公共卫生研究摘要 (2026-07-03)

共收录 60 篇研究文章

1. Factors Associated With Disability Improvement and Worsening Independent of Attacks in Patients With AQP4-IgG+ NMOSD and MOGAD: A Multicenter Cohort Study.

期刊: Neurology 发表日期: 2026-Jul-28 链接: PubMed

摘要

Disability trajectories in aquaporin-4 immunoglobulin G-seropositive neuromyelitis optica spectrum disorder (AQP4-IgG+ NMOSD) and myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) are primarily driven by attack-related damage. Confirmed disability worsening (CDW) independent of attacks has been described but occurs infrequently in AQP4-IgG+ NMOSD and MOGAD. Confirmed disability improvement (CDI) has not been evaluated in large cohorts. We determined the frequency of CDI and CDW independent of attacks and identified clinical factors associated with these outcomes in AQP4-IgG+ NMOSD and MOGAD. This retrospective, multicenter cohort study analyzed data from the German Neuromyelitis Optica Study Group (NEMOS) registry. Adult patients with AQP4-IgG+ NMOSD or MOGAD and longitudinal Expanded Disability Status Scale (EDSS) assessments were included. EDSS episodes were defined as periods with ≥3 EDSS assessments without attacks, obtained ≥90 days after attack. CDW and CDI were defined as sustained EDSS increase or decrease (≥1.5 for baseline EDSS 0; ≥1.0 for EDSS 1.0-5.5; ≥0.5 for EDSS ≥6.0) confirmed after at least 6 months. The primary outcomes were annualized CDI and CDW rates. Risk factors were assessed using multivariable Anderson-Gill regression models. A total of 338 EDSS episodes of 307 patients (n: 202/105, median age at EDSS change: 56/41 years, 88/49% female, both p < 0.001; AQP4-IgG+ NMOSD/MOGAD) were included. Adjusted annualized CDI and CDW rates did not differ between AQP4-IgG+ NMOSD (CDI: 0.083, 95% CI 0.029-0.233; CDW: 0.025, 95% CI 0.007-0.092) and MOGAD (CDI: 0.057, 95% CI 0.012-0.277; CDW: 0.036, 95% CI 0.002-0.513). In AQP4-IgG+ NMOSD, a lower number of prior attacks was associated with higher CDI rates (hazard ratio [HR] 0.89, 95% CI 0.82-0.97). Younger age was associated with increased CDI rates in both AQP4-IgG+ NMOSD and MOGAD (HR 0.96, 95% CI 0.94-0.99, for both). CDI and CDW independent of attacks, although rare, occur in AQP4-IgG+ NMOSD and MOGAD. The association between fewer prior attacks and higher CDI rates in AQP4-IgG+ NMOSD underscores the importance of early attack prevention. Limitations include the retrospective design, and the limited number of CDI and CDW events.

2. Mathematical misdefinition of adjusted cloud-fraction change limits isolation of aerosol effects.

期刊: Proceedings of the National Academy of Sciences of the United States of America 发表日期: 2026-Jul-14 链接: PubMed

摘要

3. Fatty acid regulation and phosphatidylethanolamine biosynthesis are important for hepatitis E virus replication.

期刊: Proceedings of the National Academy of Sciences of the United States of America 发表日期: 2026-Jul-07 链接: PubMed

摘要

Hepatitis E virus (HEV), a leading cause of viral hepatitis globally, is associated with adverse outcomes during pregnancy. Despite its clinical significance, the mechanisms driving enhanced HEV replication during pregnancy remain poorly understood. In this study, we uncover a lipid-mediated pathway that facilitates HEV replication, with potential implications for pregnancy-associated pathogenesis. Lipidomic profiling reveals a marked upregulation of oleic acid during HEV infection in both human liver cells and in HEV-3ra-infected pregnant rabbits. We showed that oleic acid significantly enhances HEV replication, possibly through interaction with a predicted fatty acid-binding domain (FABD) located within the papain-like cysteine protease region of the HEV ORF1 polyprotein. We further demonstrated that phosphatidylethanolamine (PE) levels are elevated during HEV-3ra infection in pregnant rabbits, and that inhibition of PE biosynthesis by CRISPR/Cas9-mediated knockdown and silencing of phosphatidylserine decarboxylase/phosphoethanolamine cytidylyltransferase genes that are responsible for PE synthesis resulted in decreased HEV replication, indicating that PE is important for HEV replication. Additionally, we found that placental lactogen hormone, which is elevated during late pregnancy, stimulated fatty acid accumulation and potentiated HEV replication, therefore providing a potential explanation for pregnancy-associated adverse outcomes. Collectively, our findings reveal an important role of host lipid metabolism in HEV replication and offer mechanistic insights into lipid-dependent enhancement of HEV replication and a potential role of lipid reprogramming in HEV pathogenesis. The results may inform potential future anti-HEV therapeutic strategies targeting lipid pathways.

4. A DEMATEL-based model to analyze causal factors affecting patients' informed consent.

期刊: International journal of health care quality assurance 发表日期: 2026-Jul-06 链接: PubMed

摘要

Patients’ informed consent is recognized as a fundamental pillar of medical ethics and patient rights. Failure to acknowledge or adequately implement informed consent carries serious consequences for the integrity and effectiveness of the healthcare system. This study aims to analyze the systematic relationships among factors influencing patients’ informed consent. This descriptive-analytical cross-sectional study was conducted at a private hospital in Tehran in early 2025. A sample of 11 specialist physicians and nurses was selected using purposive and snowball sampling methods. Data were collected using a pairwise comparison matrix questionnaire. Descriptive data analysis was performed using SPSS 26.0, and the Decision-Making Trial and Evaluation Laboratory (DEMATEL) method was applied using MATLAB software. The results showed that in the interactive model and systematic relationship analysis among components influencing the obtaining of informed consent from patients, interpersonal and individual factors belong to the group of influential factors, while organizational and environmental fact ors belong to the group of influenced factors. Interpersonal and environmental factors were identified as the most influential and most influenced factors, respectively. The DEMATEL-based model identified interpersonal and individual factors as key influencers of informed consent, while organizational and environmental factors were primarily influenced. This suggests that improving communication quality and patient understanding may generate system-wide benefits. However, findings reflect a single private hospital context and should be considered exploratory. The model provides a hypothesis-generating foundation for future validation and targeted interventions in similar Iranian healthcare settings.

5. Device-Assessed Physical Activity and Cardiometabolic Health in Chinese American Women With a History of Gestational Diabetes Mellitus.

期刊: The Journal of cardiovascular nursing 发表日期: 2026-Jul-03 链接: PubMed

摘要

While there is evidence of the benefits of healthy maternal lifestyle behaviors (eg, physical activity plus a healthy diet) on cardiometabolic health, there are limited data on the independent association between physical activity and cardiometabolic health among women with a history of gestational diabetes mellitus (GDM). In this study, our aim was to explore the association between device-assessed physical activity and cardiometabolic outcomes in Chinese American women, a group disproportionately affected by GDM and type 2 diabetes. A cross-sectional study was conducted among 33 Chinese American women (0.5-5 years after delivery) with a history of GDM in New York City in 2023 to 2024, in which we collected their device-assessed physical activity data, online survey data (in Mandarin and English), and cardiometabolic data (via fasting blood samples). Descriptive, unadjusted, and adjusted regression analyses were performed. Participants’ mean age was 38.2 ± 3.3 years (2.6 ± 1.5 years after delivery), and body mass index was 23.5 (interquartile range: 21.7-25.1) kg/m2. Among the 33 participants, 27.3% had prediabetes, 51.5% had lipid dysregulation, and 21.2% had elevated blood pressure. The duration of moderate-to-vigorous physical activity per week was 132.4 (interquartile range: 90.5-272.0) minutes, and 46.9% of the cohort met the physical activity recommendation of ≥150 minutes moderate-to-vigorous physical activity per week. In regression models, meeting the physical activity recommendations was inversely associated with total cholesterol (-27.6 ± 12.7 mg/dL) and low-density lipoprotein cholesterol (-25.5 ± 10.6 mg/dL) levels (both P <.04). The majority of participants engaged in suboptimal physical activity levels. However, meeting physical activity recommendations was associated with better total and low-density lipoprotein cholesterol levels. Targeting physical activity may be a key strategy for improving cardiometabolic health in Chinese American women recently diagnosed with GDM.

6. A historical overview of the anti-vaccine movement and its public health implications.

期刊: Vaccine 发表日期: 2026-Jul-02 链接: PubMed

摘要

Vaccination is one of the most effective public health interventions in history, yet resistance to vaccines has persisted across centuries. This narrative historical review examines the evolution of vaccine hesitancy and anti-vaccine sentiment from the smallpox era to the COVID-19 pandemic. Sources were identified through PubMed and major public health organizations, including the World Health Organization and the U.S. Centers for Disease Control and Prevention, spanning the early 18th century through 2025. Across distinct historical periods, including early smallpox vaccination, mid-20th-century vaccine controversies, the 1998 Wakefield publication, and the COVID-19 pandemic, recurring themes emerge. Concerns regarding vaccine safety, distrust of institutions, and objections grounded in personal liberty have consistently shaped resistance. While these core arguments have remained stable, the mechanisms of dissemination have transformed dramatically. Modern digital platforms enable rapid, large-scale spread of misinformation, often amplified by algorithms that prioritize emotionally engaging content. The COVID-19 pandemic marked a critical inflection point, with vaccine hesitancy becoming increasingly politicized and, in some cases, economically incentivized through monetized online content. Historical examples demonstrate that both genuine safety events and misinformation can produce long-lasting effects on public trust, even after scientific refutation. This review highlights that vaccine resistance is not solely a deficit of scientific knowledge but a complex interplay of social, political, and cultural factors. Effective public health strategies must therefore extend beyond evidence dissemination to include trust-building, transparent communication, and engagement within modern information ecosystems. Sustaining vaccine confidence will require addressing both the historical roots and contemporary drivers of hesitancy.

7. Vaccine strategies and development before and during the 1968 H3N2 influenza pandemic.

期刊: Vaccine 发表日期: 2026-Jul-02 链接: PubMed

摘要

Nearly 60 years ago, in 1968, the global population was confronted with the emerging pandemic influenza A virus (IAV) subtype H3N2 (1968 H3N2pdm). An estimate of up to two million fatalities have been linked to 1968 H3N2pdm, and the H3N2 subtype continues to circulate as seasonal IAV among humans until today. The last IAV pandemic dates back to the year 2009 but concerns about a new IAV pandemic in the near future are increasing. The global spread of H5N1 highly pathogenic avian influenza virus and its spill-over into new mammalian hosts, discovery of novel influenza A virus with zoonotic or even pandemic potential, as well as seasonal influenza viruses undergoing antigenic changes necessitate constant vigilance. Here, we highlight the proactive actions, precautionary measures and vaccination strategies used during the 1968 H3N2 IAV pandemic. Our review highlights the emergence and spread of 1968 H3N2pdm over the course of the pandemic, alongside a delineation of vaccine development before, during and after the 1968 pandemic. Updating these strategies in the context of new findings combined with our experiences during the coronavirus disease 2019 (COVID-19) pandemic is necessary to improve preparedness for the next pandemic. Influenza viruses with zoonotic potential will remain a constant threat to public health, and improving countermeasures and communication to the public is key to limit the pandemic ramifications.

8. Influence of correlated vaccination behaviors on estimates of COVID-19 vaccine effectiveness in older adults - VISION network, October 2023 - March 2024.

期刊: Vaccine 发表日期: 2026-Jul-02 链接: PubMed

摘要

Test negative design studies allow for COVID-19 vaccine effectiveness (VE) estimation while minimizing selection bias from healthcare seeking and testing practices. However, failure to consider correlation between vaccination behaviors may result in biased COVID-19 VE estimates. Using different methods to account for potential correlation between COVID-19, influenza, and respiratory syncytial virus (RSV) vaccination status, we investigated variability in VE estimates of the 2023-2024 COVID-19 vaccine against COVID-19-associated emergency department and urgent care (ED/UC) encounters and hospitalizations during the 2023-2024 respiratory virus season. Data were leveraged from VISION, an electronic health record-based platform. VE estimates ≥7 days post vaccination did not increase by more than 5 percentage points against ED/UC encounters and 3 percentage points against hospitalizations when accounting for influenza and RSV vaccination status or excluding influenza and RSV positive controls. As the magnitude of this influence depends on season-specific factors, ongoing monitoring is warranted.

9. Associations of sarcopenia with the risk of incident respiratory disease and the role of inflammation and metabolism: a prospective cohort study.

期刊: The journal of nutrition, health & aging 发表日期: 2026-Jul-02 链接: PubMed

摘要

To explore the complex associations of sarcopenia with lung function, and risks of incident respiratory disease (including its subtypes: chronic obstructive pulmonary disease [COPD], asthma, and interstitial lung disease [ILD]), as well as to explore the potential inflammatory and metabolic pathways. Prospective cohort study. We assembled data from 317,628 adults enrolled in the UK Biobank. Sarcopenia status was defined using the European Working Group on Sarcopenia in Older People 2 criteria. Lung function was assessed via a spirometer. The incident respiratory disease was ascertained through linked hospital data over a median follow-up of 14 years. Both probable sarcopenia and confirmed/severe sarcopenia were consistently associated with poorer lung function and a higher risk of incident respiratory disease. For instance, compared with their non-sarcopenic counterparts, participants with probable sarcopenia exhibited a significantly higher risk (P < 0.001) of respiratory disease (hazard ratio [HR] = 1.30; 95% confidence interval [CI]: 1.26, 1.36), COPD (HR = 1.37; 95% CI: 1.24, 1.50), asthma (HR = 1.35; 95% CI: 1.23, 1.48), and ILD (HR = 1.74; 95% CI: 1.48, 2.04). Furthermore, inflammatory markers and metabolites partially mediated the associations between probable sarcopenia and incident respiratory disease, with C-reactive protein (5.2 %-12.9 %) and albumin (2.6%-8.0%) showing relatively higher mediation proportions. Sarcopenia, even at the probable stage, was significantly associated with an increased risk of incident respiratory disease, and inflammatory and metabolic mechanisms may underlie these associations. Our findings highlight the importance of early prevention and management of sarcopenia for preserving respiratory health.

10. The interplay between Theory of Mind inferencing and visual attention in narrative comprehension in autistic preschoolers.

期刊: Journal of experimental child psychology 发表日期: 2026-Jul-02 链接: PubMed

摘要

Autistic children often display difficulties in Theory of Mind (ToM) reasoning. Though ToM skills have been extensively investigated in autistic children through narrative comprehension, our knowledge of the moment-to-moment mechanisms underlying their ability to infer others’ viewpoints is limited. This study administered a visual world eye tracking paradigm with a simultaneous narrative comprehension task to 36 autistic preschoolers and 36 age-matched non-autistic children. We aimed to investigate the groups’ processing of the story protagonists’ goals, thoughts and emotions through behavioral and eye gaze data. According to the results, autistic children answered questions about goals and cognitive ToM less accurately than their non-autistic peers. Across all three question-types, we found distinct eye gaze patterns between the two groups depending on whether the children responded accurately or not to the narrative comprehension questions. In accurate trials, autistic children exhibited more fixations and looked longer at the story characters than the non-autistic group, indicating that grasping others’ cognitive and emotional viewpoint was more effortful for them. On the other hand, in inaccurate trials, we found an over-attention bias towards objects in the autistic group only. Findings highlight the importance of narrative eye tracking techniques when investigating the social-cognitive skills of autistic children.

11. Sensor-Based Monitoring of Knee Osteoarthritis Symptoms in Free-Living Settings: Scoping Review.

期刊: Journal of medical Internet research 发表日期: 2026-Jul-02 链接: PubMed

摘要

Knee osteoarthritis is a heterogeneous condition characterized by chronic pain, stiffness, and fatigue that fluctuate rapidly over time. Traditional clinical assessments provide only static diagnoses of disease severity, failing to capture the dynamic, day-to-day symptom variability that impacts patient quality of life. While wearable technologies offer the potential for continuous, high-frequency monitoring, previous reviews have examined general technological interventions for knee osteoarthritis management, yet they lack a specific synthesis of technologies for symptom monitoring. This study aims to synthesize current research on sensor technologies used for the continuous monitoring of knee osteoarthritis symptoms in free-living or simulated daily environments. Specifically, the review seeks to (1) map sensor modalities to specific symptom domains (biomechanical, physiological, and behavioral); (2) evaluate the alignment between objective sensor metrics and patient-reported outcome measures; and (3) identify gaps in current monitoring paradigms. A systematic literature search was conducted across PubMed, Embase, Web of Science, and IEEE Xplore. The review followed the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) guidelines. Eligibility criteria included studies involving participants with knee osteoarthritis using wearable or portable sensors capable of continuous monitoring (eg, inertial measurement units and electrocardiography) and assessing clinical symptoms (eg, pain, fatigue, and stiffness). Studies relying solely on stationary laboratory equipment (eg, force plates) without a portable component were excluded to ensure relevance to real-world applicability. Data regarding sensor types, sampling frequencies, monitored symptoms, and the statistical association between objective features and subjective symptom severity (key findings) were extracted. A total of 16 studies met the inclusion criteria. The summary constructed from the results revealed a distinct technological saturation: the majority of studies (n=6) used inertial measurement units to quantify biomechanical deficits (eg, gait asymmetry and range of motion), which showed robust correlations with functional limitations. In contrast, there was a notable scarcity of research using physiological sensors (eg, electrocardiography and bioimpedance) to monitor systemic symptoms. Crucially, findings highlighted a significant discrepancy between subjective and objective data, particularly in sleep monitoring, where poor self-reported sleep quality predicted pain exacerbations despite stable objective actigraphy metrics. Furthermore, most systems operated as passive data loggers, with a lack of integration into active feedback loops. Unlike previous reviews focused solely on biomechanics, this study innovatively maps the use of sensors across a multidimensional symptom spectrum, revealing a critical gap in the monitoring of fatigue and physiological stress. The findings suggest that current sensor applications are limited by a lack of integration with subjective patient experiences. Real-world implementation requires a hybrid monitoring paradigm that combines the ecological validity of wearable sensors with the clinical relevance of patient-reported outcomes. This approach paves the way for digital phenotyping and active feedback systems, offering a personalized strategy for managing the complex symptom burden of knee osteoarthritis.

12. Effects of Immersive Virtual Reality Interventions on Symptom Management in Patients With Gastrointestinal Cancer: Systematic Review and Meta-Analysis of Randomized Controlled Trials.

期刊: Journal of medical Internet research 发表日期: 2026-Jul-02 链接: PubMed

摘要

Patients with gastrointestinal cancers experience a broad range of symptoms, including anxiety, pain, and reduced quality of life. Although immersive virtual reality (IVR) has emerged as a potential intervention, its efficacy specifically in patients with gastrointestinal cancer remains unclear. This systematic review and meta-analysis of randomized controlled trials (RCTs) evaluated the effects of IVR on symptom management in patients with gastrointestinal cancer. Twelve databases and 1 gray literature source were searched from inception to April 30, 2026. RCTs comparing IVR interventions to routine care or nonimmersive alternatives for symptom management in adults (≥18 years) with gastrointestinal cancer were eligible. Two reviewers independently screened records, extracted data, and assessed risk of bias using the Cochrane RoB 2 tool. The evidence certainty was evaluated using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach. Random-effects meta-analyses were performed for primary outcomes (anxiety, pain, quality of life) and secondary outcomes (knowledge, length of stay, vital signs, safety). Heterogeneity was explored using subgroup analyses and meta-regression. Fourteen RCTs were included, comprising individuals (N=837) with colorectal, liver, esophageal, gastric, pancreatic, and biliary tract cancers. IVR interventions-including immersive scenes, interactive games, anatomical models, and cognitive behavioral modules-were primarily delivered during perioperative and chemotherapy periods. Meta-analysis showed that IVR significantly reduced anxiety (standardized mean difference [SMD] -0.58, 95% CI -0.95 to -0.20; P=.01; 95% prediction interval [PI] -1.36 to 0.21) and pain (SMD -0.75, 95% CI -1.48 to -0.03; P=.04; 95% PI -2.21 to 0.71). Subgroup analysis revealed that the anxiolytic effect was more pronounced when IVR was administered during active treatment and when single sessions lasted ≥20 minutes. Hospital stay was significantly shorter in the IVR group (mean difference -4.11 days, 95% CI -7.39 to -0.82; P=.03; 95% PI -13.82 to 5.60 days). No significant effects were detected for quality of life, knowledge acquisition, or vital signs. The evidence certainty was moderate to very low, with common limitations including risk of bias and imprecision. This meta-analysis provides evidence that IVR is an effective nonpharmacological adjunct for symptom management in patients with gastrointestinal cancer, significantly reducing anxiety and pain when implemented during active treatment for at least 20 minutes. However, these findings should be interpreted with caution due to moderate to high heterogeneity, substantial risk of bias in the included studies, and low to very low GRADE evidence certainty. While the 95% CIs indicate a statistically significant average effect, the wide 95% PIs suggest that the true effect in future clinical settings may vary considerably, ranging from marked benefit to negligible impact. These results support the integration of IVR into perioperative and chemotherapy care pathways while underscoring the need for larger, more rigorously designed trials to establish definitive conclusions.

13. Monitoring Health Status: Development and Preliminary Validation of a Personal Health Index Using the International Classification of Functioning, Disability and Health.

期刊: JMIR human factors 发表日期: 2026-Jul-02 链接: PubMed

摘要

Effective health monitoring is essential for personalized care and comprehensive health assessment. Personal health indices and profiles offer a concise summary of an individual’s overall health, supporting both clinical decision-making and self-management. However, global standardization remains challenging due to diverse practices and data formats across countries. This study aimed to present a novel model for computing a personal health index and health profile using the International Classification of Functioning, Disability and Health (ICF) framework. The model was designed to handle incomplete and heterogeneous datasets and aimed to provide standardized, interpretable health metrics. We developed a recursive algorithm that calculates the health index based on the hierarchical structure of the ICF, using all available measurements. The model incorporates time decay and linkage reliability to weight input data. Preliminary validation was conducted on data from 505 individuals, using statistical correlation analyses with self-assessed health measures (EuroQol Visual Analogue Scale and pain ratings), and a sensitivity analysis was performed to assess model robustness. The computed health index showed moderate positive correlations with EuroQol Visual Analogue Scale scores (all P<.001) and negative correlations with maximum pain trajectories, supporting its validity. Sensitivity analysis confirmed predictable behavior in response to input changes, and the model demonstrated resilience to missing data. The proposed model offers a flexible and scientifically grounded approach to computing personal health indices and profiles within the ICF framework. It enables the integration of diverse health data sources and supports the visual representation for clinical and personal use. This model has potential applications in health monitoring, rehabilitation planning, and machine learning-based health informatics.

14. Pharmacological approaches for colitis associated colorectal cancer: a survey in preclinical studies.

期刊: Cancer treatment and research communications 发表日期: 2026-Jul-02 链接: PubMed

摘要

Colitis-associated colorectal cancer (CAC) is a severe complication of inflammatory bowel disease (IBD), characterized by a unique inflammation-driven pathogenesis that distinguishes it from sporadic colorectal cancer. Despite advances in diagnostics and therapeutic interventions for IBD, effective preventive pharmacological treatments for CAC remain a critical unmet need. Drug discovery through the design and synthesis of novel molecules consumes considerable time and expense, especially for CAC in which no single enzyme, receptor, or gene dominates. Alternative approaches involve drug repurposing and application of natural compounds. The concurrent administration of multiple existing agents, as part of combination therapy, alongside the implementation of novel drug delivery systems such as nanocarriers, presents feasible and practical approaches for discovering effective treatments for CAC. After highlighting key molecular mechanisms in CAC pathogenesis, this review comprehensively surveys applied drug discovery approaches for CAC in preclinical studies. Our review highlights the importance of early and long-term intervention to prevent CAC, primarily by inhibiting the COX-2, STAT3, and NF-κB pathways associated with inflammation. Promising advances in CAC therapy involve the use of natural compounds and repurposed drugs, often administered in combination or through nanocarriers. These strategies aim to enhance therapeutic efficacy while minimizing toxicity.

15. Association of a Polygenic Risk Score with Diagnosis and Outcomes in Idiopathic Pulmonary Fibrosis.

期刊: American journal of respiratory and critical care medicine 发表日期: 2026-Jul-02 链接: PubMed

摘要

Idiopathic Pulmonary Fibrosis (IPF) is characterized by chronic progressive pulmonary fibrosis and high mortality. Genetic markers, summarized into a polygenic risk score (PRS), associate with IPF in well-phenotyped research cohorts. To evaluate the performance of the PRS using real-world data from routinely captured electronic healthcare records. We conducted an observational study evaluating the association of a PRS for IPF with electronic healthcare record diagnosis of IPF as well as lung transplant-free survival in four independent cohorts; the Mass General Brigham Biobank (MGBB), Mayo Clinic Biobank (MCBB), Mayo Clinic Tapestry Cohort (Tapestry), and U.K. Biobank (UKBB). We used multivariable logistic regression and multivariable Cox proportional hazards models adjusting for age, gender, and principal components of ancestry. The cohorts then underwent fixed and random effects meta-analysis. Of 37,709; 44,195; 43,202; and 447,422 participants from MGBB, MCBB, Tapestry and UKBB respectively, 1,015 (2.7%) 2,879 (6.5%), 1,310 (3.0%), and 2,742 (0.6%) participants had an IPF diagnosis. Meta-analysis demonstrated a high-risk PRS associated with IPF diagnosis, OR 2.88 (95%CI 2.41-3.44) compared to all other individuals. A high-risk PRS also associated with the composite endpoint of mortality or lung transplant among those with an IPF diagnosis, HR 1.23(95%CI 1.11-1.35) compared to all other individuals. A PRS can identify those at risk for an IPF diagnosis and mortality in biobank-scale data, which may have implications for clinical decisions. Further work is necessary to evaluate the utility of adding genetics in clinical settings.

16. The Role of Gender in HIV Care Engagement Among Individuals Assigned Male Sex at Birth: Medical Monitoring Project, United States, 2015-2022.

期刊: American journal of public health 发表日期: 2026-Jul-02 链接: PubMed

摘要

Objectives. To estimate the number of US transgender women living with HIV and compare determinants of health between US transgender women and presumed cisgender men. Methods. We analyzed cross-sectional interview and medical record data (2015-2022) from the Medical Monitoring Project, a nationally representative sample of people living with HIV in the United States. Results. Weighted estimates suggest that 21 088 US transgender women are living with HIV. Across nearly every domain, transgender women reported greater barriers to care than did presumed cisgender men, including higher rates of hunger or food insecurity (34% vs 18%), unstable housing or homelessness (33% vs 18%), and lower rates of viral suppression (66% vs 74%). Conclusions. Transgender women living with HIV face greater and distinct barriers to wellness and care engagement across multiple domains than their cisgender male counterparts. Public Health Implications. Transgender identity is a critical factor in HIV-related health equity. Future research is urgently needed to understand how to support transgender women living with HIV in accessing the services they need to live healthy lives. (Am J Public Health. Published online ahead of print July 2, 2026:e1-e8. https://doi.org/10.2105/AJPH.2026.308497).

17. The Risks of Mortality, Cardiovascular Events, and Pulmonary Complications in Cancer Patients Who Smoke Cigarettes and Switch to E-Cigarettes: South Korea, 2015‒2022.

期刊: American journal of public health 发表日期: 2026-Jul-02 链接: PubMed

摘要

Objectives. To evaluate the risks of mortality, cardiovascular events, and pulmonary complications among cancer patients who quit, continued smoking, or switched to e-cigarettes after diagnosis. Methods. Using the Korean National Health Insurance Service database (2015-2022), we identified 46 834 cancer patients who were smoking at diagnosis. Patients were categorized as continued smokers (n = 17 418), quitters (n = 25 909), or e-cigarette users (n = 3507) after diagnosis. We used multivariable Cox proportional hazards models to assess associations. Results. During a median 4.2 years of follow-up, all-cause mortality was significantly lower in quitters (hazard ratio [HR] = 0.92; 95% confidence interval [CI] = 0.86, 0.98) and e-cigarette users (HR = 0.84; 95% CI = 0.72, 0.99) than continued smokers. Both groups also showed lower cardiovascular event risks (HR = 0.64; 95% CI = 0.57, 0.72 and HR = 0.72; 95% CI = 0.53, 0.97, respectively). Compared with quitters, e-cigarette users had increased pulmonary complication risk (HR = 1.26; 95% CI = 1.00, 1.58). Conclusions. E-cigarette use was associated with lower mortality and cardiovascular risks than continued smoking, though complete cessation conferred greater benefits. Elevated pulmonary complications in e-cigarette users warrant caution. (Am J Public Health. Published online ahead of print July 2, 2026:e1-e12. https://doi.org/10.2105/AJPH.2026.308512).

18. Trends in Sexual Activity, Condom Use, and Use of Pregnancy Prevention Methods Among Female Adolescents: United States, 2007-2023.

期刊: American journal of public health 发表日期: 2026-Jul-02 链接: PubMed

摘要

Objectives. To examine trends in sexual behaviors, condom use, and pregnancy prevention methods among female adolescents. Methods. We analyzed national and state Youth Risk Behavior Surveillance System data (2007-2023) among US female high school students (≥ 14 years). Outcomes included current sexual activity, condom use, and use of pregnancy prevention methods. We estimated weighted prevalence and trends overall and by region, age, and race/ethnicity and examined adolescent birthrates using Centers for Disease Control and Prevention data. Results. The proportion of respondents who were currently sexually active declined (2007-2011: 35.1%; 2019-2023: 23.8%; P < .01). Among those sexually active, nonuse of condoms increased (45.8% to 52.4%; P < .01), whereas nonuse of moderately or highly effective pregnancy prevention decreased (73.0% to 63.0%; P < .01), reflecting increased uptake of effective methods. The proportion using no pregnancy prevention method remained stable. Declines in sexual activity reduced population-level sexual risk indicators. Racial/ethnic disparities persisted. Birthrates declined substantially. Conclusions. Declines in adolescent birthrates are driven largely by reduced sexual activity, whereas condom use has declined and disparities in contraceptive use persist, indicating uneven improvements in sexual health behaviors. Public Health Implications. Efforts should strengthen comprehensive sexual health education and access to effective contraception and condoms, with targeted strategies for younger adolescents, the South, and non-Hispanic Black and Hispanic populations. (Am J Public Health. Published online ahead of print July 2, 2026:e1-e10. https://doi.org/10.2105/AJPH.2026.308511).

19. Risk Prognostication After Hypomethylating Agents Combined With Venetoclax in AML: The PRISM Risk Model.

期刊: Journal of clinical oncology : official journal of the American Society of Clinical Oncology 发表日期: 2026-Jul-02 链接: PubMed

摘要

As risk stratification for patients with AML treated with lower-intensity venetoclax-based therapy remains suboptimal, we developed and validated a prognostic model integrating clinical, cytogenetic, and molecular features. We assembled a multinational data set comprising 2,092 adults with newly diagnosed AML treated with hypomethylating agents plus venetoclax (HMA + VEN). One thousand nine hundred eighteen patients with complete data were randomly divided into training (70%) and internal validation (30%) cohorts. Two independent external validation cohorts were assembled (n = 500 and n = 222). Modeling overall survival (OS), Elastic Net regression was applied in 1,000 bootstrap samples from the training cohort to select variables for a Ridge regression, which generated a continuous Prognostic Risk Integration for Survival Modeling (PRISM) score and risk categories based on tertiles (PRISM-3: low, moderate, high). These PRISM indices were then computed for the validation cohorts and compared with the 4-gene classifier (based on mutations in FLT3-ITD, N/KRAS, and TP53). PRISM integrated 17 clinical and genomic variables and demonstrated a linear association with OS. PRISM-3 stratified survival consistently across all cohorts (median OS: 25.1-28.8 months for low risk, 12.5-14.7 months for moderate risk, and 5.8-6.7 months for high risk; P < .001). Compared with the 4-gene classifier, PRISM-3 reassigned approximately 40% of patients (and >50% of those with favorable risk) and demonstrated significantly better discrimination in validation cohorts (C-index 0.63-0.65 v 0.59-0.61; P < .05). PRISM is a validated prognostic model for patients with AML receiving HMA + VEN that improves survival risk stratification beyond current standard tools and supports individualized, risk-adapted clinical decision making. The model is publicly available at prism-aml.com.

20. Identification of transient hiatal hernia on high-resolution manometry is associated with gastroesophageal reflux disease.

期刊: Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus 发表日期: 2026-Jul-02 链接: PubMed

摘要

A swallow-induced transient hiatal hernia (tHH) is seen on high-resolution manometry (HRM) in some patients with type I esophagogastric junction (EGJ) morphology. As this finding is often overlooked, we evaluated the prevalence of tHH and its association with gastroesophageal reflux disease (GERD). We conducted a retrospective, cross-sectional study on suspected GERD patients undergoing HRM and 24-hour pH monitoring (January 2018-October 2024). Patients with manometric HH at baseline, prior foregut surgery, esophageal disorders, end-stage respiratory disease, or on acid suppression as well as suboptimal studies were excluded. We compared GERD prevalence (DeMeester score [DMS] ≥14.72) between patients with tHH (swallow-induced LES-CD separation ≥1 cm in ≥10% of swallows) and those without tHH. The association strength was evaluated via multivariate logistic regression. We included 207 patients with type I EGJ morphology (61.4% female; median age: 58 years): 31 with tHH and 176 without; the overall point prevalence of tHH was 15% (95%CI: 10.4-20.6). The tHH group showed a significantly higher prevalence of GERD (67.7% vs. 42%, P = 0.014) and a higher median DMS (24.1 [11.5-39] vs. 12.8 [4.9-26.8], P = 0.009) than the non-tHH group. The presence of tHH (any size or number of swallows) was an independent strong predictor of GERD (aOR: 3.50 [95%CI: 1.48-8.84], P = 0.006). Around 15% of patients with normal EGJ morphology without manometric HH at baseline will exhibit tHH, which is predictive of abnormal distal esophageal acid exposure. This warrants further investigation and integration of tHH into multivariate diagnostic algorithms and future EGJ manometric classifications.

21. Overlapping premorbid frailty, multimorbidity and malnutrition and their associations with poor outcomes in patients with stroke.

期刊: Age and ageing 发表日期: 2026-Jul-02 链接: PubMed

摘要

This study aimed to explore the prevalence of these overlapping premorbid geriatric conditions and examine the association between the number of these conditions and the risk of mortality and major cardiovascular events within 1 year after acute stroke. In this single-centre prospective cohort study, consecutive stroke patients admitted between November 2020 and September 2024 were enrolled. Premorbid frailty was assessed using the 33-item Rockwood Frailty Index. Multimorbidity was defined as the presence of two or more chronic comorbidities other than stroke. Malnutrition was diagnosed according to the Global Leadership Initiative on Malnutrition criteria. Patients were categorised according to the number of overlapping conditions (NOCs), ranging from 0 to 3. The primary outcome was a composite of all-cause mortality and major adverse cardiovascular events within 1 year after admission. Cox proportional hazards regression models adjusted for potential confounders were used to estimate adjusted hazard ratios. Among 781 patients (mean age 77.9 ± 12.6 years; 390 [49.9%] female), 226 patients (28.9%) were NOC 0, 289 (37.0%) were NOC 1, 161 (20.6%) were NOC 2 and 105 (13.4%) were NOC 3. Compared with NOC 0, the adjusted hazard ratios for the composite outcome were 1.52 (95% CI 0.86-2.68) for NOC 1, 2.64 (95% CI 1.44-4.85) for NOC 2 and 5.20 (95% CI 2.77-9.73) for NOC 3. One-third of patients with acute stroke had overlapping premorbid geriatric conditions. The NOCs was significantly associated with a composite event in a dose-response manner.

22. The Political Determinants of Obstetric Prescribing.

期刊: Obstetrics and gynecology 发表日期: 2026-Jul-02 链接: PubMed

摘要

23. Glucagon-Like Peptide-1 Receptor Agonists and Risk of Adverse Maternal Pregnancy Outcomes: A Systematic Review and Meta-analysis.

期刊: Obstetrics and gynecology 发表日期: 2026-Jul-02 链接: PubMed

摘要

To assess associations between pregestational and early-gestational exposure to glucagon-like peptide-1 receptor agonists (GLP-1 RAs) and maternal pregnancy complications. A comprehensive search across the PubMed and EMBASE databases was conducted from inception to November 2025. Eligibility criteria for inclusion were 1) exposure to GLP-1 RAs before or during gestation; 2) cohort, case-control, or randomized controlled trial (RCT) study reporting quantitative data on maternal obstetric outcomes; and 3) study population greater than 10. Two reviewers independently abstracted study data and assessed quality and risk of bias using the Newcastle-Ottawa Quality Assessment Scale for observational studies and the Risk of Bias for Randomized Crossover Trials tool for RCTs. Odds ratios (ORs) were pooled using random effects with the Knapp-Hartung adjustment to reduce chance of false-positives and the restricted maximum likelihood estimator for heterogeneity testing. Eight studies totaling 186,598 pregnancies (47,159 exposed) were included. No statistically significant differences were seen for gestational diabetes (OR 0.99, 95% CI, 0.61-1.61), preterm birth (OR 1.01, 95% CI, 0.76-1.33), preeclampsia (OR 1.05, 95% CI, 0.60-1.84), or hypertensive disorder of pregnancy (OR 0.79, 95% CI, 0.34-1.83), although results from leave-one-out sensitivity testing suggest that GLP-1 RA exposure may have a protective effect against developing gestational diabetes (OR 0.81, 95% CI, 0.67-0.98). Newcastle-Ottawa Quality Assessment Scale results demonstrated variability in study quality and high heterogeneity attributable to differences in exposure and outcome definitions, cohort selection, and control for confounders. Use of a GLP-1 RA in the peri-fertilization period was not associated with change in odds of maternal pregnancy complications. Exploratory sensitivity results suggest that peri-fertilization exposure may lower odds of gestational diabetes. Further research is necessary to explore these hypotheses-generating results.

24. The Contribution of Social and Economic Factors to Accelerated Biological Aging Differences Between Non-Hispanic Black and White Adults in the Health and Retirement Study.

期刊: The journals of gerontology. Series A, Biological sciences and medical sciences 发表日期: 2026-Jul-02 链接: PubMed

摘要

Biological aging predicts health outcomes beyond chronological age. The relative contribution of social, economic, and health factors to biological aging differences between Black and White adults remains unclear. In a cross-sectional analysis of 2,086 community-dwelling adults aged ≥60 years from the 2016 Health and Retirement Study (1,757 non-Hispanic White; 329 non-Hispanic Black), biological age was measured using DNA methylation-based GrimAge. Accelerated aging was defined as having a biological age older than expected for one’s chronological age. We used logistic regression to assess the impact of race on accelerated aging and decomposition analysis to determine factors explaining differences in accelerated aging between Black and White participants. Covariate blocks were: age, education, wealth, social frailty assessed using a composite index measuring social connections, financial autonomy, neighborhood environment, volunteering and employment engagement, behavioral factors (physical activity, alcohol use, sleep disorder, body mass index); medical conditions; and physical disability. Black participants had higher accelerated aging than White participants (57.1% vs 41.8%; standardized mean difference, 0.3). In the staged decomposition of the biological aging gap, age and education explained 21.1% of the difference. The cumulative explained share rose to 51.8% with wealth, 77.6% with social frailty, 80.3% with health behaviors, 90.5% with medical conditions, and 91.6% with physical disability. In multivariable logistic regression adjusting for all domains, the racial difference was no longer significant. Social and economic factors largely explained accelerated biological aging differences between non-Hispanic Black and White adults. These findings identify policy-relevant targets to improve healthy aging.

25. Domestic Returns to Predictable US Participation in the World Health Organization: Health Security and Cost.

期刊: American journal of public health 发表日期: 2026-Jul-02 链接: PubMed

摘要

This analysis assesses the domestic health security, economic, and governance implications of prospective US withdrawal or sustained retrenchment from the World Health Organization (WHO) and identifies policy-relevant options for continued engagement. WHO provides irreplaceable global public goods, including international surveillance networks and emergency convening. Evidence indicates that episodic or unpredictable funding of WHO is associated with coordination failures, delayed threat detection, supply chain disruptions, and higher emergency response costs. Reduced US participation may increase import risks, reduce visibility into emerging threats, and diminish leverage over governance reforms. Sustained US participation in core WHO functions strengthens domestic health security and represents a fiscally prudent risk management strategy. US policy should prioritize multiyear funding for core WHO capacities globally. (Am J Public Health. Published online ahead of print July 2, 2026:e1-e7. https://doi.org/10.2105/AJPH.2026.308463).

26. Decolonising sexual pleasure: elevating Global South narratives in sexual health.

期刊: Culture, health & sexuality 发表日期: 2026-Jul-02 链接: PubMed

摘要

This paper seeks to challenge the dominance of Global North frameworks in international work on sexual and reproductive health and rights (SRHR), arguing that decolonising this work requires centring Global South knowledge, lived experience, and culturally grounded understandings of sexuality, including sexual pleasure. Decolonisation is here understood as dismantling inequitable power relations, shifting epistemic authority away from Global North institutions, and prioritising Indigenous, local, and self-determined practices. Writing from within Global North academic institutions, we offer a reflexive critique that acknowledges the tension of advocating for decolonial change from inside the very systems that are under examination. We examine how dominant models have shaped SRHR research, policy, and practice, often limiting responsiveness to, and engagement with, Global South communities. Drawing on examples from Māori communities, Somalia, and West Africa, we demonstrate how culturally driven approaches that integrate pleasure and wellness can challenge inequality, broaden understandings and measures of sexual health, and open pathways to sexual liberation. In doing this, the commentary contributes to that reimagining by using real-world examples to show what becomes possible when pleasure and Global South narratives are centred - transforming how knowledge is produced, how research questions are framed, and how interventions are designed and implemented.

27. Experiences With Technology Among Adults Aging With HIV Engaged in an Online Community-Based Exercise Intervention Study: Longitudinal Qualitative Descriptive Study and Secondary Data Analysis.

期刊: JMIR rehabilitation and assistive technologies 发表日期: 2026-Jul-02 链接: PubMed

摘要

As individuals with HIV live longer, many now face the health consequences of aging and multimorbidity, known as disability. Exercise can mitigate disability; however, engagement in exercise among adults living with HIV varies. Technology-based interventions, such as telerehabilitation, may help mitigate geographical, financial, and time barriers to community-based exercise (CBE). However, little is known about the experiences with technology uptake and usage among adults living with HIV. Understanding these experiences is essential to inform the design of inclusive, accessible, and sustainable online interventions. This study aimed to describe experiences with technology uptake and usage among adults aging with HIV participating in a 6-month online CBE intervention and explore how these experiences changed over time, from baseline to postintervention. We conducted a longitudinal qualitative descriptive study and secondary analysis using interview data from adults living with HIV who were engaged in a CBE intervention study in Toronto, Canada. Participants engaged in a 6-month online CBE intervention consisting of thrice-weekly exercise supervised biweekly through online personal coaching sessions, weekly group exercise classes, and monthly self-management education sessions (via Zoom). The technology used included Zoom software and a webcam, as well as the Sweat for Good YMCA app and the YMCA Virtuagym website; participants wore a wireless physical activity monitor (Fitbit Inspire 2) throughout. Participants completed interviews at baseline and postintervention. We conducted a group-based content analysis of interview transcripts, focusing on digital access, setup, usage, and perceptions of technology. Questionnaire data describing digital literacy and access to technology provided additional context to the interview data. Eleven participants completed at least one interview. We analyzed 19 interview transcripts from 11 participants (women: n=6, 55%; men: n=5, 45%; median age 52, IQR 45-60 y). Experiences with technology uptake and usage among adults aging with HIV were characterized by four components: (1) preparations for technology (technology setup), (2) interactions with technology (preferences for different types of technology, preferences for mode of delivery, and ease of usage), (3) facilitators and satisfaction with technology (facilitators to technology uptake and usage and satisfaction with technology), and (4) challenges and frustrations with technology (barriers to technology uptake and usage and frustrations with technology). Experiences with technology across participants were influenced by intrinsic contextual factors (prior exposure to technology) and extrinsic contextual factors (COVID-19 pandemic and technological and social support). Experiences with technology among adults aging with HIV engaging in an online CBE intervention varied from increasing ease of use to increasingly burdensome over time. Results highlight the need to incorporate personal preferences and ongoing technological support when implementing online CBE with adults aging with HIV.

28. Sulfur fractionation in coronal plumes as observed by Solar Orbiter/Spectral Imaging of the Coronal Environment.

期刊: Philosophical transactions. Series A, Mathematical, physical, and engineering sciences 发表日期: 2026-Jul-02 链接: PubMed

摘要

Coronal plumes are bright, narrow structures rooted in coronal holes (CHs) that contribute to the solar wind. Their composition, particularly elemental fractionation as a function of first ionization potential (FIP), provides diagnostics of plasma properties and magnetic connectivity. Earlier plume studies of fractionation using low-FIP elements reached conflicting conclusions. Intermediate-FIP elements may provide additional diagnostic insights, since their fractionation is thought to involve processes beyond those affecting low-FIP species. We investigate sulfur (intermediate-FIP element) in plumes to assess the presence of fractionation, its evolution and its relation to wave activity. We analysed Solar Orbiter observations of two plumes in an equatorial CH during March-April 2024, using Spectral Imaging of the Coronal Environment (SPICE) to derive the sulfur-to-nitrogen ratio. Extreme ultraviolet (EUV) imaging and magnetograms provided additional context. Data were processed with the open-source Python tool Spectral Analysis, Fitting Framework, Reduction Of Noise (SAFFRON). Both plumes showed sulfur fractionation that remained constant within uncertainties. The fractionated plasma was co-located with strong magnetic footpoints, in contrast with the surrounding inter-plume plasma. These results provide the evidence for sulfur fractionation in plumes and suggest, consistent with the ponderomotive force model, wave dynamics in the chromosphere as a driver. This article is part of the Theo Murphy meeting issue ‘Solar atmospheric abundances in space and time’.

29. Impact of pre-existing schizophrenia spectrum disorder on the receipt of invasive and systemic therapy for gastric cancer: a multicenter nationwide cohort study in Japan.

期刊: Japanese journal of clinical oncology 发表日期: 2026-Jul-02 链接: PubMed

摘要

Patients with schizophrenia spectrum disorders (SSD) experience higher cancer mortality, partly because of later-stage diagnosis and lower rates of recommended treatments. While treatment disparities have been reported across several cancer types, no study has specifically examined stage-appropriate treatment for gastric cancer among patients with SSD. We conducted a retrospective cohort study using a nationwide Hospital-Based Cancer Registry linked to administrative data in Japan. Patients who received initial treatment for gastric cancer between 2018 and 2021 were included. Multivariable logistic regression models examined the association between SSD and the receipt of stage-appropriate cancer treatments, adjusting for age, sex, clinical stage, Charlson Comorbidity Index, and Barthel Index. Among 189 447 patients from 709 hospitals, 1312 had SSD. Patients with SSD were more likely to be diagnosed at advanced stages. In crude analysis, SSD was associated with lower rates of surgical or endoscopic treatment; however, this association was not statistically significant after adjustment (adjusted odds ratio [aOR], 0.90; 95% confidence interval [CI], 0.75-1.08). In contrast, SSD was independently associated with lower rates of postoperative adjuvant chemotherapy for pathological stage II/III disease (aOR, 0.64; 95% CI, 0.45-0.91) and systemic therapy for stage IV disease (aOR, 0.36; 95% CI, 0.28-0.47). Among patients with gastric cancer, SSD was associated with reduced receipt of systemic therapy but not surgical or endoscopic treatment. Efforts to improve early detection among patients with SSD may be important for reducing treatment disparities, alongside strengthened support for systemic therapy to ensure equitable access to guideline-recommended gastric cancer care.

30. Incontinence, health disparities and healthcare complexities.

期刊: British journal of community nursing 发表日期: 2026-Jul-02 链接: PubMed

摘要

Individuals may experience differences, discrepancies, disparities and inequalities in the health services available or accessible to them. Urinary incontinence is a health condition that still lacks public awareness and acknowledgement, despite its negative impact on quality of life. Disparity of services for individuals who experience urinary incontinence may result in exacerbation of clinical symptoms. This disparity may be multifactorial, ranging from lack of knowledge about continence promotion to insufficient proactive incontinence management strategies.

31. Incidence of long-term sickness absence in Japan following the COVID-19 pandemic.

期刊: Occupational medicine (Oxford, England) 发表日期: 2026-Jul-02 链接: PubMed

摘要

Although the COVID-19 pandemic has caused widespread disruptions to working life, its impact on long-term sickness absence (LTSA) remains poorly understood. To examine if the registered number of LTSA episodes, i.e. a significant indicator of productive loss at the workplace, has changed before and after the spread of COVID-19 among a Japanese working population. Data came from the Japan Epidemiology Collaboration on Occupational Health Study, in which a study-specific registry was launched to collect information on LTSA from April 2012 to December 2022. An autoregressive moving-average model was applied to incident LTSA data from April 2012 to January 2020 for forecasting from February 2020 to December 2022. We analysed and compared predicted versus observed LTSA incidences, focusing on all-cause and cause-specific LTSA, including mental disorders and other causes. All-cause LTSA fell below the lower 95% prediction interval (PI) in May 2020 and exceeded the upper PI in October 2020, October 2021, and July 2022. For mental health-related LTSA, declines were noted in March and May 2020, followed by peaks exceeding the upper 95% PI in October and November 2020, and July and October 2021. LTSA due to other causes remained low throughout most of the study period, although it did not fall below the PIs. Long-term sickness absence declined in the early phase of the COVID-19 pandemic but subsequently remained at relatively high levels. LTSA due to mental disorders persisted at elevated levels until the end of the study period.

32. Predictors of Voucher Redemption in Produce Prescription Programs in a Primarily Low-Income Population With Type 2 Diabetes.

期刊: Preventing chronic disease 发表日期: 2026-Jul-02 链接: PubMed

摘要

Food as Medicine initiatives, including produce prescription (PRx) programs, provide incentives (ie, vouchers) for participants to purchase free or reduced-cost produce. Voucher redemption is central to PRx effectiveness, yet predictors of redemption are poorly characterized. Prior evaluations often excluded nonusers, potentially overestimating effects. We applied an intent-to-treat (ITT) approach to examine the association between baseline characteristics and voucher redemption rates (VRRs) in a PRx program among primarily low-income Hispanic/Latino adults with type 2 diabetes. In this single-arm, pre-post study, 154 participants were enrolled in a 7-month PRx program offering up to $90 in fruit and vegetable vouchers for attending monthly nutrition education sessions. Binomial logistic regression assessed predictors of ITT-VRRs, including transportation access, baseline fruit and vegetable intake, and knowledge of produce preparation. The sample was majority female (66.2%), Hispanic/Latino (83.1%), and low income (using public health insurance [88.9%] or food insecure [76.0%]). Most participants shared purchased produce with others in the household (61.2%). The ITT-VRR was 65.8%, versus 84.3% in per-protocol analysis. Higher odds of ITT-VRR were associated with transportation access (personal car [odds ratio, 2.28; 95% CI, 1.94-2.67]), while little/no self-reported knowledge of how to prepare fruit and vegetables was associated with lower odds (odds ratio, 0.58; 95% CI, 0.52-0.63). Transportation access and baseline knowledge of how to prepare fruit and vegetables were associated with voucher redemption, suggesting vouchers alone may not sustain engagement or dietary change. To enhance program equity and effectiveness, future PRx programs may consider pairing vouchers with strategies addressing transportation challenges and supporting fruit and vegetable preparation-related capability.

33. Trends in anxiety and depressive symptoms among adults in Norway based on eight population-based surveys from 1995 to 2024.

期刊: Discover mental health 发表日期: 2026-Jul-02 链接: PubMed

摘要

Increasing symptoms of anxiety and depression among adolescents and emerging adults are well documented, while less attention has been given to how these symptoms have evolved among adults of all ages. We aim to describe the development of symptoms of anxiety and depression for women and men in the adult population in Norway over the past three decades. For the first time, we synthesize data from all population-based, cross-sectional surveys of symptoms of anxiety and depression among adults in Norway. Data were extracted from the Living Condition Survey (1998-2012, and 2015-2019), HUNT (1995/97-2017/19), the Tromsø Study (2001-2015/16), SAMINOR (2003/04-2012), Quality of Life Survey (2021-2024), the FHUS Agder (2019-2023), FHUS Oslo (2020-2024), and the Student’s Health and Wellbeing Study (SHoT, 2010-2022). Changes over time in symptoms were examined though sex and age stratified regression models. Data from 30 separate data collections include 584 173 adults aged 18-89 years between 1995 and 2024. We observe a clear increase in symptoms of anxiety and depression among young adults, especially among young women. Among individuals in midlife, findings are mixed, with most studies indicating stability or only minor fluctuations. In contrast, the symptoms of older adults appears to have remained stable or even improved. Results show divergent trends in symptoms of anxiety and depression among adults. There has been an increase in symptoms among young adults, while symptoms remain stable or improved in old age. The results highlight the need for targeted preventive efforts among younger adults and for careful continued observation.

34. Cardiac involvement in Behçet's syndrome: findings from a clinically driven cardiological evaluation.

期刊: Rheumatology (Oxford, England) 发表日期: 2026-Jul-02 链接: PubMed

摘要

To characterize prevalence, patterns, and clinical correlates of cardiac involvement in a cohort of patients with Behçet’s syndrome (BS) undergoing clinically-driven cardiological assessment. This retrospective study included adult patients with BS, followed at a tertiary referral center (Florence, Italy), who underwent clinically-driven cardiological evaluation. Clinical, demographic, and therapeutic characteristics were compared in patients with and without evidence of cardiac involvement. Timing, type of cardiac involvement, disease activity, cardiovascular risk factors, and treatments were analyzed. Among 312 patients with BS, 90 underwent cardiological assessment and 49 had confirmed cardiac involvement. Arrhythmias were the most frequent manifestation (n = 15), followed by pericarditis (n = 12) and ischemic heart disease (n = 8). Cardiac involvement occurred a median of 6.1 (2.5-8.7) years after BS diagnosis, although in a proportion of patients they preceded or coincided with diagnosis. Most patients had active systemic disease at the time of the cardiac involvement (93.9%), and were receiving immunosuppressant treatment (84%). Over 80% had at least one traditional cardiovascular risk factor, yet <40% were receiving cardiovascular primary prevention therapy before the first event. Male patients more frequently experienced ischemic manifestations, while arrhythmias were more common in females. No cardiac-related deaths were observed. Cardiac involvement in BS is more common than traditionally reported when actively investigated. Cardiac involvement frequently occurs during active disease and in patients with a high burden of cardiovascular risk factors but suboptimal preventive therapy. These findings support the need for integrated cardio-rheumatologic management in BS.

35. COVID-19 Testing and Containment Strategies for Children in Congregate Housing Facilities in Texas, 2021-2023.

期刊: American journal of public health 发表日期: 2026-Jul-02 链接: PubMed

摘要

Objectives. To evaluate site-specific testing and isolation procedures for preventing on-site SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) infections among unaccompanied migrant children in federal congregate care settings. Methods. From August 2021 to May 2023, the Increasing Community Access to Testing, Treatment, and Response (ICATT) program administered 385 234 rapid antigen and nucleic acid amplification tests to 68 674 children at 2 emergency intake sites in Texas. We used logistic regression, the χ2 test, and Kaplan-Meier survival analysis to estimate the number of infections acquired on-site and the number of cases prevented via implementation of ICATT comprehensive testing and isolation protocols. Results. ICATT protocols identified 83% of cases at intake, and our analyses projected that 92% of cases were isolated before on-site transmission could occur. Testing and isolation measures prevented an estimated 1335 to 2377 on-site infections, reducing caseloads by 15% to 23% and transmission by 68% to 79%. Conclusions. Site-specific, algorithmic testing and isolation protocols substantially reduced SARS-CoV-2 transmission among children in federal congregate care settings. Public Health Implications. Enhanced testing and isolation strategies should be considered to mitigate within-facility transmission among temporary residents in congregate care settings. (Am J Public Health. Published online ahead of print July 2, 2026:e1-e8. https://doi.org/10.2105/AJPH.2026.308488).

36. Molecular Dosimetry of DNA Adducts in Mice Exposed to Ethylene Oxide.

期刊: Toxicological sciences : an official journal of the Society of Toxicology 发表日期: 2026-Jul-02 链接: PubMed

摘要

Ethylene oxide (EtO) is a highly reactive industrial chemical and known human carcinogen with a mutagenic mode of action (MOA). Its genotoxicity is primarily mediated through alkylation of DNA, forming the mutagenic adduct O6-(2-hydroxyethyl)-2’-deoxyguanosine (O6-HE-dG), albeit in small quantities, and the more abundant but less- or non-mutagenic N7-(2-hydroxyethyl)guanine (N7-HE-G) adduct. However, dose-response relationships of these DNA adducts, particularly at low inhalation exposure levels (< 3 ppm), remain unknown. These data are necessary to inform the biological plausibility of different statistical dose-response models that have been applied to human or animal data used for cancer risk assessment. In this study, B6C3F1 mice were exposed to EtO (0-200 ppm) for 6 hours/day over 28 consecutive days. DNA adducts in lung, liver, bone marrow, and mammary gland were quantified using highly sensitive mass spectrometry platforms. N7-HE-G was detected in all tissues and exposure groups, showing linear dose-response relationships in the low-dose range (≤ 1 ppm) and increased sharply and exposure-disproportionately in the high-dose range (≥ 50 ppm). Despite high sensitivity, O6-HE-dG was undetectable in any tissue at exposure < 50 ppm, reflecting adduct levels that are below the current quantifiable limit. At higher exposures (≥ 50 ppm), O6-HE-dG exhibited a dose-response pattern of N7-HE-G. Notably the mammary gland, despite being anatomically distant from the site of inhalation, exhibited the second-highest levels of both adducts at higher doses. This study provides the first reliable quantitative dose-response evidence of DNA adducts in tumor target and non-target (liver) tissues across a wide range of EtO exposures. The two DNA adducts differ markedly in their abundance, repairability and mutagenic potential and together provide a molecular MOA dose-response framework to provide the biological foundation for informing quantitative cancer risk assessment and genotoxic hazard characterization.

37. Severe bottleneck of ancient Homo populations: Insights from computational modeling and relevant fossil evidence.

期刊: Molecular biology and evolution 发表日期: 2026-Jul-02 链接: PubMed

摘要

Reconstructing ancient population size history is essential for understanding the evolutionary origin of Homo sapiens. We recently developed the fast infinitesimal time coalescent process (FitCoal) and detected a severe population bottleneck occurring approximately 930 thousand years ago. However, two recent studies compared FitCoal and mushi and concluded that the severe bottleneck is a statistical artifact. In this study, we compared the two methods against a benchmark of ten billion msprime coalescent simulations. We demonstrate that FitCoal achieves both superior speed and accuracy in expected site frequency spectrum (SFS) estimation. Analyses of simulated datasets confirmed that FitCoal reliably recovers the bottleneck, whereas mushi fails under identical conditions. Independent fossil and paleoclimate evidence is consistent with the timing and evolutionary impact of this bottleneck, including associations with hominin dispersals, speciation events, and a subsequent increase in brain size. These findings refine the demographic history of Homo during the Pleistocene and highlight the importance of high-precision SFS computation for revealing critical evolutionary transitions that shaped modern human ancestry.

38. Manipulation of protein translation and stem cell self-renewal by CRISPR activation of rRNA transcription.

期刊: Science (New York, N.Y.) 发表日期: 2026-Jul-02 链接: PubMed

摘要

Ribosomal RNA (rRNA) transcription rates vary during development, and their dysregulation is linked to diseases such as cancer and ribosomopathies. Owing to their high abundance and genomic redundancy, the functional significance of rRNA-levels remains unclear. Here, we developed TAPIR (Targeted Activation of Protein Translation), a CRISPR-based approach to elevate rRNA-levels by inducing 47S rDNA transcription. TAPIR increased nucleolar size and enhanced protein synthesis, even in rapidly proliferating cells. In neural stem cells, elevated translation promoted self-renewal and proliferation in vitro and in vivo. Furthermore, TAPIR enabled the modeling and partial rescue of associated disease phenotypes. Our findings revealed that rRNA-levels directly regulate translational output and that protein synthesis capacity can act as a key determinant of mammalian stem cell behavior.

39. Prevalence and risk factors of asymptomatic Plasmodium spp. infection in the military population of the Colombian National Army.

期刊: PLoS neglected tropical diseases 发表日期: 2026-Jul-02 链接: PubMed

摘要

Asymptomatic malaria plays a critical role in sustaining transmission in endemic regions, yet its magnitude and determinants remain insufficiently characterized in military populations frequently exposed during field operations. This study sought to estimate the prevalence of asymptomatic Plasmodium spp. infection and identify associated risk factors among Colombian military personnel deployed in high-endemicity areas in 2022. A cross-sectional survey was conducted in four departments with the highest malaria transmission (Antioquia, Chocó, Córdoba, and Nariño). A total of 773 participants underwent thick blood smear microscopy, rapid diagnostic testing (RDT), conventional PCR, and real-time PCR. The prevalence of asymptomatic infection detected by conventional PCR/qPCR was 2.59%, with the highest municipal rates observed in El Bagre and Carepa (Antioquia), followed by Tumaco, Quibdó, and Tierralta. P. falciparum accounted for most infections (60%), followed by P. vivax (25%) and mixed infections (15%). qPCR demonstrated the greatest diagnostic sensitivity. Statistical analyses identified frequency of bed net use, number of lifetime and recent malaria episodes, department of origin, department and duration of patrol, number of patrol sites, and age as the main associated risk factors. These findings highlight the relevance of asymptomatic Plasmodium spp. infections among Colombian military personnel and underscore the need to integrate their detection into routine malaria surveillance. Strengthening identification of low-density infections in highly exposed populations may contribute to reducing transmission, improving clinical management, and enhancing operational readiness in endemic areas.

40. Beyond Bullying: Digital Platforms, Power and the New Landscape of Violence Against Nurses.

期刊: Issues in mental health nursing 发表日期: 2026-Jul-02 链接: PubMed

摘要

Digital communication channels and social media platforms have created new terrains in which nurses can be scrutinised, targeted, and attacked in ways that are often difficult to anticipate, detect, or contain. In this discursive paper, we draw on relevant published literature to examine digitally mediated violence against nurses as a form of occupational harm that is persistent, scalable, and difficult to contain. We consider how online harassment, intra-professional hostility in digital channels, and the non-consensual disclosure of personal information can erode wellbeing, professional identity, and workforce stability. We argue that digital aggression should be recognised and managed as a workplace safety issue rather than an individual burden. Implications are outlined for organisations, regulators, educators, and professional bodies, including clearer reporting and response pathways, workforce education for digital safety, and stronger protections for nurses who are targeted online. If left unaddressed, digitally mediated violence will continue to compound workforce pressures and retention risks.

41. Online survey of wheelchair service providers' opinions about the usefulness of a new rear anti-tip device for manual wheelchairs: a cross-sectional study.

期刊: Disability and rehabilitation. Assistive technology 发表日期: 2026-Jul-02 链接: PubMed

摘要

Purpose: To obtain the opinions of a wider and larger group of wheelchair service providers than have been previously reported about the potential usefulness of a new rear anti-tip device (the Arc-RAD) that is out of the way at rest but self-deploys through an arc when needed. Materials and Methods: In this online survey, respondents were shown video recordings of the Arc-RAD in use. For each of 20 potential uses of the Arc-RAD, participants provided a score (1-5, from “extremely not useful” to “extremely useful”) and comments. Results: 156 respondents provided data regarding at least one of the potential uses. The median values were 5.0 for 9 potential uses (mostly ones not including the aided-wheelie position), 4.0 for 10 potential uses (including many of the aided-wheelie skills) and 3.0 for one potential use (can move straight sideways). For 15 (75%) of the 20 potential uses, at least 75% of the respondents’ answers were either “extremely useful” or “somewhat useful”. Of the remaining 5 potential uses, for only one (“can move straight sideways”) did respondents’ answers of either “extremely useful” or “somewhat useful” fall below 50%. From 668 qualitative comments, there were 1,044 codes in 6 categories - positive comments about C-RADs (0.7% of codes), negative comments about C-RADs (7.5%), positive comments about Arc-RADs (27.8%), negative comments about Arc-RADs (21.6%), questions or concerns about Arc-RADs (20.7%), and other comments (21.8%). Conclusions: Wheelchair service providers are positive about most of the potential uses of the Arc-RAD. Qualitative analysis will guide further research and development. Wheelchair service providers responding to an online survey are positive about many potential uses of a new rear anti-tip device design that is out of the way at rest but self-deploys when needed.Helpful comments by wheelchair service providers will guide further research and development.

42. Mindfulness in Military Medicine: A Mixed-Methods Analysis of Army Medical Specialist Corps Officers' Mindfulness Competency, Beliefs, and Tendencies.

期刊: Military medicine 发表日期: 2026-Jul-02 链接: PubMed

摘要

Mindfulness-based interventions (MBIs) are formally endorsed within Army Holistic Health and Fitness doctrine to enhance mental readiness, cognitive performance, and psychological resilience. Despite growing empirical support for MBIs across civilian and military populations, provider preparedness for implementation within Army Medical Specialist Corps (SP) populations has not been systematically examined. This study evaluated relationships among trait mindfulness, perceived competency in delivering MBIs, and integrative health beliefs and explored implications for professional military medical education reform. A concurrent triangulation mixed-methods design was employed. Active duty Army SP Corps officers (N = 135) completed the Five Facet Mindfulness Questionnaire-Short Form (FFMQ-SF), Mindfulness Competency Questionnaire, and Complementary and Alternative Medicine Health Belief Questionnaire. Pearson correlations, analysis of variance, and multiple regression analyses were conducted (α = .05). Fourteen semi-structured interviews underwent thematic analysis. Significant positive correlations were observed among trait mindfulness, perceived competency, and integrative health beliefs (r = 0.25-0.45, P < .05). Officers reporting formal mindfulness training demonstrated higher scores across measures (P < .05). Occupational therapists demonstrated higher perceived competency compared to other specialties (P < .001). Qualitative findings identified perceived effectiveness, need for structured education, and limited implementation confidence. Structured integration of mindfulness education within professional military medical training may enhance doctrinal alignment and provider readiness.

43. Barbers' knowledge and practices regarding biological hazards in their profession: A cross-sectional study in Bangladesh.

期刊: Archives of environmental & occupational health 发表日期: 2026-Jul-02 链接: PubMed

摘要

This cross-sectional study assessed biological hazard-related knowledge and practices among 470 barbers across four districts in Bangladesh. The median knowledge score was 5 (IQR: 4-7), and the median practice score was 7 (IQR: 5-11). Approximately 45% of barbers had heard about the hepatitis B virus and 39% about the hepatitis C virus. Quantile regression revealed that higher education, monthly income (>10,000 BDT), work experience (>5 years), daily working hours (>10 h), and receipt of barbering training were significant positive predictors of knowledge scores across various quantiles. Moreover, educational attainment, higher monthly income (>20,000 BDT), receipt of barbering training, and higher knowledge scores were significantly associated with better practices. The study reveals suboptimal knowledge and practices regarding biological hazards among the participating barbers. To address these risks, policymakers should implement targeted interventions and training programs on infection control, proper sterilization methods, and disease transmission prevention among barbers in Bangladesh.

44. Aligning interprofessional collaboration in sick leave and return-to-work guidance: development of the ICF-based WARD instrument and guideline.

期刊: Disability and rehabilitation 发表日期: 2026-Jul-02 链接: PubMed

摘要

To improve interprofessional collaboration among occupational health professionals (OHPs) during the return-to-work (RTW) process, the Work Ability & Reintegration Description (WARD) instrument and a multidisciplinary guideline were developed based on the International Classification of Functioning, Disability and Health (ICF). The objectives of this study were [1]: to explore OHPs’ experiences of challenges in interprofessional collaboration during sick leave and RTW guidance; and [2] to refine the WARD instrument to improve collaboration. Five consecutive focus groups were conducted with 11 OHPs, using the Design Thinking method as a user-centred approach to explore challenges and solutions related to interprofessional collaboration during sick leave and the RTW process. The Sunnybrook framework for interprofessional team collaboration was used as an analytical framework. Challenges related to interprofessional collaboration were identified in four of the six domains of the Sunnybrook framework: role delineation, communication, interprofessional values and ethics, and shared decision-making. OHPs highlighted that current instruments primarily focus on assessing limitations rather than possibilities for RTW and emphasized the importance of incorporating environmental and personal factors into the WARD instrument. This study identified key challenges in interprofessional collaboration during sick leave and the RTW process and proposes solutions through refinements to the WARD instrument and multidisciplinary guideline. By shifting the focus of work ability assessments from functional limitations toward RTW possibilities, integrating employees’ and employers’ perspectives, and fostering shared RTW goals, these refinements have the potential to enhance collaboration and improve RTW outcomes. Effective return-to-work guidance requires interprofessional collaboration based on a shared understanding of work capacity, incorporating medical, personal, and environmental factors.Using an ICF-based instrument that focuses on work possibilities rather than limitations can support more constructive dialogue and shared decision-making among rehabilitation stakeholders.Actively involving occupational health professionals, employees, and employers in return-to-work guidance promotes alignment of perspectives and strengthens engagement in the rehabilitation process.Design Thinking offers a practical, participatory approach for developing and refining rehabilitation tools that address real-world challenges in interprofessional collaboration.

45. Clinical features, diagnostic findings, and outcomes of emphysematous cholecystitis in 35 dogs: a retrospective case series.

期刊: Journal of veterinary internal medicine 发表日期: 2026-Jul-01 链接: PubMed

摘要

Emphysematous cholecystitis (EC) is a rare and severe variant of acute cholecystitis in dogs. Published data regarding EC are limited. To retrospectively describe the clinical presentation, relevant laboratory values, ultrasonographic findings, bile cytology, bacterial culture and susceptibility results, gallbladder histopathology, treatment, and outcomes in a group of dogs diagnosed with EC. Thirty-five client-owned dogs diagnosed with EC. A retrospective review of medical records from 4 referral veterinary teaching hospitals between January 2000 and December 2024 was conducted to describe dogs diagnosed with EC via ultrasonography or computed tomography. Common clinical signs reported included vomiting (23/35, 66%), lethargy (23/35, 66%), or inappetence (15/35, 43%) in dogs. Common clinicopathologic abnormalities were an inflammatory leukogram (21/31, 68%) and elevated serum liver enzyme activity with or without hyperbilirubinemia (28/33, 85%). The most frequent bacteria isolated were Escherichia coli (13/36 isolates) and Clostridium spp. (12/36 isolates). Postoperative death among dogs that underwent cholecystectomy was 29% (4/14). Eleven of 35 (31%) dogs were treated medically and survived to discharge and 5 of 6 dogs with long-term follow-up survived > 6 months. Dogs with EC often present as clinically ill with an inflammatory leukogram, elevated serum liver enzyme activity, and mild hyperbilirubinemia. Cholecystectomy permits source control and collection of gallbladder culture to guide antimicrobial therapy, but empirical medical management can be successful.

46. From community engagement to lived experience leadership: a systematic review of HIV services among men who have sex with men.

期刊: Health promotion international 发表日期: 2026-Jul-01 链接: PubMed

摘要

Community responses are essential to achieving the global goal of Ending AIDS by 2030, yet men who have sex with men (MSM) remain underrepresented and often tokenized within HIV initiatives. While community engagement is widely emphasized, far less attention has been given to leadership rooted in lived experience. Meaningful community engagement requires recognizing MSM not merely as a target population, but as leaders shaping HIV responses. This systematic review examines how MSM perceive the use of their lived experiences in HIV responses and how institutions incorporate these experiences into service delivery. Following PRISMA guidelines, we analyzed 40 peer-reviewed studies. Results show that across diverse contexts, MSM navigate systemic barriers-including intersecting systems of oppression-that hinder equitable access to HIV care. Despite these challenges, MSM assume (in)formal roles of leadership, negotiating power, and agency within institutions that have historically marginalized them. Using lived experience leadership as a framework in HIV services characterizes meaningful community engagement among MSM and their communities, including pathways for strengthening community-engaged HIV health promotion. This synthesis underscores the need to move beyond narrow notions of community engagement and toward recognizing MSM as leaders whose experiential expertise can enhance equity, relevance, and effectiveness in HIV health promotion programs and provides actionable insights for community-engaged service design and policy.

47. Investigating the mobility and host range of mobile genetic elements harbouring antimicrobial resistance genes in enterococci.

期刊: Microbiology (Reading, England) 发表日期: 2026-Jul 链接: PubMed

摘要

In this study, the abundance and conjugation capacity of mobile genetic elements (MGEs) carrying resistance genes such as vanA, tet(M) and erm(B) were investigated to enhance our understanding of antimicrobial resistance (AMR) dissemination across the One Health continuum in high-priority, highly prevalent enterococcal pathogens. The abundance of MGEs was estimated using replicon typing and both reference-based and reference-free clustering approaches. Conjugation potential was assessed using agar plate mating between Enterococcus faecium donors and E. faecium, Enterococcus faecalis and Enterococcus hirae recipients, with conjugated MGE verified via long-read sequencing. Key findings include the identification of a vanA gene cluster from E. faecium VRE0008 associated with a Tn1546-like transposon embedded in a RepA_N-type putative plasmid (232,902 bp). This plasmid successfully conjugated with E. faecium, E. faecalis and E. hirae recipients from clinical, environmental and agricultural sources. The transfer predominantly involved the modular movement of a 46-kb region surrounding the vanA gene cluster, with E. hirae of agricultural origin (i.e. 0093A) being the exception, as it retained the entire plasmid. The tet(M) gene from E. faecium Ent0189 was located on a putative Rep_Trans-like plasmid, with features of Tn916 integrative conjugative elements. The entire plasmid from Ent0189 was successfully transferred to intra-species recipients from clinical and environmental sources, but transfer to E. faecalis and E. hirae was less common. Attempts to transfer tet(M) associated with Tn916 from bovine E. hirae to any of the E. hirae, E. faecium and E. faecalis isolates were unsuccessful. Additionally, the erm(B) gene from E. faecium NS0794 was carried by an MGE matching the RepA_N-type plasmid, but lacking the vanA gene cluster. Successful conjugative transfer of this plasmid was observed with E. faecium, E. faecalis and E. hirae of various origins, except one clinical E. faecalis isolate. These findings highlight the broad conjugation capabilities and modular mobility of MGEs carrying ARGs in enterococci, enhancing our understanding of dynamic MGE-mediated ARG dissemination and informing strategies to address the spread of AMR between species and habitats.

48. Risk and Protective Factors for Suicide Mortality in Youths: A Systematic Review and Meta-Analysis.

期刊: JAMA network open 发表日期: 2026-Jul-01 链接: PubMed

摘要

Risk and protective factors for suicide mortality in youths remain poorly synthesized, as prior reviews have focused on all ages or nonfatal outcomes. To systematically assess factors associated with risk of suicide mortality in youths. MEDLINE, PsycINFO, Embase, and CINAHL from inception to March 7, 2025. Case-control and cohort studies of youths (aged ≤24 years) examining risk and/or protective factors associated with suicide mortality vs living general-population controls were included. Two independent reviewers screened 9497 records. Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, 2 reviewers independently screened reports; 1 extracted data, verified by a second. Evidence was synthesized using vote counting and random-effects meta-analysis in April 2026. The primary outcome was suicide mortality at age 24 years or younger. Ninety reports from 68 studies, mostly from high-income countries, identified distinct risk and/or protective factors; 54 reports contributed to 30 meta-analyses. The factors associated with the highest odds of suicide risk included schizophrenia (odds ratio [OR], 22.23; 95% CI, 12.05-41.03; I2 = 85.4%; 7 reports), mood disorders (OR, 11.32; 95% CI, 6.11-20.97; I2 = 64.6%; 7 reports), and self-harm (OR, 14.06; 95% CI, 5.58-35.39; I2 = 90.1%; 10 reports). Clinical indicators of health care use were also associated with higher risk, including mental health services use in preceding year (OR, 7.39; 95% CI, 6.45-8.47; I2 = 0.0%; 5 reports) and psychiatric admission (OR, 31.96; 95% CI, 13.83-73.86; I2 = 94.8%; 6 reports). At the socioecological level, several indicators were associated with higher risk, including maltreatment (OR, 4.03; 95% CI, 1.41-11.50; I2 = 67.1%; 5 reports), out-of-home placement (OR, 4.47; 95% CI, 2.15-9.28; I2 = 42.1%; 5 reports), youth justice system involvement (OR, 2.70; 95% CI, 1.94-3.75; I2 = 64.2%; 7 reports), and low educational attainment (OR, 2.95; 95% CI, 1.66-5.24; I2 = 76.0%; 5 reports). In contrast, indicators of family stability were associated with lower risk, including living with both parents (OR, 0.55; 95% CI, 0.48-0.62; I2 = 12.1%; 11 reports). Heterogeneity was substantial across analyses, while Newcastle-Ottawa ratings indicated moderate-to-high study quality. In this systematic review and meta-analysis, suicide mortality in youths was associated with mental disorders, health care contact, and adversity, supporting both clinical care and population-level prevention, with future research needed in underrepresented populations.

49. Trauma nursing as frontline health diplomacy: A binational ATCN program for Palestinian and Israeli nurses during conflict.

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

摘要

Nurses are central to trauma care in both peacetime and conflict, where training and expertise directly affect patient outcomes. Cooperative training between healthcare professionals from opposing communities is rare in regions of ongoing violence, yet may be a powerful mechanism for strengthening regional trauma systems and advancing health diplomacy. Operating Together is a binational initiative that brings Palestinian and Israeli trauma providers together for joint training. This study describes the establishment of a regional Advanced Trauma Care for Nurses (ATCN) program serving both Israeli and Palestinian communities, evaluates course effectiveness, and health‑diplomacy attitudes. Between January 1 and December 31, 2025, six ATCN providers and two ATCN instructor courses were conducted. Participants completed anonymous questionnaires assessing satisfaction, perceived clinical relevance, and attitudes toward Palestinian-Israeli health cooperation. Descriptive statistics summarized responses, and comparisons used independent‑samples t tests and Fisher’s exact tests (significance p < 0.05). Of 52 participants, 36 completed the study (50% Israeli, 50% Palestinian). Participants reported high course satisfaction (M = 8.44/10) and perceived educational impact (M = 4.39/5). Most (94.4%) expressed interest in maintaining professional contact. The belief that cooperation improves patient care is strongly correlated with positive health‑diplomacy attitudes (rs =.74, p < .001). Palestinian nurses reported significantly higher scores regarding the role of health cooperation in conflict resolution and mutual understanding (both p = .006). Male participants had higher health‑diplomacy index scores than female participants (p = .004). In the context of ongoing conflict, joint ATCN courses for Palestinian and Israeli nurses were associated with high educational satisfaction and strong support for continued professional cooperation. Participants perceived binational training as beneficial for trauma care and contributing to a more positive climate. Joint trauma nursing education may provide a promising platform for strengthening trauma systems and advancing health diplomacy in conflict‑affected settings. Prognostic and epidemiological; Level II-III (educational intervention).

50. From Healers to Leaders: A Qualitative Study of Career Paths and Influencing Factors in Chief Physician Roles in Finnish Health Care.

期刊: The Journal of continuing education in the health professions 发表日期: 2026-Jun-30 链接: PubMed

摘要

This study examined the career trajectories of chief physicians to identify factors influencing advancement into leadership roles and to inform physician leadership development. Qualitative interviews with 15 hospital-based chief physicians were analyzed using inductive content analysis and thematic categorization. Four main career path types emerged: (1) planners systematically preparing for leadership through education and interim roles; (2) opportunists advancing by seizing emerging opportunities, often with external encouragement; (3) reluctant leaders initially avoiding leadership but transitioning because of circumstances or mentorship; and (4) challengers pursuing leadership to challenge themselves or improve systems. These paths illustrate the multifaceted, context-dependent nature of physicians’ leadership progression, reflecting a gradual shift from clinical expertise to leadership roles shaped by intrinsic motivations (desire for effect, growth, and change), professional identity dynamics (including clinical legitimacy and identity reconciliation), perceived leadership competence (self-efficacy, preparedness, education, and training), and organizational context (mentoring, culture, and structural opportunities and challenges).

51. Reducing misclassification of monoclonal gammopathy in canine leishmaniosis: Added value of immunofixation to serum protein electrophoresis.

期刊: Veterinary parasitology 发表日期: 2026-Jun-29 链接: PubMed

摘要

Canine leishmaniosis caused by Leishmania infantum commonly induces marked dysproteinemia, yet restricted or apparently monoclonal gammopathies may complicate interpretation of serum protein electrophoresis (SPE). This study characterized SPE and immunofixation findings in 38 clinically sick dogs with confirmed canine leishmaniosis and evaluated interobserver agreement in gammopathy classification. SPE and immunofixation using anti-human reagents was performed on serum from 38 sick dogs with confirmed clinical leishmaniosis and without evidence of plasma cell neoplasia. The SPE data alone and a combined SPE and immunofixation (IF) study were interpreted by 4 reviewers. Inter-observer agreement for presence of an acute phase response and gammopathy pattern by electrophoresis alone or with immunofixation was assessed using Gwet’s AC1 and quadratic weighted AC2. Change in agreement with addition of immunofixation was assessed. All dogs demonstrated hypergammaglobulinemia and decreased albumin-to-globulin ratios. Hyperproteinemia and hypoalbuminemia were common, and hyperbetaglobulinemia was frequently observed. Immunofixation labeling was predominantly IgG with minimal IgA and IgM detection. Most cases had an IgG polyclonal or restricted polyclonal gammopathy. Interobserver agreement for gammopathy classification using SPE alone was high (AC2 = 0.902), but disagreements spanned the diagnostic spectrum in some cases. The addition of immunofixation significantly improved agreement (AC2 = 0.944; P = 0.034) and reduced extreme interpretive divergence. No case was unanimously classified as monoclonal, and incorporation of immunofixation reduced suspicion for monoclonality in cases initially considered equivocal. Dogs clinically affected for canine leishmaniosis exhibit predominantly IgG-driven polyclonal hypergammaglobulinemia. Together, SPE and IF provide a more complete characterization of gammopathy patterns in dogs with leishmaniosis, particularly when SPE reveals restricted or monoclonal-like abnormalities that could otherwise raise concern for plasma cell neoplasia.

52. An electrochemiluminescence biosensor based on the hairpin-mediated exponential amplification and CRISPR/Cas12a amplification for ultrasensitive detection of MMP-2.

期刊: Colloids and surfaces. B, Biointerfaces 发表日期: 2026-Jun-29 链接: PubMed

摘要

In this study, we report a novel electrochemiluminescence (ECL) biosensor for the ultrasensitive detection of matrix metalloproteinase-2 (MMP-2), an important biomarker associated with tumor invasion and metastasis. The biosensor integrates hairpin-mediated exponential amplification with CRISPR/Cas12a-based trans-cleavage for dual-stage signal amplification. In this design, MMP-2 specifically cleaves a peptide sequence (GPLG↓VRGK) on the DNA hairpin probe (HP1), releasing an initiator peptide nucleic acid (PNA) that triggers hairpin-mediated exponential amplification reaction. The amplified DNA products then activate the Cas12a/gRNA complex, which induces collateral cleavage of ferrocene (Fc)-labeled probes immobilized on a DNA tetrahedron-modified PEI-Ti₃C₂Tx/Ru/AuNPs electrode, thereby generating a strong ECL response. The incorporation of the DNA tetrahedron nanostructure provides a well-defined three-dimensional framework that ensures ordered probe orientation, enhanced hybridization efficiency, and reduced steric hindrance on the electrode surface. This structural organization significantly improves electron transfer and signal stability compared with conventional planar immobilization. Under optimized conditions, the biosensor exhibited a broad linear range from 0.01 fM to 10 nM and an ultralow detection limit of 10 aM. It displayed high specificity against interfering proteins (thrombin, IgG, BSA, lysozyme), excellent stability, and satisfactory recoveries (96.9%-105.0%) in LO2 cell culture supernatants. Overall, this enzyme-responsive, DNA-tetrahedron-assisted, CRISPR-amplified ECL biosensor represents a robust and versatile platform for precise and rapid detection of protease activity, showing great promise for biomedical diagnostics and clinical biomarker monitoring.

53. Bifunctional covalent organic framework for rapid isolation of extracellular vesicles and proteomics-based biomarker discovery.

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

摘要

Extracellular vesicles (EVs), serving as crucial carriers of biomarkers for tumor diagnosis and prognostic evaluation, as well as drug delivery vehicles and therapeutic targets, making it a research hotspot. The isolation methods represent a key aspect of EV-associated research. In this work, an alkynyl-functionalized covalent organic framework (COF) was synthesized under acidic conditions at room temperature and further modified by photo-initiated thiol-yne click reaction, yielding a bifunctionalized COF material decorated with distearoyl phosphatidylethanolamine (DSPE) and Ti4+. This bifunctional COF material (COF-DSPE-Ti) can leverage the bifunctional synergistic effect between DSPE and Ti4+ sites, thereby facilitating the efficient isolation of EVs. This synergistic effect enables the efficient isolation of EVs within 3 min. Proteomic analysis reveals that this isolation method significantly outperforms ultracentrifugation, and an effective EV isolation and analysis can be completed using only 10 μL of plasma sample. For clinical liquid biopsy, the integration of the COF-DSPE-Ti method with proteomics lead to the identification of 64 upregulated proteins in plasma samples from colorectal cancer (CRC) patients, among which S100A9 emerged as a potential EV biomarker. In addition, KLK2, KLK3, and FOLH1, which have been established as diagnostic markers for prostate cancer (PCa), are successfully identified in EVs isolated from the urine of PCa patients. These findings demonstrate the reliability of this approach for screening EV-associated biomarkers and provide a novel strategy for the early diagnosis and prognostic assessment of CRC and PCa.

54. COMBINA: The EAAD four-level approach for depression and suicide prevention and wellbeing promotion in the community and vulnerable populations. A cross-country study protocol from the MENTBEST project.

期刊: PloS one 发表日期: 2026 链接: PubMed

摘要

Depression and suicide are leading public health problems requiring complex multilevel interventions. This study protocol details the COMBINA trial, which expands the evidence-based European Alliance Against Depression (EAAD) Community-Based 4-level intervention to also focus on improving wellbeing and tailored to five groups with increased vulnerability to depression: young people, older people, migrants/refugees, the long-term unemployed, and people with an existing mental health condition. In this prospective, non-randomised controlled trial, the COMBINA project will be newly implemented during a 24-month period, from late 2024 to late 2026, in five regions in Albania, Estonia, Greece, Ireland, and Spain. These regions will be compared to five control regions in the same countries, chosen to reflect a similar context, size, and sociodemographic characteristics. Main outcomes are a comparison between the intervention and control regions in the rates of deaths by suicide and hospitalisations for suicide attempts and the levels of wellbeing, depressive symptoms, anxiety symptoms, depression-related stigma, and willingness to seek psychological help in the general population. A process evaluation and economic evaluation will also be conducted. This intervention protocol also details the steps taken to promote successful implementation across a range of different cultural and regional contexts, with challenges including different existing mental health resources and differing capacities for the population to use digital tools. The COMBINA project includes co-creation, whereby materials and implementation strategy were designed with people from the vulnerable groups. The trial is funded by the European Union (grant agreement no. 101080651 and carried out according to the Declaration of Helsinki. Ethical approval has been obtained in all participating countries. The results will be published in peer-reviewed academic journals, presented at scientific meetings and disseminated through COMBINA stakeholders, with participation from the co-creators. This trial protocol (version 1.1, 24/10/2024) was registered in the ISRCTN registry (ISRCTN10521127) on 14/11/2025 (https://www.isrctn.com/ISRCTN10521127).

55. Muscle strength characteristics and the predictive value of handgrip strength in young obese males: A multi‑joint isokinetic and LASSO regression analysis.

期刊: PloS one 发表日期: 2026 链接: PubMed

摘要

Obesity is a primary global public health concern, often associated with impaired muscle function and an increased risk of exercise-related injuries. This cross-sectional study aimed to elucidate the associations among muscular strength, body load, and functional capacity in young adults with obesity. A total of 75 male university students were recruited, including a normal-weight group (n = 47, BMI 18.5-24.99) and an obese group (n = 28, BMI ≥ 30). Assessments included handgrip strength, one-repetition maximum (1RM) for squat, deadlift, and bench press, as well as isokinetic strength evaluations across four major joints (shoulder, elbow, hip, and knee), yielding 32 strength-related variables. After normalizing all strength measures to body weight, the obese group demonstrated significantly lower relative strength across all parameters compared to the normal-weight group (P < 0.001), indicating a distinct “strength-to-load imbalance.” To identify key predictors of handgrip strength while addressing potential overfitting, we employed least absolute shrinkage and selection operator (LASSO) regression with cross-validation. The final model retained five predictors: elbow flexion maximum work at 180°/s (EF180°Wmax), elbow flexion peak torque at 180°/s (EF180°Fmax), elbow extension peak torque at 60°/s (EE60°Fmax), shoulder flexion peak torque at 60°/s (SF60°Fmax), and group (obese vs. normal), together explaining 63.3% of the variance in handgrip strength (adjusted R² = 0.606), although this finding should be interpreted with caution due to the sample size and requires validation in larger cohorts. Notably, group membership remained a significant independent predictor (β = -0.23, P = 0.014), underscoring the persistent deficit in relative strength associated with obesity even after accounting for joint-specific strength. By incorporating a multidimensional assessment of strength across multiple joints, this study moves beyond the limitations of single-joint evaluations and offers theoretical support for the potential use of handgrip strength as a practical indicator of overall muscle function in obese populations. Further research with larger samples and longitudinal designs is needed to validate its utility as a screening tool. These findings have important implications for designing function-oriented, precision-based exercise interventions for obese populations.

56. Growth monitoring and promotion uptake and its associated factors among mothers/ caregivers of children aged under two years in Wondo District, Ethiopia: Cross-sectional Study.

期刊: PloS one 发表日期: 2026 链接: PubMed

摘要

Growth monitoring and promotion (GMP) can be used to address developmental halting before a child’s health deteriorates. However, there hasn’t been much research done on the GMP uptake in the Wondo district. The study aimed to evaluate GMP uptake and its associated factors among children aged under two years old in the Wondo District in 2024. A cross-sectional design was conducted using random sampling. The data were analysed using SPSS version 25. Descriptive statistics and logistic regression with a p-value of less than 0.05 were used. GMP uptake was 14.2%. Household income above $32 monthly [AOR = 4.857, 95% CI: (2.009-11.744), read and write [AOR = 10.625, 95% CI: (2.667-42.334)], primary education [AOR = 9.067, 95% CI: (3.218-25.546)], secondary and above[AOR = 8.060, 95% CI: (2.952-22.007)], ANC follow up, [AOR = 2.871, 95% CI: (1.158-7.120)], health facility delivery [AOR = 4.037, 95% CI: (1.706-9.554)], PNC follow up [AOR = 4.110, 95% CI: (1.898-8.900)], maternal community conversation [AOR = 4.162, 95% CI: (1.974-8.775)], and family health cards utilization [AOR = 6.825, 95% CI: (2.935-15.867)] were significant variables. The GMP uptake was 14.2%. ANC follow-up, institutional delivery, PNC follow-up, family/child health card utilization, maternal community discussions, mother’s educational status, and household income were associated factors. Community conversations, family health cards, ANC, institutional delivery, and PNC follow-up can improve GMP services.

57. A pilot randomized trial on the usability and acceptability of an app (MyIBDDiet) to improve the self-management of anti-inflammatory diet for individuals with inflammatory bowel disease: A protocol paper.

期刊: PloS one 发表日期: 2026 链接: PubMed

摘要

The role of diet in the management of inflammatory bowel disease (IBD) is increasingly recognized with recent guidelines providing specific dietary recommendations. Although mobile health apps targeting diet and lifestyle habits in IBD are emerging, few are designed for self-management or have been formally evaluated for effectiveness. We have co-designed a diet guidance and tracking app (MyIBDDiet) with and for patients with IBD with the aim of improving overall diet profile. We will be conducting a 60-day single-centre pilot randomized trial of 40 IBD patients randomized in 1:1 ratio to MyIBDDiet app or usual care. Participants in the usual care group will crossover to the MyIBDDiet app group after 30 days. Primary outcome is usability assessed using a mixed method quantitative [Theoretical Framework of Acceptability (TFA), mHealth App Usability Questionnaire (MAUQ)], and qualitative approach (semi-structured interviews). Secondary outcomes include clinical efficacy evaluated by change in diet quality [Mini-EAT questionnaire, Automated Self-administered 24-Hour Dietary Assessment Tool (ASA-24), Healthy Eating Index (HEI), Mediterranean Diet Serving Score (MDSS)], changes in biomarkers of processed food intake (spot urine sodium and chloride), changes in IBD disease activity [Patient Reported Outcome (PRO2 and PRO3), C-reactive protein, fecal calprotectin], changes in quality of life [EuroQol-5 Dimension (EQ-5D), Short Inflammatory Bowel Disease Questionnaire (SIBDQ)] and safety. Exploratory outcomes include changes in fecal microbiome and serum and fecal metabolome. Additional quantitative data will be collected from the digital analytics of MyIBDDiet app. The pilot data generated will inform the design of an adequately powered randomized trial and future mobile app development and evaluation by providing a framework for evaluation of clinical effectiveness. ClinicalTrials.gov Identifier: NCT06683105. Registered on 8 November 2024.

58. "Shining a light on chronic pain": A qualitative study of stakeholder views towards chronic pain at work and the Pain-at-Work Toolkit.

期刊: PloS one 发表日期: 2026 链接: PubMed

摘要

The study explored the views of organisational stakeholders who participated in the feasibility trial of the Pain-at-Work Toolkit towards the implementation of the toolkit in ‘real-world’ workplace settings. This digital toolkit was co-created with healthcare professionals, employers, and people with chronic pain and aimed to inform and enable individuals to self-manage their chronic pain at work. A qualitative study using semi-structured interviews with 15 stakeholders from 12 organisations that participated in a feasibility trial of the Pain-at-Work Toolkit. Purposive sampling was used to ensure the inclusion of stakeholders with management or supportive roles who have responsibility for the health and wellbeing of employees. The findings illuminate three key themes: not all disabilities are visible; not all line managers are equal; and who has control? These surmise that invisible disabilities such as chronic pain are underestimated, poorly understood, and inconsistently provisioned for in organisational policies. It highlights the key role that line managers play in employee disclosure and access to support but demonstrates that line managers vary in their delivery of support to employees. Lastly, it explores stakeholder perceptions of the roles of the employer relative to the employee with chronic pain. It confirms the need for additional resources to plug organisational gaps and give workers tools to self-manage their pain at work. This study indicates the need for resources / supports to upskill line managers so they can intervene to proactively support employees with chronic pain to reduce sickness absence and presenteeism (working when unwell). The research demonstrates organisational stakeholders’ interest in a multi-faceted approach to help employees self-manage chronic pain in all types at work, such as that provided by the Pain-at-Work Toolkit. In addition, it clearly identifies the potential for complementary resources to educate and facilitate line managers to better support their staff.

59. Operational research in infectious disease outbreak response: An analysis of the World Health Organization's Disease Outbreak News.

期刊: PLOS global public health 发表日期: 2026 链接: PubMed

摘要

Timely and effective response to infectious disease outbreaks depends on the rapid application of evidence-based policies. Operational research (OR) is conducted during emergency response to inform decision-making, and guide response strategies; however, there is no standardized mechanism for documenting how OR is conducted or communicated during outbreaks. The World Health Organization Disease Outbreak News (DONs) platform is a global reporting mechanism that provides publicly-accessible updates on acute public health emergency response activities. Although DONs reports describe outbreak response actions, the extent to which they capture OR has not been examined. This study reviewed DONs reports to characterize how outbreak response efforts are documented and to assess the visibility of OR reporting. A structured content analysis was conducted of DONs reports published between January 2012 and October 2024. Reports describing acute infectious disease outbreaks were included. Quantitative data were extracted on outbreak response activities, deployment, technical support, and OR. Reports were deductively coded using a coding framework to identify thematic patterns. 412 outbreak events were included. Most DONs reports described deployment activities (100%) and technical support (95.1%). OR was explicitly mentioned in only 9 reports (2.2%).. Thematic analysis identified four key patterns: increasing report completeness over time; frequent association of deployment with laboratory and diagnostic activities; frequent association of technical support with infection prevention and control; and inconsistent OR reporting. Terminology used to describe response varied across reports, making systematic identification of OR difficult. While DONs reports provide valuable and accessible information on outbreak response activities, they capture limited information on OR. Enhancing reporting guidance, including clearer terminology and OR documentation, could improve the ability to share lessons learned. While DONs are not intended as the sole forum for reporting OR, strengthening their role as a communication platform may support knowledge sharing and contribute to effective, evidence-informed outbreak response.

60. Preventive Strategies of Hand, Foot, and Mouth Disease in Children: A Review.

期刊: Turkish archives of pediatrics 发表日期: 2025-Dec-30 链接: PubMed

摘要

Hand, foot, and mouth disease (HFMD) is a common viral illness primarily affecting children under 5, caused mainly by enterovirus A71 (EV-A71) and Coxsackievirus A16. Although typically mild and self-limiting, HFMD can lead to severe complications such as encephalitis, pulmonary edema, and even death. The disease has become a significant public health concern, par ticularly in the Asia-Pacific region, including Indonesia. This review outlines the epidemiology, etiology, clinical manifestations, diagnosis, management, and prevention strategies for HFMD. Diagnosis is generally clinical; however, laboratory tests may be needed for atypical or severe cases. Current management is supportive, focusing on symptom relief, while severe cases may require advanced therapies. Preventive measures, including hand hygiene, breastfeeding, and environmental sanitation, have been shown to reduce transmission. Although no specific antiviral is currently available, inactivated EV-A71 vaccines developed in China show over 90% efficacy in preventing severe HFMD. This review highlights the need for comprehensive pre ventive strategies, including vaccine implementation, to reduce the HFMD burden and prevent complications in children.