, depression and anxiety symptoms, and psychological well-being. The study also sought to understand participants’ experiences with the brief format to determine whether it meets their needs. This single-arm pre-post study examined a 4-week abbreviated version of the online guided cognitive behavioral therapy-based stress recovery program FOREST among self-enrolled health care workers recruited through professional networks (N=52; mean age 39.31, SD 11.31 years; 49/52, 94.2% women). Outcomes included stress recovery (the Recovery Experience Questionnaire), perceived stress (the Perceived Stress Scale-4), depression and anxiety symptoms (the Patient Health Questionnaire-4), psychological well-being (the World Health Organization Well-being Index), and usability and acceptability ratings. We found that after the abbreviated version of the FOREST intervention participants showed moderate improvements in stress recovery (d=0.54, 95% CI 0.25-0.83); reductions in stress (d=-0.43, 95% CI -0.72 to -0.14), anxiety and depression symptoms (d=-0.51, 95% CI -0.80 to -0.22); and increase in psychological well-being (d=0.39, 95% CI 0.08-0.70). The majority (37/52, 71.2%) accessed all 6 modules. Users reported high satisfaction with the abbreviated program. While preliminary and limited by the pre-post design, these findings indicate that abbreviated internet-based stress recovery programs are a promising and practical tool for supporting the mental health of health care workers. Future research should examine the long-term effects, compare the abbreviated and standard versions, and explore implementation in routine practice.

29. The "Twilight Zone" Is a Danger Zone: Why the Occupational-Clinical Divide in Burnout Assessment Is a False Dichotomy.

期刊: Evaluation & the health professions 发表日期: 2026-Jun-05 链接: PubMed

摘要

De Beer (2026) argues that burnout’s ICD-11 classification as an “occupational phenomenon” necessitates a stricter separation between organizational screening and clinical diagnosis. This commentary challenges that “dual approach” as a false dichotomy that underestimates the biological reality of chronic stress. Drawing on biomarker research from 2024 and 2025 and the validation logic of the Burnout Assessment Tool that De Beer published on extensively in the past, I argue that the occupational-clinical split risks functioning as a liability shield rather than a care pathway. When we deny the diagnostic validity of workplace screening, we create a “Twilight Zone” where employees with severe symptoms can be given organizational “risk” labels without corresponding clinical recognition or care. I propose an Integrated Continuum Model where workplace screening functions as valid Stage 1 assessment within a coordinated care pathway, ensuring that high-risk scores trigger immediate clinical triage rather than administrative limbo. The failure to integrate these approaches does not protect employees. It leaves them without a clear path to appropriate care.

30. Preferences for Telehealth Physical Activity Participation Among a Cohort of Children and Youth With Disabling Conditions: Cross-Sectional Survey Study.

期刊: JMIR formative research 发表日期: 2026-Jun-05 链接: PubMed

摘要

Children with disabling conditions encounter numerous challenges in participating in physical activity within their community. Telehealth has emerged as an ideal method for promoting physical health and wellness, but there is a need to identify optimal implementation strategies. This study aimed to describe the telehealth physical activity preferences of active children and youth with disabling conditions to rapidly inform the development of a pilot telehealth program that could be delivered nationally. A cross-sectional survey was conducted among a convenience sample of pediatric members of a community-based wellness program. Questions probed preferences for delivery method; programming frequency, intensity, duration, and type; desired outcomes; technology access and proficiency; and additional needed supports. Of the initial 56 respondents, 4 (7.1%) over the age of 18 years were excluded, leaving 52 (92.9%) for analysis. Outcomes were summarized descriptively. Of 392 wellness program members, 56 (14.3%) responses were gathered. The mean age of the 52 analyzed respondents was 10 (SD 3; range 5-16) years. The sample predominantly comprised male (32/52, 61.5%) and White (34/52, 65.4%) individuals, with autism spectrum disorder and developmental disorder as the most common disability types (22/52, 42.3% each). Social and psychological barriers were the most frequently reported challenges to physical activity participation (36/52, 69.2% and 27/52, 51.9%, respectively). Most respondents reported an ideal exercise dose of 1 to 2 sessions per week of 30 to 45 minutes at a novice or beginner difficulty level. Winter was the preferred season for participation. The 2 most desired delivery formats were live videoconferencing and prerecorded videos. Desired program outcomes included strength improvement, mental health, developing new hobbies and activities, and social connection. Over 90% of respondents (47/52, 90.4%) reported having adequate technology at home to support virtual participation. Optimal telehealth programs for this cohort should be brief and low intensity and offered seasonally, with both live and prerecorded delivery options. Although this preferred dose does not meet US physical activity guidelines, it may represent an appropriate starting point for many inactive children with disabilities. Future research should examine behavior change strategies that motivate children to enroll in these programs and support gradual increases in physical activity over time.

31. Micro-and Nano-Plastic Exposure as an Emerging Risk for Atherosclerotic Cardiovascular Disease.

期刊: Current atherosclerosis reports 发表日期: 2026-Jun-05 链接: PubMed

摘要

This review examines micro- and nanoplastic (MNP) exposure as an emerging risk factor for atherosclerotic cardiovascular disease, focusing on how individual-level exposures shaped by behaviours, micro-environments, and lifestyle factors contribute to cumulative internal dose and cardiovascular risk. Micro- and nanoplastic (MNP) exposure occurs through multiple, continuous pathways, including inhalation of airborne particles, ingestion via food and drinking water, and contact with consumer products. Dietary intake varies substantially, with high concentrations reported in fruits, vegetables, and seafood. Indoor environments represent a dominant exposure setting due to elevated microplastic levels in household dust, synthetic textiles, and personal care products, while urban roadside environments further contribute to inhalation exposure. Marked global disparities are evident, with populations in low- and middle-income countries disproportionately affected due to concentrated plastic production, occupational exposures, and transboundary waste flows. Emerging biomonitoring and clinical evidence confirms the presence of MNPs in human blood, vascular tissues, and atherosclerotic plaques, indicating systemic exposure with potential cardiovascular implications. MNP exposure is a plausible contributor to CVD via inflammation, oxidative stress, and endothelial dysfunction. Despite limited causal evidence, findings highlight the need for improved exposure assessment, prevention strategies, and policy action.

32. [Performance-related substance use in everyday life and work].

期刊: Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz 发表日期: 2026-Jun-05 链接: PubMed

摘要

The use of potential performance-enhancing substances in everyday and working life is often linked to an increased workload, time pressure and limited opportunities for rest. This narrative review summarises recent studies on contexts of use, motives, substance groups, prevalence rates, and benefits and risks.The studies show that the use of performance-enhancing substances is primarily intended to support short-term performance demands. It occurs in particular in cases of fatigue, high cognitive demands, stress, emotional strain and physical complaints at work, including in connection with presenteeism. The substances used include stimulants, mood- or sleep-regulating agents, painkillers and dietary supplements. With the exception of the latter, these substances are often prescription-only; some stimulants are illegal. Prevalence figures vary widely due to differing study methods, settings and definitions of performance-enhancing substances. Generally accepted substances are used more frequently.The benefits of these substances are generally described as limited and context dependent. Key risks include the development of tolerance, dependence, residual effects and impairments affecting safety. Short-term benefits are often offset by long-term health and functional costs. In the context of public health and occupational medicine, performance-related substance use may indicate structural stressors. Prevention, care and work design should aim to ensure long-term functional capacity. Der Einsatz potenziell leistungssteigernder Mittel im Alltag und Berufsleben steht häufig im Zusammenhang mit Arbeitsverdichtung, Zeitdruck und begrenzten Erholungsmöglichkeiten. Diese narrative Übersichtsarbeit fasst aktuelle Studien zu Nutzungskontexten, Motiven, Substanzgruppen, Prävalenzen sowie Nutzen und Risiken zusammen.Die Studien zeigen, dass der Konsum leistungssteigernder Substanzen vor allem kurzfristige Leistungsanforderungen unterstützen soll. Er erfolgt insbesondere bei Müdigkeit, hohen kognitiven Anforderungen, Stress, emotionaler Belastung sowie körperlichen Beschwerden beim Arbeiten u. a. im Zusammenhang mit Präsentismus. Verwendet werden Stimulanzien, Mittel zur Stimmungs- oder Schlafregulation, Schmerzmittel und Nahrungsergänzungsmittel. Bis auf Letztere sind die Substanzen häufig verschreibungspflichtig; einige Stimulanzien sind illegal. Die Prävalenzwerte unterscheiden sich stark aufgrund unterschiedlicher Studienmethoden, Settings und Definitionen für leistungssteigernde Mittel. Allgemein akzeptierte Substanzen werden häufiger genutzt.Der Nutzen der Substanzen wird meist als begrenzt und kontextabhängig beschrieben. Zentrale Risiken umfassen Toleranzentwicklung, Abhängigkeit, Residualeffekte und sicherheitsrelevante Beeinträchtigungen. Kurzfristige Vorteile stehen oft langfristigen gesundheitlichen und funktionalen Kosten gegenüber. Im Kontext von Public Health und Arbeitsmedizin kann leistungsbezogener Substanzgebrauch auf strukturelle Belastungen hinweisen. Prävention, Versorgung und Arbeitsgestaltung sollten darauf abzielen, die Funktionsfähigkeit nachhaltig zu sichern.

33. Purpose in life, personal growth, life satisfaction and risk of cognitive impairment among older women.

期刊: Aging & mental health 发表日期: 2026-Jun-05 链接: PubMed

摘要

Cognitive impairment is a major public health concern among older adults. This study examined the associations of purpose in life (PIL), personal growth (PG), and life satisfaction (LS) with cognitive impairment risk, as well as potential underlying pathways. The study population comprised 1,179 U.S. women (aged 77-93 years) from the Women’s Health Initiative Memory Study - Epidemiology of Cognitive Health Outcomes (WHIMS-ECHO) cohort who completed psychological well-being assessments in 2012 and were followed until 2021. Cognitive status was evaluated annually using standardized assessments and central adjudication. Over an average of 5.4 years of follow-up, 355 participants were classified with MCI (175) or dementia (180). The association between PIL and cognitive impairment was largely mediated by lower perceived stress and higher physical activity (61%), rendering the direct effect non-significant. Women in the highest PG quartile had a 33% lower risk of impairment (HR = 0.67, 95% CI: 0.46-0.96). Mediation analyses showed both direct and indirect effects of PG. No association was found for LS. PG and PIL were linked to lower cognitive impairment risk, primarily via stress reduction and physical activity. Targeting these factors may promote cognitive health among aging populations.

34. Regional tissue oxygen saturation as an indicator of wound healing during endovascular treatment for chronic limb-threatening ischaemia.

期刊: Journal of wound care 发表日期: 2026-Jun-02 链接: PubMed

摘要

It is important to evaluate limb blood flow during the perioperative period to salvage affected limbs in patients with chronic limb-threatening ischaemia (CLTI). However, it is difficult to evaluate limb blood flow during endovascular treatment (EVT). This study aimed to investigate the usefulness of regional tissue oxygen saturation (rSO2) values measured by near-infrared spectroscopy (NIRS) techniques during EVT to predict the wound healing prognosis in patients with CLTI. Patients with CLTI who successfully underwent EVT between April 2018 and March 2022 were included. Patients who had infections or failed EVT were excluded. The rSO2 value was measured in the affected limb using the NIRS device (TOE-20, Astem Co., Ltd., Japan) during EVT. At one year after EVT, the patients were divided into two groups: healing and non-healing. Intraprocedural rSO2 values were retrospectively analysed to determine the cut-off value for wound healing using receiver operating characteristic (ROC) curve analysis. A total of 34 patients (healing group: 15; non-healing group: 19) were included in this study. Intraprocedural rSO2 values were significantly higher in the healing group than in the non-healing group (51.1±3.4% versus 44.4±5.0%, respectively; p<0.001). ROC curve analysis revealed that the optimal cut-off intraprocedural rSO2 value for wound healing within one year was 47.0% (sensitivity: 86.7%, specificity: 73.7%). The results of this study showed that intraprocedural rSO2 values during EVT may be useful in the prediction of postoperative wound healing in patients with CLTI.

35. Depressive symptoms among community service doctors in South Africa.

期刊: South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde 发表日期: 2026-Jun-02 链接: PubMed

摘要

Medical doctors face occupational stressors threatening their mental health, particularly junior doctors in South Africa. There is a higher prevalence of depressive symptoms among medical doctors compared with the general population. The consequences of this to health systems and the patients doctors treat is a major public health concern. In South Africa, prevalence of depressive symptoms among community service doctors servicing public sector healthcare is largely unknown. To determine the prevalence of possible depression, and predictive factors thereof, among doctors in their community service year in South Africa. A national descriptive cross-sectional survey was distributed electronically between October and December 2022. The Patient Health Questionnaire 9 (PHQ-9) was used to screen for depression. Demographic, occupational and individual characteristics were included as potential predictive factors. A total of 217 participants were included in the analyses. Prevalence of depressive symptoms was 96.3% (standard error 0.13, 95% confidence interval 92.87 - 98.40%). Predictors of higher scores included: women, drug use, feeling neutral or disagreeing that one worked outside of normal working hours, working in KwaZulu-Natal or North West, burnout (emotional exhaustion), working in orthopaedics, obstetrics and gynaecology departments or the National Health Laboratory Service, first choice of placement, financial difficulties, and accessing mental health services. Predictors of a lower score included: perceiving sufficient resources at work, using colleagues to cope, good work-life balance, and certain departments, particularly neurosurgery. There is an extremely high prevalence of depressive symptoms among community service doctors. Supporting these doctors at an individual, organisational and structural level should be a priority for national policy-makers.

36. Evaluation of a supermarket placement strategy to nudge healthier dietary habits: synopsis of the WRAPPED study.

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

摘要

Poor diet is a leading risk factor of non-communicable diseases. Product placement strategies in retail outlets can influence customers’ food preferences. The United Kingdom government introduced legislation in October 2022 restricting chain retailers from using location promotions on unhealthy food and drinks. High-quality scientific evidence is needed to inform the inclusion of healthier product placement approaches into these regulations. In the context of Brexit, COVID-19 and the cost-of-living crisis, this study assessed whether positioning an expanded fresh fruit and vegetable section near store entrances in discount supermarkets, which do not routinely market produce this way, improved store sales, household purchasing and diet. This natural experiment had a prospective matched controlled cluster design, involving 36 stores (18 intervention and 18 control) across England. The intervention was implemented continuously for 6 months. Control stores were matched on store sales, customer profiles and neighbourhood deprivation. Participants were women, aged 18-60 years, with loyalty cards and were assigned to their primary store (n = 280 intervention and n = 300 control). Weekly store sales and household data from loyalty cards were provided by the collaborating supermarket chain. Dietary quality, household food waste and demographic characteristics were collected through questionnaires. A process evaluation and economic evaluation were completed. Store-level sales of fruit and vegetables were greater in intervention stores than predicted at intervention implementation and 3 and 6 months’ follow-up, equivalent to ≈ 2525, ≈ 1940 and ≈ 1450 extra portions per store per week, respectively. Effect sizes were somewhat stronger in stores where the produce section moved forwards more than 14 m. The proportion of households purchasing fruit and vegetables were somewhat protected among intervention compared to control participants after 3 and 6 months. Changes in dietary quality were small but generally in the expected direction for health benefit. Changes in frequency of household fruit and vegetable waste were negligible at 3 months’ follow-up but increased at 6 months. The intervention was implemented according to the study protocol, with marked differences in the positioning of fresh fruit and vegetables between intervention and control stores post-intervention implementation. Fresh fruit and vegetable availability increased post intervention in intervention compared with control stores. Interviews with store staff demonstrated that changes in staff attitudes had a positive reinforcing effect on intervention implementation. Assessment of the policy context showed that stakeholders across the food system largely support the United Kingdom government’s unhealthy placement ban; some felt it does not go far enough. This study shows that positioning produce sections near supermarket entrances can improve the nutrition profile of store sales and may improve household purchasing and diet. The United Kingdom Food (Promotion and Placement) Regulations could be refined to require a produce section near supermarket entrances to increase its health impact. Future research should continue to build the evidence for which healthy eating interventions are effective in retail outlets. Further evaluations of real-world supermarket intervention studies using robust scientific study designs are required, alongside process and economic evaluations, to provide evidence for policy intervention to improve retail food environments in the United Kingdom and internationally. This synopsis presents independent research funded by the National Institute for Health and Care Research (NIHR) Public Health Research programme as award number 17/44/46. Supermarkets are a major source of food for families. Discount supermarkets have less-healthy environments than other supermarkets and are used more by families living on lower incomes. We worked with a United Kingdom discount supermarket chain to assess if moving a bigger fresh fruit and vegetable section near store entrances improves what people buy. A total of 580 women aged 18–60 years who regularly shopped at one of 36 stores (18 with changes and 18 with no changes) across England took part. Women did a survey over the phone four times (once before the change in layout and 1, 3 and 6 months after). The survey asked about the foods they and their young children (aged 2–6 years) usually ate, where they shopped for food and how much they spent each week, as well as their age, number of children and highest educational qualification. Information about the food each woman bought from loyalty card data and the total sales of fruit and vegetables for each store in the study was given by the supermarket. We found that the sales of fruit and vegetables were higher in stores where they had been moved to the front when compared to stores where they remained at the back of the store, though the size of the impact decreased over time. We found that during the time of Brexit, COVID-19 and the cost-of-living crisis, all families bought fewer fruit and vegetables over time. Families who shopped mostly at study stores with fruit and vegetables near the front entrance had a smaller decline in fruit and vegetable purchases than families who shopped at stores with fruit and vegetables towards the back. Our study provides new information that governments could use to make all supermarkets place fruit and vegetables near the front of their stores so people buy and eat more fresh produce.

37. Emergence of Marburg virus disease in Ethiopia: Implications for public health preparedness and its impact on Ethiopia's health system.

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

摘要

Marburg virus disease (MVD) is a rare but highly lethal viral hemorrhagic fever (VHF) caused by Marburg virus (MARV) and Ravn virus (RAVV). While MVD has historically been limited to specific areas of sub-Saharan Africa, recent outbreaks in previously unaffected countries indicate an expanding ecological and epidemiological risk. In November 2025, Ethiopia confirmed its first-ever MVD outbreak, constituting a significant national and regional public health emergency. This narrative review synthesizes publicly available epidemiological data, government situation reports, and official communications from the Ethiopian Ministry of Health (MoH), Ethiopian Public Health Institute (EPHI), Africa Centres for Disease Control and Prevention (Africa CDC), and the World Health Organization (WHO). The outbreak was initially detected in Jinka town, South Ethiopia Region, an area bordering Kenya and South Sudan. As of 25 January 2026, more than 3,800 diagnostic tests were conducted, leading to a total of 19 cases comprising 14 confirmed (including nine deaths) and five probable (all deaths) and five recoveries from MVD in the country’s South Ethiopia and Sidama regions, which were reported. A total of 857 contacts listed for monitoring all had completed their 21-day follow-up as of 25 January 2026. Ethiopia’s response included rapid notification, laboratory confirmation, activation of incident management systems, deployment of mobile high-biosafety laboratories, establishment of isolation and treatment centers, and issuance of national clinical management guidelines. International partners provided technical, financial, and logistical support. However, the outbreak exposed ongoing challenges, including health system fragility, workforce shortages, misinformation, funding limitations, and heightened cross-border transmission risk. The emergence of MVD in Ethiopia represents a pivotal moment for national and regional health security. Sustained containment will require strengthened surveillance, community engagement, cross-border collaboration, and integrated One Health approaches. Long-term investment in resilient health systems and coordinated regional preparedness is essential to prevent future spillover events and protect vulnerable populations.

38. Barriers and facilitators to pressure injury prevention in acute care hospitals in Alberta, Canada: an interpretive description.

期刊: Journal of wound care 发表日期: 2026-Jun 链接: PubMed

摘要

Hospital-acquired pressure injuries (HAPIs) are adverse events that increase patients’ pain, morbidity and length of stay. The aim of this study was to use an implementation science-informed approach to identify barriers and facilitators to HAPI prevention for adult inpatients from the perspective of different members of the healthcare team. This interpretive description study used semi-structured interviews with healthcare assistants, managers, nurses, occupational therapists and wound care specialists in acute care hospitals across Alberta, Canada. A semi-structured interview guide queried perceptions of HAPI prevention practices, risk assessment, and perceived challenges and opportunities. Interviews were audio recorded, transcribed verbatim and independently coded by two researchers. Codes were deductively mapped to the Theoretical Domains Framework (TDF) and inductively themed; both deductive and inductive approaches were bridged into an overarching thematic conceptualisation by four researchers. A total of 22 interviews, each lasting 30-60 minutes, were completed with staff from seven adult inpatient units. The themes and subthemes that emerged were: Patients (patient complexity, patient and family engagement); Staff (knowledge and skills, communication and collaboration); Resources (access and availability of equipment and devices; inappropriate use of products and resources); and Context (contextual differences, organisational culture). Most barriers were associated with the Environmental Context and Resources domain of the TDF. The identified barriers and facilitators to HAPI prevention in hospital spanned from patients to the organisational context more broadly, and may be applicable to diverse hospital settings. Further investigation should explore the causes of the barriers and facilitators to enable targeted implementation strategies to prevent the occurrence of HAPIs.

39. Adherence to dietary recommendations and the risk of developing giant cell arteritis: A nested Case-Control study.

期刊: Seminars in arthritis and rheumatism 发表日期: 2026-May-29 链接: PubMed

摘要

To investigate the relation between adherence to dietary recommendations, the quantified intake of the components of these recommendations, and the risk of developing giant cell arteritis (GCA). Participants in the Malmö Diet and Cancer Study cohort who subsequently developed GCA were identified through register linkage and validated in a structured review. Four controls, matched for age, sex, and year of inclusion, were selected per case. Diet quality was assessed using the Swedish Dietary Guidelines Score (SDGS, range 0-5). The relations for the SDGS, adherence to recommendations for each component and total intake of each component with development of GCA were assessed using logistic regression, adjusted for total energy intake, leisure-time physical activity and alcohol intake. Potential misreporters of total energy intake were excluded. There were 193 incident cases of GCA. High adherence to dietary guidelines (SDGS 4-5 vs 0-1) was associated with subsequent development of GCA (adjusted odds ratio 2.70; 95% CI 1.43-5.10). In adjusted models, adherence to recommended intake of added sugar, fish and shellfish and vegetables and fruit was associated with an increased risk of GCA. A reduced risk was seen with higher quantified consumption of added sugar, and an increased risk with higher intakes of fiber and fish and shellfish. An overall high diet quality was independently associated with an increased risk of GCA. This is compatible with the concept of an increased risk of GCA in subjects with a healthy metabolic profile, and of metabolic regulation of early disease mechanisms in GCA.

40. Cardiovascular Health Promotion and Disease Prevention in China: Calling for New-Era Strategies.

期刊: JACC. Asia 发表日期: 2026-May-27 链接: PubMed

摘要

China has prioritized the prevention of cardiovascular disease. Over the past decade, significant investments have been made in public health services, along with the implementation of various health promotion policy agendas. As a result, environmental cardiovascular hazards have been substantially reduced, and care coverage within the primary health care system has improved. Nevertheless, adherence to various healthy lifestyles within the population has exhibited different secular trends, meanwhile the underutilization of secondary prevention medications among vulnerable populations is concerning. The Healthy China Initiative 2030 outlines a roadmap to prevent, pre-empt, and mitigate cardiovascular disease. China, along with other developing countries facing similar challenges, should consider fostering supportive social environments for healthy behaviors, targeting vulnerable groups for lifestyle adherence and access to care, expanding the scope of services provided by primary care providers, leveraging new technologies to develop scalable tools, and integrating surveillance systems for health promotion and care.

41. Lessons from an early rheumatoid arthritis incident cohort.

期刊: Seminars in arthritis and rheumatism 发表日期: 2026-May-20 链接: PubMed

摘要

The Canadian Early Arthritis Cohort (CATCH) study, a pioneering national registry established in 2007, has generated robust real-world evidence that has significantly advanced early rheumatoid arthritis (ERA) care in Canada and internationally. Data have been collected from over 3800 patients across 25 sites and >35,000 study visits. This paper synthesizes 15 key learnings from CATCH that span early diagnosis, treatment strategies, patient-reported outcomes, and health equity. Findings underscore the importance of standardized data collection, early methotrexate use, and treat-to-target approaches, while also highlighting challenges such as persistent disease activity, treatment adherence, and disparities linked to sex, comorbidities, and social determinants of health. CATCH has contributed to the development and validation of novel outcome measures, supported the training of future rheumatology leaders, and informed national and international guidelines. Its infrastructure enabled continuity of research during the COVID-19 pandemic and supports pragmatic trials and innovations in care delivery. As real-world incident cohort, CATCH has helped to answer questions that impact clinical and policy decisions, and CATCH exemplifies the enduring value of well-curated patient registries in generating actionable insights to improve outcomes for people living with ERA.

42. Individual- and area-level inequalities in alcohol-related disorders and emergency hospital admissions in Catalonia.

期刊: Alcohol and alcoholism (Oxford, Oxfordshire) 发表日期: 2026-May-13 链接: PubMed

摘要

This study examines socioeconomic inequalities in alcohol-related emergency room (ER) visits in Catalonia, combining individual and area-level socioeconomic factors and comparing the results with the ones for all ER visits. This population-based study retrospectively analyzed all 7 043 795 individuals aged 12 and older who received public healthcare in Catalonia in 2022 using sociodemographic, ER visits, and medical diagnoses data. Individuals were classified by individual-based and area-based socioeconomic levels (ISL and ASL, respectively). Binomial models assessed associations between ISL and ER visits, stratifying results by sex, age, and ASL. Alternative models were performed including interactions between both socioeconomic levels. In 2022, 22.2% of individuals visited ERs, of which 0.45% accounted for alcohol-related ER visits. Socioeconomic disparities were evident: individuals in the lowest ISL had an alcohol-related ER visit prevalence six times higher than the highest ISL. This pattern persisted across ASL, with more pronounced effects in wealthier regions. Age and sex influenced trends, with middle-aged males from low ISL groups showing the highest prevalence ratios. Interaction analysis revealed that the combined effect of low individual socioeconomic status and living in disadvantaged areas was smaller than would be expected if the effects were multiplicative. Significant socioeconomic disparities in ER visits exist in Catalonia, with lower socioeconomic groups, especially at the individual level, experiencing higher rates of alcohol-related ER visits. These findings underscore the need to address socioeconomic inequalities in healthcare access, particularly concerning alcohol-related health outcomes, highlighting the need to further research ISL and ASL interactions.

43. Evaluating endometrial thickness for sonographic detection of neoplasia in diverse population of women.

期刊: International journal of gynecological cancer : official journal of the International Gynecological Cancer Society 发表日期: 2026-May-08 链接: PubMed

摘要

This study aimed to compare the diagnostic performance of 3-mm, 4-mm, and 5-mm trans-vaginal ultrasound endometrial thickness thresholds for detecting endometrial neoplasia and to determine the optimal clinical cutoff. In this prospective cohort study, 1170 women aged ≥50 years referred for endometrial evaluation between February 2014 and October 2020 were included, with follow-up through January 2021. All participants underwent trans-vaginal ultrasound performed by certified sonographers across 4 ultrasound units within a large academic medical center with an ethnically diverse patient population. Diagnostic accuracy measures (including sensitivity, specificity, positive predictive value, and negative predictive value) were calculated for each endometrial thickness threshold. The McNemar test was used to compare diagnostic performance across cutoffs. The main outcome was the detection of endometrial cancer or hyperplasia. Among the 1170 eligible women, 82 (7.0%) had endometrial cancer and 42 (3.6%) had hyperplasia. Analyses were limited to 975 cases with a clearly visualized endometrial stripe. Sensitivity for endometrial neoplasia detection was 100%, 97.8%, and 90.2% for the 3-, 4-, and 5-mm thresholds, respectively, while specificity was 9.5%, 16.1%, and 24.4%. Sensitivity and negative predictive value did not differ significantly between the 3- and 4-mm thresholds (p =.16 and p =.40); however, both metrics were significantly higher for the 3- and 4-mm thresholds compared with the 5-mm threshold (p =.005 and p =.01). The 4-mm cutoff demonstrated significantly higher specificity and positive predictive value compared with the 3-mm cutoff (p <.001). Both the 3-mm and 4-mm endometrial thickness thresholds provided excellent sensitivity for excluding endometrial neoplasia. The 4-mm cutoff achieved greater specificity, minimizing unnecessary invasive procedures, and may represent the optimal threshold for clinical application.

44. Multiple genetic lineages of the invasive brown widow spider (Araneae: Theridiidae) from inland areas in the Kanto region, Japan.

期刊: Journal of medical entomology 发表日期: 2026-May-05 链接: PubMed

摘要

The brown widow spider, Latrodectus geometricus Koch, 1841, is a medically important invasive species that possesses neurotoxic venom capable of causing latrodectism in humans. This species has recently been found in inland areas of the Kanto region in Japan, raising concerns about its ongoing range expansion and associated public health risks. Here, we analyzed partial sequences of mitochondrial cytochrome c oxidase subunit I (cox1) and 16S ribosomal DNA from 99 individuals (3 males and 96 females) collected from multiple sites in Tokyo and Kanagawa prefectures, evaluating their phylogenetic positions and introduction history. The analysis revealed two major lineages, with six cox1 haplotypes (LGc1-LGc6) and five 16S rDNA haplotypes (LGs1-LGs5). One lineage comprised previously unreported basal haplotypes, including LGc5 and LGc6 in cox1 and LGs5 in 16S rDNA. The other lineage included four haplotypes (LGc1-LGc4 and LGs1-LGs4), which have been reported from South Africa and various invaded regions globally. In Sagamihara City (Kanagawa), where numerous individuals were consistently detected in previous surveys, both lineages co-occurred, suggesting multiple introductions and/or high propagule pressure. To clarify the dispersal routes and source populations of each lineage and haplotype, more comprehensive genetic data from both its native range in Africa and globally established populations are needed.

45. Social Capital and COVID-19 Pandemic Relationship in Latin America.

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

摘要

This study examines how structural, relational, and cognitive dimensions of social capital influenced public responses to COVID-19 in 18 Latin American countries. Using Latinobarometer survey data from 2018, 2020, and 2023. This estimates multivariate Ordinary Least Squares (OLS) and Seemingly Unrelated Regression (SUR) models to assess associations between social capital and behaviors, such as risk perception, preventive measures, and evaluation of government response. Relational social capital-particularly institutional trust-was consistently associated with greater compliance with preventive measures. Cognitive and structural dimensions showed mixed effects depending on the national context. The SUR model improved efficiency and revealed stronger associations across interrelated outcomes. Social capital is a key but context-dependent factor in crisis response. Strengthening institutional trust and civic networks can enhance collective resilience. These findings underscore the need for tailored, context-sensitive community interventions in public health emergencies.

46. Strengthening system leadership for the District Health System.

期刊: South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde 发表日期: 2026-Apr-30 链接: PubMed

摘要

Those working within the South African (SA) District Health System (DHS) have various roles in addressing population health and wellbeing needs. These include motivating and co-ordinating local providers offering community, primary healthcare facility and district hospital services, including prevention and promotion services, and facilitating whole-of-government and whole-of-society collaboration with other government and social actors. These roles cannot be fulfilled by exercising traditional, command-and-control public sector managerial authority. Instead, distributed system leadership is required: a form of leadership practised by individuals and teams that enables the collective action needed to address complex health needs, and that is supported by wider organisational structures and processes. Based on a range of experience, this in-practice article presents the rationale for, and description of, system leadership within the DHS; appraises current approaches to leadership and management development in South Africa from this perspective; and outlines a system leadership development approach that offers promise for DHS and health system strengthening.

47. Cancer Surveillance and Geospatial Analytics for Cancer Prevention Research in the Catchment Area of a National Cancer Institute-Designated Comprehensive Cancer Center: The SCAN360 Experience in South Florida.

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

摘要

Although cancer centers need geospatially referenced cancer surveillance systems to track disease incidence and mortality rates for the communities they serve, most do not have the tools to allow them to identify which of the neighborhoods they serve have the greatest cancer care needs. Here, we describe the latest build of SCAN360, a web-enabled tool developed by the Sylvester Comprehensive Cancer Center, which describes disease burden and risk factors for hundreds of communities across south Florida. After describing some of the geographically encoded metrics from more than a dozen data sources, including the Florida State Cancer Registry, US census, and EPA, we describe innovative applications of geospatial analytics for cancer prevention research. Using the data harmonized within SCAN360, we applied geospatial hotspot analysis to identify locations with an unusually high burden of lung and gastric cancers, for intervention with community engagement and intervention. To help increase the precision for such efforts, we overlaid these cancer hotspots on top of choropleth maps differentiating census tracts by socioeconomic disparities that are known to affect cancer control in the population. We also demonstrate how environmental data can be integrated with cancer surveillance data for assessing climate change impacts on melanoma risk. SCAN360 and the case studies presented here offer deployment-ready examples for other cancer centers to follow when developing geospatially referenced surveillance systems for catchment area monitoring, outreach, and research.

48. Supporting doctors' mental health: Exploring the utility of a life skills programme for interns in rural Eastern Cape Province, South Africa.

期刊: South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde 发表日期: 2026-Mar-02 链接: PubMed

摘要

Occupational stress affecting junior doctors poses a serious risk to mental health, with consequences such as anxiety, burnout, substance misuse and suicide. To evaluate the utility of a life skills training programme (LSTP) developed and implemented at Nelson Mandela Academic Hospital in the Eastern Cape Province, South Africa, in improving stress levels and coping abilities among second-year medical interns. We used a quasi-experimental pre-post quantitative design without a control group. Identical surveys were administered before and after the intervention, including the Perceived Stress Scale (PSS-10) and items on coping behaviours. Descriptive statistics, paired t-tests and Wilcoxon signed-rank tests were used for analysis. Of 56 eligible interns, 45 (80.4%) completed both pre- and post-intervention assessments. Stress scores decreased significantly (from mean 2.92 to 2.51, p<0.001), while coping scores improved (from mean 3.26 to 3.48, p=0.001). Wilcoxon tests confirmed significant gains, with enhanced confidence in ethical reasoning (Z=-5.014, p<0.001), professionalism (Z=-2.673, p=0.008) and teamwork (Z=-2.357, p=0.018). Participants who were single or lived alone showed higher stress levels. Subgroup analysis also revealed that interns who were single or lived alone had lower coping scores. The LSTP improved interns’ mental wellbeing and coping mechanisms. Findings support integrating life skills training into internship programmes.

49. Diagnostic accuracy study of the multiplex Truenat MTB Ultima/COVID-19 assay for simultaneous detection of Tuberculosis and SARS-CoV2 (COVID-19).

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

摘要

The COVID-19 pandemic led to significantly disrupted tuberculosis case detection and management. Additionally, overlapping symptoms, radiological findings and risk factors make differentiating tuberculosis and COVID-19 disease difficult. We conducted a prospective multicentre diagnostic accuracy study to determine sensitivity, specificity and operational characteristics of the Truenat MTB Ultima/COVID-19 assay, using a combined sputum plus nasopharyngeal swab specimen, in a single multiplex molecular assay. Participants were consenting adults with presumptive tuberculosis enrolled via convenience sampling from Uganda, Peru, South Africa, and India between August 2022 and December 2023. A microbiological reference standard of sputum GeneXpert MTB/RIF Ultra and culture was used for tuberculosis, whereas national RT-PCR was used for COVID-19. Wilson’s score method was used to determine the sensitivity and specificity. Of 1,928 participants enrolled, median age was 38 years (IQR 28-50), 359/1928 (18.6%) previously had TB, and 287/1928 (14.9%) were HIV-positive. Overall prevalence of tuberculosis was 24.8% [95% CI 22.9-26.8%]. Prevalence of COVID-19 was 3.8% [3.1-4.8%] overall, and 4.7% [3.1-7.0%] in those with confirmed tuberculosis. Overall sensitivity of Truenat MTB Ultima/COVID-19 for tuberculosis was 79.8% [95% CI 76.0-83.2%]. When comparing paired samples, Truenat MTB Ultima/COVID-19 had a 9.5% [6.5-13.1%] decreased sensitivity against sputum TB culture, compared to GeneXpert Ultra; (82.8% [78.9-86.1%] vs 92.4% [89.4-94.5%]). Overall specificity of Truenat MTB Ultima/COVID-19 for tuberculosis was 98.9% [98.2-99.3%]. For COVID-19 detection, sensitivity of Truenat MTB Ultima/COVID-19 was 64.4% [52.9-74.4%], with specificity of 99.2% [98.7-99.5%]. Although optimal diagnostic performance was not demonstrated, the potential and need for rapid development of tests that integrate tuberculosis diagnosis with detection of other relevant respiratory infections is highlighted. The study was registered on ClinicalTrials.gov (NCT05405296).

50. Mental health and suicide literacy among school nurses in Japan: A cross-sectional study.

期刊: PloS one 发表日期: 2026 链接: PubMed

摘要

School nurses (SN) are key providers of school health services and play a vital role in promoting adolescent mental health and preventing suicide. However, research into their mental health literacy (MHL) and suicide literacy remains limited. A self-administered questionnaire survey was conducted with 337 SN from Japanese middle and high schools. The survey assessed SNs’ MHL and suicide literacy, including knowledge, attitudes, intended approaches, and confidence in addressing student mental health and suicide risks. One-third of SN incorrectly believed that they could manage psychotic symptoms by careful listening alone. Many hesitated to ask students about suicide plans, even when risk was evident. Over half lacked confidence in providing mental health education. SNs’ MHL and suicide literacy are currently insufficient in Japan. Developing evidence-based training to improve these competencies is essential to strengthen school health services and promote better adolescent mental health and lower suicide risk.

51. Construction of a public health emergency information system framework: A case study of Zhuhai city, China.

期刊: PloS one 发表日期: 2026 链接: PubMed

摘要

A public health emergency information system serves as a critical tool for collecting and analyzing data from sudden public health events, thereby providing a scientific basis for governmental decision-making. However, research on the systematic construction of such information system frameworks within China’s public health infrastructure is lacking. Taking Zhuhai city as a case study, this study aims to construct a comprehensive public health emergency information system framework applicable to public health departments at the municipal, county, and street/township levels. First, through a literature review and expert group discussion, the preliminary framework of system indicators is determined. Second, through two rounds of the Delphi method, 41 experts are invited to qualitatively select the system framework indicators, with the aim of obtaining consensus among experts. Finally, the system is improved through application, feedback, and redesign. After two rounds of consultation, the final system at the city and county levels consists of 5 first-level indicator modules and 21 second-level indicator modules, whereas the system at the city, county, and street/township levels consists of 4 first-level indicator modules and 17 second-level indicator modules. Most of the indicators in the “emergency preparedness” and “emergency response” modules are considered important and should be retained as they can play a role in collecting and analysing information on infectious disease outbreaks through practical applications. The public health emergency information system constructed in this study can be applied to public health departments such as disease prevention and control centres. Promotion can improve the efficiency of handling infectious disease outbreaks and provide a scientific basis for decision-making analysis.

52. Barriers to and enablers of childhood immunization uptake in Ethiopia's Amhara, Oromia, and Somali Regions: A multi-perspective qualitative study.

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

摘要

Ethiopia has the fourth-highest number of zero-dose children globally. Negative experiences and perceptions of immunization are recognized barriers to vaccination uptake but warrant context-specific investigation. We explored barriers and enablers to immunization uptake in selected regions of Ethiopia. We conducted a formative qualitative study involving 18 focus group discussions with men and women, in-depth interviews with 23 mothers of children with varying immunization statuses, and 42 key informant interviews with religious and community leaders and health workers in eight districts in Amhara, Oromia, and Somali regions. We identified shared and regionally distinct barriers. Common barriers included limited access to services in hard-to-reach areas, low awareness of immunization, competing household responsibilities for mothers, fear of side effects, and a lack of compassionate and respectful care from health workers. Forgetting vaccination appointments was frequently reported in Amhara and Oromia. In Amhara and Somali, mistrust of vaccinators and infrequent vaccination sessions were salient challenges. In Amhara, some believed that envy or praise by vaccinators could bring harm or misfortune to children, and that vaccination should be delayed until after baptism. In Oromia, beliefs that vaccines aggravate illness and that infants should not leave home before six months of age were reported. In Somali, perceived parental negligence and beliefs that vaccines are unnecessary were described. Engaging community, traditional, and religious leaders and fathers in immunization activities in Oromia, and aligning vaccination sessions with local holidays in Amhara, emerged as promising practices. Our findings show that knowledge and perceptions of vaccines, cultural norms, service accessibility, and experiences with vaccine-preventable diseases (VPDs) and vaccination can either encourage or discourage uptake. We recommend enhancing service delivery, improving caregiver interactions, and implementing two-way community engagement involving religious and community leaders, and caregivers of fully vaccinated children, with a focus on highlighting reductions in VPD burden.

53. "Each moon we come to weigh the pregnancy:" Exploring the experience of group antenatal care processes in Benin and their contributions to self-efficacy.

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

摘要

Group antenatal care (G-ANC) is a model that brings pregnant women with similar estimated delivery dates together for clinical assessment and participatory learning in a supportive social context. A qualitative study was nested in a trial assessing the community impact of G-ANC on ANC retention and uptake of intermittent preventive treatment of malaria in pregnancy (IPTp) in Atlantique Department, Benin. This nested qualitative study assessed women’s experience of G-ANC, and ways participation could foster self-efficacy to perform a variety of prevention and care-seeking behaviors. Ten semi-structured focus group discussions were conducted with 129 women who attended G-ANC; deductive thematic codes were informed by Bandura’s four sources of efficacy expectations. Recently pregnant women’s experiences with individual ANC versus G-ANC were assessed via household surveys. G-ANC participation proffered three sources of self-efficacy expectations: performance accomplishments, verbal persuasion, and vicarious experience. Among household survey respondents, 96% (134/140) of women who participated in G-ANC would prefer it over individual ANC for future pregnancies. While a higher proportion of G-ANC participants felt that the provider answered all their questions in a way they could understand, most women reported that not all their questions were answered, even in G-ANC. G-ANC processes fostering self-efficacy to overcome barriers to ANC attendance may have facilitated women’s participation in G-ANC meetings as well as taking more doses of IPTp. Self-efficacy of pregnant women participating in G-ANC could be strengthened by providers addressing all participants’ questions in a more complete and understandable way, contributing to more effective verbal persuasion. Other parallel processes during G-ANC need to be maintained to provide multiple sources of self-efficacy for health behaviors like timely care-seeking, pregnancy management, pregnancy self-care, and facility birth.

54. Climate change, livelihoods, gender and violence in Rukiga, Uganda: Intersections and pathways.

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

摘要

Climate change disproportionately affects poorer countries like Uganda, intensifying poverty and livelihood stress, which can escalate gender-based violence (GBV). Although the parent study was not designed to focus on GBV, GBV emerged repeatedly during interviews and focus groups; this paper presents a GBV-focused thematic analysis of those narratives. Particularly, we examine how GBV interconnects with poverty, shifting gender roles, alcoholism, environmental stress, and family planning dynamics. Between April and July 2021, we conducted an exploratory qualitative research study that comprised 28 focus group discussions (FGDs), comprising six-eight participants each, stratified by sex and age (18-25, 25-49, and mixed 50 + groups). Additionally, 40 key informant interviews (KIIs) were held in Rukiga district, Uganda. Purposive sampling was applied. Data were organised in NVivo 12 and analysed thematically. Participants perceived GBV, including intimate partner violence, non-partner sexual violence, child abuse, and early marriage, as widespread and normalised. Two main interconnected driver clusters emerged. First, poverty, male alcohol use, and shifting gender norms contributed to household instability. As men abandoned provider roles, women assumed more responsibilities, provoking conflict and sometimes violence from disempowered male partners. Second, environmental degradation and climate-related stressors (droughts, floods, soil erosion) worsened economic hardship, tensions, and GBV. Population growth and limited land access further strained livelihoods. While family planning was generally supported, male opposition sometimes triggered conflict. Climate change impacts are gendered, with GBV pathways shaped by shifting gender roles, norms, and relations destabilised by environmental and livelihood pressures. Addressing GBV in climate-affected communities requires gender-transformative environmental and livelihood programmes. This should include strengthened social and structural resilience to challenge inequitable gender norms and power imbalances.

55. Multistate animal-contact-related nontyphoidal Salmonella enterica outbreaks in the United States, 2009-2022: Network and machine learning analyses of exposure sources, settings, and serovars.

期刊: PloS one 发表日期: 2026 链接: PubMed

摘要

Nontyphoidal Salmonella enterica (NTS) is a major public‑health threat in the United States of America (U.S.). Evaluating associations between serovars, exposure sources, and settings in multistate outbreaks can reveal the drivers of NTS transmission and guide prioritization of targeted prevention and control strategies. We analyzed multistate animal‑contact-related NTS outbreaks reported to the CDC National Outbreak Reporting System during 2009-2022. We calculated incidence rates (IR) per 10 million population-years (MPY) and assessed temporal trends in IRs using Joinpoint regression. We constructed interstate co-occurrence networks linking serovars, exposure sources, settings, and states, and applied a random forest classifier to identify variables most useful for distinguishing outbreak profiles. We identified 177 multistate outbreaks (0.06 per 10 MPY) involving 40 serovars. Incidence significantly declined from 2009 to 2013 and remained stable thereafter. Random forest rankings identified birds and reptiles as the most influential exposure sources and agricultural feed stores and residential homes as the most influential exposure settings in distinguishing outbreak profiles. Co-occurrence network analysis revealed two major communities. The first included outbreaks involving serovars Enteritidis and Infantis, bird exposure source, and agricultural feed stores or farms as exposure settings, with co-occurrence hubs across the Midwest, Northeast, and Southern regions. The second community involved outbreaks linked with reptiles and mammals as exposure sources, residential homes and farms as exposure settings, and serovars Hadar, Typhimurium, and Braenderup, which were co-occurring in the Western and Southern regions. Multistate animal-contact NTS outbreaks clustered into distinct serovar-exposure, source, setting, and region patterns, suggesting different NTS outbreak transmission pathways. The persistence of NTS serovars across states, diverse animal-contact sources, and exposure settings underscores the ongoing zoonotic transmission risk at the human-animal and environmental interfaces. A region-specific One Health approach to prevent and control NTS outbreaks is suggested to reduce the health burden.

56. Cumulative metabolic stress (microfilarial infection + moult) constrains the expression of carotenoid-based honest signals in breeding male village weavers (Ploceus cucullatus) of Amurum Forest Reserve, Nigeria.

期刊: PloS one 发表日期: 2026 链接: PubMed

摘要

In wild birds, the breeding season involves a convergence of metabolically demanding life-history stages, including reproduction, moult, and immune defense. We investigated the relationships between microfilarial infection, moult, redox homeostasis, and plumage quality in breeding male village weavers (Ploceus cucullatus) at the Amurum Forest Reserve, Nigeria. We compared four groups (n = 148 total) sampled within 3 mins post-capture: infected-moulting (IM), infected-non-moulting (IN), non-infected-moulting (NM), and non-infected-non-moulting (NN). Physiological condition was assessed using the erythrocyte glutathione ratio (GSH:GSSG) and circulating glucose, while plumage reflectance traits were integrated into a composite quality axis (PC1). Microfilarial infections were present in 52.0% (n = 77) of individuals; mean parasite intensities were 6.13 ± 0.35 mf/µL (IN) and 6.45 ± 0.41 mf/µL (IM). Physiological indices varied strongly across groups. The GSH:GSSG ratio was reduced in infected birds, indicating altered redox balance (rs = -0.65). Circulating glucose was highest in the infected non-moulting group (IN) but substantially reduced in the infected moulting group (IM). Across physiological and ornamental traits, individuals experiencing both infection and moult (IM group) exhibited the strongest reductions relative to all other groups. However, this pattern reflects a statistically supported Infection × Moult interaction, rather than an untested synergistic or non-linear effect, as evidenced by significant IN vs. IM contrasts in glucose (Table 3; z = 33.43, P < 0.0001, d = 6.10) and plumage quality. This interaction was associated with reduced plumage hue and lower integrated signal quality. Our results suggest that microfilarial infection and moult impose overlapping physiological demands that constrain metabolic regulation and the expression of carotenoid-based ornaments. Intracellular redox balance emerges as a potential mechanistic link between physiological state and ornamental expression, supporting the hypothesis that village weaver plumage reflects variation in sustained physiological condition under natural ecological stress.

57. Prevalence and determinants of metabolic syndrome among long-shift healthcare professionals in primary hospitals of Central Gondar Zone, Northwest Ethiopia.

期刊: PloS one 发表日期: 2026 链接: PubMed

摘要

Metabolic syndrome (MetS) is a group of interrelated metabolic aberrations that significantly elevates the risk of poor cardiovascular outcomes and type 2 diabetes mellitus. Healthcare professionals, particularly those working long shifts, may have elevated risk due to the demanding nature of their work, irregular lifestyles, and associated stress. This study aimed to assess the prevalence and associated factors of MetS among healthcare professionals working long shifts in primary hospitals in the Central Gondar Zone, Northwest Ethiopia. An institutional-based cross-sectional study was conducted among a total of 271 healthcare professionals working in three primary hospitals (from September to December 2023). Study data were collected using structured questionairs, anthropometric measurements, and biochemical assessments. Five mililiters of fasting blood sample was collected from each participant; and serum lipid profile and glucose analyzed on Beckman Coulter DXC 700 AU chemistry analyzer. MetS was defined using the National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) criteria. Independent ttest and one-way ANOVA were used for intra and inter group comparison; and Logistic regression model was fitted to identify factors associated with MetS, and adjusted odds ratios (AORs) with 95% confidence intervals (CIs) were reported to determine the strength of associations. The prevalence of MetS among healthcare professionals was 11.44% (95% CI 8.14-15.83). Dyslipidemias were observed to be the most common forms of metabolic derangement with 145 (53.51%) of study subjects having at least one lipid profile abnormality; whereas, hyperglycemias was the least common 27 (9.96%) form of metabolic abnormalities. Age ≥ 35 years (AOR = 6.75; 95% CI: 2.34-19.46), a family history of diabetes among first-degree relatives (AOR = 7.78; 95% CI: 2.57-23.53), and short sleep duration (<6 hours per day) (AOR = 7.78; 95% CI: 2.35-25.70) were significant factors associated with MetS (p < 0.05). Metabolic syndrome is prevalent among healthcare professionals particularily those working long shifts; with age, family history of diabetes, and insufficient sleep identified as key risk factors. Hospital administrators and occupational health units should implement routine metabolic screening, optimized shift scheduling, and sleep hygiene support programs specifically for healthcare professionals working prolonged shifts, with particular attention to high-risk staff groups. Further workplace-based research is also needed to evaluate the effectiveness of these targeted interventions.