公共卫生研究摘要 (2026-06-12)

共收录 47 篇研究文章

1. Associations of atherogenic index of plasma related indices with subclinical carotid atherosclerosis.

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

摘要

Evidence regarding the relationships between atherogenic index of plasma (AIP)-related indices and carotid atherosclerosis (CA) is limited. A total of 59123 participants from the China Stroke High-risk Population Screening and Intervention Program (CSHPSIP) in Hubei Province, China, from 2017 to 2020 were included in this cross-sectional study. Three indices were developed to assess AIP-related indices: AIP-body mass index (AIP-BMI), AIP-waist circumference (AIP-WC), and AIP-waist-height ratio (AIP -WHtR). Per 1-standard deviation (SD) increase in AIP-BMI (OR = 1.36, 95% CI = 1.31-1.41), AIP-WC (1.34, 1.29-1.38), and AIP-WHtR (1.33, 1.28-1.38) were associated with CIMT. Per 1-standard deviation (SD) increase in AIP-BMI (OR = 1.32, 95% CI = 1.28-1.37), AIP-WC (1.34, 1.29-1.38), and AIP-WHtR (1.33, 1.29-1.38) were associated with plaques. AIP-BMI, AIP-WC and AIP-WHtR were positively associated with stenosis when they were divided into interquartile range (IQR), compared with the Q1 group. The ROC analyses showed that AIP-BMI had the greatest diagnostic value for CA and CIMT, with the AUC of 0.833 (0.828, 0.838) and 0.817 (0.811, 0.824), respectively. AIP-BMI, AIP-WC and AIP-WHtR had the greatest diagnostic value for plaques, with the AUC of 0.842 (0.836, 0.848), 0.842 (0.836, 0.847), and 0.842 (0.836, 0.848), respectively. Meanwhile, all the four indices (AIP, AIP-BMI, AIP-WC and AIP-WHtR) showed the same diagnostic value for plaques, with the AUC of 0.871 (0.858, 0.884). AIP-related indices were positively associated with CA, carotid intima-media thickness (CIMT), plaque and stenosis. Future prospective studies are needed to confirm our findings and clarify their clinical utility.

2. Two-step care pathways for advanced MASLD in primary and hospital care: A multicenter study.

期刊: Hepatology communications 发表日期: 2026-Jul-01 链接: PubMed

摘要

Early diagnosis of metabolic dysfunction-associated steatotic liver disease (MASLD) fibrosis may prevent liver-related morbidity and mortality. We investigated the effectiveness of multiple 2-step approaches for detecting at-risk advanced MASLD fibrosis, defined as a hierarchical clinical score comprising liver histology and VCTE depending on availability, in primary and hospital outpatient care. Patients at risk for MASLD were recruited from general practices and regional and tertiary internal medicine clinics, after excluding other liver diseases. Simultaneous measurement of non-invasive tests (NITs), including fibrosis-4 score (FIB4), metabolic dysfunction-associated fibrosis-5 score (MAF5), NAFLD fibrosis score (NFS), enhanced liver fibrosis (ELF) test, procollagen type III N-terminal propeptide (PRO-C3), procollagen type VI N-terminal propeptide (PRO-C6), and vibration-controlled transient elastography (VCTE), allowed testing of 2-step referral pathways. Referral patterns were compared with regular care between 2016 and 2024 using a predefined reference standard. Among 595 participants, 9.4% were at-risk of advanced MASLD fibrosis. A care pathway consisting of FIB4 (≥1.30) followed by VCTE yielded the greatest improvement, increasing the correct referral rate 5.0-fold (95% CI: 2.4-10.1) compared with regular care. However, care pathways incorporating MAF5 (≥1.0) or NFS (≥-1.455) followed by VCTE demonstrated markedly higher sensitivity at comparable increases in detection (both >4.5-fold). Among other second-step NITs, PRO-C3 outperformed ELF, PRO-C6, and ADAPT, resulting in a 2.2-fold (95% CI: 1.1-4.4) increase in correct referrals when used after FIB4 (≥1.30). Two-step care pathways substantially improve the detection of at-risk advanced MASLD fibrosis across care settings. Pathways using FIB4, MAF5, or NFS followed by VCTE offer the best performance overall, while PRO-C3 is the most effective alternative blood-based second-step test.

3. The incidence, frequency of late liver-related complications, and transplant likelihood in pediatric acute liver failure in Californian children.

期刊: Hepatology communications 发表日期: 2026-Jul-01 链接: PubMed

摘要

Early studies of pediatric acute liver failure (PALF) estimate that 60%-70% of patients survive with their native liver (SNL), 20%-25% require an emergent liver transplant (LT), and 10%-15% are mortalities. These studies were largely limited to academic centers and focused on short-term outcomes. Herein, we analyzed California Department of Healthcare Access and Information data, which is demographically representative of the US population. Between June 1990 and December 2018, 2270 children were admitted to California hospitals with PALF. The overall incidence of PALF was 16.75 per 100,000 live births, with no evidence of seasonality. LT was performed in 188 (8.3%) patients and 425 (18.7%) patients died. Mortality was associated with contraindications to transplant, such as concomitant hematologic malignancy or cardiac disease. With a median follow-up of 4.5 years, nearly all deaths occurred within 4 months of presentation, with no long-term liver-related comorbidities in patients with SNL. Implementation of pediatric end-stage liver disease/MELD-based organ allocation in 2002 resulted in a more than 2-fold increase in the likelihood of LT in children <10 years (subdistribution hazard ratio: 3.35). Patients receiving care at transplant centers after this change were younger (10 vs. 12 y), more often from urban areas (98.2% vs. 94%), and more likely to receive LT for metabolic, genetic, or “other” causes of PALF (up to subdistribution hazard ratio 6.4 [1.84-22.26], p<0.01). While mortality was higher at transplant centers (26.5% vs. 14.6%), the time to mortality was also increased (31 vs. 7 d), likely reflecting disease complexity requiring management in a specialized children’s hospital. In conclusion, this study supports an estimate of incidence and long-term outcomes of PALF across a large population and highlights the role of specialized pediatric transplant centers for the optimized care of PALF.

4. Our health (data) is our wealth: improving primary healthcare data access for research in Aotearoa New Zealand.

期刊: The New Zealand medical journal 发表日期: 2026-Jun-12 链接: PubMed

摘要

Primary healthcare data can be used to conduct cost-effective research that improves understanding of population health and disease, leading to more effective prevention, earlier diagnosis, better-informed health models and improved health equity. However, Aotearoa New Zealand lacks a national primary healthcare data collection and has no national infrastructure to integrate and interrogate routinely collected primary healthcare data. This paper describes new technical approaches used internationally to improve researcher access to healthcare data and considers how this may be applied in the New Zealand context using Māori data governance and ethical data stewardship principles. Data access may be improved through platform-level, algorithm-level and data-level approaches. Māori data governance and ethical data stewardship principles can be applied to these new technical approaches. A governance model requires strict management, administration and oversight. An open-access model could provide easier access for researchers to develop and test models on synthetic data within a trusted research environment. Improving primary healthcare data access for research in New Zealand requires partnership that upholds Māori data governance principles and ethical research standards. Debate of the advantages and disadvantages of these technical approaches and stewardship models including patients and the public is welcomed.

5. Clinical complexities in diagnosing and managing leptospirosis in New Zealand: a qualitative analysis.

期刊: The New Zealand medical journal 发表日期: 2026-Jun-12 链接: PubMed

摘要

Leptospirosis is a bacterial zoonosis often under-diagnosed due to its presentation as an undifferentiated febrile illness. This study aimed to explore the clinical complexities involved in diagnosing and managing leptospirosis cases in New Zealand. Qualitative content analysis of clinical notes from 42 leptospirosis cases used a dual deductive and inductive approach to identify key themes. Three key themes emerged, highlighting the critical role of clinician reasoning in early detection and appropriate clinical response: 1) multiple factors contribute to delayed diagnosis, including incomplete exposure histories and deviation of symptoms from textbook definitions, 2) there were challenges with diagnosis and the use of medication in post-acute care, and 3) interpretation and use of confirmatory tests was inconsistent and complex. Clinicians were confident in suspecting leptospirosis when clinical history taking also assessed relevant exposure. Based on these findings, we have made recommendations to prevent delayed diagnosis. We advocate updating clinical references to better reflect New Zealand-specific disease presentation and risk factors to support early diagnosis. National standardisation of diagnostic test timing, selection and interpretation is recommended, alongside clearer notification pathways. Further research could focus on early diagnostic markers to improve clinical decision making in practice.

6. Changes in life expectancy in Aotearoa New Zealand: a cause-specific decomposition analysis over 20 years.

期刊: The New Zealand medical journal 发表日期: 2026-Jun-12 链接: PubMed

摘要

Life expectancy in Aotearoa New Zealand has increased over recent decades, but these increases have not been distributed equally across population groups. Examining how changes in cause-specific mortality have contributed to changes in life expectancy can improve understanding of evolving mortality patterns and persistent inequities. This study quantified the contribution of major causes of death to changes in life expectancy over approximately two decades. Mortality data from the New Zealand Mortality Collection and population estimates from Statistics New Zealand were used to calculate life expectancy at birth for Māori, Pacific, Asian, and European and Other populations for the periods 2001-2003 and 2020-2022. Changes in life expectancy were decomposed by age and cause of death using the Arriaga method. Deaths were grouped into major disease categories and selected individual causes to estimate their contribution to the change in life expectancy. Life expectancy increased for all ethnic groups, with the largest absolute increases observed among Māori. Improvements were driven primarily by reductions in mortality at adult and older ages. Across all ethnic and sex groups, declines in cardiovascular disease and cancer mortality accounted for more than half of the total change in life expectancy. Reductions in mortality from diabetes and smoking-related conditions also contributed to increases among Māori and Pacific peoples. Despite these improvements, substantial ethnic inequities in life expectancy remain. Increases in life expectancy in Aotearoa New Zealand between 2001-2003 and 2020-2022 were driven largely by reductions in mortality from major non-communicable diseases, primarily cardiovascular disease and cancer. Māori experienced some narrowing of the life expectancy gap relative to European and Other populations, whereas the gap for Pacific peoples remained largely unchanged. Despite overall improvement, substantial inequities persist. Further increases are likely to depend on strengthening primary prevention, particularly reductions in smoking and cardiovascular risk factors, alongside improved participation in screening and early detection programmes, including the potential role of lung cancer screening, and ensuring equitable access across care pathways.

7. Validating OHIP-5 for Equitable Oral Healthcare in Nigeria.

期刊: International dental journal 发表日期: 2026-Jun-11 链接: PubMed

摘要

Healthcare access in low- and middle-income countries (LMICs) is constrained by structural and socio-cultural barriers, including language. Oral health, despite its importance to general health, is often overlooked in universal health coverage efforts. The Oral Health Impact Profile (OHIP-5) is a brief patient-reported outcome measure (PROM) for oral health-related quality of life (OHRQoL) but has not been adapted into indigenous Nigerian languages. This study aimed to translate and evaluate the Yoruba version (OHIP-5Yor), assess its psychometric performance using both English and Yoruba administrations, and explore its relevance for improving patient-centred oral healthcare access in LMICs. A cross-sectional survey of 143 adults was conducted at two dental centres in Ibadan, Nigeria. The OHIP-5 was translated using a forward-backward approach with pilot testing. Psychometric evaluation included internal consistency, inter-item correlation, convergent validity, and confirmatory factor analysis. Of the 143 participants, 52 completed the Yoruba version and 91 the English version. The mean OHIP-5 score was 6.6 ± 4.3. The instrument showed acceptable internal consistency (Cronbach’s α = 0.67) and supportive construct validity. Structural validity indices, however, indicated that the factorial structure requires further evaluation in larger and more diverse samples. The findings provide preliminary support for the reliability and validity of the OHIP-5Yor as a culturally adapted tool for assessing OHRQoL among Nigerian adult dental patients. Beyond psychometric evaluation, the instrument may help address an important equity gap by enabling non-English speakers to participate more fully in oral health assessment, thereby supporting patient-clinician communication and highlighting unmet needs. Incorporation of such tools into routine care and public health surveillance represents a potential, scalable approach to strengthening oral healthcare access in low- and middle-income countries (LMICs). The OHIP-5Yor enables brief, culturally appropriate assessment of patient-perceived oral health impacts and may support more equitable oral healthcare delivery in multilingual settings.

8. Oral Health on Sal, Cape Verde: A Population-Based, Cross-Sectional Study.

期刊: International dental journal 发表日期: 2026-Jun-11 链接: PubMed

摘要

Sal is one of the ten islands of Cape Verde, a lower-middle-income country in Africa. Local reports suggest poor oral health among residents, but no scientific data exists. This study aimed to assess oral health status and oral health-related quality of life (OHRQoL) of Sal’s dentulous inhabitants, identify risk factors associated with oral health, and explore correlations between oral health and OHRQoL in adults. A population-based cross-sectional study was conducted among dentulous Sal residents. Final-year dental students from the Academic Centre for Dentistry Amsterdam (ACTA), Faculty of Dentistry in Amsterdam, performed duplicate oral health examinations. Outcomes included caries experience (dmft/DMFT), consequences of untreated caries (pufa/PUFA), and periodontal health (DPSI; in adults only). Data on brushing frequency, toothbrush ownership, toothpaste availability, dental visits, dental insurance, and tobacco use (adults only) were collected. Adults completed the OHIP-14 questionnaire (OHRQoL). Descriptive statistics summarized characteristics; multivariable regressions assessed associations. A total of 1,371 dentulous residents participated (609 children aged 1-17 years; 762 adults aged 18-89 years). Caries prevalence was 87.5% and pufa/PUFA 52.2%. Mean dmft/DMFT was 3.7 ± 3.2 (children) and 7.5 ± 6.2 (adults). 63.1% had DPSI maximum-scores ≥3+ (periodontal disease). Toothbrush ownership was high (>96%), access to toothpaste (<90%) and dental insurance was limited (children 63%; adults 46%). Dental insurance was associated with lower dmft/DMFT (p = .019) and lower pufa/PUFA (p = .005). Higher DMFT, PUFA, and severe periodontal disease was associated with poorer OHRQoL. Oral health among Sal’s residents is poor, with a high disease burden and limited access to care. Improving preventive strategies and access to dental services is important to reduce disease prevalence and enhance quality of life.

9. From Theory to Practice: GPT-Supported Data Extraction in Observational Studies on Transcatheter Aortic Valve Replacement.

期刊: JACC. Advances 发表日期: 2026-Jun-11 链接: PubMed

摘要

Manual record abstraction is the standard method for data collection in observational studies but is labor-intensive, error-prone, and difficult to scale, particularly when information is embedded in unstructured electronic health records. Large language models (LLMs) may streamline this process, yet evidence from real-world clinical research remains limited. This study evaluated the performance of a generative pre-trained transformer (GPT)-based LLM in extracting sociodemographic, procedural, and outcome variables from free-text electronic health records of patients undergoing transcatheter aortic valve replacement. We conducted a retrospective analysis of medical and nursing records for all transcatheter aortic valve replacement procedures performed at Ca’ Foncello Hospital (Treviso, Italy) between January and June 2024. Manual abstraction by 2 reviewers served as the reference standard. Accuracy, sensitivity, and specificity with 95% CIs were calculated. Agreement for continuous variables was assessed using Bland-Altman analyses. A total of 108 cases were included. GPT achieved accuracy ranging from 0.657 (valve brand) to 1.00 (gender, Barthel index, procedure timings, and several intraoperative complications). Sensitivity reached 1.00 for rare but clinically important events, including intraoperative neurological complications, whereas specificity exceeded 0.90 for most variables. For vital parameters, Bland-Altman analyses demonstrated minimal bias and narrow limits of agreement. GPT-based data extraction showed high accuracy across a broad range of variables, particularly continuous repeated measurements and rare intraoperative outcomes. Performance was lower for some infrequent postoperative events, reflecting sparse true positives. These findings support the feasibility of integrating LLM-assisted extraction into observational research workflows, with further validation needed in larger or multicenter cohorts.

10. Palliative and End-of-Life Care Utilization in Cardiogenic Shock Complicating Acute Myocardial Infarction: A Population-Based Study.

期刊: JACC. Advances 发表日期: 2026-Jun-11 链接: PubMed

摘要

Little is known about end-of-life trajectories in survivors of cardiogenic shock complicating acute myocardial infarction (AMI-CS) who die beyond their index admission, or utilization of palliative care services in AMI-CS survivors. This study aimed to examine long-term palliative and end-of-life care among AMI-CS survivors. This was a population-based, retrospective cohort of AMI-CS survivors in Ontario, Canada, from 2009 to 2020 who died during longitudinal follow-up. We identified 3,881 AMI-CS survivors (2009-2020) who died after discharge and before March 2024. The median survival time was 1,096 days (IQR: 312-2,139 days). Overall, 2,100 patients (54.1%) died in acute care, with no difference between those who did and did not receive palliative care. Patients who did not receive palliative care were more likely to die in intensive care units (ICU) than those who did (23% vs 17%, absolute standard difference 0.15). Most patients received palliative care in the final year of life (n = 2,485, 64%); 1,057 patients (42.5%) had outpatient visits, 505 patients (20.3%) had inpatient palliative care consultations, and 327 patients (13.2%) had palliative care hospitalizations. Palliative care, however, was most commonly initiated in the last 14 days of life (1,185 patients, 47.7%). Earlier palliative care referrals were associated with reduced rates of dying in hospital (adjusted OR: 0.50; 95% CI: 0.42-0.65) and ICU (adjusted OR: 0.34; 95% CI: 0.26-0.45). Early and intermediate term palliative care involvement was associated with reduced risk of death in hospital and ICU. Such consultation may improve end-of-life outcomes in AMI-CS survivors.

11. Black-White Differences in Neonatal Survival Among Periviable Births, 1995-2019.

期刊: Obstetrics and gynecology 发表日期: 2026-Jun-11 链接: PubMed

摘要

To assess whether the previously found neonatal survival advantage for Black (vs White) periviable births (20 0/7-25 6/7 weeks of gestation) persists over a 25-year period (1995-2019) in the United States, and to quantify changes in survivability over time. Assessments conceptualize race as a marker of exposure to racialized stressors and barriers to care. This population-based observational study used 1995-2019 U.S. restricted-use, cohort-linked birth and infant death data from the National Center for Health Statistics. The study included all non-Hispanic Black (n=149,601) and non-Hispanic White (n=158,500) periviable births. We used modified Poisson regressions to estimate risks of neonatal death (before age 28 days) based on the birthing person’s race and ethnicity and year of birth (measured in 5-year periods) and their interaction. We also controlled for a set of sociodemographic variables (maternal age, socioeconomic status) and pregnancy characteristics (plurality, neonatal sex) that predict neonatal mortality. In 1995-1999, Black periviable neonates exhibited a survival advantage compared with their White counterparts (adjusted risk ratio [aRR] 0.86; 95% CI, 0.84-0.87). Over 20 years, White periviable neonates experienced a precipitous decrease in neonatal death risks (2015-2019 aRR 0.82; 95% CI, 0.80-0.83), whereas Black periviable neonates experienced slower improvements (2015-2019 Black×period aRR 1.07; 95% CI, 1.04-1.09). Estimates suggest that risks of neonatal death declined by 18% for White periviable neonates (from predicted probabilities of 53.0 in 1995-1999 to 43.3 in 2015-2019) but by only 13% for their Black counterparts (45.5-39.5). Black-White periviable risk ratios ranged from 4.0 to 3.6 over the study periods. Both Black and White periviable births exhibited declines in neonatal death risks between 1995 and 2019, with White births showing faster declines. Clinically, these findings reveal overall improvements in periviable risks. However, because Black births are disproportionately represented among periviable deliveries, slower improvements in survival sustain a disproportionate burden of periviable deaths among Black neonates.

12. Digital Health Monitoring and Intervention Suite for Stress in Frontline Nurses: Prospective Cohort Trial.

期刊: JMIR formative research 发表日期: 2026-Jun-11 链接: PubMed

摘要

Stress among health care workers (HCWs) contributes to burnout, workforce attrition, and adverse patient outcomes. Although virtual reality (VR), psychoeducation, ecological momentary assessments (EMAs), and wearables have independently shown promise in stress research, no integrated digital suite has combined controlled stress induction, intervention delivery, and longitudinal real-world monitoring in HCWs. This study aimed to evaluate the feasibility, engagement, and preliminary effectiveness of a multimodal Digital Health Monitoring and Intervention suite for Stress framework integrating VR simulation, psychoeducation, EMAs, and wearable biometrics. We examined (1) the impact of VR simulation and psychoeducation on stress outcomes and (2) associations between physiological and self-reported mental health outcomes. Ninety-nine nurses (mean age 33.7, SD 8.9 yr, 87% female) were enrolled in 2023. We conducted a single-arm prospective cohort study (NCT05923398). Using convenience sampling, participants were recruited from social media advertisements, flyers, and email notices distributed through professional listservs. Participants completed ≥2-week baseline monitoring, a single VR session (2 runs separated by a brief psychoeducation intervention), and 12-week follow-up. In-VR stress was assessed using the Subjective Units of Distress Scale (SUDS) and 4-item Moral Injury Outcome Scale (MIOS-4), with synchronous heart rate variability. Longitudinal outcomes included weekly and biweekly EMAs alongside 70 wearable-derived features. Paired t tests, aligned rank transform ANOVA, and Pearson correlations informed study objectives, with P values adjusted for multiple comparisons. Qualitative content analysis classified emotional responses during and after VR. VR significantly increased subjective stress across checkpoints in both runs, with attenuation in Run B relative to Run A (all P<.001). No significant heart rate variability differences were observed between runs (P=.15). During VR, 92% (91/99) of participants felt stressed, 36% (36/99) reported anxiety or nervousness, and 51% (50/99)-78% (77/99) endorsed anger, guilt, shame, and/or betrayal. Most (59/99, 60%) HCWs returned to an emotional baseline post-VR, although 12% (12/99) reported lingering distress. Immediate reliable improvements in anger, guilt, shame, and/or betrayal occurred for 50% (50/99)-75% (74/99) of participants post intervention. Anxiety (mean -0.53, SD 2.34; P=.03) and stress (mean -3.05, SD 11.35; P=.01) decreased 2 weeks post intervention, but were not sustained at 12 weeks. Increased sleep restlessness was the only wearable feature showing significant changes (mean 2.46%, SD 5.43; Padj<.001). In-VR stress correlated with 12-week real-world stress (SUDS: r=0.57-0.58; MIOS-4: r=0.58-0.61; all P<.01). Data completion exceeded 90%, with 71% achieving full compliance. This study moves beyond single-tool interventions to demonstrate the feasibility and preliminary effectiveness of an integrated, multimodal stress platform within a single coordinated framework. This trial demonstrates high engagement, short-term symptom responsiveness, ecological validity, and emotional safety. The framework provides a scalable model for proactive stress identification, skills training, and implementation in high-risk occupational settings. Randomized controlled trials are needed to establish sustained efficacy and optimize deployment for real-world implementation.

13. Clinical characteristics and antibiotic susceptibility of non-typhoidal Salmonella in immunocompromised children: a 15-year retrospective study in Thailand.

期刊: Journal of tropical pediatrics 发表日期: 2026-Jun-11 链接: PubMed

摘要

We aimed to evaluate the outcomes, antibiotic susceptibility of non-typhoidal Salmonella (NTS), and risk factors of invasive NTS (iNTS) infections in immunocompromised children. This is a retrospective observational study of immunocompromised children under 15 years of age with microbiologically proven NTS infections at Songklanagarind Hospital from January 2007 to December 2021. Among the 96 patients with NTS, 41 were diagnosed with hematologic malignancies, 26 with solid tumors, 6 with primary immunodeficiencies, and 23 with other immunodeficiencies, including nephrotic syndrome, autoimmune disorders treated with steroids, and aplastic anemia. NTS isolates collected during 2007-2012 and 2013-2021 demonstrated comparable susceptibility rates to ceftriaxone (100% and 93%, respectively), whereas susceptibility to ciprofloxacin decreased from 100% to 85.5%. Among the 96 patients, 21 (21.9%) had iNTS infections, including bacteremia (n = 19), urinary tract infections (UTIs; n = 2), and musculoskeletal infection (n = 1). One patient had concurrent UTI and osteomyelitis. The overall mortality rate among iNTS cases was 14.3%. In multivariable analysis, immunocompromised children with a sickly appearance, absence of gastrointestinal symptoms, and/or other immunodeficient conditions were at increased risk for iNTS infection, with predictive scores of 2.5, 2.7, and 2.8, respectively. A score ≥2.7 significantly predicted iNTS infection, with an area under the curve of 0.88. The sensitivity and specificity were 0.80 and 0.77, respectively. Nearly 22% of immunocompromised children had iNTS infection. Ceftriaxone remains an appropriate empirical treatment for suspected iNTS infection.

14. Expectations and Utilization of Paternity Leave Among Male Partners in a Postpartum Public Hospital Setting in Los Angeles, California.

期刊: American journal of public health 发表日期: 2026-Jun-11 链接: PubMed

摘要

Objectives. To examine paternity leave availability and leave-taking intentions among male partners of postpartum patients in a public county hospital and explore factors linked to not taking leave. Methods. We conducted an exploratory, cross-sectional survey of male partners of patients delivering at Los Angeles General Medical Center (November 2022-July 2023). Surveys assessed sociodemographic characteristics, workplace leave policies, leave duration, and leave-taking intentions. Multivariable logistic regression of characteristics linked to leave-taking were restricted to employed respondents. Results. We surveyed 100 respondents. Among employed respondents (n = 93), 39% reported no workplace paternity leave policy. Among those with known policies (n = 76), 47% had zero weeks available and 39% did not plan to take any leave. Although not intending to take leave was more common among non-English-speaking respondents and those without health insurance, having no paid leave policy was the primary predictor of not intending to take leave. Conclusions. More than one third of fathers from a primarily Hispanic/Latino-serving public safety net hospital reported not having a workplace paternity leave policy. Access to employment-based leave policy may underlie disparities in paternal leave-taking. (Am J Public Health. Published online ahead of print June 11, 2026:e1-e6. https://doi.org/10.2105/AJPH.2026.308556).

15. Prehospital application of pelvic binders for suspected pelvic ring injuries: a retrospective cohort study.

期刊: Prehospital emergency care 发表日期: 2026-Jun-11 链接: PubMed

摘要

Pelvic fractures are linked to morbidity and mortality from major trauma. The use of pelvic binders in the prehospital setting is recommended for initial stabilization, however indications for application vary. The primary objective of this study was to determine the proportion of patients with image confirmed pelvic fracture in which paramedics applied a pelvic binder. Additionally, patient characteristics were explored to identify associations with unstable pelvic fractures. This was an observational retrospective cohort study from a single trauma centre between January 2017 and December 2022. Patients were included if >16 years of age, transported from scene, and had a confirmed pelvic fracture on imaging. A manual review of electronic medical records and ambulance call records was performed by two reviewers. Continuous variables were summarized as means and standard deviations or medians and interquartile ranges. Categorical variables were summarized as counts and percentages. Multivariable logistic regression explored the association between predetermined prehospital predictors and unstable pelvic fracture. The results of the regression model are presented as odds ratios (OR) and 95% confidence intervals (CI). In total, 429 patients met initial criteria; 95 were excluded for no records and 15 for no imaging, resulting in a final cohort of 319 patients. The median age was 42 (27-60) years, 61.1% were male, and 72.1% suffered blunt trauma. There were 86 (27.0%) fractures classified as unstable. Overall, 30 (9.4%) patients, 17% (14/86) with unstable fractures had a prehospital pelvic binder applied. Pain on exam and lower systolic blood pressure, and lower GCS score in the prehospital setting were all associated with increased odds of pelvic instability. Nine percent of all patients, and only 17% with an unstable pelvic fracture, had a pelvic binder applied in the prehospital setting. Several physical exam findings and vital signs were associated with unstable pelvic fracture; these could be helpful for increasing prehospital identification of pelvic fractures.

16. A Structured Comparison of the Coalition for Health AI Responsible AI Guide and South Korea's Trustworthy AI Guideline for Health Care AI Assurance: Comparative Framework Analysis.

期刊: JMIR AI 发表日期: 2026-Jun-11 链接: PubMed

摘要

Trustworthy artificial intelligence (AI) in health care requires assurance frameworks that translate ethical principles into measurable governance and evaluation practices. While a growing number of AI assurance frameworks have been proposed, they differ substantially in governance structure, institutional embedding, and implementation mechanisms, reflecting differences in intended purpose and use. To date, few studies have applied standardized, rubric-based evaluation criteria to systematically compare how assurance instruments with different institutional origins operationalize ethical principles across the AI lifecycle. This study aimed to develop and apply a structured, rubric-based evaluation instrument to compare 2 health care AI assurance instruments, including the Coalition for Health AI (CHAI) responsible AI guide, a voluntary consortium-based instrument, and South Korea’s Trustworthy AI guideline, a government-issued instrument. A 7-dimension evaluation rubric was developed based on a synthesis of established international AI assurance and governance instruments. The rubric covered core principles, AI lifecycle coverage, governance context, stakeholder breadth, operational maturity, instrument design and tools, and public accessibility. Seven independent evaluators with expertise in health care AI governance assessed each instrument using a 5-point ordinal rating scale (1=absent-5=comprehensive). Each evaluator independently scored the materials using a standardized rubric. Discrepancies were resolved through structured consensus discussions, with reference to rubric definitions and source documents. Final scores were determined based on documented evidence, requiring full consensus rather than averaging. Interrater reliability was assessed using Fleiss kappa. Both instruments demonstrated strong alignment in core principles (CHAI: 4; Trustworthy AI Guideline: 5) and stakeholder breadth (both: 4). The government-issued Trustworthy AI Guideline exhibited broader AI lifecycle coverage (5 vs 4), a more formalized governance context (5 vs 3), and higher operational maturity (4 vs 2), reflecting stepwise oversight and formal embedded oversight mechanisms supported by legislation. In contrast, the voluntary CHAI instrument demonstrated greater emphasis on instrument design and implementation tools (4 vs 3) and higher public accessibility (5 vs 3), driven by open-access resources such as assurance standards guides and applied model cards. Interrater agreement of independent ratings was moderate to substantial (Fleiss kappa=0.47-0.64; P<.001), indicating consistent scoring patterns among evaluators. This comparative analysis indicates that voluntary and government-issued AI assurance instruments operationalize trustworthy AI principles in distinct but complementary ways. Voluntary instruments emphasize flexible tools and accessible implementation resources, while government-issued guidelines embed assurance functions within formal governance and oversight structures. Rather than representing competing models, these approaches address different assurance needs across the AI lifecycle. By identifying concrete areas of alignment and divergence, this study supports a more coherent comparison of assurance practices and highlights potential opportunities for alignment across documentation structures and evaluation approaches that can support safe, equitable, and scalable deployment of health care AI across diverse institutional contexts.

17. Telerehabilitation in Community Stroke Services: Mixed Methods Evaluation of Current Practice and Lessons for Sustained Use.

期刊: Journal of medical Internet research 发表日期: 2026-Jun-11 链接: PubMed

摘要

The delivery of specialist stroke rehabilitation is undergoing a significant transformation, with telerehabilitation increasingly integrated into clinical practice and supported by guidelines and policy. There is a need for the pragmatic evaluation of telerehabilitation in service, which includes insights from clinical teams and people with stroke. This evaluation sought to address that need in the context of community stroke services in the East of England. Our evaluation addressed two over-arching aims: (1) to investigate and map contemporary models and experiences of telerehabilitation delivery in community stroke services, examining how it is currently used and perceived by both health care providers and service-users; and (2) to identify practical lessons and enabling factors that support the sustained integration of telerehabilitation into routine community stroke services. This study is a two-phase exploratory sequential mixed methods evaluation. Phase one involved discussion groups with stakeholders already using telerehabilitation to explore experiences, attitudes, influences, and behaviors associated with its use. Findings from phase one directly informed phase two by the development of a conceptual framework and in shaping the content of an online survey for clinicians and people with lived experience of stroke. Quantitative and qualitative data were subsequently integrated through triangulation during analysis, interpretation, and reporting stages. Data from the discussion groups were analyzed using a recognized framework for reflexive thematic analysis within a contextualist approach. Descriptive statistics were used to summarize quantitative survey responses. A total of 20 people attended the discussion groups (n=4 groups total). Further, 96 people responded to the survey. Three themes underpinning successful use of telerehabilitation in this context were derived from triangulation across our data sources: (1) consideration of risks and benefits, with fewer than half of staff viewing telerehabilitation as equivalent in safety (22/49, 45%) or effectiveness (18/49, 37%), but most reporting that they could build rapport remotely (34/49, 69%); (2) the importance of individualized care approaches, where most clinicians reported confidence in identifying which service-users would benefit from telerehabilitation (42/49, 85%), although only 20% (10/49) offered it routinely; and (3) the need for staff support, with up to 34% of staff reporting no training in how to assess suitability for telerehabilitation. Key insights included the potential for telerehabilitation to increase efficiency and address service pressures, the importance of addressing digital exclusion, the value of individualized approaches, and the need for timely and tailored staff training. Our pragmatic, in-service evaluation demonstrates that telerehabilitation works best not as a replacement for in-person care, but as part of a responsive, blended approach grounded in individual need. These findings highlight that, with appropriate clinician training and flexibility in delivery, telerehabilitation can meet the needs of individuals through personalized approaches while supporting service responsiveness in pressurized clinical environments.

18. Sociodemographic Paradoxes and Enrollment Differences in In-Person Versus Online Recruitment to a Mobile Health Smoking Cessation Intervention for Food-Insecure Adults: Secondary Analysis of a Randomized Controlled Trial.

期刊: Journal of medical Internet research 发表日期: 2026-Jun-11 链接: PubMed

摘要

Little is known about (1) sociodemographic, psychosocial, or smoking-related differences among individuals recruited to smoking cessation randomized controlled trials (RCTs) using in-person versus online recruitment methods or (2) the relative speed of recruitment using these 2 approaches. This secondary analysis is the first to examine these comparisons in a smoking cessation RCT for people experiencing food insecurity, a vulnerable special population for whom quitting is especially urgent. To compare (1) baseline sociodemographic, smoking-related, and psychosocial characteristics; and (2) screening, eligibility, and enrollment rates of in-person versus online recruits to a smoking cessation RCT for people experiencing food insecurity. Participants completed a brief eligibility questionnaire and a baseline assessment via tablet (in person) or personal electronic device (after clicking an online advertisement). Eligibility required past-30-day food aid use, smoking ≥5 cigarettes per day, and willingness to attempt quitting within 7 days post enrollment. Responses were compared using chi-squared and Fisher exact tests (categorical variables) and 2-tailed t tests (continuous variables). Enrollees recruited online endorsed greater food insecurity (mean 4.5, SD 1.9 vs mean 3.0, SD 2.3; P<.001) and were more likely to be educated beyond high school or equivalent (69% vs 49%; P<.001), have household income of US $20,000 or more (46% vs 36%; P=.03), and be non-Hispanic White (77% vs 50%; P<.001). Online recruits indicated lower motivation to quit smoking (Contemplation Ladder; mean 7.2, SD 2.4 vs mean 8.0, SD 2.8; P<.001) and smoking cessation self-efficacy (mean 20.5, SD 8.0 vs mean 23.2, SD 8.6; P<.001). Online recruits also reported lower subjective social status (mean 4.6, SD 2.0 vs mean 5.9, SD 2.2; P<.001), greater financial strain (mean 17.9, SD 6.3 vs mean 16.2, SD 6.6; P=.004), more depressive symptoms (mean 8.6, SD 6.3 vs mean 7.4, SD 6.1; P=.04), greater loneliness (mean 6.0, SD 2.1 vs mean 5.2, SD 2.0; P<.001), less resilience (mean 19.5, SD 5.1 vs mean 20.5, SD 4.3; P=.02), less alcohol misuse (27% vs 37%; P=.02), and more past-30-day cannabis use (25% vs 15%; P=.01). Enrollment rates were higher online (64.8 per month; n=324) than in-person (7.7 per month; n=178). Although screened eligible at similar rates whether recruited online or in person (79% vs 75%; P=.10), eligible online individuals were more likely to enroll (71% vs 49%; P<.001). This study is the first to compare baseline participant characteristics by recruitment method (in person vs online) in a cessation RCT for people experiencing food insecurity and to evaluate the relative pace of recruitment via those methods. Online and in-person recruits were demographically and psychosocially distinct, and online recruitment was associated with faster accrual than in-person recruitment. These findings inform recruitment strategies for cessation interventions, especially those targeting food-insecure individuals.

19. App-Based Physical Activity Intervention for Individuals With Depression (MoodMover): Single-Arm, Pre-Post Proof-of-Concept and Feasibility Study.

期刊: JMIR formative research 发表日期: 2026-Jun-11 链接: PubMed

摘要

Depression is a prevalent mental disorder, and it remains one of the leading causes of disability in Canada and globally. Mobile app-based physical activity interventions may offer an effective and accessible treatment option for individuals with depression who cannot or prefer not to access supervised exercise programs. This study aims to investigate the feasibility, acceptability, and proof of concept of a 9-week, theory-guided, app-based physical activity promotion intervention (MoodMover) developed for people with depression. We conducted a single-arm, pre-post study from November 2024 to May 2025, following the phase IIa: Proof-of-concept and phase IIb: Pilot and Preliminary Testing of the Obesity-Related Behavioural Intervention Trials model. Physically inactive adults who either self-reported a diagnosis of major depressive disorder or reported at least mild depressive symptoms, operationalized as a minimum score of 5 on the Patient Health Questionnaire, 9-Item, were recruited. The intervention spanned 9 weeks, with the first week serving as a run-in period and including a 15-minute orientation session on the first day. Participants were instructed to use the MoodMover program, delivered via the Pathverse app. Feasibility was assessed based on 4 primary criteria: recruitment, adherence, usability, and retention. Proof-of-concept was evaluated by assessing changes in physical activity behavior and depressive symptoms over the intervention period. From November 2024 to March 2025, 32 of the 51 adults who met eligibility criteria consented to participate in this study, resulting in a recruitment rate of 63%. Twenty-eight participants completed baseline assessments, with a mean age of 39.8 (SD 13.4) years. A total of 21 participants attended the orientation session and received the intervention. Retention, adherence, and usability rates were 57% (16/28), 67% (14/21), and 50% (8/16), respectively. Regression analyses found that age consistently associated with app engagement, usability, and satisfaction. Two-tailed paired t tests indicated significant pre-post changes in self-reported moderate to vigorous physical activity and depressive symptoms across the 75%, 85%, and 95% CIs. Among participants with clinically elevated depressive symptoms at baseline (Patient Health Questionnaire, 9-Item ≥10), 75% (9/12) achieved a clinically meaningful reduction in symptom severity. Our findings suggest that MoodMover holds potential for promoting physical activity behavior among individuals with depression and supporting depression management at scale. However, the feasibility of the tested version remains suboptimal. Necessary modifications (eg, improvements to enhance the accuracy of step tracking) should be implemented and reevaluated before progressing to a more rigorous efficacy trial.

20. Development of an mHealth Intervention for Reducing Sedentary Behavior in Older Adults: Delphi Study.

期刊: Journal of medical Internet research 发表日期: 2026-Jun-11 链接: PubMed

摘要

Sedentary behavior among older adults is a major public health concern, contributing to the increased risk of chronic diseases and functional decline. With aging populations worldwide, prolonged sitting time (averaging up to 13 h/d in older adults) has been independently associated with cardiovascular disease, metabolic disorders, cognitive decline, and all-cause mortality. Mobile health (mHealth) interventions offer a promising approach to address this issue. However, there remains a lack of evidence-based, systematically developed mHealth programs specifically targeting sedentary behavior in older populations. This study aimed to develop an mHealth intervention program for reducing sedentary behavior in older adults using the Delphi consensus method. Guided by the Behavior Change Wheel framework, a preliminary mHealth intervention was developed using a combination of qualitative and quantitative methods, including a comprehensive literature review, clinical guidelines analysis, qualitative interviews, and a cross-sectional survey. The intervention was then refined through 2 rounds of Delphi surveys with 16 multidisciplinary experts in geriatric care, behavioral science, and health promotion. Consensus criteria were predefined as mean importance score >3.5 and coefficient of variation ≤0.25 on a 5-point Likert scale. Both Delphi rounds achieved 100% response rates, with high expert authority coefficients (Cr=0.900 for Round 1 and Cr=0.907 for Round 2). The Kendall coordination coefficients (Kendall W) were 0.151 (P<.001) and 0.214 (P=.001) for the 2 rounds, respectively. Following 2 rounds of expert consultation, a total of 27 intervention items were finalized, comprising 3 core components addressing capability (eg, knowledge provision and behavioral skills training), opportunity (eg, social support and environmental restructuring), and motivation (eg, goal-setting, feedback, and incentives) factors influencing sedentary behavior. This study developed a theoretical framework-based, consensus-driven mHealth intervention program for reducing sedentary behavior in older adults. The intervention uniquely integrates the Behavior Change Wheel framework with expert validation, offering a comprehensive approach that simultaneously targets capability, opportunity, and motivation. The findings provide a structured foundation for future feasibility testing and effectiveness evaluation of mHealth interventions in aging populations. Future researchers should translate the developed mHealth intervention into an adaptive mHealth platform, followed by pilot testing and large-scale randomized controlled trials to evaluate its feasibility and effectiveness in real-world settings.

21. Gender-based differences in colorectal cancer screening uptake in Singapore: a cross-sectional study.

期刊: Family practice 发表日期: 2026-Jun-11 链接: PubMed

摘要

Colorectal cancer screening is an evidence-based preventive approach. Singapore has a national screening programme, but local studies suggest poor uptake. Gender differences in screening uptake exist in the literature, and women in Singapore are exposed to cancer screening (via breast and cervical programmes) earlier than men. This study aimed to identify gender differences, as well as analyse barriers and facilitators associated with being screen-current for colorectal cancer within the genders, using the Health Belief Model. This was a cross-sectional study conducted in a large public primary care institution in Singapore. Using consecutive sampling, 426 colorectal cancer screening age-eligible (50 years and above) individuals (232 females, 54.5%) completed a single questionnaire measuring knowledge of colorectal cancer symptoms and prevention, Health Belief Model factors, and colorectal cancer information sources. Women had higher knowledge of colorectal cancer symptoms but perceived more barriers. Fewer women were screen-current (33.6%) compared to men (43.4%). Factors associated with knowledge of colorectal cancer symptoms and prevention differed between men (F[13, 178] = 4.51, R2 = 0.138) and women (F[13, 217] = 5.18, R2 = 0.171). Knowledge of symptoms and cues to action was associated with screen-currency in men (Wald χ2 = 33.93, pseudo R2 = 0.18), but the regression model failed to reach significance for women. A one-size-fits-all approach to health promotion is likely insufficient in boosting compliance with colorectal cancer screening recommendations. Further work must be done to understand the more qualitative nuances surrounding women’s challenges in being screen-current in Singapore.

22. Reimagining Value-Based Kidney Care: What Lies Beyond the Advancing American Kidney Health Initiative?

期刊: Kidney360 发表日期: 2026-Jun-11 链接: PubMed

摘要

23. Mediating role of family and workplace support on health-related quality of life among self-reported young adult cancer survivors: a cross-sectional observational study.

期刊: Journal of patient-reported outcomes 发表日期: 2026-Jun-11 链接: PubMed

摘要

The influence of family and workplace support on different domains of health-related quality of life (HRQOL) remains unclear in optimizing psychosocial interventions to improve HRQOL for young adult cancer survivors. In this study, we aimed to clarify the mediating effects of family and workplace support on the association between cancer-related symptoms and each domain of HRQOL among young adults with a self-reported cancer diagnosis (self-reported young adult cancer survivors). This cross-sectional observational study used an online survey conducted in Japan in January 2022. The survey was designed to assess demographic and clinical characteristics, physical fatigue (using Physical Fatigue subscale of the Cancer Fatigue Scale), depression (using Kessler-6), cognitive impairments (using Cognitive Functioning subscale of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30), family support (using a subscale of the Multidimensional Scale of Perceived Social Support), workplace support (using a subscale of the New Brief Job Stress Questionnaire), and HRQOL (using the 12-Item Short-Form Health Survey). We conducted structural equation modeling (SEM) using data from 192 participants. Of the 192 participants, 78% were female, 60% had undergone surgery, and 67% were permanent workers. Notably, the mean scores in the social domain of HRQOL were significantly lower than the national standard values in the Japanese population aged 20-39 years. The indirect effects of workplace support were significant for the association of cancer-related symptoms with mental (β = -0.07) and social (β = -0.06) domains of HRQOL. Similarly, the indirect effects of family support were significant for the association of cancer-related symptoms with physical (β = -0.06) and social (β = -0.05) domains of HRQOL. Family support mediated the association of cancer-related symptoms with physical and social QOL, whereas workplace support mediated the association of cancer-related symptoms with mental and social QOL. The social QOL among self-reported young adult cancer survivors was lower than that of the general Japanese population aged 20-39 years. Therefore, strategies targeting family and workplace support may be crucial for Japanese young adult cancer survivors in maintaining and improving their social QOL. Our study clarified family and workplace support related to the physical, psychological, and social aspects of health-related quality of life among self-reported young adult cancer survivors. These findings suggest more optimized strategies to improve their health-related quality of life.

24. Barriers and Facilitators to Physician-Patient Communication in Chinese Tertiary Hospitals From the Perspectives of Hospital-Based Physicians and Patient Relations Coordinators: Qualitative Study.

期刊: Interactive journal of medical research 发表日期: 2026-Jun-11 链接: PubMed

摘要

Effective physician-patient communication is essential for building trust and sustaining positive relationships, yet becomes increasingly challenging in China’s tertiary hospitals, where physicians face heavy workloads. This study explored the barriers and facilitators of physician-patient communication by synthesizing perspectives from Chinese hospital-based physicians and patient relations coordinators. A qualitative study using semistructured interviews was conducted with 17 participants (11 physicians and 6 patient relations coordinators) from tertiary hospitals in China (April-July 2025). Data were analyzed using thematic analysis following Braun and Clarke’s framework. Barriers and facilitators of physician-patient communication were organized into a multilevel framework comprising patient-level, physician-level, and system-level factors. Patient-level barriers included individual background differences, inadequate expression and limited health literacy, and psycho-emotional states with expectation misalignment, whereas facilitators included effective expectation management, good health literacy and communication readiness, and trust in physicians with shared decision-making. Physician-level barriers involved communication style deficiencies, empathy gaps, and time pressure constraints; facilitators included active listening and patient-centeredness, empathy and emotional support, and clear explanations with cultural adaptability. At the system level, barriers included hospital environment and medical visit settings, legal and policy deficiencies, insufficient communication training, and media-driven distrust with digitally mediated information challenges, while facilitators included institutional support and security assurance, educational training and policy promotion, process optimization and patient health education, and artificial intelligence-assisted baseline knowledge. Physician-patient communication is influenced by multiple factors, necessitating comprehensive intervention measures: enhancing patient education, improving physician communication skills, and strengthening organizational support systems. Notably, special attention should be directed toward addressing the unique challenges posed by digital technologies while concurrently leveraging the opportunities they present to optimize communication outcomes.

25. Racialized and Gendered Narratives for Middle-Aged African American Men as a Facilitator and Inhibitor for Self-Care Norms.

期刊: American journal of public health 发表日期: 2026-Jun-11 链接: PubMed

摘要

Middle-aged African American men experience disproportionate rates of chronic disease, reduced life expectancy, and barriers to preventive and mental health care. From a public health perspective, these inequities reflect the intersection of structural racism, medical mistrust, and gendered norms of masculinity rather than individual behavior alone. This analytic essay examines how masculinity functions as both a barrier to and facilitator of self-care among African American men in midlife using a social constructionist framework. Traditional norms emphasizing self-reliance, emotional restraint, and provider roles often discourage help-seeking and preventive care, whereas racial discrimination and chronic stress further exacerbate risk. At the same time, emerging evidence suggests that reframing masculinity around responsibility, family protection, and community engagement can promote health-supportive behaviors. The findings highlight the need for culturally responsive public health interventions that address structural barriers, affirm positive reframes of masculine identity, and leverage community strengths to reduce health disparities and improve population health outcomes. (Am J Public Health. Published online ahead of print June 11, 2026:e1-e6. https://doi.org/10.2105/AJPH.2026.308477).

26. The assembly of stress granules during foot-and-mouth disease virus infection is uncoupled from activation of cellular intrinsic antiviral signalling.

期刊: PLoS pathogens 发表日期: 2026-Jun-11 链接: PubMed

摘要

Foot-and-mouth disease virus (FMDV) is highly contagious among cloven-hoofed animals and poses a major threat to the livestock industry worldwide. A fundamental gap in knowledge for high consequence viruses such as FMDV is understanding how the virus evolved to evade cellular antiviral responses. FMDV belongs to the Picornaviridae, a family of positive-sense single-stranded RNA viruses. The detection of viral double-stranded viral RNA intermediates during infection can trigger both the assembly of cytoplasmic stress granules (SGs) and the activation of the RIG-I-like receptors (RLR)-mediated innate immune response (IIR). FMDV has been proposed to antagonize these mechanisms, suggesting that both can limit viral replication. In this study, we investigate the dynamic and importance of SG assembly for IIR activation upon dsRNA stimulation or FMDV replication in porcine epithelial kidney cells. First, we show that the formation of SG following a challenge with poly(I:C), a viral dsRNA mimic, does not modulate the activation of IIR. Our data further reveal transient assembly of SG during FMDV infection followed by virus-induced cleavage of G3BP1, a core SG protein. While SG assembly does not impact viral replication or antiviral response activation, we demonstrate that preventing their disassembly negatively impacts FMDV replication. Overall, we show that SGs assembly during infection does not modulate viral replication and is uncoupled from IIR activation, while FMDV actively cleaves G3BP1 by a 3Cpro-mediated mechanism to promote their disassembly, suggesting a potential antiviral role for persistent SGs.

27. Eliminating Disparities in Children's Lead Exposure: An Unfinished Job.

期刊: American journal of public health 发表日期: 2026-Jun-11 链接: PubMed

摘要

Objectives. To examine trends in blood lead levels (BLLs) among US children aged 5 years or younger using national and state data. Methods. We analyzed 2011 to 2023 National Health and Nutrition Examination Survey (NHANES) data by year and available demographic characteristics. We report geometric means, the prevalence of BLLs of 3.5 micrograms per deciliter or above and 5.0 micrograms per deciliter or above, and linear trends. In addition, we summarize 2017 to 2023 surveillance data from 7 states. Results. National BLLs continue to decline. In 2021 to 2023, geometric mean BLLs and the prevalence of BLLs of 3.5 micrograms per deciliter or above were lower for all groups than in previous years. Small recent NHANES sample sizes and limited state-level subgroup data constrained detailed analyses. However, state-level data revealed disparities by geography, race, and ethnicity. Conclusions. National data indicate decreasing BLLs among children and elimination of racial disparities, but state and local BLL data unmask ongoing disparities. Public Health Implications. To better describe childhood lead exposures, NHANES should increase its sample size, oversample high-risk populations, and release timely data, and states should expand surveillance and risk factors and make data publicly available. Together, the data assessed here provide benchmarks to target prevention efforts and warn of emerging risks. (Am J Public Health. Published online ahead of print June 11, 2026:e1-e9. https://doi.org/10.2105/AJPH.2026.308468).

28. Assessing the net climate benefits of improved grazing intensity in global rangelands.

期刊: Science (New York, N.Y.) 发表日期: 2026-Jun-11 链接: PubMed

摘要

Improved rangeland grazing could mitigate climate change through carbon dioxide (CO2) sequestration in soils and vegetation. However, altering grazing practices to increase ecosystem carbon storage may also decrease livestock production and/or increase greenhouse gas emissions through the supply chain, such that the net emissions impacts remain unclear. Here, we assess the global net mitigation potential of improving grazing intensity by quantifying potential CO2 sequestration alongside systems-level impacts of plant productivity changes, livestock emissions, feed requirements, and production constraints. Improving grazing intensity in global rangelands could sequester 2.2 ± 0.43 gigatons of carbon dioxide equivalent (Gt/CO2eq) per year in the near term, but maintaining livestock production through supplemental feeding would reduce net mitigation by 2 to 31% (to 1.8 ± 0.45 GT/CO2eq per year). Our results suggest that neglecting systems-level emissions impacts may substantially overestimate the global climate benefits of improved grazing.

29. Patterns of brain-wide associations reflect socioeconomics.

期刊: Science (New York, N.Y.) 发表日期: 2026-Jun-11 链接: PubMed

摘要

Previous brain-wide association studies (BWAS) have linked specific environmental and behavioral variables to brain variability. In this work, we mapped 649 variables to children’s brains and compared the resultant BWAS maps with each other and with neurobiological reference patterns. Socioeconomic status (SES) showed the strongest brain-wide associations. The SES associations were strongest in motor and sensory but not cognitive regions, a pattern shared across many BWAS maps, including intelligence quotient (IQ). A single, common BWAS brain pattern existed across variables that was most reflective of a child’s socioeconomics. Adjusting for SES weakened brain-IQ associations, eliminating the BWAS motor and sensory pattern. Brain-with-IQ associations also did not generalize when trained on higher-SES subsamples. Thus, children’s brains vary the most with SES, potentially through SES-dependent sleep deprivation and stress.

30. Exploring the Role of Spirituality in Neuropalliative Care: An Integrative Review.

期刊: Journal of religion and health 发表日期: 2026-Jun-11 链接: PubMed

摘要

Neuropalliative care aims to address the physical, psychosocial and spiritual needs of persons with progressive and life-limiting neurological conditions, while spiritual care fosters hope and meaning in life. Progressive neurological disorders with an uncertain disease trajectory present a set of complex challenges that have far-reaching consequences on the patient’s self-belief, questioning the very existence, self-identity, and belongingness. A typical neuropalliative care team consists of neurologists, nurses, psychologists, occupational therapists, and spiritual care providers. Previous research indicates that spiritual care improves coping and quality of life in persons with Parkinson’s disease and Amyotrophic lateral sclerosis. This study aimed to explore how spiritual needs are addressed in the area of neuropalliative care, examining the theoretical frameworks and empirical studies that incorporate spirituality as a component of neuropalliative care. The databases PubMed, PsycINFO, Cochrane Library, Scopus and two peer-reviewed journals were searched using a strategy based on three sets of terms “spirituality,” “progressive neurological conditions” and “neuropalliative care.” Articles included were in the English language, and mentioned spirituality in the context of neuropalliative care or palliative care for neurological conditions. Initial screening yielded 744 articles, of which 29 were selected for synthesis. Results highlighted the various challenges in ascertaining and meeting the spiritual needs in neuropalliative care. The review concludes that palliative services should be initiated early following the diagnosis of a progressive neurological condition so that the patient and family have enough time to reflect, create memories, and prepare in advance for the inevitable through dignity and resilience.

31. Work Disability and Rehabilitation in Workers with Hearing Loss: A Scoping Review.

期刊: Journal of occupational rehabilitation 发表日期: 2026-Jun-11 链接: PubMed

摘要

As organisations increasingly prioritise inclusive employment, more people with disabilities are entering the workforce. Hearing loss, a common yet often invisible disability, presents a significant and under-recognised occupational health challenge. This scoping review synthesises evidence on how individuals with hearing loss navigate workplace demands and examines the implications for occupational health policy and practice. A scoping review of literature published between 2010 and 2025 was conducted following PRISMA-ScR guidance. Systematic searches were completed across Scopus, PubMed/MEDLINE, and Web of Science to identify studies examining hearing loss in relation to work participation and occupational health outcomes. Eligible studies were synthesised using thematic analysis. Thirty-four studies met inclusion criteria across diverse countries and occupational settings. Four interrelated themes were identified: (1) individual strategies for managing hearing loss at work, including communication approaches and decisions around disclosure; (2) workplace accommodations, encompassing technological and environmental supports, training and organisational initiatives, and social connectedness, alongside persistent gaps between policy intent and practice; (3) occupational health and wellbeing outcomes, including psychosocial impacts, work-related fatigue, need for recovery, identity negotiation, and occupational stress; and (4) multi-level recommendations addressing individual, organisational, and policy domains to support sustainable employment. Hearing loss in the workplace presents substantial occupational health implications, including psychosocial stress, communication barriers, and increased need for recovery after work. Workplace accommodations show potential to support inclusion and improve health outcomes, yet implementation remains inconsistent. Further research is needed to rigorously evaluate occupational health interventions and accommodations, particularly within low- and middle-income contexts where evidence is limited.

32. Fourier transform infrared spectroscopy (FTIR) for human infectious disease diagnosis, microbial identification and strain discrimination: a systematic review (2015-2025).

期刊: Spectrochimica acta. Part A, Molecular and biomolecular spectroscopy 发表日期: 2026-Jun-08 链接: PubMed

摘要

Infectious diseases remain a persistent and evolving public health challenge, driven by factors such as antimicrobial resistance, emerging pathogens and environmental changes. In this context, this systematic review aims to analyze the analytical performance of Fourier Transform Infrared Spectroscopy (FTIR) for the microbiological identification, strain discrimination and diagnosis of human infectious diseases, based on studies published between 2015 and 2025. The review followed PRISMA guidelines and included 50 articles selected from PubMed, Scopus, and ScienceDirect databases. The findings demonstrate that FTIR is a promising analytical tool for microbial discrimination, identification, and diagnosis, particularly in studies involving cultured microorganisms combined with chemometric modelling. Most studies focused on bacteria (42%) and fungi (32%), with fewer addressing viruses (20%) and protozoa (6%). Chemometric analysis played a central role in enabling FTIR applications, particularly through the integration of unsupervised methods, such as Principal Component Analysis (PCA) and Hierarchical Cluster Analysis (HCA), with supervised techniques like Linear Discriminant Analysis (LDA), Support Vector Machines (SVM), and Artificial Neural Networks (ANN). Most studies aimed at microbial identification (58%) or diagnosis (14%), while 28% focused on discrimination without proposing predictive models. Overall, FTIR shows strong potential as a complementary tool for rapid diagnosis and screening of infectious diseases. However, its clinical implementation still depends on further standardization, robust validation, and the development of reliable spectral databases.

33. Reducing post-mortem report turnaround times at Tygerberg Forensic Pathology Service in South Africa: A quality improvement approach.

期刊: Journal of forensic and legal medicine 发表日期: 2026-Jun-06 链接: PubMed

摘要

Delays in issuing post-mortem reports at Tygerberg Forensic Pathology Service hindered judicial processes in unnatural death cases. Key challenges included inconsistent work ethics, heavy workloads, and complex forensic cases. The project aimed to reduce the average turnaround time for finalised post-mortem reports from 20 days to 10 days within three months. Root causes were identified using fishbone analysis. The intervention applied the Plan-Do-Check-Act (PDCA) cycle and introduced a cloud-based autopsy spreadsheet to track daily case progress, enabling staff to update status and monitor report issuance. The targeted turnaround time of 10 days was achieved. Process measures showed improved compliance with daily updates, streamlined case management, and better alignment with prescribed timelines. Balancing measures supported ongoing quality assurance. Enablers included clear communication, centralized tracking, and strong leadership, while barriers involved case complexity and variations in staff work ethics. This quality improvement initiative successfully reduced turnaround times, improved transparency, and fostered accountability. It demonstrated that modest interventions, combined with teamwork and structured monitoring, can significantly enhance efficiency. Extending to a Plan-Do-Study-Act (PDSA) cycle is recommended for long-term impact. The project offers a practical model for quality improvement in complex healthcare settings.

34. Prevalence, genomic diversity and emerging antimicrobial resistance of Taylorella asinigenitalis in Grand Noir du Berry breeding donkeys.

期刊: Veterinary microbiology 发表日期: 2026-Jun-06 链接: PubMed

摘要

Taylorella asinigenitalis is a fastidious Gram-negative bacterium of the equine genital tract, found more commonly in donkeys than horses. Although considered non-pathogenic, it is closely related to Taylorella equigenitalis, the agent of contagious equine metritis, and has been linked to experimental and natural cases of endometritis. The SAFRAN project (French acronym for “Sauvegarde de la fertilité de l’âne”, meaning “Preservation of donkey fertility”), launched in 2024 by the French National Research Institute for Agriculture, Food and Environment (INRAE) with support from the Centre-Val de Loire region, aims to improve the reproductive performance in an endangered French donkey species, the Grand Noir du Berry (GNB). While screening for infectious agents was not a primary objective of the SAFRAN project, a complementary study was conducted in the newly-established GNB breeding herd. Between 2024 and 2025, 28 donkeys (six males, 22 females) underwent bacteriological, mycological and molecular testing. T. asinigenitalis was detected and isolated exclusively in males, whereas T. equigenitalis was absent. PCR data suggested lower bacterial loads in semen than penile sites. Several opportunistic microorganisms were also isolated. Despite antiseptic and antibiotic treatments - including local gentamicin, systemic enrofloxacin, and subsequently systemic oxytetracycline - some males remained persistently or intermittently positive. Whole-genome sequencing revealed seven previously undescribed MLST types. Phylogenetic analyses indicated that each male initially carried a distinct strain, but later clustering around ST102 and ST104 suggested horizontal transmission. Enrofloxacin treatment selected quinolone-resistant strains carrying the GyrA S83I mutation. These findings demonstrate that T. asinigenitalis circulates efficiently among male GNB donkeys and can acquire antimicrobial resistance, emphasising the need for targeted surveillance and strict biosecurity while avoiding fluoroquinolones in herd health plans.

35. Cod protein modifications induced by lipid oxidation-derived aldehydes: Insights into multi-aldehydes environment.

期刊: Food chemistry 发表日期: 2026-Jun-05 链接: PubMed

摘要

Cod and its products are particularly vulnerable to modifications caused by lipid oxidation products especially aldehydes. Most studies have focused on the effects of individual aldehydes. However, in real food systems, multiple aldehydes may interact competitively or synergistically to alter protein functionality. Here, a model system of a clickable probe, 4-(2-propyn-1-yloxy)-2-butenal (yne-ACR, 500 μM), with five reactive carbonyls (500 μM and 1000 μM): formaldehyde (FA), malondialdehyde (MDA), methylglyoxal (MGO), glyoxal (GO), and phenylacetaldehyde (PhA)-was used to simulate and visualize protein modifications. Results showed that FA and GO had no significant effect on yne-ACR-mediated modification, whereas MDA, MGO, and PhA significantly increased the modification levels and decreased intrinsic fluorescence, indicating conformational changes and increased binding availability. Physicochemical evaluations confirmed that aldehyde treatments markedly altered the microstructure, thermal stability, and volatile profile of cod protein. This work provides new insights into the mechanisms of multi-aldehydes co-modification of cod protein and offers a theoretical basis for controlling oxidation of foods.

36. Anticoagulation in end-stage renal disease.

期刊: Thrombosis research 发表日期: 2026-Jun-04 链接: PubMed

摘要

Patients with end-stage renal disease face an increased thromboembolic risk but also have heightened susceptibility to bleeding. This dual risk poses a distinct challenge in managing conditions requiring anticoagulation. In this article, we summarize the most recent evidence on anticoagulation for patients with end-stage renal disease, focusing on stroke prevention in atrial fibrillation and the management of venous thromboembolic disease, and we highlight practical considerations for clinical decision-making. It remains unclear whether atrial fibrillation confers the same attributable risk of stroke in the end-stage renal disease population compared to the general population. The bleeding risk is also disproportionately high in kidney failure and the relative incidence of hemorrhagic stroke increases as renal function declines. All direct oral anticoagulants are eliminated by the kidneys in varying degrees and appropriate dose adjustment is required. Vitamin K antagonists should not be considered entirely safe and are probably not superior to direct oral anticoagulants for stroke prevention. There is increasing evidence that the risk of bleeding may be higher with vitamin K antagonists, compared with apixaban or rivaroxaban. However, given the relatively low risk of ischemic stroke and the high risk of bleeding, it is reasonable to avoid anticoagulation for stroke prevention for many of these patients. For the treatment of venous thromboembolic disease, parenteral anticoagulation followed by vitamin K antagonists remains the standard of care. Limited data exists with apixaban in this setting. For both indications though, the need remains for larger, randomized trials to guide management of anticoagulation in end-stage renal disease.

37. Geographic, Temporal, and Sex-Specific Trends in Mesothelioma Burden in the United States, 1990-2023.

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

摘要

Mesothelioma is a rare, aggressive cancer, strongly linked to asbestos. Although US regulations limiting asbestos use were introduced beginning in the 1970s, the long latency necessitates ongoing evaluation of population-level burden. Age-standardized incidence (ASIR) and mortality rates (ASMR), disability-adjusted life-years (DALYs), and occupational-attributable fractions were obtained from the Global Burden of Disease study for mesothelioma at the national and state levels from 1990 to 2023 for males, females, and both sexes combined. Mortality-to-incidence ratios (MIRs) were calculated. Temporal trends were evaluated using joinpoint regression to estimate annual percent change and average annual percent change. Nationally, ASIR declined 33% (0.64-0.43 per 100,000) and ASMR declined 31% (0.60-0.41) from 1990 to 2023, with markedly steeper reductions among males (ASIR, -42%; ASMR, -41%) than females (ASIR, -7%; ASMR, -8%), while absolute cases and deaths increased. The MIR rose from 0.93 to 0.95 overall and increased among males (0.95-0.98), indicating no meaningful population-level survival improvement. Occupational asbestos exposure accounted for 95.7% of deaths in 2023. Age-standardized DALY rates declined 40% overall, although absolute DALYs increased 14%. At the state level, Maine, Alaska, Washington, and Minnesota had the highest ASIRs and ASMRs. Female incidence increased in 20 states and mortality in 18, with the largest increases in South Dakota, Arkansas, Mississippi, and West Virginia. Although mesothelioma rates have declined nationally, progress has been uneven across sexes and states. Persistently high mortality-to-incidence ratios, rising female burden in multiple states, and substantial geographic heterogeneity emphasize the need for targeted surveillance, remediation of legacy asbestos, and investment in more effective therapies.

38. Exposure, Cytotoxicity and Cellular Uptake of Silver (Ag) and Gold (Au) Nanoparticles in Human Bronchial Epithelial Cells During Nanoparticle Synthesis.

期刊: Nanomaterials (Basel, Switzerland) 发表日期: 2026-Jun-01 链接: PubMed

摘要

Silver (Ag) and gold (Au) nanoparticles (NPs) are widely used in biomedicine, electronics, and catalysis, but their potential toxicity raises occupational health concerns. This study assessed the cytotoxicity and cellular interactions of Ag and Au NPs in human bronchial epithelial cells (BEAS-2B) using a standardized OECD three-tiered approach, alongside characterization of lung-deposited surface area (LDSA) concentrations during NP synthesis, which remained within ranges typically reported in occupational environments. Transmission electron microscopy revealed that AgNPs formed irregular clusters (~8.7 nm primary size, >30 nm aggregates), whereas AuNPs remained spherical (~13.4 nm). Real-time cytotoxicity analysis (xCELLigence) showed acute toxicity of AgNPs at 5 μg/cm2, while AuNPs exhibited no cytotoxic effects. Dark-field and 3D hyperspectral imaging demonstrated that some AgNPs were internalized by BEAS-2B cells, whereas AuNPs remained mostly on the cell surface, indicating that uptake alone does not determine cytotoxicity. The greater dissolution potential of AgNPs and possible release of Ag+ ions may contribute to the enhanced cytotoxic effects observed in comparison to AuNPs, as suggested in previous studies. Although oxidative stress, mitochondrial dysfunction, and related cellular mechanisms were not directly assessed in the present study, the findings demonstrate differential cellular responses following nanoparticle exposure under realistic occupational exposure conditions. These results contribute to understanding nanoparticle-cell interactions and support the need for further mechanistic investigations to inform safer nanomaterial use.

39. Development of Key Performance Indicators for a National Head and Neck Cancer Audit Feasibility Study.

期刊: Clinical oncology (Royal College of Radiologists (Great Britain)) 发表日期: 2026-May-22 链接: PubMed

摘要

To develop key performance indicators (KPIs) for evaluating quality, equity, and outcomes of head and neck cancer (HNC) care. A mixed-methods study combining literature review, measurability assessment, and multi-stakeholder consultations to identify, prioritise, and refine a set of consensus-based measurable, actionable KPIs for HNC occurrence, diagnosis, treatment and multidisciplinary care, and outcomes for the ongoing National Head and Neck Cancer Audit (NaHaNCA) Feasibility Study. National cancer audits, national guidelines, and standards were first reviewed to identify potential performance indicators, followed by measurability assessments based on the National Cancer Registration Dataset linked to national datasets curated by the National Disease Registration Service. A broad range of clinicians (eg, surgeons, oncologists, Speech and Language Therapists, allied health professionals) and patients across the country were consulted in the prioritisation and refinement of the indicators. The process was overseen by a multidisciplinary Study Steering Committee, comprising clinicians from 12 stakeholder organisations and patient representatives. We also worked closely with the Getting It Right First Time (GIRFT) team to ensure that this work complements the GIRFT programme by enabling ongoing monitoring of care quality and the impact of service improvements. Eight high-priority measurable and actionable KPIs were identified through national consultation. These address timeliness of treatment, stage distribution, curative and palliative care, recurrence, survival, and multidisciplinary involvement. This study provides the foundation for evaluating health service performance at a national level. While the work highlights the potential for a feasible and scalable national audit approach for HNC, it also identifies substantial variation in data completeness and consistency across NHS care providers, which may be the key challenges in evaluation. Addressing current data limitations through standardisation and collaboration will be essential for delivering a sustainable, impactful national audit.

40. International Society for Heart and Lung Transplantation Scientific Statement on pulmonary antibody-mediated rejection and proposed graft, antibody, and pathology (GAP) definition.

期刊: The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation 发表日期: 2026-May-21 链接: PubMed

摘要

Antibody-mediated rejection (AMR) is an increasingly recognized form of rejection and cause of graft failure after lung transplantation. AMR has been the focus of extensive research over the past decade. Despite growing awareness and recent advances in our understanding of AMR, outcomes remain dismal with a 2-year survival of only 20%. The International Society for Heart and Lung Transplantation convened a multidisciplinary workgroup of experts in AMR to review the most up-to-date research and clinical experience and to update the 2016 definition. The workgroup was divided into 9 subgroups covering a broad range of topics pertaining to AMR and used the modified Delphi method to synthesize a cohesive summary of the literature. A multidimensional definition was developed to enhance precision by reporting the specific presenting features. This Graft, Antibody, and Pathology (GAP) definition is based on the presence of Graft dysfunction, the presence and characteristics of Antibodies, and Pathological findings. The workgroup emphasized that identifying better treatments for AMR is a critical unmet need and proposed that a more precise definition might allow better management by providing a platform for testing and developing new therapies.

41. The levonorgestrel intrauterine device and ovarian cancer risk: a population-based study.

期刊: International journal of gynecological cancer : official journal of the International Gynecological Cancer Society 发表日期: 2026-May-20 链接: PubMed

摘要

There are widespread changes occurring in contraceptive use, with people moving away from oral contraceptive pills and toward intrauterine devices. Considerable data support the risk reduction for ovarian cancer with oral contraceptive use, but there is little evidence on how levonorgestrel intrauterine device use affects ovarian cancer risk. This paper examines ovarian cancer risk in levonorgestrel intrauterine device users in British Columbia, Canada, between 2002 and 2021. This research used population-based data from British Columbia to analyze the risk of ovarian cancer in levonorgestrel intrauterine device users, compared with never users, while controlling for previous oral contraceptive use and age. The final cohort included 788,736 individuals, of whom 52,888 were exposed to the levonorgestrel intrauterine device. Exposed individuals were younger on average and were more likely to have used oral contraceptives. During follow-up, ovarian cancer was diagnosed in 17 exposed individuals and 1184 unexposed individuals. After adjustment for age and oral contraceptive use, levonorgestrel intrauterine device exposure was associated with a reduced risk of ovarian cancer (adjusted hazard ratio 0.57, 95% confidence interval 0.35 to 0.93). In an age-matched 1:1 cohort (n = 105,776), the association was similar but less precise (adjusted hazard ratio 0.61, 95% confidence interval 0.24 to 1.12). In a subgroup restricted to individuals older than 60 years by the end of follow-up (n = 211,866), based on 8 exposed and 720 unexposed ovarian cancer cases, levonorgestrel intrauterine device exposure was not associated with reduced ovarian cancer risk (adjusted hazard ratio 1.59, 95% confidence interval 0.79 to 3.21). While the findings from the main cohort suggest that use of the levonorgestrel intrauterine device reduced the risk of ovarian cancer, this effect appeared to be confounded by age. These results should be interpreted with caution, as many levonorgestrel intrauterine device users are young and have not reached an age at which they are at a significant risk of ovarian cancer.

42. Song audio features are associated with the presence of alcohol references in popular music lyrics.

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

摘要

Preliminary evidence suggests that exposure to alcohol-related content in popular music is associated with drinking behaviour, especially amongst young people. Guided by Uses and Gratifications Theory, which posits that audiences select music to satisfy psychological and social needs, alcohol references, and specific audio features may co-occur as part of shared emotional and social experiences. This study assessed whether song audio features are associated with alcohol references in lyrics and whether they could support population-level surveillance of alcohol-related media exposure. We analyzed 6110 Billboard Top 100 songs released between 1959 and 2020, extracting Spotify audio features for each track. Logistic regression models were used to examine associations between audio features and the presence of alcohol references in lyrics. Alcohol references were found in 16.1% of songs, with prevalence increasing significantly over time. Songs with higher danceability (OR = 1.35, P < .001), speechiness (OR = 1.39, P < .001), liveness (OR = 1.09, P = .021), positive valence (OR = 1.11, P = .041) and major mode (OR = 1.18, P = .042) more likely to contain alcohol references. Higher acousticness (OR = 0.82, P < .001) and instrumentalness (OR = 0.85, P = .015) were associated with lower odds. Loudness, tempo, and energy were not significantly associated. Audio features may help identify songs more likely to contain alcohol references in music and may have potential utility for monitoring alcohol-related messaging across large volumes of popular music. Such tools could complement broader public health efforts to reduce alcohol exposure, especially amongst young people.

43. Aspirin after completion of standard adjuvant therapy for colorectal cancer (ASCOLT): A systematic review and meta-analysis.

期刊: American journal of surgery 发表日期: 2026-May-06 链接: PubMed

摘要

Colorectal cancer (CRC) carries a high recurrence risk. Aspirin has been proposed for secondary prevention, but its benefit remains uncertain. This systematic review and meta-analysis evaluated aspirin’s impact on disease-free survival (DFS) and overall survival (OS). A systematic search of four databases (PubMed, Embase, Scopus, the Cochrane Library) was conducted from inception to January 2025 using predefined inclusion and exclusion criteria. Screening and data extraction were performed independently. Study quality was assessed using RoB 2 and the Newcastle-Ottawa Scale. Ten studies were included, comprising retrospective cohorts, population-based cohorts, prospective observational analyses, and Phase III randomized controlled trials (RCTs). A random-effects meta-analysis was conducted to pool effect sizes as odds ratios (ORs) with 95% confidence intervals (CIs). Heterogeneity was quantified using I2 and τ2, and sensitivity analyses included leave-one-out testing. All analyses followed PRISMA guidelines. Ten studies were included. Pooled analyses of observational studies showed no statistically significant improvement in OS (OR 0.92, 95% CI 0.78-1.08) or DFS (OR 0.90, 95% CI 0.74-1.08) among aspirin users. Considerable heterogeneity and inconsistency were observed across studies. RCTs likewise demonstrated no clear survival benefit, with effect estimates close to unity. Safety data were limited and variably reported, precluding firm conclusions regarding adverse outcomes. Current evidence does not support aspirin as adjuvant therapy for secondary prevention in CRC. Future research should target biomarker-defined subgroups for potential benefits.

44. Evaluating the impact of a low-cost food storage intervention on complementary food contamination and diarrheal disease in low-income urban households: A randomized controlled trial in Dhaka, Bangladesh.

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

摘要

Diarrheal diseases remain a leading cause of under-five mortality globally, yet large-scale water, sanitation, and hygiene (WASH) interventions have shown limited effects on childhood diarrhea and growth, partly because foodborne transmission has been overlooked. In low-income urban settings, complementary foods for young children are often stored for several hours under unsafe conditions, increasing the risk of fecal contamination. This randomized controlled trial evaluated whether a low-cost wire-mesh food cabinet (“meatsafe”), paired with one-time behavior-change communication (BCC), could reduce microbial contamination and diarrhea among children aged 6-24 months in the Korail informal settlement of Dhaka, Bangladesh. A total of 290 households were randomly assigned 1:1 to receive a meatsafe plus food-hygiene handouts or no intervention. Over five biweekly post-intervention visits, we collected stored complementary food samples (≥4 h) for Escherichia coli testing and recorded 7-day caregiver-reported diarrhea. The primary outcome was the prevalence of high-level contamination (≥100 CFU E. coli/g). Prevalence ratios (PRs) were estimated using population-averaged modified Poisson regression adjusted for storage conditions. Across 1,545 food samples, contamination declined in both arms-from 49.6% to 25.2% in controls and 39.0% to 18.6% in the intervention arm-but the intervention had no effect on high-level contamination (adjusted PR = 0.83; 95% CI: 0.55-1.26) or caregiver-reported diarrhea (PR = 0.56; 95% CI: 0.24-1.31). Storing food for more than eight hours remained strongly associated with contamination (aPR = 1.49; 95% CI: 1.20-1.86). Although meatsafe adoption was high (88% at first visit, 99% at last), recall of general hygiene messages was limited. Providing a meatsafe with minimal BCC did not reduce food contamination or child diarrhea, despite excellent uptake. The findings underscore the limits of simple, passive technologies in resource-constrained settings and suggest that future strategies should integrate affordable storage innovations with more intensive and sustained hygiene promotion. ClinicalTrials.gov, NCT07332078. Registered 12 January 2026 (retrospectively registered); https://clinicaltrials.gov/study/NCT07332078.

45. Low Handgrip strength and its lifestyle and physiological correlates among Taiwanese University Students: A cross-sectional study.

期刊: PloS one 发表日期: 2026 链接: PubMed

摘要

Handgrip strength is a well-established indicator of muscular fitness and an early predictor of adverse long-term health outcomes. However, limited research has examined HGS and its determinants among young adults in East Asia. This cross-sectional study investigated the association between lifestyle and physiological factors and low HGS in 501 Taiwanese university students aged 18-25 (168 men, 333 women). Participants completed questionnaires on physical activity, sedentary time, and dietary behavior, and underwent anthropometric measurements including body mass index (BMI), mid-upper arm circumference, and handgrip strength. Low handgrip strength was defined using the sex-specific criteria established by the Asian Sarcopenia Working Group in 2019 (men < 28 kg; women <18 kg). Results showed that 6.2% of participants had low handgrip strength (8.3% in men, 5.1% in women). Men had significantly higher average handgrip strength than women (38.0 ± 7.8 kg vs. 24.6 ± 4.4 kg, p < .001). Upper arm circumference and handgrip strength showed the strongest correlation in both sexes (p < .001). Logistic regression analysis revealed that smaller upper arm circumference (OR = 0.80, p = .003 per 1 cm increase), insufficient moderate-to-vigorous physical activity (OR = 0.40, p = .055), and male sex (OR = 5.28, p = .001) were significantly associated with poor handgrip strength. Dietary habits and sedentary time were not significantly associated with handgrip strength. These findings highlight the importance of early identification of muscle weakness and promoting physical fitness training in young adults. Men with smaller arm circumference and lower activity levels showed a significant association with low HGS and may benefit from early monitoring and targeted intervention. Incorporating muscle strength assessment and activity promotion into early adulthood health programs may help preserve muscular fitness, prevent future sarcopenia, and support healthier aging trajectories in East Asian populations.

46. Community health volunteers as a frontline platform for antimicrobial resistance mitigation in sub-Saharan Africa: A scoping review.

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

摘要

Antimicrobial resistance (AMR) is a global public health crisis disproportionately affecting sub-Saharan Africa (SSA), where it was directly responsible for approximately 255,000 deaths in 2019 alone. Despite this burden, community-level mitigation strategies remain underdeveloped. Community health volunteers (CHVs), embedded within their communities and trusted by populations with limited healthcare access, represent an underutilised but promising platform for AMR mitigation. This scoping review aimed to map the breadth, nature, and outcomes of CHV-led or CHV-supported AMR interventions in SSA; identify barriers and facilitators to implementation; and identify evidence gaps to inform future research and policy. Following the Arksey and O’Malley (2005) framework and reported according to PRISMA-ScR 2018 guidelines, we systematically searched PubMed/MEDLINE, EMBASE, Cochrane Library, AJOL, WHO IRIS, and grey literature for studies published from January 2018 to January 2026. Studies conducted in SSA involving CHVs and addressing AMR mitigation through at least one of education, surveillance, diagnostics, waste management, or One Health approaches were eligible. Data were charted using a standardised extraction form and findings synthesised narratively. Of 847 records identified, 26 studies and reports met the inclusion criteria. The evidence base encompassed educational interventions (n = 14), diagnostic integration (n = 3), waste and environmental management (n = 3), and multisectoral One Health approaches (n = 6). CHV-led educational interventions improved AMR knowledge by 49.3%-97.1% and reduced inappropriate antibiotic prescribing by 18-44%. Point-of-care diagnostic integration reduced antibiotic use by up to 24.6% without increasing adverse outcomes. Key barriers included inadequate resources, training overload, weak regulation, and lack of integrated surveillance, while facilitators included tailored training, diagnostic tools, community trust, and policy alignment. The evidence supports embedding structured AMR roles for CHVs within national AMR action plans, integrated community case management, One Health frameworks, and investment in CHV training and diagnostic capacity.

47. Facilitating early diagnosis of chronic thromboembolic pulmonary hypertension with dynamic chest radiography: Protocol for a multicenter, assessor-blinded, case-wise randomized superiority reader study (FIND-DCR).

期刊: PloS one 发表日期: 2026 链接: PubMed

摘要

Chronic thromboembolic pulmonary hypertension (CTEPH) is a treatable cause of pulmonary hypertension but remains under-recognized and is often diagnosed with delay. Limited access to lung ventilation-perfusion (V/Q) scintigraphy, especially outside tertiary centers, is one contributor. Dynamic chest radiography (DCR), with a pulmonary circulation analysis program, can provide a rapid, non-invasive, and widely deployable assessment of pulmonary perfusion. We describe the protocol of a multicenter reader study testing whether adding DCR-based analysis to standard initial work-up improves diagnostic accuracy for CTEPH among patients with echocardiographically suspected pulmonary hypertension. This investigator-initiated, multicenter, assessor-blinded, case-wise randomized superiority reader study compares standard initial work-up (blood tests, chest X-ray, ECG, pulmonary function tests, and transthoracic echocardiography per guidelines) with standard work-up plus DCR-based pulmonary circulation analysis. The primary endpoint is diagnostic accuracy for discrimination between CTEPH and non-CTEPH in the intention-to-treat set. The final diagnosis of CTEPH versus non-CTEPH will be defined as the reference standard according to the Japanese and European guidelines for pulmonary hypertension. Secondary endpoints include sensitivity, specificity, positive and negative predictive values; agreement with V/Q scintigraphy regarding regional perfusion defects using κ statistics; and STARD-conformant academic performance evaluation of DCR-based pulmonary circulation analysis and lung perfusion scintigraphy in relation to the site-level final diagnosis of CTEPH versus non-CTEPH in a full analysis set. Safety endpoints include adverse events during DCR acquisition and device malfunctions. The target sample size is 108 cases with 1:1 allocation. Recruitment started on 30/07/2025 and is expected to continue until 28/02/2027, with overall study completion planned for 31/05/2027. This multicenter reader study addresses a key limitation of current CTEPH diagnostic pathways-reliance on V/Q scintigraphy, which may be delayed or unavailable outside tertiary centers-by evaluating whether DCR-based pulmonary circulation analysis can improve early discrimination of CTEPH and support timely referral. Japan Registry of Clinical Trials (jRCT), jRCT2072250027.