公共卫生研究摘要 (2026-06-20)

共收录 55 篇研究文章

1. Impact of Sexual Positioning on Stage of Syphilis at Diagnosis Among Men Who Have Sex with Men.

期刊: Sexually transmitted diseases 发表日期: 2026-Jun-22 链接: PubMed

摘要

Men who have sex with men (MSM) have a disproportionately high syphilis burden. As anal ulcers are less visible than penile ulcers, we examined whether MSM practicing receptive or versatile versus insertive anal intercourse were more likely to be diagnosed at a later syphilis stage. Using cross-sectional data from MSM enrolled in the Network Epidemiology of Syphilis Transmission (NEST) study, we evaluated the associations between sexual positioning (exclusive bottom, versatile bottom, or versatile vs. exclusive top or versatile top) and three outcomes: 1) syphilis stage diagnosed at baseline (secondary or latent vs. primary), 2) lifetime history of syphilis, and 3) history of syphilis in the past 12 months. Overall, 655 MSM enrolled in NEST; 599 had complete data on sexual positioning and syphilis stage at baseline. Of these, 57 had syphilis at baseline (Analysis 1), 506 had complete data on lifetime history of syphilis (Analysis 2), and 377 had complete data on history of syphilis in the past 12 months (Analysis 3). Among MSM with syphilis at baseline, those who practiced receptive or versatile versus insertive anal intercourse had 13 (95% CI=1.4-123) times the odds of being diagnosed with secondary or latent stage syphilis. Sexual positioning was not associated with syphilis history in the lifetime or past 12 months. These findings suggest that differences in sexual positioning may influence the stage at which syphilis is diagnosed among MSM. Further research in larger samples is needed to better understand these differences and their underlying mechanisms and to assess potential implications for clinical detection and diagnosis.

2. Corrigendum to "Environmental exposure and cancer incidence in offshore petroleum workers in Norway" [Environ. Res. 264 (2025) 121407].

期刊: Environmental research 发表日期: 2026-Jun-19 链接: PubMed

摘要

3. Geospatial correlation of industrial plastics emissions with bladder and kidney cancer burden in Ohio.

期刊: Urologic oncology 发表日期: 2026-Jun-19 链接: PubMed

摘要

While several environmental carcinogens are well-established in the development of bladder and kidney cancer, the role of microplastic exposure remains poorly understood. Micro- and nanoplastics (MNPs), often released during plastics manufacturing and recycling, are emerging pollutants that may carry carcinogenic additives or act as chemical vectors in air and water. Ohio-a major hub for plastics production-has experienced rising rates of bladder and kidney cancer, prompting an investigation into the spatial relationship between cancer incidence and exposure to plastics-processing waste. We conducted a geospatial epidemiological study using data from the Ohio Cancer Incidence Surveillance System (OCISS) from 2013 to 2021, alongside environmental exposure estimates derived from the Environmental Protection Agency (EPA’s) Toxics Release Inventory (TRI) and Risk-Screening Environmental Indicators (RSEI) model. Chemicals were categorized into adjusted plastics-processing waste (APPW), known bladder and kidney carcinogens, and combined exposures. Incidence and exposure data were analyzed at the ZIP Code Tabulation Area (ZCTA) level using spatial statistics (Moran’s I, bivariate Moran’s I, and Mantel tests), local cluster detection, and spatial regression. Between 2013 and 2021, both bladder and kidney cancer incidence increased across Ohio, with notable geographic clustering of cases. Spatial analysis demonstrated that regions with higher environmental exposure to chemicals used in plastics-processing, particularly via air, had significantly higher rates of both cancers. Airborne bladder carcinogens showed the strongest spatial association with cancer incidence (bivariate Moran’s I = 0.0510, P = 0.004; Mantel P < 0.001), followed by airborne microplastics (bivariate Moran’s I = 0.0589, P = 0.007). Waterborne microplastics, while not spatially clustered on their own, were significantly associated with higher bladder and kidney cancer rates (kidney: bivariate Moran’s I = 0.0940, P = 0.001). When combining all plastics-related exposures, spatial relationships remained robust, suggesting a cumulative effect. These patterns were most prominent in industrial ZIP codes, particularly in northern and southwestern Ohio. Our findings reveal significant spatial associations between plastics-related industrial emissions and both bladder and kidney cancer incidence in Ohio. These patterns suggest an environmental component to urologic cancer risk, with airborne exposures showing the strongest spatial alignment. The results warrant deeper mechanistic studies and targeted epidemiological investigations in high-exposure communities to further assess causality and inform public health interventions.

4. Physiotherapy management of Long-COVID: an evidence-based approach.

期刊: Brazilian journal of physical therapy 发表日期: 2026-Jun-19 链接: PubMed

摘要

Long-COVID is a heterogenous, episodic, and multisystemic condition which can result following infection with a novel pathogen, severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). Whilst a precise pathophysiological cause is unknown, several mechanisms are hypothesised, each with plausible scientific rationale. Most people experiencing persistent symptoms following COVID-19 infection recover, yet some experience severe and debilitating illness for years after infection. Strategies to manage the sequelae of Long-COVID can improve the lives of sufferers. To describe the physiotherapy management of Long-COVID based on current evidence. Those with ‘invisible illness’ (illness without outwardly visible signs), such as Long-COVID, often report stigmatisation and scepticism from healthcare systems. Validation of the experience of those with Long-COVID is therefore crucial to ensure patient-centred care. Thorough patient assessment is required to provide tailored management approaches given the diversity of Long-COVID presentations. Red flags that may contraindicate certain rehabilitation approaches (particularly exercise-based interventions) or that warrant further investigation should be considered. Assessments of fatigue, post-exertional malaise, respiratory symptoms, neurocognitive symptoms (i.e., brain fog), physical function, and orthostatic intolerance are strongly recommended. Management strategies may involve pacing and energy conservation techniques, pulmonary rehabilitation, inspiratory muscle training, dysfunctional breathing retraining, lifestyle and dietary strategies to manage orthostatic intolerance, and return-to-work planning. Physiotherapists are well positioned to deliver individualised, patient-centred, and validating care based on best available evidence.

5. Current progress and obstacles for automated classification of causes of death based on death certificates: A systematic review.

期刊: International journal of medical informatics 发表日期: 2026-Jun-19 链接: PubMed

摘要

While manual coding or rule-based software are approaches used by most countries for cause of death classification, the application of advanced deep learning tools is likely to enhance the efficiency and accuracy of national mortality statistics. To systematically review the current implementation of automated coding or categorising tools for cause of death classification, summarising the methodologies applied, performance achieved, and the progress and obstacles for application. PubMed and Scopus were systematically searched from 2018 to 2024 to identify studies that used automated tools to code or categorise the causes of death. Two researchers independently selected the papers with disagreement adjudicated by a third supervisor. For each study, the general profile, detailed methodology, and performance of the tools were extracted with progress and potential obstacles for implementation assessed qualitatively. An adapted version of QUADAS-2 was used to assess the risk of bias. Among the 46 included studies, the training sample size ranged from 165 to 10,519,268 people. The most popular approaches used were deep learning (n = 22, of which 7 were recurrent neural network and 6 were transformer) and rule-based (n = 15) automation. Large disparities existed in the performance, with recall (sensitivity) ranging from 0.253 to 1.000 and precision (positive predictive value) ranging from 0.396 to 1.000. Precision was often higher than recall and could vary substantially for different settings within the same study. Quality of text was the major obstacle to implementation of older automated tools, while for deep learning models, target task and materials were required for pre-training. The performance of deep learning was unsatisfactory for infrequent causes of death and head-to-head comparisons of performance with rule-based tools were limited. Despite deep learning applications gaining popularity over rule-based tools, their performance is inconsistent and evidence of head-to-head comparisons is insufficient. All approaches are influenced by the quality of the training data.

6. Late cerebrospinal fluid shunt infections: a Hydrocephalus Clinical Research Network study.

期刊: Journal of neurosurgery. Pediatrics 发表日期: 2026-Jun-19 链接: PubMed

摘要

Infection is a significant complication of CSF shunt surgery, with most infections occurring early in the postoperative course. While standardized perioperative protocols have successfully reduced early infections, the epidemiology, risk factors, and clinical patterns of late shunt infections are poorly characterized. This study aimed to determine the incidence, risk factors, clinical features, and outcomes of late shunt infections in a large, multicenter pediatric cohort. The Hydrocephalus Clinical Research Network (HCRN) Core Data Project was queried for all CSF shunt procedures performed between November 2016 and June 2023 in patients younger than 18 years. Each shunt surgery was treated as an index surgery, defined as the starting point for subsequent infection surveillance. Shunt surgeries were assigned to one of the following categories: no infection, early infection (≤ 6 months after the surgery), or late infection (> 6 months after the surgery). Demographic, operative, and clinical features of early versus late infections were compared, and Cox proportional hazards models were developed to assess shunt survival following early versus late infections. Of 6698 shunt procedures, 285 (4.3%) were followed by early infections and 58 (0.9%) by late infections. Late infections accounted for 16.9% of all shunt infections. Late infections were significantly more likely than early infections to be associated with abdominal pseudocysts (24.1% vs 3.5%, p < 0.001) and less likely to be diagnosed via CSF culture (53.4% vs 78.6%, p < 0.001). Clinical events that took place between the shunt surgery and the late infection included abdominal surgeries (21.4%), shunt taps (23.2%), bacteremia (9.1%), and nonoperative abdominal processes requiring hospitalization (19.6%). Vancomycin was administered less frequently in the late infection group (62.1% vs 85.3%, p < 0.001), and shunts were less likely to be initially treated with complete shunt removal (65.5% vs 88.4%, p < 0.001) and more likely to be initially managed with externalization of the distal catheter alone (34.5% vs 11.6%, p < 0.001). Shunt survival after infection did not differ significantly between early and late infections. Late CSF shunt infections are uncommon but clinically distinct from early infections and are often associated with heterogeneous secondary exposures not addressed by perioperative protocols. These findings highlight the need for long-term surveillance in patients with shunts, tailored diagnostic strategies, and expanded infection tracking efforts.

7. The association between ethnicity, socioeconomic position and outcomes following initiation of TNF inhibitors in Juvenile Idiopathic Arthritis: Results from the UK JIA Biologics Register.

期刊: Rheumatology (Oxford, England) 发表日期: 2026-Jun-19 链接: PubMed

摘要

Health outcomes in children and young people are known to vary by ethnicity and socioeconomic position. In juvenile idiopathic arthritis (JIA), it is unclear whether this relates to differential changes following one of the most common treatments, TNF-inhibitors (TNFi). This study investigated these factors, disease activity and treatment persistence following initial TNFi therapy in patients with JIA in the UK. Patients with non-systemic JIA in the UK JIA Biologic Register starting their first TNFi biologic were included. Outcomes included change in disease activity between start of TNFi and 6 months, measured by JADAS-71.Multivariable linear regression was used to assess the association between ethnicity or socioeconomic position and change in JADAS. Treatment persistence was analysed using Kaplan-Meier estimates. Cox proportional hazards models compared TNFi drug persistence by ethnic group and by socioeconomic position. A total of 1,641 patients were included; 67% female, 90% White ethnic group (6% Asian, 2% Black, 2% Mixed), 25% in the most deprived socioeconomic group. JADAS-71 improved for all ethnic and socioeconomic groups by 6 months, with no difference in improvement by group.The proportion of patients remaining on TNFi at 12 months (67%) and the likelihood of stopping was similar between all ethnic and socioeconomic groups. Outcomes following TNFi initiation are similar between ethnic and socioeconomic groups. Based on the results of this study, ethnicity and socioeconomic position do not appear to be associated with differential change in disease activity, and there is no evidence that the effects of socioeconomic position are moderated by ethnicity or vice versa.

8. Association of exposure to environmental heavy metals with markers of sepsis susceptibility: a population-based study from NHANES.

期刊: Inhalation toxicology 发表日期: 2026-Jun-19 链接: PubMed

摘要

Sepsis is a life-threatening syndrome of immune dysregulation; preexisting lymphopenia and an elevated neutrophil-to-lymphocyte ratio (NLR) heighten host susceptibility. Chronic low-dose exposure to lead (Pb), cadmium (Cd), and mercury (Hg) is immunotoxic, but its association with these pre-sepsis markers in the general population remains unclear. We analyzed 12,580 adults from NHANES 2011-2018. Outcomes were lymphopenia (absolute lymphocyte count <1.0 × 109/L) and high NLR (top quartile). Survey-weighted logistic and Weighted Quantile Sum (WQS) regressions evaluated individual and joint mixture effects. Restricted cubic splines modeled dose-response relationships. Continuous exposure models were also constructed to minimize information loss. Fully adjusted models showed higher quartiles of Pb, Cd, and Hg were each associated with greater odds of lymphopenia and high NLR. Comparing highest to lowest quartiles, ORs for lymphopenia were 1.85 (95% CI 1.42-2.41) for Pb, 1.66 (95% CI 1.28-2.15) for Cd, and 1.52 (95% CI 1.15-2.01) for Hg. Continuous models confirmed that each log2-fold increase in blood metals was associated with significantly reduced absolute lymphocyte counts and elevated NLR (all p < 0.05). The WQS index was positively associated with lymphopenia (OR 1.63) and high NLR (OR 1.48). In a nationally representative sample, chronic low-level exposure to Pb, Cd, and Hg was independently associated with an immune profile linked to sepsis susceptibility, suggesting environmental metal reduction as a potential population-level strategy to reduce sepsis risk.

9. Association between Care Recipient Frailty and Caregiver Burden Among Community-Dwelling Older Adults: Evidence from the National Study on Caregiving.

期刊: The journals of gerontology. Series B, Psychological sciences and social sciences 发表日期: 2026-Jun-19 链接: PubMed

摘要

Informal caregiving can impose substantial stress on caregivers when caring for recipients with complex health needs. Despite growing interest in caregiver burden, limited research has examined care recipients’ physical frailty as a primary driver of this burden. This study examines the association between care recipient frailty and multiple domains of caregiver burden and provides national estimates of caregivers providing care to older adults with frailty. We used data from the National Study of Caregiving to generate nationally representative estimates of caregivers providing care to frail community-dwelling older adults. Multivariable logistic regression models were run to estimate the odds, based on care recipient’s frailty status, of reporting physical, emotional, and financial difficulty, participation restrictions, and caregiver strain. In 2022, 21.3 million adults provided care to community-dwelling older adults, of which 4.6 million provided care to frail older adults (21.3%), and 12.8 million provided care to those who are prefrail (60%). In the fully adjusted model, caregiving for frail individuals was significantly associated with greater odds of caregivers experiencing physical difficulty. Specifically, caring for prefrail recipients was associated with a 76% increase in the odds of physical difficulty (OR = 1.76; 95% CI: 1.03-3.00), while caring for frail recipients was associated with a more than twofold increase in odds (OR = 2.30; 95% CI: 1.25-4.26). Our study highlights the prevalence of unpaid family caregiving for community-dwelling older adults with prefrailty and frailty and shows that frailty is associated with increased caregiver burden, particularly physical difficulty.

10. Engagement Trends in Online Vaccine Content: Longitudinal YouTube Study.

期刊: Journal of medical Internet research 发表日期: 2026-Jun-19 链接: PubMed

摘要

YouTube is the primary global video platform, hosting both authoritative health information and vaccine-skeptic viewpoints. However, engagement dynamics remain poorly understood. The aim of this study was to investigate the temporal and textual dynamics of engagement of the YouTube viewership with vaccination content, and specifically content that is in favor of or against vaccination. We contextualized these dynamics in the authority signals of the posting channel and the moderation actions taken by the platform. We conducted a 6-month daily longitudinal analysis of 7213 vaccine-related YouTube videos (November 2024 to May 2025) mentioning vaccination. We used zero-shot large language model classification with manual verification to classify the video stance toward vaccination, and the stance of their comments toward the video. The engagement and disagreement dynamics were modeled using Bayesian regression. Our findings show engagement asymmetry between content supporting and questioning vaccination. Vaccine-hesitant videos in our sample receive substantially higher raw engagement (median likes: 40 [IQR 3-846] to 59 [IQR 3-1319]; median comments: 10 [IQR 0-160] to 18 [IQR 0-311] per video versus 3 [IQR 1-15] and 0 [IQR 0-4], respectively, for strongly provaccine content) and moderate normalized engagement rates (true median combined rate: 0.073 [IQR 0.028-0.121] to 0.069 [IQR 0.027-0.118] interactions per view versus 0.026 [IQR 0.007-0.060] for strongly pro-vaccine videos, a 2.5-2.6× difference). Descriptively, vaccine-hesitant videos reach 90% of cumulative views faster (18 [IQR 8-38] days vs 32 [IQR 18-64] days; 44% faster), while negative binomial models that adjust for total engagement volume indicate that approximately 20% of this advantage reflects genuine temporal compression independent of engagement volume. Comment analysis indicated that the vaccine-hesitant videos in our sample foster echo chambers, while the provaccine content attracts battlegrounds. Considering the sources of vaccine-related content, provaccine content tends to originate from organizations, particularly news and health institutions, while vaccine-hesitant discourse is more likely to come from individual creators, even those self-identifying as medical doctors. Moderation, on the rare occasion when it occurs (about 2% of the videos were taken down), comes after engagement saturation, limiting its effectiveness. Our analysis suggests that the vaccine-hesitant content can dominate YouTube’s engagement ecosystem through rapid early-stage amplification, which has direct implications for public health intervention timing and platform governance policy.

11. Improving Local Health Through Partner Engagement and Policy: Establishing the First Performance Standards for Massachusetts Local Public Health.

期刊: Journal of public health management and practice : JPHMP 发表日期: 2026-Jun-19 链接: PubMed

摘要

The Massachusetts (MA) local public health system is highly decentralized. All 351 municipalities autonomously manage local public health infrastructure and budget, resulting in service delivery disparities. The MA Department of Public Health (MDPH) recognizes that achieving equitable access to public health services requires systems change, and successful systems change demands active participation and input from partners at all levels. To collaboratively establish the first Performance Standards (PS) with and for MA local public health to reduce inequities in public health system delivery. Partner engagement and the Framework for Applying Qualitative Methods in Health Policy and Systems Research guided PS establishment. Relevant standards from MA laws were compiled and organized using document and thematic content analyses. Partner elicitations guided edits for finalizing PS. In 2021-2023, MDPH facilitated statewide partner collaboration to establish PS. Six key MA public health organizations, representatives from 4 state agencies, and widespread MA local public health. Targeted engagement with internal partners enabled drafting PS. Widespread engagement with external partners elicited open comments to improve and finalize PS. MDPH and partners collaboratively formalized PS after analyzing 283 comments and 66 edits. Through active collaboration with partners, MA formalized the first official PS for local public health, released in October 2023. PS comprise 5 subjects, including 87 standards written into MA legislation across 4 subjects (environmental health, tobacco control, disease control and prevention, administration), plus recommended workforce standards. PS set minimum expectations for local public health credentialing and support consistent public health service delivery. PS are a steppingstone toward MA public health systems change. Collaboration is critical for partner buy-in, to establish and implement PS using shared resources structures. Effective PS implementation, synergistic with other efforts, will reduce disparities in local public health services and delivery and provide MA residents with more equitable access to public health services.

12. Role of electronic health record in stigma experiences, trust, and care decisions by women with history of pregnancy and substance use disorder: a qualitative study of perceptions of clinical note language.

期刊: Journal of the American Medical Informatics Association : JAMIA 发表日期: 2026-Jun-19 链接: PubMed

摘要

Stigma impacts outcomes across stigmatizing conditions, including substance use disorders (SUDs). Recent policy changes give patients rapid access to clinical notes in the electronic health record (EHR), which may include stigmatizing language. The objective of this study was to assess the perspectives of women with history of pregnancy and SUDs on typical language used in clinical notes. Women with a history of pregnancy and SUD were recruited through an online crowd-sourcing platform. Respondents viewed examples of clinical language and answered survey questions about perceived stigma. An inductive approach was used to analyze open-text responses, and themes were developed. Three hundred seventy survey respondents wrote a response to at least one open-text question. Thematic analysis yielded 4 major themes: (1) anticipation of future stigma facilitated by EHR documentation can affect patients’ care decisions for themselves and their babies; (2) documented SUD history could have short- and long-term effects on patients’ experience of stigma and discrimination, especially in labor and delivery; (3) phrases using “denies” and quotes within quotation marks could be perceived as stigmatizing and decrease trust in providers; (4) nonstigmatizing language and acknowledgement of recovery in notes can facilitate positive experiences for patients, but patients want more acknowledgement of recovery and positive language. Electronic health record documentation can modulate stigma experiences for women during and after pregnancy through stigmatizing language in clinical notes and facilitating discrimination, decreasing trust in providers and negatively impacting health outcomes. Raising providers’ awareness of nonstigmatizing and positive language or implementing technology to prompt nonstigmatizing terminology could contribute to positive experiences among women with a history of pregnancy and SUD.

13. The Role of Artificial Intelligence in the Prevention of Intimate Partner Violence and Sexual Violence: A Scoping Review of the Literature.

期刊: Journal of sex research 发表日期: 2026-Jun-19 链接: PubMed

摘要

Intimate partner and sexual violence (IPV/SV) remain pervasive global public health issues. Prevention efforts typically occur at the primary level (promoting consent and healthy relationships), secondary level (encouraging bystander intervention and screening), or tertiary level (supporting survivors through reporting and access to resources). The rapid emergence of artificial intelligence (AI) chatbots, including large language models (LLMs) such as ChatGPT, presents new opportunities to expand access to information and potentially strengthen prevention efforts across these levels. However, little is known about how these tools are currently being used or evaluated within IPV/SV prevention. This scoping review synthesized 40 peer-reviewed articles, preprints, and conference papers published between 2017 and 2025 that examined AI chatbots in IPV/SV contexts. Twenty-six studies described the development of domain-specific chatbots designed to support survivors by documenting incidents of violence, facilitating or streamlining reporting to authorities, and connecting users with services such as counseling. In addition, general-purpose LLMS (e.g., ChatGPT, Gemini) appeared to consistently produced evidence-based and accurate responses to questions related to IPV/SV. Findings suggest that AI chatbots may have a meaningful role in IPV/SV prevention; however, most existing applications focus on tertiary prevention after harm has occurred. This emphasis mirrors broader policy and service landscapes that prioritize crisis response over primary prevention. To realize the potential of AI in this field, future researchers should explore how chatbots and LLMs can be incorporated into primary and secondary prevention, particularly in strengthening education, promoting healthy relationships, and supporting early intervention.

14. Left ventricular non-compaction in heart failure: contemporary perspective on diagnostic challenges and treatment opportunities.

期刊: Heart failure reviews 发表日期: 2026-Jun-19 链接: PubMed

摘要

Left ventricular non-compaction (LVNC) remains one of the most debated phenotypes within the spectrum of cardiomyopathy. Increasing recognition of left ventricular hypertrabeculation (LVHT) in healthy individuals and in physiological adaptive states challenges the concept of LVNC as a distinct morphological entity. In patients with heart failure (HF), distinguishing adaptive trabeculation from true cardiomyopathic LVNC is clinically critical, as misclassification may lead to unnecessary interventions or failure to identify high-risk patients. This review summarizes current evidence on the pathophysiology, imaging features, genetic background, and clinical implications of LVHT and LVNC from an HF-centred perspective. We propose a pragmatic diagnostic approach integrating echocardiography, cardiac magnetic resonance, and selective genetic testing to improve clinical interpretation, risk stratification and management. Importantly, prognosis appears to be determined primarily by ventricular function, myocardial substrate, and arrhythmic burden rather than by the extent of trabeculation itself.

15. Nomogram prediction model for pain recurrence in patients with trigeminal neuralgia after microvascular decompression.

期刊: Neurosurgical review 发表日期: 2026-Jun-19 链接: PubMed

摘要

Microvascular decompression (MVD) is the first-line surgical treatment for trigeminal neuralgia (TN). However, some patients experience recurrence despite achieving immediate pain relief after MVD. This study aimed to identify the risk factors for TN recurrence and to develop a predictive nomogram model. We enrolled patients with TN who achieved immediate pain relief after MVD with at least 2 years of follow-up. Logistic regression analysis was used to explore the risk factors of long-term pain recurrence, based on the results of multivariate logistic regression analysis, a nomogram model for predicting pain recurrence was developed. Receiver operating characteristic curve (ROC) was used to analyze the prediction efficiency of the nomogram model, and calibration curve was used to analyze the accuracy of the nomogram model. Eventually, 264 patients were included in this study, during a mean follow-up of 43.06 ± 16.99 months, 23 patients experienced pain recurrence. Regression analysis suggested that younger age, longer pain duration, and atypical pain were the independent risk factors for long-term pain recurrence. The nomogram demonstrated excellent discriminatory power, with an area under the curve (AUC) of 0.958. The calibration curve analysis indicated good agreement between the predicted and observed probabilities. Favorable long-term outcomes could be achieved in TN patients with immediate pain relief after MVD, patients with younger age, longer pain duration and atypical pain may be at higher risk for pain recurrence.

16. Efficacy and safety of baloxavir marboxil vs. oseltamivir in Chinese outpatients with influenza B: an IPTW-adjusted real-world cohort study.

期刊: Naunyn-Schmiedeberg’s archives of pharmacology 发表日期: 2026-Jun-19 链接: PubMed

摘要

Baloxavir marboxil (baloxavir) shows satisfactory efficacy and safety for treating influenza, particularly influenza A. However, real-world evidence for influenza B in Chinese populations is scarce. This study aimed to explore the efficacy and safety of baloxavir vs. oseltamivir in Chinese outpatients with influenza B. This real-world cohort study included 811 outpatients with influenza B between November 2023 and January 2024, comprising 394 patients in the baloxavir group and 417 patients in the oseltamivir group. Inverse probability of treatment weighting (IPTW) was applied to minimize potential confounding and achieve covariate balance. In both unweighted and IPTW-weighted cohorts, time to fever resolution was shorter in the baloxavir group (median: 24.0 h) compared with the oseltamivir group (median: 48.0 h) (both P < 0.001). In both cohorts, the baloxavir group (median: 120.0 h) had a shorter time to symptom resolution than the oseltamivir group (median: 168.0 h) (both P < 0.001). Due to residual imbalance, time from symptom onset to antiviral initiation was adjusted for in the multivariable Cox model. After adjustment, the baloxavir group remained associated with faster fever resolution and symptom resolution (all P < 0.001). The incidence of any adverse events was lower in the baloxavir group than in the oseltamivir group (3.6% vs. 10.3%) (P < 0.001). Headache was more frequent (1.3% vs. 0.0%), whereas nausea (0.0% vs. 6.7%) and vomiting (0.0% vs. 6.5%) were less frequent in the baloxavir group vs. the oseltamivir group (all P < 0.05). Baloxavir achieves faster fever resolution and symptom resolution, with a better safety profile in Chinese outpatients with influenza B.

17. Identification of NOC- and NIC-Linkages to NANDA-International for the Nursing Diagnosis Risk for Elder Frailty Syndrome: A Consensus Panel Based on a Narrative Review.

期刊: International journal of nursing knowledge 发表日期: 2026-Jun-19 链接: PubMed

摘要

PurposeThis narrative review aims to identify relevant concepts from the Nursing Outcomes Classification (NOC) and Nursing Interventions Classification (NIC) for the NANDA-International nursing diagnosis Risk for elder frailty syndrome (00357). In addition, updated, evidence-based NNN linkages are provided as a basis for clinical decisions and integration into electronic health records, as well as to support future validation research.MethodsIn this theoretical study, a narrative literature review in nursing-related databases (CINAHL, MEDLINE, and Cochrane Library) and other key sources was combined with a structured consensus process. Based on the literature findings, experienced nursing scientists developed NNN linkages for this nursing diagnosis, which were reviewed and refined through expert consensus with classification specialists.FindingsSeven NOC outcomes were identified to assess the occurrence of the NANDA-I nursing diagnosis, addressing key physiological deteriorations such as cardiac, neurological, respiratory, and sensory function, as well as nutritional status. Additional NOC outcomes were systematically linked to all relevant risk factors, reflecting the multidimensional nature of frailty. Evidence-based NIC interventions such as Exercise Promotion, Family Involvement Promotion and Teaching: Prescribed Medications were identified and consistently linked to the diagnostic label, definition, and risk factors, ensuring internal coherence across the nursing process.ConclusionsThe systematic linkage between NANDA-I, NOC, and NIC enables multidimensional, evidence-based, and person-centered frailty management and improves the visibility of nursing. Only through continuous revision, validation, and empirical testing can conceptual coherence, clinical applicability, and integration into electronic health records be strengthened.Implications for nursing practiceThe results show that linked NOC outcomes enable a differentiated evaluation of frailty risks over time and can thus systematically demonstrate the effectiveness of targeted NIC interventions. Integration into electronic health records promotes clinical decision-making and strengthens the active involvement of frail individuals and their social environment in the interest of successful aging.

18. Factors Influencing Participation in Student Evaluation of Teaching (SETs): A Quality Improvement Analysis.

期刊: Journal of dental education 发表日期: 2026-Jun-19 链接: PubMed

摘要

Student evaluations of teaching (SETs) collect feedback to evaluate teaching methods, effectiveness, and outcomes. SETs are used frequently by faculty in decisions about course content, curriculum changes, and the promotion process. Reported issues with SETs in dental education include inaccuracy, faculty dissatisfaction, and low response rates. This analysis examined SET response rates over a 6-year period in which academic policies changed such that dental student participation shifted from mandatory to opt-in and then to opt-out. A secondary focus was the influence of respondent burden (i.e., volume of questions) on SET participation rates, as measured by proxy using the number of courses and credit hours. This retrospective quality improvement analysis involved SET participation data from dental students (mean 64 per class) enrolled at the University of Kentucky College of Dentistry between 2019 and 2024. Analysis of the number of SET responses per class under different participation methods was conducted using t-tests and ANOVA, with significance set at p < 0.05. Student participation was observed to change during different academic policy settings. The highest participation occurred during the mandatory policy period. When policy changed from mandatory (X = 58.6 student responses) to optional (X = 36.7 student responses), a significant decrease in participation occurred (F[1,450] = 156.51, p < 0.001). Further, when the policy changed from opt-in (X = 38.3) to opt-out (X = 31.1), a further significant decrease in participation occurred (F[2,449] = 86.68, p < 0.01). Also, participation was greater in students with a lower class (volume) load (F[1,73] = 7.24, p < 0.01). SETs were influenced by academic policies that changed from mandatory to optional. Opt-out showed the lowest participation rates compared with opt-in and mandatory. There was a negative relationship between increased course load and participation in SETs. These findings provide insights into factors that can influence SET response rates, including respondent burden and participation strategies.

19. Discordance Between Perceived Risk and Cardiovascular Health in Women of Reproductive Age.

期刊: JACC. Advances 发表日期: 2026-Jun-19 链接: PubMed

摘要

Cardiovascular disease (CVD) remains the leading cause of death among women, yet awareness has declined significantly among women of reproductive age. Risk underestimation may impede prevention efforts during this critical life stage. The objectives of the study were to evaluate concordance between perceived CVD and stroke risk and LE8-defined cardiovascular health status and to examine predictors of risk-cardiovascular health discordance among women of reproductive age. Cross-sectional study of 139 women aged 18 to 50 years in the Baltimore/Washington DC area. Participants assessed perceived CVD and stroke risk using 7-point Likert scales. Discordance was defined by cross-classifying perceived risk relative to peers with LE8-defined cardiovascular health status. Multivariable logistic regression examined predictors of underestimation. Among 139 women (mean age 32.01 years), over half underestimated both CVD (56.8%) and stroke (58.3%) risk. In multivariable models, racial/ethnic minority status was significantly associated with underestimation of both CVD (OR: 3.70; 95% CI: 1.58-8.68) and stroke risk (OR: 3.29; 95% CI: 1.44-7.51), as was medium polysocial risk (CVD: OR: 2.72; 95% CI: 1.02-7.24; stroke: OR: 2.70; 95% CI: 1.04-7.02). Low cardiovascular health literacy (OR: 5.91; 95% CI: 1.05-33.31) and older reproductive age (≥32 years; OR: 2.26; 95% CI: 1.02-5.00) were additionally associated with CVD risk underestimation. CVD and stroke risk underestimation is prevalent among women of reproductive age with marked racial and social disparities. Targeted, culturally sensitive risk communication strategies are needed to improve CVD and stroke risk perception accuracy.

20. Neuronal YTHDF2 suppresses innate immune activation in Aβ pathology by promoting m6A-dependent decay of cytosolic mitochondrial mRNAs.

期刊: Science advances 发表日期: 2026-Jun-19 链接: PubMed

摘要

Dysregulation of RNA m6A modification has been implicated in Alzheimer’s disease (AD), but the molecular mechanisms remain largely unclear. Here, we identified the presence of m6A on mitochondria-encoded messenger RNAs (mt-mRNAs) in the brain, with elevated levels correlated with amyloid-β (Aβ) deposition. Under physiological conditions, cytosolic m6A-modified mt-Nd4 is recognized and degraded by the m6A reader protein YTHDF2, thereby preventing aberrant activation of the RIG-I-MAVS innate immune pathway in neurons. Under Aβ-associated pathological conditions, YTHDF2 expression is markedly down-regulated in neurons, leading to the accumulation of m6A-modified mt-Nd4 in the cytosol. This accumulation triggers RIG-I-MAVS activation and type I interferon (IFN) responses. Neuron-derived IFN-β then amplifies neuroinflammation by activating surrounding microglia through a paracrine mechanism. Furthermore, neuronal Ythdf2 deficiency exacerbates Aβ-associated neuroinflammation and cognitive decline. Together, these findings reveal a previously unrecognized m6A/YTHDF2-dependent regulatory axis that links mitochondrial RNA metabolism to innate immune activation and neuroinflammation in Aβ pathology.

21. Statins promote muscle metabolic danger and NLRP3-mediated myopathy via lower protein-prenylation and YAP.

期刊: Science advances 发表日期: 2026-Jun-19 链接: PubMed

摘要

Statin intolerance and side effects such as low-level myopathy limit statin use and the dose for optimal cholesterol lowering. We found that priming the NLRP3 inflammasome with bacterial components like lipopolysaccharide lowered the dose of statins that caused side effects in muscle cells. We then built models of low-level statin myopathy and found that muscle cell-autonomous statin-induced myopathy occurs through the NLRP3 inflammasome in vitro and in mice. Statin-induced muscle cell death and higher Atrogin-1 were prevented by blocking NLRP3 or restoring isoprenoids but not cholesterol. Statins reduced glycolysis in muscle cells, which required lower protein prenylation. Statins lowered YAP effector genes and promoted nuclear accumulation of FOXO. Activating YAP, restoring isoprenoids, or blocking NLRP3 mitigated nuclear FOXO accumulation, statin-induced muscle atrophy, and statin-mediated lowering of protein synthesis. These results define a statin-induced myopathy pathway where metabolic danger engages the NLRP3 inflammasome and YAP via lower prenylation independent of cholesterol.

22. Bacterial infection reshapes monocyte and macrophage ontogeny at the CNS borders.

期刊: Science immunology 发表日期: 2026-Jun-19 链接: PubMed

摘要

Macrophages in the meninges contribute to immune defense of the central nervous system (CNS), yet their site-specific origin and function remain poorly understood. Using an intravenous model of streptococcal meningoencephalitis in mice, we found bacteria predominantly in the leptomeninges and dura. Nevertheless, monocyte infiltration into the leptomeninges and parenchyma strongly correlated with disease severity. In the dura, infection triggered activation and loss of resident macrophages, followed by rapid engraftment of inflammatory monocytes that transiently replenished the macrophage niche. Under homeostasis, dural monocytes were supplied CCR2 independently from adjacent skull bone marrow. During infection, this local source was insufficient, necessitating recruitment from peripheral bone marrow. Infection further reshaped monocyte ontogeny, increasing monocyte-dendritic cell progenitor-derived monocytes, which expressed higher major histocompatibility complex class II levels and persisted in the brain alongside CD4+ T cells during resolution. Together, these findings reveal dynamic, compartment-specific remodeling of monocyte recruitment and differentiation across CNS borders during bacterial meningoencephalitis.

23. Cardiovascular Genetic Epidemiology in the Genome-Wide Era: From Association Discovery to Mechanistic Dissection and Clinical Translation.

期刊: Cardiovascular drugs and therapy 发表日期: 2026-Jun-19 链接: PubMed

摘要

Despite major advances in prevention and treatment, cardiovascular disease remains a leading cause of death and disability worldwide. Cardiovascular genetic epidemiology has moved from family-based and candidate-gene studies to a genome-wide discipline supported by genome-wide association studies (GWAS), population-scale biobanks, whole-genome sequencing, and multi-omics resources. This narrative review examines how the field is shifting from locus discovery toward a continuous but still incomplete evidence chain that links variants to genes, cellular context, causal pathways, functional validation, and clinical use. We emphasize a central tension: cardiovascular genetics has been exceptionally successful at discovering associations, but robust mechanistic resolution and implementation-ready clinical translation remain uneven across diseases, populations, and use cases. We synthesize progress in coronary artery disease, blood pressure traits, atrial fibrillation, stroke, heart failure, inherited cardiovascular disorders, and intermediate phenotypes, and we distinguish established applications from promising but still emerging approaches such as polygenic risk scores, spatial omics, EHR-linked implementation, and genetically informed target prioritization. We also highlight persistent bottlenecks, including ancestry imbalance, noncoding locus interpretation, limited functional validation, imperfect polygenic score portability, data-governance constraints, and the need for privacy-preserving analytical frameworks. Overall, the next phase of cardiovascular genetic epidemiology will depend less on the mere accumulation of loci and more on rigorous evidence triangulation, context-specific functional testing, ancestry equity, and feasible clinical implementation pathways.

24. Characterization and risk of PPDs and PPD-Qs in an abandoned rubber antioxidant production site.

期刊: Journal of environmental management 发表日期: 2026-Jun-19 链接: PubMed

摘要

p-Phenylenediamine (PPD) rubber antioxidants and their quinone transformation products (PPD-Qs) are global emerging contaminants that pose severe threats to ecological environments. Abandoned antioxidant sites are key pollution sources, yet limited knowledge regarding their subsurface distribution, transformation drivers, and risks hinders precise site governance. Herein, N-(1,3-dimethylbutyl)-N’-phenyl-p-phenylenediamine (6PPD), 6PPD-Q (6PPD’s quinone), N-isopropyl-N’-phenyl-p-phenylenediamine (IPPD), IPPD-Q (IPPD’s quinone), and p-aminodiphenylamine (PADPA) at an abandoned PPD production site were investigated via field sampling, chemical analysis, correlation analysis and multi-dimensional risk assessment. Results show that the contaminant distribution was dominated by production layout and stratigraphy with weak migration. Quinone/parent compound ratios in groundwater were far higher than in shallow soil, driven by superoxide anions (O2•-) in vadose soil and regulated by pH and dissolved oxygen in groundwater. For health risks, soil 6PPD-Q and IPPD-Q showed maximum hazard index (HI) of 19.88 and 28.97, whereas the corresponding maximum acceptable concentration in groundwater was merely 1.61 ng L-1. Ecologically, 6PPD and 6PPD-Q contaminated soil exhibited maximum risk quotients (RQ) of 540.77 and 19.90, and posed significant aquatic transfer risks. This work fills critical knowledge gaps in subsurface PPD/PPD-Q pollution, and emphasizes the urgency of incorporating PPDs and PPD-Qs into site regulatory frameworks.

25. Relative contribution of climate forcing and ice phenology to water quality in surface and deep layers of an arctic lake: Results from 44 years of in-situ measurements.

期刊: Journal of environmental management 发表日期: 2026-Jun-19 链接: PubMed

摘要

Arctic lakes are exceptionally vulnerable to climate change, yet the depth-specific responses of their water quality remain largely unexplored, primarily due to the scarcity of long-term, depth-resolved water quality data. This study investigates how climatic and ice phenology conditions influence water quality in the surface and deep layers of Lake Inari, a large, oligotrophic arctic lake with minimal human-induced disturbance. Leveraging a 44-year dataset of in-situ measurements (1980-2023), we utilize canonical correlation analysis (CCA) to assess the potential interactions among key water quality parameters in the surface and deep layers of this stratified lake and climatic-ice factors. The results show a relatively robust statistical relationship between surface water quality and climatic-ice factors (R2 = 0.67, p < 0.05). These climatic-ice factors account for approximately 53% of the variance in the lake’s surface water quality. In contrast, deep-water quality exhibits a relatively moderate but statistically non-significant correlation with climatic-ice factors (R2 = 0.42, p > 0.05). The absence of statistical significance, likely a false negative due to limited power of our CCA analysis, suggests that deep-water quality responses may be delayed or indirect, potentially mediated by thermal stratification and reduced mixing. Both surface water quality and deep-water quality display exceptionally strong multivariate interactions (R2 = 0.94, p < 0.05), driven by shared variability in turbidity, chemical oxygen demand, and electrical conductivity. The overall statistically significant redundancy between surface water quality and deep-water quality is around 60% for the latter. These findings suggest that surface-layer observations, including satellite and automated-sensor data, may help inform assessments of deep-water quality in large, oligotrophic, dimictic Arctic lakes. If further validated, this approach could support more cost-effective monitoring and strengthen climate-resilient lake-management planning.

26. Elevated invertebrate methylmercury concentrations across functional feeding groups in a eutrophic bog post-flooding.

期刊: The Science of the total environment 发表日期: 2026-Jun-19 链接: PubMed

摘要

Mercury is a toxic environmental contaminant that is known to undergo long range transport, resulting in deposition in remote and pristine ecosystems. Increases in methylmercury concentration at low trophic levels may result in greater risk to top predators in food webs. As a result, low trophic level invertebrates are important sentinels for ecosystem contamination and overall ecosystem health. Big Meadow Bog, located on Brier Island, Nova Scotia, is a disturbed wetland habitat that was subject to colonization by herring gulls (Larus argentatus), resulting in significant phosphate nutrient input from guano and is also affected by a recent water table restoration. Aquatic and terrestrial invertebrate families were sampled from Big Meadow Bog in addition to surface waters to examine the impacts of nutrients and flooding on mercury speciation and accumulation. Methylmercury (MeHg) and total mercury (THg) were analyzed in all samples and water to calculate invertebrate bioconcentration factors. Methylmercury concentrations were significantly different across invertebrate families, and functional feeding groups (FFG). Concentrations of MeHg in Big Meadow Bog were on average 1.61 times higher than MeHg concentrations observed at similar undisturbed sites.

27. Job crafting as an ex-ante burnout management strategy in healthcare organisations: an emerging market perspective.

期刊: Journal of health organization and management 发表日期: 2026-Jun-19 链接: PubMed

摘要

Burnout management among employees is a persistent challenge faced by healthcare organisations, which is exacerbated in developing economies with high demographic loads. The extant literature explores measures of mitigating and adapting to occupational strain and burnout. However, the epistemic relationship between job crafting, perceived organisational support, meaningful work and burnout remains ambiguous and underexplored. The present study examines how a priori interventions such as job crafting and organisational support affect meaningful work and modulate burnout in healthcare organisations. We conducted a cross-sectional study of 373 healthcare professionals from corporate and public hospitals of different operational capacities in the North Indian region. We used PLS-SEM to test our hypothesis and validate the conceptual model. This study found a significant negative relationship between job crafting and the burnout axis, mediated by meaningful work. The perceived organisational support significantly moderates the relationship. Our study provides novel insights by testing the role of two resources based on JD-R theory, such as perceived organisational support and meaningful work, in the relationship between job crafting and burnout in Global South healthcare settings. Moreover, it underscores that participatory job crafting can be an ex-ante strategy to mitigate burnout among healthcare employees.

28. Alcohol and Steatotic Liver Disease Exhibit Divergent Associations with High Plasma Small Dense LDL-C Concentration.

期刊: The Journal of clinical endocrinology and metabolism 发表日期: 2026-Jun-19 链接: PubMed

摘要

Within the metabolic dysfunction-associated steatotic liver disease (MASLD)/MASLD with increased alcohol intake (MetALD)/alcohol-associated liver disease (ALD) framework, cardiovascular risk varies by alcohol exposure. As small dense low-density lipoprotein cholesterol (sdLDL-C) is highly atherogenic, this study assessed the relative effects of steatotic liver disease (SLD) and alcohol consumption on sdLDL-C elevation and the effects of conventional fasting lipids [low-density lipoprotein cholesterol (LDL-C)/high-density lipoprotein cholesterol (HDL-C)/triglycerides (TGs)] on these associations. This cross-sectional study enrolled 55,745 participants who underwent health screenings in Niigata, Japan between April 2024 and March 2025. Alcohol consumption was self-reported as low, moderate, or excessive. Participants were grouped by SLD status and alcohol consumption. sdLDL-C was directly measured, with high sdLDL-C defined as ≥35 mg/dL. Multivariable linear regression (sdLDL-C) and logistic regression (high sdLDL-C) analyses used two models: model 1 was adjusted for age, sex, body mass index, smoking, lipid-lowering medication, antihypertensive medication, and diabetes, and model 2 was further adjusted for LDL-C, HDL-C, and TGs. Marginal standardized prevalence and standardized prevalence differences (PDs) were estimated using g-computation with 2000 bootstrap iterations. The crude prevalence of high sdLDL-C was influenced by SLD and alcohol consumption, being highest in the SLD(+)/excessive alcohol consumption group (76.4%). In model 2, SLD-related associations were attenuated, whereas alcohol-related associations remained robust, as the PD was lower for SLD(+) than for SLD(-) within each alcohol category. Alcohol exposure contributes to an atherogenic sdLDL-C phenotype beyond conventional fasting lipids within contemporary SLD categories, indicating potential relevance for risk profiling in MetALD/ALD.

29. Associations Between Football-Related Exposures, Head Injury, Tinnitus, and Neuropsychological Health Outcomes Among Professional American-Style Football Players.

期刊: Sports medicine - open 发表日期: 2026-Jun-19 链接: PubMed

摘要

Auditory dysfunction such as tinnitus is a common sequelae of traumatic brain injury (TBI), and has been associated with neurobehavioral outcomes, including cognitive decline, depression, and anxiety. Few studies have examined associations between concussion history and tinnitus independent of confounding by blast injury or occupational noise exposure. This study investigated concussion history and tinnitus among former professional American-style football (ASF) players, and evaluated whether tinnitus mediates associations between concussion history and neurobehavioral outcomes. This cross-sectional study included former ASF players who contracted with a professional league after 1960 and completed self-administered questionnaires between 2019-2025. Surveys assessed football exposure, auditory dysfunction, and mental health. Cumulative head injury exposure was measured using self-reported concussion signs and symptoms during play. Tinnitus was self-reported and assessed concurrently with validated measures of perceived cognition, depression, and anxiety. Logistic regression evaluated associations between concussion symptom history and tinnitus, and linear regression models assessed mediation and interaction effects. Among 1085 participants (mean age 57.9 ± 13.5 years; 32.4% Black; 6.1 ± 3.7 seasons), greater concussion symptom history was associated with increased odds of tinnitus (highest vs. lowest quintile: OR = 2.90; 95%CI 1.91-4.43; p < 0.0001). Tinnitus did not mediate associations between concussion symptom history and neurobehavioral outcomes. However, associations with perceived cognition (p-interaction = 0.1), depression (p-interaction < 0.01), and anxiety (p-interaction < 0.01) were larger among participants reporting tinnitus. Greater concussion symptom history was associated with increased reporting of tinnitus, and neurobehavioral associations were stronger among those with tinnitus. Clinicians should consider tinnitus when evaluating long-term cognitive and mental health outcomes following repeated head injury.

30. Genetic variation of CBS (844ins68) and MTHFR A1298C among aluminum-exposed workers with emphasis on the role of oxidative stress.

期刊: The Journal of the Egyptian Public Health Association 发表日期: 2026-Jun-19 链接: PubMed

摘要

Aluminum (Al) is the most abundant element in the Earth’s crust. Occupational exposure to aluminum can lead to serious adverse health effects for workers in the aluminum industry. Genetic variations could be considered as contributing internal factors for the susceptibility of individuals to toxicities related to Al exposure. Different experiments have investigated genetic polymorphism variations in metabolic pathways, which could significantly modulate an individual’s susceptibility to aluminum-induced toxicity. This study aimed to evaluate the effects of aluminum exposure on oxidant-antioxidant status, parathyroid hormone (PTH), and free testosterone levels. Also, to show whether an association exists between MTHFR A1298C (rs1801131) and CBS (844ins68) gene polymorphisms with the aforementioned biochemical parameters among occupationally exposed workers to Al. Urinary heavy metals (Al, Cd, Ni, Cr, Pb) were measured through ICP-MS in 95 workers in the aluminum industry and 90 control individuals. We also analyzed serum MT-1, MDA, PTH, free testosterone, and TAC using ELISA methods. CBS (844ins68) and MTHFR A1298C gene polymorphisms were performed by (PCR-RFLP). Revealed a significant rise in serum MT-1, MDA, and urinary heavy metals levels with reductions in TAC, Free testosterone, and PTH levels. A negative relation was found between serum TAC, duration of exposure, and between age and serum free testosterone levels. In workers, the association of the wild type of MTHFR A1298C genotype with a rise in serum MT-1 and MDA levels and a decrease in TAC was observed compared to the control, while the heterozygote genotype AC was associated with reduced serum free testosterone, TAC, and PTH levels among the workers group. Moreover, serum MT-1 showed a significant rise in NN genotype of the CBS gene with a decline in serum TAC and PTH levels, while Heterozygote NI recorded reduced TAC levels among the worker group compared to the control. Significant reduction in serum TAC was shown in the heterozygote NI among the worker group compared to the control. Association of wild-type and heterozygote genotype of both MTHFR A1298C (rs1801131) (AA and AC) and CBS (844ins68) (NN and NI) with reduced TAC levels among the worker group. Moreover, the AC genotype of MTHFR was associated with a decrease in the PTH and free testosterone levels among Al industry workers.

31. Effectiveness of the Participatory Approach on Return-to-Work of Sick-Listed Workers: A Systematic Review and Meta-analysis.

期刊: Journal of occupational rehabilitation 发表日期: 2026-Jun-19 链接: PubMed

摘要

To synthesize the evidence regarding the effectiveness of the participatory approach (PA) on return to work (RTW) of sick-listed workers compared to usual care and other interventions. A systematic review and meta-analysis were conducted according to the PRISMA guidelines, searching five databases for evidence from their inception until February 2025. Studies were eligible for inclusion if they included sick-listed workers, conducted a PA intervention at the workplace focused on RTW, and included a comparison group. Data on RTW, health, and economic outcomes were extracted, and the quality of the studies was appraised. Data on time until full and lasting RTW were pooled, and a meta-analysis was conducted, followed by an assessment of the certainty of the evidence. Eight randomized controlled trials reported across 14 papers were included. Half of the studies had a good quality score, whereas the remaining studies were considered of poor (n = 3) or fair (n = 1) quality. While no significant overall effect of the PA on time until full and lasting RTW was found, a statistically significant effect in favor of the PA was observed among sick-listed workers with low back pain (LBP) compared to control conditions. The evidence provides moderate certainty that the PA is effective in reducing time to full and lasting RTW for sick-listed workers with LBP compared to usual care. However, for workers sick-listed due to mental health conditions or mixed health complaints, the evidence does not support its effectiveness, and the certainty of this evidence is very low. More high-quality research and realist evaluations across different settings and populations are needed to strengthen the evidence on the PA as an RTW intervention and to explain its underlying working mechanisms.

32. Correction: Clinicopathological profile of basal cell carcinoma: a retrospective study from Limpopo province, South Africa.

期刊: Clinical and experimental medicine 发表日期: 2026-Jun-19 链接: PubMed

摘要

33. Estrus monitoring in giant pandas revisited: The importance of assay selection.

期刊: Animal reproduction science 发表日期: 2026-Jun-18 链接: PubMed

摘要

Accurate and early prediction of ovulation is critical in captive breeding of giant pandas (Ailuropoda melanoleuca) as both natural mating and the use of artificial insemination require major logistical preparations, and the narrow fertile window limits breeding opportunities. Estrus monitoring traditionally relies on parallel measurement of urinary estrogens and progestogens to identify the estrogen-progestogen cross-over point, which marks the onset of the follicular phase 1-2 weeks before ovulation. To increase this window as much as possible, this study aimed to investigate whether differences in estrogen assays and standard selection may affect hormone concentration measurements and the timing of cross-over detection. We evaluated the suitability of estrone-based enzyme immunoassays, targeting estrone (E1), estrone-3-glucuronide (E1G), and estrone-3-sulfate (E1S), combined with E1, E1G, and E1S standards for urinary estrus monitoring in four giant pandas (n = 5 cycles). All nine assay-standard combinations yielded highly correlated estrogen profiles (r > 0.98, p < 0.001), but significantly higher concentrations were observed with the E1S standard, regardless of assay type. Comparative testing of the most cost-effective high-sensitivity approach (E1 assay, E1S standard) against a commonly used method (E1G assay, E1G standard) in an extended dataset (n = 5 pandas, 9 cycles) revealed that the E1-E1S approach detected the cross-over point 1-3 days earlier (mean ± SD: 2.11 ± 0.93 days, p < 0.01). This earlier detection offers significant logistical advantages for breeding management without increasing analytical workload or costs and highlights the importance of optimizing assay-standard selection in reproductive monitoring.

34. Telehealth utilization among adults with cognitive difficulty: Evidence from the National Health Interview Survey, 2020-2023.

期刊: International journal of medical informatics 发表日期: 2026-Jun-18 链接: PubMed

摘要

Telehealth may expand care access by reducing transportation barriers, yet little is known the extent to which cognitive difficulties impact telehealth usage. We analyzed cross-sectional data from the National Health Interview Survey (NHIS) from 2020 to 2023. Multivariate logistic regression assessed the association between cognitive difficulty and telehealth utilization, controlling for age, sex, race/ethnicity, education, insurance, and year. Among 72,611 adults (mean age 54.6 years ± 18.5 years, 57.0 % female, 11.1 % African American), telehealth use was higher among individuals with significant cognitive difficulty (51.1 %) than those without (32.7 %) (OR = 2.41, 95 % CI: 2.16-2.69). Age modified this association (interaction p < 0.001), with a weaker effect among adults ≥ 50 (OR = 1.33, 95 % CI: 1.26-1.40) than among younger adults (OR = 1.71, 95 % CI: 1.63-1.80). Participants with greater cognitive difficulty were more likely to use telehealth, though the association was attenuated in adults > 50 years.

35. Connected but Distracted: Nomophobia in the Operating Room and Its Impact on Teamwork, Awareness, and Distraction.

期刊: Journal of perianesthesia nursing : official journal of the American Society of PeriAnesthesia Nurses 发表日期: 2026-Jun-18 链接: PubMed

摘要

To adapt the Distraction Due to Mobile Phone Use scale for use in Turkey, and to examine the effect of nomophobia (mobile phone access deprivation anxiety) levels on teamwork, awareness, and distraction among operating room staff. This study was both methodological and cross-sectional. Between December 2023 and November 2024, two studies were conducted with operating room staff: a methodological study with 85 staff, and a cross-sectional study with 167 staff. Sociodemographic and Occupational Characteristics Form, the Distraction Due to Mobile Phone Use Scale, Leiden Operating Theatre and Intensive Care Safety Scale-Teamwork and Awareness Subscale, and Nomophobia Questionnaire (NMP-Q) were used for data collection. Content validity index, confirmatory factor analysis, Cronbach’s alpha and item-total score correlation were employed. Multiple linear regression analysis was applied. For the Distraction Due to Mobile Phone Use scale, the content validity index was 0.938 and Cronbach’s alpha was 0.825. The item-total score correlation ranged from 0.218 to 0.745. The X2/df ratio was 2.526, the GFI 0.902, the CFI 0.932, the SRMR 0.080, and the RMSEA 0.078 for Distraction Due to Mobile Phone Use scale. The mean age of the operating room staff was 28.4±4.9 years, and 53.5% of these staff were nurses. Of these employees, 29.3% had mild nomophobia, 44.9% had moderate nomophobia, and 25.7% had severe nomophobia. Compared to staff with mild nomophobia, those with moderate nomophobia showed a 1.829-point increase in teamwork and awareness scores, while staff with severe nomophobia exhibited a 2.261-point increase. Having moderate nomophobia caused an increase of 1.941 in mobile phone-related distraction scores, whereas having severe nomophobia caused an increase of 4.410. The Distraction Due to Mobile Phone Use scale is a reliable and valid tool. Those with moderate or severe nomophobia experienced higher levels of “teamwork and awareness” and “distraction” than those with mild nomophobia.

36. Single molecule, dual actions: GSK-3β/AChE dual inhibition for Alzheimer's disease.

期刊: European journal of medicinal chemistry 发表日期: 2026-Jun-17 链接: PubMed

摘要

The pathogenesis of Alzheimer’s disease (AD) is closely related with glycogen synthase kinase 3β (GSK-3β) and acetylcholinesterase (AChE). Our previous work verified that GL10a displayed superior GSK-3β inhibitory and neuroprotective activities relative to Tideglusib. Accordingly, a molecular hybridization strategy was applied to design and synthesize a series of dual target inhibitors against GSK-3β and AChE by conjugating GL10a and carbamate fragment of Rivastigmine’s pharmacophore. After in vitro evaluations, the compound AJ-4 was screened as the most remarkable compound with potent inhibitory activities against GSK-3β (IC50: 4.7 nM) and AChE (IC50: 2.97 μM). Meanwhile, in vitro and in vivo data revealed that the optimal compound AJ-4 with excellent enzyme selectivity could decrease amyloid precursor protein (APP) and phosphorylated Tau expressions and increase phosphorylated GSK-3β levels. With favorable pharmacokinetic characteristics and tissue distribution, AJ-4 obviously ameliorated scopolamine-induced learning and memory impairments and alleviated hippocampal neuronal injury in AD mice. In conclusion, GSK-3β/AChE dual inhibitors represent a promising strategy for developing multi-target anti-AD drugs.

37. Factors Influencing Breastfeeding Knowledge and Attitudes Among Parents of Moderate-To-Late Preterm Infants: A Cross-Sectional Study.

期刊: Advances in neonatal care : official journal of the National Association of Neonatal Nurses 发表日期: 2026-Jun-17 链接: PubMed

摘要

Prematurity constitutes a major threat to perinatal health, with moderate-to-late preterm infants accounting for over 80% of all preterm births in China. This places significant challenges on breastfeeding for the affected families. As the optimal enteral nutrition for preterm infants, human milk reduces the incidence of necrotizing enterocolitis and fulfills their growth needs. The aim of this study was to explore factors associated with breastfeeding knowledge and attitudes among parents of moderate-to-late preterm infants in the context of mother-infant separation. A total of 344 parents of moderate-to-late preterm infants were recruited. The infants were hospitalized under a no-rooming-in policy in the neonatal intensive care unit (NICU) of a maternal and child health hospital from March to August 2025. To assess breastfeeding knowledge and attitudes, participants completed a general information questionnaire, a Breastfeeding Knowledge Scale, and the Iowa Infant Feeding Attitude Scale (IIFAS). Univariate and multiple linear regression analyses were used to identify influencing factors. Gestational age, parental educational levels, and prenatal lactation education were initially associated with correct breastfeeding knowledge and feeding attitude tendencies. Higher paternal education and prenatal lactation education predicted better breastfeeding knowledge, whereas greater gestational age, higher maternal education, and prenatal lactation education predicted more positive breastfeeding attitudes. Moderate-to-late preterm infants experiencing mother-infant separation face significant feeding challenges and exhibit lower breastfeeding rates, outcomes influenced by multiple factors. To enhance breastfeeding motivation, education should be personalized and evidence-based. This involves considering the family’s socioeconomic background, parental education levels, and distribution of caregiving roles.

38. At-Home Telehealth-Supported Subcutaneous Ketamine Therapy in Adults With Moderate to Severe Depression, Anxiety, or PTSD: A Real-World Observational Study of Safety, Feasibility, and Clinical Outcomes in a Large, Heterogeneous Cohort in the United States.

期刊: Journal of medical Internet research 发表日期: 2026-Jun-17 链接: PubMed

摘要

Background: Depression, anxiety,, and PTSD are leading global causes of disability. Standard interventions utilize slow mechanisms of action, high attrition, and significant accessibility barriers. While intravenous (IV) and intranasal ketamine are rapid-acting alternatives, high cost and intensive logistical requirements limit adoption. Sublingual (SL) at-home ketamine addresses some gaps but is constrained by low bioavailability and variable absorption. Subcutaneous (SC) administration offers high bioavailability and precise dosing, potentially bridging the gap between in-clinic effectiveness and at-home accessibility. Objective: This retrospective observational study evaluated the safety, feasibility, and clinical outcomes of a telehealth, at-home SC ketamine protocol using a convenience sample of de-identified health records collected via Mindbloom’s telehealth platform across 38 states. Methods: A sample of N=3,870 patients with moderate-to-severe symptoms of depression (PHQ-9 ≥ 10), anxiety (GAD-7 ≥ 10), or PTSD (PCL-5 ≥ 33) participated in a structured program involving clinical assessment, mandatory peer monitoring, and remote physiological screening. Injection kits and blood pressure monitors were mailed home. Dosing followed a subanesthetic protocol starting at 0.5 mg/kg with clinician-guided titration. Primary outcomes were measured at baseline and after weeks 2, 4, and 6 using the PHQ-9, GAD-7, and PCL-5 via online survey. Linear mixed-effects models with cubic splines analyzed symptom trajectories and accounted for time-varying assessments. Statistical significance was defined as alpha = .05; effect sizes were reported. Sensitivity analyses utilized multiple imputation and LOCF. Results: Patients (mean age 44.7 years; 52.4% female) demonstrated high adherence, with 0.5% switching from SC to SL administration. After 6 sessions (approximately 44 days), adjusted marginal means showed significant declines: PHQ-9 scores dropped from 14.64 (13.99-15.29) to 6.30 (5.90-6.70), GAD-7 from 13.06 (12.45-13.67) to 6.09 (5.72-6.47), and PCL-5 from 46.7 (43.30-50.10) to 27.5 (25.40-29.70) with large effect sizes ($d_z$) ranging from 1.35 to 1.58. Minimal Clinically Important Difference (MCID) was achieved by 81.8% of MDD, 80% of GAD, and 84.6% of PTSD patients ($p < .001$ for all). Adverse events were low (2.8%-3.2%), with no serious complications related to SC administration. Conclusions: This study is the first large-scale evaluation of at-home SC ketamine. Results suggest at-home SC ketamine is a safe, feasible intervention associated with high rates of symptom reduction in depression, anxiety, and PTSD. It differs from existing literature by utilizing a high-bioavailability (93%) SC route in a remote setting, whereas patients typically receive infusions of this potency in-clinic. Patients achieved clinical outcomes comparable to or exceeding traditional and intranasal therapies, potentially closing the access gap for treatment-resistant populations and supporting the expansion of supervised telehealth models in mental health care.

39. From urinalysis to photoacoustic imaging: A versatile probe for malondialdehyde in atherosclerosis.

期刊: Bioorganic chemistry 发表日期: 2026-Jun-17 链接: PubMed

摘要

Malondialdehyde (MDA) is a key biomarker of lipid peroxidation and oxidative stress, playing a significant role in the progression of inflammatory and cardiovascular diseases, including atherosclerosis. A hemicyanine-based optical probe, designated as MP, was developed for the detection of MDA through a spiropyran ring-opening mechanism. The probe exhibited negligible absorption and photoacoustic signals in its resting state, which were substantially enhanced upon reaction with MDA. A linear concentration-dependent photoacoustic response was observed, and the detection sensitivity was further improved under optimized extreme conditions. The probe enabled clear differentiation between atherosclerotic mice with and without acute lung injury through in vivo photoacoustic imaging of the aortic region, which was validated by ex vivo histological analyses including CD68 and MDA staining of aortic plaques. Minimal toxicity was observed in major organs. Furthermore, the probe successfully distinguished urine samples from atherosclerotic patients from those of healthy controls. These results demonstrate that MP is a promising tool for MDA detection with potential for clinical translation.

40. Exploring risk factors for long-term sickness absence during emerging adulthood: Continuous and discrete time models using Young-HUNT data on psychological distress and chronic pain.

期刊: International journal of medical informatics 发表日期: 2026-Jun-16 链接: PubMed

摘要

Long-term sickness absence (LTSA) in young adults has important consequences for labour market participation and future work disability. Chronic pain and psychological distress are key risk factors and frequently co-occur, yet their combined impact during adolescence on later LTSA remains insufficiently understood. This study aims to explore factors that influence adolescents’ and young people’s risk of receiving LTSA benefits during emerging adulthood. This longitudinal study used data from the Young-HUNT1 (1995-1997; n = 8736) and Young-HUNT3 (2006-2008; n = 7935) cohorts linked to Norwegian registry data and followed into early adulthood. The outcome was time to LTSA (≥90 or ≥180 days). Associations were examined using Cox proportional hazards models and Kaplan-Meier analyses. Continuous- and discrete-time models were developed and evaluated using the concordance index, time-dependent AUC, and integrated Brier score. Risk factors were analysed using SurvSHAP, SHAP, and regression-based methods. Chronic pain and co-occurring pain and psychological distress were consistently associated with increased LTSA risk (adjusted HRs between 1.3 and 1.5 for pain and between 1.6 and 1.7 for co-occurrence). In contrast, psychological distress alone showed no consistent association. Model performance was moderate and similar across approaches (C-index between 0.63 and 0.67). Key predictors included female sex, low parental education, chronic pain, poor perceived health, and indicators of early health problems. Adolescent chronic pain, particularly when co-occurring with psychological distress, is an important predictor of LTSA in early adulthood. While absolute LTSA levels may vary across cohorts, underlying risk patterns remain stable. More complex models did not outperform traditional approaches. These findings highlight the importance of early-life conditions and support early identification and intervention to reduce later work absence.

41. Combined exposure to hypoxia and 17α-ethinylestradiol alters reproductive traits in marine medaka.

期刊: Aquatic toxicology (Amsterdam, Netherlands) 发表日期: 2026-Jun-15 链接: PubMed

摘要

Aquatic environments increasingly experience the co-occurrence of endocrine-disrupting contaminants and declining oxygen levels, yet their combined influence on reproductive fitness remains insufficiently understood. Here, we examined the reproductive consequences of developmental exposure to hypoxia and the synthetic estrogen 17α-ethinylestradiol (EE2) in marine medaka (Oryzias melastigma). Embryos were exposed to environmentally relevant (71 ng/L) or elevated (668 ng/L) EE2 under normoxic or hypoxic (1.8 mg O₂/L) conditions until hatching and subsequently reared in seawater to adulthood. EE2 induced feminization of sex ratios, while hypoxia altered several physiological responses during estrogenic exposure. Co-exposure resulted in distinct endpoint-specific patterns, including increased hepatosomatic and gonadosomatic indices. Although fecundity increased under combined EE2 high dose and hypoxia exposure, hatching success declined across all the EE2 treatments, indicating a shift between reproductive output and offspring viability. Transcriptomic profiling revealed stronger gene expression perturbations under co-exposure than under either stressor alone, with enriched pathways related to steroid hormone biosynthesis, progesterone-mediated oocyte maturation, extracellular matrix organization, and PI3K-Akt signaling. These molecular responses provide biological context for the observed physiological changes. Collectively, these findings demonstrate that transient developmental hypoxia can modify estrogen driven reproductive outcomes later in life, linking early life oxygen limitation with altered endocrine susceptibility. This study highlights the importance of considering co-occurring chemical and environmental stressors when evaluating reproductive risks in increasingly deoxygenated coastal ecosystems.

42. A novel imidazole derivative-based turn-on probe for rapid and sensitive detection of phosphate and carbonate in environmental samples.

期刊: Spectrochimica acta. Part A, Molecular and biomolecular spectroscopy 发表日期: 2026-Jun-15 链接: PubMed

摘要

In this study, a novel fluorescent probe, Y, based on a thieno[2,3-b]pyrrole-dibenzimidazole scaffold, was synthesized and evaluated. Probe Y exhibited high sensitivity toward phosphate (PO43-) and carbonate (CO32-) in a DMSO: H2O (9:1, v/v) medium, showing a fluorescence “turn-on” response with the emergence of an emission peak at 467 nm. Probe Y displayed strong binding affinities for both PO43- and CO32-, with detection limits of 0.67 μM and 0.26 μM, respectively. The recognition mechanisms were investigated using 1H NMR and Density Functional Theory (DFT) calculations. Experiments conducted using authentic water and soil matrices confirmed probe Y’s high sensitivity in complex samples. Simultaneously, probe Y was effectively employed in test strips, thereby confirming its high sensitivity. This illustrates its capacity as one of the few fluorescent probes that can concurrently detect PO43-and CO32-.

43. Biodegradable plastic mulches: Distinct effects on microbial communities but no impact on soil multifunctionality during cabbage production.

期刊: Journal of hazardous materials 发表日期: 2026-Jun-15 链接: PubMed

摘要

Biodegradable plastic mulches (BDMs) are increasingly promoted as environmentally friendly alternatives to conventional mulches. However, the ecological impacts of different BDMs on soil remains incompletely understood. A field experiment was conducted to investigate the effects of five poly (butylene adipate-co-terephthalate)-poly (lactic acid) composite BDMs (BASF12, Hongrui12, Hongrui14, Britain15, and Jialemi15) on soil physicochemical properties and microbial communities throughout the cabbage growth season. The results showed that BDMs application did not result in significant negative effects on soil properties or crop yield during the experimental period. Although degradation rates and aging characteristics differed among mulch types, most soil properties and soil multifunctionality remained relatively stable. Compared with no mulching, cabbage yield increased by 2.59-7.57%. Microbial analyses revealed distinct responses between bacteria and fungi. Fungal β-diversity showed a significant negative relationship with microbial nutrient limitation under BASF12 and Britain15, whereas the opposite trend was observed under Hongrui12, Hongrui14, and Jialemi15. Redundancy analysis further showed that soil nutrient-related variables, particularly dissolved organic carbon, dissolved organic nitrogen, and microbial biomass nitrogen, were key drivers of microbial communities, with fungal community exhibiting stronger environmental relevance than bacterial community. These findings provide important insights into the ecological effects of BDMs.

44. Relating perivascular imaging measures to longitudinal lesion evolution and chronic inflammation in multiple sclerosis.

期刊: Multiple sclerosis and related disorders 发表日期: 2026-Jun-13 链接: PubMed

摘要

Perivascular space (PVS) alterations may be associated with acute and chronic inflammatory activity in people with multiple sclerosis (pwMS). Investigate whether diffusion tensor image analysis along the PVS (DTI-ALPS) or PVS number/volume are associated with lesion evolution in pwMS over 5-years. 182 patients (142 relapsing-remitting MS [pwRRMS] and 40 progressive MS [pwPMS]) underwent clinical and MRI examinations at baseline and 5-year follow-up. All pwMS were assessed for contrast enhancing lesions (CELs), T2 lesions, T1 lesions and cortical lesions (CLs). A subset of 86 pwMS were analyzed for presence of paramagnetic rim lesions (PRL). Associations between DTI-ALPS, PVS number/volume and lesion types were evaluated using regression and ANCOVA models, adjusting for age, sex, disease duration and normal-appearing white matter mean diffusivity, with false discovery rate correction for multiple comparisons, resulting in q values. In pwRRMS, baseline DTI-ALPS was associated with baseline CEL number (q < 0.001), T1 lesion number (q = 0.013), T2 lesion volume (q = 0.037) and T1 lesion volume (q < 0.002). It was associated with accumulation of new/enlarging CL (q = 0.013) and T1 lesions (q = 0.007), absolute change in T1 lesion volume (q = 0.025) and trended with newly appearing PRLs (q = 0.066). Absolute 5-year change in PVS volume was related to PRL presence at baseline (q = 0.018). PVS alterations are associated with lesion evolution in pwRRMS.

45. In silico identification and prioritization of potential drug targets in Wuchereria bancrofti: Profilin as a promising therapeutic candidate.

期刊: Computational biology and chemistry 发表日期: 2026-Jun-12 链接: PubMed

摘要

Wuchereria bancrofti, a major causative agent of lymphatic filariasis, poses a significant public health burden in tropical and subtropical countries. Despite the availability of antifilarial drugs used in mass drug administration programs, issues such as non-compliance, low coverage, emerging resistance, and incomplete parasite clearance underscore the need for novel therapeutic targets. In this study, we analyzed potential drug targets identified from our previous subtractive proteomic analysis of W. bancrofti. Computational analysis of these targets highlighted Profilin as a potential candidate based on its essential biological role and druggability. We carried out detailed in-silico analyses of Profilin, including homology modeling, molecular docking, SwissADME based pharmacokinetic profiling, and molecular dynamics to assess binding affinity of the protein along with the protein-ligand complex. One of the lead compounds demonstrated strong and stable interactions with Profilin, alongside favorable pharmacokinetic properties. These findings support Profilin as a viable therapeutic target in W. bancrofti and highlight the identified compound as promising candidate for further validation.

46. Qi Wei Zhi Gan formulation alleviates progressive fibrosis in metabolic dysfunction-associated steatohepatitis through suppressing Peroxidasin-collagen IV crosslinking.

期刊: Phytomedicine : international journal of phytotherapy and phytopharmacology 发表日期: 2026-Jun-11 链接: PubMed

摘要

Metabolic dysfunction-associated steatohepatitis (MASH) is a progressive liver disorder involving steatosis, inflammation, and frequent fibrosis. Qi Wei Zhi Gan (QWZG) formulation, a traditional Chinese herbal formulation, has demonstrated therapeutic effects against MASH though its mechanisms remain not fully elucidated. This study investigates the anti-fibrotic effects of QWZG formulation and explores its mechanism related to extracellular matrix (ECM) remodeling. MASH was induced in mice by choline-deficient, l-amino acid-defined (CDAA) diet. QWZG efficacy was assessed via lipid profiles, liver function biomarkers, and histology. Proteomics identified candidate targets, validated by RT-qPCR, western blot, and immunofluorescence in primary hepatocytes. To explore potential mechanistic involvement, an in vivo experiment was performed using adenovirus-mediated Pxdn overexpression (Pxdn_OE) in CDAA-fed mice, with or without QWZG treatment. Human bulk, single-nucleus RNA sequencing (snRNA-seq) and spatial transcriptomics analyses support the key target and mechanism in MASH fibrosis. QWZG treatment markedly reduced obesity, hepatomegaly, and lipid accumulation, and inflammation in MASH model. Proteomics revealed strong modulation of ECM and fibrosis pathway, with downregulation of Col1a1 and αSMA. Specifically, Pxdn emerged as the most upregulated protein in MASH mice and was suppressed following QWZG, an effect notably predominant in hepatocytes. Immunofluorescence further revealed colocalization of Pxdn and Col4a1 in primary hepatocytes. QWZG potently inhibited Pxdn-driven Col4a1 crosslinking, this suppression subsequently reduced the expression of fibrotic markers such as αSMA and Col1a1, indicating suppressed hepatic stellate cell activation. Adenovirus-mediated Pxdn_OE in CDAA-fed mice enhanced Pxdn-Col4a1 colocalization, indicating increased crosslinking activity, which was reversed by QWZG. SnRNA-seq and spatial transcriptomics further demonstrated a strong association between Pxdn expression and Col4a1, especially for fibrosis severity, supporting clinical relevance. QWZG ameliorates liver fibrosis, which may be partly mediated by inhibition of Pxdn-mediated collagen IV crosslinking, reducing ECM deposition and improving basement membrane microenvironment. These results highlight the potential of QWZG as a novel therapeutic strategy for MASH.

47. Development and external validation of an interpretable machine learning model for early prediction of stroke-associated pneumonia: a multicenter study.

期刊: International journal of medical informatics 发表日期: 2026-Jun-10 链接: PubMed

摘要

To develop and externally validate an interpretable machine learning model for predicting 7-day stroke-associated pneumonia (SAP) using routine clinical data collected within 24 h of admission. This multicenter study utilized a development cohort from the Henan Stroke Cohort and an independent external validation cohort from three Zhengzhou hospitals. Adult patients with imaging-confirmed ischemic or hemorrhagic stroke were eligible. Patients with infection at admission or who developed SAP within 24 h of admission were excluded. We evaluated 26 candidate predictors obtained within 24 h of admission. Nine machine learning algorithms were trained following recursive feature elimination. Model performance was evaluated based on discrimination, calibration, and clinical utility. The optimal model was interpreted using SHapley Additive exPlanations (SHAP) and deployed as an online calculator. The development and external validation cohorts comprised 1201 and 645 patients, with 7-day SAP incidences of 20.6 % (n = 247) and 24.8 % (n = 160), respectively. Among the nine algorithms, stochastic gradient boosting (SGBT) demonstrated the most balanced overall performance. In internal validation, SGBT achieved an area under the receiver operating characteristic curve (AUC) of 0.947 in the training set and 0.905 in the test set. In external validation, the model yielded an AUC of 0.906, alongside an accuracy of 0.864, sensitivity of 0.712, specificity of 0.918, positive predictive value (PPV) of 0.756, negative predictive value (NPV) of 0.899, and F1-score of 0.733. The final model retained 10 predictors: stroke subtype, fibrinogen, D-dimer, C-reactive protein, uric acid, triglycerides, homocysteine, and clinical scores (ADL, GCS, NIHSS). SHAP analysis identified early neurological impairment and inflammatory burden as the primary contributors to SAP prediction. An interpretable SGBT model utilizing routine admission data accurately predicted 7-day SAP and remained robust during external validation. The accompanying online calculator facilitates individualized risk estimation to support early preventive decision-making in hospitalized patients with stroke.

48. Health and care workforce planning must move from technical procedures towards governing a complex ecosystem in uncertain times.

期刊: European journal of public health 发表日期: 2026-Jun-10 链接: PubMed

摘要

49. Multidimensional poverty in Scotland and health across adulthood-the paradoxical associations with food, fuel, and financial insecurity in later life.

期刊: European journal of public health 发表日期: 2026-Jun-10 链接: PubMed

摘要

Little is known about the impact that older age and the cost-of-living crisis have on health and wellbeing in Scotland, a country with the lowest life expectancy in Western Europe. Using Scotland as a case study, we aim to capture multidimensional poverty across adulthood and study the associations with health. Relying on the Joseph Rowntree Foundation’s 2023 Poverty in Scotland Survey, we measured the odds of self-reported food, fuel, and financial insecurities across adulthood. We then assessed the association between these insecurities and self-reported physical, mental, and social domains of health. Overall, older adults (aged 65+) report less food, fuel, and financial insecurity. However, lower-income adults aged 35-74 reported significantly higher odds of fuel insecurity compared to younger, upper-income adults. All dimensions of insecurity are significantly associated with higher odds of poor health outcomes, especially among younger adults. Older adults paradoxically report largely fewer negative health impacts despite existing evidence of the group’s health vulnerability to these insecurities. This study shows the importance of analysing poverty multi-dimensionally. It evidences that while pensions are associated with lower reported levels of food and financial insecurity, these associations do not maintain for fuel insecurity, especially among lower-income groups. The results support the reintroduction of non-means-tested winter heating benefits for older adults in Scotland. All three insecurities impact self-reported health, yet reports from older adults do not mirror health across the life course. This may be influenced by survey administration, question framing, understandings of health, problematization of insecurities and stigma.

50. Spirulina platensis and β-glucan mitigate cyclophosphamide-induced Immunosuppression in broilers: Differential effects of preventive and therapeutic strategies via redox-inflammatory modulation.

期刊: Poultry science 发表日期: 2026-Jun-10 链接: PubMed

摘要

Immunosuppression remains a major constraint in intensive poultry production, compromising growth performance and increasing susceptibility to disease. This study investigated the comparative preventive and therapeutic efficacy of dietary Spirulina platensis and β-glucan in broiler chickens subjected to cyclophosphamide-induced immunosuppression. A total of 240 one-day-old Sasso broiler chicks were casually allotted into six experimental groups (n = 40/group; 4 replicates of 10 birds). Treatments included a control, a cyclophosphamide-treated group, and groups supplemented with Spirulina or β-glucan in either preventive or therapeutic regimens. Growth performance, lymphoid organ indices, hematological parameters, phagocytic activity, oxidative stress biomarkers, inflammatory gene expression, and histopathological alterations were evaluated on days 21 and 28. Cyclophosphamide administration significantly impaired growth performance, reduced lymphoid organ indices, suppressed leukocyte counts and phagocytic activity, and induced oxidative stress, as evidenced by augmented malondialdehyde levels and reduced glutathione content and catalase activity. These changes were accompanied by upregulation of nuclear factor kappa B (NF-κB) and downregulation of interleukin-10 (IL-10) expression in lymphoid tissues. Dietary supplementation with Spirulina or β-glucan significantly ameliorated these adverse effects, restoring growth performance, enhancing immune function, improving antioxidant status, and modulating inflammatory responses. Histopathological examination confirmed marked recovery of lymphoid tissue architecture, with more pronounced improvements observed under preventive supplementation.In conclusion, Spirulina platensis and β-glucan effectively mitigate cyclophosphamide-induced immunosuppression in broiler chickens, with preventive administration providing superior protection. These findings support their application as functional feed additives to enhance immune competence and productivity in poultry production systems.

51. Broiler stunning in electrical water bath: Validation of an animal welfare-based method for assessing stunning effectiveness.

期刊: Poultry science 发表日期: 2026-Jun-09 链接: PubMed

摘要

Electrical water bath stunning remains the predominant method for poultry slaughter in Europe, yet its welfare implications are still debated. This study assessed the current status of stunning effectiveness in broiler chickens under commercial conditions, providing a foundation for future comparisons with controlled atmosphere stunning. Behavioral observations were made in 1 slaughterhouse over 2 study years (2021 and 2022) and were analyzed separately for each year across broilers from 4 fattening methods (LIT: light conventional fattening method, HEV: heavy conventional fattening method, LBL: label fattening method, ORG: organic fattening method). The analysis aimed to explore whether stunning performance differs according to fattening method, animal age, transport duration, carcass weight, weather conditions, and total electrical current in the electrical water bath. Stunning effectiveness was evaluated in 3 phases: pre-stunning (shackling), during stunning, and post-stunning. In each phase, key behavioral indicators, such as signs of inadequate stunning (e.g., wing flapping, body movements, rhythmic breathing), were systematically recorded. The results showed that pre-stunning behavior varied among fattening methods in 2022 (defensive reactions: ORG [0.82%] vs. LBL [0.05%]; wing flapping: LIT [29.00%] vs. OGR [17.00%], HEV [21.00%], and LBL [12.60%]), with older and lighter animals showing more pronounced defensive or flapping responses. After stunning in 2021, only ORG broilers showed cases of inadequate stunning (0.01%), whereas no incidences were observed in LIT (0.00%) and HEV broilers (0.00%). These findings highlight that even minor differences in handling and animal characteristics can significantly affect stunning effectiveness and animal welfare.

52. Predicting Anthracycline-Induced Cardiotoxicity Using the HFA-ICOS Risk Score: A Validation Study From AIC Registry.

期刊: JACC. Asia 发表日期: 2026-Jun-05 链接: PubMed

摘要

53. Feasibility of rearing broilers in open-sided houses for extended periods: impacts of feed withdrawal approaches on growth, carcass traits, and meat quality metrics.

期刊: Poultry science 发表日期: 2026-Jun-01 链接: PubMed

摘要

The present study evaluated the feasibility of rearing fast-growing broiler chickens in an open-sided house for 42 days in Bangladesh using different feed withdrawal strategies, with particular emphasis on growth performance, meat quality, survivability, and economic returns. A total of 480 Indian River meat-type day-old chicks (DOCs) were reared up to 42 days and randomly allocated into four treatment groups. The first group was a control that provided ad libitum feeding throughout the production cycle (AdLF). The remaining groups received ad libitum feeding for the first 7 days, followed by daily feed withdrawal for 8 h. Accordingly, the second group was subjected to feed withdrawal from 8 to 28 days (3-WksFW), the third group from 8 to 35 days (4-WksFW), and the fourth group from 8 to 42 days (5-WksFW). Each treatment consisted of six replicates with 20 birds per replicate. Key performance indicators, including body weight (BW), body weight gain (BWG), feed intake (FI), feed conversion ratio (FCR), survivability, carcass yield, meat quality, and benefit-cost ratio (BCR), were evaluated. As expected, the overall BWG was significantly higher in the AdLF group (3170.52 g/bird; P = 0.000), followed by the 3-WksFW (3040.43 g/bird) and 4-WksFW (2878.86 g/bird) groups, with the lowest value observed in the 5-WksFW group (2510.85 g/bird). Similar trends were observed for final BW and FI. Despite the higher BW, BWG, and FI in the AdLF group, feed withdrawal strategies improved survivability, meat quality, and, notably, economic efficiency. The highest BCR was recorded in the 4-WksFW group (1.14), followed by the 3-WksFW (1.07), 5-WksFW (1.07), and AdLF (1.05) groups. FCR was not significantly affected by treatment; however, abdominal fat deposition was reduced in birds subjected to feed withdrawal. Overall, feed withdrawal improved water holding capacity with a significant decreased of cooking loss, although the meat color was unaffected. In conclusion, the 4-WksFW strategy is recommended for rearing broilers up to 42 days in open-sided housing under local conditions, as it optimizes meat quality, survivability, and profitability in small-scale production systems.

54. From Glacier to In Silico: Integrated LC-MS Metabolomics and Multi-Level Computational Prioritization of Antimicrobial Metabolites From Alcaligenes pakistanensis LTP10.

期刊: Chemistry & biodiversity 发表日期: 2026-Jun 链接: PubMed

摘要

Antibiotic resistance is a global threat requiring new potential antimicrobial sources. Secondary metabolites from cold-adapted microorganisms may provide unique antimicrobial compounds. Ethyl-acetate extract of Alcaligenes pakistanensis LTP10 from Passu glacier was explored for antimicrobial potential against clinical isolates. Cytotoxicity was determined by Brine shrimp lethality assay. The extract is analyzed by LC-MS/MS and the data is processed by MZmine. Important compounds were evaluated by molecular docking and in silico study. The extract demonstrated activity against clinical isolates Staphylococcus aureus, Escherichia coli, Salmonella enterica, Pseudomonas aeruginosa, and Candida albicans with zone of inhibition ranging from 16 mm to 24 mm, with no killing of nauplii suggested non-cytotoxic nature. LC-MS/MS analysis established presence of important putative antimicrobial metabolites (E)-3-(acetyloxymethyl)-5-(2-formyl-4-hydroxy-5,5,8a-trimethyl-1,4,4a,6,7,8-hexahydronaphthalen-1-yl)pent-2-enoic acid, cyclizidine-F, neovasipyridone-G, paenibacillin-A, and tricholomenyn-A. Molecular docking study of these metabolites by AutoDock Vina against dihydrofolate reductase of S. aureus demonstrated binding affinities from -6.8 kcal/mol to -8.5 kcal/mol, while against enoyl-ACP reductase of E. coli showed binding affinity values from -6.3 kcal/mol to -7.9 kcal/mol. In silico analysis predicted considerable absorption, distribution, metabolism, excretion, safety, and druglikeness properties. These results suggest that metabolites from A. pakistanensis LTP10 possess antimicrobial potential and warrant advanced post-docking validation via molecular dynamics, free-energy, and mechanistic analyses for future antibiotic development.

55. Intra- and inter-rater reproducibility of the echocardiographic data of the Nigerian UPRIGHT-HTM trial participants.

期刊: Cardiovascular journal of Africa 发表日期: 2026-Mar-13 链接: PubMed

摘要

Echocardiography is the guideline- recommended tool for risk stratification in asymptomatic high-risk patients, but its reproducibility in sub-Saharan Africa remains largely undocumented. This study assessed the intra- and inter-rater repeatability of the risk-carrying echocardiographic traits among 42 patients enrolled in the UPRIGHT-HTM trial at three Nigerian sites. The echocardiographic images (168 for intra- and 84 for inter-rater agreement) were acquired according to current recommendations and blindly analysed by randomising the order of the digitised images. The study focused on left ventricular mass (LVM) index to body surface area of height 2.7 and ejection fraction (EF) and left ventricular diastolic dysfunction (LVDD). Repeatability was assessed by the Bland and Altman approach, the coefficient of variation (CV), the intra-class correlation coefficient (ICC) and Cohen’s κ statistic. The current findings were compared with a systematic literature review of 27 publications. LVM showed a slight but significant intra-rater bias, but no inter-rater bias. CVs for LVM were approximately 30%, ICCs ranged from 0.74 to 0.84, and κ statistics for LV hypertrophy (LVH) varied from 0.49 to 0.64. For EF, intra- and inter-rater CVs ranged from 13.0% to 14.5%, ICCs from 0.60 to 0.69, and statistics were 0.71 and 0.53, respectively. LVDD reproducibility was moderate, with κ values around 0.50. These findings were consistent with most of the reviewed literature. The risk-carrying echocardiographic traits were obtained with moderate repeatability in three Nigerian tertiary referral centres. As data quality augments with expertise, these findings call for a Nigerian training programme in echocardiography with certification.