公共卫生研究摘要 (2026-06-28)

共收录 59 篇研究文章

1. Co-creating antimicrobial resistance (AMR) literacy in Zimbabwean higher education institutions: A participatory, qualitative study following the one health approach.

期刊: Global public health 发表日期: 2026-Dec-31 链接: PubMed

摘要

Antimicrobial resistance (AMR) is a global health challenge that encompasses social, economic, and ecological risks, and the relationship between human, animal, and environmental health is emerging as a key factor. Addressing AMR means developing capacities across health sectors, with training of health practitioners through higher education institutions (HEIs) essential for strengthening one’s health literacy. This paper explores how Zimbabwean University lecturers and students co-create an understanding of AMR, contributing to the development of AMR literacy. A participatory qualitative study using research workshops was conducted at two Zimbabwean HEIs, engaging 60 interdisciplinary participants in vignette-based discussions of AMR. Using thematic analysis, three key themes were identified: (1) reflective engagement with antimicrobial use impacting environmental, human, and animal health; (2) preventive actions to protect environmental, human, and animal health; and (3) holistic health promotion grounded in social and ecological care. AMR literacy is outlined as interdisciplinary and context-dependent, encompassing biomedical understanding, critical ethical reflections, and pluralistic reasoning, enabling context-relevant approaches and decision-making. This study contributes to global health research by highlighting the potential of participatory and contextually sensitive educational approaches to address AMR. Operationalising AMR literacy could support cross-sectoral collaboration among health practitioners, strengthening global health efforts to address sustainable health challenges.

2. Compensatory Effects of Joint Bracing From a Kinetic Chain Perspective: Lower Limb Movement Coordination Analysis During Badminton Lunge Movements.

期刊: European journal of sport science 发表日期: 2026-Jul 链接: PubMed

摘要

This study investigated ankle, knee, and hip joint movement coordination during brace use via a lower-limb kinematic chain approach, which may influence biomechanical factors associated with injury risk. Twenty badminton players performed a left forecourt kick lunge under four brace conditions. Kinematic and kinetic data were collected using a motion capture system (Qualisys Arqus A12, 200 Hz) and force plates (Kistler 569×, 1000 Hz). A one-way repeated-measures ANOVA was applied for statistical analysis. At initial contact, elastic ankle brace use reduced ankle inversion angle (p = 0.001) and knee varus angle (p = 0.010) compared to the no-brace condition. The use of a sleeve-type knee brace increased knee varus angle (p = 0.041) and knee varus moments (p < 0.001), while decreasing hip eversion moments (p = 0.006). Combined ankle and knee bracing increased knee varus angle (p = 0.009). The use of elastic ankle and sleeve-type knee braces was associated with condition-dependent changes in stability and inter-joint coordination due to the kinetic chain linking the hip, knee, and ankle. Protecting one joint may reflect compensatory adjustments in adjacent joints, which may have implications for brace selection. These findings should be interpreted cautiously in relation to injury prevention.

3. A trajectory analysis of blood pressure development during pregnancy. An inception cohort study.

期刊: Pregnancy hypertension 发表日期: 2026-Jun-27 链接: PubMed

摘要

To identify latent trajectories of blood pressure throughout pregnancy and evaluate their associations with body mass index (BMI), physical fitness (estimated via oxygen uptake), and serum relaxin levels in a cohort of healthy pregnant women. Prospective inception cohort study. Group-based trajectory modelling was used to characterize systolic and diastolic blood pressure patterns across gestation. Multiple logistic regression analyses were conducted to identify predictors of trajectory group membership. Longitudinal trajectories of systolic and diastolic blood pressure during pregnancy. A total of 492 women were included in early pregnancy. Three distinct and stable trajectories were identified for both systolic and diastolic blood pressure. Nulliparous women and those with BMI >25 kg/m2 had significantly increased odds of belonging to the highest blood pressure trajectory group (adjusted odds ratio [aOR] 2.47; 95% CI: 1.58-3.86 and aOR 1.61: 95% CI 1.04-2.49), respectively). No significant associations were observed between trajectory group membership and maternal age, physical fitness, or early-pregnancy serum relaxin concentrations. Early pregnancy blood pressure may serve as a clinically relevant marker for gestational hypertension risk. Women with lower baseline readings may require less frequent antenatal monitoring, whereas those with elevated initial values could benefit from closer surveillance. Nulliparity and overweight status were associated with higher blood pressure trajectories, highlighting their relevance in antenatal risk stratification. Physical fitness and relaxin levels did not demonstrate predictive value in this context.

4. Subcapsular versus total orchiectomy in advanced prostate cancer: A systematic review and meta-analysis of clinical and patient-reported outcomes.

期刊: Urologic oncology 发表日期: 2026-Jun-27 链接: PubMed

摘要

Prostate cancer (CaP) is a leading malignancy in men, frequently diagnosed at advanced stages where androgen deprivation therapy remains the standard treatment. Surgical castration, either subcapsular or total orchiectomy, offers a definitive and cost-effective approach to androgen deprivation therapy. This study systematically compares clinical and patient-reported outcomes between subcapsular and total orchiectomy in patients with advanced CaP. A systematic search was conducted in PubMed, Scopus, and Cochrane Library through July 2025. Eligible studies included men with advanced CaP undergoing subcapsular or total orchiectomy. Risk of bias was assessed using RoB 2 for randomized trials and Newcastle-Ottawa Scale for nonrandomized studies. Data were analyzed using RevMan, and certainty of evidence was evaluated using GRADE approach. Twelve studies involving 759 patients were included. Subcapsular orchiectomy was associated with significantly higher postoperative testosterone levels (mean difference = 4.03, 95% confidence intervals 2.78-5.28), higher prostate-specific antigen (PSA) levels (mean difference = 0.94; 95% CI 0.54-1.33), and greater treatment satisfaction (odds ratios = 3.78; 95% confidence intervals 1.98-7.19) compared to total orchiectomy. No significant differences were found in overall functional assessment of cancer therapy-prostate scores, including physical, social, emotional, and functional well-being domains, prostate cancer subscale, operative time, and luteinizing hormone levels. Subcapsular orchiectomy may provide less effective hormonal and PSA suppression but greater treatment satisfaction, with comparable quality of life outcomes and operative time compared with total orchiectomy, suggesting a trade-off between biochemical suppression and patient-centered benefits.

5. Assessment of risk factors of bovine astrovirus and diarrhea in dairy farms of Northern India.

期刊: Preventive veterinary medicine 发表日期: 2026-Jun-27 链接: PubMed

摘要

Bovine astrovirus (BoAstV) has been frequently detected in the feces of bovine calves irrespective of presence or absence of diarrhea. However, information on its epidemiological determinants, such as associations with host-level factors, diarrhea, age or species susceptibility, and farm-level factors such as housing, feed, disinfection, and weaning, remains limited. The present study aimed to identify potential animal- and farm-level risk factors associated with BoAstV and animal-level risk factors for diarrhea in cattle and buffalo calves. A total of 134 rectal swab samples (67 from diarrheic and 67 from healthy animals) were collected from 44 dairy farms in 13 districts in northern India. Data on farm management and animal health practices were obtained from farm owners using structured questionnaires. Of the screened calves, 23.1% were positive for BoAstV, and 34% of the farms were positive for BoAstV. Statistical analysis indicated a higher BoAstV detection in dewormed calves (34.9%) than in non-dewormed calves (12%), identifying this as a statistically significant risk factor (p < 0.05). Dairy farms that practiced early weaning had a statistically higher occurrence of BoAstV (66.7%) than those that did not (28.9%) (p < 0.05). This study found no association between the presence of BoAstV and diarrhea (p > 0.05). Furthermore, no significant associations were identified between age, sex, species, housing type, feeding practices, vaccination, or disinfection methods. When comparing the occurrence of diarrhea in bovine calves, age was identified as a potential risk factor (P < 0.05); however, the presence of diarrhea was not influenced by sex, species, or deworming status. These findings emphasize that BoAstV may circulate subclinically within dairy herds of North India, with deworming identified as a significant risk factor for viral presence. The findings support a multifactorial etiology of calf diarrhea involving complex interactions between management practices and multiple enteric pathogens.

6. Identifying subgroups of ICU patients with high mortality rates using machine learning: A nationwide, population-based study.

期刊: Journal of critical care 发表日期: 2026-Jun-27 链接: PubMed

摘要

Identifying subgroups of intensive care unit (ICU) patients with high mortality rates can provide directions in policy making about appropriate intensive care medicine. The objective of the study was to identify demographical and clinical characteristics of subgroups of ICU patients with high (≥80%) mortality rates at six months post-ICU admission. Data from all Dutch ICU patients admitted between 2013 and 2023 are used. Data are obtained from the Dutch National Intensive Care Evaluation (NICE) registry, including 807,727 ICU admissions from 84 hospitals. A machine learning model was trained on four samples, defined at different stages of the ICU admission with varying amounts of available data. Training was performed on 70% of the hospitals and validation on the other 30% for the years 2013-2022. A temporal validation was performed on data from 2023. Ten high-mortality subgroups were identified. Reduced urine output and a low combined score on the eye & motor components of the Glasgow Coma Scale (GCS) were the most common risk factors defining high-mortality subgroups. External validation showed small deviations in mortality (median absolute deviations -1% and -2%), with one subgroup falling below the 80% mortality threshold. Interpretable machine learning can identify ICU patient subgroups with ≥80% 6-month mortality using routinely collected data. These groups are predominantly marked by impaired consciousness and reduced urine output. Future work should integrate these insights into ethical, patient-centered frameworks that support appropriate care.

7. Frailty and Heart Failure: An Integrated Review of a Bidirectional Relationship.

期刊: ESC heart failure 发表日期: 2026-Jun-27 链接: PubMed

摘要

Heart failure (HF) and frailty frequently coexist in older adults and are associated with poor clinical outcomes. Frailty affects 15-76% of patients with chronic HF depending on the clinical setting and assessment tool used, with prevalence approaching 90% in hospitalised patients with heart failure with preserved ejection fraction (HFpEF). This integrated review synthesises current evidence on the bidirectional relationship between frailty and HF, including shared pathophysiological mechanisms, epidemiology, prognostic implications, assessment strategies, and contemporary management approaches. Available evidence indicates that frailty independently predicts incident HF and is associated with progressive deterioration in cardiac structure and function. Conversely, HF accelerates frailty progression through systemic inflammation, skeletal muscle hypoperfusion, sarcopenia, neurohormonal activation, malnutrition, and hospital-associated deconditioning. Frailty contributes to impaired quality of life, reduced self-care capacity, prolonged hospitalisation, poorer tolerance of guideline-directed medical therapy, and higher all-cause mortality risk. Current assessment strategies include physical performance measures, multidimensional frailty instruments, and comprehensive geriatric assessment. The recently developed Heart Failure Frailty Score (HFFS) represents the first HF-specific multidimensional frailty instrument. Management strategies include exercise rehabilitation, nutritional optimisation, structured medication review, and integration of frailty assessment into advanced HF decision-making. Future research should prioritise prospective validation of HF-specific frailty tools and randomised trials evaluating frailty-targeted interventions in HF populations.

8. Respiratory bacterial epidemiology at three primary ciliary dyskinesia clinical centers.

期刊: Journal of the Pediatric Infectious Diseases Society 发表日期: 2026-Jun-27 链接: PubMed

摘要

Primary ciliary dyskinesia (PCD) is a rare congenital disorder marked by impaired motile ciliary function, resulting in chronic oto-sino-pulmonary infections, including Pseudomonas aeruginosa . While enhanced infection prevention and control (IPC) practices have successfully reduced P. aeruginosa prevalence and transmission in cystic fibrosis (CF), comparable IPC strategies have not been evaluated in PCD. This study aimed to characterize bacterial epidemiology across PCD Clinical Centers, hypothesizing that P. aeruginosa prevalence would be higher at centers lacking enhanced IPC measures. We performed a retrospective observational study assessing the period prevalence and chronic infection rates of P. aeruginosa and other respiratory microorganisms at three pediatric PCD Centers and one adult Center. Between-center comparisons of patients ever infected status used Fisher’s exact test, with age-adjusted repeated-measures analyses conducted via Bayesian mixed-effects logistic regression. The cohort included 41 pediatric patients from Center A (Standard Precautions), 25 from Center B (clinic cohorting), and 30 from Center C (enhanced IPC based on CF Foundation Guidelines, CF-IPC). An additional 13 adult patients from Center A were included for descriptive analysis only. P. aeruginosa period prevalence at pediatric Centers A, B, and C was 37%, 32%, and 47%, respectively (p = 0.55). In contrast, pediatric Haemophilus influenzae prevalence (p=0.001) and chronic H. influenzae infection rates (p<0.0001) were significantly higher at Center A compared with Centers B and C. Age-stratified analysis across all pediatric Centers demonstrated increasing P. aeruginosa prevalence beginning around age 10, while H. influenzae prevalence declined with age. Nearly 85% of adults had a history of P. aeruginosa infection. Our findings suggest that CF- IPC protocols may not exert the same influence on bacterial epidemiology in PCD as they do in CF. P. aeruginosa may be more prevalent in PCD than previously recognized, and variations in IPC strategies were not significantly associated with differences in P. aeruginosa rates across pediatric PCD Centers.

9. Epidemiology and Outcomes of Mycobacterium abscessus Infections in immunocompetent children in Singapore.

期刊: Journal of the Pediatric Infectious Diseases Society 发表日期: 2026-Jun-27 链接: PubMed

摘要

We describe Mycobacterium abscessus infections in immunocompetent children with cervicofacial lymphadenitis and localized soft tissue infections. The presence of multi-nodal disease was significantly associated with refractory infection in cervicofacial lymphadenitis. Almost all children were treated with both antimicrobials and surgery, and close to half required repeat surgery.

10. Anti-fibrotic therapy in Crohn's disease: hype or reality-can intestinal fibrosis Be targeted effectively?

期刊: Expert review of gastroenterology & hepatology 发表日期: 2026-Jun-27 链接: PubMed

摘要

Fibrostenotic Crohn’s disease remains a major unmet clinical need, as currently licensed therapies primarily target inflammation and have not been shown to prevent fibrosis progression or reverse established strictures. Renewed interest in intestinal fibrosis, coupled with an expanding therapeutic pipeline, has prompted renewed debate over whether anti-fibrotic therapy in Crohn’s disease represents hype or a realistic therapeutic opportunity. This special report summarizes emerging anti-fibrotic strategies in Crohn’s disease, including clinical data for ontunisertib and preclinical evidence for anti-TL1A therapies and obefazimod. It also examines lessons from successful anti-fibrotic drug development in pulmonary and hepatic fibrosis, focusing on pathway selection, patient stratification, endpoint development, and trial design. Early clinical and translational findings suggest that targeting fibrosis in Crohn’s disease may be feasible. In the authors’ view, the greater challenge lies in developing the tools and trial frameworks needed to demonstrate that therapies can alter the course of fibrostenotic disease.

11. Hospitalisation and healthcare burden of respiratory syncytial virus in adults aged 50 years and older in France, 2015-2022.

期刊: Infectious diseases (London, England) 发表日期: 2026-Jun-27 链接: PubMed

摘要

Respiratory Syncytial Virus (RSV) can cause severe illness in adults, leading to respiratory and non-respiratory complications, functional decline, hospitalisation, and death. This study describes French patients aged ≥50 years hospitalised with RSV (2015-2022) and their care pathways, including hospitalisation and outpatient healthcare use and costs. Data were extracted from the French National Health Data System (SNDS). Patients were classified into four risk groups (high: immunocompromised; medium: underlying predisposition; other; no comorbidities) and four age groups (50-59, 60-64, 65-74, ≥75 years). Healthcare use (laboratory tests, imaging, pharmacy, GP visits, rehospitalisations) and costs were analysed across three periods: 60-30 days pre-hospitalisation (reference period), index hospitalisation, and 30 days post-hospitalisation. We identified 15,509 RSV-related hospitalisations for 15,169 adults ≥50 years. Median age was 80 years, with age ≥75 years comprising 61.7% of the cohort. 15.9% were high risk, 71.4% medium risk, 4.8% other, and 7.8% had no comorbidities. Intensive care was required in 25.4% of cases. In-hospital mortality was 8.5%, with an additional 3.8% dying within 30 days post-discharge. Rehospitalisation occurred in 17.8% of patients, nearly half for cardiorespiratory causes. Median index hospitalisation cost was €4,252 (Q1; Q3: €3,077; €7,007), and post-hospitalisation costs increased across all ages and risk profiles compared to the reference period. RSV imposes a substantial hospitalisation and cost burden in adults ≥50 years, especially older patients and those with comorbidities. Expanded preventive vaccination strategies could help reduce this impact.

12. Factors Affecting the Early Resignation of Newly Employed Nurses: A prospective observational study.

期刊: Journal of occupational health 发表日期: 2026-Jun-27 链接: PubMed

摘要

Nurse resignation is a major issue in global healthcare systems. Nurses experience health problems due to irregular night shift work and excessive work demands. This study investigated the association between initial factors at the start of employment and the early resignation of newly employed nurses at two university hospitals. This study conducted a prospective follow-up of 641 new nurses for 6 months. Data on sleep problems, depression, anxiety, and stress-related factors were collected during job orientation. Early resignation was defined as voluntary resignation within 6 months of starting work. Multiple logistic regression analysis was conducted to identify significant factors. The mean age of participants was 23.7 years, and most were female (86.6%). During the 6-month follow-up, 243 nurses (37.9%) resigned. Nurses who resigned early were slightly older and reported higher baseline levels of perceived stress, depression, and anxiety, as well as fewer stress-relievers. Early resignation was also more frequent among participants with perceived socioeconomic vulnerability (PSV). In adjusted analyses, high perceived stress (adjusted odds ratio [aOR], 2.203; 95% confidence interval [CI], 1.088-4.459; P = 0.028) and PSV (aOR, 1.622; 95% CI, 1.162-2.264; P = 0.005) remained independently associated with early resignation. Depression and fewer stress-relievers were associated with early resignation in crude analyses. Voluntary early resignation was more common among newly employed nurses who reported high perceived stress and PSV before starting work. High perceived stress and PSV served as independent predictors of early resignation, while depression and limited stress-relief resources may represent additional potential risk factors during the early transition period. Early stress assessment, mental health-oriented support, and tailored educational interventions for new nurses may help reduce early resignation rates.

13. Key outcomes from a stakeholder workshop on genomic newborn screening: recommended next steps for the integration of genomics into public health programs.

期刊: Public health genomics 发表日期: 2026-Jun-27 链接: PubMed

摘要

Technical advances and decreasing costs of next-generation sequencing have generated global interest in its potential for newborn screening (NBS). Genomic NBS (gNBS) enables the expansion of detectable conditions as a first-tier test and can improve screening accuracy as a second-tier test. A shared vision among all involved stakeholders is essential to guide the next steps for gNBS in public health programs. A Dutch stakeholder workshop on gNBS was organized and attended by 56 participants from different fields, including clinical care, genetics, research, and NBS. The workshop aimed to inform about developments, identify challenges, foster connections, and build a shared vision. Based on the workshop outcomes, recommended next steps were formulated to support policy and practice decision-making for the integration of genomics into NBS. Six key themes were identified from the workshop data: (1) expansion of the scope of NBS with genomics, (2) clinical aspects, (3) technical and workflow feasibility, (4) data storage and privacy issues, (5) information provision and consent, and (6) stakeholder roles and responsibilities. Participants highlighted challenges for gNBS, including reaching consensus on scope definition, systematic gene selection, standards for variant reporting, the large data volume, the complexity of information provision, and the current representation of stakeholders in NBS. The recommended next steps, derived from stakeholders’ perceived challenges and considerations, reflect the complex and interconnected nature of integrating genomics into NBS, emphasizing the importance of alignment and coordination across disciplines. Translating these recommendations into public health NBS practice requires strong stakeholder engagement and enhanced multidisciplinary collaboration.

14. Equity-by-design for socially assistive robots as digital health tools.

期刊: Journal of the American Medical Informatics Association : JAMIA 发表日期: 2026-Jun-27 链接: PubMed

摘要

To propose an equity-by-design agenda for socially assistive robots (SARs) as embodied digital health informatics interventions. We developed this Perspective via a purposive narrative synthesis of SARs healthcare studies, digital health equity, informatics governance, and human-robot interaction ethics/equity, integrating care- and technology-ethics to derive a 3-level equity framework. We outline equity requirements at product (user), institutional (meso), and policy/evaluation (macro) levels and operationalize them as a checklist covering co-design, accessibility, privacy, data governance, equitable access and financing, and equity-oriented evaluation. Applying equity-by-design to SARs highlights how embodied sensing, workflow fit and organizational readiness, and governance/reimbursement incentives determine who benefits, which risks are borne, and whether deployments narrow or widen digital divides. Treating SARs as embodied informatics interventions and operationalizing equity across micro (product), meso (institution), and macro (policy) levels can guide designers, informatics teams, providers, and payers toward deployments that are safe, acceptable, and just.

15. Generative AI in healthcare: redefining clinical practice through digital transformation.

期刊: Health economics review 发表日期: 2026-Jun-27 链接: PubMed

摘要

Although generative AI (GenAI) has transformative potential for healthcare systems, this timely issue has not yet been sufficiently explored. This study investigates the application effectiveness and underlying mechanisms of GenAI in the healthcare sector, using a dataset comprising 1,440 samples from 160 hospitals across 31 provinces in China, covering the period from 2021 to 2024. The results show that GenAI significantly enhances healthcare effectiveness, including improving diagnostic accuracy, optimizing operational efficiency, and increasing patient satisfaction. The degree of industrial digitalization positively moderates these effects, with highly digitalized regions experiencing greater AI effectiveness. This study not only enriches the theoretical framework of technology diffusion but also provides valuable insights into the practical implementation and policy optimization of GenAI in healthcare.

16. Factors Associated with Childhood Vaccination in Sub-Saharan African Countries Experiencing Armed Conflicts: A Scoping Review.

期刊: Journal of epidemiology and global health 发表日期: 2026-Jun-27 链接: PubMed

摘要

Armed conflicts substantially disrupt health systems and undermine routine childhood immunization, increasing the risk of vaccine-preventable disease outbreaks. While declines in vaccination coverage in conflict settings are well documented, less is known about the multi-level determinants associated with childhood vaccination outcomes in African countries affected by armed conflict. This scoping review maps and synthesizes existing empirical evidence on factors associated with childhood vaccination in these settings. A scoping review was conducted in accordance with PRISMA-ScR guidelines. Systematic searches were performed in PubMed, Embase, and Scopus, with supplementary searches in Google Scholar. Peer-reviewed observational studies and systematic reviews published from January 2015 onwards were included if they examined determinants associated with childhood vaccination outcomes in African countries affected by armed conflict. Findings were synthesized narratively and grouped into thematic determinant domains encompassing caregiver characteristics, socioeconomic factors, geographic barriers, conflict-related determinants, and health-system constraints. Twenty-eight studies met the inclusion criteria. Evidence was geographically concentrated in a limited number of countries, particularly Ethiopia, Somalia/Somaliland, the Democratic Republic of Congo, and Nigeria. Maternal/caregiver education and empowerment, geographic access barriers/remoteness, and household/community poverty and wealth were the most frequently reported determinant categories. Across settings, maternal education, antenatal care attendance, and facility-based delivery were consistently associated with higher vaccination uptake. Conversely, poverty, rural residence, insecurity, displacement, and disruption of routine services were recurrent barriers to complete and timely immunization. Health-system constraints such as stock-outs, limited outreach services, and shortages of trained personnel further compounded inequities in vaccination access. Childhood vaccination in conflict-affected African countries is shaped by a complex interplay of socioeconomic vulnerability, caregiver characteristics, conflict dynamics, and health-system disruption. Armed conflict appears to amplify pre-existing inequities in access to routine immunization services. The current evidence base remains geographically uneven, highlighting important gaps in several conflict-affected settings. Strengthening context-specific research is essential to inform resilient, effective, and equitable immunization strategies in conflict-affected settings.

17. Do ecosystem improvements enhance the cognitive function of older adults: quasi-Experimental evidence from China.

期刊: Aging & mental health 发表日期: 2026-Jun-27 链接: PubMed

摘要

Although growing evidence indicates that ecosystems shape human health, their effects on older adults-a group highly sensitive to environmental stressors-remain underexplored. This study examines the effect of China’s National Key Ecological Function Zones (NKEFZs), a large-scale ecosystem improvement program, on the cognitive function of older adults and explores the underlying mechanisms. Using five waves (2011-2020) of data from the China Health and Retirement Longitudinal study (CHARLS; n = 16,003), this study employes a staggered difference-in-differences design to estimate the effects of policy on cognitive health. NKEFZs significantly enhanced cognitive function and episodic memory by 0.467 and 0.372 points, respectively. Mechanism analysis identifies reductions in industrial smoke and dust emissions and a higher likelihood of using clean fuels for cooking or heating as possible channels through which NKEFZs contribute to improved cognitive health. Heterogeneity analyses indicate that the beneficial effects varied by gender, education, marital status, household size, health status, and smoking or drinking behaviors. These findings highlight the role of ecosystem improvements in maintaining cognitive health and reveal disparities in the effects of such population-level interventions across individual characteristics. These insights inform other countries in developing upstream environmental strategies for dementia prevention and risk reduction.

18. The Revival of Psychiatry in Cambodia.

期刊: Transcultural psychiatry 发表日期: 2026-Jun-27 链接: PubMed

摘要

Following the near-total destruction of mental health services during the Khmer Rouge regime (1975-1979), psychiatry in Cambodia underwent a gradual and resource-constrained revival from the early 1990s onward. This article traces the history of psychiatry in Cambodia from its early institutional foundations in the colonial period, through its collapse during the Khmer Rouge genocide, to its re-establishment and progressive institutionalization in the post-conflict era. Drawing on historical archives, policy documents, and published literature, the paper describes three main phases of development: initial reconstruction and training (1992-2000), expansion of services and education (2001-2015), and recent efforts toward institutionalization and specialization (2015-present). Particular attention is given to the interaction between western psychiatric models and Cambodian cultural frameworks of distress rooted in Buddhism, animism, and community-based healing practices. The article highlights the central role of international collaboration, nongovernmental organizations, and emerging local leadership in shaping psychiatric services, while also documenting persistent challenges including workforce shortages, uneven geographic distribution of care, limited inpatient capacity, and enduring stigma. By situating psychiatry within Cambodia’s broader sociocultural and historical context, this review contributes to a transcultural understanding of mental health system reconstruction in post-conflict settings. It also underscores the importance of culturally responsive, community-oriented approaches for sustainable development.

19. Plasma proteins associated with disability and mortality risks in Japanese community-dwelling octogenarians.

期刊: GeroScience 发表日期: 2026-Jun-27 链接: PubMed

摘要

Japan has one of the world’s longest life expectancies, yet biomarkers associated with disability and mortality in very old adults remain uncertain. The goal of this study was to identify plasma proteins associated with incident disability and mortality in community-dwelling octogenarians. Two prospective cohorts were analyzed: the Kawasaki Aging Well-being Project (KAWP; 2017-2018; 4.5-year follow-up) as discovery and Invecchiare in Chianti (InCHIANTI; 1998-2000; 15-year follow-up) for external replication. The discovery sample comprised 230 disability-free adults aged 85-89 years (50.4% women). Twenty-nine plasma proteins were assayed using Luminex xMAP. Associations with incident disability and mortality were estimated with elastic net-regularized Cox models and tested in multivariable Cox models in the full KAWP cohort and in InCHIANTI. Higher beta-2-microglobulin and cystatin C levels were associated with an increased risk of disability (hazard ratio [HR] 1.35, 95% confidence interval [CI] 1.11-1.64; HR 1.42, 95% CI 1.14-1.76). For mortality, epidermal growth factor was inversely associated (HR 0.51, 95% CI 0.27-0.96), while interferon gamma-induced protein 10 was positively associated (HR 1.23, 95% CI 1.06-1.44). Associations with disability were broadly replicated in the full KAWP cohort and among InCHIANTI participants aged ≥ 80 years, whereas mortality-related findings were not replicated. In conclusion, beta-2-microglobulin and cystatin C may serve as biomarkers of future disability. These patterns implicate kidney dysfunction and inflammation as drivers of health decline in very old adults and support early risk stratification to guide preventive interventions.

20. Screening optimum reference genes for quantitative real-time polymerase chain reaction analysis in invasive apple snail, Pomacea canaliculata under different conditions.

期刊: Molecular biology reports 发表日期: 2026-Jun-27 链接: PubMed

摘要

The golden apple snail (Pomacea spp.), a globally significant invasive aquatic species, poses serious threats to biodiversity, agricultural production, and public health. Although real-time quantitative PCR (RT-qPCR) is a widely used and robust technique for gene expression analysis, relatively few studies have applied it to quantify gene expression in Pomacea spp. The selection of stable reference genes is essential for accurate mRNA quantification in RT-qPCR. In this study, we systematically evaluated nine candidate reference genes (ACT, H3, UBI, EF1-α, TUB, GAPDH, 18 S, PRAP and AK) in P. canaliculata across various developmental stages, multiple tissue types, and under extreme temperature conditions. Using a comprehensive set of algorithms (geNorm, NormFinder, BestKeeper, the ΔCt method, and RefFinder), we determined that the use of three reference genes was optimal for normalization, as supported by pairwise variation values above 0.15 under all experimental conditions. The most stable gene combinations were identified as follows: UBI, ACT, and AK for developmental stages; 18 S, GAPDH, and ACT for tissue comparisons; AK, PRAP, and ACT under cold stress; and ACT, H3, and UBI under heat stress. The expression of SACS, which encodes sacsin molecular chaperone gene, was used to validate the selected reference genes. Results confirmed that the use of unstable reference genes led to significant quantification bias, whereas the multi-gene normalization strategy markedly improved accuracy. These findings provide reliable, condition-specific reference gene sets for future gene expression studies in P. canaliculata, offering crucial methodological support for molecular research on this invasive species.

21. The microbiome-epigenome axis: Regulation of host genome function across development and disease.

期刊: Cancer treatment and research communications 发表日期: 2026-Jun-27 链接: PubMed

摘要

The gut microbiome is increasingly recognized as a metabolically active regulator of host gene expression, translating environmental exposures-particularly diet-into epigenetic signals that shape development, immunity, metabolism, and disease susceptibility. This narrative review synthesizes current evidence for a microbiome-epigenome axis in which microbial metabolites and regulatory molecules modulate DNA methylation, histone modifications, non-coding RNA networks, RNA epitranscriptomic marks, and higher-order chromatin organization. Short-chain fatty acids act as histone deacetylase inhibitors, acyl-CoA donors, and regulators of histone acetyltransferase activity; microbially derived B vitamins influence one-carbon metabolism and S-adenosylmethionine availability; and bile acids, indoles, trimethylamine-N-oxide, and extracellular vesicle cargo signal through host metabolic, immune, and transcriptional pathways. Evidence from germ-free and recolonization models, genetic perturbation studies, in vitro systems, and human cohorts indicates that microbial signals exert particularly strong effects during developmental windows of heightened epigenetic plasticity, contributing to immune tolerance, trained innate immunity, and long-term metabolic programming. Dysbiosis may disrupt these regulatory circuits and promote inflammatory bowel disease, colorectal cancer, cardiometabolic and atherosclerotic disorders, and neurodevelopmental or neurodegenerative conditions. By integrating microbial metabolism with chromatin regulation, RNA-based control, and genome topology, this review highlights the microbiome as a dynamic epigenetic interface between environment and host physiology. Key challenges include establishing causality in humans, resolving temporal and tissue-specific mechanisms, and developing longitudinal multi-omics studies with functional validation. Targeted microbiome modulation may ultimately restore epigenetic homeostasis and support precision prevention and therapy.

22. Associations of diverse diseases with work productivity among Japanese workers in context of multimorbidity: additional analysis of a database study.

期刊: Journal of occupational health 发表日期: 2026-Jun-27 链接: PubMed

摘要

Building on the previous descriptive study of work productivity across various diseases among Japanese workers, this additional analysis aimed to assess the associations between multimorbidity and work productivity, as well as independent associations between each disease and work productivity, accounting for coexisting diseases. From the original study population of the secondary dataset derived from health insurance claims and online surveys, including workers aged ≥19-years who completed the work productivity and activity impairment questionnaire-General Health in an online survey in 2021, we analyzed participants aged <65 years (N=30,953). The association of a work productivity and activity impairment score >0% with diseases count and each target disease adjusted for other diseases was explored using logistic regression, and the predicted probabilities of having a score >0% for each disease were derived. The odds ratios for having a work productivity and activity impairment score of >0% increased (odds ratio>1) per additional disease. In males, migraine, depression, dysthymia, diarrheal disorders, and insomnia, and in females, migraine, insomnia, and atopic dermatitis were associated with higher odds of having a score >0%. Femoral neck fracture, dysthymia, depression, migraine, and menopausal disorder in males, and migraine and ischemic heart disease in females were among the top diseases with high predicted probabilities. Each incremental disease was significantly associated with impaired work productivity. After adjusting for other comorbidities, work productivity impairment was associated with psychiatric disorders and migraines. These findings underscore the importance of optimal management of preexisting conditions and prevention of comorbidities.

23. Oral Health, Periodontitis, and Respiratory Diseases: Biological Pathways.

期刊: Journal of periodontal research 发表日期: 2026-Jun-27 链接: PubMed

摘要

Poor oral hygiene and periodontitis influence lung diseases such as pneumonia, chronic obstructive pulmonary disease (COPD), COVID-19, and asthma. The normal lung is not sterile, with a distinct microbial ecosystem that is spatially varied along the respiratory tract. The biogeography of the lung microbiome is balanced between microbial microaspiration from the oral-pharynx and clearance. The mouth is an important reservoir for respiratory pathogens including Streptococcus pneumoniae, Haemophilus influenzae, Pseudomonas aeruginosa, and Staphylococcus aureus, as well as oral microbes (Porphyromonas, Prevotella, Fusobacterium, etc.). Poor oral hygiene and periodontitis increase the bacterial load that can be aspirated, and the host produces pro-inflammatory components that enhance microbial virulence and compromize epithelial integrity. Both poor oral hygiene and periodontitis have been associated with pneumonia, particularly in hospitals and nursing home settings. Periodontitis may also facilitate viral pneumonia (including COVID-19) by altering receptor expression and immune function. Periodontitis correlates with COPD severity and exacerbation frequency through pathways involving matrix metalloproteinases and cytokines. Periodontitis also is associated with asthma and acute exacerbations. Inflammation shapes the lung microbiome by impacting microbial nutrient availability through vascular leakage, inducing changes to epithelial cells which facilitate bacterial adherence, and inducing the production of cytokines, leading to mucus overproduction, inhibition of phagocytosis, and enhancement of microbial pathogen virulence. Multiple biological pathways have been examined in vitro that suggest how “the oral-lung axis” influences pneumonia, COPD, and asthma. Periodontal treatment and effective oral hygiene should be well integrated into medical care to prevent and manage respiratory diseases.

24. Targeting Inflammation in Obesity and the Cardiovascular-Kidney-Metabolic (CKM) Syndrome Spectrum: A Narrative Review.

期刊: Obesity facts 发表日期: 2026-Jun-27 链接: PubMed

摘要

Cardiovascular-kidney-metabolic (CKM) syndrome refers to a multi-systemic condition with established pathophysiological connections between obesity, diabetes mellitus, chronic kidney disease (CKD), and cardiovascular disease (CVD). Chronic low-grade inflammation has been recognized as a common pathophysiological theme linking metabolic dysfunction to multisystem damage of the heart, kidneys, and vasculature. The aim of this narrative review is to summarize the major pharmacologic strategies that target inflammatory pathways in obesity and across the cardiovascular-kidney-metabolic (CKM) disease spectrum, including metabolic therapies with indirect anti-inflammatory effects and targeted immunomodulatory agents. New therapies have markedly changed the obesity and the CKM treatment paradigm, with evidence that currently available metabolic medications confer cardiovascular and renal benefits in addition to glycemic control or weight improvement. Nutrient-Stimulated Hormone (NuSH) therapies, and sodium-glucose cotransporter-2 inhibitors (SGLT2i), work synergistically to positively modulate systemic inflammation while maintaining cardiovascular health and cardiometabolic function throughout therapy. Additionally, emerging clinical data for direct anti-inflammatory treatments, such as interleukin-1β/interleukin-6 inhibition and low-dose colchicine, have established inflammation as a modifiable cardiovascular risk factor. Furthermore, therapies that target the liver such as resmetirom, fibroblast growth factor-21 (FGF21) analogues, and peroxisome proliferator-activated receptors (pan-PPAR) agonists, have highlighted the role of the liver-adipose axis in metabolic inflammation and CKM progression. Together, both metabolic and direct anti-inflammatory therapies represent the most recent evolution of a combined approach to treating metabolic dysfunction and inflammation. This type of approach has the potential to revolutionize the prevention and treatment of CKM across the spectrum of diseases and usher in personalized medicine for obesity-related cardiometabolic diseases. However, further studies are needed to determine when these therapies should be initiated, which patients are most likely to benefit, and whether combination approaches can alter disease progression beyond the current standard of care.

25. Selenium Nanoparticles Inhibited H2O2-Induced Endothelial Cell Dysfunction by Alleviating Oxidative Stress.

期刊: Biological trace element research 发表日期: 2026-Jun-27 链接: PubMed

摘要

Endothelial dysfunction is one of the important pathological bases of atherosclerosis, and cardiovascular diseases caused by atherosclerosis are the first major cause of human death. Our previous studies indicated that selenium nanoparticles (SeNPs) could prevent experimental atherosclerosis in animals, while their association with endothelial dysfunction remain unclear. Meanwhile, the size and surface properties of nanomaterials have a great influence on their biological functions. In this study, we prepared SeNPs with different sizes and surface charges to study their effects on H2O2-induced endothelial dysfunction in endothelial cells and the possible mechanisms. The results showed that SeNPs pretreatment significantly reduced the endothelial cell injury and dysfunction caused by H2O2. SeNPs pretreatment also significantly inhibited H2O2-induced oxidative stress, probably by enhancing cellular Se content and antioxidant selenoprotein expression in endothelial cells. Additionally, SeNPs pretreatment reversed H2O2-induced changes of Nrf2/Keap1 pathway. Moreover, SeNPs with middle size (around 40 nm) exhibited advantage in increasing cellular Se uptake and expression of antioxidant selenoproteins compared with smaller size (around 20 nm) or larger size (around 80 nm). Overall, SeNPs protect endothelial cells from H2O2-induced endothelial dysfunction by alleviating oxidative stress, and this activity may be dependent on their particle size. These results provided a deeper understanding of the anti-endothelial dysfunction activity of SeNPs and contribute to the potential use of SeNPs as a therapeutic agent against atherosclerosis in the future.

26. Metabolic disruptions through a three-dimensional genomic lens.

期刊: Current opinion in structural biology 发表日期: 2026-Jun-27 链接: PubMed

摘要

Chromatin architecture - encompassing epigenetic states and three-dimensional (3D) nuclear organization - operates at the interface of genotype, cellular metabolism, and transcriptional regulation. Chromatin loops physically connect gene promoters with distal regulatory elements, providing a structural basis through which non-coding genetic variants modulate target gene expression and contribute to metabolic disease risk. Although the precise mechanisms linking loop dynamics to transcriptional output remain incompletely understood, 3D genomic approaches are rapidly advancing our ability to interpret non-coding variation in disease. Beyond genetic predisposition, chromatin architecture responds dynamically to environmental signals, including diet and circadian oscillations, in a cell-type-specific manner. Here, we review recent advances in mammalian 3D chromatin biology and their implications for transcriptional regulation in metabolic health and disease.

27. Metabolic interactions enable aerobic degradation of the environmental pollutant BDE-47.

期刊: The ISME journal 发表日期: 2026-Jun-27 链接: PubMed

摘要

As a prevalent congener of polybrominated diphenyl ethers (PBDEs), 2,2’,4,4’-tetrabromodiphenyl ether (BDE-47) poses significant environmental and health risks due to its persistence and bioaccumulation. However, the limited understanding of the microbial degradation mechanism of BDE-47 has hindered the development of effective bioremediation strategies. Here, we decipher an aerobic catabolic pathway of BDE-47 mediated by metabolic relay within a synthetic consortium composed of two environmental isolates, Rhizorhabdus wittichii YL-JM2C and Cupriavidus necator JMP134. Bioaugmentation with this consortium achieved complete removal of BDE-47 in real wastewater samples. The molecular basis underlying this cooperative degradation was elucidated through the heterologous expression and functional characterization of key enzymes involved. Namely, the dioxygenase TcsAaAb from strain YL-JM2C catalyzed the initial conversion of BDE-47 into 2,4-dibromophenol (2,4-DBP) and 3,5-dibromocatechol (3,5-DBC). As a dead-end intermediate in strain YL-JM2C, the former (2,4-DBP) was subsequently transformed into the latter (3,5-DBC) by the hydroxylase TfdB from strain JMP134. The resulting 3,5-DBC was catabolized through the downstream ortho-cleavage pathway present in both strains. These key enzymes for BDE-47 degradation coexist across diverse environments, including soil, seawater, and marine sediments. Global marine metagenomic profiling revealed a significant enrichment of these catabolic signatures in the Mariana Trench, implying that microorganisms in the hadal zone possess the genetic potential for PBDE catabolism. This study unveils previously unrecognized aerobic catabolic mechanisms for BDE-47 within natural ecosystems, offering promising bioremediation strategies for PBDE-contaminated environments.

28. Differential Effects of Prenatal Depression and Anxiety on Infant Sleep: Dual-Pathway Mechanisms Involving the HPA Axis and the Gut-Brain Axis.

期刊: Sleep 发表日期: 2026-Jun-27 链接: PubMed

摘要

Prenatal psychological distress is associated with adverse offspring outcomes, including infant sleep disturbances and altered gut microbiota, yet the mediating roles of neonatal gut microbiome and tryptophan metabolism remain underexplored. This prospective birth cohort study enrolled 2288 mother-infant pairs, using questionnaires to assess prenatal anxiety/depression and infant sleep patterns up to 12 months. A 112-pair sub-cohort underwent multi-omics analyses: meconium microbiota profiling via 16S rRNA sequencing and cord blood tryptophan metabolite quantification via LC-MS/MS. LASSO regression, mediation analyses, and XGBoost modeling were applied. Results showed prenatal depression-only was a significant risk factor for infant sleep disturbance (fully adjusted OR = 1.53, 95% CI:1.04-2.25), with a stronger effect in female infants (OR = 2.11, p = 0.022). Cord blood cortisol partially mediated this link (ACME = -7.47, 95% CI: [-14.82, -0.12], p = 0.048). Prenatal anxiety correlated with reduced meconium microbial alpha-diversity, lower Bifidobacterium abundance, and decreased 3-HAA/serotonin levels, which were associated with sleep disturbance; serial mediation confirmed the gut microbiota-tryptophan metabolism pathway. The XGBoost predictive model achieved an AUC of 0.727, with microbial diversity, Streptococcus abundance, dopamine, and 3-HAA as top contributors. This study identifies distinct mediating pathways for depression and anxiety, providing targets for personalized infant sleep health interventions.

29. Testosterone replacement therapy and cardiovascular safety in older men: lessons from TRAVERSE and beyond.

期刊: Journal of endocrinological investigation 发表日期: 2026-Jun-27 链接: PubMed

摘要

The cardiovascular safety of testosterone replacement therapy (TRT) in older men with hypogonadism has been debated for over a decade, largely on the basis of underpowered trials and conflicting observational data. The TRAVERSE trial, published in 2023, provided the first adequately powered, placebo-controlled evidence on this question. This review synthesises current evidence on the cardiovascular safety of TRT in older men, with particular attention to the interpretation of TRAVERSE findings, the clinical significance of non-MACE safety signals, and the practical management of organic versus functional hypogonadism. A systematic search of PubMed/MEDLINE, Embase, and the Cochrane Central Register of Controlled Trials (CENTRAL) was conducted through March 2026. Approximately 450 articles were identified; 64 met the inclusion criteria and were selected for review. Evidence was appraised according to study design, with RCTs and meta-analyses weighted above observational data. TRAVERSE demonstrated non-inferiority of TRT versus placebo for major adverse cardiovascular events (MACE) in men with confirmed hypogonadism and elevated cardiovascular risk (HR 0.96, 95% CI 0.78-1.17) [5]. Non-MACE signals - including atrial fibrillation (3.1% vs. 2.4%), pulmonary embolism (2.0% vs. 1.5%), and acute kidney injury (2.3% vs. 1.5%) - were numerically higher in the TRT arm but did not reach statistical significance within the trial. In contrast, large observational cohorts consistently report statistically significant associations between TRT and AF and VTE. Erythrocytosis was the most reproducible adverse effect (17.0% vs. 3.3%, p < 0.001). Functional hypogonadism secondary to obesity or metabolic syndrome responds to lifestyle intervention and GLP-1/GIP agonists, with testosterone normalisation in 81.4% at 6 months and 89.5% at 24 months after bariatric surgery [45]. TRT does not increase MACE risk in men with confirmed organic hypogonadism when titrated to physiological levels. Non-MACE signals warrant vigilance rather than contraindication. Metabolic optimisation should precede TRT in functional hypogonadism. Individualised monitoring and careful patient selection remain essential.

30. Hyperspectral image processing techniques for environmental monitoring: a comprehensive review.

期刊: Environmental monitoring and assessment 发表日期: 2026-Jun-27 链接: PubMed

摘要

Remote sensing and environmental monitoring have significantly advanced with the emergence of hyperspectral image processing techniques, offering unparalleled detail in spectral analysis. Traditional remote sensing methods, such as multispectral and panchromatic imaging, often lack the spectral resolution necessary to detect subtle environmental changes. This limitation hampers the accuracy of monitoring applications such as vegetation stress, pollution detection, and land cover classification. This study reviews hyperspectral image processing techniques to enhance the accuracy of environmental monitoring. It aims to improve the detection and classification of subtle changes in land cover, vegetation health, and pollution levels. The study explores the evolving landscape of hyperspectral image processing methods and their critical role in remote sensing applications. Techniques for spectral and spatial feature extraction, dimensionality reduction, and data fusion address the complexity of hyperspectral data. Challenges like high dimensionality, noise, limited labeled data, and model interpretability are discussed. The review also highlights recent advancements, including deep learning architectures, attention mechanisms, transfer learning, generative models, and cloud-based solutions for real-time processing. Practical applications in land cover classification, vegetation health, water quality assessment, disaster response, and urban development are examined. These integrated approaches aim to enhance monitoring accuracy, efficiency, and decision-making in real-world scenarios. Future research may focus on improving real-time processing capabilities through edge computing and AI-driven models, expanding labeled datasets, and enhancing model interpretability to further advance hyperspectral imaging applications.

31. Cardiovascular risk factors and carotid plaque components in a multi-ethnic cohort using 3 Tesla MRI: the HELIUS study.

期刊: European radiology 发表日期: 2026-Jun-27 链接: PubMed

摘要

Carotid plaque composition, including calcifications, lipid-rich necrotic core (LRNC), and intraplaque haemorrhage (IPH), is associated with an increased risk of cardiovascular disease (CVD). Its association with cardiovascular risk factors remains unclear, particularly in midlife and across ethnic groups. We examined the relation between cardiovascular risk factors and carotid plaque components using MRI. We conducted 3-T MRI of the carotid arteries in 356 Dutch, South-Asian Surinamese, and Moroccan participants from the HELIUS study. Median follow-up time between the cardiovascular risk factor visit and MRI was 8.4 years. Multivariable logistic mixed regression models assessed associations between cardiovascular risk factors and plaque components RESULTS: At baseline, participants had a median age of 54.0 years [IQR: 48.0-59.0] with 42.1% women. Plaque calcifications, LRNC, and IPH were present in 62.6%, 21.3%, and 3.9% of participants, respectively. Hypertension was strongly associated with calcifications (OR 4.02, 95% CI: 1.59-10.12), while smoking was both related to the presence of calcifications (OR 4.94, 95% CI: 1.79-13.62) and LRNC (OR 2.88, 95% CI: 1.30-6.40). The significant associations between both history of CVD and diabetes with calcifications were attenuated after adjusting for other risk factors. No significant associations were found for IPH, likely due to its low prevalence. There were no differences in plaque component prevalence between South-Asian Surinamese and Dutch, while Moroccans had a lower prevalence of calcifications. Unfavourable cardiovascular risk profiles in midlife were associated with an increased prevalence of carotid plaque components later in life, with ethnic differences in their prevalence. Question There is limited understanding of how cardiovascular risk factors in midlife are associated with carotid plaque components across ethnicities, hampering targeted prevention of CVD. Findings Hypertension and smoking were strongly associated with carotid plaque calcifications; smoking was associated with LRNCs, while for IPH, no associations were found. Clinical relevance Unfavourable cardiovascular risk profiles in midlife increase the prevalence of carotid plaque components later in life, with ethnic differences in their prevalence, highlighting opportunities for personalised, targeted prevention strategies to reduce CVD.

32. Japanese Encephalitis Vaccine Preferences and Uptake in Western Travelers and Locals: Strategies to Enhance Vaccine Uptake.

期刊: Value in health regional issues 发表日期: 2026-Jun-26 链接: PubMed

摘要

Understanding the preferences aids in improving Japanese encephalitis (JE) vaccine uptake among populations at risk. This study aimed to determine the preferences, willingness to pay (WTP), and acceptance for JE vaccines of Western travelers and Thai locals. A discrete choice experiment was embedded in a survey of 300 Western travelers visiting Thailand and 200 Thai locals from July to November 2023. A mixed logit model assessed the conditional relative importance of vaccine attribute, estimate WTP, and identified preferred vaccines. Western travelers showed a significant preference for European-manufactured vaccines over Thai-produced ones (P < .05). For this group, higher vaccine efficacy was nearly as important as lower cost. In contrast, Thai locals did not favor European manufacturing; for them, affordability was almost twice as important as efficacy. Model-based marginal WTP estimates indicated that Western travelers valued the inactivated Vero cell JE vaccine (JE-VC) higher than live chimeric Vero cell vaccine (JE-CV), (USD 858.16 vs 756.11), whereas Thai locals valued JE-CV higher than inactivated JE-VC, (USD 614.75 vs 483.44). Vaccine choice differs by population: travelers prioritize efficacy alongside cost, whereas residents emphasize affordability. Travelers also reported higher acceptance in real-world contexts. These divergent preferences underscore the importance of tailoring vaccine policy and further evaluating the immunogenicity of JE-CV after an initial JE-VC dose.

33. Silicosis in the Artificial Stone Countertop Industry: An Official American Thoracic Society Workshop Report.

期刊: Annals of the American Thoracic Society 发表日期: 2026-Jun-26 链接: PubMed

摘要

Artificial stone-associated silicosis (AS silicosis) has emerged over the past decade as a severe, rapidly progressive, and preventable occupational lung disease affecting workers who manufacture, fabricate, and install artificial stone countertops. Characterized by short latency, accelerated progression, and high morbidity and mortality, AS silicosis disproportionately affects young workers employed in precarious conditions. In response to the growing global burden of disease, this American Thoracic Society workshop was convened in 2025 to review the current state of knowledge regarding AS silicosis, synthesize the current evidence, and identify priorities for research, clinical care, public health surveillance, and prevention. Workshop participants reviewed data spanning exposure science, epidemiology, clinical manifestations, health equity, and policy responses. Evidence demonstrates that artificial stone (AS) dust is highly toxic, containing high concentrations of respirable crystalline silica, resin-derived volatile compounds, and trace metals, resulting in exposures that routinely exceed occupational exposure limits. Despite widespread implementation of wet methods, ventilation, and respiratory protection, hazardous exposures persist across diverse settings globally, highlighting fundamental limitations of existing control strategies. Clinically, AS silicosis is associated with high rates of progressive massive fibrosis, autoimmune disease, infection, respiratory failure, and increasing need for lung transplantation. Treatment options remain limited, underscoring the importance of early detection and exposure cessation. The workshop identified critical gaps in medical screening and public health surveillance worldwide, with inconsistent regulatory frameworks, low compliance, underreporting, and delayed diagnoses. Case detection is often dependent on symptomatic presentation rather than proactive screening, exacerbating disease severity and inequities in care. International experiences illustrate both the consequences of regulatory inaction and the potential impact of decisive interventions, including Australia’s prohibition of crystalline silica-containing artificial stone. This report concludes that AS silicosis represents a failure of primary prevention and calls for coordinated global action. Key priorities include strengthening surveillance systems, ensuring equitable access to screening and care, developing effective therapeutics, advancing exposure science, and implementing higher-order preventive strategies, including the elimination or substitution of high-silica AS. Without urgent and sustained intervention, these products will continue to impose devastating and avoidable harm on workers worldwide.

34. A Multi-Level Approach to Health Promotion for Long-Haul Truck Drivers.

期刊: Healthcare management forum 发表日期: 2026-Jun-26 链接: PubMed

摘要

Long-Haul Truck Drivers (LHTDs) have been identified as a high-risk population for chronic conditions. Health promotion programs have largely focused on individual behaviours, with less emphasis placed on the broader environmental factors. However, there is growing evidence that effective strategies must consider both individual and environmental factors. Through a social-ecological lens this mixed-methods study explored how the mobile work environment impacts health and health behaviours amongst LHTDs on the Canadian Prairies. Data were collected through semi-structured interviews with 13 participants, diet and activity logs, and a mobile work environment assessment of the Trans-Canada Highway between Manitoba and Alberta. Individual, occupational and policy level influences on the health and health practices of LHTDs were identified. Leaders in health policy are in a key position to build inter-sectoral, collaborative relationships and advocate for the necessary policy changes to create a healthy work environment for LHTDs.

35. Host genotype and edaphic factors shaped bacterial communities associated with native and endemic medicinal Artemisia species in arid environment.

期刊: Environmental microbiome 发表日期: 2026-Jun-26 链接: PubMed

摘要

Plant-associated microbiomes are key contributors to plant nutrition and stress tolerance, particularly in arid ecosystems where extreme abiotic conditions strongly shape plant-microbe interactions. Despite this, the abiotic drivers of microbiome assembly across different plant compartments in wild medicinal species from these environments remain poorly understood. In this study, we investigated bacterial community structure across multiple niches, including bulk soil, rhizosphere, root, and shoot, in three wild Artemisia species (Artemisia herba-alba Asso., Artemisia negrei L., and Artemisia mesatlantica Maire), the latter two being endemic to arid regions of Morocco. Using amplicon sequencing, we observed diverse bacterial associations with each plant niche harboring distinct taxa. Host plant species significantly influenced bacteriome composition (p = 0.026), particularly in Artemisia mesatlantica, which hosted the most specific bacterial taxa compared to its other relatives. Plant compartment emerged as key drivers of belowground bacterial community assembly with additional structuring by host species and edaphic factors. Soil pH, calcium carbonate content, organic matter and electrical conductivity were strongly correlated with shifts in bacterial diversity and composition, emphasizing the role of soil physicochemical properties as an environmental filter under extreme alkaline and arid conditions. Despite these species- and environment-specific variations, a conserved core bacteriome was identified across all Artemisia species, and compartments except shoot, comprising of Bacillus, Microvirga and Rhizobium. Our results demonstrate that the interplay between host identity and soil properties orchestrates distinct, yet functionally coherent bacterial communities in wild Artemisia species. Bacterial taxa identified as core are well-known for their roles in plant growth promotion, biocontrol and production of bioactive secondary metabolites. The persistence of this core bacterium comprising of Bacillus, Microvirga and Rhizobium suggests a stable association across hosts and compartments, potentially reflecting conserved ecological roles, although functional contributions were not directly assessed in this study. Overall, our findings reveal how the interplay between soil properties and host identity shapes the assembly of distinct, yet compositionally consistent bacterial communities in wild medicinal Artemisia species.

36. Assessment of occupational injury and associated factors among Awash Wine Beverage Factory workers in Addis Ababa, Ethiopia.

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

摘要

Occupational injury is a major public health and workplace safety problem in manufacturing industries. In Ethiopia, the magnitude of occupational injury among beverage factory workers ranges from 20.9% to 44.66%. Uncontrolled occupational injuries can lead to permanent disability, reduced work capacity, psychological stress, loss of income, decreased productivity, and death. These injuries also impose economic burdens on workers, families, industries, and the national healthcare system and negatively affect quality of life and community stability. This study aimed to assess the magnitude of occupational injury and its associated factors among workers at the Awash Wine Beverage Factory in Addis Ababa, Ethiopia, in 2024. An institution-based cross-sectional study was conducted among 279 randomly selected workers from 3 branches of the Awash Wine Beverage Factory. Data were collected using a structured interviewer-administered questionnaire and a workplace observation checklist. Data were entered into EpiData 3.1 and analyzed using STATA 15.1 (Stata Corp LLC). Chi-square tests and logistic regression analyses were performed. Variables with P < .25 in bivariate analysis were included in multivariable logistic regression. A P-value of <.05 at a 95% confidence interval (CI) was considered statistically significant. The prevalence of occupational injury within the previous 12 months was 43 (15.9%; 95% CI: 11.8%-19.9%), while injuries in the 2 weeks before data collection were 14 (5.2%; 95% CI: 2.6%-8.1%). Workers with ≤5 years of work experience were more likely to sustain injuries (adjusted odds ratio [AOR] = 5.86; 95% CI: 1.72-20.10). Not using personal protective equipment (PPE; AOR = 2.06; 95% CI: 1.02-2.23) and working at heights (AOR = 8.69; 95% CI: 5.94-8.85) were also more likely to sustain injuries. In addition, lack of regular health and safety supervision was significantly associated with injury (AOR = 5.9; 95% CI: 1.77-19.62). Occupational injury remains a serious concern among Awash Wine Beverage Factory workers. Short work experience, lack of PPE use, unsafe working conditions, and poor safety supervision were significantly associated variables. Strengthening safety training, improving PPE utilization, enhancing workplace conditions, and ensuring regular supervision are essential to reduce injuries and improve worker safety and productivity.

37. Exploratory 6-year prediction of LTCI certification using KCL data: A decision tree analysis in a retrospective observational study.

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

摘要

Amid the progression of an aging society, it is essential to develop a long-term predictive model capable of distinguishing between older adults with high and low risks of requiring Long-Term Care Insurance (LTCI) services. However, previous models were limited in that they could not simultaneously examine multiple and heterogeneous relationships, despite the fact that risk factors interact in complex and multifaceted ways. In addition, the existing model was restricted to a short-term prediction span. This study aimed to develop a predictive model for LTCI certification using Kihon Checklist data and a 6-year follow-up data with a decision tree analysis. This study was designed as a retrospective cohort, longitudinal, and observational study. Data were obtained from 3263 individuals aged 65 and older in a community-dweller. The dependent variable was LTCI certification status after 6 years. Independent variables included 6 Kihon Checklist domains, age, and gender. Decision tree analysis and a confusion matrix were used to make and evaluate the model. The decision tree model identified age, gender, and depression risk as key predictive factors. The model demonstrated moderate specificity (79.4%) and high negative predictive value (97.1%) but limited sensitivity (52.2%) and positive predictive value (11.1%). These findings indicate that the model performs better in identifying individuals unlikely to require LTCI certification than in detecting future LTCI users. Although it may provide preliminary population-level risk stratification over a 6-year horizon, its predictive performance is insufficient for standalone clinical or policy decision-making, and further refinement and validation are required.

38. Exploring oral health awareness, barriers to dental hygiene, and socioeconomic factors in Saudi Arabia: A cross-sectional observational study.

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

摘要

Oral health is integral to overall well-being and is influenced by socioeconomic, regional, and occupational factors. Despite its significance, disparities in oral health awareness and practices persist in Saudi Arabia, warranting a comprehensive investigation to inform targeted public health strategies. This study aimed to assess oral health awareness, hygiene practices, and barriers to maintaining oral health among residents of Saudi Arabia, with a focus on socioeconomic and regional variations. A cross-sectional observational study was conducted with 967 participants from all 5 main regions of Saudi Arabia. Data were collected using a structured, self-administered questionnaire that assessed demographics, oral hygiene practices, barriers to dental care, and awareness of oral health’s impact on general health. Multivariable logistic regression analyses were performed to identify factors associated with oral health awareness and barriers. Nine hundred ten of the participants (52.5%) were aware of the systemic impact of oral health on general health, while adherence to recommended hygiene practices remained low, with 36.7% brushing twice daily and 40% using dental floss regularly. Southern residents had significantly lower awareness (odds ratio = 0.27, 95% confidence interval, 0.13-0.54, P < .001). Financial constraints (49.1%) and occupational barriers (38.5%) were the most frequently reported challenges, while fear of dental procedures (42.4%) and lack of awareness about the importance of regular visits (43.6%) deterred dentist visits. In the multivariable adjusted model, region of residence and oral hygiene practice frequency were the primary independent predictors of awareness; education and income did not reach statistical significance after adjustment. Significant disparities in oral health awareness and practices exist across Saudi Arabia, influenced by regional, socioeconomic, and occupational factors. Targeted public health interventions, including educational campaigns, workplace wellness programs, and regional outreach initiatives, are essential to addressing these gaps. Aligning these efforts with Saudi Vision 2030 can enhance healthcare equity and improve population health outcomes.

39. Participants with long-chain 3-hydroxy-acylCoA dehydrogenase deficiency (LCHADD)/trifunctional protein deficiency (TFPD) report consistent low-fat diet intake over time.

期刊: Molecular genetics and metabolism 发表日期: 2026-Jun-25 链接: PubMed

摘要

Patients with LCHADD/TFPD are counseled to follow a diet low in long-chain fats (LCT) and supplement with medium-chain fats (MCT) with adequate micronutrients, but there is limited data on patient implementation of recommendations. We analyzed diet intake of LCHADD/TFPD participants twice, 2 years apart. Participants enrolled in the longitudinal Natural History of LCHAD Retinopathy study completed a 3-day food record and supplement logs at baseline and 2 years later. Differences in %LCT and MCT intake over time, and intra-individual and population variation, were analyzed. Percentage of participants meeting estimated average requirements (EAR) for fat-soluble (A, D, E, K) and water-soluble vitamins (B1, B2, B3, C) were calculated. Forty participants were enrolled, 2-36 years (48% female), 25% G1528C homozygous, 68% G1528C heterozygous, and 7% TFPD. Thirty-five baseline and 38 follow-up diet records were included. Fat intake was consistent over time; baseline 13.7% LCT, 18.8% MCT, follow-up 14.7% LCT, 20.6% MCT. Intra-individual variation ranged from 22% to 32% for MCT and LCT, respectively, but both were less than the overall population variation 49% MCT and 36% LCT. An average of 38.8% of participants took a multivitamin; however, only 51% met the EAR for fat-soluble vitamins compared to 81% for water-soluble vitamins. LCHADD/TFPD patients are consistently consuming a low-fat diet with appropriate supplementation of MCT. Day-to-day variation in %LCT was comparable to the general population, but absolute amount of fat was lower. A greater proportion of patients are still not meeting EAR for fat-soluble vitamins compared to water-soluble vitamins.

40. Institutional social isolation and preventive health check-up attendance among public assistance recipients in Japan: A qualitative dominant mixed-methods study.

期刊: Social science & medicine (1982) 发表日期: 2026-Jun-25 链接: PubMed

摘要

Social isolation is a major social determinant of health, yet little is known about how institutionally shaped isolation influences preventive healthcare engagement among public assistance recipients. This study examined how social isolation affects preventive health check-up attendance among public assistance recipients in Japan. We employed a qualitative-dominant convergent mixed-methods design in an urban municipality in Japan. Quantitative survey data were collected from 444 recipients, including indicators of social contact and support. Preventive health check-up attendance during the current fiscal year was verified through claims-based medical assistance records. In-depth semi-structured interviews were conducted with 25 recipients and analyzed thematically using Braun and Clarke’s approach. Quantitative and qualitative findings were integrated side-by-side. Absence of weekly face-to-face contact was highly prevalent (79.7%). In adjusted logistic regression models controlling for sex, age, household size, and employment status, participants with weekly face-to-face contact had significantly higher odds of attending preventive health check-ups (aOR = 3.59, 95% CI: 1.85-6.94). Qualitative analysis identified four interrelated themes: (1) institutional and economic constraints producing isolation, (2) stigma-driven avoidance of healthcare, (3) small ties within shared welfare spaces enabling engagement, and (4) the limits of individualized prevention and the need for structurally supported pathways, including social prescribing. Preventive health check-up attendance among public assistance recipients is not solely an individual behavioral responsibility but is socially and institutionally mediated through welfare-related displacement, stigma, and everyday interpersonal ties. Policies should incorporate socially supported preventive pathways to reduce isolation and promote health equity among marginalized welfare populations.

41. New biomarkers for antibody-drug conjugates in lung cancer the pathologist's perspective.

期刊: Lung cancer (Amsterdam, Netherlands) 发表日期: 2026-Jun-23 链接: PubMed

摘要

Antibody-drug conjugates (ADC) as a new treatment modality have enabled novel, promising treatment options in lung cancer. However, biomarkers for the selection of appropriate treatments are still under development, posing novel challenges for tissue selection and development of companion diagnostics (CDx). In this review, we address the challenges and discuss best practice for fast, reliable and robust implementation of novel biomarkers in treatment selection of ADCs in lung cancer.

42. Syndemic interactions in northwest Italy: education, place of birth, and the co-occurrence of type 2 diabetes and depression.

期刊: Social science & medicine (1982) 发表日期: 2026-Jun-23 链接: PubMed

摘要

Type 2 diabetes (T2DM) and depression often co-occur, generating substantial health burdens. Social determinants may shape vulnerability to both conditions. Using a syndemic framework, this study examines the clustering of T2DM, depression, education, and place of birth in a large cohort in Piedmont, Italy. We analysed 861,300 males and 917,545 females aged 45-75 years from the Piedmont Longitudinal Study. T2DM and depression were identified from electronic health records; education was classified into three levels, and place of birth as Italy/high-income countries (HIC) versus low- and middle-income countries (LMIC). Latent class analysis identified patterns of clustering. Cox proportional hazards models estimated associations of latent classes (LC) with emergency room (ER) access and all-cause mortality over five years. Three LC were identified in both sexes. In both, the class with high comorbidity and low education had the poorest outcomes. Among males, this group had 31% higher ER use (95% CI 1.29-1.33) and 60% higher mortality (95% CI 1.55-1.66) than the reference. Among females, risks were 30% higher for ER use (95% CI 1.28-1.33) and 43% higher for mortality (95% CI 1.37-1.49). Migration background influenced outcomes differently: males from LMIC had lower mortality without higher ER use, while females showed slightly higher ER use but lower mortality. T2DM and depression cluster with low educational level, with patterns differing by sex and migration background. The syndemic framework highlights the need for integrated interventions addressing both conditions and social determinants to promote health equity.

43. Latent profile analysis of pregnant exercise adherence and the relationship with demographic and socio-psychological factors: a multicentre cross-sectional study.

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

摘要

Pregnancy physical activity (PA) and exercise benefits both mothers and babies, but requires sustained adherence. Many pregnant women fail to meet recommended levels. The reasons for low adherence comprised fluctuating physiological and environmental factors. This study aims to identify discrete profiles of pregnant women based on exercise adherence and to examine differences in demographic and socio-psychological factors across these profiles. A survey was conducted among 1,255 pregnant women in three hospitals in Shenzhen, Dongguan, and Shunde, China, using the Exercise Adherence Rating Scale (EARS), the Pregnancy Exercise Self-Efficacy Scale (P-ESES), and the Pregnancy Physical Activity Social Support Scale (P-PASSS). In the analysis, EARS items were scored higher, indicating a healthier state (e.g., sufficient time and energy). Latent profile analysis (LPA) was employed to classify adherence profiles, and multinomial logistic regression was used to examine differences in demographic, self-efficacy, and social support across four groups. Four profiles of exercise adherence were identified: (1) Profile 1 (16.97%), characterized by deficits in time and energy, (2) Profile 2 (15.22%), a group with sufficient time resources but the lowest self-efficacy, (3) Profile 3 (43.98%), characterized by high adherence despite moderate barriers, and (4) Profile 4 (23.83%), a group with optimal exercise adherence, confidence, and resources. Women with higher P-ESES (OR: 1.14-1.38) and P-PASSS (OR: 1.04-1.06) scores were more likely to be in Profiles 3 and 4. Additionally, women’s partners who never or occasionally exercise were significantly more likely to be categorized into Profile 1 (OR = 0.18 for Profile 4 vs. Profile 1). Furthermore, the first trimester emerged as a significant risk period for lower exercise adherence, whereas overweight/obesity was independently associated with higher odds of membership in Profile 4. The study identified four distinct profiles of exercise adherence among pregnant women. 32.19% of participants were in the two lower exercise-adherence groups. Pregnant women in Profile 1 were characterized by challenges related to a lack of time and knowledge. Participants in Profile 2 showed the lowest exercise self-efficacy and social support among the four profiles. Furthermore, women in early pregnancy were more likely to have lower adherence profiles. Hence, targeted interventions addressing these specific groups are warranted to improve exercise adherence during pregnancy.

44. Insights from adaptive immune regulation for disease resistance breeding in livestock and poultry.

期刊: Science China. Life sciences 发表日期: 2026-Jun-23 链接: PubMed

摘要

As a crucial component of agriculture, livestock and poultry production supplies high-quality animal protein and is essential for the stability of food safety, ecological environment, human health, and global sustainability. However, frequent epidemics have emerged as a major constraint on industry development, with traditional vaccine and drug-based controls facing challenges such as rapid pathogen mutation, environmental pollution, and drug residue risks. Disease-resistant breeding thus offers a crucial strategy for sustainable livestock farming, yet its progress is hindered by the lack of effective molecular targets for major epizootics. Extensive studies on adaptive immune regulation have identified numerous regulatory genes and molecular targets associated with disease resistance, offering significant potential for breeding applications. Nevertheless, despite the well-established role of adaptive immunity in human medicine, its utilization in livestock breeding remains largely underdeveloped. This review outlines the significance and current status of disease-resistant breeding, focuses on adaptive immune mechanisms, and proposes innovative strategies.

45. Eating disorder severity and treatment outcome across race/ethnicity, sexual orientation, and socioeconomic status: Intersectional inequities in a clinical sample.

期刊: Social science & medicine (1982) 发表日期: 2026-Jun-18 链接: PubMed

摘要

Marginalized populations experience increased eating disorder (ED) risk and encounter significant barriers to treatment. Intersectionality provides a framework for understanding how systemic oppression contributes to inequities in EDs; however, intersectional approaches have yet to be applied to a clinical ED sample. The current study examined inequities in ED severity and treatment outcome across the intersections of race/ethnicity, sexual orientation, and socioeconomic status (SES). Adult women (N=3016; M = 27.2 years) with transdiagnostic EDs presenting to affiliated treatment sites across the United States completed the Eating Disorder Examination-Questionnaire (EDE-Q) at admission and discharge. Race/ethnicity and sexual orientation were self-reported; SES was measured using the area deprivation index of participants’ neighborhoods. Multilevel Analysis of Individual Heterogeneity and Discriminatory Accuracy (MAIHDA) was used to estimate baseline EDE-Q global score; change in EDE-Q global score and binge eating, self-induced vomiting, laxative use, and driven exercise frequency from admission to discharge; and reason for discharge (routine or non-routine) across intersectional subgroups. In this sample of women with access to treatment, MAIHDA models predicted higher baseline levels of overall ED pathology among sexual minorities (predicted M = 4.10). Few differences in ED symptom improvement were observed across intersectional subgroups, with some small yet potentially meaningful inequities. Racially/ethnically minoritized subgroups appeared slightly less likely to complete treatment (predicted percent non-routine discharge = 41.50%). Future research should build on these findings by analyzing other dimensions of inequity (e.g., gender, weight status, disability status) to further characterize and address intersecting systems of oppression that disparately influence ED outcomes.

46. Ternary pattern-driven feature extraction and self-attending GRU for clinical score prediction in Alzheimer's disease.

期刊: Psychiatry research. Neuroimaging 发表日期: 2026-Jun-08 链接: PubMed

摘要

This article presents a unique deep learning technique to identify AD using data from magnetic resonance imaging (MRI). However, deep learning models’ lack of interpretability prevents them from being used in clinical settings, where explainability is crucial for winning over medical personnel. In order to diagnose AD, this work proposes a self-attending bidirectional gated recurrent unit (SA-Bi-GRU) method based on explainable AI (XAI) that makes use of a deep learning model. Before the diagnosis process, an integrated Ternary pattern and Fourier-Bessel series expansion based empirical wavelet transform (TP-FBSE-EWT) method is used to extract features. Then, a hybrid binary teaching learning and Horse herd optimization (H-BTL-HHO) algorithm is presented to minimize the dimensions and screen properties of brain regions associated with AD. Additionally, by using the Gradient-weighted Class Activation Mapping (Grad-CAM) technique, the proposed structure seeks to improve the interpretability of deep learning models, giving clinicians important insights into disease diagnosis and an understanding of the decision-making process. The process is implemented using the MATLAB tool. The simulation findings reveal that the proposed CAD system for clinical score prediction outperforms prevailing systems by boosting accuracy, sensitivity, and specificity to 99.97%, 99.34%, and 98.89% for multi-class problems, respectively.

47. ER stress amplifies inflammation via a dual mechanism involving IκBζ-XBP1s synergism and Regnase-1 degradation.

期刊: Journal of immunology (Baltimore, Md. : 1950) 发表日期: 2026-Jun-07 链接: PubMed

摘要

Inflammatory diseases arise from complex interactions between immune signaling and cellular stress. Although endoplasmic reticulum (ER) stress is a key modulator of immunity, the mechanisms by which it promotes inflammatory pathology remain incompletely understood. Notably, ER stress-induced NF-κB activation alone is insufficient to account for robust IL-6 production, thus suggesting the involvement of additional regulators. Using bone marrow-derived macrophages and sepsis model mice, we identified the inducible transcription factor IκBζ as a critical mediator of this response, with ER stress synergizing with TLR signaling to markedly upregulate IκBζ. Mechanistically, ER stress triggered calcium-dependent signaling that led to IκB kinase-mediated degradation of the RNase Regnase-1, likely stabilizing Nfkbiz mRNA and promoting the accumulation of IκBζ, which was found to cooperate with the ER stress factor XBP1s to drive transcription of selected secondary-response genes, particularly Il6 and Nos2. Importantly, this synergy was required for excessive IL-6 production in septic mice, highlighting a gene-specific amplification pathway. Together, these findings identify a dual mechanism in which transcriptional synergy between IκBζ and XBP1s is coupled to posttranscriptional mRNA stabilization via Regnase-1 degradation, thereby linking proteotoxic stress to hyperinflammatory responses. Our results establish ER stress-mediated IκBζ accumulation as a key driver of inflammatory pathogenesis and a potential therapeutic target in ER stress-associated inflammatory disorders.

48. Prognostic significance of Myb protein and its downstream target genes in lacrimal gland adenoid cystic carcinoma.

期刊: American journal of clinical pathology 发表日期: 2026-Jun-04 链接: PubMed

摘要

Lacrimal gland adenoid cystic carcinoma (ACC) is a rare and lethal malignancy associated with a poor prognosis, with no known therapeutic targets. The clinical relevance of Myb, Sox4, c-Kit protein expression, and the MYB::NFIB fusion gene in lacrimal gland ACC is not well known. The current study aims to investigate the prognostic significance of Myb, Sox-4, c-Kit protein, and the MYB::NFIB fusion gene in lacrimal gland ACC. A total of 30 histopathologically diagnosed lacrimal gland ACC cases were included in this study. Myb, Sox4, c-Kit expression, and MYB::NFIB gene fusion were evaluated by immunohistochemistry and fluorescence in situ hybridization, respectively. The results were correlated with clinicopathologic features and patient survival. Immunoexpression of Myb, Sox4, and c-Kit was observed in 70%, 63%, and 63% of ACC cases, respectively. Myb expression showed a significant association with the solid and cribriform histologic patterns, Sox-4 expression, and disease-free survival. On univariate analysis, Myb expression, solid histologic pattern, bone erosion, intracranial extension, and advanced tumor stage were indicators of poor prognosis. c-Kit expression showed a significant association with advanced tumor stage. MYB::NFIB fusion, detected in 47% of cases, was significantly associated with intracranial extension. Myb protein emerged as a prognostic indicator in the pathogenesis and clinical outcomes of patients with lacrimal gland ACC.

49. Evaluation of the effect of respiratory disease protection education given to adolescents in Kemalpasa, Turkiye.

期刊: JPMA. The Journal of the Pakistan Medical Association 发表日期: 2026-Jun 链接: PubMed

摘要

To evaluate the effectiveness of education given to adolescents about protection against respiratory-transmitted diseases. The quasi-experimental, multi-phase study was conducted from October 1, 2020, to June 11, 2021, at a vocational and technical high school in Anatolia, Turkiye, after approval from the ethics review committee of Ege University, Turkiye, and comprised students of either gender in grades 9, 10, 11, and 12 in the 2020-2021 academic year. Data wascollected during face-to-face interviews through the Student Information Formand the Scale for Assessing Perceptions and Attitudes Towards the Coronavirus Disease-2019 Outbreak. Educational material and video films of the Ministry of Health were edited and used during the education phase. To evaluate the effectiveness of the education, the students’ level of knowledge about protection from respiratory-transmitted diseases was tested again 3 months after the education intervention. Baseline and post-intervention leveks were compared to assess the impact of the intervention. Data was analysed using SPSS 26. Of the 665 students, 302(45.4%) participated in the pre-test, while 374(56.2%) attended the education phase, and 365(54.9%) participated in the post-test. The open-ended question in the post-test was answered by 310(84.9%) subjects. The majority of the students were male 284(94.0%), and aged 13-16 years 283 (93.8%). The statement “Respiratory diseases are caused by bacteria” was correctly affirmed by 236(78.1%) of the students before and 278(76.2%) after the education. There was a significant difference between the awareness of the students post-intervention compared to baseline about the transmission route of the infectious agent, the disease process, and the importance of wearing a mask. The difference was also significant in terms of students’ perception of danger, contagiousness, causes, conspiracy, environment, macro, avoidance behaviours, cognitive avoidance, avoidance of common areas, and avoidance of personal contact (p<0.05). Continuous education of adolescents, families and teachers within the scope of school health contributed to the prevention of respiratory diseases and health promotion.

50. Composition and Biochemical Determinants of Renal Stones: A Comprehensive Analysis of Urinary and Serum Mineral Profiles.

期刊: Urology research & practice 发表日期: 2026-May-20 链接: PubMed

摘要

Renal stone formation is closely linked to disturbances in urinary and serum mineral metabolism. Analysis of stone composition along with biochemical parameters is essential for understanding the pathogenesis of different stone types. A prospective observational study was conducted among 371 patients with renal stones. Stone composition was analyzed using Fourier transform infrared spectroscopy, X-ray diffraction, and scanning electron microscopy- Energy-Dispersive X-ray Spectroscopy techniques. Serum and 24-hour urinary biochemical parameters, including calcium, oxalate, citrate, phosphate, uric acid, pH, and urine volume, were evaluated. Statistical analysis was performed to assess differences and correlations between stone types and biochemical variables. The mean age was 45.3 years, with male predominance and 39.9% recurrence. Calcium oxalate monohydrate was most common. Stone types differed significantly in urinary volume, pH, and mineral excretion. Uric acid stones showed low urine pH and volume, while calcium phosphate stones had higher calcium excretion and alkaline pH, with related serum differences. Renal stone composition is strongly associated with specific urinary and serum biochemical abnormalities. Metabolic evaluation is crucial for identifying etiological factors and for guiding individualized preventive strategies in stone disease management. Cite this article as: Prakash P, Agarwal S, Sarpal R, Dogra AK, Prakash A. Composition and biochemical determinants of renal stones: A comprehensive analysis of urinary and serum mineral profiles. Urol Res Pract. 2026, 52, 0015, doi: 10.5152/tud.2026.26015.

51. Clinical and Demographic Characteristics of Patients Subjected to Physical Restraint in a Psychiatric Intensive Care Unit: A Retrospective Descriptive Cross-Sectional Study.

期刊: The Eurasian journal of medicine 发表日期: 2026-May-12 链接: PubMed

摘要

Psychiatric intensive care units have significant implications for patient safety and clinical outcomes. Understanding the demographic and clinical characteristics of restrained patients is essential for developing evidence-based protocols and reducing unnecessary restraint use. The aim of this retrospective descriptive cross-sectional study was to determine the clinical and demographic characteristics of patients subjected to physical restraint in a psychiatric intensive care unit. This descriptive cross-sectional study analyzed 138 patients subjected to physical restraint in a psychiatric intensive care unit between January 2023 and December 2023. Data were collected through systematic chart review using a standardized physical restraint monitoring form from the Hospital Quality and Standards System, designed specifically for type 2 (behavioral safety) restraint documentation. Variables included demographic characteristics, primary diagnoses, restraint indications, and clinical outcomes. Statistical analysis was performed using SPSS, version 28.0. The study followed STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) guidelines. Statistical analysis was performed using descriptive statistics. Out of 138 patients, 95 (68.8%) were male with a mean age of 51.48 Å} 15.02 years. Primary restraint indications included noncompliance with medical treatment (39 patients, 28.3%), severe agitation (37 patients, 26.8%), orientation disturbances (32 patients, 23.2%), and self-harm behaviors (30 patients, 21.7%). The most common primary diagnoses were nonorganic psychosis (55 patients, 39.9%), bipolar disorder (30 patients, 21.7%), and delirium tremens (20 patients, 14.5%). Mean intensive care unit length of stay was 11.87 Å} 14.04 days. This study provides essential baseline data on physical restraint use in psychiatric intensive care, demonstrating male predominance and identifying key clinical indicators. These findings support the development of targeted interventions and evidence-based restraint protocols to optimize patient care while minimizing restrictive practices. Cite this article as: Cengisiz C, Nehir S. Clinical and demographic characteristics of patients subjected to physical restraint in a psychiatric intensive care unit: A retrospective descriptive cross-sectional study. Eurasian J Med. 2026, 58(3), 0961, doi: 10.5152/ eurasianjmed.2026.25961.

52. Integrated botanical and cultural strategies for management of major insect pests in maize.

期刊: Journal of insect science (Online) 发表日期: 2026-May-05 链接: PubMed

摘要

Maize (Zea mays L.) is a staple crop for millions of people worldwide, yet its productivity is constantly under threat from pests such as fall armyworm (Spodoptera frugiperda J.E. Smith), stem borers (Busseola fusca Fuller and Chilo partellus Swinhoe), maize aphids (Rhopalosiphum maidis Fitch), and maize weevil (Sitophilus zeamais Motschulsky). These pests can cause devastating losses of 20-50% in the field and up to 40% during storage. The pests are increasingly resistant to chemical insecticides, and there are growing concerns about environmental and health impacts. Sustainable alternatives are urgently needed. This review brings together insights from 34 studies (2000-2025) on plant-based insecticides, cultural practices, and their integration for maize pest management. Across the selected studies, larval mortality due to botanical extracts ranged from 45% to 92%, depending on the plant species used, formulation, and target pest. These values reflect the range reported in different studies rather than results from a formal meta-analysis. Cultural practices like intercropping, crop rotation, adjusting planting dates, and field sanitation lowered pest pressure by 18-80% and boosted yields by 8-45%. Combining these approaches was even more powerful, reducing fall armyworm damage by 65-88%, increasing yields up to 52%, and supporting beneficial insects. Despite these successes, challenges remain, especially in understanding how farmers adopt these methods and how they perform across different locations and seasons. Overall, this evidence shows that integrated, environmentally friendly strategies can protect maize, support farmers, and promote resilient, low-input farming systems. Future work should focus on long-term field trials, practical adoption, and socio-economic benefits to make these strategies widely accessible. A systematic literature search was conducted using databases such as Scopus, Web of Science, and Google Scholar covering studies published between 2000 and 2025.

53. Gut Microbiota and Thyroid Diseases.

期刊: The Eurasian journal of medicine 发表日期: 2026-Apr-21 链接: PubMed

摘要

The gut microbiota plays a pivotal role in maintaining the homeostasis of the digestive and immune systems. Dysbiosis compromises the intestinal barrier and triggers systemic inflammation, thereby contributing to metabolic and immune dysregulation. Emerging evidence suggests a bidirectional relationship between the gut microbiota and thyroid function. The microbiota influences the absorption and metabolism of micronutrients essential for thyroid hormone synthesis, including iodine, selenium, iron, and zinc. Dysbiosis enhances intestinal permeability, facilitating the translocation of bacterial components into systemic circulation and potentially triggering autoimmune thyroid diseases (AITD) such as Hashimoto’s thyroiditis and Graves’ disease. Animal studies further demonstrate that hypothyroidism, hyperthyroidism, and thyroidectomy can alter the diversity and composition of gut microbiota. Environmental exposures such as particulate matter 2.5 reshape microbial and metabolic profiles, influencing the hypothalamus-pituitary-thyroid axis and thyroid hormone homeostasis. Clinical studies show reduced abundance of beneficial bacteria (Bifidobacterium and Lactobacillus) and enrichment of proinflammatory taxa in AITD patients. These findings highlight the complex bidirectional interactions between gut microbiota, thyroid function, and immune tolerance. Microbiotatargeted therapies may represent promising strategies for the prevention and management of thyroid disorders. This review aims to summarize current evidence regarding the bidirectional relationship between gut microbiota and thyroid disorders, with particular emphasis on dysbiosis, immune regulation, micronutrient metabolism, and autoimmune thyroid disease. Cite this article as: Beyhan YE, Işık Ş. Gut microbiota and thyroid diseases. Eurasian J Med. 2026, 58(3), 1232, doi: 10.5152/eurasianjmed.2026.251232.

54. Rising burden of fall-induced hip fractures in China: accelerating male-specific trends and persistent gender disparities from Global Burden of Disease 2021.

期刊: Acta orthopaedica et traumatologica turcica 发表日期: 2026-Mar-12 链接: PubMed

摘要

To develop effective strategies for addressing hip fractures caused by falls in China, a comprehensive assessment of the disease burden is essential. Data on the characteristics of fall-related hip fractures in China-including incidence, prevalence, years lived with disability (YLDs), and their age-standardized rates-were obtained from the Global Burden of Disease 2021 study. Joinpoint regression analysis was used to examine the changes in disease burden; decomposition analysis was applied to quantify the contributions of aging, population growth, and epidemiological factors to burden changes; and autoregressive integrated moving average model was employed to forecast the burden through 2036. In 2021, there were 2.537 million new cases of fall-related hip fractures in China (ASIR = 144.12 per 100 000), with a higher burden among females (age-standardized incidence rate [ASIR]: 158.47 vs. 117.93 per 100 000 for males). From 1990 to 2021, the total number of incident cases increased by 386.1%, and the ASIR rose by 83.43%, with a marked acceleration after 2010 (age-period-cohort = 6.72%). The age-period-cohort model indicated a stronger period effect in males (net drift 0.74% per year vs. 0.5% per year in females), and an exponential increase in age effect among those aged 65 years and above. Decomposition analysis revealed epidemiological factors contributed 56.6%-75.3% to incidence/prevalence, while aging accounted for 57.4%-165.2% of YLDs growth. Autoregressive integrated moving average projections suggest that by 2036, the ASIR will decline to 109.85 per 100 000, but the age-standardized prevalence rate in males will rise by 2.01%. The burden of hip fractures due to falls in China continues to intensify, with a higher incidence in females but a more rapid long-term increase in males. Integrated fall prevention strategies are urgently needed to address the challenges posed by an aging population.   Cite this article as: Xu D, Lu Z, Yan H, Yang Z. Rising burden of fall-induced hip fractures in China: accelerating male-specific trends and persistent gender disparities from GBD 2021. Acta Orthop Traumatol Turc. 2026; 60(2), 0673, doi: 10.5152/j.aott.2026.25673.

55. Audit of needlestick injuries in dental and dermatology sections: insights and strategies for safer practices.

期刊: JPMA. The Journal of the Pakistan Medical Association 发表日期: 2026-Mar 链接: PubMed

摘要

To assess the incidence of needlestick and sharp injuries among healthcare workers in dental and dermatology sections, to identify root causes, and to evaluate adherence to safety protocols. The single-centre audit was conducted at the Aga Khan University Hospital, Karachi, and comprised data from the Department of Infection Prevention and Hospital Epidemiology and the institutional Adverse Event Management System from January 1, 2019, to December 31, 2020. The ‘Five Whys’ technique was used for root cause analysis and a fishbone diagram was generated to identify contributing factors of needlestick and sharp injuries reported in the dental and dermatology sections. Based on the findings, an improvement plan was developed using the Occupational Safety and Health Administration hierarchy of controls, which included workshops and training sessions aimed at enhancing safety practices. A follow-up audit was conducted from January 1, 2021, to December 31, 2022, to evaluate the effectiveness of the implemented measures. In the first audit, 15 needlestick and sharp injuries were reported, with dental staff experiencing 12(80%) of them. The main causes included improper needle handling and recapping in the dental section, and cuts from surgical blades in the dermatology section. Post-intervention, the incidence of needlestick and sharp injuries decreased to 4 cases, with 3(75%) in the dental section. Critical gaps in safety protocols were identified in the first round of audit. The significant reduction in needlestick and sharp injuries post-intervention highlighted the effectiveness of quality improvement measures in enhancing occupational safety and reducing exposure to bloodborne pathogens.

56. Relationship Between Sleep-Related Worry, Compassion Fatigue, and Retention Intention Among Nurses: A Multicenter Cross-Sectional Study.

期刊: Journal of nursing management 发表日期: 2026 链接: PubMed

摘要

To examine the current situation of sleep-related worry, compassion fatigue, and retention intention among nurses in general hospitals in China, and explore whether there might be any connection among the three. This study adopts a cross-sectional and descriptive design. From January to February 2024, a survey was conducted on 1831 on-duty nurses from eight tertiary general hospitals in China (Sichuan, Hubei, and Shenzhen) using a convenience sampling method. The survey instruments included general information questionnaires, The Anxiety and Preoccupation about Sleep Questionnaire, The Compassion Fatigue Short Scale, and The Questionnaire for Nurse Intention to Remain Employed. Collected data were subsequently analyzed. The mean scores for sleep-related worry, compassion fatigue, and retention intention among nurses in general hospitals in China were 30.40 ± 11.28, 48.03 ± 27.26, and 22.79 ± 3.71, respectively. Significant negative correlations were observed between retention intention and both compassion fatigue and sleep-related worry, while a significant positive correlation was found between sleep-related worry and compassion fatigue. Furthermore, compassion fatigue partially mediated the relationship between sleep-related worry and retention intention, with the mediation effect accounting for 65.15% of the total effect. This study indicates that nurses’ sleep-related worry and compassion fatigue may be related to their retention intention. This study reveals that there may be a certain connection between nurses’ sleep-related worry, compassion fatigue, and retention intention. It is suggested that nursing managers should prioritize improving nurses’ sleep quality, alleviating their sleep-related worry, and enhancing organizational support. These measures may to some extent alleviate the phenomenon of compassion fatigue and even change the retention intention of nurses, thereby effectively curbing the brain drain of talents.

57. Identifying Change Fatigue in Nurses From Southwestern China via Latent Profile Analysis: A Multicenter Cross-Sectional Study.

期刊: Journal of nursing management 发表日期: 2026 链接: PubMed

摘要

To identify latent profiles of change fatigue among nurses in Southwestern China and explore factors associated with distinct profiles. Healthcare resources in Southwestern China are unevenly distributed, and the region features considerable ethnic diversity. Against the backdrop of ongoing reforms in the healthcare system, nurses-as frontline implementers-are constantly exposed to intensive and frequent updates in policies, technologies, and workflows, making them susceptible to change fatigue. This sustained exposure precipitates “change fatigue,” a syndrome that erodes psychological resilience and professional identity, and is prospectively linked to heightened turnover intention, measurable deterioration in nursing quality and an increased incidence of patient-safety events. From July to September 2025, we recruited nurses from various tiers and types of medical institutions across Southwestern China. Data were collected using a general information questionnaire, the Change-Related Stress Scale, the Grandey Emotional Labor Strategy Scale, the Connor-Davidson Resilience Scale (CD-RISC), and the Chinese Nurse Job Stressors Scale. Latent profile analysis (LPA) was employed to identify subgroups of change fatigue. Univariate analysis and multinomial logistic regression with Firth’s penalized likelihood estimation were used to examine factors associated with profile membership. A total of 1383 valid questionnaires were included. LPA revealed three distinct profiles of change fatigue: low fatigue (17.5%, n = 242), moderate fatigue (61.6%, n = 852), and high fatigue (20.9%, n = 289). Multinomial logistic regression showed that nurses in the high fatigue group were significantly more likely to work in the intensive care unit (OR = 2.31, 95% CI: 1.40-3.85, p = 0.001) and internal medicine (OR = 2.12, 95% CI: 1.26-3.61, p = 0.005). Working 1-2 night shifts per week increased odds of high fatigue by 53% (OR = 1.53, 95% CI: 1.03-2.27, p = 0.034). Compared with minimal emotional labor (Level 1, 14-30 points), both moderate (Level 2, 31-50 points: OR = 0.14, p = 0.030) and high (Level 3, 51-70 points: OR = 0.09, p = 0.010) emotional labor levels were associated with significantly lower odds of high fatigue, suggesting that deficient emotional labor engagement may represent a risk configuration. Work stress Level 3 increased odds of high fatigue 33-fold (OR = 32.71, 95% CI: 13.27-103.37, p < 0.001). Psychological resilience showed no independent significant association with profile membership in multivariate models. Change fatigue exhibits a heterogeneous tripartite structure. Minimal emotional labor engagement (Level 1) was associated with higher odds of high fatigue compared with moderate and high levels, suggesting that deficient emotional labor may represent a distinct risk configuration. Both modifiable workplace factors (ICU/internal medicine placement, night shifts, and job stress) and emotional labor patterns were associated with profile membership, supporting the potential value of organizational interventions and targeted emotional labor training. These findings provide an evidence-based foundation for precision prevention. Nursing leaders should integrate the six-item Change Fatigue Measurement Scale into routine occupational health surveillance to enable profile-based risk stratification. High-fatigue nurses (20.9%) require immediate workload relief and mental health referral; moderate-fatigue nurses (61.6%) represent a critical prevention window for resilience training and peer support; low-fatigue nurses (17.5%) should serve as peer mentors and change champions. Priority interventions should target ICU and internal medicine units given the 2- to 2.3-fold increased high-fatigue risk. Leaders should limit consecutive night duties to ≤ 2 shifts, ensure ≥ 11 h rest between shifts, and enforce weekly overtime caps (≤ 8 h). Differentiated emotional labor training is essential: Nurses with minimal engagement need professional identity strengthening and authentic expression workshops, while those with excessive engagement require boundary-setting training and mindfulness-based stress reduction. Resilience-building interventions must be embedded within organizational support initiatives rather than implemented as standalone programs. In ethnically diverse, resource-constrained contexts, culturally tailored change communications and phased implementation timelines are critical to avoid “reform stacking.”

58. The Association Between Physical Activity and Epigastric Pain: A Mendelian Randomization and Cross-Sectional Study.

期刊: Pain research & management 发表日期: 2026 链接: PubMed

摘要

The relationship between physical activity (PA) and epigastric pain is not well established. This study uniquely combined Mendelian randomization (MR) for causal inference with a cross-sectional analysis for epidemiological validation. We performed an MR analysis using inverse variance weighting (IVW) as the primary method. For the cross-sectional study, we analyzed data from the National Health and Nutrition Examination Survey (NHANES), categorizing PA (leisure-time, occupational, and transportation) according to U.S. Genetically predicted walking for pleasure was inversely associated with epigastric pain (IVW OR = 0.966, 95% CI: 0.948-0.985, P = 3.912 × 10-4). A cross-sectional analysis revealed contrasting domain-specific effects: occupation-related PA meeting guidelines (≥ 150 min/week) increased the risk of epigastric pain (OR: 1.271, 95% CI: 1.119-1.443, P = 0.0002), while sufficient leisure-time PA (≥ 300 minutes/week) was protective (OR: 0.822, 95% CI: 0.693-0.976, P = 0.0253). Transportation-related and total PA showed no significant associations in fully adjusted models. The integration of genetic and observational evidence demonstrates that the effect of PA on epigastric pain is context-dependent. Leisure-time PA is protective, whereas occupation-related PA may increase risk. These findings highlight the context-dependent role of PA in gastrointestinal health.

59. Antinuclear antibodies in women with recurrent early pregnancy loss: prevalence and impact on subsequent pregnancy outcome.

期刊: Reproductive biomedicine online 发表日期: 2025-Nov-29 链接: PubMed

摘要

What is the prevalence of antinuclear antibodies (ANA) in women with recurrent early pregnancy loss (REPL), and do they affect subsequent pregnancy outcome? This single-centre, retrospective cohort study included 960 women consulting for REPL between January 2014 and December 2019. REPL was defined as ≥2 pregnancy losses before 10 weeks’ gestation, including natural and autologous IVF/intracytoplasmic sperm injection pregnancies. ANA testing via indirect immunofluorescence on HEp-20-10 cells was part of routine evaluation. Confirmed systemic autoimmune diseases, uterine anomalies, parental chromosomal abnormalities, uncontrolled endocrine disorders and age ≥40 years were exclusion criteria. ANA prevalence and its association with subsequent pregnancy outcomes were assessed. The primary outcome was early pregnancy loss (EPL); secondary outcomes were biochemical pregnancy loss, clinical miscarriage and live birth rates. ANA screening of ≥1:80 was observed in 125/960 women (13.0%), comparable to the general population. No significant differences were seen in maternal age, body mass index, ethnicity or conception method between ANA-positive and ANA-negative women. The mean number of prior EPL was similar (2.7 versus 2.8, P = 0.06), but the percentage of women with thyroid antibodies was higher among ANA-positive women (21.6% versus 10.2%, P < 0.001). The subsequent EPL rate was similar (34.9% versus 40.5%, P = 0.33). Logistic regression showed no independent effect of ANA positivity for additional EPL (odds ratio 0.73, 95% CI 0.45-1.20, P = 0.22). Live birth rates were also similar (P = 0.50). ANA prevalence in women experiencing REPL was 13.0%, comparable to general population rates. ANA positivity did not negatively impact subsequent pregnancy outcomes. These findings do not support routine ANA testing in REPL or use of immunological add-ons based solely on ANA positivity.