公共卫生研究摘要 (2026-06-19)

共收录 56 篇研究文章

1. Long-Term Outcomes After Ischemic Stroke Across Atrial Fibrillation Phenotypes Defined by Detection Timing and Prior Anticoagulation Status.

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

摘要

Atrial fibrillation (AF)-associated ischemic stroke is often managed as a single clinical entity; however, prognosis may vary depending on whether AF was detected after the stroke or whether the stroke occurred despite prior oral anticoagulant (OAC) use. We aimed to describe long-term outcomes after ischemic stroke across 3 distinct AF phenotypes: AF complicated by ischemic stroke despite prior anticoagulation (AFIDA), AF complicated by ischemic stroke without prior anticoagulation (OAC-naive AF), and AF detected after stroke (AFDAS). This nationwide cohort study used the DeSC-IQVIA database, an administrative claims database covering approximately 16 million individuals in Japan. Adult stroke survivors with AF discharged with OAC prescriptions between April 2014 and January 2025 were included. Three mutually exclusive AF phenotypes defined by AF detection timing and prior anticoagulation status: AFIDA, OAC-naive AF, and AFDAS (diagnosed during the index hospitalization). The primary outcomes were hospitalization for recurrent ischemic stroke or systemic embolism (SE). The secondary outcomes included major bleeding, heart failure (HF) hospitalization, and all-cause mortality. Cumulative incidence was estimated using the Aalen-Johansen method, accounting for the competing risk of death. Adjusted subdistribution hazard ratios (aSHRs) were estimated using Fine-Gray models. Among 21,586 patients (median age, 83 years [interquartile range (IQR), 78-88 years]; 10,604 [49.1%] female), 6,604 (30.6%) were classified as having AFIDA, 11,875 (55.0%) as having OAC-naive AF, and 3,107 (14.4%) as having AFDAS. During the 38,593 person-years of follow-up, 2,028 patients experienced stroke/SE. The 5-year cumulative incidence of stroke/SE was highest in AFIDA (18.6% [95% CI 17.0%-20.2%]), followed by OAC-naive AF (13.0% [95% CI 12.0%-13.9%]) and AFDAS (10.5% [95% CI 9.0%-12.1%]). Compared with OAC-naive AF, AFIDA was associated with a higher risk of recurrent stroke/SE (aSHR, 1.38; 95% CI 1.25-1.52), whereas AFDAS was associated with a lower risk (aSHR, 0.87; 95% CI 0.75-1.00). Among secondary outcomes, AFIDA showed an increased risk of HF hospitalization (aSHR, 1.15; 95% CI 1.02-1.31). Long-term prognosis after AF-associated stroke is heterogeneous across AF phenotypes, with AFIDA representing a high-risk group and AFDAS representing a low-risk group. These findings highlight the need to treat these clinically identifiable phenotypes as distinct target populations for secondary prevention strategies and future clinical trials.

2. Frequency of Suicidal Ideation and Associations With Autonomic, Motor, and Cognitive Dysfunction in People With REM Sleep Behavior Disorders.

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

摘要

REM sleep behavior disorder (RBD) is characterized by loss of REM sleep atonia leading to dream enactment behavior. Isolated RBD (iRBD) is a known prodrome of alpha-synuclein pathology including Parkinson disease (PD) and dementia with Lewy bodies (DLB). Depression is also a common prodromal symptom of PD/DLB, and death by suicide is greater among individuals with PD. Patients with RBD are at greater risk of comorbid depression, but the prevalence of suicidal ideation in this population is unknown. We aim to assess the frequency of suicidal ideation and whether it is associated with autonomic, motor, and cognitive dysfunction in the North American Prodromal Synucleinopathy 2 (NAPS2) consortium. NAPS2 is a longitudinal study that includes measurements of autonomic function (SCOPA-AUT, orthostatic blood pressure), motor function (UPDRS), cognition (MoCA), and suicidal ideation (PHQ-9). We used a linear mixed-effects model, adjusting for age, sex, impulsivity, current carbidopa/levodopa use, and PHQ-9 score, to compare those who endorsed recent suicidal ideation with those who did not. Of 489 total participants, 40 endorsed suicidal ideation at the first visit (22.5% female, mean age 61.5) and 449 denied suicidal ideation (19.4% female, mean age 64.6). Higher PHQ-9 scores were significantly associated with higher SCOPA-AUT scores (+0.566; SE = 0.045; p < 2 × 10-16), higher UPDRS II scores (+0.372; SE = 0.03; p < 2 × 10-16), higher UPDRS III scores (+0.265; SE = 0.057; p = 3.80 × 10-6), and lower MoCA scores (-0.078; SE = 0.021; p = 3 × 10-4). The PHQ-9 score was not significantly associated with orthostatic blood pressure drops. Recent suicidal ideation occurred in approximately 1 of 12 patients with iRBD, a prodromal syndrome of PD with an increased risk of death by suicide. Individuals with iRBD who scored higher on PHQ-9 had on average greater autonomic dysfunction on SCOPA-AUT, more motor findings, and greater cognitive deficits. This study establishes that suicidal ideation is common in iRBD and suggests an iRBD phenotype that identifies individuals at high risk of depression and suicide. Future studies should expand on these findings and target interventions to decrease mortality and self-harm.

3. Reconciling the Literature on Sex-Based Disparities in Reimbursement.

期刊: Obstetrics and gynecology 发表日期: 2026-Jul-01 链接: PubMed

摘要

Significant disparities in surgical reimbursement by patient sex have been documented for decades, although debate exists regarding their cause, and studies have approached the issue with different methodologies, arriving at seemingly divergent conclusions. In our analysis, we have found that the preponderance of the literature, including the most comprehensive studies, supports a conclusion that there are real payment disparities at the work relative value unit (RVU) level for gynecologic care. Disparities in funding and reimbursement result in differing health care resource allocation and access and ultimately systemic and persistent devaluation of female bodies. We advocate for robust interventions to promote equity rather than a limited approach focused on revising a handful of Current Procedural Terminology codes. Reforms should include broader RVU reassessment, specialty compensation parity, and rigorous yet inclusive comparisons of sex-specific procedures.

4. Comprehensive Analysis and Prognostic Modeling of Epithelioid Trophoblastic Tumor.

期刊: Obstetrics and gynecology 发表日期: 2026-Jul-01 链接: PubMed

摘要

To evaluate clinicopathologic factors associated with progression-free survival in patients with epithelioid trophoblastic tumor and to construct validated prognostic models. This study combined a retrospective institutional case series (57 patients) with systematically identified literature cases (150 patients), totaling 207 individuals with epithelioid trophoblastic tumor diagnosed between 1998 and 2024. The primary end point was progression-free survival. Prognostic variables were identified with Cox and least absolute shrinkage and selection operator regression. Two nomograms were developed: a clinical model and a clinicopathologic model. Internal validation was performed with 1,000 bootstrap resamples. Model performance was assessed with concordance index, time-dependent receiver operating characteristic curves, calibration plots, and decision-curve analysis. Patients with stage IV disease had the shortest median progression-free survival (9.0 months); those with stage II-III disease and solitary extrauterine lesions had outcomes similar to those of patients with stage I disease (P=.219). Independent prognostic factors included high mitotic count (5 or more per 10 high-power fields; hazard ratio [HR] 17.91, 95% CI, 4.13-77.70, P<.001), interval from last pregnancy of 20 months or more (HR 2.59, 95% CI, 1.32-5.08, P=.006), tumor size 4 cm or larger (HR 1.81, 95% CI, 1.05-3.15, P=.034), and International Federation of Gynecology and Obstetrics stage IV (HR 4.46, 95% CI, 1.67-11.93, P=.003). Model discrimination (C index) was 0.72 (95% CI, 0.69-0.75) for the clinical model and 0.82 (95% CI, 0.78-0.86) for the clinicopathologic model. Clinicopathologic characteristics are significantly associated with prognosis in epithelioid trophoblastic tumor. The validated nomogram-based model may support individualized clinical risk assessment.

5. The Effects of Climate Change on Obstetric and Gynecologic Health.

期刊: Obstetrics and gynecology 发表日期: 2026-Jul-01 链接: PubMed

摘要

In the United States and globally, the negative effects of climate change, such as extremes of heat, wildfire smoke, and air pollution, are associated with early pregnancy loss, preterm birth, preeclampsia, hypertensive disorders of pregnancy, and stillbirth. Climate change amplifies existing gender-based disparities, which include elevated risks of infectious diseases, malnutrition, sexual violence, mental health disorders, lack of reproductive control, negative obstetric outcomes, and death, when compared with men. These adverse effects disproportionately affect marginalized groups. With the ongoing and increasing threats of climate change and environmental pollutants on human health, it is imperative that obstetrician-gynecologists (ob-gyns) educate not only themselves but students, other health care professionals, their patients, and communities about the adverse effects these threats have on gynecologic and obstetric health. Institutions should encourage the inclusion of climate change education in medical curricula. Ob-gyns should incorporate environmental health education into all prepregnancy counseling visits, with a focus on identifying any potential harmful exposures and determining what mitigation efforts can be initiated before pregnancy.

6. Kyasanur Forest Disease: Advances in Experimental Animal Models, Immune Assays, and Challenges in Vaccine Development.

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

摘要

Kyasanur Forest Disease (KFD) is a tick-borne viral haemorrhagic fever endemic to forested regions of South India, with case fatality rates ranging from 3% to 10% and seasonal outbreaks causing recurrent illness among at-risk populations such as forest workers and villagers. The historically used formalin-inactivated KFD vaccine showed limited effectiveness in field studies, providing only about 62% protection. This moderate level of protection highlights the need for improved vaccines that offer higher efficacy and longer-lasting immunity for populations living in endemic areas. A major challenge in vaccine development is the limited understanding of immune responses that protect against KFD, along with the lack of preclinical models that fully reflect the disease as it occurs in humans. Existing animal models-including murine systems and limited non-human primate studies -have contributed to understanding viral replication, lethality, viraemia kinetics, and basic immunological responses. However, murine models often fail to reproduce the full spectrum of human immunopathology, particularly haemorrhagic manifestations and complex host immune responses, while non-human primate models remain limited by cost, accessibility, and incomplete characterisation. Furthermore, variability in experimental endpoints and the absence of standardized immunogenicity and neutralisation assays restrict cross-study comparability and hinder identification of immune correlates of protection. This review critically synthesises current knowledge on KFD animal models and host immune responses, identifying key gaps in translational relevance. We propose a prioritised roadmap that includes: (i) development and validation of advanced preclinical models that better mimic human disease progression and immune dysregulation; (ii) systematic identification of serological and cellular correlates of protection; and (iii) standardisation of virological, serological, and immunological assays to support regulatory evaluation and vaccine benchmarking. Addressing these challenges through coordinated interdisciplinary efforts will accelerate the development of next-generation KFD vaccines and therapeutics tailored to endemic populations.

7. On the Label: Implementation of Health Warnings on Alcohol Products in 13 European Countries.

期刊: Drug and alcohol review 发表日期: 2026-Jul 链接: PubMed

摘要

Alcohol health warning labels are an important part of a comprehensive alcohol policy, but there is a lack of recent implementation data across Europe. This study examined the presence, content and format of health warnings across 13 European countries. Store audits were conducted across 32 stores in 23 cities. The sampled products were assessed for the presence, topic and format of health warnings. Among the 1636 investigated products, 69.7% displayed health warnings. The most common topics were pregnancy (68.0%), drink-driving (21.4%) and age restrictions (16.6%), followed by responsible drinking messages (6.9%) and health harms due to alcohol use (0.3%). About one in four (26.7%) products contained a multi-topic warning. The majority of products featured only a pictogram (62.3%), while 6.7% included both pictogram and text, and 0.7% contained text only. Lithuania, France and the Netherlands had the highest proportions of products displaying at least one warning (above 90%). Proportions were lowest in Croatia, Poland, Slovenia and Greece (under 50% of products with health warnings). Existing warnings predominantly focus on messages relevant to at-risk population groups rather than on alcohol harms affecting the general population. The current implementation largely reflects the alcohol producers’ voluntary commitments, although the highest implementation is found in countries with existing legislation. There is underutilised potential to inform Europeans about the health harms of alcohol through warning labels. Stronger regulatory approaches at the EU or Member State level could improve the quality of information provided directly to consumers.

8. Movement Through Time: The Evolution of Treatment for People With Parkinson Disease.

期刊: Journal of neurologic physical therapy : JNPT 发表日期: 2026-Jul-01 链接: PubMed

摘要

Parkinson disease (PD) is the fastest-growing neurological disorder worldwide, projected to affect approximately 25 million people by 2050. Despite effective pharmacologic management of motor symptoms, patients consistently identify walking, mobility, and balance as their greatest challenges. This Special Interest paper, based on the 2026 Anne Shumway-Cook Lectureship, summarizes a program of research aimed at building the evidence base for rehabilitation in PD and translating that evidence into improved real-world outcomes. Four interrelated themes are addressed: (1) the historical development of the evidence base, from 11 randomized controlled trials in 2001 to more than 240 today; (2) the capacity-performance gap and the importance of targeting real-world walking, not only clinic-based function; (3) complementary intervention approaches, including cognitive-behavioral strategies, closed-loop rhythmic auditory stimulation, and soft-robotic assistance for freezing of gait, that address psychological, neural, and biomechanical barriers to everyday mobility; and (4) a proposed secondary-prevention model of care that initiates rehabilitation at diagnosis and sustains it longitudinally. Taken together, this body of work argues for a fundamental restructuring of physical therapy for people with PD: from a reactive, late-stage response to a proactive, lifelong strategy that reduces disability, preserves independence, and improves healthspan.

9. Mycoelectronics: Bioprinted living fungal bioelectronics for artificial sensation.

期刊: Proceedings of the National Academy of Sciences of the United States of America 发表日期: 2026-Jun-30 链接: PubMed

摘要

The intelligence of the human biological system is enabled by the highly distributed sensing receptors on soft skin that can distinguish various stimulations or environmental cues, thus establishing the fundamental logic of sensing and physiological regulation or response. To replicate biological perception, biohybrid systems integrating living organisms with electronics have been developed to sense environmental cues. However, current eukaryote-based biohybrids face slow growth, strict culture needs, and short lifespans, limiting real-world use. Here, we introduce fungi-based printable “Mycoelectronics” which are created by additive bioprinting of living fungal mycelium networks onto stretchable electronics, as a practical living thermoresponsive sensory platform. This mycoelectronics approach leverages fung’s capabilities for rapid biological responsiveness, cultivability with exponential growth, stability and self-healing in ambient conditions, bioprintability for scalable manufacturing, and mechanical flexibility for seamless integration with soft electronics. We show that the thermal responsiveness of the fungal network arises from intrinsic cellular processes-specifically, heat-induced vacuole remodeling and fusion, which modulate ionic transport and thus the electrical conductivity of the mycelial cells and networks, enabling a rapid response. By bridging the gap between cell biology and soft electronics, the mycoelectronics device, with a living mycelial network, functions as a thermal sensation system with rapid response and intrinsic self-healing properties, autonomously restoring sensing capabilities after damage and establishing sensing pathways in hard-to-reach locations. Application demonstrations in environmental and agricultural monitoring and wearable sensing systems for humans and robots highlight the versatility of this living fungal sensor platform, suggesting promising opportunities in healthcare and the environment.

10. Genome-edited rice variety with low-cadmium accumulation in the grain.

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

摘要

Cadmium (Cd) is a toxic and carcinogenic heavy metal, and rice, as a staple food, is a major source of dietary Cd intake. Therefore, limiting the transfer of Cd from soil to rice grain without compromising grain yield is a critical issue for human health. In this study, through base-editing-mediated mutagenesis screening targeting OsNramp5, a major transporter gene for manganese (Mn) and Cd uptake, we identified a single amino acid substitution at position 441 (Ile to Thr) that significantly reduced Cd accumulation in both shoots and grains without affecting the accumulation of other essential metals. Functional analysis revealed that this point mutation did not alter gene expression, protein abundance, subcellular localization, or Cd and Mn transport activity in yeast. However, we found that OsNramp5 also transports zinc (Zn), and the point mutation increased its selectivity for Zn. It is likely that elevated Zn levels in root cells competitively inhibit Cd release into the xylem, thereby reducing root-to-shoot Cd translocation. A field trial confirmed that the mutated OsNramp5 did not affect grain yield or essential micronutrient concentration but significantly decreased Cd accumulation in grains. Our findings suggest that precise editing of this key residue in OsNramp5 offers an effective strategy to reduce Cd transfer from soil to rice grain without yield penalty.

11. TL1A/DR3 signaling deletion attenuates mucosal inflammation and alveolar bone loss in a murine model of spontaneous periodontitis.

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

摘要

TL1A and its receptor DR3 are key regulators of mucosal immune responses, but their role in periodontal disease is unknown. Herein, we investigated whether TL1A/DR3 signaling contributes to mucosal immune amplification and tissue-destructive inflammation in periodontitis using SAMP1/YitFc (SAMP) mice, which develop spontaneous ileitis and periodontal disease. DR3 deficiency markedly attenuated alveolar bone loss and improved periodontal architecture, restoring a phenotype comparable to healthy AKR (parental) controls. Gingival tissues from wild-type SAMP mice exhibited increased expression of both Tnfsf15 (encoding TL1A) and Tnfrsf25 (encoding DR3), with both positively correlating with disease severity. This was accompanied by elevated levels of IL-17, TNF-α, and IL-1β, and by increased numbers of CD4+ T helper cells and neutrophils. Conversely, SAMPxDR3-/- mice exhibited reduced inflammatory cytokine production and immune cell accumulation. These findings support a model in which the TL1A/DR3 axis is associated with amplification of mucosal immune responses in periodontal disease, linking effector T cell activation, increased cytokine production, and recruitment of innate immune cells. Altogether, our data identify the TL1A/DR3 cytokine-receptor pair as a potential regulator of inflammatory circuits that drive periodontal pathology. Blocking this pathway may provide a therapeutic modality for patients affected by chronic periodontitis.

12. Nurses' uncertainty in gender-affirming care: Implications for nursing leadership and organizational practice.

期刊: Nursing management 发表日期: 2026-Jun-19 链接: PubMed

摘要

Despite established standards for gender-affirming care (GAC), transgender and gender diverse (TGD) individuals continue to experience health care disparities. Nurses play a critical role in delivering affirming care, but organizational systems and leadership practices may influence care consistency. To explore clinical nurses’ perceptions and beliefs regarding the provision of GAC and to examine how organizational policies, leadership practices, and clinical systems influence nurses’ ability to deliver GAC to TGD clients. A qualitative descriptive study was conducted using semistructured interviews with 22 clinical nurses from a region of the US. Data were analyzed using thematic analysis. Three themes were identified: Uncertainty about Gender-Affirming Care, Fear of Offending, and Inconsistencies in Organizational Support for Gender-Affirming Care. Nurses described uncertainty related to initial interactions and care decisions, concern about unintentional harm through miscommunication, and variability in care practices across organizational contexts. Inconsistent leadership support, unclear policy enforcement, and limitations within electronic health records contributed to these challenges. Nursing leadership and organizational systems play a central role in shaping nurses’ ability to deliver GAC. Addressing policy clarity, documentation practices, and leadership accountability may reduce uncertainty and improve equity in care for TGD populations.

13. Environmental hazards at work and mental health: a UK Biobank Retrospective Cohort Study.

期刊: Journal of occupational and environmental medicine 发表日期: 2026-Jun-19 链接: PubMed

摘要

This study aims to examine the associations between exposure to very noisy, hot, or cold work environments and mental health. This retrospective cohort study included 117,675 UK Biobank participants. Linear regression analyses were used to analyse the association between retrospective full-time equivalent years of exposure to environmental hazards and self-reported mental health. A generalised additive model with penalised cubic spline was used to examine the non-linear association of cumulative exposure to hazards with mental health. Exposure to each work environmental hazard was associated with worse mental health. Non-linear association analysis showed a possible ceiling effect after 2-3 years of exposure to very hot environments. The associations were less pronounced in those working in professional/managerial roles and male participants. The results support establishing safe noise and temperature levels for mental health.

14. Promoting Brain Health in the Context of Normal Aging and Mild Cognitive Impairment: A Tutorial.

期刊: American journal of speech-language pathology 发表日期: 2026-Jun-18 链接: PubMed

摘要

There are significant opportunities for speech-language pathologists (SLPs) to play important roles in the primary and secondary prevention of Alzheimer’s disease and related dementias (ADRD) beyond current practices. This tutorial, developed by members of the Joint Committee on Interprofessional Relations between the American Psychological Association and the American Speech-Language-Hearing Association, is intended to support SLPs in these efforts and to facilitate collaboration between SLPs and neuropsychologists. This tutorial synthesizes interdisciplinary literature on cognitive aging, ADRD, public health, clinical psychology, speech-language pathology, and motivational interviewing. We provide an evidence-based overview of cognitive aging, ADRD, modifiable aspects of brain health, and practical strategies for engaging with middle-age and older adults to promote brain health across the lifespan. While discussions about cognitive aging, Alzheimer’s disease, and dementia have long been avoided, stigmatized, and demoralizing, there is much more to be positive about than in the past. Forty-five percent or more cases of dementia can be delayed or prevented by addressing modifiable risk factors across the lifespan, and brain health and resilience can be improved at any age. As the population ages worldwide, it will require SLPs and neuropsychologists working together and with other helping professions to raise awareness, contribute to public health initiatives, advocate for reimbursement for efficacious services, and educate and motivate their clients to improve brain health. Even small effects in the primary and secondary prevention of dementia can translate into significant personal and societal outcomes.

15. Predictive Biomarkers for Immune Checkpoint Inhibitor Efficacy: Challenges, Innovations, and a Pathway to Precision Medicine in the Era of Cancer Immunotherapy.

期刊: Clinical chemistry 发表日期: 2026-Jun-18 链接: PubMed

摘要

Immune checkpoint inhibitors (ICIs) have transformed oncology practice. However, treatment response remains heterogeneous, rendering predictive biomarkers critical for optimal patient care. The 3 established biomarkers, programmed death-ligand 1, tumor mutational burden (TMB), and microsatellite instability-high/deficient mismatch repair, are approved and clinically validated but are modest predictors of benefit. As a result, multiple novel predictive biomarkers remain under investigation. This review highlights established and investigational predictive ICI efficacy biomarkers. For established biomarkers, we describe biology, assay modalities, approved companion diagnostics, landmark studies, and notable limitations. Due to the multisystem nature of antitumor immune effects, investigational biomarkers span multiple domains, including tumor genomic biomarkers (e.g., mutational signatures, TMB, neoantigen clonality), tumor microenvironment (e.g., tumor-infiltrating lymphocytes [TILs], tertiary lymphoid structures), systemic immune biomarkers (e.g., cytokines, autoantibodies, glycoproteins, peripheral blood mononuclear cells), and the microbiome (e.g., gastrointestinal microbial diversity, responder-enriched taxa). The established biomarkers PD-L1, TMB, and microsatellite instability-high/deficient mismatch repair inform ICI use in clinical practice but have important limitations. Multiple investigational biomarkers show promise in refining patient selection and optimizing therapy. Moving forward, increased assay harmonization, prospective validation, and standardized parameters may improve performance. Composite models integrating complementary signals across domains may further individualize treatment and lead to an era of personalized cancer immunotherapy.

16. Addressing the public health gap in respiratory protective devices in the United States.

期刊: Journal of occupational and environmental hygiene 发表日期: 2026-Jun-18 链接: PubMed

摘要

Public health crises like the COVID-19 pandemic and major wildfires have exposed significant confusion about how members of the public can effectively protect themselves from inhaling harmful airborne particles. Unlike many other nations, no single federal agency oversees respiratory protective devices (RPDs) designed for public use against inhaled contaminants. The National Institute for Occupational Safety and Health (NIOSH) currently holds the authority for establishing standards and approving respirators used in workplaces; however, for public sector use, there is a lack of standards for their design and construction, conformity assessment to ensure conformance, risk assessment in selecting devices, and guidance for proper use and maintenance. Without RPDs specifically designed for public use, individuals are left to purchase industrial products intended for workplaces, which do not generally suit the needs of the public, or to rely on domestic and foreign products that have uncertain quality and effectiveness. The development of specific standards for public-use devices, robust conformity assessment practices, and clear guidance on their selection, use, and care is needed. A risk assessment framework for selecting devices for common hazards like wildfire smoke, general air pollution (including pollens and allergens), and infectious particles is presented. Respiratory protection for the public must consider those with physical and mental disabilities and is discussed. Given that nearly all governmental expertise in RPD testing, efficacy determination, and systems oversight resides within NIOSH, its authority could be expanded to assist in developing public-specific standards and conformity assessments. This expansion would enable the public to have confidence that the RPDs they purchase are effective for the protections manufacturers claim.

17. Occupational exposure limit variability and hazard characterization alignment-implications for protection from respiratory irritation.

期刊: Journal of occupational and environmental hygiene 发表日期: 2026-Jun-18 链接: PubMed

摘要

The primary purpose of this study was to examine patterns in the reliance on respiratory tract irritation as a toxicological basis for occupational exposure limits (OELs), focused on U.S.-based OELs. This study pursued three aims: (1) to evaluate the degree to which OELs are based on respiratory irritation, or more broadly, on respiratory effects; (2) to assess the variability in the OEL values across organizations; and (3) to determine how well surrogate endpoints align with respiratory irritation for OELs having respiratory tract effects as their critical effect. To address these aims, a database was developed that listed the chemical OELs from the German MAK (Maximale Arbeitsplatz-Konzentration) Commission, U.S. National Institute for Occupational Safety and Health (NIOSH), U.S. Occupational Safety and Health Administration (OSHA), California OSHA, American Conference of Governmental Industrial Hygienists (ACGIH®), and the Workplace Environmental Exposure Levels Committee (WEEL; initially derived under the American Industrial Hygiene Association (AIHA®), and after 2012 via Toxicology Excellence for Risk Assessment (TERA)). Information on inhalation toxicity, specifically respiratory irritation, was also included. Analyses of the collated data found the following. Most chemicals in the database with at least one OEL had three or four OELs from different organizations; there was variability among the OEL numeric values, but most chemicals differed by a factor of less than 10. The respiratory tract was the site of the critical or co-critical effect (i.e., the one occurring at the lowest concentration) for ∼50% of the chemicals in the database, illustrating the importance of consideration of this target organ in OEL development. Inconsistencies between GESTIS-curated Globally Harmonized System (GHS) Hazard (H) codes and OEL documentation regarding respiratory effects were identified, suggesting that the potential for respiratory effects may not be adequately addressed in assigning H codes. Neither skin nor eye irritation-related H codes are sufficiently sensitive to predict potential respiratory irritation, so other surrogate measures are needed to evaluate the potential to cause respiratory irritation of chemicals for which inhalation toxicity data are not available.

18. Evaluation of total VOC exposure and ventilation controls in funeral home preparation rooms: A case study from Grenada.

期刊: Journal of occupational and environmental hygiene 发表日期: 2026-Jun-18 链接: PubMed

摘要

Funeral home (FH) preparation rooms pose potential occupational health hazards due to exposure to volatile organic compounds (VOCs) emitted during embalming and autopsy procedures. This analytical observational study assessed indoor air quality (IAQ) hygiene conditions in all three funeral homes operating in Grenada using total volatile organic compound (TVOC) concentrations as an exposure indicator. Air sampling was conducted during 18 embalming and autopsy sessions between February and June 2025 using a GrayWolf AdvancedSense Pro monitor with a photoionization detector. Concurrent measurements of hydrogen sulfide, carbon monoxide, temperature, and relative humidity were recorded. A brief survey was administered to embalmers and support staff to assess work-related health symptoms. Mean TVOC concentrations exceeded the German recommended IAQ hygiene guideline of 0.3 mg/m³ in two of the three funeral homes. Funeral home #1 (FH1) recorded the highest geometric mean TVOC concentration (7.7 mg/m³), whereas Funeral home #3 (FH3) maintained the lowest (0.20 mg/m³). Elevated concentrations were associated with inadequate ventilation and smaller room volume. FH3’s continuous fresh air ventilation system-maintained levels below the German IAQ guideline. Self-reported health data from embalmers and reception staff indicated musculoskeletal and respiratory complaints across facilities, though limited sample sizes precluded meaningful comparison between funeral homes or job categories. These results illustrate the practical utility of TVOC measurements in assessing IAQ and provide funeral home directors with valuable guidance on designing and maintaining ventilation systems to safeguard the occupational health of funeral service providers.

19. Age and postoperative unplanned reintubation: A retrospective observational study using the NSQIP Pediatric database.

期刊: The Journal of urology 发表日期: 2026-Jun-18 链接: PubMed

摘要

To evaluate perioperative anesthesia risk in relation to age among children undergoing elective outpatient surgery and assess whether 6 months of age represents a potential inflection point in risk. We performed a retrospective cohort study using the National Surgical Quality Improvement Program-Pediatrics database from 2019-2022. Patients aged <19 years who underwent general anesthesia were included. Exclusions were inpatient status, transfer from an acute care facility, or urgent/emergent cases. We examined age as a continuous variable with restricted cubic splines and as a categorical variable with cutoffs at 6 months, 12 months, 18 months, 3 years, and 6 years. Main study outcomes were respiratory failure requiring unplanned reintubation and a composite outcome of 30-day serious adverse events. Adjusted odds ratios were estimated using multivariable firth penalized logistic regression adjusting for comorbidities including prematurity. Among 145,965 elective outpatient cases, respiratory failure requiring reintubation occurred in 85 patients (<0.1%) and 30-day serious adverse events occurred in 126 patients (<0.1%). When age was modeled as a continuous variable with restricted cubic splines, age demonstrated a significant non-linear association with the odds of reintubation (p<0.001). In multivariable analyses with age as a categorical variable, all age categories ≥6 months were associated with significantly decreased odds of respiratory failure requiring reintubation and 30-day serious adverse events compared to <6 months. Rates of reintubation and 30-day serious adverse events were low across 145,965 elective, outpatient pediatric surgical cases. Children aged 6-11 months had 76% lower odds of reintubation, respiratory failure, cardiac arrest, or death compared with those younger than 6 months. These findings suggest that children under 6 months old undergoing surgery may warrant heightened perioperative vigilance.

20. The Open Syndrome Definition as a Machine-Readable Standard for Public Health: Design and Implementation Study.

期刊: Journal of medical Internet research 发表日期: 2026-Jun-18 链接: PubMed

摘要

Case definitions are essential for effectively communicating public health threats. However, the absence of a standardized, machine-readable format poses significant challenges to interoperability, epidemiological research, data sharing, and the application of computational methods, including artificial intelligence. These barriers complicate collaboration across regions and organizations and hinder technological progress in public health. This study aims to propose and release the first open, machine-readable format for representing case and syndrome definitions, together with tools and resources that enable their standardized and scalable use. We developed the Open Syndrome Definition, a structured, machine-readable schema for representing case and syndrome definitions. We compiled official public health case definitions from multiple institutions and converted them into standardized, machine-readable representations using open-source tools. These tools, available through GitHub under the Massachusetts Institute of Technology license, automate the translation of narrative definitions into structured data. We also created a platform for browsing, analyzing, and contributing new definitions on our initiative website. The Open Syndrome Definition format enabled consistent, automated representation of case definitions across different diseases and jurisdictions. The conversion tools achieved high semantic fidelity, as assessed by qualitative expert review, between narrative and structured representations, supporting human verification and automated analysis. The dataset and accompanying tools demonstrated structural and semantic interoperability by standardizing definitions from various health systems into a unified format and integrating existing medical ontologies through JSON for Linked Data. To further illustrate practical applicability and downstream usage, we introduced a data filtering prototype that allows users to upload their own datasets and verify the results against the standardized definitions. The Open Syndrome Definition establishes a foundation for consistent and machine-readable public health definitions, facilitating reproducible research and interoperability at scale. By enabling systematic data exchange and artificial intelligence-driven analysis, it strengthens public health preparedness and supports more rapid, coordinated responses to emerging health threats.

21. Naloxone Distribution in the United States, 2018-2023.

期刊: American journal of public health 发表日期: 2026-Jun-18 链接: PubMed

摘要

Objectives. To assess US patterns of distribution for all naloxone products. Methods. We conducted a retrospective, cross-sectional study using manufacturer reports (total US naloxone distribution) and IQVIA National Sales Perspectives (estimated sales to US health care settings) to assess naloxone distribution quantity and patterns from 2018 to 2023. Results. Aggregated manufacturer-reported data showed that total US distribution of naloxone increased from 7.65 million units (vials, syringes, devices) to 29.7 million units from 2018 to 2023; the largest increase was in distribution of nasal spray devices (2.9 million to 23.4 million devices). Although sales to health care settings doubled (6.3 million units in 2018 and 13.6 million units in 2023), we infer that naloxone distributed to non-health care settings increased from 1.39 million units in 2018 to 16.1 million in 2023, accounting for 54% of total naloxone distributed in the United States by 2023. Conclusions. Distribution of naloxone markedly increased between 2018 and 2023, with the largest increases in distribution to non-health care settings and for nasal spray devices. Public Health Implications. This comprehensive overview of the naloxone supply, with insights into changes in distribution for community use, may help inform assessments, including those involving factors contributing to recent declines in opioid overdose deaths. (Am J Public Health. Published online ahead of print June 18, 2026:e1-e4. https://doi.org/10.2105/AJPH.2026.308541).

22. Big Ebola outbreak puts research spotlight on little-known virus.

期刊: Science (New York, N.Y.) 发表日期: 2026-Jun-18 链接: PubMed

摘要

The Bundibugyo virus only emerged twice before. Now, scientists see a chance to get to know it better.

23. Association of Respiratory Syncytial Virus Vaccination During Pregnancy With Adverse Obstetric and Neonatal Outcomes.

期刊: Obstetrics and gynecology 发表日期: 2026-Jun-18 链接: PubMed

摘要

To assess adverse pregnancy and birth outcomes after bivalent prefusion F subunit-based respiratory syncytial virus vaccine (RSVpreF) vaccination during the first season of availability. This was a target trial emulation study including eight health systems across eight states (California, Oregon, Washington, Colorado, Maryland, Virginia, Minnesota, and Wisconsin) and Washington, DC, in the Vaccine Safety Datalink (VSD). We included pregnant patients aged 16-49 years who had enrolled at a VSD site between September 22, 2023, and February 29, 2024. Exposure was defined as receipt of RSVpreF vaccination between 32 and less than 37 weeks of gestation. Outcomes included preterm birth (PTB), stillbirth, small-for-gestational-age (SGA) birth weight, and hypertensive disorders of pregnancy (HDP) assessed with electronic health record data. Stillbirth cases were confirmed through chart review. Pregnant patients exposed to RSVpreF vaccines were matched 1:1 to unexposed pregnant patients at the gestational week of vaccination by propensity to be vaccinated and VSD site. Unexposed pregnant patients were assigned an index date equivalent to the gestational day of vaccination for their vaccinated match. If the unvaccinated match was subsequently vaccinated, the pair was censored. We report adverse event risks and adjusted risk ratios (aRRs) with corresponding 95% CIs adjusted for nulliparity using a log binomial model with robust variance. We identified 13,966 pregnant patients who received the RSVpreF vaccine. A higher percentage of nulliparous patients were in the vaccinated group (46.4%) compared with the unvaccinated group (38.7%). Comparing RSVpreF vaccinated pregnant patients and their unvaccinated matches, rates of PTB (4.0% vs 4.5%, respectively; aRR 0.90, 95% CI, 0.80-1.00), stillbirth (0.79/1,000 and 0.72/1,000; aRR 0.99, 95% CI, 0.41-2.36), and SGA birth weight (6.8% and 6.5%; aRR 1.02, 95% CI, 0.92-1.12) did not significantly differ. The rate of any HDP among RSVpreF vaccinated patients was 17.3% vs 15.0% among their unvaccinated matches (aRR 1.13, 95% CI, 1.07-1.19). Initial prenatal RSVpreF safety surveillance shows a largely favorable safety profile. Although we identified a small but statistically significant increased risk for HDP after RSVpreF vaccination, there was no increased risk for PTB, SGA birth weight, or stillbirth.

24. Tweets Surrounding Pharmaceutical Drug Brands With Top Direct-to-Consumer TV-Advertising Budgets: Social Media Listening Study.

期刊: Online journal of public health informatics 发表日期: 2026-Jun-18 链接: PubMed

摘要

Direct-to-consumer (DTC) pharmaceutical advertising allocates billions annually in the United States; however, the analysis of conversations on social media about DTC drugs remains sparse. Twitter (subsequently rebranded X) is serving as a forum for pharmaceutical companies, their constituents, and social media health influencers to discuss topics related to DTC drugs with high advertising budgets. This study aims to examine user-generated topics discussed for the highest-budgeted DTC pharmaceutical drugs and to identify the agenda-setting themes and uses and gratifications that emerged. This social media listening study used Brandwatch to analyze Twitter conversations (August 2021-August 2023) surrounding top-budgeted DTC brands from 2020 to 2022. A dataset of 44,700 mentions from 26,800 unique authors was analyzed for content, sentiment, and thematic relevance using agenda-setting and uses and gratifications frameworks. Four dominant themes emerged: (1) patient experiences/testimonials, (2) drug pricing/insurance concerns, (3) pharmaceutical news, and (4) advertising commentary. The content shows a range of potentially agenda-setting topics, including pharmaceutical companies, their DTC drugs, patient experiences, costs, insurance, and advertising commentary. The uses and gratifications we found included information, entertainment, economic benefits, and social benefits, with information being the most prevalent. Our study provides an important glimpse into what is being discussed on Twitter by, with, and about pharmaceutical drugs that spend billions on advertising each year [1]. Although more tweets were neutral than positive or negative, the overall sentiment of the top terms was negative. The predominance of negative sentiment in our findings suggests that many social media users express apprehensions or criticisms about these drugs, highlighting the need for improved communication, transparency, and engagement strategies. Further implications are also discussed surrounding public policy and industry practice. Suggested future research directions include NodeXL network analysis and qualitative inquiry into user motivations.

25. A GP-Led health system for diabetes care: A patient-centered structure or a systemic constraint?

期刊: Community health equity research & policy 发表日期: 2026-Jun-18 链接: PubMed

摘要

Modern diabetes care faces increasing clinical and technological complexity. While generalist-led models are widely promoted for continuity and accessibility, they may fall short in addressing the nuanced needs of patients with diabetes, particularly in complex or rapidly evolving clinical contexts. The aim of the article is to critically evaluate whether general practitioner (GP)-led models of diabetes care adequately meet patient needs and to explore the role of specialist access within contemporary health systems. A narrative and conceptual analysis of current literature was applied, focusing on patient-centered care, equity, and the organization of diabetes services. Patient-centeredness and equity should underpin diabetes care, including individualized goal setting and shared decision-making. However, overreliance on generalist-led care may contribute to delays, suboptimal care, and reduced clinical precision in complex cases. Open access to specialist care may enhance patient autonomy and enable more timely, comprehensive, and personalized management. At the same time, general practitioners remain essential for holistic care, coordination, and long-term patient engagement. Integrating specialists within primary care through hybrid or collaborative models may combine the strengths of generalists and specialists and improve outcomes, while maintaining equity. Strategic policy initiatives, workforce planning, and technological innovation are necessary to sustainably expand access.

26. Maintenance Pemetrexed/Pembrolizumab Versus Pembrolizumab in Non-Small Cell Lung Cancer: A Propensity Score-Weighted Analysis.

期刊: JCO oncology practice 发表日期: 2026-Jun-18 链接: PubMed

摘要

Pemetrexed remains part of guideline-recommended maintenance pemetrexed/pembrolizumab in advanced/metastatic non-oncogene-driven nonsquamous non-small cell lung cancer (NSCLC). Whether pemetrexed contributes to the combination’s survival benefit is unknown. In this propensity-weighted analysis of US Veterans Affairs data, we compared real-world effectiveness and safety of maintenance pemetrexed/pembrolizumab versus maintenance pembrolizumab alone and estimated US government payer spending on maintenance pemetrexed. We identified Veterans who received four cycles of carboplatin/cisplatin, pemetrexed, and pembrolizumab followed by at least one dose of maintenance pemetrexed/pembrolizumab or pembrolizumab. A propensity-weighted Cox model was used to adjust for baseline between-group differences using inverse probability of treatment weights. The primary effectiveness outcome was overall survival (OS; time from first maintenance dose to death). The primary financial outcome was the estimated spending on maintenance pemetrexed across VA, Medicare Part B, and Medicaid (2017-2022). The real-world outcomes cohort included 622 patients (473 pemetrexed/pembrolizumab; 149 pembrolizumab alone). After propensity weighting, pemetrexed was not associated with improved OS (adjusted hazard ratio [aHR] pemetrexed/pembrolizumab v pembrolizumab, 1.06 [95% CI, 0.83 to 1.36, P = .62]) but was associated with higher toxicity risk (grade ≥3 acute kidney injury [aHR 3.35, 95% CI, 1.08 to 10.41, P = .04]; neutropenia [aHR 2.86, 95% CI, 1.44 to 3.05; P = .004]; anemia [aHR 1.65, 95% CI, 1.11 to 2.47, P = .014]). Findings were robust to sensitivity analysis in which patients who crossed over from pembrolizumab to pemetrexed/pembrolizumab were excluded. Estimated government payer spending on maintenance pemetrexed from 2017 to 2022 totaled $1.588 billion (2024 USD). Adding pemetrexed to maintenance pembrolizumab was not associated with improved survival but was associated with increased toxicity. Reassessing legacy chemotherapy components may improve the safety and cost-effectiveness of cancer care. Prospective evaluation of maintenance pemetrexed’s incremental benefit in NSCLC in the immunotherapy era is needed.

27. Preserving Public Health Data Systems: Safeguarding the Foundation of US Health Policy.

期刊: American journal of public health 发表日期: 2026-Jun-18 链接: PubMed

摘要

28. Circulating Tumor DNA Testing in Solid Tumors and Lymphoma: ASCO Guideline.

期刊: JCO oncology practice 发表日期: 2026-Jun-18 链接: PubMed

摘要

ASCO Guidelines provide recommendations with comprehensive review and analyses of the relevant literature for each recommendation, following the guideline development process as outlined in the ASCO Guidelines Methodology Manual. ASCO Guidelines follow the ASCO Conflict of Interest Policy for Clinical Practice Guidelines.Clinical Practice Guidelines and other guidance (“Guidance”) provided by ASCO is not a comprehensive or definitive guide to treatment options. It is intended for voluntary use by clinicians and should be used in conjunction with independent professional judgment. Guidance may not be applicable to all patients, interventions, diseases, or stages of diseases. Guidance is based on review and analysis of relevant literature and is not intended as a statement of the standard of care. ASCO does not endorse third-party drugs, devices, services, or therapies and assumes no responsibility for any harm arising from or related to the use of this information. See complete disclaimer in Appendix 1 and 2 (online only) for more. To provide guidance on the use of circulating tumor DNA (ctDNA) testing in patients with solid tumors or lymphoma. A systematic review by a multidisciplinary panel with patient representation was conducted. The PubMed database was searched from January 2017 to February 2025. Guideline recommendations were based on consideration of the identified evidence. Fifty-four meta-analyses and 22 study reports were identified, including reports of seven randomized trials. ctDNA testing for tumor genetic alterations may be used in situations where: tumor tissue testing is challenging, not feasible, or tumor biopsy represents unacceptable risks to the patient; tumor tissue testing results may not be available within a clinically actionable time frame to determine appropriate management options; or a drug’s regulatory approved indication allows for or requires ctDNA testing. If ctDNA testing results are negative, inconclusive, or inconsistent with the clinical scenario, tissue-based confirmation should be sought. Other than testing for genetic alterations, ctDNA testing may be offered if a specific, evidence-based action can be taken with the results or there is conflict or ambiguity with standard-of-care assessment that may be resolved by ctDNA testing. Fractional, percentage, or concentration-based measures of ctDNA or total cell-free DNA concentration are not recommended as a surrogate measure of disease. The panel recognizes this is a rapidly evolving field and guidelines are anticipated to change, bringing in tumor-type specific recommendations and incorporating more data on molecular residual disease settings.Additional information is available at www.asco.org/molecular-testing-and-biomarkers-guidelines.

29. EU Omnibus proposal increases pesticide risks.

期刊: Science (New York, N.Y.) 发表日期: 2026-Jun-18 链接: PubMed

摘要

More efficient environmental risk assessment and stronger protection are achievable.

30. Negotiating Narratives: Including Patient Perspectives in Mental Health Nursing Documentation.

期刊: Issues in mental health nursing 发表日期: 2026-Jun-18 链接: PubMed

摘要

Electronic health records (EHRs) are increasingly central in mental health and substance use care, yet how patient perspectives are captured within standardised systems remains uncertain. This qualitative study explores how healthcare staff experience and perceive the inclusion of patients’ perspectives in clinical documentation in Norwegian mental health and substance use services. Guided by Gadamer’s philosophical hermeneutics, we conducted in-depth interviews with 12 experienced professionals across specialist and primary care settings. The analysis revealed five overarching themes: negotiating narratives, highlighting how language shapes understanding and either validate or stigmatise patients; documenting in the shadows, reflecting tensions between transparency, privacy and safety; between care and control, capturing pressures to emphasise symptoms and risks due to legal and organisational demands; patient`journal as a bridge or barrier and subjective realities, illustrating challenges in balancing objectivity with the relational and emotional nature of mental health work. Across themes, participants expressed that standardised templates, biomedical framings and time constraints often hinder the meaningful inclusion of patient voices. At the same time, recovery‑orientated values underscore the importance of documentation that reflects lived experiences, goals and agency. The findings demonstrate that documentation is not a neutral task but an ethical, relational practice that requires systems and guidelines that support genuine patient involvement.

31. Encouraging Adults at Risk for Type 2 Diabetes to Enroll in Diabetes Prevention Programs Through a Media Campaign in Hawai'i: Cross-Sectional Study.

期刊: JMIR public health and surveillance 发表日期: 2026-Jun-18 链接: PubMed

摘要

The National Diabetes Prevention Program (DPP) is an evidence-based intervention proven to delay or prevent progression to type 2 diabetes, yet most at-risk people do not enroll. In Hawai’i, Native Hawaiian and Other Pacific Islander (NHOPI) and Filipino adults experience disproportionately high rates of prediabetes and diabetes but have low DPP enrollment. From July to October 2024, the Hawai’i State Department of Health launched Beat Diabetes, a statewide media campaign encouraging DPP enrollment among at-risk adults, with a focus on NHOPI and Filipino communities. This evaluation assessed whether campaign exposure was associated with self-reported likelihood of joining a DPP among Hawai’i adults at risk for diabetes, particularly NHOPI or Filipino adults. A postcampaign cross-sectional online survey was conducted from October to December 2024, with Hawai’i residents aged 35-64 years who reported at least 1 diabetes risk factor. NHOPI or Filipino adults were oversampled to determine campaign effectiveness among the target audience. The survey measured self-reported likelihood of joining a lifestyle change program (main outcome), campaign recall (main exposure), demographic characteristics, diabetes risk factors, and beliefs that could affect DPP enrollment likelihood, including intrinsic motivation, perceived inevitability of developing diabetes, and perceived health benefits of DPP participation. Three general linear regression models examined the association between campaign exposure and DPP enrollment likelihood ratings, adjusted for demographic characteristics, diabetes risk factors, and belief variables. A sensitivity analysis among just those diagnosed with prediabetes was conducted. A total of 860 adults completed the survey, with 34.7% (298/860) and 12.2% (105/860) self-identifying as NHOPI and Filipino, respectively. In total, 40% (346/860) reported campaign exposure. Exposed individuals had higher mean DPP enrollment likelihood ratings and higher inevitability belief scores than those not exposed. A large proportion of exposed respondents reported that enrolling in a DPP would “improve their health a lot.” No significant differences in campaign exposure were observed across ethnicities. All 3 regression models showed a significant positive association between campaign exposure and DPP enrollment likelihood ratings. In the final adjusted model controlling for all covariates, significant predictors included campaign exposure (β=.52, P<.001), male gender (β=.34, P=.01), residence outside Honolulu County (β=.31, P=.02), motivation index scores (β=.38, P<.001), inevitability belief (β=.20, P<.001), and the belief that DPP improves health “a little” (β=.76, P<.001) or “a lot” (β=1.63, P<.001). The sensitivity analysis among those diagnosed showed exposure was not associated with likelihood ratings (β=.30, P=.27). Campaign exposure was associated with higher ratings of likelihood to join a DPP among at-risk adults with no prediabetes diagnosis. Perceived positive health impact of DPP participation was the strongest contributor to likelihood ratings. Campaigns aiming to increase awareness of DPP and intentions to join should promote DPP effectiveness and the urgency of preventative actions.

32. Tailored weight loss programs for adults with serious mental illness: 12-month follow-up of a randomized clinical trial of CoachToFit.

期刊: Psychological services 发表日期: 2026-Jun-18 链接: PubMed

摘要

This study aimed to determine whether improvements among veterans at the end of a 6-month weight loss program tailored to those with serious mental illness (SMI) were maintained at 12 months. From 2021 to 2025, 256 veterans at the Pittsburgh VHA Medical Center who had SMI and were obese were randomized to either Usual Care or CoachToFit, which included weekly calls from a Veteran Health Administration peer specialist, a Bluetooth-enabled scale and fitness tracker, and a smartphone app that provides health education and tracks steps, goals, and weight. Participants’ weight, body mass index, and meters walked in 6 min were assessed at baseline, 6, and 12 months. CoachToFit participants had 1.88 times greater odds of being in a higher 5% weight loss category by 12 months (achieved never, achieved ever, sustained) compared to Usual Care and 2.34 times greater odds of reaching a higher category of 7% weight loss. Average weight loss and meters walked did not differ between groups at 12 months. A greater number of veterans with SMI who were obese achieved and sustained significant weight loss as a result of a peer-supported and tailored technology weight-management program, which may be a good option for this population. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

33. Salutogenic Principles in Workplace Health Promotion Interventions: A Scoping Review.

期刊: Journal of prevention (2022) 发表日期: 2026-Jun-18 链接: PubMed

摘要

While workplace health promotion has traditionally emphasized risk reduction, knowledge about the extent to which interventions incorporate health-promoting resources such as Sense of Coherence, Participation, Goal-Setting, Variability, and Empowerment is fragmented. This scoping review examined how these salutogenic principles are operationalized in behavioral workplace health promotion programs focused on primary prevention. A systematic search across five databases identified 128 intervention studies published between 2014 and 2024. Each program was assessed using a Salutogenesis-Score (0-5) reflecting the number of salutogenic principles integrated into its design and delivery. Overall, the incorporation of salutogenic principles was moderate. Empowerment, Variability, and Sense of Coherence were most frequently represented, whereas Participation and Goal-Setting appeared considerably less often. For instance, tailored interventions that included individualized counseling or self-management tools achieved high scores, with multi-component programs showing the strongest overall alignment. Although many programs contain elements that support health-promoting behavior, their potential to fully activate salutogenic mechanisms remains underused. Strengthening participatory approaches and personalized goal-setting may enhance employee agency, adaptability, and long-term engagement, thereby fostering more sustainable and empowering workplace health promotion.

34. Csi-Bantam Delivered by Clonorchis sinensis Extracellular Vesicles Promotes Liver Fibrosis via Targeting TRIM35.

期刊: Journal of agricultural and food chemistry 发表日期: 2026-Jun-18 链接: PubMed

摘要

Freshwater fish is widely consumed, yet raw or undercooked freshwater fish can transmit foodborne zoonotic pathogens. Clonorchiasis, caused by Clonorchis sinensis, is a major foodborne parasitic disease associated with hepatobiliary injury and fibrosis. The biological functions and mechanisms underlying liver injury mediated by C. sinensis-derived extracellular vesicles (EVs) encapsulated microRNAs in fibrogenic remodeling remain poorly defined. Here, we isolated and characterized EVs from adult C. sinensis, confirmed their uptake by hepatic stellate cells (HSCs), and identified Csi-bantam as a CsEV-enriched microRNA. Csi-bantam enhances HSC activation and upregulates fibrogenic markers, including α-SMA, COL1A1, and COL3A1, both in vitro and in a mice infection model. Bioinformatic prediction and dual-luciferase assays validated TRIM35 as a target of Csi-bantam. TRIM35 silencing phenocopied Csi-bantam overexpression and increased PI3K/AKT phosphorylation, whereas Csi-bantam inhibition restored TRIM35 and attenuated fibrogenic markers. Collectively, CsEV-associated Csi-bantam promotes HSC activation via the TRIM35-PI3K/AKT axis, suggesting a potential target for antifibrotic intervention in clonorchiasis. These findings provide mechanistic insight into how infection acquired from raw or undercooked freshwater fish harboring infective C. sinensis metacercariae can lead to hepatobiliary injury and fibrogenic remodeling, supporting food safety risk assessment and future prevention of fish-borne parasitic hazards.

35. PARG Governs a PARylation-Ubiquitination Toggle that Stabilizes RAD51AP1 to Drive Homologous Recombination-Mediated Chemoresistance.

期刊: Cancer research 发表日期: 2026-Jun-18 链接: PubMed

摘要

Gastric cancer (GC) is a lethal malignancy with limited targeted therapeutic options, particularly for HER2-negative disease. Through integrated bioinformatic analysis of multiple GC cohorts, we identified poly(ADP-ribose) glycohydrolase (PARG) as a DNA damage response protein that is frequently overexpressed and associated with poor prognosis. While PARG inhibition as a monotherapy showed limited efficacy, high-throughput screening of FDA-approved drugs revealed a synthetic lethal interaction between PARG inhibition and fluoropyrimidines, including 5-fluorouracil (5-FU). Mechanistically, PARG directly bound the homologous recombination (HR) cofactor RAD51AP1 via its N-terminal domain and removed poly(ADP-ribose) (PAR) chains. The dePARylation prevented RNF169-mediated K48-linked ubiquitination of RAD51AP1, thereby protecting RAD51AP1 from proteasomal degradation. Consequently, loss of PARG destabilized RAD51AP1 and impaired HR repair, resulting in increased sensitivity to fluoropyrimidine-induced DNA lesions. In patient-derived xenograft models, PARG inhibition significantly enhanced the efficacy of both 5-FU and the oral prodrug capecitabine. Moreover, restoring RAD51AP1 expression substantially reversed the chemosensitizing effect conferred by PARG deficiency. Clinically, PARG and RAD51AP1 protein levels were strongly correlated in GC tissues, and their co-expression defined a subset of patients with the worst survival. Collectively, these findings identify a PARylation-ubiquitination switch regulated by PARG that stabilizes RAD51AP1 to enhance HR repair, unveiling the PARG-RAD51AP1 axis as a key determinant of fluoropyrimidine sensitivity and a biomarker-directed target for combination therapy in GC.

36. Pesticides-induced histopathological and biochemical alterations in fish: Impacts and restoration strategies.

期刊: The Science of the total environment 发表日期: 2026-Jun-18 链接: PubMed

摘要

The extensive application of pesticides in urban and agricultural areas contaminates surface water. When these substances enter aquatic environments through runoff, they can cause various abnormalities in fish species. The most commonly used pesticides in agricultural farmlands and urban environments are herbicides, fungicides, and insecticides. Although pesticides are beneficial for agricultural production, they have been shown to pose significant hazards to both human health and the environment. These chemicals have a high potential for bioaccumulation, environmental persistence, and toxicity. The degradation rate of pesticides can vary from a few hours to several days or even years, depending on environmental conditions and their chemical composition. However, pesticides induce various biochemical alterations, particularly changing the enzymatic activity, including alkaline phosphatase (APT), alanine aminotransferase (ALT), aspartate aminotransferase (AST), succinate dehydrogenase (SDH), peroxidase, catalase (CAT), and superoxide dismutase (SOD). Additionally, pesticides induce histopathological changes in organs such as the gills, brain, liver, kidneys, intestine, and muscles. These histopathological alterations include pyknosis, cytoplasmic infiltrations, changes in the primary and secondary lamellae, lesions and deformities, tissue degeneration, atrophy, hyperplasia, congestion, necrosis, and apoptosis. Various techniques have been employed to control the effects of pesticides on fish species, including water treatment methods, hybrid technologies, and bioremediation approaches. Water treatment methods for pesticide removal include photo-fenton, chlorination, nanotechnology, and adsorption. Hybrid technologies include ultrafiltration and coagulation treatments, advanced oxidation processes (AOPs), and photochemical degradation. Furthermore, bioremediation strategies, often combined with advanced technologies, are being employed to minimize pesticide pollution. This review highlights the effects of various pesticides on the histopathological and biochemical alterations in farmed fish, as well as potential strategies for mitigating pesticide contamination.

37. Enhancing noise reduction in 3D-printed earmuffs through geometric design of internal structures.

期刊: Journal of occupational and environmental hygiene 发表日期: 2026-Jun-18 链接: PubMed

摘要

Exposure to occupational noise remains a significant health hazard, necessitating effective hearing protection strategies. This study evaluated the impact of internal geometric design on the noise attenuation performance of 3D-printed earmuffs fabricated from acrylonitrile butadiene styrene (ABS)/clay nanocomposite. Five earmuff variants were produced with identical external dimensions but differing middle-layer geometries: hexagonal (honeycomb), square, circular, rectangular, and triangular. Insertion loss (IL) was measured across frequencies from 125 Hz to 8000 Hz using an Acoustic Test Fixture (ATF) in accordance with ANSI/ASA S12.42-2010 Methods for the Measurement of Insertion Loss of Hearing Protection Devices in Continuous or Impulsive Noise Using Microphone-in-Real-Ear or Acoustic Test Fixture Procedures and ISO 4869-3:2007 Acoustics-Hearing Protectors-Part 3: Measurement of Insertion Loss of Earmuff Type Protectors Using an Acoustic Test Fixture. Results showed that geometric configuration notably influenced sound attenuation. The triangular structure achieved the highest IL at 500 Hz (25.5 dB) and 8000 Hz (31.8 dB), while the hexagonal design provided superior broadband performance, particularly at 1-4 kHz (19.1-24.9 dB). In contrast, all structured designs exhibited reduced effectiveness at 125-250 Hz, likely due to structural resonance and minor seal leakage. These findings demonstrate that strategic geometric patterning of internal earmuff layers can enhance passive noise control without increasing weight or material cost.

38. Bridging the Gap: A Quantitative Framework Correlating Static and Dynamic Adsorption Capacities for VOCs Removal Prediction.

期刊: Environmental science & technology 发表日期: 2026-Jun-18 链接: PubMed

摘要

Volatile organic compounds (VOCs) pose substantial environmental and health hazards. Adsorption is a crucial VOCs control technology, and the advancement of adsorbents is highly dependent on precise characterization via both static and dynamic adsorption measurements. Theoretically, a specific conversion relationship should exist between these two measurement methods. However, due to discrepancies in focus and testing conditions, the differences in adsorption capacities obtained by the two methods often vary considerably and lack regularity. In this study, a quantitative framework was established to bridge the gap between static and dynamic adsorption capacities by correlating them under identical partial pressures. Results indicate that the dynamic saturation adsorption capacity (Qds) is ca. 0.93 times the static adsorption capacity (Qs) at the matched partial pressure (Qds= 0.93 × Qs). Additionally, the dynamic penetration capacity (Qdp) is systematically related to Qds through the slope (k) of the adsorption isotherm. Furthermore, by normalizing partial pressures (P/P0), a unified predictive equation (Qdp= (1-0.15 × k) × Qds) was derived. This equation can predict the concentration-dependent evolution of penetration capacity directly from equilibrium isotherms, effectively eliminating temperature effects and ensuring universal applicability. This research establishes a universal approach for calculating dynamic adsorption performance from static isotherm data, which can guide the development of tailored adsorbents for various industrial scenarios.

39. Spectral Characterization, Isomerization Behavior, and Antioxidant Activity of ζ-Carotene Geometric Isomers: From Biosynthetic Intermediates to Functional Ingredients.

期刊: Journal of agricultural and food chemistry 发表日期: 2026-Jun-18 链接: PubMed

摘要

ζ-Carotene is a key biosynthetic intermediate of lycopene that is widely distributed in plants and fungi but difficult to purify, which has limited detailed physicochemical and biological studies. Here, we established a purification strategy that affords four ζ-carotene geometric isomers (all-E-, 9Z, 9Z,9’Z, and 9Z,13Z,9’Z-isomers) in high purity and elucidated their structures fully using nuclear magnetic resonance spectroscopy. Photochemical experiments showed that, unlike many carotenoids that photoisomerize toward the all-E-form, ζ-carotene yields a photostationary mixture dominated by the 9Z-isomer. For the major Z-isomers, (9Z)- and (9Z,9’Z)-ζ-carotene, we determined solvent-dependent spectral properties, color parameters, and ultraviolet (UV)-shielding capacities, revealing remarkably strong UV-A shielding. These Z-isomers also exhibited potent singlet oxygen quenching and pronounced inhibition of fluorescent advanced glycation end-product formation, together with detectable hydroxyl radical scavenging. Our findings provide fundamental data supporting ζ-carotene as a promising natural UV-A filter and skin health-promoting functional ingredient.

40. Changes in wildlife activity patterns in response to war in Ukraine.

期刊: Science (New York, N.Y.) 发表日期: 2026-Jun-18 链接: PubMed

摘要

Conflict zones are inherently hazardous and inaccessible for researchers, which results in a knowledge gap about the immediate effects of armed conflicts on the environment, particularly wildlife. We used camera-trap detections to investigate the impact of armed conflict on wildlife activity patterns before, during, and after the Russian occupation of the Chornobyl Exclusion Zone (Ukraine) in 2022 and compared it to the same period in 2021. Mammal species responded to armed conflict through immediate behavioral adjustments, including reduced activity during night and on dates when armed-conflict activities intensified. Our results provide insight into wildlife’s behavioral responses to armed conflict in real time and underscore the potential of camera trapping to quantify the ecological effects of war.

41. The ATHENA heuristic: A proposed algorithm for analysis of time-series exposure monitoring data.

期刊: Journal of occupational and environmental hygiene 发表日期: 2026-Jun-18 链接: PubMed

摘要

Exposure monitoring data available to industrial hygienists will eventually surpass the ability of a practitioner to effectively interpret without a consolidating computational approach. For large sets of time-series exposure data, the most important question that can be answered to determine if further exposure evaluation is required may be formulated as: Does this exposure data contain any period of time during which the identified occupational exposure limit value could be exceeded? Determining the answer to this question may be computationally intensive using current exposure decision methodology, better suited for small data sets consisting of single time-weighted average exposures. The authors instead proposed an algorithmic method for evaluating large sets of time-series exposure data without clearly defined exposure start and stop times, while also incorporating recommended data cleaning methods and an evaluation of statistical uncertainty. The outcome of this analysis was a binary “thumbs up,” indicating the time-series exposure data did not contain any time period that may have exceeded the limit value when considering confidence intervals, or “thumbs down,” indicating the opposite. Finally, the authors demonstrated the algorithmic heuristic using a proof-of-concept available to the public at no cost at https://athena-heuristic.streamlit.app/.

42. A ferritin prediction model to determine individual blood donation frequencies.

期刊: Transfusion 发表日期: 2026-Jun-18 链接: PubMed

摘要

Ferritin-guided donation intervals are effective in reducing iron deficiency and low hemoglobin rates. However, many donors still present with low ferritin levels after multiple donations, which results in less donor availability. Model predictions of ferritin levels can help in setting donation frequencies that, proactively, keep ferritin levels above thresholds and donors available for donation. We created a physiology informed model to predict ferritin levels in whole blood donors. This model takes as input: baseline ferritin and hemoglobin, donation intervals, donated volume and height and weight of a donor. We used data from several studies to tune our model and validated ferritin predictions on routinely collected donation data from new donors in the Netherlands that started in 2021. The model predicted ferritin levels after five donations accurately, with 71% being within the range determined from the measurement uncertainty. Average ferritin predictions show a slight underestimation and accuracy varied by sex and age. We created tables of optimal donation frequencies given baseline ferritin levels and weight, which were shown to have the most influence on predicted ferritin levels after multiple whole-blood donations. Personalized donation intervals offer a promising approach to shift from a reactive management of iron deficiency to proactively protect donor health and preserve long-term donor availability. The healthy donor effect could explain the slight underestimation of predictions on average, and model accuracy may be further improved by, for instance, adding information on menstrual blood loss to account for sex- and age-related differences.

43. Occurrence and Thermal-Activation-Induced Variations of Metal Elements (Ca, Fe, Cu, Zn, Sr, Mo) in Commercially Available Self-Heating Meals.

期刊: Biological trace element research 发表日期: 2026-Jun-18 链接: PubMed

摘要

Self-heating ready-to-eat meals have emerged as a rapidly growing convenience-food category. However, the data for metals alterations during process remain unclear. In this study, we aimed to detect the contents of calcium (Ca), iron (Fe), copper (Cu), zinc (Zn), strontium (Sr) and molybdenum (Mo) in commercially available self-heating meals collected from multiple regions of China. Metal contents were measured by Olympus Vanta VCR handheld XRF metal analyzer. Paired measurements were obtained for each food matrix before and after activation. Geographical distribution of metal occurrence was visualised using ArcGIS. The activation process produced matrix-dependent changes in metal contents. Vegetable components showed the most pronounced decreases, with significant reductions in Ca, Fe and Zn (p < 0.05), consistent with leaching into the cooking medium and thermal degradation of the food matrix. In contrast, meat components exhibited modest but consistent increases in Fe and Zn after activation, which may reflect redistribution among co-heated ingredients, moisture-related concentration effects, or migration from metallic components of the heating pack or packaging; these explanations remain hypotheses that require confirmation in dedicated migration and mass-balance experiments. Rice and noodle matrices showed smaller and less consistent variations. Geographical mapping suggested comparatively higher Fe and Zn levels in samples sourced from eastern coastal provinces, although sampling representativeness should be considered when interpreting this pattern. Overall, the present surveillance data indicate that self-heating activation can alter the metal element profile of ready-to-eat meals in a matrix-specific manner, and support the need for routine monitoring of both nutritionally relevant and potentially packaging-derived metals in this emerging product category.

44. From perception to practice: technical and social drivers and barriers to biosecurity implementation on French cattle farms.

期刊: Research in veterinary science 发表日期: 2026-Jun-16 链接: PubMed

摘要

Biosecurity is a cornerstone of infectious disease prevention in cattle farming, yet its implementation remains suboptimal. This study aimed to identify psychosocial and socio-technical factors significantly associated with the adoption of biosecurity measures among French cattle farmers. An online survey collected data on practices and perceptions from 412 respondents, and multivariable logistic regression models were employed to evaluate four key domains: inter-herd contact, animal introduction, visitor management, and the wildlife-livestock interface. The results identified risk perception as the most consistent driver across all themes; farmers acknowledging a real risk were significantly more likely to implement protective measures. A major catalyst for behavioural change was the biosecurity audit, which increased the likelihood of performing pre-purchase blood tests at the seller’s farm. Furthermore, a spillover effect was observed, where multi-species farming (including swine or poultry) acted as a protective factor for visitor protocols and sourcing. Conversely, infrastructural constraints, such as unsuitable building layouts, were major barriers to quarantine. A strictly regulatory mindset also significantly hindered proactive prevention, particularly for wildlife-related measures. These findings demonstrate that biosecurity adoption depends more on individualised technical support and structural feasibility than on general awareness. Public policies should therefore prioritise participatory approaches, such as tailored audits, to effectively enhance on-farm biosecurity.

45. Real-World Outcomes of Barbed Versus Interrupted Sutures for Laparoscopic Choledochotomy: A 12-Month Follow-Up in Patients With Choledocholithiasis.

期刊: Surgical laparoscopy, endoscopy & percutaneous techniques 发表日期: 2026-Jun-16 链接: PubMed

摘要

The optimal suture technique for primary closure after laparoscopic choledochotomy remains uncertain. We compared real-world outcomes of barbed continuous and conventional interrupted sutures in patients with choledocholithiasis. This single-center retrospective cohort included 200 patients with choledocholithiasis who underwent laparoscopic common bile duct exploration with primary duct closure (January 2019 to December 2023). Patients received barbed continuous sutures (n=102) or interrupted sutures (n=98) according to surgeon preference in routine practice. The primary endpoint was biliary adverse events (bile leakage or biliary stricture) within 12 months. Multivariable logistic regression and supportive Cox models were used to explore associations after adjustment for recorded clinical covariates; intraoperative duct inflammation and wall-thickness grading were not prospectively standardized and therefore were unavailable for adjusted analyses. Biliary adverse events occurred in 25.0% (50/200). The 12-month event rates were 19.6% (20/102) with barbed sutures and 30.6% (30/98) with interrupted sutures. Barbed sutures were associated with fewer adverse events (OR 0.74, 95% CI: 0.36-1.52; HR 0.61, 95% CI: 0.34-1.10). Independent predictors were age ≥70 years (HR 2.08), CBD diameter <8 mm (HR 2.56), maximum stone diameter ≥10 mm (HR 2.15), and surgeon experience ≤5 years (HR 2.51). Barbed sutures were associated with shorter suturing time, operative duration, postoperative stay, and drain duration (all P<0.001). Barbed continuous sutures were associated with greater operative efficiency and faster recovery, whereas biliary adverse event rates did not differ significantly after adjustment. Given the nonrandomized retrospective design and unmeasured intraoperative confounding, these findings should be interpreted as exploratory.

46. Broad-spectrum biocontrol of postharvest rot in cold-stored table grapes by psychrotrophic yeasts and grapevine-derived extracts.

期刊: International journal of food microbiology 发表日期: 2026-Jun-15 链接: PubMed

摘要

Under postharvest conditions, table grapes are exposed to multiple fungal pathogens that coexist and interact on the fruit surface. Therefore, effective biocontrol agents should exert antagonistic activity across multiple pathogens (broad-spectrum biocontrol) while operating within a complex host-microbiota-pathogen system. In this context, four psychrotrophic yeast strains, Metschnikowia pulcherrima RCM2 and ULA146, and Aureobasidium pullulans FUL14 and FUL18, were evaluated for their broad-spectrum biocontrol performance in Red Globe table grapes. Grapevine-derived extracts, rich in phenolic compounds, were included as complementary components capable of enhancing antagonistic activity. Yeasts were tested alone and in combination with extracts from canes (5% and 25%) and bunch stems (5%) on cold-stored table grapes. Treatments were evaluated under three scenarios: single-pathogen inoculation with Botrytis cinerea or Penicillium polonicum, pathogen co-inoculation with B. cinerea, P. polonicum and Alternaria alternata, and non-inoculated storage conditions. A quantitative integrative framework was applied to support the selection of broad-spectrum biocontrol treatments. Overall, the yeast strains showed biocontrol activity against all three pathogens. Yeast-extract combinations significantly reduced P. polonicum infection (p < 0.05). RCM2 exhibited the most consistent performance under pathogen co-inoculation and non-inoculated storage conditions, reaching levels comparable to sulfur dioxide (SO2) treatment. These results support the potential of psychrotrophic yeasts and grapevine by-products as eco-friendly tools for broad-spectrum postharvest disease control in table grapes. They also highlight the importance of integrative approaches that account for pathogen co-occurrence and host complexity when selecting biocontrol agents for successful technological development.

47. Epidemiological status of bovine viral diarrhea virus in water buffalo (Bubalus bubalis): A global systematic review and meta-analysis.

期刊: Research in veterinary science 发表日期: 2026-Jun-15 链接: PubMed

摘要

Bovine viral diarrhea virus (BVDV) remains a neglected viral disease in water buffalo despite its significant economic impact in production systems. Although limited epidemiological studies have been reported worldwide, the serostatus and active infection in buffalo have not been systematically reviewed. A systematic review and meta-analysis were conducted to estimate BVDV prevalence in water buffalo and identify associated epidemiological factors. Relevant studies published up to January 31, 2026, were retrieved from five electronic databases. A total of 49 studies were identified from 15 different countries were found for inclusion. A random-effects model was used to estimate pooled-prevalence and assess heterogeneity among studies. A meta-analysis of 37 studies (9270 buffalo) estimated a pooled BVDV seroprevalence of 30.5%, while analysis of 16 studies (7189 animals) indicated an antigen prevalence of 16.5%. Continent-wise analysis revealed the highest BVDV seroprevalence in South-America (44.0%), while antigen prevalence was highest in Africa (21.2%) followed by Asia at 12.2%, and no BVDV data reported from North-America. Among the different countries, the highest BVDV seroprevalence was detected in Turkey (61.6%) and Argentina (59.0%), while antigen prevalence was highest in Egypt (21.2%), with lower estimates in Brazil (11.8%) and Iraq (11.3%). Notably, high heterogeneity (I2 > 90%) was observed in the all-pooled estimates, indicating variations in sampling period, age, sex, sample source and types, diagnostic methods, production-system, and study quality. These findings demonstrate the widespread presence of BVDV in water buffalo populations and indicate the need for targeted control strategies to mitigate its impact on health and productivity.

48. Real-World Patient Characteristics, Mutational Landscape, and Outcomes in Advanced/Metastatic HER2-Mutant Non-Small Cell Lung Cancer.

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

摘要

This observational study assessed the real-world characteristics, treatments, and outcomes of US patients with HER2-mutant advanced non-small cell lung cancer (NSCLC) overall and according to HER2 mutation type (tyrosine kinase domain [TKD] and non-TKD). Deidentified data were extracted for patients with advanced/metastatic NSCLC from the Flatiron Health-Foundation Medicine NSCLC Clinico-Genomic Database. Patients with oncogenic HER2 mutations were included. The primary objectives were to assess the prevalence of HER2 mutations and coaberrations, treatment patterns, and real-world overall survival (OS). Overall, 559/14,768 (3.8%) patients had HER2 mutations; 262 (1.8%) were oncogenic. Patients with oncogenic TKD mutations (n = 197) were more frequently younger, female, and never-smokers than those with oncogenic non-TKD mutations (n = 65) and had fewer oncogenic coaberrations. Among patients with oncogenic HER2 mutations who underwent first-line treatment (n = 193), most received platinum-based chemoimmunotherapy (30.5%) or chemotherapy alone (27.9%); 119 patients (61.7%) received second-line treatment. Median OS after first and second lines of treatment was 13.5 months (95% CI, 11.6 to 16.9) and 11.1 months (95% CI, 9.2 to 13.6), respectively. Median OS with first-line platinum-based chemoimmunotherapy was 21.1 (95% CI, 12.2 to NA) and 11.7 months (95% CI, 8.3 to NA) in patients with TKD/non-TKD mutations, respectively, and median OS with platinum-based chemotherapy alone was 9.1 (95% CI, 5.7 to 16.0) and 17.3 (95% CI, 13.6 to NA) months, respectively. NSCLC patients with oncogenic TKD HER2 mutations had different characteristics and genetic features than patients with non-TKD mutations. Real-world outcomes with first- and second-line standard-of-care treatment were suboptimal, highlighting the need for new treatment options for patients with advanced HER2-mutant NSCLC.

49. Linking Minimally Important Differences (MID) and Acceptable Regret to Elicit Values and Preferences in Health Decision Models.

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

摘要

Most methods for elicitation of values and preferences (V&P) ask respondents directly to make explicit numerical trade-offs across outcomes, such as judging how many strokes equal one death. Although conceptually straightforward, these tasks are cognitively demanding, uncomfortable for many patients and panellists, and prone to instability when multiple outcomes must be compared. This paper proposes an integrated framework that starts with minimally important differences (MIDs), links them to acceptable regret, and then converts them into relative values (RVs) for use as V&P in decision-analytical models. We describe a three-step approach. First, respondents identify the smallest absolute change in outcome frequency that would be important enough to justify a different decision. Second, acceptable regret is used to interpret and calibrate these thresholds as the amount of utility loss from a wrong decision that patients can tolerate. Third, MIDs are transformed into RVs on a common scale anchored to a worst outcome, usually death, and entered as V&P into a weighted disutility expected utility model. The resulting framework is designed to replace difficult, cognitively demanding elicitation of V&P with simpler threshold judgements, maintains proportional relationships among outcomes regardless of the chosen anchor, reduces the number of required judgements, and yields internally consistent weights for multiple benefits and harms. A worked example shows how MID thresholds for death, stroke, myocardial infarction, major bleeding and brain bleeding are converted into RVs and then incorporated into a transparent benefit-harm calculation. Integrating MIDs, acceptable regret and RVs offer a coherent approach to eliciting values and preferences for clinical decision-making, guideline development and health policy. The approach is easy to explain, well aligned with human decision processes and readily applicable at both individual and population levels.

50. Sunscreen is overwhelmingly promoted on TikTok, but content with misinformation exhibits proportionally high levels of audience interaction.

期刊: PLOS digital health 发表日期: 2026-Jun 链接: PubMed

摘要

This study examined the presence, engagement levels, and characteristics of sunscreen-related misinformation on TikTok. We conducted a content analysis on 971 of the most viewed TikTok videos across the five most popular and relevant sunscreen-related hashtags (#sunscreen, #sunscreenviral, #spf, #sunscreenreview, and #sunprotection). To assess differences in audience engagement (views, likes, shares, and comments) between TikToks that only promoted sunscreen, those that included both promotion and critique, and those that solely critiqued sunscreen, we used Kruskal-Wallis tests and Dunn’s post hoc tests with a Bonferroni adjustment. Most videos promoted sunscreen use (86.8%), typically to prevent skin damage (17.4%), acne (15.3%), aging (11.5%), and cancer (6.1%). Only a small fraction contained critiques (6.0%), with very few asserting sunscreen causes harm (1.5%) or prevents health benefits (1.2%). While differences in view counts were not statistically significant (p = 0.182), TikToks with only critique showed significantly higher engagement in likes (p = 0.0069), shares (p = 0.0028), and comments (p = 0.0012) compared to those with only promotion. Contrary to claims that TikTok is rife with sunscreen misinformation, our findings indicate that such content constitutes a small portion of the most viewed videos. However, these critique focused TikToks, despite being few, consistently generated significantly more audience interaction. This suggests that critical or contrarian content may attract disproportionate attention even when not widely represented. Overall, the dominant narrative on TikTok promotes sunscreen use, and widespread misinformation does not appear prevalent among the platform’s most visible content. Therefore, sunscreen misinformation on TikTok constitutes an area of concern not for the total sum of overarching influence in terms of content production but rather in how strongly some sunscreen misinformation ideas resonated among particular audiences.

51. Before the Race Even Starts: Early Intervention to Prevent Long-Term Late Effects From Childhood Cancer Therapies.

期刊: American Society of Clinical Oncology educational book. American Society of Clinical Oncology. Annual Meeting 发表日期: 2026-Jun 链接: PubMed

摘要

Increasing treatment intensity has improved survival rates for children with cancer, resulting in an increasing population burdened with late effects from treatment. The Children’s Oncology Group Survivorship Guidelines provide a compendium of late effects with recommendations for risk-adapted surveillance based on treatment components and intensity. However, many late effects from therapy are permanent; alternative strategies are therefore necessary to prevent their debilitating impact on the quality of life for childhood cancer survivors. Prevention of late effects via early intervention is an increasingly vital component of pediatric cancer therapy. In this review, we highlight three common and debilitating late effects amenable to this strategy: oncofertility and fertility preservation, cisplatin-induced ototoxicity (hearing loss) and otoprotection, and radiation-induced neurocognitive deficits and cognitive-sparing approaches. For each toxicity, current practice, knowledge gaps, and future directions are discussed.

52. LED Railway Signal Detection Rather Than Recognition is Affected by Both Refractive and Non-refractive Blur.

期刊: Ophthalmic & physiological optics : the journal of the British College of Ophthalmic Opticians (Optometrists) 发表日期: 2026-May 链接: PubMed

摘要

Previous research has reported a significant effect of refractive defocus on the correct identification of red signals. The purpose of this study is to investigate the effects of both refractive defocus and non-refractive defocus (using Bangerter filters) on the perception of rail signals using the Railway LED Lantern Test (RLLT). The RLLT is the simulated practical test nominated in the Australian National Standard for Health Assessment of Railway Safety Workers. Participants were 19-59 years old, and the best corrected visual acuity (BVCA) was required to be no worse than 6/9 binocularly. Subjects with current or active ocular conditions were excluded, and sufficiency in English was required. Best corrected refraction, visual acuity and colour vision were assessed. Participants carried out the RLLT binocularly under five conditions: best corrected, +0.50 DS, +0.75 DS and Bangerter filters 1.0 and 0.8. Ten male and 10 female subjects completed the study; age range 20-25 and mean age 22.4 ± 1.1 years. BVCA was 6/6 (logMAR 0.0 or better). Errors occurred far more often with red than with yellow or green (p < 0.0001) and with Bangerter filter blur more than refractive blur (p < 0.0001). Failing to see a red signal, rather than misnaming the red as yellow or green, was the predominant error (p < 0.0001) and was induced far more frequently by Bangerter filters than refractive blur (p < 0.0001). This error was far more common than miscalling red as yellow (p < 0.0001) (paired t-tests). These findings suggest that a large proportion of errors are due to not seeing the red signal rather than miscalling the red as yellow or green. Non-refractive blur was found to cause a greater increase in colour errors.

53. Implementation research to develop and optimize delivery models for evidence-based anemia control interventions in India: Protocol for the precision-driven response for anemia control and sustainable health (PRAKASH) study.

期刊: PloS one 发表日期: 2026 链接: PubMed

摘要

Government of India launched Anemia Mukt Bharat (AMB) program in 2018. Despite its implementation, the prevalence of anemia remains high. To address the gaps in coverage, adherence and effective implementation, the Indian Council of Medical Research (ICMR) initiated the Precision driven Response for Anemia Control and Sustainable Health (PRAKASH) study. It is an implementation research study aimed at co-developing and optimizing a district-level model of evidence-based anemia control interventions. The intended goal is to reduce anemia prevalence to 20% or lower through scalable, context-specific, and sustainable strategies. This multi-site study targets six key population groups: children (aged 6-59 months and 5-9 years), adolescents boys and girls (10-19 years), women of reproductive age (20-49 years) and pregnant women. Interventions are anchored in six pillar i. Test-Treat-Track until resolution, ii. prophylactic iron and folic acid supplementation, ensuring high complianceiii. anemia-relevant health interventions, iv. fortified rice distribution, v. dietary diversification and promotion of iron-rich foods, and vi. behavior change communication through Jan Andolan. Anemia prevalence will be estimated through a series of community-based cross-sectional surveys. Mixed methods approach will be employed to assess barriers and enablers at the individual, household, facility, and community levels. The study will utilize implementation science frameworks, including Consolidated Framework for Implementation Research (CFIR) and Expert Recommendations for Implementing Change (ERIC), to guide iterative implementation, real-time model refinement, and monitoring of performance. Information on outcome indicators will be collected to evaluate anemia prevalence, fidelity, feasibility, and service delivery improvements. The study will try to readdress the implementation challenges across diverse regions and aims to develop a comprehensive and replicable model for the AMB 2.0 program. The study is likely to contribute to the global evidence base on implementation science for anemia reduction in low- and middle-income countries.

54. Healthier dietary habits are associated with lower depression and anxiety among medical students at a private university in Lima, Peru: A cross-sectional study.

期刊: PloS one 发表日期: 2026 链接: PubMed

摘要

Anxiety and depression are common conditions among medical students. In recent years, numerous factors associated with these disorders have been investigated; however, evidence regarding the role of dietary habits remains limited. To evaluate the association between dietary habits and the presence of anxiety and depressive symptoms among medical students at a private university in Lima, Peru. An analytical cross-sectional study was conducted in 2025 among medical students aged 18 years and older. Dietary habits were assessed using the Healthy Eating Index, while anxiety and depression were measured using the GAD-7 and PHQ-9 scales, respectively. Poisson regression with robust variance was used to calculate prevalence ratios (PR). A total of 264 students were included. Only a minority had healthy dietary habits (1.1%), and the prevalences of anxiety (34.9%) and depression (45.1%) were high. For each additional point in the Healthy Eating Index, the prevalence of anxiety decreased by 3% (aPR: 0.97; 95% CI: 0.95 to 0.98), while the prevalence of depression decreased by 2% (aPR: 0.98; 95% CI: 0.96 to 0.99). Dietary habits were inversely associated with the prevalence of anxiety and depression among medical students. These findings highlight the importance of promoting healthy dietary patterns as part of comprehensive strategies for the prevention and promotion of mental health in this population.

55. [Prevention of erosion of hard dental tissues in patients with gastroesophageal reflux disease].

期刊: Stomatologiia 发表日期: 2026 链接: PubMed

摘要

Gastroesophageal reflux disease (GERD) is a common chronic disease of the gastrointestinal tract and is a problem in developed countries. In particular, clinicians are interested in the extraesophageal manifestations of this disease, and recently, dentists have been studying the erosion of hard dental tissues. This article provides a literature review of scientific papers published over the past 8 years that provide evidence-based experimental and clinical data on the most recent issues related to the prevention of hard dental tissue erosion in patients with gastroesophageal reflux disease. The meta-analysis used the resources of the eLibrary search engines, the PubMed website, and the data from the disserCat dissertation abstracts. The purpose of the study was to comprehensively examine the prevention of erosive lesions of hard dental tissues in patients with GERD. It was important to consider this issue from a preventive perspective, as it is often overlooked. Гастроэзофагеальная рефлюксная болезнь (ГЭРБ) — распространенное хроническое заболевание желудочно-кишечного тракта, представляющее собой проблему в экономически развитых странах. В наибольшей степени клиницистов привлекают внепищеводные проявления этого заболевания, а в недавнее время для стоматологов областью исследования по теме стали эрозии твердых тканей зубов. Представлен обзор научных трудов за последние 8 лет, содержащих доказательную экспериментальную и клиническую базу по наиболее современным вопросам профилактики эрозии твердых тканей зубов у пациентов с ГЭРБ. Для метаанализа использованы ресурсы поисковых систем eLibrary, сайта PubMed и данные авторефератов диссертаций disserCat. Эффективная профилактика эрозивного поражения зубов при ГЭРБ не может быть достигнута усилиями лишь одной клинической дисциплины и требует мультифакторного подхода. В целом можно выделить такие ключевые направления, как медикаментозная терапия с учетом коррекции диеты и образа жизни; специализированные стоматологические мероприятия, включающие обучение гигиене рта, повышение резистентности эмали и стимуляцию защитных свойств слюны, а также частые профессиональные осмотры у стоматолога.

56. Oral health in professional Slovak soccer players: Assessment of dental risks, subgingival microbiota and genetic influences.

期刊: PloS one 发表日期: 2026 链接: PubMed

摘要

Recent studies reveal high rates of dental issues among professional soccer players, worsened by poor hygiene, frequent sport drinks consumption and limited preventive care. Busy schedules, frequent relocations and changing clubs further disrupt dental routines, impacting performance and well-being. Therefore, we decided to assess the oral health status of professional Slovak soccer players and address these critical concerns. We assessed the oral health of 51 male soccer players from two elite Slovak soccer clubs during 2023/2024 season. Data collection included two paper-based questionnaires and a clinical oral examination by dentists. Additionally, clinical laboratory data were collected from saliva to test for presence of periopathogenic bacteria and DNA polymorphisms. Although 92.2% had valid health insurance, 36% did not attend dental check-ups in the past year, indicating underutilization of preventive care. While 86.2% brushed their teeth more than twice daily, only 48% practiced interdental cleaning and 35.3% used mouthwash. A significant 83.7% consumed sports drinks high in sugar and acid, influencing oral health risks. Clinical examinations revealed that 86.3% had a moderate to high DMF index (mean decayed teeth: 3.8) and 54.9% exhibited gingivitis. Bacterial analyses showed 25.5-74.5% carried highly periopathogenic bacteria, indicating a high risk for periodontitis. Additionally, 15.7% of players exhibited presence of DNA polymorphisms associated with risk of periodontitis onset. This study reveals a gap in preventive dental care among professional soccer players, emphasizing the urgent need for integrated oral health strategies within sports programs.