公共卫生研究摘要 (2026-06-29)

共收录 58 篇研究文章

1. A scoping review of opioid agonist treatment in Australian general practice.

期刊: Australian journal of primary health 发表日期: 2026-Aug-17 链接: PubMed

摘要

In Australia, opioid use disorder is a major public health concern, and opioid agonist treatment (OAT) is an effective and evidence-based approach for treating opioid use disorder, reducing morbidity, mortality and societal cost. In Australia, 60% of OAT prescribing occurs in general practice, but significant barriers exist. This scoping review aimed to find research describing the characteristics and evaluation of different models of primary care-based OAT in Australia. Following the PRISMA guidelines for scoping reviews, a systematic search was conducted of PubMed, Embase, Scopus and CINAHL, and several grey literature databases. We conducted a narrative synthesis, and derived study themes inductively from included studies. We identified 24 relevant articles over 34 years that reported primary research on general practice-based OAT. Seven studies evaluated general practice OAT; eight examined prescriber attitudes, behaviour and workforce; two described single-models of care; four investigated primary care OAT policy; and two studies examined consumer experiences. The studies showed primary care OAT was as effective as specialist care for retention in OAT; however, prescriber deficits exist, with lack of remuneration and stigma identified as common barriers. The multidisciplinary models of care all received external funding, with GPs well placed, but underfunded, to coordinate care. The limited research demonstrates research gaps in service delivery, models of care, funding and views of people who use drugs. Future research scope needs to be broadened to encompass improved national monitoring datasets, patient views, models of care, holistic support and coordination, and structural supports to recruit and retain active prescribers.

2. Towards vaccine equity for Aboriginal and Torres Strait Islander children aged 0-5 years: a rapid review of enablers, barriers and characteristics of successful programs.

期刊: Australian journal of primary health 发表日期: 2026-Aug-17 链接: PubMed

摘要

Well-implemented vaccination programs can reduce infectious disease burden in an equitable and cost-effective manner. This rapid review used a strengths-based approach to identify enablers and barriers to vaccination for Aboriginal and Torres Strait Islander children aged 0-5 years, and identify the characteristics of effective programs to improve vaccination coverage and timeliness. Databases and grey literature sources were searched for articles published between 2013 and 2025. Following screening, an inductive coding process informed by Braun and Clarke’s reflexive thematic analysis was utilised to consolidate qualitative data. Twelve studies discussing enablers, barriers and characteristics of successful programs to increase vaccination rates were included. These studies were heterogenous in design and population. Despite variability between settings and communities, service access barriers, such as lack of adequate transport and opening hours, were commonly cited throughout the included studies, as well as lack of cultural safety. This review emphasises the value of community ownership and local responsiveness of programs aimed at increasing vaccination timeliness and coverage, and the importance of strengthening the Aboriginal and Torres Strait Islander health workforce.

3. Perceptions of People From South Asian Backgrounds With Chronic Kidney Disease on Digital Health Interventions: Patient and Public Involvement and Engagement Consultation Focus Group.

期刊: Health expectations : an international journal of public participation in health care and health policy 发表日期: 2026-Aug 链接: PubMed

摘要

Digital health interventions (DHIs) are increasingly popular as a potential method to address educational and support needs of individuals with long-term conditions, as they are largely accessible to most people, can be highly effective, and delivered at low cost. We have developed a DHI to better support chronic kidney disease (CKD) self-management and demonstrated its efficacy in a UK-based clinical trial. The trial population, however, was fairly homogeneous, and those from underserved populations (including ethnic minority groups), who would have likely benefited from the DHI, were underrepresented. Understanding how ethnic minority communities perceive DHIs is essential for identifying their needs, priorities and challenges, and for ensuring that future DHIs are relevant, acceptable and equitable. Given the potential impact of DHIs, patients should be actively involved in their design and implementation. To support this, patient and public involvement and engagement (PPIE) consultations were conducted to: 1) understand people with CKD from South Asian (SA) backgrounds’ perspectives of DHIs; 2) identify factors that require consideration when adapting DHIs to address health inequities; and 3) clarify how best to conduct PPIE projects in adapting DHIs for traditionally underserved groups, particularly ethnic minority groups. PPIE consultation focus groups were conducted in-person with ten individuals (60% male, age: 69 ± 7) from SA backgrounds thrice, audio-recorded and transcribed verbatim. Data were analysed using thematic analysis. Participants identified several barriers and facilitators to accessing and using DHIs. Language was reported to be the biggest barrier to accessing and using online health information. Having culturally appropriate information available in their own language would increase the acceptability and uptake of the DHI among SAs. Not making assumptions and being respectful about individual choices, cultural or religious beliefs, was considered key to engaging people. Promotion by a trusted person (doctors, peers, community leaders) was perceived to help alleviate the fear of DHIs and improve uptake and usage. People from SA backgrounds are open to using DHIs, but they need to be available in their own language and be culturally appropriate. The findings will be used to adapt our CKD self-management DHI to better address the needs of those from SA backgrounds. Patients and members of the public were directly involved in the participation of the patient and public involvement and engagement (PPIE) consultations. Community engagement officers from the Centre of Ethnic Health, who were from South Asian backgrounds, were involved in the PPIE consultation, recruitment, development of a semi-structured focus group guide, and facilitation of consultation focus groups. Digital health tools are becoming an important way to help people manage long‐term health conditions because they are easy to access, cost‐effective, and can provide useful support. We developed a digital health intervention (DHI) to help people with chronic kidney disease (CKD) manage their condition and showed that it works well in a clinical trial. However, the trial included mostly similar participants, and people from underserved communities, who might benefit the most, were not well represented. This study looked at what makes it easier or harder for people from South Asian backgrounds to use DHIs. We held patient and public involvement and engagement (PPIE) consultation focus groups with 10 participants and analysed their views. The biggest barrier was language, and participants said they would be more likely to use DHIs if information was available in their own language and reflected their cultural needs. They also felt that recommendations from trusted people, such as doctors or community leaders, would help build confidence. These findings will guide changes to make our CKD DHI more inclusive.

4. Prevalence and social-structural correlates of forced moves among women living with HIV in metro vancouver, Canada.

期刊: Health & place 发表日期: 2026-Jun-28 链接: PubMed

摘要

Housing instability is a social determinant of health, with eviction being an extreme form of housing instability. There is little research on eviction among women living with HIV despite evidence that housing stability is critical for supporting the wellbeing of people living with HIV, and women in particular face gendered risks to housing stability. This study examined the associations between social-structural factors and forced moves among women living with HIV with data drawn from the Sexual Health & HIV/AIDS Longitudinal Women’s Needs Assessment, a community-based cohort study of women living with and accessing HIV care in Metro Vancouver, Canada (2014-2025). Bivariate and multivariable logistic regression models using generalized estimating equations (GEE) for repeated measures over time were used to identify associations between social-structural factors and forced moves. Adjusted odds ratios (aOR) and 95% confidence intervals (95%CI) are reported. Overall, 361 women contributed 2567 observations over the study period with 13.3% reporting a forced move (n = 48) at least once, and of these, 31.2% (n = 15) experiencing > one forced moves in the study period. In multivariable logistic regression using GEE with multiple imputation, reporting marginalized and minoritized gender identities (adjusted Odds Ratio (aOR): 2.31, 95% Confidence Interval (95%CI): [1.13-4.72]) and being not formally employed (aOR: 7.18, 95%CI: [1.72-29.97] remained significantly associated with forced move (p < 0.05). Interventions are recommended to address forced moves, including legal protections against discriminatory evictions as well as creation of affordable and/or supportive housing including gender-responsive designs, tailoring interventions with and for women living with HIV.

5. Harm reduction vending machines: An opportunity to bridge the resource access gap in non-urban communities.

期刊: Health & place 发表日期: 2026-Jun-28 链接: PubMed

摘要

Overdose mortality in the U.S. remains high. Widespread availability of naloxone and other risk reduction materials can decrease fatal overdose risk and other drug use related harms, yet barriers to supply access remain. Harm reduction vending machines (HRVMs) may offer a solution, yet the intervention has not been scaled up within the US. In this study, we interview people who use drugs (PWUD) representing urban, suburban, and rural communities in the state of Maryland to examine naloxone access and attitudes towards HRVMs. In-depth interviews (N = 22) were conducted with PWUD from high-density urban, suburban, and rural areas within Maryland between April and November 2023. Eligibility included being 18 or older, having used opioids in the past three months, and recently responding to an overdose with naloxone. Participants were asked about naloxone access and perspectives on HRVMs. Thematic analysis was engaged to characterize attitudes and examine differences by urbanicity. Naloxone access differed among participants based upon urbanicity: those in suburban and rural settings reported access barriers, while those in the urban setting did not. Most participants were in favor of HRVMs, though some expressed concerns. Participants identified suggestions for HRVM contents, ideal placement, and oversight. This study adds to the emerging literature on HRVM implementation within the US. We suggest intentional placement of HRVMs in Maryland, particularly within rural and suburban communities facing known harm reduction access barriers. Near universal support among participants suggests that HRVMs may be a highly feasible and acceptable intervention, particularly within areas of mixed urbanicity.

6. Injury incidence in NCAA women's sports during 2019/20-2021/22: findings from injury surveillance during the COVID-19 pandemic.

期刊: Research in sports medicine (Print) 发表日期: 2026-Jun-28 链接: PubMed

摘要

National Collegiate Athletic Association (NCAA) women’s sport programs feature elite-level athletes operating under high-performance demands. We describe the epidemiology of injuries in NCAA women’s sports during 2019/20-2021/22. We characterized injury frequencies and distributions by sport, event type, body part, diagnosis, and mechanism of injury. Using a Bayesian negative binomial modeling framework, we estimated injury incidence rates and evaluated differential incidence across sport, event type, NCAA division, and academic year. A total of 10,417 injuries were reported across the study period; injuries to the lower leg and foot accounted for 29.6% of all injuries. The posterior mean overall injury rate was 5.2 per 1,000 AEs (95% CrI: [4.7, 5.3]), and overall injury incidence was estimated to be highest in gymnastics (posterior mean rate = 7.9; 95% CrI: [3.8, 14.1]). Our results indicate that the nature of injuries sustained by NCAA women athletes remains tethered to sport-specific gameplay dynamics.

7. [Towards the elimination of iodine deficiency in Hungary].

期刊: Orvosi hetilap 发表日期: 2026-Jun-28 链接: PubMed

摘要

In an iodine-deficient population, the consequences affect all age groups. In mild to moderate deficiency, goiter and, later in life, nodularity and thyroid dysfunction may develop. Fetal iodine insufficiency interferes with the development of the central nervous system of the fetus, resulting in lower IQ in later life. In order to eliminate iodine deficiency in Hungary, goiter screening and measurement of median urine iodine concentration in schoolchildren were introduced in recent decades, as well as promotion of access to information on the importance of conscious consumption of iodized salt and the importance of iodine-containing prenatal multivitamin use in pregnancy was initiated. An important government measure was the 2014 regulation which made the use of iodized salt mandatory in public catering. The aim of our work was to assess the iodine supply of the population in Hungary. Our laboratory is one of the accredited European centers for the measurement of urinary iodine excretion. Here we report on our recent study performed in four settlements in Eastern Hungary. Between 2018 and 2023, urinary iodine concentrations of 583 school-age children were measured to determine the current iodine supply. Results show that current iodine intake is adequate, with a median urinary iodine excretion of 202.4 µg/L (Q1: 133.5 µg/L, Q3: 317.3 µg/L). In order to ensure the current iodine intake level, continued widespread use of iodized salt, regular monitoring of iodine supply, and appropriate and continuous information of the population are necessary. With the collaboration of endocrinologists, public health experts and the entire medical community, the efforts of the past 50 years has achieved the complete elimination of iodine deficiency in Hungary. However, the consequences of iodine deficiency suffered in childhood remain present in the currently middle-aged population for decades. Orv Hetil. 2026; 167(26): 1027-1033. Bevezetés: Jódhiányos populációban annak következményei minden korosztályt érintenek. Zavart szenved a pajzsmirigyműködés, és már enyhe jódhiány esetén is strúma, magzati korban elszenvedett jódhiány esetén a központi idegrendszer fejlődésének alacsonyabb IQ-t okozó zavara léphet fel. Hazánkban az elmúlt évtizedekben a jódhiány felszámolására tett lépések között szerepelt az iskolai golyvaszűrés, majd a vizelet jódkoncentrációjának meghatározása és a lakosság figyelmének felhívása a jódozott só tudatos fogyasztására, várandósság esetén pedig a jódtartalmú terhesvitaminok alkalmazására. 2014-től rendelet írja elő a jódozott só használatát a közétkeztetésben. Célkitűzés: Munkánk célja annak felmérése volt, hogy milyen a lakosság jódellátottsága Magyarországon. Módszer: Tanszékünk laboratóriuma európai szinten akkreditált a vizeletjód-ürítés meghatározására. Kutatócsoportunk négy kelet-magyarországi településen végzett populációs vizsgálatot 2018 és 2023 között 583 iskoláskorú gyermek körében annak megállapítására, hogy milyen a jódellátottság jelenleg ebben a régióban. Eredmények: A vizsgálat alapján a jódellátottság megfelelőnek bizonyult, a vizeletjód-ürítés mediánja 202,4 µg/l (Q1: 133,5 µg/l, Q3: 317,3 µg/l) volt. Megbeszélés és következtetés: Ahhoz, hogy ez továbbra is így maradjon, a jódozott só folyamatos, széles körű használatára, a jódellátottság rendszeres monitorozására, valamint a lakosság megfelelő és folyamatos tájékoztatására van szükség. Az endokrinológusok, a népegészségügyi szakemberek és a hazai orvostársadalom összefogásával az elmúlt 50 év munkájával napjainkra sikerült felszámolni Magyarországon a jódhiányt, de a középkorú lakosságot a korábban elszenvedett jódhiány következményei még évtizedekig elkísérik. Orv Hetil. 2026; 167(26): 1027–1033.

8. Innovative webinar-based training to support evidence-to-recommendation decision-making by national immunization technical advisory groups: multi-country experience with hexavalent vaccines.

期刊: Vaccine 发表日期: 2026-Jun-28 链接: PubMed

摘要

Since endorsement of the Global Vaccine Action Plan, and continued emphasis under Immunization Agenda 2030, the number of functional National Immunization Technical Advisory Groups (NITAGs) has expanded rapidly, creating increased demand for training in evidence-informed decision making. To support timely national policy decisions relating to immunization, innovative and flexible training approaches are needed. This paper describes and evaluates a novel, webinar-based Evidence-to-Recommendation (EtR) training designed to support NITAGs in developing evidence-based recommendations for transitioning from pentavalent plus inactivated polio vaccine to combined hexavalent vaccines. Between January and June 2025, a five-part EtR webinar series focused on the hexavalent vaccine transition was delivered to countries, primarily within the WHO African Region, who qualify to receive financial and technical support from Gavi, the Vaccine Alliance, to help introduce new vaccines and strengthen their immunization systems. The series emphasized identification of evidence across EtR domains, and a cohort-based model to facilitate regional peer learning. Effectiveness of the webinar series was assessed through electronic post-webinar surveys and virtual key informant interviews. NITAGs from 32 countries participated in one or more webinars, including nine in three or more. Across participating countries, participants consistently rated the webinars as useful, particularly valuing country experiences and practical guidance on EtR domains. Qualitative feedback highlighted peer learning as the most valuable component of the webinar series, alongside practice guidance on EtR domains such as feasibility and resource considerations, and NITAGs showed strong interest in continued technical support, practical, peer-to-peer learning or “twinning”, and operational guidance for hexavalent vaccine introduction.

9. Under-vaccination as a systems failure: A Monte Carlo simulation of the 2025 CDC/ACIP hepatitis B birth-dose policy shift and multi-level intervention packages, 2025-2035.

期刊: Vaccine 发表日期: 2026-Jun-28 链接: PubMed

摘要

In 2025, the CDC/ACIP reclassified the hepatitis B (HBV) birth-dose recommendation from universal vaccination to a shared clinical decision-making (SCDM) model. U.S. adult HBV vaccination rates remain stagnant at 30-32%, reflecting systemic delivery failures. The projected impact of this policy shift and whether multi-level interventions can protect vulnerable populations remains unquantified. We developed a Monte Carlo simulation (N = 50,000 iterations) projecting U.S. vaccination outcomes from 2025 to 2035 across five scenarios: (A) policy-only; (B) hospital standing orders; (C) EHR-driven clinic workflow optimization; (D) community health worker (CHW) outreach; and (E) a comprehensive multi-level intervention. Parameters derived from published surveillance data, clinical trials, and implementation studies. Primary outcomes included birth-dose coverage, adult series completion, perinatal infections, and chronic HBV cases. Under Policy-Only (Scenario A), birth-dose coverage fell from 91.8% to 75.7% by Year 10, yielding 19,306 perinatal HBV infections (95% CrI: 15,851-24,279) and 17,376 chronic cases. The comprehensive intervention (Scenario E) maintained birth-dose coverage at 89.7% (95% CrI: 80.3-97.0%) and adult vaccination at 95.0% by Year 10, reducing perinatal infections to 1952 (95% CrI: 729-3869)-equivalent to 10.4 million additional adult vaccinations over Policy-Only. Maternal screening sensitivity was the strongest predictor of perinatal outcomes (r = -0.909). The 2025 SCDM policy, absent structural safeguards, is projected to reduce perinatal HBV protection and widen health disparities over the next decade. A comprehensive multi-level intervention-combining standing orders, EHR-driven workflows, and CHW outreach-is necessary to offset projected harm. Policy revision alone is insufficient; protecting vulnerable populations requires fundamental redesign of healthcare delivery.

10. Co-Creating an Intervention to Prevent Injuries in Police Force Recruits: A Concept Mapping Study of Police Force Recruits, Police Force Staff, Health Professionals, and Research Experts.

期刊: Sports medicine - open 发表日期: 2026-Jun-28 链接: PubMed

摘要

Police force recruits have a high musculoskeletal injury burden, which results in a substantial economic burden and can lead to attrition. The objective of this study was to identify and prioritise the strategies perceived as important and feasible to reduce the prevalence, incidence, and burden of injury in police force recruits. Mixed-methods concept mapping study. Forty-eight participants were recruited from four broad groups: police force recruits/officers; police force staff; health professionals; and research experts. Participants brainstormed statements in response to a prompt (“To prevent injury and/or reduce the impact of injury on law enforcement recruit training, I think it’s important to….”) before sorting and rating the statements/strategies for importance and feasibility. Descriptive statistics, multi-dimensional scaling, hierarchical cluster analysis, pattern matching and Welch’s t-tests were applied. Ninety-six unique prevention strategies were identified (42 were above the grand mean for both importance and feasibility). Eight clusters appropriately represented all statements. From highest to lowest mean cluster importance these were: i) clearly communicate physical training program expectations and requirements; ii) prepare for, monitor and manage physical training load; iii) provide best practice injury identification, prevention and management; iv) educate recruits, staff and other stakeholders involved in academy training delivery; v) provide a supportive training environment that promotes health, wellbeing and injury reporting; vi) have experienced staff deliver training and use appropriate equipment; vii) deliver a comprehensive and holistic physical training program; and viii) have appropriate physical entry standards and requirements. We identified 42 strategies above the grand means for both importance and feasibility to reduce the burden of injury in police force recruits. These strategies can be implemented by recruits, staff delivering the training program, and/ or staff managing or governing the training program. Future research should refine how these strategies can be implemented in practice and policy.

11. Subjective energy poverty and attitudes on climate change mitigation measures: Empirical and ethical considerations.

期刊: Ambio 发表日期: 2026-Jun-28 链接: PubMed

摘要

Objective energy poverty-commonly defined using indicators such as the relationship between energy costs, income, and energy required for adequate living-has been widely studied, yet less is known about how subjective energy poverty shapes attitudes toward climate change mitigation measures. This study examines theoretical and empirical links between subjective energy poverty and support for climate measures, including fossil fuel taxation and two climate nudges. We argue that “leaving behind” harm arises from subjective energy poverty independently of objective conditions, whereas economic harms from climate nudges are more likely among individuals experiencing only objective energy poverty. Empirically, we analyze nationally representative Finnish survey data from 2023 (n = 5909) using ordered probit regression. Results show that higher subjective energy poverty is associated with lower support for climate measures. The findings highlight the importance of addressing energy poverty in designing and communicating climate policy.

12. Content validity, face validity and comprehensiveness of generic quality-of-life measures in adults and children with rare genetic conditions and their carers: a think aloud qualitative study.

期刊: Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation 发表日期: 2026-Jun-28 链接: PubMed

摘要

This study aims to assess the content validity, face validity and comprehensiveness of the: (a) EQ-5D-5L, EQ-HWB, and ASCOT SCT4, for adults with rare genetic conditions; (b) the EQ-5D-5L, EQ-HWB, and ASCOT-carer for carers of adults or children with rare genetic conditions; and (c) the EQ-5D-Y-5L carer proxy-complete for children with rare genetic conditions. In total, 60 qualitative think-aloud interviews were conducted in Australia and England to understand individuals’ thought process during the completion of the QoL measures. Participants were subsequently led through a semi-structured discussion. Transcripts were analysed for whether participants demonstrated understanding of the measures and thematic analysis was conducted on responses to the semi-structured discussion. The majority of participants showed good understanding and supported the validity of the measures for people experiencing rare conditions. For carers, however, a broader evaluative space than health-related QoL was preferred. Several non-health domains were identified as important to both patients and carers, including treatment availability, impact on employment and finance, information and uncertainty, medication and carer burden, impact of passing on a condition, relationships and social connection, and experience with the healthcare system. This study provides some support for the face validity and comprehensiveness of the measures for people experiencing rare conditions. However, several participants felt that the narrow health domains were inadequate to capture the breadth of their lived experience. Future research should explore the extent to which the measures capture differences and changes in the QoL domains identified as important to patients and carers.

13. Explaining inequalities in quality of life: a longitudinal study of health disparities in Norway.

期刊: Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation 发表日期: 2026-Jun-28 链接: PubMed

摘要

Studies of health inequalities often examine the association between a single health indicator and a single socioeconomic indicator. Recent research has increasingly explored social disparities in self-reported quality of life. However, most evidences are based on cross-sectional survey and the role of health behaviours is frequently overlooked in these analyses. This study aims to integrate broader sets of socioeconomic and behavioural variables to better explain health disparities that emerge in later adulthood. Using longitudinal data from the Norwegian population-based Tromsø Study, we followed 11,313 adults aged 25-54 at baseline over 21 years. A series of self-reported outcomes were studied, particularly EQ-5D-5L values, EQ-VAS scores, and Self-Rated Health. Predictors included three socioeconomic indicators (childhood living standard, own and spouse’s educational attainment) and three health behaviours (smoking, physical activity, obesity). Shapley value decompositions were used to quantify each predictor’s contribution to explained variance. For all three health outcomes, health behaviours accounted for the majority of the explained variance compared to socioeconomic factors: 80% for EQ-5D-5L, 75% for EQ VAS, and 67% for Self-Rated Health. When adjusting for differences in baseline health, the relative importance of health behaviours increased slightly. This study underscores the critical role of health behaviours in explaining inequalities in quality of life, providing new insights into the mechanisms driving these disparities. While preventing childhood deprivation would have significant impact on adult health, potential health benefits of promoting healthy behaviours are substantial. Both types of policy interventions could thereby contribute to reducing health inequalities.

14. Invisible in the Storm: Climate Change and the Lived Realities of Transmasculine People in India.

期刊: Health promotion practice 发表日期: 2026-Jun-28 链接: PubMed

摘要

Climate change is increasingly recognized as a public health issue that exacerbates existing social and structural inequities. While growing attention has been paid to gendered impacts of climate-related hazards, transgender populations remain largely absent from climate research, policy, and practice, especially in low- and middle-income country contexts. This article introduces Invisible in the Storm: Climate Change and the Lived Realities of Transmasculine People in India, a community-led and produced health promotion resource developed by Transmen Collective, India’s first national organization dedicated to transmasculine rights and well-being. Based on a mixed-method, survey-based study conducted with transmasculine participants across multiple regions of India, the report documents how climate events such as heatwaves, floods, and water scarcity intersect with gender identity, health care and resource access, and mental and emotional well-being. Quantitative findings highlighted exposure to climate stressors and disruptions to essential resources, while qualitative narratives illuminated how climate stress is embodied through constraints on gender expression and experiences of discrimination. Together, these findings reveal how climate change amplifies existing inequities and how the needs of the transgender community are rendered invisible in climate planning and responses. Positioned as a community-led health promotion resource, Invisible in the Storm offers insights for practitioners, organizations, and policymakers across climate, disaster, and public health sectors, highlighting the urgent need to integrate gender-diverse perspectives into climate responses. The report also underscores the importance of integrating lived experience into climate responses and demonstrates the value of gender-inclusive approaches to advance climate justice and health equity.

15. The relationship between parent eco-anxiety and child depression/anxiety and the mediating role of child hopelessness.

期刊: Acta psychologica 发表日期: 2026-Jun-28 链接: PubMed

摘要

Emerging perspectives suggest that parental eco-anxiety may influence youth mental health. Building on this framework and established models linking parental distress to child internalizing symptoms, this study examined associations between parental eco-anxiety and children’s depression and anxiety, as well as the mediating role of hopelessness. A cross-sectional study included 175 parent-adolescent dyads recruited from a general pediatrics outpatient clinic. Parents completed a measure of eco-anxiety, and children completed measures of hopelessness, depression, and anxiety. Correlational analyses and structural equation modeling with bootstrapping assessed direct and indirect pathways. Parental eco-anxiety was significantly associated with child depression, anxiety, and hopelessness after adjustment for sociodemographic variables (all p < .001). Mediation analyses showed that child hopelessness significantly mediated the associations between parental eco-anxiety and child depression (B = 0.124, 95% CI [0.065, 0.194]) and child anxiety (B = 0.172, 95% CI [0.084, 0.290]). Subdimension-based analyses further indicated that the behavioral symptoms component of eco-anxiety was significantly associated with child hopelessness (B = 0.661, p = .002) and with indirect associations with both child depression (B = 0.361, 95% CI [0.138, 0.668]) and child anxiety (B = 0.507, 95% CI [0.174, 1.001]). Our findings indicate that parental eco-anxiety is associated with children’s depression and anxiety through a pathway involving child hopelessness, with the behavioral symptoms component of eco-anxiety playing a key role. These preliminary results highlight parental eco-anxiety and child hopelessness as relevant targets for preventive approaches to youth internalizing symptoms in the context of the climate crisis.

16. Calcineurin-Dependent Stress Adaptation Enables Caspofungin Heteroresistance Leading to Stable Resistance in Candida Glabrata.

期刊: Advanced science (Weinheim, Baden-Wurttemberg, Germany) 发表日期: 2026-Jun-28 链接: PubMed

摘要

Antifungal heteroresistance has emerged as a clinical challenge across diverse species. In Candida glabrata, however, it has rarely been reported. Here, we characterized heteroresistance in a multicenter collection of 156 C. glabrata isolates, revealing a 25% prevalence with caspofungin specificity and 37°C dependent phenotypes. Transcriptomic profiling of the heteroresistant subpopulation under escalating drug pressure revealed an adaptive program centered on cell cycle and cell wall integrity, including several members of the calcineurin pathway. Mechanically, we identified that the phenotype was abolished by pharmacological inhibition or Δcnb1, Δcrz1 genetic deletion, confirming the regulatory role of calcineurin. Crucially, heteroresistance functioned as a reservoir for resistance, with in vitro descendant strains spanning a spectrum of MIC alterations. Mechanistically, we found the heteroresistance phenotype mostly independent of aneuploidy. To decipher the genetic basis, we applied an unbiased machine-learning framework to genomic data, which not only identified the canonical FKS2_F659del mutation but also prioritized novel candidate PIR2_G149_I167del, demonstrating its power to uncover drivers of resistance from complex datasets. In summary, our study established a stepwise model of heteroresistance in C. glabrata, wherein calcineurin serves as a master regulator that promotes a resistance reservoir, revealing a potential vulnerability that could be exploited to prevent treatment failure.

17. RSVpreF: A Vaccine for the Respiratory Syncytial Virus.

期刊: The Annals of pharmacotherapy 发表日期: 2026-Jun-28 链接: PubMed

摘要

This article reviews data encompassing the pharmacology, efficacy, and safety of RSVpreF (Abrysvo®), a subunit vaccine approved to prevent respiratory syncytial virus (RSV) in adults aged ≥60 years, infants via maternal transfer of antibodies, and adults aged 18 to 59 at increased risk of severe disease, including immunocompromised populations. A literature review was conducted in PubMed, MEDLINE, National Institutes of Health Clinical Trials Registry, and ClinicalTrials.gov from inception through May 2026, using the search terms Abrysvo, RSVpreF, RSV vaccine, and respiratory syncytial virus. Articles from reference lists were included to identify potentially relevant literature. Guidance documents, including Food and Drug Administration (FDA) briefing documents, package inserts, and recommendations from Advisory Committee on Immunization Practices were included. Data were limited to human clinical studies published in the English language, which evaluated the efficacy, immunogenicity, and safety of RSVpreF. Eight studies are included describing RSVpreF, consisting of 1 phase I, 2 phase II, 4 phase III, and 1 phase IV clinical study.Relevance to Patient Care and Clinical Practice in Comparison to Existing Agents:To protect vulnerable infants, maternal immunization is recommended as a single dose between 32 and 36 weeks of gestation, typically from September through January. Current clinical guidance recommends vaccination for all adults aged ≥75, and those aged 60 to 74 with one or more risk factors for severe RSV disease. RSVpreF provides protection against RSV for older adults, high-risk/immunocompromised populations, and infants via maternal transfer. RSVpreF effectively reduces the incidence of severe lower respiratory tract infections, bronchiolitis, and hospitalizations.

18. Life in the Driver's Seat: A Qualitative Analysis of Rideshare Drivers' Perspectives of Their Work and Well-Being Using Reddit Posts.

期刊: American journal of industrial medicine 发表日期: 2026-Jun-28 链接: PubMed

摘要

Rideshare driving has become a common occupation within the emerging gig and platform economies. Despite offering a high degree of scheduling flexibility, rideshare driving provides little employment stability, an unstable income, and minimal employment benefits. This precarity, combined with the use of algorithmic labor management to guide drivers’ actions, has garnered attention for its potential impacts on these workers’ health. To examine rideshare drivers’ perspectives of their work and its implications for their well-being, this exploratory study examined posts (n = 1034) to the digital platform Reddit in the year 2024 using thematic analysis. Themes indicated that workers experience financial precarity but also appreciate the flexibility of rideshare driving. Drivers are also aware of the algorithms that guide their work and, at times, feel that these prevent them from increasing their earnings. Drivers posted about experiences with passengers-both positive and negative-while also discussing the mental stressors of ride sharing and concerns about their physical safety on the job. These findings underscore the varied experiences rideshare drivers encounter in their workplace, while highlighting potential implications for their physical and mental well-being. Understanding these first-hand accounts may inform efforts to improve the well-being of platform-based workers.

19. Natural plant colourants used for hair dye applications and phytochemical profile by LC-MS/MS analysis.

期刊: Natural product research 发表日期: 2026-Jun-28 链接: PubMed

摘要

This study explores plant extracts’ potential as natural hair dye colourants, emphasising its eco-friendly advantages and antioxidant qualities. DPPH tests, reducing power, and phenolic and flavonoid content analysis were used to assess antioxidant activity. The LC-MS/MS analysis revealed the highest concentration of tannic acids in Juglans regia L. extract. Quinic acid, protocatecchuic acid, and quercetin were identified in the majority of extracts. Protocatecchuic acid was most abundant, especially in Allium cepa L. extract (220.14 mg/g DW). The greatest phenolic content (684.5 µg GAE/mg) and DPPH scavenging activity (78%-93% inhibition) were found in onion peel. Oxalic acid was added to dye compositions containing these extracts to boost colour intensity and wash fastness; CIEL ab values verified the better outcomes. The findings suggest that plant-based dyes, with their strong antioxidant properties, provide an effective, safe, and sustainable alternative to synthetic dyes, delivering vibrant colours while supporting hair health and environmental sustainability.

20. Functionalized SiO2 nanoparticle-mediated release and transport of Cd through soil porous media: implications for their application in soil remediation.

期刊: Environmental geochemistry and health 发表日期: 2026-Jun-28 链接: PubMed

摘要

Silica-based nanomaterials have shown promise for remediating heavy metal-contaminated soils. However, their remediation stability may be compromised by natural and anthropogenic activities such as rainfall and irrigation. This work systematically investigates the leaching behavior of Cd from soils amended with unmodified SiO2 and thiol-functionalized SiO2 (SH-SiO2) nanoparticles, along with nanoparticle-mediated Cd release and transport through soil porous media. The results demonstrated that the leaching concentrations of Cd2+ from the soil remediated by SH-SiO2 were the least and followed the order of SH-SiO2 < SiO2 ≈ control (untreated Cd-contaminated soil) under simulated acid rain conditions (pH 5.6). This confirms that thiol-functionalized silica effectively immobilizes Cd due to its strong chelating ability. However, co-transport experiments revealed that both SiO2 and SH-SiO2 nanoparticles could act as carriers that enhanced Cd2+ transport, governed by their Cd-binding capacity and intrinsic mobility over a pH range of 5.0-8.0, with greater facilitation at higher pH levels. Notably, SH-SiO2 exhibited a much stronger facilitation effect, attributable to its higher affinity for Cd2+, greater mobility in porous media, and resistance to desorption of SH-SiO2-bound Cd2+. At a nanoparticle concentration of 50 mg/L, the maximum breakthrough of Cd2+ reached 10.1% for SiO2 and 75.2% for SH-SiO2. While SH-SiO2 demonstrates excellent Cd immobilization capacity and acid-rain resistance, any disturbance that remobilizes these nanoparticles may facilitate the mobility of Cd2+, potentially expanding the scope of heavy metal contamination. Therefore, when applying remediation agents for soil rehabilitation, it is crucial to consider their long-term effectiveness and stability.

21. Assessing the impact of polycyclic aromatic hydrocarbon exposure on liver cancer using network toxicology and molecular docking.

期刊: Molecular diversity 发表日期: 2026-Jun-28 链接: PubMed

摘要

Liver hepatocellular carcinoma (LIHC) remains a critical health challenge with limited treatments. This study employed network toxicology and molecular docking to investigate how polycyclic aromatic hydrocarbons (PAHs), as environmental carcinogens, promote LIHC. By analyzing TCGA LIHC data and screening genes via the Comparative Toxicogenomics Database, 1,817 key PAH-LIHC-related genes were identified. Enrichment analyses revealed associated biological pathways, and a protein-protein interaction network pinpointed 321 MCODE-derived functional module genes. A prognostic risk model based on 14 model genes was developed, demonstrating high accuracy in predicting 1 year survival for LIHC patients. Immune infiltration analysis showed distinct profiles between high- and low-risk groups. Molecular docking showed favorable docking scores and potential binding conformations of PAHs to key genes (ANXA5, LOX, HSP90AA1). Among these, the ANXA5-805-PAH complex was further subjected to a 50 ns molecular dynamics simulation to describe its short-term dynamic behavior. The results provide exploratory computational clues for PAH-related candidate targets, but further confirmation is required through rigorous docking protocol validation, repeated simulations, and experimental studies. This research provides a PAH-related prognostic model and elucidates molecular mechanisms of environmental toxin-driven liver cancer.

22. Enhancing chlorpyrifos degradation and plant growth through biochar-assisted microbial remediation.

期刊: Biodegradation 发表日期: 2026-Jun-28 链接: PubMed

摘要

The extensive use of chlorpyrifos (CPF) in agriculture has led to persistent soil contamination, posing serious risks to environmental and human health. Developing sustainable, in situ remediation strategies is therefore a priority. This study evaluated an integrated plant-microbe-biochar system for the remediation of CPF-contaminated soils. Indigenous CPF-degrading bacteria were isolated from agricultural soils and screened for degradation efficiency in mineral salts medium (MSM) and soil microcosms. The most efficient isolate, designated C78, was identified by 16S rRNA gene sequencing as Klebsiella pneumoniae. In MSM supplemented with 200 mg/L CPF, K. pneumoniae C78 degraded > 80% of the pesticide within 72 h. The strain also exhibited multiple plant growth-promoting traits, including indole-3-acetic acid production, phosphate solubilization, and ammonia production, and retained these functions in the presence of CPF. Soil microcosm and pot experiments were conducted using Ricinus communis L. grown in soils spiked with CPF (100 and 200 mg/kg), with and without biochar amendment and bacterial inoculation. Inoculation with K. pneumoniae C78 significantly accelerated CPF dissipation compared with non-inoculated controls, and the combined treatment with biochar further enhanced degradation, leading to near-complete CPF removal within 21 days. GC-MS/MS analysis showed no accumulation of common toxic intermediates such as 3,5,6-trichloro-2-pyridinol (TCP) or DETP/TMP. Biochar amendment improved soil conditions and supported higher microbial activity, while plant-microbe interactions in the rhizosphere promoted seed germination, seedling vigor, biomass production, chlorophyll content, and protein levels under CPF stress. Overall, the results demonstrate that integrating CPF-degrading K. pneumoniae C78 with R. communis L. and biochar amendment constitutes a promising, eco-compatible strategy for enhancing CPF degradation and restoring the productivity of contaminated agricultural soils.

23. Association Between Mental Health of Patients with Work-Related Injury and Their Compensation Claim Status: Exploratory Findings from the IMPRovE Trial.

期刊: Journal of occupational rehabilitation 发表日期: 2026-Jun-28 链接: PubMed

摘要

Workers’ compensation claims processes may exacerbate mental health symptoms for individuals with work-related mental health conditions (WR-MHCs). This study examined associations between mental health outcomes and contemporaneous claim status. Data of this cohort study were drawn from 153 general practice patients with WR-MHCs providing 422 observations, enrolled in the IMPRovE trial across Australia. Workers’ compensation claim status (accepted, rejected, being assessed, or no claim), working status, and mental health outcomes (Depression Anxiety Stress Scale-21 (DASS-21) and Short-form health survey) were assessed via 3-monthly surveys. Mixed-effects linear regression models were used to assess the relationship between claim status and outcomes, adjusting for intervention status, working status, time-point, state, clinic size, location, age, and gender. On the DASS-21, patients with a claim application being assessed reported significantly poorer overall mental health outcomes than those with accepted claims (e.g. stress: β = 5.73, 95% CI 1.69-9.77), rejected claims (e.g. depression: β = 5.88, 95% CI 1.12-10.63), or no claim (e.g. overall mental health: β = 6.14, 95% CI 2.87-9.42). No significant differences were found between patients with accepted, rejected, or no claim. In this cohort, poorer mental health outcomes were observed amongst individuals with work-related mental health conditions whose workers’ compensation claims were being assessed, compared with other claim statuses. No differences were observed between accepted, rejected, or no-claim groups. These findings indicate that the adjudication phase of the claims process may be particularly challenging for some individuals and warrant targeted clinical and system-level attention. Further research is needed to establish causality and design interventions that can address causal mechanisms.

24. Postsurgical Opioid Prescribing Among Injured Workers in Washington State: 2017-2020 Trends and Policy Effects.

期刊: American journal of industrial medicine 发表日期: 2026-Jun-28 链接: PubMed

摘要

The widespread adoption of longer duration opioid prescribing for acute pain management following surgeries has coincided with concerning increases in misuse, dependence, and overdose. We evaluated the impact of voluntary opioid prescribing guidelines and concurrent state pharmacy rules on prescribing trends following surgeries for work-related injuries. We analyzed claims data for surgical and postoperative care in the Washington State workers’ compensation system, linked with prescription drug monitoring program data, from 2017 to 2020. We evaluated whether rates of long-duration opioid prescribing (> 14 opioid days) or persistent opioid prescribing (3-6 months post-surgery) decreased after the implementation of Washington State’s postsurgical opioid prescribing guidelines and pharmacy rules (2018-2019), using an interrupted time-series analysis, stratified by surgical severity. Prior to policy implementation, longer duration opioid prescribing was declining at a rate of 0.52 percentage points per month, on average, among all surgeries. Following the promulgation of guidelines and rules, this decline slowed significantly to 0.14 percentage points monthly (slope change: +0.38 percentage points; 95% CI: 0.11, 0.65). Similar decelerations were observed across surgical severity types. Persistent opioid use following surgery remained steady, around 6.8%. Overall declines in longer duration opioid prescribing continued steadily after policy implementation, however, Washington State’s postsurgical opioid prescribing guidelines and rules were associated with a modest slowing of pre-existing downward trends in longer duration opioid prescribing, counter to expectations. These findings suggest that voluntary guidelines may have had limited impact. More robust implementation strategies may be needed to further reduce longer duration postsurgical opioid prescribing patterns in a workers’ compensation setting.

25. Clarithromycin Resistance Patterns of Helicobacter pylori across Different Gastric Diseases in Uzbekistan.

期刊: Journal of gastrointestinal and liver diseases : JGLD 发表日期: 2026-Jun-27 链接: PubMed

摘要

Helicobacter pylori (H. pylori) eradication is crucial for gastric cancer (GC) prevention. However, increasing clarithromycin (CLR) resistance (CLRR) poses significant challenges. This study aimed to investigate CLRR patterns across different gastric diseases in Uzbekistan. We retrospectively analyzed 279 H. pylori-infected patients with chronic non-atrophic gastritis (CNAG), chronic atrophic gastritis (CAG), gastric ulcer (GU), mucosa-associated lymphoid tissue lymphoma (MALT-L), or GC between 2020-2022. Among 194 cagA-positive patients who received eradication therapy, CLRR was defined by 23S rRNA mutations (A2142G, A2142C, A2143G) or treatment failure with CLR-based regimens. Logistic regression identified factors associated with CLRR, evaluated by univariate and multivariate analysis, and predicted probability models were generated based on disease type and patient characteristics. The overall CLRR rate was 44.8% (87/194), with 41.2% showing genotypic resistance. CLRR rates increased with disease severity: CNAG (33.3%), CAG (31.7%), GU (59.3%), MALT-L (54.1%), and GC (69.6%). Multivariate analysis identified older age (OR=2.27, 95%CI: 1.05-5.10), GU (OR=2.65, 95%CI: 1.04-6.96), and GC (OR=3.73, 95%CI: 1.34-11.2) as independent CLRR predictors. Disease-specific patterns emerged: GU and GC showed positive associations between age / body mass index and CLRR probability, while MALT-L demonstrated inverse relationships. High CLRR rates in Uzbekistan correlate with gastric disease severity. The disease-specific CLRR probability patterns identified in our study provide a practical framework for optimizing empirical therapy selection when comprehensive resistance testing is unavailable.

26. A Pilot Real-life Study Opioid Induced Constipation in Neoplastic Patients Admitted to Internal Medicine Ward. Outcome of Naldemedine Therapy According to Available Guidelines.

期刊: Journal of gastrointestinal and liver diseases : JGLD 发表日期: 2026-Jun-27 链接: PubMed

摘要

The use of opioids has expanded significantly worldwide in patients with cancer-related pain. Therefore, opioid-induced constipation (OIC) is emerging as one of the most frequent and distressing gastrointestinal side effects. Despite the high prevalence, OIC is frequently underdiagnosed and inadequately managed, with critical effects on the quality of life of patients. The present study assessed the real-life prevalence of opioid use and OIC in 316 consecutive cancer patients hospitalized in an Internal Medicine ward and evaluated the outcomes following PEG or naldemedine during hospitalization. When OIC was diagnosed (Rome IV criteria), all patients underwent polyethylene glycol (PEG). Naldemedine was subsequently administered in refractory OIC. A total of 82 patients (26% of admissions) were assuming opioids for cancer pain, with constipation diagnosed in 62% and 24% of patients with or without opioid treatment, respectively. The risk of OIC was higher during combined opioids than in monotherapy, and fentanyl was associated with the highest OIC prevalence. Among patients with OIC, 47% responded to polyethylene glycol (PEG), whereas 52.9% started naldemedine 200 micrograms/day for a refractory OIC, with subsequent improvement in 59.3% of cases. The prevalence of opioid use and OIC is relevant among hospitalized cancer patients. The systematic adoption of standardized diagnostic tools can improve recognition and the clinical management in patients with OIC, in particular in case of refractory OIC. It is essential to increase awareness on this condition and to implement management pathways based on existing guidelines.

27. Clinical, Metabolic, and Virological Insights into Hepatitis C Virus-Infected Patients through the Combinatorial Metabolic Dysfunction-associated Steatotic Liver Disease Framework: Evidence from an Italian Cohort.

期刊: Journal of gastrointestinal and liver diseases : JGLD 发表日期: 2026-Jun-27 链接: PubMed

摘要

Metabolic dysfunction-associated steatotic liver disease (MASLD) frequently overlaps with hepatitis C virus (HCV) infection, yet the recently proposed combinatorial MASLD (cMASLD) classification remains poorly characterized in this setting. This study aimed to evaluate the prevalence, metabolic profile, and virological determinants of cMASLD in an Italian cohort of HCV-infected patients. We conducted a cross-sectional study on 169 HCV-infected patients evaluated at two referral Centers in Southern Italy (between 2020 and 2024). All subjects underwent transient elastography, and cMASLD was diagnosed according to international guidelines. Group comparisons were performed using ANOVA or Kruskal-Wallis tests with appropriate post-hoc analyses, categorical variables by Chi-square or Fisher’s exact test, and multivariate logistic regression to identify factors independently associated with cMASLD (p<0.05). Among 169 patients, n=52 (31%) fulfilled cMASLD criteria, n=14 (8%) had HCV with liver steatosis, and n=103 (61%) had HCV infection alone. Compared with other groups, cMASLD patients showed higher body mass index (28±8 kg/m²; p<0.001), larger waist circumference (p<0.001), increased controlled attenuation parameter (298±41 dB/m; p<0.001), and higher fasting insulin (p=0.029). HCV RNA levels were significantly elevated in the cMASLD group (p=0.014). Multivariate logistic regression identified HCV RNA as independently associated with cMASLD (OR=1.48; 95%CI: 1.01-2.17; p=0.045). Applying the cMASLD nomenclature emphasizes the need for a multidisciplinary management approach integrating antiviral and metabolic care. This classification provides a more comprehensive understanding of liver injury mechanisms in patients with overlapping metabolic and viral etiologies.

28. Bowel Urgency in Inflammatory Bowel Disease: Prevalence, Psychosocial Burden, and Challenges in Assessment.

期刊: Journal of gastrointestinal and liver diseases : JGLD 发表日期: 2026-Jun-27 链接: PubMed

摘要

Bowel urgency (BU) is a highly prevalent and distressing symptom in inflammatory bowel disease (IBD), yet its assessment remains inconsistent and insufficiently standardized. Although recent clinical trials and emerging guidelines increasingly recognize its clinical relevance, no standardized, multidimensional instrument specifically designed to assess BU has been established. This narrative review synthesizes current evidence on the prevalence, clinical and psychosocial burden, prognostic role, and measurement of BU. It outlines key priorities for developing a BU-specific patient-reported outcome (PRO). BU is reported by 30-98% of patients and frequently persists despite clinical or endoscopic remission. BU is independently associated with higher risks of hospitalization, corticosteroid use, colectomy, and disease relapse. Reported psychosocial effects included anxiety, avoidance behaviours, reduced physical activity, decreased work productivity, and impaired health-related quality of life. Existing assessment tools do not fully capture the complexity of BU: traditional disease activity indices overlook urgency, numeric rating scales assess severity alone, and behavioral measures focus on secondary coping strategies. Evidence from trials of JAK inhibitors, S1P modulators, and IL-23 inhibitors supports BU as a sensitive and early marker of treatment response. In conclusion, BU is a prevalent, burdensome, and prognostically relevant symptom in IBD. Current assessment instruments are limited and fail to encompass the emotional, behavioral, and functional dimensions of BU. A multidimensional BU-specific PRO is needed to enhance clinical evaluation, support patient-centered care, and refine outcome assessment in therapeutic trials.

29. Sodium-Glucose Cotransporter-2 Inhibitors Are Associated with Improved Survival in Patients with Cirrhosis.

期刊: Journal of gastrointestinal and liver diseases : JGLD 发表日期: 2026-Jun-27 链接: PubMed

摘要

Sodium-glucose cotransporter-2 inhibitors (SGLT2i) may have favorable hepatic effects, but long-term outcomes in cirrhosis are uncertain. We investigated the relationship between SGLT2i exposure and 5-year outcomes among adults with cirrhosis. We performed a retrospective cohort study in the TriNetX US Collaborative Network (March 2013- January 2025). Adults (≥18 years) with cirrhosis were classified as SGLT2i users (first exposure on/after cirrhosis diagnosis) or non-users (no SGLT2i exposure) and propensity score matched 1:1. Outcomes were assessed over 5 years beginning 1 day after index. Primary outcomes were all-cause mortality and hospitalization burden (inpatient encounters per patient). Secondary outcomes included hepatic decompensation complications and prespecified adverse events; tertiary outcomes were the most recent liver- and kidney-related laboratory values during follow-up. After matching, 24,559 patients were included per cohort. SGLT2i use was associated with lower all-cause mortality (11.8% vs 26.0%; OR=0.381, 95%CI: 0.363-0.399; p<0.001) and fewer hospitalizations (mean 3.6±10.7 vs 5.4±13.4; p<0.001). Composite hepatic decompensation was less frequent (OR=0.617, 95%CI: 0.580-0.656; p<0.001), including lower odds of ascites, spontaneous bacterial peritonitis, and hepatorenal syndrome; hepatic encephalopathy did not differ. Acute kidney failure and urinary tract infection were less frequent, while diabetic ketoacidosis did not differ. Laboratory profiles favored SGLT2i use (lower aspartate aminotransferase and bilirubin, higher albumin, lower international normalized ratio, and improved renal indices). In this matched real-world cohort, SGLT2i exposure after cirrhosis diagnosis was associated with an improved 5-year survival, fewer hospitalizations, and fewer decompensation events.

30. Romanian National Study on the Epidemiology of Inflammatory Bowel Diseases.

期刊: Journal of gastrointestinal and liver diseases : JGLD 发表日期: 2026-Jun-27 链接: PubMed

摘要

Inflammatory bowel diseases (IBD), including Crohn’s disease (CD), ulcerative colitis (UC), and IBD-unclassified (IBD-U), are increasingly recognized across Eastern Europe, including Romania, where historical data indicated low incidence. Contemporary real-time epidemiological data for our country are scarce. This study evaluated the short-term frequency and epidemiological characteristics of IBD patients presenting to major Romanian gastroenterology centers. We conducted a prospective, cross-sectional observational study over a 14-day period in November 2024 across 18 university-affiliated tertiary gastroenterology clinical sites in Romania. All consecutive adult patients with confirmed IBD were enrolled using a centralized online platform. Demographics, disease type and phenotype, severity, and treatment were recorded and analyzed descriptively. A total of 1,045 patients were registered: 52.4% CD, 46.9% UC, and 0.7% IBD-U. Geographical distribution revealed a statistically significant variation, with Crohn’s disease being more frequent in Southern Romania, while UC predominated in the Eastern and Central-western regions (p=0.0009). Most patients resided in urban areas, and the majority were in clinical remission at presentation. Phenotypic analysis revealed ileocolonic CD (L3) and left-sided/pancolitis UC (E2/E3) as most frequent. Severe disease history was more common in CD, and prior surgery was significantly higher in CD than UC. Smoking and appendectomy were more frequently associated with CD as previously reported. Therapeutic patterns reflected disease type: anti-TNF use predominated in CD, while other biologics and small molecules were more common in UC. Regional differences in therapy were observed, with southern centers showing higher use of novel therapies, likely reflecting a more mature IBD population, with a higher CD prevalence. Notably, the number of IBD diagnoses increased over time, correlating with Romania’s GDP growth (R² = 0.89, p < 0.001), suggesting that socioeconomic factors may influence disease recognition and diagnosis. This study offers the most recent snapshot of IBD epidemiology in Romania, highlighting a transition toward medium-incidence patterns and growing clinical complexity. These findings provide evidence for the need to establish nationwide population-based surveillance systems and healthcare planning initiatives aimed at mitigating the rising burden of IBD.

31. Early twice-daily toothbrushing and adolescent dental caries: a causal inference analysis using the Longitudinal Study of Australian Children.

期刊: BMC oral health 发表日期: 2026-Jun-27 链接: PubMed

摘要

Dental caries is a highly prevalent chronic childhood condition, yet longitudinal evidence linking early oral hygiene behaviours to long-term outcomes remains limited. This study estimated whether twice-daily toothbrushing at age 2-3 years was associated with lower incident dental caries through adolescence, under a target trial emulation framework. Data were from the Longitudinal Study of Australian Children (LSAC) B-cohort (N = 5,107). Children with caries at or before Wave 2 (age 2-3) were excluded, yielding an incident sample of 2,970. Associations were estimated using multivariable logistic regression, propensity score matching, inverse probability of treatment weighting (IPTW), targeted maximum likelihood estimation (TMLE), and g-computation. The outcome was carer-reported dental caries. Confounders were identified via directed acyclic graph (DAG) analysis. Effect modification by area-level socioeconomic position (SEP) was assessed through a pre-specified equity analysis. Among 2,941 children in the analytic sample, 1,559 (53.0%) developed carer-reported caries by age 14-15. Caries incidence was lower among children who brushed twice daily: 660 of 1,359 (48.6%) versus 899 of 1,582 (56.8%) in the less frequent group. The primary adjusted odds ratio (aOR) was 0.73 (95% CI: 0.63-0.85, p < 0.001). A dose-response gradient was observed (p-trend < 0.001). Effect estimates were similar across analytical approaches (OR range: 0.72-0.75). In non-disadvantaged areas, protective associations were observed (aOR = 0.65, 95% CI: 0.54-0.79). In disadvantaged areas, the association was weaker and not statistically significant (aOR = 0.91, 95% CI: 0.71-1.17; interaction p = 0.035). An exploratory falsification analysis using dental pain yielded a null result (aOR = 1.06, 95% CI: 0.91-1.23, p = 0.47), but this outcome was interpreted cautiously because dental pain may lie downstream of caries. Twice-daily toothbrushing by age 2-3 years was associated with a lower risk of incident adolescent caries. Estimates from multiple causal inference approaches were consistent with an absolute risk reduction of approximately 8% points (NNT ≈ 13), under assumptions of no unmeasured confounding, adequate positivity, and correct model specification. Protective associations appeared concentrated in non-disadvantaged areas, suggesting that oral hygiene promotion should be combined with broader preventive strategies addressing structural determinants of oral health.

32. Perceived professional preparedness of final-year nursing students in Iran: a cross-sectional study.

期刊: BMC nursing 发表日期: 2026-Jun-27 链接: PubMed

摘要

Final-year nursing students are expected to acquire sufficient competencies to ensure a safe transition into clinical practice. Perceived professional preparedness (PPPNS) is a critical determinant of their ability to assume professional roles. Evidence on this topic in Iran is limited; therefore, this study aimed to assess PPPNS among final-year nursing students and to identify associated factors. A descriptive-analytical cross-sectional study was conducted among 305 final-year nursing students from medical universities across Iran. Data were collected online using a demographic information form and the Perceived Professional Preparedness of Senior Nursing Students Questionnaire. Statistical analyses were performed using SPSS version 24. The overall mean score of professional preparedness was at a good level. Nursing students from Tehran-based universities demonstrated significantly higher preparedness scores compared with those from other institutions (p-value < 0.0001). In addition, higher academic grade point averages were positively correlated with greater professional preparedness (p-value < 0.05) after adjusting for age and gender. Iranian final-year nursing students reported good levels of PPP. Strengthening educational strategies outside Tehran and promoting students’ academic performance may further enhance their readiness for professional practice.

33. Sacred choices and willing hearts: exploring spiritual beliefs in body donation - a cross-sectional study of Nigerian medical and allied health students.

期刊: BMC medical ethics 发表日期: 2026-Jun-27 链接: PubMed

摘要

The link between spirituality and body donation is an important consideration, especially in Nigeria, where there is currently no formal body bequest program for medical education and research purposes. This study delved into students’ spiritual perspectives, gauging their impact on their willingness to donate their bodies for educational or research purposes. This cross-sectional study assessed 1158 Nigerian medical and allied health students who have been exposed to cadaver dissection via an online questionnaire developed from interviews and the Spirituality Orientation Inventory, which included questions on spiritual beliefs, willingness, and reasons for body donation. Descriptive analysis and chi-squared tests were used to decide proportions and relationships between the study variables, with statistical significance set at p < 0.05. About students’ familiarity and attitudes towards body donation, 15.2% were unfamiliar with the concept. In terms of their stance, 35.23% expressed support for body donation, while nearly half, 49.49%, remained neutral on the subject. Most students (63.65%) refused to consider body donation after death. Only a few respondents (17.62%) were open to donating for education or research or if they would benefit from it (10.49%). More than half (56.24%) agreed that they followed their religion’s teachings. 76.37% believed in life after death, 40% were uncertain about reincarnation while 54.28% were unaware of their religion’s stance on body donation. However, belief in reincarnation is significantly associated with students’ willingness to donate their bodies (p = 0.026). Awareness of body donation among Nigerian medical students is low, with many expressing neutral attitudes and limited understanding of their religion’s stance. Willingness to donate is generally poor, and while spirituality plays a role, specific beliefs such as reincarnation appear more influential than overall religiosity. These findings highlight the need for targeted education and culturally sensitive awareness initiatives.

34. Aetiology, survival time and mortality predictors among early neonates at two tertiary hospitals of Lusaka, Zambia.

期刊: BMC pregnancy and childbirth 发表日期: 2026-Jun-27 链接: PubMed

摘要

Over 2.3 million neonatal deaths occurred globally in 2022, representing 1 in 58 newborns, with neonatal deaths of about 6,300 every day. Of these, 73% died in the early neonatal period and one third within 24 h. Despite the 47% globally neonatal deaths decline from 2000 to 2015, Zambia’s perinatal and neonatal mortality rates have remained high at 33 and 27 per 1000 total births, respectively. This study aimed to determine the aetiology of early neonatal deaths and to analyse survival time and mortality predictors among normal and low birthweight early neonates in the neonatal intensive care units at two tertiary hospitals of Lusaka, Zambia. A prospective cohort study was conducted involving neonatal deaths that occurred in the neonatal intensive care units at the Women Newborn Hospital (WNH) and Levy Mwanawasa Teaching Hospital (LMUTH) tertiary hospitals of Lusaka, Zambia from September 1, 2023 to January 30, 2024. Data were analysed using SPSS Version 30. Associations with death were studied using Chi square and Fischer’s exact tests. Descriptive statistics were used to summarise frequency distributions, and cox proportional hazard regression to analyze predictors of early neonatal deaths and survival time. Among the 404 participants, prematurity, sepsis, birth asphyxia and congenital anomalies were notable causes of death. A total of 62 neonates (42.5%) died within the first 30 min of admission, while 224 (58.8%) died within 1.5 h of arrival. Predictors of shorter neonatal survivor included maternal age > 35 AHR 5.70 (95% CI: 1.41-23.10, p < 0.015), foetal seizures AHR 1.81 (95% CI: 1.33-2.46, p < 0.0001), ANC booking had strong association with birthweight (p = 0.001) but was not in the adjusted model. and Rhesus negative 10 (2.5%) AHR 4.48 (95% CI: 1.58-12.70, p < 0.005). Low birthweight babies had AHR 1.95 (1.33-2.86, p < 0.001), walking and use of public transport to hospital had AHR 4.99 (95% CI: 1.07-23.28, p < 0.041) and 4.24 (95% CI: 1.10-16.36, p < 0.036), respectively and foetal anomalies AHR 2.48 (95% CI: 1.25-4.94, p < 0.010). Almost 60% of early neonatal deaths occurred within 1.5 h of admission, with the majority (42%) having been within 30 min. Major causes of death included prematurity, sepsis, birth asphyxia, and congenital anomalies. Predictors to shorter survival time highlight critical areas that need attention. There is need to strengthen health promotion on the importance of early antenatal booking. This will enhance early detection of disease, targeted interventions to manage of high-risk pregnancies and access to comprehensive emergency obstetrics and neonatal care sites.

35. Psychophysiological restoration in nature: a randomized controlled trial investigating the cognitive, affective, and physiological benefits of green exercise.

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

摘要

The escalating pace of urbanization has made chronic stress and attentional fatigue significant public health challenges. This study employed a randomized controlled trial ([Formula: see text]) to investigate the psychophysiological restorative effects of a standardized 30-minute walk in an urban forest environment (Outdoor Green) compared to a laboratory setting (Indoor Control). Cognitive function was assessed via the Digit Span Task, affective states were evaluated using the Profile of Mood States (POMS) and self-esteem measures, and physiological stress responses were objectively quantified through salivary cortisol and heart rate variability (HRV-RMSSD). Results indicated that the Outdoor Green group exhibited significantly greater improvements in directed attention ([Formula: see text]) and total mood disturbance ([Formula: see text]) compared to the Indoor Control group. Physiologically, the outdoor group showed a more pronounced reduction in salivary cortisol (interaction [Formula: see text]) and a greater increase in parasympathetic activity (HRV-RMSSD, interaction [Formula: see text]). Furthermore, mediation analysis revealed that the alleviation of negative affective states partially mediated the relationship between environmental exposure and cognitive restoration. These findings demonstrate that green exercise exerts synergistic benefits across cognitive, affective, and physiological domains, providing robust evidence for nature-based interventions as effective strategies for mental health promotion.

36. Study on the adoption intention of the cognitive impairment screening mini program based on TAM and TPB models.

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

摘要

With growing attention to cognitive impairment screening, digital screening tools have become an important approach for early detection and intervention. However, considerable uncertainty remains regarding users’ acceptance of such mini programs, particularly among middle-aged and older adults. Based on the Technology Acceptance Model (TAM) and the Theory of Planned Behavior (TPB), this study developed an extended model to investigate the key factors influencing users’ intention to adopt a cognitive impairment screening mini program. The extended model incorporated perceived usefulness (PU), perceived ease of use (PEOU), attitude (ATT), trust (TRU), subjective norm (SN), perceived behavioral control (PBC), and perceived privacy risk(PVR), and was empirically tested using structural equation model (SEM). The analysis of 610 valid questionnaires showed that PU was significantly and positively associated with ATT, while PEOU significantly and positively predicted PU. Both TRU and ATT were significantly and positively associated with users’ behavioral intention (BI). In addition, SN and PBC had significant indirect effects on BI through ATT and TRU. PVR was significantly and negatively associated with both TRU and ATT, and also had a negative indirect effect on BI. These findings offer practical implications for the design, privacy management, and promotion of digital health tools, particularly the cognitive impairment screening mini programs.

37. Dentists' perceived barriers to implementing preventive actions in dental practice: a qualitative study of professional and structural influences.

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

摘要

Oral diseases remain a major public health challenge in Mexico. Despite the proven effectiveness of preventive measures, dentists do not consistently implement them in clinical practice. Understanding the factors underlying this gap is essential to strengthening prevention-oriented care. To identify perceived barriers to implementing preventive actions in dental practice. A qualitative study based on grounded theory was conducted using focus groups. Twenty-seven dental professionals from urban, semi-urban, and rural settings in Mexico participated in five virtual sessions. Data were recorded, transcribed, and analyzed using thematic coding. Barriers to implementing preventive actions in dental practice were grouped into three categories: patient-related (lack of preventive habits, misinformation, financial constraints, fear of dental visits); dentist-related (biomedical training, professional prestige linked to complex procedures, financial incentives, and time constraints); and structural (limited institutional support, unequal service distribution, and poor integration of oral health into health policies). A subgroup of dentists reported consistent implementation of preventive actions, characterized by a biopsychosocial approach, stronger communication skills, and a health promotion-oriented professional identity. Cultural, professional, and structural factors interact to shape the implementation of prevention in dental practice in Mexico. Strengthening communication skills, reorienting dental education toward prevention, and enhancing institutional support may facilitate the integration of preventive actions into routine care. Understanding multilevel barriers to prevention may help dentists integrate preventive actions into routine care by strengthening communication strategies, addressing patient expectations, and adapting clinical decision-making to social and structural contexts.

38. Moral distress among physicians and nursing staff in surgical settings: a comparative study.

期刊: BMC health services research 发表日期: 2026-Jun-27 链接: PubMed

摘要

Moral distress is a relevant occupational health issue in hospital settings, particularly in high-complexity environments such as surgical units, where organizational constraints, ethical dilemmas, and interprofessional dynamics shape professionals’ experiences. Comparative evidence is needed to understand how moral distress manifests across professional groups working within the same clinical context. This cross-sectional comparative study examined moral distress among physicians and nursing staff working in surgical settings at a public university hospital in southern Brazil. Data were collected from 245 healthcare professionals (167 physicians and 78 nursing staff) using the Brazilian Moral Distress Scale - Short Version (EDME-BR-VR). Group differences in moral distress dimensions were assessed using descriptive statistics and Mann-Whitney U tests. Comparative structural analyses were conducted using Partial Least Squares Structural Equation Modeling (PLS-SEM), with separate models estimated for each professional group to examine similarities and differences in structural relationships. Significant differences between physicians and nursing staff were observed in selected moral distress dimensions, particularly Safe and Qualified Care, Defense of Values and Rights, and Working Conditions. Across both groups, Recognition, Power, and Professional Identity emerged as a central antecedent of moral distress, showing significant associations with teamwork, working conditions, safe and qualified care, and ethical violations. Comparative PLS-SEM results indicated similar overall relational patterns across groups, with differences in the magnitude of specific structural paths reflecting profession-specific dynamics. Moral distress among physicians and nursing staff in surgical settings is shaped by shared organizational factors as well as profession-specific ethical pressures. Comparative analysis highlights the central role of professional recognition and identity while underscoring the need for differentiated organizational strategies to address moral distress across professional groups. These findings provide actionable insights for healthcare managers seeking to promote ethical practice, psychological safety, and sustainable work environments in surgical care.

39. Structural color-based microneedle patch with NIR-triggered on-demand drug release for intelligent treatment of infected wounds.

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

摘要

Bacterial-infected wounds present a critical clinical challenge due to persistent inflammation, impaired angiogenesis, and the lack of real-time treatment monitoring. To address these issues, we developed an innovative colloidal crystal hydrogel microneedle (CT MNs) patch based on CuS nanoparticles (CuS NPs) and tannic acid-berberine nanoparticles (TB NPs). This system integrates synergistic antibacterial/antioxidant therapy with structural color-based drug release self-reporting capability. Specifically, the CT MNs combine photothermal CuS NPs for near‑infrared (NIR)-triggered hyperthermia and temperature‑controlled drug release, the release of TB NPs for potent antibacterial/antioxidant activities, and the color changes of the inverse opal colloidal crystal for real‑time monitoring of drug release. In vitro assays demonstrated strong antibacterial effects (95.65% and 95.92% against E. coli and S. aureus, respectively) and outstanding ROS‑scavenging capacity (92.93% for DPPH and 97.36% for ABTS⁺). In infected rat models, the CT MNs + NIR group achieved rapid wound closure (94.41% by day 10), significantly outperforming the controls. This accelerated healing was attributed to the synergistic effects of photothermal ablation, TB NPs-mediated bacterial clearance, and ROS-scavenging-driven inflammation alleviation. Therefore, this work presents a theranostic dressing that merges targeted combination therapy with non‑invasive optical monitoring of drug release, offering a promising strategy for intelligent wound management.

40. Delusional parasitosis with shared psychotic features secondary to vitamin B12 deficiency and mild cognitive impairment: a case report.

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

摘要

Visual illusions are misperceptions of real external stimuli and, when persistent, may indicate underlying neurological or metabolic disorders. Delusional parasitosis is characterized by a fixed belief of infestation without medical evidence and may occur secondary to medical conditions. However, the relationship between visual illusion-related perceptual abnormalities and delusion formation, particularly in reversible metabolic states such as vitamin B12 deficiency, remains unclear. An 80-year-old man presented with a persistent belief that mites infested his body and environment. His delusion was preceded by misinterpretation of real stimuli, including lint and skin debris, consistent with visual illusions. Cognitive assessment indicated mild cognitive impairment. His wife gradually came to share his delusional beliefs. Laboratory findings revealed marked vitamin B12 deficiency. Brain perfusion imaging demonstrated hypoperfusion in the medial occipital and parietal association cortices. Treatment with low-dose quetiapine and mecobalamin resulted in rapid resolution of visual illusions and subsequent disappearance of delusional parasitosis. Quetiapine was discontinued without relapse, and follow-up imaging showed improvement in cerebral perfusion. The wife’s shared beliefs resolved following clinical improvement and separation. This case suggests that visual illusions due to reversible metabolic disturbances may precipitate delusional parasitosis in cognitively vulnerable individuals and highlights the importance of evaluating all suspected patients and closely associated individuals.

41. Co-exposure to environmental lead and hypertension exacerbates anxiety and depression via mtDNA-mediated cGAS phase separation.

期刊: Environmental pollution (Barking, Essex : 1987) 发表日期: 2026-Jun-27 链接: PubMed

摘要

Environmental exposure to heavy metals such as lead (Pb) and the growing prevalence of hypertension (HTN) represent significant and often coexisting global health threats. However, the combined neurotoxic effects of Pb and HTN, particularly in terms of mood disorders such as anxiety and depression, remain poorly understood. Herein, using a combined exposure model, we found co-exposure to Pb and HTN markedly aggravates anxiety- and depression-like behaviors in mice compared with Pb and HTN exposure alone. The prefrontal cortex was identified as the most vulnerable brain region, with astrocytes as the most susceptible cell type to senescence. Notably, treatment with dasatinib and quercetin, a senolytic regimen that selectively eliminates senescent cells, significantly alleviated the behavioral deficits induced by Pb and HTN co-exposure. Further investigation revealed Pb and angiotensin II (AngII) co-exposure promoted phase separation of cyclic GMP-AMP synthase (cGAS), a key DNA sensor. Pharmacological disruption of biomolecular condensates with 1,6-hexanediol (1,6-HD) partially rescued astrocyte senescence induced by Pb and AngII co-exposure. Inhibition of mitochondrial DNA (mtDNA) replication with ethidium bromide (EtBr) markedly reduced cytosolic mtDNA accumulation caused by co-exposure, suppressed cGAS phase separation, and downregulated the expression of senescence-associated proteins including P16, P211, γH2AX, and SASP. These findings uncover a previously unrecognized role of mtDNA-dependent cGAS phase separation in driving astrocyte senescence and environment-related neuropsychiatric dysfunction, and highlight cGAS phase separation as a promising therapeutic target for preventing anxiety and depression in individuals simultaneously exposed to Pb and HTN.

42. Dyslipidaemia state modifies the association of urinary heavy metals with all-cause mortality: Findings from the NHANES and GEHAS cohorts.

期刊: Ecotoxicology and environmental safety 发表日期: 2026-Jun-27 链接: PubMed

摘要

Heavy metals persist in global populations, yet their independent and combined effects on all-cause mortality remain inconclusive. The potential moderating role of dyslipidaemia on these associations has not been systematically evaluated. We analysed data from two cohorts-GEHAS (2018-2019) and NHANES (2003-2016)-and measured urinary metal and lipid profiles at baseline. Dyslipidaemia was defined per international standards. Mortality was confirmed via the National Death Index. Cox regression was used to assess the associations between heavy metals and mortality, and restricted cubic spline (RCS) regression was used to evaluate nonlinearities. Interactions between metals and dyslipidaemia were analysed multiplicatively and additively. The quantile-based G-computation (QGComp) method was used to evaluate the combined effects of metal mixtures. The baseline metal distributions differed between the cohorts; thallium was inversely related to mortality in both cohorts (GEHAS: HR = 0.56, 95%CI: 0.36 - 0.88); NHANES: HR = 0.08, 95%CI: 0.02 - 0.34). Arsenic was correlated positively with mortality only in the GEHAS (HR = 1.72, 95%CI: 1.08 - 2.75). In the NHANES, elevated cadmium (HR = 3.35, 95%CI: 2.44 - 4.61), molybdenum (HR = 1.22, 95%CI: 1.00 - 1.48), antimony (HR = 2.64, 95%CI: 1.03 - 6.77), and cobalt (HR = 1.56, 95%CI: 1.21 - 2.01) concentrations increased mortality risk. Dyslipidaemia significantly influenced the association between heavy metals and all-cause mortality across both cohorts, In the GEHAS study, the association between Pb and all-cause mortality was influenced by dyslipidemia status, shifting from a positive linear relationship (HR = 4.22, 95%CI: 1.38 - 12.86) to a non-linear association (P-nonlinear = 0.042). In the dyslipidaemia cohort of the NHANES study, Co exhibited a linear relationship with mortality (P-overall = 0.034), whereas Tl, U, and W demonstrated non-linear associations with mortality (P-nonlinear < 0.05); these relationships were not observed in the Individuals without dyslipidaemia. Metal exposure significantly increased the all-cause mortality risk in both study cohorts. Furthermore, dyslipidaemia exerts a modulatory effect on heavy metal toxicity, specifically influencing the mode of action of lead (Pb) in the GEHAS cohort and amplifying the risk intensity of cobalt (Co), thallium (Tl), uranium (U), and tungsten (W) in the NHANES cohort. Subsequent research should focus on elucidating the underlying pathophysiological pathways.

43. Genetic discrimination in workplace, insurance industry and legal system: A review.

期刊: Legal medicine (Tokyo, Japan) 发表日期: 2026-Jun-26 链接: PubMed

摘要

Unfair treatment of a person based on specific genetic characteristics is generally called genetic discrimination (GD). GD is a large-scale issue, as it is commonly perceived as such in many different contexts (e.g., work environment, insurance industry, legal system). Many entities that are often not directly connected to healthcare have lawful access to large amounts of genetic information, and the individual right to control access to and use of them or even to request their erasure must be balanced with other public and private interests. Given the complexity of the issue, in this paper we review the main regulatory and medico-legal aspects connected to GD, with specific regard to the main contexts where it is present. Two independent reviewers (SG and AC) conducted a narrative review using PubMed, Google Scholar, and the Genetic Discrimination Observatory (GDO). Boolean search combined “genetic information” AND “genetic discrimination” with (“regulation” OR “law” OR “insurance” OR “right to be forgotten” OR “right to erasure” OR “employment” OR “workplace” OR “justice system” OR “antisocial behavior”). Inclusion criteria comprised: (1) full-text articles available in English; (2) publications between January 1, 2001, and December 31, 2025; (3) studies addressing GD or relevant legal frameworks. Exclusion criteria comprised duplicate records, studies not primarily focused on GD, irrelevant publications, unavailable full texts, and non-English articles. G7 countries were prioritized. the results of our review were divided into different paragraphs, following the main aspects/contexts of GD: national and supranational regulations against GD; right to be forgotten; GD in the insurance industry; GD in the workplace; GD in criminal justice. Our review showed a significant international variability in addressing this issue, with legal approaches that vary from relatively static to highly dynamic. Some hot topics, like right to be forgotten, are inadequately or not addressed in most countries, with individual rights in specific contexts that struggle to be regulated. While in insurance industry variable trade-offs between individual and industry interests have been proposed, concerns about GD in workplaces and legal system (with specific reference to behavioral genetics) require a strict and codified regulation and a sound scientific basis to justify lawful and ethical use of genetic information in these contexts. Indeed, in these contexts, unforeseen negative consequences (different from the intended use) for the person who freely gave access to his/her genetic data represent the main hazard. These consequences tend to mainly concern the same economic/social minorities that are already exposed to a high risk of unequal social/employment/legal treatment.

44. A policy analysis of the three-month waiting period for new and returning residents to access provincial health insurance in Ontario, Canada.

期刊: Health policy (Amsterdam, Netherlands) 发表日期: 2026-Jun-25 链接: PubMed

摘要

Ontario’s three-month waiting period (Regulation 552, subsection 5 (1) for health insurance eligibility under the Ontario Health Insurance Plan (OHIP) was implemented in 1994 amidst a severe economic recession. Justified by legislators as a cost-saving measure, the policy has affected newcomers during a vulnerable resettlement period. This analysis examines the policy and political factors underpinning both the policy’s implementation in 1994 and temporary suspension during the Covid-19 pandemic in 2020. This is a descriptive health policy analysis using the 3i + E framework. We conducted an environmental scan to identify and analyze publicly available documents related to the policy under study. The implementation of the waiting period policy reflected a complex interplay of institutional developments, including permissive federal regulations, jurisdictional fragmentation, and a legacy of provincial autonomy. Politically, it targeted a marginal group with limited electoral influence, serving as a low-cost, symbolic measure to signal fiscal discipline. Public discourses of fairness, moral deservingness, and economic nationalism framed the exclusion as acceptable. The policy endured due to institutional inertia and path dependence. In contrast, the temporary suspension in 2020 was driven by a shift in public health priorities, stakeholder convergence, and an ideational reframing of health as a collective good. The policy illustrates how exclusionary health policies are not only fiscal decisions but also reflect deeper institutional structures and dominant political narratives. While the pandemic opened a rare window for reform, the policy’s entrenchment underscores the need for structural change, including stronger federal enforcement of equity-based health access.

45. Joint associations between gestational environmental chemical mixtures and child behavioral outcomes.

期刊: Environment international 发表日期: 2026-Jun-25 链接: PubMed

摘要

Gestational exposure to environmental chemicals contributes to adverse neurodevelopmental outcomes in children. We aim to evaluate the joint associations between gestational chemical biomarkers and behavioral functioning in preschool-aged children. We pooled data from 695 mother-child dyads (female, n = 353; male, n = 342) enrolled in the Health Outcomes and Measures of the Environment (HOME) & Maternal-Infant Research on Environmental Chemicals (MIREC) Studies. We assessed concentrations of 29 EDC biomarkers at gestation and assessed the child’s behavior and executive functioning at 3 years using the Behavioral Assessment System for Children (BASC-2) and Behavior Rating Inventory of Executive Function-Preschool Version (BRIEF-P). Higher scores on these instruments indicate adverse behavioral outcomes. We applied quantile g-computation to estimate joint associations, adjusting for covariates. Every quartile increase in chemical biomarker mixture was associated with a 0.84-point higher behavior symptom index score (95% CI: -0.89, 2.57), 1.38-point higher externalizing behavior score (95% CI: -0.65, 3.41), and 1.34-point higher internalizing behavior score (95%CI: -0.97, 3.65); these associations were imprecise with confidence intervals including null. Although the interaction by child sex remained null (p = 0.69) for internalizing behavior scores, gestational chemical mixture was associated with higher internalizing behavior scores in males (Ψ: 3.59; 95%CI: 0.42, 6.75), but not in females. We found evidence of sex-specific trends for working memory scores (interaction p = 0.02), with an imprecise positive trend in males (Ψ: 3.04; 95%CI: -0.46, 6.55) and a negative trend in females. Gestational exposure to a mixture of environmental chemicals showed suggestive but imprecise associations with internalizing problems and poorer working memory among preschool-age males, but not females. Associations were more pronounced in the HOME Study, which includes participants with higher concentrations for many chemical biomarkers, than in MIREC, raising the possibility that pooled estimates reflect cohort-specific exposure contexts. Sex-specific patterns, particularly for working memory, need further investigation, and our findings should be interpreted cautiously given the imprecision of subgroup estimates.

46. Growing up with ADHD: findings from an 18-year longitudinal follow-up study of adults with childhood ADHD, their siblings, and controls.

期刊: Psychiatry research 发表日期: 2026-Jun-24 链接: PubMed

摘要

The prevalent childhood-onset disorder attention-deficit/hyperactivity disorder (ADHD) (5-7%) poses risks for adult functioning, which should be identified with long-term prospective follow-up studies including a broad range of outcomes. Differences in outcomes (measures of psychiatric status, behavioural/emotional problems, academic/professional functioning, adaptive functioning, neurocognition, physical health, healthcare service use) were investigated in an 18-year follow-up study of adults with childhood ADHD (n=154, M±SD age=27.4±3.7, 68% males), their siblings without childhood ADHD (n=138, M±SD age=29.6±4.4, 35% males), and controls (n=129, M±SD age=28.2±3.5, 40% males). Post-hoc tests investigated whether observed differences between the ADHD group and controls may be driven by a current ADHD diagnosis, by comparing persistent ADHD, remitted ADHD, and control groups. Childhood ADHD was related to worse functioning in adulthood on >60% of outcomes across all domains with small to large-sized effects (e.g., moderate/large differences in increased rates of ADHD and depression, externalizing problems, autistic traits, and worse neurocognitive outcomes). Siblings showed comparable functioning to controls. Persistent ADHD showed worse functioning on specific outcomes in the psychiatric, behavioural/emotional, adaptive, and physical health domains, as compared to remitted ADHD. Both ADHD groups had worse functioning compared to controls. Childhood ADHD increased the risk for worse functioning in adulthood. Siblings of the childhood ADHD group were not at risk for adverse outcomes. The current study identifies childhood ADHD as a risk condition for poorer long-term functioning, although substantial heterogeneity in outcomes across groups was noted. Heterogeneity within the childhood ADHD group seemed partly attributable to a current ADHD diagnosis.

47. Exposure to SVOCs in bedrooms and their associations with oxidative stress and neurotransmitter levels in children from North China.

期刊: Environment international 发表日期: 2026-Jun-24 链接: PubMed

摘要

Semi-volatile organic compounds (SVOCs) are significant contributors to adverse health effects, yet information regarding bedroom SVOCs, their contributions to body burden in children, and associations with health biomarkers is lacking. This study analyzed nearly 1,000 SVOCs in 47 paired bedroom air and dust samples collected in Dalian and Linyi, China, along with 12 phthalate metabolites and 3 biomarkers (malondialdehyde, 8-hydroxydeoxyguanosine, and serotonin) in urine samples collected from child residents. In bedroom environments, 99 SVOCs were identified in air and 141 in dust. The total concentrations of SVOCs ranged from 1.23 to 84.6 μg/m3 in air and from 142 to 4350 μg/g in dust, with phthalates accounting for more than 34.4 % on average. Concentrations of dimethyl phthalate, di-isobutyl phthalate, and di-n-butyl phthalate in bedroom air were significantly associated with their corresponding urinary metabolites. The median contributions of these compounds via bedroom air exposure ranged from 6.96 % to 23.4 % of children’s body burden. Multiple linear regression analyses showed that six SVOCs in bedroom environments were significantly associated with serotonin or malondialdehyde levels, with four compounds originating from bedroom air. These findings highlight the non-negligible role of SVOCs from bedroom air in children’s body burden, as well as in alterations of oxidative stress and neurotransmitter levels. Overall, the results call for targeted interventions on bedroom air quality to address child health risks associated with SVOC exposure.

48. Source-specific nitrate and nitrite intake and bladder cancer: findings from the Danish Diet, Cancer and Health Cohort.

期刊: Environment international 发表日期: 2026-Jun-23 链接: PubMed

摘要

Nitrate and nitrite, present in ground and drinking water, as well as foods, may contribute to bladder cancer through the formation of carcinogenic N-nitrosamines. However, risk likely depends on both the source and endogenous nitrosating factors. Among participants of the Danish Diet, Cancer, and Health Cohort (N = 54,610) with no history of cancer, source-specific nitrate and nitrite intakes (drinking water, plant sources, naturally occurring animal sources, and additive-permitted meat sources) were estimated from national water monitoring data and food frequency questionnaires using food databases. Bladder cancer cases were ascertained through the Danish Cancer Registry. Multivariable-adjusted Cox proportional hazards models were used to examine associations, and analyses were stratified by established bladder cancer risk factors and factors hypothesized to influence endogenous N-nitrosamine formation to explore potential effect modification. During 27 years of follow-up, 1,058 bladder cancer cases were identified. No associations were observed for nitrate intake [HRlog (95% CI) per doubling of intake (mg/d): drinking water: 0.88 (0.73, 1.08), plant sources: 0.91 (0.74, 1.12), naturally occurring animal sources: 0.83 (0.67, 1.02), additive permitted meat sources 1.06 (0.84, 1.32)]. Similar estimates were observed for source-specific nitrite intakes. Associations did not appear to be modified by bladder cancer risk factors or endogenous nitrosating factors. The lack of associations between nitrate and nitrite exposure and bladder cancer may reflect either a true absence of effect or exposure levels that are too low be biologically relevant for bladder carcinogenesis. Future studies in populations with higher exposure levels are warranted.

49. Exploring the influence of resilience on midwives' and student midwives' career-related decisions: Findings from a constructivist grounded theory study from the UK.

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

摘要

Many midwives experience emotional distress, low morale and job dissatisfaction, and are making the decision to leave the profession as a result. There is limited evidence on how resilience shapes midwives’ career experiences, choices, and trajectories, particularly during early exposure to workplace stress and dissatisfaction. To conduct a UK based study to explore midwives’ and student midwives’ perceptions, attitudes, and experiences of the influence of resilience in relation to any decisions they make about their careers. A constructivist grounded theory design was used to explore the influence of resilience on midwives’ and student midwives’ career-related decisions. Thirty-six participants recruited from three NHS Trusts in the North of England took part. A purposive and theoretical sampling approach using individual semi-structured interviews between 2019 and 2021 was adopted. The influence of resilience in relation to any career-related decisions participants’ made, resulted in the substantive grounded theory (GT), ‘Time to change’. ‘Time to Change’ developed comprising four core concepts: ‘Fitting in’, ‘Being valued,’ ‘Feeling in control’ and ‘Getting the balance right’. Central to the theory was the importance of confidence, experience, and perceived support on fluctuating levels of resilience, and midwives’ subsequent ability to make career-related decisions. Participants’ perceived resilience, alongside a number of other influences, has a significant role in midwives’ career-related decisions. The findings provide novel insight into the influence of resilience in midwifery that has relevance for the profession and the potential to inform midwifery policy, practice, and education for the future.

50. A community-based One Health approach to the pandemic dynamics of Escherichia coli ST131.

期刊: Antimicrobial agents and chemotherapy 发表日期: 2026-Jun-23 链接: PubMed

摘要

Large-scale genomic studies have advanced our understanding of the global dissemination of antimicrobial-resistant (AMR) bacteria, yet most have been limited by inconsistent sampling periods, heterogeneous geographic coverage, and weak epidemiological linkages among isolates. Consequently, the fine-scale processes underlying the establishment and maintenance of AMR pandemics remain unclear. To address these limitations, we established a rigorously controlled community- and household-integrated One Health framework that incorporates human, animal, and environmental reservoirs within a single urban area and unified sampling period, focusing on the pandemic fluoroquinolone-resistant (FQ-R) Escherichia coli sequence type (ST) 131. Using this model, we analyzed FQ-R E. coli isolates collected from humans, companion animals, sewage, and livestock in the Sapporo area, Japan, during 2021-2022. Among 2,358 E. coli isolates, 235 FQ-R isolates, including 88 ST131 isolates, underwent genomic analyses based on pan-, accessory-, and core genome data. These analyses revealed high clonal diversity but clear population structuring within ST131, with several subclusters shared between human and companion animal sources. High-resolution core genome SNP analysis delineated community-level transmission dynamics, demonstrating ST131 carriage among healthy humans and suggesting asymptomatic human-to-human spread and household-level human-companion animal transmission. These carriage isolates harbored multiple AMR genes and virulence factors and exhibited high genetic similarity to clinical isolates, indicating potential contributions to hospital-associated infections. Phylogenetic integration with international ST131 genomes demonstrated that transmission events in Sapporo are embedded within the broader global expansion of ST131. This study provides a scalable model for resolving local-to-global AMR dissemination and underscores the need for community- and household-level interventions within a One Health framework.

51. Ultrasensitive quantification of Hg2+ in real samples using colorimetric, fluorimetric and smartphone-based triple-mode system integrated with a new indoline-fused chromenylium-cyanine chemodosimeter.

期刊: Spectrochimica acta. Part A, Molecular and biomolecular spectroscopy 发表日期: 2026-Jun-23 链接: PubMed

摘要

Mercury is one of the most toxic heavy metal, posing severe threats to environmental safety and human health due to its persistence, bioaccumulation, and detrimental neurological and systemic effects. Therefore, the development of fast, sensitive, selective, and on-site detection methods for Hg2+ remains an urgent priority. Herein, we present a phenylthiourea-derived indoline-fused chromenylium-cyanine chemodosimeter (INIR2), engineered as a “turn-on” near-infrared (NIR) fluorescent and colorimetric probe for Hg2+ recognition. Upon coordination with Hg2+, INIR2 undergoes a specific chemical transformation that results in a distinct color change and a remarkable fluorescence enhancement in the NIR region (λem = 766 nm) within 10 s. The probe exhibited ultralow detection limits (UV-Vis: 1.13 × 10-8 M (2.27 ng/mL); fluorescence: 1.83 × 10-8 M (3.67 ng/mL)) and outstanding selectivity among a wide range of competing metal ions. INIR2 also demonstrated robust performance across diverse matrices, including environmental waters (tap, drinking and lake) and food samples (corn and rice), achieving near-quantitative recoveries. Most importantly, the analysis of Hg2+ from micromolar to nanomolar levels (LOD: 2.10 × 10-8 M) was performed using a smartphone-based RGB application among molecular turn-on probes. This method has significant potential for cost-effective and real-time monitoring of Hg2+ in the field, even at ultra-trace levels. Cellular studies confirmed low cytotoxicity and selective fluorescence activation in Hg2+-treated cells, further highlighting its bioimaging capability. These findings demonstrate that INIR2 is a highly sensitive and versatile tool for instantaneous and on-site mercury detection, with promising applications in environmental monitoring, food safety and biomedical research.

52. Evaluation of suicide statistics in Türkiye between 2015 and 2024.

期刊: Legal medicine (Tokyo, Japan) 发表日期: 2026-Jun-19 链接: PubMed

摘要

This study aims to evaluate suicide statistics from the Turkish Statistical Institute (TURKSTAT) from 2015 to 2024 in terms of demographic and sociocultural characteristics, while also providing a forensic medicine perspective through comparison with the literature. Suicide data were obtained from TURKSTAT’s “Cause of Death Statistics” database and classified according to age group, sex, marital status, educational level, cause, and method of suicide. The annual crude suicide rate in Türkiye ranged between 3.94 and 5.22 per 100,000 population, with males consistently exhibiting a substantially higher mortality risk than females (6.84 vs. 2.14). Across specific age cohorts, sex-specific suicide rates peaked among young adult males aged 25-29 (11.27) and elderly males aged over 75 (11.98), whereas the highest rate among females was observed in the 15-19 age bracket (4.76). Disease-related factors represented the leading category among specified administrative causes (peaking at 1.31), while hanging emerged as the predominant method, accounting for 47.03% of all cumulative cases. By educational attainment, the highest longitudinal suicide rates over the decade were consistently documented among individuals with lower secondary (up to 8.32) and upper secondary education (up to 7.67). These findings suggest that suicide mortality in Türkiye is associated with a complex interplay of systemic health problems, socioeconomic stressors, and distinct sociodemographic vulnerabilities rather than isolated psychiatric conditions. Consequently, integrating macro-level epidemiological insights and sociocultural dimensions into forensic medical evaluations can support the development of targeted public health interventions and evidence-based preventive policies.

53. Comparative effectiveness of oral cooling and moisturizing interventions for managing postoperative thirst in post-anesthesia care unit patients: A systematic review and network meta-analysis.

期刊: International journal of nursing studies 发表日期: 2026-Jun-15 链接: PubMed

摘要

Postoperative thirst in the post-anesthesia care unit is a common symptom that can have adverse physiological and psychological effects. Although various cooling and moisturizing interventions have been shown to alleviate postoperative thirst, their relative effectiveness remains unclear. To compare the effects of cooling and moisturizing interventions on postoperative thirst relief in patients in the post-anesthesia care unit. A systematic review and network meta-analysis. PubMed, Web of Science, CINAHL, EMBASE, and Scopus were systematically searched from inception to January 16, 2026. Two reviewers independently conducted study screening, quality assessment, and data extraction. A random-effects network meta-analysis was undertaken to compare the relative effects of oral cooling and moisturizing interventions on postoperative thirst. A total of eleven RCTs involving 3098 participants and eight oral interventions were included. The network meta-analysis showed that, compared with the nil by mouth (NPO) control group (i.e., no oral intake or oral intervention), the interventions showing the largest reductions in postoperative thirst intensity were menthol ice (MD = -4.84; 95% CI, -6.42 to -3.26), followed by ice (MD = -4.17; 95% CI, -5.82 to -2.51) and water (MD = -4.07; 95% CI, -5.36 to -2.78). In contrast, citric acid spray, aromatic solution spray, water spray, wet gauze, and wet cotton swab did not show statistically significant reductions in postoperative thirst intensity. Menthol ice, ice, and water emerged as the most promising options for reducing postoperative thirst intensity. However, the current evidence remains limited, and further high-quality studies with standardized protocols are needed to confirm these findings. https://www.crd.york.ac.uk/prospero/ CRD42024610113, registered 4/11/2024.

54. Facial iPPG heatmap patterns based on period-aware autoencoder show association with carotid atherosclerosis towards non-contact hemodynamic assessment.

期刊: Computer methods and programs in biomedicine 发表日期: 2026-Jun-09 链接: PubMed

摘要

Early identification of carotid atherosclerosis (CAS) is critical for preventing cardio-cerebrovascular diseases. Mainstream screening methods (e.g. ultrasound, CTA) are operator-dependent and high cost. This study aimed to propose a novel non-contact facial imaging photoplethysmography (iPPG) approach for CAS risk assessment. A total of 95 middle-aged and elderly participants were enrolled, with synchronous facial iPPG signals and carotid/lower-extremity ultrasound data collected. A deep learning-based Period-aware Autoencoder (PA-AE) with bidirectional cross-modal attention was developed to reconstruct high-fidelity iPPG signals with periodic peak constraint and full-face reference signal fusion for robust noise suppression. Facial hemodynamic heatmaps were generated via signal-to-spatial mapping, interquartile range-based outlier removal, and spatial proximity repair. We analyzed the association between heatmap patterns and atherosclerosis using Pearson chi-square tests and Odds Ratios (OR). The PA-AE outperformed traditional wavelet and LSTM-AE methods in signal periodicity preservation and noise reduction. The Type 3 facial iPPG heatmap (characterized by ≤ 20% red area distributed in the facial periphery) was significantly associated with carotid atherosclerosis (P=0.048), whereas no association was observed for lower extremity atherosclerosis (P=0.674). After adjusting for age, BMI, and hypertension in multivariable logistic regression, heatmap Type 3 still showed a positive trend with CAS (adjusted OR=2.29, 95%CI: 0.56-9.41), and robust statistical analyses including stratified analyses (age < 65 and non-hypertensive subgroups), ridge regression, and continuous red-area ratio quantification consistently confirmed this significant association. Facial iPPG heatmaps, enhanced by the PA-AE, demonstrate significant potential as a non-invasive tool for identifying CAS risk, offering a promising avenue for accessible community healthcare screening.

55. Flower-rich and diverse road verges support pollinators, but traffic speed limits the ecological benefits across Europe.

期刊: Ecological applications : a publication of the Ecological Society of America 发表日期: 2026-Jun 链接: PubMed

摘要

Roads are vital for human societies, yet they can also have negative impacts on the ecological communities that live in close proximity to them. Insect pollinators, which nest and forage in road verges running alongside roads, are a group of particular importance. These verges may act as an “ecological trap,” drawing insect pollinators into contact with traffic, increasing the risk of pollinator-traffic collisions. Spanning six European regions, we evaluated the complex relationships between traffic, road verge floral composition, and surrounding land use to understand how these factors influence abundance and richness of bees, butterflies, and hoverflies sampled within road verges. Across the study, we observed 10,960 pollinators belonging to 293 species of bees, butterflies, and hoverflies. We observed greater pollinator abundance in verges with higher flower cover, and greater pollinator richness in verges with more species of flowering plants. Lower abundances of bees and butterflies and lower species richness of bees were observed when traffic speed in the adjacent road was higher. This study indicates that road verges with abundant and diverse floral resources support more abundant and diverse pollinator populations, especially on verges alongside lower speed roads. We recommend that lower speed roads should be prioritized for floral enhancements.

56. Usefulness of ChatGPT in physiotherapy practice: A scoping review.

期刊: Physiotherapy 发表日期: 2026-May-22 链接: PubMed

摘要

To map the current evidence examining the use of ChatGPT within musculoskeletal (MSK) physiotherapy, with a focus on how the technology has been studied rather than on claims of effectiveness or readiness for clinical practice. A scoping review was conducted in accordance with PRISMA-ScR guidance. Electronic searches were performed in MEDLINE (via PubMed), Embase, CINAHL, PEDro and the Cochrane Library, with the most recent update conducted in November 2025. Empirical studies evaluating ChatGPT in physiotherapy-relevant or MSK rehabilitation contexts were included in this review. Included studies were mapped descriptively according to clinical task, study design, comparator, outcome domain, and interaction conditions, including prompt structure. No critical appraisal of effectiveness or safety was undertaken. Fourteen studies published between 2023 and 2025 met the inclusion criteria. Study designs, clinical tasks, comparators and outcome measures were highly heterogeneous. ChatGPT was evaluated across diagnostic, treatment, educational and informational tasks, using different types of MSK scenario or guideline-derived questions. Outcome domains included agreement with expert judgement, alignment with clinical practice guidelines, and ratings of clarity or appropriateness. No shared or standardised evaluation framework was used across studies. Apparent differences in reported agreement between diagnostic and treatment-related tasks were largely attributable to differences in task framing, reference standards, and evaluation methods rather than intrinsic model capability. The current evidence base examining ChatGPT in MSK physiotherapy is exploratory and methodologically immature. Reported accuracy or alignment metrics cannot be interpreted independently of study design and interaction conditions. Future research should prioritise physiotherapy-focused study designs that clearly define diagnostic and treatment tasks, specify prompt and interaction conditions, and examine how artificial-intelligence-generated outputs are interpreted and used by clinicians, students and patients.

57. Cortex Mori Radicis Mitigates Inflammation and Fibrosis in Pulmonary Fibrosis Through PI3K/AKT Pathway Suppression.

期刊: Canadian respiratory journal 发表日期: 2026 链接: PubMed

摘要

Early in the pathogenesis of pulmonary fibrosis (PF), there are multiple inflammatory cell infiltrations in the damaged lung tissue. When lung injury persists, inflammatory cytokines prompt local fibroblasts migration and hyperproliferation, triggering abnormal deposition of extracellular matrix in the lung interstitium. This excessive repair leads to interstitial cell reorganization, triggering lung tissue fibrosis and further activation of inflammatory cells. Therefore, modulation of inflammatory mediators is of great significance in the treatment and prevention in the process of fibrosis. Cortex Mori Radicis (CMR) is a traditional Chinese herb with anti-inflammatory and antifibrotic properties. In this study, we investigated the therapeutic effects of CMR on bleomycin-induced PF using in vivo and in vitro models. In vivo experiments showed that CMR treatment significantly reduced inflammation, attenuated fibrosis, and alleviated lung function decline. In vitro, CMR inhibited migration, proliferation, and epithelial-mesenchymal transition (EMT) in A549 lung epithelial cells. Network pharmacological analysis identified 25 bioactive components and 10 key therapeutic targets in CMR, with the PI3K/AKT signaling pathway emerging as the core regulatory mechanism. Subsequent in vivo validation confirmed that CMR could inhibit the activation of the PI3K/AKT pathway. In conclusion, CMR exerts protective effects against PF by modulating the PI3K/AKT pathway, thereby attenuating inflammation and fibrotic remodeling. This study provides both pharmacodynamic evidence and mechanistic insight supporting the clinical potential of CMR and underscores the advantages of multitargeted intervention strategies offered by traditional Chinese medicine in the treatment of PF.

58. Current perspectives on the pathogenesis of multiple sclerosis: A minireview.

期刊: Endocrine regulations 发表日期: 2026-Jan-01 链接: PubMed

摘要

Multiple sclerosis (MS) is a chronic immune-mediated demyelinating disease of the central nervous system characterized by inflammation, reactive gliosis, and progressive neuroaxonal damage resulting in heterogeneous clinical and histopathological manifestations. As MS often leads to disability at a young age, it represents a substantial socio-economic burden in developed countries. The etiopathogenesis of MS is multifactorial and incompletely understood, involving genetic, immunologic, and environmental factors. Recent research highlights immune responses to Epstein-Barr virus, blood-brain barrier disruption, microbiome-gut-brain axis alterations, oxidative damage, and mitochondrial dysfunction. Studying patients with newly diagnosed MS without significant comorbidities provides insight into early disease mechanisms before disability development or long-term treatment effects. This mini-review focuses on early vascular and metabolic alterations that may contribute to MS, including lipoprotein subfractions as markers of incipient atherosclerosis, endothelial dysfunction as an initiating vascular event, and autonomic nervous system imbalance during disease progression. It also addresses insulin sensitivity as a key metabolic factor alongside chronic inflammation and oxidative damage as interconnected mechanisms driving tissue injury. Metabolic changes reflecting neuronal impairment, mitochondrial dysfunction, and astroglial activation are detectable in both lesional and normal-appearing white matter in early stages. Reduced antioxidant capacity supports a role of oxidative damage in MS pathogenesis. Accelerated vascular aging, independent of traditional cardiovascular risk factors, may progress from endothelial dysfunction to structural atherosclerotic changes. Subtle alterations in lipoprotein profiles further suggest an increased risk of atherosclerosis, potentially influenced by inflammatory activity and oxidative damage, with possible sex-specific differences. Autonomic dysfunction appears to develop secondary to disease progression rather than as a primary driver of pathogenesis.