公共卫生研究摘要 (2026-07-06)

共收录 56 篇研究文章

1. Artificial intelligence for sexual, reproductive and maternal health in Latin America and the Caribbean: a scoping review.

期刊: Journal of obstetrics and gynaecology : the journal of the Institute of Obstetrics and Gynaecology 发表日期: 2026-Dec 链接: PubMed

摘要

Artificial intelligence (AI) holds considerable promise for strengthening sexual, reproductive and maternal health (SRMH) by enhancing diagnosis, optimising service delivery and expanding access to information. In Latin America and the Caribbean (LAC), however, the scope, focus and maturity of AI applications in SRMH remain poorly described. To identify, map and analyse existing applications of AI in SRMH priority services in LAC, characterising thematic areas, target populations, and types of AI tools, whilst highlighting gaps and future research needs. We conducted a scoping review guided by the Arksey and O’Malley framework and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews (PRISMA-ScR). Searches were performed in PubMed, SciELO, Cochrane and LILACS up to August 2023, complemented by targeted Google searches and snowballing. We included records reporting AI applications in SRMH services in LAC and extracted data on setting, population, SRMH domain, AI techniques and implementation stage. A total of 1,518 records were identified, of which 143 met the inclusion criteria. Most were published between 2020 and 2023 and originated from Mexico, Colombia, Peru, Brazil and Argentina. Over half were peer-reviewed articles, with additional theses and web-based reports. Applications concentrated on prenatal, childbirth and postnatal care (36%) and reproductive organ cancers (31%), with far fewer initiatives addressing sexual health, contraception, gender-based violence, sexual satisfaction or counselling. Machine learning methods predominated (52%), followed by deep learning (41%). Almost half of initiatives (48%) were exploratory projects, 17% implemented tools without outcome data and 35% reported performance in real-world contexts. AI applications in SRMH in LAC are expanding but remain thematically narrow, population-selective and predominantly exploratory, highlighting the need for more diverse, rigorously evaluated and equity-oriented tools. This review explores how artificial intelligence (AI) is being used to improve health care access and information about sexual, maternal, and reproductive health in Latin America and the Caribbean. These include access to contraception, care during pregnancy and childbirth, prevention and treatment of sexually transmitted infections, among others.We reviewed 143 publications and found that most AI tools focus on pregnancy care and cancer detection. Far fewer initiatives focus on sexual health or contraception. Many tools are still in early development and have not yet been tested in real health care settings. Others have been implemented but lack reports about their efficiency and/or effectiveness.This study highlights the need to expand the use of AI to a broader range of health services and populations. AI has the potential to reduce inequalities and improve access to care, but only if it is designed in a responsible way.

2. Shared Genetic Risk Between Acute Pancreatitis and Metabolic Syndrome Converges on a BCAT1-Positive Fibroblast Subpopulation and MAPK14-Driven Inflammation.

期刊: FASEB journal : official publication of the Federation of American Societies for Experimental Biology 发表日期: 2026-Jul-15 链接: PubMed

摘要

Metabolic syndrome (MetS) has been associated with increased acute pancreatitis (AP) severity. This study aimed to identify shared differentially expressed genes (CDEGs) between MetS and AP and to prioritize mechanistically relevant targets. The shared genetic basis and causal effect of MetS on AP were first assessed using linkage disequilibrium score regression (LDSC) and two-sample Mendelian randomization (MR). Public Gene Expression Omnibus (GEO) datasets were analyzed to define shared CDEGs. A multi-step pipeline incorporating functional enrichment, protein-protein interaction (PPI) analysis, and transcription factor mapping was used to identify AP hub genes (AP-HGs). Functional relatedness and putative causal relationships were evaluated using GeneMANIA, MR, and single-cell RNA sequencing (scRNA-seq). Finally, computational drug prediction and molecular docking were performed to identify potential therapeutic agents. Key findings were further validated in a hyperlipidemia AP (HAP) model. A positive genetic correlation between MetS and AP was identified by LDSC, and MR supported a causal effect of MetS on increased AP risk. BCAT1, GPAT3, ANP32C, and ZNF683 were identified as CDEGs between MetS and AP. MAPK14 was identified as a central AP-HG. MAPK14, BCAT1, and GPAT3 were effective predictors for severe AP (SAP), with AUCs of 0.738, 0.722, and 0.744, respectively. GeneMANIA predicted a high degree of physical interaction (77.6%) among these genes. MR analysis provided supportive genetic evidence linking MAPK14 expression to inflammatory mediators including IL-1ra and TNFR-1. scRNA-seq analysis in an experimental AP model localized Mapk14 expression predominantly to macrophages, while Bcat1 marked a unique, proliferative fibroblast subpopulation that emerged transiently during inflammation and exhibited an anabolic metabolic signature. Ozagrel was prioritized as an exploratory candidate with favorable predicted binding affinities and requires further validation. In a HAP model, aggravated pancreatic injury and upregulation of BCAT1 and MAPK14 were confirmed under the high-fat background. A genetic and transcriptomic link between MetS and AP was identified. MAPK14-associated inflammation and Bcat1-positive fibroblast remodeling may contribute to AP aggravation under metabolic disturbance. These findings provide candidate biomarkers for SAP prediction and support BCAT1 and MAPK14 as potential mechanistic targets.

3. Brown Adipose Tissue Secreted Nrg4 Prevents Bone Loss by Orchestrates Bone Resorption and Angiogenesis.

期刊: FASEB journal : official publication of the Federation of American Societies for Experimental Biology 发表日期: 2026-Jul-15 链接: PubMed

摘要

Beyond established roles in metabolic regulation, adipose tissue-derived factors are increasingly recognized as critical modulators of bone mass. Nevertheless, the underlying mechanisms that coordinate the osteoclastogenesis-angiogenesis-osteogenesis axis to maintain skeletal homeostasis remain poorly defined. Mouse models including brown adipose tissue (BAT) removal, Neuregulin 4 (Nrg4) knockout (Nrg4-/-), and BAT transplantation were used to evaluate the role of BAT-secreted Nrg4 in bone homeostasis. In vitro experiments were performed to explore the effects of Nrg4 on osteoclastogenesis and the angiogenesis-osteogenesis coupling. Additionally, exogenous Nrg4 treatment was applied to ovariectomy (OVX)-induced osteoporotic mice to assess its therapeutic potential. BAT removal or Nrg4 knockout resulted in increased bone resorption and decreased bone formation, thereby accelerating bone loss in mice; conversely, BAT transplantation rescued the skeletal phenotype of Nrg4-/- mice. In vitro, Nrg4 significantly inhibited osteoclastogenesis, at least partially through the NF-κB inflammatory signaling pathway, while simultaneously activating the angiogenesis-osteogenesis coupling via PDGF-BB derived from preosteoclasts. Furthermore, exogenous Nrg4 treatment effectively attenuated bone loss in OVX-induced osteoporotic mice. These findings demonstrate that BAT-derived Nrg4 acts as a key regulator of bone homeostasis and represents a promising therapeutic target for bone loss disorders by orchestrating crosstalk between osteoclasts and endothelial cells.

4. Leukemia mortality analysis in the pediatric population in São Paulo state, Brazil, 2000-2019.

期刊: Leukemia & lymphoma 发表日期: 2026-Jul-05 链接: PubMed

摘要

Childhood leukemia is the leading cause of cancerrelated death among children. In Brazil, limited data on pediatric leukemia trends hinder public health strategies. This study analyzed leukemia mortality in individuals aged 0-19years in São Paulo State, Brazil, from 2000 to 2019. An ecological time-series design was applied using official Mortality Information System (SIM/ DATASUS) microdata, identifying leukemia cases through ICD-10 codes C91-C96. Mortality trends were assessed using the Prais- Winsten regression model and Durbin-Watson test, estimating annual percent change (APC) and 95% confidence intervals. Between 2000 and 2019, 3687 deaths occurred (24.34/100,000), with a decreasing trend (APC: -0.017), from 1.69/100,000 in 2000 to 1.21/100,000 in 2019. Mortality was higher among males (56%), white individuals (71%), and adolescents aged 15-19years (30.8%). Acute lymphoblastic leukemia (C910) accounted for 50.8% of deaths, and unspecified septicemia (A419) was the most frequent associated cause (25.8%). SIGNIFICANCE STATEMENT Analyzing pediatric leukemia mortality trends in São Paulo state provides valuable epidemiological evidence to support surveillance, guide public health policies, and identify regional disparities. As one of Brazil’s main referral centers, São Paulo offers important insights into the impact of demographic, socioeconomic, and healthcare factors on mortality, contributing to improved prevention and management strategies nationwide. The study of pediatric leukemia mortality helps understand the disease’s epidemiology and trends in São Paulo state, a national reference. Analyzing temporal evolution supports epidemiological surveillance and the development of prevention strategies to reduce mortality. The scarcity of studies on leukemia trends in Brazilian children challenges the creation of effective public health policies and the allocation of resources. Demographic and socioeconomic factors, along with advances in personalized medicine and early detection, influence mortality outcomes. Mortality data analysis reveals patterns and disparities, guiding more effective, targeted strategies to improve outcomes and quality of life for affected children. Understanding São Paulo’s reality is essential to grasp the complexities of pediatric leukemia and foster continued progress in prevention, treatment, and control across Brazil.

5. Caregivers living with HIV experience elevated caregiver strain and sexual identity-specific aging concerns.

期刊: Aging & mental health 发表日期: 2026-Jul-05 链接: PubMed

摘要

While there is broad research among caregivers in general, much less is focused on caregivers living with HIV, a gap we beging to fill here. Data come from the Columbus Healthy Aging Project (N=794) which assessed several domains of health among adults aged ≥50 years in Columbus, Ohio, USA. Using multivariable regression models, we examined the likelihood of being a caregiver, number of care recipients, and caregiver strain among people living with HIV alongside measures of aging concerns. People living with HIV (n=32) were more likely to serve as caregivers (aOR=2.92; 95% CI: 1.22, 7.02) and experience elevated caregiver strain (B=1.31; 95% CI: 0.06, 2.56) than those who are HIV-negative. There was no association nor moderation between HIV status, caregiver status, and general aging concerns. Separately, caregivers (B=1.02; 95% CI: 0.20, 1.83) and those diagnosed with HIV (B=2.13; 95% CI: 0.60, 3.67) each reported increased sexual identity-specific aging concerns. We also observed significant moderation between these variables (B=6.53; 95% CI: 3.61, 9.46). These results suggest there are unique forms of stress that are elevated among caregivers living with HIV, a critical area of research as elevated stress is well known to lead to comorbid conditions among those living with HIV.

6. Impact of Early Dose Adjustment of Piperacillin/Tazobactam on Mortality in Critically Ill Patients With Acute Kidney Injury: A Retrospective Multicenter Cohort Study.

期刊: The Annals of pharmacotherapy 发表日期: 2026-Jul-05 链接: PubMed

摘要

Acute kidney injury (AKI) is common in critically ill patients, but the optimal dosing of beta-lactam antibiotics in this setting remains controversial. It is not known whether the benefit of initiating beta-lactams at normal doses outweighs the risk of accumulation and toxicity. We aimed to evaluate the association between early dose adjustment of piperacillin/tazobactam (PT) and 28-day intensive care unit (ICU) mortality in critically ill patients with AKI. We conducted a retrospective multicenter cohort study using the eICU Collaborative Research Database v2.0 and included adult ICU patients with AKI who received PT and had a pretreatment serum creatinine level corresponding to an estimated glomerular filtration rate (eGFR) <40 mL/min/1.73 m2. The exposure was PT dose in the first 24 hours, which was categorized as normal (≥13.5 g/24 h) or adjusted (<13.5 g/24 h). The primary outcome was 28-day ICU mortality. Among 1639 eligible patients, 224 (13.7%) received normal-dose PT and 1415 (86.3%) received adjusted doses. The overall 28-day ICU mortality was 11%, with significantly lower mortality in the normal-dose group (6.7%) compared with the adjusted-dose group (11.7%) (unadjusted odds ratio [OR] 1.85, 95% confidence interval [CI] 1.07-3.20; P = .028). After multivariable adjustment, early dose adjustment was independently associated with higher 28-day ICU mortality (adjusted OR 2.11, 95% CI 1.13-3.96; P = .020). Results were consistent across multiple subgroup and sensitivity analyses, but statistical significance was attenuated when the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation was used for eGFR estimation. Early dose adjustment of PT in critically ill patients with AKI is associated with increased 28-day ICU mortality. This finding suggests that renal dose adjustment of PT should be deferred beyond the first 24 hours of therapy in this population. Prospective studies are needed to confirm this finding, define the optimal timing of subsequent dose adjustments, and assess safety outcomes.

7. Healthcare Costs Following Medical Gender-Affirmation: Evidence From Whole-of-Population Australian Administrative Data.

期刊: Health economics 发表日期: 2026-Jul-05 链接: PubMed

摘要

Gender incongruence in trans and nonbinary (“trans”) populations is often associated with psychological distress and increased demand for mental healthcare. Gender-affirming hormone therapy (GAHT) is a key component of care for many trans people, yet long-term evidence around its cost implications remains limited despite increasing uptake and policy attention worldwide. We provide the first population-based evidence on the healthcare costs of GAHT initiation using longitudinal administrative data from 32,313 trans Australians who initiated testosterone-based GAHT (tGAHT) or estradiol-based GAHT (eGAHT) between 2013 and 2024. Employing a dynamic difference-in-differences design, we estimate the impacts on government expenditure and patient out-of-pocket costs in the 6 years after initiation, using future initiators as controls. We find that initiating tGAHT leads to an additional AUD$3119 (USD$2246) in government expenditure and AUD$143 (USD$103) in out-of-pocket costs over 6 years; corresponding estimates were AUD$8348 (USD$6011) and AUD$1269 (USD$914) for eGAHT recipients. For tGAHT recipients, both government and out-of-pocket costs declined after initiation, with mental healthcare reductions exceeding ongoing hormone therapy expenditure after 6 years. For eGAHT recipients, costs also fell but remained above baseline, driven by sustained prescription spending. Taken together with quality-of-life benefits, our results suggest GAHT is likely to be cost-effective.

8. In Vivo Activity of Antimicrobial Peptoid Oligomers against HSV-1 in a Mouse Model of Herpes Labialis.

期刊: ACS infectious diseases 发表日期: 2026-Jul-05 链接: PubMed

摘要

Herpes simplex virus type-1 (HSV-1) infections cause recurrent oral lesions and are the primary cause of infectious blindness and genital lesions in developed countries. HSV-1 can also lead to life-threatening infections in immunocompromised individuals. Currently, the primary class of antiviral therapeutics for HSV-1 treatment are nucleoside analogues such as acyclovir. However, these therapeutics are only partially effective and are subject to development of resistance. Thus, the development of new, effective antiviral agents, which can be used topically to inactivate HSV-1, is a necessity. We have recently demonstrated the potent antiviral activity of a family of biomimetic compounds. These ‘peptoid’ (N-substituted glycine) oligomers mimic the structure and activity of antimicrobial peptides like LL-37, while being highly resistant to proteases. Antiviral peptoids rapidly inactivate HSV-1 in vitro by disruption of the viral envelope, likely through interaction with the lipid phosphatidylserine on the outer membrane leaflet. To test the in vivo activity of these peptoids, we optimized a lip treatment model of HSV-1 infection. We demonstrate that delivery of a clinical isolate of HSV-1, strain 294.1, onto scarified lips of BALB/c mice led to reproducible lesions within 5 days. Treatment of these lesions on day 2 post infection with increasing concentrations of an antiviral peptoid resulted in a dose-dependent inhibition of lesion formation, comparable to acyclovir cream, and the host defense peptide LL-37. The same dose-dependence was observed when quantifying viral DNA from both the lip and the trigeminal ganglion by qPCR. The results demonstrate the ability of these peptoids to be developed as topical antiviral agents to prevent herpes labialis infections caused by HSV-1.

9. Rickettsial Diseases and Vaccines: Is There an Opportunity for Plant-Made Vaccine Technology?

期刊: Biotechnology and bioengineering 发表日期: 2026-Jul-05 链接: PubMed

摘要

Rickettsiosis is a zoonotic disease caused by obligate intracellular bacteria of the family Rickettsiae, transmitted by arthropods. No commercial vaccine exists, despite the efficacy of experimental prototypes based on whole cells, DNAs, nanosystems, and recombinant antigens. Plants have been used as a platform for producing and delivering recombinant antigens, allowing the commercial vaccines for COVID-19 and Influenza. This technology can be used for recombinant Rickettsia vaccines for the target host, potentially for vector arthropods. These aspects are reviewed in this work, considering a brief immunobiology of Rickettsiae, experimental vaccines against Rickettsiosis, step-by-step genetic engineering in plants for recombinant antigen production and immunological assessment, representative successful examples of plant-made vaccines, and the analysis of the potential of plant-made vaccines to control arthropod-transmitted Rickettsiae. Perspectives in this field are offered, highlighting hurdles and opportunities.

10. [Long-COVID syndrome and lung-specific abnormalities following COVID-19].

期刊: Orvosi hetilap 发表日期: 2026-Jul-05 链接: PubMed

摘要

Following the acute phase of a SARS-CoV-2 infection, post-COVID - or long-COVID - syndrome may develop. This condition is characterized by unpleasant, persistent or new-onset symptoms following the acute phase of the infection. It might lead to an impaired health-related quality of life of affected patients and may involve multiple organ systems. It often poses diagnostic and therapeutic challenges for the healthcare system, and its exact course and outcomes are not yet fully understood. A multidisciplinary approach is required for diagnosis, including imaging studies (e.g., chest CT), tests to assess functional status (e.g., 6-minute walk test, pulmonary function tests, cardiopulmonary exercise testing) and the evaluation of parameters reported by patients subjectively (e.g., symptom burden, health-related quality of life). As part of long-COVID, lung parenchymal changes or abnormalities resulting from the viral infection can be detected on imaging studies in some cases, referred as post-COVID pulmonary fibrosis. Currently, therapeutic options are limited and largely based on symptomatic or organ-specific approaches. However, antiviral treatments used in the acute phase, such as remdesivir or nirmatrelvir/ritonavir, may be potentially beneficial regarding the development of late complications. Prevention, particularly COVID-19 vaccination, plays a key role, as it has been shown to reduce the risk of severe acute disease and the later probability of long-COVID syndrome. Further long-term patient follow-up is necessary to better understand the pathomechanisms underlying long-term effects of the virus, such as long-COVID and post-COVID pulmonary fibrosis. This article aims to present an up-to-date, comprehensive review of long-COVID syndrome and post-COVID pulmonary fibrosis. Orv Hetil. 2026; 167(27): 1051-1058. Az akut COVID–19 lezajlását követően post-COVID-, avagy long-COVID-szindróma léphet fel, mely a fertőzés akut időszaka után is fennálló kellemetlen perzisztáló vagy új keletű tünetekkel jellemezhető, az érintett betegek életminőségét ronthatja, és egynél több szervrendszert is érinthet. Az állapot sokszor diagnosztikus és főként terápiás kihívást jelenthet az ellátórendszernek, pontos lefolyása és kimenetelei egyelőre nem ismertek teljes mértékben. A diagnosztikus megközelítés multidiszciplináris szemléletet igényel, amelyben kiemelt szerepet kapnak a képalkotó vizsgálatok (például mellkasi CT), a funkcionális állapotot felmérő vizsgálatok (6 perces járásteszt, légzésfunkció, cardiopulmonalis terheléses teszt), valamint a betegek által szubjektíven jelzett paraméterek (tüneti profil, életminőség) felmérése is. A long-COVID-állapot részeként bizonyos esetekben a vírusinfekció következményeként a tüdőparenchyma kiterjedt károsodása detektálható képalkotó felvételeken, melyet a szakirodalom post-COVID-tüdőfibrosisként említ. A terápiás lehetőségek jelenleg korlátozottak, és nagyrészt tüneti, illetve szervspecifikus megközelítésen alapulnak, ugyanakkor az akut fázisban alkalmazott antivirális kezelések, mint a remdesivir vagy a nirmatrelvir/ritonavir, potenciálisan befolyásolhatják a késői szövődmények kialakulását. A megelőzés kulcsszerepet játszik, különös tekintettel a vakcinációra, amely bizonyítottan csökkenti a súlyos betegség és feltehetően a long-COVID kialakulásának kockázatát is. A long-COVID-szindróma és a post-COVID-tüdőfibrosis patomechanizmusának pontosabb megértéséhez további hosszú távú betegkövetés lehet szükséges. A jelen közlemény célja a long-COVID-szindróma és a post-COVID-tüdőfibrosis bemutatása egy naprakész, átfogó összefoglaló formájában. Orv Hetil. 2026; 167(27): 1051–158.

11. Sustainable water-based green extraction of momilactones A and B from rice husk with enhanced cytotoxic and antibacterial activities.

期刊: Natural product research 发表日期: 2026-Jul-05 链接: PubMed

摘要

Momilactones A (MA) and B (MB) are bioactive diterpenoid lactones found in rice husk; however, conventional extraction relies on solvent-intensive methanolic methods and exhibits limited efficiency, raising environmental sustainability concerns. This study evaluates water-based green extraction approaches to improve the yields and biological performance of momilactone-enriched extracts while reducing solvent consumption. Freezing (FRH), sonication (SRH), combined freezing-sonication (PFS), and cellulase-assisted extraction (E) were compared with conventional methanolic extraction (MRH) as a control. Freezing at -20 °C for 16 h (FRH2) and sonication for 2 h (SRH1) achieved the highest enrichment of MA (51.9 and 52.7 µg/g, respectively) and MB (32.5 and 34.3 µg/g, respectively), representing 1.2-1.4-fold increases over MRH. These extracts exhibited enhanced cytotoxicity against K562, U937, and THP-1 cell lines (IC50: 80.36-124.76 µg/mL) and antibacterial activity against Staphylococcus aureus (MIC: 2 mg/mL). Overall, water-based physical pre-treatments offer a sustainable platform for momilactone extraction in functional food and pharmaceutical applications.

12. Radical Cascades on Seawater Microdroplets Drive Atmospheric Mercury Oxidation.

期刊: Journal of the American Chemical Society 发表日期: 2026-Jul-05 链接: PubMed

摘要

The air-water interface of aqueous microdroplets enables the spontaneous generation of hydroxyl radicals (·OH). However, the environmental fate and effect of these primary oxidants in complex, ion-rich media such as seawater remains uncharted. Here, we discover that the interface of seawater microdroplets sustains a radical cascade, which markedly amplifies their oxidative power beyond that of pure water microdroplets. Spontaneously produced ·OH at the interface quickly engages in synergistic reactions with abundant bromide and bicarbonate ions, initiating a network of secondary radicals, including reactive bromine (·Br) and carbonate (·CO3-) species. The coexistence and interconversion within this self-sustaining interfacial cycle are demonstrated through radical trapping and spectroscopic methods. To assess the environmental implications of this process, we have quantified its role in the dark oxidation of gaseous elemental mercury. Our findings advance the understanding from mere interfacial oxidant generation to the radical networks by specific ions, offering a novel framework for predicting chemical reactivity in environmental aqueous microdroplets.

13. Noninvasive repeated sampling technique reveals specific respiratory cytokine signatures for people who use electronic-cigarette and dual-products obtained from a remote cohort of young adults.

期刊: Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco 发表日期: 2026-Jul-05 链接: PubMed

摘要

E-cigarette use has been linked to respiratory mucosal inflammation and other markers of toxicity. Dual use, or the use of e-cigarettes in combination with conventional cigarettes or other inhaled products has increased in prevalence, but there is limited understanding of the health effects associated with dual use. The aim of this study was to establish whether nasal mucosal cytokine profiles among people who never use tobacco, people who exclusively use electronic cigarettes, and people who dual tobacco product use change over time and whether dual use significantly differs from exclusive e-cigarette use. This study utilized a repeated sampling study design, collecting nasal epithelial lining fluid from young adult participants (n=64) who never used tobacco, exclusively used electronic cigarettes, and used dual tobacco products, once weekly for four weeks using a remote, non-invasive sampling technique. Nasal mucosal immune mediators and salivary cotinine were then analyzed by ELISA. Differences in mucosal immune mediators were identified between e-cigarette, dual tobacco product and never tobacco product participant groups; however, these markers did not vary across time within group. People who exclusively use e-cigs or dual tobacco products exhibited increased proinflammatory markers compared to people who never use. Chemokine profiles were uniquely altered in the dual tobacco product group. Sex differences were identified in cytokine and chemokine production across groups. Conclusions: These results suggest that remote, non-invasive nasal sampling is adequate for assessing immune profiles from people who use tobacco products and cross-sectional sampling is likely representative of consistent respiratory immune profiles across multiple weeks. Dual product use results in distinct respiratory immune profiles, which suggests that long term disease outcomes may differ from people who exclusively use e-cigs.

14. Assessment of molecular and biochemical biomarkers in Oreochromis niloticus following acute exposure to the pesticide ZEUS®.

期刊: Journal of toxicology and environmental health. Part A 发表日期: 2026-Jul-05 链接: PubMed

摘要

The increasing use of pyrethroids and neonicotinoids, such as those present in the commercial formulation ZEUSⓇ (Ihara, Brazil), has raised environmental concerns attributed to enhanced risk of aquatic contamination. Fish are valuable bioindicators due to their ability to bioaccumulate and metabolically respond to contaminants. This study evaluated the acute effects of ZEUSⓇ exposure in Nile tilapia (Oreochromis niloticus) using biochemical and molecular biomarkers. Male juvenile fish (n = 10 per treatment) were exposed for 24 hr to ZEUSⓇ at 0.05, 0.1, or 0.2 mg/L. Hepatic gene transcription of genes related to xenobiotic biotransformation, antioxidant defense, inflammation, and apoptosis was assessed, together with glutathione S-transferase (Gst) and catalase (Cat) activities and lipid peroxidation levels. Lambda-cyhalothrin and dinotefuran were not detected in the muscle tissue. Biomarker responses revealed a significant 4-fold downregulation of carboxylesterase (cbe3) transcription at 0.1 mg/L, and a 40% reduction in Gst activity at 0.2 mg/L. Lipid peroxidation increased approximately 6-fold and 8-fold at 0.05 and 0.2 mg/L, respectively. No significant changes were observed in antioxidant-, inflammatory-, or apoptosis-related gene transcription. These findings indicate that acute ZEUSⓇ exposure alters detoxification processes and induces oxidative lipid damage, indicating the need for longer-term studies evaluating tissue-specific responses and bioaccumulation dynamics.

15. Allergic Contact Dermatitis Caused by Online-Purchased Black Henna Temporary Tattoos.

期刊: The Australasian journal of dermatology 发表日期: 2026-Jul-05 链接: PubMed

摘要

16. Conflicts of interest as a barrier to the development of health technology assessment in Iran: a qualitative study.

期刊: Journal of health, population, and nutrition 发表日期: 2026-Jul-04 链接: PubMed

摘要

Health Technology Assessment (HTA) is vital for evidence-based decision-making and efficient resource allocation. Although HTA has gained importance in Iran’s health policy agenda, its development faces major barriers. Among these, conflicts of interest (COI) remain a critical yet understudied challenge that can undermine the integrity of HTA processes. This study explored how COI manifest within Iran’s HTA environment and hinder its development. A qualitative design was used, employing purposive sampling to select key informants involved in HTA and health policymaking. Twenty-eight semi-structured interviews were conducted with policymakers, academics, healthcare professionals, and representatives from regulatory and insurance bodies. Data were analyzed thematically using an inductive approach to identify the types, sources, and impacts of COI. Participants described multiple personal, institutional, and systemic COI influencing HTA. Key themes included the lack of formal disclosure and management mechanisms, strong industry influence, overlapping roles of decision-makers, and weak regulatory oversight. These factors distorted priority-setting, delayed the adoption of cost-effective technologies, and eroded public trust. Cultural norms favoring informal relationships and political patronage further reinforced these problems. COI threaten the credibility and transparency of HTA in Iran. Strengthening governance frameworks, ensuring institutional independence, and promoting ethical accountability are essential to enhance HTA integrity. The findings provide insights for other low- and middle-income countries seeking to institutionalize HTA within complex governance systems. This study highlights that managing COI requires not only technical solutions but also interdisciplinary approaches, particularly drawing on legal frameworks and organizational management theories, to address governance failures in Iran’s health system.

17. "It's more than just blood pressure and stitches": a critical examination of paramedic services from the perspectives of intimate partner violence advocates.

期刊: BMC health services research 发表日期: 2026-Jul-04 链接: PubMed

摘要

As a detrimental and persistent criminal, social, and health issue, intimate partner violence (IPV) is a severe threat to the well-being of survivors. The healthcare system, specifically the emergency department, has provided access to services and supports for survivors of IPV when seeking healthcare. However, many survivors of IPV are unable to attend the hospital and access the corresponding services. Paramedics, versatile in-community service providers, could play a vital role in linking survivors to healthcare and support services. In-community IPV advocates understand the circumstances of survivors and have expert knowledge of services. To examine how the perspectives of IPV advocates can inform our understanding of paramedic services. Actioning an interpretive description approach in the context of paramedicine, IPV advocates in western Canada participated in semi-structured focus groups. Focus groups were transcribed verbatim and de-identified. De-identified transcripts were inductively analyzed (NVivo) for patterns. N = 17 IPV advocates (all women; age 42 ± 12) participated in focus groups. Participants indicated that primary and emergency healthcare, recognition of and validation for situations involving IPV, and the referral to specialized resources were desirable services paramedics could provide. Challenges for survivors accessing services through paramedics were paramedic conduct, paramedic capacity, paramedic service shortcomings, situational logistics, concurrent conditions, service access, and patient and perpetrator factors. Solutions for these challenges include adopting safe, equitable, and patient-centred practice, establishing and maintaining functional working capacities for paramedics, developing functional infrastructure and supporting policy, providing adaptable and versatile service options, avoiding biases and stereotypes, and considering holistic patient concerns, generating innovative methods to promote service access for all patients, and integrating techniques to facilitate patient engagement and mitigating perpetrator interference. Given the desired services from paramedics and the challenges identified for survivors, it is likely that a practice gap exists among paramedics and paramedic services. IPV advocate-derived solutions may help inform paramedics and paramedic services to address these challenges. If the best available evidence is utilized to develop positive change, paramedics could advance into specialist resources for survivors of IPV.

18. In vivo MRI assessment of position dependent capsulolabral gap differences between neutral and flexion abduction external rotation hip positions.

期刊: Scientific reports 发表日期: 2026-Jul-04 链接: PubMed

摘要

The acetabular labrum plays an essential role in resisting distraction stress by closely coupling the femoral head. A previous cadaveric study suggested that specific hip postures allow the joint capsule to approximate the labrum, potentially enhancing labral adherence to the femoral head. However, whether such position-dependent changes occur in vivo remains unclear. This study aimed to investigate differences in the capsulolabral gap-the distance between the anterosuperior-joint capsule and labrum-between the hip neutral and flexion-abduction-external rotation (FABER) positions, and the location where these differences occur. Twenty-four hips of 24 healthy volunteers were examined using magnetic resonance imaging. A capsulolabral gap was evident around the anterior inferior iliac spine (AIIS) in the hip neutral but not in the FABER position. The largest capsulolabral gap (2.11 ± 0.93 mm) was significantly associated with the AIIS location (r = 0.65, p = 0.004). The maximal gap distance in the hip neutral position was positively significantly correlated with the articular-cavity area at the femoral neck in FABER (r = 0.85, p < 0.001). The capsulolabral gap around the AIIS in the hip neutral position was reduced in FABER owing to close capsule-labrum contact as the entire joint capsule changed, suggesting that the hip capsule contributes to a position-dependent labral-support mechanism.

19. Integrated comparative genomic and transcriptomic analysis reveals a wsv249 mutation drives enhanced pathogenicity in white spot syndrome virus.

期刊: Scientific reports 发表日期: 2026-Jul-04 链接: PubMed

摘要

Despite causing catastrophic losses across shrimp-farming regions worldwide, the molecular determinants that drive virulence differences among WSSV isolates remain poorly understood. Despite the remarkable conservation of WSSV genomes, outbreaks frequently exhibit differences in virulence among virus isolates. However, the molecular determinants underlying these differences remain unclear. This study aims to discover factors that enhance WSSV virulence and to elucidate the molecular mechanisms that regulate WSSV pathogenicity. Comparative genome analysis of four WSSV isolates from Thailand (SK1, SK2, CB1, and CB2) revealed that all isolates shared a highly conserved genome and structural stability. However, phylogenetic analysis revealed distinct evolutionary structuring, notably clustering SK1 and CB2 despite their different geographical origins. Infection experiments demonstrated differences in mortality rates among isolates, with the CB2 isolate exhibiting the highest mortality rate. Selection pressure analysis identified the immediate-early gene WSV249, encoding a RING finger E3 ubiquitin ligase, as positive selection (ω > 1) in high-virulence isolates. Functional validation through RNA interference (RNAi) targeting WSV249 resulted in 100% shrimp survival and a significant suppression of essential viral genes, including VP28 and thymidylate kinase. Furthermore, transcriptomic profiling revealed that WSV249 silencing prevented the host transcriptional disruption typically induced by WSSV, particularly in metabolic and immune-signaling pathways. These findings provide mechanistic insight into WSSV virulence determinants and identify WSV249 as a target for disease control strategies in shrimp aquaculture.

20. GLP-1 receptor agonists in pediatric obesity.

期刊: Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver 发表日期: 2026-Jul-04 链接: PubMed

摘要

Glucagon-like peptide-1 receptor agonists (GLP-1RAs) have transformed the management of obesity in adults and are now gaining attention in pediatric populations facing a dramatic rise of obesity prevalence and related comorbidities. In addition to weight loss, their role extends to cardiometabolic effects and improvements of kidney function. Liraglutide and semaglutide have demonstrated clinically meaningful efficacy in adolescents, leading to FDA and EMA approvals for patients ≥12 years. Ongoing trials are being conducted to combine GLP-1 analogues with other effective molecules or with bariatric surgery. Current evidence on safety most frequently highlights gastrointestinal adverse events, with no consistent impact on growth or pubertal development reported to date. Psychosocial dimensions, including stigma, mental health risks, and potential disordered eating, together with economic barriers and disparities in access, require careful consideration and efforts to be overcome. Implementing intensive lifestyle interventions is mandatory, including nutritional education, physical activity promotion, and family-based behavioral strategies, to support long-term weight management and address the broader determinants of health. Preliminary studies suggest complementary roles for GLP-1RAs alongside metabolic bariatric surgery in selected high-risk patients. Long-term data on safety and multidisciplinary approaches are required to define the optimal integration of pharmacotherapy into comprehensive, family-centered pediatric obesity care models.

21. Gratitude for Food as a Driver of Improved Dietary Behaviors: A Scoping Review.

期刊: Appetite 发表日期: 2026-Jul-04 链接: PubMed

摘要

Gratitude for food (GF) is a positive emotional response linked to healthier dietary behaviors, mindful eating, and food waste reduction. Despite increasing research interest internationally and in Japan, existing research has not been systematically integrated, and measurement tools remain fragmented. This study aims to systematically map and synthesize international and Japanese studies on GF, clarify current knowledge, detail the characteristics and thematic focuses of existing research, critically examine the variety and validation status of GF measurement tools, and identify the cultural and methodological gaps within the literature. A scoping review following PRISMA-ScR guidelines was conducted. Searches of five databases-SCOPUS, PubMed, EBSCO host, Ichushi-web, and J-stage-in English and Japanese were conducted covering publications from 1995 to 2025. Data extraction included study characteristics, GF measurement tools, and intervention details. Quantitative text mining analyzed the research themes. Thirty-nine studies were included, encompassing cross-sectional, intervention, qualitative, mixed-methods, and scale development designs. Five research focus clusters emerged: school lunches, nutrition education programs, food waste, mindful eating, and scale development. Five validated GF scales were identified, some with cross-cultural adaptations, but their use and validation were fragmented. Intervention studies were predominantly non-randomized controlled trials in Japan, focusing on school-aged children, with mixed evidence on effectiveness. GF is a culturally nuanced construct with important implications for promoting healthier dietary habits, reducing food waste, and fostering mindful eating. Future research should focus on harmonizing measurement tools and conducting rigorous intervention studies to advance the field.

22. Refining Oxygen-Carrying Capacity Metrics in Assessing Mortality Risk from Pneumonia in Children.

期刊: The Journal of pediatrics 发表日期: 2026-Jul-04 链接: PubMed

摘要

23. Recognizing military service as scholarship of application in pharmacy promotion and tenure.

期刊: Currents in pharmacy teaching & learning 发表日期: 2026-Jul-04 链接: PubMed

摘要

Pharmacy promotion and tenure (P&T) frameworks emphasize the scholarship of discovery and teaching, while the scholarship of application is inconsistently defined and undervalued, a gap documented across the health professions. Military service is a high-value but frequently overlooked example. Without clear criteria for applied scholarship, military scholarly products and graduate leadership credentials remain undervalued, weakening faculty diversity and curricular capacity in areas pharmacy education increasingly requires. Drawing on Boyer’s scholarship of application and community-engaged scholarship frameworks, this commentary argues that military contributions constitute rigorous scholarship, illustrated by Pacific Island humanitarian missions as one example. Explicit recognition of applied scholarship, including military service, strengthens faculty development and helps pharmacy programs meet contemporary educational priorities.

24. Parabens exposure in systemic lupus erythematosus: insights from network toxicology and molecular docking.

期刊: BMC pharmacology & toxicology 发表日期: 2026-Jul-04 链接: PubMed

摘要

Systemic lupus erythematosus (SLE) is an autoimmune disease driven by immune dysregulation. Parabens, commonly used preservatives, are potential environmental factors that may influence immune function and contribute to autoimmune diseases like SLE, although the underlying mechanisms remain unclear. A network toxicology approach was used to investigate potential associations between parabens and SLE-related genes. Paraben target genes were identified from ChEMBL, STITCH, and SwissTargetPrediction, while SLE-related genes were obtained from GeneCards, OMIM, and TTD. Shared paraben-SLE genes were subjected using gene ontology (GO) and Kyoto encyclopedia of genes and genomes (KEGG) enrichment analyses. Hub genes were identified via network analysis with Cytoscape and further evaluated using three gene expression omnibus datasets. Molecular docking simulations were performed to predict potential interactions between parabens and proteins encoded by the identified hub genes. 56 shared paraben-SLE genes were identified and were enriched in immune-related processes, including leukocyte proliferation, T cell activation, and cytokine receptor binding. KEGG analysis highlighted enrichment in immune response pathways, including Toll-like receptor (TLR) signaling. Candidate hub genes, including TLR4, cytotoxic T-lymphocyte associated protein 4 (CTLA4), and CD86, were differentially expressed across three independent SLE gene expression datasets. Molecular docking simulations predicted potential binding interactions between parabens and these hub gene proteins. This study identified candidate genes and pathways potentially associated with both paraben exposure and immune dysregulation in SLE, particularly TLR4, CTLA4, and CD86. These findings are based on computational predictions and require further experimental and clinical studies to determine their biological relevance and potential implications for autoimmune diseases.

25. Development of a cognitive rehabilitation intervention to support patients during and after intensive care admission: a stakeholder-informed study.

期刊: BMC health services research 发表日期: 2026-Jul-04 链接: PubMed

摘要

Patients who survive critical illness and intensive care unit (ICU) admission often experience long-lasting physical, psychological, and cognitive impairments. Cognitive impairments are common and may persist well beyond ICU discharge. Few structured interventions address these impairments across the care continuum, from the ICU to post-discharge recovery. This gap informed the development of a stakeholder-driven cognitive rehabilitation intervention. The aim was to develop a cognitive rehabilitation intervention for critically ill patients that bridges the period from ICU admission to post-discharge recovery. The intervention was developed using a multiphase process guided by the 2021 Medical Research Council (MRC) framework for complex interventions and reported in line with the GUIDED and TIDieR checklists. Stakeholder input was gathered through: (1) a workshop (n = 11) to identify end-user needs; (2) a three-round Delphi process (n = 39) to prioritise interventions using a seven-point Likert scale; and (3) expert consultations to refine selected components. Qualitative data from the workshop and open-ended Delphi responses were analysed thematically, while quantitative analysis identified consensus, defined a priori as ≥80% agreement on importance. The process generated a range of proposed interventions, including both novel and established elements. Interventions reaching stakeholder consensus were further reviewed by experts for clinical relevance and feasibility. Two prototype interventions were selected: (1) a Mindfulness-based intervention and (2) a Brain Training intervention. This study outlines a stakeholder-informed process for developing a cognitive rehabilitation intervention tailored to ICU patients across the care continuum. The co-design approach improved contextual fit and clinical applicability. These findings support the planned feasibility evaluation of the proposed interventions. The overall research study received ethics approval, while formal ethics committee approval was not required for the workshop and Delphi activities under Danish legislation (osf.io/5a4xq).

26. Direct cost of occupational asthma and associated factors in the private sector in central Tunisia.

期刊: BMC health services research 发表日期: 2026-Jul-04 链接: PubMed

摘要

Occupational asthma (OA) is a significant public health concern due to its high prevalence and socioeconomic burden. In Tunisia, direct costs of OA have not been previously evaluated, highlighting an important knowledge gap for health policy planning. This study aimed to assess the direct cost of OA in the private sector of central Tunisia and identify factors influencing this cost. A retrospective claims-based cohort study was conducted using data from the National Health Insurance Fund (CNAM) on OA cases recognised between 2015 and 2017 in the governorates of Sousse, Monastir, Mahdia and Kairouan, central Tunisia. Direct costs were estimated from the CNAM payer perspective. The costs were tracked from the date of recognition until 31 December 2020 and expressed in 2020 Tunisian dinars (TND). Statistical analyses included univariate tests and generalized linear models (GLM) with gamma family and log link for right-skewed cost data, reporting adjusted incidence rate ratios (aIRR) with Huber-White (HC1) robust standard errors. A total of 157 cases of OA were analyzed, predominantly female (75.8%), with a mean age of 43.41 ± 7.29 years. The textile sector represented 72% of cases. High-molecular weight allergens, particularly vegetable textile dust (70.7%), were the agents most frequently implicated. The median total direct cost was 4,593.52 TND (€1,467.24) per case [IQR: 3,408.00-6,871.72]. The median annualized cost was 1,114.03 TND (€355.94) per person-year. Cash benefits (96.8% of patients) dominated over in-kind benefits (22.9%). In multivariate analysis, age ≥ 40 years was the only significant independent predictor of medical costs (adjusted incidence rate ratio [aIRR] = 2.84, 95% CI: 1.59-5.07; p < 0.001), whereas no clinical or demographic factor predicted indemnity costs. Univariate analysis additionally identified male sex (p = 0.04), higher PPD rate (p < 0.001), and absence of prior occupational disease history (p = 0.001) as factors associated with higher total direct costs. This study highlights the considerable direct costs associated with occupational asthma in central Tunisia’s private sector, and the resulting burden placed on the healthcare system and the affected workforce. These findings underscore the need to strengthen primary prevention strategies, particularly in the textile industry, to reduce both the health and economic impact of this disease.

27. Strengthening field-informed for-profit private sector engagement strategy in malaria elimination: insights from a single-group quasi-experimental pilot study in Bangladesh.

期刊: Malaria journal 发表日期: 2026-Jul-04 链接: PubMed

摘要

Despite the dramatic achievements in malaria control, Bangladesh continues to face persistent transmission in high-endemic regions such as Bandarban in the Chittagong Hill Tracts. One important strategy to close surveillance and case management gaps is to involve the for-profit private sector that serves marginalized populations including high-risk occupational groups and communities facing geographical obstacles. The objectives of this study were to determine the practicality and the effects of involving the private healthcare providers in the national malaria surveillance system in Alikadam Upazila, Bandarban. A One-month pilot study was conducted in March 2023 in 10 for-profit private healthcare facilities in Alikadam Upazila, Bandarban. The providers were trained to do rapid diagnostic tests on suspected malaria patients and to refer positive cases to government or partner NGO facilities. Data on adherence to diagnostic protocols, the detection of malaria cases, the reporting, the referral and patient satisfaction were collected using standard registers, reporting forms and supervision checklists. These data were entered into an electronic database and analysed descriptively. Quality assurance was taken care of by monitoring and evaluation mechanisms, including regular supervisory visits. Rapid diagnostic tests were done on 440 patients in the pilot, and 1.8% were positive of malaria (Plasmodium falciparum and P. vivax were equally distributed). The study period has shown that the private sector has a share of 20% in all the reported cases of malaria in Alikadam. Most of the participants were males (54.6%), and 4.0 percent of the women were pregnant. The level of patient satisfaction was also good as 100 percent of the people who were surveyed claimed that they were confident in the private providers and the referral process. The accuracy of data recording rose as the providers performed better over time with a rate of 37.5 in week one but in the fifth week, it was 87.5. Although these successes have been achieved, referral gaps and lack of financial incentives to the private providers were a challenge. The research highlighted private healthcare providers’ potential in malaria surveillance and case detection in remote, vulnerable populations. Integrating them into national programs could strengthen health systems and eradication efforts, but scaling requires addressing challenges like sustained training, financial incentives, and adequate service coverage.

28. Encapsulating the burden and social determinants of self-reported general health problems among a specific sub-group of transgender women in Dhaka, Bangladesh: a mixed-methods study.

期刊: International journal for equity in health 发表日期: 2026-Jul-04 链接: PubMed

摘要

In Bangladesh and other resource-constrained settings, a sub-group of transgender women (predominantly known as hijra in South Asia) encounter systemic marginalization, which unfairly predisposes them to health disadvantages. Although studies are beginning to illuminate the emerging burden of various communicable and non-communicable diseases, the global scholarship has predominantly confined these marginalized people within HIV/STI research framework. Our study explored the burden of diverse self-reported health problems and their underlying contexts among hijra in Dhaka, Bangladesh. A mixed-methods cross-sectional study was conducted among 483 hijra. The quantitative component applied systematic sampling approaches from eight drop-in centers. Moreover, in-depth interviews and focus group discussions were convened with hijra and key-informant interviews with hijra leaders known as hijra guru, DIC staff, and public health experts. Qualitative findings were manually analyzed using the social determinants of health framework and equity lenses, within the domain of thematic analysis. Hijra living in Dhaka, Bangladesh reported heightened levels of general health ailments, exacerbated by the stigma, socio-economic marginalization, and limited healthcare access. Findings reflected high health burdens (58.4% with at least one ailment in the past year); self-reported mental health concerns (61.3%), anal conditions (55.7%), cold/cough (51.1%), asthma (41.5%), hypertension (33.3%), and diabetes (24.8%). Qualitative findings linked these health ailments to various contexts underpinned by structural inequities and social determinants, e.g. mental health concerns were linked to educational and familial exclusion, infectious diseases were exacerbated by poor living conditions, and non-communicable diseases were perpetuated by food insecurities and hormone intake linked to occupational risks. Findings demonstrated the burden and variegated contexts of general health problems among hijra. However, these problems are often buried beneath the HIV paradigm. Their health problems were linked to structural inequities, marginalization, and healthcare constraints, and these inequities need to be addressed to ensure their health and wellbeing. Solely biomedical and public health frameworks may not suffice for hijra, rather we need to move towards a comprehensive equity-oriented approach.

29. On-site safety practices and knowledge in deathcare work: a phenomenological account of the lived-experiences of deathcare workers in Ghana.

期刊: BMC health services research 发表日期: 2026-Jul-04 链接: PubMed

摘要

While deathcare services in developed countries are provided by well-trained, adequately resourced professionals, the industry in Sub-Saharan Africa (SSA) is characterized by minimal training, apprenticeship, and severe resource constraints. Consequently, workers in SSA often lack knowledge of industry policies, fail to adhere to proper personal protective equipment (PPE) protocols, and maintain poor personal and hand hygiene. Therefore, this study explored the knowledge, on-site safety practices, and experiences of deathcare workers in selected facilities within the Central and Western North regions of Ghana. Using a 10-item interview guide and observation checklists, we collected data from 35 participants selected using purposive sampling method. We employed a realistic phenomenological design and observational analysis to interpret the findings. Deathcare workers have limited knowledge of industry regulations designed to protect their health and safety. On-site practices are inconsistent with the Ministry of Health (MoH), Ghana, Occupational Health and Safety (OHS) and Infection Prevention and Control (IPC) guidelines. Specifically, workers fail to use PPE correctly, and their hand and personal hygiene practices do not conform to MoH standard operating procedures. These workers engaged in inappropriate handling of dead bodies risking exposure to infection. These deathcare workers have very limited knowledge required to provide safe deathcare services and were unable to advocate for their rights under existing policy guidelines. The MoH must develop a policy to standardize the recruitment of deathcare workers, while training current workers for protection.

30. Worsening frailty and declining quality of life in older survivors of non-metastatic breast cancer.

期刊: Journal of the National Cancer Institute 发表日期: 2026-Jul-03 链接: PubMed

摘要

Breast cancer treatment can worsen frailty, but the impact of this decline on long-term quality of life (QoL) remains uncertain. We identified women ≥65 years old with non-metastatic breast cancer from the Life and Longevity after Cancer survivorship cohort of the Women’s Health Initiative. We examined the association between clinically-significant worsening of frailty, measured by a validated claims-based index one year post-diagnosis, and long-term decline in QoL, assessed on a ten-point scale 4 to 6 years post-diagnosis. Among 1,061 eligible patients, 692 (65.2%) were robust (not living with frailty), 343 (32.3%) were living with pre-frailty, and 26 (2.5%) were living with frailty at cancer diagnosis. Clinically-significant worsening of frailty occurred in 19.5% of patients. In fully adjusted models, worsening frailty was significantly associated with long-term QoL declines (Odds Ratio 1.48; 95% Confidence Interval [1.07 to 2.04]). These findings highlight the need for interventions to prevent worsening frailty during breast cancer treatment.

31. Association Between Air Pollution and Post Acute Sequelae of SARS-CoV-2 (PASC).

期刊: American journal of respiratory and critical care medicine 发表日期: 2026-Jul-03 链接: PubMed

摘要

32. Manganese@Gold cluster-coordinated covalent organic frameworks-based artificial metalloenzymes with cascade biocatalysis and amplified systemic stimulation to combat malignant tumor metastasis.

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

摘要

Reactive oxygen species (ROS)-catalytic artificial enzymes have emerged as a promising way to combat malignant tumors, yet their efficacy remains constrained by tumor hypoxia, oxygen dependence, and robust antioxidant defenses. Herein, we report the de novo design of a bioinspired manganese@gold cluster-coordinated covalent organic frameworks-based artificial metalloenzymes (AuC@SCOF-Mn) with efficient cascade biocatalysis and amplified systemic stimulation to combat malignant tumor metastasis. Experimental and theoretical results demonstrate that the AuC@SCOF-Mn heterojunction architecture accelerates electron transfer and drives oxygen-independent type I photoreactions under low-dose light irradiation, which confer dual-enzyme-like activities to catalyze glucose-to-H2O2-to-ROS conversion and deplete intracellular glutathione. The multiple functionalities not only disrupt redox homeostasis to amplify ROS accumulation but also elicit potent tumoricidal effects through mitochondrial dysfunction and DNA damage. Beyond direct cytotoxicity, AuC-SCOF-Mn effectively reprograms the tumor microenvironment by enhancing cytokine-cytokine receptor interactions, thereby promoting dendritic cell antigen presentation, CD8+T cell activation, and NK cell infiltration. Correspondingly, AuC@SCOF-Mn demonstrates potent tumor suppression and long-term inhibition of tumor recurrence in vivo. When combined with checkpoint therapy, it further amplifies systemic antitumor responses and inhibits malignant tumor lung metastasis. We believe the innovative design of ROS-catalytic, photo-activable artificial enzymes will open a promising avenue for treating malignancies.

33. Longitudinal effects of comorbidities on brain structure and cognition in older breast cancer survivors.

期刊: Journal of the National Cancer Institute 发表日期: 2026-Jul-03 链接: PubMed

摘要

Neural substrates of cancer-related cognitive impairment (CRCI) remain poorly understood, especially in older adults facing aging-related cognitive decline and comorbid chronic conditions. Breast cancer survivors aged ≥60 years (n = 64) and non-cancer controls (n = 62) completed structural MRI and neuropsychological testing and self-reported cognition and health information at pretreatment baseline and 12- and 24-month follow-ups. Regional gray matter volume and brain age were evaluated using FreeSurfer and brainageR. Longitudinal linear mixed models tested effects of group, time, and group-by-time interactions on volume. Secondary analyses examined relationships between group, comorbidities, age, gray matter volume, and cognition. Survivors exhibited frontal (p = 0.025, q = 0.058), thalamic (p = 0.008, q = 0.052), and limbic (p = 0.015, q = 0.052) gray matter decline relative to controls over 24 months, with smaller effects in parietal (p = 0.055, q = 0.097) and temporal (p = 0.091, q = 0.127) regions. Survivors showed average yearly frontal and thalamic volume loss at twice the rate of controls (p < 0.05). Survivors with a high comorbidity burden (≥3 comorbidities) exhibited the lowest frontal gray matter volume at all timepoints. A trend-level group-by-time interaction for brain age (p = 0.093) suggested accelerated brain aging in survivors. Survivors failed to show practice effects in the attention, processing speed, and executive functioning neuropsychological domain, whereas controls improved significantly over time (group-by-time interaction p = 0.030). Older breast cancer survivors tended to demonstrate gray matter decline and accelerated brain aging throughout the first two years of survivorship, with comorbidity burden amplifying frontal vulnerability. Findings highlight the need for longitudinal cognitive monitoring and targeted intervention, particularly for older survivors with high comorbidity burden.

34. Bullying and sexual harassment of medical and nursing students, in relation to stress, burnout and intention to dropout.

期刊: International journal of medical education 发表日期: 2026-Jul-02 链接: PubMed

摘要

This study examines the prevalence and impact of bullying and sexual harassment among students in nursing and medical education programmes in Sweden. This cross-sectional survey targeted students from 38 universities. A total of 18,582 individuals responded to the questionnaire, yielding a 25% response rate. The sample included students enrolled in nursing (N = 1,083) and medical (N = 431) programmes. Data were analysed using descriptive statistics and two-sample t-tests. Among female students who experienced bullying, higher levels of stress ( t (1188) = 4.91, p < .001), burnout (t(1188) = 5.83, p < .001), and intention to quit studies ( t (1186) = 4.30, p < .001) were reported. Bullied male students showed elevated stress ( t (317) = 3.15, p = .002), burnout ( t (317) = 3.49, p < .001), and intention to quit ( t (316) = 3.67, p < .001). Female students who experienced sexual harassment reported increased stress ( t (1185) = 4.02, p < .001), burnout ( t (1185) = 4.10, p < .001), and intention to quit ( t (1184) = 2.73, p = .006). In contrast, sexually harassed male students reported higher stress ( t (314) = 2.04, p = .042), but no significant differences in burnout ( t (314) = 0.80, p = .425) or intention to quit ( t (314) = 1.86, p = .064). Students from the nursing- and medical programme reported a higher prevalence of bullying and sexual harassment than other students. Given the high prevalence and detrimental effects of bullying and sexual harassment in nursing and medical education, targeted interventions are needed to prevent and address these behaviours.

35. One-Tube RPA-CRISPR-Cas13a assay with rational design for single-molecule detection of waterborne viruses in drinking water treatment.

期刊: Biosensors & bioelectronics 发表日期: 2026-Jul-02 链接: PubMed

摘要

The global rise in waterborne viral infections has created an urgent need for portable, highly efficient environmental virus detection technologies. CRISPR-based nucleic acid detection coupled with isothermal amplification (e.g., Recombinase Polymerase Amplification, RPA) shows great promise for field applications. However, most reported designs fail to achieve the single-molecule sensitivity, which significantly limits their practical applications. To bridge the gap, we proposed a rational design strategy for the RPA primer and the CRISPR-Cas13a crRNA, suggesting that sensitivity can be enhanced by simplifying the secondary structure of the crRNA spacer region. Subsequently, we established a portable, one-tube CRISPR-Cas13a bioassay to detect two major waterborne viruses, achieving ultrasensitive detection limits of 5/8 aM for norovirus and 2/3 aM for rotavirus within 40 min. Thereafter, seasonal sampling across different treatment stages of a drinking water treatment plant was conducted, and water samples were analyzed using the one-tube CRISPR-Cas13a bioassay in comparison with qPCR and dPCR, revealing a positive detection rate of 15.79% (6/38) for the one-tube CRISPR-Cas13a bioassay, 18.42% (7/38) for qPCR, and 15.79% (6/38) for dPCR. The assay’s modular design allows for broad applicability to other pathogens by simply modifying the target nucleic acid sequence, offering high sensitivity and specificity. This innovation paves the way for deployable point-of-care testing and large-scale spatiotemporal virus monitoring.

36. Association of Valvular Disease Progression Using Echocardiographic Findings in a Large U.S. Cohort.

期刊: Echocardiography (Mount Kisco, N.Y.) 发表日期: 2026-Jul 链接: PubMed

摘要

The prevalence of valvular disease in the US is approximately 2.5%. Given that over 5 million Americans are affected, it is crucial to find those at higher risk of progression. The goal of this paper is to uncover which patients are more likely to have valvular disease progression using demographic factors, EKG and echocardiogram (ECHO) findings. This paper utilized the EchoNext Database, which pairs 100,000 electrocardiograms and echocardiograms based on specific structural heart disease labels. Univariate and multivariate logistic regression were used to find risk factors for progression for aortic stenosis (AS), aortic regurgitation (AR), mitral regurgitation (MR), tricuspid regurgitation (TR) and pulmonary insufficiency (PI). Progression was defined as worsened valvular disease on follow up ECHOs. There were 100,000 encounters of EKGs/ECHOs included in the study, and 36,286 individual patients. Independent risk factors of AS progression were age and QRS duration. Age, QRS duration, AS, AR, MR and pericardial effusion were independent risk factors for AR progression. MR progression was independently associated with PR, QRS and QTc durations, MR and left ventricular ejection fraction. QRS duration, MR, TR and right ventricular function were independent factors for TR progression. Lastly, for PI progression, male sex and AS were found to be independent risk factors. The combination of demographic, electrocardiographic and echocardiographic findings can help better assess the progression of valvular disease.

37. Left Atrial Appendage Mechanical Dysfunction in De Novo Organized Left Atrial Tachyarrhythmia: A Multicenter Pre-Ablation Study.

期刊: Echocardiography (Mount Kisco, N.Y.) 发表日期: 2026-Jul 链接: PubMed

摘要

Whether de novo organized left atrial tachyarrhythmia (LAT) shows preserved left atrial appendage (LAA) mechanics has not been adequately characterized. We compared LAA peak emptying velocity across atrial fibrillation (AF) phenotypes and de novo LAT. Multicenter retrospective cohort of 634 consecutive first-ablation candidates undergoing pre-ablation transesophageal echocardiography (TEE) at five centers: paroxysmal AF (PAF, n = 146), persistent AF (PeAF, n = 310), long-standing persistent AF (LsPeAF, n = 86), and LAT (n = 92). Markedly reduced LAA function was peak emptying velocity <25 cm/s. Multivariable regression adjusted for rhythm during TEE, CHA2DS2-VASc, body mass index (BMI), left ventricular ejection fraction (LVEF), and left atrial (LA) diameter. Mean LAA velocity was 55.7 ± 19.4 (PAF), 44.3 ± 18.5 (PeAF), 31.0 ± 12.5 (LsPeAF), and 36.6 ± 13.5 cm/s (LAT); p < 0.001. LAT lay closer to LsPeAF than to PAF and did not differ from LsPeAF (Tukey p = 0.140). Prevalence of velocity <25 cm/s: 2.7%, 11.9%, 32.6% and 18.5% (p < 0.001). After adjustment, larger LA diameter (β = -0.53/mm, p < 0.001) and higher CHA2DS2-VASc (β = -1.93/point, p < 0.001) were independently associated with lower velocity. Compared with LAT, PAF had lower odds of velocity <25 cm/s (OR 0.19, 95% CI 0.06-0.62). De novo organized LAT exhibits LAA mechanical dysfunction comparable to long-standing persistent AF rather than to PAF. Organized rhythm does not imply preserved appendage function. LAA peak emptying velocity may serve as a functional remodeling marker for pre-ablation phenotyping.

38. Determinants of Infant and Young Child Feeding Practices of Children With Severe Acute Malnutrition in Agrarian and Pastoralist Settings of Ethiopia.

期刊: Maternal & child nutrition 发表日期: 2026-Jul 链接: PubMed

摘要

Previous research has established determinants of young child feeding (IYCF) practices in the general child population, but determinants of these practices in children with severe acute malnutrition (SAM) are unknown. This study assessed the determinants of IYCF practices among children aged 6-23 months with SAM and under SAM treatment in a pastoralist and a predominantly agrarian setting in Ethiopia. As part of the baseline survey for the R-SWITCH cluster randomized control trial, we screened ~28,000 under-fives and included 486 children aged 6-23 months with SAM and under SAM treatment. Multivariable regression analysis was used to identify determinants on household, caregiver and child levels. Minimum meal frequency (MMF) was similar between children from the agrarian (53.9%) and pastoralist (51.9%) setting. The prevalence of children with minimum dietary diversity (MDD) was low overall but higher among pastoralist children (31.5%) than children from the agrarian setting (19.0%; p = 0.012). The consumption of egg/flesh foods was lower among pastoralist children (5.6%) than agrarian children (16.9%, p = 0.085). Caregiver literacy was positively associated with a higher likelihood of MMF (IRR = 1.21; 95% CI:1.02-1.43; p = 0.030), while caregiver depression was associated with a lower likelihood of MMF (RR = 0.97; 95% CI:0.95-0.99; p = 0.003). Improved water source (RR = 1.59; 95% CI:1.06-2.38; p = 0.037), caregiver literacy (RR = 2.04; 95% CI:1.25-3.34; p = 0.002), caregiver MDD (RR = 2.21; 95% CI:1.60-3.05; p ≤ 0.001), older children(RR = 1.05; 95% CI: 1.02-1.08;p ≤ 0.001), and pastoralist setting (RR = 1.62; 95% CI:1.07-2.44; p = 0.014) were associated with a significantly higher likelihood of meeting MDD. Conversely, caregiver depression (RR = 0.94; 95% CI:0.90-0.97; p < 0.001), caregiver mobility restriction (IRR = 0.94; 95% CI:0.89-1.00; p = 0.025), and food insecurity (RR = 0.64; 95% CI:0.41-1.01; p = 0.05) were associated with reduced MDD likelihood. Caregiver community involvement (IRR = 1.12; 95% CI:1.00-1.26; p = 0.038), caregiver MDD (RR = 1.67; 95% CI:1.10-2.53; p = 0.043), and older children (RR = 1.08; 95% CI:1.05-1.12; p < 0.001) were associated with increased egg/flesh-food consumption among children, while living in a pastoralist setting was associated with reduced it (RR = 0.36; 95% CI:0.13-0.97; p = 0.038). Integrated and Targeted interventions recommended: caregiver literacy/depression support to improve IYCF; livelihood-specific foods (eggs/flesh, fruits/vegetables); WaSH enhancements; community engagement; and IYCF counseling within CMAM programs.

39. Updated structured report for dynamic ultrasonography in patients with suspected or known endometriosis: Recommendations of the international society for gynecologic endoscopy (ISGE).

期刊: European journal of obstetrics, gynecology, and reproductive biology 发表日期: 2026-Jul-01 链接: PubMed

摘要

To update the 2021 International Society for Gynecologic Endoscopy (ISGE) recommendations for structured reporting of dynamic ultrasound findings in patients with suspected or known endometriosis, integrating recent technical and methodological advances and contemporary diagnostic evidence. Study design A multidisciplinary ISGE working group (sonologists, surgeons, radiologists, methodologists) performed a focused, non-systematic literature review (January 2015-September 2025), prioritizing prospective multicentre diagnostic accuracy studies, high-quality cohorts, systematic reviews and intersociety consensus statements. Draft items were derived from validated frameworks (International Deep Endometriosis Analysis, Morphological Uterus Sonographic Assessment, International Endometrial Tumor Analysis, International Ovarian Tumor Analysis) and the #Enzian classification, refined by a writing subgroup and scored iteratively using Delphi rounds. Evidence quality and recommendation strength were graded using the Grading of Recommendations Assessment, Development and Evaluation system. When performed by experienced operators, dynamic ultrasound shows high specificity and generally high sensitivity for ovarian endometriomas, many forms of deep endometriosis, and adenomyosis; sensitivity is more variable, particularly for parametrial involvement and small superficial peritoneal lesions. Structured, compartment-based reporting improved completeness and may increase concordance with intraoperative mapping compared with unstructured reports. The 2026 ISGE update expands the 2021 template with standardized superficial peritoneal descriptors, lateral compartment subdivision (parametrium, pelvic sidewall, pelvic nerve assessment) and detailed quantitative pelvic metrics. Optional advanced fields capture items supported by lower-quality or emerging evidence. Implementation recommendations include targeted training, Picture Archiving and Communication System integration, and staged adoption. The 2026 ISGE structured ultrasound report provides a practical, surgically actionable template. Prospective multicentre validation and standardized training are priorities.

40. Comparative analysis of gut viromes in four penguin species reveals diverse novel viruses and host-associated differences.

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

摘要

Penguins, as distinctive marine birds, play important roles in polar and sub-Antarctic ecosystems, yet the diversity and species-specific distribution of their gut viromes remain insufficiently understood. Here, we used viral metagenomics to characterize the cloacal viromes of four penguin species-Spheniscus humboldti (S. humboldti), Pygoscelis papua (P. papua), Pygoscelis adeliae (P. adeliae), and Aptenodytes forsteri (A. forsteri)-collected at Chimelong Ocean Kingdom. A total of 219 viral sequences representing potentially novel lineages were identified, with more than 94% sharing <80% amino acid similarity with previously known viruses. These sequences were assigned to several viral families, including Parvoviridae, Caliciviridae, Anelloviridae, Circoviridae, and Microviridae, among others. Marked interspecies differences in virome composition were observed: Parvoviridae dominated in S. humboldti, Microviridae were enriched in P. papua, Caliciviridae accounted for a substantial proportion in A. forsteri, and P. adeliae displayed the greatest overall virome diversity. Multiple-virus co-detections, particularly involving Parvoviridae, were frequent in S. humboldti. Phylogenetic analyses showed that many penguin-associated viruses clustered with viruses infecting other avian and fish hosts, suggesting possible dietary or environmental origins of some detected viral sequences. These findings expand current knowledge of penguin gut virome diversity and host-associated differences and provide a valuable foundation for evaluating the ecological roles, health implications, and transmission risks of penguin-associated viruses.IMPORTANCEThis study uncovers significant diversity in the gut viromes of four penguin species, revealing over 219 viral sequences representing potentially novel lineages, many of which showed host-associated distribution patterns. Using viral metagenomics, we identified notable interspecies differences, with Parvoviridae predominating in Spheniscus humboldti and Microviridae being enriched in Pygoscelis papua. These findings highlight the complexity of viral community structures in penguins, including frequent viral co-detections, which could impact host health and ecological adaptation. Additionally, novel bacteriophage communities were identified, emphasizing their potential role in shaping the gut microbiome and influencing viral dynamics. This work provides new insights into viral diversity in wildlife and lays the groundwork for future studies on viral transmission risks and ecological conservation.

41. Liquiritigenin ameliorates adipocyte insulin resistance by inhibiting pro-inflammatory polarization of macrophages via regulation of the mtROS/OXPHOS axis.

期刊: Phytomedicine : international journal of phytotherapy and phytopharmacology 发表日期: 2026-Jun-29 链接: PubMed

摘要

Obesity-induced insulin resistance (IR) is closely associated with chronic inflammation and metabolic dysfunction in adipose tissue, in which macrophage polarization plays a pivotal role. Liquiritigenin (LQ), a natural flavonoid derived from licorice, exhibits potential metabolic regulatory effects; however, its role in high-fat diet (HFD)-induced obesity and insulin resistance, as well as the underlying mechanisms, remains unclear. In this study, an HFD-induced obese mouse model combined with multi-omics analyses and an in vitro co-culture system was employed to investigate the effects of LQ. LQ significantly improved glucose tolerance, insulin sensitivity, and lipid metabolism, and restored the expression of p-IRS1/IRS1, p-AKT/AKT, and GLUT4 in epididymal adipose tissue. Integrated analyses of network pharmacology, transcriptomics, and metabolomics revealed that LQ markedly reversed HFD-induced alterations in oxidative stress, mitochondrial dysfunction, and inflammatory pathways. Mechanistically, palmitic acid (PA) at physiologically relevant concentrations did not directly induce insulin resistance in adipocytes but instead promoted macrophage polarization toward the pro-inflammatory M1 phenotype, thereby impairing adipocyte insulin signaling. Further investigation showed that PA and HFD increased mitochondrial reactive oxygen species (mtROS), disrupted oxidative phosphorylation (OXPHOS), and induced mitochondrial dysfunction in macrophages, ultimately driving M1 polarization; these effects were markedly attenuated by the mtROS scavenger Mito-TEMPO. In contrast, LQ reduced mtROS levels, restored OXPHOS function, and maintained mitochondrial homeostasis, thereby suppressing pro-inflammatory macrophage polarization and improving insulin signaling and glucose uptake in adipocytes. Notably, these effects were more pronounced than those observed with dexamethasone under the same experimental conditions. These protective effects were abolished by the mtROS activator DMNQ. In conclusion, LQ alleviates adipose tissue insulin resistance by modulating macrophage polarization through the mtROS/OXPHOS axis, providing new mechanistic insights into immunometabolic regulation and supporting of applying LQ as a potential phytotherapy strategy for obesity-related metabolic disorders.

42. [COMORBIDITY IN THE HEALTH STATUS OF ADOLESCENTS AND YOUNG ADULTS - REPRESENTATIVES OF GENERATION Z WITH FUNCTIONAL GASTROINTESTINAL DISORDERS].

期刊: Problemy sotsial’noi gigieny, zdravookhraneniia i istorii meditsiny 发表日期: 2026-Jun-27 链接: PubMed

摘要

In the young population, a persistent trend toward an increase in functional gastrointestinal disorders (FGIDs) is observed, with Generation Z representatives showing higher rates. The phenomenon of increased referrals of Generation Z individuals to gastroenterologists for FGIDs is indicative: these conditions account for nearly half of all initial consultations in this age group, driven by a combination of high medical awareness, a tendency toward self-diagnosis, and heightened sensitivity to somatic manifestations of psychoemotional stress. Emotional burnout, resulting from academic and professional workloads amid constant digital engagement, acts as a significant risk factor for reduced adaptive potential and deterioration in somatic and mental health indicators. In adolescents and young adults, multiple concomitant FGIDs are often identified, such as combined irritable bowel syndrome, functional dyspepsia, functional abdominal pain disorders, functional constipation, inflammatory bowel diseases, obesity, and others. FGIDs are frequently classified as disorders of gut-brain interaction (DGBI), reflecting the key role of bidirectional communication between the gut and the brain in their development and their impact on the comorbidity of psychological conditions. Accounting for the specific manifestations of comorbidity in the health status of adolescents and young adults with FGIDs is essential for developing effective treatment and preventive programs. В молодёжной популяции определяется устойчивая тенденция к росту функциональных расстройств желудочно-кишечного тракта (ФР ЖКТ), причём представители поколения Z демонстрируют более высокие показатели. Показателен феномен повышенной обращаемости представителей поколения Z к врачам-гастроэнтерологам по поводу ФР ЖКТ: данные состояния составляют почти половину всех первичных консультаций в данной возрастной группе, что обусловлено сочетанием высокой медицинской информированности, склонности к самодиагностике и повышенной чувствительности к соматическим проявлениям психоэмоционального напряжения. Эмоциональное выгорание, обусловленное академическими и профессиональными нагрузками в условиях постоянной цифровой включённости, выступает значимым фактором риска снижения адаптационного потенциала и ухудшения показателей соматического и ментального здоровья. У подростков и молодёжи часто выявляют несколько сопутствующих ФР ЖКТ, например, сочетанные синдром раздражённого кишечника, функциональная диспепсия, функциональные болевые абдоминальные расстройства, функциональный запор, воспалительные заболевания кишечника, ожирение и др. ФР ЖКТ часто относят к расстройствам взаимодействия кишечника и головного мозга, что отражает ключевую роль двунаправленной коммуникации между кишечником и мозгом в развитии этих расстройств и их влияние на коморбидность психологических состояний. Учёт особенностей проявления коморбидности в состоянии здоровья подростков и молодёжи, имеющих ФР ЖКТ, необходим для построения эффективных лечебно-профилактических программ.

43. [REVIEW OF RESEARCH ON THE ECOLOGY OF STRESS AND ITS IMPACT ON THE RUSSIAN POPULATION].

期刊: Problemy sotsial’noi gigieny, zdravookhraneniia i istorii meditsiny 发表日期: 2026-Jun-27 链接: PubMed

摘要

The article provides a comprehensive assessment of the psychological state of the Russian population in the face of multiple external challenges. According to the April 2024 survey conducted by the All-Russian Public Opinion Research Center, nine out of ten Russians experience stress on a regular basis, with one in five experiencing stress on a regular basis. The index of need for psychological assistance reached 30 out of 100 in late 2024, marking the highest level in the past 15 years. The purpose of this study is to analyze the current state of attitudes towards stress in Russian society based on data from large-scale sociological and psychological studies conducted in 2024-2025. The study examines the factors that influence an environmentally friendly attitude towards stress and the ability to cope with it. The main objectives include systematizing scientific approaches to studying stress, analyzing methods for diagnosing stress conditions, summarizing data on the prevalence of stress among the Russian population, and identifying dominant coping strategies. В статье проведена комплексная оценка психологического состояния российского населения в условиях множественных внешних вызовов. По данным Всероссийского центра изучения общественного мнения за апрель 2024 г., с разной периодичностью со стрессом сталкиваются 9 из 10 россиян, при этом каждый пятый испытывает стресс на регулярной основе. Индекс потребности в психологической помощи в конце 2024 г. достиг 30 пунктов из 100 возможных, что является максимальным показателем за последние 15 лет. Целью настоящего исследования является анализ современного состояния отношения к стрессу в российском обществе на основе данных крупных социологических и психологических исследований 2024—2025 гг. В работе исследованы факторы, влияющие на экологичное отношение к стрессу и умению противостоять ему. Основные задачи включают систематизацию научных подходов к изучению стресса, анализ методов диагностики стрессовых состояний, обобщение данных о распространённости стресса среди населения России и выявление доминирующих копинг-стратегий.

44. [RISK FACTORS FOR MORTALITY AND INJURY IN ROAD TRAFFIC ACCIDENTS].

期刊: Problemy sotsial’noi gigieny, zdravookhraneniia i istorii meditsiny 发表日期: 2026-Jun-27 链接: PubMed

摘要

Road accidents are a significant public health issue and a common cause of death. This article analyzes the main risk factors for road accidents and their impact on road mortality and injury. The most significant of these are speeding, alcohol consumption, and motorcycle use. Age, gender, and mobile phone use while driving are also significant factors. Seasonality, time of day, and road surface quality have a lesser impact on the risk of road accidents. Knowledge of road accident risk factors will enable the implementation of more effective measures to prevent road incidents. This, in turn, will reduce road user fatalities and injuries and reduce the material costs associated with the consequences of road accidents. Дорожно-транспортные происшествия (ДТП) — важная проблема системы здравоохранения и распространённая причина смертности населения. В статье анализируются основные факторы риска ДТП и их влияние на смертность и травматизм на дороге. Наиболее существенные из них — превышение скорости, употребление алкогольных напитков, а также использование в качестве средства передвижения мотоцикла. Кроме того, важно влияние возрастных, гендерных факторов, использование мобильных телефонов за рулём. В меньшей степени на риск возникновения ДТП влияют сезонность, время суток и качество дорожного полотна. Знания о факторах риска ДТП позволят внедрять более эффективные мероприятия в отношении профилактики дорожных инцидентов. Это, в свою очередь, позволит снизить летальность, травматизм участников дорожного движения и уменьшить материальные затраты, связанные с последствиями ДТП.

45. [MEDICAL AND DEMOGRAPHIC INDICATORS IN THE STRUCTURE OF THE INTEGRATED ASSESSMENT OF QUALITY OF LIFE: THEORETICAL AND APPLIED ASPECT].

期刊: Problemy sotsial’noi gigieny, zdravookhraneniia i istorii meditsiny 发表日期: 2026-Jun-27 链接: PubMed

摘要

In the context of modern socio-economic transformations and global challenges to systemic healthcare, the problem of an objective assessment of the quality of life of the population is of paramount importance. Traditional economic indicators (for example, GDP per capita) do not fully reflect the state of public health and social well-being. In this regard, the development of integrated assessment tools synthesizing heterogeneous data is becoming a key task for substantiating management decisions in the field of social and demographic policy. A special role in such systems is played by medical and demographic indicators, which act as objective markers of the quality of human potential. The study is based on data from Rosstat and the Ministry of Health of the Russian Federation for the period 2015-2024 for 85 regions of the Federation. The purpose of the study is to theoretically substantiate and test in practice the methodology of integrated assessment of the quality of life of the population of the subjects of the Russian Federation using a system of key medical and demographic indicators, to determine their structural contribution to the final index. В условиях современных социально-экономических трансформаций и глобальных вызовов системному здравоохранению проблема объективной оценки качества жизни населения приобретает первостепенное значение. Традиционные экономические индикаторы (например, ВВП на душу населения) не отражают в полной мере состояние общественного здоровья и социального благополучия. В этой связи разработка интегральных инструментов оценки, синтезирующих разнородные данные, становится ключевой задачей для обоснования управленческих решений в сфере социальной и демографической политики. Особую роль в таких системах играют медико-демографические показатели, выступающие объективными маркерами качества человеческого потенциала. Исследование основано на данных Росстата и Министерства здравоохранения России за 2015—2024 гг. по 85 субъектам РФ. Цель исследования: теоретически обосновать и апробировать на практике методику интегральной оценки качества жизни населения субъектов РФ с использованием системы ключевых медико-демографических индикаторов, определить их структурный вклад в итоговый индекс.

46. [FORMATION OF A YOUNG DOCTOR'S PRIMARY PROFESSIONAL IDENTITY: THE DEFORMING INFLUENCE OF THE CLINICAL ENVIRONMENT AND ORGANIZATIONAL SUPPORT].

期刊: Problemy sotsial’noi gigieny, zdravookhraneniia i istorii meditsiny 发表日期: 2026-Jun-27 链接: PubMed

摘要

The study aimed to assess the impact of key parameters of the organizational and clinical environment on the formation of the primary professional identity and emotional well-being of a young doctor in order to identify priority areas for changing organizational support. It is concluded that the successful professional development of a medical university graduate, which involves the integration of value-motivational, operational-role, and socio-communicative components, is a critical condition for ensuring the quality of medical care, the emotional well-being of young doctors, and the staff sustainability of the healthcare system as a whole. It is substantiated that overcoming the adaptation crisis requires shifting the focus from the individual competencies of the young specialist to the organizational conditions of his or her work. An important direction for modernizing the human resource policy of healthcare institutions should be the purposeful design of a professionally enriching environment, which includes: reducing bureaucratic dissonance; transforming organizational culture towards a supportive, collegial model; institutionalizing “safe” spaces for professional reflection; rethinking the role of mentoring as an element of the organizational system; and shifting the focus of managerial key performance indicators from formal metrics to indicators of sustainable professional development. В работе ставилась цель оценки влияния ключевых параметров организационно-клинической среды на формирование компонентов первичной профессиональной идентичности и эмоционального благополучия молодого врача для определения приоритетных направлений изменения организационной поддержки. Сделан вывод о том, что успешное профессиональное становление выпускника медицинского вуза, предполагающее интеграцию ценностно-мотивационного, операционально-ролевого, социально-коммуникативного компонентов, является критическим условием для обеспечения качества медицинской помощи, эмоционального благополучия молодого врача и кадровой устойчивости системы здравоохранения в целом. Обосновано, что преодоление кризиса адаптации требует смещения фокуса с индивидуальных компетенций молодого специалиста на организационные условия его работы. Значимым направлением модернизации кадровой политики лечебно-профилактических учреждений должно стать целенаправленное конструирование профессионально-обогащающей среды, которое включает: снижение бюрократического диссонанса; трансформацию организационной культуры в сторону поддерживающе-коллегиальной модели; институционализацию «безопасных» пространств для профессиональной рефлексии; переосмысление роли наставничества как элемента организационной системы; смещение фокуса управленческих ключевых показателей эффективности с формальных показателей на показатели устойчивости профессионального развития.

47. [SOCIAL AND LEGAL ASPECTS OF THE DEVELOPMENT OF RUSSIAN-CHINESE COOPERATION IN THE SPHERE OF PUBLIC HEALTHCARE].

期刊: Problemy sotsial’noi gigieny, zdravookhraneniia i istorii meditsiny 发表日期: 2026-Jun-27 链接: PubMed

摘要

The article discusses the socio-legal aspects of the development mutual cooperation between Russia and China in the public health. This direction of the current Russian-Chinese political agenda is caused by some factors. One of them is the common nature of public health problems and challenges faced by the healthcare systems. Also the reason is the growth of cross-border mobility of the population of both countries, which necessitates coordination of efforts in the field of regulation, ensuring the quality of services, protecting patients rights and epidemiological control. In this regard, the objective of the study is to analyze the key areas, legal mechanisms and social challenges that influence the development of interaction between Russia and China in the field of public health. Based on the results of the study, the main vectors in the Russian-Chinese cooperation in the field of public health are defined. They include: 1) prevention and control of infectious diseases; 2) digital transformation of healthcare; 3) oncology and nuclear medicine; 4) medical education and science; 5) ethical problems. The main mechanisms of interaction between Russia and China in public healthcare are legal regulatory (bilateral agreements, interdepartmental protocols, harmonization of regulatory requirements) and projects in scientific and educational sphere. Overall, cooperation between Russia and China in healthcare is dynamically developing, multifaceted, and promising. However, there are a number of limitations and problems, including cultural barriers, legal restrictions and ethical challenges. To sum up, the Russian-Chinese cooperation in the field of public health has significant potential, but requires the development of a legal framework and a systematic approach. Одним из актуальных направлений в развитии отношений между Россией и Китаем на современном этапе является сотрудничество обоих государств в сфере общественного здравоохранения. Данный вектор российско-китайской политической повестки обусловлен рядом фактором, а именно: общим характером проблем здоровья населения и вызовами, с которыми сталкиваются системы здравоохранения, ростом трансграничной мобильности населения обеих стран, что вызывает необходимость координации усилий в области регулирования, обеспечения качества услуг, защиты прав пациентов и эпидемиологического контроля, которые обусловливают исследовательский интерес к изучению социально-правовых аспектов в развитии российско-китайского сотрудничества в сфере общественного здоровья. В этой связи цель данного исследования заключается в проведении анализа ключевых направлений, правовых механизмов и социальных вызовов, которые влияют на развитие взаимодействия между Россией и Китаем в сфере общественного здоровья. По результатам проведённого исследования на основе принципа методологической триангуляции были выявлены основные векторы в российско-китайском сотрудничестве в сфере общественного здоровья: 1) профилактика и борьба с инфекционными заболеваниями (в 2025 г. Россия и Китай подписали меморандум о сотрудничестве в области борьбы с инфекционными болезнями); 2) цифровая трансформация здравоохранения (в 2025 г. Минздрав России и Государственный комитет КНР по здравоохранению подписали Меморандум о взаимопонимании в области цифровой трансформации здравоохранения); 3) онкология и ядерная медицина; 4) медицинское образование и наука (образована Российско-Китайская ассоциация медицинских университетов, которая способствует обмену специалистами, разработке совместных образовательных программ и взаимному признанию дипломов о медицинском образовании). Основными механизмами взаимодействия России и Китая в сфере общественного здравоохранения выступают: нормативно-правовые (двусторонние соглашения, межведомственные протоколы, гармонизация регуляторных требований) и научно-образовательные (совместные исследования, обмен кадрами, образовательные программы). В целом, сотрудничество России и Китая в сфере здравоохранения можно охарактеризовать как динамично развивающееся, многогранное и перспективное. Однако есть ряд ограничений и проблем, включая культурные барьеры, правовые ограничения и этические вызовы. Сделан вывод о том, что российско-китайское сотрудничество в сфере общественного здоровья имеет значительный потенциал, но требует разработки правовой базы и системного подхода.

48. [CORPORATE HEALTH IN THE PERSONNEL MANAGEMENT SYSTEM: THE THEORETICAL ASPECT].

期刊: Problemy sotsial’noi gigieny, zdravookhraneniia i istorii meditsiny 发表日期: 2026-Jun-27 链接: PubMed

摘要

The article considers corporate health as an important element of the modern HR management system. The relevance of the topic is due to the shift in the management paradigm from a narrow understanding of occupational safety to a broader approach that includes the physical, mental and social well-being of employees as a resource for the sustainability of the organization. It is shown that the concept of corporate health is formed at the intersection of human resource management, occupational safety, organizational psychology and workplace well-being policy. It is proved that, theoretically, corporate health should be considered not as a set of disparate wellness activities, but as an integrated subsystem of personnel management related to the quality of the work environment, organizational support, employee participation practices, occupational risk prevention and the development of well-being-oriented HR practices. It is concluded that corporate health is both a factor in preserving human capital, a tool for improving organizational stability, and an indicator of the maturity of personnel policy. В статье рассматривается корпоративное здоровье как значимый элемент современной системы кадрового менеджмента. Актуальность темы обусловлена смещением управленческой парадигмы от узкого понимания охраны труда к более широкому подходу, включающему физическое, психическое и социальное благополучие работников как ресурс устойчивости организации. Показано, что концепт корпоративного здоровья формируется на стыке управления человеческими ресурсами, охраны труда, организационной психологии и политики благополучия на рабочем месте. Обосновывается, что в теоретическом плане корпоративное здоровье следует рассматривать не как набор разрозненных wellness-мероприятий, а как интегрированную подсистему кадрового менеджмента, связанную с качеством трудовой среды, организационной поддержкой, практиками участия работников, профилактикой профессиональных рисков и развитием well-being-ориентированных HR-практик. Делается вывод о том, что корпоративное здоровье выступает одновременно фактором сохранения человеческого капитала, инструментом повышения организационной устойчивости и индикатором зрелости кадровой политики.

49. [THE MAIN FACTORS OF HEALTH SYSTEM RESILIENCE IN DIFFERENT CRISIS SITUATIONS].

期刊: Problemy sotsial’noi gigieny, zdravookhraneniia i istorii meditsiny 发表日期: 2026-Jun-27 链接: PubMed

摘要

This article considers the main approaches to assessing the sustainability of the health care system in the development of emergencies of different nature. Based on the analysis and synthesis of data from foreign publications, the most significant factors affecting the efficiency of functioning of national health care systems, as well as the characteristics of their resilience to crisis phenomena are systematised. Experts consider flexible resource management, training of qualified and motivated medical personnel, the possibility of redistribution of powers within the system, both horizontally and vertically, as well as intersectoral cooperation in overcoming crisis situations as the most obvious solutions to improve the viability of the health care system. В статье рассмотрены основные подходы к оценке устойчивости системы здравоохранения в условиях развития чрезвычайных ситуаций различной природы. На основании анализа и обобщения данных зарубежных публикаций систематизированы наиболее значимые факторы, влияющие на эффективность функционирования национальных систем здравоохранения, а также характеристики их устойчивости к кризисным явлениям. Наиболее очевидными решениями по повышению жизнеспособности системы здравоохранения эксперты считают гибкое управление ресурсами, подготовку квалифицированных и мотивированных медицинских кадров, возможность перераспределения полномочий внутри системы как по горизонтали, так и по вертикали, а также межсекторальное взаимодействие в преодолении кризисных ситуаций.

50. Post-intervention effectiveness of a computerized personalized cognitive stimulation program adapted according to cognitive reserve in older adults without cognitive impairment in Primary Care: A randomized clinical trial.

期刊: Archives of gerontology and geriatrics 发表日期: 2026-Jun-27 链接: PubMed

摘要

Cognitive reserve may influence responsiveness to cognitive interventions, yet it is rarely used to tailor computerized stimulation. To evaluate the effectiveness of a computerized cognitive stimulation program personalized according to cognitive reserve on cognition, reserve-related activities, and digital competence in community-dwelling older adults without cognitive impairment in Primary Care. In this randomized clinical trial, 102 adults aged ≥65 years with normal cognitive performance were recruited from three primary care centers in Zaragoza, Spain, and stratified by cognitive reserve level before random allocation to intervention or control. The intervention comprised digital literacy sessions followed by 8 weeks of home-based computerized cognitive stimulation tailored to participants’ cognitive reserve profiles and life history. Controls received a single group-based health education session focused on maintaining everyday cognitive activity. Outcomes were assessed at baseline and post-intervention using global cognition (MEC-35), the Cognitive Reserve Questionnaire, the Mobile Device Proficiency Questionnaire-16, and domain-specific neuropsychological tests. A total of 100 participants completed the final evaluation and were included in complete-case analyses. Compared with controls, the intervention group showed greater adjusted post-intervention improvements in global cognition (MEC-35 between-group difference: 1.8 points) and several cognitive measures, including temporal orientation, calculation, attention, praxis, verbal fluency, processing speed, executive functions, and verbal learning. CRQ scores and digital competence also improved, with small-to-large effect sizes. A computerized cognitive stimulation program adapted according to cognitive reserve appears feasible in Primary Care and may improve cognition, engagement in reserve-related activities, and digital competence in older adults without cognitive impairment.

51. [EFFECTIVENESS OF DIGITAL SOLUTIONS FOR HEALTH MONITORING OF VESSEL CREW MEMBERS].

期刊: Problemy sotsial’noi gigieny, zdravookhraneniia i istorii meditsiny 发表日期: 2026-Jun-27 链接: PubMed

摘要

The article explores the current issue of medical support for merchant ship crews working in conditions of prolonged professional isolation, limited access to qualified medical care, and specific risk factors of the maritime environment. The author conducts a systematic analysis of modern digital healthcare technologies, such as wearable biometric devices, telemedicine platforms, mobile medical applications, and cloud-based data storage systems, in terms of their applicability for continuous monitoring of seafarers health during voyages. The paper presents an original methodology for assessing the comprehensive effectiveness of the implementation of digital monitoring systems, based on a multi-criteria weighted matrix, where the components correspond to medical, technical, ergonomic (household), economic, and compliance with standards. A target efficiency threshold of 0.85 has been established, which provides for a 15% reserve for possible technical failures, human factors, and unforeseen circumstances. Based on the analysis, a set of practical recommendations has been formulated for shipping companies and regulatory authorities. The results of the study allow for the optimization of health-saving strategies in the maritime industry, reducing occupational risks, improving the availability of medical care, and minimizing economic losses associated with crew illnesses during voyages. The proposed methodology can be adapted for other industries with similar working conditions. В статье исследуется актуальная проблема медицинского обеспечения экипажей судов торгового флота, работающих в условиях длительной профессиональной изоляции, ограниченного доступа к квалифицированной медицинской помощи и специфических факторов риска морской среды. Автор проводит системный анализ современных цифровых технологий здравоохранения — носимых биометрических устройств, платформ телемедицины, мобильных медицинских приложений и облачных систем хранения данных — с точки зрения их применимости для непрерывного мониторинга состояния здоровья моряков в рейсовых условиях. В работе представлена оригинальная методология оценки комплексной эффективности внедрения цифровых систем мониторинга, основанная на многокритериальной взвешенной матрице, где компоненты соответствуют медицинской, технической, эргономической (бытовой), экономической эффективности и соответствию стандартам. Установлен целевой пороговый показатель эффективности 0,85, что предусматривает 15% резерв на возможные технические сбои, человеческий фактор и непредвиденные обстоятельства. На основе проведённого анализа сформулирован комплекс практических рекомендаций для судоходных компаний и регуляторных органов. Результаты исследования позволяют оптимизировать стратегии здоровьесбережения в морской отрасли, снижая профессиональные риски, улучшая доступность медицинской помощи и минимизируя экономические потери, связанные с заболеваниями экипажей в рейсах. Предложенная методология может быть адаптирована для других отраслей с аналогичными условиями труда.

52. [TECHNOSTRESS AS A NEW FACTOR DISTURBING THE PSYCHOLOGICAL HEALTH OF SEAMEN].

期刊: Problemy sotsial’noi gigieny, zdravookhraneniia i istorii meditsiny 发表日期: 2026-Jun-27 链接: PubMed

摘要

Maritime service is a challenging profession. In addition to demanding physical labor under real risks to life and health, it requires seafarers not only to forgo many aspects of psychological well-being but also to embrace new digital challenges. Intensive work involving modern information technology is accompanied by a number of undesirable consequences (cognitive overload, emotional distress, the erosion of boundaries between work and personal life, etc.), which lead to decreased job satisfaction and pose risks to psychological health. In this article, the author explores the etymology of the concepts of «occupational stress» and «technostress,» identifies stress factors in seafarers professional activities, and identifies the main signs of psychological disorders associated with the development of advanced technologies. Based on the research results, practical recommendations for preventing the development of negative trends are formulated. Морская служба — это одна из сложных профессий. Помимо тяжёлого физического труда в условиях настоящей опасности для жизни и здоровья, она требует от моряков не только разлуки со многими составляющими психологического комфорта, но и принятия новых цифровых вызовов. Интенсивная работа, связанная с современными информационными технологиями, сопровождается рядом нежелательных последствий (когнитивная перегрузка, эмоциональный дистресс, разрушение границ между работой и личной жизнью и пр.), которые провоцируют снижение удовлетворённости работой и создают риски для психологического здоровья. В представленной статье автором раскрыта этимология понятий «профессиональный стресс» и «техностресс», выявлены стресс-факторы профессиональной деятельности моряков, а также установлены основные признаки проявления психологических расстройств в связи с развитием прогрессивных технологий. На основе результатов исследования сформулированы практические рекомендации по предупреждению развития негативных тенденций.

53. [REGULATORY AND LEGAL REGULATION OF WORKING HOURS OF MEDICAL WORKERS].

期刊: Problemy sotsial’noi gigieny, zdravookhraneniia i istorii meditsiny 发表日期: 2026-Jun-27 链接: PubMed

摘要

The article analyzes the legal regulation of working hours of medical workers in Russia. The relevance of the study is due to the increased social significance of the MRs work, which is carried out in special conditions associated with high psychoemotional stress, responsibility for the life and health of patients, and the need to ensure round-the-clock availability of medical care. The purpose of the work is to identify systemic contradictions and gaps in the legal regulation of MRs working hours and to develop proposals for improving current legislation. The research applied general scientific methods (system analysis, synthesis, comparison) and private scientific methods (formal legal, comparative legal, legal modeling method). The author applies an integrated approach when considering the institution of MR working time as a complex, multicomponent phenomenon located at the intersection of labor, administrative and medical law. The paper identifies and characterizes the specifics of the application of the general norms of the Labor Code of the Russian Federation in relation to MR, analyzes the special norms enshrined in subordinate regulatory legal acts, and determines their relationship with the constitutional principles of health protection and the right to favorable working conditions. As a result of the research, the types of working time accounting used in medical organizations (daily, cumulative) are systematized, the specifics of establishing reduced working hours are detailed, and the legal working hours at night, weekends, and non-working holidays are analyzed. The key problems of law enforcement practice related to violations of standard working hours, failure to account for overwork, and a formal approach to shift schedules have been identified. Specific proposals have been formulated to improve legislation aimed at optimizing legal mechanisms for regulating working hours, taking into account the need to maintain a balance between the interests of patients (continuity and quality of care) and the rights of MR (occupational safety, recreation, prevention of professional burnout). В статье проведён анализ нормативно-правового регулирования рабочего времени медицинских работников (МР) в России. Актуальность исследования обусловлена повышенной социальной значимостью труда МР, который осуществляется в особых условиях, сопряжённых с высокой психоэмоциональной нагрузкой, ответственностью за жизнь и здоровье пациентов, необходимостью обеспечения круглосуточной доступности медицинской помощи. Цель работы заключается в выявлении системных противоречий и пробелов в правовом регулировании рабочего времени МР и разработке предложений по совершенствованию действующего законодательства. В рамках исследования применялись общенаучные методы (системный анализ, синтез, сравнение) и частно-научные методы (формально-юридический, сравнительно-правовой, метод правового моделирования). Автор применяет комплексный подход при рассмотрении института рабочего времени МР как сложного, многокомпонентного явления, находящегося на стыке трудового, административного и медицинского права. В работе выявлена и охарактеризована специфика применения общих норм Трудового кодекса РФ в отношении МР, проанализированы специальные нормы, закреплённые в подзаконных нормативных правовых актах, и определена их взаимосвязь с конституционными принципами охраны здоровья и права на благоприятные условия труда. В результате исследования систематизированы виды учёта рабочего времени, применяемые в медицинских организациях (подённый, суммированный), детализированы особенности установления сокращённой продолжительности рабочего времени, а также проанализированы правовые режимы работы в ночное время, выходные и нерабочие праздничные дни. Выявлены ключевые проблемы правоприменительной практики, связанные с нарушением нормативной продолжительности рабочего времени, неучётом переработок, формальным подходом к составлению графиков сменности. Сформулированы конкретные предложения по совершенствованию законодательства, направленные на оптимизацию правовых механизмов регулирования рабочего времени с учётом необходимости соблюдения баланса между интересами пациентов (непрерывность и качество помощи) и правами МР (охрана труда, отдых, профилактика профессионального выгорания).

54. The use of teleorthodontics and artificial intelligence for orthodontic triage and screening in a publicly funded healthcare system: A crossover randomized controlled trial.

期刊: European journal of orthodontics 发表日期: 2026-Jun-02 链接: PubMed

摘要

Artificial intelligence has been gaining popularity in all fields of dentistry. Orthodontic screening is needed to categorize patients for treatment eligibility and urgency of care in public orthodontic clinics. However, screening is time consuming due to high demand. This is the first study to investigate the use of artificial intelligence-supported teleorthodontics for orthodontic screening and triage. The objective of this study was to investigate the validity of teleorthodontics and artificial intelligence (TAI) in orthodontic screening and triage in comparison to face-to-face (F2F) screening. This study was designed as a single-centre crossover randomized controlled trial. A total of 255 patients referred for public orthodontic treatment were randomized into two sequences: control, F2F triage first, and test, TAI triage first. A total of 178 participants completed the trial (age range: 7-38 years) with 95 participants enrolled initially to the control and 83 to the test sequence, respectively. For TAI triage, patients submitted intraoral scans using Dental Monitoring™ (DM™), extraoral photos, and an online patient history survey. After a 2-month washout period, participants were re-triaged with the other method. The primary outcome was the validity of TAI triage in referral acceptance or rejection based on a minimum Index of Orthodontic Treatment Need (IOTN) Dental Health Component (DHC) threshold of ≥3. Secondary outcomes were diagnostic validity of TAI for all IOTN grades, at referral acceptance threshold IOTN ≥ 4, and triage duration comparison. Patients were randomized using a permuted randomized block design (allocation ratio 1:1). Investigators and participants could not be blinded to sequence allocation. Referral acceptance or rejection at IOTN ≥ 3, TAI triage had a sensitivity of 1, a specificity of 0.67, and an overall diagnostic accuracy of 0.98, with three referrals incorrectly rejected by TAI. Artificial intelligence could not detect OB and OJ correctly for some patients and did not measure important traits, including crossbite, contact point displacement, and functional shift. Teleorthodontic triage duration was 2.9 times faster than F2F. This study was conducted in a public orthodontic clinic, and results apply to this setting when using IOTN and the hybrid method used in this investigation. Teleorthodontics combined with DM™ is a valid and reliable tool for orthodontic screening of patients with mild and severe malocclusions but cannot be used to confidently assign IOTN-DHC grade for patients with borderline malocclusion severity yet. The duration of screening is significantly shorter using TAI. Australian New Zealand Clinical Trials Registry ID: ACTRN12623000327684.

55. Parvovirus B19 infection presenting as polyarthritis: a nationwide clinical and epidemiological study.

期刊: ARP rheumatology 发表日期: 2026 链接: PubMed

摘要

Viral arthritis accounts for approximately 1% of acute arthritis cases and may be caused by several viruses, particularly parvovirus B19 (B19V). Diagnosis relies on clinical presentation, B19V immunoglobulin M (IgM) and/or immunoglobulin G (IgG) seropositivity, and the exclusion of other infectious and non-infectious etiologies. Following a European outbreak of B19V between March and May 2024, we conducted a multicenter retrospective study. The primary outcomes were the clinical and laboratory manifestations of B19V-associated arthritis; secondary outcomes included progression to chronic inflammatory disease and the need for escalation to disease-modifying antirheumatic drugs (DMARDs). A total of 28 patients (25 women and 3 men) were included, with a mean age of 44±11.4 years; 16 patients (57.1%) reported epidemiological risk factors. Acute, additive, symmetrical inflammatory polyarthralgia was the predominant clinical feature (26 patients, 92.9%), while axial inflammatory pain was reported by four patients (14.3%). Laboratory evaluation revealed positivity for antinuclear antibody (ANA) in 32.1%, rheumatoid factor (RF) in 19.7%, and HLA-B27 in 7.1% of patients. Anti-double-stranded DNA (dsDNA) and anti-cyclic citrullinated peptide antibodies (ACPA) were negative in all cases. Complement consumption was observed in a minority of patients, with low C3 levels in four (14.3%) and low C4 levels in three patients (10.7%). Regarding treatment, 39.3% of patients received nonsteroidal anti-inflammatory drugs (NSAIDs), while 60.7% were treated with systemic corticosteroids (prednisolone 10-40 mg/day); one patient required intravenous methylprednisolone (125 mg). Clinical remission was achieved in 24 patients (85.7%) after a mean duration of 34±47.0 days. However, four patients experienced relapse during corticosteroid tapering, suggesting potential progression to a chronic inflammatory condition. Among these, one patient achieved adequate symptom control with intermittent courses of NSAID alone, whereas the remaining three required initiation of DMARD therapy. This study provides one of the most comprehensive characterizations of B19V-associated arthritis in immunocompetent adults. Our findings emphasizes B19V infection as a significant viral mimic of early inflammatory rheumatic diseases and suggests considering it in the differential diagnosis of acute polyarthritis. Moreover, our study highlights the uncommon but notable potential of B19V infection to induce persistent inflammatory responses requiring immunosuppressive therapy.

56. Serum caspase-1 is correlated with vasculitis activity at diagnosis and associated with all-cause mortality in patients with antineutrophil cytoplasmic antibody-associated vasculitis.

期刊: ARP rheumatology 发表日期: 2026 链接: PubMed

摘要

Caspase-1, a key protein involved in the inflammasome activation pathway, induces pyroptosis and inflammasome-mediated cytokine activation and release. In this study, we investigated whether serum caspase-1 could guess cross-sectional vasculitis activity and predict future all-cause mortality in patients with antineutrophil cytoplasmic antibody-associated vasculitis (AAV). This study included 73 patients with AAV. Their clinical data at AAV diagnosis and during follow-up were collected and recorded. Disease activity was assessed using the Birmingham vasculitis activity score (BVAS). Serum caspase-1 was measured from the stored sera collected at AAV diagnosis. The end-point of a poor outcome in this study was set as all-cause mortality. The median age of the 73 patients was 64.0 years, and 30 and 43 patients were male and female, respectively. The median BVAS was 5.0, and the median levels of serum caspase-1 were 124.2 pg/mL. During follow-up, the rate of all-cause mortality was identified as 8.2%. Serum caspase-1 was positively correlated with BVAS (r = 0.241, P = 0.040). In multivariable Cox proportional analysis, serum caspase-1 (hazard ratio [HR] 1.003, 95% confidence interval [CI] 1.000, 1.006) along with dyslipidaemia (HR 36.610, 95% CI 2.050, 653.701) at AAV diagnosis were significantly and independently associated with all-cause mortality during follow-up in patients with AAV. This study demonstrated that serum caspase-1 at AAV diagnosis could guess cross-sectional AAV activity, as represented by BVAS and further predict future all-cause mortality during follow-up in patients with AAV.