公共卫生研究摘要 (2026-06-24)

共收录 60 篇研究文章

1. Impact of school nurse education on factors influencing HPV vaccine communication with parents.

期刊: Human vaccines & immunotherapeutics 发表日期: 2026-Dec 链接: PubMed

摘要

Human papillomavirus (HPV) can cause six cancer types but can be prevented with timely vaccination in early adolescence. However, despite the wide availability of the HPV vaccine, uptake remains suboptimal among US adolescents. School nurses are invaluable resources to students and their families regarding adolescent immunization needs. As part of the All for Them vaccination program, we assessed the impact of the continued nurse education (CNE) intervention on school nurses’ HPV vaccine communication with parents. Seventy-two school nurses and nurse administrators in Texas participated in the study. Using a single-arm study design, we measured participants’ potential barriers to and self-efficacy for recommending the HPV vaccine, and knowledge about HPV and the vaccine. Data were collected between November 2021 and May 2023. We evaluated differences in survey responses using paired t-test and McNemar-Bowker chi-square test. Participants’ uncertainty about HPV vaccine efficacy was significantly reduced at follow-up (P < .001). More participants indicated that their HPV knowledge (P = .003) and understanding of the recommended dosing schedule for the vaccine (P = .003) were not barriers at all at follow-up. Participants’ confidence to communicate with parents about HPV vaccination significantly increased across six self-efficacy variables at follow-up (P < .001). The CNE intervention appeared to improve nurses’ HPV and HPV vaccine-related knowledge and increased their self-efficacy to communicate about HPV vaccination with parents, while lessening their perceived barriers to do so. The CNE can be a key resource to support school nurses’ professional practice, facilitating their high-quality HPV vaccine recommendations to adolescents and parents.

2. Mental health and psychosocial support during ongoing armed conflict: position paper of the Global Collaboration on Traumatic Stress.

期刊: European journal of psychotraumatology 发表日期: 2026-Dec 链接: PubMed

摘要

In this position paper, we highlight the urgent need for mental health and psychosocial support (MHPSS) systems adapted to the realities of populations affected by ongoing armed conflicts and, therefore, continuous traumatic stress. Existing frameworks largely address post-disaster contexts, offering limited guidance for settings of sustained threat. Drawing on an extensive literature search, a scoping review on MHPSS during ongoing armed conflicts, and clinical experience, we outline key mental health challenges during ongoing armed conflict and identify a critical gap in scalable, culturally responsive interventions. Based on this analysis, we propose recommendations across policy, training, staff care, and research domains. We advocate for trauma-informed, rights-based, participatory, and adaptive care systems that strengthen local capacity, integrate measurement-based approaches, and utilize digital and transdiagnostic stepped-care models. Through this paper, we aim to catalyse research, inspire innovation, and encourage global collaboration to more effectively support the mental health of communities living under the enduring strain of armed conflict. Current MHPSS frameworks are largely designed for post-disaster contexts and provide limited guidance for populations living under ongoing armed conflict and continuous traumatic stress.Evidence on effective MHPSS interventions during active armed conflict and ongoing threat remains scarce and methodologically limited, highlighting an urgent need for context-sensitive research and evaluation.We propose a set of recommendations on principles of policy, research, and staff training to collect more robust evidence in the near future.

3. Atrial fibrillation in patients with alcohol-associated hepatitis leads to increased mortality.

期刊: European journal of gastroenterology & hepatology 发表日期: 2026-Aug-01 链接: PubMed

摘要

Alcohol consumption is associated with increased risk for development of atrial fibrillation. Outcomes of patients with atrial fibrillation in the context of acute alcohol-associated hepatitis have yet to be investigated. We performed a retrospective study of patients with alcohol-associated hepatitis from the National Inpatient Sample (2016-2019), comparing those with and without concurrent atrial fibrillation. Subgroup analysis with and without cirrhosis was alone performed. Statistical analysis performed using STATA 16.1 and multivariate logistic and linear regression. Among 475 600 patients with alcohol-associated hepatitis, 27 675 (5.8%) had atrial fibrillation. Patients with atrial fibrillation had a nearly two-fold increased in-hospital mortality (6.9%) compared with those without atrial fibrillation (3.9%) [adjusted odds ratio (OR) = 1.35, 95% confidence interval (CI) = 1.20-1.53] and higher odds of developing acute kidney injury (OR = 1.23, 95% CI = 1.15-1.32). They also had longer hospital stays and higher total hospital charges (7.5 vs. 6.0 days and $20 005 vs. $14 714, respectively). Among patients with alcohol-associated hepatitis and atrial fibrillation, 33% also had cirrhosis (n = 9190), and these patients had an even higher mortality rate (11.3%) than those with alcohol-associated hepatitis and atrial fibrillation alone (4.7%). Acute coronary syndrome, chronic kidney disease, and obesity were independently associated with increased mortality. Patients with alcohol-associated hepatitis who have atrial fibrillation have an increased risk of in-hospital mortality and underlying cirrhosis compounds this risk. Early recognition of the effect of concomitant atrial fibrillation and alcohol-associated hepatitis could provide an opportunity for intervention.

4. Association between albumin-bilirubin score, model for end-stage liver disease score, platelet-albumin-bilirubin score, and acute-on-chronic liver failure complications: a cross-sectional study in a Chinese population.

期刊: European journal of gastroenterology & hepatology 发表日期: 2026-Aug-01 链接: PubMed

摘要

Acute-on-chronic liver failure (ACLF) is characterized by acute decompensation and high short-term mortality. We investigated whether the albumin-bilirubin (ALBI) score, model for end-stage liver disease (MELD) score, and platelet-albumin-bilirubin (PALBI) score independently predict major ACLF complications. This retrospective cross-sectional study enrolled 2104 ACLF patients (2017-2024) fulfilling Asian Pacific Association for the Study of the Liver 2019 criteria. ALBI, MELD, and PALBI were calculated within 48 h of admission. Multivariable logistic regression, restricted cubic spline, and receiver operating characteristic (ROC) analyses assessed associations with ascites, hepatic encephalopathy, hepatorenal syndrome (HRS), coagulopathy, splenomegaly, and spontaneous bacterial peritonitis. All three scores increased significantly with worsening Child-Pugh class (P < 0.001). Per SD increase, ALBI predicted all six complications with adjusted odds ratios (ORs) ranging from 1.98 to 8.73. MELD showed similar predictive ability (ORs: 2.58-7.26). PALBI quartiles 2 and 3 remained significantly associated with HRS (P = 0.007 and P = 0.011, respectively). Restricted cubic spline revealed nonlinear dose-response relationships (P-nonlinearity < 0.005). ROC area under the curve values were consistently higher for MELD than ALBI and PALBI. Subgroup analyses confirmed stability across age, sex, BMI, smoking, and alcohol use. ALBI, MELD, and PALBI scores simply and reliably identify ACLF complications, helping clinicians intensify monitoring and tailor therapy for high-risk patients.

5. Indirect comparison of endoscopic balloon dilatation, stent placement, and stricturotomy for lower gastrointestinal strictures in Crohn's disease: a systematic review and meta-analysis.

期刊: European journal of gastroenterology & hepatology 发表日期: 2026-Aug-01 链接: PubMed

摘要

Outcomes of endoscopic balloon dilatation (EBD), endoscopic stent placement (ESP), and endoscopic stricturotomy for Crohn’s disease-related strictures vary across studies. We conducted an indirect meta-analysis to synthesize and compare outcomes. Data were extracted from multiple online databases. Primary outcomes of interest were: clinical success and technical success. Secondary outcomes of interest were: rate of adverse events, the rates of repeat endoscopic procedures, and surgery. Pooled proportions along with 95% confidence interval (CI) and odds ratio (OR) of each outcome were calculated. We analyzed 39 studies: 25 on EBD (n = 1353), nine on ESP (n = 159), and five on endoscopic stricturotomy (n = 102). Pooled outcomes for EBD, ESP, and endoscopic stricturotomy, respectively, were: technical success (88, 93, and 95%), clinical success (62, 59, and 49%), adverse events (7, 25, and 17%), repeat procedures (17, 7, and 56%), and surgery (13, 25, and 9%). Compared with EBD, endoscopic stricturotomy showed significantly higher repeat endoscopy rates (OR = 6.165, 95% CI: 2.328-6.328, P < 0.05). Both endoscopic stricturotomy and ESP had higher adverse event rates than EBD (endoscopic stricturotomy: OR = 2.610, 95% CI: 1.095-6.221; ESP: OR = 4.214, 95% CI: 2.070-8.579; both P < 0.05). Differences in clinical and technical success, repeat procedures with ESP, and surgery were NS. Clinical and technical success were not significantly different between EBD, ESP, and endoscopic stricturotomy for Crohn’s disease-related strictures. However, adverse events and repeat procedures were higher in ESP and endoscopic stricturotomy when compared with EBD.

6. Identifying Japanese mothers of infants and toddlers at risk of parenting isolation: A validation study of cutoff scores and associated psychosocial measures.

期刊: Japan journal of nursing science : JJNS 发表日期: 2026-Jul 链接: PubMed

摘要

To determine a cutoff score for the Social Connectivity of Mothers with People in the Community Scale (SCMPCS) and revalidate the scale using additional psychosocial indicators. A cross-sectional analysis used baseline data from one arm of a randomized trial including 259 mothers with children under 3 years of age in Sapporo City, Japan. Reliability and structural validity were reassessed using Cronbach’s alpha and confirmatory factor analysis. Parenting isolation was operationally defined as the absence of support from informal, community-based, and formal sources and used as the reference classification for ROC analysis. Predictive validity was examined using logistic regression adjusted for maternal age, educational attainment, daycare use, and perceived economic status. Criterion-related validity was evaluated using Mann-Whitney U tests. The SCMPCS showed good internal consistency (α = 0.85) and acceptable model fit (CFI = 0.90, RMSEA = 0.073). ROC analysis identified a cutoff of 30 or lower with moderate discriminatory ability (AUC = 0.73; sensitivity = 0.92; specificity = 0.50). Mothers at or below the cutoff had higher odds of meeting the operational reference classification of parenting isolation (OR = 11.94, 95% CI: 2.74-52.03) and reported lower self-efficacy and capacity to receive support, greater loneliness, and poorer well-being. The SCMPCS demonstrated stable psychometric performance, and the validated cutoff may support broad preventive screening to identify mothers who may need further assessment and early follow-up. Rather than serving as a diagnostic threshold, this cutoff may help maternal and child health services provide timely preventive support.

7. Caveats on Using Firth's Penalization in the Model-Based Regression Standardization for Rare Diseases.

期刊: Statistics in medicine 发表日期: 2026-Jul 链接: PubMed

摘要

Model-based regression standardization, also known as the parametric g-formula, is widely used to estimate marginal effect measures. However, in rare disease settings, the small number of observed events relative to the number of covariates can lead to (quasi-)complete separation, resulting in non-convergent estimates in the regression models. Firth’s penalized likelihood estimates are a common solution to this issue, ensuring finite parameter estimates even for separated data. While effective for estimating regression coefficients, Firth’s method introduces bias into model-based regression standardization because of its tendency to shrink the predicted probabilities to 0.5, leading to discrepancies between the predicted and observed event rates. We examined the implications of applying Firth’s method to model-based regression standardization, illustrating its potential bias through an empirical study on surgical site infections (SSI) in orthopedic surgeries. We also proposed two ad hoc corrections (i.e., Firth’s logistic regression with intercept correction and added covariate) to mitigate this bias and evaluated these methods via simulation studies, comparing them with propensity score-based approaches. Finally, we applied the proposed method to assess the association between SSI, a rare disease, and smoking status in a clinical database of orthopedic surgeries.

8. Prognostic Biomarker Signature of Relapse in Neuromyelitis Optica Spectrum Disorders in the CIRCLES Observational Study.

期刊: Neurology(R) neuroimmunology & neuroinflammation 发表日期: 2026-Jul 链接: PubMed

摘要

Neuromyelitis optica spectrum disorders (NMOSDs) comprise rare autoimmune diseases of the CNS in which disabilities accrue with relapses. The ability to predict and prevent relapses could dramatically improve clinical outcomes, potentially reducing morbidity and quality-of-life declines. This proteomic study aimed to identify individual and composite candidate serum biomarkers predictive of NMOSD relapse. Patients with NMOSD previously enrolled in the Collaborative International Research in Clinical and Longitudinal Experience Study (CIRCLES) cohort were selected based on documented relapses simultaneous with retrievable banked cryopreserved serum. Longitudinal serum proteomic profiles were characterized using high-resolution mass spectrometry. We used linear models with logistic regression, Cox proportional hazards models with fixed-time intervals, and time-dependent Cox proportional hazards models to analyze individual proteins and proteomic profiles for their association with future relapses factoring demographics, clinical phenotype/course, and treatments. We characterized a total of 305 longitudinally collected serum samples (N = 126), using high-resolution mass spectrometry, and identified 265 proteins overall. There was a 10-protein signature with the highest average association coefficient consistently across at least 4 of the 6 modeling analyses, including factor XI, surfactant protein B, C1RL, filamin A, cholesteryl ester transfer protein, cathelicidin antimicrobial peptide, C4A, transferrin receptor, for consistency immunoglobulin kappa constant, and serum amyloid A2 protein. This signature could significantly stratify patients with higher vs lower risk of subsequent relapse. These proteins differed in their increasing or decreasing abundance trajectories in advance of relapse. Most belong to pathways plausibly related to the immunopathology of NMOSD. Collectively, these findings provide a basis for novel biomarker development to predict NMOSD relapses sufficiently in advance to enable preventive treatment.

9. Polyphosphate-based hemostatic gauze preserves distal perfusion compared with QuikClot Combat Gauze in a porcine extremity trauma model with hemorrhagic shock.

期刊: The journal of trauma and acute care surgery 发表日期: 2026-Jul-01 链接: PubMed

摘要

Uncontrolled hemorrhage remains the leading preventable cause of death after trauma. Current prehospital strategies emphasize rapid bleeding control, yet benchmark kaolin-based dressings may impair distal perfusion through intraluminal thrombosis. Polyphosphate (PolyP)-based dressings could offer effective hemostasis while maintaining arterial flow. In a prospective, randomized, controlled large-animal extremity trauma model with hemorrhagic shock, PolyP gauze was compared with kaolin-based Combat Gauze (CG) under a standardized compression and resuscitation protocol. Primary endpoints were survival time and survival proportion; secondary endpoints included distal femoral flow, blood loss, hemodynamics, metabolic status, and coagulation. Outcome assessment was investigator blinded. Baseline characteristics were comparable between groups (n = 11 per group). Survival at 120 minutes (PolyP 90.9% vs. CG 81.8%) and total blood loss (1,780 ± 219 vs. 1,847 ± 484 mL, p = 0.72) did not differ significantly. First-pass hemostasis was achieved in 63.6% of PolyP- and 81.8% of CG-treated animals (p = 0.64). In contrast, distal pulsatile femoral flow was restored in 90.9% of PolyP-treated animals compared with 27.3% after CG (p = 0.0075). Hemodynamics, metabolic markers (lactate, base excess, pH, hemoglobin), and systemic coagulation assays (prothrombin time, fibrinogen, activated partial thromboplastin time) evolved similarly across groups. In this swine extremity trauma model with shock, PolyP gauze provided hemostasis equivalent to the current benchmark while significantly improving distal arterial perfusion. These findings support expanding performance benchmarks for prehospital hemostatic dressings to include downstream perfusion and justify further translational and field evaluation. (J Trauma Acute Care Surg. 2026;101: 129-135. Copyright © 2026 Wolters Kluwer Health, Inc. All rights reserved.).

10. Antibiotic use in emergency general surgery: What you need to know.

期刊: The journal of trauma and acute care surgery 发表日期: 2026-Jul-01 链接: PubMed

摘要

Antimicrobials are among the classes of pharmaceuticals most used by acute care surgeons, with many emergency general surgery conditions either related to infections or at high risk of infectious complications. As such, knowledge of proper use of antimicrobial agents, especially in this era of increasing antimicrobial resistance, is imperative for optimal outcomes. This review focuses on the advanced infectious diseases and antimicrobial utilization knowledge required to treat complicated and critically ill surgical patients. Overall concepts pertaining to antibiotics are discussed, followed by a more in-depth discussion of conditions common in emergency general surgery. Key themes include the importance of source control and accurate culture data, the frequent need for broad-spectrum, empiric antimicrobial therapy, subsequent careful de-escalation of antibiotics, and minimizing treatment duration. (J Trauma Acute Care Surg. 2026;101: 13-27. Copyright © 2026 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American Association for the Surgery of Trauma.).

11. Modeling framework to demonstrate elimination of a vector population: Tsetse elimination in Chad.

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

摘要

Every year, over 700,000 people, particularly children under five, die from vector-borne diseases worldwide. Effectively controlling endemics and preventing new outbreaks requires an integrated approach that can lead to the elimination of both vectors and diseases. In the last two decades, integrating medical interventions and vector control has significantly reduced the incidence of Gambian Human African Trypanosomiasis (g-HAT), with the World Health Organization validating eight countries as having eliminated the disease as a public health problem. However, elimination of the tsetse vector has not been confirmed, leaving the possibility of re-emergence. We developed a six-step modeling framework to assess vector elimination by calculating: i) the probability of vector capture; ii) the probability of observing a series of zero catches, even without actual elimination; iii) the probability of natural elimination; iv) the probability of failing to detect a rebound; v) the reinvasion risk; and vi) the sensitivity analysis. Our case study is g-HAT in Mandoul, Chad, and the elimination of Glossina fuscipes fuscipes. We used vector control from 2014 to 2025 with no tsetse detected since 2018. We cannot yet conclude, with over 90% confidence, that tsetse has been eliminated from Mandoul, nor that any remnant population will be naturally eliminated. However, since vector control stopped in April 2025, we estimate that with continued sampling over the next 2 y, and no tsetse detected, elimination could be demonstrated with 99% confidence. Our multistep modeling framework can be applied to other vectors, providing policymakers with guidelines for ongoing and future efforts.

12. Yield of Fecal Immunochemical Test Screening for Colorectal Cancer in Adults Aged 45-49 vs 50-54 years.

期刊: The American journal of gastroenterology 发表日期: 2026-Jun-24 链接: PubMed

摘要

The rising incidence of early-onset colorectal cancer (CRC) has prompted debate over lowering screening initiation age. However, real-world evidence on fecal immunochemical test (FIT)-based screening effectiveness in 45-49 years remains limited. Our study aimed to evaluate screening yield of FIT-based CRC screening between 45-49 and 50-54 years. Conducted within a provincial CRC screening program in China, this study employed two-sample FIT screening followed by colonoscopy for positive results. Screening outcomes, including FIT positivity, colonoscopy completion, positive predictive values (PPVs) and detection rates of adenoma and advanced colorectal neoplasia, were compared between participants aged 45-49 and 50-54 years. Robust Poisson regression was used to estimate adjusted risk ratios (aRRs), using 50-54-year-old group as reference. Among 733,137 participants, 89,446 were aged 45-49 years and 643,691 aged 50-54 years. Participants aged 45-49 years had higher FIT positivity (10.61%) and colonoscopy completion (46.75%) than those aged 50-54 years. However, detection rates for advanced neoplasia (0.30% vs. 0.39%; aRR, 0.78; 95% CI, 0.68-0.88) and any adenoma (0.78% vs. 0.95%; aRR, 0.83; 95% CI, 0.77-0.90) were significantly lower in the younger group, with similar results observed for PPVs. Within the 45-49 year group, comparable detection rates to 50-54 year age group were observed among individuals with established risk factors, most notably among smokers (RR, 1.50; 95% CI, 1.22-1.84), frequent alcohol drinkers (RR, 1.33; 95% CI, 1.01-1.75), and males (RR, 1.20; 95% CI, 1.03-1.40). Overall, adults aged 45-49 years showed higher screening participation but lower screening yield than those aged 50-54 years. These findings highlight the importance of prioritizing individuals with elevated risk profiles for CRC screening in younger populations.

13. Correctional-staff wellness in a statewide jail system: health appraisals, occupational strain and priorities for organizational support.

期刊: International journal of prison health 发表日期: 2026-Jun-24 链接: PubMed

摘要

Although substantial research has examined correctional officer health, fewer studies have focused on jail staff, and even fewer have done so within a unified, statewide jail system. This study aims to address this gap by examining staff perceptions of health and wellness across Tennessee’s county jails, where centralized oversight enables system level insight. Open-ended questionnaire data from 412 correctional personnel were analyzed following survey distribution to staff across all 120 Tennessee county jails. While jails are typically decentralized, Tennessee’s system operates under unified oversight, allowing consistent access and comparable analysis. Responses were analyzed thematically to identify health statuses, health threats and health resources. Staff identified chronic stress, burnout, trauma exposure and environmental hazards as central threats. Understaffing, mandatory overtime and unpredictable demands were consistently linked to limited rest and declining health. Participants also highlighted organizational needs, including mental health resources, improved air quality, and healthier nutrition options. This study underscores the importance of system-level, jail-specific research on correctional staff health and well-being. By demonstrating how organizational structures, environmental conditions and staffing practices shape cumulative health risks across an entire statewide jail system, the findings highlight limitations of single-site and prison-focused studies that dominate the literature. Future research should prioritize multisite and longitudinal designs that examine how changes in staffing models, shift structures and physical environments influence health trajectories over time. In addition, integrating staff-centred qualitative methods with objective health indicators would strengthen causal inference and advance theory on occupational strain, recovery and cumulative load in correctional settings. The findings provide clear guidance for correctional administrators and policymakers seeking to improve staff well-being. Participants consistently identified practical priorities, including confidential mental health services, trauma-responsive supports, improved air quality and nutrition, access to fitness resources, and staffing reforms that protect recovery time. Importantly, the study illustrates that wellness initiatives are unlikely to succeed without addressing structural constraints such as chronic understaffing and mandatory overtime. Agencies should therefore shift from isolated, program-based interventions toward integrated, system-level strategies that align organizational design with health promotion. Centralized oversight bodies can play a key role in standardizing and supporting these efforts across facilities. Correctional staff health has implications that extend beyond the workforce to incarcerated populations, families and communities. Poor staff well-being contributes to burnout, turnover and organizational instability, which can undermine safety, continuity of care and rehabilitative programming within jails. By identifying staff-defined priorities for healthier working conditions, this study supports broader public health goals related to institutional safety, ethical care and workforce sustainability. Improving correctional staff well-being may also reduce stigma surrounding mental health in custodial environments and promote healthier interactions between staff and incarcerated individuals, ultimately contributing to more humane, stable and socially responsive correctional systems. This study advances correctional health research by focusing on jail staff within a unified statewide framework. System wide data enhance generalizability and policy relevance while centering staff perspectives.

14. Equal outcomes and fewer admissions with high patient satisfaction: Antenatal telemonitoring integrated in the electronic health record.

期刊: Pregnancy hypertension 发表日期: 2026-Jun-23 链接: PubMed

摘要

We evaluated an antenatal telemonitoring program for pregnant women at increased risk of preeclampsia, fully integrated in the hospital electronic health record (EHR). In this retrospective case-control study, 20 women receiving telemonitoring were compared with 20 women receiving usual care. Primary outcomes were hypertension-related outpatient visits and hospital admissions; secondary outcomes included other contacts, diagnostics, and patient experience. Outpatient visits were similar, but hospital admissions were significantly lower in the telemonitoring group. Asynchronous patient messages increased, while other process outcomes were comparable. Patient satisfaction and willingness to reuse telemonitoring were high, supporting feasibility and acceptability of EHR-embedded telemonitoring.

15. Tick-borne diseases in Illinois (USA): A retrospective case analysis.

期刊: Ticks and tick-borne diseases 发表日期: 2026-Jun-23 链接: PubMed

摘要

Illinois is known to have established populations of four vector tick species of human health concern: Ixodes scapularis, Dermacentor variabilis, Amblyomma americanum, and Amblyomma maculatum. These ticks can transmit pathogens causing eight reportable tick-borne diseases (TBDs): anaplasmosis, babesiosis, ehrlichiosis, Lyme disease, spotted fever group rickettsioses (SFG rickettsioses), Powassan virus disease, Heartland virus disease, and Bourbon virus disease. The incidence of these diseases is spatially varied and has been changing over time. The purpose of this research is to describe factors associated with human incidence of the various tick-borne diseases in Illinois and to compare this to factors associated with canine seroprevalence to similar tick-borne diseases. All cases of tick-borne diseases in humans reported to the Illinois Department of Public Health (IDPH) between 2004 (when reporting began) and 2022 were reviewed (n = 6423), with all county-level seropositivity and canine test data reported by the Companion Animal Parasite Council between 2009 (when reporting began) and 2022. Descriptive statistics were performed to identify spatial and temporal variation. Comparison with known risk factors was conducted using zero-inflated spatiotemporal modeling for anaplasmosis, ehrlichiosis, Lyme disease, and SFG rickettsioses in humans and anaplasmosis, ehrlichiosis, and Lyme disease in dogs. Every county in Illinois reported at least one case of a human TBD from 2004 to 2022. Most reported cases were in males (61%), white (71%), and non-Hispanic (64%) residents over 40 years of age (56%). On average, the annual number of human cases increased by 23 cases every year (95% CI: 15, 31), despite large year-to-year fluctuations, with 343 in 2022 and 645 in 2021. The spatial hotspots were noted in southern Illinois for human TBDs associated with A. americanum, and D. variabilis, and for dog exposure associated with A. americanum. Hotspots were also noted in northern Illinois for diseases and exposure associated with I. scapularis for both humans and dogs and across the 2004-2022 study period. Case incidence was higher in rural counties, counties with higher deer harvests, and counties with lower median household income. These findings can be used to guide public health efforts that target self-prevention strategies to decrease the risk of a tick bite and tick-borne diseases in Illinois and are applicable in similar midwestern states with expanding TBD risk.

16. Global Report on High Pathogenicity Avian Influenza in Antarctica and sub-Antarctic Islands.

期刊: Canadian journal of microbiology 发表日期: 2026-Jun-23 链接: PubMed

摘要

Geographical isolation and extreme climates have resulted in the long isolation of Antarctica and sub-Antarctic islands. The result is a unique assemblage of animals, many endemics to the region. Low pathogenicity avian influenza is present in Antarctica; however, we have a poor understanding of the epidemiology, ecology and evolution of these viruses in the region. Of concern is the arrival of high pathogenicity avian influenza (HPAI) H5N1 clade 2.3.4.4b in the austral summer of 2023/24, and subsequent range expansion in the 2024/25 austral summer. Herein we review data and information from the literature (including all pre-prints, reports, and press releases), providing a narrative of events in the sub-Antarctic and Antarctica. We also address the impacts of HPAI H5N1 on Antarctic wildlife, and the unique challenges of working in the region.

17. Exploring the Lived Experience of Acne in the United States and the United Kingdom: Social Media Analysis.

期刊: JMIR dermatology 发表日期: 2026-Jun-23 链接: PubMed

摘要

Acne is a chronic skin condition that primarily affects adolescents and young adults but can persist into adulthood. It can have repercussions on physical and mental health, self-esteem, and body image. The increasing use of social media for health information and peer support offers an opportunity to explore real-life experiences with acne. This study aims to analyze social media messages from users in the United States and the United Kingdom using artificial intelligence to assess the impact of acne on quality of life (QoL), identify discussion topics, and explore unmet needs. The data were extracted from public platforms using a query containing the word “acne” between January 1 and December 31, 2024. Data cleaning and filtering were performed using natural language processing, machine learning methods, and algorithms. Biterm topic modeling was used to identify the main discussion topics, and QoL impact was assessed using a deep learning algorithm adapted from the EuroQol 5-Dimension Questionnaire or the 36-Item Short Form Health Survey. Unmet needs were identified through manual annotation using the saturation method. A total of 646,809 messages posted by 432,234 users were identified. The main topics included skincare routines and product recommendations (n=154,907, 23.9%), acne scars (n=135,643, 21%), and general treatment information (n=97,177, 15%). Engagement varied across topics and platforms. On Instagram, dietary and nutritional strategies (0.16%, SD 6.36%) showed the highest mean engagement, followed by skincare routines and product recommendations (0.11%, SD 4.81%). In general, engagement scores were higher in the United Kingdom compared to the United States across all topics. On TikTok, content about makeup and acne had the highest mean engagement score (3.03%, SD 92.65%). Overall, 52.9% (228,613/432,234) of the users expressed at least 1 QoL impact, most frequently related to signs and symptoms (175,604/228,613, 76.8%), social functioning (n=149,234, 65.3%), mental health (n=107,155, 46.9%), and cost (n=62,008, 27.1%). Of 3200 annotated messages, 582 contained unmet needs, including effective solutions for hormonal acne (111/582, 19.1%), clarity in identifying acne triggers (n=84, 14.4%), treatment guidance (n=68, 11.7%), and psychological support (n=68, 11.7%). This study revealed the significant physical, psychological, social, and financial impact of acne on QoL and identified several unmet needs. Given the growing role of social media, these findings highlight opportunities for dermatologists and health professionals to educate and engage with the acne community through digital platforms.

18. Epidemiology of tuberculosis, scabies, and enteric infections in Polish prisons (2002-2023): A nationwide data analysis and systematic review.

期刊: Advances in clinical and experimental medicine : official organ Wroclaw Medical University 发表日期: 2026-Jun-23 链接: PubMed

摘要

The specific conditions prevailing in prisons increase the risk of disease transmission among inmates. Several factors influence the risk of infectious disease transmission in prisons, including overcrowding, limited access to water, delayed diagnosis, and poor ventilation. The aim of this study was to assess the burden of selected infectious diseases among Polish prisoners between 2002 and 2023 and to analyze the literature addressing these diseases published between 2015 and 2025. In the 1st part, a systematic review was conducted. In the 2nd part, the results of the authors’ own research were presented. The source material was obtained from Statistics Poland. An increase in tuberculosis (TB) cases was observed from the early to mid-2010s, peaking in 2012. Subsequently, a decrease in TB cases was noted after 2012, reaching a nadir in 2021, followed by a resurgence in 2023. A decrease in scabies cases was also observed. However, from 2009 onward, this trend reversed, with cases increasing and peaking in 2014. Subsequently, the number of cases reached a new low in 2022, before increasing again in 2023. For Salmonella/Shigella, the number of tests remained around 5,000 in the early years, reaching a peak of 8,876 in 2020. This was followed by a decline, with 5,204 tests recorded in 2023. To minimize the risk of infectious disease transmission in prisons, several preventive measures should be implemented, including screening of newly admitted prisoners, introduction of prophylactic programs, and development of standardized procedures to follow in cases of infection.

19. Global, regional, and national burden of gastroesophageal reflux disease (GERD), 1990-2021, with projections to 2050.

期刊: Advances in clinical and experimental medicine : official organ Wroclaw Medical University 发表日期: 2026-Jun-23 链接: PubMed

摘要

Gastroesophageal reflux disease (GERD) is a common digestive system disorder encountered in clinical practice. In recent years, the prevalence of GERD has increased, substantially affecting patients’ daily lives. This study aimed to address this issue by leveraging data from the Global Burden of Disease (GBD) 2021 database to systematically evaluate the burden and epidemiological characteristics of GERD and to predict trends in GERD burden from 2022 to 2050. We comprehensively analyzed the burden of GERD from 1990 to 2021, evaluated years lived with disability (YLDs), prevalence and incidence rates, and conducted stratified analyses according to geographical region, Sociodemographic Index (SDI), sex, and age groups ranging from 0 to 95 years. Globally, in 2021, there were 324 million (95% uncertainty interval (95% UI): 287.7-358.9 million) incident cases, 826 million (95% UI: 733-926 million) prevalent cases, and 6.34 million (95% UI: 3.19-11.24 million) YLDs attributable to GERD. Among individuals aged 0-95 years, women aged 35-39 years had the highest prevalence, estimated at 45.32 million (95% UI: 32.92-61.05 million). The burden was highest in middle-SDI regions and lowest in high-SDI regions. Predictions using autoregressive integrated moving average (ARIMA) modeling indicated that the global burden of GERD will continue to increase from 2022 to 2050, posing increasingly severe challenges to global healthcare systems, particularly among women. It is projected that by 2050, women will account for 54% of new cases.

20. US Virgin Islands Launches Modernized NBS 7 Disease Surveillance System to Transform Public Health: Implementation Report.

期刊: JMIR medical informatics 发表日期: 2026-Jun-23 链接: PubMed

摘要

During January 2024, the US Virgin Islands (USVI) Department of Health (VIDOH) identified a critical need to maintain the cloud-hosted National Electronic Disease Surveillance System Base System (NBS) instance and support the local data modernization initiative. After consulting with federal partners and subject matter experts, VIDOH’s leadership chose to migrate the integrated disease surveillance system to a new platform hosted on Amazon Web Services (AWS) and update the NBS instance to the most advanced version, NBS 7. The primary aim was to support a USVI disease surveillance system that is modern, functional, and cost-efficient by migrating the VIDOH NBS instance from a vendor-managed environment to a jurisdiction-managed AWS cloud-based infrastructure while upgrading to NBS 7. The VIDOH implemented a phased migration strategy that included planning and cost-benefit assessment, deployment of NBS 7 within AWS, database migration, validation and optimization, and staged reonboarding of electronic reporting facilities. The USVI NBS 7 instance went live on May 6, 2025, with USVI becoming the first US jurisdiction using AWS for implementation of NBS 7 and the second using NBS 7 in production, overall. Benefits of this change included nearly 90% cost savings (preliminarily estimated at 80%), additional bandwidth, real-time data ingestion and updates, an opportunity to build local informatics capacity, and the ability to have greater autonomy over the data and its end points. To date, the VIDOH successfully reonboarded 106 of 109 (97%) previously connected electronic reporting facilities and onboarded 1 new reporting laboratory previously unable to connect due to interoperability barriers. Updating the USVI database to NBS 7 in a locally owned, cloud-hosted, AWS environment has improved disease surveillance specifically by providing the most up-to-date Centers for Disease Control and Prevention-supported data system, improving timeliness of reporting by offering local providers more flexibility in electronic reporting options, and giving USVI direct control over workflow decision functionality. Furthermore, improved interoperability and maintaining a cloud-based platform were additional benefits of the database migration. This important investment in public health infrastructure will allow USVI public health professionals, clinicians, policymakers, and other stakeholders to be able to monitor and respond to disease threats quickly and inform appropriate public health action.

21. Reddit Discussions During the 2022 Mpox Outbreak: Observational Analysis of Sentiment, Topics, and Audience Engagement.

期刊: Journal of medical Internet research 发表日期: 2026-Jun-23 链接: PubMed

摘要

Public health crises often reshape online discourse by amplifying uncertainty, frustration, stigma, and misinformation, with important implications for risk communication. This study examines these dynamics on Reddit (Reddit Inc) during a recent outbreak, using Mpox as a case study. We analyzed sentiment, topical themes, and audience engagement in posts and comments drawn from 4 Mpox-related subreddits. Using natural language processing methods, we applied sentiment analysis and latent Dirichlet allocation to classify 1169 posts and 6571 comments (from July 21, 2021, to July 16, 2025) into sentiment categories and 9 distinct topics. Of the 1169 posts, 611 (52.3%) were neutral, 370 (31.6%) were negative, and 188 (16.1%) were positive. Among comments, 2825 of 6571 (43%) were neutral, 1962 (29.9%) were negative, and 1784 (27.1%) were positive. We then used Kruskal-Wallis tests, Dunn post hoc comparisons, and Vargha-Delaney A to assess relationships among sentiment, topic, and engagement metrics. Engagement differed significantly by sentiment (P<.001) and topic (P<.001). Negative posts had higher median scores (median 7, IQR 2-27) than positive ones (median 5, IQR 2-16; z score=6.02; adjusted P<.001; Vargha-Delaney A=0.55). Posts about systemic public health failures (Topic 4) received lower median scores (median 4, IQR 1.75-14.25) than other topics. Topic 9 accounted for 980 of 6571 (14.9%) comments, dominating discussions regardless of original post topic. Positive posts generated 284 of 922 (30.8%) positive comments, whereas negative posts received 526 of 1615 (32.6%) negative comments. Comments on positive posts had higher sentiment scores (Vargha-Delaney A=0.550), whereas comments on negative posts had lower sentiment scores (Vargha-Delaney A=0.463). Topic-level differences in comment sentiment were also observed: comments responding to posts on scientific- and policy-related debates (Topic 8) were more positive (Vargha-Delaney A=0.531), whereas those on systemic failures (Topic 4) were more negative (Vargha-Delaney A=0.478). Overall, the findings highlight how audience reactions can amplify emotionally charged narratives and reframe technical information into socially and politically charged debates. These insights can inform public health communication strategies by anticipating likely audience responses, mitigating stigma and misinformation, and fostering constructive dialogue during health crises.

22. Digital Health Intervention to Promote Lifelong Specialized Care in Adults With Congenital Heart Disease: Theory-Driven Community Co-Designed Study.

期刊: Journal of medical Internet research 发表日期: 2026-Jun-23 链接: PubMed

摘要

Adults with congenital heart disease frequently experience gaps in lifelong adult congenital heart disease (ACHD) specialty care, leading to preventable complications, hospitalizations, and premature mortality. However, effective, scalable, accessible, and sustainable strategies to reduce these gaps are lacking. Digital health offers potential solutions but requires a rigorous scientific approach in its design to address the needs of the target population. This study aims to describe the development of a theory-based, community co-designed digital health intervention to improve lifelong ACHD care. We integrated theory-based behavioral frameworks, semistructured qualitative interviews with patients and clinicians, and a community-engaged approach to develop a digital health intervention for ACHD. The primary behavioral target was completing an ACHD specialist appointment. We conducted Capability, Opportunity, Motivation, and Behavior (COM-B)-guided semistructured interviews with patients with ACHD and clinicians to identify barriers to specialized care amenable to a digital intervention, and patient-centered goals for the digital tool. The community partners helped develop key intervention objectives, create a theory-driven framework, and specify how each intervention component targets specific COM-B barriers. We interviewed 54 participants (n=37 patients with ACHD, and n=17 clinicians) and engaged 21 community partners representing 4 advocacy organizations. Design objectives emphasized addressing patient loneliness, ensuring accessibility and credibility, and enabling scalability while centering patient perspectives. Participants identified 4 priorities: providing credible resources, uplifting patient voices, customizing to patient needs, and centering positivity and joy. The digital tool, named by community partners as Empower My Congenital Heart (EMCH), was designed within the web- and mobile-based, Apple- and Android-compatible, Eureka Digital Research platform (University of California, San Francisco). Key intervention components included educational modules, peer support, appointment planning nudges, and a digital medical passport. The EMCH’s theory-driven framework specifies how each intervention component targets specific COM-B barriers to specialized ACHD care. The theory-driven, community co-designed EMCH digital tool provides a scalable approach to promote lifelong ACHD specialist care. Ongoing process evaluation and a planned randomized controlled trial will assess acceptability, engagement, and effectiveness in reducing care gaps. If proven effective, EMCH has the potential to prevent complications, emergency hospitalizations, and mortality affecting the majority of adults with congenital heart disease.

23. Risk of First Adjustment Disorder in U.S. Army Soldiers.

期刊: Military medicine 发表日期: 2026-Jun-23 链接: PubMed

摘要

Adjustment disorder is the most common mental health diagnosis in the U.S. military and one of the most common globally, yet its patterns and predictors are rarely studied. Identifying career phases and characteristics associated with increased risk of first adjustment disorder (AD) diagnosis among U.S. Army soldiers can inform targeted prevention and intervention efforts. This longitudinal, retrospective cohort study analyzed data from the Study to Assess Risk and Resilience in Servicemembers-Longitudinal Study (STARRS-LS). Administrative medical and personnel records from active duty Regular Army enlisted soldiers (2015-19) were used to identify all 118,735 person-months with a first AD diagnosis and a representative, stratified probability sample of control person-months with no history of AD diagnosis (n = 316,275). Risk of first AD diagnosis was estimated as function of time in service, stratified by sex and occupation. Logistic regression examined socio-demographic, service-related, and mental health risk factors for first AD diagnosis during periods of greatest risk. This study was approved by the Institutional Review Boards of STARRS-LS collaborating institutions. AD cases were 77.2% male, 54.9% ≤24 years old, and 51.0% White Non-Hispanic. For 63.7% of cases, AD was their first documented mental disorder during service. Of those, 25.5% had been diagnosed with a stressor or marital problem in the previous 12 months. Risk of first AD by time in service was bimodal, with elevated risk during the first 1-4 years (“early-career”) and years 17-20 (“late-career”). This pattern was consistent across sex and occupational groups. Based on a sample size-adjusted alpha level, 12 of 13 multivariable risk factors were associated with early-career AD, whereas 7 of 13 were associated with late-career AD. Notable risk factors among early- and late-career soldiers were female sex (early-career: OR = 2.0; 95% CI = 1.9-2.0; late-career: OR = 1.4; 95% CI = 1.3-1.5), deployment status (early: never-deployed, OR = 2.0; 95% CI = 1.9-2.2, previously-deployed, OR = 1.6; 95% CI = 1.4-1.8; late: previously-deployed, OR = 1.7; 95% CI = 1.5-2.0), and recency of previous mental health diagnosis (early: past-month, OR = 3.7; 95% CI = 3.6-3.8; late: past-month, OR = 4.2; 95% CI = 3.9-4.5), stressor/marital problems (early: past-month, OR = 5.7; 95% CI = 5.5-5.8; late: past-month, OR = 4.1; 95% CI = 3.8-4.6), and postconcussive syndrome (early: past-month, OR = 3.0; 95% CI = 2.6-3.5; late: past 2-3-months, OR = 2.7; 95% CI = 1.5-4.8). Magnitudes of other significant ORs were more modest. Interactions indicated that associations of 9 risk factors differed for early versus late career soldiers. First AD risk is highest among soldiers either beginning their Army careers or approaching retirement eligibility. Differences in risk factors across groups highlight the importance of considering distinct military and life experiences/stressors when attempting to target and tailor interventions for those at risk of AD.

24. Potential Impact of the OPTN Status Escalation Policy for Adult Heart Transplant Candidates With Durable LVADs.

期刊: Circulation. Heart failure 发表日期: 2026-Jun-23 链接: PubMed

摘要

The 2018 heart allocation policy change substantially lowered the priority of candidates supported with durable left ventricular assist devices (LVADs) for heart transplantation. To provide stable candidates supported by durable LVADs with a quicker path to transplantation before they suffer complications, the Organ Procurement and Transplantation Network (OPTN) approved a policy stipulating that stable patients supported by durable LVADs for 6 and 8 years will obtain statuses 3 and 2, respectively. Using OPTN data, we identified all adult heart transplant candidates with a durable LVAD implanted between October 18, 2018 and May 31, 2025. We estimated the cumulative incidence of LVAD-related complications, treating transplantation and waitlist removal before experiencing complications as competing events. Furthermore, we assessed how the OPTN policy change would impact the status distribution of the waitlist. In our study cohort, 4967 adult patients who were listed for heart transplant received a durable LVAD. Transplant centers submitted 2879 justifications for status upgrades due to LVAD-related complications for 1812 (36.5%) patients. At 6 years after durable LVAD implantation, the cumulative incidence of complications and status upgrades was 42.1% (95% CI, 40.5%-43.8%), and that of transplantation was 36.0% (95% CI, 34.6%-37.6%). Of the 3779 patients who were not censored administratively, only 47 (1.2%) remained on the waitlist by 6 years after durable LVAD implantation. Had the 6- to 8-year OPTN policy change been implemented on June 1, 2025, only 4.7% of the waitlist would have changed statuses instantaneously. Almost all listed candidates with durable LVADs either experience a complication, status upgrade or are removed from the waitlist within 6 years of obtaining a durable LVAD. The upcoming OPTN policy is unlikely to prevent device complications before granting status upgrades and will likely impact a small percentage of candidates with durable LVADs.

25. Herbal, dietary supplements, oligo and trace elements consumption among chronic liver disease patients and caregivers: a cross-sectional study.

期刊: Internal and emergency medicine 发表日期: 2026-Jun-23 链接: PubMed

摘要

Use of herbal and dietary supplements (HDS) is widespread among patients with chronic liver disease (CLD). Despite the potential for adverse effects (AEs) and drug interactions (ADRs), these products are often perceived as “natural,” safe, and not requiring medical prescription. This study aimed to assess HDS, oligo and trace element consumption among patients with CLD, to examine sociodemographic correlates, to determine the extent to which use is overseen by general practitioners or specialists versus self-medication, and to document reasons for use and perceived benefits. Over a 6-month period, patients with CLD attending the outpatient clinic of the Internal Medicine and Hepatology Unit of the University Hospital of Palermo, along with their caregivers, were surveyed regarding their use of supplements. A self-administered questionnaire collected information on demographics, lifestyle habits, supplement use, motivations, perceived benefits, and prescription awareness. A total of 323 participants were enrolled: 220 (68.1%) were CLD patients and 103 (31.9%) were caregivers. Overall, 110 (34%) subjects, 39 patients and 71 caregivers, reported using at least one supplement. Consumption was slightly more frequent among caregivers than patients (37.9% vs 32.3% p = ns). Among users, HDS were the predominant products (87/110; 79.1%), followed by oligo and trace elements (36/110; 33.0%); 21/110 (19.1%) reported combined use. The most common reasons for supplement use were anxiety and sleep disorders (each 15/110; 13.6%), osteoporosis/osteoarthrosis (15/110; 13,6%), dyslipidemia (12/110; 10.9%), and dyspepsia (11/110; 10.0%). Compared with caregivers, patients more frequently used supplements for anemia (7.3%), anxiety (13.6%), and steatotic liver disease (7.3%). Perceived benefit was reported by 70.9% of users, whereas AEs and ADRs were uncommon (3.6%). Supplement consumption for liver steatosis was more common among males than females (14.3% vs 2.9%; p = 0.034). Osteoporosis-related supplement use showed a significant positive correlation with age (p = 0.019). Consumption of HDS, oligo and trace elements is common among CLD patients, and it increases with age. Their use appears driven by perceived health knowledge and a desire for well-being. Further studies are needed to enhance health education and prevent inappropriate or excessive use of these products.

26. Regenerative therapies in rehabilitation with interfaces with occupational medicine, geriatrics, and oncology: the example of extracorporeal shock wave therapy.

期刊: Wiener medizinische Wochenschrift (1946) 发表日期: 2026-Jun-23 链接: PubMed

摘要

Regenerative therapies are increasingly integrated into modern rehabilitation medicine. Extracorporeal shock wave therapy (ESWT) represents a central modality within this framework, extending beyond symptom control toward enabling functional recovery across disciplines including occupational medicine, geriatrics, and oncology. In addition, its potential socioeconomic impact is of growing relevance. This work comprises a narrative synthesis integrating concepts of regenerative medicine, rehabilitation, prehabilitation, prevention, and health economics, with a focus on ESWT as a mechanotherapeutic intervention. Rehabilitation is based on a biopsychosocial model targeting body functions, activities, and participation. By reducing pain, modulating inflammation, and promoting tissue regeneration, ESWT acts as a biological “enabler” thereby, facilitating active rehabilitation strategies. In oncological settings, ESWT may support the management of treatment-related functional impairments. In occupational medicine and geriatrics, it contributes to maintaining ability to work and independence. From a socioeconomic perspective, ESWT may reduce healthcare utilization, prevent chronicity, shorten the duration of rehabilitation, and facilitate return to work, thereby lowering indirect costs. While evidence for primary prevention is lacking, ESWT is relevant in tertiary and quaternary prevention. Extracorporeal shock wave therapy represents a key component of regenerative rehabilitation strategies. Its function-oriented and potentially cost-effective application enhances mobility, participation, and quality of life, particularly in ageing and multimorbid populations. HINTERGRUND: Regenerative Therapien werden zunehmend in die moderne Rehabilitationsmedizin integriert. Die extrakorporale Stoßwellentherapie (ESWT) stellte eine zentrale Modalität in diesem Rahmen dar, sie erstreckt sich über die reine Symptomkontrolle hinaus auf die Ermöglichung der funktionellen Genesung über verschiedene Fachgebiete hinweg einschließlich Arbeitsmedizin, Geriatrie und Onkologie. Außerdem ist ihr Potenzial für sozioökonomische Auswirkungen von zunehmender Relevanz. Die vorliegende Arbeit umfasst eine narrative Synthese integrativer Konzepte der regenerativen Medizin, Rehabilitation, Prähabilitation, Prävention und Gesundheitsökonomie; der Fokus liegt dabei auf der ESWT als einer mechanotherapeutischen Intervention. Rehabilitation basiert auf einem biopsychosozialen Modell, das auf Körperfunktionen, Aktivitäten und Teilhabe abzielt. Durch Schmerzlinderung, Beeinflussung von Entzündungsprozessen und Förderung der Geweberegeneration wirkt die ESWT wie ein biologischer „Wegbereiter“, der so aktive Rehabilitationsstrategien erleichtert. In onkologischen Zusammenhängen kann die ESWT die Behandlung therapiebedingter funktioneller Beeinträchtigungen unterstützen. In der Arbeitsmedizin und der Geriatrie trägt sie zur Erhaltung der Arbeitsfähigkeit und Unabhängigkeit bei. Aus sozioökonomischer Sicht kann die ESWT die Inanspruchnahme des Gesundheitswesens vermindern, einer Chronifizierung vorbeugen, die Dauer der Rehabilitation verkürzen und die Rückkehr ins Berufsleben erleichtern und somit die indirekten Kosten senken. Es fehlt zwar noch Evidenz für die Primärprävention, aber in der Tertiär- und Quartärprävention ist die ESWT relevant. Die ESWT stellt eine Schlüsselkomponente der regenerativen Rehabilitationsstrategien dar. Ihre funktionsorientierte und potenziell kostengünstige Anwendung fördert die Mobilität, Teilhabe und Lebensqualität, insbesondere in alternden und multimorbiden Populationen.

27. Self-Reported Mental Health and Desired Workplace Improvements Among Working Parents, United States, 2024.

期刊: Public health reports (Washington, D.C. : 1974) 发表日期: 2026-Jun-23 链接: PubMed

摘要

Few studies have examined the mental health burden faced by working parents. We assessed the prevalence of fair or poor self-reported mental health and identified desired workplace improvements among US working parents. We conducted a descriptive analysis of the 2024 SummerStyles survey, a nationally representative web-based panel survey of US adults aged ≥18 years. Working parents were defined as adults employed full- or part-time with ≥1 child aged <18 years. We calculated weighted percentages and 95% CIs to characterize mental health status and workplace priorities across demographic and occupational groups. Among 1201 working parents, 15.3% (weighted n = 126) reported fair or poor mental health. The prevalence of self-reported fair or poor mental health was higher among women than among men (20.0% vs 11.4%), among those with lower annual household income (<$25 000: 31.6%) versus higher annual household income ($25 000-$49 999: 20.1%; $50 000-$99 999: 19.6%; >$100 000: 10.0%), among those with less versus more educational attainment (high school graduate or less: 20.2%; some college: 20.0%; ≥bachelor’s degree: 10.9%), and among those with retail/stores/shopping jobs (26.8%) versus jobs in other industries (health care: 20.4%; education and tutoring: 8.0%; professional, scientific, technical, and business services: 11.4%; finance, banking, and health insurance: 10.2%). Desired workplace improvements included increased paid leave (20%), ability to work remotely/telework (20%), and flexible work schedules (19%), with differences by demographic and occupational characteristics. Tailored workplace policies, such as flexible scheduling and expanded leave benefits, may support the mental health of US working parents. Additional research should explore industry-specific nuances of preferred workplace flexibilities among US working parents to guide work-based interventions.

28. Nanoencapsulated buriti oil: toxicological assessment in Caenorhabditis elegans, simulated digestion and enhanced biological potential.

期刊: Journal of the science of food and agriculture 发表日期: 2026-Jun-23 链接: PubMed

摘要

Buriti oil (Mauritia flexuosa) (BO) possesses high nutritional and functional value due to its carotenoids, phenolics, and unsaturated fatty acids, which exhibit antioxidant and antimicrobial properties. However, its lipophilic nature and susceptibility to oxidation limit its industrial application. Nanoencapsulation overcomes these obstacles by increasing oxidative stability and water dispersibility and by enhancing bioactivity. This study investigated the effects of BO nanoencapsulation in porcine gelatin (OPG) on toxicity (cell cultures and Caenorhabditis elegans), simulated digestion, as well as redox-modulating, antioxidant, and antifungal properties. The OPG nanoformulation had a diameter of 69.72 nm, a high encapsulation efficiency (95.79%), and high water dispersibility (79.91%). No activity was observed against human cervical cancer cells (HeLa) or Chinese hamster ovary cells (CHO-K1) for either OPG or BO, but both exhibited activity against 3T3 cells (P < 0.05) at 500 μg mL⁻¹. In C. elegans assays, no toxicity on egg hatching or body size was observed at the evaluated concentrations (0.1, 0.2, and 1.0 mg mL-1). Linoleic acid was preferentially released in the intestinal phase (56.12%) during simulated digestion. Compared with BO (2.24 ± 0.003 mg ascorbic acid equivalent [AAE] g⁻¹), OPG exhibited a significantly higher total antioxidant capacity (23.40 ± 0.004 mg AAE g⁻¹), greater antifungal activity against Candida spp. (minimum inhibitory concentration (MIC) and minimum fungicidal concentration (MFC) = 5 mg mL⁻¹), and an enhanced redox-modulating dose-response in C. elegans. Buriti oil nanoparticles in porcine gelatin were safe in cellular and animal models in a dose-dependent manner while demonstrating antifungal efficacy against Candida spp. The nanoencapsulation technology protects the oil from gastric digestion, ensuring intestinal release and enhancing antioxidant capacity. These results demonstrate that nanoencapsulation enhanced the bioactive properties of BO. © 2026 Society of Chemical Industry.

29. American, British, and Italian Online Information on the Health Risks Associated With Eating Meat: Cross-Sectional Study.

期刊: JMIR formative research 发表日期: 2026-Jun-23 链接: PubMed

摘要

The quality of online information regarding the risks associated with meat consumption could play a crucial role in shaping consumers’ behavior. This study aimed to investigate the quality of Italian, British, and American websites addressing this topic. A cross-sectional assessment of the top 100 British, Italian, and American web pages on the risks attributable to meat consumption was performed using the JAMA benchmarks tool, evaluating authorship by certified professionals and the inclusion of information on recommended meat consumption, potential meat substitutes, and coverage of issues such as diet sustainability and cancer, cardiovascular, and chronic disease prevention. Websites were then classified according to their stance toward meat consumption (neutral, promoting, or demonizing). American and British websites were classified as high quality in 61% (61/100) and 78.1% (75/96) of cases, respectively, while only 22.3% (21/94) of Italian websites were classified as high quality. Multinomial regression showed that web pages with a demonizing stance toward meat consumption and those authored by certified health professionals were less likely to be Italian than American. Similarly, web pages discussing environmental risks and chronic diseases associated with excessive meat consumption were less likely to be Italian. Compared with American web pages, those promoting meat consumption and those authored by qualified professionals were less likely to be British. Web pages discussing chronic disease risks were also less likely to be British, whereas those mentioning cancer risks were more likely to be British. The widespread prevalence of poor online information quality, especially in certain countries, demands action. Promoting user education in assessing the reliability of websites and involving health professionals in this educational effort may represent viable strategies.

30. Social Infrastructures for Healthy Aging: The Intersection of Space, Activity, and Community Engagement in China's Urban Neighborhoods.

期刊: Research on aging 发表日期: 2026-Jun-23 链接: PubMed

摘要

Population aging presents urgent challenges for global urban health, especially in China. This study examines how three types of neighborhood social infrastructures - public green spaces, gated green spaces, and neighborhood centers - affect health among older adults through physical and social activities and community engagement. Using survey data from Hangzhou, we estimated multilevel regression models. Results show that physical activity in public green spaces and social activities in both public green spaces and neighborhood centers were significantly associated with better health, while gated green spaces showed no independent effects. Higher community engagement was positively associated with health but did not moderate most activity-health relationships, except in neighborhood centers where diminishing returns were observed. Findings highlight that meaningful engagement, rather than access alone, underpins the health benefits of neighborhood environments and provide insights for developing age-friendly communities in rapidly urbanizing contexts.

31. A Nonhazardous Alternative to Mercury in Liquid Intrusion Porosimetry: Systematic Study of Intrusion/Extrusion Behavior of a Gallium-Based Liquid Metal (eGaInSn) into Meso- and Macroporous Silica, Alumina, and Carbon Materials.

期刊: Langmuir : the ACS journal of surfaces and colloids 发表日期: 2026-Jun-23 链接: PubMed

摘要

Mercury porosimetry is considered the standard method for the characterization of macroporous solids. However, health risks and environmental concerns make a replacement for mercury sought-after. Despite many advances in various techniques, so far, no alternative method is available. Here, we introduce a novel method using, instead of mercury, eGaInSn (Galinstan), a nonhazardous, eutectic gallium alloy, liquid at ambient temperatures, which is already widely used as a replacement for mercury (e.g., thermometers). We utilize a conventional porosimeter with only minor but necessary modifications in sample cell design and filling procedure. To evaluate its potential for pore characterization, we systematically studied the phase and wetting behavior of eGaInSn via intrusion/extrusion experiments in a series of well-defined meso- and macroporous silica (controlled pore glasses), alumina, and disordered carbon materials, including certified reference materials, exhibiting mode pore sizes from the narrow meso- (<20 nm) to the macropore range (1.7 μm). Our results suggest that the intrusion mechanism of eGaInSn represents, analogue to mercury, a confinement-induced shift of the vapor-liquid phase transition of a nonwetting fluid to pressures larger than the saturation vapor pressure. Comparing the pore size/volume distributions obtained by eGaInSn reveals excellent agreement with state-of-the-art mercury porosimetry. Furthermore, we systematically studied the effect of pretreatment conditions of the porous materials, e.g., degassing temperature, on the intrusion/extrusion behavior of eGaInSn and find that the degassing temperature has essentially no influence on the eGaInSn intrusion pressure and curve, but significantly affects the extrusion behavior. We demonstrate that, under certain, well-defined experimental conditions, the intrinsic eGaInSn intrusion-extrusion hysteresis loop is revealed, which contains important additional textural information. In conclusion, our work can be considered the first systematic study of the effect of confinement on the wetting and phase behavior of eGaInSn utilizing intrusion/extrusion measurements with a novel method offering potential to finally replace toxic mercury in the analysis of meso- and macroporous solids.

32. Ultra-Radiostable Covalent Conformationally Interlocked Networks Enabling a Universal Radiometal-Labeling Platform for Cancer Radioembolization.

期刊: Advanced science (Weinheim, Baden-Wurttemberg, Germany) 发表日期: 2026-Jun-23 链接: PubMed

摘要

Transcatheter arterial embolization (TARE) has emerged as a highly effective locoregional treatment for advanced liver cancer, which represents a significant advancement in clinical practice. Nonetheless, the utilization of traditional radioactive microspheres in TARE is hindered by various material and technical challenges that necessitate resolution. Herein, we present, for the first time, well-designed and synthesized conjugated poly(imide dioxime) ligand-based microspheres (PID-Ms) with a remarkable radiometal coordinate covalent conformational interlocked network. PID-Ms can be radiolabeled with various radionuclides, including 177Lu, 90Y, 188Re, 68Ga, and 99mTc, can be achieved at low temperatures (40°C), and for diagnostic imaging and radiotherapy applications. The combined strategy of extended x-ray absorption fine structure spectroscopy (EXAFS), DFT calculations, and in vitro and in vivo radiostability experiments collectively confirmed that radiometal-PID complexes exhibit ultra-high radiostability. 177Lu-PID-Ms were employed to accurately predict normal organ shunts and radiotherapy in rat and rabbit VX2 orthotopic live tumor models, demonstrating their ultra-radiostability and remarkable anti-tumor efficacy. Furthermore, Radiometals-PID-Ms have an adjustable shelf life, enabling on-demand radiolabeling for drug preparation, achieving rapid ‘on-demand’ capability. This innovative approach has the potential to inspire the synthesis of numerous coordination polymeric materials for various applications in PET/SPECT-mediated radiopharmaceutical therapy, alpha-nucleophile-targeted radiotherapy, and MRI contrast agents.

33. 2025 International Academy of Toxicologic Pathology (IATP) Satellite Symposium: Pathology Working Groups (PWGs) in Toxicologic Pathology.

期刊: Toxicologic pathology 发表日期: 2026-Jun-23 链接: PubMed

摘要

The International Academy of Toxicologic Pathology (IATP) Satellite Symposium on Pathology Working Groups (PWGs) in Toxicologic Pathology, organized in the United Kingdom, addressed the value and importance of PWGs and expert working groups in assuring the accurate evaluation of chronic/carcinogenicity studies. These specialized panels of expert pathologists play a crucial role in confirming data quality and accurate interpretation in support of human safety and risk decisions of xenobiotics. While not every carcinogenicity bioassay may require a PWG to evaluate the quality and accuracy of study interpretation, it was the consensus of the workshop that it can be a highly valuable addition to traditional peer review. Performing a PWG should be given serious consideration, especially when it is anticipated that the chronic/carcinogenicity study will be used for making significant regulatory or business decisions.

34. Radioactivity in Bottled Drinking Water from Greater Dhaka City and Concomitant Ingestion Doses to Consumers.

期刊: Health physics 发表日期: 2026-Jun-23 链接: PubMed

摘要

Activity concentrations of 226Ra, 232Th, and 40K radionuclides were determined in various brands of bottled drinking water commonly available in the local markets of Greater Dhaka City; additionally, the annual effective dose following the ingestion pathway was assessed. Radioactivity of 226Ra in the bottled water (purified, mineral, and drinking) samples varied from 0.61 ± 0.27 Bq L-1 to 10.64 ± 1.34 Bq L-1 with a mean value of 4.73 ± 1.02 Bq L-1. For 232Th, the concentration ranged between 0.35 ± 0.27 Bq L-1 and 5.71 ± 3.37 Bq L-1 with a mean of 2.97 ± 1.61 Bq L-1; for 40K, it ranged from 3.48 ± 2.92 Bq L-1 to 93.58 ± 26.74 Bq L-1 with a mean of 36.31 ± 10.63 Bq L-1. Purified bottled water exhibited the highest activity concentrations of 226Ra and 40K, whereas drinking water showed the highest 232Th concentration compared to purified and mineral bottled water samples. Infants received higher annual ingestion doses compared to children and adults. The average value of the threshold consumption rate remained below the limit. The 226Ra shows statistical significance, whereas 232Th and 40K are the opposite; 226Ra shows greater heterogeneity.

35. Early support in occupational health care reduced work disability risk.

期刊: Occupational medicine (Oxford, England) 发表日期: 2026-Jun-23 链接: PubMed

摘要

As the dependency ratio declines, ensuring good work ability (WA) among the working-age population becomes increasingly important. Occupational health care (OHC) provides services to support WA, but more information is needed on their effectiveness and timeliness. This study examined the relationship between the timing of WA support services and work disability among OHC patients with mental health and/or musculoskeletal disorders. This study used patient data on individuals first diagnosed during the follow-up period (2019-22) with mental health and/or musculoskeletal disorders from a nationwide OHC provider in Finland (n = 54 933), linked with national registers on disability benefits, sickness absences and sociodemographic information. The association between the timing of the first WA support action (including WA contacts and negotiations) and work disability was analysed using logistic regression adjusted for sex, age and the number of OHC contacts. Work disability was defined as being granted a permanent or temporary disability pension or accumulating >300 days of sickness absence. Delayed initial WA support contact after the first diagnosis of a mental health or musculoskeletal disorder increased the risk of work disability. A similar finding was observed regarding the timing of WA negotiations among patients with mental health disorders. OHC practice should emphasise the early initiation of WA support services for patients diagnosed with a mental health or musculoskeletal disorder, as delayed support was shown to be associated with work disability.

36. Personality (dys)Function and Psychological Readiness for Specialised Naval Utilisation: A Validation of the PID-5-BF+M.

期刊: Psychological reports 发表日期: 2026-Jun-23 链接: PubMed

摘要

Personality dysfunction is increasingly conceptualised dimensionally, yet evidence for the occupational validity of contemporary personality disorder models in military settings remains limited. This study examined psychometric validity and applied utility of the PID-5-BF+M in a naval sample (N = 1874) using archival occupational health data. Structural validity was evaluated using confirmatory factor analysis and gender-based measurement invariance testing, while internal consistency, construct validity, and associations with resilience, borderline personality indicators, and real-world adjustment outcomes were also examined. The six-domain structure of the PID-5-BF+M was supported, with acceptable internal consistency for the total score and most domains. Negative affectivity and disinhibition showed expected associations with borderline personality indicators, while higher personality dysfunction was moderately associated with lower resilience. Notably, negative affectivity and detachment independently predicted probable ICD-11 Adjustment Disorder, explaining approximately 30% of variance. Algorithm-based identification of possible personality disorder yielded markedly different prevalence estimates depending on facet- versus domain-level thresholds, highlighting risks of false-positive classification in occupational samples. Elevated anankastia traits were common but largely unrelated to maladjustment, suggesting contextual adaptiveness in structured naval environments. Findings support the PID-5-BF+M total score as a pragmatic global index of personality dysfunction severity for use in occupational health screening, while underlining the necessity of context-sensitive, multi-method interpretation. Personality assessment in military settings should prioritise functional impairment over trait elevation per se.

37. Fatal pediatric collapse with bilateral subdural hematoma and retinal hemorrhage occurring in a public park: a forensic case study.

期刊: Journal of forensic and legal medicine 发表日期: 2026-Jun-21 链接: PubMed

摘要

We report the death of a one-month-old infant who developed sudden neurological collapse in a public park and was later found to have bilateral subdural hematomas, extensive retinal hemorrhages, hypoxic-ischemic encephalopathy, and cerebral venous sinus thrombosis. No external or internal traumatic injuries were identified at autopsy, and the death was certified as natural. The public park setting was important because the same intracranial and ocular findings, if arising in a private setting without witnesses, might have prompted suspicion of abusive head trauma. This case illustrates the forensic importance of considering medical causes, including cerebral venous sinus thrombosis, in infants with subdural and retinal hemorrhages, and of avoiding diagnostic conclusions based primarily on the absence of an adequate caregiver explanation.

38. Artificial intelligence-assisted microsphere immunoassay for ultrasensitive Salmonella detection through microfluidic translocation event counting.

期刊: Biosensors & bioelectronics 发表日期: 2026-Jun-19 链接: PubMed

摘要

Salmonella pose significant threats to public health, necessitating rapid and sensitive detection strategies for effective food safety monitoring. Here, we present an artificial intelligence-assisted microsphere immunoassay (AIMI) that converts pathogen recognition into an ultrasensitive event level quantitative readout through microsphere-based microfluidic analysis. In this system, antibody-coated magnetic nanoparticles (MNPs) and polystyrene beads (PS) form sandwich immunocomplexes with Salmonella. These complexes are selectively depleted by magnetic separation, leaving residual unbound PS beads whose number inversely correlates with target concentration. When introduced into a microfluidic channel, these detection microspheres generate flow regulated signals that can be resolved at the event level and characterized by microsphere number and translocation dynamics. In AIMI, pulsed low-velocity transport refers to transient microsphere movement generated by briefly activating the syringe pump for 1 s under a preset flow rate of 1.5 μL min-1. Motion based correction further compensates for flow induced displacement variations, corrects motion related counting bias, and improves quantitative accuracy. With displacement informed correction, the linearity of detection improves from 0.983 to 0.99. The assay achieves a broad linear detection range of 10-106 CFU mL-1 and a limit of detection of 2.51 CFU mL-1. As a result, this AIMI platform achieves accurate translocation event counting at the single microsphere level, providing an effective strategy for ultrasensitive detection of Salmonella contamination.

39. Intrinsic links between obsessive-compulsive symptoms and other psychopathological symptoms: A network analysis of clinical and community populations.

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

摘要

The interconnectedness of core mental health features is associated with more severe illness impairment and less effective treatment outcomes. This study aimed to evaluate the network of relationships between obsessive-compulsive symptoms and other psychopathological symptoms in both obsessive-compulsive disorder (OCD) patients and community populations, identifying symptom interconnections. A cross-sectional study was conducted from January 1, 2020, to June 30, 2024. The Chinese versions of the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) and the Symptom Checklist-90 (SCL-90) were used to measure obsessive-compulsive symptoms and other psychopathological symptoms, respectively. Measurement invariance testing was performed using Mplus software (version 8.11). Network structure, centrality, stability, and network comparisons were analyzed using R software (version 4.4.1). The study included 4223 OCD patients and 5253 community participants. In the symptom networks of both groups, SCL3 (“Depression”) and SCL4 (“Anxiety”) were common core symptoms. SCL10 (“Psychoticism”) was a specific core symptom for OCD patients, while SCL2 (“Interpersonal sensitivity”) was specific to the community group. Additionally, SCL8 (“Obsessive symptoms”) and YBOCS3 (“Distress caused by obsessions”) served as bridge symptoms in both groups. The cross-sectional design limited causal inferences; self-report measures were subject to recall bias and other confounding factors; sample representativeness and the range of variables included in the analysis were limited. Depressive and anxiety symptoms emerged as common core symptoms in both OCD patients and community populations. Psychoticism was specifically identified as a core symptom in OCD patients, while obsessive symptoms and obsession-related distress served as bridging symptoms linking OCD with other psychopathological symptoms, highlighting important targets for clinical assessment.

40. Depressive and anxiety symptoms in mothers and fathers and child socioemotional outcomes: A nationwide Canadian study.

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

摘要

This study examined associations between single-versus dual-parental depressive and anxiety symptoms during the antenatal and postpartum period with child socioemotional problems from 12 to 24 months of age. In this nationwide Canadian longitudinal cohort study of women and their cohabitating partners, generalized estimating equations were used to examine associations between antenatal maternal and paternal depressive (Edinburgh Postnatal Depression Scale) and anxiety (State-Trait Anxiety Inventory) symptoms measured retrospectively within 3 weeks postpartum, and postnatal symptoms measured prospectively at 3, 6, 9, 12, and 18 months postpartum and their children’s socioemotional development (Brief Infant-toddler Social and Emotional Assessment) from 12 to 24 months of age. The study included 3217 cohabitating couples. Adjusting for covariates, mother-only (range of ORs = 1.50 [95% CI, 1.08-2.10] for antenatal anxiety symptoms to 2.03 [95% CI, 1.13-3.65] for antenatal comorbid symptoms), father-only (range of ORs = 1.57 [95% CI, 1.18-2.09] for postpartum anxiety symptoms to 2.44 [95% CI, 1.33-4.47] for antenatal comorbid symptoms), and dual-parental (range of ORs = 1.78 [95% CI, 1.00-3.15] for antenatal anxiety symptoms to 4.34 [95% CI, 1.83-10.29] for antenatal depressive symptoms) depressive and anxiety symptoms in both the antenatal and postpartum periods were associated with increased child socioemotional problems. Maternal and paternal depressive and anxiety symptoms during the antenatal and postpartum periods are associated with increased child socioemotional problems in early childhood, with roughly equal magnitude. Dual-parental mental health conditions and comorbid conditions have the strongest associations with socioemotional problems. Findings underscore the importance of considering the well-being of mothers and fathers in promoting healthy socioemotional development.

41. Neglected parathyroids: Fluoride's trigger for skeletal fluorosis and endocrine domino effect.

期刊: Journal of trace elements in medicine and biology : organ of the Society for Minerals and Trace Elements (GMS) 发表日期: 2026-Jun-19 链接: PubMed

摘要

Fluoride is a necessary micromineral for bone and dental health but excessive exposure can lead to dental and skeletal fluorosis. This review investigates the effects of fluoride on the parathyroid gland focusing on its structure and functions. Research papers were collected using various methods of data collection like PubMed, Scopus, and Google Scholar, and then reviewed thoroughly. Fluoride impacts parathyroid gland function through dose and time dependent modulation of PTH secretion. Various in-vitro and in-vivo studies have shown that fluoride inhibits the cAMP accumulation, and alters the morphology of parathyroid gland which might lead to endocrine dysregulation. In humans’ fluoride exposure is related to disrupted serum PTH, calcium and vit. D levels particularly in case of high fluoride intake. Studies suggest that fluoride disrupts the balance of calcium and phosphate that may have significant implications on bone health and endocrine function. Fluoride affects the PTH hormone secretion, calcium homeostasis, calcium and vit. D levels. This type of study provides critical insights into pathophysiology of fluoride toxicity. These findings are crucial for health officials so that they can guide people about safe exposure limits of fluoride and damages caused at higher concentrations.

42. A scoping review of patient-provider communication about weight and weight management among adults with higher body weight.

期刊: Patient education and counseling 发表日期: 2026-Jun-18 链接: PubMed

摘要

This scoping review describes the characteristics of studies that were designed to address two research questions: 1) What is the nature of patient-provider communication about weight or weight management among adults, including antecedents and consequences of this communication?; and 2) What are the communication strategies or intervention approaches to improve patient-provider communication about weight or key weight-related behaviors? Following the PRISMA-ScR, we searched five databases for peer-reviewed empirical studies published in English between January 1, 1970 (marking the emergence of obesity research in response to rising obesity rates), and June 25, 2024. A total of 101 studies met the inclusion criteria. The number of studies that examine the nature of communication (first research question) or strategies to improve it (second research question) has significantly increased since 2013-the year in which the American Medical Association declared obesity a chronic disease. Despite its growth, the overwhelming majority of studies (98.0%) were conducted in Western countries. Additionally, most studies (90.1%) focused on describing the nature of communication, while only 10 studies addressed interventions. Notably, all intervention studies were still in early research phases. Finally, while nearly all studies (98.9%) assessed verbal behaviors, only 15 (16.5%) and 16 (17.6%) studies examined paraverbal and nonverbal behaviors, respectively, reflecting a predominant reliance on qualitative methods. These gaps identified in this scoping review underscore the need for more diverse, methodologically rigorous, and culturally inclusive research that reflects the full complexity of patient-provider communication to support the development of evidence-informed interventions for improving patient-provider communication about weight and weight management. Findings from this scoping review highlight several important directions for future research to advance the literature on patient-provider communication about weight and weight management. These include using mixed methods designs, assessing all behavioral communication channels, and developing and testing interventions.

43. Developing a patient decision aid for Femoroacetabular Impingement Syndrome: A mixed-methods study.

期刊: Musculoskeletal science & practice 发表日期: 2026-Jun-17 链接: PubMed

摘要

Femoroacetabular Impingement Syndrome (FAIS) is a prominent source of non-arthritic hip pain and is highly prevalent in young active populations. Decisions to undergo surgery are significant in nature and require proper understanding of potential benefits and risks. To develop and user-test a patient decision aid comparing non-surgical management and hip arthroscopy for FAIS with an additional military-related section. Mixed-methods. The initial draft of the decision aid was developed by a multidisciplinary steering group. An iterative process of semi-structured interviews, re-drafting and further interviews provided feedback on the decision aid. The interviews were analysed reflexively using thematic analysis for qualitative findings. Acceptability questionnaires were analysed using descriptive statistics for quantitative findings. We interviewed 27-participants; 13 clinicians (6 physiotherapists, 3 orthopaedic surgeons, 2 general practitioners, 1 sports medicine doctor, 1 anaesthesia pain physician) and 14 patients. Most participants rated the decision aid’s acceptability as good-to-excellent. Participants agreed on most aspects of the decision aid including the introduction, treatment options, comparison of outcomes and questions to consider asking a health professional. Participants agreed on including more information on the treatment options and provide more long-term outcomes comparing the options. Our decision aid met all 6 of the International Patient Decision Aid Standards qualifying criteria. Our decision aid was considered a useful tool that may help patients choose an appropriate treatment option for the management of FAIS. A clinical trial evaluating the impact of the decision aid on decision making for patients considering surgery for FAIS is needed.

44. No genetic evidence for an association of apolipoprotein A-I with cardiovascular outcomes at different LDL cholesterol levels: drug-target Mendelian randomization analyses.

期刊: Atherosclerosis 发表日期: 2026-Jun-16 链接: PubMed

摘要

Exploratory post-hoc analyses of the AEGIS-II trial suggested that the efficacy of CSL112 (apolipoprotein A-I infusion) may be greater in patients with high baseline LDL-C. This genetic study aimed to assess whether LDL-C levels modify the effect of apoA-I on cardiovascular outcomes. We conducted drug-target Mendelian randomization analyses using data from 339,210 UK Biobank participants. Genetic proxies for apoA-I elevation (cis-acting variants within APOA1 gene) were used to mimic the effect of CSL112 therapy. The primary outcome was a composite of ischemic heart disease, myocardial infarction, and stroke; secondary outcomes were the individual components. To mitigate collider bias, we stratified by residual LDL-C, derived from a model adjusting LDL-C for the genetic instrument, age, sex, genotyping array and top 40 genetic principal components. Sensitivity analyses included alternative genetic instruments and formal tests for effect modification. Genetically proxied apoA-I elevation was associated with elevated circulating apoA-I and HDL-C, but there was no concomitant association with any cardiovascular outcome. Null findings were consistent across strata of residual LDL-C. Sensitivity analyses with alternative instrument sets and formal interaction tests uniformly confirmed the absence of any association or effect modification. Genetically proxied lifelong elevation of apoA-I concentration was not associated with reduced cardiovascular risk, even among individuals with high residual LDL-C.

45. Sudden death from non-traumatic right atrial appendage rupture: an autopsy case.

期刊: Legal medicine (Tokyo, Japan) 发表日期: 2026-Jun-14 链接: PubMed

摘要

Myocardial rupture most often involves the ventricles following acute myocardial infarction, whereas non-traumatic atrial rupture is extremely uncommon, and typically confirmed histologically. Isolated atrial infarction is rare and diagnostically challenging, requiring careful distinction from traumatic causes in forensic practice. We report a fatal case of non-traumatic rupture of the right atrial appendage (RAA). The patient was a 43-year-old woman with systemic lupus erythematosus. Postmortem computed tomography revealed high-density areas within the pericardial space. Autopsy demonstrated a 250 mL pericardial hematoma. The rupture site was identified at the apex of the RAA, located directly above the tricuspid valve in the inflow tract of the right atrial vestibule. Localized hemorrhage was present around the rupture site, and thrombus attachment was observed at this location. Histological examination of the RAA revealed wavy myocardial fibers with early coagulative necrosis surrounding the rupture site. Some fibers exhibited eosinophilia, thinning, loss of striation, and band necrosis. The right coronary artery adjacent to the rupture site showed atherosclerotic stenosis with a platelet thrombus. Based on these findings, the cause of death was determined to be endogenous rupture of the RAA secondary to atrial infarction. Although non-traumatic rupture of the RAA is extremely rare, distinguishing it from traumatic rupture in forensic practice is critically important and requires recognition of its characteristic histological features.

46. Effect of a digital mindfulness intervention for mild-to-moderate late-life depression: A randomized controlled trial.

期刊: Journal of psychiatric research 发表日期: 2026-Jun-06 链接: PubMed

摘要

Late-life depression (LLD) is a growing public health concern in aging populations. Although digital mindfulness interventions show promise for depression, anxiety, and insomnia, their efficacy and electroencephalogram (EEG) correlates in older adults with LLD remain unclear. This study evaluated the FocusZen Mindfulness Stress Reduction System, a digital mindfulness intervention with EEG feedback, in mild-to-moderate LLD. Fifty-four participants with mild-to-moderate LLD were randomly assigned to a 6-week intervention group (n = 27; daily FocusZen sessions) or a control group (n = 27; general health education). The primary outcome was the change in HAMD-17 score. Secondary outcomes included anxiety, sleep quality, cognition, and frontal EEG spectral activity. Data were analyzed using mixed-effects models and intention-to-treat principles. The intervention group demonstrated significant reductions in depressive symptoms [HAMD-17: F(3, 132.69) = 8.83, P < 0.001], anxiety [HAMA: F(3, 129.95) = 8.34, P < 0.001], and sleep disturbances [PSQI: F(3, 128.91) = 5.55, P = 0.01], alongside improved cognition [MOCA: F(3, 133.19) = 5.14, P = 0.01]. Response and remission rates were higher in the intervention group. Exploratory EEG analysis showed increased frontal theta [F(1.96, 43.12) = 25.28, P < 0.001] and alpha activity [F(1.44, 31.73) = 22.92, P < 0.001]. FocusZen-based digital mindfulness reduced depressive, anxiety, and sleep symptoms and improved cognition in mild-to-moderate LLD, potentially accompanied by enhanced frontal theta and alpha activity. Chinese Clinical Trial Registry Identifier: ChiCTR2400086063; https://www.chictr.org.cn/.

47. N95 filtering facepiece respirator fit assessment outcomes by gender, age, race, and facial hair in a community population sample.

期刊: Annals of work exposures and health 发表日期: 2026-Jun-03 链接: PubMed

摘要

The necessity for respiratory protection has increased due to global threats such as pandemics, industrial accidents, and extreme weather events. The effectiveness of N95 filtering facepiece respirators depends on how well they fit the user’s face and seal sufficiently. The objective of this study was to assess the critical issue of N95 filtering facepiece respirator fit test pass rates in the general population, specifically examining the influences of gender, age group, and race. Methods This cross-sectional study was conducted with Minnesota State Fair attendees in 2021 and 2022. Participants were asked to complete a demographic questionnaire, which included details on age, gender, race/ethnicity, and facial hair. A quantitative single-exercise fit assessment of N95 filtering facepiece respirators was conducted using a TSI PortaCount Pro+ (Model 8038). The assessment was based on the talking exercise derived from the Occupational Safety and Health Administration respiratory protection protocol, with a criterion of a fit factor ≥100 for passing the fit assessment. Descriptive statistics and multiple logistic regression analyses were performed using RStudio (version 4.4.2) to assess the influence of demographic variables on respirator fit assessment results. Results A total of 384 participants were enrolled, with 63.8% being female and 80.2% identifying as White. Respirator fit assessment pass rates were significantly lower for males with facial hair compared to females and males without facial hair. None of the participants with full beards achieved an acceptable fit. Participants aged 19 yrs or younger had the highest pass rates. Females were 83% more likely to pass the fit assessment compared with males without facial hair (odds ratio [OR] = 1.83, 95% CI: 1.02 to 3.38), while males with facial hair were 68% less likely to pass the fit assessment than males without facial hair (OR = 0.32, 95% CI: 0.13 to 0.73). Nonlinear age-related differences in fit assessment results were observed, with the lowest odds of passing among participants in their 30 and 40 s compared with those aged 19 yrs or younger. No significant differences in the fit assessment pass rates between racial and ethnic groups were observed. Conclusion Gender, age, and facial hair type were found to significantly affect the likelihood of participants passing the fit assessment for N95 filtering facepiece respirators. No significant disparities were observed among racial and ethnic groups. These findings underscore the importance of considering gender, age, and facial hair when developing public health guidelines for respirator protection.

48. The societal costs of food insecurity: implications for managed care strategies.

期刊: The American journal of managed care 发表日期: 2026-Jun 链接: PubMed

摘要

To estimate the direct health care costs and indirect economic implications of food insecurity among working-age adults in the US from a societal perspective. We conducted a retrospective longitudinal cohort study using the 2016-2017 and 2021-2022 Medical Expenditure Panel Survey. Our sample included 17,524 working-age adults. Our outcomes included health care spending, employment status, and income. The primary independent variable was food insecurity. Lagged dependent variable models assessed the association between food insecurity in year 1 and outcomes in year 2, adjusting for baseline characteristics. Our lagged dependent variable models showed that food insecurity was not associated with total health care spending in year 2, but it was associated with a $132 (95% CI, $25-$239) increase in emergency department spending. Although food insecurity was not associated with employment, it was associated with increased likelihood of having a seasonal job or a temporary job and missing work due to illness in year 2 by 2.4 (95% CI, 1.0-3.8), 3.7 (95% CI, 1.1-6.3), and 4.8 (95% CI, 1.9-7.7) percentage points, respectively. Furthermore, food insecurity was associated with a decrease of $2521 (95% CI, -$4129 to -$914) in annual individual-level income in year 2, which was primarily driven by a decline in wages of $2030 (95% CI, -$3438 to -$621). Food insecurity was associated with economic burdens beyond medical spending, particularly through lost income and employment instability. These findings suggest that food insecurity is linked to economic instability while placing targeted demands on the health system, underscoring the importance of addressing food insecurity as a policy and public health priority.

49. Availability of hospital financial assistance documents in non-English languages.

期刊: The American journal of managed care 发表日期: 2026-Jun 链接: PubMed

摘要

Millions of people struggle to afford hospital care in the US, and individuals who speak languages other than English (LOTE) are particularly vulnerable due to language barriers in understanding and accessing hospital financial assistance policies (FAPs). Nonprofit hospitals are required under Internal Revenue Service (IRS) rules to provide translated financial documents in any language spoken by at least 1000 individuals or 5% of the population in their service area. However, adherence to these requirements is unknown, and to our knowledge, no study has evaluated whether for-profit or government hospitals voluntarily offer translations of FAP documents to aid individuals who speak LOTE. Cross-sectional study. We reviewed the websites of all 426 nonfederal hospitals in the 10 most linguistically diverse US core-based statistical areas (CBSAs), focusing on the availability of 4 financial documents in multiple languages: financial assistance policies, plain language summaries, financial assistance applications, and billing/collections policies. We assessed the association between the number of languages served and hospitals’ system and ownership status (nonprofit, for-profit, government) using multivariate regression, adjusting for CBSA. The study findings demonstrate that system-affiliated and nonprofit hospitals provide more translated documents than their for-profit, governmental, and unaffiliated counterparts. Nonprofit hospitals provided significantly more language options across all document types, suggesting compliance with IRS requirements. System-affiliated hospitals also performed better, possibly due to greater administrative resources. The study highlights a gap in multilingual access among for-profit, governmental, and unaffiliated hospitals, raising concerns that individuals who speak LOTE may face greater challenges navigating financial assistance and medical billing at these hospitals.

50. Social needs screening and supplemental benefits in Medicare Advantage.

期刊: The American journal of managed care 发表日期: 2026-Jun 链接: PubMed

摘要

Social determinants of health (SDOH) impact the health outcomes of older adults. Recognizing the importance of screening for and addressing social needs, CMS allowed Medicare Advantage (MA) plans to begin offering SDOH screening and providing social needs-oriented Special Supplemental Benefits for the Chronically Ill (SSBCI) in 2024. In this article, we describe MA plans that screen for SDOH and provide SSBCI addressing social needs, and we explore how offerings align with communities’ social needs. Retrospective, cross-sectional descriptive analysis. We analyzed 2024 MA Plan Benefit Package and enrollment files and SVI data. We assessed the number of and enrollment in plans and their geographic distribution compared with SVI, a measure to quantify social needs. In the first year of implementing screening for SDOH, MA plans had low uptake (20% of plans). Of plans that screened for SDOH, approximately half offered interventions to address SDOH through SSBCI; most screened for SDOH and offered SSBCI in communities with greater social need, but many of the highest-need areas had no such plans. These findings highlight the opportunity to expand SDOH screening and SSBCI, particularly in areas with the highest social needs, as MA becomes the largest provider of health care for older adults.

51. Changes in persistence to basal insulin following the Medicare out-of-pocket cost cap.

期刊: The American journal of managed care 发表日期: 2026-Jun-01 链接: PubMed

摘要

To evaluate changes in persistence to basal insulin following the implementation of the $35 monthly out-of-pocket cost cap for insulin for Medicare beneficiaries. We completed a retrospective cohort analysis of a nationally representative Medicare Advantage sample from 2022 to 2023. We compared precap rates of persistence to basal insulin in 2022 with postcap rates in 2023 using Persistence to Basal Insulin, a health plan performance measure used in Medicare Part D quality programs, among the study population and multiple subgroups. A statistically significant increase (+1.3 percentage points; P < .001) was seen in overall patient persistence to basal insulin in the first year of the implementation of the insulin cost cap. Subgroup analyses showed greater increases in persistence in several subpopulations, including patients aged 45 to 54 and 65 to 74 years, male patients, non-Hispanic Black patients, and patients residing in certain census divisions, especially those with a high prevalence of type 2 diabetes. In addition to providing financial relief to Medicare patients, the implementation of the insulin cost cap was associated with an improvement in patients’ treatment persistence to basal insulin therapy, a measure associated with positive health and economic outcomes. These results lend useful insight into future policy evaluations and proposals that seek to improve treatment access and address disparities in appropriate medication use.

52. Community Perspectives on Japanese Encephalitis Risk and Prevention in an Endemic Region of Australia.

期刊: The Australian journal of rural health 发表日期: 2026-Jun 链接: PubMed

摘要

Japanese encephalitis (JE) is a mosquito-borne disease caused by JE virus (JEV) infection, detected for the first time in south-eastern Australia in 2022. In New South Wales (NSW), detections of JEV in mosquitoes and animal hosts, human JE cases, and climate and environmental considerations have informed which areas are considered high risk for JEV and which populations are eligible for vaccination (funded by Australian states and territories). However, early evidence indicates slower-than-expected uptake in these high-risk areas. We aimed to explore how community members and healthcare professionals (HCPs), including general practitioners (GPs), pharmacists, and nurses, perceive and have responded to JEV risk through vaccination and personal mosquito-bite prevention practices. Tamworth is classified as high-risk for JEV by NSW Health. Semi-structured interviews with community participants (n = 15), GPs (n = 7), nurses (n = 3), and pharmacists (n = 3). An interpretative qualitative study. Data were analysed using an inductive thematic approach. Three themes were identified: (1) Risk awareness shaped by experience, not policy: “I didn’t realise Tamworth was identified as an area as well, I just was totally unaware,” (2) Vaccine eligibility does not translate into uptake: “There isn’t really much promotion at the moment,” and (3) Building community-level preparedness through communication: “Messaging that the whole community knows about.” Despite early public health efforts, awareness of JE and uptake of preventive measures remained limited in a high-risk regional setting. Supporting trusted healthcare providers with clear, consistent communication is critical to optimising JE vaccine uptake.

53. Health care utilization in veterans with Alzheimer disease.

期刊: The American journal of managed care 发表日期: 2026-Jun-01 链接: PubMed

摘要

To evaluate health care utilization in veterans with Alzheimer disease (AD) in the Veterans Affairs health system (VAHS). This retrospective analysis identified veterans with AD using clinical notes extracted from the VAHS electronic health record from fiscal years 2010 to 2019. The first note identifying AD was the index date. Health care utilization in veterans with AD and a 1:1 matched comparison group without AD was evaluated at 2 years preindex, 1 year preindex, 1 year post index, and 2 years post index. From clinical notes, we identified 571,671 veterans with AD and 571,671 for the comparison group (overall: mean age, 74 years; 96% male; 75% White). In those with AD, outpatient visits per patient per year peaked 1 year post index at 67 and remained elevated 2 years post index at 57; without AD, the rate was approximately 19 at all time points. Hospitalization rates peaked at 1 year post index with AD but were lower and generally stable without AD. Nursing home utilization was relatively low overall. Veterans meeting the 2-code criteria (n = 56,305), defined as having 2 diagnostic codes for AD recorded at least 30 days apart, had consistently higher utilization than veterans without AD (especially post index). Veterans with AD have higher health care utilization than veterans without AD, especially around the time of AD diagnosis.

54. A Harmonized International Database of More Than 10,000 Pediatric Renal Tumor Patients From 30 Years of SIOP-RTSG Studies.

期刊: JCO clinical cancer informatics 发表日期: 2026-Apr 链接: PubMed

摘要

Historical data sources for rare cancers are valuable for data-driven research. The International Society of Pediatric Oncology Renal Tumors Study Group (SIOP-RTSG) has been conducting clinical research on pediatric renal tumors for more than 50 years. Since 1993, data have been collected across multiple countries, using standardized paper-based case report forms that were digitally transcribed into electronic databases. Until 2019, prospectively collected data are present in nine different electronic sources from three consecutive clinical studies. More than 10,000 patient cases of kidney cancer in children are registered in totality. However, the necessary merging of numerous sources to answer a research question is repetitive, time consuming, and unsustainable in the long term. By mapping and formatting the structure of these nine databases, a single database was created that was similar in design to the prospective study database. This allows the data from the past and current studies to be accessed and queried efficiently with standardized syntax and reports. We validated this new database by reviewing whether uploads were complete and successful, mapped items were coded correctly, or discrepancy appeared in the export. Comparisons with retrospective reports were made to ensure the datasets were reproducible. Researchers have access to a large number of patients through this validated aggregated database. Data maintenance and extraction is efficient, and it offers the possibility to complete missing data directly into the central database. This ultimately ensures long-term availability in a secure, flexible, and responsible manner, in accordance with FAIR principles. Researchers can send questions to SIOP-RTSG and, if necessary, gain access to the database after short training. Access granted would depend on user’s role.

55. Exploring perceptions towards health and child nutrition: A qualitative study among tribal mothers in Southern Karnataka.

期刊: PloS one 发表日期: 2026 链接: PubMed

摘要

Malnutrition accounts for nearly one-third of child deaths globally and continues to be a major concern in India. Despite economic progress, undernutrition remains prevalent, with one-third of children underweight and over two-thirds anemic. Within India, marginalized groups such as the Koraga tribe face greater risks due to poverty, limited healthcare access and cultural barriers that compound child health challenges. Understanding maternal perceptions is crucial to effectively address these challenges. In-depth interviews were conducted with Koraga tribal mothers of children aged 5-10 years. Participants were selected using criterion-based purposive sampling to ensure representation across different age groups and household contexts. Interviews were audio-recorded in local languages (Tulu and Kannada), transcribed verbatim, translated into English and analysed inductively using thematic analysis with NVivo software (version 14). Twenty Koraga tribal mothers were interviewed between October 2023- March 2024. Thematic analysis revealed five major themes: evolving perceptions of health and wellbeing; nutrition beliefs and practices; hygiene and health promotion; traditional healing with modern care and barriers and community solutions. These findings highlighted key challenges such as limited healthcare access, poverty and educational constraints, while also capturing community-driven strategies including reliance on health workers and government food-schemes. Maternal perceptions, shaped by cultural norms and socioeconomic constraints, play a critical role in influencing health and child nutrition in the Koraga community. The findings highlight the need for policy measures that integrate culturally informed nutrition education with strengthened frontline health services, alongside community-based programs involving women’s self-help groups to improve health outcomes in marginalised tribal populations.

56. From traits to daily experiences: An adaptation of the Selflessness/Self-centeredness Inventory to day-level assessment.

期刊: PloS one 发表日期: 2026 链接: PubMed

摘要

Conceptualized as distinct psychological functionings respectively linked to authentic-durable and fluctuating happiness, selflessness and self-centeredness have recently been the subject of instrument development to evaluate their manifestations at the trait-level. Along the lines of this work, the goal of the current research was to adapt the psychometric instrument at the day-level: the Selflessness/Self-centeredness Inventory - Day-level (SSI-D). Consistent with the trait-version, both exploratory analysis (Study 1, N = 853) and confirmatory analysis (Study 2, N = 265) indicated that the SSI-D measured seven factors organized into two latent variables (i.e., selflessness divided into four components, self-centeredness divided into three dimensions). Correlational analysis (Study 3, N = 1409) provided initial evidence that day-level selflessness and self-centeredness can be differentiated psychometrically and showed theoretically meaningful patterns of association with mental health, interpersonal health, and pro-environmental outcomes. Invariance analyses were satisfactory, and preliminary validity evidence was generally consistent with theoretical expectations, although further validation using more comprehensive and jointly administered criterion measures is needed.

57. Education outside the classroom in Germany: An interdisciplinary multi-methods Study Protocol.

期刊: PloS one 发表日期: 2026 链接: PubMed

摘要

Schools are a central place in the lives of both children and teachers, with the potential to counteract current challenges such as a physical and emotional disconnection from nature, insufficient physical activity, and increased social isolation. Concepts like Education Outside the Classroom (EOtC) offer a variety of approaches and are already established in the curriculum in other countries, while in Germany EOtC is still in the early stages of implementation. Previous studies have focused on the effects of EOtC on students, with little attention paid to teachers, environmental perception, or behavioural analyses. This study aims to evaluate the impact of EOtC on teachers’ stress level, teachers’ well-being and physical activity, pupils’ cognitive performance, school-related well-being, basic psychological needs and classroom behaviour. In addition, this study investigates how the biodiversity of selected outside learning environments affects pupils’ and teachers’ nature connectedness, appreciation of nature and species knowledge. This study protocol describes an exploratory, quasi-experimental, interdisciplinary study conducted in a total of 33 schools throughout Germany. Data collection will be carried out from September 2025 to November 2026. The first results of the data collection are expected in October 2026. It includes approximately 50 EOtC teachers, 50 non-EOtC teachers, 50 EOtC classes, and 18 non-EOtC classes with for intra- and interindividual comparisons. Data collection covers aspects from the fields of health, ecology, school pedagogy, and sociology and includes both pupils and teachers as target groups, as well as the various outdoor learning environments. For pupils and teachers, the study examines the effects of EOtC on nature connectedness, appreciation of nature, and plant and animal species knowledge. This is assessed twice per school year with questionnaires and compared to control classes within the same schools. In addition, for pupils, cognitive performance, measured by electroencephalography (EEG), school-related well-being, and basic psychological needs - both assessed via questionnaires - will be analysed. For teachers, stress levels, emotional well-being, and physical activity will be assessed using salivary cortisol samples, accelerometery, and questionnaires on both EOtC and regular teaching days, enabling intraindividual analyses. Moreover, teaching characteristics will be documented, and video-based analyses of social interactions between teachers, pupils, the outdoor learning environment, and teaching objects are conducted. Finally, biodiversity at the outdoor learning sites and their effects on the other study variables (e.g., nature connectedness, appreciation of nature, species knowledge and well-being of pupils and teachers) will be statistically analysed. This interdisciplinary study design provides a realistic analysis of the potential effects of EOtC on pupils, as well as teachers, while minimizing interference with the regular teaching process. A strength of this study is the consisted inclusion of teachers as a target group, as well as the ecological perspective and the use of innovative survey methods such as the recording of biodiversity, the video analysis of interactions and the analysis of lesson characteristics in the context of EOtC. This study will thus contribute to closing central research gaps in the German context and provide valuable insights for international EOtC research.

58. Effect of high-intensity interval training in patients with chronic hepatitis B and hepatic steatosis: A randomised controlled trial.

期刊: PloS one 发表日期: 2026 链接: PubMed

摘要

Having both chronic hepatitis B and hepatic steatosis increases the risk of liver-related morbidity and mortality. We aimed to investigate if high-intensity interval training could decrease the liver fat-fraction and improve liver status, body composition, lipid- and glucose metabolism, and blood pressure in patients with chronic hepatitis B and hepatic steatosis. In a randomised, controlled trial, patients with chronic hepatitis B and hepatic steatosis were randomised 1:1 to high-intensity interval training over 12 weeks or no intervention. The primary outcome was reduction in liver fat-fraction (≥ 2.8%), assessed by magnetic resonance imaging. Secondary outcomes were body composition, indices of glucose metabolism, blood lipids, blood pressure, alanine aminotransferase, physical fitness assessed by maximal oxygen consumption (VO2max), and self-assessed health. The trial was discontinued before reaching the planned sample size due to slow recruitment. Nineteen patients were included, and 14 completed the trial (seven per group). Changes in liver fat-fraction showed a between-group difference of -2.03% [95% CI: -5.5 to 1.4; p = 0.22]. Exercising patients improved VO2max by 5.6 mL/kg/min [1.7 to 9.5; p < 0.05] and emotional well-being by 18.07 points [6.6 to 29.6; p < 0.05]. The exercise intervention did not affect total body fat -0.35% [-2.8 to 2.1] or lean body mass 0.6 kg [-0.7 to 1.9]. Changes in glucose tolerance, insulin secretion, Matsuda index -0.89 [-2.5 to 0.5; p = 0.18], cholesterol 0.29 mmol/L [-0.3 to 0.9; p = 0.32] and systolic blood pressure 6.36 mmHg [-6.4 to 19.1; p = 0.29] did not differ significantly between groups. We did not observe a significant effect of high-intensity interval training on liver fat-fraction in patients with chronic hepatitis B and hepatic steatosis. Due to premature discontinuation and the resulting limited sample size, the study was underpowered, and the findings should be interpreted as exploratory. Nevertheless, the intervention improved physical fitness and emotional well-being.

59. Physical and emotional health among nurses in protracted crisis settings in Lebanon and Jordan: A cross-sectional study.

期刊: PloS one 发表日期: 2026 链接: PubMed

摘要

Nurses working in crisis-affected and refugee-hosting settings face demanding conditions that may compromise their physical and emotional health. Evidence on the prevalence and determinants of these outcomes in such contexts remains limited. This study assessed nurses’ physical and emotional health in Lebanon and Jordan and identified key associated factors using regression and random forest models. A cross-sectional survey was conducted among hospital nurses providing care to Syrian refugees in Lebanon (n = 976; response rate 52%) and Jordan (n = 2,012; response rate 80.5%). Back pain, general weakness and emotional exhaustion outcomes were assessed alongside sociodemographic, work-related, and psychosocial work variables. Logistic, linear regression and random forest models were performed on merged and country-specific datasets. Nearly six in ten nurses in Lebanon and more than seven in ten in Jordan reported strong general weakness, and over 60% in both countries experienced strong back pain. Emotional exhaustion was prevalent and higher among Jordanian nurses (4.13, SD = 1.39) compared to Lebanese nurses (3.49, SD = 1.70). Age, gender, working hours, and work unit were significant demographic and occupational predictors, while job conflict, self-perceived workload, lack of job preparation, and workload stress emerged as important work environment factors. Nursing resources and teamwork were consistently protective. Random forest models confirmed the relative importance of workload-related factors and highlighted the close association between physical health and emotional exhaustion. Hospital nurses caring for refugees in Lebanon and Jordan experience high levels of physical and emotional health strains associated with workload, work unit, psychosocial strain, and organizational resources. Findings highlight the need for system-level workforce policies, including workload regulation, staffing optimization, and strengthened organizational support to promote nurse well-being and enhance health system resilience in refugee-hosting and resource-constrained settings.

60. Mechanism of auranofin toxicity: Inhibition of tetrahydrobiopterin metabolism.

期刊: Toxicology and applied pharmacology 发表日期: 2026-Jan 链接: PubMed

摘要

Auranofin is a gold-containing anti-inflammatory drug used for the treatment of rheumatoid arthritis. Recent studies indicate that auranofin targets cellular antioxidants including the thioredoxin system and the ubiquitin-proteasome system, which can result in cellular oxidative stress. In the present studies, we identified a novel mechanistic site of action of auranofin, namely tetrahydrobiopterin (BH4) biosynthesis. BH4 is an essential cofactor required for aromatic amino acid hydroxylases, nitric oxide synthase and alkylglycerol monooxygenase, enzymes that produce mediators important in regulating inflammation. It is synthesized de novo from GTP via the action of GTP cyclohydrolase I, 6-pyruvoyl-tetrahydrobiopterin synthase and sepiapterin reductase (SPR), which leads to the production of dihydrobiopterin (BH2). Further metabolism of BH2 to BH4 is mediated by dihydrofolate reductase (DHFR). We discovered that auranofin causes a rapid depletion of cellular BH4 in several different cell types; PC12 cells were most sensitive to auranofin followed by Jurkat cells, BeWo cells, HaCaT cells, SKNMC cells, RAW246.7 cells and CX-1 cells. This was due to the inhibition of both SPR and DHFR. BH4 is required for tyrosine hydroxylase and tryptophan hydroxylase, enzymes mediating the synthesis of dopamine and serotonin, respectively. In PC12 cells, blocking BH4 biosynthesis with auranofin correlated directly with inhibition of serotonin and dopamine production indicating that the drug targeted aromatic amino acid hydroxylase activity. Our findings provide novel insights into the metabolic consequences of treating inflammatory diseases or cancer cell growth and metastasis with auranofin.