公共卫生研究摘要 (2026-06-07)

共收录 60 篇研究文章

1. A body roundness index (BRI)-based predictive model for metabolic syndrome in perimenopausal and postmenopausal women-from a cross-sectional machine learning study to a longitudinal dynamic assessment.

期刊: Annals of medicine 发表日期: 2026-Dec 链接: PubMed

摘要

Metabolic syndrome (MetS) is highly prevalent among perimenopausal and postmenopausal women and poses a major public health challenge because of its association with cardiovascular disease, type 2 diabetes, and premature mortality. However, prediction tools for this population remain limited. Therefore, this study aimed to develop a Body Roundness Index (BRI)-based prediction model for MetS by integrating cross-sectional machine learning and longitudinal assessment. Cross-sectional models were trained using NHANES 2007-2020 and validated in the Affiliated Hospital of Dalian University (2023-2024). Sixteen predictors were selected via LASSO and Boruta, and eight models were evaluated using AUC, calibration, and decision curve analysis. SHAP ranked high-contribution factors. Longitudinal analysis used a 10-year cohort. Annualized change rates and cumulative exposure metrics of five key predictors were combined with baseline values to build Cox models, compared by C-index and time-dependent ROC.The artificial neural network (ANN) demonstrated optimal cross-sectional performance (internal AUC: 0.854; external AUC: 0.878) with good calibration and clinical benefit. SHAP identified BRI, WBC, ALT, MCV, and AST as top contributors, with BRI showing the strongest impact. Longitudinal analysis revealed that integrating annual change rates and annual cumulative exposure of these five predictors achieved optimal discriminative ability (C-index: 0.847), with time-dependent AUCs of 0.853, 0.859, and 0.847 at 1, 3, and 5 years, respectively. BRI is significantly associated with MetS in perimenopausal and postmenopausal women. The ANN model provides an efficient cross-sectional screening tool, while incorporating longitudinal trajectories of BRI and key laboratory indicators enhances long-term MetS risk prediction.

2. Synergistic Oncogenesis Cooperative Role of Epstein Barr Virus and Human Papillomavirus in Cancer Progression.

期刊: Reviews in medical virology 发表日期: 2026-Jul 链接: PubMed

摘要

Oncogenic viruses cause approximately 20% of cancers globally burden, with Epstein-Barr virus and high-risk Human papillomavirus recognized as major contributors to epithelial malignancies. Increasing evidence suggests that EBV-HPV co-infection may enhance tumour progression through overlapping molecular and immunological mechanisms, particularly in cervical, oropharyngeal, and nasopharyngeal cancers. This review critically summarizes current evidence regarding the cooperative role of EBV and HPV in carcinogenesis while distinguishing viral co-presence from biologically active co-infection. EBV latent proteins, including LMP1, LMP2A, and EBNA1, activate oncogenic signalling pathways such as NF-κB, PI3K/Akt, and JAK/STAT, whereas HPV oncoproteins E6 and E7 disrupt p53 and retinoblastoma (Rb) tumour suppressor pathways. Together, these alterations may promote genomic instability, chronic inflammation, immune evasion, epigenetic dysregulation, and epithelial-mesenchymal transition (EMT), thereby enhancing invasive and metastatic potential. Epidemiological studies report higher frequencies of EBV-HPV co-detection in advanced lesions and aggressive tumours; however, causal synergy remains insufficiently validated because of methodological heterogeneity and variability in viral detection techniques, including PCR, in situ hybridization, and immunohistochemistry. Emerging technologies such as spatial transcriptomics and single-cell profiling may improve characterization of biologically meaningful co-infection. In addition, circulating viral DNA, viral microRNAs, and HPV genotyping are being explored as biomarkers for disease monitoring and prognosis. Therapeutic strategies targeting viral oncogenes, immune checkpoints, and gene-editing technologies also represent promising investigational approaches. Overall, EBV-HPV co-infection represents a biologically plausible but incompletely understood contributor to tumour aggressiveness, emphasizing the need for standardized diagnostics, longitudinal studies, and functional experimental models.

3. Size Does Matter! Prioritizing Rare Diseases for Luck Egalitarian Reasons.

期刊: Bioethics 发表日期: 2026-Jun-06 链接: PubMed

摘要

Rarity provides a challenging case for contemporary priority setting. On the one hand, many philosophers and economists argue that rarity has no inherent moral value, and thus that rare diseases merit no special treatment in priority setting decisions simply because they are rare. On the other hand, existing priority-setting practices demonstrate a higher willingness to pay for rare disease treatments. We argue that special priority for rare diseases might be justified on egalitarian grounds. Specifically, we develop and defend what we call the “bad numbers luck” argument for prioritizing rare diseases. This is a variant of the luck egalitarian idea of bad price luck. We conclude by discussing how higher willingness to pay, adjusted priority-setting processes, and a broader societal focus on rare diseases could address such injustices. Recognising bad numbers luck clarifies the relationship between fairness and efficiency in health care priority setting.

4. The association between assistive device use and the change in informal caregiving hours among community-dwelling older adults: analysis of the Canadian Longitudinal Study on Aging (CLSA).

期刊: Disability and rehabilitation. Assistive technology 发表日期: 2026-Jun-06 链接: PubMed

摘要

To investigate whether assistive device (AD) use within the past 12 months (self-reported at baseline) affects the change in the amount of informal caregiving hours received over time (three-years), among community-dwelling older adults (≥ 65 years) in comparison to those who did not use AD at all. Data from the Tracking (n = 236) and Comprehensive (n = 420) cohorts of the Canadian Longitudinal Study on Ageing (CLSA) were analysed using multiple linear regression models to regress the changes in the amount of informal caregiving hours received (follow-up - baseline) on AD use (yes/no) while accounting for a set of sociodemographic, health, functionality, psychological, and support covariates. We did not find significant associations between AD use and changes in the amount of informal care hours received among older adults (Tracking cohort:β̂= 3.10, 95% CI = -77.98 to 84.17; Comprehensive cohort:β̂= -5.05, 95% CI = -47.19 to 37.09). Our results did not provide sufficient evidence for an association between AD use and informal caregiver time. Future studies addressing this issue should employ longer follow-up periods, analyse by device type, and obtain caregiving hours directly from informal caregivers. Nonetheless, these findings remain valuable for informing future research directions, prompting re-examination of existing theories, and guiding evidence-based policy and practice decisions. To the authors’ knowledge, this is the first study to examine the association between assistive device use and the change in informal caregiving hours over time among community-dwelling older adults aged 65 years or over, emphasising the need for further research.Rehabilitation efforts should interpret the null findings with caution, as they may reflect characteristics of the study sample (e.g., healthier participants, underrepresentation of older adults with cognitive impairment), reliance on care recipient reports of caregiving hours, the three-year follow-up period, and the grouping of all device types together.

5. Timing Matters: How Unconditional Cash Transfer Frequency Shapes Dietary Choices Among Vulnerable Older Adults.

期刊: Health economics 发表日期: 2026-Jun-06 链接: PubMed

摘要

Low-income elderly consumers, often overlooked in studies of public financial assistance programs, may face challenges in managing resources to maintain dietary health. This study examines how the payment frequency of an unconditional cash transfer program impacts dietary behaviors among low-income elderly populations in Colombia. Using nationally representative data from a federal financial assistance program, we implement a Multivalued Treatment Model with Propensity Score Matching and Augmented Inverse Probability Weighting to assess the effects of monthly versus bi-monthly payments on food expenditures, dietary diversity, and diet quality. Results show that monthly payments enhance dietary diversity and diet quality by supporting healthier food purchases compared to bi-monthly payments. Subgroup analyses revealed that older seniors and males benefit most from monthly payments. Mechanisms explored include consumption smoothing and subjective wealth perceptions, with findings suggesting that more frequent and predictable income flows may foster greater perceived financial stability. The study advances consumer behavior theory by linking payment frequency to dietary outcomes and offers practical implications for optimizing financial assistance programs. While bi-monthly payments reduce administrative costs, monthly payments are recommended to improve dietary health. These findings contribute to understanding income timing’s role in fostering healthier consumer behavior.

6. Prevalence and prognostic role of untreated moderate-to-severe tricuspid regurgitation: a systematic review and meta-analysis.

期刊: European journal of heart failure 发表日期: 2026-Jun-06 链接: PubMed

摘要

We aimed to assess the prognostic role of untreated moderate-to-severe tricuspid regurgitation (TR) by a systematic review and meta-analysis. We searched Pubmed from database inception to 14 August 2025. Studies reporting data on clinical outcomes associated with different TR grades not receiving treatment were considered eligible. The primary endpoint was all-cause mortality; secondary endpoints included cardiovascular (CV) mortality and heart failure (HF) hospitalization. Pooled estimates were calculated using random-effects models. Our literature search yielded 2,727 articles, of which 225 were assessed for full-text eligibility. A total of 106 studies (107 comparisons) comprising 961,136 patients, were included in the quantitative synthesis. The overall prevalence of untreated moderate-to-severe TR was 13.5%, but varied widely across population subgroups. Moderate-to-severe TR was associated with a significantly higher all-cause mortality compared with none-to-mild TR (unadjusted HR 2.07; 95% CI 1.89-2.26; p < 0.001). The association was confirmed in adjusted models and among different subgroups (i.e., patients performing a general echocardiographic irrespective of indication, patients with left-side valvular heart disease [LSVHD], HF without LSVHD, patients undergoing cardiac implantable electronic device implantation, left ventricular assist device recipients and in patients with pulmonary artery hypertension), but not after heart transplantation. A stepwise increase in mortality was observed with increasing TR severity. Moderate-to-severe TR was also associated with higher risk of CV mortality and HF hospitalization (HR 1.92 [1.64-2.26] and HR 1.63[1.44-1.84], respectively). Untreated moderate-to-severe TR is associated with higher risk of all-cause mortality, CV mortality and HF hospitalization, underlying the role of timely diagnosis and appropriate management.

7. Willingness-to-Pay for HIV Pre-Exposure Prophylaxis Among Men Who Have Sex with Men in the United States.

期刊: AIDS and behavior 发表日期: 2026-Jun-06 链接: PubMed

摘要

Pre-exposure prophylaxis (PrEP) is highly effective for preventing HIV, but out-of-pocket costs represent a critical barrier to uptake. We conducted an online survey from May 2020 to October 2021. Gay and bisexual men who have sex with men (GBMSM) in New England recruited through social networking apps were randomly assigned to view different monthly PrEP costs ($0-$105) and asked about their willingness to pay. Among 612 participants, each $10 increase in monthly costs was associated with a 6.0% point decrease in willingness to pay (p < 0.001). In logistic regression, each $1 increase reduced the odds of willingness to pay by 4% (odds ratio, 0.960; 95% CI, 0.952-0.968; p < 0.001). At $40 per month, 68% were willing to pay. Lower-income participants (<$75,000 annually) showed greater cost sensitivity (8.0% point decrease per $10 increase; p < 0.001). Participants at higher HIV acquisition risk (HIRI-MSM ≥ 10) were more willing to pay (β = 0.119; p = 0.001), as were those perceiving they definitely needed PrEP (β=-0.134 for those who may not or definitely did not need it; p = 0.005). These findings support policies that minimize or eliminate cost-sharing for PrEP to achieve HIV prevention goals. La profilaxis previa a la exposición (PrEP) es muy eficaz para prevenir el VIH, pero los costos de bolsillo representan una barrera crítica para su adopción. Realizamos una encuesta en línea desde mayo de 2020 hasta octubre de 2021. Hombres gay y bisexuales que tienen sexo con hombres (GBMSM) de Nueva Inglaterra reclutados a través de aplicaciones de redes sociales fueron asignados al azar para ver diferentes costos mensuales de PrEP (de $0 a $105) y se les preguntó sobre su disposición a pagar. Entre 612 participantes, cada incremento de $10 en los costos mensuales se asoció con una disminución de 6.0 puntos porcentuales en la disposición a pagar (p < 0.001). En la regresión logística, cada aumento de $1 redujo las probabilidades de disposición a pagar en un 4% (proporción de probabilidades: 0.960; IC del 95%: 0.952–0.968; p < 0.001). Con un costo de $40 al mes, el 68% estaba dispuesto a pagar. Los participantes de menores ingresos (menos de $75,000 anuales) mostraron una mayor sensibilidad al costo (disminución de 8.0 puntos porcentuales por cada aumento de $10; p < 0.001). Los participantes con mayor riesgo de adquirir VIH (HIRI-MSM ≥ 10) mostraron mayor disposición a pagar (β = 0.119; p = 0.001), al igual que quienes percibían que definitivamente necesitaban la PrEP (β=−0.134 para quienes creían que tal vez no o definitivamente no la necesitaban; p = 0.005). Estos hallazgos respaldan las políticas que minimizan o eliminan el reparto de costos para la PrEP a fin de lograr los objetivos de prevención del VIH.

8. Sleep-related breathing disorders beyond infancy following open spina bifida repair.

期刊: European journal of pediatrics 发表日期: 2026-Jun-06 链接: PubMed

摘要

In patients with repaired open spina bifida, there are limited data on respiratory outcomes beyond the first year of life. We hypothesize that after 1 year of age there is 1) resolution of sleep-related breathing disorders (SRBD), 2) improvement of oxygenation and 3) no difference in SRBD between prenatally vs. postnatally repaired groups. We reviewed 67 patients with repaired open spina bifida and polysomnography (PSG) after age 1 year seen at Children’s Hospital Los Angeles between 2015-2025. Demographics, neural tube defect location, surgery type, PSG results, and respiratory support data were collected. There were 34/67 subjects with PSG before and after 1 year of age. Before 1 year of age, 19/34 had central sleep apnea (CSA), 33/34 had obstructive sleep apnea (OSA) and 30/34 required supplemental oxygen. At age 12 to 35 months, the prevalence of OSA (p < .001) and supplemental oxygen requirement (p = .006) decreased, however CSA persisted. There were no differences in SRBD between those with prenatal repair and postnatal repair of open spina bifida. There were 33/67 subjects with PSG after age 1 year only. In children ages 3 to 17 years, up to 92% had OSA, 11% had CSA, and 44% required supplemental oxygen.Conclusion: In patients with repaired open spina bifida, OSA and supplemental oxygen requirement improved after 1 year of age, however, the majority still had SRBD without difference between those prenatally vs. postnatally repaired. Our findings highlight the importance of continued surveillance with PSG in this population. What is Known: • Infants with prenatally or postnatally repaired open spina bifida have sleep-related breathing disorders • Current guidelines do not require formal evaluation with polysomnography as standard of care What is New: • After age 1 year, obstructive sleep apnea prevalence decreased, but persisted in the majority of patients • Oxygen supplementation requirement prevalence decreased.

9. Years of life lost from metastatic prostate cancer according to household income.

期刊: World journal of urology 发表日期: 2026-Jun-06 链接: PubMed

摘要

Years of life lost (YLL) from metastatic prostate cancer (mPCa) according to household income, relative to population controls, have not been quantified. Within the Surveillance, Epidemiology, and End Results (SEER) database (2004-2021), mPCa patients aged 40-80 years were identified and stratified between low vs. high household income based on the median distribution. For each patient, an age- and sex-matched control was generated from Social Security Administration life tables using Monte Carlo simulation. YLL of low vs. high income mPCa patients were quantified relative to simulated controls, until the age of 80 years, using Kaplan-Meier methodology. Subsequently, multivariable competing risks regression (CRR) models were fitted. Overall, 37,094 mPCa patients were included. The median household income ranged from $75k to $80k/year, with 20,004 (53.9%) low vs. 17,090 (46.1%) high income mPCa patients. YLL values were 7.7 in low vs. 5.9 in high income mPCa patients (Δ: 1.8). In sensitivity analyses among metastatic substages, YLL values were as follows: 6.2 vs. 4.7 (Δ: 1.5) in M1a, 7.5 vs. 5.6 (Δ: 1.9) in M1b, 8.9 vs. 7.3 (Δ: 1.6) in M1c, in low vs. high income mPCa patients, respectively. In multivariable CRR models, household income independently predicted 1.1-fold higher cancer-specific mortality (CSM, multivariable hazard ratio [mHR] 1.14; p < 0.001). In sensitivity analyses stratified by metastatic substage, mHRs for CSM were as follows: 1.22 (p < 0.001) in M1a, 1.14 (p < 0.001) in M1b, 1.11 in M1c (p < 0.001). Low household income is associated with less favorable overall survival and higher CSM in mPCa patients. In consequence, measures aimed at reducing or ideally eliminating these survival disadvantages should be implemented.

10. Impact of long COVID on health-related quality-of-life among Japanese adults: findings of CARE Japan study.

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-06 链接: PubMed

摘要

This study aimed to comprehensively assess the implications of long COVID on the health-related quality-of-life (HRQoL) among Japanese adults and to identify its associated factors. This study used prospective cohort data from the CARE Japan Study between January 2022 and January 2023. The outcome of this study was HRQoL, which was measured using SF-12 questionnaire. Self-reported long COVID was the primary independent variable. We fitted adjusted beta regression models to calculate beta regression coefficients with 95% confidence intervals (CI) and average marginal effects (AME) to explore the determinants of HRQoL. We also performed latent class analysis (LCA) to identify unobserved patterns of long COVID symptoms. Final sample size was 1,285. Compared to the participants with no long COVID, the HRQoL among long COVID patients (β: -0.25; 95% CI: -0.36 to -0.14; AME: -0.036) was significantly lower. The effect of long COVID on HRQoL was the most pronounced among the respondents with pre-existing lung diseases (β: -0.72; 95% CI: -1.29 to -0.16; AME: -0.114). LCA identified three subgroups of long COVID patients - class 1, 2, and 3. Compared to the participants with no long COVID, participants belonged to class 1 (β: -0.47; 95% CI: -0.57 to -0.36; AME: -0.065), class 2 (β: -0.48; 95% CI: -0.60 to -0.35; AME: -0.066), and class 3 (β: -0.93; 95% CI: -1.06 to -0.79; AME: -0.148) had poorer HRQoL. Long COVID patients had reduced HRQoL. Female gender, young-age, thin BMI or pre-existing psychological disorders were associated with lower HRQoL. Now, after five years of COVID-19 pandemic about 779 million of COVID-19 cases were reported, as of October 2025. Survivors of COVID − 19 often report complex, multisystemic, persistent or relapsing symptoms for weeks, months, or even years after the initial infection of COVID-19. When the symptoms are persistent or relapsing even after 12 weeks of initial acute infection, it is termed as long COVID. Due to high prevalence, heterogeneous nature, lack of clear diagnostic markers, prolonged, and obscure recovery process, long COVD is posing challenges on individuals’ lives, public healthcare systems, and workforce. Increasing evidence is suggesting that long COVID is impairing functional and cognitive capacity of the patients resulting poor health-related quality-of-life. Longitudinal studies on health-related quality-of-life among COVID-19 survivors with long follow up period is scarce in Japan. Therefore, in our study we measured the impact of COVID-19 infection on the health-related quality-of-life among Japanese adults with follow up period of 1 year. We found that, long COVID patients had lower health-related quality-of-life compared to the COVID-19 survivors without long COVID. The presence of minimal long COVID symptoms lowered the health-related quality-of-life. For COVID-19 cases with lung disease as a comorbid condition, the risk of reduced quality of life remains high even after recovery. Findings of this research will enhance the understanding of the implications of long COVD on individual’s lives and will underscore the need of coordinated approach for long-term treatment, care, and prevention of long COVID through policies, interventions, and integrated health care system.

11. The associations between per- and polyfluoroalkyl substances (PFAS) exposure and low body height and weight of US children-a revisitation of 2013-2014 NHANES biospecimen data.

期刊: Environmental science and pollution research international 发表日期: 2026-Jun-06 链接: PubMed

摘要

Per- and polyfluoroalkyl substances (PFAS) are ubiquitous environmental contaminants implicated in endocrine disruption and altered child growth. Previous studies of PFAS exposure and pediatric anthropometry have produced inconsistent findings. We analyzed biospecimen data from the National Health and Nutrition Examination Survey (NHANES) 2013-2014 cycle, which was re-released in 2022 following the removal of records initially included in error. Children aged 3-11 years (N = 525) were included in the current analyses. Five PFAS detected in all participants, PFNA, PFHxS, n-PFOA, n-PFOS, and Sm-PFOS, were evaluated. Serum PFAS concentrations were categorized into low (first quarter), moderate (second and third quarters), and high (fourth quarter). Age- and sex-specific percentiles of anthropometric measures were calculated using the CDC 2000 growth charts. Mean percentiles were then compared across PFAS exposure categories. An inverse correlation was detected between body height and all 5 PFAS; a one-standard-deviation increase in total PFOA (≈1.17 ng/mL) corresponded to a 5.8-point decrease in height percentile. Children in the highest quarter of total PFOA (> 2.70 ng/mL) had height and weight percentiles 14.6 (95% CI: 0.4, 28.8) and 13.2 (95% CI: 0.9, 25.5) points lower, respectively, than those in the lowest quarter (≤ 1.41 ng/mL; p for trend = 0.04). High Sm-PFOS levels were associated with a 10.1-point reduction in height percentile (95% CI: 1.1, 19.2; p for trend = 0.03). Moderate PFAS level associated with intermediate percentiles for both height and weight. No pattern was detected for body mass index percentile. Elevated serum PFAS concentrations are linked to lower body weight-for-age and height-for-age percentiles in children. These findings support a potential role for PFAS exposure in growth impairment and developmental delay.

12. Self-mastery buffers associations between stressful life events and mental quality of life and fatigue in people living with multiple sclerosis.

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-06 链接: PubMed

摘要

Multiple sclerosis (MS) is a chronic immune-mediated inflammatory disease of the central nervous system, often accompanied by fatigue and reduced quality of life (QoL). Stressful life events (SLEs) may heighten stress in people with MS (pwMS), compounding the challenges of living with the condition. While mastery is acknowledged as a psychological resource for resilience, its protective role against SLEs remains unclear. We examined whether mastery modifies associations between SLEs and QoL and fatigue in pwMS. We analysed cross-sectional survey data from an international sample of 948 pwMS. Mastery (Pearlin mastery scale) was categorised into tertiles (low, moderate, high). QoL (MSQoL-54) was summarised as mental and physical composite scores. Clinically significant fatigue was defined as fatigue severity scale (FSS) > 5. SLEs exposure (Holmes-Rahe social readjustment rating scale) was assessed as total number and load (severity). Multivariable regression models assessed associations between SLEs and outcomes, and interaction terms tested effect modification by mastery. Higher number and load of SLEs were associated with clinically meaningful lower mental QoL (- 7 to - 8 points) among pwMS with low or moderate mastery, but not among pwMS with high mastery. Higher number and load of SLEs were also associated with 3- 5 fold higher odds of clinically significant fatigue, primarily among pwMS with low mastery. Higher mastery may buffer adverse associations between SLEs exposure and mental QoL and fatigue. Prospective studies are needed to confirm temporal relationships; however, interventions that support mastery may help mitigate stress-related impacts on wellbeing in MS.

13. Kinetic Modelling of the Decay of Respiratory Syncytial Viruses (RSV) Facilitated a Robust Wastewater-Based Surveillance for RSV.

期刊: Food and environmental virology 发表日期: 2026-Jun-06 链接: PubMed

摘要

Wastewater-based epidemiology (WBE) is a promising tool for monitoring respiratory pathogens, yet the rapid in-sewer decay of viruses limits its application in low-incidence settings. This study investigates the decay rates of respiratory syncytial virus (RSV) in wastewater under various conditions to enhance the utility of WBE for forecasting RSV outbreaks. Laboratory-scale recirculating sewer systems were employed to simulate in-sewer decay of RSV at different temperatures, organic concentrations, and total suspended solids (TSS) levels. A first-order decay model revealed a significant temperature dependence, with the decay rate increasing approximately 30-fold from 4 to 35 °C. Conversely, higher TSS concentrations provided substantial protection to RSV particles, extending the T90 by up to sevenfold, whereas SCOD exhibited minimal impact. Based on these findings, a multiple linear regression model was established to identify key predictors. This study underscores the importance of understanding RSV decay kinetics for accurate WBE and highlights the value of kinetic modelling in correcting in-sewer viral loss for optimized wastewater surveillance.

14. Psychoactive drug use among athletes: motives and risk factors beyond sports performance - A scoping review.

期刊: The International journal on drug policy 发表日期: 2026-Jun-06 链接: PubMed

摘要

Organised competitive sport represents a unique socio-cultural environment in which performance demands, social influences within sport and anti-doping frameworks shape athletes’ substance use behaviours. In 2021, the World Anti-Doping Agency introduced a ‘Substances of Abuse’ category to address athletes’ drug use outside the context of sport. Athletes may use psychoactive drugs, for example, to manage sports related pressure, stress and mental health challenges rather than to enhance performance. While doping in sport remains a widely studied phenomenon, less attention has been given to psychoactive drug use behaviours among athletes involved in organised sports that are driven by motives other than performance enhancement. This scoping review explored psychosocial motivations and associated risk factors for psychoactive drug use across varied athletic populations including young, professional, elite and retired athletes. A scoping review was conducted using a systematic search strategy in the Scopus, Web of Science and PsycINFO databases. The review followed JBI guidelines and the PRISMA-ScR framework. It focused on peer reviewed studies published between 2014 and 2024. Covidence software was utilised for researchers’ independent screening processes and the Sport Drug Control Model guided the review’s thematic analysis. 38 studies were included. Most studies were conducted in a North American context and were primarily focused on young athletes (55.3%). Cannabis was the most examined drug (68.4%). Athletes’ motives for psychoactive drug use were related to benefit appraisal, especially perceived benefits for mood enhancement (for example, relaxation after a game or coping with injuries). Risk factors included young age, male gender, low perceived competence, mood disorders, peer use, contact sports, injuries and career transitions. The findings highlight the importance of ensuring that drug use prevention and harm reduction interventions reach at-risk athletic populations, particularly adolescent athletes, while also addressing sport specific risk factors.

15. Increased Risk of Infections in People Living With Diabetes.

期刊: Diabetes 发表日期: 2026-Jun-06 链接: PubMed

摘要

Infections represent major but underrecognized complications of type 1 diabetes (T1D), type 2 diabetes (T2D), and prediabetes. This recent overview includes use of linked U.K. primary care, hospitalization, and mortality data to examine infection risk for >800,000 individuals with diabetes or prediabetes, compared with an age-, sex-, and ethnicity-matched group without diabetes. We assessed 1) infections in primary care and requiring a prescription, 2) infections leading to hospitalization, and 3) infection-related mortality, over 5 years (2015-2019). Infection risks were consistently elevated across all forms of diabetes, compared with risk for those without diabetes. The highest relative risks were observed in T1D and lowest in prediabetes. While relative risks were similar across different ethnicities, the population burden of infections attributable to diabetes was highest among South Asians. There were independently strong graded associations for average HbA1c level and visit-to-visit HbA1c variability with infection risk, particularly for hospitalization infections. Among individuals with T1D, the strongest associations with infection risk were seen for elevated HbA1c levels, whereas for T2D, variability contributed more to the excess burden of infections. Infection-related mortality across all ICD-10 chapters was substantial, representing the third leading cause of death in T2D after cardiovascular disease and cancer. Further, it might be underreported, as sepsis is rarely coded as the underlying cause of death. These findings highlight the importance of improved glycemic control, earlier recognition and treatment of infections, and stronger emphasis on infection management in clinical guidelines. Incorporation of HbA1c variability into diabetes risk algorithms, and evaluation of interventions that might stabilize control, such as continuous glucose monitoring, may enhance infection prevention and reduce complications.

16. The Link Between Diabetes and Cancer: Converging Mechanistic and Epidemiologic Evidence.

期刊: Diabetes 发表日期: 2026-Jun-06 链接: PubMed

摘要

Accumulating evidence indicates that diabetes is associated with increased risk of several cancers. The strongest evidence has been reported for cancers of the breast, colorectum, endometrium, liver, pancreas, and gallbladder. However, distinguishing causal relationships from associations driven by shared risk factors such as obesity, aging, and lifestyle behaviors remains challenging. Several biological mechanisms have been proposed to explain these associations. Key pathways include the effects of insulin resistance and compensatory hyperinsulinemia on mitogenic signaling pathways, including PI3K/AKT/mTOR and MAPK, as well as the influence of adiposity, chronic inflammation, and altered metabolic substrates on tumor initiation and progression. Hyperglycemia may also contribute by promoting tumor metabolism and cellular proliferation, although its independent contribution remains debated. These mechanisms likely interact to create a protumorigenic metabolic environment in individuals with diabetes. Obesity, which frequently co-occurs with diabetes, further amplifies these risks through altered adipokine secretion and increased estrogen production, highlighting the interrelated contributions of metabolic and hormonal factors. The relationship between diabetes and cancer has important clinical implications. Diabetes has been associated with worse cancer prognosis and higher cancer-related mortality, highlighting the importance of integrated management strategies. The impact of antihyperglycemic therapy on cancer risk and progression has been extensively studied, and ongoing research continues to evaluate potential protective or tumor-modifying effects. In this article, we summarize the epidemiologic and pathophysiologic evidence describing the relationship between diabetes and cancer and discuss strategies for risk mitigation, screening, and management.

17. Insulin Cost Caps, Trade-Offs, and Pharmacoequity in Diabetes.

期刊: JAMA 发表日期: 2026-Jun-06 链接: PubMed

摘要

18. Physiotherapist and nurse perspectives on the acceptability and timing of patient-reported outcome measures in clinical practice: Balancing standardisation and flexibility.

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-06 链接: PubMed

摘要

Patient-reported outcome measures (PROMs), when used at the point-of-care, provide a mechanism to systematically integrate patients’ voices into shared decision-making. We examined clinicians’ perspectives on the acceptability and preferred timing of PROM completion in routine clinical care for respiratory, musculoskeletal, cardiac, kidney and diabetic condition management. Semi-structured interviews were conducted over videoconference between October 2024 and May 2025. Participants worked at various New South Wales Health clinics, providing care for patients with chronic conditions, and were eligible to collect and review PROMs digitally using the Health Outcomes Patient Experience platform (NSW PRMs-HOPE program). Reflexive thematic analysis was undertaken. Twenty-two physiotherapists and nurses were interviewed. Acceptability themes included: (1) purpose of PROMs; (2) broader ethical considerations for PROMs collection and use; (3) practical aspects of PROM administration. Findings highlighted the elusiveness of an “ideal” timing for PROMs. Timing themes included: (1) (mis)alignment in timing of PROM administration; (2) preferences for fixed or customised timing and frequency of administration; (3) temporal fit and workflow alignment. PROMs were reported as most acceptable when their selection, content, and timing aligned with clinical purpose, scope of practice, and existing workflows. Flexibility in PROM administration was perceived to enhance relevance at the point-of-care and support timely, condition-specific clinical conversations and interventions. However, clinicians also recognised that increased flexibility may reduce the comparability of aggregated PROM data across cohorts, highlighting an inherent acceptability trade-off between meeting individual clinical needs and supporting system-level performance monitoring and benchmarking. People with long‑term health conditions can fill out health surveys called patient‑reported outcome measures (PROMs). These health surveys help patients share how they are coping day to day and how their health condition or treatment is affecting their quality of life. PROMs are used more in healthcare now, but we do not know enough about how clinicians feel about using them or when they should be given to patients to improve their care.In this study, we spoke with physiotherapists and nurses who use PROMs. They told us what they think about PROMs and when these should be completed by patients.Physiotherapists and nurses said PROMs can help them better understand their patients, find changes in their patients’ health, and support conversations about care. But they also said they needed extra time to help patients fill in PROMs, some of the questions were unclear for patients, there were language and cultural barriers for some patients, and they did not always know how to use the results.Overall, physiotherapists and nurses wanted more choice in which PROMs they use and when patients complete them. They felt this would make PROMs more useful for patient care. But, too much choice could make it harder to compare results across clinics and to see how well services are looking after people.

19. Should we be testing pregnant patients' urine for drugs? An applied ethics approach.

期刊: Medicine, health care, and philosophy 发表日期: 2026-Jun-06 链接: PubMed

摘要

Urine toxicology testing among birthing people in the United States remains a clinical practice often informed more by personal values and conscious and unconscious biases, than by medical evidence and ethical obligations. As empirical evidence addressing harms and benefits of toxicology testing in pregnancy grows, and national organizations are taking a moral stance around clinical practice, no published structure explicitly positions the evolving data within an ethical framework. We draw on a model of applied ethics to inform a set of concrete recommendations about what clinicians ought to do with regards to the practice of urine toxicology testing of pregnant patients. These methods facilitate a relationship between empirical data regarding toxicology testing in pregnancy and ethical norms. Our findings serve as a practical guide for clinicians and policymakers seeking clinical guidance around urine toxicology testing in pregnancy as well as a model for future translation of theoretical approaches into clinical action.

20. Utilization and outcomes of COVID-19 positive donors in pediatric kidney transplantation-a population-based study.

期刊: Pediatric nephrology (Berlin, Germany) 发表日期: 2026-Jun-06 链接: PubMed

摘要

COVID-19 infection has been associated with significant morbidity and mortality across all age groups, yet data on pediatric kidney transplant outcomes associated with COVID-19 positive (COVID +) donors remain limited. Using the Scientific Registry of Transplant Recipients, we identified 143 pediatric kidney recipients (< 18 years) of COVID + donors transplanted between September 2020 and February 2025 and compared them with 1808 recipients of COVID-19 negative (COVID -) donors using propensity score weighting to account for transplant year, age at transplant, sex, race, human leukocyte antigen mismatch, prior transplant, and immunosuppression. Among 1940 pediatric recipients, 7.3% received kidneys from COVID + donors, with utilization increasing from 2.5% in 2020 to 10.5% in 2025. No statistically significant differences were observed in patient survival (HR 0.83, 95% CI 0.10-6.73, p = 0.86) and overall graft failure (HR 1.35, 95% CI 0.67-2.73, p = 0.41) between COVID + and COVID - groups over a median follow-up of 1.2 years. Delayed graft function (7.7% vs. 7.2%) and median initial hospital stay (8.0 vs. 8.0 days) were also comparable. The use of COVID + donors for pediatric kidney transplantation has increased over time. The posttransplant outcomes are similar between COVID + and COVID - pediatric recipients, supporting the use of COVID + donors in this population.

21. The impact of health literacy on health-related quality of life among individuals with physical disabilities: a path analysis based on the integrated model of health literacy.

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-06 链接: PubMed

摘要

This study examined the direct and indirect associations among health literacy (HL), its determinants, and health-related quality of life (HRQoL) in individuals with physical disabilities based on the Integrated Model of Health Literacy (IMHL). This cross-sectional study analyzed data from 441 adults with physical disabilities obtained from the 2021 Korea Health Panel Survey. Based on the IMHL, path analysis was conducted to examine the direct and indirect associations of situational determinants (usual source of care, need for care) and societal and environmental determinants (employment status, unmet healthcare needs) on HL and HRQoL. Among the participants, 44.0% were classified as having inadequate HL and 22.3% as problematic. Need for care was negatively associated with both HL (β = - 0.12, p = .002) and HRQoL (β = - 0.33, p < .001). Unmet healthcare needs also had a significant negative direct association with HRQoL (β = - 0.17, p < .001). Employment status (β = 0.15, p < .001) and HL (β = 0.13, p = .005) were positively associated with HRQoL. HL partially mediated the relationship between need for care and HRQoL (β = - 0.02, p = .044). These findings highlight the role of HL in relation to HRQoL among individuals with physical disabilities. Improving HRQoL in this population may require approaches that go beyond individual-level HL promotion and also address support for care-dependent individuals and structural factors, including healthcare accessibility and employment opportunities. Individuals with physical disabilities often experience worse health and lower quality of life than the general population. This study examined whether health literacy affects health-related quality of life among individuals with physical disabilities in South Korea. It also explored how determinants of health literacy are linked to health literacy and health-related quality of life. The main finding is that health literacy plays an important role in health-related quality of life. The results showed that many participants had low health literacy. Those who needed more care or could not receive the healthcare they needed reported lower health-related quality of life. In contrast, individuals who had jobs and better health literacy reported better health-related quality of life. Health literacy helped explain why the need for care was linked to health-related quality of life. These findings suggest that helping individuals with physical disabilities better understand health information, making healthcare easier to access, and supporting employment opportunities may improve their health-related quality of life and reduce health inequalities.

22. Public and patient involvement in developing a survey on re-consent for pediatric genomic data sharing in Japan: a GRIPP2-LF report.

期刊: Journal of community genetics 发表日期: 2026-Jun-06 链接: PubMed

摘要

In Japan, adolescents who entered genomic research under proxy consent are asked to re-consent at age 16 for newly collected data, while previously collected data remain usable without consent. Public perspectives on re-consent and data sharing are not well understood. To prepare a survey for adolescents, we used public and patient involvement (PPI) to refine the questionnaire and information sheet. Four stages of PPI were conducted: a kickoff meeting, two rounds of web-based feedback, and a final discussion. Five PPI members (aged 20-60 s, diverse backgrounds) provided iterative feedback on survey design, wording, and framing. All revisions were documented using GRIPP2-Long Form. PPI members expressed diverse views on re-consent and acceptable secondary data use, supporting the relevance of the survey design. Feedback resulted in major revisions, including clearer terminology, unified wording, improved explanations of parent-child context, existing versus newly collected data, age categorization, and Japan’s opt-out procedures. Of 36 comments in the first round, 30 (83%) were incorporated; of 23 comments in the second round, 20 (87%) were incorporated. PPI enhanced the clarity, cultural relevance, and acceptability of materials for a survey on re-consent in pediatric genomic data sharing. As one of the first systematic PPI reports from Japan, this work demonstrates how systematic involvement strengthens ethically sensitive research and provides a transparent foundation for forthcoming surveys.

23. Excess of post-resistance exercise energy expenditure: a comparison between morning and evening.

期刊: European journal of applied physiology 发表日期: 2026-Jun-06 链接: PubMed

摘要

Excess post-exercise energy expenditure (EPEEE) refers to sustained elevation in energy expenditure above resting levels after exercise. This study compared the effect of morning (AM) and evening (PM) resistance exercise on EPEEE, with and without circadian rhythm (CR) adjustments. In this randomized crossover study, 13 men with prior resistance training experience performed six resistance exercises, each with three sets of 10 repetitions at 60% one-repetition maximum, in separate AM and PM sessions. Resting energy expenditure (REE) and post-exercise energy expenditure (PEEE) were measured via exhaled gas analysis; EPEEE was calculated by subtracting REE from PEEE. CR-adjusted values were calculated using a sinusoidal model of energy expenditure across the day to derive REE-CR, PEEE-CR, and EPEEE-CR. REE did not differ significantly between AM and PM. Mean REE-CR values for AM and PM were similar. PEEE-CR in AM (194.4 ± 27.5 kcal/2 h) was significantly higher than that in PM (183.5 ± 32.2 kcal/2 h; P = 0.030), though insignificant in unadjusted PEEE. EPEEE was significantly higher in AM (49.8 ± 21.0 kcal/2 h) than in PM (30.1 ± 18.8 kcal/2 h; P = 0.049). CR adjustment attenuated EPEEE enhancement at AM; moreover, the difference in EPEEE-CR between AM and PM was no longer significant (AM: 47.3 ± 20.8 kcal/2 h; PM: 31.4 ± 18.9 kcal/2 h; P = 0.100). Compared to evening exercise, morning resistance exercise increases EPEEE; however, this difference diminishes when CRs are considered. These findings offer practical implications for optimizing resistance exercise prescriptions aimed at improving metabolism and cardiometabolic health.

24. Individual and Community Characteristics Associated With Participation in a Digital Nutrition and Dental Health Intervention for Caregivers of Young Children From Low-Income Communities.

期刊: American journal of health promotion : AJHP 发表日期: 2026-Jun-06 链接: PubMed

摘要

PurposeRecruitment and retention challenges hinder development of interventions to reduce income-related inequities in childhood obesity and dental caries. We examined whether participation in a digital nutrition and oral health intervention differed by participant and community characteristics.DesignLongitudinal analysis of an ongoing randomized clinical trial (RCT).SettingLow-income communities.Subjects216 caregivers of 2-6-year-old children completed a recruiting program; 154 consented and 79 completed the first component of the RCT.InterventionWe used a digital tailored message program to recruit participants into a RCT, where a virtual, dietitian-facilitated motivational interviewing (MI) session was the first required component for continued participation in the intervention.MeasuresWe assessed demographics and ZIP-code level community characteristics.AnalysisWe used logistic regression models to examine consent for and completion of MI sessions by participant and community characteristics.ResultsCaregivers reporting healthier child diets were more likely to consent to (OR = 1.3, 95% CI = 1.1-1.5 per 20-point on liking-based measure) and complete the MI session (OR = 1.2, 95% CI = 1.0-1.3 per 1-point on frequency-based measure). Those participating in food assistance or educational programs for low-income children (OR = 0.5; 95% CI = 0.2-0.9), and from communities with greater social vulnerability related to housing/transportation (OR = 0.7, 95% CI = 0.5-1.0) were less likely to complete the MI session.ConclusionsApproaches are needed that engage vulnerable families in nutrition and oral health interventions, thereby enhancing efforts to promote health equity.

25. History repeats in sweet solutions: toxicological concerns and targeted recommendations following the cough syrup-linked paediatric mortalities in India.

期刊: Drug and chemical toxicology 发表日期: 2026-Jun-06 链接: PubMed

摘要

The latest episode of cough syrup-associated pediatric deaths in India linked to the reported diethylene glycol (DEG) contamination reverberates a long-standing catastrophic history from the Elixir Sulfanilamide disaster in the USA to the similar incidents in Haiti, Panama, and Gambia. Such recurring preventable tragedies highlight continuing concerns on global pharmaceutical regulation enforcement, toxicological implications on public health, and drug safety, particularly in low- and middle-income countries. In spite of clearly established pharmacopeial limits of diethylene glycol and other excipients used in pharmaceutical industry, probable gaps in excipient verification, insufficient quality control measures, and patchy regulatory monitoring have continued to be discussed in relation to contaminated drug formulations reaching global markets. Existing conventional strategies to combat reoccurrences, such as mandatory analytical testing of excipients and final drug products, vendor qualification, and strict pharmacovigilance programs, are necessary but not sufficient. This article describes the toxicological aspects of diethylene glycol poisoning, provides a brief overview of the historical events, and critically examines the reasons behind recurrence of DEG-related poisonings. Further, it provides specific recommendations to eradicate such catastrophes by employing futuristic strategies using block chain technology and artificial intelligence-based solutions.

26. Skin bridge versus conventional rods for loop enterostomies: a systematic literature review and meta-analysis.

期刊: Acta chirurgica Belgica 发表日期: 2026-Jun-06 链接: PubMed

摘要

Ostomy rods are used to prevent stoma-related morbidity. However, their effectiveness remains questionable, and to date, no standard technique has been recommended. We sought to identify the most suitable method by comparing skin bridge- and conventional rod-supported loop enterostomies. In accordance with PRISMA guidelines, a systematic literature search was conducted in PubMed (MEDLINE), the Cochrane Central Register of Controlled Trials, and Google Scholar databases for all comparative studies evaluating skin bridges and conventional ostomy rods. Odds ratios (ORs) and standardized mean differences (SMDs) with 95% confidence intervals (CIs) were calculated for outcomes of both methods. Risk of bias and certainty of evidence were assessed using ROBINS-I and GRADE, respectively. The study protocol was registered in PROSPERO (ID: 420251028945). A total of four eligible studies encompassing 323 patients were included (skin bridge: n = 155, control: n = 168). Loop ileostomies with a skin bridge were associated with significantly lower rates of peristomal dermatitis (OR = 0.13; 95% CI [0.06-0.29]; p < 0.00001, I2 = 0%) and mucocutaneous separation (OR = 0.12; 95% CI [0.05-0.29]; p < 0.00001, I2 = 0%) compared with conventional ostomy rods. Other analyzed outcomes, including parastomal hernia, ostomy prolapse, ostomy retraction, ostomy stenosis, and surgical site infection, did not differ significantly between the two groups. Skin bridges appear to reduce the number of ostomy wafers replaced per week and overall ostomy-related costs. Loop ileostomy creation with a skin bridge appears to be a safe and feasible method for preventing early ostomy-related morbidity.

27. Correction: Resistance to FGFR1-targeted therapy leads to autophagy via TAK1/AMPK activation in gastric cancer.

期刊: Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association 发表日期: 2026-Jun-06 链接: PubMed

摘要

28. Infectious complications in paediatric kidney transplantation: prevention and management.

期刊: Pediatric nephrology (Berlin, Germany) 发表日期: 2026-Jun-06 链接: PubMed

摘要

Infections after kidney transplantation are a principal cause of morbidity, allograft failure and mortality. Paediatric recipients are less likely to have immunity through prior exposure to pathogens linked to graft failure such as CMV and EBV. This immunological naivety results in a need for meticulous donor screening, the deployment of strategies to minimise the risk of severe disease, and prompt treatment once infection is diagnosed. This review provides an up-to-date overview of major pathogens contributing to infection in paediatric kidney transplant recipients and we discuss prophylaxis, treatment and lifestyle modifications that can be employed to mitigate infection risk.

29. EGFL6 predicts unfavorable prognosis and serves as a potential indicator in esophageal carcinoma.

期刊: Discover oncology 发表日期: 2026-Jun-06 链接: PubMed

摘要

The EGF-like domain multiple 6 (EGFL6) has been documented as an oncogene across diverse cancer types. Despite its known importance in tumorigenesis, EGFL6’s involvement in esophageal carcinoma (ESCA) remains largely unexplored. Herein, we integrated multi-source omics data to characterize EGFL6’s expression landscape, biological functions, and immunological implications in ESCA-with a focus on its prognostic value. To identify dysregulated basement membrane-related genes (BMRGs) in ESCA, we performed Venn overlap analysis on RNA-seq data from The Cancer Genome Atlas (TCGA), Gene Expression Omnibus (GEO), and a curated BMRG reference list. Weighted gene co-expression analysis (WGCNA) was used to identify EGFL6-related modules and functional enrichment of differentially expressed genes (DEGs) were identified via Gene Ontology (GO), Kyoto Encyclopedia of Genes and Genomes (KEGG), and gene set enrichment analysis (GSEA). EGFL6-specific epigenetic (DNA methylation) and genetic alterations were validated using Methsurv and cBioPortal. Single-sample GSEA (ssGSEA) was applied to explore immune infiltration and its correlation with EGFL6. Prognostic significance of EGFL6 was examined via Kaplan-Meier and receiver operating characteristic (ROC) analyses. Venn overlap analysis indicated EGFL6 as a significantly overexpressed gene in ESCA that closely correlated with multiple clinical and pathological features. WGCNA and subsequent functional enrichment analysis revealed that EGFL6-related DEGs participate in critical biological processes. Kaplan-Meier analysis demonstrated that increased EGFL6 contributed to reduced disease-specific survival (DSS) and progression-free interval (PFI) in patients with ESCA. In vitro experiments confirmed that EGFL6 promotes ESCA by enhancing cell proliferation, invasion and regulating cell-cycle progression. EGFL6 is significantly upregulated in ESCA and is related to various clinical factors, immune modulation and reduced prognosis. EGFL6 could be identified as a novel prognostic biomarker and a viable therapeutic target for the development of personalized treatment approaches in ESCA.

30. Mechanistic insights into NaOH-driven crystal destruction and selective lithium extraction from spent LiFePO4 via mechanochemistry.

期刊: Waste management (New York, N.Y.) 发表日期: 2026-Jun-06 链接: PubMed

摘要

The rapid increase in spent lithium iron phosphate (LiFePO4) batteries brings significant challenges related to environmental pollution, human health risks, and resource sustainability. Conventional recycling technologies are often hampered by high energy consumption, secondary pollution, and operational hazards. This study proposes a sustainable mechanochemical approach for recycling spent LiFePO4 black mass, based on the targeted destruction of the stable LiFePO4 crystal structure. Using sodium hydroxide as an efficient co-grinding agent in a solvent-free system, a superior lithium leaching efficiency of 98.83 % was achieved under optimized conditions, while iron co-leaching was effectively suppressed to 0.27 %. Comprehensive characterizations, including X-ray diffraction, X-ray photoelectron spectroscopy, and Mössbauer spectroscopy confirmed the destruction of the LiFePO4 crystal structure, the formation of Li3PO4, and the oxidation of Fe2+. An economic assessment demonstrates the viability of this procedure, yielding a net profit of $0.9659 per kilogram of LiFePO4 black mass. This work presents an efficient, economically viable, and environmentally benign mechanochemical strategy for LiFePO4 battery recycling, offering fundamental insights into crystal structure destruction for sustainable resource recovery.

31. Exploring psychological flexibility processes in adults with spinal cord injury: a qualitative study.

期刊: Disability and rehabilitation 发表日期: 2026-Jun-06 链接: PubMed

摘要

Psychological flexibility, the capacity to remain open to difficult internal experiences while engaging in values-based action, has been linked to better mental health after spinal cord injury (SCI). Yet how these processes are enacted in daily life is underexplored. This study qualitatively examined lived experiences of psychological flexibility and its processes among adults with SCI. Sixteen adults with SCI were purposively sampled from a larger U.S. survey to maximize variation in psychological flexibility and mental health outcomes. Semi-structured videoconference interviews addressed acceptance, defusion, present-moment awareness, self-as-context, values, committed action, and perceived barriers/supports. Data were analyzed using interpretative phenomenological analysis. Four themes emerged: (1) navigating emotional pain and complexity; (2) strategies for emotional regulation and mindful coping; (3) reconstructing identity and reconnecting with values; and (4) barriers and systemic constraints (inaccessibility, fragmented care, financial/insurance burdens). Psychological flexibility was described as active, effortful, and context-dependent rather than a fixed trait. Adults with SCI recognize, cultivate, and apply psychological flexibility while navigating persistent physical, relational, and structural demands. Findings support integrating psychological flexibility-based approaches (e.g., acceptance and commitment therapy) across the rehabilitation continuum, paired with system-level changes to improve accessibility, continuity of psychosocial care, and insurance processes. Psychological flexibility, including acceptance of difficult emotions, self-compassionate reframing, present-moment focus, and values-based action, may be an important target for supporting emotional adjustment and participation in daily life after spinal cord injury.Interventions that build psychological flexibility, such as acceptance and commitment therapy, may be useful across the rehabilitation continuum from inpatient care through long-term community living.Rehabilitation services may benefit from modules and supports that emphasize mindful acceptance, authenticity, values-based goal setting, peer connection, storytelling/self-advocacy, and opportunities to reclaim agency in daily routines and valued roles.Rehabilitation may benefit from pairing individual coping skills support with advocacy for environmental access, continuity of psychosocial support, and reduced administrative burden.

32. Impact of Noncondensable Gases on Solar-Driven Evaporation.

期刊: Advanced materials (Deerfield Beach, Fla.) 发表日期: 2026-Jun-06 链接: PubMed

摘要

Solar-driven interfacial evaporation (SDIE) has emerged as a promising approach for sustainable clean water harvesting, wastewater treatment, and resource recovery by leveraging photothermal transduction to confine heat energy at the water-vapor interface. Although remarkable water production rates above 5.0 L.m-2.h-1 have been made possible by substantial advancements in photothermal materials and device architectures, the buildup of non-condensable gases (NCGs) continues to hinder practical deployment. NCGs, originating from dissolved air, organic decomposition, and biological activity, converge at the liquid-vapor interface, forming a mass-transfer barrier that inhibits vapor diffusion and leads to fogging inside the condensation chamber. This phenomenon not only suppresses water yield but also compromises optical transparency and long-term system stability. In this review, we discuss the sources, transport mechanisms, and impacts of NCG accumulation on evaporation efficiency, condensation dynamics, and water quality. We summarize recent strategies to mitigate NCG-induced fogging, including chamber design optimization, gas-purging techniques, membrane-assisted separation, and catalytic decomposition. Furthermore, we highlight knowledge gaps in quantifying NCG concentration under operating conditions and propose standardized testing protocols for evaluating anti-fogging performance. Finally, we outline future research directions for developing fouling-resistant, self-purging, and gas-selective solar evaporators that remain efficient under realistic, fluctuating outdoor conditions. Addressing NCG accumulation is crucial to unlock the full potential of SDIE technologies for decentralized, energy-efficient clean water generation in both low-resource and industrial settings.

33. Clinical outcomes following fractional flow reserve-guided revascularization using nicorandil versus conventional hyperemic agents: insights from the J-PRIDE Registry.

期刊: Cardiovascular intervention and therapeutics 发表日期: 2026-Jun-06 链接: PubMed

摘要

The diagnostic accuracy of nicorandil for fractional flow reserve (FFR) measurement has been validated, whereas data on outcomes of FFR-guided revascularization strategy using nicorandil remain limited. This study aimed to compare clinical outcomes following FFR-guided strategy using nicorandil versus conventional hyperemic agents, such as adenosine or papaverine. From the J-PRIDE registry, 2369 patients (3295 lesions) and 831 patients (1009 lesions) were classified into the nicorandil and non-nicorandil groups, respectively. The primary study endpoint was the cumulative 1-year incidence of target vessel failure (TVF; a composite of cardiac death, target vessel myocardial infarction, and target vessel revascularization) on a lesion basis. Patients with multivessel disease, aortic stenosis, and severe angiographic stenosis were more likely to receive nicorandil. Overall, the cumulative 1-year incidence of TVF did not differ significantly between the nicorandil and non-nicorandil groups (3.2% versus 2.4%; adjusted hazard ratio [aHR]: 1.23; 95% confidence interval [CI]: 0.78-1.94; P = 0.37). Similarly, in both the deferred and revascularized population, the 1-year TVF rate was comparable between the two groups (2.9% versus 2.5%; aHR: 1.07; 95% CI: 0.62-1.86; P = 0.80; 3.6% versus 2.1%; aHR: 1.35; 95% CI: 0.58-3.11; P = 0.48, respectively). A significant interaction was observed only between the effect of nicorandil on TVF and hemodialysis (P for interaction = 0.028). The 1-year TVF rate was comparable between the nicorandil and non-nicorandil groups, supporting the clinical applicability of nicorandil for FFR measurement in clinical practice.

34. Boosting workplace safety: the effect of health belief model-based education on personal protective equipment use among workers in a cosmetics and personal care products factory in Yasuj.

期刊: International journal of occupational safety and ergonomics : JOSE 发表日期: 2026-Jun-06 链接: PubMed

摘要

Objectives. Proper use of personal protective equipment (PPE) is essential for worker safety, but many employees fail to use it correctly due to limited knowledge, negative attitudes and low perceived control. This study assessed the effectiveness of a health belief model (HBM)-based educational intervention on PPE use among factory workers in Yasuj. Methods. This quasi-experimental study (2022-2023) randomly assigned 109 workers were to experimental (n = 56) and control (n = 53) groups. The intervention included six 60-min in-person sessions delivered by a researcher and an occupational health expert. Data were collected via an HBM-based questionnaire before and 2 months after the intervention. Statistical analyses included paired t tests, independent t tests and χ2 tests using SPSS version 27. Results. Pre-intervention assessments showed no significant differences between groups (p > 0.05). Post intervention, the experimental group demonstrated significant improvements in all HBM constructs - knowledge, attitudes, perceived susceptibility and severity, perceived benefits and barriers, self-efficacy, guidance for action - as well as PPE-related behavior (p = 0.001). Conclusion. HBM-based educational interventions effectively enhance PPE usage by improving knowledge, shaping positive attitudes and addressing perceived barriers and benefits. These findings support structured educational programs as a key strategy for promoting workplace health and safety.

35. Group-based versus one-to-one occupational therapy to improve ADL ability in people with chronic conditions: a pilot and feasibility RCT of the Go:OT study.

期刊: Pilot and feasibility studies 发表日期: 2026-Jun-06 链接: PubMed

摘要

Occupational therapy interventions can improve the ability to perform activities of daily living (ADL) in individuals with chronic conditions. The group-based ADAPT program was developed as an alternative to usual one-to-one occupational therapy (UOT), aiming to enhance ADL ability through structured problem-solving processes and implementation of adaptational strategies. This pilot and feasibility study evaluated the feasibility of delivering ADAPT 3.0 in a municipal setting and informed the design of a future full-scale randomised controlled trial (RCT). A two-armed pilot RCT was conducted in a Danish municipality, comparing outcomes of ADAPT 3.0 to UOT. Eligible clients (≥ 18 years, chronic conditions, decreased ADL ability) were randomised to either intervention or control group. Outcomes included recruitment and retention, trial participation, impact on staff, access to UOT documentation, completion of outcome measures, and fidelity to the ADAPT manual. Descriptive statistics, logbook notes, and predefined progression criteria guided the evaluation. Twelve clients and four ADAPT-trained occupational therapists participated. ADAPT 3.0 was delivered with high fidelity and dose. Most progression criteria were met, including access to UOT documentation and successful delivery of ADAPT 3.0. However, recruitment was slower than anticipated, and clients in the UOT group reported to receive limited trial-related information. Completion rates of follow-up evaluations were acceptable in the ADAPT group but lower in the UOT group. Minor structural and procedural challenges were identified. The study supports the feasibility of delivering ADAPT 3.0 in a municipal setting and progressing to a full-scale RCT. To ensure robust trial conduct, key refinements are needed in recruitment procedures, participant information for the UOT group, and clarity of outcome measures. ClinicalTrials.gov Identifier: NCT05775653.

36. Clinical, social, and situational determinants of prolonged recovery after commuting.

期刊: Archives of public health = Archives belges de sante publique 发表日期: 2026-Jun-06 链接: PubMed

摘要

Prolonged recovery from work following commuting accidents entails substantial personal, social, and economic costs; however, the social and health determinants of delayed recovery remain comparatively underexplored. Identifying factors associated with extended recovery is essential for informing prevention strategies and strengthening return-to-work policies. Administrative records from Mutual de Seguridad (Chile) were analyzed using a balanced sample of 10,940 commuting accidents (50% with recoveries of ≥ 90 days and 50% with recoveries of < 90 days). Prolonged recovery was defined as an absence of 90 days or more. A probit model was estimated, and average marginal effects (AMEs) were computed. The dataset was randomly divided into training (70%) and validation (30%) samples to assess model stability. The validation model confirmed the robustness of the estimated effects. A greater probability of prolonged recovery was observed among male workers (10%), individuals aged 45 years or older (12%), individuals with multiple diagnoses (20%), and cases classified as severe (59%). Situational factors were also relevant: Commuting accidents occurring between 18:00 and 24:00 h (6%) and during the Friday-Sunday period (5%) were associated with an increased likelihood of extended absence. In contrast, injuries classified as traumatic were associated with a lower probability of prolonged recovery (-43%). The findings underscore the importance of considering not only individual and clinical characteristics but also situational factors when designing prevention and return-to-work strategies for commuting-related injuries. Preventive policies should prioritize older workers, men, and late-day and late-week (Friday-Sunday) commuting contexts while recognizing that accident frequency does not necessarily coincide with the recovery burden. A commuting-specific perspective may strengthen occupational risk management and contribute to reducing prolonged work absence. La recuperación prolongada tras accidentes de trayecto genera importantes costos personales, sociales y económicos; no obstante, los determinantes sociales y de salud asociados a la ausencia laboral prolongada siguen siendo poco estudiados, especialmente en países de ingresos medios. Identificar los factores vinculados a recuperaciones prolongadas es clave para orientar estrategias de prevención y políticas de reintegro laboral desde una perspectiva de salud pública. MéTODOS: Se analizaron registros administrativos de Mutual de Seguridad (Chile), utilizando una muestra balanceada de 10.940 accidentes de trayecto (50% con ausencias ≥90 días y 50% con ausencias <90 días). La recuperación prolongada se definió como una ausencia laboral igual o superior a 90 días. Se estimó un modelo probit y se calcularon efectos marginales promedio (AMEs). Para evaluar la estabilidad del modelo, la base de datos se dividió aleatoriamente en una muestra de estimación (70%) y una de validación (30%). El modelo de validación confirmó la robustez de los resultados. Se observó una mayor probabilidad de recuperación prolongada entre hombres, personas de 45 años o más, trabajadores con múltiples diagnósticos y accidentes clasificados como severos. Asimismo, los accidentes ocurridos entre las 18:00 y las 24:00 horas y durante el período viernes–domingo se asociaron con una mayor probabilidad de ausencia prolongada. En contraste, las lesiones traumáticas se asociaron con una menor probabilidad de recuperación prolongada. Los resultados destacan la importancia de considerar no solo factores individuales y clínicos, sino también condiciones situacionales del accidente al diseñar estrategias de prevención y políticas de reintegro laboral. Desde una perspectiva de salud pública, las intervenciones preventivas deberían priorizar a trabajadores mayores, hombres y trayectos asociados con mayor carga de severidad, reconociendo que la frecuencia de los accidentes no siempre coincide con su impacto en términos de recuperación y carga social.

37. Efficacy of a digitally designed anatomical repositioning splint for adolescent temporomandibular joint anterior disc displacement with reduction: a randomized controlled trial.

期刊: BMC oral health 发表日期: 2026-Jun-05 链接: PubMed

摘要

Anterior disc displacement with reduction (ADDwR) is a common temporomandibular joint disorder in adolescents. Conventional anterior repositioning splints (ARS) often lack anatomical adaptation, which may limit their therapeutic precision and patient comfort. This study aimed to compare the efficacy of a digitally designed anatomical repositioning splint (D-ARS) with that of a conventional ARS in adolescent ADDwR patients. In this randomized controlled trial, 82 adolescents (aged 12-16 years) with ADDwR were randomly allocated to receive either a D-ARS (n = 41) or an ARS (n = 41). At the 6‑month follow‑up, clinical outcomes were evaluated through three modalities: disc recapture was assessed by magnetic resonance imaging (MRI), condylar volume changes were measured using cone‑beam computed tomography (CBCT), and patient‑reported wearing comfort was quantified with the Oral Impacts on Daily Performance (OIDP) questionnaire. Statistical analyses included chi-square tests, t-tests, and non-parametric tests as appropriate. The D-ARS group achieved a significantly higher disc recapture rate than the ARS group (94.44% vs. 79.63%, p = 0.022). Both groups showed significant increases in condylar volume [D-ARS: +202.17 mm³ (95% CI: 177.72-226.63), ARS: +208.9 mm³ (95% CI: 178.8-241.25), both p < 0.001], with no intergroup difference (p = 0.5615). Patient-reported comfort was superior in the D-ARS group, with lower OIDP scores (14.43% vs. 35.63%, p < 0.001). At the 6-month follow-up, the D-ARS group exhibited significantly better disc recapture success and patient-reported wearing comfort than the ARS group, while no significant difference was observed between the two groups in terms of condylar growth promotion. Chinese Clinical Trial Registry (ChiCTR2400080947, registered on February 19, 2024). Available from: http://www.chictr.org.cn/.

38. The small dense LDL cholesterol-glucose index combined with visceral adiposity (sdLG-cVAI) as a novel predictor of incident cardiovascular disease: a prospective cohort study.

期刊: Lipids in health and disease 发表日期: 2026-Jun-05 链接: PubMed

摘要

Dyslipidemia, impaired glucose metabolism, and obesity are established cardiovascular disease (CVD) risk factors. Composite markers like the triglyceride-glucose (TyG) index reflect lipid quantity but overlook qualitative features such as small dense low-density lipoprotein cholesterol (sdLDL-C), a highly atherogenic subfraction linked to dysglycemia. This study aimed to develop a novel sdLDL-C-glucose (sdLG) index, combine it with obesity indicators to enhance CVD risk stratification, and evaluate its predictive value for incident CVD. Adults aged ≥ 45 years without baseline CVD from the China Health and Retirement Longitudinal Study (CHARLS) were included (2011-2020). CVD (heart disease and stroke) events were identified during follow-up. The sdLG index, calculated from sdLDL-C and fasting glucose, was integrated with obesity indicators to form derived indices. The predictive performance of the indices was compared using time-dependent area under the receiver operating characteristic curve (AUC), Concordance index (C-index), and net reclassification improvement/integrated discrimination improvement (NRI/IDI) to select the optimal index. Dose-response relationships were examined via restricted cubic splines (RCS). Associations of the optimal index (baseline, cumulative exposure, and trajectory patterns) with incident CVD were evaluated using Cox proportional hazards models, supplemented by subgroup and sensitivity analyses. Among 3,969 participants, 1,029 incident CVD events occurred. The sdLG index outperformed TyG index in long-term discrimination. Among derived indices, sdLG index combined with the Chinese visceral adiposity index (sdLG-cVAI) showed the best discrimination and reclassification performance. Dose-response relationships for baseline (P for overall < 0.001; P for nonlinearity = 0.105) and cumulative sdLG-cVAI (cusdLG-cVAI) (P for overall < 0.001; P for nonlinearity = 0.522) were linear. In fully adjusted models, the highest vs. lowest quartile was associated with increased CVD risk for both baseline sdLG-cVAI (HR 1.77, 95% CI 1.44-2.16, P < 0.001) and cumulative sdLG-cVAI (HR 1.87, 95% CI 1.53-2.29, P < 0.001). Participants in the persistently high trajectory cluster faced higher risk than those in the stable low cluster (HR 1.75, 95% CI 1.46-2.10, P < 0.001). Subgroup analyses revealed some heterogeneity. Sensitivity analyses yielded results consistent with the main regression analyses. The sdLG index outperforms the traditional TyG index for long-term CVD risk prediction. The novel composite sdLG-cVAI independently predicts incident CVD and improves risk stratification in middle-aged and older adults.

39. Validation of NEWS2 as a triage tool for ambulance transport requests for patients assessed by healthcare professionals.

期刊: BMC emergency medicine 发表日期: 2026-Jun-05 链接: PubMed

摘要

The National Early Warning Score (NEWS2) system, commonly used in hospitals, has shown potential to be an effective prehospital triage tool for ambulance transport requests. This study evaluates the application of NEWS2 for triaging patients in need of transport by ambulance, after assessment by a healthcare professional. The study aims to validate an electronic triage form developed at Oslo Emergency Medical Communication Center (EMCC), focusing on its correlation with patient outcomes and the impact of operator-adjusted emergency codes. A retrospective cross-sectional analysis was conducted on 36,865 ambulance transport cases documented at Oslo EMCC from December 2018 to December 2020. Data from the electronic triage form, EMCC’s journal records and the Norwegian Cause of Death Registry were linked and analyzed to assess the relationship between NEWS2 scores, emergency codes and patient mortality. Associations between NEWS2 score and mortality at 1, 7 and 30 days were assessed using univariable logistic regression analyses, alongside descriptive sensitivity and specificity analyses. Operator adjustments to system-recommended emergency codes were also evaluated for their influence on outcomes. Increasing NEWS2 scores were significantly associated with increased mortality at 1, 7 and 30 days, with the strongest association observed for 1-day mortality. In total 40% of cases were upgraded by either the system (17%) or the operator (23%). System-initiated upgrades effectively identified critically ill patients, while operator-initiated adjustments showed minimal impact on mortality. The findings support the use of NEWS2 as a reliable tool for prehospital triage, aligning with in-hospital findings and supporting consistent patient assessments. While operator discretion plays a role in refining urgency, its impact on mortality was not always significant. The results emphasize the importance of accurate triage to optimize patient outcomes and highlight the need for ongoing evaluation and integration of NEWS2 into EMCC practices. Future research should explore additional outcome measures beyond mortality to assess the broader efficacy of NEWS2 in prehospital settings. Not applicable.

40. Early immune events during SARS-CoV-2 infection impact memory T and B cell responses.

期刊: Communications biology 发表日期: 2026-Jun-05 链接: PubMed

摘要

Immune responses elicited by natural infection of the coronavirus SARS-CoV-2 (COVID-19) show significant heterogeneity in the magnitude and quality of memory T and B cell responses. However, little is known about the contributing factors. In this study, we investigated the early immune factors that contribute to this variability using RNA-seq, targeted proteomics, and flow cytometry analyses. Specifically, we sought to investigate associations between early immune responses and SARS-CoV-2 memory immunity in a longitudinal cohort of 46 individuals hospitalized for COVID-19 from May 2020 to March 2021. These participants returned for follow-up visits up to one-year post-hospitalization where we characterized antibody titers, antibody neutralization, antibody durability, and cellular memory T and B cell responses with multiple assays. Additionally, using integration analysis of Omic measurements, we identified common genes, proteins, and cellular pathways associated with differential memory response outcomes. Our data suggests that high levels of inflammatory proteins, and co-stimulatory molecules during the early stages of COVID-19 lead to enhanced memory T and B cell responses and improved durability. Alternatively, molecules that have a negative effect on dendritic cell maturation including TNFSF11 and FLT3LG correlated with suboptimal memory immune responses. Importantly, we were able to identify early markers that are positively and negatively associated with durable antibody responses in infected participants. This study provides a unique and thorough examination of both innate and memory immunity in the same patients over time, offering valuable insights into the long-term durability of SARS-CoV-2 immunity.

41. Medicaid coverage for fixed-dose combination antihypertensive medications - fifty states and Washington, D.C., 2022.

期刊: Journal of human hypertension 发表日期: 2026-Jun-05 链接: PubMed

摘要

Nearly 93 million adults in the United States (US) have uncontrolled hypertension, a leading risk factor for heart disease and stroke. Increasing the use of fixed-dose combination antihypertensives (FDCs) has been proposed as a strategy to improve hypertension control. Using publicly available 2022 coverage information from 282 state Medicaid fee-for-service and managed care plans, we assessed coverage of FDCs in the 50 US states and Washington, D.C. No FDC had preferred coverage status in all plans. Losartan/hydrochlorothiazide had preferred status in 99.3% of plans. At least two FDCs-containing an angiotensin converting enzyme inhibitor (ACEI) or angiotensin receptor blocker (ARB) plus a thiazide diuretic, and an ACEI or ARB plus a calcium channel blocker-had preferred status in 100 and 80.1% of plans, respectively. At least one triple combination FDC was preferred in nearly half (49.6%) of plans. Comprehensive coverage was limited. To enhance hypertension control, State Medicaid plans may consider approaches to remove barriers to accessing FDCs.

42. Cumulative mild stress during early life alters prefrontal astrocytic proteins and elevates peripheral S100B in young adult mice.

期刊: Translational psychiatry 发表日期: 2026-Jun-05 链接: PubMed

摘要

The prevalence of major depressive disorder (MDD) in young adulthood has increased in recent decades and represents a leading cause of psychological burden, highlighting the importance of prevention and early intervention for depression in young adults. Early-life stress has been closely associated with the onset of depression in young adulthood, leading to adverse outcomes, including reduced quality of life, impaired social functioning, and socioeconomic burden. Among the various neuropathological features of depression, astrocytic abnormalities are increasingly recognized as key contributors. Therefore, we aimed to investigate the association between dysregulated astrocyte expression and depression in young adults. We utilized CPMS (cumulative mild prenatal stress, maternal separation and social defeat) mice as a young adult depression model, in which animals were exposed to a cumulative mild stress (CMS) paradigm during development, including prenatal stress, maternal separation, and social defeat. We further categorized CPMS mice into susceptible and resilient groups based on social interaction behavior. To explore the translational relevance of our findings, we subsequently analyzed blood samples from drug-naïve patients with MDD in young adulthood (mean age of 24 years). CPMS-susceptible mice of both sexes exhibited anxiety- and depression-like behaviors, accompanied by reduced expression of astrocytic markers in the prefrontal cortex. Furthermore, elevated S100B protein levels were observed in the blood of both CPMS mice and patients, showing a positive correlation with the severity of clinical symptoms. Together, these findings indicate that exposure to CMS during early life is associated with altered astrocytic protein expression and elevated circulating S100B, highlighting its potential relevance as a biomarker for depression in young adulthood.

43. Moisture-wicking clothing but not a spacer garment improves perceived thermal strain in Dutch military personnel.

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

摘要

This study evaluated the effects of moisture-wicking clothing and spacer garments on heat strain among Royal Netherlands Marechaussee personnel. In a within-subject design, 19 participants (4 females, 15 males) stationed in the Dutch Caribbean participated in the study; were scheduled to complete 4 shifts while wearing their usual gear, a spacer garment, a moisture-wicking garment, or both a spacer garment and a moisture-wicking garment. Thermal sensation and comfort were assessed hourly, and skin temperatures were continuously monitored. Linear mixed models showed that moisture-wicking clothing without a spacer garment improved thermal comfort (-3 to +3) by 0.49 points (95% CI: 0.16 to 0.82) without affecting mean skin temperature, while standard gear with a spacer garment reduced thermal comfort by 0.36 points (95% CI: -0.68 to -0.04) and increased chest skin temperature by 0.41 °C (95% CI: 0.04 to 0.78). Moisture-wicking clothing enhances perceived comfort, whereas spacer garments may increase thermal strain. This study examined how different gear configurations affect heat strain in Royal Netherlands Marechaussee personnel. Findings show that moisture-wicking clothing enhances perceived comfort, while spacer garments may increase thermal strain. Practical implications highlight the need for simple, implementable clothing strategies to mitigate heat strain without reducing operational effectiveness.

44. Implementing Occupational Therapy Quality Indicators in a Large HealthCare System: Lessons From a Five-Year Performance Monitoring Study.

期刊: International journal for quality in health care : journal of the International Society for Quality in Health Care 发表日期: 2026-Jun-05 链接: PubMed

摘要

Performance measurement tools, such as quality indicators, shape how services are organized, delivered, and evaluated; they are central to monitoring and improving health system performance. This study examines five years of implementing occupational therapy quality indicators within a large public healthcare organisation and assesses how structured performance measurement can support routine monitoring, accountability, and quality improvement in occupational therapy service delivery. We conducted this retrospective, repeated cross-sectional study within Clalit Health Services, Israel’s largest public healthcare organisation, serving more than 4.9 million members across nine districts. We analysed performance trends (2021 to 2025) for five occupational therapy quality indicators implemented system-wide: children-parental conversations, children-treatment interruption, frail older adults, stroke, and hip fracture. Data were extracted from electronic health records and administrative databases. The analytic sample included all CHS members eligible for at least one occupational therapy quality indicator during the study period. Performance for each occupational therapy quality indicator was calculated as numerator/denominator * 100 national-level longitudinal trends and subgroup associations were analysed. Four of the five OT-QIs improved significantly over time. from 8.1% to 3.7%, occupational therapy service delivery to frail older adults increased from 51.8% to 77.4%, and occupational therapy after stroke increased from 52.2% to 59.9% (P < 0.001 for all). The hip fracture indicator showed no statistically significant overall change, increasing slightly from 71.3% to 71.8% (P = 0.706), despite fluctuations during the monitoring period. Methodological changes to the denominator definition highlighted the sensitivity of performance metrics to operational definitions. Subgroup analyses further identified socio-demographic and geographic variation in occupational therapy quality indicator performance, particularly by age, socio-economic position, ethnicity, and peripherality, although patterns differed across indicators. Implementing occupational therapy quality indicators within a nationwide community rehabilitation system enabled routine longitudinal monitoring of access, timeliness, family engagement, continuity of care, and service consistency. These indicators provided a structured framework for identifying service gaps, improving national-level visibility, and informing organisational decision-making. The findings support the feasibility and value of profession-specific quality indicators as a scalable model for performance monitoring and quality improvement in rehabilitation and allied health services. Future research should link occupational therapy quality indicator performance to patient-level functional, participation, and quality-of-life outcomes and examine geographic and socio-demographic inequities in service delivery.

45. I Can See Your HALO: Consensus-based List of High Acuity, Low Occurrence Procedures for Critical Care Medicine Fellowship Training.

期刊: ATS scholar 发表日期: 2026-Jun-05 链接: PubMed

摘要

The Accreditation Council of Graduate Medical Education (ACGME) requires proficiency in procedures such as endotracheal intubation, central line insertion, and bronchoscopy for certification in critical care medicine (CCM). These are common in the intensive care unit and gaining sufficient exposure to attain competence during fellowship training is generally not challenging. However, intensivists are also expected to perform several high-risk procedures that are less frequent. Such high-acuity, low-occurrence (HALO) procedures lack a clear designation, possibly due to a lack of consensus on training standards, and exposure to them during fellowships can be inconsistent. We aimed to identify HALO procedures specific to CCM fellowship training. A modified Delphi methodology was employed to gather iterative data from and reach consensus among a diverse panel of CCM-trained fellowship faculty with expertise in fellowship curricula. Three rounds of quantitative data were completed, with a final round of qualitative data collected to better define why experts chose certain procedures over others. Experts were blinded to the responses of each other, and investigators were blinded to the responses of individual experts. Six procedures (namely, awake bronchoscopic intubation, bronchoscopic intubation under sedation, cricothyrotomy, esophageal balloon tamponade, pericardiocentesis, and surgical chest tube placement requiring blunt dissection) qualified as HALO procedures relevant to CCM fellowship training. According to feedback from experts, procedures were selected based on their relevance to high-risk situations in the ICU, their frequency of occurrence, and the typical scope of practice of ICU providers. This study provides a consensus-based list of qualifying HALO procedures in CCM training. This list can inform curriculum development and support the integration of targeted training strategies to better prepare CCM fellows for rare, high-risk procedures. N/A. N/A.

46. Utilization of health and supportive services amongst children with prenatal opioid exposure: a mixed methods and community-initiated analysis.

期刊: BMC health services research 发表日期: 2026-Jun-05 链接: PubMed

摘要

Research suggests long-term developmental implications of prenatal opioid exposure (POE) that may contribute to healthcare and educational service utilization patterns, such as lower utilization of preventative healthcare services, higher utilization of emergency department and inpatient services, and higher utilization of supportive educational services. However, research on how families navigate these services, including challenges and benefits, is limited. Parents and caregivers of children with POE worked with the study team to design, collect, and descriptively analyze mixed-method data. Data were collected through a survey (n = 148) and two focus groups (n = 15) from a convenience sample, 75% in West Virginia and Massachusetts. The vast majority of children in the sample received some type of supportive service, with Early Intervention (80%) and/or Individualized Education Plans (39%) being the most commonly reported. Additionally, children commonly received outpatient services such as occupational therapy (35%) or mental health counseling (31%), among others. Caregivers expressed navigating significant challenges in trying to access services for their children with POE, from a fractured and complex system to providers who do not see their child’s struggles or believe they are connected to POE. Utilization patterns did not vary between children with just POE and children with exposures to additional substances prenatally. Based on families’ reported experiences, investments in professional development for pediatricians and educators, a clinical understanding of the long-term implications of POE, best practices beyond the NICU, more integrated screening and services, and greater access to mental health services are top priorities.

47. Communicator and collaborator - a Finnish national repeated cross-sectional survey of the two CanMEDS competencies by specialty group.

期刊: BMC medical education 发表日期: 2026-Jun-05 链接: PubMed

摘要

The aim of this study was to find out if experience of two acquired competencies, communication skills and collaboration skills, differ by specialty group or graduation year in post-graduate medical training in Finland. A repeated cross-sectional survey conducted in 2018 and 2023. For this study a subsample of physicians who completed their specialist training after 2007 (n = 2 772) was extracted. Respondents were categorised into three graduation cohorts: 2008-2012, 2013-2017, and 2018-2023 and asked to assess the perceived adequacy of teaching and guidance during specialization across two CanMEDS competency domains. Differences were examined in five specialty categories: operative specialties, conservative specialties, diagnostic specialties, psychiatric specialties, and general practice along with occupational health. On average, 72% of respondents reported adequate teaching and supervision related to the Communicator role during specialist training. The cohort specialized in 2008-2012 reported insufficient teaching and supervision (OR 1.48; 95% CI 1.20 - 1.82) more frequently than those who completed their specialist training in 2013-2017 (OR 1.01; 95% CI 0.83 - 1.21) across all communicator subdomains. Specialists in operative fields (OR 1.64; 95% CI 1.34-2.00) most frequently reported insufficient teaching and supervision within this role. Correspondingly, related to Collaborator role, 62% of respondents reported adequate teaching and supervision. Compared with the 2008-2012 cohort, the proportion reporting insufficient teaching and supervision in team leadership, consultation, and teamwork skills was significantly lower in the 2013-2017 cohort. Related to this role, child and adolescent psychiatrists less frequently experienced deficiencies in communication skills than adult psychiatrists. The majority of the respondents were satisfied with the teaching they received during specialist training related to The CanMEDS competency domains Communicator and Collaborator. These skills play an important role in both the development of education and the quality of care across all specialties. However, it seems that within operative specialties the teaching of communication skills and within psychiatry the teaching of consultation skills could be increased.

48. Short-, medium-, and long-chain chlorinated paraffins in human serum from South China: Evidence of LCCP exposure and CP substitution.

期刊: Journal of hazardous materials 发表日期: 2026-Jun-04 链接: PubMed

摘要

Chlorinated paraffins (CPs) are widely used industrial chemicals of emerging concern, but human internal exposure to long-chain chlorinated paraffins (LCCPs) remains poorly characterized because of analytical challenges. In this study, we quantified different CP congener groups in serum samples from 571 adults residing in Shenzhen, a major manufacturing hub in South China, collected during 2021-2023. Ninety-three CP congener, including 24 short-chain chlorinated paraffins (SCCPs), 34 medium-chain chlorinated paraffins (MCCPs) and 35 LCCPs, were detected in nearly all samples. The ∑CPs concentrations in serum ranged from 29.1 to 4810 ng/mL (weight wet [ww]) with a median concentration of 189 ng/mL ww. SCCPs were the dominant CPs congener group with a median concentration of 148 ng/mL ww, followed by MCCPs (34.0 ng/mL ww) and LCCPs (0.668 ng/mL ww). The widespread detection of LCCPs indicates that this rarely monitored CP class contributes to human internal exposure. Demographic factors explained approximately 27% of the variability in serum SCCP concentrations, although most interindividual variability remained unexplained. Integration with published Chinese biomonitoring data suggested that serum SCCP concentrations declined after 2021, temporally consistent with regulatory restrictions, whereas MCCPs showed an increased contribution, consistent with their use as SCCP substitutes. These findings highlight the need to include LCCPs in human biomonitoring frameworks and to improve analytical standardization for CP exposure assessment.

49. Dietary context determines the metabolic toxicity of organochlorine pesticides: Protective effects of intermittent calorie restriction.

期刊: Journal of hazardous materials 发表日期: 2026-Jun-04 链接: PubMed

摘要

Organochlorine pesticides (OCPs) remain a persistent environmental threat because of their chemical stability, strong lipophilicity, and bioaccumulation in adipose tissue, where they disrupt metabolic regulation. In this study, we examined how dietary context modulates the metabolic toxicity of an organochlorine pesticide mixture (OCPM; chlordane, heptachlor, p,p’-DDT, β-HCH, and hexachlorobenzene in a 1:1:1:1:1 ratio) using a murine model chronically exposed to environmentally relevant doses (0.05-2 mg/kg body weight). Mice were maintained either on a high-fat diet (HFD, 60 kcal%) or under an intermittent calorie restriction (ICR) regimen consisting of alternating two-week cycles of HFD and low-fat diet (LFD, 10 kcal%) for 12 weeks. Under HFD conditions, OCPM exposure induced hyperglycemia, elevated triglycerides and TNF-α, reduced adiponectin, and suppressed insulin signaling (IRβ, p-PI3K, p-AKT, and GLUT4 expression), accompanied by hepatic lipid accumulation and pancreatic β-cell disorganization. In contrast, ICR markedly attenuated these abnormalities by restoring lipid and inflammatory profiles, improving insulin sensitivity (lower HOMA-IR and higher QUICKI), and preserving hepatic mitochondrial content, glycogen stores, and islet morphology. Notably, the lowest dose of OCPM (0.05 mg/kg) produced the greatest metabolic impairment, consistent with a non-monotonic endocrine-disrupting response. Collectively, these findings demonstrate that dietary context critically shapes the metabolic consequences of chronic OCP exposure and suggest that intermittent nutritional modulation enhances metabolic resilience and may represent a practical strategy to mitigate pollutant-induced metabolic dysfunction.

50. Developmental lithium exposure and neurodevelopment: Epidemiological evidence, biological pathways, and implications for autism.

期刊: Journal of hazardous materials 发表日期: 2026-Jun-03 链接: PubMed

摘要

Autism is a heterogeneous neurodevelopmental condition arising from complex interactions between genetic susceptibility and environmental factors. Lithium, a naturally occurring element used therapeutically for bipolar disorder and present in food and drinking water, warrants careful evaluation because it readily crosses the placenta and modulates biological pathways critical for brain development. We conducted a structured literature review of PubMed, Embase, and Web of Science through February 20, 2026, and identified 72 human, animal, and in vitro studies examining lithium exposure in relation to autism or neurodevelopmental outcomes. Epidemiologic evidence remains limited, with few studies directly assessing prenatal exposure and insufficient evidence to establish environmental lithium exposure as a neurodevelopmental risk factor. Most human clinical studies reflect therapeutic contexts and demonstrate the mood-stabilizing effects of lithium, whereas human biomarker and experimental studies provide evidence for modulation of glycogen synthase kinase-3β (GSK3β) signaling and thyroid function. Experimental studies indicate that lithium can normalize disease-associated phenotypes in autism-relevant models, yet it also induces behavioral and neurological alterations in non-mutant control models, particularly following high-dose or prenatal exposure. Across evidence streams, convergent findings implicate phosphatidylinositol-calcium signaling, GSK3β-dependent pathways, glutamatergic synapse function, and thyroid hormone regulation, supporting the biological plausibility of lithium-related neurodevelopmental effects. Overall, lithium-associated neurodevelopmental effects appear dose-, context-, and timing-dependent. Knowledge gaps remain regarding environmentally relevant prenatal exposures and long-term neurodevelopmental outcomes, underscoring the need for rigorous epidemiologic and mechanistic studies incorporating refined exposure assessment, developmental timing, and genetic susceptibility.

51. Reductive degradation of bromate in drinking water by far-UVC photolysis of sulfite.

期刊: Journal of hazardous materials 发表日期: 2026-Jun-03 链接: PubMed

摘要

Bromate has been strictly regulated in drinking water (< 10 μg L-1), due to its potential carcinogenicity and its poor removal efficacy by conventional water treatment processes. Although low-pressure UV-based advanced reduction processes (ARPs) can degrade bromate, their real‑world application is hindered by low efficiency under aerobic conditions and high energy demand. Herein, we demonstrated that the far-UVC (UV222)/sulfite process achieved efficient bromate removal under aerobic conditions at a fluence-based degradation rate constant of (5.08 ± 0.32) × 10-2 cm2 mJ-1 in deionized water at pH 9.0, which is 103.46 times higher than that of the conventional UV254/sulfite process. The UV222/sulfite process also exhibited robust performance in removing bromate in real tap water and surface water. The enhancement in efficiency is primarily attributed to the generation of higher concentrations of reductive radicals in the UV222/sulfite process. Kinetic modeling revealed a pronounced contribution of sulfite radicals (SO3•-) and hydrated electron (eaq-) to bromate degradation under aerobic conditions, accounting for 53.17% and 43.52%, respectively. The degradation of bromate in the UV222/sulfite process was promoted by increasing pH and initial sulfite dosage, and by decreasing the initial bromate concentration, whereas carbonate, nitrate, and natural organic matter (NOM) exerted inhibitory effects. The UV222/sulfite process reduced the formation of chlorinated disinfection byproducts (DBPs) in the post-chlorination and lowered the total calculated toxicity of the treated water by 78.29%. The UV222/sulfite process is thus established as a practical and energy-efficient technology to achieve effective bromate control in water under aerobic conditions.

52. Quercetin alleviates Streptococcus agalactiae-induced mastitis in mice by inhibiting the NF-κB/NLRP3 signaling pathway and ferroptosis.

期刊: Research in veterinary science 发表日期: 2026-Jun-02 链接: PubMed

摘要

Mastitis is the most common dairy disease, impairing milk quality and yield. Quercetin (QUE), a natural compound with anti-inflammatory, antioxidant, and antimicrobial activities, lacks a clear mechanism against mastitis. This study evaluated QUE in a mouse model of Streptococcus agalactiae (commonly known as Group B Streptococcus (GBS))-induced mastitis. Mice (n = 25) were randomized into five groups (n = 5/group): control, GBS model, and QUE (25, 50, 100 mg/kg). QUE or vehicle was administered intraperitoneally 24 h before mammary duct injection of GBS. Pathohistological analysis demonstrated that QUE inhibited GBS-induced histopathological damage and myeloperoxidase activity in mouse mammary tissue (p < 0.01). Immunofluorescence experiments revealed that QUE upregulated the tight junction proteins Occludin and tight junction protein 1, thereby maintaining the integrity of the mammary blood-milk barrier. The results of qPCR and ELISA demonstrated that QUE was effective in reducing the gene expression and content of pro-inflammatory factors IL-6, IL-1β, and TNF-α (p < 0.01). Western blotting and qPCR demonstrated that QUE impeded the NF-κB pathway and diminished the activity of the NLRP3 inflammasome. Concurrently, QUE diminished the iron content of mouse mammary tissues induced by GBS, repressed TfR and ACSL4 protein expression, and FTH1, PTGS2, NCOA4 gene transcript levels, while elevating SLC7A11 and GPX4 protein expression (p < 0.01). These findings indicated that QUE mitigated GBS-induced mammary gland injury in mice by inhibiting the NF-κB/NLRP3 signaling pathway and ferroptosis. This study elucidated the potential mechanism of QUE on GBS-induced mastitis and enhanced the theoretical foundation for future prevention and treatment of mastitis.

53. Ecological and health risk assessment of soil metal(loid)s based on machine learning approaches.

期刊: Journal of hazardous materials 发表日期: 2026-Jun-02 链接: PubMed

摘要

Ecological risk assessment (ERA) and health risk assessment (HRA) of metal(loid)-contaminated soils are essential for the achievement of risk mitigation and sustainable soil management. While conventional risk assessment methodologies are constrained by static modeling and a lack of multivariate considerations, machine learning (ML) has demonstrated significant potential in soil metal(loid) ERA and HRA by leveraging robust data mining and pattern recognition capabilities. Following the PRISMA guidelines, the review included 54 peer-reviewed studies regarding ML-based ERA and HRA in metal(loid)-contaminated soils from the Web of Science and Scopus databases. The analysis of 54 reviewed studies reveals an upward trend in research within this field from 2021 to 2025, focusing on Cd, Pb, As, Cr, Cu, Zn, Ni, and Hg. Input data for ML approaches include environmental covariates (94.44%) and hyperspectral data (5.56%). ML applications in risk assessment comprise four distinct pathways: risk assessment based on direct modeling of risk indicators (29.23%), risk assessment based on predicted concentrations (32.31%), source-oriented risk assessments (32.31%), and risk assessments improved by environmental factors (6.15%). Specifically, ERA is mainly applied through direct modeling of risk indicators (42.86%), whereas source-oriented risk assessment (46.67%) is the primary pathway for HRA. This review provides a comprehensive synthesis of the current status and developmental trends, an overview and selection guidelines for ML approaches, a summary of common input variables, and a detailed analysis of application pathways, while addressing existing challenges and future perspectives.

54. Public-private partnership framework for highly pathogenic avian influenza surveillance: A Korean model.

期刊: Preventive veterinary medicine 发表日期: 2026-Jun-01 链接: PubMed

摘要

This study provides the first comprehensive PPP model for livestock disease surveillance in Korea. Highly pathogenic avian influenza (HPAI) outbreaks have increased globally, placing growing pressure on veterinary services. In the Republic of Korea, the proportion of unfilled public veterinary positions rose from 29.5% in 2019-41.4% in 2023. This study proposes a public-private partnership (PPP) framework for HPAI surveillance using the World Organisation for Animal Health (WOAH) PPP framework. We analyzed international PPP models from Australia’s Emergency Animal Disease Response Agreement, Japan’s focus-area system, and the European Union’s SIGMA project. We also evaluated a 2024 pilot project conducted by three private testing facilities across four provinces and covering 267 farms, using WOAH’s 44 evaluation criteria. The international comparison showed diverse PPP approaches emphasizing government-industry cost sharing, inter-ministerial coordination, and automated reporting systems. The Korean pilot project revealed major challenges, including farmer non-cooperation, regulatory constraints, and limited private facility capacity. Gap analysis identified major deficiencies in the legal framework, resource allocation, and information sharing domains. Based on these findings, we propose a phased Korean PPP model with clearly defined roles: MAFRA for policy coordination, APQA for technical support and confirmatory testing, provincial laboratories for supervision, and private facilities for M-gene screening. Successful implementation will require clear legal authority, sustainable funding, quality assurance through ISO 17025 certification, and improved information sharing via the Korea Animal Health Integrated System (KAHIS). This study provides the first comprehensive PPP model for livestock disease surveillance in Korea.

55. SIGLEC6 impairs trophoblast function and orchestrates macrophage M1 polarization via suppression of Akt signaling in early-onset preeclampsia.

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

摘要

Early-onset preeclampsia (EO-PE) is a severe pregnancy complication driven by defective trophoblast syncytialization and an exacerbated inflammatory microenvironment. Although Sialic acid-binding immunoglobulin-like lectin 6 (SIGLEC6) is implicated in PE, its precise cellular localization, functional impact on trophoblast-immune crosstalk, and the underlying molecular signaling driving these pathologies remain largely uncharacterized. Public transcriptomic and single-cell RNA sequencing datasets were integrated to characterize aberrant SIGLEC6 expression and cellular localization. In vitro gain- and loss-of-function assays were utilized to evaluate the impact of SIGLEC6 on trophoblast syncytialization, migration, and macrophage recruitment and polarization by Immunofluorescence staining, transwell assay, qRT-PCR, western blotting and flow cytometry analysis. The regulatory role of SIGLEC6 on CXCL10-mediated macrophage modulation was validated using qRT-PCR and neutralizing antibodies. Downstream signaling mechanisms were elucidated via bioinformatics, western blotting, and rescue experiments using the Akt activator SC79. SIGLEC6 was identified as a hypoxia-responsive gene specifically upregulated in cytotrophoblasts and syncytiotrophoblasts of EO-PE placentas. Functionally, SIGLEC6 overexpression compromised trophoblast syncytialization and migration while concurrently fostering an inflammatory niche by driving CXCL10-mediated macrophage recruitment and M1 polarization. Mechanistically, Akt signaling was significantly suppressed in SIGLEC6-overexpressing trophoblasts. Restoring Akt activity with SC79 not only rescued trophoblast function but also attenuated CXCL10 secretion and mitigated macrophage M1 polarization. This study establishes SIGLEC6 as a pivotal mediator of trophoblast dysfunction and placental inflammation via the Akt signaling pathway. These findings provide novel insights into SIGLEC6-driven PE progression and highlight the targeting of the SIGLEC6-Akt signaling pathway as a potential therapeutic strategy.

56. Resource Use in Swedish Nursing Homes: A Repeated Cross-Sectional Follow-Up Study.

期刊: International journal of geriatric psychiatry 发表日期: 2026-Jun 链接: PubMed

摘要

Nursing homes in Sweden provide housing and care for people aged 65 years or older who require assistance with everyday activities. An increasing number of nursing home residents have cognitive and functional decline, which can result in additional time needed for care provision. This study aimed to explore changes in resource use and associated factors in Swedish nursing homes over a 5-year period. This repeated cross-sectional study analyzed baseline (2013-2014) and follow-up (2018-2019) proxy-rated data from 4599 participants from the Swedish National Inventory of Care and Health in Residential Aged Care study. Resource use was measured using the Resource Use in Dementia scale. Descriptive statistics, t-tests, chi-square tests, and multiple linear regressions were performed. Total resource use increased from 7.15 h/day to 7.83 h/day between baseline and follow-up. The number of residents living in a dementia unit increased from 34.6% to 43%. Higher independence in activities of daily living was associated with lower total resource use at follow-up while living in a dementia unit was associated with higher total resource use. Higher total resource use was associated with seven neuropsychiatric symptoms. For residents living in a dementia unit, four neuropsychiatric symptoms were associated with higher total resource use. Resource use in Swedish nursing homes increased between baseline and follow-up. These results may inform future policy, financing, and implementation decisions to support resource utilization in nursing homes.

57. Particulate matter-bound metals and chlorinated paraffins co-exposure: A population-based study on attention-deficit/hyperactivity disorder in Chinese youth.

期刊: Journal of hazardous materials 发表日期: 2026-May-22 链接: PubMed

摘要

Recent studies have indicated that heavy metals and chlorinated paraffins (CPs) are risk factors for neurodevelopmental disorders. However, evidence regarding their potential combined effects remains limited. To investigate the joint associations of heavy metals and CPs with attention-deficit/hyperactivity disorder (ADHD) symptoms, we recruited 122,965 participants under 18 from the Pearl River Delta in China. We measured concentrations of six heavy metals (Pb, As, Cd, Hg, Mn and Ni) and three types of CPs (SCCPs, MCCPs and LCCPs) in atmospheric particulate matter (PM2.5) samples. ADHD symptoms was defined according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria. Generalized linear mixed-effects models (GLMMs) were used to evaluate the associations between individual pollutants and ADHD symptoms. We investigated the combined effects using a weighted quantile sum (WQS) regression model and examined potential interactions through both multiplicative and additive models. In single-pollutant models, all metals and CPs demonstrated significant positive associations with ADHD symptoms. Additive interaction analyses revealed significant synergistic effects between heavy metals and CPs, particularly between SCCPs and Mn (RERI = 4.63, 95% CI: 4.38, 4.88) and between SCCPs and Pb (RERI = 4.15, 95% CI: 3.92, 4.39). WQS analysis demonstrated a positive association between mixed exposure and ADHD symptoms, with Mn, Pb, and SCCPs as the main contributors. Boys and children younger than 12 years were more susceptible to these combined effects. These findings suggest that heavy metals and CPs may exert synergistic effects on the odds of ADHD symptoms, highlighting the importance of coordinated regulatory strategies targeting both pollutants.

58. Thriving beyond the pandemic: Exploring post-traumatic growth in college students with and without disabilities.

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

摘要

Objectives: Identify post-traumatic growth (PTG) and the roles of mindfulness, social support, and loneliness in PTG among college students with and without disabilities post-COVID-19. Participants: Six hundred college students enrolled at two universities in Texas. Methods: Participants completed self-report questionnaires via an online Qualtrics survey. Descriptive, bivariate correlation, independent t-test, and regression analyses were conducted. Results: The average PTG score was 28.34 (SD = 12.66), with 45.2% scoring 32 or above, indicating personal growth. Students with disabilities had significantly lower PTG scores (p < .001). For these students, identifying as Black, family loss due to COVID-19, and friends support were associated with higher PTG. Among those without disabilities, racial minority status, family loss, and mentor support were associated with higher PTG. Conclusions: Post-pandemic PTG is notably low among college students, especially those with disabilities, underscoring the need for greater support. Strengthening social connections may improve their PTG, mental health, and academic success.

59. Estimates of vaccine effectiveness against measles and mumps: 14 years follow-up of a large cohort in Wales, UK.

期刊: International journal of epidemiology 发表日期: 2026-Apr-17 链接: PubMed

摘要

Uptake of the measles-mumps-rubella vaccine in Wales is high. However, sporadic measles cases still occur and there are large mumps outbreaks every few years. In this study, the long-term vaccine effectiveness (VE) of vaccines containing measles and mumps is assessed. A retrospective cohort of 822 116 individuals aged 1-30 years were followed up between 1 January 2007 and 31 December 2020. Welsh Demographic Service data were linked to vaccination status from the national vaccination register and primary care records. Outcomes were identified by linking to laboratory confirmations (measles and mumps) and notifications (mumps) data. Complications were sourced from hospital admissions and primary care data. Extended Cox regression was used to calculate hazard ratios. The adjusted VE (aVE) against confirmed measles after two doses remained high after 15 years 99.7% [95% confidence interval (CI) 99.2-99.9]. The aVE for confirmed mumps was lower, with decline over time: 93.6% (95% CI 90.2-95.8) in the first 5 years after vaccination with dose two and 49.9% (95% CI 34.4-61.8) after ≥15 years. A third dose of mumps vaccine temporarily increases protection (87.6%, 95% CI 71.7-94.6). The aVE estimates for mumps were lower when based on clinical suspicion. The VE was high against complications for both infections. The high, sustained VE for measles strengthens evidence that elimination remains possible and the high VE against mumps complications is encouraging. Evidence for the waning of mumps immunity may be important when deciding to implement a third dose in outbreak settings. With the increased use of data linkage, studies should be conducted to corroborate these findings.

60. On contributions made by methodological research to applied epidemiology.

期刊: International journal of epidemiology 发表日期: 2026-Apr-17 链接: PubMed

摘要