公共卫生研究摘要 (2026-07-05)

共收录 56 篇研究文章

1. Microbial metabolite Urolithin A protects against inorganic arsenic-induced gut barrier dysfunction in humanized AS3MT mice.

期刊: Gut microbes 发表日期: 2026-Dec-31 链接: PubMed

摘要

Chronic exposure to inorganic arsenic (iAs) remains a major environmental health concern and is associated with significant gastrointestinal (GI) disorders, including gastroenteritis, diarrhea, and inflammatory bowel disease-like symptoms. Gut microbiota plays a critical role in mitigating arsenic toxicity, as germ-free or antibiotic-treated mice exhibit reduced fecal arsenic excretion and greater tissue accumulation. We previously showed that the microbial metabolite Urolithin A (UroA) protects against iAs-induced cytotoxicity, apoptosis, oxidative stress, and ROS production in vitro. In this study, using humanized AS3MT mice (mouse arsenic methyltransferase gene (As3mt)replaced with human AS3MT, hAS3MT), we evaluated the in vivo effects of iAs and UroA on gut barrier function. Long-term iAs exposure (100 ppb for 28 weeks) significantly reduced expression of tight junction proteins, indicating compromised intestinal barrier integrity. UroA treatment protected hAS3MT mice from iAs-induced gut permeability, inflammation, colon shortening, and elevated colon weight/length ratio. UroA also reduced iAs-induced inflammatory cytokines, myeloperoxidase (MPO) activity and preserved intestinal epithelial cell tight junction protein expression. Further, microbiome and metabolomic analysis suggested that UroA treatment protected from iAs-induced gut microbial dysbiosis, especially restored several beneficial bacterial strains and short chain fatty acids (e.g., acetate and butyrate) and led to gut homeostasis. Together, these findings demonstrate that UroA mitigates iAs-induced gut toxicity and restores microbiota homeostasis.

2. Talking gender, ethnicity race, and change: How mothers scaffold girls' identity meaning-making during puberty.

期刊: Journal of research on adolescence : the official journal of the Society for Research on Adolescence 发表日期: 2026-Sep 链接: PubMed

摘要

Early adolescence is marked by intensified identity exploration, yet little research has examined how meanings of gender and ethnic-racial identity are co-constructed within family relationships during the pubertal transition. The present qualitative study investigated how mothers and daughters construct and negotiate meanings of gender, ethnic-racial identity, and their intersection through dyadic conversation, and how these processes vary by daughters’ pubertal status. Participants included mother-daughter dyads of Black girls (N = 45; Mage = 9.93, SD = .97; 69% identified as Black, 31% Black biracial) who engaged in structured identity dialogue tasks. Using reflexive thematic analysis followed by dyadic synthesis, we identified interactional processes through which identity meanings were initiated, scaffolded, negotiated, and stabilized. Across dyads, puberty functioned as a contextual intensifier, heightening emotional salience and social comparison in identity talk. In the early puberty dyads, mothers more frequently guided and defined identity meanings, whereas in the advanced puberty dyads, daughters increasingly asserted interpretive authority. Mother-daughter scaffolding operated as a relational coping process, with mothers and daughters jointly shaping how embodied change and social positioning were interpreted. Moments of misalignment and repair revealed how identity meanings were negotiated rather than transmitted. Grounded in the Phenomenological Variant of Ecological Systems Theory, findings position identity development during puberty as a relational, phenomenological process embedded within sociocultural context. By foregrounding dyadic interaction, this study extends developmental theory and highlights family dialogue as a critical microsystem linking pubertal vulnerability to identity formation.

3. Savor-Aging: The Art of Savoring Positive Emotions in Older Adulthood-A Randomized Controlled Trial.

期刊: Applied psychology. Health and well-being 发表日期: 2026-Aug 链接: PubMed

摘要

Savoring has been identified as a promising strategy to foster emotional and psychological well-being and to reduce depression in elders. However, research on online savoring interventions for this population remains limited. This registered RCT aimed to examine the effectiveness of a 3-week online intervention (six activities), Savor-Aging, in promoting subjective and psychological well-being and reducing depressive symptoms. Seventy-six healthy older adults (M = 69.9, SD = 4.8) were randomly assigned to a savoring group or a positive emotion (PE) group. Life satisfaction, positive and negative affect, flourishing, and depression were assessed at baseline (T0), post-intervention (T1), and 1-month follow-up (T2) to test psychological changes. Longitudinal quantitative data were analyzed using linear mixed-effects models, whereas qualitative feedback was thematically analyzed. Significant overall time effects emerged for negative affect and depressive symptoms. Although most time × group interactions were not significant, the savoring condition showed more consistent improvements over time, including reductions in negative affect and depressive symptoms that were maintained at follow-up. Significant time effects emerged for flourishing only in the savoring group immediately after the intervention. Participants described the savoring intervention as pleasant, engaging, and meaningful. Overall, Savor-Aging appears to be a feasible and effective self-help intervention to support emotional well-being and reduce depression in older adults, offering an accessible approach to positive aging.

4. Predictive Factors and Survival Outcomes of Nasogastric Tube Removal in Community-Dwelling Residents: A Retrospective Cohort Study.

期刊: Journal of applied gerontology : the official journal of the Southern Gerontological Society 发表日期: 2026-Aug 链接: PubMed

摘要

ObjectivesTo develop a predictive model for nasogastric tube (NGT) removal and examine survival-related factors among community-dwelling residents.DesignRetrospective cohort study (2016-2020) using medical records.Setting and ParticipantsA total of 255 home care residents with NGTs from a regional hospital in Taiwan.MethodsThis retrospective study was conducted to identify predictors across 30 variables from clinical records and nursing assessments. Logistic regression and Cox proportional hazards models assessed predictors of successful NGT removal, with model performance evaluated using ROC curve.ResultsKey predictors of successful NGT removal (18.0%, n = 46) and 12-month survival were activities of daily living, instrumental activities of daily living, and upper limb strength. Survival was higher in the removal group, and the model showed good accuracy (AUC = 0.811).ConclusionThis model provides a clinically applicable tool that incorporates functional and medical indicators to assess NGT removal readiness, demonstrating strong predictive validity.

5. "That's All We Wanted, to Be Heard, Listened to, Just to Be Validated and Believed": Family Experiences of Advocacy Support in Maternity and Neonatal Services.

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

摘要

Systemic failures in maternity and neonatal care have resulted in adverse outcomes for families. The 2020 Ockenden review (interim findings) recommended creating an Independent Senior Advocate Role as an Immediate and Essential Action. During 2024-March 2026, the Maternity and Neonatal Independent Senior Advocate (MNISA) service was piloted in 16 Integrated Care Boards (ICBs)1 and aimed to (1) enable families to feel listened to and heard, with their concerns acted upon, and (2) influence system change. MNISAs supported families following the death or serious injury of a mother or baby during NHS care. To explore the experiences of families who did, and did not, receive MNISA support and the perceived impact of MNISAs. A rapid qualitative study with families who did, and did not, receive MNISA support in 11 ICBs. Interviews were conducted, or written responses to interview questions were collected via an electronic survey tool. All responses were analysed using rapid assessment procedure sheets and inductive thematic analysis. We interviewed 34 families (n = 31 received support and n = 3 did not, but were eligible). Findings indicate that MNISAs met service aims by listening to and validating families, enabling their voices to be heard, supporting them to navigate investigative processes and understand their care, facilitating family-led change. MNISA support was continuous, which helped to alleviate the emotional overwhelm that families experienced. Important barriers to access and engagement were identified. Families who did not receive the service indicated that they would have valued independent advocacy support. All families felt that the service should continue. Independent advocacy in maternity care creates opportunities for families to be heard and listened to, supporting family-led change. Further research is essential to understand the ongoing and sustained impact of independent advocacy on family experiences, how the positioning of these services can facilitate equitable access and their role in preventing avoidable harm.

6. How Preferences and Reality on Where We Die Unfold: A Four-Country Longitudinal Qualitative Study (EOLinPLACE).

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

摘要

While there is a growing body of evidence on end-of-life (EOL) care preferences such as place of death, research remains limited in key areas. This includes gaps in understanding preferred and actual places of EOL care and death (dying places), potential shifts of preferences over time, and their (non-)alignment with reality. We aimed to explore how preferred and actual dying places unfold for adults with life-threatening illness and their family caregivers in different socio-cultural settings. A qualitative longitudinal study in the Netherlands, Portugal, Uganda, and the United States (June 2023-August 2025) in adults (≥ 18 y) with cancer, dementia, neuromuscular or heart and cerebrovascular disease and their family caregivers. We conducted a semi-structured interview at inclusion, followed by at least 2 interviews (between 3 weeks to 18 months after), including post-death with the family caregiver. Fieldnotes of informal conversations and observations complemented the transcripts. Analysis was based on principles of applied qualitative ethnography, combining applied thematic analysis with thematic network analysis. Fourteen patients participated, eight of whom were followed until death. Home was the most preferred dying place. We identified 3 themes: (1) Beyond the preferred: choosing otherwise highlighted how factors (the burden of receiving care, anticipated trauma of death at home, and urgent care needs) drove decisions around place; (2) Family caregiver commitment and burden affecting realisation of patient preferences illustrated the critical role of family caregivers; and (3) Navigating care shapes dying places showed how the healthcare system and skills to navigate it, influenced dying places. Preferences and decisions were influenced by a complex interplay of personal, relational, and contextual considerations. The prominence of these considerations may vary by country, but their interaction and the way they shape preferred and actual dying places appear to be a shared phenomenon. Clinicians, policymakers, educators, and researchers must consider patients’ and family caregivers’ preferences along with influencing drivers that can support or limit choice. Patient and public involvement and engagement (PPIE) was embedded in this international project from the start, through formal partnerships established with two international organisations representing patients and informal carers, namely the International Alliance of Patients’ Organisations (IAPO) and Eurocarers. Representatives of both organisations worked closely with the research team and are members of the project advisory board. They contributed to the development of the study design and materials, to the training of researchers helping ensure interviews with patients and family caregivers were conducted in a sensitive and appropriate manner, and to the interpretation of findings through various meetings. They will also help to disseminate the findings to engage patients, informal carers and the wider public.

7. Adeno-Associated Virus Gene Therapy for Spinal Muscular Atrophy Induces Hepatotoxicity via Cytokine and Macrophage Activation.

期刊: Liver international : official journal of the International Association for the Study of the Liver 发表日期: 2026-Aug 链接: PubMed

摘要

Hepatotoxicity is a common and significant adverse effect associated with adeno-associated virus (AAV) gene therapy; however, the underlying mechanisms remain unknown. In this study, we demonstrated innate immune activation in two patients with spinal muscular atrophy shortly after receiving AAV9 gene therapy with onasemnogene abeparvovec. Both patients developed marked hyperferritinemia accompanied by hepatotoxicity, thrombocytopenia, hypertriglyceridemia, and hypofibrinogenemia, all of which are the diagnostic criteria for macrophage activation syndrome. To evaluate their immune responses, serial analyses of serum cytokines/chemokines and flow cytometry were performed. Surges in macrophage-associated cytokine levels were observed in proportion to the severity of adverse events within 1 week after AAV vector infusion, suggesting that macrophage activation contributed to the pathogenesis of these adverse effects. Our findings clarify the immunological basis underlying hepatotoxicity in patients after AAV gene therapy. Furthermore, these findings provide a rationale for using various immunosuppressants or chemokine blockers in patients exhibiting severe adverse effects.

8. Internalising or Externalising? Latent Profile Identification and Longitudinal Transitions of Severe Psychological Crisis and Mental Health Problems in College Students: The Influence of Underlying Psychological Distress.

期刊: Stress and health : journal of the International Society for the Investigation of Stress 发表日期: 2026-Aug 链接: PubMed

摘要

College student mental health issues are receiving increasing attention from various stakeholders. However, research on the longitudinal trends of college student mental health remains scarce. This study enrolled 5479 college students from a Chinese university. Using Latent Profile Analysis (LPA), it identified distinct classes characterising comorbid patterns of severe psychological crisis with internalising and externalising psychological problems during the period from 2022 to 2024. Latent Transition Analysis (LTA) was then employed to examine the stability of these classes across the three-year period. For the comorbid pattern of severe psychological crisis and internalising problems, the LPA yielded four distinct mental health classes: Secure Group, Low Internalising Problems Group, Low Crisis-High Internalising Problems Group, and High-Risk Group. Similarly, for the comorbid pattern of severe psychological crisis and externalising problems, four classes emerged: Secure Group, Low Crisis Group, Sub-High-Risk Group, and High-Risk Group. Longitudinal analysis via the LTA model revealed that, within both comorbid patterns, the Secure Group exhibited the highest stability, while the remaining classes demonstrated varying degrees of change. These findings underscore the need for stakeholders to prioritise college student mental health concerns and develop timely intervention strategies to accurately guide mental health promotion, prevention, and intervention efforts.

9. Exploring the Acceptability of Integrating Dietitians Into Primary Care Dental Services for Children.

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

摘要

Dental caries is a common childhood non-communicable disease strongly associated with high sugar intake. Beyond oral health, a poor diet can affect children’s growth, development, and overall well-being. While dietary advice is central to preventive dental care, some primary care dental clinics have introduced body mass index (BMI) assessments and further dietary advice to address wider nutritional concerns in children. However, these efforts are often constrained by limited nutrition training, time constraints and concerns about sensitivity. Integrating dietitians into primary dental care may help overcome these barriers by enhancing dietary guidance, supporting broader nutritional needs and facilitating structured BMI assessments with appropriate follow-up. To explore the acceptability of integrating dietitians into primary dental care for children, guided by the theoretical framework of acceptability (TFA). Dental professionals and caregivers were recruited from South West England, and dietitians from across the United Kingdom (April-December 2024). Semi-structured interviews were analysed inductively using reflexive thematic analysis. Findings were interpreted through the TFA to examine how emotional, ethical and structural factors shaped perceptions of acceptability. Semi-structured interviews were conducted with 23 participants: 10 dental professionals, 6 dietitians and 7 caregivers. Four inductive themes captured participants reasoning: (1) Balancing enthusiasm and sensitivity; (2) Negotiating the realities of integration; (3) Clarifying boundaries and expertise and (4) Building collective confidence. These themes aligned closely with the TFA, showing how emotional, ethical and structural factors interacted. Acceptability emerged as a dynamic balance of emotional and ethical alignment, practical feasibility, conceptual clarity and shared confidence. Perceived effectiveness was a unifying thread, with integration seen as acceptable when safeguards ensured emotional safety, ethical grounding and organisational support. Integrating dietitians was viewed as widely acceptable when collaboratively, sensitively and structurally delivered and supported.

10. Managing Asthma Well and Sustainably - Patient Perspectives Explored.

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

摘要

Asthma affects 300 million people worldwide. The widespread use of short-acting beta2-agonist (SABA) relievers, commonly delivered via pressurised metered dose inhalers (pMDIs), is contrary to evidence-based guidelines. SABA overuse is associated with poor asthma control and high carbon emissions. Reducing reliance presents a dual opportunity to improve patient outcomes while decreasing environmental impact, yet patient perspectives remain unclear. The aim of this study was to explore the perspectives, understanding, and preferences of a sample of Australians living with asthma regarding inhaler types, medication options, self-management, and environmental impact. We conducted in-depth interviews with adults who regularly used inhalers to manage their asthma (n = 23), recruited via consumer health networks. Participants completed an online pre-interview survey on demographics, asthma history and inhaler use. Interviews were semi-structured, following a guide developed with advice from the consumer panel. Data were analysed thematically using an inductive framework. Survey data were summarised descriptively. Predominantly female (91%) participants had limited awareness of different device types and their environmental impact, with many surprised by pMDI emissions. While most valued environmental sustainability, they prioritised access to fast-acting SABA pMDIs, perceived to be the most effective emergency treatment by many. Familiarity, psychological comfort, and concern about reliable relief during acute asthma attacks were key barriers to switching device types. Health professional recommendation strongly influenced choice of inhaler, with most participants relying on clinician advice and expressing limited involvement in decision-making. Barriers to accessing care and information, such as cost, time and rurality, contributed to knowledge gaps and potential overreliance on SABAs. Positive experiences with asthma care nurses and pharmacists highlighted opportunities for multi-disciplinary care teams to improve support. Environmental concern is important to patients but, alone, is insufficient to drive change in asthma management. Treatment is shaped by familiarity, habit and fear of exacerbations, with strong reliance on clinician expertise. A consumer panel of asthma patients provided lived-experience insights during study conception, helped shape interview materials, and reviewed our findings and conclusions. Asthma Australia (Australia’s peak asthma consumer advocacy body) and the Health Care Consumers’ Association were engaged in this project since inception of the study idea, collaborated in co-designing the funding proposal, recruiting participants and their representatives contributed to the research as co-authors. Their involvement ensures our research reflects real-world experiences and perspectives.

11. Holding Complex Spaces Through Relational Work: A Qualitative Descriptive Study of Co-Design Facilitation.

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

摘要

Involving patients and the public in healthcare research, development and innovation is becoming mandatory. Co-design is a structured approach to collaboratively investigating and finding solutions to complex problems that brings together relevant actors and interest groups. Including experiences and insights from patients and the public in multi-actor co-design processes can help to generate and evaluate solutions to complex problems. While toolkits support co-design project organisation, little is known about the relational work required when facilitating co-design workshops, especially in healthcare, where professionals often learn facilitation skills ‘on the job’. Reflective accounts are scarce, despite the complexity and unpredictability of co-design. Based on reflective conversations between two co-design workshop facilitators, this article explores co-design facilitation as relational work and offers a conceptual model to guide reflection. Authors B.H. and K.C. facilitated five co-design workshops involving people living with chronic pain between September 2023 and January 2024. Within 24 h of each workshop, individual reflective interviews (B.H., n = 5; K.C., n = 5) and dyadic reflective discussions between the two authors (n = 5) about the learning and insights gained from the workshop facilitation were recorded. The average length of the interviews and dyadic discussion was approximately 18 min. The data were automatically transcribed and analysed in a reflexive thematic analysis. Facilitation required managing unpredictability alongside structural considerations. Three interconnected themes were identified: (1) the planning, evaluation and learning space; (2) the workshop-holding space, comprising structural, emotional, physical and activation subspaces and (3) the tacit space. We present an overarching theme and conceptual reflection model: ‘Holding complex spaces through relational work’. Findings show that co-design facilitation is demanding relational work that involves continuous interpretation and awareness. The conceptual model provides a flexible reflective tool for understanding facilitation complexity, rather than a procedural guide. This case study shows that co-design facilitators must hold complex, unpredictable relational spaces. While toolkits offer useful structure, facilitation hinges on navigating relational dynamics. Our conceptual reflection model provides a flexible way to understand this complexity through interconnected spaces and to support reflective skill development. Developed in chronic pain contexts, the model may be transferable to other healthcare settings; future work should examine its value for facilitator training in co-design. Two patient representatives are co-authors of this publication and provided critical input on the findings and their interpretation. Both have been co-researchers in the reported co-design project since its inception and contributed throughout study planning, workshop delivery, the reflective analysis and reporting of results in the current study.

12. Bacterial respiratory infections: advances in diagnostic strategies.

期刊: Expert review of molecular diagnostics 发表日期: 2026-Jul-04 链接: PubMed

摘要

Respiratory tract infections (RTIs) are among the most common causes of medical consultation in children. Although the majority of upper respiratory tract infections are viral and self-limiting, bacterial pathogens remain responsible for a relevant proportion of cases and may require targeted antimicrobial therapy. Accurate microbiological diagnosis is therefore essential to guide clinical management and support antimicrobial stewardship. This review discusses the etiology and clinical presentation of pediatric respiratory infections and examines current diagnostic approaches, including traditional culture-based methods and nucleic acid amplification tests (NAATs). The advantages of molecular diagnostics - such as rapid turnaround time, high sensitivity, and improved pathogen detection - are highlighted alongside their role in antimicrobial stewardship and public health surveillance. At the same time, important limitations are explored, including difficulties in distinguishing colonization from active infection, challenges in polymicrobial detection, absence of host-response information, and barriers related to cost and accessibility. Emerging technologies and future perspectives in pediatric molecular diagnostics are also addressed. While molecular diagnostics have transformed pathogen detection, their clinical interpretation remains complex. Future diagnostic strategies should integrate molecular data with quantitative pathogen measurements, host-response biomarkers, and clinical phenotyping to better distinguish infection from colonization. Interdisciplinary research, real-world implementation studies, and cost-effectiveness evaluations will be essential to translate technological advances into meaningful improvements in pediatric infectious disease care.

13. Preferences and perceptions around uptake of different TB preventive therapy regimens: An exploratory study in Gauteng and Limpopo, South Africa.

期刊: Health policy and planning 发表日期: 2026-Jul-04 链接: PubMed

摘要

TB preventive therapy (TPT) is one of three key interventions for reducing TB in South Africa, but uptake and completion rates remain low. In South Africa, the current TPT options include isoniazid and rifapentine or isoniazid and rifampicin. Evidence and lessons learned from programmatic uses of isoniazid preventative therapy (IPT) could provide operational advice to enhance the implementation of new TPT regimens. We conducted 28 in-depth provider interviews (IDIs) to elicit experiences of and preferences for the different TPT regimens between 04/2022 and 12/2022 in the City of Johannesburg, Gauteng and Greater Tzaneen sub-district, Mopani district, Limpopo Provinces. We used purposive sampling to recruit doctors (n=7), pharmacists (n=8) and nurses (n=13) in high and low volume TB and/or HIV facilities. IDIs were recorded for quality, transcription, and translation purposes. Data analysis was conducted using a thematic approach in NVivo 11. We present provider preferences and perspectives for TPT uptake. The most important attributes relating to preferences for TPT regimens attributes among healthcare providers included medication safety, efficacy and low pill burden. Despite valid preferences for different regimens, healthcare service providers had varied experiences around factors that influence the uptake of the different TPT regimens they offered at their facilities. Many providers indicated that patient booking errors, missing patient records, staff shortages, long queues, medication side effects and limited understanding of the benefits of TPT were reasons for poor patient TPT uptake and adherence. Limited knowledge was attributed to a lack of educational materials and insufficient staff-patient engagement time. Providers noted that increased clinician awareness and patient counselling contribute to a higher rate of TPT prescriptions, as well as improved patient uptake and adherence. Thus counselling, staff training, side-effects management, and improved file documentation are key factors for TPT uptake.

14. Asthma as a Predictor of Depression, Anxiety and Their Comorbidity in Australian Men.

期刊: American journal of health promotion : AJHP 发表日期: 2026-Jul-04 链接: PubMed

摘要

PurposeExamine the long-term association between asthma and mental health conditions in Australian men.DesignRetrospective cohort study.SettingTen to Men project from four waves (2014-2022).Subjects16,021 Australian men (aged ≥ 18 years) at baseline.MeasuresExposure was self-reported asthma. Outcome measures were depression, anxiety and their comorbidity, assessed through self-reports and validated screening tools. Key covariates included survey year (waves), sociodemographic, lifestyle variables and comorbidities.AnalysisChi-square test (χ²) of independence for prevalence analysis and generalised estimating equation models for examining associations between asthma and mental health conditions, adjusting for relevant covariates.ResultsAcross survey years, the prevalence of depression ranged from 12.8% to 33.2%, while anxiety ranged from 17.3% to 51.3%. Comorbid depression with anxiety ranged from 11% to 28%, with the highest prevalence reported in 2020. Asthma was significantly associated with higher risks of depression (RR = 1.23, 95% CI: 1.16, 1.30), anxiety (RR = 1.12, 95% CI: 1.05, 1.18), and comorbid depression with anxiety (RR = 1.27, 95% CI: 1.17, 1.38). Significant risk factors included survey year (2020 and 2022), sleep disturbances and being a former or current smoker.ConclusionA significant association between asthma and mental health disorders, particularly depression, anxiety, and their comorbidity was identified in Australian men. These highlight the need for an integrated approach to respiratory and mental health care, with particular emphasis on targeted screening and interventions.

15. Mental Health and More: Small, Low-Wage Businesses' Workplace Wellness Needs After the COVID-19 Pandemic.

期刊: Health promotion practice 发表日期: 2026-Jul-04 链接: PubMed

摘要

As businesses continue to adapt post-COVID-19 pandemic, there is increased interest among employers in their employees’ mental health and work-life balance. However, few studies have looked at how the pandemic may have impacted employer perceptions of workplace health promotion (WHP), despite its role in addressing mental health and work-life balance. Small low-wage businesses have unique characteristics, including thin profit margins, limited financial reserves, and few employees, so the impact of the pandemic hit them particularly hard. Using a framework guided by social marketing principles, 25 small-business employers from across the United States were interviewed. Questions included what they thought was most needed in post-pandemic WHP, how the pandemic changed WHP, how comfortable they would be providing support to their employees around physical health, mental health, and work-life balance, and what avenues they would use to promote those benefits and resources. Interviews were coded and analyzed via thematic analysis. Small low-wage business employers value the importance of WHP programs and recognize how the pandemic highlighted the need to support employee mental health. These employers are interested in providing support in the domains of mental health, physical health, and work-life balance; they would use similar avenues to promote resources in these domains; and they agree that the source of these supports should be trustworthy. Small-business employers now find WHP programs incomplete if they do not support employee mental health; health promotion practitioners should collaborate with employers to identify resources suitable for small businesses and determine how best to integrate them into existing offerings.

16. Modulating Electronic Structure via Bimetallic D-Band Engineering toward an Ultrasensitive Sensor Platform for Caffeic Acid in Food.

期刊: ACS sensors 发表日期: 2026-Jul-04 链接: PubMed

摘要

To overcome the poor conductivity of pure MOFs and the structural collapse of MOF-derived carbons, this study constructed an electrochemical sensing interface by integrating high-surface-area UiO-66-NH2 with catalytically active bimetallic CoFe alloy-embedded N-doped carbon nanosheets (CoFe@NC). The composite exhibits uniform morphology, clear crystal structure, and a large specific surface area (227.58 m2·g-1), which contribute to enhanced enrichment and detection performance toward CA. This sensor demonstrates a wide linear range (0.001-7 μM) and an ultralow detection limit (0.29 nM), along with excellent anti-interference ability, reproducibility, and stability. By combining density functional theory (DFT) calculations with electrochemical experiments and in-situ Raman characterization, the roles of various components in composite materials during the CA oxidation process, the regulatory mechanism of bimetallic alloys on the electronic structure of the material, the reaction mechanism of CA at the sensing interface, and the synergistic enhancement effect of the bimetallic system were elucidated. When applied to red wine, green tea, blueberries, and apple peel, recoveries of this sensor ranged from 97.2 to 103.8%. The quantitative results were in excellent agreement with those obtained by ultraviolet-visible (UV-vis) spectrophotometry and high performance liquid chromatography (HPLC), confirming the high accuracy and reliability of this sensor. This work not only provides a high-performance sensing platform for trace CA detection in food but also offers a novel strategy for the design and application of electrochemical sensors based on hierarchically structured MOF composites through the deep integration of experimental and theoretical approaches.

17. Retrospective Evaluation of an Artificial Intelligence-Assisted Video Laryngoscope System for Tracheal Intubation in Infants and Neonates.

期刊: Paediatric anaesthesia 发表日期: 2026-Jul-03 链接: PubMed

摘要

18. Toward a nuanced framework for the Medical development of ibogaine and its analogues and derivatives: implications for psychopharmacology.

期刊: Expert opinion on drug discovery 发表日期: 2026-Jul-03 链接: PubMed

摘要

Ibogaine is a naturally occurring indole alkaloid with suggested therapeutic potential across substance use disorders, trauma-related conditions, mood disorders, and suicidality. However, its clinical translation has been hindered by safety concerns, regulatory barriers, and uncertainty regarding its complex pharmacology. Recent interest has surged in developing ibogaine analogs and derivatives that retain therapeutic efficacy while minimizing safety risks. Ibogaine pharmacology is complex with many affected targets, which complicates these efforts. Herein, the authors propose a conceptual framework that distinguishes between two primary strategies: (1) development of ibogaine-like compounds that preserve broad, polypharmacological effects while mitigating key safety liabilities, and (2) creation of more selective, purpose-built ‘bespoke’ analogs designed to optimally target specific neurobiological pathways and clinical indications - such as opioid use disorder (OUD), traumatic brain injury, or post-traumatic stress disorder (PTSD). Furthermore, the authors critically evaluate the current evidence supporting each approach, and discuss the translational trade-offs related to safety, efficacy, comorbidity, and scalability. The authors also highlight the importance of individual variability, including pharmacogenetics in treatment response. It is important, and particularly within policy-driven research initiatives, that this evolving field must resist oversimplified narratives that frame derivatives as uniformly superior or interchangeable. Greater conceptual clarity and mechanistic humility are also essential as ibogaine-based therapies move toward regulated medical use within Westernized healthcare models.

19. Mapping exposure to violence and abuse among young people: the Norwegian YouthViolence surveys.

期刊: Scandinavian journal of public health 发表日期: 2026-Jul-03 链接: PubMed

摘要

The YouthViolence surveys were conducted to retrospectively map young Norwegians’ (age 16-19 years) exposure to violence and abuse, both within their families and in their peer relations. The aim was to provide high-quality data for victimisation research and policy development and for monitoring and evaluating prevention work. This study design article outlines the relevance of the YouthViolence study and its characteristics. Data were obtained from three repeated cross-sectional surveys conducted in 2007 (N = 7,103), 2015 (N = 4,530) and 2023 (N = 16,081) with national samples of Norwegian senior high school students. The first two surveys included students in their final year of senior high school, while the 2023 survey sampled students from all three senior high school levels. A subsample of the 2007 participants (n = 3,319) was followed longitudinally until 2021 (age 32-33 years) based on linked survey-administrative data. The YouthViolence survey findings provide important knowledge on topics such as direct and indirect parental violence, physical and digital sexual violence, and polyvictimisation, as well as on procedures for mapping violence and abuse among youth and have led to the publication of over 25 scientific papers. The study also provides extensive knowledge inputs for governmental whitepapers and strategies on the prevention and handling of violence and abuse and to non-governmental organisations that offer victim support. The YouthViolence survey findings and their wide applicability in knowledge and policy development highlight the importance of continuously and systematically mapping young people’s exposure to violence and abuse.

20. Supervised Exercise Interventions: Evidence, Outcomes, and Policy Implications for Chronic Disease Management.

期刊: American journal of health promotion : AJHP 发表日期: 2026-Jul-03 链接: PubMed

摘要

ContextPhysical inactivity is a major contributor to chronic disease, disability, and premature mortality in the United States and is associated with substantial healthcare expenditures. Although regular physical activity improves health outcomes, individuals with chronic conditions often require structured supervision to exercise safely and effectively. Building upon this context, the objective of this review is to synthesize evidence on the clinical, psychosocial, and economic impacts of supervised exercise interventions (SEIs) and to examine policy and implementation factors influencing their adoption. To achieve this objective, a structured literature review was conducted, guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) framework.Eligibility CriteriaStudies published in English between 2010 and 2024 that involved adults aged 18 years or older and evaluated supervised exercise interventions with reported clinical, psychosocial, economic, or policy-related outcomes were included.Study SelectionPubMed, Web of Science, and the Cumulative Index to Nursing and Allied Health Literature (CINAHL) were searched using predefined keywords. Reference lists of relevant studies were also reviewed to identify additional eligible articles.Main Outcome MeasuresClinical outcomes (eg, mortality, aerobic capacity, HbA1c), psychosocial outcomes (eg, adherence, depression, quality of life), and economic and policy outcomes (eg, cost-effectiveness, reimbursement).ResultsTwenty studies met the inclusion criteria. Across cardiovascular, metabolic, oncologic, pulmonary, and geriatric populations, SEIs were associated with improved clinical outcomes, including reduced rehospitalization and mortality, enhanced aerobic capacity, improved glycemic control, and reductions in fatigue and depressive symptoms. SEIs were cost-effective across disease categories, with several studies reporting healthcare cost savings within 1 year. However, disparities in referral and participation persisted among racial and ethnic minorities, rural populations, and individuals with lower socioeconomic status.ConclusionSEIs are effective and scalable strategies for managing chronic diseases and preventing secondary complications. Evidence indicates that supervised exercise improves clinical, psychosocial, and economic outcomes across diverse populations. Expanding reimbursement and strengthening integration within health systems will be critical to improving equitable access to SEIs.

21. Perspectives on harm reduction kit implementation in heterogeneous outpatient clinics.

期刊: Substance abuse treatment, prevention, and policy 发表日期: 2026-Jul-03 链接: PubMed

摘要

The evolving U.S. drug market has fueled a public health crisis with rising drug use-associated morbidity and mortality, revealing a mismatch between current abstinence-based addiction care and the needs of people who use drugs (PWUD) to access evidence-based harm reduction services (HRS). Co-locating HRS into outpatient clinics could reduce mortality and improve clinical outcomes. We investigated barriers and facilitators of HRS implementation through kit distribution at three heterogenous outpatient addiction clinics using pre- and post-implementation focus groups. Using a qualitative description approach, we conducted 1-hour virtual focus groups and individual interviews with clinic staff and providers both pre- and post-implementation of kit distribution. Interview guides were based on the Consolidated Framework for Implementation Research to assess anticipated and actual implementation barriers and facilitators. Interviews were analyzed using thematic analysis. Five providers and six staff participated in pre-implementation data collection. Dominant themes pre-implementation included participant enthusiasm for HRS integration and anticipated barriers of personal knowledge and external stigma against PWUD. Six providers and five staff participated post-implementation. Participants reported successful kit implementation with few actual barriers, though external stigma at the individual, health system, and community levels, along with issues related to patient use and interactions with child protective services, law enforcement, and pharmacies, occasionally disrupted the process. The lack of sustainable funding for supplies and labor emerged as a primary concern for long-term sustainability, with clinics actively seeking alternative funding sources. Implementation of HRS in outpatient addiction clinics was well-received by providers and staff and supported by pre-implementation trainings, site champions, and favorable implementation environments. Further efforts are needed to reduce stigma in the greater community and achieve sustainable funding for HRS.

22. Ultrasound-guided botulinum toxin injections for abdominal spasticity and dyspnea in an ambulatory patient with an incomplete cervical spinal cord injury: a case report.

期刊: Journal of medical case reports 发表日期: 2026-Jul-03 链接: PubMed

摘要

Abdominal spasticity in spinal cord injury (SCI) patients may remain unrecognized, despite its impact on quality of life. We report a 47-year-old white Dutch man with incomplete C4 SCI (AIS D) presenting with dyspnea, abdominal pain, and discomfort from involuntary abdominal muscle contractions. Five year post-injury, the patient developed bloating and pronounced abdominal pain, pain in the lower back, and in the intercostal muscles. In addition, a 7-cm diastasis developed in the abdominal midline. These complaints reduced ambulatory capacity and quality of life. Initial management with systemic antispasticity treatment (tolperisone 50 mg, 3×/day) relieved leg spasticity and closed the diastasis, yet failed to alleviate dyspnea. Ultrasound imaging confirmed spasticity predominantly in the internal oblique and transverse abdominal muscles. Given the persistence of abdominal spasticity complaints, we initiated a series of ultrasound-guided botulinum toxin (100-150E incobotulinum toxin-A) injections to the internal and external oblique muscles-with one session also targeting transversus. The injection protocol was refined over successive treatments to achieve an optimal distribution while minimizing side effects on core stability. Although the patient experienced transient balance issues and lower back pain during the initial adjustment period, these effects were minor and resolved within 2-3 weeks. This case underscores that in ambulatory SCI patients, systemic treatments alone may not sufficiently address abdominal spasticity and concomitant symptoms like dyspnea. Low-dose ultrasound-guided botulinum toxin injections targeting the abdominal muscles can provide significant symptom relief and improve overall functional capacity, offering a safe and effective addition to low-dose systemic treatment.

23. Evaluating the impacts of critical time intervention implementation on health service utilization among homeless-experienced veterans: a retrospective observational study.

期刊: BMC health services research 发表日期: 2026-Jul-03 链接: PubMed

摘要

Critical Time Intervention (CTI) is an evidence-based, time-limited case management practice that improves housing outcomes among homeless-experienced adults. While CTI’s effect on housing outcomes has been well-studied, its impacts on health services utilization are less clear. In the context of a U.S Department of Veterans Affairs (VA) CTI implementation effort, we assessed relationships between CTI implementation, including fidelity, and Veterans’ VA health services utilization. We conducted a retrospective observational study of 9,051 Veterans who received services, 10/1/2019 to 5/1/2025, from one of 156 case management sites that worked with VA; 32 of these sites implemented CTI. Within the 18 implementing CTI sites that completed fidelity ratings, we compared health services utilization for Veterans (n = 2,022) at sites with adequate (n = 12 sites) vs. inadequate (n = 6 sites) fidelity. We performed multivariate regression using generalized estimating equations with clustering by site, adjusting for Veterans’ demographics and diagnoses, and VA facility complexity. Regression models identified the impacts of CTI (versus non-CTI), and fidelity (adequate versus inadequate), on health service utilization; we used negative binomial regression for count outcomes (number of primary care, emergency department [ED], behavioral health, homeless services, outpatient medical-surgical visits) and logistic regression for binary outcomes (presence of inpatient mental health, or medical-surgical hospitalizations). CTI Veterans had lower rates of utilization across all service types compared to non-CTI, including primary care (IRR = 0.98, 95% CI: 0.97-0.98), ED (IRR = 0.93, 95% CI: 0.90-0.95), homeless services (IRR = 0.91, 95%CI: 0.89-0.93) and hospitalizations (AOR = 0.79, 95%CI: 0.68-0.91). Among CTI Veterans, Veterans at sites with adequate fidelity had more primary care use (IRR = 1.04, 95% CI: 1.02-1.07), less ED use (IRR = 0.84, 95% CI: 0.80-0.90) and more homeless service use (IRR = 1.10, 95% CI: 1.05-1.15). CTI Veterans had lower service utilization rates compared to non-CTI Veterans. However, adequate CTI fidelity is associated with increased primary care use and decreased ED use; this finding may be due to high-quality CTI implementation and/or site-level characteristics that enabled better CTI fidelity. Ensuring fidelity to CTI implementation may hold value in promoting optimal care linkages for homeless-experienced Veterans and other clients with high needs.

24. Development and validation of machine learning-based model for macrosomia and spontaneous preterm birth: A retrospective cohort study.

期刊: International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics 发表日期: 2026-Jul-03 链接: PubMed

摘要

This study aimed to develop and externally validate machine learning-based models for predicting macrosomia and spontaneous preterm birth (sPTB) using multidimensional clinical data. This retrospective cohort study included 14 238 pregnant women who received prenatal care between 2018 and 2023. Demographic characteristics, laboratory parameters, and delivery outcomes were integrated, with Least Absolute Shrinkage and Selection Operator regression used for feature selection. Predictive models were developed using logistic regression and machine learning algorithms (Light Gradient Boosting Machine, Adaptive Boosting, and gradient boosting decision tree), and performance was evaluated using the area under the curve (AUC), Brier score, decision curve analysis, and external validation results. Key predictors of macrosomia included pre-pregnancy body mass index, 1-h postprandial glucose, maternal education level, and comorbidities. The logistic regression model for macrosomia achieved an AUC of 0.742 (95% CI: 0.617-0.866) in external validation. For sPTB, significant predictors were comorbidities, aspartate aminotransferase, and uric acid, with the logistic regression model yielding an AUC of 0.706 (95% CI: 0.587-0.824) in external validation. Both models showed good calibration, with Brier scores of 0.182 (macrosomia) and 0.192 (sPTB). The predictive models effectively identify pregnancies at high risk of macrosomia and sPTB, facilitating early identification and targeted intervention. External validation highlights the need for prospective, multicenter studies in diverse populations to enhance generalizability.

25. Multiple-level regulation of a plant sterol methyltransferase during rice stripe virus infection.

期刊: Plant communications 发表日期: 2026-Jul-03 链接: PubMed

摘要

The plant sterol biosynthesis pathway is essential for the normal growth and development of plants, yet its relationship with plant virus infections remains poorly understood. In this study, we investigated the regulation of sterol methyltransferase 2 (SMT2), a key component of the plant sterol synthesis pathway, during rice stripe virus (RSV) infection. Our findings demonstrate that Nicotiana benthamiana SMT2 (NbSMT2) was regulated transcriptionally during RSV infection. Together with other sterol synthesis pathway proteins, namely sterol 4α-methyl oxidase 2 (SMO2) and sterol Δ(7)-reductase (DWF5), NbSMT2 acted as a positive regulator of RSV intercellular movement protein pc4 and facilitated virus movement. However, in response to RSV infection, NbSMT2 was polyubiquitinated and degraded through the ubiquitin-26S proteasome pathway mediated by the accumulation of reactive oxygen species (ROS), which conferred resistance to RSV. Additionally, NbSMT2 protein formed intercellular disulfide bonds to prevent complete degradation and maintain its protein pool. This study indicates that N. benthamiana appears to balance normal growth and development with antiviral through multiple regulatory mechanisms targeting NbSMT2.

26. Association Between the Modified Frailty Index and Short-Term Total Thyroidectomy Complications.

期刊: The Laryngoscope 发表日期: 2026-Jul-03 链接: PubMed

摘要

The Modified Frailty Index (mFI-5) is a validated preoperative risk stratification tool across surgical settings. This study evaluated the predictive value of the mFI-5 score for postoperative outcomes following total thyroidectomy. This retrospective cohort study utilized the TriNetX U.S. Network to identify adults who underwent total thyroidectomy between 2006 and 2025. Patients were stratified by mFI-5 scores (0, 1, 2, ≥ 3) based on the presence of five ICD-10-coded comorbidities. Propensity score matching was used to control for demographic and clinical covariates. Postoperative complications-hypocalcemia, vocal fold paralysis, surgical-site infection, hematoma, tracheostomy, and mortality-as well as emergency department visits-were assessed within 30 days of surgery. Each mFI-5 group ≥ 1 was compared to the mFI-5 = 0 cohort using logistic regression to estimate odds ratios (ORs) with 95% confidence intervals (α = 0.05). Among 65,866 total thyroidectomy patients, postoperative complications increased significantly with higher frailty. Odds of hypocalcemia rose from mFI-5 = 1 (OR = 1.22 [95% CI, 1.14-1.32]) to mFI-5 ≥ 3 (OR = 1.59 [95% CI, 1.29-1.95]). Vocal fold paralysis was more likely at mFI-5 ≥ 3 (OR = 2.27 [95% CI, 1.49-3.46]). Emergency department visits increased progressively with frailty, from mFI-5 = 1 (OR = 1.36 [95% CI, 1.23-1.51]) to mFI-5 ≥ 3 (OR = 2.28 [95% CI, 1.72-3.03]). Surgical-site infection and tracheostomy were elevated at mFI-5 = 2 (OR = 1.93 [95% CI, 1.20-3.10] and OR = 2.00 [95% CI, 1.08-3.73], respectively), though mFI-5 ≥ 3 groups were limited by sample size. Postprocedural neck hematoma risk was significantly higher at mFI-5 ≥ 3 (OR = 2.60 [95% CI, 1.45-4.64]). Mortality events were rare and precluded reliable estimation. Higher mFI-5 scores were associated with increased postoperative complications after total thyroidectomy. Incorporating frailty assessment into preoperative evaluation may improve risk stratification and patient outcomes.

27. Human umbilical cord blood mononuclear cells ameliorate vascular dementia by modulating microglial myelin debris handling and white matter injury.

期刊: Journal of neuroinflammation 发表日期: 2026-Jul-03 链接: PubMed

摘要

Vascular dementia (VaD), characterized by white matter damage and cognitive decline, currently lacks effective therapeutic options. Human umbilical cord blood mononuclear cells (hUCB-MNCs) have shown neuroprotective and immunomodulatory properties; however, their therapeutic efficacy and underlying mechanisms in VaD remain incompletely understood. In this study, we investigated the effects of hUCB-MNCs treatment in a mouse model of VaD induced by bilateral common carotid artery stenosis (BCAS). Behavioral assessments showed that hUCB-MNCs treatment improved cognitive performance, affective-like behaviors, and motor coordination in BCAS mice. Histopathological analyses demonstrated that hUCB-MNCs treatment attenuated white matter injury, preserved myelin integrity, and mitigated neuronal and synaptic damage. Integrated transcriptomic and proteomic analyses of corpus callosum (CC) tissues revealed enrichment of immune-regulatory, phagocytosis-related, and phosphoinositide 3-kinase/protein kinase B (PI3K/AKT)-associated pathways after hUCB-MNCs treatment. In vivo and in vitro analyses further indicated that hUCB-MNCs helped preserve microglial homeostatic features and improved myelin debris-handling responses. Collectively, these findings suggest that hUCB-MNCs ameliorate VaD-associated pathology, at least in part, by modulating microglial myelin debris-handling responses and PI3K/AKT-related signaling, highlighting hUCB-MNCs as a promising cell-based therapeutic candidate for VaD.

28. The burden of ovarian cancer attributable to occupational asbestos exposure in Asia from 1990 to 2021: an analysis of the global burden of disease study 2021.

期刊: Tropical medicine and health 发表日期: 2026-Jul-03 链接: PubMed

摘要

Ovarian cancer (OC) ranks among the deadliest gynecological malignancies worldwide. Occupational asbestos exposure has been linked to an elevated risk of OC. Asia accounts for a substantial share of global asbestos consumption; nevertheless, regional analyses focusing on OC burden attributable to occupational asbestos exposure under the Global Burden of Disease (GBD) framework remain scarce. This study aimed to assess the burden of OC attributable to occupational asbestos exposure across Asia and delineate its temporal trends from 1990 to 2021. Data on all-age deaths, disability-adjusted life years (DALYs), age-standardized rates, and crude rates of OC attributable to occupational asbestos exposure among Asian females were retrieved from the 2021 GBD dataset and its comparative risk assessment framework for subsequent burden analyses. The Age-Period-Cohort (APC) model was adopted to characterize long-term trends of the disease burden, although decomposition analysis was performed to quantify the respective contributions of population growth, population aging, and epidemiological shifts. Between 1990 and 2021, the age-standardized mortality rate (ASMR) of OC attributable to occupational asbestos exposure in Asia declined from 0.41 per 10,000 population to 0.37 per 10,000 population, with an estimated annual percentage change (EAPC) of - 0.29 (95% CI  - 0.52, - 0.06). Meanwhile, the age-standardized DALY rate (ASDR) decreased from 7.89 per 10,000 population to 6.74 per 10,000 population (EAPC =  - 0.50, 95% CI  - 0.66, - 0.33). Over the study period, the total number of deaths and DALYs increased by 161.10% and 131.38%, respectively. Marked regional disparities were observed: ASMR and ASDR trended upward in South and Southeast Asia, declined in high-income Asia-Pacific regions, and stayed relatively stable across East Asia, with Central Asia bearing the highest overall disease burden. In terms of age distribution, OC burden increased with advancing age, peaked in the 70-74 age group and then declined gradually. Both crude mortality rate (CMR) and crude DALY rate (CDR) exhibited rising tendencies among the elderly population. APC analysis revealed that the age effects for mortality and DALY rates increased among middle-aged and older adults but decreased in the advanced age groups. Period effects presented an overall upward trend, whereas cohort effects declined generally. Decomposition analysis identified population aging and population expansion as the primary drivers of the growth in absolute disease burden, and epidemiological transitions exerted a mitigating effect on the overall OC burden. Based on estimations from the GBD 2021 framework, the age-standardized burden of OC attributable to occupational asbestos exposure has fallen across Asia. However, the absolute burden continues to climb due to population growth and aging, accompanied by prominent regional heterogeneity. Targeted interventions regarding data surveillance, exposure regulation, and occupational health policies are therefore urgently required for future prevention and control.

29. Surgical site infection prevention among surgical healthcare workers in Syria: a nationwide cross-sectional study.

期刊: Antimicrobial resistance and infection control 发表日期: 2026-Jul-03 链接: PubMed

摘要

Surgical site infections (SSIs), infections at or near surgical incisions, represent 20-30% of nosocomial infections globally, with higher prevalence in low- and middle-income countries such as Syria. This study assessed SSI prevalence in two Syrian hospitals alongside a nationwide evaluation of surgical healthcare workers’ knowledge, practices, compliance, and barriers to WHO/CDC SSI prevention guidelines. A cross-sectional survey was conducted among 375 healthcare workers in surgical settings across Syria. A structured questionnaire collected data on demographics, educational background, work experience, self-reported practices, knowledge of WHO guidelines, and perceived barriers to implementation. Composite knowledge and practice scores were calculated. Data were analyzed using descriptive statistics, Pearson correlation, and ANOVA. Adherence to basic preventive practices was high, including hand preparation (89.33%) and intraoperative sterilization (91.47%). However, gaps persisted in avoiding preoperative shaving, appropriate antibiotic prophylaxis timing and duration, and postoperative antibiotic discontinuation. Major barriers included lack of role models (68%), inadequate training (63%), and staff shortages. Pearson analysis revealed positive correlations between compliance and practice scores (r = 0.5203, p < 0.001) and compliance and knowledge scores (r = 0.3372, p < 0.001). Crucially, the weakest correlation was found between knowledge and practice scores (r = 0.2662, p < 0.001), highlighting a prominent know-do gap. Hospital-reported SSI prevalence was 9.5% in one hospital and 1.47% in the other. This study identified suboptimal knowledge and inconsistent implementation of high-impact SSI prevention practices among Syrian surgical healthcare workers despite strong adherence to basic aseptic measures. Targeted training, improved surveillance systems, and institutional support are needed to strengthen guideline adherence and reduce preventable SSIs.

30. Scaling up community-based non-communicable disease research into practice in Pokhara Metropolitan City of Nepal (SCALE-NCD) trial: study protocol for a cluster-randomized controlled trial.

期刊: Trials 发表日期: 2026-Jul-03 链接: PubMed

摘要

Rapid globalization and urbanization continue to escalate the burden of non-communicable diseases (NCDs) across the world, disproportionally affecting low- and middle-income countries (LMICs). To date, trials have documented that task-sharing with community health workers (CHWs) can reduce systolic blood pressure (SBP), reduce fasting blood glucose, and achieve smoking cessation. However, most studies have been conducted in rural settings or focused on managing a single condition, such as hypertension only. We propose an open-label, two-armed, community-based cluster-randomized controlled trial in Pokhara Metropolitan City of Nepal, the second largest city in Nepal. A total of 30 clusters will be randomized into intervention or control arm in a 1:1 ratio. An individual is eligible if living in Pokhara Metropolitan City and having one or more of the following conditions: hypertension, type 2 diabetes, and tobacco smoking. The participants will be recruited through study team home visits. The intervention group will receive an intervention package “SCALE-NCD” which includes (1) home-based monitoring, referral, and counseling for self-management of hypertension, diabetes, and tobacco smoking by Female Community Health Volunteers (FCHVs), and (2) weekly mobile phone messages to promote healthy lifestyle. FCHVs are CHWs in Nepal whose usual tasks are limited to maternal and child health care services. The control group will receive usual care, where there is neither of aforementioned two components. Primary outcomes are change in SBP, change in fasting plasma glucose, and change in smoking cessation, the required sample size for which is 405, 105, and 525 per arm, respectively. This study will inform us of the effectiveness of FCHV-led home-based management of the top three NCD risk factors coupled with weekly mobile phone messages in urban Nepal. Building on the previous studies that measured the efficacy of FCHV-led home-based management of a single NCD risk factor in a small geographical area, this scaled-up study will provide us with the realistic impact that FCHVs may have if they are trained to provide primary care services for management of major NCD risk factors. ClinicalTrials.gov NCT06740708. Registered on 2024-12-13.

31. Autistic Trait Dimensions and Alcohol Use in College Attending Emerging Adults.

期刊: Substance use & misuse 发表日期: 2026-Jul-03 链接: PubMed

摘要

Emerging adults on the autism spectrum struggle with a variety of social and environmental stressors, putting them at a higher risk for alcohol use problems (Brosnan & Adams, 2020). However, findings examining the relationship between autism and alcohol use outcomes remain conflicting, suggesting the need to examine specific dimensions of autism in relation to alcohol use. Addressing this gap, the current study examines how dimensions of autism, including social skills, switching, routines, imagination, and pattern fixation, may relate to alcohol use in a non-clinical sample of college students. A sample of 1,854 college students between ages 18-25 (Mage = 18.99, SD = 1.28; 56.4% Hispanic/Latine; 67.3% female, 30.2% male, 2.5% transgender or nonbinary) completed the Autism Spectrum Quotient (ASQ; Hoekstra et al., 2011) and the Alcohol Use Disorder Identification Test (AUDIT; Saunders et al., 1993). Tests of direct effects models indicated that individuals with social skills difficulties reported lower alcohol consumption. Individuals with greater adherence to routines reported lower alcohol dependence. In contrast, individuals high in imagination and pattern fixation reported greater alcohol use dependence. Findings suggest that specific dimensions of autism may vary in predicting alcohol consumption and dependence among college-attending emerging adults. However, additional research is needed on specific dimensions of autism in relation to mental health outcomes that could impact maladaptive substance use to better understand such outcomes.

32. Perspectives in Pediatric Ambulatory Anesthesia: Part 2-One Center's 15 Year Experience Improving Quality and Safety Outcomes.

期刊: Paediatric anaesthesia 发表日期: 2026-Jul-03 链接: PubMed

摘要

Pediatric ambulatory surgery has become the dominant model of surgical care in the United States, driven primarily by economic forces. There is variability in regional practice patterns, quality improvement cycles, and outcomes. Opportunity exists to overcome knowledge gaps and provide sustainable pathways of quality improvement. Our unique capability of describing the evolution of our pediatric ambulatory quality improvement practice allows us to contribute a single center’s perspective. We chose to complete a comprehensive retrospective review of our quality improvement process, outcome, and balancing metrics contained in our electronic health record (EHR) from our free-standing pediatric ambulatory surgery center (ASC) from July 2010 through December 2024. A commercial software system extracted de-identified, aggregated health data from the system’s EHR. The data are processed and presented in statistical process control charts. This methodology allows clinicians to distinguish between common cause and special cause variation. Improvement themes (opioid-free anesthesia and stewardship, enhanced recovery, environmental efforts, positive deviance, and learning healthcare system) are described. Improvements in all six domains of quality (effectiveness, efficiency/timeliness, patient experience, equity, and safety) are illustrated with reliable sustainability. Our system achieved approximately a 13-fold increase in quality improvement (QI) project completion rate with self-serve, real-world data access; enabling the team to take on improvement tasks previously deemed too big, lengthy, or risky to complete. We provide preliminary evidence that these methods may be generalizable. Requirements include engaged leadership, a standard framework for improvement with experienced leadership or accessible support, and easy access to real-world electronic medical record data (i.e., learning healthcare system [LHS]). Lastly, leaders must create a culture supportive of teamwork, change, and continuous improvement. Systems facilitate adoption and hinder resistance to standards, always with implementation and sustainability in mind. Meaningful, large-scale improvements in healthcare outcomes require collaboration across LHSs.

33. Structural Associations Between Palatal Morphology and Upper Airway Dimensions: Genetic and Environmental Contributions From A Twin Study.

期刊: Orthodontics & craniofacial research 发表日期: 2026-Jul-03 链接: PubMed

摘要

This study aimed to investigate the structural associations between palatal morphology and upper airway dimensions in twins with completed craniofacial growth, while evaluating genetic and environmental contributions. The sample comprised 53 twin pairs (27 monozygotic, 26 dizygotic; mean age 17.8 years). Palatal parameters were obtained from digital 3D casts, and upper airway dimensions were assessed using lateral cephalograms. Pearson correlation analysis was performed, and multiple comparisons were controlled using the Benjamini-Hochberg false discovery rate procedure. Heritability estimates were derived using structural equation modelling within the classical twin design (ACE model). Interpremolar and intermolar widths were positively correlated with the PCV-AH distance (posterior cervical vertebra to anterior hyoid) (r = 0.27-0.43, p ≤ 0.005), representing the sagittal distance between the posterior pharyngeal wall and the anterior hyoid bone. Palatal surface area (r = 0.30, p ≤ 0.003) and palatal volume (r = 0.29, p ≤ 0.003) were also associated with PCV-AH. Palatal height showed moderate correlations with PCV-AH (r = 0.29-0.30). Several palatal parameters were significantly associated with the PCV-AH distance, a measure showing substantial shared environmental influence. The environmental predominance of this airway parameter suggests functional plasticity within the maxilla-hypopharyngeal relationship. These findings indicate that structural maxillary characteristics may interact with environmental or functional factors and may be responsive to environmental or functional influences.

34. Personal listening device usage, leisure noise exposure, hearing protection usage and hearing at standard frequencies: a longitudinal study from child/adolescence to young adulthood.

期刊: International journal of audiology 发表日期: 2026-Jul-03 链接: PubMed

摘要

To compare personal listening device (PLD) listening behaviours, leisure noise exposure, audiometric outcomes, hearing protection (HP) usage and self-reported hearing loss (HL) symptoms at Time 1: 2009/2010 and Time 2: 2022/2023. Mean hearing thresholds (HTs), pure-tone average HL prevalence, PLD volume levels, durations, earbud/headphone tightness, and sex among matched pairs, at Time 1 and 2, were compared. Longitudinal design. Questionnaire evaluating PLD listening behaviours, leisure noise exposure and HL symptoms. Multivariate regression analysis used to determine relationship between variables and audiometry. 59 Participants, aged 22-30, of original cohort (n = 237, aged 10-17) were re-tested (Time 2). Over time, tinnitus following leisure noise tripled, HP doubled and higher average PLD listening time was observed (7 vs. 18 h/week); longer durations for males. High volume listening was 20% at both timepoints. Leisure noise exposure and HL prevalence were similar across time, however mean HTs were higher at Time 1. Among matched pairs, more Time 2 participants created tight-fitting earbuds/headphones and responded affirmatively to some HL symptom questions. Subtle auditory changes, such as hidden HL, may be occurring over time. Educational outreach regarding HL prevention would be beneficial. Further longitudinal research needed due to the small follow-up sample.

35. Immersive physical and occupational therapy in the neonatal intensive care unit: a non-randomized comparative cohort trial protocol.

期刊: Pilot and feasibility studies 发表日期: 2026-Jul-03 链接: PubMed

摘要

Infants in the Neonatal Intensive Care Unit (NICU) benefit most from occupational therapy (OT) and physical therapy (PT) when delivered at high frequencies. However, implementing these recommendations in clinical practice remains challenging. This study will investigate the impact of different therapy care delivery models on extremely preterm infants and their mothers. This pilot study uses a non-randomized comparative cohort design with historical controls. A retrospective cohort of 30 infants will represent usual care therapies (UCT). Two prospective cohorts (n = 30 each) will be enrolled following the launch of a new Small Baby Unit (SBU) at a Level IV NICU. The first prospective group will receive UCT within the SBU (SBU + UCT), while the second will receive an Immersive Therapy Model (SBU + ITM). Mothers of infants in the prospective groups will be invited to participate. The SBU introduces developmentally supportive medical and environmental protocols, with ITM adding structured, high-frequency therapy as well as parent-delivered developmental activities. As a pilot study, primary outcomes include the following: (1) feasibility of ITM implementation, measured by changes in therapy frequency and parent-administered activities and (2) comparisons of infant motor and neurobehavioral outcomes, as well as maternal stress and parenting competence. Secondarily, we will evaluate the preliminary efficacy of the SBU + ITM model on infant motor and neurobehavioral outcomes, as well as maternal stress and sense of competence. Finally, we will explore the ITM’s potential influence on two important drivers of health care costs in the NICU as compared to UCT: (1) time to infant achievement of independent oral feeds and (2) length of hospitalization. Findings may inform neonatal physical and occupational therapy practices by evaluating a novel care model aimed at improving outcomes for both infants and parents. Given its practical implementation and potential for significant impact, the ITM could represent a paradigm shift in NICU-based therapy care. ClinicalTrials.gov, NCT06927037, Registered 16 April 2025, https://clinicaltrials.gov/study/NCT06927037?intr=Immersive%20Physical%20Therapy&term=preterm%20infant&rank=1. Version 5, 2/16/2026.

36. Distance to central-place drives species-specific habitat selection in sympatric insectivorous birds.

期刊: Movement ecology 发表日期: 2026-Jul-03 链接: PubMed

摘要

Agricultural intensification is a major driver of land use change, thereby reducing biodiversity and leading to population declines across various animal groups. In response, animals can mediate some negative fitness impacts and navigate through agricultural landscapes with reduced resource availability by changing their habitat selection via movement decisions - particularly when constrained by central-place foraging, which requires balancing travel costs against energetic returns. Here, using miniature ATLAS tags (Advanced Tracking and Localisation of Animals in real-life Systems), we tracked 101 house martins and 87 barn swallows at high-resolution to investigate their state-specific habitat selection and mapped the insect abundance and diversity across an intensively used agricultural landscape. Both species mainly avoided arable fields and increasingly selected for forests and water bodies with distance from the colonies. House martins ranged farther from colonies than barn swallows and also showed strong distance-dependent selection for structurally complex habitats, such as extensive grasslands and green areas within villages. Furthermore, house martins selected for proximity to water bodies, while barn swallows’ selection focused on proximity to woody vegetation structures. During our 2023 insect sampling window, habitat selection tracked mapped insect richness more closely than mapped insect abundance. Distance-dependent divergence in space use suggests horizontal niche differentiation between sympatric central-place foragers, with potential implications for coexistence. Combined, our findings point to the importance of maintaining extensively used grasslands and small-scale habitat structures within intensively managed farmland to improve the abundance and diversity of prey for farmland passerines.

37. Occupational exposure to air pollution and respiratory health among urban street vendors in South India.

期刊: BMC public health 发表日期: 2026-Jul-03 链接: PubMed

摘要

Street vending is a non-formal, vital domestic workforce in most developing nations. The street vendors operate in an unregulated environment and are frequently exposed to hazardous environmental pollutants, which is linked to chronic respiratory health problems. However, there is underreporting of this public health problem in literature, creating a blind spot in global health. To assess the association between air quality, occupational exposure characteristics, and pulmonary function among street vendors in an urban community. A cross-sectional study was conducted among 298 street vendors in Chennai city, India. Pulmonary function was assessed using peak expiratory flow rate (PEFR) and breath-holding time (BHT). Respiratory symptoms were evaluated using the Modified Borg Dyspnea Scale. Air quality was measured using the Air Quality Index (AQI). Linear regression analysis identified independent variables associated with PEFR. The mean age of participants was 38.5 ± 11.08 years, with 65.4% female. Mean PEFR was 376.1 ± 71.39 L/min, and BHT was 33.32 ± 9.07 s. High prevalence of respiratory symptoms was observed: coughing at work (58.7%) and morning phlegm (44%). Variables negatively associated with the PEFR included years working as a vendor (β=-3.34, p < 0.001), daily outdoor exposure hours (β=-6.48, p < 0.001), annual AQI (β=-1.80, p = 0.002), weight (β=-1.19, p < 0.001), and dyspnea at rest. BHT showed a strong positive association with PEFR (β = 3.03, p < 0.001). Only 2.3% of vendors reported using masks during work. Street vendors demonstrate measurable respiratory compromise associated with cumulative occupational exposure to air pollution. Long-term exposure metrics (annual AQI, years of work) were stronger indicators than short-term measures, emphasizing the chronic nature of occupational health risk. Findings underscore the need for targeted respiratory screening, awareness programs, and feasible protective interventions for this vulnerable informal workforce.

38. MEET & MAKE CleaR PROCESS: a new framework for sharing serious information.

期刊: BMC medical education 发表日期: 2026-Jul-03 链接: PubMed

摘要

Sharing serious information (SSI) is a critical communication skill for physicians. Existing frameworks vary in their teaching and application, and many physicians desire better training. This study aimed to develop a theory-informed framework and cognitive aid for sharing serious information (SSI) through a multiphased development process involving a systematic review and expert focus groups. A multiphased approach was used: (1) a systematic review of four databases (1983-2024) to identify core components of SSI; and (2) twelve multidisciplinary focus groups (2022-2024) using the nominal group technique to integrate these components into a structured framework. A modified PICO/PEO approach (Population, Exposure/Intervention, Outcomes) guided study selection, and the AMSTAR2 tool was only used for quality appraisal of systematic reviews. From 4,892 titles/abstracts, 52 were selected for inclusion. Thematic synthesis identified eight themes for optimal SSI: (1) limiting delay between diagnosis and SSI, (2) preparation time for meetings, (3) patient-centered communication, (4) discussion of emotions, (5) verifying understanding, (6) affirmation of treatment options, (7) offering a confidant, and (8) providing information resources. These themes, interpreted cautiously across heterogeneous evidence sources, informed the development of the MEET & MAKE CleaR PROCESS framework, encompassing preparation (MEET), sharing (MAKE), clarification (CleaR), and ongoing plan (PROCESS). The MEET & MAKE CleaR PROCESS framework and its cognitive aid aim to equip educators and clinicians with a structured approach to instructing and managing SSI encounters especially with simulation-based education. We believe this up-to-date framework could minimize the negative impact of SSI on patients, relatives, and physicians.

39. Association between residential physical environmental exposures and multidimensional successful ageing in the UK biobank.

期刊: BMC public health 发表日期: 2026-Jul-03 链接: PubMed

摘要

Successful ageing is a global priority, yet the impact of the physical environment on this multidimensional process is not fully understood. Previous research has predominantly focused on isolated exposures or specific diseases, overlooking the complex physical “exposome.” We aimed to evaluate the associations between a comprehensive array of environmental exposures and a holistic Successful Ageing Index (SAI). In this cross-sectional study of 28,090 UK Biobank participants aged ≥ 60 years, we constructed a continuous SAI integrating 11 indicators across cognitive, physical, psychosocial, and disease domains. Fourteen residential environmental exposures-including air pollutants, noise, and natural environments-were assessed. We used multivariable linear regression, restricted cubic splines, and mediation analyses to evaluate independent associations, non-linearity, and biological pathways. In crude models, most air pollutants were negatively associated, and natural environments positively associated, with the SAI. However, after extensive adjustment for sociodemographic and lifestyle factors, associations with natural environments were largely attenuated. Conversely, PM2.5 (β = -0.15; 95% CI: -0.27, -0.04; P = 0.010, per 1-SD increase), No2 (β = -0.14; 95% CI: -0.26, -0.02; P = 0.022, per 1-SD increase) and NOx (β = -0.16; 95% CI: -0.28, -0.05; P = 0.005, per 1-SD increase) remained significantly and independently associated with a lower SAI. These adverse effects were most pronounced in the physical and psychosocial domains and were stronger among males and individuals with lower socioeconomic status. Non-linear dose-response relationships were observed for NO2 and greenspace. Mediation analysis identified chronic inflammation and metabolic dysfunction as significant biological pathways linking air pollution to reduced successful ageing. Higher baseline residential traffic-related air pollution indicators were associated with lower multidimensional SAI in this cross-sectional analysis, after adjustment for sociodemographic and lifestyle factors. These findings suggest that reducing traffic-related air pollution may be relevant to population healthy ageing, although longitudinal studies are needed to determine whether such interventions can extend healthy lifespan or reduce late-life morbidity.

40. Assessment of hepatitis B and tetanus toxoid vaccination coverage and associated factors among healthcare workers at Kabul University of Medical Sciences affiliated hospitals in Afghanistan.

期刊: BMC public health 发表日期: 2026-Jul-03 链接: PubMed

摘要

Hepatitis B and tetanus remain significant public health challenges in Afghanistan, a developing country where vaccination coverage is suboptimal. Healthcare workers are particularly at risk due to their exposure to infected blood and bodily fluids, and they play a vital role as health role models; however, their vaccination rates for hepatitis B and tetanus are often inadequate, risking both their health and potential transmission to patients. This study aimed to assess the vaccination coverage and associated factors among health personnel in teaching hospitals affiliated with Kabul University of Medical Sciences, providing insights to inform strategies for improving immunization practices and occupational safety. A cross-sectional study was conducted at three teaching hospitals affiliated with Kabul University of Medical Sciences. The study sample included medical personnel (physicians, nurses, midwives, laboratory technicians, and other clinical staff) actively engaged in patient care with direct exposure to blood or bodily secretions. Demographic and vaccination information were gathered from them using questionnaires. Descriptive statistics and logistic regression were performed using Stata version 18.0. A total of 284 professional staff members from the three teaching hospitals of Kabul University of Medical Sciences participated in this study from 20 December 2024 to 20 March 2025. The majority were male (52.8%), with ages ranging from 19 to 62 years. Hepatitis B vaccination coverage was 57.8% (full) and 67.3% (partial or full); tetanus toxoid vaccination coverage was 45.5% (full) and 49.3% (partial or full). Factors associated with hepatitis B vaccination included profession and work experience. Tetanus vaccination was strongly associated with gender and profession, with a trend toward higher odds among those with higher income. The most commonly cited reason for non-vaccination was lack of access (48.4%), including geographical barriers, unavailability of vaccines at health facilities, and cost. Hepatitis B and tetanus vaccination coverage among healthcare workers in Kabul was suboptimal but comparable to that reported in other developing countries, with distinct factors driving uptake for each vaccine. Despite near-universal positive attitudes toward vaccination, the primary barrier was lack of access, highlighting systemic gaps in occupational health services. Institutional vaccination programs with free, on-site access are needed to protect healthcare workers and their patients. Further studies with larger samples across diverse settings are needed to confirm these findings.

41. Single-Center Experience in Pediatric Lung Transplantation: Clinical Characteristics, Survival, and Post-Transplant Morbidity.

期刊: Pediatric transplantation 发表日期: 2026-Jul 链接: PubMed

摘要

Pediatric lung transplantation remains a life-saving option for selected children and adolescents with end-stage lung disease. We aimed to describe clinical characteristics, survival, post-transplant morbidity, and exploratory factors associated with mortality in a single-center Saudi cohort. We retrospectively reviewed all pediatric patients who underwent lung transplantation between January 2010 and December 2023. Demographic, anthropometric, perioperative, and post-transplant data were extracted. Survival was assessed with Kaplan-Meier analysis, and Cox regression was used to explore associations with mortality. Twenty-eight recipients underwent transplantation, predominantly bilateral sequential procedures, at a median age of 16 years. All recipients were adolescents, and cystic fibrosis (CF) was the most common indication. Severe undernutrition was common, with 64.3% meeting failure-to-thrive criteria (< 1st centile for weight) and 71.4% below the 3rd centile. Intraoperative extracorporeal membrane oxygenation replaced cardiopulmonary bypass after 2016. One-year survival was 96.4%, and median post-transplant survival was 6.8 years. Survival did not differ significantly by intraoperative extracorporeal support, but median survival was shorter in CF than in non-CF recipients (2.9 vs. 8.9 years). Hypertension developed in 53.5% of patients, diabetes in 28.5%, and acute kidney injury in 46.4%. In age- and sex-adjusted Cox models, CF, longer waiting time, Pseudomonas aeruginosa colonization, and diabetes at 1 year were associated with mortality. Pediatric lung transplantation in this cohort achieved excellent short-term survival but substantial long-term morbidity. Mortality associations should be interpreted cautiously, given the small sample size and event count. The shorter survival observed in CF recipients warrants further study, particularly in the context of severe undernutrition and chronic airway colonization.

42. Competing Mortality Redefines the Net Benefit of Additional Surgery After Endoscopic Resection for T1 Colorectal Cancer in Older Adults.

期刊: Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society 发表日期: 2026-Jul 链接: PubMed

摘要

The oncologic benefit of additional surgery after endoscopic resection (ER) for the treatment of T1 colorectal cancer (CRC) remains uncertain in older adults, because competing causes of mortality may attenuate the gain in survival. The proportion of patients aged ≥ 80 years has increased steadily, reflecting population aging. For patients with high-risk T1 CRC, the aim of additional bowel resection is to remove occult lymph node metastasis and reduce the risk of recurrence, and long-term studies have shown improvements in T1 CRC-related outcomes. However, age modifies the magnitude of this benefit. Cohort studies of high-risk T1 CRC have shown only small differences in 5-year cancer-specific survival between patients who underwent additional surgery and those who did not. Moreover, most deaths in the nonsurgical group were attributable to causes other than cancer. Data from meta-analyses have further suggested that the survival advantage associated with surgery becomes evident only after 10 years, indicating a substantial delay in its benefits. In contrast, the incidences of perioperative morbidity and short-term mortality increase with age and have immediate effects on prognosis. These findings indicate that the net survival benefit of additional surgery in older patients depends on the balance between the delayed oncologic benefit and the immediate treatment-related risks. Thus, although surgery remains appropriate for selected fit individuals, clinicians should consider the pathologic risk, frailty, comorbidity burden, and competing mortality of individual older patients with pT1 CRC in their decision-making to optimize outcomes.

43. Soil Microbial Diversity and Network Organization Respond to Land Use and Agricultural Inputs Worldwide.

期刊: Global change biology 发表日期: 2026-Jul 链接: PubMed

摘要

Soil microbiomes are critical for ecosystem functioning, yet the global influences of climate and agricultural practices on their diversity and structure remain incompletely characterized. Here we analyzed 1921 soil samples from 33 countries worldwide across diverse biomes to assess how climate gradients and agricultural inputs, including pesticides and fertilizers, shape prokaryotic and fungal communities. We found that microbial diversity peaks at intermediate temperatures and differs markedly between natural and agricultural soils, with agriculture increasing microbial diversity while altering community composition and ecological guilds. Pesticide use selectively reduced bacterial diversity and shifted fungal guilds, decreasing ectomycorrhizal fungi while increasing saprotrophs, whereas fertilization reduced microbial network cohesion, with organic and inorganic fertilizers eliciting distinct community responses. These findings reveal that climatic factors and agricultural management jointly influence soil microbial diversity, community structure, and network connectivity, with implications for soil health and ecosystem resilience in managed landscapes. Overall, our results demonstrate that agricultural practices, including the use of pesticides and both organic and inorganic fertilizers, act as strong ecological filters that reshape soil microbiomes worldwide-enhancing apparent diversity but driving a functional shift toward less mutualistic, more fragmented, and potentially less resilient communities.

44. Pioneer of Medical Mycology: In Memory of Prof. Friedrich Staib, MD, DVM.

期刊: Mycoses 发表日期: 2026-Jul 链接: PubMed

摘要

At the beginning of Friedrich Staib’s academic career in the 1950s, medical mycology was a young discipline in Germany. He studied veterinary and human medicine, earning two doctorates. Initially fascinated by the changes in intestinal flora caused by the newly emerging broad-spectrum antibacterials, i.e., the selection of fungi. In 1953, he began setting up a mycological laboratory at the University of Würzburg and qualified as a professor in microbiology in 1962. In 1968, he became the head of the mycology department, which he established, at the Robert Koch Institute, Germany’s public health Institute in Berlin. His work focused on improving the identification of fungi, both within hosts and the environment. His research on Cryptococcus neoformans (Staib agar indicator medium based on the virulence factor melanin for cultivation) gained him international recognition. He was the first to describe secreted proteases from Candida albicans as a virulence mechanism of the main human fungal pathogen. Later, nosocomial exposure of immunocompromised individuals to Aspergillus fumigatus became an issue for him. He cultivated intensive collaboration with clinicians and pathologists, which had a major influence on his research. Staib’s broad interest in fungal diagnostics, virulence factors, and environmental niches of fungal pathogens was groundbreaking for medical mycology in Germany and beyond at a time when systemic mycoses were becoming increasingly important. With his systems thinking, he influenced doctoral students and was a role model for public health.

45. Divergence From Temperate Models: Pollution Dominance and Stochastic Assembly in a Continental Freshwater System Under Compressed Modernity.

期刊: Global change biology 发表日期: 2026-Jul 链接: PubMed

摘要

Current understanding of how multiple stressors shape freshwater biodiversity at continental scales relies heavily on evidence from postindustrial temperate regions, potentially misrepresenting the dynamics of ecosystems facing rapid development and extreme environmental heterogeneity. Here, we present a standardized, continental-scale field survey of benthic macroinvertebrates across 502 sites in China to test the universality of established macroecological patterns. Contrary to the expectation that physical habitat and climatic gradients primarily drive community structure, we found that organic pollution, with a focus on oxygen-demand assays (COD and BOD), emerged as the single most influential variable, explaining the largest proportion of variation in taxonomic, functional, and phylogenetic diversity. Together with total nitrogen and total phosphorus loading, this chemical pressure largely overrode the explanatory contribution of land-use and climatic drivers, with stressor interactions characterized by asymmetric dominance rather than the synergistic amplification commonly predicted. Furthermore, despite steep environmental gradients that theoretically favor deterministic sorting, community assembly was overwhelmingly dominated by stochastic processes ( ∼ \(\sim\) 86%, based on overall pairwise comparisons across all sites). We suggest this pattern is consistent with a “stochastic trap” hypothesis, potentially arising from high-frequency anthropogenic disturbances that weaken trait-environment matching. These findings indicate that biodiversity frameworks derived from stabilized, temperate systems may not generalize to the compressed modernity of developing regions. We propose that global conservation strategies should consider prioritizing the reduction of chemical bottlenecks, which may act as critical physiological constraints on freshwater resilience in the Anthropocene.

46. Truth or Consequences Revisited: Policymaking in Modern Organ Transplant.

期刊: Pediatric transplantation 发表日期: 2026-Jul 链接: PubMed

摘要

Often in policymaking in medicine, there is a balance to strike between pursuing principles that defend vulnerable stakeholders with passion and coherence and backing positions that are sellable to the public. I argue that when these two ambitions are at odds, transplant ethicists should pursue a pragmatism in policymaking that maximizes the likelihood of their being invited into, mattering, and remaining in the proverbial room of deliberation. As Dan Brock argued upon recalling his time serving on the President’s Commission for the Study of Ethical Problems in Medicine from 1981 to 1982, achieving relevance as a philosopher is something that may require concessions in “truth-telling.” I invoke examples of this pragmatism, looking at different attitudes one may adopt in prioritizing pediatric patients for organ allocation and, using Brock as a guide, draw an analogy to a controversial issue the OPTN Ethics Committee recently addressed pertaining to the procurement of deceased organs. This examination of differing approaches to pediatric transplant allocation reveals a preference one should adopt for favoring policies addressing the particular needs of pediatric recipients without automatically placing such recipients at the top of waitlists. Like many proposals considered in medicine based on sound, principle-based ethical analyses, transplant policies that are balanced and pursue a position of strong advocacy tempered by pragmatism and consideration of a diversity of perspectives are the likeliest to be successful, just as their advocates are the likeliest to be included in the process of deliberation.

47. Pragmatic Reasonable Accommodation in Everyday Medicine for People With Intellectual Disabilities: A Qualitative Study of Non-Psychiatric Physicians in Japan.

期刊: Journal of applied research in intellectual disabilities : JARID 发表日期: 2026-Jul 链接: PubMed

摘要

In Japan, providing reasonable accommodation for people with intellectual disabilities became mandatory on 1 April 2024, but evidence from non-psychiatric hospital care is limited. We conducted semi-structured interviews with nine hospital-based non-psychiatric physicians in Japan (October 2023-March 2024) and analysed data using inductive thematic analysis. Physicians described accommodations in (1) medication management tailored to understanding, preferences, and home support; (2) relationship-centred communication to elicit symptoms and confirm comprehension; and (3) flexible care processes, including time, environment, and team roles. They mitigated risks through witnessed explanations, clear documentation, and proactive coordination with nurses and family members. Practical, workflow-embedded accommodations are common in non-psychiatric settings and could be strengthened by structured communication supports and systematic information sharing. Non‐psychiatric hospital doctors in Japan described practical ways to adjust care for people with intellectual disabilities. Helpful changes included clearer step‐by‐step explanations, extra time, and medication plans that match support available at home. Risk was reduced by witnessed explanations, clear documentation, and proactive coordination with nurses and family members. Future work should test structured communication tools and hospital workflows that make reasonable accommodation more consistent and safer.

48. Evaluation of Oculomotor Function Following Sleep Improvement With Lemborexant in Older Adults With Insomnia.

期刊: Human psychopharmacology 发表日期: 2026-Jul 链接: PubMed

摘要

Insomnia impairs cognitive and brain function, and its treatment improves outcomes. Eye movements are objective biomarkers of neurocognitive state and are sensitive to sleep loss, but whether treatment improves oculomotor function remains unclear. We examined associations between sleep improvement and eye movement changes after hypnotic intervention. In this open-label, single-arm study, 31 Japanese adults aged ≥ 50 years with insomnia and preserved cognition received nightly lemborexant (5-10 mg) and were assessed at baseline, week 4, and week 12. Eye movements were measured using free-viewing, smooth pursuit, and fixation tasks. Objective sleep was assessed with a portable electroencephalogram, and subjective sleep and sleepiness with the Pittsburgh Sleep Quality Index (PSQI) and Epworth Sleepiness Scale (ESS). Associations were analyzed using linear mixed-effects models. Improvements in ESS and PSQI scores were associated with enhanced visual search performance in the free-viewing task, including increased saccade amplitude, scanpath length, and velocity. ESS improvement correlated with better tracking accuracy during smooth pursuit, reflected by fewer gaze fixations and saccades. Longer total sleep duration was associated with increased saccade duration. Selected eye movement metrics were modestly associated with improvements in subjective sleep symptoms following hypnotic treatment in older adults with insomnia.

49. Value of Genetically Rare Cord Blood Units Beyond Conventional Quality Metrics.

期刊: HLA 发表日期: 2026-Jul 链接: PubMed

摘要

Allogeneic haematopoietic stem cell transplantation (HSCT) is a cornerstone therapy for haematological and genetic disorders. Owing to the limited availability of HLA-identical related donors, umbilical cord blood (UCB) has become a valuable alternative source of haematopoietic progenitors. However, many UCB units are excluded from banking based on quality criteria, despite potentially harbouring rare and underrepresented HLA profiles, particularly within certain demographic groups. This study evaluated the strategic value of immunogenetically rare but low-quality UCB units in expanding donor options for patients with uncommon HLA profiles. HLA-A, -B, and -DRB1 typing was performed on 577 UCB units, and allelic, haplotypic, and genetic diversity analyses were conducted using the HLA-net GENE[RATE] tool. Units were categorised using the Search Prognosis Application as good (6/6), fair (5/6), or poor (< 5/6 matches). Genotype frequency was used as a proxy for immunogenetic rarity and evaluated as an operational criterion for defining retention thresholds. ROC analyses were interpreted as concordance analyses between genotype frequency and Search Prognosis classification rather than as independent predictive validation. Statistical significance was assessed by chi-square and residual analyses. The cohort displayed remarkable allelic diversity, particularly at the HLA-B locus, strong linkage disequilibrium among loci, and a large proportion of unique genotypes. Matching-prognosis classification identified 66.72% of units as good, 31.54% as fair, and 1.73% as poor. Caucasian genotypes were overrepresented in the good category, whereas Asian-Pacific-Islander and African-American haplotypes were enriched in poorer matching-prognosis categories. ROC analysis showed strong concordance between genotype frequency and Search Prognosis classification (AUC 0.80-0.99) and population-specific genotype frequency thresholds. Our findings suggest that immunogenetic rarity provides complementary value to conventional quality metrics. While low-cell-dose units may have limited direct clinical utility, those with rare HLA genotypes may retain strategic importance, particularly for patients with uncommon immunogenetic profiles. Integrative approaches combining biological and immunogenetic parameters may improve cord blood banking strategies.

50. Opposing Estrous Cycle-Dependent Norepinephrine and Dopamine Regulation in Response to Methamphetamine.

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

摘要

The central catecholamine systems, norepinephrine and dopamine, play a critical role in encoding the valence of environmental stimuli to promote engagement in behaviors that potentiate an organism’s survival. Furthermore, both neurochemicals in limbic brain areas such as the nucleus accumbens (NAc) and bed nucleus of the stria terminalis (BNST) are major targets of stimulant drugs. Canonically, limbic norepinephrine signaling is enhanced in the presence of aversive or noxious stimuli whereas dopamine transmission is generally considered to increase in response to appetitive or rewarding stimuli. However, it remains to be elucidated whether sex differences, especially at different stages of the estrous cycle, distinctly regulate catecholamine transmission in vivo. In this study we (i) identified estrous cycle-dependent changes in catecholamine regulation via their transporters and autoreceptors in the BNST and NAc of anesthetized rats and (ii) determined how the psychostimulant methamphetamine (METH) impacts norepinephrine and dopamine transmission in the BNST and NAc, respectively, in male and freely cycling female rats using in vivo fast-scan cyclic voltammetry. Our results demonstrate electrically evoked BNST norepinephrine levels are increased by METH the greatest during the non-estrus (diestrus/proestrus) stages while NAc dopamine release evoked by electrical stimulation and METH is heightened in estrus. This limbic norepinephrine and dopamine regulation suggests a critical role of estrous cycle stage on catecholamine dynamics. These findings offer new insights into the role of estrous cycle stage on how the brain encodes environmental stimuli and provide a new framework for sex-specific therapies for targeting the central catecholamine systems in health and disease ranging from drug use disorders to obesity.

51. A causal association between Epstein-Barr virus infection and lung cancer: A two-sample Mendelian Randomization study.

期刊: Cancer biomarkers : section A of Disease markers 发表日期: 2026 链接: PubMed

摘要

BackgroundThe association between Epstein-Barr virus (EBV) and lung cancer risk remains controversial. Here, we used a two-sample Mendelian randomization (MR) analysis to test the causal relationship between EBV and lung cancer.MethodsData regarding lung cancer (outcomes) were collected from the Finnish database; the Genome-Wide Association Study (GWAS) summary-level dataset for EBV was obtained from the Open Forum Infect Dis. The inverse-variance weighted (IVW) method was used as a primary analytical approach; weighted median, MR-Egger, and weighted mode methods were used to ensure the robustness of the data. The MR-Egger regression assessed horizontal pleiotropy, and the MR pleiotropy residual sum and outlier (MR-PRESSO) method identified potential outliers. Cochran’s Q test evaluated heterogeneity among instrumental variables (IVs).ResultsIVW analysis indicated several significant causal effects. Genetically elevated levels of EBV ZEBRA and EBNA-1 antibodies increased the risk of SQC (OR=1.26 and OR=1.33, respectively). Increased EBNA-1 antibodies also raised the risk of overall lung cancer and small cell lung cancer. Conversely, higher VCA p18 antibody levels were associated with a decreased risk of lung adenocarcinoma (OR=0.70). Sensitivity analyses suggested these findings were robust, with no significant evidence of horizontal pleiotropy or heterogeneity.ConclusionOur data suggests a causal effect between EBV and the progression of lung cancer.

52. Couples' optimism, stress, and quality of life when undergoing fertility treatments: A cross-sectional study with prospective outcome assessment.

期刊: Women’s health (London, England) 发表日期: 2026 链接: PubMed

摘要

BackgroundCouples experiencing infertility often seek medical help to achieve a pregnancy using assisted reproductive technology, which might cause stress and affect their quality of life.ObjectivesThe purpose of the current study was to investigate the mutual effects of optimism and stress on fertility-related quality of life among women and their husbands during the process of in vitro fertilization (IVF), as well as the success of the treatment.DesignA cross-sectional study with a prospective outcome assessment design aimed at assessing psychological variables, with a short-term prospective follow-up, among 51 couples undergoing IVF treatment.MethodsParticipants completed questionnaires on fertility-related stress, optimism, and fertility-related quality of life. Two weeks after embryo transfer they were contacted by a researcher to check for pregnancy. The dyadic associations were analyzed using the Actor-Partner Interdependence Mediation Model (APIM).ResultsWomen’s fertility-related quality of life correlated negatively with their stress (r=-.67; p<.01) and positively with their husbands’ fertility-related quality of life (r=.31; p<.05). Husbands’ fertility-related quality of life correlated positively with their optimism (r=.35; p<.05) and negatively with their stress (r=-.56; p<.01) and their wife’s stress (r=-.33; p<.01). A positive correlation was found between women’s optimism and their husbands’ optimism. Women’s stress was higher and their fertility-related quality of life lower than those of their husbands. The APIM analysis revealed actor (B=.22, p<.001) and partner (B=.12, p=.02) effects of optimism on fertility-related quality of life. The only predictor of pregnancy was younger age.ConclusionsBoth spouses experience stress during IVF treatments, therefore psychological support should be offered to both during this time, including stress management interventions and couple-based support aimed at strengthening dyadic coping. The positive correlations between women’s fertility-related quality of life and that of their husbands, and between women’s fertility-related quality of life and their husbands’ optimism, highlight the importance of spouses’ support for each other.

53. Association of C-Reactive Protein-Triglyceride Glucose Index With Chronic Obstructive Pulmonary Disease: Results From the NHANES and CHARLS Cohorts.

期刊: Mediators of inflammation 发表日期: 2026 链接: PubMed

摘要

The C-reactive protein (CRP)-triglyceride glucose index (CTI) is a new composite biomarker used to assess inflammation and insulin resistance (IR) severity. Inflammation and IR play important roles in chronic obstructive pulmonary disease (COPD). However, the impact of CTI on COPD remains unknown. To explore the association between CTI and the prevalence of COPD, a total of 8682 participants from the China Health and Retirement Longitudinal Study (CHARLS) and 8986 participants from the US National Health and Nutrition Examination Survey (NHANES) were included. We used logistic multivariate regression to evaluate the association between CTI and COPD. In addition, smooth curve fitting analyzed dose-response relationships, while subgroup analyses explored effect heterogeneity. We found a positive correlation between CTI and the risk of COPD after adjusting for all covariates in the NHANES database (OR = 1.34, 95% confidence interval [CI]: 1.18-1.53), which is consistent with the findings obtained from Cox regression analysis in the CHARLS database (HR = 1.16, 95% CI: 1.07-1.26), with consistent dose-response trends confirmed by restricted cubic spline (RCS) analyses. Subgroup analyses confirmed consistency across most strata, with a significant interaction detected with cardiovascular disease (CVD). Sensitivity analyses further confirmed the robustness of associations. These findings indicate a significant association between CTI and COPD, suggesting its potential role as a biomarker for the prevention and treatment of COPD.

54. Impact of Operative Time on Postoperative Severe Complications in Elderly Patients With Colorectal Cancer: A Multicenter Retrospective Study.

期刊: Asian journal of endoscopic surgery 发表日期: 2026 链接: PubMed

摘要

A high proportion of elderly patients have multiple comorbidities, and postoperative complications may contribute to poor outcomes. The purpose of this study is to investigate whether operation time could affect the occurrence of postoperative complications in elderly patients who have undergone colorectal surgery. The study included 1316 colorectal cancer patients aged ≥ 80 years who underwent colorectal cancer surgery between 2016 and 2024. We classified patients into two groups based on operative time (≥ 250 min [n = 418] and < 250 min [n = 898]). Clinical and perioperative features were compared between the groups. Blood loss was higher (39 mL vs. 16 mL; p < 0.001), postoperative complications were higher (30.4% vs. 19.8%; p < 0.001), and hospital stay was longer (16 days vs. 14 days; p < 0.001) in the ≥ 250 group. Multivariate analysis revealed that open surgery (p = 0.003; odds ratio 2.438; 95% confidence interval 1.350-4.402) and operative time ≥ 250 min (p = 0.004; odds ratio 1.966; 95% confidence interval 1.233-3.135) were independent predictors for postoperative severe complications. In elderly patients undergoing colorectal cancer surgery, high-risk cases should be managed by expert surgeons using minimally invasive techniques and with efforts to minimize operative time.

55. Evaluating current bronchiectasis care in Italy according to the 2025 European respiratory society recommendations.

期刊: Therapeutic advances in respiratory disease 发表日期: 2026 链接: PubMed

摘要

National quality standards for bronchiectasis in Italy were last defined in 2016. The publication of the 2025 European Respiratory Society (ERS) guidelines offers the opportunity to evaluate current clinical practice against updated evidence-based recommendations. To assess the extent to which Italian bronchiectasis centers align with key statements from the 2025 ERS guidelines. National, multicenter, cross-sectional observational study based on a structured survey of Italian bronchiectasis centers, aligned with the 2025 ERS recommendations. A national survey was conducted across Italian bronchiectasis centers affiliated with the Italian Bronchiectasis Patient Association (AIB). The structured questionnaire assessed center organization, diagnostic resources, multidisciplinary care, and alignment with ten predefined core management domains derived from the 2025 ERS recommendations. Most centers reported universal access to minimum bundle etiological tests, with improved capacity compared with 2016. However, specialized diagnostics for rare causes, structured physiotherapy programs, and written self-management plans remain inconsistently available. Long-term inhaled antibiotics and macrolides were widely prescribed, though access barriers persist. Monitoring practices were heterogeneous. Despite clear progress, substantial variability persists in physiotherapy access, rare disease diagnostics, self-management tools, and routine monitoring. Updated Italian quality standards aligned with ERS 2025 principles are warranted. Understanding bronchiectasis care in ItalyBronchiectasis is a chronic lung disease that causes coughing, infections, and mucus build-up. In Italy, national standards for treating this condition had not been reviewed since 2016. This study describes how bronchiectasis is currently managed across Italian hospitals, using data from a recent national survey. Most centers now perform the key tests needed to understand the cause of bronchiectasis and provide the essential treatments recommended by experts. However, more advanced diagnostic tests—such as those for rare genetic conditions—are not available everywhere. Access to specialist physiotherapy and written self-management plans is also uneven. The way hospitals monitor patients over time varies widely across the country. Overall, care for bronchiectasis in Italy has improved compared with past years, but important differences remain. Updating national standards in line with new European guidelines could help ensure more consistent, high-quality care for all patients.

56. Is It My Responsibility? Professional Organizations' Perspectives on Disability Inclusion in Health Professions Education and Practice.

期刊: The clinical teacher 发表日期: 2026 链接: PubMed

摘要

Disabled healthcare professionals offer valuable expertise yet face systemic barriers in education and practice. This study explores perspectives of professional organizations on the inclusion of students (SRA) and practitioners (PRA) requiring accommodations in health and human service (HHS) professions. Using an exploratory qualitative design framed within a critical disability studies lens, 28 representatives from professional organizations across 10 HHS professions in Canada participated in semistructured interviews. Data were analysed to identify key themes related to their perceived roles and perspectives on challenges faced by SRA/PRA, and how organizational policies impact inclusion. Three key themes highlighted the multilayered challenges of acknowledging and supporting SRA/PRA: (1) We do not know what we do not know; (2) not our responsibility; and (3) between a rock and a hard place. Many participants reported that this study marked the first time they had explicitly considered SRA/PRA within their organizational mandate, a foundational finding underpinning all three themes. Findings revealed limited awareness of SRA/PRA needs and experiences within organizational structure, uncertainty about their responsibility for addressing accessibility, often in favour of public protection or professional standards, and systemic obstacles constraining their ability to implement inclusive policies. Inclusion of SRA/PRA represents a ‘wicked problem’: While equity and inclusion are already embedded in many professional mandates, tacit ableist discourses constrain the agency of professional organization representatives and perpetuate the systemic marginalization of SRA/PRA in HHS professions. Results provide insights and recommendations for dismantling these barriers and promoting equitable and accessible pathways into and through HHS education and practice.