公共卫生研究摘要 (2026-06-09)

共收录 56 篇研究文章

1. Continuing Glucagon-Like Peptide-1 Receptor Agonists Into the First Trimester of Pregnancy and Pregnancy Outcomes : A Target Trial Emulation Study Using Claims Information.

期刊: Annals of internal medicine 发表日期: 2026-Jun-09 链接: PubMed

摘要

Glucagon-like peptide-1 receptor agonist (GLP-1RA) use has increased among women of reproductive age, but limited data exist on safety in pregnancy. To estimate the risk for nonlive birth, abnormal fetal growth, and major congenital malformation (MCM) with GLP-1RA dispensing in early pregnancy. In an observational cohort of pregnant women aged 16 to 55 years with a GLP-1RA dispensation in the 90 days before the last menstrual period (LMP), a target trial with 2 treatment strategies was emulated: continuation of dispensing into the first trimester (≥1 further dispensation), or noncontinuation. Merative MarketScan U.S. insurance claims data (2011 to 2024). 3572 pregnancies (41.1% [n = 1467] among women with type 2 diabetes). Risk for nonlive birth was estimated using a weighted Kaplan-Meier estimator. Among live-birth pregnancies linked to infants, the weighted prevalence of MCM, small for gestational age (SGA), and large for gestational age (LGA) was estimated. The weighted risk for nonlive birth was 29.7% with continuation and 27.1% with noncontinuation (adjusted risk ratio, 1.09 [95% CI, 0.98 to 1.23]). Among 2529 live-birth pregnancies, 1443 (57.1%) received at least 1 GLP-1RA dispensation after LMP and 1499 (829 continuers) were linked to an infant. Weighted prevalence ratios for continuation versus noncontinuation were 1.29 (CI, 0.82 to 2.06) for SGA, 1.08 (CI, 0.84 to 1.40) for LGA, and 1.21 (CI, 0.83 to 1.82) for MCM. Potential residual confounding by prior glycemic control. Risks for nonlive birth, SGA, LGA, and MCM were not definitively higher with continuation of GLP-1RAs into early pregnancy. However, estimates for MCM and SGA were imprecise and were compatible with both no increased risk and clinically relevant differences in risk. National Institutes of Health.

2. Estimating the Effect of Hospital Admission on Health Care Outcomes and Spending Among Persons With Dementia : A Quasi-experimental Study.

期刊: Annals of internal medicine 发表日期: 2026-Jun-09 链接: PubMed

摘要

Because transitions in care settings can be confusing for persons with dementia (PWD), hospital admissions can negatively affect their physical and cognitive function. However, the effect of hospital admissions on patient outcomes and health care spending remains largely unknown. To estimate the effects of hospital admissions on health outcomes and health care spending among PWD. Quasi-experimental instrumental variable method, using emergency physicians’ admission propensity as the instrument. United States. Medicare fee-for-service beneficiaries aged 66 years or older with dementia who visited an emergency department (ED) in 2017 to 2019. Death, inpatient days (excluding the index hospital admission), and health care spending (excluding the index ED visit and hospital admission) within 30 and 90 days of ED visits. Among 872 085 ED visits (62.9% women; mean age, 83.1 years) included in the analysis, 482 208 (55.3%) resulted in hospital admission. There was no evidence that hospital admission was associated with 30-day mortality rate (adjusted risk difference, -2.6 percentage points [pp] [95% CI, -5.2 to 0.1 pp]) or inpatient days (adjusted difference, 0.1 days [CI, -0.2 to 0.5 days]). Hospital admission was associated with higher 30-day health care spending (adjusted difference, $2547 [CI, $1390 to $3703]). Patterns were similar for 90-day outcomes. Residual confounding. Among Medicare beneficiaries with dementia who visited an ED, there was no evidence that hospital admission was associated with mortality rates. Under conventional statistical criteria, an effect of hospital admissions between a 5.2-pp decrease and a 0.1-pp increase in 30-day mortality rates was highly compatible with the data. On the contrary, hospital admission was associated with higher health care spending. None.

3. Hypertension.

期刊: Annals of internal medicine 发表日期: 2026-Jun-09 链接: PubMed

摘要

Updated U.S. and international hypertension guidelines reflect new studies and analyses that support changes in hypertension management. The 2025 U.S. guideline for prevention, detection, evaluation, and management of high blood pressure (BP) recommends lower BP targets, greater use of out-of-office BP for diagnosis and medication titration, and a different approach to severe hypertension presenting without acute or evolving cardiovascular disease symptoms or signs. New treatments for resistant hypertension are recommended. Trial evidence supports benefit from tighter BP control to prevent mild cognitive impairment and dementia, further emphasizing the importance of lower BP goals.

4. Review Topic: Don't Cancer Doctors Offer Good-Quality Care?

期刊: JCO oncology practice 发表日期: 2026-Jun-08 链接: PubMed

摘要

We offer the perspectives of two veterans on the last quarter century of quality improvement efforts in oncology care. We believe that our colleagues deliver high quality care, but challenges remain in demonstrating this assertion to patients, payers, policy makers and to our colleagues. The journey began with the American College of Surgeons (ACOS) establishing minimum standards for cancer surgery in 1919 and evolved through state cancer registries, culminating in the Surveillance, Epidemiology, and End Results (SEER) program. Donabedian’s structure-process-outcome framework and Porter’s value equation provided conceptual frameworks for action. ASCO developed the Quality Oncology Practice Initiative (QOPI) in 2002. Physician-led self-assessment and chart abstraction could drive improvement. QOPI expanded to include certification programs and safety standards. Integrating quality measurement and improvement with payment incentives has proven challenging. Medicare’s successive payment reform attempts-from Resource-Based Relative Value (RBRVS) through the Oncology Care Model (OCM) to the Enhancing Oncology Model-have shown mixed results, with minimal to no improvements in quality measures and limited cost-savings. Private payer initiatives based on clinical pathways largely failed to reduce costs and have been scaled back. Contemporary challenges include vertical integration of health care systems without clear quality benefits, rising drug costs, physician burnout, and erosion of public trust. New tools and iterations offer hope: artificial intelligence (AI)-powered clinical documentation and analysis could dramatically reduce administrative burdens, cross-platform electronic record sharing should enable longitudinal quality analysis, and restoration of patient agency through market forces and social media may better align quality incentives. We posit that better future results require returning to bottom-up, physician-led quality improvement while leveraging AI and data-sharing technologies to make quality measurement a natural component of cancer care rather than an externally imposed burden.

5. Cannabis Effects on Neurocognition and HIV-Related Outcomes: Protocol for a Longitudinal Observational Cohort Study.

期刊: JMIR research protocols 发表日期: 2026-Jun-08 链接: PubMed

摘要

Heavy cannabis use may impact neurocognitive functions, particularly prefrontal and limbic systems responsible for risk/reward processing and executive function, which are essential for certain health behaviors, such as HIV prevention. Rigorous research into the effects of cannabis on neurocognitive functions remains limited, particularly among populations with a high burden of HIV. This study aims to (1) evaluate associations between cannabis use and neurocognition, (2) evaluate associations between cannabis use and engagement in HIV status-neutral care outcomes (eg, pre-exposure prophylaxis persistence, viral suppression), and (3) assess whether cannabis use motivations modify associations between cannabis use and engagement in HIV status-neutral care outcomes. This longitudinal cohort study is enrolling a community-based sample of individuals aged 16 to 29 years residing in Chicago using multiple recruitment strategies. Participants complete 3 in-person assessments annually over 2 years that include (1) computer-assisted questionnaires, (2) neurocognitive assessments (functional magnetic resonance imaging, executive function tasks), and (3) biospecimen collection. Triangulation approaches combine objective and self-reported measures. The Frontal Lobe Outcomes and Well-Being (FLOW) Study was funded by the National Institutes of Health in April 2023, with data collection commencing in October 2023. As of April 2026, 148 participants have been enrolled and completed baseline assessments, with 63 participants completing their first follow-up appointment and 4 participants completing their second follow-up appointment. Following a temporary administrative pause from March to August 2025 and subsequent federal review confirming regulatory compliance, the study resumed operations in July 2025. Recruitment is currently ongoing, with data collection expected to continue through June 2027. Preliminary analyses are pending completion of longitudinal data collection. This study addresses critical knowledge gaps by examining potential associations between cannabis use, neurocognition, and HIV. While geographic specificity, structural barriers, measurement challenges, and sample size constraints present some limitations, our methodological approaches-including longitudinal design, triangulation of both objective and self-reported measures, and rigorous neurocognitive assessments-strengthen the investigation. Findings will advance understanding of how cannabis use impacts neurocognition and HIV-related health behaviors, potentially informing targeted interventions that address both substance use and HIV transmission.

6. Objectively Measured Individual-Level Daytime Versus Nighttime Light Exposure and Cardiovascular Disease Mortality in U.S. Adults.

期刊: European journal of preventive cardiology 发表日期: 2026-Jun-08 链接: PubMed

摘要

As the primary circadian entrainer, light may affect cardiovascular health through circadian disruption or enhancement, depending on its timing. Epidemiologic studies on the associations of daytime and nighttime light exposures with cardiovascular disease (CVD) risk are limited and have examined these exposures separately, yielding contradictory findings. We aimed to examine the association between the distinction between daytime and nighttime light exposure and CVD mortality risk. This population-based retrospective cohort study included 7,607 adults from the U.S. National Health and Nutrition Examination Survey (2011-2014) who wore an accelerometer with a light sensor for a week. CVD mortality data were obtained through linkage to the National Death Index until 2019. We estimated differences in time between daytime light exposure above 1000 lux versus nighttime light exposure above 1 lux. We used Cox models to estimate hazard ratios (HRs) for CVD mortality, adjusting for physical activity, sleep duration, chronotype, serum 25(OH)D, and other covariates. The study population (46.8% male, 67.9% non-Hispanic White) had a baseline mean age of 49.4 years (SE, 0.4). Over a median follow-up of 6.8 years, 233 CVD deaths occurred. Greater differences in daytime versus nighttime light exposure were associated with a lower CVD mortality risk in a linear dose-response pattern (per 1-hour increment: HR, 0.88 [95% CI, 0.78-0.98]; Pnonlinearity=0.92). The association showed no evidence of heterogeneity by age or sex. Greater distinctions between daytime and nighttime light exposure were associated with lower cardiovascular disease mortality among U.S. adults. In a nationally representative study of U.S. adults, greater contrast between daytime and nighttime light exposure was associated with a lower risk of cardiovascular disease mortality.Each additional hour of “bright daytime” exposure (≥1000 lux) relative to “light at night” exposure (≥1 lux) was associated with an approximately 12% lower risk of cardiovascular disease mortality.This association remained statistically significant after accounting for key lifestyle factors (including physical activity and sleep) and chronic health conditions, did not vary by age or sex, and showed an approximately linear dose–response relationship.

7. Upstream nurse-community partnership strategies to improve social determinants of health: A scoping review.

期刊: Nursing outlook 发表日期: 2026-Jun-08 链接: PubMed

摘要

Nurses are vital in improving the social determinants of health (SDOH) through community partnerships. While individual-level SDOH interventions are well studied, less is known about nursing strategies that support systemic, community-based change. To examine the scope, characteristics, and gaps in the literature on nurse-community partnership strategies to address SDOH. A scoping review was conducted using PubMed, CINAHL, Scopus, Academic Search Premier, and SocINDEX. The search identified 20 records describing nursing strategies implemented with community partners to address SDOH in community or population health practice settings. Nurse-community partnership strategies addressed multiple, intersecting SDOH domains, including economic stability, education, healthcare access, social and community context, neighborhood and built environment, and planetary conditions. Strategies included community-level services, co-design, shared governance, coalition-building, culturally responsive health promotion, systems redesign, and policy advocacy. Nurses leveraged trust-building, relational practice, multisector collaboration, and community-defined priorities to strengthen SDOH-related efforts. However, the literature primarily documented short-term or intermediate outcomes, with limited empirical evaluation of long-term, structural, or sustained impacts. Findings underscore the need to integrate partnership-building, policy advocacy, systems thinking, and upstream practice competencies into nursing education and role expectations, and to expand organizational and policy support for nurse-led, community-engaged SDOH initiatives. Nurse-community partnerships are a promising strategy for advancing health equity by addressing both immediate community needs and upstream social determinants of health. Future research should evaluate the structural impact, durability, sustainability, and enabling organizational conditions of these partnerships over time.

8. Spousal Bereavement and Mental Health Among Japanese Older Adults.

期刊: Research on aging 发表日期: 2026-Jun-08 链接: PubMed

摘要

Spousal loss is a major life event with profound mental health implications. Despite abundant research on the psychological well-being of widows, most studies rely on post-bereavement data, risking recall bias. Therefore, this study analysed data from the National Survey of the Japanese Elderly to enhance our understanding of the bereavement process. We observed the levels and trajectories of depressive symptoms before, during, and after spousal loss using the first seven waves of the survey from 1987 to 2006. The results showed a modest increase in symptoms prior to loss and a significant spike at bereavement, with no subsequent decline. Participants’ age at loss moderated recovery, with later life bereavement being associated with quicker adjustment. These findings highlight the need to address mental health deterioration in later life and indicate age-related resilience with increasing age globally.

9. Artificial Intelligence Governance in Health Systems: Systematic Review of Frameworks and Integrative Model Proposal.

期刊: Journal of medical Internet research 发表日期: 2026-Jun-08 链接: PubMed

摘要

Several artificial intelligence (AI) governance frameworks have emerged to help health systems (HS) address AI-related risks. However, most fail to capture the multidimensional and evolving nature of real-world governance. This systematic review aimed to synthesize existing AI governance frameworks for HS and to propose an integrative AI governance model identifying key components to guide AI-related policy, practice, and research in HS. A comprehensive search was conducted in 8 academic databases (PubMed, MEDLINE, Embase, ACM Digital Library, Web of Science, Scopus, Social Sciences Abstracts, and PsycINFO), gray literature databases, and international organization web portals in October 2024 (updates: July 2025 and March 2026) and limited to studies published from November 2014 to March 2026 in English, French, Spanish, or Portuguese. Eligible documents included peer-reviewed articles and reports proposing AI governance frameworks for HS. Two reviewers independently selected the frameworks, assessed their quality using the Appraisal of Guidelines for Research and Evaluation for Health Systems, and extracted data. Results were synthesized using thematic analysis. The research retrieved 10,175 records, among which 19 AI governance frameworks were identified. Most were published between 2022 and 2024 (n=13, 68%), half (n=10, 53%) were developed by authors based in North America, and only one-third (n=6, 32%) were derived from primary studies. The frameworks focused on 4 levels of AI governance: international (n=3, 16%), national (n=5, 26%), local (n=3, 16%), and organizational (n=8, 42%). All of them underline the crucial role of multidisciplinary bodies in the structure of AI governance in HS. Six key AI governance processes in HS emerged as critical: (1) need and/or problem identification (n=14, 74%), (2) data governance (n=17, 89%), (3) risk assessment and management (n=17, 89%), (4) validation and/or evaluation (n=18, 95%), (5) maintenance and monitoring (n=16, 84%), and (6) integration (n=9, 47%). Additionally, 4 pivotal relational mechanisms were identified: (1) ethical principles and/or values (n=17, 89%), (2) education and training (n=14, 74%), (3) communication (n=12, 63%), and (4) standards and regulations (n=13, 68%). Our study provides a comprehensive synthesis of existing AI governance frameworks for HS across 4 levels (local, regional, national, and international), underpinned by a quality assessment of the 19 identified frameworks. It differs from existing studies that concentrate on specific dimensions or settings by contributing an integrative AI governance model for HS comprising 2 dimensions and 4 relational mechanisms across the 4 levels, explicitly modeling their interactions. Future research should test and operationalize the proposed model to enhance its practical applicability. Strengthening the methodological rigor of AI governance frameworks will be essential for the responsible integration of AI in HS. As the framework is primarily grounded in Global North and English-language literature, validation in other contexts is warranted.

10. What Makes an Emergency Visit 'Avoidable'? A Qualitative Systematic Review of Multidisciplinary Clinician Perspectives on Acute Oncology Care Delivery.

期刊: The American journal of hospice & palliative care 发表日期: 2026-Jun-08 链接: PubMed

摘要

BackgroundEmergency department (ED) presentations by patients with cancer are increasing globally. Policy frameworks often classify these as “potentially preventable emergency department visits” (PPEDVs) using administrative coding, yet the validity of this approach is contested. No qualitative systematic review of clinician perspectives on avoidable oncology ED use currently exists.ObjectiveTo synthesise multidisciplinary clinician perspectives on avoidable ED use in oncology and identify the barriers and facilitators that must be addressed to support alternatives to emergency attendance.MethodsWe searched CINAHL, PsycINFO, PubMed, and Scopus from inception to April 2026 for qualitative studies on clinician perceptions of avoidable oncology ED use. Data from 7 included studies (n = 180 clinicians) were synthesised using a three-stage thematic synthesis approach. Quality was assessed using the CASP Qualitative Checklist and GRADE-CERQual.ResultsFour analytical constructs were identified: (1) professional risk aversion under diagnostic uncertainty makes ED escalation a rational choice; (2) fractured communication across professional silos acts as a structural driver of attendance; (3) the ED serves as an organisational proxy for inaccessible 24/7 specialist care; and (4) clinicians contest policy-based definitions of “avoidability,” particularly at the end of life.ConclusionsAvoidable ED use in oncology is primarily a product of system failures rather than clinical misuse. Reducing these visits requires concurrent investment in 24/7 specialist-led pathways, shared information infrastructure, anticipatory patient guidance, cross-specialty training, and accountable care coordination models.

11. Air quality impacts of the trade-off between renewable diesel and sustainable aviation fuels in California.

期刊: Journal of the Air & Waste Management Association (1995) 发表日期: 2026-Jun-08 链接: PubMed

摘要

Renewable diesel (RD) and sustainable aviation fuel (SAF) are lower-carbon alternatives to conventional petroleum fuels that have begun to enter the U.S. market at commercial scale, largely driven by policy. The most widely deployed forms of RD and SAF are hydrotreated lipids, produced by similar processes, using vegetable or waste oil as the feedstock. Both RD and SAF typically result in lower air pollutant emissions than their petroleum equivalents, especially particulate matter and sulfur oxides (SOx), however the quantity and location of these reductions are different. The dependence of both RD and SAF on the same pool of feedstock and production capacity means that in the near term, increased SAF production may come at the expense of RD. This study investigates the possible air quality effects of such a shift, with a focus on potential impacts in disadvantaged communities. We develop two emissions scenarios in California, for which diesel and aviation emissions are scaled to reflect policies that favor SAF or RD. The air quality associated with each emissions scenario is then simulated using a chemical transport model. Health impacts from the air quality exposure fields are estimated for three major urban areas and exposure disparities are calculated based on historical socioeconomic data. The results of this show minimal air quality and public health changes between the high SAF and high RD scenarios for the California cities analyzed in the present study because California’s current diesel emission regulations limit the potential air quality benefit from RD. This suggests that air quality considerations should not be a dominant motivation when evaluating policy-driven shifts in the relative prevalence of RD and SAF in California. Other regions using less advanced diesel engine technology may see more significant air quality tradeoffs between SAF and RD.Implications: Hydrotreated alternative fuels like renewable diesel (RD) and sustainable aviation fuel (SAF) are entering the market at large scale, drawing from a limited global pool of feedstock (vegetable oil and non-fossil waste oils) and using similar production processes. Policymakers have explored expanding SAF consumption; likely near-term approaches to this would result in a commensurate reduction in RD. This paper evaluates whether this trade-off would cause significant impacts on air quality if it were to occur in California, where a SAF-focused policy change was considered in 2024. We find no significant regional air quality impact from such a shift.

12. Meaningful voluntary work design and dual pathways for healthy aging (MVP-HA): A cross-sectional and mixed-methods study in Hong Kong.

期刊: The journals of gerontology. Series B, Psychological sciences and social sciences 发表日期: 2026-Jun-08 链接: PubMed

摘要

Volunteering supports healthy aging. However, research has largely examined its health benefits rather than how volunteer work design shapes healthy aging. This study introduces and validates the meaningful voluntary work design and dual pathways for healthy aging (MVP-HA) framework, exploring how volunteer work characteristics (VWCs) relate to subjective well-being (SWB) and cognition via two pathways: quality (role engagement) and quantity (volunteering hours) of volunteering. It also assesses whether sociodemographic factors moderate these relationships. Using an explanatory sequential mixed-methods design, cross-sectional data were collected from 457 adults aged 60+ in Hong Kong (2023-2024), in addition to seven focus groups involving 46 older adults. VWCs (e.g., skill variety, task significance, feedback, social support, and recognition) were measured using the adapted Work Design Questionnaire. Path analysis revealed that recognition (β  =  0.22, p < .001) and social support (β  =  0.14, p < .05) were positively associated with SWB, whereas VWC did not directly relate to cognition. Task significance, social support, and recognition influenced SWB via role engagement, whereas volunteering hours mediated associations between skill variety, feedback, and recognition, and cognition. Age, gender, education, and income moderated these mediating effects. Qualitative findings contextualized meaningful VWCs in late-life volunteering, including emotional task meaningfulness, prosocial vitality growth, co-productive ownership, social support, and organizational recognition. Our findings advance literature by showing that health benefits require intentional role design and vary across sociodemographic contexts. Our framework offers policy implications for optimizing the design of volunteering for healthy aging.

13. Simulated Reasoning and Self-Verification for Psychiatric Diagnosis in Generalist Large Language Models: Comparative Evaluation.

期刊: JMIR AI 发表日期: 2026-Jun-08 链接: PubMed

摘要

Large language models (LLMs) and, more recently, large reasoning models (LRMs) have rapidly garnered significant interest for application in psychiatry and behavioral health. However, recent studies have identified significant shortcomings and potential risks in the performance of LLM-based systems, complicating their application to psychiatric diagnosis. Two promising approaches to addressing these challenges and improving the efficacy of these models are simulated reasoning (SR) and self-verification (SV), in which additional “reasoning tokens” are used to guide model output, either during or after inference. We aimed to explore how the use of SR (via LRMs) and SV (via supplemental prompting) affects the psychiatric diagnostic performance of LLMs. 106 case vignettes and associated diagnoses were extracted from the DSM-5-TR (Diagnostic and Statistical Manual, Version 5, Text Revision) Clinical Cases book, with permission. Both an LLM and an LRM model were selected from the latest available model generation for each of the two vendors studied (OpenAI and Google). Two inference approaches were developed: a Basic approach that directly prompted models to provide diagnoses and a SV approach that augmented the Basic approach with additional prompts. All case vignettes were processed by the two LLMs, two LRMs, and two inference approaches, and diagnostic performance was evaluated using the sensitivity and positive predictive value (PPV). Binomial generalized linear mixed models were used to test for significant differences between the model vendors (OpenAI, Google), type (LLM, LRM), and the addition of an SV prompt. All vignettes were successfully processed by each model and inference approach. Sensitivity ranged from 0.732 to 0.817, and PPV ranged from 0.534 to 0.779. The best overall performance was found in the o3-pro LRM using SV, with a sensitivity of 0.782 and a PPV of 0.779. No statistically significant fixed effects were found for sensitivity. For PPV, a statistically significant effect was found for prompt type (SV, P=.007) and model type (LRM, P=.009). No significant interaction effects were identified. We found that both SR and SV yielded statistically significant improvements in the PPV, without significant differences in the sensitivity. The addition of the manually specified SV prompt improved the PPV even when simulated reasoning was used. This suggests that future efforts to apply language models in behavioral health could benefit from manually crafted reasoning prompts and automated SR.

14. Effectiveness of School-Based Interventions on Risk Factors of Non-Communicable Diseases in Middle School Children of Hilly Urban Settings of Nepal.

期刊: American journal of health promotion : AJHP 发表日期: 2026-Jun-08 链接: PubMed

摘要

PurposeThe study aimed to evaluate the effectiveness of a school-based health promotion program in reducing key risk factors for NCDs in Nepal.DesignA repeated cross-sectional, quasi-experimental study design.SettingSchool.SampleThe sample size for each of the intervention and control arms was 209.InterventionHealth education intervention.MeasuresMeasurement of change in metabolic equivalent of task (MET), body mass index, body fat percentage, fruit and vegetable servings per day, and other risk factors of non-communicable diseases.AnalysisData for both groups were summarized as frequencies and percentages at baseline (T0), after the first intervention (T1), and after the second intervention (T2). Intervention and control groups were compared using the Chi-square test, Mann-Whitney U test, independent-samples t-test, Mood’s median test, and Cluster-level Difference-in-Difference (DiD) analysis.ResultsA total of 423, 366, and 270 adolescents (intervention: 214, 176, 135; control: 209, 190, 125) from 9 schools (5 intervention, 4 control) participated at baseline, T1, and T2. Cluster-level DiD analysis to assess the effectiveness of the intervention found improvements in BMI, body fat percentage, fruit and vegetable purchase frequency, and school canteen fruit availability, but none were statistically significant.ConclusionAlthough not statistically significant, the intervention produced directionally favorable changes in physical activity, anthropometric measures, and dietary behaviors, suggesting potential public health benefits at the school level.

15. Real-World Meditation App Engagement: Longitudinal Study of the Medito Meditation App.

期刊: JMIR mHealth and uHealth 发表日期: 2026-Jun-08 链接: PubMed

摘要

Meditation apps are increasingly popular but face significant engagement challenges. Most research does not meaningfully capture real-world engagement or associated user characteristics. Engagement patterns and reasons for engaging or disengaging remain relatively unexplored. This study aimed to examine Medito app user engagement over the first 30 days after download and how intended use, demographics, user traits, and mental health factors predict engagement. A prospective online survey was conducted among 668 Medito app users from 30 countries. Factors assessed included demographic factors (eg, age, sex, education, employment, and country of residence); user factors (eg, number of apps tried, hours of experience, meditation-related adverse events, expectations, readiness to change, and personality); and mental health factors (eg, quality of life, perceived stress, psychological distress, well-being, and satisfaction with life). Detailed engagement data included days of use, meditations completed, app opens, and minutes of use obtained via a data-sharing agreement with Medito. Minutes of use in the first 30 days after download served as the main outcome variable. App use was relatively low, with 50% (328/655) of users engaging for a total of 16 minutes or less in the first month after download (median 16.11, IQR 0-74.51 min). Fewer than 20% (124/655, 18.86%) of users continued using the app after 14 days. Intended use (mean 418.56, SD 472.5) significantly exceeded actual use (mean 70.02, SD 176.81; d=0.710; P<.001). In terms of user factors, expectation match (ie, extent to which outcomes from the app matched initial expectations; ρ=0.214; P=.002), expectations for anxiety (ρ=0.102; P=.01), expectations for attention or focus (ρ=0.091; P=.02), and conscientiousness (ρ=0.124; P=.003) were associated with higher engagement. Neuroticism was negatively associated with engagement (ρ=-0.103; P=.010). For mental health factors, satisfaction with life (ρ=0.123; P=.002) and well-being (ρ=0.135, P<.001) were associated with higher engagement, while perceived stress (ρ=-0.107; P=.007), psychological distress (ρ=-0.138, P<.001), and quality of life (ρ=-0.100; P=.011) were associated with lower engagement. Only readiness to change showed unique associations with higher engagement (semipartial r=0.156; P<.001). Regression analysis showed that only perceived stress predicted higher engagement (β=.020; P=.04). However, when mental health was included as a single component, expectations for anxiety (β=.015; P=.049) and readiness to change (β=.011; P=.048) predicted greater engagement, and mental ill health predicted lower engagement (β=-0.008; P=.049). Overall, app engagement is generally quite low. Acute stress motivated meditation app use, while chronic stress disrupted it. Engagement is optimal when experiences match expectations and users are prepared to make a change. More transparency is necessary in the promotion of meditation apps so that users have a realistic understanding of the time and effort required to achieve benefits.

16. Beneficiary feedback mechanisms: Exploring ways to systematically integrate community feedback in mass drug administration delivery for NTDs.

期刊: PLoS neglected tropical diseases 发表日期: 2026-Jun-08 链接: PubMed

摘要

Neglected tropical diseases (NTDs) affect over one billion people globally and disproportionately impact marginalized populations in low- and middle-income countries. Mass drug administration (MDA) is the WHO recommended strategy for controlling five major NTDs. However, persistent operational challenges, like treatment fatigue, mistrust, and systematically missed populations, undermine MDA effectiveness. Beneficiary Feedback Mechanisms (BFM) are emerging tools in global health that enable structured collection of community input to improve program delivery, but their application in NTD programs remains limited and understudied. This study examines how BFM are operationalized within routine MDA programs, providing operational insight into their perceived value, practical applications, and implementation challenges across diverse stakeholder roles. This study used semi-structured key informant interviews (KII) to examine how BFM can be operationalized to enhance MDA delivery. Interviews were conducted with 14 informants involved in MDA implementation, funding, monitoring and evaluation, and research, primarily across countries in sub-Saharan Africa that were supported by the Accelerating the Sustainable Control and Elimination of Neglected tropical Diseases (ASCEND) program. Participants were selected purposively based on their professional experience with BFM and MDA. Transcripts were analyzed using a thematic analysis approach in NVivo software, applying both inductive and deductive coding strategies to identify patterns and develop meaningful themes. Informants identified that BFM yielded timely and actionable feedback, particularly through daily community drug distributor meetings and post-MDA surveys, as the most impactful. Integrating BFM into existing systems was favored over new platforms, particularly in resource-constrained settings. Key barriers included limited integration into digital monitoring systems and lack of dedicated personnel to review and respond to feedback. BFM also highlighted issues that may have hindered optimal drug coverage in some communities, including gender barriers and misinformation. Informants emphasized that closing the loop, communicating back to communities how their feedback was used, was essential to maintaining trust and engagement in future MDA activities. BFM were perceived by informants as a promising pathway to enhance the equity, responsiveness, and effectiveness of MDA programs. Their success depends on timely use, integration into routine systems, and capacity to address community concerns. Multilateral organizations such as WHO can support scale-up by issuing guidance and standardizing tools. Further research is needed to evaluate impact and best practices for implementation.

17. Short-term effects of ocrelizumab on cortical pathology in patients with multiple sclerosis.

期刊: Neurotherapeutics : the journal of the American Society for Experimental NeuroTherapeutics 发表日期: 2026-Jun-08 链接: PubMed

摘要

Cortical lesions (CLs) are a common finding in multiple sclerosis (MS) but data regarding the impact of treatment on their evolution are lacking. This study evaluates CLs status and new CLs accrual over two-year follow-up in a cohort of patients treated with ocrelizumab (OCR) and the correlation with brain structural metrics and clinical measures. 87 relapsing-remitting MS patients [59 (67.8%) women, mean (SD) age 39.2 (10) years, median (IQR) baseline EDSS 2.5 (1.75)] underwent clinical, neuropsychological assessment and brain 3T MRI at baseline and two years after OCR start. CLs were manually segmented using Artificial Intelligence-Driven Imaging Reconstruction (AIDIR) sequences. At baseline, 21 patients (24.1%) had no CLs, 30 (34.5%) had 1 CL, 17 (19.5%) had 2 CLs, and 19 (21.8%) had ≥ 3 CLs. Higher CLs number and volume were associated with lower normalized TBV (r = -0.29, p = 0.01; r = -0.23, p = 0.03) and SDMT-raw score (r = -0.28, p = 0.02; r = -0.26, p = 0.03). After multiple-comparison correction, CLs number remained associated with normalized TBV. 14 patients (16.1%) experienced white matter lesions (WMLs) accrual and 15 patients (17.2%) disability progression over follow-up, but none of them developed new CLs. We observed the formation of only one CL at follow-up in a female patient that showed improved physical disability and no cognitive decline without concurrent WMLs accrual. OCR might also prevent lesion-driven cortical atrophy. These data seem to confirm the role of cortical pathology as an early marker of disease severity in MS, support OCR efficacy in minimizing lesion accrual and suggest distinct mechanisms underlying CLs and WMLs development.

18. Achieving at Least 15% Weight Loss Within 2 Years of Type 2 Diabetes Diagnosis Is Associated With Lower Risks of Macrovascular and Microvascular Complications: A U.K. Cohort Study.

期刊: Diabetes care 发表日期: 2026-Jun-08 链接: PubMed

摘要

This study aimed to evaluate whether achieving a minimum of 15% weight loss early after type 2 diabetes diagnosis was associated with subsequent lower risks of developing macrovascular and microvascular complications. Using U.K. primary care data from Clinical Practice Research Datalink Aurum linked to hospital and mortality data, we conducted a cohort study (2000-2024) of adults with obesity and type 2 diabetes. Individuals with ≥15% weight loss within 2 years of type 2 diabetes diagnosis were propensity score matched 1:4 to control subjects maintaining a stable weight (<2% weight change). Cumulative incidence rates were determined, and time to first macrovascular (myocardial infarction, stroke, angina, peripheral arterial disease) and microvascular (chronic kidney disease, retinopathy, neuropathy) events was analyzed using Cox proportional hazards regression. The matched cohort included 14,496 individuals with ≥15% weight loss and 57,984 control subjects. Compared with control subjects, the weight loss group had significantly lower risk of first macrovascular (hazard ratio 0.86, 95% CI 0.81-0.91) and microvascular (hazard ratio 0.90, 95% CI 0.86-0.94) events. Individually, significantly lower risks were observed for myocardial infarction, angina, chronic kidney disease, and retinopathy. The weight loss group also demonstrated better glycemic and blood pressure levels, despite fewer medications. Achieving ≥15% weight loss early in type 2 diabetes was associated with clinically meaningful lower risks for macro- and microvascular complications and better glycemic control compared with stable weight. These real-world findings support prioritizing early, substantial weight reduction as a core therapeutic strategy to improve glycemic control and prevent end-organ damage.

19. Longitudinal clinical proteomics reveals pneumonia type-specific protein biomarkers and autoantibodies.

期刊: JCI insight 发表日期: 2026-Jun-08 链接: PubMed

摘要

Community-acquired pneumonia is a major cause of morbidity and mortality globally. Specific molecular endotypes are currently not well defined, and different viral or bacterial pathogens may trigger specific host responses and pathogenic mechanisms. We performed longitudinal proteomic profiling of bronchoalveolar lavage fluid and plasma from bacterial, influenza, and SARS-CoV-2-driven pneumonia. Our analysis revealed highly pneumonia type-specific proteomic signatures, including COVID-19-specific antibodies locally produced in the lung. These antibodies showed biased immunoglobulin V-domain usage, linked to a CD69/CD83 plasma cell state associated with disease severity and degree of autoimmunity. Using mass spectrometry-driven autoantibody profiling in 2 independent COVID-19 cohorts, we identified 177 putative autoantibodies targeting extracellular matrix, nuclear, and immune-related proteins. Of note, temporal changes in autoantibody profiles correlated with clinical markers of inflammation, organ dysfunction, and duration of hospitalization. These findings highlight the autoimmune aspects of COVID-19 and provide potential biomarkers and therapeutic targets to help improve patient outcomes.

20. User Perspectives on a Clinical Decision Tool to Support Individualized Exercise Prescriptions for Breast Cancer Survivors Not Meeting Exercise Guidelines: Cross-Sectional Survey.

期刊: JMIR formative research 发表日期: 2026-Jun-08 链接: PubMed

摘要

More than 80% of breast cancer survivors do not meet the recommended levels of exercise, and <50% of health care providers promote exercise as part of survivorship care. Patient-provider communication may enhance exercise engagement by increasing patients’ understanding of exercise benefits and linking patients to resources, such as rehabilitation and exercise programs. This study aimed to explore perspectives on a novel clinical decision tool designed to support individualized exercise discussions and prescriptions among breast cancer survivors who do not meet exercise guidelines and health care providers who primarily treat such survivors. We conducted a cross-sectional online survey among US breast cancer survivors and health care providers. Participants were (1) female breast cancer survivors aged ≥35 years engaging in ≤150 minutes/week of moderate-intensity aerobic exercise or ≤2 days/week of muscle-strengthening exercise and (2) health care providers who had cared for breast cancer survivors within the past 12 months and reported below-average guideline adherence among their patients. Respondents reviewed a paper draft of a web-based clinical decision prototype tool for supporting individualized exercise discussions and prescriptions based on patients’ demographic, clinical, and contextual characteristics. We assessed perceived usefulness, potential uses (eg, counseling), preferred timing of access within clinical encounters, and preferences for tool characteristics (inputs/outputs). The analytic sample comprised 26 breast cancer survivors and 69 health care providers. The survivors’ median age was 48 (IQR 37-65) years. Providers included patient navigators/social workers/nurses (29/69, 42.0%), breast oncologists (13/69, 18.8%), and occupational/physical therapists (12/69, 17.4%). The majority of providers (62/69, 89.9%, 95% CI 80.2%-95.8%) and survivors (23/26, 88.5%, 95% CI 69.8%-97.6%) reported that they would find the tool useful. Similarly, 85.5% of providers (59/69, 95% CI 75.0%-92.8%) and 84.6% of survivors (22/26, 95% CI 65.1%-95.6%) reported that the tool would increase their confidence to discuss exercise in a clinical setting. Both groups preferred that survivors access the tool with staff after a medical appointment (survivors: 20/26, 76.9%, 95% CI 56.4%-91.0%; providers: 58/67, 86.6%, 95% CI 76.0%-93.7%). Both groups also endorsed treatment history and readiness to exercise to consider as key inputs and improved quality of life and reduced treatment-related side effects as exercise benefits to communicate as tool outputs. The prototype tool concept was well received, with high endorsement of individual characteristics to consider and clinical benefits of exercise to communicate. Findings will inform refinement of the tool and future implementation testing in an understudied population of breast cancer survivors.

21. Development and Preliminary Validation of ORCA-PD, an Online Rapid Cognitive Assessment for Parkinson Disease: Mixed Methods Study.

期刊: Journal of medical Internet research 发表日期: 2026-Jun-08 链接: PubMed

摘要

Traditional in-person neuropsychological tests for Parkinson disease (PD) lack accessibility, scalability, and PD specificity. Mobility impairments hinder access to in-person assessments, and long waiting times for expert evaluation limit scalability. Common tools for cognitive screening, such as the Montreal Cognitive Assessment, are generic and not specific to PD. The goal of this study was to address these challenges by leveraging the internet. This study aimed to develop a sensitive tool to detect cognitive impairments in early- to mid-stage PD in an accessible and scalable manner. We developed the Online Rapid Cognitive Assessment for Parkinson’s Disease (ORCA-PD), a brief (~15 min), fully self-administered tool, tailored to detect PD-specific impairments remotely. In a cross-sectional study, 112 participants from diverse geographical locations completed the ORCA-PD and a usability questionnaire. Task selection for ORCA-PD was guided by meta-analyses and comprehensive reviews, which demonstrated medium-to-high sensitivity to PD compared to healthy controls. Participants from more than 30 geographical locations showed a 93% (135/145) completion rate, with median usability ratings of 4 to 5 (IQRs 0-1) out of 5, indicating strong usability across a diverse sample. The ORCA-PD score significantly correlated with the Montreal Cognitive Assessment score (ρ=0.45, 95% CI 0.21-0.64; P<.001; n=56), supporting convergent validity. The ORCA-PD scores also followed expected significant trends: neurotypical controls scored higher than participants with PD (β=4.18; P=.048) and participants with PD without mild cognitive impairment scored higher than participants with PD with mild cognitive impairment (β=7.22; P=.046), confirming 2 discriminative abilities. ORCA-PD demonstrated usability and preliminary validity. ORCA-PD offers an accessible, scalable, and PD-sensitive cognitive screening test that could complement traditional in-person, supervised tools.

22. Digital Interventions Addressing Cognitive and Psychological Symptoms in Long COVID: Scoping Review of Multicomponent Approaches.

期刊: Interactive journal of medical research 发表日期: 2026-Jun-08 链接: PubMed

摘要

Long COVID, or postacute COVID-19 syndrome, presents with persistent cognitive and psychological symptoms such as brain fog, anxiety, depression, and fatigue, significantly impacting quality of life and daily functioning. Digital health interventions offer a scalable, accessible solution to bridge care gaps, especially where conventional neuropsychological support is limited. However, evidence regarding their effectiveness for neuropsychiatric symptoms in long COVID remains fragmented. This scoping review aimed to systematically identify and map the existing evidence on digital interventions targeting cognitive and psychological symptoms in individuals with long COVID. The review also sought to categorize intervention types, assess reported outcomes, and identify methodological gaps to inform future clinical and research priorities. The review followed the Arksey and O’Malley framework and adhered to the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) guidelines. Comprehensive searches were conducted in 4 databases (PubMed, Scopus, Web of Science, and ScienceDirect) from December 2024 to February 2025. Eligible studies included peer-reviewed and gray literature published in English or Spanish since 2020. Studies were screened and selected based on predefined inclusion and exclusion criteria. Data were extracted using a standardized charting form and synthesized narratively, with thematic grouping by intervention type. Of 888 records identified, 25 (2.82%) were included. Intervention types encompassed telehealth platforms, mobile health apps, virtual reality, online cognitive and psychological therapies, game-based cognitive training, neuromodulation (transcranial direct current stimulation), and multicomponent programs. Most studies reported improvements in psychological well-being, emotional regulation, and cognitive domains such as attention and memory. However, findings varied, with some interventions showing no significant cognitive gains or sustained effects. Common limitations included small sample sizes, lack of control groups, heterogeneity in outcomes and intervention protocols, and short follow-up durations. The underrepresentation of older adults and underserved populations was also noted. Digital interventions show promise for addressing cognitive and psychological symptoms in long COVID, particularly when delivered as multicomponent programs. Nonetheless, the evidence base remains preliminary. Future research should prioritize high-quality randomized trials with standardized outcome measures, long-term follow-up, and diverse participant samples. Addressing barriers related to digital literacy and access will be essential to ensure equity and real-world effectiveness.

23. Exosome Nanotherapy Rescues Male Fertility by Delivering Integrin β1 to Repair Environmental Stress-Damaged Testes.

期刊: Molecular pharmaceutics 发表日期: 2026-Jun-08 链接: PubMed

摘要

Environmental thermal-mechanical (T&M) stress threatens male fertility globally, yet no molecular therapies exist for stress-induced testicular damage. We demonstrate that macrophage-derived exosomes (Mφ-EVs) function as precision nanomedicines restoring fertility by delivering Integrin β1 (ITGB1) to repair damaged spermatogenic cytoskeletons. Using validated T&M stress models in C57BL/6 mice and GC-2 spermatocytes, we characterized severe reproductive dysfunction: 14.4% motility reduction (83.0 ± 2.0% to 71.3 ± 1.7%), 69.2% increased abnormalities (8.7 ± 2.3% to 14.7 ± 2.3%), and disrupted cytoskeletal homeostasis with Layilin (2.87-fold), Talin (3.90-fold), and Vinculin (4.24-fold) upregulation (P < 0.05). Mφ-EVs treatment achieved remarkable therapeutic efficacy: motility recovered to 80.8 ± 6.8%, abnormalities normalized to 11.6 ± 1.6% (all P < 0.05). Biodistribution tracking showed that exosomes accumulate in testicular tissue (peak 8 h). Molecular docking and cellular thermal shift assays revealed exosomal ITGB1 forms high-affinity ITGA1 complexes (score -222.76), stabilizing protein structure and normalizing cytoskeletal expression. This first proof-of-concept establishes exosome-based nanotherapy as a clinically translatable, noninvasive intervention for occupational and climate-related fertility disorders, with scalable manufacturing addressing millions of men worldwide.

24. Structured Telehealth Community Health Worker-Clinician Feedback and Diabetes Outcomes: A Randomized Clinical Trial.

期刊: JAMA internal medicine 发表日期: 2026-Jun-08 链接: PubMed

摘要

Community health workers (CHWs) improve chronic disease management in underserved populations, but scalable integration strategies are limited. To evaluate whether a multidimensional intervention incorporating telementored CHWs and a structured participant-CHW-clinician feedback loop can improve diabetes outcomes. This 12-month randomized clinical trial was conducted at 3 institutionally and geographically diverse community clinics in Texas between September 1, 2023, and April 30, 2025, and included low-income, uninsured White Hispanic adults with type 2 diabetes identified through clinic databases. Data were analyzed between May 1 and July 31, 2025. Individuals were randomized 1:1 to the intervention or control. For the intervention, CHWs delivered (1) group diabetes education, (2) individualized telehealth-based coaching, and (3) a novel participant-CHW-clinician feedback loop to facilitate communication, address participant concerns, and improve care coordination. The control was usual care (quarterly clinician visits and access to multidisciplinary and social services). The primary outcome was baseline to 12-month change in hemoglobin A1c (HbA1c) level. Secondary outcomes included changes in cholesterol levels, American Diabetes Association (ADA) guideline adherence, participant recruitment, intervention fidelity, and feedback loop issue resolution. Of 257 participants included in the intention-to-treat analysis (mean [SD] age 54 [11] years; 166 [64.6%] female), 129 were in the intervention group and 128 were in the control group. The intervention reduced HbA1c (net difference, -1.0 [95% CI, -1.5 to -0.4] percentage points [pp]; P = .001), total cholesterol (net difference, -35.4 mg/dL; 95% CI, -54.6 to -17.2 mg/dL; P = .02), and low-density lipoprotein cholesterol (net difference, -29.7 mg/dL; 95% CI, -44.5 to -14.9 mg/dL; P < .001) levels compared with control. ADA guideline adherence improved for foot examinations (absolute risk [AR], 19.2 [95% CI, 7.4-30.9] pp; relative risk [RR], 1.65 [95% CI, 1.19-2.27]; P = .03) and urine microalbumin screening (AR, 15.8 [95% CI, 5.3-26.3] pp; RR, 1.24 [95% CI, 1.07-1.43]; P = .048). CHWs addressed 490 participant concerns (87.2%) via the feedback loop, including medication refills, glucose management, and access to care. In this randomized clinical trial, the CHW intervention significantly improved diabetes outcomes in low-income settings, potentially by reducing fragmentation through structured feedback. Findings also highlight limitations in usual care, underscoring the need for scalable strategies to strengthen chronic disease management in low-income populations. ClinicalTrials.gov Identifier: NCT04835493.

25. Associations of formal and informal organizational support with employed cancer survivors' intent to stay.

期刊: Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer 发表日期: 2026-Jun-08 链接: PubMed

摘要

Cancer has broad effects on survivors, including on their employment and work ability, defined as the capacity to carry out job demands. When organizations provide informal social support and formal support policies, survivors’ work ability and intent to remain with their employer may be enhanced. We hypothesized positive associations between two forms of support (formal, informal) and survivors’ intent to stay, with work ability as a potential mediator of this pathway. An online cross-sectional survey was administered between May 2017 and October 2018 to working breast cancer survivors who completed primary treatment within 36 months. We conducted ordinary least square regressions path analysis to test hypothesized associations. Percentile bootstrap estimation approach was used with 10,000 samples to test indirect effects. Respondents (n = 157) had a mean age of 51 and were mostly female (98%), White and Non-Hispanic (85%), married or partnered (74%), and college educated (78%). Hypothesis testing showed statistically significant direct effects between both informal and formal support and intent to stay, as well as indirect effects whereby work ability partially mediated the relationship between both types of support and intent to stay. In a sample of breast cancer survivors, we showed a novel association between organizational support and intent to stay through work ability. Employer initiatives and structures that provide increased informal and formal support may enhance employment sustainability among cancer survivors by helping them to meet job demands and perform effectively. We provide evidence that both formal and informal organizational support are associated with cancer survivors’ work ability and intent to remain employed, offering insights that may inform future workplace research, policies, and support programs aimed at improving employment sustainability after cancer.

26. Reliability and Validity of the Japanese Adelaide Driving Self-Efficacy Scale in Community-Dwelling Drivers.

期刊: OTJR : occupation, participation and health 发表日期: 2026-Jun-08 链接: PubMed

摘要

Driving self-efficacy influences driving behavior and decisions about continuing to drive, yet no validated Japanese measure has been available. This study examined the reliability and validity of the Japanese version of the Adelaide Driving Self-Efficacy Scale (ADSES-J) in 100 community-dwelling licensed drivers, with a 2-week retest in 20 participants. Internal consistency was assessed using Cronbach’s α and test-retest reliability using ICC (2,1). Convergent validity was examined through correlations with driving-related measures, and discriminant validity through correlations with general self-efficacy and mental health scales. Exploratory factor analysis supported a unidimensional structure explaining 71.6% of the variance. The ADSES-J demonstrated excellent internal consistency (α = .962) and test-retest reliability (ICC = .965), with no floor or ceiling effects at the total score level, although Item 1 showed a ceiling effect. These findings indicate that the ADSES-J is a reliable and valid instrument for assessing driving-specific self-efficacy among community-dwelling drivers in Japan. Understanding Driving Self-Efficacy: A Japanese Questionnaire for Everyday DriversAutomobile driving supports community life through commuting, shopping, and social participation. For many people, including older adults and individuals with brain injuries, driving helps maintain independence and social roles. When considering whether to continue or resume driving safely, it is important not only to assess driving ability but also how accurately individuals judge their own ability. Driving self-efficacy refers to a person’s belief in their capability to manage driving situations safely and effectively. This study examined the reliability and validity of the Japanese version of the Adelaide Driving Self-Efficacy Scale (ADSES-J) in community-dwelling drivers in Japan. We surveyed 100 licensed drivers who had driven within the past year, and 20 participants completed the questionnaire again after two weeks to examine score stability. We evaluated whether the items consistently measured a single concept and whether scores were stable over time. We also examined how ADSES-J scores related to driving-related measures, including driving style and driving workload, and whether the scores were distinct from general self-efficacy and mental health. In addition, we assessed the questionnaire’s factor structure. The ADSES-J showed excellent internal consistency and very high test–retest reliability. The total score did not show floor or ceiling effects, although one item showed a ceiling effect. ADSES-J scores were positively associated with confidence in driving skills and negatively associated with several aspects of driving workload, but were not associated with general self-efficacy or mental health. Factor analysis supported a clear one-factor structure. These findings indicate that the ADSES-J is a reliable and valid tool for assessing driving-specific self-efficacy in Japan. It may support discussions about driving safety and appropriate driving support. Further studies in older and clinical populations are needed.

27. The Active-Empathic Listening Scale (AELS): Conceptualization and evidence of validity within the healthcare context.

期刊: Patient education and counseling 发表日期: 2026-Jun-07 链接: PubMed

摘要

Listening is a central component of patient-clinician communication and shapes how patients interpret empathy, support, and care quality. Active empathic listening (AEL)-the active and emotional involvement of a listener-is particularly relevant for healthcare. The Active Empathic Listening Scale (AELS) offers a theoretically grounded framework for assessing the dimensions of listening (sensing, processing, responding), yet its psychometric performance in healthcare remains unexamined. This study evaluated the structural and convergent validity and reliability of the 11-item AELS adapted for patient-clinician interactions. A nationally representative sample of U.S. adults (N = 1257) completed an online survey describing a recent clinician interaction, with follow-up measures referring to that interaction, including the AELS, as well as supportive message quality (SMQ) and satisfaction with the interaction. Exploratory factor analysis (EFA) was performed and the EFA factor structure was confirmed via confirmatory factor analysis (CFA). Structural equation modeling (SEM) was used to assess convergent validity with SMQ and satisfaction. EFA supported the three-factor structure of the AELS. CFA revealed a weak loading for Item 2 (λ =.495) and was removed. CFA of the 10-item AELS confirmed an excellent fit for a first-order and second-order model. A chi-square difference test indicated the refined 10-item model fit significantly better than the 11-item model. In the interest of parsimony, we retained the second-order model to assess convergent validity. SEM yielded a significant overall model, with significant paths to SMQ and satisfaction. The 10-item AELS demonstrated strong internal consistency across sensing (α =.86), processing (α =.93), and responding (α =.96). The refined 10-item AELS demonstrated excellent calibration, strong factorial stability, and meaningful associations with SMQ and satisfaction. These findings support the AELS as a practical patient-reported instrument for evaluating listening quality in clinical interactions.

28. Sustained antigen-specific CD8+ T cell immunity post-mRNA booster requires notch pathway activation.

期刊: Journal of immunology (Baltimore, Md. : 1950) 发表日期: 2026-Jun-07 链接: PubMed

摘要

Messenger RNA (mRNA) vaccines effectively induce protective immunity, but antigen-specific CD8+ T cell responses exhibit limited persistence. In this study, we aimed to assess CD8+ T cell responses following a third dose of the Pfizer BNT162b2 COVID-19 vaccine and identify factors contributing to their longevity. Using HLA tetramers, we analyzed antigen-specific CD8+ T cells in 141 vaccinated individuals (86.5% female) and identified 2 groups: those with strong responses (strong group) and those with weak responses (weak group) 6 mo after the third mRNA vaccination. Transcriptomic analysis revealed that Notch signaling was upregulated in the strong group, and in vitro, the inhibition of Notch signaling significantly reduced CD8+ T cell expansion. These findings suggest that Notch signaling may contribute to maintain long-term antigen-specific CD8+ T cell responses following mRNA vaccination. Targeting this pathway could offer novel strategies for enhancing vaccine-induced cellular immunity and long-lasting protection.

29. Air pollution and mortality across socioeconomic groups in the Netherlands.

期刊: Environment international 发表日期: 2026-Jun-06 链接: PubMed

摘要

We investigated whether associations betweenlong-termair pollution and(cause-specific)mortality outcomes differ across socioeconomic position (SEP) groups in the Netherlands. This nationwide cohort study included 9.9 million adults aged ≥30 years, from 2014 to 2019 in the Netherlands. We linkedannual averageresidential exposure toparticulate matter (PM2.5, PM10), andnitrogen dioxide(NO2)withhousehold- and neighbourhood-level socioeconomic indicators (financial welfare, education, employment history), as well as the national death register. Using Cox proportional hazards models, we estimated hazard ratios (HRs) and absolute rate differences to assess relative and absolute inequalities in air pollution-related mortality. Higher air pollution exposure was associated with increased mortality across pollutants and mortality outcomes. For example, a 5 µg/m3 increase in PM2.5was associated with a HR of 1.07 (95% CI: 1.06-1.08) for all natural-cause mortality.Relative risk estimates showed no consistentsocioeconomic gradient and varieddepending onthe indicator used.Absolute rate differences, however, showeda more consistentpattern wheregroups with lowerhousehold-levelsocioeconomic positionexperiencedgreater absolute mortality burdensfrom air pollution, driven bytheirhigher baseline mortality rates. While air pollution increases mortality across all socioeconomic groups, disadvantaged populations bear disproportionate absolute burdens. Absolute risk measures reveal steeper health disparities than relative risks, underscoring the importance of reporting both metrics to fully capture environmental health inequities.

30. Dual-functional Z‑scheme heterojunction nanozymes with surface encapsulation of porphyrin-based metal-organic framework on covalent organic framework for integrated detection and removal of aflatoxin B1 in foods.

期刊: Journal of hazardous materials 发表日期: 2026-Jun-06 链接: PubMed

摘要

Aflatoxin B1 (AFB1) contamination poses a serious threat to food safety and environmental health, thus making an active area of research in development of efficient detection and removal strategies. Herein, the Z‑scheme heterojunction nanozyme with high peroxidase (POD)‑like activity was constructed by growing porphyrin‑based metal‑organic framework (TCPP‑Fe) on the surface of covalent organic framework (TATP) for simultaneous detection and efficient removal of AFB1 in foods. The enhanced POD-like activity of TATP/TCPP‑Fe composite can be attributed to the promoted interfacial charge transfer within heterojunction. The steady-state kinetic parameters of Km can reach 0.21 and 0.24 mmol/L for hydrogen peroxide (H2O2) and 3,3’,5,5’-tetramethylbenzidine (TMB) calculated by Michaelis-Menten equation. The detailed catalytic process of reactive oxygen species (ROS) generated and the specific catalytic mechanism of inter charge transfer within TATP/TCPP‑Fe are proposed. The direct detection and removal method for AFB1 was established based on the strong oxidizing ability of the generated ROS, including hydroxyl radicals (•OH) and superoxide anions (•O2-). The low detection limit (LOD) of 0.34 μg/L and high removal rate of 99.8% can be reached with the TATP/TCPP‑Fe composite. This integrated detection and removal strategy was successfully applied to real dried fruit samples, demonstrating its potential for on‑site monitoring and green remediation of AFB1 contamination in food and environmental matrices.

31. Co-occurrence of resistance and virulence plasmids in a blaNDM-5-positive Escherichia coli ST602 clone across One Health sectors in China.

期刊: Journal of hazardous materials 发表日期: 2026-Jun-05 链接: PubMed

摘要

Carbapenem-resistant bacteria circulating across human, animal, and environmental sectors are a growing public health concern. We investigated blaNDM-5-positive Escherichia coli ST602 from an integrated duck-egg farming ecosystem in China using whole-genome sequencing with plasmid characterization. Among 44 representative carbapenem-resistant E. coli (CREC) isolates selected from a larger collection of 103 CREC isolates, seven belonged to ST602 and formed a genetically related O103:H21 cluster recovered from human, duck, and environmental samples within the same farm ecosystem. To place these isolates in context, we analyzed a curated global dataset of 628 ST602 genomes. The local ST602 isolates clustered within a phylogroup B1 O103:H21-associated subclade in a global dataset dominated by European and North American genomes. In all seven isolates, blaNDM-5 was carried on conjugative IncHI2/IncHI2A plasmids with a conserved IS5-blaNDM-5-ble-trpF-IS26 structure. The same isolates co-harbored a non-conjugative IncFIB/IncFIC(FII) plasmid carrying virulence-associated genes (iutA, iroBCDEN, iucABCD, hlyF, iss, traT) together with additional resistance determinants. Comparative analyses also indicated enrichment of genes encoding bacteriocins and recurrent co-occurrence patterns between blaNDM-5 and other resistance genes. These findings further document a genetically related O103:H21-ST602 cluster within a duck-farm One Health setting that co-harbors transferable carbapenem resistance and conserved virulence-associated plasmids, underscoring the need for integrated genomic surveillance of locally emerging CREC lineages.

32. Pathological complete response and postmastectomy radiation therapy after primary systemic therapy: results from the ReSTORE study.

期刊: Breast (Edinburgh, Scotland) 发表日期: 2026-Jun-05 链接: PubMed

摘要

The ReSTORE study aimed to evaluate oncological outcomes and explore the association between pathological complete response (pCR), postmastectomy radiotherapy and nodal irradiation (PMRT), and recurrence. This multicentre retrospective study included patients with breast cancer treated with chemotherapy-based primary systemic therapy (PST) followed by skin-or nipple-sparing mastectomy and immediate reconstruction. Locoregional recurrence-free survival (LRRFS) and disease-free survival (DFS) were analysed. A total of 256 patients were analysed, with a median follow-up of 82 months (range 16-166). In multivariable analysis, node-positive disease at diagnosis was associated with worse LRRFS (HR 8.28, 95% CI 1.06-64.34; p = 0.043). PMRT was associated with a non-significant reduction in locoregional recurrence (HR 0.74, 95% CI 0.29-1.92; p = 0.54). pCR was significantly associated with improved DFS (HR 0.48, 95% CI 0.28-0.82; p = 0.008). Among patients receiving PMRT, those achieving pCR had superior DFS compared with those without pCR (HR 0.23, 95% CI 0.09-0.60; p = 0.002). No significant associations with DFS were observed for age, BRCA status, tumour stage, or receptor status. In this cohort, pCR and baseline nodal status were key prognostic factors, whereas the true impact of PMRT on outcomes remained uncertain. Nonetheless, our findings do not support omission of PMRT based on pCR alone. Prospective trials and long follow up are required to define response-adapted locoregional treatment strategies.

33. S-scheme Bi2S3/FeIn2S4 heterojunction for ultrasensitive photoelectrochemical detection of flutamide.

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

摘要

Flutamide (FLU), a nonsteroidal antiandrogen drug for prostate cancer therapy, requires sensitive monitoring due to its narrow therapeutic window. Herein, we constructed a novel photoelectrochemical sensor based on an S-scheme Bi2S3/FeIn2S4 heterojunction for ultrasensitive FLU detection. This charge transfer mechanism was confirmed through density functional theory calculations and electron paramagnetic resonance tests. FLU can act as a hole scavenger by transforming its nitro group into a nitroso derivative via a 2e-/2H+ transfer process, thereby amplifying the photocurrent signal. The sensor outperformed traditional techniques, exhibiting a wide dual-range linear detection capability (0.02 - 20 μM and 20 - 110 μM) with an ultralow detection limit of 10 nM. The designed sensor exhibits good repeatability and long-term storage stability (>92.8%). Moreover, this sensor was successfully applied in human serum and urine, with recovery rates ranging from 96.9% to 100.2%.

34. Daytime assessment of attention and orientation is associated with clinical outcomes in patients with delirium: A prospective observational study.

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

摘要

Delirium is a common neuropsychiatric syndrome in hospitalized patients and is associated with increased mortality and poor outcomes. This study examined whether a brief bedside assessment of attention and orientation is associated with clinical outcomes in delirium. This prospective observational study included acutely hospitalized patients with delirium who underwent psychiatric consultation at a general hospital. Attention and orientation were assessed during the initial daytime bedside consultation using a brief cognitive assessment completed within a few minutes. Patients were classified into high cognitive function (HCF) and low cognitive function (LCF) groups based on receiver operating characteristic analysis. Primary outcomes were delirium remission at 1 week and mortality at 6 months. Multivariable logistic regression and Cox proportional hazards models were used to examine associations between cognitive performance and outcomes, adjusting for major covariates. Ultimately, 65 patients were included. Delirium remission at 1 week occurred in 90.0% and 22.2% of patients in the HCF and LCF groups, respectively. The overall 6-month mortality rate was 30.8%, with rates of 5.0% and 42.2% in the HCF and LCF groups, respectively. In multivariable analyses, LCF was independently associated with higher 6-month mortality (hazard ratio 13.51, 95% confidence interval [CI] 1.52-120.6; odds ratio 32.7, 95% CI 2.12-503.5). The HCF group showed higher odds of delirium remission at 1 week (odds ratio 18.3, 95% CI 2.45-136.0). A simple cognitive assessment focused on attention and orientation may provide useful prognostic information for delirium management in general hospitals.

35. A critical review focusing on the production and application of GO-CNC-based nanosorbents in wastewater treatment: Removal of toxicants by fixed bed column adsorption study.

期刊: Journal of contaminant hydrology 发表日期: 2026-Jun-04 链接: PubMed

摘要

Approximately 80% of the hundreds of billions of cubic meters of wastewater produced annually worldwide is released into the environment untreated, representing a global environmental and public health challenge that needs urgent deployment of advanced nanosorbents. Among all the treatment methods, adsorption is a scalable, low-cost, environmentally friendly method for treating wastewater. Graphene oxide (GO) and cellulose nanocrystals (CNC) are some of the most researched advanced nanosorbents. Both GO and CNC together form a porous, oxygen-rich matrix and carbonaceous active materials along with a substantial amount of binding/receptor sites that overcome individual precursor limitations, showing synergistic effects of electrostatic attraction, hydrogen bonding, and π-π stacking altogether to remove toxicants from industrial wastewater bodies at such efficiencies that neither precursor could do individually. Detailed preparation of precursors, fifteen fabrication routes, fourteen characterization techniques, effects of flow rate, bed height, pH, and GO: CNC ratio on breakthrough behavior, different column adsorption models, and a comparative study between GO-CNC-based adsorbents are provided. This review also deals with challenges: multi-pollutant selectivity, regeneration limits, and reactor scalability. Renewable biomass feedstocks, spent-sorbent reuse in supercapacitors and construction, and a zero-waste path across eleven UN SDGs are mentioned as a future pathway for environmental sustainability, and eco-industrial as well as technological developments.

36. A stochastic meta-population model of Ebola virus disease transmission for informing public health decisions.

期刊: Epidemics 发表日期: 2026-Jun-04 链接: PubMed

摘要

Ebola virus disease (EVD) remains a constant international public health threat. Developing models that integrate the complex transmission dynamics of EVD is essential for informing evidence-based strategies for outbreak preparedness and response. Here, we introduce a stochastic, meta-population, compartmental model of EVD epidemics which accounts for key stages of the disease transmission including ecologically-driven zoonotic introductions, person-to-person transmission, spatial spread, and potentially complex interventions. Our model can distinguish between different transmission modes (direct transmission from contact with infectious cases, funeral exposures, or sexual transmission from contact with convalescent individuals) as well as different intervention mechanisms (overall reduction of contacts, safe and dignified burials, and vaccination). We illustrate our approach by simulating EVD epidemics in an area at high risk of zoonotic introduction in the Democratic Republic of the Congo, and show how it can be used to identify potential future transmission hotspots and help assess the scaling of future responses. Our model is implemented in a computer-efficient, free, open-source software, and can be used for informing public health policies.

37. DNA barcoding reveals novel biodiversity in ticks (Acari: Ixodida: Ixodidae) of Ethiopia.

期刊: Veterinary parasitology 发表日期: 2026-Jun-04 链接: PubMed

摘要

Identification of hard ticks (Acari: Ixodida: Ixodidae) is problematic due to inconsistent diagnostic characters, sexual dimorphism, individual variation, and vast morphological differences among life stages, as well as distortion through blood feeding. DNA barcoding has proven useful in delineating tick species, but available genetic databases are littered with misleading mis-identifications, hindering tick-borne disease mitigation strategies. Efforts are needed to generate high quality reference sequences from expertly identified and morphologically vouchered samples. To date, 56 species of hard ticks are reported from Ethiopia. Here, we subsampled and e-vouchered exemplars of 22 expert-validated hard tick species from 25,343 total ticks collected on a range of livestock from five regions across Ethiopia. We successfully sequenced the barcoding region of the mitochondrial cytochrome c oxidase subunit I (COI) for 208 individual ticks, representing 21 of these target taxa (The COI gene of one tick species, Haemaphysalis parmata, was not able to be amplified). Our data suggest the presence of 29 species-level groupings among the 21 morphologically identified taxa successfully sequenced, an increase of 38%, reiterating the gaps and challenges of accurate tick identification in Ethiopia, as well as the greater East Africa region. Here we report novel hidden diversity in Amblyomma variegatum, Hyalomma truncatum, Rhipicephalus lunulatus, and Rh. praetextatus in Ethiopia, and provide the first expertly-verified mtDNA COI barcodes for Hae. aciculifer and Rh. bergeoni. Molecular confirmation of the presence of Hy. marginatum in Ethiopia is documented for the first time. Dorsal and ventral photographic vouchers are provided for examples of all known and newly discovered COI barcodes sequenced in this study, enhancing accuracy in future taxonomic and ecologic studies of ticks in Ethiopia and across East Africa. This validated barcoding resource improves tick-borne disease surveillance across East Africa, and provides a framework for broader vector-borne disease biosurveillance efforts.

38. Effect-based spatiotemporal assessment of suspended particulate matter in the River Rhine: An early warning platform for environmental monitoring.

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

摘要

Effective early warning systems for aquatic contamination require monitoring strategies capable of detecting subtle, long-term shifts in mixture-driven biological activity. Suspended particulate matter (SPM) serves as a carrier and reservoir for complex contaminant mixtures, facilitating their transport and persistence in aquatic systems, yet systematic toxicological time series for archived SPM remain scarce. Regulatory monitoring predominantly targets Priority Substances and River Basin Specific Pollutants, leaving the temporal trends of particle-associated mixture toxicity largely unresolved. Leveraging 18 years (2005-2022) of cryogenically archived annual SPM composites from the Rhine River, we conducted a spatiotemporal effect-based assessment integrating receptor-mediated effects, oxidative stress analysis and untargeted Cell Painting phenomics. This integrated toolbox enabled evaluation of pathway-specific responses and multi-compartment cellular perturbations associated with particle-bound contaminant mixtures. Polar SPM-associated chemicals elicited oxidative stress response and caused endocrine disruption through estrogen receptor α (ERα) activation and androgen receptor inhibition (anti-AR). Trend analysis showed spatiotemporal variation along the river, with statistically increasing trends of oxidative stress and anti-AR activity over time at Koblenz, driven by polar chemicals. Both polar and non-polar SPM extracts activated the aryl hydrocarbon receptor (AhR), indicating presence of compounds capable of triggering xenobiotic response pathways. Several subcellular compartments were affected, with mitochondrial features being among the most affected. These findings demonstrate that SPM-associated chemicals elicit diverse toxicological effects by acting on several receptors and impacting diverse cellular structures. Combining targeted and phenomics-based effect approaches provided comprehensive mechanistic insights and valuable information to support the early warning systems for chemical contamination in aquatic environments.

39. Disinfectant quaternary ammonium compounds hijack the NAMPT-NAD⁺ axis to impair trophoblast function.

期刊: Environment international 发表日期: 2026-Jun-03 链接: PubMed

摘要

The escalating use of quaternary ammonium compounds (QACs) as antimicrobial substitutes-further intensified in the post-pandemic era-has raised significant public health concerns regarding their environmental prevalence and potential toxicity. Despite growing evidence of developmental toxicity, the molecular mechanisms driving these effects remain largely undefined. As placental development is a key determinant of fetal growth, with trophoblast function playing a central role in this process, we used trophoblast migration assays to screen six major QACs commonly detected in human serum, identifying C14-BAC as the most potent analog. Notably, C14-BAC significantly inhibited trophoblast invasion and disrupted mitochondrial homeostasis at nanomolar levels. By integrating global chemoproteomics with systems biology, we identified nicotinamide phosphoribosyl transferase (NAMPT) as a key functionally relevant target of C14-BAC, which was further validated by genetic, pharmacological, and metabolic rescue approaches in trophoblasts. Mechanistically, C14-BAC directly bound to and inhibited NAMPT, the rate-limiting enzyme in the NAD⁺ salvage pathway, with a dissociation constant (Kd) of 886 nM, triggering pronounced NAD⁺ depletion, redox imbalance, and mitochondrial dysfunction. Furthermore, comparative screening across QAC analogs linked NAMPT binding affinity to toxic potency, pinpointing the benzyl aromatic moiety as a critical structural driver of this interaction. Collectively, our findings establish the NAMPT-NAD⁺ axis as a critical metabolic vulnerability in reproduction that can be hijacked by a pervasive class of disinfectants, underscoring the need to re-evaluate the safety of widely used QACs, and providing a structure-activity basis for the selection of disinfectant chemicals.

40. Environmental phthalate exposure impairs cognition in aged males by coupling myelin injury to synaptic dysfunction via Nogo-A/S1PR2 signaling.

期刊: Environment international 发表日期: 2026-Jun-02 链接: PubMed

摘要

Di-(2-ethylhexyl) phthalate (DEHP) is a widespread environmental contaminant linked to endocrine disruption, neurotoxicity, and cognitive aging. However, its effects on hippocampal function in aging populations remain unclear. In this study, 22-month-old male C57BL/6J mice were orally exposed to DEHP (0.2, 20, or 200  mg/kg/day) for 5 weeks to model environmentally relevant and toxicological exposure scenarios. Cognitive performance was evaluated using the Morris water maze and novel object recognition tests, while hippocampal alterations were assessed through histology, immunofluorescence, and molecular analyses. DEHP exposure at higher doses impaired spatial learning and memory, whereas the lowest dose induced subtle molecular changes. Mechanistically, DEHP reduced oligodendrocyte maturation and myelin integrity, inhibited oligodendrocyte precursor cell (OPC) differentiation, and induced local thyroid hormone disruption and neuroinflammation. Notably, DEHP activated the Nogo-A/S1PR2 pathway and its downstream RhoA/ROCK2 signaling, contributing to synaptic deficits marked by decreased PSD95 expression. In summary, subacute DEHP exposure disrupts hippocampal homeostasis in aged male mice by impairing myelin integrity, glial function, and synaptic stability. Activation of the Nogo-A/S1PR2 axis represents a key mechanistic link underlying these effects, providing insight into how environmental phthalates may accelerate age-related cognitive decline.

41. One-shot quantification of 313 PPCPs and pesticides in bovine milk by modified-QuEChERS-UHPLC-MS/MS.

期刊: Food chemistry 发表日期: 2026-Jun-02 链接: PubMed

摘要

A high-throughput method based on modified QuEChERS and ultra-high performance liquid chromatography-tandem mass spectrometry was developed for the simultaneous determination of 313 pharmaceuticals and personal care products (PPCPs) and pesticides in bovine milk. The sample preparation procedure was strategically optimized, selecting 2% acetic acid in acetonitrile as the extraction solvent and diatomaceous earth as the sole clean-up sorbent. The method demonstrated excellent sensitivity, with limits of detection and quantification ranging from 0.5 to 500 ng/kg and 1 to 1000 ng/kg, respectively. The mean recoveries ranged from 70.1% to 110.8%, with intra-day and inter-day relative standard deviations below 15% for the vast majority of compounds. The practical applicability of the proposed method was confirmed by analyzing commercial milk samples, revealing the presence of 37 residues, including certain prohibited substances. This method presents a robust, efficient, and reliable tool for the large-scale monitoring of multi-class contaminants in milk.

42. Microplastics as vectors for virus transport in saturated quartz sand: Reduced PRD1 bacteriophage infectivity and enhanced mobility.

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

摘要

Microplastics originating from pellets, paints, fragmented macroplastics, textiles, tire wear, and personal care products enter sewage and can aggregate with viruses during treatment. After sludge application, these aggregates may infiltrate soils and enter groundwater, yet their aggregation mechanisms and effects on virus survival and transport remain unclear. To address this gap, we conducted a laboratory study to examine the effect of microplastics on virus persistence and transport in groundwater. Batch experiments were conducted by mixing the PRD1 bacteriophage (a surrogate for adenovirus) with microplastics in groundwater at various temperatures. Column experiments using saturated quartz sand were performed to evaluate the effect of microplastics on virus transport in groundwater. Microplastic particles were quantified using solid-phase cytometry, while PRD1 was enumerated using both molecular and culture-based methods. Experimental data were analyzed using the HYDRUS-1D 2-site attachment-detachment model and colloid filtration theory. Our experimental findings suggest that microplastics significantly influence viral stability and transport in groundwater. Batch experiments revealed a marked decrease in the persistence of infective viruses in the presence of microplastics, reducing viral longevity in the environment. On the other hand, co-transport experiments showed that microplastics promoted the transport of both total and infective viruses through saturated quartz sand. This dual role underscores the complex influence of microplastics in groundwater: while they may reduce virus viability, their ability to enhance viral mobility represents a significant pathway for virus dissemination. These findings highlight the need to consider microplastics not only as pollutants but also as vectors that can potentially increase the risk of waterborne transmission and compromise groundwater safety.

43. The optimal blood pressure target in old and very old patients with hypertension.

期刊: Age and ageing 发表日期: 2026-Jun-01 链接: PubMed

摘要

With the rise in older population globally, the optimal blood pressure (BP) target for antihypertensive therapy in those aged 60 and above remains to be evaluated in the real-world practice. This study evaluated the effectiveness and safety of standard versus lower BP targets in old (aged 60-79) and very old (aged ≥80) patients with hypertension in real-world clinical settings. We emulated a target trial using electronic medical records from the Hong Kong Hospital Authority, including patients aged 60 years or above with a diagnosis of hypertension, uncontrolled BP and records of antihypertensives adjustments from 2008 to 2013. Patients were first categorized into 3 age groups (60-69, 70-79, ≥ 80) and then assigned to BP targets of either 130-140/80-90 mmHg or below 130/80 mmHg. Outcomes included major cardiovascular disease (CVD), end-stage renal disease, all-cause mortality and major adverse events related to antihypertensive treatment. Of 132 430 eligible patients identified, 52 553, 28 661 and 7106 patients aged 60-69, 70-79 and ≥ 80 years had BP targets of 130-140/80-90 mmHg, respectively; 11 148, 5636 and 1203 of patients in the same age groups had targets below 130/80 mmHg. Lower BP target was associated with reduced overall CVD and all-cause mortality: aged 60-69 years (CVD HR: 0.91 [95% CI, 0.85-0.96]; all-cause mortality: 0.89 [0.81-0.98]), aged 70-79 years (CVD: 0.87 [0.82-0.93]; all-cause mortality: 0.84 [0.78-0.91]), and aged≥80 years (CVD: 0.77 [0.69-0.86]; all-cause mortality: 0.80 [0.72-0.89]). No significant increase in major adverse events was observed in any age group. Results were consistent across all subgroups. Lowering BP of below 130/80 mmHg in old and very old patients was associated with better cardiovascular and mortality outcomes without increased adverse events. These findings suggest that a lower BP target may be beneficial and safe for older patients with hypertension.

44. Parkinsonian signs and cognitive trajectories in older adults: a population-based longitudinal study.

期刊: Age and ageing 发表日期: 2026-Jun-01 链接: PubMed

摘要

Cognitive impairment is common in parkinsonian disorders, but its extent among older adults with subtle motor abnormalities without a diagnosed movement disorder remains unclear. We examined cognitive decline, domain-specific cognitive function and incident dementia in older adults with subthreshold parkinsonism and parkinsonism (primary analysis). Sensitivity analyses were repeated using an additional definition of Mild Parkinsonian Signs for comparison. In the longitudinal general-population study Good Ageing in Skåne, 398 older adults aged 80-101 years (mean 86) were examined using the Unified Parkinson’s Disease Rating Scale part III and a comprehensive cognitive test battery. Participants were followed for a mean of 2.67 (0-9) years. Linear mixed models adjusted for age, sex and education were used to examine cognitive trajectories. At baseline, 54.4% of participants met the criteria for subthreshold parkinsonism and 23.6% for parkinsonism. Subthreshold parkinsonism was associated with reduced performance in perceptual speed (z-score estimate: -0.51), language (-0.36), executive function (-0.36) and global cognition (-0.33). Parkinsonism was associated with reduced performance in memory (-0.30), perceptual speed (-0.40), language (-0.33), executive function (-0.32) and global cognition (-0.34). Memory decline was most pronounced in both groups. During follow-up, 18% of participants developed dementia; of these, 46% had subthreshold parkinsonism and 26% parkinsonism at baseline. Subthreshold parkinsonism and parkinsonism are associated with cognitive impairment, particularly perceptual speed, language, executive function and global cognition that progress over time. These findings support parkinsonian signs as a prodromal state and highlight the importance of early detection for dementia prevention.

45. Patient-centered consultation in neuro-oncology: A qualitative meta-synthesis of brain tumor patients' experiences with treatment decision-making.

期刊: Patient education and counseling 发表日期: 2026-May-29 链接: PubMed

摘要

This meta-synthesis integrates qualitative evidence on how brain tumor patients’ experiences of treatment decision-making consultations in order to identify the essential elements of a patient-centered consultation framework tailored to their needs. We used a Thomas and Harden’s approach. Systematic search was conducted in Web of Science, PubMed, Embase, and Scopus for studies until June 15th, 2025. All included studies were critically appraised using the Joanna Briggs Institute (JBI) Critical Appraisal Checklist for Qualitative Research. The study was registered on PROSPERO with registration number CRD42023457607. This synthesis identified four analytical themes that should guide healthcare providers: (1) consultations must address emotional and existential concerns; (2) communication should be personalized; (3) decision-making must remain flexible, allowing patients to delegate control to trusted others when desired; and (4) the irreplaceable and multifaceted roles of family and social support. Our findings reveal a persistent gap in shared decision-making among brain tumor patients, many of whom defer decisions to physicians due to emotional distress, cognitive limitations, and informational barriers. Enhancing patient-centered care therefore requires strategies that strengthen trust, support patient engagement, and address these structural and emotional challenges. Clinical consultation should consider about patients’ emotional and existential concerns, incorporate personalized communication, adopt a flexible approach to decision-making, and appropriately involve family and social support.

46. Incidence of common cancers in Georgia in 2015-2019: A national cancer registry study.

期刊: Cancer treatment and research communications 发表日期: 2026-May-29 链接: PubMed

摘要

Cancer is the second leading cause of death worldwide, including in Georgia. This study aimed to evaluate the number of new cancer cases, identify the most common cancer sites, analyze sex differences, and evaluate age-standardized rates (ASR) and age-specific rates from 2015 to 2019 in Georgia. We used the Georgia National Cancer Registry data for all registered cancer cases, excluding non-melanoma of skin, and the National Statistics Office of Georgia population data. ASRs per 100,000 population were calculated using the direct standardization method, with the WHO’s world standard population as a reference. Between 2015 and 2019, 50,098 cancer cases (ICD-10 codes C00-96 exc. C44) were diagnosed in Georgia, including 21,802 in men (ASR 175.5/100,000) and 28,296 in women (ASR 192.8/100,000). Among men, the most common cancer sites were lung (16%, ASR 28.0/100,000); prostate (14%, ASR 22.0/100,000); bladder (10%, ASR 16.3/100,000); colorectal (10%, ASR 16.2/100,0000); and larynx (6%, ASR 10.9/100,000). Among women, the most common cancer sites were breast (34%, ASR 64.5/100,000), thyroid (14%, ASR 34.3/100,000), colorectal (7%, 10.3/100,000), cervix (6%, ASR 12.6/100,000) and corpus uteri (6%, ASR 11.4/100,000), respectively. This is the first comprehensive evaluation of cancer incidence in Georgia. Beyond sex-specific cancers such as breast and prostate, lung cancer was more common in men, while thyroid cancer was more common in women. The overall cancer incidence in Georgia was lower than the 2022 GLOBOCAN-estimated ASR for the 27 EU countries. Differences in healthcare infrastructure, screening uptake, or reporting accuracy may explain these disparities.

47. Towards reliable semi-quantification of PFAS in aquatic biota: A similarity-based approach and practical recommendations.

期刊: Talanta 发表日期: 2026-May-28 链接: PubMed

摘要

Numerous per- and polyfluoroalkyl substances (PFAS) are persistent, bioaccumulative, toxic and highly mobile in aquatic environments, making aquatic biota a relevant matrix to study PFAS contamination. Currently, hundreds of PFAS have been revealed by non-target screening. Quantifying exposure levels to these compounds is crucial for assessing risks and advising regulatory measures. For this, a comprehensive extraction protocol and accurate concentration estimation is required. In this study, the exhaustiveness of a sample preparation protocol was evaluated on a reference mussel matrix spiked with standards and aqueous film-forming foams (AFFF), covering 143 compounds. In addition, a similarity-based semi-quantification method was developed for PFAS in marine biota. The approach relies on the use of the most similar available standard, selected based on chemical fingerprints (ECFP6, MACCS) and fluorine content. Sample preparation proved effective for most compounds, and normalization against internal standards corrected losses and matrix effects. This method was applied to a spiked matrix, a field-collected mussel sample, and a fish CRM, with mean and median fold errors below 1.73. Despite matrix complexity, low concentrations could still be determined (e.g., 23 pg/g dw of FHpSA in mussel, fold error 1.13). The behavior of PFAS in ESI was evaluated and the in-source fragmentation of 6:2 FTSAm was described for the first time. Because it relies on systematic and reproducible calculations applicable to any PFAS, the proposed method can be readily implemented and, combined with the recommendations provided, aims to improve the reliability of PFAS semi-quantification in non-targeted analysis of biological samples.

48. Clinical Insights and Case Analysis of Disorders Attributed to Cicadas in the Emergency Department.

期刊: The western journal of emergency medicine 发表日期: 2026-May-15 链接: PubMed

摘要

In 2024 the United States experienced a rare co-emergence of two periodical cicada broods (XIII and XIX), along with annual cicadas. Although not inherently dangerous, cicadas have been linked to allergic reactions and unintentional injuries. The public health impact of this extraordinary event is poorly understood. In this study we aimed to characterize emergency department (ED) and urgent care (UC) visits associated with the 2024 cicada emergence. We conducted a retrospective chart review across ED and UC sites in a large healthcare system in the Midwest and Southeast that coincides with the ranges of the periodical cicada broods, from April 1-July 31, 2024. Electronic health records were searched for “cicada” and common variants. Two emergency physicians in each region reviewed identified records. Data extracted included demographics, diagnoses, visit characteristics, diagnostics, treatments, and outcomes. Of 1,304,743 total visits, 68 mentioned “cicada” or a variant; 42 were confirmed as cicada related. Patient ages ranged from 7 weeks to 87 years of age (median 38 years). Trauma was the most common cicada-related presentation (33), followed by falls (21), blunt trauma (6), vehicular/bicycle accidents (3), and other mechanisms. Additional cases involved allergic reactions (3), environmental exposure (2), and neurologic symptoms (2). Imaging was common: 57% had radiographs and 43% computed tomography. Seven patients sustained fractures; one required laceration repair, and six were admitted. While the overall health system impact was limited, cicada-related visits revealed important patterns of injury. Findings support the need for public education and preparedness during future mass insect events.

49. Creating and Maintaining a "Climate-Smart" Emergency Department: A Scoping Review of Current Progress and Future Potential.

期刊: The western journal of emergency medicine 发表日期: 2026-May-03 链接: PubMed

摘要

Climate change represents one of the most significant global health threats, with emergency departments (ED) serving as frontline responders to climate-related health emergencies. While EDs are major contributors to healthcare’s environmental footprint and critical responders for climate disasters, no comprehensive review has examined sustainability and climate-resilience initiatives specifically implemented in ED settings. We conducted a scoping review examining literature on sustainable and climate-resilient measures in EDs. Comprehensive searches of PubMed, Scopus, and Embase were performed from inception through November 2024, using terms related to EDs combined with sustainability and climate-resilience concepts. Two reviewers independently screened papers, with inclusion criteria requiring ED-specific focus and concrete sustainability or resilience interventions. Seven studies met inclusion criteria, representing diverse geographic contexts. Three addressed sustainability interventions including waste reduction, sustainable procurement, device reprocessing, and renewable energy adoption. Case examples demonstrated co-benefits, such as 31% reduction in ambulance carbon dioxide emissions and $3 million savings from device reprocessing programs. All studies described resilience interventions encompassing disaster preparedness, surge capacity, infrastructure continuity, and clinical protocols. However, significant gaps were identified: Only 13-20% of hospitals in surveyed countries had disaster plans, and no studies documented fully operational climate-smart EDs. Global frameworks were referenced but not operationalized in ED settings. There is a limited body of peer-reviewed studies that describe measures to close the implementation gap between current climate science and operational practices in EDs. Despite extensive policy recommendations and demonstrated benefits, no studies have described any existing programs. Emergency medicine requires translation of conceptual frameworks into measurable interventions, standardized outcome measures, and systematic implementation of climate-smart healthcare practices.

50. HIV and Syphilis Testing Among Patients Tested for Gonorrhea and Chlamydia in Emergency Departments.

期刊: The western journal of emergency medicine 发表日期: 2026-Apr-21 链接: PubMed

摘要

Sexually transmitted infections (STIs), including HIV and syphilis, are increasing. In 2023, there were over 2.4 million reported cases of chlamydia, gonorrhea, and syphilis in the United States, a 32.5% increase from 2014. Emergency departments (EDs) are vital touchpoints for STI testing, yet HIV and syphilis testing among patients undergoing Neisseria gonorrhoeae (NG) and Chlamydia trachomatis (CT) testing is suboptimal. We aimed to determine testing frequency and to identify factors associated with HIV and syphilis co-testing among ED patients undergoing NG/CT testing. We conducted a retrospective observational study of all patients tested for NG/CT from 2021-2024 at two Los Angeles EDs. Covariates including sociodemographic and behavioral data were extracted from the medical record. The primary outcome was complete STI testing, defined as both HIV and syphilis testing during or up to six months prior to an ED encounter with NG/CT testing. Multivariable logistic regression was used to evaluate factors associated with complete STI testing. Of 3,940 patients, 459 (11.7%) received complete STI testing. Among patients receiving complete STI testing, 176 (38.3%) were female, 282 (61.4%) were male, 96 (20.9%) were Hispanic, 98 (21.4%) were non-Hispanic Black, 195 (42.5%) were non-Hispanic White, 220 (47.9%) had Medicare insurance, 132 (28.8%) had private insurance, 225 (49.0%) were experiencing homelessness, 14 (3.1%) identified as bisexual, and 90 (19.6%) identified as heterosexual. In multivariable analysis, patients who were bisexual (adjusted odds ratio [aOR] 2.51; 95% CI, 1.32-4.80; P = .005); had Medicare insurance (aOR 1.89; 1.20-2.98; P = .006); or were experiencing homelessness (aOR 5.21; 4.00-6.78; P < .001) had higher odds of complete STI testing. Patients who were Hispanic (aOR 0.69; 0.52-0.92; P = .01); non-Hispanic Black (aOR 0.75; 0.56-1.00, P = .05); or female (aOR 0.68; 0.54-0.85; P = .001) had lower odds. Of 261 patients with multiple ED encounters, 217 (83.1%) never received complete testing. Complete HIV and syphilis testing among ED patients tested for N. gonorrhoeae and C. trachomatis was low, even among patients with multiple ED encounters. Lower testing among Hispanic and non-Hispanic Black patients may exacerbate existing disparities in STIs. Implementation research is needed to improve the integration of STI testing in EDs.

51. The Impact of Care Delivered Through the Self-Management Promotion Model on Health Literacy Levels in Patients With Chronic Obstructive Pulmonary Disease: Quasi-Experimental Research.

期刊: Health literacy research and practice 发表日期: 2026-Apr 链接: PubMed

摘要

Chronic obstructive pulmonary disease (COPD) is one of the leading causes of death worldwide. Many patients with COPD lack the necessary skills to manage their condition independently, often due to insufficient health literacy. This deficiency leads to frequent re-hospitalizations and decreased quality of life. Implementing interventions to address these factors is essential, with the self-management promotion model being a particularly effective approach for chronic patients. Therefore, this study was designed to examine the impact of implementing care based on the self-management promotion model on health literacy levels among patients with COPD attending Shahrekord teaching hospitals in 2024. The aim of this study was to examine the impact of implementing care based on the self-management promotion model on health literacy levels among patients with chronic obstructive pulmonary disease attending Shahrekord teaching hospitals in 2024. This semiexperimental study involved 70 patients with COPD at educational hospital afield to Shahrekord University of Medical Sciences. Participants were selected gradually based on study criteria, and random assignment divided them into control and intervention groups, with 35 individuals in each group. In addition to routine care, the intervention group received a self-management enhancement program consisting of eight in-person and virtual sessions. Patients completed demographic questionnaires and health literacy assessments at the study’s commencement, immediately postintervention, and 2 months later. Data analysis was conducted using SPSS 21 software. The average age of participants was 57.19 ± 11.2 years. Three months’ postintervention, a significant improvement in health literacy scores was noted in the intervention group (p = .001), while no significant change was observed in the control group (p = .183). The findings of this study demonstrate the effectiveness of the self-management promotion model intervention in enhancing health literacy among patients with COPD. Consequently, implementing this model is recommended as a valuable component of chronic patient empowerment programs. Additionally, the inclusion of patients’ families was identified as a positive factor contributing to improved health literacy and self-care in this patient population.

52. Advanced glycation end product accumulation was associated with renal function impairment in males in large health examination population.

期刊: PloS one 发表日期: 2026 链接: PubMed

摘要

The accumulation of advanced glycation end products (AGEs) is a risk factor for renal dysfunction. However, no investigation has been conducted on the association between AGEs and renal function in health screening participants. Therefore, this study aimed to examine the association between AGEs and kidney function in health screening participants who underwent health screening examination. Overall, 1,651 health screening examinees without a history of renal dysfunction diagnosis were recruited and AGE accumulation was measured by skin autofluorescence (SAF). The association between estimated glomerular filtration rate (eGFR) and AGEs was subsequently investigated in all examinees. The mean age was 56.6 ± 9.5 years; 812 (49.1%) were males, and the mean eGFR was 73.3 ± 13.4 mL/min. Multiple regression analysis identified that AGEs were significantly negatively associated with eGFR. This finding was also observed in examinees with normal eGFR (≧ 90 mL/min/1.73 m2, G1 stage according to the Japanese Society of Nephrology: N = 207). In conclusion, skin AGEs were significantly negatively associated with eGFR. To clarify whether AGEs contribute to renal dysfunction progression, additional research is required.

53. Elevated high sensitivity cardiac troponin T among men with HIV who use stimulants: A cross-sectional study of subclinical cardiovascular injury.

期刊: PloS one 发表日期: 2026 链接: PubMed

摘要

People with HIV (PWH) experience elevated cardiovascular disease risk compared to people without HIV. Stimulant use may further increase subclinical myocardial injury among PWH, but data on cardiovascular biomarkers, including serum high-sensitivity cardiac troponin T (hs-cTnT) in this population is limited. This cross-sectional secondary analysis included 72 cisgender men with and without HIV enrolled in a South Florida cohort. Stimulant exposure was defined as any non-prescribed stimulant use in the past 3 months and/or a reactive urine toxicology screen, creating four HIV-by-stimulant use groups (i.e., HIV+Stim + , HIV+Stim-, HIV-Stim + , and HIV-Stim-). hs-cTnT was measured using a Roche high-sensitivity assay, with values below the limit of detection treated as undetectable. We used a two-part model (logistic for detectability; log-normal among participants with detectable hs-cTnT), adjusted for age and recent tobacco use, with sensitivity analyses adding renal function and cardiometabolic factors. After adjusting for age and recent tobacco use, HIV+Stim+ participants had higher odds of detectable hs-cTnT (aOR = 7.48, 95% CI: 1.25, 44.62) and higher estimated mean concentration of hs-cTnT (β = 0.51, p = 0.031, mean = 12) than the HIV-Stim- group. Exploratory analyses suggested a positive dose-response association between amphetamine metabolite levels and hs-cTnT (r(11) = 0.86, p < 0.0001). Co-occurring HIV and stimulant use were associated with higher hs-cTnT in this sample. However, given that hs-cTnT may reflect a range of acute, subacute, and chronic processes, and the small sample size and restricted generalizability, these findings should be interpreted as exploratory and hypothesis-generating and require confirmation in larger studies.

54. Improvements in Infant Mortality From Congenital Cardiovascular Abnormalities Differ by Race in Wisconsin and the US, 1995-2022.

期刊: WMJ : official publication of the State Medical Society of Wisconsin 发表日期: 2026 链接: PubMed

摘要

Infant mortality from congenital cardiovascular defects (CCDs) is the leading cause of death among individuals with birth defects. A descriptive analysis of infant mortality due to CCDs in Wisconsin and the United States was performed using data from the Centers for Disease Control and Prevention’s Wide-ranging ONline Database for Epidemiological Research (WONDER) from 1995 to 2022. Congenital cardiovascular defect-related infant mortality (CCDIM) declined during this period in the United States (P < .0001) and in Wisconsin (P = .024). In the United States, African American and American Indian or Alaska Native populations experienced higher rates than Asian or White populations. In Wisconsin, non-White populations experienced higher CCDIM rates than White populations. CCDIM in Wisconsin has declined over time. However, an excess of CCDIM in non-White populations persists compared with White populations. Because many risk factors for CCDIM are related to behavioral, environmental, and socioeconomic factors, these observed differences may represent opportunities for targeted prevention efforts.

55. Challenges and opportunities for plastic versus mixed waste enterprises in Greater Accra and Kisumu: A qualitative study.

期刊: PloS one 发表日期: 2026 链接: PubMed

摘要

Consumption of products packaged in plastics is growing in Sub-Saharan African cities, whose populations often lack solid waste management (SWM) services. The informal sector often fills gaps in plastic waste collection and recovery that are not met by formal SWM. To reduce plastic waste mismanagement and its associated health risks, SWM systems are needed that separate plastic waste for reuse or recycling. However, little is known about the contributions and challenges facing the mixed formal-informal enterprises in such cities’ SWM chains. This multi-country qualitative study therefore aimed to contrast the specific challenges of plastic waste collectors with those facing general waste collectors. Eleven focus group discussions (FGDs), 6-12 participants per FGD (n = 87 in total), were held with plastic main collectors and sub-collectors (4 FGDs), and general waste collectors (2 FGDs)in Greater Accra, Ghana, and waste sub-collectors (2FGDs), waste intermediaries (2FGDs) and apex plastic traders (1FGD) in Kisumu, Kenya, differentiating business types and plastic from mixed waste enterprises. Barriers, enablers, and solutions were identified through thematic coding and analysis of transcripts. We find differing SWM trajectories in Accra versus Kisumu. Domestic waste separation remains low in Kisumu, whilst Accra’s SWM system evolved from flexible to rigid plastic separation. Mixed and plastic waste collectors reported shared challenges, such as lack of crushing or transport equipment, harassment, greater hazardous faecal matter in waste streams, and lack of societal recognition. Additionally, specialist plastic waste workers in Greater Accra reported business-specific challenges, notably price volatility from seasonally variable plastic waste generation and from bulk international waste plastic imports, alongside theft of separated plastics. Accra’s informal plastic waste sub-collectors were mostly elderly women who reported occupational health challenges from bending and lifting waste. Our findings highlight the need for context-sensitive plastic SWM programmes, including fair bargaining and price regulation measures, occupational health programmes and safer diaper SWM.

56. Strand-specific quantification of L1 ORF0 and related transcripts by multiplex reverse transcription with tagged primers.

期刊: BioTechniques 发表日期: 2026 链接: PubMed

摘要

Long interspersed nuclear element-1 (LINE-1 or L1) is the only autonomously active retrotransposon in the human genome and produces both sense and antisense transcripts from its 5’ untranslated region (5’UTR) of L1Hs, a human-specific L1 subfamily. Among these, ORF0 is an antisense transcript-derived protein implicated in retrotransposition activity, yet its mRNA expression has been difficult to quantify because strand discrimination is required for accurate detection. Here, we developed a strand-specific quantitative polymerase chain reaction (qPCR) method incorporating multiplex gene-specific tagged primers in the reverse transcription (RT) step, which enables simultaneous quantification of antisense ORF0 and sense 5’UTR and ORF2 transcripts. Validation in 5-aza-2’-deoxycytidine-treated neuroblastoma cells confirmed dose-dependent increases in expression of ORF0 and sense transcripts, demonstrating the strand specificity and functionality of this method. Application to human postmortem prefrontal cortex and cerebellum samples revealed stable expression of ORF0 and sense transcripts. This assay provides a robust and scalable tool for the precise quantification of strand-specific L1 transcription, complementing locus-specific analyses, and offering a platform for future studies on the role of ORF0 and L1 antisense transcription. Retrotransposon LINE-1 (L1) is a repetitive DNA element that makes up about 17% of the human genome. Some copies of L1Hs, a human-specific L1 subfamily, remain active and can move to other locations in the genome. L1Hs produces transcripts in both sense and antisense directions from its promoter region. Sense transcription generates full-length L1 RNA, whereas antisense transcription produces transcripts that encode a small protein called ORF0. ORF0 may regulate L1 jumping activity. However, it is difficult to measure ORF0 transcripts because common quantitative polymerase chain reaction (qPCR) methods cannot distinguish which RNA strand they detect. In this study, we developed a qPCR method that can distinguish sense and antisense ORF0 transcripts by employing uniquely tagged primers in the reverse transcription step. We tested this method in human neuroblastoma cells treated with a DNA methylation inhibitor and in postmortem brain samples. It successfully detected L1 transcripts, including ORF0. This simple and reliable method will be useful for studying the function of ORF0.