公共卫生研究摘要 (2026-06-27)

共收录 58 篇研究文章

1. Health system responsiveness to older adults with functional limitations and socio-economic vulnerability in India.

期刊: Global health action 发表日期: 2026-Dec 链接: PubMed

摘要

Health system responsiveness (HSR) is a core health system goal yet remains underexamined for older adults with functional limitations and socio-economic vulnerability in India. To present a novel assessment of HSR among older adults aged 60+ with functional limitations and socio-economic vulnerability in India across six domains: prompt attention, dignity, communication, confidentiality, choice of providers, and quality of amenities. We analysed data from the nationally representative Longitudinal Ageing Study in India Wave 1 (2017-2018), including 16,659 older adults for outpatient care and 2,358 for inpatient care. Multivariable linear regressions assessed the association between HSR and functional limitations, multimorbidity, and socio-economic factors. Functional limitations were defined as one or more limitations in Activities of Daily Living and/or Instrumental Activities of Daily Living. Overall HSR score was calculated by summing across domains. Median HSR score was 24 (range 6-30), equivalent to approximately 75 on a 0-100 scale, for outpatient and inpatient care. Older adults with functional limitations experienced poorer responsiveness in outpatient (β = -0.62; 95%CI: -0.84, -0.41) and inpatient care (β = -0.62; 95%CI: -1.14, -0.09). Negative associations were observed in public facilities, while in private facilities this was significant only for outpatient care. Among those with functional limitations, lower castes and lower economic status reported poorer responsiveness. Older adults with functional limitations in India experience poorer HSR, with worse care among lower castes and poorer groups. These findings suggest the presence of ableism within the Indian health system that needs to be systematically identified and tackled to ensure equitable and responsive healthcare. Main findings: Older adults with functional limitations in India experience poorer health system responsiveness in both outpatient and inpatient care, with disparities particularly pronounced in public facilities and further amplified by socio-economic disadvantage.Added knowledge: This study provides one of the first nationally representative assessments across India of health system responsiveness among older adults with functional limitations, highlighting how ageing, functional limitations, and socio-economic vulnerability intersect to shape non-clinical care experiences.Global health impact for policy and action: Strengthening health system responsiveness through policy action and health system reforms to address structural ableism is essential to provide equitable, disability-responsive care for India’s ageing population, especially those with functional limitations and socio-economic disadvantage.

2. Global research landscape of 3D printing and patient-specific instrumentation in musculoskeletal tumor resection: Trends from a Scopus-based bibliometric analysis (2010-2026).

期刊: Journal of clinical orthopaedics and trauma 发表日期: 2026-Sep 链接: PubMed

摘要

Three-dimensional (3D) printing and patient-specific instrumentation (PSI) have increasingly influenced musculoskeletal oncology by supporting precision tumor resection, personalized reconstruction, and limb-salvage surgery. Despite growing research output, the global scientific landscape, thematic evolution, and clinical translation of these technologies remain insufficiently characterized. This study uses a Scopus-based bibliometric analysis (2010-2026) to map research output, identify key themes, influential publications, leading institutions, and patterns of international collaboration. A bibliometric analysis was conducted using Scopus database and analyzed using VOSviewer and the Bibliometrix R-package (Biblioshiny). Performance analysis assessed publication outputs, leading authors, institutions, countries, and journals, while science mapping examined co-citation structures, keyword co-occurrence networks, and thematic evolution. A total of 493 articles were analyzed. The most-cited authors were LU M (n = 43), WANG J (n = 32), and ZHANG Y (n = 31). Leading institutions were Sichuan University, China (n = 68), Irccs Istituto Ortopedico Rizzoli, Italy (n = 19), and Mayo Clinic, USA (n = 19). China (n = 427), USA (n = 228), and Italy (n = 107) were the top contributing countries. The most frequent journals were Frontiers in Oncology (n = 16), BMC Musculoskeletal Disorders (n = 13), and International Orthopaedics (n = 8). Early publications (2010-2016) showed high citations per article, reflecting foundational impact. From 2020 onward, research shifted toward disease-specific clinical applications, with emerging keywords such as osteosarcoma, reconstruction, and 3D-printed implants highlighting the growing focus on patient-specific surgical solutions. The global research landscape of 3D printing and Patient-Specific Instrumentation (PSI) in musculoskeletal oncology has evolved substantially over the past decade, with increasing emphasis on clinically applicable and patient-centered reconstructive strategies. Emerging trends indicate growing interest in customized implants, complex oncologic reconstruction, and precision-guided limb-salvage procedures. Future research should prioritize multicenter prospective studies, long-term functional and oncologic outcomes, and cost-effective technological innovations to facilitate broader clinical implementation and global accessibility.

3. Molecular Characteristics and Differentiation Control Mechanisms of Bergmann Glia-Like Progenitors in the Postnatal Mouse Cerebellum.

期刊: Glia 发表日期: 2026-Aug 链接: PubMed

摘要

In the mammalian cerebellum, three types of astroglial cells-Bergmann glial cells (BGs), inner granule cell layer (IGL) astrocytes, and white matter (WM) astrocytes-arise in postnatal timing from two types of progenitors: Bergmann glia-like progenitors (BGLPs) and astrocyte-like progenitors (AsLPs). In contrast to AsLPs, which are commonly observed in other brain regions, BGLPs have not been well studied. Here, we investigate differentiation abilities, gene expression profiles and differentiation control mechanisms of BGLPs at postnatal stages. BGLPs and AsLPs decrease in number as development progresses from postnatal day 0 (P0), and are almost absent by P10. By utilizing an electroporation-based method to BGLPs, we found that P6 BGLPs differentiate into BGs and IGL astrocytes, but not into WM astrocytes, consistent with a previous report. However, P0 BGLPs were observed to differentiate into not only BGs and IGL astrocytes, but also WM astrocytes and a small number of molecular layer inhibitory neurons. By conducting spatial transcriptomic analysis with over 5000 probes (Xenium), we successfully identified distinct clusters corresponding to BGLPs at P0 and P6, respectively, and genes preferentially expressed in P0 and P6 BGLPs. In addition, upstream regulatory analysis using Enrichr identified Foxm1 and Nfia as candidate regulators that affect stage-specific properties of BGLPs. in vivo knockdown and overexpression experiments further demonstrated that precise regulation of Foxm1 and Nfia expression is important for proper progeny production from postnatal BGLPs. This study gives insights into understanding molecular nature and differentiation ability control of BGLPs during postnatal cerebellar development.

4. Targeting the HMGB1 Pathway With Glycyrrhizic Acid and Amlexanox Attenuates RSV-Induced Injury and Viral Propagation.

期刊: FASEB journal : official publication of the Federation of American Societies for Experimental Biology 发表日期: 2026-Jul-15 链接: PubMed

摘要

Respiratory syncytial virus (RSV) is the leading cause of acute respiratory infections globally, with particularly severe implications for infants and the elderly population. Despite the substantial burden on public health, effective therapeutic options for the treatment of RSV infections remain limited. The pathogenesis of RSV is characterized by complex inflammatory responses, while high-mobility group box 1 (HMGB1), a damage-associated molecular pattern protein, is known to play a role in amplifying inflammation. However, the specific role of HMGB1 in RSV infection has not been thoroughly investigated. This study aims to elucidate the role of HMGB1 in RSV replication and to evaluate its potential as a target for antiviral therapy. The interaction between the RSV nucleocapsid (N) protein and HMGB1 was demonstrated through co-immunoprecipitation and mass spectrometry. Knockdown or overexpression of HMGB1 by small interfering RNA or pCMV-HA-HMGB1 resulted in a significant reduction or induction in RSV replication in vitro, thereby confirming the critical role of HMGB1 in viral propagation. Moreover, structure-based molecular docking analyses identified glycyrrhizic acid (GA) and amlexanox (AMX) as high-affinity ligands for HMGB1. In cellular studies, both GA and AMX effectively inhibited RSV replication in a dose-dependent manner while selectively suppressing HMGB1’s secretion to the cytoplasm or extracellular space from RSV-infected cells. AMX was found to down-regulate HMGB1 expression while GA did not. In experiments using lethal murine RSV infection models, treatment with GA and AMX significantly improved survival rates and reduced lung pathology. In conclusion, these findings suggest that HMGB1 is a promising therapeutic target for RSV infection and highlight GA and AMX as potential antiviral candidates that can modulate HMGB1-mediated immunopathology.

5. Virus-Specific Impact of Respiratory Viruses on Adult Emergency Department Outcomes.

期刊: Journal of medical virology 发表日期: 2026-Jul 链接: PubMed

摘要

Few studies have examined the impact of community-acquired respiratory viruses (CRVs) on emergency department visits and outcomes in adults. This study aimed to characterize the epidemiology of CRV infections and assess associations between virus types and clinical outcomes. We retrospectively reviewed adult patients with respiratory symptoms who underwent rapid influenza testing at a community hospital emergency department in Okinawa, Japan, from February 2020 to January 2021. Residual samples were tested using multiplex polymerase chain reaction assays to identify CRVs. Among 551 cases, 228 (41%) tested positive for viruses. Compared with virus-negative patients, there were no significant differences in median age (64 years, range 20-99) or the proportions requiring oxygen supplementation (n = 60) or hospitalization (n = 125). The common cold was more frequent in virus-positive patients (n = 74, p = 0.002). Rhinovirus was the most prevalent virus (n = 111) and accounted for the highest numbers of oxygen supplementation (n = 26) and hospitalizations (n = 61). Seasonal coronavirus was significantly associated with oxygen supplementation (p = 0.029), and co-detection of multiple viruses was associated with hospitalization (p = 0.046). These findings highlight the clinical impact of CRVs on adult emergency department outcomes. Point-of-care virus diagnostics may improve risk stratification and prediction of outcomes based on virus types and co-infections.

6. A Sequence-Based Update on Amino Acid Substitutions in Influenza Polymerase Acidic Protein in Europe That Alter Baloxavir Susceptibility From 2009 to 2025.

期刊: Influenza and other respiratory viruses 发表日期: 2026-Jul 链接: PubMed

摘要

Influenza causes 650,000 deaths, 3-5 million hospitalizations, and 1 billion cases worldwide each year. There is a limited repertoire of antivirals available to tackle this burden, highlighting the risk of developing resistance to current drugs. An effort to develop new influenza antivirals has been made, leading to the approval of baloxavir. Some mutations leading to reduced susceptibility to baloxavir have been reported, but information about their epidemiology is scarce. Thus, we aim to evaluate the prevalence of substitutions in the polymerase acidic (PA) subunit associated with baloxavir susceptibility over 16 epidemiological seasons in Europe. We evaluated 87,266 sequences collected from 2009 to 2025 in Europe, annotated the mutations, and identified all known amino acid substitutions related to changes in baloxavir susceptibility to assess their prevalence. A total of 149 (0.2%) sequences with at least one substitution were identified, 81 (0.09%) exhibiting reduced susceptibility. Overall, 17 different substitutions were detected, located both inside and outside baloxavir binding site. The number of substitutions detected ranged from 0 to 15 per season, with E23K, E23R, K34R, A36V, I38F, I38L, and E120D emerging after baloxavir approval in Europe. Double and triple concurrent substitutions were also identified. While the prevalence of sequences with substitutions that alter baloxavir susceptibility remains stable, the number of circulating substitutions increases over time. This implies the emergence of amino acid substitutions that did not circulate before and the concurrence of double and triple substitutions that might synergize their individual effects. These results highlight the need for virological surveillance and novel antiviral treatments.

7. [Environmental Impact of Pharmaceuticals - How can doctors lead sustainable prescribing practices?].

期刊: Laeknabladid 发表日期: 2026-Jul 链接: PubMed

摘要

Medicines are the most common and, in many cases, the most effective treatment for disease. Medicine use is expected to continue to rise in the coming years, due in part to an ageing population. At the same time, knowledge of the environmental impact of pharmaceuticals has grown. Therefore, there is increasing discussion of the need for clinicians to take such impacts into account when selecting treatment for their patients. The World Health Organization has proposed the One Health approach, which emphasises the interconnection between human health, animal health and the environment. According to the One Health approach, all of these dimensions must be considered in order to respond effectively to contemporary health threats. Medicines are designed to have specific effects on living organisms, and many of them withstand a wide range of environmental conditions without breaking down or losing activity. Pharmaceuticals can have adverse environmental effects in three ways: through pollution and the carbon footprint associated with their manufacture and distribution; through excretion of unchanged drug or active metabolites into the environment via urine or faeces; or through improper disposal. This article discusses the environmental impact of pharmaceuticals, their potential effects on human health, the current situation in Iceland, and measures to mitigate adverse effects and counter further deterioration.

8. Effectiveness of simulation-based continuing education in neonatal resuscitation among Moroccan midwives: A quasi-experimental study.

期刊: African journal of reproductive health 发表日期: 2026-Jun-26 链接: PubMed

摘要

Neonatal mortality remains a critical public health issue, particularly in resource-limited settings. Simulation-based programs such as Helping Babies Breathe (HBB) have proven effective in strengthening midwives’ knowledge and skills in neonatal resuscitation, yet no study has evaluated their impact among practicing Moroccan midwives. The objective of this study was to assess the effectiveness of HBB training on satisfaction, self-efficacy, theoretical knowledge, one-year knowledge retention, and technical skills among practicing Moroccan midwives. A quasi-experimental pre-post study was conducted with 96 midwives. The intervention included a didactic session, hands-on practice, and formative simulation. Satisfaction, self-efficacy, and knowledge were measured through questionnaires; technical skills were evaluated using OSCE checklists for the Golden Minute and positive pressure ventilation. Satisfaction was 100%, and full self-efficacy increased markedly post-training. Knowledge improved significantly and remained stable at follow-up. Technical skills showed high scores with minimal failure rates. Knowledge moderately correlated with ventilation performance. In conclusion, HBB simulation-based training significantly enhances and sustains neonatal resuscitation competencies among Moroccan midwives, supporting its systematic integration into continuous professional development. La mortalité néonatale reste un problème majeur de santé publique, particulièrement dans les contextes aux ressources limitées. Les programmes basés sur la simulation, tels que « Helping Babies Breathe » (HBB), ont prouvé leur efficacité pour renforcer les connaissances et les compétences des sages-femmes en réanimation néonatale, mais aucune étude n’a encore évalué leur impact chez les sages-femmes marocaines en exercice. L’objectif de cette étude était d’évaluer l’efficacité de la formation HBB sur la satisfaction, le sentiment d’auto-efficacité, les connaissances théoriques, le maintien des connaissances à un an et les compétences techniques chez les sages-femmes marocaines en activité. Une étude quasi-expérimentale avant-après a été menée auprès de 96 sages-femmes. L’intervention comprenait une session didactique, une pratique supervisée et une simulation formative. La satisfaction, le sentiment d’auto-efficacité et les connaissances ont été mesurées par questionnaires ; les compétences techniques ont été évaluées à l’aide de grilles ECOS pour la « Minute d’or » et la ventilation à pression positive. La satisfaction était de 100 %, et le sentiment d’auto-efficacité a nettement amélioré après la formation. Les connaissances se sont significativement améliorées et sont restées stables au suivi. Les compétences techniques ont montré des scores élevés avec un taux d’échec minimal. Les connaissances étaient modérément corrélées à la performance en ventilation. En conclusion, la formation basée sur la simulation HBB améliore significativement et durablement les compétences en réanimation néonatale des sages-femmes marocaines, ce qui plaide en faveur de son intégration systématique dans le développement professionnel continu.(.

9. Association of coffee intake with body composition in an older adult study population in Finland.

期刊: International journal of food sciences and nutrition 发表日期: 2026-Jun-26 链接: PubMed

摘要

Changes in body composition with ageing, such as fat gain and muscle loss, pose significant health challenges. Coffee consumption may influence body composition, but evidence remains inconclusive. This cross-sectional study examined associations between coffee consumption and body composition in an older Finnish population with high habitual coffee intake. The analysis included 528 men and women (mean age 67.7 years). Coffee intake was assessed using a food-frequency questionnaire, and body composition was measured by dual-energy X-ray absorptiometry (DXA). Multivariable-adjusted associations between coffee consumption (<375, 375, and >375 ml/day) and lean mass index, appendicular lean mass index, fat mass index, body mass index, and android/gynoid ratio were analysed using sex-stratified ANCOVA, with Bonferroni correction applied. Mean ± SD coffee intake was 370 ± 214 ml/day. No statistically significant differences between the coffee intake categories were observed for any body composition outcome (p-values > 0.06). In this older Finnish population, coffee consumption was not associated with DXA-assessed body composition.

10. A Global Survey on Intra-operative Neuromonitoring (IONM) Practices, Attitudes Towards Its Use, and Barriers Among Spine Surgeons.

期刊: Global spine journal 发表日期: 2026-Jun-26 链接: PubMed

摘要

Study DesignCross-sectional survey study.ObjectivesTo provide a contemporary global overview of intra-operative neuromonitoring (IONM) practices, attitudes, and perceived barriers among spine surgeons.MethodsA web-based questionnaire was distributed to AO Spine surgeon members worldwide between April and May 2025 to collect data on surgeon demographics, access to and utilization of IONM, models of service delivery, intra-operative responses to neuromonitoring alerts, attitudes toward IONM, and perceived limitations. Attitudes were assessed using 13 Likert-scale statements. Logistic regression analysis was performed to identify factors associated with a positive attitude toward IONM. Significance was set at p<0.05.ResultsA total of 529 spine surgeons responded to the survey. Consistent access to IONM was reported by 55.5% of respondents, occasional access by 35.7%, and no access by 8.8%. External service providers were the most used IONM model (59.5%). Neuromonitoring technicians most frequently interpret intraoperative data (63.6%). In response to unexpected signal loss, most surgeons reported using a standardized checklist (76.3%). Overall attitudes toward IONM were predominantly positive, with most respondents agreeing that IONM improves patient outcomes, provides medicolegal protection, and offers surgeon reassurance. Economic constraints (38.2%), logistical challenges (27.4%), and lack of training (25.6%) were the most reported barriers. Multivariate analysis identified geographic region, specialty, and access to IONM as independent predictors of a positive attitude.ConclusionsThis global survey demonstrates widespread acceptance of IONM among spine surgeons, particularly for high-risk procedures. However, disparities in access and persistent economic and logistical barriers remain, highlighting the need for strategies to improve equitable implementation worldwide.

11. Randomised Controlled Feasibility Trial of an Intervention to Reduce Infant Bathing.

期刊: The British journal of dermatology 发表日期: 2026-Jun-26 链接: PubMed

摘要

Bathing, even in tap water, alters skin physiology. Frequent infant bathing may increase the risk of eczema developing.

To undertake a randomised controlled feasibility trial of an intervention to reduce infant bathing frequency and intensity.

Randomised controlled trial. 105 pregnant women (≥ 16 years) with family history of atopy, carrying a healthy singleton child (54 male, 51 female) were randomised in a 1:1 ratio during pregnancy, or postnatally prior to the first infant bath. The intervention group were asked to reduce bathing frequency (no more than once a week for the first six months of age) and intensity (keep baths short, not too hot and washing in plain water is usually sufficient). The control group received the routine postnatal infant care advice offered in their maternity unit.The primary feasibility outcome was the proportion of eligible families willing to be randomised to the intervention. The secondary clinical outcome was a blinded assessment of infant eczema at age 6 months, using an adaptation of the UK Working Party Diagnostic Criteria for Atopic Dermatitis.

261 pregnant women were screened, of whom 21 were ineligible and 105/240 (44%) were randomised to the intervention (52) and control (53) groups. Adherence to the intervention was high with 79.6% (35/44) in the intervention arm bathing their infant once a week or less, compared to 28.6% (14/49) in the control group. In the intervention group 95% (38/40) agreed or strongly agreed that the intervention was acceptable. There was minimal contamination of the control group (1/46). Follow-up was high with 89% (93/105) of families completing the final 6-month questionnaire and 82% (86/105) attended the final visit. Eczema outcomes occurred less frequently in the intervention arm compared to the control arm: visible eczema 15.8% (6/38) vs 29.2% (14/48); parent reported eczema 9.1% (4/44) vs 12.2% (6/49); and doctor diagnosed parent reported eczema 6.8% (3/44) vs 10.2% (5/49). No noteworthy adverse effects of the intervention were reported. These findings support the feasibility of randomising infants during pregnancy to a reduced frequency and intensity bathing intervention for eczema prevention. ISRCTN51491794 (Registered 24/07/2023).

12. Top Ten Tips Palliative Care Clinicians Should Know About Addressing Suicidality.

期刊: Journal of palliative medicine 发表日期: 2026-Jun-26 链接: PubMed

摘要

Suicidal ideation (SI) is a complex phenomenon occurring across populations and is especially prevalent among patients with serious illness. Palliative care (PC) clinicians often care for patients at elevated risk for SI and are well positioned to identify and respond to suicidality. Clinical encounters may require distinguishing passive wishes for death from active suicidal intent, addressing modifiable sources of suffering, and supporting patients and families through emotionally complex conversations. Practical, evidence-informed guidance can help clinicians approach these encounters with greater clarity and confidence. In this article, an interdisciplinary group of PC, psychiatry, psychology, social work, and chaplaincy clinicians shares ten tips for caring for patients with serious illness who experience SI.

13. Low Serum Testosterone Concentrations Predict Incident Frailty in Men with HIV.

期刊: The Journal of clinical endocrinology and metabolism 发表日期: 2026-Jun-26 链接: PubMed

摘要

Older men with HIV (MWH) experience a higher burden of frailty than age-matched men without HIV, but the biological mechanisms underlying this vulnerability are not completely understood. Testosterone (T) deficiency may contribute to frailty through effects on muscle mass and physical function. To evaluate the associations of free (T), total T, and sex hormone-binding globulin (SHBG) with incident frailty among men with HIV. Prospective cohort study. The MACS/WIHS Combined Cohort Study. 306 non-frail MWH (129 robust, 177 prefrail) with longitudinal frailty assessments. Incident frailty defined using the Fried frailty phenotype. Free T, Total T and SHBG were measured, with free T assessed by equilibrium dialysis. Marginal structural models were used to estimate associations with frailty outcomes while accounting for time and related covariates. Over a mean follow-up of 9.0 years, low free T (<54 pg/mL) and low total T (<300 ng/dL) were associated with higher risk of incident frailty compared with higher concentrations (HR: 2.49, 95%CI:1.21-5.11; HR: 3.31, 95%CI: 1.26-8.68, respectively). SHBG concentrations were not consistently associated with frailty outcomes. Low T levels predict incident frailty in men with HIV. Assessment of androgen status may help identify men at increased frailty risk. Further investigations are warranted to assess the role of T therapy in frailty prevention.

14. Does Gestational Diabetes Increase Urinary Incontinence During Pregnancy? A Cross-Sectional Study of Symptom Patterns and Incontinence-Related Quality of Life.

期刊: Neurourology and urodynamics 发表日期: 2026-Jun-26 链接: PubMed

摘要

This study aimed to evaluate the association between gestational diabetes mellitus and urinary incontinence during pregnancy, including symptom subtype, symptom severity, and incontinence-related quality of life. This cross-sectional study included pregnant women who underwent a 75-g oral glucose tolerance test at 24-28 weeks of gestation. GDM was diagnosed using International Association of Diabetes and Pregnancy Study Groups criteria. Urinary incontinence was assessed using the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI SF), and incontinence-related quality of life with the Incontinence Quality of Life (I-QOL) questionnaire. Participants were compared by GDM status. Multivariable logistic regression analysis was performed to evaluate factors associated with urinary incontinence. A total of 309 pregnant women were included, of whom 110 had GDM. Incontinence subtype distribution differed by GDM status. Urinary incontinence was observed in 146 women (47.2%), with no significant difference in prevalence between women with and without GDM. Subtype distribution differed: urgency urinary incontinence was significantly more frequent in women with GDM, whereas stress and mixed urinary incontinence were more common in those without GDM. Total ICIQ-UI SF scores were comparable between groups. Women with GDM had higher total I-QOL and psychosocial impact scores. Parity was higher among women with urinary incontinence than among those without. Gestational diabetes mellitus was not associated with increased prevalence of urinary incontinence during pregnancy. Obstetric factors, particularly parity, appeared to be more closely associated with urinary incontinence than GDM status. Higher I-QOL scores in women with GDM should be interpreted cautiously and may reflect healthcare-related or perceptual factors rather than a protective association. However, urgency urinary incontinence was more frequent in women with GDM.

15. Patient-led, home-based follow-up for colorectal cancer: the DISTANCE multicentre stepped-wedge cluster-randomised trial.

期刊: The British journal of surgery 发表日期: 2026-Jun-26 链接: PubMed

摘要

Colorectal cancer (CRC) incidence is rising, consequentially traditional follow-up care models are increasingly unsustainable. Patient-led, home-based follow-up (PHFU) may offer a promising alternative to reduce hospital visits while maintaining patient well-being. The DISTANCE trial is a stepped-wedge cluster randomised trial conducted in six hospitals in the Netherlands. A total of 354 stage I-III CRC survivors, disease-free at 12 months post-surgery, assigned to either PHFU or standard follow-up. The primary endpoint was the number of hospital contacts. Secondary endpoints included quality of life (QoL, EORTC QLQ-C30), cancer-related worry (CWS), and psychological distress (HADS). In the intention-to-treat (ITT) analysis, no significant difference in hospital contacts was observed. In the as-treated (AT) analysis, PHFU reduced hospital contacts by 38% compared to standard follow-up (RR 0.62, 95% CI 0.51-0.75, p < 0.001). There was substantial crossover, with 117 patients assigned to PHFU receiving standard follow-up and 10 patients assigned to standard follow-up receiving PHFU. No significant differences were found in QoL or psychological distress between the two groups. The DISTANCE trial suggests that PHFU is a feasible and effective alternative to standard hospital-based follow-up for CRC survivors.TOC Summary.

16. EAACI Guidelines on Environmental Science for Allergy and Asthma-Evidence-Based Recommendations for Prevention and Public Health Action to Mitigate the Impact of Pollen Exposure on Respiratory Allergy.

期刊: Allergy 发表日期: 2026-Jun-26 链接: PubMed

摘要

Developed using the GRADE methodology, these EAACI guidelines provide evidence-based recommendations on the effectiveness of pollen reduction/avoidance strategies for allergic rhinitis (AR) and asthma, the utility of biomarkers for monitoring pollen-induced asthma and the efficiency of mitigation measures and of public health strategies. Systematic and narrative reviews and health economic analysis support the recommendations. According to GRADE, the certainty of evidence was moderate to very low, therefore conditional recommendations are provided to guide healthcare professionals, patients, and policymakers in developing personalized, preventive, and scalable interventions. Reducing/avoiding exposure to pollen should be recommended to reduce the risk of severe asthma exacerbations. Lung function decrease and exhaled nitric oxide increase may be predictive for pollen-induced asthma exacerbations. Real-time pollen monitoring and pollen concentration-based forecast may be recommended for managing pollen-induced AR and/or asthma. Pollutant information should be included in pollen information systems. Combined forecast (weather, pollen, pollutants) and warning systems might reduce the impact of thunderstorm asthma (TA). Emergency department/asthma-related services should be strengthened during pollen season and in TA. Personalized frameworks covering the types and allergenic potential of pollen, the coaggressors and the vulnerability of each patient are needed in daily practice. The fundamental role of prevention should be further prioritized.

17. Elucidating Characteristics of Co-Existent Overactive and Underactive Bladder in Participants of the 2023 Japan Community Health Survey (JaCS 2023) With Nocturia.

期刊: Neurourology and urodynamics 发表日期: 2026-Jun-26 链接: PubMed

摘要

To clarify the characteristics of co-existent overactive and underactive bladder (COUB) in participants with nocturia from the 2023 Japan Community Health Survey. Participants reporting nocturia (≥1 episode per night) were divided into four groups: COUB, overactive bladder (OAB) alone, underactive bladder (UAB) alone, and neither OAB nor UAB (non-OAB/UAB). Nocturia-related variables were compared across groups. Multivariable analyses were performed to identify predictors of clinical nocturia (nocturia ≥ 2) and factors associated with reporting nocturia as the most impactful symptom in daily life. Among 2,006 men and 1,787 women with nocturia, the prevalence of COUB was 6.1% and 2.6%, respectively. The proportion of nocturia ≥2 increased significantly in ascending order across four groups in men (non-OAB/UAB, UAB alone, OAB alone, COUB) and women (non-OAB/UAB, OAB alone, UAB alone, COUB) (p < 0.001 for both). Subjective nighttime voided volume (VV) compared to daytime VV and nocturnal voiding trigger also showed significant differences among the four groups in both genders (all p < 0.001). COUB independently predicted nocturia ≥ 2 in men (odds ratio OR: 2.50, p < 0.001) and women (OR: 2.39, p = 0.028). Although nocturia was ranked as the most impactful symptom in all groups, COUB was inversely associated with reporting nocturia as the most impactful symptom (men: OR: 0.43, p = 0.014; women: OR: 0.18, p = 0.002). COUB represents a distinct and severe phenotype among symptom syndromes and is independently associated with nocturia severity.

18. Effects of organochlorine pesticides (OCPs) on adolescent body composition: Integrating epidemiology and bioinformatics.

期刊: Journal of environmental science and health. Part A, Toxic/hazardous substances & environmental engineering 发表日期: 2026-Jun-26 链接: PubMed

摘要

Exposure to organochlorine pesticides (OCPs) may disrupt adolescent development; however, their precise impacts remain unclear. Using data from the National Health and Nutrition Examination Survey (NHANES) 2011-2016, we examined associations between OCPs and adolescent body composition indicators, including body mass index (BMI) z_score, appendicular lean mass (ALM), trunk fat (TRF), total fat (TOF), total lean mass (TLM), and total percent fat (TPF). We fitted several statistical models including linear regression, weighted quantile sum (WQS) regression, and Bayesian kernel machine regression (BKMR). Mediation analysis evaluated the effect of serum albumin, while network toxicology and molecular docking identified key targets and pathways. Linear regression showed that OCPs were negatively correlated with BMI z_score, ALM, TRF, TOF, TLM, and TPF in adolescents, particularly in males. The WQS and BKMR revealed a negative relationship between OCPs mixtures and BMI z_score, TRF, TOF, and TPF, with hexachlorobenzene (HCB) as the major contributor. Albumin mediated the negative effects of HCB on all body composition indicators. Preliminary bioinformatics analyses suggested that HCB may influence body composition through inflammation, metabolic regulation, and apoptosis involving the MAPK, PI3K-Akt, and Ras signaling pathways. These findings suggest that HCB exposure may adversely affect adolescent growth and nutritional health, particularly among males.

19. Impact of Integrated Continuous Team Midwifery Care on Breastfeeding Success within the Iranian Health System: A Randomized Controlled Trial.

期刊: Breastfeeding medicine : the official journal of the Academy of Breastfeeding Medicine 发表日期: 2026-Jun-26 链接: PubMed

摘要

Supporting women during the perinatal period helps build confidence, strengthens early bonding between mother and baby, and encourages successful breastfeeding. Continuous midwifery care models are one of the ways that support women in this periods. This study aimed to evaluate the effect of integrated continuous team midwifery care (ICTMC) in enhancing breastfeeding success in the Iranian health system. In this randomized controlled trial, 200 low-risk primiparous women with a gestational age of less than 12 weeks were recruited from public health centers. Participants were randomly assigned to either the intervention group, which received continuous midwifery care throughout pregnancy, childbirth, and postnatal follow-up, or the control group, which received routine care. The primary outcomes were early skin-to-skin contact and breastfeeding success at the time of discharge and at 4-6 weeks postpartum. Data were analyzed using Stata, employing descriptive statistics, Chi-square, independent t-test, Phi/Cramer’s V, and Cohen’s d. The p < 0.05 is significant. Data were analyzed with SPSS 26. ICTMC groups were significantly more likely to initiate skin-to-skin contactearly skin-to-skin contact immediately after birth (92% vs. 74%, p < 0.001) and achieve successful breastfeeding at the discharge time (88% vs. 70%, p = 0.002) compared to the control group. At 6 weeks postpartum, breastfeeding success remained higher in the intervention group (82% vs. 65%, p = 0.004). Women with ICTMC, effectively support skin-to-skin contactearly mother-infant bonding and enhance breastfeeding success among low-risk primiparous women. Integrating this model into routine maternal care may improve perinatal outcomes.

20. Association of facility- and hospital medicine group-level characteristics on the impact of burnout among hospitalists in the Veteran's Health Administration.

期刊: Journal of hospital medicine 发表日期: 2026-Jun-26 链接: PubMed

摘要

Burnout is highly prevalent in hospital medicine (HM). Few studies have examined the impact of hospitalist burnout within the Veteran’s Health Administration (VHA) or how the practice environment and work characteristics impact burnout. Describe associations between facility- and HM group-level characteristics and perceived burnout. We surveyed HM leaders at 121 VHA acute care facilities on workload structure, staffing models, and experiences. Our primary outcome, leader’s perception of the impact of burnout, was rated on a 5-point Likert-type scale and dichotomized for moderate/high/severe impact. Overall, 117 HM groups (97%) had complete information. Facility-level characteristics associated with higher odds of moderate/high/severe leader-perceived impact of burnout included a higher number of operating beds (odds ratio [OR] per 10 additional beds 1.09, 95% confiidence interval [CI]: 1.02-1.18), higher mean daily admissions (OR per 10 additional admissions 1.06, 95% CI: 1.01-1.12) and working at a higher complexity facility (OR: 2.63, 95% CI: 1.14-6.25). Group-level factors included having any vacant physician position (OR: 35.5, 95% CI: 7.11-345.5) and each additional 10% increase in vacant HM physician positions (OR: 1.52, 95% CI: 1.01-2.48). Secondary analysis showed increased association between facility complexity, maximum patient load per team, and physician vacancies with high/severe leader-perceived impact of burnout. Facility-level factors such as hospital complexity and number of operating beds were associated with the HM leader’s perceived impact of burnout, as were group-level characteristics, including maximum patient load per team and physician staffing vacancies. Group-level characteristics may be amenable to modification, providing potential opportunities for VHA leaders to address these factors.

21. Machine Learning Algorithms to Accelerate Etiological Diagnosis of Congenital Disorders of Adrenal Steroidogenesis.

期刊: The Journal of clinical endocrinology and metabolism 发表日期: 2026-Jun-26 链接: PubMed

摘要

Early and accurate etiological diagnosis of congenital disorders of adrenal steroidogenesis (CDAS) is critical as timely targeted management can prevent life-threatening complications and improve long-term outcomes. To develop and validate a machine learning-assisted decision tree model for classifying CDAS using plasma steroid hormone profiles quantified by liquid chromatography-mass spectrometry (LC-MS/MS). A development cohort of 1027 participants (325 genetically confirmed CDAS patients representing eight subtypes/702 controls) was used for model construction. The Light Gradient Boosting Machine algorithm identified key discriminatory steroid hormones, which were integrated into an optimized decision-tree classifier. Internal performance was assessed through five-fold cross-validation. The performance of the model was further evaluated using a validation cohort comprising 507 independent LC-MS/MS steroid profiles. Additional analyses included Shapley additive explanations (SHAP), confusion matrix visualization, Principal Component Analysis (PCA), and Uniform Manifold Approximation and Projection (UMAP). In the development cohort, the model achieved a mean overall accuracy of 97.1%, sensitivity of 99.5%, and specificity of 93.7%, with a macro-AUC (area under curve) of 0.97. Subtype-level accuracy exceeded 98% for most major CDAS subtypes. In the validation cohort, overall accuracy was 98.9%, sensitivity 93.6%, specificity 99.8%. Feature importance analysis and SHAP identified 11-deoxycortisol, 17-hydroxyprogesterone, 21-deoxycortisol, and corticosterone as the strongest discriminators. PCA and UMAP revealed distinct clustering of CDAS subtypes, confirming the biological coherence of model predictions. Machine learning-assisted steroid profiling provides an accurate and highly interpretable diagnostic approach for CDAS, with potential for integration into pediatric endocrine diagnostics and decision-support systems.

22. The E-cadherin-Wnt-mir-994 Axis Repurposes a Cadherin Switch for Niche Robustness and Germline Stem Cell Maintenance.

期刊: Cell proliferation 发表日期: 2026-Jun-26 链接: PubMed

摘要

The resilience and robustness of the stem cell niche are critical for long-term tissue homeostasis, yet the molecular circuits that ensure this stability remain poorly understood. In the Drosophila ovarian germline stem cell niche, we investigate this fundamental question through the lens of adhesion, focusing on the role of N-cadherin in the somatic inner germarial sheath (IGS) cells. While the specific loss of N-cadherin alone is inconsequential, we discover that it becomes essential upon the loss of E-cadherin, revealing a critical, context-dependent function. This functional interplay is governed by a precise molecular circuit wherein E-cadherin cell-autonomously represses N-cadherin expression via a linear Wnt-mir-994 signalling axis. Strikingly, this regulatory relationship constitutes a cadherin switch, which is repurposed within the niche not to promote dispersal, but to enforce resilience. The E-cadherin-to-N-cadherin switch acts as a vital compensatory mechanism: the ectopic upregulation of N-cadherin upon E-cadherin depletion is essential to maintain IGS cell survival and their long cellular processes, thereby rescuing niche integrity and preventing GSC loss. Our study defines the function for N-cadherin in IGS cells, unveils the E-cadherin-Wnt-mir-994-N-cadherin axis and demonstrates the repurposing of a classic developmental module as a robustness circuit to safeguard the stem cell niche. This repurposed cadherin switch reveals an axis for targeting the resilience of niche-stem cell interplay, and also informs new strategies for stabilizing niche environments in regenerative medicine or targeting the resilient cancer stem cell microenvironment.

23. Diversity of Iodinated Water Disinfection Byproducts and Their Formation Dynamics Discovered Using Exposome-Scale Nontargeted Analysis and Machine Learning.

期刊: Environmental science & technology 发表日期: 2026-Jun-26 链接: PubMed

摘要

Water disinfection is critical to minimizing microbial risk, but unintentionally produces disinfection byproducts (DBPs). Exposure to the currently regulated chloro- and bromo-DBPs in water cannot fully account for the health effects observed from epidemiological studies. Iodinated disinfection byproducts (I-DBPs) are among the most toxic DBPs, but they have not been fully characterized because of significant technical challenges. We report here the first exposome-scale study of iodinated disinfection byproducts formed under environmentally relevant conditions. Here, “exposome-scale” refers to broad-scope, nontargeted profiling of exposure-relevant environmental contaminants. The machine-learning-assisted nontargeted analysis of chloramine-treated water enabled detection and characterization of 8551 and 1541 high-confidence iodinated molecular features, generated under the negative and positive ionization modes, respectively. Sixty-two new iodinated disinfection byproducts were identified, with 11 I-DBPs confirmed using authentic standards. Across four Environmental Protection Agency toxicity prediction end points (fathead minnow, Daphnia magna, Tetrahymena pyriformis, and rat), the 11 I-DBPs consistently showed higher or comparable toxicities relative to both the regulated DBPs and the four known I-DBPs, with predicted toxicities reaching up to 2-3 orders of magnitude greater than benchmark compounds such as chloroform and iodoacetic acid. This study demonstrates improved understanding of the diversity and formation dynamics of highly toxic I-DBPs, enabled by advances in integrating exposomics with machine learning techniques.

24. From aggregation to detection: AIEgen-based sensors for fluoride and cyanide monitoring.

期刊: Physical chemistry chemical physics : PCCP 发表日期: 2026-Jun-26 链接: PubMed

摘要

Aggregation-induced emission luminogens (AIEgens) have emerged as promising platforms for sensing applications owing to their distinctive fluorescence enhancement in the aggregated state. This review highlights recent advances in AIEgen-based sensors for the selective and sensitive detection of fluoride (F-) and cyanide (CN-) ions, both of which pose significant environmental and health concerns. The design strategies focus on incorporation of specific recognition units, such as hydrogen-bond donors and electrophilic centers, into AIE-active frameworks to achieve high selectivity. The sensing mechanisms for fluoride are primarily governed by hydrogen bonding or deprotonation mechanisms, whereas cyanide detection often involves nucleophilic addition reactions that induce distinct photophysical changes. In this review, we summarize some representative advances in AIEgen-based sensors for anion recognition through different sensing mechanisms, such as deprotonation or hydrogen bonding, nucleophilic addition, Lewis acid-base interactions, etc., reported in recent years. We believe that this review on host-guest anion recognition using AIEgens will provide guidance for the rational design and preparation of advanced functional sensors for real-time anion recognition with promising practical applications.

25. Morphometric Analysis of the Anterior Clinoid Process and Its Relationship With the Internal Carotid Artery Using MDCT Angiography.

期刊: The Journal of craniofacial surgery 发表日期: 2026-Jun-26 链接: PubMed

摘要

The anterior clinoid process (ACP) is a critical osseous structure in skull base surgery because of its close anatomic relationship with the optic nerve and internal carotid artery (ICA). This study aimed to evaluate the morphometric characteristics of the ACP and its relationship with adjacent ICA segments using computed tomography angiography (CTA) in a Turkish population. Cranial CTA images of 200 patients (100 males and 100 females; aged 20-65 y) were retrospectively analyzed. ACP length, width, apical angle, distance to the sagittal midline, and distances to the C4 and C5 ICA segments were measured bilaterally using multiplanar reconstructions in 3D Slicer software. No significant sex differences were observed in ACP length, width, angle, or midline distance (P>0.05), except for a greater ACP-C5 ICA distance in males (P<0.05). Right-sided ACP length, width, and apical angle were significantly greater than those on the left side (P<0.05). The ACP demonstrated close proximity to the ICA, with significantly greater ACP-ICA distances on the right side for both the C4 and C5 segments (P<0.05). Mean ACP length was 13.11±2.47 mm on the right and 12.62±2.70 mm on the left, whereas mean ACP-C4 ICA distance was 1.92±1.02 mm on the right and 1.86±0.60 mm on the left. These findings demonstrate significant morphometric variability of the ACP and emphasize its close anatomic relationship with the ICA, factors that may directly influence the technical complexity and safety of anterior clinoidectomy. CTA-based preoperative evaluation may provide valuable anatomic guidance for safer surgical planning and reduction of neurovascular complications.

26. Silencing Triglycerides: The Clinical Impact of Plozasiran and apoC-III Inhibition in Severe Hypertriglyceridemia.

期刊: Journal of cardiovascular pharmacology 发表日期: 2026-Jun-16 链接: PubMed

摘要

Severe hypertriglyceridemia (sHTG) is a critical metabolic disorder that substantially elevates the risk of atherosclerotic vascular disease and acute pancreatitis. Despite its clinical significance, many conventional triglyceride-lowering therapies often fail to adequately reduce triglyceride levels or prevent these life-threatening complications. This unmet need has spurred interest in targeting regulatory proteins involved in triglyceride metabolism, such as apolipoprotein C3 (apoC-III), a key inhibitor of lipoprotein lipase activity that promotes triglyceride-rich lipoprotein (TRL) accumulation. Plozasiran, an investigational small interfering RNA (siRNA) therapy, has emerged as a breakthrough in sHTG management by selectively degrading hepatic APOC3 mRNA. Indeed, clinical trials demonstrate this drug’s robust efficacy in reducing triglyceride levels, concomitant with reduced non-HDL cholesterol and apolipoprotein B-key markers of cardiovascular risk. Notably, the Phase III PALISADE trial in familial chylomicronemia syndrome patients revealed plozasiran’s potential to mitigate acute pancreatitis risk by normalizing triglyceride levels with a favorable safety profile. Current guidelines emphasize a multimodal approach to sHTG, combining dietary restriction of fats and simple carbohydrates with pharmacotherapy. However, plozasiran’s prolonged dosing interval and mechanism-based action position it as a transformative option, particularly for patients refractory to existing treatments. While long-term cardiovascular outcome data remain pending, its ability to durably modulate APOC3 expression offers new hope for breaking the cycle of dyslipidemia-driven organ damage. As research progresses, this therapy may redefine standards of care for high-risk populations, bridging a critical gap in preventive cardiology and pancreatology.

27. Aspirin in primary prevention: a case for selective use.

期刊: Journal of cardiovascular pharmacology 发表日期: 2026-Jun-05 链接: PubMed

摘要

Low-dose aspirin has a well-established role in secondary prevention of cardiovascular disease but use in primary prevention remains uncommon due to limited evidence of benefit and risk of adverse effects such as bleeding. While benefit of aspirin in primary prevention may not outweigh risk in the general population, it may still be appropriate for particular groups in which benefit would be greater. Novel biomarkers for cardiovascular risk can help identify these groups. These include imaging markers such as coronary artery calcium scoring and carotid plaque assessment, and laboratory markers such as lipoprotein(a) and high sensitivity C-reactive protein. Use of these biomarkers for more effective risk stratification can delineate groups of patients with greater potential benefit from aspirin and help guide risk-benefit conversations regarding primary prevention.

28. Ongoing multi-country outbreak of carbapenem-resistant Enterobacter hormaechei ST1344 carrying bla NDM-5 in the European Union/European Economic Area, March 2025 to April 2026.

期刊: Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin 发表日期: 2026-Jun 链接: PubMed

摘要

In seven EU/EEA countries, the emergence of NDM-5-producing Enterobacter hormaechei ST1344 among patients has been detected. In minimum spanning tree analysis of core genome-multilocus sequence-typing (cgMLST) profiles, isolates cluster with ≤ 4 allelic differences. The outbreak includes 57 cases (29 female/28 male; median age: 73 years), which occurred between March 2025 and April 2026. Many were hospitalised (n = 45), some with extensive prior medical treatment, and only three reported travel abroad. A cross-border investigation, including coordinated exposure questionnaires, has not yet identified a source.

29. Population-based prevalence and screening gaps of hepatitis C, B and D, Germany, 2020 to 2021.

期刊: Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin 发表日期: 2026-Jun 链接: PubMed

摘要

BACKGROUNDChronic hepatitis C (HCV) and hepatitis B (HBV) viruses remain major causes of liver-related morbidity and mortality. Despite a low prevalence in Germany, migration from higher-endemic regions and screening gaps may hinder progress towards World Health Organization (WHO) 2030 elimination targets. Population-based data are needed for surveillance, screening and elimination.AIMWe aimed to estimate prevalence of HCV, HBV and hepatitis D virus (HDV) in adults in Germany.METHODSWe retrospectively analysed 10,000 serum samples from the Multilocal and Serial Prevalence Study of Antibodies against SARS-CoV-2 in Germany (MuSPAD, 2020-2021), by age and gender distribution. Samples were pooled and tested for HCV and HBV by PCR, for HBV surface antigen (HBsAg) and for antibodies against HCV and HBV. Samples positive for HBsAg were analysed for HDV.RESULTSActive HCV infection (HCV RNA) was detected in four (0.04%; 95% CI: 0.02-0.1) persons. Seroprevalence for HCV was 0.17% (95% CI: 0.11-0.27), highest among 60-69-year-olds (0.53%). Active HBV infection (HBV DNA and/or HBsAg) was detected in 21 participants (0.21%; 95% confidence interval (CI): 0.14-0.32), peaking at 0.44% among 30-39-year-olds. No HDV infection was confirmed.CONCLUSIONRecognising that relevant high-risk groups may be underrepresented in our data, the overall HCV and HBV prevalence in Germany appears low but non-negligible. Adults under 35 years are not covered by the national health check programme for all adults aged ≥ 35 years, suggesting potential screening gaps. Systematic HDV testing among HBV-positive individuals and targeted testing strategies may support progress towards WHO elimination goals.

30. First steps in establishing surveillance of bloodstream infections from electronic health record derived data, EU/EEA countries, March 2023 to March 2025.

期刊: Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin 发表日期: 2026-Jun 链接: PubMed

摘要

BACKGROUNDEnhancing surveillance of bloodstream infections (BSIs) by extracting data from electronic health records (EHR) is often the first step in automating the surveillance of healthcare-associated infections (HAIs).AIMWe assessed existing BSI surveillance systems and the progress in implementing EHR-BSI surveillance within the ECDC project Surveillance from Electronic Health Data (SUREHD).METHODSWe summarised information on BSI surveillance systems through meetings with national representatives and review of national surveillance protocols and reports.RESULTSOf the 30 EU/EEA countries invited to join the SUREHD project, 17 actively participated from March 2023 to March 2025. All 17 countries conducted BSI surveillance within HAI or antimicrobial resistance programmes, and EHR-BSI surveillance was being implemented nationally (n = 9), regionally (n = 2) or at hospital level (n = 6). Reported challenges included data standardisation (n = 13), IT capacity (n = 10), data linkage (n = 7), system integration (n = 7) and data protection (n = 6). Few countries had access to structured EHR data on patient symptoms (n = 1), infection origin (n = 2) and catheter-related variables (n = 5). Most countries had not yet implemented data validation processes (n = 12) nor decided on standardised vocabularies for most variables. All countries aimed to automate EHR-BSI surveillance.CONCLUSIONAutomation of BSI surveillance is critically relevant for the development of surveillance systems and to support infection and control measures (IPC) for HAIs. Implementation of automated EHR-based BSI surveillance varied between countries; a generic protocol and a network of experts have established a way forward. Future efforts should focus on harmonisation, data quality, and leveraging EHR-BSI data to strengthen HAI surveillance and to improve IPC.

31. Gaps in Guideline-Directed Medical Therapy for Heart Failure: A Cross-Sectional Study in an Underserved Population.

期刊: Cureus 发表日期: 2026-Jun 链接: PubMed

摘要

Heart failure (HF) remains a major clinical and public health challenge. Guideline-directed medical therapy (GDMT) has been shown to improve outcomes in patients with HF; however, gaps in the prescription and implementation of these therapies persist. These treatment gaps may contribute to suboptimal disease management and adverse clinical outcomes, highlighting the need to better understand patterns of GDMT utilization in diverse patient populations. In this study, we assessed and evaluated the prescribing patterns of GDMTs to an underserved population at an urban federally qualified health center (FQHC). We conducted a retrospective chart review of patients diagnosed with HF from May 2022 to June 2024 to assess the prescription of GDMT. Patients were classified based on echocardiographic findings as HF with reduced ejection fraction (HFrEF) (< 50%) and HF with preserved ejection fraction (HFpEF) (≥ 50%). Baseline demographics and prescription of GDMTs were compared between the two HF diagnoses. Fifty patients with HF were identified in the study period, including 41 with HFrEF and nine with HFpEF. There was a significant difference in the mean age between patients diagnosed with HFpEF (68 years) as compared to patients with HFrEF (58 years) (p=0.02). Among patients with HFrEF, 93% (n=38) were prescribed beta-blockers (BB), 83% (n=34) were prescribed angiotensin-converting enzyme inhibitors/angiotensin II receptor blockers/angiotensin receptor-neprilysin inhibitors (ACEi/ARB/ARNi), 29% (n=12) were prescribed mineralocorticoid receptor antagonists (MRA), and 34% (n=14) were prescribed sodium-glucose cotransporter-2 inhibitors (SGLT2). Prescriptions for these medical therapies were similar among patients with HFpEF, except that 0% were prescribed an SGLT2 medication (p=0.05 for comparison with patients with HFrEF). GDMT is under-prescribed in underserved populations, underscoring the need for specific interventions to address financial, systemic, and educational barriers. Interventions such as patient education initiatives, financial counseling support, provider training programs, and policy changes to improve medication affordability and access should be prioritized to help close these treatment gaps.

32. Association between neurodevelopmental disorders and recidivism among forensic outpatients under the Medical Treatment and Supervision Act in Japan: A retrospective cohort study.

期刊: PCN reports : psychiatry and clinical neurosciences 发表日期: 2026-Jun 链接: PubMed

摘要

Some features of neurodevelopmental disorders (NDDs) have been discussed as potential factors related to criminal behavior, and addressing their characteristics may help prevent recidivism among forensic patients. However, evidence from Japan remains limited. This study examined the association between NDDs and recidivism among forensic outpatients receiving treatment under Japan’s Medical Treatment and Supervision Act (MTSA). This retrospective cohort study used the national database of Japanese forensic outpatients who received treatment under the MTSA between 2005 and 2017. Generalized linear models analyzed the association between NDDs, including intellectual disability (ID), autism spectrum disorder (ASD), and attention deficit hyperactivity disorder (ADHD), and recidivism during outpatient treatment. A total of 2135 patients were included in the analysis, of whom 221 (10.4%) exhibited recidivism. ID, ASD, and ADHD were observed in 10.0%, 3.9%, and 0.3% of patients, respectively. Both ID (adjusted odds ratio [aOR] = 1.92, 95% confidence interval [CI]: 1.29-2.87) and ASD (aOR = 2.94, 95% CI: 1.64-5.27) were associated with an increased risk of recidivism. ID was associated with a higher risk of physical violence (aOR = 2.01, 95% CI: 1.28-3.14) and arson (aOR = 3.43, 95% CI: 1.01-11.71), whereas ASD was associated with physical violence (aOR = 2.87, 95% CI: 1.51-5.46). Among Japanese forensic outpatients, ASD and ID were associated with an increased risk of recidivism during outpatient treatment. These findings highlight the importance of developing tailored support and multidisciplinary interventions that address the specific needs of individuals with NDDs.

33. Author's correction for Euro Surveill. 2026;31(24).

期刊: Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin 发表日期: 2026-Jun 链接: PubMed

摘要

34. Characteristics and Clinical Outcomes of Lyme Arthritis: A Retrospective Study.

期刊: Open forum infectious diseases 发表日期: 2026-Jun 链接: PubMed

摘要

Lyme arthritis is the most common late manifestation of disseminated Lyme disease in the United States. While most patients respond to antibiotic therapy, a subset develops postantibiotic Lyme arthritis (PALA), characterized by persistent noninfectious inflammatory arthritis. Data describing predictors of PALA and treatment patterns remain limited. We conducted a retrospective observational cohort study of patients with polymerase chain reaction (PCR)-confirmed native joint Lyme arthritis treated at our institution from 2004 to 2025. Clinical, laboratory, imaging, treatment, and outcome data were abstracted from electronic health records. Continuous variables were compared using the Mann-Whitney U test, and categorical variables using Fisher’s exact test. Seventy-seven patients with PCR-confirmed native joint Lyme arthritis were identified: 64 adults and 13 children. Children more frequently presented with fever and had significantly higher synovial fluid white blood cell counts compared with adults. Knee monoarthritis was the predominant presentation in both groups. Among adults, 41 (64%) achieved complete symptomatic resolution following antibiotic therapy, while 19 (29.7%) developed PALA. Adults who developed PALA had significantly lower synovial fluid white blood cell counts and more extensive joint involvement. The use of intravenous antibiotics and longer total antibiotic duration was more common among PALA patients without evidence of improved outcomes. In this cohort of PCR-confirmed native joint Lyme arthritis, a substantial proportion of adults developed PALA. Failure to respond to initial antibiotic therapy and certain clinical features may identify patients at increased risk. These findings support judicious antibiotic use and early consideration of noninfectious mechanisms in persistent arthritis.

35. Cytotoxicity and Genotoxicity of Fluoride Toothpastes in Buccal Cells.

期刊: Acta stomatologica Croatica 发表日期: 2026-Jun 链接: PubMed

摘要

This study investigated whether toothpastes containing different fluoride compounds influence cytotoxic and genotoxic alterations in buccal mucosal cells, with particular attention to the type of fluoride, the presence of fluoride itself, and the duration of exposure. Eighty-eight participants were randomly assigned to four parallel groups: a control group using fluoride-free toothpaste and three intervention groups using formulations containing sodium fluoride, sodium monofluorophosphate, or amine fluoride. Buccal cell samples were obtained at baseline (T0), after 30 days (T1), and after 45 days (T2), and evaluated using the buccal micronucleus cytome assay to quantify nuclear abnormalities and cytotoxic markers. All fluoride-containing toothpastes led to higher frequencies of micronuclei, nuclear buds, and “broken egg” cells at T1 and T2 compared with the control group (P ≤ 0.001). Amine fluoride and sodium monofluorophosphate produced sustained increases in cytogenetic markers, including nuclear buds (AmF: P = 0.013; NaMFP: P ≤ 0.001) and “broken egg” cells (AmF: P ≤ 0.001; NaMFP: P = 0.004), while sodium fluoride demonstrated a slower, progressive increase in “broken egg” cells (P = 0.036). The findings suggest that fluoride-based toothpastes may modulate cytogenetic responses in buccal epithelial cells, and that these effects differ according to the fluoride compound and exposure duration. The findings should be interpreted with caution due to study limitations, and further research is needed to clarify the long-term biological consequences of repeated fluoride exposure in oral hygiene.

36. Perspectives on COVID-19-related relief measures and experience of food insecurity among low-wage worker families in two US cities.

期刊: Journal of hunger & environmental nutrition 发表日期: 2026-Apr-23 链接: PubMed

摘要

To explore how 2020-2022 federal COVID-19 relief measures impacted food security, economic hardship and housing stability, we interviewed low-income workers in Minneapolis, MN and Raleigh, NC. Participants were a subset of 40 from a larger study with at least one child. We identified themes including mechanisms of potential impact: food assistance, increased household cash, promoting housing stability, and reducing household expenses. No single measure ameliorated hardship. Participants reported healthier food behaviors. Flexible relief measures allowed people to spend according to their needs. These effects were not durable because relief measures were temporary. Nonetheless, relief measures likely averted worse outcomes.

37. Integration of the serum metabolome and gut microbiome underscores the importance of altered lipid metabolism and potential immune modulation in Parkinson's Disease.

期刊: Brain disorders (Amsterdam, Netherlands) 发表日期: 2026-Mar 链接: PubMed

摘要

Single-omics studies have deepened our understanding of disease-related molecular processes, though integrated approaches are needed to uncover cross-system interactions. We previously reported changes in the serum metabolome and gut microbiome in Parkinson’s disease (PD). To build on these findings, we conducted a multi-omics integration analysis to examine the interplay between the gut microbiome and human metabolism in PD. In a community-based study of 113 PD patients from rural California, microbiome profiles were obtained via 16S rRNA gene sequencing of fecal samples. Serum metabolomic profiles were generated using untargeted high-resolution LC-MS. Residual matrices of metabolomics data were extracted after adjusting for age, sex, racial minority status, and study wave. We identified PD-associated bacterial genera and summarized their abundance using principal component analysis. Using this summary score as the dependent variable, we performed partial least squares (PLS) regression to identify serum metabolites associated with the PD-related gut microbiome. Pathway enrichment analysis was then conducted on selected metabolite features from the PLS model. We identified 266 metabolite features and annotated 29 metabolic compounds associated with PD-related microbes (p < 0.1). Enrichment analysis revealed perturbed pathways in lipid metabolism, including fatty acid activation and metabolism, linoleate metabolism, and glycerophospholipid metabolism, as well as carbohydrate metabolism such as hexose phosphorylation and starch/sucrose metabolism. Our multi-omics integration analysis revealed that PD-associated gut microbiota are involved in host lipid metabolism, immune-related pathways, and potentially vitamin B-mediated regulation of kynurenine pathway metabolism, providing insights into potential microbiome-metabolome interactions in PD pathophysiology.

38. Advancing women's health through equity in quantitative sciences: promoting sex- and gender-based modeling in clinical trials and real-world studies.

期刊: Frontiers in digital health 发表日期: 2026 链接: PubMed

摘要

39. Hospitals alike, hospitals different: spatial clustering of inequality around Boston's hospitals.

期刊: Frontiers in sociology 发表日期: 2026 链接: PubMed

摘要

This brief research report investigates how racial and socioeconomic segregation shape spatial inequalities in health outcomes and healthcare access across Boston, Massachusetts. It examines the spatial clustering of race, poverty, and poor health, and analyzes how these patterns align with the locations of major hospitals in the city. We integrated data from the 2018-2022 American Community Survey, CDC PLACES, and the Massachusetts Center for Health Information and Analysis (CHIA) for all non-specialized acute care hospitals in Boston. Spatial autocorrelation was assessed using Global Moran’s I statistics and Bivariate Local Indicators of Spatial Association (BiLISA) maps to identify co-clustering of non-White population, poverty, and poor health at the census tract level. All three measures showed statistically significant positive spatial autocorrelation (p < 0.001), confirming moderate-strong spatial clustering across Boston. Bivariate maps show racial composition, poverty, and poor health outcomes to have significant spatial clustering around hospitals. Historical segregation patterns still exist to this day and shape how people receive healthcare in the city. Patterns around recently closed Carney Hospital further underscored the spatial burden of care redistribution. Safety-net hospitals disproportionately serve neighborhoods with the greatest health and economic vulnerabilities while wealthier hospitals are embedded in healthier areas. These findings highlight the need for interhospital collaboration, equitable resource distribution, and policy interventions that explicitly address the spatial legacy of structural racism in healthcare delivery in American cities.

40. Young female sex workers lived experiences of selling sex and accessing sexual and reproductive health services in Tanzania: implications for HIV prevention.

期刊: Frontiers in public health 发表日期: 2026 链接: PubMed

摘要

Adolescent girls and young women who sell sex are at a heightened risk of acquiring HIV compared to those who do not. Their access to Sexual and Reproductive Health (SRH) services is also limited. This study explored the context of sex work for young female sex workers (YFSWs) and how they accessed sexual and reproductive health (SRH) services, including HIV services, to gain insights for enhancing demand for and access to these services. This study utilized an ethnographic research design involving 38 in-depth interviews and photovoice with YFSWs aged 18-24 years and six SRH program implementers. Thematic analysis was conducted with the aid of NVIVO software. Five themes emerged: (1) “Selling sex in a setting where it is illegal”; (2) Nature of SRH services available to YFSWs; (3) Stigma as a barrier to accessing services; (4) Preference for differentiated type of SRH services; and (5) Peer influencers in creating demand for SRH services. Participants reported that sex work was illegal in Tanzania and highly stigmatized. YFSWs operated discreetly for fear of police arrests, and stigma and discrimination. Stigma and discrimination hindered access to SRH services. Peers were important in influencing YFSWs’ decision on whether to use or not and where and how to access the SRH services. YFSWS operate under stressful conditions and had limited access to SRH services. Peers of YFSWs played a key role in access to and use of SRH services. There is a need for differentiated care for YFSWs and building an enabling environment to motivate YFSW to access SRHs. Given the numerous challenges faced by YFSWs in accessing SRH services, interventions targeted at this group should focus on multi-level barriers: (a) at health facility level, provide differentiated SRH care/services that are friendly and trusted; (b) at community level, address stigma and social norms that promote gender inequalities; (c) at individual level, provide SRH knowledge and livelihood options and; and finally, (d) at policy level, address policies that criminalize sex work.

41. Configuration of policy tools for promoting national fitness infrastructure supply: evidence from China.

期刊: Frontiers in public health 发表日期: 2026 链接: PubMed

摘要

Against the backdrop of significant regional disparities in China’s public fitness infrastructure provision, this study aims to deeply analyze the diverse pathways and complex mechanisms driving high-level infrastructure supply from the perspective of policy tool combinations. This study utilizes a sample of 88 national fitness policy documents obtained from the 31 provincial-level administrative regions of China, covering the period from 2021 to 2025. It employs a mixed-methods approach: initially, the Latent Dirichlet Allocation (LDA) model is used to objectively identify policy instruments. Subsequently, a combination of Necessity Condition Analysis (NCA) and Fuzzy Set Qualitative Comparative Analysis (fsQCA) is applied to examine the bottleneck constraints and the configuration effects of various policy instruments on infrastructure supply. The analysis of the LDA model identified five principal policy instruments: improve the public service system, organize scientific fitness guidance, build smart sports facilities, enhance fitness media outreach, and provide financial support. NCA indicated that no individual policy instrument is a necessary condition for the high-level supply of infrastructure, suggesting that isolated measures may be insufficient to overcome supply constraints. fsQCA uncovered three effective pathways that drive high-level supply, which can be categorized into two typical models: the “combined soft and hard measures” foundation-based path and the “public service-led” multi-element collaborative path. The former underscores the integration of scientific fitness guidance (soft) with the construction of intelligent facilities (hard), whereas the latter reflects comprehensive coordination of various resources centered on the public service system. The provision of advanced national fitness infrastructure results from the coordinated implementation of multiple policy instruments. Governments at all levels should transition from reliance on isolated policies to adopting flexible deployment strategies tailored to their resource endowments, thereby improving the overall governance effectiveness of policy tools through the organic integration of technological empowerment, service optimization, and institutional safeguards.

42. The impact of mandatory physical fitness testing on students' intrinsic motivation and sustained participation in physical activity: a self-determination theory perspective.

期刊: Frontiers in psychology 发表日期: 2026 链接: PubMed

摘要

With physical education included in China’s high school entrance examination, the high-stakes Physical Education Entrance Examination (PEEE) has altered school physical education arrangement. Previous studies mainly focus on physical fitness outcomes but lack in-depth exploration of motivational mechanisms from Self-Determination Theory (SDT). This research aims to examine how PEEE influences students’ sport motivation and sustained physical activity participation by affecting their three basic psychological needs of autonomy, competence and relatedness. A qualitative approach was employed. Twenty-four junior high students and eight PE teachers from four geographically diverse middle schools were selected via purposive sampling. Data were collected through individual semi-structured interviews, focus group talks and classroom observations, and thematic analysis based on Braun and Clarke’s framework was conducted with NVivo 12 software. The PEEE increases institutional and parental attention to PE and improves short-term physical fitness and self-confidence for part of students. However, rigid exam-oriented courses limit students’ autonomous choices; individual physical gaps result in polarized feelings of competence; score competition erodes supportive interpersonal relatedness. Most students form extrinsic exercise motivation instead of internalized interest, and teachers face persistent conflicts between educational ideals and exam assessment pressure. Although the PEEE partially achieves fitness promotion goals, it distorts three core psychological needs proposed by SDT and blocks the internalization of sport motivation. To foster lifelong exercise behavior, future PE reform should replace unified high-stakes testing with diversified process evaluation and adopt autonomy-supportive teaching strategies.

43. The safety and efficacy of human umbilical cord mesenchymal stem cell for acute respiratory distress syndrome: an open-label and multicenter phase 1 clinical trial.

期刊: Frontiers in immunology 发表日期: 2026 链接: PubMed

摘要

Acute Respiratory Distress Syndrome (ARDS) remains a life-threatening critical illness with high mortality and limited specific therapies. This open-label, multicenter Phase I clinical trial aimed to evaluate the safety, tolerability, and preliminary efficacy of allogeneic human umbilical cord mesenchymal stem cells (hUC-MSCs, BC-U001) in patients with mild-to-moderate ARDS. A total of 12 eligible patients were enrolled into three dose groups following a “3 + 3” dose-escalation design from 2019 to 2024. All patients received standard ARDS care plus a single intravenous infusion of BC-U001, with 28-day follow-up to assess safety and efficacy as well as exploratory immunological indicators (immunoglobulins, inflammatory cytokines, lymphocyte subsets). Baseline characteristics were balanced across groups except for more severe baseline lung injury in high dose patients (P = 0.027). No dose-limiting toxicity, treatment-related severe adverse events (SAE), or Suspected Unexpected Serious Adverse Reactions (SUSAR) were observed across all dose groups. The overall 28-day all-cause mortality rate was 8.3% (1/12), with 0% mortality among 5 COVID-19-related ARDS patients. Efficacy analysis showed significant improvements in the middle dose group, including a marked increase in PaO2/FiO2 (+100.07 mmHg, P < 0.001) and PaO2 (+21.88 mmHg, P = 0.002), as well as significant reductions in Lung Injury Score (LIS), Sequential Organ Failure Assessment (SOFA), and Acute Physiology and Chronic Health Evaluation (APACHE) II scores, without dose-dependent effects observed. Exploratory analyses preliminarily revealed that hUC-MSCs modulated the inflammatory response and restored immune balance. These findings demonstrate that hUC-MSCs are safe and well-tolerated in mild-to-moderate ARDS patients, with the middle dose showing promising therapeutic effects. This trial provides critical data to support the design of future large-scale, randomized controlled trials to confirm the efficacy of hUC-MSCs for ARDS.

44. Resveratrol in Oral Squamous Cell Carcinoma: Preclinical Evidence and Translational Opportunities.

期刊: Oncology research 发表日期: 2026 链接: PubMed

摘要

Polyphenolic stilbenes are plant-derived compounds that have attracted increasing interest for their potential anticancer properties. Among them, resveratrol is the most extensively investigated molecule. Oral squamous cell carcinoma (OSCC) represents a major global health challenge due to its aggressive biological behavior, frequent late diagnosis, and limited improvement in survival outcomes despite advances in treatment. This review aims to summarize current experimental evidence on the anticancer effects of resveratrol in OSCC, also considering structurally related derivatives such as polydatin and pinostilbene hydrate. A structured review of the literature was performed to identify experimental studies investigating the activity of these compounds in OSCC models. Overall, the available evidence indicates that resveratrol exerts multiple antitumor effects in OSCC, including inhibition of cell proliferation, induction of apoptosis and ferroptosis, cell-cycle arrest, and suppression of migration, invasion, and epithelial-mesenchymal transition. These effects are associated with the modulation of several oncogenic signaling pathways and components of the tumor microenvironment. In addition, resveratrol has been reported to enhance the efficacy of chemotherapy, radiotherapy, and targeted therapies, and to counteract mechanisms of drug resistance. However, most findings derive from in vitro studies using concentrations that may not be readily achievable in vivo due to limited bioavailability. Further in vivo and clinical investigations are therefore required to clarify the translational potential of resveratrol in OSCC management.

45. Relationship between body segment movements and center of pressure shifts during trunk lean movements while sitting in healthy adults.

期刊: Frontiers in rehabilitation sciences 发表日期: 2026 链接: PubMed

摘要

Sitting activities involve trunk leaning, which requires precise coordination of the head, trunk, and pelvis to maintain the center of pressure (COP) within limits of stability. However, how the movement in each segment is associated with COP displacement remains unclear. Twenty-eight healthy volunteers performed seated trunk leaning twice in left, right, forward, and backward directions. COP displacements and angular changes were measured in head, trunk, and pelvic tilt in all directions, and additionally in the hip during forward-backward leaning. Within-session reliability of measured indices was assessed using intraclass correlation coefficients (ICCs) and Bland-Altman analyses, and relationships between segment angle changes and COP displacements were examined using mixed-effects models. ICCs between two trials showed substantial to very high correlations (ICC = 0.84-0.95), and Bland-Altman analyses showed neither fixed nor proportional bias, suggesting sufficient reliability. Pelvic tilt angle changes were significantly associated with COP displacements during left-right and forward-backward leaning (p < 0.001). Head, trunk, and hip angle changes were also significantly associated with COP displacement during forward-backward leaning (all p < 0.01). Pelvic tilt was associated with COP displacement during leaning, regardless of direction, indicating the importance of pelvic shifts in strategies for maintaining sitting balance in healthy adults.

46. Adulthood as a social construct: Critical discourse analysis of transition preparation consultations for youth with chronic conditions.

期刊: Health care transitions 发表日期: 2026 链接: PubMed

摘要

Little is known about how interventions designed to empower youth with chronic conditions operate in natural clinical contexts during the transition from pediatric to adult care. Such interventions may contribute to social learning through discourse about the future, illness, and adolescence, thereby shaping youths’ understandings of identity and empowerment. This study examined how meanings of transition are discursively constructed during Transition Preparation Consultations (TPCs), a structured intervention delivered within the AD’venir transition unit in France for youth with diverse chronic conditions. We conducted a critical discourse analysis of 26 TPCs, focusing on the discursive resources and positioning practices through which youth and physicians constructed meanings of transition. TPCs framed transition as a psychological and social process, encouraging youth to develop experiential understandings of illness and identity. Consultations primarily focused on self-management, living with a chronic condition in adulthood, and health maintenance, while discussions were frequently anchored in bodily changes associated with adolescence. Although physicians often adopted pedagogical and dialogic forms of communication, interactions remained largely structured by prescriptive discourses regarding responsibility, self-management, and adult health behaviors. Transition programs function not only as organizational interventions but also as discursive spaces in which meanings of illness, responsibility, autonomy, and adulthood are actively produced. Recognizing these processes may support critical reflection and the ongoing refinement of transition practices.

47. Association of body mass index trajectories with incidence of stroke among elderly Chinese adults: a 10-year cohort study.

期刊: Frontiers in nutrition 发表日期: 2026 链接: PubMed

摘要

Limited data exists on relationship between body mass index (BMI) trajectory and stroke risk among elderly Chinese individuals. This study aimed to examine the association of BMI trajectory with stroke among people aged 65 years and older in China. 150, 813 participants with at least three BMI measurements from 2012 to 2022 were included. Group-based trajectory modeling was used to identify BMI trajectories. Cox proportional hazards regression models were used to examine the association between BMI trajectories and incidence of stroke. We identified 3 (stable, slowly increased, greatly increased), 4 (slightly decreased, stable, slowly increased, sharply increased), 4 (large decreased, slightly decreased, stable, moderate increased) and 4 (substantially decreased, slightly decreased, stable, slightly increased) BMI trajectories in groups with underweight, normal weight, overweight and obesity at baseline, respectively. Taking the stable weight subgroup as the reference group, among subjects with normal weight, the adjusted hazard ratios (HRs) [95% confidence interval (CI)] were 0.93 (0.88, 0.99) for slightly decreased group, 1.07 (1.03, 1.13) for slowly increased group, and 1.12 (1.02, 1.23) for sharply increased group. Among participants with overweight, the HRs (95% CI) were 0.84 (0.75, 0.95) for large decreased group and 0.94 (0.89, 0.99) for slightly decreased group. Among participants with obesity, the HRs (95% CI) were 0.79 (0.64, 0.96) for large decreased group. Among people aged 65 years and older, increased BMI was associated with a higher risk of stroke, while decreased BMI was related to reduced risk of stroke.

48. From Engel's Bio-Psycho-Social model to the personalized health determinants model: a comprehensive framework and illustrative operationalization for precision health.

期刊: Frontiers in digital health 发表日期: 2026 链接: PubMed

摘要

Engel’s Bio-Psycho-Social (BPS) model (1977) reframed healthcare by integrating biological, psychological, and social perspectives. Despite its influence, the model has been criticized for insufficient specificity in domains critical to precision health, including nutrition, lifestyle, socioeconomic, environmental, and structural factors. To address these limitations, we propose the Personalized Health Determinants Model (PHDm), a comprehensive nine-dimension framework, Biological, Psychological, Social, Cultural, Environmental, Economic, Political, Spiritual, and Lifestyle, synthesized from Engel’s BPS model, the WHO Commission on Social Determinants of Health, CDC frameworks, and related literature. Section 2.0 provides a detailed evidence-based rationale for the dimensions and their relationship to prior frameworks. The PHDm organizes each dimension hierarchically into categories, sub-categories, and measurable health elements (theoretical maximum -72,000), with only tailored, clinically relevant subsets applied in practice. Using obesity as a case study, we illustrate operationalization through a Bayesian Network and a complementary rule-based scoring system. Four exemplar factors, insulin sensitivity, dietary fiber, caloric intake, and activity frequency, are mapped into both models, enabling individualized obesity risk quantification and intervention simulation. Preliminary evaluation on NHANES data yielded -85% predictive accuracy for the Bayesian Network and -80% concordance for the rule-based system. This manuscript presents the PHDm as a conceptual framework with illustrative operationalization. While the Bayesian Network and rule-based approaches demonstrate promising preliminary performance on NHANES data, the current model, based on four simplified factors and binary thresholds, remains a proof-of-concept prototype and is not yet a clinically validated decision-support tool. Further development, external validation, and integration into electronic health records will be required before clinical deployment.

49. Violet teaming as a resilient framework for bridging civilian-military electronic health record interoperability.

期刊: Frontiers in digital health 发表日期: 2026 链接: PubMed

摘要

The rapid digitization of healthcare through electronic health records (EHRs) and artificial intelligence (AI) is transforming clinical decision-making, data integration, and healthcare delivery. However, increasing dependence on interconnected digital systems introduces significant cybersecurity, interoperability, ethical, and operational challenges that EHRs already face, further compounded by the operational complexity of military-civilian healthcare environments where information-sharing requirements are highly sensitive. AI-enabled systems intensify these concerns through opaque decision processes, extensive data demands, and expanding attack surfaces. This article introduces and applies an integrated cybersecurity framework that advances beyond traditional purple teaming by incorporating human factors, governance, ethical considerations, and operational continuity into resilience planning. The paper highlights how this approach can improve secure interoperability, identify systemic vulnerabilities earlier in the development and deployment lifecycle, and support more resilient military-civilian health data exchange architectures. The article further argues that resilience in digital healthcare systems cannot be achieved through technical safeguards alone but instead requires a sociotechnical framework that balances cybersecurity and clinical operations. Originally conceptualized in the context of the biotechnology governance, this paper extends violet teaming into the domain of military-civilian electronic health record interoperability through an illustrative vignette, demonstrating how the framework may support proactive resilience, governance, and cybersecurity integration within complex healthcare data ecosystems, ultimately mitigating risks to patient safety and human life.

50. Latent fingerprint development ability of spinel copper aluminate (CuAl2O4) nanoparticles.

期刊: Frontiers in chemistry 发表日期: 2026 链接: PubMed

摘要

Fingerprints are still one of the most effective means of forensic detection but degradation during the recovery process leads to a loss of contrast between ridge and background, making them difficult to visualize. In this study spinel copper aluminate (CuAl2O4) nanoparticles were synthesized by a facile and cost effective sol-gel method and evaluated for latent fingerprints (LFPs) development on both porous (paper, ceramic, wood) and non-porous (plastic, steel, glass) substrates. Structural characterizations revealed an average crystallite size of 24.5 nm that was found to be smaller than the average particle size of 36.9 nm confirming that the particles consists of nanoscale crystalline domains with some agglomeration. The developed fingerprint exhibited substrate-dependent contrast with normalized contrast ratios increasing from ∼0.30 (paper) to ∼0.60 (glass) under white light and further enhanced to ∼0.74 under UV excitation. UV-assisted visualization enabled improved ridge clarity and facilitated the observation of Level 1 and Level 2 details, with partial enhancement towards finer features. Aging studies demonstrated that identifiable ridge patterns were retained up to 30 days, with improved visibility under UV illumination compared to white light conditions. These findings demonstrate that CuAl2O4 nanoparticles provide simple, cost-effective, and reliable approach for fingerprint development, combining surface adhesion and luminescent enhancement for improved forensic applicability.

51. Modified string test to improve and confirm by molecular characterization for bacterial identification.

期刊: Access microbiology 发表日期: 2026 链接: PubMed

摘要

Rapid and reliable identification of bacteria is essential in clinical and environmental microbiology. Gram staining remains a widely used method for preliminary classification; however, it may require additional steps and can be difficult to interpret under certain conditions. To address these limitations, we evaluated a modified potassium hydroxide (KOH) string test incorporating methylene blue to enhance visualization of DNA release and facilitate differentiation between Gram-positive and Gram-negative bacteria. A total of 185 samples from clinical and environmental sources (including hospitals, soil, salt mines and honeycombs) were analysed. Samples were first assessed using Gram staining and subsequently tested using the modified KOH method. In this procedure, a 3% KOH solution was applied to bacterial colonies, followed by the addition of methylene blue to improve visualization of filament formation. All Gram-negative isolates demonstrated visible string formation, while Gram-positive isolates showed no string formation, indicating complete concordance with Gram staining results within the tested dataset. Selected isolates were further examined using 16S rRNA gene analysis to support taxonomic identification. The modified KOH string test provides a rapid, simple and low-cost approach for preliminary bacterial differentiation. While it does not replace conventional or molecular identification methods, it may serve as a useful complementary tool, particularly in resource-limited or high-throughput laboratory settings.

52. Temporal trends in semen parameters among men attending a fertility center in the UAE (2012 - 2022): a retrospective study.

期刊: Frontiers in physiology 发表日期: 2026 链接: PubMed

摘要

Decline in semen quality have been widely debated for decades, however, most global assessments lack data from the Middle East. To address this gap, this study characterized eleven-year temporal trends in semen parameters among Emirati men, accounting for the effects of age and body mass index (BMI). A retrospective longitudinal analysis was conducted using 13,276 semen samples collected from 2,730 Emirati men attending a fertility center in the United Arab Emirates between 2012 and 2022. Semen parameters, including semen volume, sperm concentration, total sperm count (TSC), progressive motility, and total motility, were analyzed for temporal trends and stratified by age and BMI using generalized estimating equation (GEE) modelling. Yearly differences were assessed using ANOVA with Bonferroni or Tukey’s post-hoc tests. All measured semen parameters remained above the World Health Organization lower reference limits, but significant year-to-year fluctuations in key measures were observed. A pronounced dip in semen volume, sperm concentration, and TSC occurred in 2016, with partial recovery in subsequent years. In contrast, both progressive and total sperm motility declined steadily throughout the decade, with yearly decreases of 6% to 17%. Age above 35 years was consistently associated with declines in volume and motility, and higher BMI was linked to reduced semen quality, though the rate of decline over time did not differ significantly by BMI. Temporal changes in semen parameters among Emirati men visiting a fertility clinic echoes trends observed globally but is shaped by unique demographic and environmental factors of the region. These findings underscore the complexity of male fertility trends, and it is recommended that studies integrating environmental, lifestyle, and demographic data to understand reproductive status in the Middle East be conducted.

53. The changes of chemical exposure and control measures in general dental offices in Isfahan city, Iran, in 2001-2023.

期刊: Dental research journal 发表日期: 2026 链接: PubMed

摘要

Exposure to chemical substances is one of the occupational hazards among dentists. Therefore, this study aimed to investigate the changes in chemical exposure and control measures in general dental offices in Isfahan city, Iran, from 2001 to 2023. This study was performed with a repeated cross-sectional design. 184 offices were surveyed in 2001 and 250 offices in 2003. Data were collected by a researcher-made checklist. This tool has four parts, including questions related to demographic characteristics, questions related to the time period of exposure, questions related to exposure type and its consequences, and questions related to control measures. The results showed that although the use of some chemicals has increased or remained unchanged, the use of most chemicals, such as resin-based dental restorative materials, acid etch materials, latex, dental plaster, common disinfectants, and hand hygiene products, has decreased in 2023 compared to 2001 (P < 0.028). Moreover, the results indicated that professional control measures, including education, personal protective equipment, engineering control, and several measures, have significantly improved in 2023 compared to those in 2001 (P < 0.001). These findings highlight the importance of improving workplace conditions, implementing control measures, and applying less hazardous materials in dental offices.

54. Development and content validation of a bodyweight-based HIIT training module for Chinese college students.

期刊: Frontiers in physiology 发表日期: 2026 链接: PubMed

摘要

Physical fitness levels among Chinese college students have declined in recent years, representing a growing public health concern. High-intensity interval training (HIIT) is a time-efficient exercise modality with well-documented physiological benefits; however, validated HIIT training modules specifically tailored for Chinese college students remain limited. This study aimed to develop and establish the content validity of a bodyweight-based HIIT training module tailored for Chinese college students. This methodological study employed a modified Delphi technique. HIIT movements were identified through a systematic literature review of studies published between 2014 and 2025. In the first round, 10 college physical education teachers screened the identified movements for feasibility and practicality. In the second round, nine experts evaluated the retained movements using Lawshe’s method to determine the Content Validity Ratio (CVR) and a four-point Likert scale to assess the Content Validity Index (CVI). Movements meeting the predefined validity thresholds were retained. Twenty eligible studies were included, from which 48 HIIT movements were extracted. Following expert screening, 36 movements were excluded. Of the remaining 12 movements, eight (High Knees, Jumping Lunges, Jumping Jacks, Bodyweight Squats, Burpees, Butt Kicks, Mountain Climbers, and Push-ups) met the predefined criteria and were retained. All retained movements demonstrated acceptable item-level validity (I-CVI ≥ 0.78), and the overall scale-level validity was excellent (S-CVI = 0.976), indicating strong expert agreement. This study developed a bodyweight-based HIIT training module with excellent content validity for Chinese college students. The content-validated module provides a structured and accessible framework for exercise implementation and may serve as a foundation for future intervention studies to evaluate its effectiveness in improving physical fitness and related health outcomes.

55. Safety culture in the polish mining and extractive sector: trend analysis for 2019-2025.

期刊: Frontiers in public health 发表日期: 2026 链接: PubMed

摘要

This study analyzes occupational safety culture in the Polish hard coal mining sector, based on surveys conducted in 2019 and repeated in 2025 among managerial staff in three major mining companies. The research utilized expert diagnostics and audit questionnaires, covering seven key areas of safety culture, including leadership, risk analysis, safety briefings, and regulatory compliance. Results from 2019 revealed deficits in management participation and adherence to organizational and legal regulations, with a workforce skewed toward mid- and long-term tenure, indicating a potential generational gap. By 2025, improvements were observed across most areas, particularly in leadership, vision, and safety briefings, reflecting greater engagement and a proactive approach to occupational health and safety. Minor decreases in some areas were linked to workforce reductions and restructuring. Benchmarking against three safety culture segments indicated a shift from the Responsibility-Based Organization level in 2019 to the Responsibility-Oriented Safety Culture level in 2025, demonstrating the integration of safety as a core organizational value. The study highlights the importance of managerial leadership, employee engagement, and systemic measures in sustaining and further developing workplace safety culture in mining enterprises. The survey conducted in 2025 aimed to assess changes in employees’ attitudes, behaviors, and safety awareness related to occupational health and safety.

56. Night shift work exposure shapes neurobehavioral and cardiometabolic profiles in female healthcare workers: a cross-sectional study.

期刊: Frontiers in public health 发表日期: 2026 链接: PubMed

摘要

Night shift work has been associated with adverse neurobehavioral and cardiometabolic outcomes, but the role of cumulative and long-term exposure, particularly among female healthcare workers, remains incompletely characterized. This study adopted a multidimensional approach to examine associations between night shift exposure and integrated health profiles. This cross-sectional study included 243 female healthcare workers (96 day-shift, 147 night-shift). Night shift exposure was assessed using multiple metrics: status, cumulative lifetime shifts (<500 vs. ≥ 500), and duration (1-10 vs. 11-35 years). Sociodemographic, reproductive, lifestyle, and occupational data were collected. Neurobehavioral outcomes were evaluated using validated questionnaires (sleep quality, psychological well-being, work ability), while cardiometabolic assessment included BMI, WHtR, insulin resistance indices (METS-IR, TyG, WyG), and cardiovascular risk index (IRCV). Analyses comprised stratification, correlation, and multivariable regression adjusted for age, smoking, and menopausal status. Higher cumulative exposure was associated with lower physical activity (p = 0.012), poorer sleep (p = 0.019), reduced work ability (p = 0.023), and early insulin resistance (p = 0.043). Long-term exposure was linked to poorer psychological well-being (p = 0.009), higher adiposity (p = 0.034; p = 0.028), and increased IRCV (p = 0.006). In adjusted models, sleep quality was consistently associated with all exposure metrics, while metabolic outcomes were more strongly linked to duration of exposure and individual factors. Correlation analyses revealed clustering of sleep, neurobehavioral, and cardiometabolic variables, with strength of the associations increasing with exposure level. Night shift work, particularly with cumulative and long-term exposure, is associated with sleep disruption, reduced well-being, and early cardiometabolic alterations in female healthcare workers. Sleep impairment emerges as a robust exposure-related marker, while metabolic risk reflects combined occupational and individual susceptibility. These findings support life-course exposure assessment and suggests the use of early subclinical indicators for implementation of precision prevention, as well as early intervention strategies. Future research may further benefit from a life-course exposome framework integrating environmental, occupational, and biological exposures.

57. Burnout among mental healthcare providers in Jordan: a cross-sectional study.

期刊: Frontiers in medicine 发表日期: 2026 链接: PubMed

摘要

Mental healthcare providers (MHPs) face high burnout due to emotional demands and workload pressures. In Jordan, limited resources and public stigma may further increase occupational strain, underscoring the need to assess burnout among MHPs. This study aims to assess burnout levels among MHPs in Jordan, compare burnout dimensions across professional groups, and examine associations with demographic and work-related factors. This cross-sectional study included 221 MHPs in Jordan. Burnout was measured using the Arabic Maslach Burnout Inventory (MBI), which assesses emotional exhaustion (EE), depersonalization (DP), and personal accomplishment (PA). Data was collected from February 11 to 25, 2025, through online questionnaires (Google Forms; n = 100) and paper-based surveys (n = 121). Analyses were conducted using SPSS version 29.0. Group differences were examined using t-tests and ANOVA/MANOVA, with Scheffé post-hoc tests as appropriate. Statistical significance was set at p < 0.05. The mean scores indicated high EE (19.06 ± 12.26), low DP (6.21 ± 6.90), and moderate PA (31.57 ± 11.61). In total, 42.5% reported high EE, 71.9% low DP, and 48.4% high PA, suggesting lower burnout in this area. MANOVA identified significant effects of age (p = 0.036) and weekly working hours (p = 0.007) on burnout. Follow-up analyses found significant differences in PA by age (p = 0.034) and working hours (p = 0.003). Participants aged 45 or older reported higher PA than younger groups (Scheffé, p < 0.05). Those working 40-49 or 50 or more hours per week reported higher PA than those working 20-29 h per week. MHPs in Jordan face high EE, low DP, and moderate PA. This necessitates improving organizational support, adequate staffing, managing workloads, regulating overtime, implementing supportive supervision and well-being programs to sustain providers’ performance, enhance resilience and coping with work-related stress.

58. Assessment of Depression and Quality of Life among Hypertensive Patients in Madinah City, Saudi Arabia.

期刊: International journal of preventive medicine 发表日期: 2026 链接: PubMed

摘要

Hypertension is a global health problem. Studies show a relationship between hypertension, depression, and low quality of life. This study aimed to assess depression and quality of life among hypertensive patients in Madinah City, Saudi Arabia. This cross-sectional study was conducted among adult patients with hypertension in Madinah City between October 2021 and July 2022. Sociodemographic data, clinical history of hypertension, depression, and quality of life characteristics were collected using an electronic self-administered questionnaire. Validated Arabic versions of the Hospital Anxiety and Depression Scale (HADS) and World Health Organization Quality of Life-BREF (WHOQOL-BREF) scale were used. 482 hypertensive adults were included. 35.7% were borderline cases of depression, and 18.3% were depressed. Non-Saudi nationality, widowed, having a rented house, unemployed, having a monthly income <5000 SR, and living alone participants were associated with higher scores on (HADS) and lower scores on (WHOQOL-BREF) (p = <0.05). A significant positive correlation was found between the (HADS) scores and patients’ systolic and diastolic blood pressure (BP) last readings and the number of follow-ups last year (p = <0.05), a significant negative correlation between the WHOQOL-BREF score and patients’ systolic and diastolic BP last readings. Nationality, marital status, systolic hypertension and living condition were the predictors of (HADS) and (WHOQOL-BREF) scores. Depression was found in 18.3% of hypertensive patients. This suggests the importance of early detection of mental conditions in hypertensive patients to enable early interventions.