公共卫生研究摘要 (2026-07-01)

共收录 60 篇研究文章

1. The authors reply.

期刊: Critical care medicine 发表日期: 2026-Jul-01 链接: PubMed

摘要

2. Modeling the Cost-Effectiveness of Incorporating Extracorporeal Cardiopulmonary Resuscitation Strategy in Out-of-Hospital Cardiac Arrest Patients.

期刊: Critical care medicine 发表日期: 2026-Jul-01 链接: PubMed

摘要

To evaluate the cost-effectiveness of implementing an extracorporeal cardiopulmonary resuscitation (ECPR) strategy for refractory out-of-hospital cardiac arrest (OHCA) compared with current practice in Singapore, where it is not routinely used. We performed a simulation-based cost-effectiveness analysis using a decision tree to model acute phase and a Markov model for long-term outcomes over a lifetime horizon, from a healthcare provider perspective. Singapore healthcare system. Nontraumatic adult OHCA patients from Singapore with initial shockable rhythm and no prehospital return of spontaneous circulation were analyzed. We modeled the implementation of an ECPR strategy and compared it with current practice using only conventional cardiopulmonary resuscitation. Transition probabilities of existing practice were derived from the nationwide Singapore OHCA registry (Pan-Asian Resuscitation Outcomes Study: PAROS), (2010-2016), while ECPR outcomes were based on the Comprehensive Registry of Intensive Care for OHCA Survival in Osaka (Osaka CRITICAL study) (2012-2019). Costs and quality-adjusted life-years (QALYs) were compared between strategies, with scenario analyses conducted to assess the impact of lower age eligibility thresholds and increased transport time to extracorporeal membrane oxygenation-capable hospitals. Incremental cost-effectiveness ratios (ICERs) were estimated using a willingness-to-pay threshold of S$45,000 per QALY. A total of 1462 OHCA cases from Singapore were analyzed; the mean age of patients was 57 years (sd, 11 yr), and 87% were male. In base-case analysis, ICER was estimated at $34,320/QALY, with a positive net monetary benefit of $8,532. Scenario analyses demonstrated that an age-restricted ECPR strategy (< 65 yr) yielded a similar ICER ($33,469/QALY) to the base case. In contrast, incorporating a 10-minute transport extension slightly exceeded the willingness-to-pay threshold ($47,158/QALY). In this modeling study, adopting an ECPR strategy for OHCA in Singapore was likely to be cost-effective across different age-based eligibility thresholds; however, it was sensitive to delays in transport time. Further implementation research is important to guide scale-up and policy decisions.

3. Skeletal Muscle Mass Is Independently Associated With Water Turnover in Male Athletes.

期刊: Scandinavian journal of medicine & science in sports 发表日期: 2026-Jul 链接: PubMed

摘要

Fat-free mass (FFM) is a key component of body composition that contributes moderately to water turnover (WT). However, FFM consists of multiple components, and the extent of its contribution to WT, especially in relation to skeletal muscle mass (SMM) in athletes, remains unclear. This study aimed to examine the association between WT and body composition in athletes. Thirty male participants (20 ± 2 years old) were members of college sports clubs or athletic organizations. WT was determined using the deuterium dilution method for 1 week. Total body water (TBW), intracellular water (ICW), and extracellular water (ECW) were measured using deuterium and sodium bromide dilution. Bone mineral content was measured using DXA, and four-component models were used to calculate FFM and total body protein (TBP). MRI and MRS were used to evaluate SMM and muscle glycogen. WT was positively associated with TBW (r = 0.563), ICW (r = 0.549), SMM (r = 0.548), and ambient temperature (r = 0.519). To overcome mathematical coupling and multicollinearity, regularized regression analyses (LASSO and Elastic Net) were performed. Because TBW and TBP are algebraically dependent on the deuterium-derived water space from which WT was calculated, they were excluded from the candidate predictors. Both models retained SMM, ICW, and ambient temperature as predictors of WT, whereas ECW, bone mineral content, muscle glycogen, and relative humidity were not retained. The modest cross-validated performance (leave-one-out R2 = 0.20-0.23) suggests that WT in athletes is also influenced by behavioral and unmeasured environmental factors. Functional body composition compartments, specifically SMM and ICW, were associated with WT in athletes beyond the mathematical dependency between WT and TBW; SMM, measured independently by MRI, was an independent correlate, whereas the association of ICW-derived in part from TBW-was not fully independent of the WT measurement.

4. Integration of Three-Dimensional Cell Culture Techniques and Photobiomodulation for Supportive Differentiation of Adipose-Derived Stem Cells into Smooth Muscle.

期刊: Cell biochemistry and function 发表日期: 2026-Jul 链接: PubMed

摘要

Photobiomodulation (PBM) has gained recognition as a promising, non-invasive strategy to enhance the differentiation of adipose-derived stem cells (ADSCs) into smooth muscle cells (SMCs), particularly when used together with a three-dimensional (3D) hydrogel culture system. This review explores the key mechanisms by which PBM modulates cellular behavior, along with its role in the promotion of SMCs lineage commitment in ADSCs. We investigate the influence of various light parameters including wavelength, intensity, energy density, exposure time and duration on cell responses such as proliferation, metabolic activity, gene expression and functional maturation. Moreover, we scrutinize the different hydrogel scaffolds, their compositions and the respective effects on PBM efficacy and consequential cellular outcomes. We also highlight the importance of scaffold design in mimicking the native extracellular matrix and how along with certain mechanical cues, they play a vital role in supporting stem cell behavior. By identifying current challenges, gaps in the literature and proposing future recommendations; this review aims to provide insights into the optimization of PBM protocols to improve SMCs differentiation of ADSCs, ultimately with the intention of integrating PBM to optimize regenerative therapies for use in regenerative medicine and tissue engineering (TE) strategies for vascular conditions and other smooth muscle-related diseases.

5. Abnormal B-Cell Exosome Proapoptotic and Antiapoptotic Cargo in Multiple Sclerosis: Potential Implication in Progressive Disease Biology.

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

摘要

Compartmentalized CNS inflammation involving B cells is implicated in gray matter injury and disease progression in multiple sclerosis (MS). Products secreted by B cells of patients with MS can kill oligodendrocytes and neurons, a cytotoxicity conferred by their exosome-enriched extracellular vesicle (Ex En) fraction. To explore the potential molecular mediators of this cytotoxicity, we profiled proteomic and transcriptomic cargo of Ex En isolated from B cells of patients with treatment-naive MS and matched healthy controls. MS B-cell-derived Ex En appeared enriched in cell-death-associated proteins (including fibrinogen, complement C9, APP, and SPARC) and deficient in cell-survival-associated proteins (such as galectin-3). Abnormal enrichment for cell-death proteins was supported by gene set enrichment analysis. Protein pathway analysis revealed densely connected prodeath modules in the MS B-cell-derived Ex En, contrasting with homeostatic signatures in controls. Transcriptomic analysis further revealed that Ex En of MS B cells appeared to carry reduced levels of miRNAs (miR-182, miR-212, and miR-1270) known to inhibit apoptosis. Our findings indicate that B-cell-derived Ex En of patients with MS, previously shown to impair neuronal and glial survival, harbor an abnormal cytotoxic molecular profile that may contribute to CNS-compartmentalized injury and progressive MS biology.

6. Work-Related Factors, Sleep Problems, and Metabolic Syndrome among Taiwanese Workers: Sex-Specific Implications for Occupational Health Nursing.

期刊: ANS. Advances in nursing science 发表日期: 2026-Jul-01 链接: PubMed

摘要

This cross-sectional study examined associations among work-related characteristics, sleep problems, and metabolic syndrome in Taiwanese workers. A total of 348 workers undergoing routine occupational health examinations were analyzed using multivariate logistic regression. The prevalence of metabolic syndrome was 26.4%, higher in men (33.3%) than in women (19.3%). Among women, shift work and body mass index were associated with metabolic syndrome, whereas among men, sleep disturbances, sleep latency, and body mass index were significant predictors. These findings suggest sex-specific pathways linking occupational conditions, sleep characteristics, and metabolic risk and highlight the importance of targeted occupational health nursing interventions.

7. Phase 1 trial of intranasal NDV-HXP-S in previously vaccinated adults.

期刊: Vaccine 发表日期: 2026-Jun-30 链接: PubMed

摘要

Newcastle disease virus hexapro spike (NDV-HXP-S) is a recombinant vaccine designed to elicit both systemic and mucosal immunity against SARS-CoV-2. Intramuscular vaccines protect against severe disease but provide limited mucosal protection. We conducted a Phase 1 trial of live NDV-HXP-S administered intranasally (IN), intramuscularly (IM), or simultaneously (IN+IM) in previously vaccinated adults. Thirty-five healthy adults without prior COVID-19 were enrolled at a single site in New York City (Feb 2022-Apr 2024). Participants received low- or high-dose NDV-HXP-S via IN, IM, or IN+IM routes, or placebo. Safety was monitored for 365 days; immune responses in serum and saliva were measured through day 84. All 35 participants completed follow-up. NDV-HXP-S was safe and well tolerated, with only grade 1-2 adverse events. Placebo recipients showed waning antibody titers, whereas NDV-HXP-S maintained or boosted serum IgG and neutralizing activity. Salivary sIgA rose modestly. Participants with low baseline CD4+ T-cell activity exhibited increases by day 28. The study was not powered for statistical significance. Live NDV-HXP-S was safe and well tolerated in this small Phase 1 study. Exploratory immunogenicity analyses showed variable systemic and mucosal responses, supporting further evaluation of updated NDV-HXP-S formulations in larger controlled studies. Supported by the Icahn School of Medicine Dean’s Philanthropic Fund, CastleVax Inc., Mount Sinai CTSA (UL1TR004419), and philanthropic and federal grants. ClinicalTrials.govNCT05181709.

8. Public health benefits of maternal influenza vaccination among pregnant women and infants <6 months in the United States, 2011-2020.

期刊: Vaccine 发表日期: 2026-Jun-30 链接: PubMed

摘要

Pregnant women and infants <6 months are at increased risk of influenza-associated complications. Maternal influenza vaccination during pregnancy has a strong safety record and is effective in reducing the risk of illness in these groups. Here, we estimate influenza disease burden, and the burden prevented by maternal influenza vaccination, among pregnant women and their infants <6 months in the United States during the 2011/12-2019/20 influenza seasons. We applied a multiplier model and compartmental framework to data that included monthly influenza-associated hospitalizations among pregnant women and infants <6 months, influenza vaccination coverage among pregnant women, and influenza vaccine effectiveness. We estimated the number of influenza-associated hospitalizations and intensive care unit (ICU) admissions among pregnant women and infants <6 months, and the corresponding number prevented by vaccination. We also simulated alternative vaccination coverage scenarios to investigate whether increased and/or earlier influenza vaccination uptake each season could have prevented additional hospitalizations. From 2011/12 to 2019/20, we estimated that 2670-10,000 influenza-associated hospitalizations and 76-486 ICU admissions occurred annually among pregnant women, and 3960-13,100 hospitalizations and 457-1830 ICU admissions occurred annually among infants <6 months. Influenza vaccination prevented an estimated 33-2440 hospitalizations and 1-166 ICU admissions annually among pregnant women, and 29-1350 hospitalizations and 4-178 ICU admissions annually among infants <6 months. We projected that increased influenza vaccination uptake would have prevented more hospitalizations among pregnant women than earlier vaccination, whereas the converse was true for infants <6 months. Together, we estimated increased and earlier vaccination uptake could have prevented an additional 12-942 influenza-associated hospitalizations annually among pregnant women and 17-1010 hospitalizations annually among infants <6 months. Our findings suggest maternal influenza vaccination reduces disease burden among pregnant women and their infants <6 months who are too young to be vaccinated.

9. Factors influencing implementation decisions in health care: A discrete choice experiment of intervention adoption.

期刊: Healthcare (Amsterdam, Netherlands) 发表日期: 2026-Jun-30 链接: PubMed

摘要

To overcome barriers to the implementation of effective interventions, it is important to understand the factors which may influence stakeholders’ implementation decisions. We aimed to identify these factors and quantify their relative importance in the decision-making process. Stakeholders included those wishing to implement an intervention (e.g., health service researchers and providers), and those funding implementation efforts (e.g., administrators and policymakers). We utilized discrete choice experiment methodology to explore several factors relevant to implementation decisions. The survey instrument was developed through a systematic review and expert consultation process. Conditional and mixed logit models were used to capture observed and unobserved preference heterogeneity. We tested the robustness of our results with subgroup and sensitivity analyses. We received 131 survey responses. There was a strong preference for intervention factors that 1) met stakeholders’ needs, 2) had excellent levels of evidence, and 3) demonstrated strong organizational readiness. Respondents showed a preference for the mid-level cost ($150,000) over the lowest cost level ($100,000) within the experimental cost attribute (relative to an annual budget of $5 million). This suggests that respondents may prioritize the other three factors over the cost of implementation. These results remained relatively consistent across professional subgroups and sensitivity analyses. Meeting stakeholders’ needs, levels of evidence, and organizational readiness had a large influence on implementation decisions. These factors were ranked of higher importance than implementation costs, administrative processes, and the presence of local champions within an organization. Designing research programs that support these influential factors will encourage successful implementation and ensure optimal healthcare delivery.

10. Comment on 'Global inequities in hepatitis B and C genomic surveillance revealed through an interactive data integration dashboard'.

期刊: Public health 发表日期: 2026-Jun-30 链接: PubMed

摘要

11. A global systematic review and meta-analysis on preterm birth and air pollution exposure.

期刊: Public health 发表日期: 2026-Jun-30 链接: PubMed

摘要

Evidence on the association between ambient air pollutants and preterm birth (PTB) is increasing, yet findings remain inconsistent. This study aims to systematically review and synthesize evidence on the association between maternal exposure to ambient pollutants (PM2.5, PM10, NO2, SO2, and O3) and the risk of PTB. A systematic review and meta-analysis. A comprehensive search of PubMed, Web of Science, and Scopus (2014-2024) identified 69 eligible studies. Of these, 66 studies (n = 66) were included in the meta-analysis. Using random-effects models, the study evaluated the impact of air pollutants on PTB risk. Based on cohort studies, which provide the highest level of evidence, an increase of 1 μg/m3 in air pollutants (PM2.5, PM10, NO2, and O3) was significantly associated with an increased risk of PTB. The results are presented as follows: (PM2.5: pooled RR = 1.016, 95% CI: 1.010-1.021, PM10: (pooled RR = 1.004, 95% CI: 1.002-1.007), NO2 (pooled RR = 1.007, 95% CI: 1.00-1.013), O3 (pooled RR = 1.004, 95% CI: 1.001-1.006). Additionally, this study examined the association between air pollutants and PTB across the three trimesters of pregnancy. Based on cohort studies, a significant association was observed between NO2 and particulate matter exposure during the third trimester and PTB. Although the number of observational studies in this field is limited and further research is needed, current evidence suggests that air pollutants, particularly particulate matter, may increase the risk of PTB. Therefore, effective health policies are essential to mitigate these harmful effects.

12. Comment on 'Multidomain expert evaluation of leading large language models as providers of vaccination and preventive medicine information'.

期刊: Public health 发表日期: 2026-Jun-30 链接: PubMed

摘要

13. Impact of the Italian antimicrobial resistance National Action Plan on antibiotic consumption in primary care: An interrupted time series analysis from 1999 to 2024.

期刊: Public health 发表日期: 2026-Jun-30 链接: PubMed

摘要

Antimicrobial resistance (AMR) is a major global health threat, largely driven by inappropriate and excessive antibiotic use. Italy has historically reported antibiotic consumption rates above the European average, especially in primary care. In 2017, Italy implemented the National Action Plan on Antimicrobial Resistance (NAP-AMR), including targets for reducing overall community antibiotic and fluoroquinolone use. This study evaluated the impact of NAP-AMR on antibiotic consumption trends in Italian primary care from 1999 to 2024. Quasi-experimental interrupted time series study. Annual ECDC data were expressed as defined daily doses (DDD) per 1000 inhabitants per day. Total antibiotic consumption was analyzed for 1999-2024 and fluoroquinolone consumption for 2005-2024. Segmented linear regression with Newey-West standard errors estimated post-2017 changes in level and trend. Total systemic antibiotic consumption was the primary outcome, and fluoroquinolone consumption was the secondary outcome. Total antibiotic consumption showed a significant pre-intervention upward trend, increasing annually by 0.10 DDD per 1000 inhabitants per day (annual change = 0.096; p = 0.032; 95% CI: 0.014 to 0.178). NAP-AMR implementation was associated with a significant immediate reduction in total antibiotic use (mean level difference = -4.940; p = 0.003; 95% CI: -7.864 to -2.016), while the post-intervention slope change was not significant (annual change = 0.126; p = 0.606; 95% CI: -0.346 to 0.599). Fluoroquinolone consumption showed a significant pre-intervention upward trend (annual change = 0.039; p = 0.016; 95% CI: 0.011 to 0.066) and a significant immediate reduction (mean level difference = -1.079; p = 0.023; 95% CI: -1.910 to -0.248). The post-intervention trend was negative but not significant (annual change = -0.219; p = 0.096; 95% CI: -0.459 to 0.021). NAP-AMR was associated with immediate reductions in total antibiotic and fluoroquinolone consumption, but sustained trend changes were not statistically significant. No significant long-term trend change was observed, underscoring ongoing surveillance and future evaluation.

14. Effect of malaria parasitaemia on antibody responses to single-dose and two-dose HPV vaccination: results from the DoRIS dose-reduction immunogenicity trial in Tanzanian girls.

期刊: Vaccine 发表日期: 2026-Jun-30 链接: PubMed

摘要

Human papillomavirus (HPV) vaccination is a key component of the World Health Organization’s global strategy for cervical cancer elimination. The effect of malaria, a known immunomodulator, on HPV vaccine immunogenicity is poorly understood. This study assessed the effect of malaria parasitaemia at the time of vaccination on HPV vaccine immune responses among participants in a dose-reduction immunogenicity trial (DoRIS). 930 HIV-negative Tanzanian schoolgirls aged 9-14 years were randomised to receive one, two or three doses of Cervarix® or Gardasil®9 (155 per arm) and followed to month (M)36. One-dose and two-dose arms participants were enrolled in a long-term extension and are included in this malaria sub-study. Dried blood spots at each vaccination visit were tested for malaria parasitaemia by quantitative polymerase chain reaction. HPV16/18 antibody responses were measured at M12, 24, 36 and 60. In the one-dose arms, there was no evidence of a difference in antibody geometric mean concentrations (GMC) or avidity index (AI) between participants with and without malaria at the time of vaccination. In the two-dose Cervarix® arm, M36 HPV16 antibody GMCs and AI results were lower in participants with malaria at either vaccination visit (HPV16 GMC ratio = 0.74, 95%CI = 0.55-0.99; AI ratio = 0.95, 95%CI = 0.91-0.99). In the two-dose Gardasil®9 arm, M36 HPV18 antibody GMCs and AI results were lower in participants with malaria at the first vaccine dose than those without malaria (HPV18 GMC ratio = 0.58, 95%CI = 0.37-0.92; AI ratio = 0.93, 95%CI = 0.87-0.99). These trends were also observed at M60. Whilst some effect of malaria on antibody responses was observed in the two-dose arms, these were mostly small in magnitude and unlikely to have clinical significance. Single-dose arms results are reassuring but further evaluations in larger populations would be valuable to confirm the findings. The potential for an effect of moderate or severe infection with greater parasite burden remains unclear. (NCT02834637).

15. Wearable device-telemonitored Baduanjin for chronic heart failure: A systematic review of effects on exercise tolerance and cardiac function.

期刊: Complementary therapies in medicine 发表日期: 2026-Jun-30 链接: PubMed

摘要

This review evaluates the effects of wearable device-telemonitored Baduanjin on exercise tolerance and cardiac function in patients with chronic heart failure (CHF). A comprehensive literature search was performed in PubMed, Web of Science, China National Knowledge Infrastructure (CNKI), Wanfang Database, VIP Database and Chinese Biomedical Literature Database (CBM) from their inception to 1 January 2026. The search aimed to identify randomised controlled trials investigating Baduanjin for CHF that explicitly used wearable devices. Study screening, data extraction and Cochrane RoB 2.0 bias assessment were performed independently by two reviewers with discrepancies were resolved by a third. Given significant clinical heterogeneity across the included studies, a narrative synthesis of the findings was conducted, supported by tabulated presentation of outcome data. Three randomized controlled trials involving 248 participants were included. Individual studies reported that wearable device-telemonitored Baduanjin was associated with improvements in several clinical outcomes in patients with CHF. Reported benefits included increased 6-minute walking distance (568.58 m vs. 367.47 m, P < 0.05), higher peak oxygen uptake (19.00 vs. 17.00 ml/[kg·min], P < 0.001) and improved left ventricular ejection fraction (52.60% vs. 45.28% and 42.79%, P < 0.05). Improvements were also observed in quality of life, depression symptoms, cardiovascular readmission in the intervention group of individual studies. No exercise-related adverse events were reported. Current evidence suggests that wearable device-telemonitored Baduanjin may potentially improve key outcomes in patients with chronic heart failure, However, these findings are based on a narrative synthesis of individual studies and should therefore be interpreted cautiously. Further high-quality, standardised randomised controlled trials are urgently needed.

16. Machine Learning-Based Identification and Ranking of Mortality Predictors After Hip Fracture Surgery: An Analysis of the Australian and New Zealand Hip Fracture Registry.

期刊: Anesthesia and analgesia 发表日期: 2026-Jun-30 链接: PubMed

摘要

Hip fractures are a major global health issue with high mortality and morbidity, especially in older adults. One-year mortality post-surgery ranges from 22% to 36%, with many patients never regaining baseline mobility. While several predictors of mortality have been identified, their relative contribution to mortality risk within a unified survival prediction framework remains unclear. This study used machine learning to rank key perioperative predictors of mortality following hip fracture surgery. Over 11,000 patients from the Australian and New Zealand Hip Fracture Registry were analyzed. Twenty demographic, clinical, and perioperative variables were assessed using a Random Survival Forest (RSF) model. Model performance was evaluated using the concordance index and Brier scores. Permutation-based feature importance ranked predictors according to their contribution to predictive performance for mortality risk. During the follow-up period (median 630 days), 31% of patients died. The RSF model performed well (test C index: 0.7305). The four most important predictors of mortality were American Society of Anesthesiologists (ASA) grade (importance score: 0.051), pre-existing dementia (0.036), age (0.019), and preadmission walking ability (0.016). Other factors like male sex (0.009) and acute hospital stay (0.006) had weaker associations with mortality prediction in this model. Machine learning identified ASA grade, dementia, age, and mobility as the top predictors of mortality after hip fracture surgery. RSF modeling offered strong performance and better interpretability than traditional methods. These findings support individualized stratification to inform perioperative discussions and goals-of-care planning in this high-risk population.

17. Anticholinergic Medication Use in Veterans Affairs Long-Term Care Residents: Clinical Patterns and Opportunities for Deprescribing.

期刊: Journal of the American Geriatrics Society 发表日期: 2026-Jun-30 链接: PubMed

摘要

Anticholinergic exposure is common in nursing homes; however, the true burden may be underestimated, particularly due to over-the-counter agents such as first-generation antihistamines that are not consistently captured in prior claims-based studies. This gap limits accurate characterization of anticholinergic use and its clinical implications in older adults. Veterans aged ≥ 65 years with stays ≥ 90 days (N = 45,183) residing in US Department of Veterans Affairs (VA) Community Living Centers (CLC). This study is a secondary data analysis of residents identified during fiscal years 2007-2019. True anticholinergic exposure through barcode-based medication administration dispensing records allowed daily measurement of anticholinergic exposure, with follow-up extending from admission to discharge, death, or April 1, 2025. Anticholinergic medication use was defined as use ≥ 4 days per week during the CLC stay. Drugs were identified using VA classifications aligned with the 2023 American Geriatrics Society Beers Criteria and grouped into nine anticholinergic classes. Outcomes included prevalence, duration, and number of anticholinergic drug classes used; patterns by dementia status; and temporal trends over time. Among 45,183 CLC residents, 33.4% (n = 15,074) used anticholinergic medications. Residents with dementia (n = 20,254) showed substantial exposure to neuropsychiatric anticholinergics, including second-generation antipsychotics (30.6%) and antiparkinsonian agents (10.1%). First-generation antihistamine use remained high in this group (29.5%). Residents without dementia (n = 24,929) more frequently received antihistamines (34.4%), bladder antimuscarinics (23.7%), and skeletal muscle relaxants (11.1%). From FY2007-2019, anticholinergic use declined modestly, with decreases in antihistamines (12.1%-8.8%), antidepressants (6.8%-3.5%), and antiemetic/antivertigo agents (5.2%-1.2%). Most residents used a single anticholinergic class, increasing from 75.5% to 82.2% over time. Although some anticholinergic classes may be clinically necessary, our findings highlight potentially underrecognized and modifiable sources of exposure, particularly first-generation antihistamines, underscoring the need for deprescribing efforts.

18. Implementation-focused consensus recommendations for oral cavity cancer prevention and early detection in Latin America and the Caribbean: A Delphi study.

期刊: Oral oncology 发表日期: 2026-Jun-30 链接: PubMed

摘要

Oral cavity cancer represents a public health challenge in Latin America and the Caribbean (LAC), where exposure to modifiable risk factors such as tobacco and alcohol remains high and inequalities in access to health services contribute to delayed diagnosis and poor outcomes. This study aimed to develop consensus-based recommendations to strengthen the prevention and early detection of oral cavity cancer and oral potentially malignant disorders in LAC. A multi-phase study using a Delphi approach was conducted. An initial qualitative survey with regional experts identified barriers, facilitators, and priority actions for oral cavity cancer prevention and early detection. Preliminary recommendations were refined through feasibility assessment by international advisors and subsequently evaluated in a quantitative Delphi round using a Likert scale. Twenty-four experts from 12 LAC countries participated in the Delphi process, including research investigators, clinicians, and health service managers. The panel had a mean age of 49.4 (SD 10.3) years and included 41.7 % women. Seven recommendations achieved consensus, addressing key domains of oral cavity cancer control including primary prevention interventions, screening of high-risk individuals, establishment of structured referral pathways, improved surveillance systems, and expansion of access to diagnostic services in underserved populations. High levels of agreement were observed across all recommendations. These consensus-based recommendations provide a regionally informed framework to guide oral cavity cancer prevention and early detection strategies in LAC. Strengthening coordinated actions across the continuum of care, including primary prevention, screening, referral, and diagnostic capacity, may contribute to reducing diagnostic delays and improving outcomes in the region.

19. Centers for Medicare & Medicaid Services to Launch Landmark ACCESS Program.

期刊: Journal of medical Internet research 发表日期: 2026-Jun-30 链接: PubMed

摘要

This July, the US Centers for Medicare & Medicaid Services will launch its ACCESS program, a decade-long experiment in outcome-based payment expanded to digital care options. In this News and Perspectives article, JMIR Correspondent Delaney Rebernik reports on the players, promise, and potential pitfalls of this initiative.

20. Expedited Transition to Digital Delivery of Recovery Support Services Due to the COVID-19 Pandemic: Mixed Methods Needs Assessment.

期刊: JMIR formative research 发表日期: 2026-Jun-30 链接: PubMed

摘要

Recovery support services (RSS) are an evidence-based approach to support recovery from substance use disorders, most often composed of peer-to-peer support, referrals to housing, job training, and other forms of prosocial engagement and activities. During the COVID-19 pandemic, RSS providers quickly converted in-person services to digital delivery to avoid disruption. It is unclear if this rapid conversion impacted the delivery of services or if this delivery model could enhance RSS reach and uptake more generally by extending the reach of RSS providers and offering an alternative delivery method and access point. The goal of this study was to identify how RSS providers in Texas adapted their services for digital delivery and to what extent, if at all, technology limitations (eg, lack of digital infrastructure) were present. We conducted an electronic survey of 85 RSS providers, assessing their current capacity and methods for the digital recovery support service (D-RSS), followed by semistructured online interviews with a subset of 20 respondents. Most survey respondents (74/85, 87.1%) used D-RSS, though they used many dated technologies, devices, and platforms for service delivery. Many respondents indicated that they use Zoom (Zoom Video Communications) videoconferencing to communicate with participants; however, providers also indicated that they must use several different technology platforms to accomplish their service delivery goals. Four main themes emerged from the interviews: (1) the impact of the COVID-19 pandemic on RSS, (2) barriers and facilitators to technology-delivered D-RSS, (3) awareness and expectations regarding the use of D-RSS, and (4) training needs to deliver D-RSS. RSS organizations have access to technology for D-RSS; however, the technology is often outdated. Because the pandemic required a rapid and unexpected shift to D-RSS to maintain and potentially expand access during a public health emergency, providers desire guidance for training staff and participants on how to best use technology. A subset of providers endorsed the potential of a unified platform for D-RSS delivery, especially for data capture. Most barriers to D-RSS identified by our respondents may be addressable through the streamlined deployment of technology resources, rigorous training and onboarding programs in best practices for providers and participants, and tailored implementation strategies for varying local contexts.

21. Contraceptive Access for Active Duty Service Women: Evaluation of Women and Infant Community Care Clinics in the Military Health System.

期刊: Military medicine 发表日期: 2026-Jun-30 链接: PubMed

摘要

Active duty Service Women (ADSW) face unique challenges in accessing reproductive care. To overcome these issues, the Defense Health Agency Procedural Instruction (DHA-PI) 6200.02 was introduced in May 2019 and Women and Infant Community Clinics (WICCs) were established to facilitate its implementation. This study examined the impact of WICCs on improving access to extended contraception and contraceptive counseling services. A retrospective observational cohort design was employed. ADSW 18 and 55 years, with TRICARE enrollment between January 1, 2016, and September 30, 2022, who were enrolled at or received care at a site at a WICC were included in the cohort. The primary outcome was the rate of extended contraception defined as 168+ days’ supply and rate of family planning/contraception counseling. Separate calculations were conducted for ADSW with direct care encounters at family practice, family medicine, or OB/GYN clinics at WICC sites, defined as the “opportunity” perspective, and ADSW enrolled at WICC sites regardless of whether they had a direct care encounter, defined as the “responsibility” perspective. Interrupted time series (ITS) analysis was utilized to evaluate both immediate and sustained impact of WICCs on these outcomes. The study was granted exemption from the Defense Health Agency Institutional Review Board and informed consent was waived (DHQ-24-2011). Sixteen WICC sites were identified, where 114,768 ADSW received care and 75,399 were enrolled at those sites. Although there was a slight increase in the percentage of ADSW receiving extended contraception supply (short-acting reversible contraception [SARC], long-acting reversible contraception [LARC], or permanent contraception) post-implementation, this trend was not sustained. Among ADSW with direct care encounters, extended coverage rates declined over time. Additionally, measures assessing access to family planning and contraceptive counseling showed a significant downward trend compared with projected trends expected in the absence of WICC implementation. WICC sites did not lead to sustained improvements in extended contraceptive access or family planning/contraception counseling. These findings may be attributed to the early implementation phase of WICCs. Future research should assess the effectiveness of WICCs following the standardization of policies across the Military Health System.

22. Persistent postpartum proteinuria, renal dysfunction, and future chronic kidney disease risk in women with preeclampsia.

期刊: Pregnancy hypertension 发表日期: 2026-Jun-30 链接: PubMed

摘要

Previous studies demonstrated that preeclampsia (PE) with proteinuria is associated with concurrent renal injury. However, it is unclear how renal damage that occurs during pregnancy changes after delivery. This study was conducted to assess postpartum renal impairment in women with PE and to examine its possible link to the subsequent development of chronic kidney disease (CKD). We conducted a retrospective cohort study analyzing a group of women with PE and proteinuria (PE-UP (+)) (N = 30). Control data were obtained from normotensive participants at 35 weeks of gestation (N = 20) and 12 weeks postpartum (N = 15). Serum hyaluronan (glycocalyx injury), urinary podocalyxin (podocyte injury), urinary liver-type fatty acid-binding protein (L-FABP) and N-acetyl-β-D-glucosaminidase (NAG) (tubular injury) were measured at PE diagnosis and at 12 weeks postpartum. Based on the urinary protein/creatinine ratio (UPCR) at 12 weeks postpartum, the PE-UP (+) group was stratified into the PE-UP improved group (UPCR <0.15 g/g Cr; N = 20) and PE-UP persistent group (UPCR ≥0.15 g/g Cr; N = 10). The urinary L-FABP and NAG levels in the PE-UP improved group were significantly lower than those in the PE-UP persistent group. In contrast, the levels of hyaluronan and podocalyxin remained significantly elevated in both PE subgroups compared to those in the postpartum controls. Postpartum women with PE and prolonged proteinuria exhibit residual tubular dysfunction. Women with PE in whom proteinuria has resolved may still have residual glomerular damage at 12 weeks postpartum. The clinical trial described in this paper was registered at the UMIN Clinical Trials Registry under registration number UMIN000058351. URL of registration: https://center6.umin.ac.jp/cgi-open-bin/ctr/ctr_view.cgi?recptno=R000066708.

23. Correction: HealthData@MAD-R&I: Protocol for Design and Development of a Regional Health Data Infrastructure to Enable Secondary Use of Health Data in Research and Innovation.

期刊: JMIR research protocols 发表日期: 2026-Jun-30 链接: PubMed

摘要

[This corrects the article DOI: 10.2196/82815.].

24. Understanding University Students' Experiences of Engaging With AI and Apps for Their Mental Health and Well-Being: Qualitative Study.

期刊: Journal of medical Internet research 发表日期: 2026-Jun-30 链接: PubMed

摘要

Fully automated digital technologies, such as artificial intelligence (AI) and apps, provide a particularly promising way to promote and support mental health and well-being in university students due to their accessibility, scalability, and cost-effectiveness, among other factors. Nevertheless, they are currently impeded by suboptimal engagement and high dropout rates, limiting their effectiveness to promote and support mental health and well-being. This study aimed to understand university students’ experiences of engaging with AI and apps to promote and support mental health and well-being. University students who did not currently experience a mental health condition were recruited to ensure a nonclinical sample. Qualitative semistructured interviews were adopted and focused on students’ experiences of engagement with AI and apps for their mental health and well-being. These interviews were conducted in April and May 2023 and lasted 30 minutes, 2 seconds (SD 9 min, 49 s), on average. Interviews were transcribed verbatim and analyzed using a reflexive thematic analysis. A total of 21 interviews were conducted, and 4 main themes and 4 subthemes were constructed. The first main theme refers to the “need” to engage with AI and apps for mental health and well-being. Specifically, this theme describes how nonclinical students would primarily use these technologies as a support strategy when their mental health and well-being deteriorate, and their preexisting mental health and well-being strategies are insufficient. The second theme refers to AI and apps as both a barrier and solution to stigma; while students are less inclined to access mental health apps due to stigma, they also consider apps to be less intrusive compared with other forms of support. The third theme considers a lack of trust in AI and apps. This lack of trust primarily exists due to skepticism about the capabilities of AI and apps supporting and promoting mental health and well-being, and skepticism about their ability to safeguard mental health and well-being. The final theme describes how usage is dependent on unique AI and app characteristics. Students may engage more in AI and apps when humanity, warmth, and care are considered less crucial, and when a lack of judgment and pressure is considered imperative. Overall, nonclinical university students were more likely to engage with AI and apps when they experienced a decline in their mental health and well-being. Thus, it could be more beneficial to adopt apps as a support strategy rather than as a promotional strategy in a nonclinical sample. Furthermore, future policy and practice should implement strategies to safeguard mental health and well-being and provide open and honest communication about the capabilities of AI and apps in order to build trust and enhance engagement with digital technologies for mental health support.

25. Moving Research to Practice: A Qualitative Study Exploring Patient Perspectives of the Implementation and Sustainability of a Digital Health Intervention for Chronic Kidney Disease.

期刊: Journal of medical Internet research 发表日期: 2026-Jun-30 链接: PubMed

摘要

My Kidneys & Me (MK&M) is a digital health intervention (DHI) codeveloped to provide specialist health and lifestyle education aimed at enhancing self-management among individuals with chronic kidney disease. The MK&M DHI was shown to improve self-management behaviors in a multicenter randomized controlled trial (SMILE-K), but strategies to support effective integration into routine clinical practice are not known. This study aimed to explore patient perspectives about real-world implementation and sustainability of the MK&M DHI. For this substudy, participants from the SMILE-K trial were invited to take part in a semistructured qualitative interview to explore their perspectives on the implementation and sustainability of the MK&M DHI in routine clinical practice. Barriers and facilitators that could potentially influence the uptake and usage of the program in real-world settings, outside of a clinical trial, were also explored. Topics included accessibility, usability, integration into routine care, and types of support required to sustain engagement over time. Data were analyzed using reflexive thematic analysis. A total of 42 interviews were conducted with 35 individuals (mean age 62.5, SD 9.9, range 38-84 years; 23/35, 66% male; 33/35, 94% White British; estimated glomerular filtration rate: mean 33.5, SD 12.4 mL/min/1.73 m2). Five themes were identified, encompassing a range of critical factors that should be addressed to ensure the successful implementation of MK&M into routine kidney care and its alignment with real-world clinical needs. These include ensuring that information is timely, relevant, and tailored to individual needs. Participants highlighted the importance of promotion through multimodal strategies and approaches, leveraging diverse communication channels to maximize reach and engagement. Equitable access was identified as a priority, with potential barriers, such as digital literacy and digital poverty, requiring attention. Building trust, through reassurance and endorsement from trusted health care professionals, was seen as essential to strengthen confidence in MK&M. Finally, participants stressed the need for continued engagement and sustainability, ensuring that MK&M is successfully integrated into care pathways and supported over time to maintain its impact. The study findings highlight that timely, well-targeted communication using diverse strategies will be critical for the successful uptake of MK&M among people living with chronic kidney disease. The identification of perceived factors that will influence implementation of the program provides actionable insights to guide the development of tailored implementation strategies to ensure that MK&M is relevant, acceptable, and feasible in real-world practice. These findings provide a foundation for designing approaches that are not only patient-centered and inclusive but also adaptable to diverse clinical contexts. By addressing these factors proactively, implementation efforts can promote equitable access, foster sustained engagement, and support the long-term integration of DHIs, such as MK&M, into routine kidney care.

26. Endometriosis as a chronic endothelial disorder: thromboinflammation, vascular reprogramming, and systemic cardiovascular risk.

期刊: International immunopharmacology 发表日期: 2026-Jun-30 链接: PubMed

摘要

Microvascular thromboinflammation is a pervasive yet under-recognized driver of multisystem morbidity that links focal endothelial injury to distal organ dysfunction through interacting cellular and plasmatic networks. Contemporary paradigms remain fragmented: clinicians often treat symptoms or isolated pathways, trials enroll biologically heterogenous populations, and candidate biomarkers lack harmonized standards-together impeding translation from mechanistic insight to durable patient benefit. In this review we synthesize the evidence into a cohesive, systems-level architecture in which endothelial activation, platelet hyperreactivity, innate immune effectors (including NETosis), and impaired fibrinolysis form predictable feed-forward circuits that generate organ-selective vulnerability. We propose an integrated diagnostic-translational toolkit that anchors spatially resolved imaging endophenotypes (molecular PET, quantitative perfusion MRI, advanced flow imaging) to fluid-phase molecular readouts (cfDNA topology, NET fragments, platelet transcriptomes, endothelial microparticles) and multi-omic modules. This framework enables reproducible endotype discovery and supports biomarker-guided, stage-specific interventions. Translational strategies prioritized here include targeted anti-NET approaches, precision layering of antiplatelet/anticoagulant therapy, endothelial-directed redox and metabolic reprogramming, selective epigenetic modulation, and lesion-directed nanoparticle delivery; each is linked to companion biomarker and imaging readouts and tailored safety considerations-especially for reproductive-age populations. To accelerate clinical impact we recommend a coordinated roadmap: (i) rigorous causal validation across human-relevant platforms and scaled animal models; (ii) consensus preanalytic and analytic standards with reference materials for key thromboinflammatory biomarkers; (iii) prospective cohorts embedding serial imaging and liquid-biopsy multi-omics to derive and validate endotypes; and (iv) adaptive, biomarker-enriched clinical trials with organ-relevant surrogate endpoints and long-term vascular surveillance. By aligning mechanistic clarity, diagnostic fidelity, and pragmatic trial design, this integrated approach aims to convert mechanistic knowledge into precision diagnostics and therapies-and to transform microvascular thromboinflammation from an intractable clinical problem into a tractable target for prevention and repair.

27. Effectiveness of community-based physical activity models in improving quality of life among elderly: A systematic review.

期刊: Atencion primaria 发表日期: 2026-Jun-30 链接: PubMed

摘要

To evaluate the effectiveness of community-based physical activity models in improving the physical, psychological, and social dimensions of quality of life (QoL) among community-dwelling older adults aged 60 years and above. Systematic review. PubMed, Scopus, and ScienceDirect (January 2020 to July 2025). Empirical studies, including randomized controlled trials (RCTs), quasi-experimental, and pre-post designs, focusing on community-based physical activity programs for older adults aged ≥60 years compared to inactive controls, standard care, or non-physical interventions. Independent data extraction and risk of bias assessment using Cochrane RoB 2 and ROBINS-I tools. A systematic narrative synthesis adhering to Synthesis Without Meta-analysis (SWiM) guidelines was conducted. Thirteen studies involving 2256 older adults were included. Multicomponent programs yielded the most consistent improvements. Significant physical findings included a fall incidence reduction from 51.8% to 31.4%, an 0.81-point increase in Short Physical Performance Battery (SPPB) scores, and a 7.5-point increase in the Barthel Index. Cognitive outcomes improved, evidenced by a 3-point average increase in Montreal Cognitive Assessment (MoCA) scores. Psychologically, resistance and yoga interventions reduced psychological distress by approximately 18%, while high-intensity aerobic exercise yielded an 8.6-point decrease in Hamilton Depression Rating Scale (HAMD-17) scores. Community-based, multicomponent physical activity interventions sustained for ≥12 weeks at a frequency of 2-5 sessions per week are highly effective in improving physical, cognitive, and psychological outcomes. Integrating culturally adapted practices and digital technologies enhances intervention feasibility, adherence, and long-term engagement.

28. Long-Term Mobile-Based Glycemic Intervention for Secondary Prevention in Patients With Diabetes Undergoing Surgical Revascularization: Multicenter Randomized Controlled Trial.

期刊: Journal of medical Internet research 发表日期: 2026-Jun-30 链接: PubMed

摘要

Despite the growing amount of patients who underwent coronary artery bypass grafting (CABG) in low- and middle-income countries like China, their glucose control was suboptimal, likely due to poor adherence to healthy lifestyles and preventive medications. Mobile health tools facilitating secondary prevention seem promising, but evidence focusing on this high-risk population is scarce. This study aimed to evaluate the significance of mobile health tools in long-term glycemic management for post-CABG patients with comorbid diabetes mellitus. GUIDEME (glycemic control using mini program-based intervention in patients with diabetes undergoing coronary artery bypass to promote self-management) is a multicenter, open-label, closed-user group, randomized controlled trial, in which 1066 patients with diabetes who had recently undergone CABG were enrolled and allocated into 2 groups. Patients in the control group received conventional health education before discharge, whereas those in the intervention group additionally received automatic delivery of bite-sized health education and medication reminders through a smartphone app during the 6 months after discharge. The primary end point was a change in glycosylated hemoglobin (HbA1c) from baseline to 6 months. Among the 1066 eligible participants enrolled, a total of 1038 (97.4%) had completed the follow-up, while 1000 (93.8%) had 6-month HbA1c results available. Although only 79 (14.9%) patients in the intervention group were defined as active users, a greater reduction of HbA1c in the intervention group was observed (adjusted between-group mean difference -0.13, 95% CI -0.25 to -0.01; P=.04). The intervention group also had a high proportion of good medication adherence (96.1% vs 93.2%, P=.04). There was no difference between the 2 groups regarding the secondary end points. Health education and medication reminders based on smartphone app achieved a statistically significant but modest between-group difference in HbA1c, the clinical relevance of which remains uncertain.

29. Mpox on Instagram: Content Analytic Study.

期刊: JMIR infodemiology 发表日期: 2026-Jun-30 链接: PubMed

摘要

Mpox was declared a public health emergency of international concern in 2022. Instagram is widely used by age groups and communities disproportionately affected by mpox; yet platform-specific evidence on mpox information characteristics and engagement remains limited. The aim of this study is to characterize sources, content, and engagement features of mpox-related Instagram posts, to describe prevention and treatment framing, and to compare the top 10% most-liked posts with the remaining corpus. We retrieved English-language public Instagram posts via CrowdTangle containing “mpox” or “monkeypox” dated May 5, 2022, to January 17, 2023 (initial N=18,616). Using a pretested, deductive codebook adapted from prior Instagram health studies, 2 coders completed 2 pilot rounds; variables with low agreement were excluded. A randomized analytic sample of 1000 posts was coded for source type, content features, and prevention/treatment framing. Descriptive statistics were computed. For engagement contrasts, we compared the top 10% most-liked posts with the bottom 90% using tests of differences in independent proportions (mean differences [MD] with P values). Most posts originated from organizations (760/1000, 76%) versus individuals (240/1000, 24%). Organizational sources most commonly included businesses (436/760, 57.4%) and news/media outlets (401/760, 52.8%); government (174/760, 22.9%), nonprofits (131/760, 17.3%), and health care organizations (70/760, 9.2%) were less frequent. About one-third of posts cited a source (344/1000, 34.4%), most often the World Health Organization (WHO) and Centers for Disease Control and Prevention (CDC)/other federal entity. Posts predominantly used illustrated images/infographics (827/1000, 82.7%); photos appeared in 47.3% (473/1000) and videos in 12.4% (124/1000) of posts. Prevention content appeared in 38.4% (384/1000) of posts, most commonly vaccination (684/1000, 68.5% of prevention posts), followed by avoiding close contact (145/1000, 14.5%), avoiding contact with objects (83/1000, 8.3%), abstaining from sexual activity (76/1000, 7.6%), and condom use (13/1000, 1.3%); 28.9% (289/1000) of prevention posts noted barriers. Treatment mentions were uncommon (25/1000, 2.5% traditional biomedical; 2/1000, 0.2% alternative). Compared with the bottom 90%, the top 10% most-liked posts (1) were more likely to originate from public figures/celebrities among individuals (MD=-0.591; P<.001) and from businesses (MD=-0.299; P<.001) or news/media (MD=-0.350; P<.001) among organizations; (2) were less likely to be from government (P<.001) , nonprofit (P=.006), or health care organizations (P=.005); and (3) more often included nonmoving images (MD=-0.119; P=.024), visible lesion depictions (MD=-0.081; P=.035), prevalence mentions (MD=-0.180; P<.001), and citations (MD=-0.162; P=.001). During the initial outbreak period, the highly engaged mpox content on Instagram skewed toward posts by public figures and news/business accounts and toward static, citation-bearing visuals that included prevalence context and occasionally lesion imagery. Public-health communicators seeking reach on Instagram should prioritize clear static infographics with explicit source citation and epidemiologic context and consider copublishing with trusted creators and news outlets, while addressing access barriers highlighted in prevention posts.

30. Swine waste stabilization ponds as hotspots for antimicrobial resistance gene accumulation: a longitudinal metagenomic study.

期刊: International journal of hygiene and environmental health 发表日期: 2026-Jun-30 链接: PubMed

摘要

Using next-generation sequencing, this study provides a comprehensive longitudinal assessment of bacterial communities, antimicrobial resistance genes (ARGs), mobile genetic elements (MGEs), and metabolic pathways in a full-scale swine waste treatment system in Brazil. Samples were collected from the first (WSP1) and final (WSP4) waste stabilization ponds of a farrow-to-finish farm during four sampling events between October 2022 and January 2023. Antibiotic molecules were additionally identified and quantified using solid-phase extraction coupled with liquid chromatography-tandem mass spectrometry. Bacterial community composition remained remarkably stable over time. Similarly, the resistome and mobilome showed pronounced temporal stability, although a consistently higher relative abundance of ARGs and MGEs was observed in the final treatment process (WSP4). Genes encoding resistance markers of human-health relevance were detected in WSP4, including Paer_PhoP_CST, associated with polymyxin (colistin) resistance; PRC-1, linked to resistance to third-generation cephalosporins; and quinolone resistance determinants such as adeF, Paer_parE_FLO, and Mtub_gyrB_FLO. Genes encoding efflux pump complexes associated with multidrug resistance were also identified, including Paer_CpxR, PmpM, YajC, MuxB, and MexW. Supporting these findings, fluoroquinolones (ciprofloxacin and norfloxacin), lincomycin, and tetracycline molecules were detected in the waste ponds, indicating sustained selective pressure within the system. The accumulation of clinically relevant resistance determinants in the final of the waste treatment process, whose effluent is reused for agricultural irrigation, highlights waste stabilization ponds as potential hotspots for the persistence and environmental dissemination of antimicrobial resistance. These findings underscore the urgent need for improved monitoring and management of livestock waste treatment systems to mitigate antimicrobial resistance dissemination across agroecosystems.

31. A Clinician-Supported Mobile App to Reduce Mental Health Symptoms Among World Trade Center Responders in Florida: Protocol for a Randomized Controlled Trial.

期刊: JMIR research protocols 发表日期: 2026-Jun-30 链接: PubMed

摘要

World Trade Center (WTC) general responders (GRs) continue to experience long-term mental health conditions, including posttraumatic stress disorder (PTSD), depression, anxiety, and sleep disturbance. A growing number of GRs reside in Florida, where barriers such as stigma, limited access to specialty care, and age-related limitations contribute to persistent unmet mental health needs. PTSD Coach, a mobile app originally developed for trauma-exposed veterans, has shown promise but has not been evaluated with WTC GRs or adapted for Spanish-speaking responders. This study aims to evaluate the feasibility, acceptability, and efficacy of Clinician-Supported (CS) PTSD Coach for reducing PTSD symptoms among English-speaking and Spanish-speaking WTC GRs living in Florida. Secondary objectives include evaluating effects on depression, anxiety, and sleep disturbance; comparing CS PTSD Coach with Self-Managed (SM) PTSD Coach and a waitlist control; and adapting and delivering a Spanish-language version of the intervention. This study is a 3-arm randomized controlled trial comparing CS PTSD Coach, SM PTSD Coach, and a waitlist control for reducing PTSD, depression, anxiety, and sleep disturbance among English-speaking and Spanish-speaking WTC GRs living in Florida. A total of 120 participants are randomized and assessed at baseline, 8 weeks, and a 12-week follow-up. CS PTSD Coach includes 4 clinician-guided sessions integrated with app-based activities, whereas SM PTSD Coach includes a single orientation session. Outcomes include PTSD symptoms (PTSD Checklist for DSM-5), depression (Patient Health Questionnaire-9), anxiety (Generalized Anxiety Disorder-7), and sleep disturbance (Insomnia Severity Index). Feasibility and acceptability are assessed using app use data, satisfaction ratings, and usability measures. Primary analyses focus on between-group differences after the intervention (8 weeks), with secondary longitudinal analyses incorporating all assessment time points. The notice of award was received in September 2024, and institutional review board approval, including amendments, was granted in January 2025. Recruitment began in February 2025, with data collection initiated in March 2025. As of April 2026, 63 participants have been enrolled, and outcome data collection is ongoing. Data analysis will commence following completion of follow-up assessments, with dissemination of results anticipated in 2027. This trial will provide the first randomized controlled evaluation of a clinician-supported mobile PTSD intervention for WTC responders, including Spanish-speaking GRs. Findings will inform the feasibility, acceptability, and potential scalability of supported digital mental health interventions for aging, geographically dispersed disaster-exposed populations.

32. Technology-assisted physical activity among hospitalized medical patients: a cluster randomized trial.

期刊: European journal of preventive cardiology 发表日期: 2026-Jun-30 链接: PubMed

摘要

Hospitalization is associated with physical inactivity, resulting in loss of functional capacity and elevated risk of complications for medical patients. The aim of the study is to assess the effect of an accelerometer-based physical activity monitoring system with visual feedback and encouragement to increase walking activity on time spent out of bed during hospitalization. This study is a cluster randomized trial performed in a tertiary hospital in Denmark. A total of 354 adults with independent ambulatory function were admitted to one of four medical wards (two cardiology, one respiratory, and one geriatric). Intervention group was encouraged to walk via the accelerometer-based physical activity recording system with visual feedback on a tablet placed on the bedside table for 1-7 days. Control group had the same physical activity recording but without feedback or encouragement. Primary outcome was the average time spent out of bed in minutes per day. Secondary outcomes included number of steps, length of stay, readmission, and mortality. Mean age of the participants was 72.9 years, and 53% were females. On average, the intervention and control groups spent 143.5 (SD 96.6) and 120.8 (SD 75.2) min/day out of bed, respectively. Intervention group spent 23.6 min more out of bed per day (95% CI 13.7-33.5) and took 440 steps/day more than the control group. No significant differences were observed between groups for length of stay, readmissions, falls, or mortality. Among hospitalized patients, technology-assisted physical activity monitoring with visual feedback significantly increases daily time out of bed, approaching clinically meaningful thresholds for improving functional outcomes and reducing adverse events. ClinicalTrial.gov.: NCT04555330. A cluster randomized hospital study in Denmark tested whether bedside visual feedback from a wearable activity monitor could help medical patients who could walk independently spend more time out of bed during hospital admission. Patients receiving visual feedback and encouragement spent 23.6 more min out of bed per day and took 440 more steps per day than controls. No clear differences were observed in length of stay, 90-day readmissions, in-hospital falls, or in-hospital mortality.

33. Occupational exposure assessment modeling and statistical tools: Recommendations for compliance-focused practitioners to improve risk communication.

期刊: Journal of occupational and environmental hygiene 发表日期: 2026-Jun-30 链接: PubMed

摘要

Studies have shown that industrial hygiene exposure assessments are subject to inaccurate judgment, may not be different from random chance, and may be biased low, resulting in underestimation of exposures. However, these limitations can be mitigated by the use of modeling and statistical tools. This study shows that before sample collection or when few samples have been taken, modeling tools such as the Structured Deterministic Model (SDM) 2.0 and Expostats can augment a practitioner’s risk communication to an employer. SDM and Expostats were used to analyze compliance datasets as follows: (1) comparing the performance of the SDM tool to predict airborne lead and silica overexposures as confirmed by sample data; (2) comparing statistical outputs for similar exposure groups (SEGs) between initial samples that did not contain overexposures and respective follow-up samples that did contain overexposures for airborne lead and iron oxide, and noise; and (3) statistical analysis of airborne lead and silica, and noise datasets that did not contain overexposures to determine the prevalence of unacceptable overexposure risk. In evaluation one, SDM correctly predicted overexposures in all SEGs where samples were above the exposure limit. Evaluation two results showed that inferential statistics from the initial results indicated an unacceptable risk of overexposure, and this was confirmed by follow-up samples that contained overexposures. In evaluation three, results suggested an unacceptable risk of overexposure in half of the datasets analyzed. The results of this study demonstrate that compliance-focused practitioners could also voluntarily leverage modeling and statistical outputs to communicate overexposure risk and encourage controls to reduce the risk of future occupational illnesses and compliance activity.

34. Low-burden data-driven work addiction screening: Comparing demographic and psychosocial predictors using machine learning.

期刊: Journal of behavioral addictions 发表日期: 2026-Jun-30 链接: PubMed

摘要

Identifying employees at risk for work addiction is critical for early intervention, yet systematic screening approaches face practical challenges for organizations. This study compared two screening strategies: a demographic-only model that requires no additional data collection versus a psychosocial model that incorporates job satisfaction and job stress assessments. We analyzed data from employees across 85 countries or territories. Dataset 1 (psychosocial model, n = 22,136) included demographic, occupational, and psychosocial variables. Dataset 2 (demographic model, n = 23,219) used only readily available information. Work addiction risk was assessed using the International Work Addiction Scale. Five machine learning algorithms (Logistic Regression, Random Forest, XGBoost, Neural Networks, Ensemble Voting) were evaluated on both full and Elastic Net-selected feature sets using cross-validation. The psychosocial model demonstrated superior performance. The best-balanced model (Logistic Regression with Elastic Net selection) achieved balanced accuracy of 0.72 ± 0.01, AUC-ROC of 0.80 ± 0.01, and Youden’s J of 0.45 ± 0.02, correctly identifying 72.7% of at-risk individuals while maintaining 72.2% specificity. The demographic model demonstrated moderate performance (Ensemble Voting: balanced accuracy 0.61 ± 0.01, AUC-ROC 0.65 ± 0.01), yet retained practical utility, detecting 57.0% of at-risk cases. High-sensitivity configurations achieved detection rates of 71%, but with elevated false-positive rates, presenting important trade-offs for screening design. While psychosocial variables provide superior prediction, demographic-only models offer a practical screening alternative that can identify over half of at-risk individuals without an additional data-collection burden. This trade-off between predictive performance and implementation feasibility has important implications for organizational screening programs.

35. Feasibility and Acceptability of a Co-Designed Model of Prehabilitation for Head and Neck Cancer Patients Undergoing Radiotherapy.

期刊: Head & neck 发表日期: 2026-Jun-30 链接: PubMed

摘要

Radiotherapy for head and neck cancer (HNC) has significant physical and emotional effects. This study investigated the feasibility of delivering “Prep-4-Radiotherapy (RT)”, a multi-modal, risk-stratified approach to prehabilitation for people with HNC. HNC patients planned for radiotherapy were screened for psychological distress, malnutrition, sarcopenia, dysphagia, and reduced physical function using self-report measures. Low-risk patients were provided access to self-management resources. High-risk patients were additionally referred to relevant allied health disciplines for specialist prehabilitation and provided access to self-management resources. The feasibility of Prep-4-RT was judged against a priori criteria. Primary feasibility outcomes included patient adoption (uptake: ≥ 70% of eligible patients consent to screening; intention to try: ≥ 60% of patients utilize self-management resources and ≥ 70% of high-risk patient participants verbally accept referrals to specialist prehabilitation) and fidelity (adherence to specialist pathway: ≥ 70% of high-risk patients receive specialist prehabilitation and attend ≥ 70% of scheduled prehabilitation appointments). Point estimates for four of five primary outcomes indicated acceptable feasibility. The point estimate for the fifth primary outcome, adherence as assessed by the percentage of high-risk patients assigned to specialist prehabilitation who received care from required clinicians before radiotherapy, indicated feasibility with further revision. Prep-4-RT appears to offer a feasible risk-stratified program to provide prehabilitation to HNC patients prior to radiotherapy, though results for some criteria were characterized by notable missing data. Further evaluation is required to determine its effect on clinical and health service outcomes. ANZCTA (Australian New Zealand Clinical Trials Registry) ACTRN12623000770662.

36. Sustainable Practice in Occupational Therapy: An Exploratory Survey of Israeli Practitioners' Knowledge, Challenges, and Practice.

期刊: OTJR : occupation, participation and health 发表日期: 2026-Jun-30 链接: PubMed

摘要

The World Federation of Occupational Therapists emphasizes sustainability as a core component of occupational therapy education and practice. This study examined how Israeli occupational therapists perceive and apply sustainability, formally recognized but inconsistently embedded in health and social care systems. Using a cross-sectional, exploratory design, an online survey with open- and closed-ended questions was distributed via email and social media. One hundred eleven occupational therapists from diverse practice areas participated. Data were analyzed using descriptive statistics and directed content analysis. Social equity was rated as the most important sustainability principle (78.4%), followed by economic prosperity (41.4%) and environmental integrity (31.5%). Reported barriers included lack of knowledge (21%), time constraints (15%), limited organizational support (14%), limited influence (11%), and lack of incentives (11%). Findings indicate that while Israeli occupational therapists value sustainability, additional education, resources, and institutional support are needed to facilitate its integration into practice, consistent with international patterns. Understanding Sustainability in Occupational Therapy: What Israeli Therapists Know, Value, and Need to PracticeSustainability refers to meeting present needs without compromising the ability of future generations to meet their own. In healthcare, this includes reducing waste, conserving resources, promoting economic and social responsibility, and ensuring equitable access to services. Occupational therapists support individuals’ participation in meaningful daily activities that promote health and engagement in everyday life, thereby playing an important role in advancing sustainable healthcare practices. In Israel, there is no educational, regulatory, or licensure pathway for occupational therapy assistants; therefore, occupational therapy services are provided exclusively by licensed occupational therapists. Accordingly, this manuscript refers only to occupational therapists. This study examined how occupational therapists in Israel understand and apply sustainability in their professional practice. An online survey was distributed nationwide, and 111 occupational therapists responded. The survey included questions addressing knowledge, attitudes, skills, and perceived barriers related to sustainability. Results indicated that most therapists valued sustainability and recognized its importance for individuals, communities, and the environment. Social equity, ensuring fairness and equal opportunities for all, was identified as the most important sustainability principle. However, participants reported limited knowledge about sustainability in occupational therapy and indicated that the topic had not been included in their professional education. The main barriers to implementing sustainable practices were a lack of knowledge, limited time, insufficient organizational support, and a lack of incentives. These findings suggest that although Israeli occupational therapists value sustainability, additional education, training, and workplace support are needed to integrate it into professional practice and promote more sustainable healthcare systems.

37. Attitudes of healthcare professionals towards the use of parenteral methotrexate in rheumatoid arthritis patients: a qualitative study.

期刊: International journal of clinical pharmacy 发表日期: 2026-Jun-30 链接: PubMed

摘要

Methotrexate is a cornerstone disease-modifying antirheumatic drug for rheumatoid arthritis (RA), effectively controlling disease activity and reducing cardiovascular mortality. Despite its efficacy, parenteral methotrexate, which offers higher bioavailability, faster response, and fewer gastrointestinal side effects compared to oral administration, remains underutilized in clinical practice. Understanding the factors influencing its utilization is critical to improving RA management. To explore the barriers and enablers towards using parenteral methotrexate in rheumatoid arthritis patients from the perspective of Australian healthcare professionals (HCPs). A qualitative study was conducted using semi-structured interviews between May and August 2022. Participants were recruited via advertising and snowballing. The Theoretical Domains Framework was used to guide the development of the interview guide and data analysis (directed content analysis), supplemented by conventional content analysis (inductive content analysis) to identify emergent themes. Nineteen HCPs (57.9% male, 42.1% female, 63.2% with more than 10 years of experience) were interviewed, including 14 rheumatologists, 3 pharmacists and 2 nurses. Findings related to domains “environmental context and resources”, “social influences” and “skills” were frequently identified, whereas the domains “intention”, “reinforcement” and “emotion” were least reported. The most prominent enablers related to HCPs’ knowledge and skills. Necessary skills were grouped into communication, logistical planning, and patient selection. Other enablers included the accessibility of injection support services, availability of prefilled syringes and online resources for patients (“environmental context and resources”) and social influences. The most common identified barriers related to the logistics of implementing parenteral methotrexate. Other barriers included issues with the Occupational Health and Safety guidelines, time constraints (“environmental context and resources”), concerns about patients withdrawing methotrexate from the vial (“emotion”) and patients’ low acceptability or affordability of the injectable medication (“social influences”). Our findings suggest that training and guidance on selecting appropriate patients, utilization of systems to support education of patients and to minimize occupational exposure, and availability of patient-friendly devices would support greater implementation of parenteral methotrexate in practice.

38. Mechanistic insights into chromium immobilization and uptake inhibition in lettuce mediated by endophyte-loaded biochar.

期刊: Journal of hazardous materials 发表日期: 2026-Jun-29 链接: PubMed

摘要

Chromium (Cr) contamination poses severe environmental and food-safety risks due to the high mobility and toxicity of Cr(VI) in agricultural soils. Microbial immobilization technology (MIT) has emerged as a promising approach for Cr detoxification; however, the mechanisms underlying endophyte-loaded biochar systems remain insufficiently understood. In this study, we evaluated the synergistic remediation potential of biochar (BC), the endophyte Serratia sp. Y-13 (SR1), and their immobilized composite (BSR1), employing morphological, physiological, transcriptomic, and metabolomic analyses. Results showed that SR1 mitigated Cr stress via cell-wall adsorption, periplasmic accumulation, and Cr(VI) reduction, while biochar loading further strengthened oxygen-containing functional groups (C-O and OC-O) on the composite surface. Thus, BSR1 exhibited the highest efficiency, reducing soil Cr(VI) and exchangeable Cr fractions by 94.2% and 84.1%, respectively, compared to the control. This was accompanied by a significant decrease in Cr translocation from roots to shoots. In addition, BSR1 altered antioxidant-enzyme activities and induced extensive transcriptional and metabolic reprogramming. Integrated transcriptomic and root-exudate metabolomics analyses revealed enrichment of phenylpropanoid metabolism, ABC transporter pathways, and defense-related metabolites under BSR1 treatment. RT-qPCR validation of six representative DEGs showed expression trends consistent with those obtained from RNA-seq. Collectively, the results suggest that BSR1 enhances Cr immobilization and promotes plant adaptation to Cr stress through coordinated soil and plant responses. The study provides mechanistic insights into how endophyte-loaded biochar enhances Cr(VI) reduction and Cr immobilization, supporting the development of sustainable amendments for reducing Cr bioavailability in contaminated soils.

39. Bufalin mitigates corneal damage in herpes simplex keratitis mice via inhibiting viral replication.

期刊: Phytomedicine : international journal of phytotherapy and phytopharmacology 发表日期: 2026-Jun-28 链接: PubMed

摘要

Herpes simplex keratitis (HSK) is an ocular viral infectious disease with limited therapeutic options and increasing resistance, leading cause of infectious blindness worldwide. Bufalin is a cardiotonic steroid, more specifically a bufadienolide, which can be found in many plant or animal species, but their main sources are skin and parotid gland secretions of toads (such as Bufo bufo gargarizans Cantor), which constitutes the traditional Chinese medicine preparation known as Chan Su (Venenum Bufonis). Despite its broad pharmacological activities, the potential role of bufalin in controlling HSK progression remains to be systematically investigated. This study systematically evaluates the antiviral and anti-inflammatory activities of commercial bufalin standards along with the underlying mechanisms in an HSK mouse model, aiming to discover lead compounds for the treatment of drug-resistant HSK. In vivo studies were conducted using an HSK mouse model established via corneal infection with either HSV-1F or the clinically acyclovir (ACV)-resistant strain HSV-1/153. In vitro experiments were conducted in ARPE-19 and HCEC cell lines, commonly used in ophthalmic research. Plaque assay, RT-qPCR, Western blot, CCK-8, sodium fluorescein staining, H&E staining, and other related experiments were employed to evaluate the antiviral and anti-inflammatory activities of bufalin. The ocular and systemic toxicities of topical bufalin were evaluated using in vivo confocal microscopy, TUNEL staining, body weight monitoring, and organ index analysis. Bufalin and Chan Su alleviates corneal damage in HSK mice, due to its antiviral and anti‑inflammatory activities both in vitro and in vivo. Bufalin not only inhibits the replication of viruses including HSV-1F and HSV-1/153 strains but also reduces inflammatory infiltration and the expression of inflammatory cytokines (IL-1β and IL-6) in the corneas of HSK mice. RNA-seq analysis reveals that bufalin may act as a potential broad-spectrum antiviral agent by upregulating OAS1 and ISG15 expression, which may represent a distinct antiviral mechanism distinct from ACV. No systemic or ocular toxicity was observed with bufalin at therapeutic doses in this study. These findings identify the natural product bufalin as a potential candidate against drug-resistant HSK by modulating the expression of broad-spectrum antiviral factors OAS1 and ISG15. This study expands the pharmacological application scope of bufalin, and thereby establishes a novel strategic direction for developing plant-derived bufalin and its derivatives as anti‑herpesvirus agents.

40. Mental and somatic multimorbidity among individuals with alcohol use disorder: A sex-stratified registry study.

期刊: Drug and alcohol dependence 发表日期: 2026-Jun-27 链接: PubMed

摘要

Alcohol use disorder (AUD) is a serious public health challenge associated with increased morbidity and mortality. While AUD is more common among males, the sex gap is narrowing; nevertheless, AUD remains underdiagnosed in females. Identifying sex-specific multimorbidity patterns could improve targeted screening and identification. Using the Norwegian Patient Registry, we identified 67,358 individuals with AUD (31.2% female) and age- and sex-matched controls. We compared sex differences in the prevalence of the 20 most common mental and somatic diagnoses within and between the AUD group and controls. We analysed multimorbidity using upset plots and correlation networks. Females with AUD had higher overall multimorbidity than males (median 9 [IQR: 5-14] vs. 6 [3-11] diagnoses). Asthma, eating disorders, and dementia were overrepresented among females with AUD. The most common diagnosis combinations in females with AUD involved overlaps between mental and somatic conditions, particularly other substance use disorders or depression combined with soft tissue disorders, urinary tract infections, or medical abortion. Males predominantly showed within-domain combinations. Correlation network analyses revealed a distinct pain-related cluster linking mental and somatic conditions in females with AUD, but not in control females. Females with AUD experience a disproportionately high level of multimorbidity, with distinct patterns, often involving combinations of somatic and mental diagnoses. Pain conditions serve as important links between mental and somatic comorbidity, especially for females. These findings support further investigation into sex-specific screening protocols, recognition of distinct clinical contact points, and integrated treatment approaches for AUD.

41. Early in vitro response to Toxoplasma gondii infection in macrophages and neutrophils from sheep immunized with a commercial vaccine.

期刊: Veterinary immunology and immunopathology 发表日期: 2026-Jun-27 链接: PubMed

摘要

Although commercial vaccination against ovine toxoplasmosis (Ovilis® Toxovax) has been used to prevent the disease for decades, the mechanisms behind this protection and its effects on target immune cells such as macrophages and neutrophils remain poorly understood. Therefore, peripheral blood monocytes and neutrophils were obtained from vaccinated (n = 5) and non-vaccinated (n = 5) sheep. Ovine monocyte-derived macrophages (OvMØs) were first differentiated in vitro. Neutrophils and OvMØs were inoculated with different T. gondii isolates: TgShSp1 (type II, ToxoDB#3), TgShSp24 (type III, ToxoDB#2) and S48 (type I, Ovilis® Toxovax) and incubated for 3 and 8 h, respectively. Interleukins (ILs) 12, 6, 10 and 1β, along with tumor necrosis factor (TNF), TLR2, TLR8 and macrophage inflammatory protein-1beta (MIP-1β) were significantly upregulated in OvMØs from non-vaccinated sheep compared to vaccinated sheep. However, the transcription levels of iNOS were upregulated in OvMØs from vaccinated ewes. The response of the OvMØs was similar within each group regardless the T. gondii isolate. Similarly, transcription levels of TNF, IL-1β, IL-8, TLR2 and TLR4 were upregulated in neutrophils from non-vaccinated sheep, however no differences in the quantification through fluorimetry of extracellular DNA derived from NETs were observed. These results suggest that vaccination predispose macrophages and neutrophils towards a contained immune response against T. gondii, although it could enhance parasite elimination by macrophages through a higher intracellular production of nitric oxide. Further in vitro studies involving parasite quantification in these cell populations might help to better understand its role in the immune response after vaccination.

42. Dairy farm waste as a source of novel and globally disseminated multidrug-resistant Escherichia coli clones: A genomic and phylogeographic study.

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

摘要

Dairy farm waste may serve as a reservoir for multidrug-resistant (MDR) Escherichia coli clones, but the genomic characteristics and dissemination potential of such clones remain incompletely understood. Here, we performed whole-genome sequencing and comprehensive genomic analysis of 64 MDR E. coli strains isolated from feces and sewage samples collected from two large dairy farms in Gansu Province, China. Genomic analysis revealed that strains carried 16-32 antibiotic resistance genes (ARGs), 1-6 plasmid replicon types, and 26-96 virulence genes (VGs), with numerically higher (though not statistically significant) counts in feces compared to sewage isolates. Multi-locus sequence typing (MLST) identified globally disseminated clones (ST10, ST38, ST58, ST155) and, for the first time in China, documented the presence of ST1508 (the predominant clone, 42% of isolates), as well as ST2520, ST7207, and ST7588 from dairy farm waste. Network analysis showed co-occurrence of these clones with transferable IncF plasmids harboring broad-spectrum resistance genes (e.g., rmtB, blaCTX-M-55) and multidrug efflux systems (e.g., acrAB-tolC). Contig-level analysis suggested that tet(A) and aph(3’)-IIa were located on IncX1 plasmids, blaTEM-1B on IncFIC(FII), and blaCTX-M-55 on IncI1 plasmids, indicating potential for horizontal gene transfer. These findings identify dairy farm waste as a potential environmental reservoir of MDR E. coli clones with genomic features associated with resistance and virulence. While functional validation of transferability and environmental persistence is needed, the presence of these clones - particularly the emerging ST1508 lineage in untreated farm waste suggests that improved waste management, enhanced surveillance, and integrated One Health strategies may help mitigate dissemination risks. Further studies incorporating environmental sampling, persistence assays, and conjugation experiments are required to establish the actual hazard status.

43. Fine particulate matter accelerates the senescence of bone marrow-conserved stem cells in a type 2 diabetes mellitus mouse model.

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

摘要

Fine particulate matter (PM, diameter < 2.5 μm) is a significant public health concern because it can disrupt the bone marrow (BM) microenvironment through oxidative stress and systemic inflammation. Patients with type 2 diabetes mellitus (T2DM) exhibit heightened vulnerability to environmental stressors such as PM2.5, which exacerbates metabolic dysfunction. However, the effects of PM2.5 on BM resident stem cells in the context of diabetes have not been explored. In this study, we investigated the impact of atmospherically relevant PM2.5 exposure on BM-resident stem cells in T2DM mice. Diabetes and non-diabetes mice were exposed to artificial PM2.5 in an atmospheric simulation chamber (ASC) replicating real-world conditions. PM2.5 exacerbated tissue damage in the lung and liver by elevating levels of proinflammatory cytokines and disrupting pancreatic insulin-glucagon homeostasis. Additionally, PM2.5 skewed the BM microenvironment toward an aged phenotype, marked by mesenchymal stem cell (MSC) senescence and preferential adipogenesis over osteogenesis. Further, hematopoietic stem cells (HSCs) in T2DM mice exhibited enhanced senescence and functional deficits in clonogenic capacity and repopulation potential compared to those from wild-type (WT) mice. The deleterious effects of PM2.5 on MSCs and HSCs in T2DM were reversed by an NLR family pyrin domain-containing 3 (NLRP3) inhibitor, which ultimately maintains BM homeostasis. These findings indicate that PM2.5 exacerbates T2DM-induced BM stem cell dysfunction, at least in part by activating the NLRP3 inflammasome, revealing a synergistic interaction between environmental pollutants and metabolic disease.

44. Genomic and functional characterization of Bacillus phage BCE1 targeting a key gut bacterium in Aedes albopictus larvae.

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

摘要

Vector-borne diseases remain a major global health challenge, underscoring the need for innovative and ecologically sustainable control strategies. Targeted manipulation of the gut microbiota is emerging as a promising next-generation vector control approach. In our previous study, we demonstrated an innovative bacteriophage-mediated strategy for depletion of an essential gut symbiont (Bacillus cereus) to dissect host-microbe interaction mechanism and to disrupt mosquito larval development in a gnotobiotic Aedes albopictus model. Here we present a detailed characterization of the bacteriophage vB_BceS-BCE1 (BCE1) used in the previous work. Host range, adsorption and replication kinetics, effective multiplicity of infection (MOI), environmental stability, virion morphology, and complete genome architecture were analyzed following contemporary standards. BCE1 exhibited siphovirus morphology and strictly lytic activity against B. cereus, with rapid adsorption rate (∼65% adsorption within 15 min), a short latency period (∼20 min), a moderate burst size (∼60 PFU per infected cell), and strong bacteriolytic activity even at a low initial MOI (0.01). Stability assays showed that BCE1 retained substantial infectivity (∼60%) under highly alkaline conditions (pH 11), consistent with the hyperalkaline ionic milieu of mosquito larval midgut. The 42.1-kb dsDNA genome encoded at least 55 coding sequences and lacked antimicrobial resistance genes, toxin genes, integrase-related genes, and tRNAs, supporting its suitability for field applications. Phylogenetic analyses suggested a close affiliation of BCE1 with the recently described genus Layangavirus, representing a novel species and a novel genus. Together, these findings outline a broader framework for the bacteriophage attributes essential to developing gut microbiota modulation-based vector control strategies in future.

45. Multifunctional MXene/PVDF nanofiber membrane with electroactivity and mild photothermal effect for guided bone regeneration.

期刊: Colloids and surfaces. B, Biointerfaces 发表日期: 2026-Jun-26 链接: PubMed

摘要

Bone defects have become a major challenge restricting the long-term success of dental implant restoration. Conventional barrier membranes often exhibit limited capability in guided bone regeneration, particularly in severe defect cases. To address these issues, a novel multifunctional MXene/PVDF nanofiber membrane was fabricated via electrospinning. First, the membrane possesses favorable mechanical and physical barrier properties, effectively preventing the invasion of soft tissue cells into the bone defect area while providing stable mechanical support. Second, the composite membrane is endowed with excellent “electroactive + mild photothermal” functionality. Through in vitro cellular assays and in vivo animal experiments, we have demonstrated that the membrane exhibits good biocompatibility and can promote bone tissue regeneration through the combined effects of electrical response and photothermal stimulation. Finally, the long-term chemical stability and safety of the MXene/PVDF nanofiber membrane have been preliminarily validated. In summary, the MXene/PVDF nanofiber membrane exhibits outstanding “barrier + electroactive + mild photothermal” performance and holds great potential for guided bone regeneration.

46. Diagnostic distribution of psychiatric inpatients in general hospital psychiatry: A nationwide Japanese survey and its implications for postgraduate medical education.

期刊: Asian journal of psychiatry 发表日期: 2026-Jun-25 链接: PubMed

摘要

47. Cryogenic expansion-induced remodeling of pore architecture in δ-MnO2/montmorillonite for enhanced formaldehyde oxidation.

期刊: Journal of hazardous materials 发表日期: 2026-Jun-25 链接: PubMed

摘要

Indoor formaldehyde (HCHO) poses a severe threat to human health, underscoring the need for efficient, sustainable purification solutions. In this work, a novel δ-MnO2/montmorillonite composite was synthesized via an ice bath-assisted co-precipitation method combined with freeze-drying. The ice bath condition effectively controlled the reaction rate and prevented the formation of aggregated δ-MnO2 on the montmorillonite surface, leading to uniform nanosheet dispersion and abundant lattice defects. Furthermore, the freeze-drying process, conducted under low temperature and pressure, causes liquid water to rapidly freeze into ice, expanding in volume during freezing and forming unique pore channels. This results in a specific surface area 2.17 times larger than that of oven-dried samples and 21.5 times larger than that of δ-MnO2, while effectively preserving structural hydroxyl groups and adsorbed water. Moreover, the as-prepared composite materials demonstrated excellent catalytic performance, achieving complete HCHO removal within 120 min, and its mineralization efficiency exceeded 91%. The superior performance of the composite materials from the synergistic effects of high dispersion, an optimal Mn3+/Mn4+ ratio, abundant surface hydroxyl groups, and a hierarchical porous structure. Overall, this study developed a mineral-based catalyst with a porous structure and high catalytic activity, enabling efficient indoor formaldehyde purification at room temperature.

48. The added value of 3.0 T quantitative multivoxel proton 1H-MR spectroscopy in the diagnostic work-up of breast lesions.

期刊: European journal of radiology 发表日期: 2026-Jun-24 链接: PubMed

摘要

To evaluate whether 3.0 T Multivoxel Proton Magnetic Resonance Spectroscopy (1H-MRS) can reliably and safely rule out malignancy in enhancing breast lesions with a size of at least 8 mm. Reducing the number of false positive (FP) MRI findings is essential to avoid unnecessary biopsies of benign lesions. This prospective study evaluated a consecutive series of 49 enhancing breast lesions ≥ 8 mm using multivoxel 1H-MRS (included 2017-2022). Each lesion’s highest choline concentration was calculated and compared across histopathological subtypes. Stratified analysis was performed based on lesion size (<1 versus ≥ 1 cm). Highest choline concentration > 1.70 mmol/L was considered indicative of malignancy. ROC curves, sensitivity, specificity, negative predictive values (NPV), FP and false negative (FN) values were calculated. Out of 49 lesions (in women with a mean age of 41, range 23-71), 17 were malignant. The median highest choline (mmol/L, ± IQR, range) was significantly higher in malignant lesions [1.73(±1.14, 0.11-8.24)] compared to benign lesions [0.87 (±0.84, 0.09-6.37)(p = 0.02)]. ROC curve showed an AUC of 0.70(95%-CI 0.54-0.87). Using a cut-off value of 1.70 mmol/L sensitivity was 59%, specificity 91% specificity, and NPV 81% across all lesions. In lesions ≥ 1 cm (n = 37) only 3 FN and 2 FP cases were found, with a 70% sensitivity, 93% specificity and NPV of 89%. MRS could prevent target ultrasound (n = 9) or ultrasound plus biopsy (n = 6) in benign enhancing breast lesions ≥ 1 cm. 3.0 T 1H-MRS shows promising diagnostic performance in differentiating malignant from benign BI-RADS 3-5 breast lesions ≥ 1 cm. In smaller breast lesions the performance of MRS seems insufficient.

49. Rural cancer research activity across Europe: A bibliometric analysis on patterns, gaps and policy implications.

期刊: European journal of oncology nursing : the official journal of European Oncology Nursing Society 发表日期: 2026-Jun-24 链接: PubMed

摘要

Rural populations comprise around 27% of Europeans and face persistent challenges across the cancer pathway. Although rurality is recognised as a contributor to cancer inequalities, most evidence has historically been generated outside Europe. No comprehensive mapping of European rural cancer research exists and understanding where evidence is concentrated or absent is important for informing equitable cancer-policy planning. We mapped rural cancer research activity across Europe, including publication trends, geographical distribution, collaboration patterns, and thematic focus. We conducted a bibliometric review in accordance with the BIBLIO Guidelines for Reporting Bibliometric Reviews of the Biomedical Literature. Data were retrieved from Scopus and Web of Science (1940-2025), processed in R (4.5.1), and analysed using the bibliometrix package. Analyses included annual output, citation metrics, country and institutional productivity, collaboration networks, thematic mapping, and Multiple Correspondence Analysis. A total of 2050 publications were analysed. Annual output increased at a growth rate of 6.04%. Research activity was unevenly distributed, with the UK, France, Germany, Poland, and Italy as the most productive countries. Collaboration networks were strong, especially among Western European nations. Thematic analysis showed a focus on screening, epidemiology, and specific tumour types, with limited research on treatment, survivorship, and service delivery-patterns relevant for European cancer policy. Rural cancer research in Europe is uneven and thematically narrow. Integrating rurality into cancer-inequality monitoring, incorporating rural indicators into EU policy frameworks, and strengthening research capacity in under-represented countries are timely, achievable steps to support more equitable cancer policy and planning.

50. The chemistry of the cobalt corrinoids - Recent advances and emerging themes. Part 3. Cobalamins and health.

期刊: Journal of inorganic biochemistry 发表日期: 2026-Jun-23 链接: PubMed

摘要

Vitamin B12 (cobalamin) is an essential micronutrient whose biological importance extends beyond its traditional classification as a haematinic vitamin. This third and final part of a review covering work published between 2020 and 2025 synthesises selected illustrative studies that have advanced understanding of B12 physiology, nutrition, deficiency, delivery, and systems-level biology. At the molecular level, B12 functions as a cofactor in one‑carbon metabolism and mitochondrial pathways, influencing DNA synthesis, methylation capacity, and energy metabolism. These biochemical roles translate into organism-level consequences, particularly in the nervous system, where deficiency may cause irreversible neurological injury even in the absence of overt haematological abnormalities.Population-level analyses show that B12 status reflects the interaction of didetary intake, absorption efficiency, life stage, and food-system dynamics. Although animal-source foods remain the most reliable sources, shifts towards plant-based diets and inconsistent fortification practices are altering risk profiles. Clinical evidence further indicates that B12 deficiency is heterogeneous, frequently under-recognised, and complicated by the limitations of conventional biomarkers. Advances in delivery science point towards more controlled and targeted interventions, including encapsulation technologies, alternative administration routes, and receptor-mediated transport strategies. Emerging evidence also suggests biological activities for cobalamin derivatives beyond classical cofactor function, while microbiome research increasingly implicates corrinoid metabolism in host-microbe interactions relevant to immune and metabolic regulation. These developments support an integrated systems-level view of B12 biology spanning dietary supply, physiology, microbial ecology, and therapeutic innovation. SYNOPSIS: The final part of this review examines recent advances in vitamin B12 biology, spanning physiology, nutrition, deficiency, biomarker limitations, therapeutic delivery, and microbiome-linked corrinoid metabolism. These developments support an integrated systems-level view linking molecular function, dietary ecology, population health, and emerging therapeutic opportunities.

51. Associations between MRI features and pain in first metatarsophalangeal joint osteoarthritis.

期刊: Seminars in arthritis and rheumatism 发表日期: 2026-Jun-18 链接: PubMed

摘要

First metatarsophalangeal (MTP) joint osteoarthritis (OA) is a common and disabling foot condition, but the relationship between localised joint changes with pain severity is poorly understood. This study aimed to investigate the association between joint changes on magnetic resonance imaging (MRI) with pain severity in individuals with first MTP joint OA. This cross-sectional study used baseline data from 80 participants aged 36 to 74 years (mean [SD] = 57.5 [8.8]) with first MTP joint OA enrolled in two randomised trials. MRI atlas features assessed included osteophytes, bone marrow lesions, bone cysts, effusion-synovitis, cartilage loss, and joint space narrowing. Pain severity was measured using a visual analogue scale. Regression analyses included linear, multivariable models, with exploratory stepwise forward-selection analyses to identify MRI features associated with pain severity. Osteophytes, joint space narrowing, bone marrow lesions in the proximal phalanx and sesamoids, cysts, and effusion-synovitis were not associated with pain severity in unadjusted or adjusted analyses. In contrast, first metatarsal head bone marrow lesions (involving >66% of the first metatarsal head) were significantly associated with pain severity in adjusted (p = 0.025) and subsequent stepwise analyses (p = 0.039). Cartilage loss was additionally associated with pain severity in the stepwise analysis (p = 0.047). MRI-detected bone marrow lesions in the first metatarsal head and cartilage loss are associated with pain severity in first MTP joint OA. These findings provide insights into local mechanisms contributing to pain severity in the first MTP joint OA and may support the development of targeted interventions. Further research is needed to clarify the temporal relationship between MRI-detected pathology and symptoms.

52. Detection and removal methods of antibiotic-resistance genes in drinking water sources: a review.

期刊: Journal of water and health 发表日期: 2026-Jun 链接: PubMed

摘要

The natural evolutionary process of bacterial resistance has been catastrophically amplified into a planetary health crisis through anthropogenic antibiotic pollution. Antibiotic accumulation in the environment has become a key driver of antimicrobial resistance (AMR) proliferation. This is particularly critical in wastewater and drinking water systems (DWSs). The presence of antibiotics selects for resistant strains and facilitates horizontal gene transfer of antibiotic resistance genes (ARGs). This phenomenon arises from excessive antibiotic usage coupled with inefficient removal through conventional water treatments, which fail to eliminate residual antibiotics or impede ARG dissemination. This review systematically summarizes current knowledge on bacterial resistance mechanisms in DWSs and recent advancements in detection methodologies of ARGs. Furthermore, we discussed the efficiency of conventional water treatment processes against antimicrobial containment and the emerging solutions to help curb the menace of AMR effectively. Overall, this study aims to establish a theoretical foundation for accurately assessing health risks posed by ARGs in DWSs and implementing effective prevention and control measures. This review can serve as a foundational resource for guiding policy recommendations to protect drinking water sources and public health.

53. Causal inference for targeted public health interventions: interactions among environmental, social, and economic determinants within the one health framework.

期刊: Journal of water and health 发表日期: 2026-Jun 链接: PubMed

摘要

The One Health framework emphasizes the interconnection between human, animal, and environmental systems in shaping infectious disease dynamics. Multiple environmental, social, and economic determinants jointly influence disease transmission, operating through interconnected pathways within this system. However, the causal mechanisms linking these determinants to infectious disease outcomes remain poorly understood. This study systematically reviews and synthesizes evidence on the causal interrelationships among key determinants to better elucidate their contributions to infectious disease incidence. Drawing on literature across urbanization, climate change, land-use change, population mobility, and water, sanitation, and hygiene (WaSH) conditions, we examine how these factors interact to influence transmission dynamics through complex environmental and socioeconomic pathways. Our findings indicate that no single determinant independently drives disease transmission; rather, overlapping exposures and interactions create complex feedback loops that amplify public health vulnerabilities, particularly in resource-constrained settings. We advocate for the integration of causal inference to move beyond traditional correlation-based analyses and to identify the pathways through which these determinants influence disease dynamics. Embedding causal reasoning within the One Health framework can strengthen evidence-based policy and support the design of targeted, context-specific, and resilient public health interventions aimed at reducing the burden of infectious diseases.

54. When cancer meets acute coronary syndrome: moving beyond the 'cancer disadvantage'.

期刊: Journal of cardiovascular medicine (Hagerstown, Md.) 发表日期: 2026-Jun-01 链接: PubMed

摘要

55. Socioeconomic and attitudinal predictors of bottled water use among lower-income households in Southwest Virginia.

期刊: Journal of water and health 发表日期: 2026-Jun 链接: PubMed

摘要

Bottled water consumption is rising, influenced by perceptions of taste, convenience, safety, and concerns about other drinking water sources. However, bottled water use raises quality, environmental, and economic concerns. Despite poorer economic and health outcomes in Central Appalachia, there is a severe lack of research about drinking water in the region. This small-scale study explored predictors of bottled water usage among 27 households with utility-supplied water in Virginia. Logistic regression analyses considered the following as potential predictors of bottled water use: income, level of education, marital status, and tap water quality perceptions. About 78% of households reported using bottled water as a primary or secondary source, for reasons including perceptions of taste (43%), convenience (29%), safety (15%), and other reasons (13%). In this study, socioeconomic indicators were not significantly associated with bottled water use, but the perceived quality of households’ tap water was a significant predictor of primary bottled water use. This study contributes to our understanding drivers of bottled water use with a focus on the under-studied region of central Appalachia.

56. Epidemiology of Tuberculosis in Qatar: Eight-year Retrospective Cohort Study.

期刊: International journal of mycobacteriology 发表日期: 2026-Apr-01 链接: PubMed

摘要

Tuberculosis (TB) remains a major global health challenge, responsible for substantial morbidity and mortality. Understanding national epidemiological patterns, particularly in countries with large expatriate populations, is essential to update and guide both local and international TB control strategies. This study describes the epidemiology of TB in Qatar over an 8-year period (2016-2023). A retrospective cohort analysis using the Communicable Disease Center national TB registry. All individuals with confirmed Mycobacterium tuberculosis infection were included. Demographic characteristics, incidence, mortality, site of disease, and drug resistance patterns were included. Incidence rates were calculated using national population estimates and stratified by age, sex, nationality, and clinical form. A total of 6373 TB cases were reported during the study period. Annual incidence fluctuated between 20 and 37 per 100,000 population, consistently below both the global average and the World Health Organization End TB 2025 milestone target. A temporary spike was observed in 2021, possibly related to COVID-19 disruptions in health services and migration patterns. The majority of cases occurred in the 25-54 years age group. Males had consistently higher incidence rates than females. Non-Qataris accounted for the overwhelming majority of cases, particularly expatriates from high TB burden countries. The proportion of rifampicin-resistant or multidrug-resistant TB remained stable at 0.5%-1.8%, below the global average, with two cases of extensively drug-resistant TB identified. TB incidence in Qatar remains relatively low, with the burden falling disproportionately on working-age male expatriates from high-incidence countries. The findings highlight the importance of targeted screening, continuity of TB services during health system disruptions, and sustained surveillance of drug-resistant TB. These results provide insights relevant not only to Qatar but also to other low-incidence, high-migration countries striving to achieve global TB elimination goals.

57. Cultural adaptation and psychometric validation of the Health Literacy Instrument for Adults with Tuberculosis (HELIA-TB) in India.

期刊: PloS one 发表日期: 2026 链接: PubMed

摘要

Tuberculosis (TB) remains a critical public health challenge in India, where sustained patient engagement is essential for its effective management. Despite the pivotal role of health literacy, the ability to access, understand, appraise, and apply health-related information in treatment adherence and outcomes, few tools are TB specific, culturally attuned to India, and psychometrically validated. The Health Literacy Instrument for Adults (HELIA), developed in Iran, is a multidimensional, World Health Organization (WHO)-aligned measure with proven reliability and open access, making it an ideal candidate for adaptation. This study aimed to culturally adapt and validate the HELIA for use among adults receiving TB treatment in India (HELIA-TB). An exploratory sequential mixed-methods design was employed for the cultural adaptation and psychometric validation of the HELIA-TB in Junagadh district, Gujarat, India, between March 2024 and March 2025. The qualitative phase included expert review, forward translation, cognitive interviews with adults with TB and  frontline healthcare workers, back translation, and pilot testing, following international cross-cultural validation guidelines. Findings from the qualitative phase directly informed item modification, simplification of terminology, and contextual adaptation of the HELIA-TB prior to quantitative psychometric validation. The finalized instrument was subsequently administered to 393 adults with TB to assess internal consistency, test-retest reliability, content validity, and construct validity. HELIA-TB retained the original five domains, access, reading, understanding, appraisal, decision-making with TB specific modifications. Internal consistency and test-retest reliability were high (α = 0.82-0.89 across domains; 0.86 overall; ICC = 0.88), and so was content validity (S-CVI/Ave = 0.92). Health literacy scores were significantly associated with treatment adherence (Cohen’s d = 0.89, p < 0.001) and self-rated health (Cohen’s d = 0.76, p < 0.001). No significant differences were observed by TB type or drug resistance status. The adapted HELIA-TB demonstrated satisfactory psychometric properties and may support assessment of health literacy and development of targeted TB care interventions in the Indian context.

58. Vestibular Migraine Revisited: A Narrative Review of Diagnostic Challenges and Treatment Strategies.

期刊: The journal of international advanced otology 发表日期: 2025-Sep-29 链接: PubMed

摘要

Vestibular migraine (VM) is a common yet frequently underdiagnosed neurological condition, marked by recurrent episodes of vertigo and other vestibular symptoms in association with migraine features. It predominantly affects women aged 30-50 years and has an estimated prevalence of 1%-5% in the general population. This narrative review explores current knowledge surrounding VM, including its epidemiology, proposed mechanisms, diagnostic complexities, and treatment approaches. The pathophysiology remains incompletely understood but may involve dysfunction in vestibule-cerebellar pathways, ion channel abnormalities, and trigeminal system activation. Diagnosing VM is clinically driven, requiring careful evaluation of vestibular complaints alongside migraine-associated symptoms. Patients commonly report vertigo and headaches, while clinical assessment may uncover ocular motor disturbances, canal paresis, and balance issues. Supplementary tests such as ocular and cervical vestibular evoked myogenic potentials can aid in diagnosis, though they are not definitive. Differential diagnosis is essential due to symptom overlap with other vestibular disorders like Ménière’s disease, episodic ataxia type 2, and benign paroxysmal positional vertigo. Treatment includes acute interventions with vestibular suppressants and triptans, vestibular rehabilitation programs, and preventive pharmacotherapy such as β-blockers, calcium channel blockers, and certain antidepressants. Despite these options, clinical evidence remains scarce, primarily relying on small-scale trials and expert consensus. No universally effective regimen has yet been identified. Overall, VM poses significant diagnostic and therapeutic challenges, underscoring the need for further research to clarify its mechanisms, improve diagnostic precision, and develop evidence-based treatment strategies that could lessen its burden and improve patient outcomes.

59. Profession-led vs collaborative workforce models in dental, vision, and hearing care for older adults in community care: A mixed-methods systematic review.

期刊: Health care management review 发表日期: 链接: PubMed

摘要

Dental, vision, and hearing impairments are among the most prevalent long-term conditions affecting older adults, contributing to late-life disability and reducing quality of life. Early detection and prevention may reduce avoidable emergency hospitalizations and health system costs while enhancing well-being. Despite this, integrated service delivery across these sensory and oral health domains remains limited, especially in community care settings. This systematic review aimed to synthesize evidence on integrated workforce models involving dental, vision, and hearing professionals within community care settings for older adults. A mixed-method systematic review was conducted using a comprehensive three-step search strategy across MEDLINE, CINAHL, Web of Science, Embase, and Scopus spanning January 2010 to December 2024, and updated in October 2025. In all, 798 articles were identified, with 14 meeting inclusion criteria for convergent integrated synthesis. Included studies involved adults aged 60+ or with samples containing at least 50% older adults, examining community-based models where dental, vision, or hearing personnel collaborated with at least one other health or welfare provider. Critical appraisal and data synthesis followed the Joanna Briggs Institute methodology. Of the 14 studies (5 qualitative, 6 mixed methods, 3 quantitative), 9 focused on dental, 3 on vision, and 2 on hearing workforce models. Studies were primarily from the United States (n=8), Australia (n=2), the Netherlands (n=2), Germany (n=1), and Norway (n=1). Two workforce model types emerged inductively: profession-led models (n=10), characterized by leadership and care coordination, and led by a dental, vision or hearing expert, and collaborative-led models (n=4), featuring shared leadership and an extended skill mix. Profession-led models emphasized clinical interventions; collaborative-led models prioritized health promotion and prevention. Reported outcomes primarily related to service delivery, workforce processes, and patient experiences, including patient satisfaction. Evidence of clinical effectiveness outcomes was limited, and studies varied substantially in design, context and outcome measures. Integrated workforce models in dental, vision, and hearing for older adults in community care show promise in improving care delivery processes and patient-reported outcomes. However, the current evidence base is limited and heterogenous, with few robust evaluations of clinical effectiveness. As such, these models need to undergo further rigorous research to assess their effectiveness, scalability, and context-specific implementation.

60. [Structural and functional cardiac parameters in older adults residing in a long-term social care facility.].

期刊: Advances in gerontology = Uspekhi gerontologii 发表日期: 2026 链接: PubMed

摘要

The aging of the population is accompanied by an increase in the prevalence of chronic heart failure, including those with preserved ejection fraction, which necessitates the early detection of structural and functional changes in the myocardium in the elderly and senile, especially in long-term care facilities. The aim of the study was to identify the features of the structural and functional state and diastolic function of the myocardium in elderly and senile patients with various rehabilitation profiles according to transthoracic echocardiography. The study included residents of the residential care home for the elderly and disabled No. 1 in St. Petersburg, divided into cognitive, motor and mixed rehabilitation groups. All participants underwent transthoracic echocardiography with an assessment of the size of the chambers of the heart, the thickness of the interventricular septum and the posterior wall of the left ventricle, myocardial mass, ejection fraction, parameters of diastolic function and indicators of pulmonary hemodynamics. All the examined patients showed age-associated signs of thickening of the walls and an increase in the relative thickness of the myocardium. At the same time, the severity of diastolic dysfunction and signs of pulmonary hypertension was statistically significantly higher in the cognitive and mixed groups compared with the motor ones. Against the background of preserved systolic function, hemodynamically significant disorders of diastolic filling were recorded in a significant proportion of patients, indicating early stages of heart failure with preserved ejection fraction. The data obtained confirm the expediency of including echocardiographic indicators in the algorithms of clinical and functional stratification of elderly patients and planning personalized medical and social rehabilitation programs in the long-term care system. Старение населения сопровождается увеличением распространённости ХСН, в том числе с сохранённой ФВ, что обусловливает необходимость раннего выявления структурно-функциональных изменений миокарда у лиц пожилого и старческого возраста, особенно в условиях учреждений длительного ухода. Цель исследования — выявить особенности структурно-функционального состояния и диастолической функции миокарда у пациентов пожилого и старческого возраста с различными реабилитационными профилями по данным трансторакальной эхо-КГ. В исследование были включены резиденты дома-интерната для престарелых и инвалидов № 1 Санкт-Петербурга, распределённые на когнитивную, двигательную и смешанную реабилитационные группы. Всем участникам была выполнена трансторакальная эхо-КГ с оценкой размеров камер сердца, толщины межжелудочковой перегородки и задней стенки ЛЖ, массы миокарда, ФВ, параметров диастолической функции и показателей лёгочной гемодинамики. У всех обследованных выявлены возраст-ассоциированные признаки утолщения стенок и увеличения относительной толщины миокарда. При этом выраженность диастолической дисфункции и признаков лёгочной гипертензии была статистически значимо выше в когнитивной и смешанной группах по сравнению с двигательной. На фоне сохранённой систолической функции у значительной части пациентов регистрировали гемодинамически значимые нарушения диастолического наполнения, указывающие на ранние стадии сердечной недостаточности с сохранённой ФВ. Полученные данные подтверждают целесообразность включения эхокардиографических показателей в алгоритмы клинико-функциональной стратификации пожилых пациентов и планирования персонализированных программ медико-социальной реабилитации в системе долговременного ухода.