公共卫生研究摘要 (2026-06-23)

共收录 59 篇研究文章

1. Female orgasm frequency, correlates and measurement in the preconception period.

期刊: Sexual health 发表日期: 2026-Aug-17 链接: PubMed

摘要

Orgasm can be an important component of sexual wellbeing broadly and specifically in the preconception period, yet epidemiologic research on orgasm is limited. We used cross-sectional data from Pregnancy Study Online (PRESTO), a cohort study of females attempting conception with one male partner (N = 6022; 2020-2025), to descriptively evaluate orgasm frequency, its correlates and its relationship to orgasm intensity. We used self-reported data to assess orgasm frequency (Likert scale: never/rarely to always/almost always) and intensity (0-10). Across correlates (e.g. encompassing sociodemographic, medical, behavioral factors), we calculated the absolute difference and 95% confidence interval (CI) in the percentage of participants reporting the highest versus lowest orgasm frequency within levels of each correlate, standardized relative to the difference in the full sample. Over half of the sample reported orgasming ‘always’, ‘almost always’ or ‘most times’ during sexual activity. Partner support was a strong correlate; participants whose partner ‘rarely’ provided love/affection and emotional support reported less frequent orgasms (standardized percentage-point differences of -11.0, 95% CI -36.7, 14.7 and -27.5, 95% CI -44.4, -10.6, respectively). Irritable bladder syndrome (standardized percentage point difference -15.4, 95% CI -25.5, -5.3), diabetes (standardized percentage point difference -5.8, 95% CI -18.2, 6.7) and depressive symptoms (highest category standardized percentage point difference -11.6, 95% CI -19.3, -4.0) were strong correlates of less frequent orgasms. Participants with lower function on other domains of sexual function reported fewer orgasms. Important correlates of preconception orgasm frequency spanned relational, clinical and sexual function factors. We discuss implications for conducting etiologic orgasm research.

2. Risk perceptions of chlamydia and gonorrhoea among Dutch youth prior to a new sexually transmitted infection testing policy: a cross-sectional survey study.

期刊: Sexual health 发表日期: 2026-Aug-17 链接: PubMed

摘要

Perceptions of chlamydia and gonorrhoea may influence sexually transmitted infection (STI) testing and prevention. Understanding these perceptions is essential, as many countries are considering more restrictive chlamydia testing. This study compared perceived susceptibility and severity of chlamydia and gonorrhoea among young heterosexuals in the Netherlands and explored underlying determinants and reasons. An online cross-sectional survey (April-June 2024) among young people (16-34 year-old) was distributed via social media and sexual health clinics. Multivariable logistic regression identified determinants of perceived susceptibility and severity. Thematic analysis explored underlying reasons. Among participants (n = 1605), perceived susceptibility was low for chlamydia (75%) and gonorrhoea (81%), but both were considered severe (chlamydia 76%; gonorrhoea 82%). Determinants of perceived susceptibility differed by partner type. For those with steady partners, low impulsivity was associated with low perceived susceptibility, while multiple partners and low health goals were associated with high susceptibility. Among those with casual partners, multiple partners, no condom use at last sex, and low health goals were associated with high susceptibility. Perceived severity was lower among those with university education, low health goals, and multiple partners. Reasons for susceptibility related to sexual behaviour; severity to relationship concerns and STI aversion. Most young heterosexuals perceive chlamydia and gonorrhoea as severe, but many underestimate their personal risk, even when engaging in behaviours associated with increased risk of acquiring an STI. Misconceptions and limited awareness contribute to gaps between risk perception and preventive action. Targeted interventions and clear, infection-specific communication are needed as STI testing policies evolve.

3. Response to Comment on Sakaki et al. Quantitative β-Cell Mass Imaging Redefines Disease Staging and Glycemic Control in Type 1 Diabetes.

期刊: Diabetes 发表日期: 2026-Jul-01 链接: PubMed

摘要

4. Correlates of human Cytomegalovirus Cervical Shedding in Seropositive Women: Implications for Vaccine Development.

期刊: The Journal of infectious diseases 发表日期: 2026-Jun-23 链接: PubMed

摘要

Congenital human cytomegalovirus (HCMV) infection, caused by maternal transmission, is a leading cause of congenital disabilities and poses a substantial global disease burden. Historically, HCMV vaccine development has centered on protecting seronegative women. However, accumulating evidence indicates that the majority of HCMV infections in newborns stem from non-primary infections (reinfection or reactivation). Although HCMV shedding may have diagnostic value, the relationship between viral shedding and host immune status in seropositive individuals remains poorly elucidated. A total of 142 HCMV-seropositive women of reproductive age were enrolled from the Reproductive Medicine Clinic of Taizhou People’s Hospital, Jiangsu Province, China. Serum samples and cervical secretions were collected, and antibody levels and HCMV DNA loads were detected, respectively. Serum IgG binding to postfusion glycoprotein B (gB), cell-surface-expressed gB, and pentameric complex (PC) was significantly associated with HCMV shedding in cervical secretions. In contrast, no significant associations were observed between cervical shedding and Serum IgG binding to prefusion gB or the structural antigen pp150, nor with neutralizing antibody (NAb) titers against Towne and ADR131 strains in MRC-5 cells or ADR131 strain in ARPE-19 cells. These findings advance the current understanding of the interplay between viral shedding and humoral immunity in HCMV-seropositive individuals. Importantly, they provide novel evidence supporting site-specific HCMV shedding as a potential biomarker for reinfection/reactivation, and a potential exploratory surrogate marker for subsequent vaccine endpoint validation. This study thus offers new insights for the development of HCMV vaccines targeting seropositive populations.

5. Comparative 10-year performance of mammography artificial intelligence, polygenic, and clinical breast cancer risk models in the Kaiser Permanente Research Bank.

期刊: Journal of the National Cancer Institute 发表日期: 2026-Jun-23 链接: PubMed

摘要

We compared performance across 3 breast cancer risk domains-clinical, polygenic, and mammography artificial intelligence-alone and in combination over a 10-year time horizon among women with a negative screening mammogram within a Kaiser Permanente Research Bank (KPRB) prospective cohort. The study included 82 957 women (61 962 non-Hispanic White, 7256 Asian, 3414 Black, and 5466 Latina) who enrolled in KPRB between 2003 to 2020. Women with a prior history of breast cancer or high/moderate-penetrant gene mutation were excluded. The negative screening mammogram (no clinically visible cancer) closest to enrollment was used to generate the Mirai mammography AI risk score. KPRB survey and electronic health record data were used to generate the Breast Cancer Surveillance Consortium version 3 (BCSCv3) clinical risk score. Genome-wide genotypes were used to compute the 313-SNP polygenic risk score, adjusted for genetic ancestry (PRS313adj). Risks of breast cancer (invasive or ductal carcinoma in situ) at 0 to 10 years after the mammogram were estimated using Cox models, with 5-fold cross-validation used to estimate the C-index. During 10 years of follow-up, 2471 women developed breast cancer. The C-index (95% CI) for the combined model with all 3 risk scores (0.70; 95% CI = 0.69 to 0.71) was significantly higher than for univariate models with only the BCSCv3 (0.62; 95% CI = 0.61 to 0.63), PRS313adj (0.61; 95% CI = 0.60 to 0.62), or Mirai (0.66; 95% CI = 0.65 to 0.67) risk score. Integrating mammographic AI and polygenic risk scores with clinical risk models significantly improved breast cancer risk discrimination, supporting use of combined models for personalized screening and prevention.

6. Heart failure, inequality, and the decades before admission.

期刊: European heart journal. Quality of care & clinical outcomes 发表日期: 2026-Jun-23 链接: PubMed

摘要

7. Disseminated Tuberculosis With Cavitary Lung Disease in a Very Preterm Infant.

期刊: Pediatrics 发表日期: 2026-Jun-23 链接: PubMed

摘要

Tuberculosis (TB) is an important cause of poor health outcomes and mortality for pregnant women and their infants globally. Screening during pregnancy helps diagnose TB at a critical period to avert morbidity and mortality but may be overlooked. TB incidence in the United States is low but has been increasing since 2020, alongside a global resurgence. The Centers for Disease Control and Prevention (CDC) recommends TB screening for all individuals with epidemiologic risk factors, including birth, residence, or prolonged travel in medium- or high-prevalence settings; immunosuppression; and close contact with individuals with TB disease. Careful attention is needed to discern possible TB disease in individuals with compatible symptoms, which are often nonspecific and can be initially subtle in pregnant women and in infants. We describe a mother-infant dyad who both developed severe disseminated TB, with likely congenital transmission to the infant. The infant was born very preterm and developed severe TB characterized by cavitary lung disease and central nervous system involvement. Delayed recognition of TB risk and symptoms in both the mother and the infant contributed to delayed diagnosis and treatment initiation. We discuss opportunities for timely perinatal TB diagnosis and care through antenatal screening, careful assessment of TB symptoms and signs, and prompt anti-tuberculous treatment initiation as soon as the diagnosis is suspected. The severe outcomes in this case highlight the importance of perinatal TB awareness in the United States.

8. Longitudinal effects of daily practices on presenteeism and mental health of teleworkers in Japan.

期刊: Journal of occupational and environmental medicine 发表日期: 2026-Jun-23 链接: PubMed

摘要

To investigate longitudinal associations between daily teleworking practices, mental health, and work performance among Japanese teleworkers. We conducted a two‑year longitudinal study of 710 teleworkers employed by five companies in metropolitan Tokyo. Baseline teleworking practices included maintaining a comfortable workspace, setting daily goals, regulating work hours, maintaining sleep routines, and chatting with colleagues. Depressive symptoms and work performance were assessed at baseline and follow‑up. Having a comfortable workspace (β = -1.28; 95% confidence interval [CI], -2.32 to -0.24) was associated with fewer depressive symptoms. Maintaining sleep routines (β = 3.98; 95% CI, 0.27-7.70) and setting daily goals (β = 4.10; 95% CI, 0.77-7.43) were associated with better work performance. Occupational health interventions for teleworkers should focus on workspace quality and goal setting behaviors.

9. Flexible work arrangements and workplace productivity: a qualitative study from the perspective of employees with disabilities.

期刊: Disability and rehabilitation 发表日期: 2026-Jun-22 链接: PubMed

摘要

This study explores how flexible work arrangements affect work productivity from the perspective of employees with disabilities and chronic health conditions. The research questions are: (1) How do employees with disabilities perceive their flexible work arrangements? (2) What impacts do they think these arrangements have on their work productivity? (3) From the perspective of employees with disabilities, what are the benefits and drawbacks of flexible work arrangements? Semi-structured interviews were conducted with 46 employees with disabilities who have flexible work arrangements in large, private and public organizations, including higher education, healthcare, government, social services, and rehabilitation. Our methodology was guided by a hybrid Thematic Analysis (TA) approach using MAXDQA software and refined to focus on work productivity. Participants reported improvement in overall job performance, regardless of disability type. Reported benefits were job retention, disability self-management, and choice and control. Barriers included discriminatory attitudes, challenging accommodation processes, and inaccessible environments. Most employees with disabilities found flexible arrangements beneficial for work productivity; however, some encountered barriers related to policy and access. Future research on long-term job retention and a comparison of employees’ and employers’ perceptions would expand knowledge of flexible work arrangements for employees with disabilities. Recent attitudinal changes post-pandemic around flexible work arrangements have resulted in both benefits and barriers for employees with disabilities.Most employees with disabilities found that flexible work arrangements enhance their work potential; however, flexible work arrangements have also been reported to create drawbacks for specific types of disabilities.Many employees with disabilities found that a lack of knowledge or limited understanding of disability and employment laws (e.g., Americans with Disabilities Act, Equality Act 2010; Family and Medical Leave Act) can contribute to misinterpretations or discriminatory attitudes from co-workers and supervisors, often leading to barriers in accessing and retaining flexible work arrangements.Though many organizations now provide some type of structural flexible work arrangement, employees with disabilities often found it necessary to have additional formal or informal arrangements.

10. Real-world use of Dalbavancin for vascular graft and Endograft infections.

期刊: Infectious diseases now 发表日期: 2026-Jun-22 链接: PubMed

摘要

To describe the clinical effectiveness and safety of dalbavancin (DAL) for the treatment of Vascular Graft and Endograft Infections (VGEI). A retrospective, single-center observational study was conducted at a tertiary-care university hospital in Rome from January 2020 to December 2024, including all consecutive patients diagnosed with VGEI who received at least one dose of DAL. Cases were identified through the hospital electronic medical record database. VGEIs were diagnosed using MAGIC criteria. Primary outcomes were clinical and radiological response at the end of treatment (EOT) and at six-month follow-up. Thirteen patients were included (median age: 76 years; 92% of males; median Charlson Comorbidity Index 5). Aortic vessels were involved in 61.5% of cases, peripheral vessel in 38.5%. Microbiological identification was achieved in 84.6% of cases, with Staphylococcus aureus (MSSA and MRSA) being the most frequent pathogen. Surgical explant was performed in 53.8% of patients, predominantly for peripheral VGEIs. DAL was used to facilitate early discharge (69.2%) or as suppressive antibiotic therapy (30.8%). No adverse events related to DAL were reported. Clinical success was achieved in 84.6% of patients at EOT and maintained in 61.5% at six-month follow-up. DAL appears to be an effective and well-tolerated option for the management of VGEI, particularly in frail patients or those not eligible for surgery, both to facilitate early discharge and as long-term SAT. Further prospective studies are needed to confirm these findings.

11. Editorial Comment on "Perioperative Predictors of Length of Stay and Readmission After Simple Cystectomy And Urinary Diversion in Non-Ambulatory Adults With Neurogenic Bladder".

期刊: Urology 发表日期: 2026-Jun-22 链接: PubMed

摘要

12. Neutrophil-to-Lymphocyte Ratio in Patients with Low-Flow Aortic Stenosis Undergoing Transcatheter Aortic Valve Implantation.

期刊: Journal of cardiology 发表日期: 2026-Jun-22 链接: PubMed

摘要

The neutrophil-to-lymphocyte ratio (NLR) is a marker of systemic inflammation and is associated with adverse cardiovascular outcomes. Low-flow (LF) aortic stenosis (AS) is a high-risk phenotype marked by advanced remodeling, frailty, and poor prognosis. We investigated whether NLR can improve risk stratification in patients with severe LF-AS evaluated for transcatheter aortic valve implantation (TAVI). A total of 925 consecutive patients with severe LF-AS referred for TAVI were evaluated. Primary endpoint was all-cause mortality. Mean age was 79.8±9.3 years; 291 (39.0%) patients were female; 745 (80.5%) underwent TAVI. During a mean follow-up of 25.6 months, death occurred in 187 (20.2%). In spline modeling, excess mortality appeared at NLR ≥4.5 and rose thereafter. In multivariable analysis, the highest baseline quartile vs. all other quartiles of NLR was associated with increased risk of death at 5 years [39% vs. 24%; adjusted hazard ratio (HR) 1.80; 95% confidence interval (CI), 1.22-2.65; p=0.003], even after adjustments for pertinent covariates. Patients in the upper NLR quartile who underwent TAVI experienced over a 3-fold increased risk of death (HR 3.18, 95% CI: 1.93-5.24, p<0.001). The survival benefit associated with TAVI was attenuated by 57% (interaction term p=0.002, p for improved survival = 0.42). Higher NLR was associated with more frequent paravalvular leak (13.2% vs. 7.5%, p=0.05). In patients with severe LF-AS, baseline high NLR was independently associated with almost doubling of the 5-year mortality risk. Patients in the upper NLR quartile who underwent TAVI showed lower survival benefit and more frequent paravalvular leak, suggesting that systemic inflammation may influence procedural outcomes and long-term prognosis.

13. Formulation-resolved VOC emission factors measured in a dynamic chamber and corresponding secondary formation potentials for selected architectural paints.

期刊: Environmental pollution (Barking, Essex : 1987) 发表日期: 2026-Jun-22 链接: PubMed

摘要

Architectural paints represent an important source of volatile organic compounds (VOCs) in urban environments. The ongoing shift from solvent-based to water-based formulations can substantially alter VOC composition, emission factors, and associated secondary formation potentials; however, these effects remain poorly quantified and may introduce biases in current emission inventories. In this study, dynamic-chamber evaporation experiments were performed on selected architectural paint products spanning water-based and solvent-based formulations to obtain their VOC composition profiles and emission factors and to estimate their ozone formation potential (OFP) and secondary organic aerosol formation potential (SOAP). The selected water-based paints were dominated by oxygenated VOCs (OVOCs) and alkenes, with an average total emission factor of 56 g VOC kg-1 paint. In contrast, the solvent-based products contained abundant alkanes, OVOCs, and aromatics, resulting in a higher total emission factor of 228 g VOC kg-1 paint. For the water-based products, the emission-factor-derived OFP was 90 g O3 kg-1 paint, mainly contributed by acetaldehyde and limonene, while the SOAP was 0.8 g SOA kg-1 paint and was also dominated by limonene. In solvent-based products, the emission-factor-derived OFP and SOAP were 482 g O3 kg-1 paint and 5.3 g SOA kg-1 paint, respectively, with aromatics (e.g., toluene and ethylbenzene) and alkanes (e.g., n-octane) being the major contributors to both. Comparison between the mass-fraction- and emission-factor-based calculations showed distinct OFP and SOAP estimates, indicating that apportioning total emissions according to VOC composition may affect the accuracy of assessments of secondary pollution formation potentials. This study provides compound-specific and formulation-resolved emission factors for the selected architectural paint products and suggests that emission-factor-based characterization offers a more reliable assessment of their secondary formation potentials.

14. Primary Hepatic Neuroendocrine Tumors: A Stepwise Decision-Making Framework for Diagnosis and Surgical Management.

期刊: The American surgeon 发表日期: 2026-Jun-22 链接: PubMed

摘要

Primary hepatic neuroendocrine tumors (PHNETs) are exceptionally rare, posing significant challenges in diagnosis and management. To address these challenges, this study establishes an actionable, surgeon-facing decision framework that transforms clinical evidence into a stepwise management algorithm. By synthesizing evidence from the Surveillance, Epidemiology, and End Results (SEER) program (n = 446) and clinical series, we propose a structured pathway that explicitly links diagnostic confirmation, biological characteristics, and therapeutic strategy. The framework first necessitates the definitive exclusion of extrahepatic primary lesions through functional imaging (eg, PET-CT) and origin-specific markers to confirm the diagnosis. Subsequent operative decision-making is guided by biological assessment; higher tumor grades (G3: HR 2.94; G4: HR 3.04) are strong independent predictors of poorer survival, warranting a shift toward systemic control for high-grade disease. For localized disease, surgical resection remains the cornerstone of management, offering 5-year survival rates of 60-80%, whereas liver transplantation is prioritized as a viable curative strategy for unresectable, liver-confined G1/G2 tumors (5-year survival 70-80%). In advanced or multifocal stages, locoregional approaches provide effective palliation. This structured decision framework enables practicing surgeons to determine the optimal intervention-whether resection, transplantation, or palliation-based on individualized tumor grade, burden, and distribution, thereby optimizing long-term outcomes for this rare malignancy.

15. Bacterial epidemiology of male urinary tract infections in France: An expert review.

期刊: Infectious diseases now 发表日期: 2026-Jun-22 链接: PubMed

摘要

Urinary tract infections (UTIs) in men, though less frequent than in women, represent a significant clinical challenge due to their increasing incidence with age and distinct microbiological profiles. This expert review analyzed data of urine cultures in men with community-acquired UTIs, collected from emergency departments of 15 french hospitals, from the private laboratory group Atoutbio (21 sites in Meurthe-et-Moselle and the Vosges French departments, alongside primary care records from the AntibioClic tool and the PRIMO database, to characterize the bacterial epidemiology of community-acquired male UTIs in France. Escherichia coli (39-40%) dominated, followed by Enterococcus faecalis (13-15%), Klebsiella pneumoniae (6-8%), and Proteus mirabilis (5-6%). Resistance rates were as follows amoxicillin (47-53.5%), amoxicillin-clavulanate (24-35.7%), trimethoprim-sulfamethoxazole (25.4-31.5%), and fluoroquinolones (16.3-20.2%). Resistance to third-generation cephalosporins (6.6-9.3%) and mecillinam (6.8-8.9%) was lower, while fosfomycin (1.4-1.5%) and nitrofurantoin (0.4-0.7%) retained high susceptibility. Extended-spectrum β-lactamase (ESBL)-producing E. coli ranged from 2 to 8.4%, with carbapenemase producers remaining rare (0.1%). Resistance was higher in men >65 years, particularly in nursing homes, where 3GC resistance reached 15-18%. « Emerging uropathogens » (Aerococcus urinae 1-1.1%, Actinotignum schaalii 0.1-0.4%) were rare. This study highlights the greater microbial diversity in male UTIs compared to women and underscores the need for systematic urine culture, susceptibility testing, and empirical therapy tailored to resistance patterns, age, and risk factors.

16. The Metabolomic Characterization of Healthy Individuals Exposed to Complex Pollutants: Exploring the Relationships between Metabolites, Pollutants, and Subclinical Biomarkers.

期刊: Environmental pollution (Barking, Essex : 1987) 发表日期: 2026-Jun-22 链接: PubMed

摘要

Identifying primary pollutants and key health effects of complex pollutant exposure is challenging. Metabolomics may offer new insights into the comprehensive health impacts of e-waste exposure. Serum samples from 37 e-waste-exposed and 31 reference participants were analyzed via untargeted metabolomics. Significantly altered metabolites were identified using OPLS-DA models and Wilcoxon Mann-Whitney tests. Spearman correlation and Mediation analyses were conducted to validate the pollutant - metabolite - subclinical biomarker pathways. A total of 33 significantly changed metabolites were identified in exposed group, indicating apparent metabolic differences from the control subjects. Among these, 9 were amino acids (AAs) and derivatives. Nine were environmental pollutants (derivatives), including 6 pesticide metabolites, all of which were elevated in the e-waste exposed group. Mediation analysis found potential key metabolites, most were AAs (derivatives), whose biological functions are related to the nervous system. Potential primary pollutants included rare earth elements (REEs), Dechlorane Plus (DPs), and pesticides. Potential major health outcomes involved oxidative stress, the endocrine system, and the nervous system. Thus, the nervous system may be a major primary target of health effects. This study demonstrated metabolic differences between e-waste exposed and reference healthy participants in the metabolic level. It suggests the metabolomic approach can be used to characterize the comprehensive health impacts in the complex pollutants’ exposure scenario. The significant pollutant - metabolite - subclinical biomarker pathways preliminarily screened the potential primary pollutants, potential key metabolites, and potential major health outcomes. These results may provide directions and priorities of the future work and provide the scientific basis for pollution control and health protection in the Taizhou e-waste dismantling area.

17. Hepatic artery infusion pump chemotherapy for unresectable intrahepatic cholangiocarcinoma: Pooled individual patient-level analysis of four clinical trials.

期刊: Journal of hepatology 发表日期: 2026-Jun-22 链接: PubMed

摘要

Systemic therapy is the standard of care for unresectable intrahepatic cholangiocarcinoma (iCCA), but overall survival (OS) remains poor. Hepatic artery infusion pump (HAIP) chemotherapy with floxuridine (FUDR) has shown prolonged survival but is limited to expert centers. We assessed long-term OS among patients with unresectable, liver-confined iCCA treated with HAIP chemotherapy. Individual patient data from four phase II trials were pooled, including 142 patients with unresectable, liver-confined iCCA, with or without resectable regional lymph node metastases. Patients received HAIP chemotherapy with FUDR, with or without systemic therapy. The primary outcome was OS. Cox models examined associations between preselected covariates and OS. Multifocal disease was found in 92 patients (65%) and 58 (41%) had tumors larger than 10 cm. Twenty-five patients (18%) received prior systemic treatment. Partial response on imaging was achieved in 73/139 patients (53%), with a disease control rate of 96%. Thirteen patients (9%) underwent resection; 4 achieved complete pathological response. The pooled median OS was 26 months (95% CI: 22-30), 3-year OS rate was 28% (95% CI: 22%-37%), and 5-year OS rate was 15% (95% CI: 10%-23%). OS was similar across trials (p=0.95). The intention to treat 3-year and 5-year OS rates were 26% and 14%, respectively, which included 12 patients (7.8%) who did not undergo HAIP chemotherapy due to peritoneal disease. Hepatic disease progression was independently associated with worse OS (HR: 4.46, 95% CI: 2.69-7.40; p<0.001). Patients with unresectable, liver-confined iCCA who underwent HAIP with systemic chemotherapy had a 3-year OS rate of 28% and 5-year OS rate of 15% across four phase II trials. These results provide long-term benchmark results for a selected patient population. Unresectable, locally advanced intrahepatic cholangiocarcinoma remains a disease with poor long-term survival, and evidence supporting liver-directed strategies is limited to small, heterogeneous single-arm studies. By pooling individual patient data from all prospective phase II trials of hepatic artery infusion pump chemotherapy with extended follow-up, this study provides the most comprehensive and mature long-term survival benchmarks. These findings inform multidisciplinary decision-making at specialized centers and support further prospective evaluation of hepatic artery infusion pump chemotherapy within modern multimodality treatment strategies.

18. Associations between population-level BCG and yellow fever vaccination and aortic mortality: A 29-year observational analysis using causal inference methods.

期刊: International journal of cardiology 发表日期: 2026-Jun-22 链接: PubMed

摘要

Diseases of the aorta are driven by chronic inflammation and matrix metalloproteinase activity. Vaccines such as Yellow Fever (YF) and BCG may be associated with vascular protection through “trained immunity”, epigenetic reprogramming of innate immune cells that attenuates systemic inflammatory responses. We investigated the association between population-level vaccination coverage and aortic mortality using contemporary causal inference methods. This ecological study analyzed 27 Brazilian states over 29 years (1994-2022), encompassing 783 state-year observations and 185,429 deaths. Poisson fixed-effects models with state and year intercepts were employed to isolate within-state effects. States with high YF coverage (>80%) showed a 16% lower age-standardized aortic mortality compared to low-coverage states (IRR 0.84; 95% CI 0.76-0.93; P = 0.001). E-value analysis for this association was 1.67, indicating robustness against moderate unmeasured confounding. For BCG, associations followed a biologically plausible lag structure, peaking at 15 years post-vaccination (IRR 0.91 per 10 pp. increase; 95% CI 0.85-0.98; P = 0.009). Negative control analysis using Diphtheria-Tetanus-Pertussis (DTP) vaccine, which lacks trained immunity effects, showed no association with aortic mortality (IRR 1.02; P = 0.578), arguing against residual confounding from healthcare access. Causal mediation analysis suggested that 65% of the YF vaccine’s association operated through pathways independent of infectious disease reduction. Population-level vaccination with YF and BCG is associated with lower aortic mortality in this ecological analysis. These hypothesis-generating findings, supported by negative control validation and temporal consistency across three decades, are compatible with a trained immunity pathway but require confirmation in prospective individual-level studies before causal conclusions can be drawn.

19. Deep Learning-based Quantification of Knee Effusion-Synovitis Volume on MRI - Technique Development and Validation.

期刊: Osteoarthritis and cartilage 发表日期: 2026-Jun-22 链接: PubMed

摘要

To develop and validate a deep learning (DL) model for automatic quantification of knee effusion-synovitis volume (ESV) on MRI, assess correlations of ESV with semiquantitative effusion-synovitis (sqES) scores, and compare associations of ESV and sqES with MRI features and symptoms of knee osteoarthritis. A DL model was developed to quantify ESV on baseline right-knee MRI from the Osteoarthritis Initiative (n=4,698), which was trained and tested using manual segmentations from 101 randomly selected knees. Dice coefficients were used to quantify segmentation performance. Spearman correlations were computed between ESV and sqES scores from Whole-Organ Magnetic Resonance Imaging Score (WORMSES) and MRI Osteoarthritis Knee Score (MOAKSES). Paired differences in standardized β coefficients (Δβstd) from linear models were used to compare associations of ESV with tissue-specific WORMS scores and the total score of the Western Ontario McMaster Universities Arthritis Index (WOMAC). The DL model achieved a mean Dice coefficient of 0.79 (95% Confidence Interval [CI] 0.71-0.86) on the test set. ESV showed moderate correlations with WORMSES (ρ=0.50, 95% CI 0.47-0.53) and MOAKSES (ρ=0.65, 95% CI 0.63-0.67) and demonstrated larger effect sizes for associations with WORMS features (minimum Δβstd=0.03 [95% CI 0.00-0.07]) and knee OA symptoms (minimum Δβstd=0.03 [95% CI 0.00-0.07]) than sqES scores. A DL model for automated quantification of knee ESV on MRI was developed and validated. While our results demonstrate the potential of ESV as a scalable imaging biomarker in osteoarthritis research, validation in independent cohorts is necessary to confirm its utility.

20. Action for a healthier global tax system.

期刊: BMJ (Clinical research ed.) 发表日期: 2026-Jun-22 链接: PubMed

摘要

21. Barriers, facilitators and promising interventions for reducing sedentary behaviour during and after stroke rehabilitation - A scoping review.

期刊: Disability and rehabilitation 发表日期: 2026-Jun-22 链接: PubMed

摘要

Reducing sedentary behaviour (SB) in stroke rehabilitation is essential, yet effects of most interventions remain limited. This review used the Behaviour Change Wheel to identify: (1) barriers and facilitators for reducing SB of stroke survivors and (2) Behaviour Change Techniques (BCTs) incorporated in “promising” interventions. Seven databases were searched from inception to January 2025. Data were systematically extracted and coded using the Capacity Opportunity Motivation - Behaviour model (COM‑B) and the Theoretical Domains Framework (TDF). Thirty-nine studies on barriers and facilitators were included, identifying 32 different barriers and 30 facilitators in inpatient settings and 109 barriers and 73 facilitators in outpatient/community settings, spanning all COM-B domains. Four of seven interventions were rated as “promising” (predefined criterion: statistically significant changes within or between group(s)). These interventions applied 11-34 BCTs, including goal setting, action planning, reviewing goals, feedback, social support, instruction, and demonstration. Given the variety of barriers and facilitators experienced, personalised approaches are essential. Promising interventions share components that can inform SB‑focused intervention design, but further research is needed to determine how these components can be combined and tailored to support sustained SB reduction. An analysis of each stroke survivor’s individual behaviour and context should guide the application of promising Behaviour Change Techniques (BCTs), to ensure interventions address the barriers and strengthen the facilitators, identified for that individual.The broad heterogeneity of barriers and facilitators across COM‑B domains highlights the importance of a person‑centred approach, as individual physical, cognitive, emotional, and contextual profiles strongly influence the potential to reduce sedentary behaviour.Clinicians may use the recurring Behaviour Change Techniques observed in promising interventions—such as goal setting, action planning, reviewing behaviour goals, feedback, instruction, demonstration, and social support—to structure behaviour‑change interventions.

22. Racial and Demographic Trends in Abortion Method Selection in Minnesota Among in-State Patients at or under 11 Weeks Gestational Duration, 2021-2024.

期刊: Contraception 发表日期: 2026-Jun-22 链接: PubMed

摘要

Little is known about populations utilizing recently expanded access to telehealth medication abortion (TeleMAB) or how structural determinants may exacerbate access inequities. This study assesses demographic and racial trends between telehealth and in-clinic abortion patients with pregnancies 11 weeks or less in Minnesota. We conducted a retrospective cohort analysis using Planned Parenthood North Central States electronic health record data of Minnesota abortion patients at 11 weeks gestation or less between 2021-2024. Descriptive statistics and multinomial logit models results are reported using relative risk ratios. A total of 20,360 abortions at or less than 11 weeks gestational duration occurred during the study period. 92.5% of the abortions were provided in person (64.9% medication, 27.6% procedural), and 7.6% were TeleMAB. TeleMAB patients were older, more likely to be white, live in rural counties, and have had a previous abortion compared to patients who received abortion care in person. Patients who self-identify as Black, Hispanic, multi-racial, or whose primary language is not English, are more likely to receive in-clinic care, specifically procedural abortions. Telehealth expansion can improve abortion access for rural patients but may not reach other impacted communities in Minnesota. More research is needed to examine other structural barriers that may impede patients from selecting the abortion modality they prefer. Telehealth abortion is key to retaining abortion access. However, this health care delivery shift has occurred concurrently with closures of brick-and-mortar clinics. Broadening telehealth and in-clinic care may support the autonomy patients seek in their reproductive care.

23. Characterizing updated and living meta-analyses Part 1: A methodological scoping review on methods for conducting meta-analyses in updated and living systematic reviews.

期刊: Journal of clinical epidemiology 发表日期: 2026-Jun-22 链接: PubMed

摘要

Systematic reviews (SRs) provide the highest level of evidence for clinical and policy decision-making but quickly become outdated as new studies emerge. Updated systematic reviews (USRs) and living systematic reviews (LSRs) offer two frameworks to maintain currency; however, statistical approaches for repeated updates of pairwise meta-analyses (PMA) and network meta-analyses (NMA) remain heterogeneous. This scoping review aimed to identify, categorize, and summarize existing methods for conducting updated meta-analyses (primarily PMAs and, subject to available evidence, NMAs) in the context of USRs and LSRs, highlighting their properties, as well as their reported advantages and limitations. A scoping review was conducted to identify studies that described or compared methods for updating PMAs or NMAs within USRs or LSRs. We followed the 2020 JBI methodology and searched across major bibliographic databases (MEDLINE, Embase, the Cochrane Library, Cochrane CENTRAL, the Cochrane Methodology Register, ERIC, and PsycINFO) from inception to March 6, 2024. Grey literature and expert recommendations supplemented our literature search. Two reviewers independently screened records, extracted data, and categorized methods. Of 2710 records identified, 51 studies and one companion report met inclusion criteria. The studies were grouped into nine methodological categories: Traditional/Cumulative Meta-analysis, Law of Iterated Logarithm, Shuster Sequential Method, Sequential Meta-analysis, Trial Sequential Analysis, Stochastic Curtailment, Adaptive Design, Likelihood Ratio Test, and Bayesian Meta-analysis. Most studies focused on USRs (72.5%) and PMAs (98%). Trial Sequential Analysis was the most frequently encountered approach (46/51), while only one study described an extension to NMA. Methods varied widely in error control and ability to adjust for heterogeneity. While most approaches addressed type I error, fewer considered type II error or heterogeneity. This scoping review provides the first comprehensive mapping of methods for updated and living meta-analyses. Despite a range of available approaches, no single method demonstrated superiority across contexts. Further research should compare methods empirically, develop accessible software to support reliable, continuously updated evidence synthesis, and extend frameworks to NMA, especially as only a single methodological study was found for NMA.

24. Strengthening Advocacy Through Clinician Partnerships with Government Relations and Other Policy Experts: Recent Advances.

期刊: Academic pediatrics 发表日期: 2026-Jun-22 链接: PubMed

摘要

25. Terminology and core components of co-design intervention in chronic pain management: An international Delphi study.

期刊: The journal of pain 发表日期: 2026-Jun-22 链接: PubMed

摘要

Co-design is increasingly used in chronic pain research; however, terminology remains inconsistent, guidance is lacking, and most research is concentrated in high-income countries. This international three-round e-Delphi study aimed to establish consensus on key terminology and core components, and to identify common barriers and strategies for co-design in chronic pain management. The e-Delphi survey was conducted from November 2024 to June 2025. Panel used a five-point Likert scale to rate agreement and importance, with consensus defined 75% thresh-hlod agreement. Open-ended responses on barriers and strategies were analysed using thematic content analysis. A total of 117 panel members participated in Round 1, 98 in Round 2, and 92 in Round 3, representing 30 countries. Though panel members prioritise “co-design” and “collaborative design” as the most appropriate standardised terms to describe the collaboration process in developing and evaluating chronic pain interventions, “co-design” has the highest percentage agreement. Twelve core components of co-designed interventions were identified, including engaging people with lived experience and key interest-holders, addressing biopsychosocial factors, ensuring accessibility and availability, applying evidence-based practices, emphasising person-centredness, conducting needs assessments, supporting goal-oriented care, empowering self-management, promoting interdisciplinary collaboration, ensuring sustainability, incorporating patient-reported outcome measures, and integrating technology. The identified five barriers to co-design were: resource, cultural and contextual; knowledge and educational; interpersonal and professional; and system and policy. Corresponding strategies included enhanced resource allocation, training and education, improved communication, strengthened interdisciplinary collaboration, and supportive policy and organisational structures. These findings provide a clear, consensus-based guide for developing and implementing co-designed chronic pain interventions. PERSPECTIVE: This e-Delphi study established standardised terminology, core components for co-designed chronic pain intervention development, and outlined key barriers and overcoming strategies for them. The findings could enhance research and clinical communication and support embedding co-design principles into clinical service development to improve shared decision-making and patient-centred care.

26. Racial, ethnic, and nativity disparities in elevated symptoms and diagnosis of perinatal mood and anxiety disorders: A population-level study.

期刊: Journal of affective disorders 发表日期: 2026-Jun-22 链接: PubMed

摘要

This study evaluated racial, ethnic, and nativity disparities in diagnosis of perinatal mood and anxiety disorders (PMADs) for individuals with elevated symptoms in a state with universal screening of perinatal depression. This was a cross-sectional analysis of linked New Jersey birth records and hospital discharge records between January 2016 and December 2019 (n = 338,537 births). Primary outcomes were a positive screen for elevated symptoms using the Edinburgh Postnatal Depression Scale (EPDS ≥ 10) and positive EPDS with a PMAD diagnosis on the delivery hospitalization discharge record. Logistic regression was used to estimate associations between racial, ethnic, and nativity groups and outcomes. We also examined associations between screening and diagnosis outcomes at delivery and postpartum use emergency department (ED) use. Compared with White US-born, births to Asian/Pacific Islander foreign-born mothers had significantly higher odds of positive EPDS(adjusted OR 1.84, 95%CI 1.73-1.96), but lower odds of positive EPDS with PMAD diagnosis (AOR 0.36 95%CI 0.29-0.45). Similar differences were found for Black US-born, Black foreign-born, Hispanic US-born, and White foreign-born births. Compared to those with a negative screen, a positive screen without a diagnosis was associated with higher odds of a psychiatric ED visit in the first year postpartum(AOR 2.23, 95%CI 1.99-2.51). This population-level study found that in a setting with universal screening of perinatal depression, there remain substantial racial and ethnic disparities in the pathway from screening to diagnosis. Further research is needed to understand the mechanisms behind these findings and identify policies to improve equity in perinatal mental health care.

27. Integrating artificial intelligence and machine learning into risk prediction for type 2 diabetes: A model for early identification of high-risk populations.

期刊: Diabetes research and clinical practice 发表日期: 2026-Jun-22 链接: PubMed

摘要

Family history, body mass index (BMI), and ethnicity are three key, well-established determinants of susceptibility to type 2 diabetes mellitus (T2DM), reflecting genetic predisposition, modifiable metabolic risk, and biological as well as social influences, respectively. These factors interact in complex, non-linear patterns that are not fully captured by conventional risk prediction models. This review examines how artificial intelligence (AI) and machine learning approaches can integrate these variables to improve risk stratification and early identification of individuals at high risk of T2DM. By leveraging large-scale, longitudinal datasets, data-driven models facilitate the capture of population-level heterogeneity and identify risk patterns that extend beyond static thresholds. Incorporating AI-enhanced prediction tools into clinical and public health settings could enable more timely, targeted, and equitable interventions. Ultimately, integrating advances in AI with a deeper understanding of the interplay between BMI, ethnicity, and genetic predisposition may support more personalised prevention strategies and risk-stratified care pathways for T2DM.

28. Comment on "Associations between animal and plant protein intakes and the mortality and hospitalization of patients with chronic heart failure".

期刊: Clinical nutrition ESPEN 发表日期: 2026-Jun-22 链接: PubMed

摘要

29. Development of Data-Driven Models for Just-in-Time Digital Self-Management Advice to Improve Physical Functioning in Hip and Knee Osteoarthritis: Protocol for the e-cOAch Cross-Over Study.

期刊: JMIR research protocols 发表日期: 2026-Jun-22 链接: PubMed

摘要

Clinical guidelines recommend a stepped-care strategy for patients with hip and knee osteoarthritis that begins with nonoperative approaches, including education, pain medication, and self-care. However, the implementation of stepped-care remains limited. Digital self-management interventions have the potential to support patients in applying lifestyle advice and self-care strategies, but current tools often provide generic support without long-term continuity. Artificial intelligence offers new opportunities to deliver personalized, just-in-time self-management interventions for people with osteoarthritis. The development of such artificial intelligence algorithms is limited due to a lack of rich, longitudinal datasets. The primary objective of this study is to develop and evaluate data-driven models that support personalized recommendations on the optimal timing and optimal advice (physical activity promotion, sleep optimization, weight management, no program) for individuals with hip or knee osteoarthritis. This prospective cross-over study aims to include 600 people with hip or knee osteoarthritis, meeting the National Institute for Health and Care Excellence criteria. The study is registered at ClinicalTrials.gov (registered February 2, 2026, NCT07423858). We aim to screen digital health literacy in our sample. Participants will be recruited across the Netherlands and will use the e-cOAch web app, with 3 self-care programs (ie, physical activity promotion, weight management, and sleep optimization). Each participant will complete all three 12-week programs and one 12-week control period in a randomized sequence. Participants will be followed for 12 months, with biweekly assessments conducted via the app. The primary outcome for model development will be deterioration in physical functioning, measured by a decrease in the Hip Disability and Osteoarthritis Outcome Score subscale activities of daily living of 6.7 or the Knee Injury and Osteoarthritis Outcome Score subscale activities of daily living of 8.2. Secondary outcomes will be pain and participation. Additional measures will include patient characteristics (date of birth, sex, height, level of education, comorbidity, ethnicity, use of a walking device, use of pain medication, device for e-cOAch, duration of osteoarthritis complaints, health and digital literacy, smoking, alcohol use), physical activity, sleep quality and insomnia, psychosocial factors, behavioral determinants, and engagement with the app. These data will inform the development of data-driven models using supervised (causal) machine learning. The funding for the study was granted in 2023. At the time of manuscript submission, 520 participants had been recruited. Recruitment is expected to be completed in March 2026, with data collection projected to conclude in April 2027. The publication of the results is anticipated in spring 2028. This study will provide data-driven models that forecast changes in physical functioning over time and support personalized recommendations on the optimal timing of specific self-care programs for people with hip or knee osteoarthritis. These models will be integrated into a new iteration of a self-management app, e-cOAch (version 2), to provide personalized support for people with osteoarthritis across varying levels of digital health literacy.

30. Exploring quality and patient safety competencies and competency frameworks: A scoping review.

期刊: International journal for quality in health care : journal of the International Society for Quality in Health Care 发表日期: 2026-Jun-22 链接: PubMed

摘要

Sustaining quality and patient safety (QPS) is a global priority due to risks such as patient harm, poor experiences, inequity, and resource waste. Training and education in key competency areas can support continuous improvement and enhance workforce performance. Clearly defining core QPS competencies for healthcare staff is essential to ensure preparedness to provide quality, safe care. Competency frameworks provide structured support for training and curriculum development, with many developed globally as strategic initiatives, some using evidence-based approaches. However, there is no consensus on core competencies to promote quality and patient safety, definitions of relevant terms can vary, and evidence on framework effectiveness is mixed. To address this research gap, the objective of this review was to systematically explore and collate evidence to provide insight into the current landscape of QPS competencies and frameworks. Additionally, this review sought to identify how competencies and competency frameworks have been designed, developed, implemented and evaluated. We searched for studies on QPS competencies and frameworks in PubMed, CINAHL, Web of Science, PsycINFO, and Cochrane Library from Jan 2010 to April 2023. We also conducted grey literature searches on Google Scholar, Opengrey, and the National Institute for Health and Clinical Excellence (NICE). All studies that described QPS competencies and/or frameworks were included. Since the studies varied in type, a narrative approach was adopted to synthesise the included studies. Out of the initial 14,144 studies found, 118 were deemed relevant after thoroughly reviewing abstracts and full texts. Of these, 36 studies outlined specific QPS competency frameworks, while the remaining 82 studies assessed various QPS competencies across diverse contexts. Upon analysing data from all 118 studies, we identified 37 QPS topic areas and a variety of competency statements encompassing skills, knowledge, and behaviours deemed relevant for promoting QPS. The most frequent QPS topic areas included communication, patient safety culture, teamwork and collaboration, risk monitoring and management and patient-centred care. The review has highlighted key insights into education and training related to QPS competencies. Core competency topic areas have been identified that are essential for workforce development and the promotion of quality and patient safety in healthcare settings. However, there is a gap in research on strategies to effectively implement and integrate QPS frameworks into practice, leading to insufficient evidence on translating these competencies into real-world application.

31. Toxocariasis Presenting with Peripheral Eosinophilia and Eosinophilic Pleural Effusion: A Case Report.

期刊: Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy 发表日期: 2026-Jun-22 链接: PubMed

摘要

Human toxocariasis is a parasitic infection caused by Toxocara species and is important in the differential diagnosis of patients presenting with unexplained eosinophilia. A case of toxocariasis with an eosinophilic pleural effusion is presented. A 67-year-old Japanese man presented with progressive dyspnea. Laboratory investigations showed marked peripheral eosinophilia and a markedly elevated serum immunoglobulin E level. Chest imaging demonstrated bilateral ground-glass opacities and a left-sided pleural effusion. Analysis of the pleural fluid showed eosinophil predominance without evidence of malignancy or bacterial infection. Extensive diagnostic evaluations, including autoimmune serology, bone marrow examination, and genetic analyses for myeloid neoplasms with eosinophilia, yielded negative results. Serological test using an enzyme-linked immunosorbent assay demonstrated elevated anti-Toxocara antibody level, which were subsequently confirmed by western blot analysis, leading to a diagnosis of human toxocariasis presenting with visceral larva migrans. The patient had no clear history of animal contact or ingestion of raw meat or liver. Treatment with oral albendazole for four weeks resulted in marked clinical improvement, with resolution of the pleural effusion and pulmonary infiltrates, normalization of peripheral eosinophil counts, and a significant decrease in anti-Toxocara antibody level. This case emphasizes the importance of considering toxocariasis in the differential diagnosis of an eosinophilic pleural effusion and pulmonary infiltrates, even in the absence of identifiable exposure risks. Early serological testing can facilitate prompt diagnosis and appropriate anthelmintic therapy, potentially preventing unnecessary invasive procedures and delayed treatment.

32. Targeting fibrillin-1 disrupts the fibrogenic niche formation and ameliorates kidney fibrosis.

期刊: Journal of advanced research 发表日期: 2026-Jun-22 链接: PubMed

摘要

Kidney fibrosis is a common pathological pathway of chronic kidney disease (CKD), driven by the formation of fibrogenic niche. Fibroblasts undergo proliferation and activation in this specialized microenvironment, but the precise mechanism by which the fibrogenic niche modulates fibroblast behavior remains elusive. This study aimed to clarify how fibrillin-1 (FBN1), a core structural component of the fibrogenic niche, governs fibroblast proliferation and activation. We further evaluated targeted disruption of the FBN1-EGFR interaction as a therapeutic strategy to block kidney fibrosis progression. Spatial transcriptomics localized FBN1 within the fibrogenic niche. Validation was performed using decellularized kidney scaffolds (KTS), NRK-49F cells, and primary renal fibroblasts. Mechanistic studies included co-immunoprecipitation, RNA sequencing, and genetic knockdown models. Tubule-specific Fbn1 knockout mice provided in vivo evidence. High-throughput screening identified FBN1-EGFR disruptors. FBN1 was enriched in the fibrogenic niche and potently stimulated fibroblast activation. Mechanistically, tubule-derived FBN1 bound fibroblast EGFR, triggering persistent MAPK signaling that accelerated fibrosis. Pharmacological inhibition of EGFR/MAPK signaling blocked these effects. High-throughput screening revealed fucosterol as a potent FBN1-EGFR interaction disruptor that competitively blocked binding, subsequently suppressing MAPK activation and attenuating renal fibrosis. FBN1 acts as a core functional molecule to shape and maintain the fibrogenic niche, and further drives kidney fibrosis by activating the downstream EGFR/MAPK cascade within this niche. By disrupting the FBN1-EGFR interaction, fucosterol provides a promising therapeutic strategy for inhibiting fibrogenic niche formation and blocking kidney fibrosis progression at the source.

33. A α-synuclein aggregation inhibitor exerts neuroprotective effects via mitochondrial resilience in Parkinson's disease.

期刊: Journal of advanced research 发表日期: 2026-Jun-22 链接: PubMed

摘要

The pathogenesis of Parkinson’s disease (PD) is driven by a vicious cycle of α-synuclein (α-Syn) aggregation and mitochondrial collapse. Breaking this pathogenic loop requires disease-modifying therapeutics capable of destabilizing the toxic structural core of α-Syn while simultaneously rescuing bioenergetic failure, highlighting an urgent need for novel dual-action neuroprotective agents. To identify and characterize A14, a novel small-molecule modulator, and evaluate its dual capacity to inhibit α-Syn fibrillization and mitigate downstream mitochondrial deficits in PD. Structure-based virtual screening was employed to identify A14 as a targeted inhibitor of the α-Syn fibril β-sheet interface. Its biophysical mechanisms were elucidated using multi-dimensional structural assays. In cellular models and A53T α-Syn transgenic mice, systematically evaluated the therapeutic efficacy, wherein transcriptomics and transmission electron microscopy were adopted to detect mitochondrial integrity, and functional magnetic resonance imaging (fMRI) together with electrophysiology were utilized for the assessment of nigral circuit function. A14 binds the β-sheet core of α-Syn fibrils with high affinity (Kd = 27.9 ± 2.16 nM), significantly reducing β-sheet content from 21.4% to 9.3% and redirecting the aggregation trajectory into small (< 20 nm), protease-sensitive intermediates. In neuronal models, A14 robustly reduced intracellular α-Syn inclusions via direct biophysical modulation, independent of major proteostasis pathways. In vivo, A14 disrupted the pathological interaction between α-Syn and mitochondria, rescuing cristae ultrastructure, oxidative phosphorylation, and overall bioenergetics. This coordinated restoration of proteostasis and mitochondrial function prevented dopaminergic neuron loss, normalized cortico-basal ganglia-nigral functional connectivity, and significantly ameliorated motor deficits in A53T transgenic mice. Our findings demonstrate that the A14 engages complementary mechanisms to inhibit α-Syn aggregation and rescue mitochondrial deficits. This dual action stabilizes proteostasis and sustains mitochondrial functionality, nominating A14 as a promising therapeutic candidate for the treatment of PD.

34. Resveratrol alleviates neurological disorders and motor dysfunction in 3-NP induced- Huntington Disease in rats: Role of activating AMPK/SIRT1/ULK1 autophagy pathway.

期刊: Neuropharmacology 发表日期: 2026-Jun-22 链接: PubMed

摘要

Huntington’s disease (HD) is a genetic neurodegenerative disease characterized by striatum damage, which results in a number of uncontrollable muscle movements alongside intellectual and cognitive impairment. The progression of HD is accompanied by neuroinflammation, oxidative stress, and neuronal apoptosis. Resveratrol (RESV) is a naturally occurring compound known for its potent antioxidant and anti-inflammatory effects. RESV showed promising neuroprotective effects against Alzheimer’s and Parkinson’s disease. The current research aims to study the neuroprotective effects of RESV against 3-nitropropionic acid (3-NP)-induced HD. Forty adult male rats were divided equally into four groups as follows: Group 1- normal control group. Group 2- RESV (25 mg/kg/day, p.o) - treated rats. Group 3- rats treated with 3-NP (10 mg/kg/day, i.p). Group 4- rats treated with 3-NP (10 mg/kg/day, i.p) +RESV (25 mg/kg/day, p.o). The results showed that RESV alleviated the behavioral deficits observed in 3-NP treated rats. In addition, the histopathological images showed obvious improvement in RESV-treated rats. RESV activated the AMP-activated protein kinase (AMPK)-related autophagy pathway that resulted in neuroprotection and cell survival. Moreover, RESV showed anti-inflammatory and antioxidant effects by decreasing levels of inflammatory biomarkers including tumor necrosis factor (TNF)-α, nuclear factor kappa (NF-κ)-B, and interleukin (IL)-1β, alongside increasing neuronal antioxidant capacity by stimulating reduced glutathione (GSH), superoxide dismutase (SOD), and preventing lipid peroxidation. In conclusion, our study showed that RESV has a potent neuroprotective effect as evidenced by its ability to significantly alleviate biochemical and behavioral hallmarks of HD.

35. Quaternary ammonium compounds in paired indoor dust and human urine: suspect screening and exposure associations.

期刊: Environmental pollution (Barking, Essex : 1987) 发表日期: 2026-Jun-22 链接: PubMed

摘要

The occurrence of quaternary ammonium compounds (QACs) in the environment has received increasing attention due to their widespread applications. Indoor dust is an important medium for human exposure, yet knowledge regarding the influence of dust exposure and human metabolism on the composition profiles of QACs in excretions remains limited. In this study, an integrated workflow combining targeted analysis and suspect screening was developed to comprehensively identify QACs in paired indoor dust and urine samples collected across China. A total of 69 compounds were detected in indoor dust, including 23 target analytes and 46 emerging analogues spanning both traditional hydrocarbon-based structures and subclasses bearing additional functional groups, such as choline, betaine, ester, amide, aryl, and pyridine. In urine, both traditional (n = 12) and emerging (n = 15) analogues were also detected, along with four hydroxyl or carboxyl metabolites of benzalkonium chlorides (BAC). Several influencing factors derived from the questionnaire survey (e.g., household income and frequency of personal care product use) were positively associated with QAC concentrations in indoor dust. After controlling for these covariates, the total concentration of BACs in dust remained positively correlated with that of the carboxyl metabolites in urine, suggesting these metabolites could serve as exposure biomarkers. By exploring the chemical space of QACs in paired samples, this study provides the first evidence linking indoor dust exposure to human urinary excretion.

36. Urbanization-induced cropland intensification and fragmentation result in threshold responses in soil antibiotic contamination.

期刊: Environmental pollution (Barking, Essex : 1987) 发表日期: 2026-Jun-22 链接: PubMed

摘要

Urbanization substantially alters the intensity of human activities and land-use patterns, potentially accelerating the accumulation of antibiotics in soil environments and thereby posing risks to human health and crop productivity. However, studies directly examining the impacts of urbanization on soil antibiotic contamination remain limited, and the response characteristics of soil antibiotic contamination to urbanization, as well as the mechanisms, remain poorly understood. In this study, an urbanization index (UI) was constructed using multi-source socioeconomic variables whose optimal weights were determined by a genetic algorithm (GA) combined with a random forest (RF) model. The UI was then used to identify the threshold responses of soil antibiotic contamination to urbanization levels, and a structural equation model (SEM) was employed to reveal the mechanisms. The results showed an inverted U-shaped relationship between soil antibiotic contamination and urbanization level within the study area. This threshold effect can be attributed to shifts in the mechanisms of soil antibiotic contamination across different stages of urbanization. Below the threshold, urbanization indirectly promoted the accumulation of antibiotics in soil by intensifying agricultural production activities, whereas above the threshold, urban spatial expansion increased farmland fragmentation, thereby reducing the input of agricultural pollution sources. This study reveals the response characteristics of soil antibiotic contamination to urbanization and the mechanisms of this response, providing new scientific evidence for the identification and management of soil antibiotic contamination risks in rapidly urbanizing regions.

37. Multi-Omics Analyses Reveal BPA Accelerates Glioma Progression via Cell Cycle Dysregulation.

期刊: Environmental pollution (Barking, Essex : 1987) 发表日期: 2026-Jun-22 链接: PubMed

摘要

Bisphenol A (BPA), a pervasive environmental endocrine disruptor, its role in glioma progression is unclear. We sought to elucidate how BPA influences glioma malignancy by integrating multi-omics analyses with experimental validation. Candidate targets of BPA were gathered from the ChEMBL database and predicted using the SwissTargetPrediction and Similarity Ensemble Approach (SEA) tools. Glioma-associated genes were identified based on Gene Expression Omnibus (GEO) datasets. Machine learning models were constructed to evaluate the diagnostic potential of these hub genes, while molecular docking was performed to assess BPA-target protein interactions. Single-cell RNA sequencing (scRNA-seq) data were leveraged to define the cellular context of BPA action. Key findings were further verified through in vitro and in vivo experiments. Our results demonstrate that BPA promotes glioma progression by exhibiting potential binding interactions with cell cycle-related proteins, thereby enhancing the proliferative capacity of glioma cells. This study provides novel mechanistic insights into the role of environmental pollutants in driving glioma pathogenesis and highlights the potential health risks associated with BPA exposure.

38. The Hepato-Exposome Axis: How Endocrine Disruptors Hijack Liver Receptors to Drive MASLD.

期刊: Journal of hepatology 发表日期: 2026-Jun-22 链接: PubMed

摘要

Metabolically dysfunction-associated steatotic liver disease (MASLD) is rising worldwide at a pace that cannot be fully explained by obesity, diet, or genetics alone. Emerging evidence supports a mechanistic dissection of how defined endocrine-disrupting chemicals (EDCs) rewire hepatic transcriptional and metabolic networks relevant to MASLD. This review focuses on the molecular interfaces through which major EDC families intersect with hepatic metabolic regulation. We propose the “hepato-exposome axis” as a receptor-centric framework that maps specific EDC classes to nuclear receptors (NRs) and key metabolic pathways that regulate lipid metabolism, glucose homeostasis, mitochondrial dysfunction and inflammatory signalling implicated in MASLD progression. We summarise key EDC groups linked to liver disease, including organochlorine pesticides, pyrethroids, bisphenols, phthalates, organophosphate esters, and per- and polyfluoroalkyl substances (PFAS). We then integrate current understanding of hepatic metabolic and xenobiotic pathways in homeostasis and MASLD, emphasising xenobiotic-sensing and metabolic NRs (AhR, PXR, CAR, PPARs, FXR, LXRs, RXR) as convergence points for EDC action. Drawing on in vivo and in vitro studies, we show that distinct EDC families imprint overlapping molecular signatures onto pathways that control de novo lipogenesis, β-oxidation, glucose handling, antioxidant defences, and inflammatory/immune signalling, collectively fostering a pro-steatotic and pro-inflammatory hepatic milieu. We further discuss vulnerable populations, critical windows of exposure, mixture effects, and sex-specific responses, positioning EDCs as environmental modifiers of the MASLD trajectory across the life course. Finally, we outline priorities for mechanistic and translational research, including mixture toxicology, multi-omics exposome profiling, and biomarker discovery, to better quantify and mitigate endocrine disruptors’ contribution to the global MASLD burden.

39. Extracellular polysaccharide-facilitated selenium nanoparticle assembly and metabolic reprogramming support efficient selenite biotransformation by ARTP-mutagenized Lactiplantibacillus plantarum Vse252.

期刊: Bioresource technology 发表日期: 2026-Jun-22 链接: PubMed

摘要

The environmental accumulation of toxic selenite poses a significant threat to public health and ecosystem sustainability. To improve the capability of microorganisms in selenite detoxification and biotransformation, a superior mutant of Lactiplantibacillus plantarum Vse252 was obtained via ARTP mutagenesis integrated with adaptive evolution. The mutant displayed remarkably enhanced selenite tolerance, with a maximum tolerable concentration reaching 300 mM. Furthermore, it converted 60 % of selenite to elemental selenium in 48 h, showing a remarkable improvement in selenium nanoparticles (SeNPs) biosynthesis. Electron microscopic observations showed that mutant maintained intact cell walls under selenite stress and abundantly produced uniformly dispersed SeNPs. Notably, the mutant produced 216.71 mg/L of extracellular polysaccharide (EPS) under selenite induction, a level markedly higher than that of the WT strain. Proteomic and metabolomic analyses revealed a global metabolic reprogramming in mutant, the upregulation of the pentose phosphate pathway and amino/nucleotide sugar metabolism (RfbA/RfbC) supplied NADPH and precursors for cell wall and EPS synthesis, while elevated oxidoreductases (GshR/Gpo) and cofactors (FMN/FAD) drove efficient selenite reduction. Four key mutated genes, including EmrE, MreC, MoaA, and AcpP, were identified via comparative genomic analysis, further confirming that cell wall homeostasis and transmembrane substance transport play critical regulatory roles in shaping the phenotypic characteristics of the mutant strain. This study reveals a tight association between the biosynthesis of extracellular SeNPs and EPS during microbial resistance to inorganic selenium stress, and highlights their pivotal roles in microbial detoxification, providing mechanistic insights and candidate targets for engineering strains toward selenium bioremediation and functional SeNPs production.

40. Urogenital Schistosomiasis in Africa South of the Sahara: A Systematic Review and Meta-Analysis of Knowledge, Attitudes, and Practices for the WHO 2030 NTD Roadmap.

期刊: Acta tropica 发表日期: 2026-Jun-22 链接: PubMed

摘要

Urogenital schistosomiasis affects >112 million people in Africa south of the Sahara, with 56 million women suffering from female genital schistosomiasis. Community knowledge, attitudes, and practices (KAP) are essential for sustained control, but no systematic review has synthesized KAP evidence across the region. We estimated the pooled prevalence of good knowledge, positive attitudes, and good preventive practices to inform the WHO 2030 NTD Roadmap. We searched PubMed, Scopus, Web of Science, African Journals Online, and WHO Global Index Medicus from inception to 21 November 2025. Cross-sectional studies reporting quantitative KAP data from Africa south of the Sahara were included. Two independent reviewers performed screening, data extraction, and JBI risk-of-bias assessment. Random-effects meta-analyses, subgroup analyses, meta-regression, sensitivity analyses, and publication bias tests were conducted. GRADE certainty was assessed. Twenty-one studies (total 9,681 participants) contributed to the knowledge analysis; 15 studies (total 8,205 participants) to the attitude analysis; and 16 studies (total 8,538 participants) to the practice analysis. Note that participants from studies reporting multiple outcomes are counted separately in each analysis. Regional pooled estimates ranged from 46.45% to 69.76% (knowledge), 52.33% to 61.88% (attitudes), and 39.71% to 56.43% (practices). Continent-wide estimates were 51.73% (knowledge), 57.40% (attitudes), and 45.12% (practices), but are heavily weighted towards West Africa. Extreme heterogeneity (I² = 98-99%) limits confidence; individual study ranges: 23.3-91.2% (knowledge), 22.7-82.9% (attitudes), 13.9-85.4% (practices). A descriptive attitude-practice gap of 12.28 percentage points was observed. No publication bias was detected. Meta-regression suggested a tentative decline in preventive practices over time (p=0.024), but this finding is hypothesis-generating given persistent high heterogeneity; no temporal trends were observed for knowledge or attitudes. GRADE certainty was low due to serious inconsistency. KAP towards urogenital schistosomiasis in Africa south of the Sahara remains suboptimal, with less than half of at-risk individuals adopting preventive behaviors. The wide range of findings highlights the need for context-specific interventions. Behavior change communication, school- and reproductive-health education, and WASH investments are urgently needed. Restriction to English-language articles is a major limitation.

41. Neurobehavioral, cholinergic and histopathological alterations induced by copper oxide nanoparticles in male mice.

期刊: Toxicology letters 发表日期: 2026-Jun-22 链接: PubMed

摘要

Copper is an essential element involved in metabolic processes in both plants and animals. However, in its nanoparticle form, copper is widely used in industrial and biomedical applications, raising concerns about its potential health risks. This study aimed to evaluate the impact of CuO-NPs on cognitive and memory functions in mice, with a particular focus on the cholinergic system and oxidative stress pathways. Adult male mice were exposed to CuO-NPs at different doses (0, 5, and 10mg/kg bw) via intraperitoneal administration over a period of 21 days. Behavioral assessments, including the open field test (OF), novel object recognition test (NORT), and Morris water maze (MWM), revealed significant impairments in spatial learning, short-term memory, and recognition ability in the group treated with 10mg/kg CuO-NPs. In contrast, no alterations in memory or anxiety-like behaviors were observed at the low dose (5mg/kg) compared to controls. Biochemical analyses of brain tissues showed increased lipid peroxidation and altered antioxidant and cholinesterase activities, while qRT-PCR analysis revealed significant downregulation of cholinergic-related genes in mice exposed to the high dose (10mg/kg) compared with controls. Additionally, histopathological examination confirmed pronounced neuronal damage, particularly in the hippocampus and cortex, indicating severe neuropathological lesions at the highest dose. Importantly, no significant toxic effects were observed at the 5mg/kg dose. These findings suggest that CuO-NPs are relatively safe at lower doses; however, higher exposure may impair cognitive and memory functions by disrupting cholinergic neurotransmission and inducing oxidative stress, emphasizing the need for caution in their widespread application.

42. Virulence and Antimicrobial Resistance Gene Profiling of Salmonella Isolated from Dead-in-Shell Eggs and Hatchery Environments with Emphasis on Class 1 Integron Gene Cassette Sequencing in XDR Strains.

期刊: Microbial pathogenesis 发表日期: 2026-Jun-22 链接: PubMed

摘要

Dead-in-shell embryos may result from bacterial contamination of eggs, particularly infections caused by Salmonella spp. This study was conducted to investigate Salmonella prevalence in chicken farms in Ismailia Governorate, Egypt, characterization of serogroups, antimicrobial resistance profiles, biofilm-forming ability, virulence determinants (fimA, fimH, invA, stn, pefA, sopB, sopE1, and hilA), antimicrobial resistance genes (qnrS, qnrA, blaTEM, blaSHV, blaCTX-M, floR, tetA, and mcr-1), integrase genes (intI1 and intI3) and sequence analysis of gene cassettes associated with class 1 integrons. A total of 350 samples were collected, including dead-in-shell embryos (n = 285), egg nests (n = 33), and hatchery environments (n = 32). Bacteriological analysis, serogrouping, antimicrobial sensitivity testing, biofilm formation was performed as well as screening of virulence, antimicrobial resistance and integrase genes using PCR. Adding, sequencing of class 1 integron-associated gene cassettes. The overall prevalence of Salmonella was 9.71%. Salmonella Enteritidis was the predominant serovar (29.41%). Among the recovered isolates, 23.53% were classified as extensively drug-resistant (XDR), while 76.47% exhibited multidrug resistance (MDR), with a notably high resistance to colistin (88.24%). Biofilm was detected in 79.41% of the isolates at varying degrees. All tested isolates (100%) harbored the examined virulence genes (fimA, fimH, invA, stn, pefA, sopB, sopE1, and hilA) as well as the antimicrobial resistance genes qnrS, blaTEM, and blaSHV, with a high prevalence of the mcr-1 gene (87.5%). The class 1 integron integrase gene (intI1) was detected in 87.5% of the tested isolates, whereas all isolates were negative for the class 3 integron gene (intI3). Sequencing of the integron-associated gene cassettes revealed the presence of estX, aadA alleles, purL, dfrA, and lnuF genes. Given the critical role of hatcheries in poultry production chain, the emergence of XDR and MDR Salmonella strains facilitates early colonization of hatched chicks, promoting persistence and dissemination throughout the poultry production system. The emergence of highly virulent XDR and MDR Salmonella strains represents a significant public health threat, underscoring the urgent need for a One Health approach that integrates human, animal, and environmental health strategies to mitigate the spread of antimicrobial resistance and prevent further escalation of this alarming phenomenon.

43. Operative Cultures Rarely Necessitate Change to Periprosthetic Joint Infection Antibiotic Plan Based on Monomicrobial Preoperative Aspiration.

期刊: The Journal of arthroplasty 发表日期: 2026-Jun-22 链接: PubMed

摘要

Periprosthetic joint infections (PJI) are complex to manage and frequently result in prolonged hospitalization while awaiting outpatient antibiotic therapy coordination. Moving this work to the preoperative setting for nonemergent PJI cases could potentially provide more efficient and cost-effective care. This study sought to evaluate the appropriateness of antibiotic treatment plans based upon monomicrobial preoperative cultures. We identified 925 PJIs (312 hips of 613 knees) in 831 patients treated at a single institution between 2013 and 2022. Preoperative aspirations were culture negative in 171 joints (18%) and had polymicrobial growth in 107 joints (12%), leaving 641 joints (70%) with a single organism PJI based on preoperative culture from which an antibiotic treatment plan could be made. Operative cultures were evaluated for concordance with preoperative cultures. An infectious disease specialist reviewed discordant results for clinical significance and whether a change in antibiotic therapy was necessary. Among the 641 PJIs with a single organism identified preoperatively, an antibiotic plan based on preoperative culture was appropriate for 97% of PJIs. Only 17 PJIs (3%) had discordant operative cultures requiring a change in antibiotic plan. Compared with preoperative culture results, operative cultures were concordant in 484 PJIs (76%); negative in 80 PJIs (12%); discordant but determined to be a contaminant by an infectious disease specialist in 52 PJIs (8%); and discordant, but still appropriately covered by the preoperative antibiotic plan in eight PJIs (1%). In 70% of PJIs, preoperative aspiration yields a single identifiable pathogen. An antibiotic plan targeting this pathogen will be highly likely to provide effective therapy. These findings suggest that most PJI treatment regimens can be finalized preoperatively to facilitate earlier hospital dismissal and potentially more cost-effective PJI care.

44. Night-Shift Intensity, Duration, Cardiovascular Susceptibility and Incident Cardiovascular Disease: UK Biobank Study.

期刊: The American journal of medicine 发表日期: 2026-Jun-22 链接: PubMed

摘要

Night-shift work has been associated with adverse cardiovascular outcomes. It remains unclear whether the cardiovascular association of night-shift exposure differs according to underlying baseline cardiovascular susceptibility and whether short-term intensity and longer-term duration show similar patterns. We analyzed 85,322 UK Biobank participants with occupational night-shift information. Baseline cardiovascular disease risk profile was classified as low, intermediate, or high using a composite score based on cardiovascular disease polygenic risk score tertiles, current smoking, obesity, low moderate-to-vigorous physical activity, and insomnia. Night-shift exposure was evaluated in two ways: monthly intensity and yearly duration, each categorized as none, low, or high. Incident cardiovascular disease was identified from inpatient records. Cox proportional hazards models were evaluated for the associations. Of 85,322 participants, 24,696 were classified as low cardiovascular disease risk, 49,332 as intermediate risk, and 11,294 as high risk. Across all strata, workers without night-shift exposure generally had the lowest incidence of cardiovascular disease . In the low-risk group, high monthly intensity and high yearly duration were each associated with similar increased risk and having more pronounced in high-risk group. For monthly intensity, the aHR were 1.35 (95% CI 1.19-1.52) and 1.22 (95% CI 1.08-1.37) for low- and high-intensity groups, respectively, whereas for yearly duration the corresponding aHR were 1.21 (95% CI 1.06-1.37) and 1.34 (95% CI 1.19-1.51). Among workers with occupational night-shift information, the association between night-shift exposure and incident cardiovascular disease was strongest in those with greater baseline cardiovascular susceptibility. Compared with monthly intensity, yearly duration showed a more consistent exposure-response pattern.

45. Quantitative Postural Evaluation in Orchestral Musicians (the OPErA Project): Protocol for a Cross-Sectional Study.

期刊: JMIR research protocols 发表日期: 2026-Jun-22 链接: PubMed

摘要

Musicians are at high risk for playing-related musculoskeletal disorders due to prolonged static postures and asymmetrical movements. Despite the prevalence of these disorders, objective ergonomic assessments in orchestral settings are limited. The primary aim of this study (the Orchestral Posture Ergonomic Assessment [OPErA] project) is to quantify postural deviations in professional orchestral musicians, with and without their instruments, and to investigate their association with pain and pain leading to performance limitation. Secondary aims include exploring demographic, clinical, and occupational factors associated with these outcomes. This cross-sectional study will enroll 250 professional musicians from Italian orchestras, excluding pianists. Postural assessments will be conducted in 2 phases-without and with the instrument-using the Physical Analyzer Portable, a device for calibrated photo acquisition. Anatomical landmarks will be marked with electrocardiogram electrodes to measure inclination, rotation, and asymmetries in the frontal and sagittal planes. Pain and disability will be evaluated using validated questionnaires (Quick Disabilities of the Arm, Shoulder and Hand [QuickDASH]; Modified Oswestry Disability Index; and Neck Disability Index). Statistical analysis will include descriptive statistics, 2-tailed t tests, chi-square tests, and regression models to explore associations between posture and pain. The protocol was approved in November 2022 and funded in 2025. Data collection was conducted from May 2023 to April 2026. By the time of manuscript submission (February 2026), 240 of the target 250 participants had been enrolled. Data analysis is ongoing, and the results are expected to be published in July 2026. This study will provide quantitative insights into postural deviations and their relationships with pain and pain leading to performance limitation. The findings are expected to identify instrument-specific associated factors and compensatory behaviors, supporting the development of targeted ergonomic interventions and preventive strategies for musicians’ health.

46. A socioecological framework for physician advocacy: motivators, enablers, and barriers.

期刊: CMAJ : Canadian Medical Association journal = journal de l’Association medicale canadienne 发表日期: 2026-Jun-21 链接: PubMed

摘要

Advocacy is a professional competency for Canadian physicians, yet adoption into medical education, academic medicine, and physician practice varies. We sought to explore perspectives on why and how physicians integrate health advocacy into their professional identity and to develop a model framework. We used a phenomenological approach to develop a socioecological framework. Using purposeful and chain sampling, we conducted semi-structured interviews with physician advocates of diverse backgrounds, clinical specialties, and advocacy interests from across Canada. We used thematic analysis to identify themes, which we then mapped onto the socioecological model. We interviewed 27 participants. We derived 7 themes: intrinsic motivation, role synergy, peers and institutions, external incentives, positionality, advocacy training, and strategic mindset. Themes layered onto or between 4 levels of the socioecological model. Within the intrapersonal level, identity, lived experiences, and exposures to injustice shaped advocacy commitment. Within the interpersonal level, patient relationships and moral injury motivated action; professional responsibility informed advocacy tactics. Within the organizational level, institutional constraints, political considerations, limited academic recognition, and fear of polarization and backlash were barriers; peer and institutional support were enablers. Within the community and society level, physicians described a tension between insider versus outsider roles and efficacy and needing to balance rapid public engagement with long-term institutional influence. Participants emphasized hands-on learning, mentorship, and a hidden curriculum. Physician advocates are influenced by lived experiences and perceived injustice, empowered by training and mentorship, constrained by perceived political and institutional barriers, and fear backlash. Formal curricula and aligned institutional culture support physicians in their role as advocates.

47. Ebola virus disease.

期刊: CMAJ : Canadian Medical Association journal = journal de l’Association medicale canadienne 发表日期: 2026-Jun-21 链接: PubMed

摘要

48. Trophoblast cell-surface antigen 2 evaluation in intraepithelial neoplasia and intraductal carcinoma of the prostate: An immunopathological study.

期刊: Tissue & cell 发表日期: 2026-Jun-20 链接: PubMed

摘要

The origin of intraductal carcinoma of the prostate (IDC-P) in presence of prostate adenocarcinoma (PCa) is a matter of debate. This study evaluates trophoblast cell-surface antigen 2 (Trop-2) expression in prostatic high-grade intraepithelial neoplasia (HGPIN), IDC-P and PCa to explain the possible mechanism for IDC-P arising. Trop-2 was localized in the luminal epithelium of normal prostate gland, HGPIN and IDC-P. The quantitative analysis of immunohistochemistry showed no difference of Trop-2 expression between HGPIN and IDC-P, while statistically significant differences were observed comparing the two pathologies with normal tissues. Contrarily, Trop-2 was expressed in 2.5% of the basal cells in normal prostate gland and in 1% of HGPIN while Trop-2 was expressed in 8% of cells in IDC-P samples. We suggest that Trop-2 present in the basal cells may acquire neoplastic changes. The neoplastic cells could grow into the glandular lumen as HGPIN and/or spread into the duct as IDC-P or spread into the stroma as PCa. In conclusion, our data in part support the theory of intraductal carcinoma origin through retrograde glandular colonization.

49. Interactions of environmentally relevant polyethylene terephthalate (PET) micro-nanoplastics with toxic elements and organic co-pollutants: Chemical corona formation and impact on toxicity and bioavailability during gastrointestinal co-ingestion.

期刊: Journal of hazardous materials 发表日期: 2026-Jun-20 链接: PubMed

摘要

The ability of environmental pollutants (EPs) to interact with and form chemical coronas on micro-nanoplastics (MNPs) raises significant concerns about potential toxicological effects in biological systems. Here, we investigated the formation of chemical coronas of toxic elements (Arsenic-As, Lead-Pb, and Chromium-Cr) and organic pollutants (PFOS and boscalid), on polyethylene terephthalate (PET) PM10 MNPs generated by simulating a key scenario of the degradation lifecycle of plastics: cryomilling (mimics fragmentation process) followed by 21-day UV photo-oxidation (aged MNPs). Additionally, a small intestinal epithelium (SIE) model, coupled with three-phase simulated gastrointestinal digestion, was employed to evaluate the fate of EP coronas across the gastrointestinal tract (GIT) and the toxicity and bioavailability of MNPs and EPs. PET MNPs sorbed substantial amounts of toxic elements and organic pollutants in water (fasting food model). However, EP fate across the GIT during digestion was EP-specific, with toxic elements (As and Pb) generally being desorbed across GIT to a significantly greater extent than organic pollutants. PET MNPs and EPs alone, and their co-ingested mixture (PET MNPs + EPs), were not cytotoxic, but PET MNPs + EPs increased the intracellular oxidative stress in the SIE. More importantly, the presence of PET MNPs increased the translocation of most EPs (As, Pb, PFOS, and boscalid) in the SIE, while the presence of EPs had no effect on uptake and translocation of co-ingested PET MNPs. The enhanced bioavailability of EPs promoted by PET MNPs was associated with downregulation of cell junction genes, indicating modulation of epithelial barrier-associated pathways at the molecular level. The study highlights potential public health concerns arising from co-ingestion of EPs and MNPs, including the formation of EP chemical coronas on MNPs and their influence on EP bioavailability.

50. Competitive secondary formation and evolving sources drive the stage-dependent evolution of PM2.5-bound PAHs and their derivatives associated health risks.

期刊: Journal of hazardous materials 发表日期: 2026-Jun-19 链接: PubMed

摘要

Polycyclic aromatic hydrocarbons (PAHs) and their oxygenated (OPAHs) and nitrated (NPAHs) derivatives are critical carcinogenic constituents of PM2.5, yet high-resolution observations of their dynamic evolution remain scarce. This study characterized the 4-h spatiotemporal evolution and source-apportioned risks of these compounds across four Guanzhong Plain cities including Xi’an (XA), Baoji (BJ), Tongchuan (TC), and Weinan (WN). The analysis spanned the development (S1), persistence (S2), and abatement (S3) stages of winter haze episode. Average ΣPAHs and ΣOPAHs concentration was 105.18 ± 83.35 ng·m-3 and 23.76 ± 51.50 ng·m-3, respectively, and peaked in TC and WN, driven by primary combustion. ΣNPAHs increased to 36.3% in XA during stage S2, highlighting enhanced secondary formation. Stage-resolved source apportionment identified coal and biomass combustion as dominant drivers during stage S1 and S3, while secondary NPAHs increased during S2. Machine learning revealed an episode-specific non-linear framework in which NO2 and relative humidity serve as the primary regulators governing the competitive balance between inorganic and organic nitration. The humidity-driven promotion of secondary NPAHs emerges only when NO2-driven competition is weakened, explaining the localized pollution surges observed during the stage S2. Monte Carlo assessments indicated that episode-specific carcinogenic risks were primarily driven by coal combustion and biomass burning during S1 and S3, whereas secondary formation emerged as a prominent risk contributor in XA during S2. These findings underscore stage-specific mitigation strategies that prioritize primary combustion emissions during S1 periods and shift toward precursor reduction during S2 periods, thereby minimizing the episode-specific health risks associated with PAHs and their derivatives.

51. The Smokerface poster campaign for adolescent smoking prevention in schools: A cluster-randomized controlled trial.

期刊: European journal of cancer (Oxford, England : 1990) 发表日期: 2026-Jun-19 链接: PubMed

摘要

Tobacco use remains a leading cause of preventable morbidity and mortality and is commonly initiated in adolescence. We evaluated whether Smokerface-Poster, a low-intensity, appearance-based school campaign promoting a photoaging app, could attenuate smoking uptake among early adolescents. In this two-arm cluster-randomized controlled trial, 126 German secondary schools (9797 grade 6/7 students; 96.0% were 11-13 years old; 51.4% male; 48.6% female) were allocated to intervention or control. Intervention schools displayed two classroom posters for 24 months. Smoking behavior was assessed at baseline and 24 months. As primary outcome, we investigated the between‑group difference in the change in 30-day smoking prevalence, with a number needed to treat (NNT) of < 100 students predefined as clinically relevant per protocol. Baseline smoking prevalence was 7.4% in the control vs. 7.9% in the intervention group. At 24 months post-intervention, smoking prevalence increased by 19.2 %age points in control vs. 18.1 %age points in the intervention group (number needed to treat=93; adjusted ratio of odds ratios 0.87, 95% CI 0.69-1.09; p = 0.228). Favorable, non-significant patterns were also observed for anti-smoking intentions and attitudes. Although the between-group difference was not statistically significant, the intervention reached the predefined threshold for clinical relevance, with an NNT of 93. This suggests that, for every 93 students exposed to the Smokerface-Poster campaign, one fewer adolescent would be expected to smoke over the two-year follow-up. Given its low cost of < €50 per 100 students, the intervention appears to be a promising approach to supporting school-based smoking prevention.

52. Efficiency and safety of argon laser in trichiasis: A systematic review and meta-analysis.

期刊: Indian journal of ophthalmology 发表日期: 2026-Jun-17 链接: PubMed

摘要

To conduct a systematic review and meta-analysis evaluating the efficacy and safety outcomes of argon laser treatment for trichiasis, a common eye condition that can lead to blindness. We conducted a systematic review and meta-analysis. PubMed, Cochrane Library, Science Direct, Embase, and ClinicalTrials.gov databases were searched for studies on argon laser treatment of trichiasis, without language restriction, up to March 2025. We computed random-effect meta-analysis and meta-regressions on putative influencing factors. The PRISMA guidelines were followed. The meta-analysis was registered on PROSPERO (ID: CRD42024546074). Twenty-seven articles were included in the systematic review, and 20 in the meta-analysis, for a total of 1044 patients. The prevalence of trichiasis recurrence at the end of follow-up was 4.1% (95% CI 2.7 to 5.5%), ranging from 0% to 37.7%, reflecting substantial heterogeneity between studies (I2 91.5%). After only one session, the prevalence of trichiasis recurrence was 35.8% (25.9 to 45.7%, I2 91.5%). The prevalence of lid complications was 0.1% (-0.2 to 0.5%). Reported complications included notching (0.1%; 95% CI, -0.2% to 0.5%), hypopigmentation (0.0%; 95% CI, -0.1% to 0.2%), and rash (0.0%; 95% CI, -0.3% to 0.3%). The prevalence of pain was 0.0% (-0.1 to 0.2%). The certainty of the evidence was assessed using the GRADE approach, and most outcomes were rated as low certainty due to limitations in study design and heterogeneity. Argon laser for trichiasis is an effective procedure, but several sessions may be necessary. The safety profile of this technique is very good with few and mild complications.

53. Cannabidiol Limits Early Aβ-Induced Glial Activation and Preserves Synaptic Integrity in Primary Mouse Hippocampal Neuron-Glia Cultures.

期刊: The European journal of neuroscience 发表日期: 2026-Jun 链接: PubMed

摘要

Alzheimer’s disease (AD) initiates with subtle neuroimmune alterations that precede overt synaptic loss and neuronal death, yet the early sequence linking Aβ exposure to glial activation remains incompletely understood. To capture early neuroimmune dynamics with greater physiological relevance, we employed primary mixed neuron-glia cultures derived from the hippocampi of postnatal day 1 (P1) mice. Unlike conventional coculture systems, these hippocampal mixed cultures preserve intrinsic neuron-astrocyte-microglia communication and recapitulate key features of the in vivo hippocampal microenvironment. Using this model, we investigated whether cannabidiol (CBD) modulates the initial pathogenic events triggered by Aβ25-35 during a 24h simultaneous cotreatment in cell culture. Aβ exposure induced robust hippocampal glial activation, oxidative stress, and elevated levels of proinflammatory mediators, particularly IL-1β, IL-6, and TNF-α. Notably, hippocampal synaptic and neurogenic markers (5HT1A, Gria1, GRIN1, DCX, PSD-95) remained largely unaltered at this early stage, revealing a temporal dissociation in which glial-driven inflammation precedes synaptic dysfunction. CBD significantly attenuated inflammatory and oxidative responses and prevented Aβ-induced cellular damage, indicating engagement of endocannabinoid-related mechanisms that constrain early hippocampal glial reactivity. Although CBD did not fully normalize all glial alterations, it preserved hippocampal synaptic integrity and halted progression toward neuronal dysfunction. Together, these findings identify early hippocampal glial inflammation as a primary target of CBD and provide mechanistic insight into the temporal sequence linking Aβ exposure to neuroimmune activation. These results highlight early glial responses as a critical window for therapeutic intervention and support cannabinoid-based strategies to modulate the initial stages of Alzheimer’s disease pathogenesis.

54. Microbiologically confirmed tissue expander and breast implant infections: Evaluating risk factors for recurrence and optimal treatment strategies.

期刊: Journal of plastic, reconstructive & aesthetic surgery : JPRAS 发表日期: 2026-May-30 链接: PubMed

摘要

In 2024, approximately 760,000 breast reconstructions were performed in the United States, including over 160,000 post-mastectomy procedures. Breast prosthesis infections, reported in 1-35% of cases, compromise esthetic outcomes, delay adjuvant therapy, and increase morbidity and recurrence risk. Data on predictors of recurrence and the impact of surgical strategies remain limited. We conducted a single-center retrospective cohort study of adult women with microbiologically confirmed implant or tissue expander infections (2017-2024). The primary outcome was infection recurrence within 12 months of intervention. Secondary outcomes included post-operative complications (hematoma, seroma, capsular contracture, necrosis). Outcomes were compared across three surgical strategies - one-stage exchange, two-stage exchange, and explantation - using logistic regression and time-to-event analyses to assess recurrence-free survival. 67 implant and 107 tissue expander infections were included. Recurrence occurred in 16% of implant and 21% of tissue expander cases. One-stage exchange had the highest recurrence (38% implant, 60% tissue expander), while two-stage exchange and explantation were associated with lower recurrence rates. In multivariable models, these strategies were associated with reduced recurrence risk, although some comparisons did not reach statistical significance. Kaplan-Meier analysis demonstrated inferior recurrence-free survival with one-stage exchange. Among tissue expander cases, antibiotic spacer use was independently associated with increased recurrence risk (adjusted OR 5.38, 95% CI 1.06-27.22). Two-stage exchange and explantation were associated with lower infection recurrence and may represent favorable strategies in selected patients. Delayed reconstruction should be considered when feasible. The association between spacer use and recurrence warrants further investigation.

55. Training and Communication Package for Acute Fever Case Management and Antibiotic Prescriptions: A Qualitative Exploration into Changing Behaviors of Healthcare Workers, Patients, and Caregivers in Chandigarh, India.

期刊: Indian journal of public health 发表日期: 2026-Apr-01 链接: PubMed

摘要

Antimicrobial resistance is a growing public health concern in India. It is driven largely by the misuse and overuse of antibiotics. This qualitative study aimed to examine how the Training and Communication (T and C) package influenced antibiotic prescribing practices of healthcare providers and prescription adherence among patients and caregivers at Civil Hospital, Manimajra, Chandigarh. A grounded theory approach was applied to qualitative data collected at baseline and endline. Purposive sampling was used to conduct focus group discussions and in-depth interviews with healthcare workers, patients, and caregivers. The topic guides were developed with reference to the capacity, opportunity, motivation-behavior framework. Data were transcribed, translated, manually coded, and thematically analyzed to identify drivers and barriers to prescription adherence before and after the intervention. Drivers of, and barriers to, prescription adherence included patient characteristics, doctor’s workload, patient’s knowledge about antibiotic uses, expectations for cheaper medicines, and the attitude of healthcare providers before the intervention. Based on these findings, a T and C package was developed for healthcare providers and patient communication. The use of rapid diagnostic tests and prescription communication helped in early diagnosis and increased patient’s adherence to the prescribed medicine after the intervention. Patients in the intervention arm reported supportive engagement with the healthcare professionals. The affordability of medicine was a major barrier to prescription adherence across arms, pre- and postintervention. Training of service providers and communication with patients were important for ensuring prescription adherence and optimal use of antibiotics. The affordability of medicines was the biggest challenge.

56. Determinants Influencing the Health Outcomes of Coal Mine Workers in Central India: A Cross Sectional Study.

期刊: Indian journal of public health 发表日期: 2026-Apr-01 链接: PubMed

摘要

Despite the health risks, coal mining remains essential for meeting much of the world’s energy demands. While mining drives economic growth, it also harms the environment and workers’ health. The objective of this study was to study common health problems and sociodemographic factors among coal mine workers and provide appropriate recommendations. A cross-sectional study was carried out in an underground Coal mine in Central India. A predesigned, pretested pro forma was used to interview 250 Coal mine workers. Qualitative data were expressed by number and percentage, and quantitative data were expressed in terms of mean and standard deviation. Chi-square test was applied to observe the differences between proportions. P < 0.05 was taken as statistically significant. Maximum study participants, 96 (38.4%), were in the age group of 56-60 years. Among study participants, 108 (43.2%) reported having musculoskeletal disorders. Other health problems found in this study were hypertension 95 (38%), diabetes mellitus 79 (31.6%), etc. Musculoskeletal disorders were found to be the most prevalent ailment among coal mine workers in this study. This study found that older age, longer duration of job, and type of shifts were associated with musculoskeletal disorders among coal mine workers.

57. Speech Transmissibility in a Tertiary Care Hospital in North India: An Unexplored Consequence of Hospital Noise.

期刊: Indian journal of public health 发表日期: 2026-Apr-01 链接: PubMed

摘要

Hospital noise causes speech interference between patients and staff, leading to miscommunication, uncertainty, irritation, frustration, and medical errors. Speech transmission index (STI) is a metric ranging from 0 to 1 representing the transmission quality of speech with respect to its comprehension and intelligibility. The objective of this study was to assess the speech intelligibility in a tertiary care hospital. A cross-sectional study was conducted in a 1600-bedded tertiary care hospital. STI for public address systems-Pro - an application meeting the existing IEC-60268-16:2011 standards for speech intelligibility, was used to measure STI of 30 sites in the hospital during the day and night, both during the weekdays and the weekends. An STI measure of ≥0.75 was deemed good for speech transmissibility. The mean STI measured was 0.62 (standard deviation ± 0.17). Among indoor sites, STI ranged between 0.25 at the outpatient department (OPD) registration and 0.95 at the first floor of the OPD block. During the weekdays, OPD registration recorded the poorest STI (0.25) during the daytime. The poorest STI at night was observed at the emergency registration (0.48) and the emergency room (0.52). Out of the 23 indoor sites, 3 sites reported poor speech intelligibility, while 13 sites reported only fair speech intelligibility. Findings from sites, like the OPD registration, medicine wards, and emergency, were of concern. Interventions to reduce background noise and improve the acoustic environment need to be considered.

58. Combined healthy lifestyles and osteoarthritis among middle-aged and older adults: A cross-sectional study in US adults.

期刊: Science progress 发表日期: 2026 链接: PubMed

摘要

ObjectiveThis cross-sectional study aimed to examine the association between combined healthy lifestyle factors and the prevalence of osteoarthritis (OA) among middle-aged and older U.S. adults using nationally representative data from the National Health and Nutrition Examination Survey (NHANES).MethodsData were collected from 15,617 adults participating in NHANES (2005-2020). A healthy lifestyle score (range 0-6) was constructed based on six modifiable factors: smoking status, alcohol consumption, physical activity, diet quality, waist circumference, and sleep duration. Weighted multivariable logistic regression models were utilized to analyze the relationships between healthy lifestyle scores and the prevalence of OA, controlling for demographic, socioeconomic, and health-related variables. Robustness was assessed through stratified, interaction, and sensitivity analyses, including propensity score adjustment, E-value analysis, and restricted cubic spline modeling.ResultsAmong 15,617 participants, OA was present in 2,275 individuals. In the crude model, the association between the healthy lifestyle score and OA was not statistically significant for the per-factor trend. After adjustment for covariates, a higher healthy lifestyle score was significantly associated with lower odds of OA. Participants with 5-6 healthy lifestyle factors had 31% lower odds of OA, and each additional factor was associated with 7% lower odds of OA. Key factors associated with lower odds of OA included non-smoking, optimal waist circumference, and adequate sleep. The association was more pronounced in adults under 60 years. Sensitivity analyses confirmed a consistent inverse association between the lifestyle score and OA odds.ConclusionsOur findings suggest that adherence to a greater number of healthy lifestyle factors may be associated with lower odds of OA, particularly among younger adults. Notably, smoking avoidance, maintaining optimal waist circumference, and adequate sleep duration demonstrated particularly robust inverse associations. These results highlight the potential of integrated lifestyle modifications for OA-related public health strategies at both individual and population levels.

59. [Effect of exclusive breastfeeding on infant hospitalizations].

期刊: Medicina 发表日期: 2026 链接: PubMed

摘要

Exclusive breastfeeding (EBF) provides essential nutrients and strengthens the immune system, significantly reducing the risk of infant hospitalization during the first six months of life. This study aims to evaluate the association between EBF and the risk of hospitalization during the first year of life in a cohort of 370 postpartum women. A prospective cohort study was conducted with postpartum women recruited from a maternity ward between August 2022 and 2023, with a one-year follow-up period. All postpartum women admitted during the same period who voluntarily agreed to participate in the study were included. The women were grouped by EBF and non-EBF status. Demographic and clinical variables and infant health outcomes were compared. The study included 370 dyads (postpartum women and their newborns), of which only three were lost to follow-up. Of the remaining 367 dyads, 163 maintained exclusive breastfeeding (EBF) and 204 did not. The non-EBF group had a higher hospitalization rate (35.5% vs. 22.7%; p < 0.001). Multivariate analysis showed that not practicing EBF doubled the risk of hospitalization (OR: 2.0; 95% CI: 1.4-2.8), regardless of other variables. Maintaining exclusive breastfeeding (EBF) is associated with a significant reduction in the risk of hospitalization during the first year of life, supporting its promotion as a public health strategy. Introducción: La lactancia materna exclusiva (LME) durante los primeros seis meses de vida aporta nutrientes esenciales, fortalece el sistema inmunológico y se asocia a una disminución del riesgo de hospitalización infantil. El objetivo es evaluar la asociación LME y el riesgo de hospitalización durante el primer año de vida en una cohorte de 370 puérperas. Materiales y métodos: Estudio de cohorte prospectivo que reclutó mujeres puérperas entre agosto de 2022 y 2023 en un servicio de maternidad con un seguimiento de 1 año. Se incluyeron sistemáticamente todas las mujeres puérperas que presentaron internación conjunta que aceptaron participar voluntariamente en el estudio. Estas fueron agrupadas por LME y no LME. Se compararon variables demográficas, clínicas y resultados de salud infantil. Resultados: En el estudio se reclutaron 370 diadas (mujeres puérperas y recién nacidos) de las cuales solo 3 se perdieron en el seguimiento. De los 367 restantes, 163 mantuvieron LME y 204 no LME. El grupo de no LME presentó una mayor tasa de hospitalización (35.5 % vs. 22.7 %; p < 0.001). El análisis multivariado mostró que no realizar LME duplicó el riesgo de hospitalización (OR: 2.0; IC 95 %: 1.4‐2.8), independientemente de otras variables. Conclusión: El mantenimiento de LME se asocia a una disminución del riesgo de hospitalización durante el primer año de vida, respaldando su promoción como estrategia de salud pública.