公共卫生研究摘要 (2026-06-08)

共收录 56 篇研究文章

1. Reliability and Validity of Hand Hygiene Behavior Questionnaire for Primary School Students.

期刊: The Journal of school health 发表日期: 2026-Jul 链接: PubMed

摘要

Reliable and valid assessment tools are critical for evaluating and improving primary school students’ hand hygiene behaviors, yet corresponding adaptable assessment methods are currently limited. We aimed to develop and validate a Hand Hygiene Behavior Questionnaire for Primary School Students (HHBQ-PSS). Cluster sampling recruited 376 Grade 4-5 students from two central primary schools. The 15-item HHBQ-PSS encompasses three dimensions (capability, opportunity, motivation) of hand hygiene, using a 5-point Likert scale. HHBQ-PSS was evaluated through internal consistency reliability, split-half reliability, exploratory factor analysis (EFA), and confirmatory factor analysis (CFA). The Cronbach’s α coefficient of HHBQ-PSS was 0.844, and all Cronbach’s α coefficients remained above 0.750 after corresponding dimensions were deleted. The Spearman-Brown coefficient was 0.784. EFA extracted four common factors (cumulative variance contribution rate = 58.67%). CFA confirmed adequate model fit (χ2/df = 2.832, CFI = 0.905, GFI = 0.927, AGFI = 0.893, and RMSEA = 0.070). The reliable and valid HHBQ-PSS may inform the implementation of targeted health interventions and the improvement of hand hygiene levels among primary school students. HHBQ-PSS demonstrates good reliability and validity to assess hand hygiene behaviors in Chinese primary school students.

2. Prevalence of School Active Commuting and Associated Factors in Chilean Children: Analysis of the National Survey on Physical Activity and Sport Habits.

期刊: The Journal of school health 发表日期: 2026-Jul 链接: PubMed

摘要

School active commuting is a key behavior to promote physical activity in children, yet limited evidence exists in Chile. This study examined its prevalence and associated factors among Chilean schoolchildren. A cross-sectional study was conducted using data from the Chilean National Physical Activity and Sports Habits Survey, including a subsample of 1137 children aged 5-10 years derived from a nationally representative survey. School active commuting was defined as the dependent variable. Independent variables included sex, area of residence, socioeconomic status (SES), caregiver’s education, self-rated health, leisure activities, and home-based physical or sedentary behaviors. About one in three children (35%) reported commuting actively to school. Boys showed higher participation than girls, and active commuting was more common among children from lower SES households and among those whose caregivers had lower educational attainment. Children who preferred physical activities during leisure time were also more likely to commute actively. No differences were observed by geographic area, self-rated health, or home-based activity levels. Schools and local communities should work together to ensure safe, equitable, and accessible environments that support active commuting. Active commuting remains low in Chilean children, emphasizing the need for multisectoral policies to promote physical activity and reduce inequalities.

3. Breastfeeding Education in Kindergarten Through 12th Grade: A Content Analysis of United States Health Curriculum Standards.

期刊: The Journal of school health 发表日期: 2026-Jul 链接: PubMed

摘要

Breastfeeding provides critical health benefits for both infants and mothers, yet misconceptions and social discomfort persist. Schools can play an essential role in shaping positive attitudes toward breastfeeding; however, little is known about how this topic is addressed in United States (US) curricula. Using qualitative content analysis, the authors systematically examined kindergarten-12th grade (K-12) health education standards from all 50 US states to identify mentions of breastfeeding and related terms. Only three states’ standards include breastfeeding as a beneficial practice, with Arkansas being the only state to mandate age-appropriate breastfeeding education. More frequently, states referenced breasts or breast milk in negative contexts related to breast cancer or human immunodeficiency virus. These findings reveal a national gap in state-required breastfeeding education in primary and secondary schools. Although this study did not assess classroom-, school-, and district-level practices, incorporating accurate and developmentally appropriate breastfeeding content into state-mandated learning standards may help ensure that all public-school students are exposed to this topic. Such integration has the potential to normalize breastfeeding and support broader public health objectives. To move toward a more equitable and health-promoting education system, breastfeeding should be formally integrated into K-12 health standards through clear curricular guidance and teacher support.

4. Proportion of fentanyl reports in illicit drug seizures and nonfatal overdose emergency department visits in the United States, 2021-2024.

期刊: The International journal on drug policy 发表日期: 2026-Jun-07 链接: PubMed

摘要

The increasing presence of fentanyl in the illicit drug supply has been associated with rising overdose mortality in the United States, but the extent to which it is associated with nonfatal overdose morbidity remains unknown. We examined the association between the proportion of fentanyl reports in illicit drug seizures and state-level rates of nonfatal overdose emergency department (ED) visits. We conducted a longitudinal ecological analysis of 40 US states from 2021 to 2024. Outcomes were annual state-level rates of nonfatal overdose ED visits per 10,000 ED visits, obtained from Drug Overdose Surveillance and Epidemiology Syndromic Surveillance System. The proportion of fentanyl reports among all illicit drug seizure reports was obtained from the National Forensic Laboratory Information System. Annual state-level sociodemographic covariates were obtained from the American Community Survey. Adjusted associations and 95% confidence intervals (CIs) were estimated via linear regression using generalized estimating equations. After adjusting for covariates, a 10 percentage-point increase in fentanyl seizure proportion was significantly associated with higher nonfatal overdose ED visit rates: opioid-involved (2.18 increase, 95% CI: 0.89, 3.46), fentanyl-involved (0.73 increase, 95% CI: 0.27, 1.18), and cocaine-involved (0.08 increase, 95% CI: 0.01, 0.15). There was no evidence of statistically significant associations with heroin-, stimulant-, methamphetamine-, and benzodiazepine-involved overdose ED visit rates. Greater fentanyl penetration in illicit drug seizure reports was significantly associated with higher opioid-, fentanyl-, and cocaine-involved nonfatal overdose ED visit rates across states. These findings suggest that fentanyl saturation is not only a driver of overdose mortality but also contributes to nonfatal overdose burden, with important implications for health system demand and public health preparedness.

5. Microplastic inhalation in waste management workers: evidence from nasal lavage and sputum analysis in a municipal landfill setting.

期刊: Waste management (New York, N.Y.) 发表日期: 2026-Jun-07 链接: PubMed

摘要

Although landfills are considered significant sources of microplastics, workers’ inhalation exposure has not yet been measured. This study provides direct evidence of microplastic inhalation among landfill workers by examining pre- and post-shift changes in respiratory samples and across occupational groups. 23 personnel were divided into three groups: office (n = 7), field (n = 12), and recycling plant (n = 4). Nasal lavage and induced sputum samples were collected before/after the work shift. Microplastics were extracted after digestion and density separation, identified under a stereomicroscope, and their polymer type was confirmed by Raman spectroscopy. Nonparametric tests were used to analyze intra- and inter-group differences. Microplastics were found in 100% of the samples, and their concentration increased significantly in both sample types after the shift. The mean particle count rose from 20.5 to 28.5 MPs/10 ml in nasal lavage and from 12.1 to 19.4 particles/10 ml in sputum (p < 0.001). Fibers were dominant (>70% pre-shift; >60% post-shift. Low-Density Polyethylene, polyamide, polypropylene and polyethylene Terephthalate constituted the main distribution of polymers. Regression models identified occupational exposure and smoking as the main determining factors for significantly increasing post-shift microplastic loads in both respiratory samples. The load of microplastics in nasal lavage and sputum was also highly correlated (rs > 0.85). Occupational activity in landfills significantly increases the burden of inhalable microplastics and shows a clear pattern of increasing exposure with increasing occupational exposure (recycling > field > office). Nasal lavage is a valid, less invasive indicator for occupational monitoring and extensive epidemiological assessments.

6. The roadmap for community engagement: co-design and evaluation of a toolkit to strengthen community-academic research partnerships.

期刊: Journal of public health (Oxford, England) 发表日期: 2026-Jun-07 链接: PubMed

摘要

The Roadmap for Community Engagement (Roadmap) is a publicly online available resource co-designed with community partners that aims to support effective research engagement. The Roadmap is designed to be accessible and useful to a wide range of community members, public health practitioners, researchers, and community health advocates. The current study aimed to assess the Roadmap’s perceived usefulness, relevance, and potential for implementation. Data were collected over 12 months using a mixed methods design. Partner surveys, focus groups, and field notes were collected from biweekly academic-community partner collaboration sessions, two Roadmap content-review cycles, and a 2-day evaluation event with community partners. Data were analyzed separately and combined using a concurrent narrative format. Among 90 community partners, 94% reported the Roadmap was useful, 92% anticipated strengthened connections, and 89% agreed it addressed organizational needs. Qualitative themes highlighted accessibility, adaptability, and feasibility for sustaining partnerships as strengths of the Roadmap. Potential challenges included language access, limited infrastructure to implement the Roadmap, financial and time constraints. The Roadmap is a rigorously co-developed, adaptable toolkit that can support equitable research partnerships. Findings justify formal effectiveness testing and implementation studies on scalability across settings to advance health equity.

7. Associations between residential environments and the risk of incident Alzheimer's disease and mild cognitive impairment: a 13-year prospective cohort study with 426,220 participants.

期刊: Aging & mental health 发表日期: 2026-Jun-07 链接: PubMed

摘要

Evidence linking residential environments to Alzheimer’s disease (AD) and mild cognitive impairment (MCI) remains limited. We followed 426,220 dementia-free UK Biobank participants for a median 13.6 years. Cox models evaluated associations between green, blue spaces, and natural environment (300 and 1000 m buffers) and AD/MCI risk, alongside exploratory mediation and gene-environment interactions. Incident cases included 3513 AD and 864 MCI. For AD, higher green space, blue space, and natural environment within 300 m lowered risk (decreases of 5.8, 0.8, and 5.7% per IQR, respectively). At 1000 m, only green space (6.7%) and natural environment (5.7%) remained inversely associated. Blue space exhibited a non-linear AD association. For MCI, green and natural spaces consistently lowered risk across both buffers (14.9-22.2% reductions); blue space was non-significant. Analyses showed limited mediation by air pollutants and selective additive gene-environment synergy. Higher residential green space and natural environment are observationally associated with reduced AD and MCI risks, whereas blue space associations with MCI remain inconclusive. Underlying mechanisms and exploratory gene-environment synergies require further validation.

8. Implementation of a One Health Surveillance System in the Democratic Republic of the Congo.

期刊: EcoHealth 发表日期: 2026-Jun-07 链接: PubMed

摘要

Active animal disease surveillance is essential for detecting zoonotic emerging infectious diseases. In the Democratic Republic of the Congo (DRC), limited infrastructure, economic instability, and armed conflict constrain surveillance capability. This ongoing work to characterize the prevalence of zoonoses like Crimean-Congo hemorrhagic fever virus implements an in-country One Health approach to disease surveillance and capacity building in a limited-resource setting. Veterinarians and technicians from the DRC’s Central Veterinary Laboratory with technical support from national and international partners completed 135 site visits across 9 provinces between June 2023 and July 2024 collecting bovine, porcine, and human serum samples along with attached and grossly engorged ticks. At each site, community animal health workers and local veterinarians were invited to participate for training in clinical competencies and emerging zoonosis identification. Facility survey data revealed that, while more than half of sites report using antibiotics (63% of sites with cattle; 75% of sites with swine), only a quarter of sites vaccinate livestock (18% of sites with cattle; 28% of sites with swine)-a larger trend of curative care outpacing preventative action. This disparity demonstrates a need for veterinary capacity strengthening to realize long-term gains in disease prevention and economic stability.

9. Doping Prevalence in Sport from Indirect Estimation Models: A Systematic Review and Meta-analysis.

期刊: Sports medicine - open 发表日期: 2026-Jun-07 链接: PubMed

摘要

To our knowledge, no previous systematic review and meta-analysis of doping prevalence in sport from indirect estimation models (IEM) exists. To conduct a systematic review and meta-analysis of empirical IEM-based studies of admitted doping prevalence in sport. We conducted electronic database and ad hoc searches up to March 2025, and estimated lifetime and past year prevalence rates through a cross-classified model including prevalence (lifetime vs. past year), sample (competitive vs. recreational) and sports (multi-sport vs. single-sport) types. Forty-six records (K) were included in the review (k [subset records included in the meta-analysis] = 30, n [independent studies from the records] = 34). The World Anti-Doping Agency’s definition of doping use was applied for data collection in most studies (k = 18), and doping prevalence was mostly assessed as past year/season (k = 20). Studies included in the meta-analysis were mostly conducted in Europe (k = 22) and applied the Unrelated Question (k = 8) and Forced Response with Cheater Detection (k = 6) models. Study participants were mostly multi-sport (k = 20) and competed at diverse levels, and most data (k = 28) was collected outside sport events. The corpus included articles that re-analysed existing data (k = 4). Lifetime prevalence was highest for multi-sport competitive athletes (22.6%) and lowest for single-sport competitive athletes (12.7%), whereas past year prevalence was highest for single-sport recreational sportspersons (15.5%) and lowest for multi-sport recreational sportspersons (8.7%). Under IEM, about one of five multi-sport competitive athletes admitted to ever doping whereas about one of six of single-sport recreational sportspersons admitted to doping in the past year. Furthermore, multi-sport (vs. single-sport) competitive athletes show relatively higher doping prevalences, whereas single-sport (vs. multi-sport) recreational sportspersons report relatively higher doping prevalences. Secondary (re-)analysis presents a novel methodological challenge for meta-analyses. Registration PROSPERO: CRD42022373691.

10. Life's Essential 8 score and SCORE2 for Cardiovascular Risk Prediction in a Middle-Aged Cohort from the General Population: The Akershus Cardiac Examination 1950 Study.

期刊: European journal of preventive cardiology 发表日期: 2026-Jun-07 链接: PubMed

摘要

Better control of modifiable risk factors offers substantial potential to prevent cardiovascular disease (CVD). Risk scores can be used to identify and quantify risk and for health promotion, based on prediction of CVD. We aimed to evaluate and compare the prognostic value of Life’s Essential 8 (LE8) and its components, and to contrast LE8 with the established risk prediction tool SCORE2. The Akershus Cardiac Examination 1950 (ACE1950) Study is an ongoing prospective birth cohort study including all men and women born in 1950 residing in Akershus County, Norway. Calculation of Life’s Essential 8 (LE8) and SCORE2 was performed at the baseline visit (2012-2015). Participants were followed through 2022 for incident major adverse cardiovascular events (MACE). Among 3,706 participants (attendance rate 64%), 2,938 without established CVD and with complete LE8 data were included. Mean age 63.9 years, 53% women, with a mean SCORE2 of 6.1 and a LE8 score of 63.9. Only 9.8% had “Optimal” cardiovascular health (CVH) according to LE8. During a median follow-up of 8.3 years, 6.7% experienced incident MACE. Both LE8 (total score, domains, and number of optimal components) and SCORE2 were significantly associated with MACE, with comparable predictive performance (LE 8 HR 1.53, 95% CI 1.35-1.73; SCORE 2 HR 1.82, 95% CI 1.57-2.10, p for comparison = 0.30). The highest risk was observed among participants with “Poor” CVH. LE8 can be used in health promotion based on prognostic value comparable to SCORE2, for counselling to a healthier lifestyle to preserve cardiovascular health. This study found that the American Heart Association’s Life’s Essential 8 (LE8) cardiovascular health score predicts future heart and stroke events as well as the widely used SCORE2 risk calculator and may serve as a useful alternative approach that also incorporates lifestyle behaviors such as diet, physical activity, sleep, and smoking. LE8 was a strong predictor of cardiovascular events and performed similarly to SCORE2. In nearly 3,000 Norwegian adults without existing cardiovascular disease, poorer LE8 scores were associated with a substantially higher risk of major cardiovascular events over 8.3 years, and LE8’s overall predictive ability was comparable to the established SCORE2 risk model. Less than 10% of participants achieved “optimal” cardiovascular health; poor blood pressure control and low physical activity were particularly common, highlighting opportunities for prevention.

11. Levels of Physical Activity and Sedentary Lifestyle in Patients With Hematological Cancer Treated With Monoclonal Antibodies as a Monotherapy or Combination Therapy (Immunochemotherapy): A Comparative Study With Healthy Individuals.

期刊: Medical science monitor : international medical journal of experimental and clinical research 发表日期: 2026-Jun-07 链接: PubMed

摘要

BACKGROUND Blood cancers account for 7% of all malignant neoplastic diseases worldwide. However, there has been an increase in the survival rate of patients with hematological cancer. These data indicate the need to make patients aware of the importance of physical activity. We aimed to assess the level of physical activity and sedentary lifestyle of patients with hematological cancer treated with monoclonal antibodies as a monotherapy or combination therapy (immunochemotherapy), compared with that of healthy individuals. MATERIAL AND METHODS Patients (n=155) treated for hematological malignancies (study group) and healthy individuals (n=137) were divided using World Health Organization (WHO) recommendations on physical activity into groups of adults aged 18-64 years and 65 years and older. All participants completed the International Physical Activity Questionnaire (IPAQ). RESULTS In the younger adult group, the median IPAQ total score in the study group was 1235.00 compared with 3186.00 in healthy individuals (P<0.0001). Importantly, the study group also differed from healthy individuals in terms of sitting time: 1200.00 vs 360.00 (P<0.0001). In the older adult group, no significant difference was found in the median IPAQ total score: 1188.00 vs 1777.00 (P=0.25); however, significant differences were observed for sitting time: 900.00 vs 300.00 (P<0.0001). CONCLUSIONS Patients with hematological cancer treated with monoclonal antibodies as a monotherapy or combination therapy (immunochemotherapy) show, regardless of age, lower levels of physical activity and longer sitting time than healthy individuals, indicating the need for education and promotion of physical activity in this group of patients.

12. The PDE5 inhibitor vardenafil enhances glutamatergic transmission through amyloid-beta and cellular prion protein.

期刊: Neurotherapeutics : the journal of the American Society for Experimental NeuroTherapeutics 发表日期: 2026-Jun-07 链接: PubMed

摘要

Memory and synaptic plasticity are regulated by cyclic guanosine monophosphate (cGMP) signaling. Phosphodiesterase 5 (PDE5) inhibitors, such as vardenafil (VDF), elevate intracellular cGMP levels and represent potential therapeutics for cognitive disorders, including Alzheimer’s disease (AD). However, the signaling pathways linking PDE5 inhibition to excitatory synaptic transmission remain incompletely defined. In particular, whether PDE5 inhibition engages amyloid-β (Aβ)-dependent mechanisms to regulate glutamatergic synapses remains unclear. Using biochemical, immunocytochemical, and electrophysiological approaches in neuronal systems, we show that VDF activates an Aβ-cellular prion protein (PrPC)-dependent pathway that enhances presynaptic glutamatergic function. Specifically, VDF increases Aβ levels, leading to a marked reduction in PrPC surface exposure, an effect prevented by blocking Aβ production. We further demonstrate that PrPC facilitates Aβ internalization, supporting a dynamic coupling between Aβ and PrPC trafficking. Functionally, VDF selectively augments presynaptic excitatory transmission, as indicated by increased VGLUT1 puncta density and elevated miniature excitatory postsynaptic current (mEPSC) frequency, without changes in mEPSC amplitude. Disrupting Aβ-PrPC interaction abolishes these presynaptic effects, establishing this axis as a required mediator of the synaptic response to VDF. Together, these findings identify a functional link between PDE5 inhibition and Aβ-PrPC-dependent modulation of presynaptic glutamatergic transmission, expanding the framework of Aβ-PrPC signaling beyond neurotoxicity and highlighting its context-dependent role in synaptic regulation.

13. Evolocumab in Patients With High-Risk Diabetes: Results From the VESALIUS-CV Trial.

期刊: Diabetes care 发表日期: 2026-Jun-07 链接: PubMed

摘要

This prespecified analysis of Effect of Evolocumab in Patients at High Cardiovascular Risk Without Prior Myocardial Infarction or Stroke (VESALIUS-CV) evaluated the efficacy of the PCSK9 inhibitor evolocumab for preventing first cardiovascular events in patients with high-risk diabetes. VESALIUS-CV randomized patients with high-risk diabetes (microvascular disease, insulin use, or duration ≥10 years) or qualifying atherosclerosis, but no prior myocardial infarction (MI) or stroke, and LDL cholesterol (LDL-C) ≥90 mg/dL to evolocumab 140 mg or matching placebo every 2 weeks. The dual primary end points were a composite of coronary heart disease death, MI or ischemic stroke (three-point major adverse cardiovascular event [3P-MACE]) and 3P-MACE plus ischemia-driven arterial revascularization (four-point [4P]-MACE). Of the 6,002 patients with high-risk diabetes, 67% were on a high-intensity statin and 24% were on an sodium-glucose cotransporter 2 inhibitor (SGLT2i) or a glucagon-like peptide 1 receptor agonist (GLP-1RA) at baseline. The median LDL-C at 48 weeks was 47 mg/dL and 109 mg/dL in the evolocumab and placebo arms, respectively (P < 0.0001). After a median follow-up of 4.6 years, evolocumab decreased the relative rates of 3P-MACE and 4P-MACE by 29% (hazard ratio [HR] 0.71; 95% CI 0.59, 0.86; P = 0.0004) and 21% (HR 0.79; 95% CI 0.69, 0.91; P = 0.0013), respectively. These findings were consistent regardless of the presence or absence of qualifying atherosclerosis, baseline LDL-C, statin intensity, and SGLT2i or GLP-1RA use (Pint > 0.05 for each). The porportion of patients with all-cause death was 8.8% vs. 11.0% in the evolocumab versus placebo arms (HR 0.79; 95% CI 0.67, 0.93). Evolocumab reduced the rate of cardiovascular events in patients with high-risk diabetes, regardless of the presence or absence of qualifying atherosclerosis and background use of other cardioprotective agents.

14. Facing the challenges of treating rare diseases: a scoping review of the role of pharmacists.

期刊: The International journal of pharmacy practice 发表日期: 2026-Jun-07 链接: PubMed

摘要

Rare diseases affect a small percentage of the population compared with prevalent diseases. Despite being individually rare health conditions, this population faces common challenges and unmet medical and social needs worldwide. This scoping review aimed to map and synthesize available evidence on the role and impact of pharmacists on rare diseases care. The review was developed according to the Joanna Briggs Institute (JBI) Methodology and reported following Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). Three electronic databases were consulted. The list of rare diseases for the search was established by consulting documents from the health systems of Brazil, the UK, Ireland, the USA, and China. The pharmacist’s interventions were reported based on a framework for medicine management. The protocol for the methodological approach has been previously published. In total, 6303 records were identified, of which 68 studies fully met the eligibility criteria. Most were observational studies conducted in the USA and focused on 11 different rare diseases. The pharmaceutical services most commonly performed included educating and counseling patients and caregivers (n = 52; 76.5%) and prescription monitoring and medication review service (n = 48; 70.6%). The studies suggest that pharmaceutical care interventions may improve access to treatment, increase medication adherence, prevent medication errors, reduce disease relapses, as well as the need for emergency services and hospitalization. Findings indicate positive outcomes in managing treatments for rare diseases. Additional research is needed to better understand the impact of pharmaceutical services, inform decision-makers about their value, and support the expansion of these services within public health systems.

15. Metagenomic insights into potential horizontal transfer of resistance/virulence genes in gut microbiota from patients with Crohn disease.

期刊: Inflammatory bowel diseases 发表日期: 2026-Jun-07 链接: PubMed

摘要

Unraveling the potential horizontal transfer of resistance genes/virulence genes (RGs/VGs) in gut microbiota from patients with Crohn disease (CD) is an interesting but poorly characterized issue. Quantitative assessment was performed to estimate the relative abundance and diversity of RGs/VGs/mobile genetic elements (MGEs). Differential analysis was applied to identify the CD-specific enriched genetic subtypes. A species-RGs/VGs/MGEs association network was constructed to explore possible co-occurrence patterns of these genetic elements across potential microbial hosts. Integrated with topological metrics and Zi-Pi computational modeling, co-occurrence network analysis was conducted to characterize potential associations among RGs, VGs, and MGEs. Comparative metagenomic analyses indicated that the microbiome in group CD exhibited significantly higher relative abundance of RGs compared to that in healthy controls (HC; P = .040), with 131 specific RG/VG subtypes (eg, acrA/T6SS) exhibiting marked enrichment (P < .05). The co-occurrence network revealed intensified interconnectivity between RGs/VGs and MGEs in group CD, in which MGEs accounted for 71% of network nodes (vs 60.80% in HC), and 99.14% of the edges were positively correlated (vs 93.60% in HC). Network topology and Zi-Pi analysis further suggested reduced modularity (0.709 vs 0.979 in HC) and enhanced intergene connectivity (average degree: 12.288 vs 2.156; average weighted degree: 23.359 vs 3.688 in HC). There were no network hubs (0 vs 5 in HC) but abundant modular hubs (60 vs 25 in HC), peripheral nodes (2317 vs 1549 in HC), and connectors (61 vs 36 in HC), which may reflect conditions favorable for enhanced gene transfer potential. Cross-species transfer events were predicted across clinical-environmental-commensal boundaries, exemplified by tet(M) dissemination between Clostridioides difficile and Bacteroides sp., probably implying progressive erosion of ecological barriers. Collectively, we inferred that the gut microbiome of CD patients might represent a high-risk reservoir for the horizontal transfer of pathogenic determinants, which may pose a potential threat for public health and biosecurity. This study indicated that gut microbiota in patients with Crohn disease carried more genes involved in resistance and virulence traits, compared to that in healthy controls. These genes were closely linked to mobile genetic elements, which might create a high-risk environment for their spread across species and would pose a broader public health concern.

16. Eclipta prostrata leaf extract derived carbon dots integrated TiO2 nanocomposites using for enhanced 4-nitrophenol reduction, antioxidant and antibacterial activity.

期刊: Discover nano 发表日期: 2026-Jun-07 链接: PubMed

摘要

Water contamination by organic pollutants and microbes causes serious environmental problem and risks the life of living things. 4-Nitrophenol is a major constituent of several industrial effluents can damage the health of human. This study presents the development of a titanium dioxide (TiO₂) nanoparticles integrated with carbon dots (CDs) of Eclipta prostrata leaf extract designed for the catalytic reduction of 4-nitrophenol in water and antibacterial applications. CDs/TiO2 nanocomposites were synthesized via a green, hydrothermal method. The structural and morphological analysis were performed by X-ray diffraction and microscopic analysis. The optical properties and stability of CDs/TiO2 nanocomposites was studied using UV-visible and zeta potential measurements. The CDs/TiO₂ nanocomposite exhibited concentration-dependent antioxidant activity, results 90-95% radical scavenging efficiency, compared with the performance of ascorbic acid at 125 µg/mL in both 2,2-diphenyl-1-picrylhydrazyl (DPPH) and ferric reducing antioxidant power assays. Antibacterial studies showed strong activity against Staphylococcus aureus and Klebsiella pneumoniae, with zone of inhibition of 18.4 mm and 19.3 mm, respectively, at 50 µg/mL. The catalytic activity of CDs/TiO2 nanoparticles were tested through the reduction of 4-nitrophenol (4-NP) into 4-aminophenol through hydrogenation. CDs/TiO2 nanocomposites possess excellent catalytic activity in the reduction of nitrophenol, achieving near-complete conversion within 20 min with a rate of 0.168 min-1 follows pseudo first order kinetic reaction. These findings suggest the enhanced catalytic and antibacterial property of CDs/TiO2 nanocomposites can be potentially employed for the remediation of 4-NP and microbial contaminated water.

17. Gene × sex interactions on cognition in the philadelphia neurodevelopmental cohort.

期刊: Biology of sex differences 发表日期: 2026-Jun-07 链接: PubMed

摘要

Small differences between females and males in cognitive abilities have been consistently reported, but the factors underlying these sex differences remain unclear. Social and cultural factors are thought to play a key role, but studies on this topic have been inconclusive. Examination of genetic factors may shed some light on the mechanisms underlying cognitive sex differences. Using data from the Philadelphia Neurodevelopmental Cohort, a large, general population sample of individuals aged 8 to 21 years old (N = 4,694), we tested for sex differences in the genetic factors (i.e., Gene × Sex interactions) underlying cognitive ability. Participants completed the Penn Computerized Neurocognitive Battery, which consists of 14 tests designed to capture accuracy and speed in five domains: 1) executive function (abstraction and mental flexibility, attention, working memory), 2) episodic memory (verbal, facial, spatial), 3) complex cognition (verbal reasoning, nonverbal reasoning, spatial processing), 4) social cognition (emotion identification, emotion differentiation, age differentiation), and 5) speed (motor, sensorimotor). Composite domain scores were derived using confirmatory factor analysis, and general accuracy (g) and speed (gs) using principal component analysis. Small sex differences were observed on most cognitive measures (standardized mean difference (SMD) = 0.061-0.182). Males showed significantly higher genetic variance and lower environmental variance in executive (female σ2g = 0.301 v. male σ2g = 0.598, p = 0.001, female σ2e = 0.243 v. male σ2e = 0.024, p = 0.007), and complex (female σ2g = 0.291 v. male σ2g = 0.610, p = 0.001, female σ2e = 0.259 v. male σ2e = 0.023, p = 0.006) accuracy. Females showed significantly higher genetic and lower environmental variance on complex (female σ2g = 0.575 v. male σ2g = 0.135, p = 0.009, female σ2e = 0.222 v. male σ2e = 0.641, p = 0.012) and social (female σ2g = 0.589 v. male σ2g = 0.129, p = 0.009, female σ2e = 0.236 v. male σ2e = 0.672, p = 0.012) speed. Genetic correlations between females and males were not significantly different from 1 on any cognitive measure. Altogether, our results suggest that while the same genetic factors influence cognition in females and males, the magnitude of effect of these genetic factors differs. We observed small differences between females and males on most cognitive measures, as well as sex differences in heritability on some measures. Future studies are needed to delineate how environmental, genetic, and other biological factors jointly influence cognition. Small differences in cognition between females and males have been consistently reported across abilities, cultures, and decades. However, the factors underlying these cognitive sex differences remain unclear. Social and cultural factors are thought to play a key role, but there has been less examination of potential genetic factors. We tested for sex differences in the genetic factors underlying a range of cognitive abilities in a large, general population sample of individuals aged 8 to 21 years old. Small sex differences were observed across most cognitive domains, with female advantages in memory and social cognition, and male advantages in executive and complex cognition. Moreover, differences between females and males in the magnitude of genetic factors underlying cognition were observed for executive, complex, and social cognition, suggesting that some cognitive sex differences are partly driven by sex differences in underlying genetic factors. Most research on the underlying causes of sex differences in cognitive abilities has focused on social and cultural factors, but our findings highlight the importance of considering genetic factors, as well as how these genetic factors act jointly with social and cultural factors to impact cognition. Given the impact of cognition on social, emotional, and health outcomes, further work is needed to delineate the interplay between environmental and genetic factors that underlie cognitive sex differences.

18. Mechanistic understanding of female reproductive aging based on the chicken model.

期刊: Journal of animal science and biotechnology 发表日期: 2026-Jun-07 链接: PubMed

摘要

Female reproductive aging is a fundamental biological process characterized by a progressive decline in ovarian function, oocyte quality, and endocrine homeostasis, ultimately leading to reduced fertility and increased susceptibility to age-related diseases. Accumulating evidence indicates that reproductive aging is not merely a passive consequence of time but rather a tightly regulated process governed by complex genetic, epigenetic, and metabolic mechanisms. However, mechanistic dissection and translational exploration of female reproductive aging remain constrained by the limited availability of suitable animal models that faithfully recapitulate the human reproductive trajectory. In this review, we synthesize the current advances in understanding the molecular regulatory networks underlying female reproductive aging, with particular emphasis on key signaling pathways, cellular senescence, epigenetic regulation, hormonal control, and mitochondrial dysfunction coupled with oxidative stress. We highlight how the dysregulation of these interconnected mechanisms contributes to ovarian reserve depletion, follicular atresia, and declining oocyte competence across species. We propose that laying hens are a powerful and underutilized model for studying female reproductive aging. Laying hens exhibit a well-defined and highly reproducible reproductive lifespan characterized by distinct phases of peak and declining reproductive output, closely paralleling the age-related fertility decline in women. At the molecular level, hens share conserved regulatory features with humans, including hormonal signaling via the hypothalamic-pituitary-ovarian axis, age-associated oxidative stress, mitochondrial dysfunction, and epigenetic modulation of reproductive tissues. The daily ovulation cycle, measurable reproductive output, and responsiveness to metabolic and environmental interventions in hens further facilitate high-resolution and high-throughput investigations into aging-related mechanisms. By integrating evidence from human studies, mammalian models, and avian systems, this review highlights the translational value of laying hens in elucidating conserved genetic and epigenetic drivers of female reproductive aging. We discuss the current limitations and future perspectives for cross-species validation and multi-omics integration, aiming to facilitate the identification of actionable targets for delaying reproductive aging and improving female reproductive health.

19. Parenthood regret: an under-recognised aspect of parental wellbeing.

期刊: Journal of reproductive and infant psychology 发表日期: 2026-Jun-07 链接: PubMed

摘要

20. The Effect of Occupational Integration on Musculoskeletal Injury in Female Marines in the Fleet: An Epidemiological Cohort Study.

期刊: Military medicine 发表日期: 2026-Jun-07 链接: PubMed

摘要

Musculoskeletal injuries (MSKIs) are ubiquitous in the U.S. military, especially among high-performing service members such as Marines. Given that female service members only started to be assigned to ground combat roles since December 2015, evaluation of sex on MSKI risk in ground combat occupations has not been possible until there was an ample population to study. The purpose of this population-level epidemiological study was to assess (1) if female sex was a salient risk factor for MSKI in Marines serving in different military occupations, including combat arms, and (2) the effects of integration period on MSKI risk among female Marines. A population-based epidemiological retrospective cohort study of all U.S. Marines was performed assessing female sex, occupation, and integration period on the prevalence of MSKI from 2011 through 2020. The Military Health System Data Repository was utilized to identify initial healthcare encounters for diagnosed ankle-foot, knee, lumbopelvic-hip, thoracocostal, cervicothoracic, shoulder, elbow, or wrist-hand complex injuries. Prevalence was calculated for female and male Marines in each occupational category (combat, combat support, aviators, aviation support, services) during the pre-integration (2011-2015) and post-integration (2016-2020) periods. During the pre-integration period, 520/1,000 female Marines (n = 13,985) and 299/1,000 male Marines (n = 142,158) incurred MSKIs. In the post-integration period, the prevalence increased to 565/1,000 female Marines (n = 17,608) and 348/1,000 male Marines (n = 161,429). In the multivariable evaluation of sex, occupation, integration period, and the interaction of sex and occupation on combined MSKIs, only female sex was a significant factor for injury (prevalence ratio [PR]=1.99), with service in ground combat and aviation occupations identified as protective factors when compared with services occupations (PR = 0.69). When these same factors were evaluated for specific MSKI outcomes, female sex remained a robust factor in all lower quarter (PR = 1.75-2.63) and upper quarter (PR = 1.38-2.36) injuries except for shoulder injuries. Service in ground combat and aviation occupations was protective for all lower quarter injuries (PR = 0.46-0.71). In the upper quarter, ground combat was protective for all injuries except for elbow injuries (PR = 0.67-0.77). Serving as an aviator was a risk factor for cervicothoracic (PR = 1.57) and thoracocostal (PR = 1.22) injuries and a protective factor for shoulder (PR = 0.73) and wrist-hand (PR = 0.46) injuries. Adjusted risk for lumbopelvic-hip (PR = 1.13), ankle-foot (PR = 1.53), cervicothoracic (PR = 1.19), thoracocostal (PR = 1.14), and elbow (PR = 1.48) injuries significantly increased during the post-integration period. There was a significant sex-by-period interaction for shoulder injuries alone, with female sex in the post-integration epoch found to be salient (PR = 1.26). Female sex was a significant factor for MSKI, with service in ground combat and aviation occupations identified as protective factors when compared with services occupations. In the evaluation of specific MSKIs, female sex remained a robust and significant factor in all lower quarter injuries and upper quarter injuries except for shoulder injuries. There was only a significant sex-by-period interaction for shoulder conditions, with an increased risk of these injuries in female Marines in the post-integration period.

21. Hypertension, use of antihypertensive medications and breast cancer survival among Black women.

期刊: Breast cancer research : BCR 发表日期: 2026-Jun-06 链接: PubMed

摘要

Black women in the United States experience disproportionately high breast cancer mortality and have high rates of comorbid hypertension; however, the associations of hypertension and antihypertensive medication use with breast cancer survival are unclear. We examined these associations among 2474 Black Women’s Health Study participants with invasive breast cancer. Hypertension and antihypertensive medication use were assessed biennially, and breast cancer diagnoses were confirmed through medical records and cancer registries. We used Cox proportional hazards models, adjusted for clinical and lifestyle factors and cancer treatment, to estimate hazard ratios (HR) for breast cancer-specific death. In the full study population, the HR for untreated hypertension compared to no hypertension was 1.17 (95% CI = 0.75-1.82), while the HR for treated hypertension compared to no hypertension was 0.81 (95% CI = 0.60-1.10). For ER+ cases, there was no association between untreated hypertension and breast cancer specific-death (HR = 0.96, 95% CI = 0.50-1.82), but a strong inverse association between treated hypertension and breast cancer-specific death (HR = 0.53, 95% CI = 0.34-0.83). In contrast, for ER- cases, we observed an increased risk of breast cancer specific death among those with untreated hypertension (HR = 2.19, 95% CI = 1.09-4.39), but there was little evidence of an association with treated hypertension (HR = 1.32, 95% CI = 0.80-2.19). Overall, our findings indicate that Black breast cancer patients with hypertension have better survival when their hypertension is treated, possibly due to regular healthcare engagement or the tumor suppressing actions of antihypertensive medications. Randomized trials are needed to establish causality and inform optimal cardiovascular management in oncology.

22. The Integral Role of Dentists During Disasters: Restoring Function, Nutrition, and Dignity.

期刊: Public health reports (Washington, D.C. : 1974) 发表日期: 2026-Jun-06 链接: PubMed

摘要

Dentistry is often portrayed in disaster literature as ancillary (forensics, logistics), while its clinical role in restoring oral function, preventing malnutrition, and supporting psychosocial recovery is underemphasized. The objective of this research was to highlight the role of dentists in disaster response. This conceptual analysis synthesized published accounts, policy statements, and field examples to reframe dental contributions in disaster settings as essential components of survival and recovery. It examined oral/maxillofacial trauma care, infection control, links between oral health and nutrition, and dignity-restoring prosthodontic interventions. Dentists provided interventions that stabilized airways, reduced infection risk, controlled pain, restored chewing and speech, and supported nutritional rehabilitation, outcomes that materially affect survival and recovery. Despite these contributions, dental professionals are rarely integrated into disaster health systems and emergency medical teams (EMTs). Incorporating dental capabilities into disaster frameworks (EMTs, US National Disaster Medical System), predeployment training, mobile dental assets, and nutrition-oral health integration can improve functional recovery and dignity for disaster survivors. Research and policy development are needed to quantify the effect of dental interventions on health outcomes and to standardize deployment pathways.

23. A rapid evaluation of the preparedness of Ethiopia's disease surveillance system for Mpox outbreak: a cross-sectional study of perspectives from professionals across various levels.

期刊: Tropical medicine and health 发表日期: 2026-Jun-06 链接: PubMed

摘要

The potential re-emergence of Mpox poses an increasing public health concern in the Horn of Africa, particularly in Ethiopia. This study examined perceptions of preparedness among surveyed surveillance professionals in Ethiopia regarding the disease surveillance system’s ability to detect and respond to a potential Mpox outbreak. A descriptive cross-sectional survey design was employed, utilizing a structured 58-item questionnaire that assessed preparedness across five domains: general awareness and understanding, surveillance infrastructure and resources, coordination and communication, preparedness and response, and policy, training, and equity. The survey was distributed to disease surveillance professionals at both federal and regional levels through purposive sampling. The data were analyzed using descriptive statistics, Mann-Whitney U tests, Cramér’s V, and content analysis. Among the 42 surveyed surveillance professionals, 45.3% believed that the surveillance system could effectively respond to an Mpox outbreak, while 54.7% disagreed, reflecting divided perceptions within the sample. Respondents identified several perceived gaps, including limited awareness of Mpox-specific protocols, insufficient training, inadequate diagnostic capacity, and fragmented coordination across sectors. A substantial proportion of respondents reported system-related challenges, with 83.3% perceiving laboratory facilities as inadequate and 78.6% noting the absence of contingency plans. In addition, 57.1% indicated that their organizations lacked staff trained on Mpox, and 59.5% reported no stockpiles of personal protective equipment. Overall, the surveyed professionals expressed mixed perceptions of preparedness, with notable concerns regarding resource allocation, infrastructure, and policy implementation. The study identifies perceived gaps among the 42 surveyed surveillance professionals regarding Mpox preparedness in Ethiopia, highlighting the need for enhanced training, strengthened infrastructure, improved coordination, and more equitable resource distribution. Addressing these gaps through targeted interventions may help strengthen disease surveillance capacity and improve the ability to detect, respond to, and manage emerging health threats such as Mpox.

24. Municipal implementation of community-based preventive programs during the COVID-19 pandemic and long-term care certification trends in Japan: a nationwide ecological analysis.

期刊: BMC health services research 发表日期: 2026-Jun-06 链接: PubMed

摘要

The coronavirus disease (COVID-19) pandemic disrupted community-based preventive services for older adults. However, population-level evidence linking municipal implementation of such services during the pandemic to subsequent care-need outcomes remains limited. Japan’s long-term care insurance (LTCI) system, in which municipalities administer preventive programs and care-need certification is conducted through a standardized process, provides an appropriate setting for examining this association. This study examined whether municipal implementation status of preventive programs planned for FY2020 was associated with subsequent trends in LTCI certification rates. We conducted a nationwide ecological analysis linking a municipal survey conducted in 2021 to annual LTCI certification rates for FY2018-2023. The exposure was full versus incomplete implementation of programs planned for FY2020 across five prevention domains: physical activity, social participation, cognitive training, nutrition, and health check-ups. Collapsed difference-in-differences models compared changes in certification rates from the pre-pandemic period (FY2018-2019) to the pandemic (FY2020-2021) and post-pandemic (FY2022-2023) periods. Event-study models estimated year-specific differences in certification-rate changes. Models were adjusted for baseline LTCI certification rate, aging rate, log-transformed population size, and fiscal capacity index. Sensitivity analyses assessed additional contextual adjustment, exclusion of municipalities without planned programs, alternative LTCI certification outcomes, and potential nonresponse bias. Of 1,741 municipalities invited, 1,114 were included in the primary analysis. Full implementation was reported by 174 municipalities (15.6%) for physical activity and 158 (14.2%) for cognitive training. Full implementation of physical activity programs was associated with smaller increases in LTCI certification rates during the pandemic period compared with incomplete implementation (-0.12% points [pp], 95% confidence intervals [CI]: -0.23 to -0.01). A comparable association was observed for cognitive training (-0.14 pp, 95%CI: -0.25 to -0.03). Sensitivity analyses generally showed similar directional patterns, although estimates were modest and less precise when additional contextual adjustment was applied, municipalities without planned programs were excluded, or alternative certification thresholds were used. In this nationwide ecological analysis, full implementation of physical activity and cognitive training programs planned for FY2020 was associated with smaller subsequent increases in municipal LTCI certification rates. These findings suggest that municipal implementation status during the COVID-19 pandemic may be related to population-level care-need trends. However, causal interpretation is limited by the ecological design, single-time assessment of implementation status, potential exposure misclassification, and possible pandemic-related changes in LTCI certification procedures.

25. Modifying the Meaning of the Upper Anchor Predictably Shapes Ratings of Perceived Effort: A Randomized Crossover Trial.

期刊: Sports medicine - open 发表日期: 2026-Jun-06 链接: PubMed

摘要

Ratings of perceived effort (RPE) are used to prescribe and monitor training. Yet, the influence of how the upper anchor (“10”) is defined remains underexplored, despite holding theoretical and practical value. Here, we examined whether modifying the upper anchor predictably modifies RPEs during isometric exercises. We conducted a within-subject, randomized crossover study in 26 resistance-trained adults. Participants performed isometric contractions at 20-100% of maximal voluntary contraction (MVC) in three exercises: unilateral plantar flexion, unilateral knee extension, and the isometric mid-thigh pull. After each contraction, participants reported RPE (0-10) relative to one session-specific anchor: same-task (maximal effort in the task performed), different-task (maximal effort in the isometric mid-thigh pull), or self-selected (the most effortful task ever experienced or imagined). We estimated expected RPEs and slopes relating RPE to %MVC for each exercise-anchor combination. Preregistered comparisons assessed anchor effects, muscle-mass dose-response, and approximate scale invariance across anchors. Anchor type substantially influenced RPE. Same-task anchors consistently produced the highest RPEs, self-selected the lowest, and different-task anchors intermediate values, with effects most pronounced at 80-100% MVC. The ratings increased with %MVC across all conditions. Under the self-selected anchors, exercises engaging greater muscle mass tended to yield higher RPEs. The relative differences between exercises were largely preserved across anchors, indicating that anchor choice alters RPE while maintaining approximate scale invariance. Upper anchors predictably shape RPE across tasks and intensities. Researchers and applied practitioners using RPE in resistance training should explicitly define, justify, and consistently report anchoring procedures, and align anchor choice with the intended purpose to support valid interpretation and comparisons.

26. Abdominal aortic tortuosity is not associated with other vascular peripheral pathologies or classical cardiovascular risk factors.

期刊: Scientific reports 发表日期: 2026-Jun-06 链接: PubMed

摘要

Atherosclerosis is a chronic disease which can lead to peripheral vascular occlusion causing cardiovascular, cerebrovascular, and peripheral artery diseases (PAD). Key contributors to PAD include ageing, classical cardiovascular risk factors, diabetes mellitus, and hypertension. For decades, these factors have also been related to arterial tortuosity, potentially indicating vascular fragility or arteriopathies. We aimed to evaluate the association between abdominal aortic tortuosity (AAT) and arteriopathies from other vascular beds and to assess its potential role as a subclinical marker of peripheral vascular disease. Atherosclerosis is a chronic disease which can lead to peripheral vascular occlusion causing cardiovascular, cerebrovascular, and peripheral artery diseases (PAD). Key contributors to PAD include ageing, classical cardiovascular risk factors, diabetes mellitus, and hypertension. For decades, these factors have also been related to arterial tortuosity, potentially indicating vascular fragility or arteriopathies. We aimed to evaluate the association between abdominal aortic tortuosity (AAT) and arteriopathies from other vascular beds and to assess its potential role as a subclinical marker of peripheral vascular disease. We included individuals aged ≥ 50 years and excluded those with dorsolumbar scoliosis. We built a multivariate log-linear regression model to identify factors associated with AAT. The model was adjusted by carotid calcification, stiffness, and stenosis as well as individual clinical characteristics and previously registered vascular diseases. A total of 490 individuals (mean age, 66.92 years; range, 50-98 years; 44.29% of women) from the Ageing Imageomics Study were included in this analysis. We observed that the AAT index was strongly dependent on age and also with diastolic blood pressure and estimated glomerular filtration rate (eGFR), but to a lesser extent. In contrast, other classical cardiovascular risk factors like diabetes mellitus, hypertension, smoking, aortic stiffness, and calcification did not play a significant role. Our results do not support the AAT index as a subclinical marker of cardiac, cerebrovascular, or peripheral vascular disease. AAT was not associated with classical cardiovascular risk factors and comorbidities.

27. IQGAP3 bridges matrix stiffness with glioma stem cell maintenance and radioresistance by stabilizing SOX2.

期刊: Nature communications 发表日期: 2026-Jun-06 链接: PubMed

摘要

Drivers of therapeutic resistance in cancer include evolving tumor cell heterogeneity and the tumor microenvironment (TME). We find that increased matrix stiffness promotes radioresistance in glioblastoma (GBM) and maintains tumor cell hierarchies. Differential gene expression reveals that stiff matrices induce expression of IQGAP3 (IQ Motif Containing GTPase Activating Protein 3) through YAP1 and TEAD transcription factors in GBM stem cells (GSCs). IQGAP3 promotes GSC self-renewal and survival upon radiation treatment through binding and stabilization of core stem cell transcription factor, SOX2. Targeting IQGAP3 reduces SOX2 protein levels in vitro and in vivo, increasing GSC radiosensitivity and inhibiting tumor growth. Structure-function drug screening of FDA-approved agents blocking IQGAP3-SOX2 binding identifies trimetrexate as a brain penetrant pharmacologic disruptor of IQGAP3 function in radioresistance, sensitizing GSCs to radiotherapy. These results identify molecular underpinnings for biomechanical promotion of cancer stem cell maintenance and therapeutic resistance, informing therapeutic strategies to augment efficacy of radiotherapy.

28. A cross-modal framework for evaluating the mental health benefits of urban and natural landscapes in sustainable cities: an empirical study based on undergraduate students.

期刊: BMC psychology 发表日期: 2026-Jun-06 链接: PubMed

摘要

Rapid urbanization has heightened the need for evidence-based healthy city planning. To resolve the methodological limitations of parallel biometric data stacking, this study developed a synchronized cross-modal framework to evaluate the restorative potential of a 9-typology urban-to-natural landscape continuum. A laboratory experiment was conducted with 42 healthy undergraduate students (21 males, 21 females; mean age = 21.4 ± 1.8 years). Brain activity (EEG), visual attention (eye-tracking), and peripheral autonomic signals (EDA, HRV, respiration) were synchronously recorded alongside the Profile of Mood States (POMS) scale. To integrate these multi-scale data streams, we formulated the Cross-Modal Restorative Index (CMRI). The empirical findings reveal a distinct, non-linear hierarchy of environmental restoration. Pristine natural environments, especially Mountainous and Field landscapes, elicited complete “Integrated Restoration,” characterized by significant systemic convergence: central cognitive relaxation via posterior α power activation (Field: 7.35; Water: 7.03), robust parasympathetic upregulation (Field HF: 12518.77), and profound down-regulations in subjective tension (Mountainous: 18.6 → 12.3) and fatigue. Conversely, built landscapes demonstrated “Fragmented Restoration.” Notably, Road scenes exhibited a localized dissociation where physiological calming (sharp increase in posterior α wave SD from 15.11 to 20.54) was decoupled from visual and psychological domains, with over 74% of visual dwell time remaining locked on artificial elements and subjective fatigue rising (15.3 → 16.2). These findings provide quantitative, systems-level evidence for integrating ecologically authentic blue-green infrastructure into resilient urban design.

29. The price of survival: comparative adaptation to high altitudes between yaks and cattle.

期刊: Animal microbiome 发表日期: 2026-Jun-06 链接: PubMed

摘要

The yak (Bos grunniens) serves as an exceptional model for studying high-altitude adaptation mechanisms due to its evolutionary success in the hypoxic environment of the Qinghai-Tibet Plateau. Previous research has largely focused on genetic and physiological traits of yaks; however, the interactions between rumen microbiota and host physiology under hypoxic conditions are poorly understood. As the largest digestive organ in ruminants, the rumen and its microbiota play a central role in digestion and host nutrition. In this study, a comparative analysis of digestive metabolism and rumen microbiota was carried out in yaks and cattle (Bos taurus) under two distinct atmospheric oxygen scenarios: baseline (2,200 m) and hypoxic (3,800 m). Our findings reveal that yaks have developed unique microbial strategies to cope with energy deficits in hypoxic stress. These strategies include a shift in rumen microbiota toward amino acid degradation, providing more available energy substrates for host utilization, and enhanced long-chain fatty acid biosynthesis, enabling more efficient energy storage and utilization. This improves energy acquisition in yaks despite their reduced nutritional intake. However, this metabolic adaptation comes at a physiological cost - reduced microbial crude protein (MCP) synthesis, leading to elevated ruminal NH3-N levels, and increased fatty acid metabolism and urea cycle activity contributing to hepatic stress. Our results showed that under high-altitude conditions, yak MCP synthesis decreased by 47.3%; and ruminal NH3-N and serum ALT (a hepatic stress marker) increased by 147.2 and 19.7%, respectively. This study presents evidence of potential metabolic trade-offs in high-altitude adaptation, indicating that yaks may optimize microbially mediated energy production at the cost of liver health. These insights deepen our understanding of host-microbiome coevolution mechanisms in extreme environments and highlight biological costs associated with adaptation to high altitudes.

30. N-Methyl-D-aspartate receptors: structure, signaling and roles in atherosclerosis.

期刊: Journal of translational medicine 发表日期: 2026-Jun-06 链接: PubMed

摘要

Atherosclerosis, a chronic inflammatory disease of the arterial wall, is a leading cause of cardiovascular diseases worldwide. The complex pathogenesis of atherosclerosis involves genetic predisposition, environmental factors, and immune responses. N-Methyl-d-aspartate receptors (NMDARs), a subclass of glutamate receptors, are critical for synaptic plasticity, learning, and memory in the central nervous system (CNS). Non-neuronal NMDARs are poorly understood compared to neuronal receptors, but there is a developing consensus that they have distinct structural and functional properties when activated by glutamate and NMDARs co-agonists. Emerging evidence indicates that non-neuronal NMDARs may participate in an array of physiological and pathophysiological processes, including but not limited to driving macrophage polarization, lipid dysregulation in macrophages, inflammation response, vascular smooth muscle cells phenotype switching and endothelial dysfunction, thereby fueling atherogenesis. This review discusses the association between NMDARs genes and atherosclerosis risk, molecular mechanisms underlying NMDARs-mediated regulation of atherosclerosis-related cells, and potential therapeutic implications. Besides, we introduce some pharmacological tools that can be used for studying NMDARs outside the CNS, which reflect modern subunit-selective agents to provide more precise insight into NMDARs mediate the various effects. Overall, the study of NMDARs may provide insights into the pathogenesis of atherosclerosis and lead to the development of more effective therapeutic strategies.

31. Exploring technology-delivered cognitive training in the perioperative period for the prevention of postoperative delirium: a scoping review.

期刊: Psychology, health & medicine 发表日期: 2026-Jun-06 链接: PubMed

摘要

To review extant literature for the use of digital technology to deliver cognitive training perioperatively to prevent or mitigate postoperative delirium (POD). Increasing rates of surgical care place pressures on healthcare systems. POD is a prevalent complication in older adults, worsening patient outcomes and up to 40% may be preventable. Since preoperative cognitive dysfunction is a primary risk factor, understanding the impact of technology-assisted cognitive enhancement on POD may improve patient experience and alleviate costs. Five databases were searched, and articles were reviewed by two investigators. Clinical trials that used digital technology perioperatively to prevent POD in older adults and written in English or French were included in the study. Relevant information was extracted. Out of the 630 articles identified, six (n = 6) were included. Surgical type, targeted cognitive domains and intervention dosing varied, exclusion criteria were restrictive and effectiveness was both positive and null. Relatively few relevant studies were identified indicating the literature is in its infancy. While two of the studies showed positive outcome trends, further research is needed to address adherence, modifiability of cognitive training programs, intervention dosage and less restrictive sampling.

32. Children's perspectives on preventive youth health services: a focus group study among Dutch children.

期刊: BMC health services research 发表日期: 2026-Jun-06 链接: PubMed

摘要

Children’s perspectives on optimal health care are rarely considered in health care research. These routine health assessments are carried out by Youth Health Care services (YHC), which provide school health care as part of preventive care for children. The aim of this study is to explore the perspectives of children aged 9 to 12 years old, on current routine health assessments in Dutch school health services and how these could be improved to better align their preferences and needs. We conducted a qualitative focus group study with Dutch primary school children, 9 to 12 years old, who received their routine health assessment from YHC in the past twelve months. Discussion topics included experiences with preventive youth health care services, preferences regarding involvement of parents, and suggestions for improvement of the services. Reflexive thematic analysis was conducted using the 6-step approach by Braun and Clarke. Six focus groups were conducted with in total 41 children. We identified four main themes; ‘We want more! Monitoring health matters to children’; ‘Feeling safe and comfortable: be the nice and sweet professional in a two-way conversation’; ‘Parents know a lot, but not everything: mixed feelings on their role and presence’, and ‘Preventive youth health care should be organized more attractive’. Our sample of Dutch children perceived preventive routine health assessments as important to monitor their health and suggested more frequent and comprehensive assessments. The children’s perspectives, provided relevant insights in how to design child-friendly preventive youth health care.

33. Smartphone addiction and its associated factors among public university students in Malaysia: a cross-sectional study.

期刊: BMC psychology 发表日期: 2026-Jun-06 链接: PubMed

摘要

Smartphone use has become deeply embedded in daily life, particularly among university students, who may adopt it as a coping mechanism for psychological distress. Excessive or maladaptive use may lead to smartphone addiction, a growing public health concern linked to adverse mental health outcomes. This study aimed to determine the prevalence of smartphone addiction and examine its association with depression, anxiety, and loneliness among public university students in Malaysia. A cross-sectional online survey was conducted between July 2022 and January 2024 among 7,278 students from 20 Malaysian public universities. Data were collected using validated instruments, including the Smartphone Addiction Scale-Short Version (SAS-SV), Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), and the De Jong Gierveld Loneliness Scale (DJGLS-6). Descriptive statistics were used to estimate prevalence, and multivariable logistic regression was performed to identify associated factors of smartphone addiction. The prevalence of smartphone addiction was 30.1%. Depression (42.6%), anxiety (41.9%), and loneliness (83.8%) were also highly prevalent. After adjustment, factors associated with smartphone addiction included female gender (AOR 1.148; 95% CI 1.021-1.291), Bumiputera Sabah or Sarawak ethnicity (AOR 1.235; 95% CI 1.031-1.479), higher academic year, and daily smartphone use exceeding 10 h (AOR 5.277; 95% CI 3.514-7.925). Depression (AOR 1.968; 95% CI 1.745-2.218), anxiety (AOR 2.060; 95% CI 1.789-2.372), and loneliness (AOR 1.438; 95% CI 1.207-1.714) were independently associated with smartphone addiction. Smartphone addiction is common among Malaysian university students and is strongly associated with demographic factors, psychological distress, and excessive smartphone use. Interventions addressing mental well-being and promoting healthier digital behaviors are essential to reduce addiction risk in this population.

34. Minimal clinically important difference for cognitive scales in people with Parkinson's disease with cognitive impairment.

期刊: Scientific reports 发表日期: 2026-Jun-06 链接: PubMed

摘要

Cognitive impairment (CI) is a significant non-motor symptom of Parkinson’s disease (PD), necessitating effective assessment tools to evaluate treatment efficacy. Minimal Clinically Important Difference (MCID) thresholds provide critical benchmarks for interpreting cognitive intervention outcomes. This study establishes MCID values for PD Cognitive Rating Scale (PD-CRS), Scales for Outcomes in PD-Cognition (SCOPA-COG), and Montreal Cognitive Assessment (MoCA) in PD-CI. A total of 110 patients with PD-CI were recruited; 105 (mean age 71.96 ± 2.40 years) completed the 12-week Dual-Task Training (DTT) program and were included in the final analyses. Cognitive function was assessed using PD-CRS, SCOPA-COG, and MoCA at baseline and post-intervention, with the Global Rating of Change (GRoC) questionnaire serving as an anchor. The MCID value was determined using anchor-based and distribution-based approaches. Receiver Operating Characteristic (ROC) analysis was employed to evaluate these thresholds. Significant improvements were observed across all cognitive measures post-intervention. The anchor-based MCID values were 7.70 points for PD-CRS, 3.11 points for SCOPA-COG, and 2.05 points for MoCA, respectively. Additionally, ROC curve analysis further determined that MCID cut-off points were > 3 points for the PD-CRS, > 2 points for the SCOPA-COG, and > 1 point for the MoCA. The distribution-based MCID values ranged from 1.48 to 4.10 points for PD-CRS, 1.37 to 5.95 points for SCOPA-COG, and 0.54 to 3.71 points for MoCA. This study established MCID thresholds for PD-CRS, SCOPA-COG, and MoCA in PD-CI, providing essential tools for clinicians and researchers to assess clinically meaningful changes after cognitive intervention.

35. Discovery and functional characterization of katG mutations mediating Isoniazid resistance in Mycobacterium tuberculosis.

期刊: Diagnostic microbiology and infectious disease 发表日期: 2026-Jun-05 链接: PubMed

摘要

To identify isoniazid (INH)-resistance-associated mutations in the katG of Mycobacterium tuberculosis (MTB) using whole genome sequencing (WGS) and validate mutations through functional studies. Clinical MTB isolates from tuberculosis patients at Shijiazhuang Fifth Hospital (June 1, 2020-June 30, 2022) were stratified into INH-resistant and INH-susceptible groups based on minimum inhibitory concentration (MIC). 67 isolates from each group underwent WGS. Based on the WHO drug resistance database, select katG mutation sites that are not yet confirmed as resistance-conferring in the WHO 2024 catalog, and predict their interactions with INH through molecular docking and molecular dynamics simulations. Functional validation was performed by overexpressing mutant katG alleles in the model organism Mycobacterium smegmatis mc²155 and assessing MIC shifts. WGS revealed 15 katG mutation sites, including 9 variants not catalogued in WHO databases. Structural modeling demonstrated reduced binding stability between INH and the G124R mutant compared to wild-type katG. Functional assays confirmed that mc²155 overexpressing katG-G124R exhibited a two-fold MIC increase, while V151I and G124D mutants showed no significant resistance changes. 9 katG mutations were identified in INH-resistant MTB, with experimental validation confirming that the G124R substitution enhances INH resistance through impaired drug-target interaction.

36. Perceived changes in sexual experience after voluntary medical male circumcision among men who have sex with men.

期刊: The journal of sexual medicine 发表日期: 2026-Jun-05 链接: PubMed

摘要

37. Predictors of clomiphene citrate response in the treatment of men with testosterone deficiency.

期刊: The journal of sexual medicine 发表日期: 2026-Jun-05 链接: PubMed

摘要

Clomiphene citrate (CC) is an established treatment for men with low testosterone, but predictors of treatment response remain poorly defined. To identify factors associated with clinically meaningful increases in serum testosterone levels during CC therapy. This retrospective study analyzed men diagnosed with low testosterone and treated with CC. Inclusion criteria were (1) a diagnosis of low testosterone (total testosterone (TT) ≤300 ng/dL with symptoms) or borderline low testosterone (TT 300-400 ng/dL with objective signs of low testosterone (low bone density or elevated HbA1c)), (2) laboratory follow-up within 12-weeks of initiation, and (4) no prior testosterone therapy. Initial CC dosing was 25 mg every other day (QOD), with escalation to 50 mg QOD if TT remained <400 ng/dL. Labs were redrawn every 4-weeks following dose changes until TT was at goal or until CC discontinuation. Discontinuation within 12-weeks without documented response constituted treatment failure. TT was assessed using liquid chromatography-mass spectrometry. Multivariable models were used to identify predictors of treatment response. The primary outcome was achievement of treatment response, defined as TT ≥400 ng/dL on treatment plus an increase in TT ≥200 ng/dL from baseline. The study included 292 men with median age of 60 (IQR 50, 66) years, median baseline TT (219, 314) 264 ng/dL, and median baseline luteinizing hormone (LH) of 3.5 (2.6, 5.1) mIU/mL. Comorbidities included diabetes (18%), hyperlipidemia (46%), hypertension (44%), prior radical prostatectomy (41%), prostate radiotherapy (12%), and androgen deprivation therapy (ADT) (4.5%). Treatment response was achieved in 136 of 292 (47%) patients; 156 (53%) failed to meet response criteria within 12-weeks. Multivariable analysis identified baseline LH (increase per mIU/mL) (OR 0.82, CI = 0.71-0.95, P = .008) as a significant negative predictor for achieving treatment response. Likewise, prior ADT was predictive for poor response (OR 0.11, CI = 0.01-0.6, P = .039). Baseline TT and age at start of CC treatment were not predictive. The study included 292 men with median age of 60 (IQR 50, 66) years, median baseline TT (219, 314) 264 ng/dL, and median baseline LH of 3.5 (2.6, 5.1) mIU/mL. Comorbidities included diabetes (18%), hyperlipidemia (46%), hypertension (44%), prior radical prostatectomy (41%), prostate radiotherapy (12%), and ADT (4.5%). Treatment response was achieved in 136 of 292 (47%) patients; 156 (53%) failed to meet response criteria within 12-weeks. Multivariable analysis identified baseline LH (increase per mIU/mL) (OR 0.82, CI = 0.71-0.95, P = .008) as a significant negative predictor for achieving treatment response. Likewise, prior ADT was predictive for poor response (OR 0.11, CI = 0.01-0.6, P = .039). Baseline TT and age at start of CC treatment were not predictive. Identification of predictors for CC treatment response enables individualized counseling, leading to better informed treatment decisions and avoidance of treatment failure. Strengths include cohort size, utilization of the gold-standard lab assessment for TT (LCMS), and standardized reproducible clinical pathways. Limitations include having a study population that is skewed older and less healthy than average, lack of long-term follow-up, and lack of quantifiable data on symptoms. In men with low testosterone, this study found that higher baseline LH and history of prior ADT predicted worse response to CC therapy.

38. The decline in pharmacy access across Minnesota, 2009-2025.

期刊: Journal of the American Pharmacists Association : JAPhA 发表日期: 2026-Jun-05 链接: PubMed

摘要

Community pharmacies continue to be a valuable access point for community health needs, bridging the gap in healthcare between patients and resources. Despite their expansion of services and positive impact on patient health outcomes, an increasing number of pharmacies across the country are closing, leaving a large number of patients without pharmacy access. To understand pharmacy access across Minnesota communities, including tracking pharmacy openings and closures over time to identify pharmacy deserts and develop a foundational structure for ongoing monitoring of pharmacy access and informing public health and policy decisions. We conducted retrospective data review of community pharmacy openings and closures across Minnesota between October 2009 and August 2025 using activity status of a pharmacy license per the Minnesota Board of Pharmacy and ERSI ArcGIS software to geocode active community pharmacies across 6 time points between 2009 and 2025. Pharmacy deserts were defined and identified at the census tract level at each time period. Keystone pharmacies were defined as pharmacies that were the only one serving a census tract within the defined distance threshold. Between October 2009 and August 2025, there was a net loss of 156 (15%) community pharmacies. Census tracts classified as pharmacy deserts increased from 44 to 58 (3.9% of Minnesota census tracts), with the population living in pharmacy deserts increasing from 142,659 to 189,222 (3.3% of Minnesota residents). Of the remaining 867 pharmacies, 129 (15%) were identified as keystone pharmacies. Pharmacy access across Minnesota has worsened in the last 15 years, leaving fewer pharmacies to serve a growing population. Further monitoring of pharmacy access is necessary to advocate for policy reform and the protection of community health access.

39. PNPLA3 polymorphisms and risk of hepatic and extrahepatic outcomes in MASLD: a meta-analysis of observational studies.

期刊: JHEP reports : innovation in hepatology 发表日期: 2026-Jun-05 链接: PubMed

摘要

The rs738409 C>G polymorphism in the patatin-like phospholipase domain-containing protein 3 gene (PNPLA3 I148M variant) contributes to the largest fraction of metabolic dysfunction-associated steatotic liver disease (MASLD) heritability. However, its prognostic impact on long-term clinical outcomes related to MASLD remains incompletely characterized. We performed a meta-analysis of observational studies to quantify the impact of PNPLA3 polymorphisms on the risk of developing hepatic and extrahepatic outcomes in MASLD. We systematically searched PubMed, Scopus, and Cochrane Central for observational studies evaluating PNPLA3 polymorphisms and clinical outcomes in MASLD. Primary outcome was liver-related events(LRE); secondary outcomes included new-onset hepatocellular carcinoma (HCC), liver-related mortality, cardiovascular events, extrahepatic cancers, and all-cause mortality. We compared homozygous risk-allele carriers (GG) and heterozygous carriers (CG) with wild-type homozygous (CC) individuals using random-effects genotypic models. The study was registered on PROSPERO (CRD#420251176886). Twenty-one observational longitudinal studies, including 232,033 adult individuals with MASLD (median follow-up: 7.2 years), were analysed. Individuals with the GG genotype had significantly higher risks of incident LRE(hazard ratio[HR] 2.87, 95%CI 1.92-4.27) and HCC(HR 2.54, 95%CI 1.86-3.47) compared with the CC genotype. CG carriers also had an increased risk of LRE(HR 1.57, 95%CI 1.12-2.19), but not of HCC. PNPLA3 genotypes did not affect the risk of major cardiovascular events, extrahepatic cancers, or all-cause mortality. PNPLA3 I148M polymorphism confers dose-dependent increases in LRE and HCC risk in MASLD, with liver-specific rather than systemic effects. These findings suggest that PNPLA3 genotyping may inform risk stratification strategies in MASLD, particularly for identifying individuals at higher risk of liver-related events and HCC who might benefit from closer monitoring.

40. The human cost of resistance: Ethical implications of coping with isolation for multi-drug resistant organisms.

期刊: Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases 发表日期: 2026-Jun-05 链接: PubMed

摘要

Isolation of individuals colonized or infected with multidrug-resistant organisms (MDROs) is an established strategy to prevent transmission in healthcare settings. While protective measures such as single-room placement and use of personal protective equipment are designed to safeguard vulnerable patients, growing evidence suggests that community transmission contributes substantially to the spread of certain MDROs, raising questions about the proportionality and necessity of routine isolation. At the same time, isolation has been associated with adverse effects, including reduced quality of clinical care, delays in treatment, and psychological and social burdens that may negatively influence recovery. These observations yield ethical tension between ensuring patient and public safety and respecting the autonomy and wellbeing of isolated individuals. This narrative review synthesizes current clinical evidence and ethical debate surrounding MDRO-related isolation practices. We examine outcomes associated with isolation, discuss ethical implications and potential alternatives, and propose an integrative epistemic-ethical perspective that combines empirical data with normative analysis. Our findings highlight the need for transparent, proportionate, and evidence-based decision-making supported by interdisciplinary dialogue. Moving toward a more balanced and human-centered approach to infection prevention requires frameworks that mitigate harm, maintain safety, and promote compassionate, sustainable healthcare practice.

41. Hydrophilicity engineering of amphiphilic macrocyclic MRI contrast agents for enhanced hepatic targeting efficiency.

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

摘要

Effective hepatic enhancement and high kinetic inertness are pivotal driving forces for developing gadolinium-based hepatobiliary MRI contrast agents (CAs). Although lipophilic modifications have dominated efforts to promote hepatic uptake, the vital role of hydrophilicity has been overlooked. Herein, we investigated the structure-activity relationship by fine-tuning of an amphiphilic macrocyclic complex through hydrophilicity engineering. The water-soluble Gd-HE(BnOPh)-DO3A exhibited exceptional kinetic inertness with a dissociation half-life of 8.3 h at pH 1.2, nearly 5-fold longer than the 1.7 h observed for the non-hydroxyl Gd-BnOBn-DO3A. More importantly, Gd-HE(BnOPh)-DO3A achieved rapid and pronounced hepatic enhancement, with a 3.1-fold increase in signal intensity observed as early as 2 min post-injection, while the amphiphilic Gd-BnOBn-DO3A displayed delayed hepatic enhancement, peaking at 30 min. These markedly different pharmacokinetic profiles might arise from altered molecular assembly behavior. Hydroxyl incorporation in Gd-HE(BnOPh)-DO3A disrupted amphiphilic equilibrium and prevented nanoparticle self-assembly, enabling rapid hepatic enhancement in the form of small molecules. Conversely, Gd-BnOBn-DO3A dynamically formed nanoparticles with hydrodynamic size over 200 nm, leading to slower hepatic uptake. In summary, this work established strategic hydrophilicity engineering as an effective, previously underappreciated approach to optimizing hepatic targeting of CAs, offering unique insights into MRI agent design.

42. A decision-oriented framework for genomic testing across the prostate cancer continuum.

期刊: Cancer genetics 发表日期: 2026-Jun-04 链接: PubMed

摘要

Genomic testing is now embedded in contemporary prostate cancer care, yet the clinical meaning of different genomic platforms varies substantially by disease state and clinical context. In localized disease, tissue-based genomic classifiers primarily serve prognostic functions by refining risk estimates beyond clinicopathologic variables, whereas in advanced disease, germline and somatic testing identify predictive biomarkers linked to therapy selection. This distinction is clinically consequential because the supporting evidence, endpoints, and implementation challenges differ across assays and across points on the disease continuum. In this review, we position tissue-based assays, germline testing, somatic sequencing, circulating tumor DNA (ctDNA), and artificial intelligence-enabled biomarkers within a unified clinical framework spanning localized disease, biochemical recurrence, and metastatic progression. We critically compare commercially available genomic assays with respect to methodology, specimen type, intended use, validation cohorts, and clinically relevant outcomes. We distinguish prognostic classifiers from predictive biomarkers such as homologous recombination repair deficiency and mismatch repair deficiency, and we evaluate emerging approaches, including liquid biopsy, multimodal integration with imaging, and digital pathology-based algorithms. We further address implementation barriers that may limit real-world impact, including reimbursement uncertainty, disparities in access to next-generation sequencing, limited provider familiarity with genomic interpretation, and the need for patient-centered communication and navigation in genomics-informed care. A clinically useful framework for prostate cancer genomics must therefore move beyond cataloging tests and instead clarify when genomic results change management, where evidence remains immature, and how implementation strategies can improve equity and actionability.

43. A comprehensive review of emerging frontiers in starch biomacromolecules for targeted drug delivery, precision nutrition, and sustainability.

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

摘要

Starch is one of the biopolymers gaining renewed attention for its versatility and sustainability to enable applications in personalized nutrition, targeted drug delivery, and environmental technologies. Starch complexes, a naturally occurring biopolymer, are an ideal substrate for next-generation functional systems due to their intrinsic biodegradability, adjustable physicochemical characteristics, and compatibility with other biopolymers. Accordingly, this review focuses on the current advancements in modifying the structure and functional aspects of starch, highlighting the importance of molecular structure alteration in improving performance in biological systems. Furthermore, in the context of personalized nutrition, this study highlights how starch-based macromolecules can effectively modulate nutrient availability, achieve controlled release, and enable tailored dietary solutions aligned with individual metabolic profiles. Also, the review sheds light on the emerging role played by starch biomacromolecules in targeted drug delivery, where the components demonstrate promising outcomes in encapsulation efficiency, enzyme-responsive release, and site-specific delivery. Moreover, green synthesis methods, biodegradability, and low-impact production techniques have made starch a sustainable substitute for synthetic polymers, especially in the packaging sector, where it serves as a sustainable material capable of forming films that have the potential to replace conventional plastics with reduced ecological impacts. Finally, the current review outlines the existing challenges, safety considerations, regulatory perspectives, and future directions needed to translate starch-based biomaterials into clinically and industrially viable solutions. Therefore, this work offers a comprehensive recap of starch’s potential in medical, environmental, and health applications, which is eventually beneficial for the public domain.

44. Does implementing strengths-based approaches improve adult social care outcomes in England? An econometric analysis of the Care Act 2014.

期刊: Health policy (Amsterdam, Netherlands) 发表日期: 2026-Jun-03 链接: PubMed

摘要

Population ageing and strained healthcare budgets are making adult social care a pressing global challenge. In England, the Care Act 2014 reformed provision of social care by encouraging strengths-based approaches-which emphasize individual and community assets over deficits (i.e., weaknesses, limitations, needs, or problems). Subsequent commissioning and integration initiatives diversified practice, yet quantitative evidence on outcomes remains scarce. To estimate the effect of the 2014 Care Acton adult social care outcomes across local authorities in England. Partial proportional odds regression models were estimated on repeated cross-section survey data from 2010 to 2019 on a large representative sample of adult social care outcome recipients in England (n = 1659,564). Six dependent variables capturing service effectiveness and recipients’ experience with social care services, and several controls including age, sex, subjective health status, and region fixed effects, were considered. Estimates indicated that the reform led to improvements in recipients’ perceived quality of life, safety, and control over daily activities. Other dimensions, particularly satisfaction with the care and support services received, also improved but to a lesser degree and showing lagged effects. Distributional effects were observed, where the positive mean changes in service effectiveness and recipients’ experience were mostly driven by improvements at the lower end of the outcome spectrum. Reforms incorporating strengths-based approaches can improve recipients’ reported outcomes and therefore alleviate the significant human and economic burden of adult social care. Future research should expand on this study and ultimately improve decision-making and outcomes for care recipients and providers.

45. Soil microbial functional recovery and community resilience driven by biogenic magnetite nanoparticles under carbendazim stress.

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

摘要

The persistence of fungicides in agricultural soils poses a major threat to soil health, as these compounds disrupt microbial communities and compromise key ecosystem functions. Carbendazim, a commonly used systemic fungicide, is known for its ability to inhibit microbial activity and nutrient cycling. This study assessed the capacity of biogenic magnetite nanoparticles to mitigate carbendazim-induced disturbance and facilitate the recovery of soil microbial function. Citrate-stabilized magnetite nanoparticles were applied to an agricultural Andisol intentionally contaminated with carbendazim (10 mg kg⁻¹) under controlled microcosm conditions. Soil enzyme activities related to carbon, nitrogen, and phosphorus cycling (β-glucosidase, urease, acid phosphatase), microbial gene abundances (16S rRNA, amoA, amoB copy number), community structure, and pesticide dissipation kinetics were measured for a 30-day period. Magnetite nanoparticles significantly accelerated carbendazim dissipation, reducing their half-life by approximately 50% compared to pesticide-only treatments. Nanoparticle application partially mitigated the inhibitory effects of carbendazim on soil enzymes. It showed trends towards the recovery of bacterial and nitrifier abundances, with community composition and diversity patterns aligning more closely with those of untreated soils. Co-occurrence network and multivariate analyses of the soil bacterial community, assessed through 16S rRNA amplicon sequencing, revealed patterns indicative of a partial restoration of bacterial interaction structure, with Carb/FeNPs-EC treatments showing increased network connectivity and modularity compared to carbendazim-only soils, approaching the interaction patterns characteristic of undisturbed bacterial assemblages. These findings offer preliminary evidence that biogenic magnetite nanoparticles may reduce pesticide pressure in agricultural soils while supporting microbial functional trends indicative of recovery. The use of onion peel waste as an eco-friendly precursor further highlights the circular potential of this approach. Onion peel is a widely generated agro-industrial by-product particularly rich in polyphenolic compounds, especially quercetin and its derivatives, which act as natural reducing and stabilizing agents during nanoparticle biosynthesis, eliminating the need for toxic chemical reagents and contributing to a lower environmental footprint. This dual role as both a waste valorization strategy and a source of bioactive capping agents warrants further evaluation of this approach as a sustainable soil amendment strategy.

46. Role of Artificial Intelligence in Cleft Lip and/or Cleft Palate in Diagnosis and Detection-An Umbrella Review.

期刊: Clinical and experimental dental research 发表日期: 2026-Jun 链接: PubMed

摘要

Early diagnosis and treatment are essential in managing congenital cleft conditions. Use of artificial intelligence (AI) in routine diagnosis can substantially improve management of chronic conditions; however, in the context of CL/P, evidence remains fragmented. Thus, an umbrella review was planned to explore the applications of AI-based diagnostic systems in managing orofacial clefts. Priori protocol was registered with PROSPERO. Five electronic databases were thoroughly searched (PubMed/MEDLINE, Scopus, Embase, Google Scholar, ScienceDirect), based on the pre-defined PICO framework. The data extraction form was designed in accordance with the Joanna Briggs Institute (JBI) guidelines and analyzed. Results were presented in the form of tables, supported by narrative summaries. Overlap assessment was conducted to avoid overemphasis and duplication of the overall results. Methodological robustness of the included studies was assessed using AMSTAR 2.0 tool. Of 395 initially retrieved articles, only three systematic reviews were included for this study. Overlap assessment indicated a high percentage of overlap among studies, with the corrected covered area to be 13.89%. Overall analysis revealed that AI models-DCNN (97% to 96%), RF (99% to 96%), and SVM (94% to 93%) demonstrated high accuracy in diagnosing orofacial clefts. Deep learning models were extensively used in diagnosing and predicting the orofacial cleft with accuracies across models ranging over 90%. Machine learning models also demonstrated good performance in identifying genetic risk. However, the lowest accuracies were demonstrated by the DesNet model (nearly 73% accuracy). Also, methodological robustness indicated a moderate level of confidence, suggesting limitations in the generalizability of the findings. Findings present the potential of AI models in diagnosing and detecting orofacial clefts. AI models can support the early diagnosis of orofacial clefts; however, this study highlights the need for more comprehensive research to determine how different AI models can improve early diagnosis and treatment outcomes. PROSPERO Registration Number: CRD420251125934.

47. Implementing multidomain non-pharmaceutical interventions for preventing cognitive decline in community-dwelling older adults in China: An embedded mixed-methods implementation study of determinants and strategies.

期刊: Alzheimer’s & dementia : the journal of the Alzheimer’s Association 发表日期: 2026-Jun 链接: PubMed

摘要

The WW-FINGERS network has demonstrated the efficacy of multidomain non-pharmaceutical interventions (NPIs) but left their real-world implementation largely unexplored, prompting this study in Changxing County to identify key determinants and develop actionable strategies for community-based delivery. An embedded mixed-methods retrospective evaluation using the Consolidated Framework for Implementation Research (CFIR) was conducted. Data from 42 stakeholders across six communities were analyzed via a hybrid deductive-inductive approach and coincidence analysis (CNA). Strategies were matched using the ERIC compendium and refined by a stakeholder panel. We identified 202 determinants, revealing six core facilitator themes (e.g., policy-academia-community synergy) and six barrier themes(e.g., unsustainable funding). CNA delineated potential pathways. Three strategy bundles were finalized: Capacity Building, Collaborative Network Building, and an AI-enabled digital platform. This study provides a practical, theory-informed framework for implementing complex NPIs, bridging the science-to-practice gap in dementia prevention. The AI-enabled platform offers a forward-looking approach for sustained delivery.

48. From Root Cause Analysis to Systems Thinking: A Comparative Content Analysis of Patient Safety Incident Investigation Reports in Mental Healthcare.

期刊: Journal of evaluation in clinical practice 发表日期: 2026-Jun 链接: PubMed

摘要

The National Health Service, UK, has recently implemented a new patient safety strategy, replacing root cause analysis (RCA) incident investigation with systems-based approaches. It is unknown if this change will optimise learning and improve care outcomes. We aimed to analyse safety recommendations/actions/improvements/solutions from comprehensive incident investigations by comparing those that adopted root cause analysis with systems-based approaches. The evaluation adopted a sequential multi methods design. Reports were extracted between January 2022 and January 2023. The quality of the incident investigation was graded using a validated tool (Learning Response Review and Improvement Tool). Investigation identified solution types were organised using qualitative content analysis, adopting inductive and deductive orientations. These were then classified into system factors and the effectiveness of the solution scored. Descriptive statistics were computed to investigate differences between incident investigation type. Grading the quality of reports demonstrated that the expectations set out within the change in safety strategy were mostly being realised in practice. A total of 135 solutions were extracted from systems-based and 57 from RCA reports, where the type of solutions identified were similar between each investigation approach. Organisational system factors were the most frequent for systems-based whilst task system-work factors were most frequent for RCA reports. For both investigation types, most of these solutions were deemed to fall in the least effective category: administrative controls. The evaluation provides important insights into how the shift to systems-based investigations are shaping the quality of investigations and the recommendations that aim to prevent a recurrence of harm. Changing from RCA to systems-based investigations led to more patient/carer/family involvement and systems-focussed solutions, however weaker administrative recommendations remained prominent. Policy, practice and research need to ensure that the change in conceptual thinking and investigative orientation also contributes to improvements in learning and the development of stronger controls or barriers that prevent harm.

49. Intraindividual cognitive variability predicts amyloid beta, tau PET, and dementia conversion in Down syndrome: a potential marker of cognitive resilience.

期刊: Alzheimer’s & dementia : the journal of the Alzheimer’s Association 发表日期: 2026-Jun 链接: PubMed

摘要

Adults with Down syndrome (DS) are at risk for Alzheimer’s disease (AD), yet identifying the preclinical phase remains challenging. Intraindividual cognitive variability (IICV) may be a sensitive marker of early AD-related changes but remains understudied in DS. Adults from the Alzheimer’s Biomarker Consortium-DS (ABC-DS) study (N = 460, mean age 43.3 years; 45.7% female) were included. Generalized linear models examined whether baseline IICV predicted incident mild cognitive impairment (MCI)/dementia, cognitive decline, and amyloid and tau positron emission tomography outcomes, adjusting for demographics, intellectual disability, apolipoprotein E ε4, site, assessment interval, and mean cognitive performance, with Bonferroni correction. Greater IICV predicted incident MCI/dementia (odds ratio = 4.63 to 5.13, p < 0.05), greater amyloid burden, early tau accumulation, and higher tau across Braak stages, independent of mean cognition. Exploratory analyses suggested sex-specific interactions with tau outcomes. IICV is a sensitive marker of dementia risk and cognitive resilience in DS, with potential utility for secondary prevention and trial enrichment.

50. Association between Plasma Uric Acid level and Mortality Rate in Children with Sepsis and Acute Kidney Injury.

期刊: Urology journal 发表日期: 2026-May-24 链接: PubMed

摘要

Acute kidney injury is a common disease in hospitalized patients, which can have a significant impact on outcomes, including an increase in overall complications and mortality rates, criteria such as serum creatinine level, urinary output, And scoring systems such as KDIGO in acute conditions do not have acceptable specificity and sensitivity to evaluate the kidney function of people; Therefore, this study was conducted with the aim of determining the relationship between plasma uric acid level and mortality rate in patients with sepsis and acute kidney failure. In this descriptive-analytical (cross-sectional) study   included 52 children , with the age range of one month to 15 years with sepsis (based on qSOFA criteria) and acute kidney failure (based on serum creatinine level) PICU of Ali Bin Abi Taleb Hospital from October 1401 to October 1402 were admitted and hospitalized, they were studied by census method. Within 48 hours after the admission of patients to the ICU, blood samples should be collected to check serum uric acid levels, electrolytes, albumin, complete blood count (CBC), kidney function tests, arterial blood gases, and chest x-rays. All patients were followed up until discharge or death due to progression of kidney failure. Finally, the findings of the research were analyzed using SPSS version 26 statistical software. The mean age of patients was 3.66±4.92.The expired number in the hyperuricemia group was significantly higher than in the normal uric acid group (p-value = 0.03), an odds ratio of 3.45 indicates that a high level of uric acid is a risk factor for death. In this study, the duration of hospitalization was longer in those who survived (p-value = 0.02). A particularly strong predictor in our analysis was the QSOFA score (p < 0.001), highlighting its critical role in outcome alive or dead. Serum uric acid level and QSOFA scale showed no significant difference, in totally (p-value = 0.76), subgroup analysis from alive and death patients between uric acid and the QSOFA scale presented the same result (p-value = 0.203, p-value = 0.29, respectively) Conclusion: Finally, it can be stated that the level of uric acid can be considered as a laboratory variable to predict the prognosis of patients.

51. A cohort study of forced vital capacity, airway obstruction, and survival in the multinational Burden of Obstructive Lung Disease study.

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

摘要

In the USA, higher forced vital capacity (FVC) is linked with longer survival, and FVC is associated with survival independently of ethnicity. The implications for the low FVC values in parts of Asia and Africa are unknown. We used data from 16 sites of the multinational Burden of Obstructive Lung Disease (BOLD) study that completed follow-up of participants between 2019 and 2021 and reported at least five deaths between baseline and follow-up. We assessed the association of mortality with FVC and Forced Expiratory Volume in 1 second (FEV1)/FVC ratio within each site using Cox proportional hazards models. These models were adjusted for age, smoking, height, and weight. Effect estimates from all sites were combined using meta-analysis. Systematic regional differences were investigated. Of 9927 study participants with follow-up data, 1120 (11.3%) had died [mean follow-up = 8.7 years, standard deviation (SD) = 3.3 years]. Baseline post-bronchodilator FVC and FEV1/FVC were inversely associated with mortality. When both FVC and FEV1/FVC were mutually adjusted for each other, the decreased mortality rates were more pronounced for each SD higher FVC at baseline [44% (95% confidence interval (CI): 25%, 58%) for men and 28% (95% CI: 11%, 41%) for women] than for FEV1/FVC at baseline [14% (95% CI: 8%, 20%) for men and 7% (95% CI: -10%, 21%) for women]. The probability of true regional differences was low. People with a higher FVC adjusted for age, sex, and height have a longer survival. Regional adjustments to lung function standards are inappropriate when assessing prognosis.

52. Data Resource Profile Update: The Dutch National Intensive Care Evaluation (NICE) registry.

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

摘要

53. Neuropsychopharmacological effects of Aronia melanocarpa: A narrative review.

期刊: Psychiatria Danubina 发表日期: 2026-Apr 链接: PubMed

摘要

This narrative review examines the neuropsychopharmacological effects of Aronia melanocarpa (black chokeberry), focusing on its potential in the prevention and treatment of neuropsychiatric disorders such as anxiety, depression, and cognitive decline. A comprehensive literature search across Web of Science, Scopus, and Google Scholar identified 29 original studies, based on in vitro, animal, and human research. Findings demonstrated that Aronia melanocarpa, rich in polyphenols like anthocyanins and proanthocyanidins, exerts cognitive-enhancing, anxiolytic-like, and antidepressant-like effects. These outcomes are mediated by mechanisms involving antioxidant activity, modulation of neurotransmitter systems, inhibition of monoamine oxidases, reduction of neuroinflammation, modulation of gut microbiota, and upregulation of brain-derived neurotrophic factor (BDNF). Animal models of Alzheimer’s disease and stress-induced disorders, along with human clinical trials, corroborated these effects. The review underscores the therapeutic promise of Aronia melanocarpa nutraceuticals in neuropsychiatric health and highlights the need for further clinical validation.

54. The effects of social isolation measures due to the COVID-19 pandemic on education perception, anxiety, sleep, and physical activity in healthcare students.

期刊: Psychiatria Danubina 发表日期: 2026-Apr 链接: PubMed

摘要

The novel coronavirus disease (COVID-19) emerged at the end of 2019 and has since affected Türkiye as well as the rest of the World. The main purpose of this study is to examine the effects of social isolation measures during the COVID-19 epidemic on education perceptions, anxiety levels, sleep quality, and physical activity levels of healthcare students, as well as the relationship between anxiety with sleep quality and physical activity level. The cross-sectional and descriptive study was conducted between May and June 2020. The sample consisted of 457 physiotherapy, nursing, and occupational therapy students aged 18-41. Before to starting the survey, electronic consent was obtained from all participants. The data were collected through the Google Forms web survey platform using the convenience sampling method. The demographic information form, Beck Anxiety Inventory, Pittsburgh Sleep Quality Inventory, and Rapid Assessment of Physical Activity were used to collect data. The data were analyzed using the Statistical Package for Social Sciences (SPSS) for Windows 22 (IBM SPSS Inc., Chicago, IL) at a significance level of 0.05. The majority of students expressed concerns regarding the insufficiency of distance education (82.5%). Over half (53.39%) of the study participants reported experiencing mild, moderate, and severe anxiety. In addition, students exhibited poor sleep quality (67.5%) and low levels of physical activity (61.1%). A statistically significant positive correlation was found between the total scores of the Beck Anxiety Inventory and the Pittsburgh Sleep Quality Index (r = 0.425, p < 0.001). Healthcare students were concerned about distance education during the first wave of the pandemic. Universities should provide all students with guidance on mental health and encourage them to perform more physical activity. Moreover, different methods and techniques should be developed for applied science during distance education.

55. Epidemiology and risk factors of colorectal polyp detection: a regional, single-center retrospective study.

期刊: Annals of Saudi medicine 发表日期: 2026 链接: PubMed

摘要

Colorectal polyps are the most important precursor lesions of colorectal cancer. Their epidemiological characteristics and risk factors exhibit substantial regional and population-based variations. Qinghai Province, located on the Qinghai-Tibet Plateau in China, is characterized by a unique hypoxic environment and a multi-ethnic population. However, large-scale epidemiological data on colorectal polyps in this region is limited. To characterize the detection rate, temporal trends, demographic distribution, and risk factors for colorectal polyps in Qinghai Province. Retrospective study. A single tertiary medical center in Qinghai Province, China. We enrolled 33059 patients who underwent colonoscopy at Qinghai University Affiliated Hospital (2021-2025). Data on demographics and endoscopic findings were collected. Temporal trends were analyzed using the linear-by-linear association LLA test, and independent risk factors were identified by binary logistic regression. Colorectal polyp detection rate and risk factors. 33059 patients. The overall colorectal polyp detection rate was 31.82% (10519/33059), with a slight upward trend over the study period. Rates were significantly higher in males (39.01%) than females (24.04%) and increased sharply with age. Multivariable analysis identified male sex (OR=2.493, 95 %CI:2.106-2.950, P<.001), age 41-64 years (OR=2.535, 95% CI:2.056-3.125, P<.001), and age ≥65 years (OR=4.379, 95% CI:3.328-5.761, P<.001) as independent risk factors. Tibetan and Hui ethnicities were associated with lower risk compared with Han (OR=0.611, 95% CI:0.448-0.833, P=.002). Colorectal polyp detection is high and rising in Qinghai. Male sex and advanced age are major risk factors. Notably, Tibetan or Hui ethnicity appear as potential protective factors, offering new insights into genetic interactions that may inform region-specific screening strategies. Single-center retrospective design, potential selection bias, lack of lifestyle and metabolic data.

56. Acute exacerbation of chronic rhinosinusitis: clinical and microbiological perspectives from a Saudi tertiary care center.

期刊: Annals of Saudi medicine 发表日期: 2026 链接: PubMed

摘要

Acute exacerbations of chronic rhinosinusitis (AECRS) are increasingly recognized as a distinct clinical entity that significantly impacts quality of life. Despite its clinical relevance, data on its prevalence, clinical characteristics, and underlying bacteriology remain limited. This study investigated the clinical features of AECRS and characterized the bacterial profile of middle meatus cultures during exacerbation episodes. Furthermore, characteristics of AECRS were compared across chronic rhinosinusitis (CRS) phenotypes. Retrospective cohort study. Single tertiary care referral center, King Saud University Medical City (KSUMC). Medical records from patients with established AECRS with positive middle meatus cultures from 2015 to 2025 were extracted. Data included demographics, CRS phenotype, comorbidities, prior treatments, microbiological findings, and clinical outcomes. Bacterial etiology and clinical characteristics of AECRS across phenotypes, including chronic rhinosinusitis with nasal polyposis, chronic rhinosinusitis without nasal polyposis, and allergic fungal rhinosinusitis. 104. The study enrolled 104 patients (mean age 39.9 years); 49 (47.1%) had asthma and 21 (20.2%) had aspirin-exacerbated respiratory disease. Endoscopic pus was present in 71 (68.3%), and 77 (74%) had prior sinus surgery. The most common isolates were methicillin-sensitive Staphylococcus aureus 35 (33%), methicillin-resistant Staphylococcus aureus 26 (25%), and Pseudomonas species 24 (23.1%). Oral antibiotics were administered in 75 (72.1%) of AECRS episodes, while oral steroids were used in 27 (26%). Clinical improvement following antibiotic therapy was documented in 64 (85.3%) cases. High resistance was observed for ampicillin, penicillin, and oxacillin. AECRS presents considerable heterogeneity in both clinical presentation and microbiology. Therefore, culture-directed therapy is recommended due to variable antibiotic resistance patterns. Asthma was strongly associated with treatment failure. These findings emphasize the importance of individualized management strategies in AECRS. Retrospective design, and single tertiary care center.