公共卫生研究摘要 (2026-07-10)

共收录 50 篇研究文章

1. Comprehensive Care Goals in Myasthenia Gravis: Expert Consensus Recommendations Using the RAND/UCLA Appropriateness Method.

期刊: Neurology. Clinical practice 发表日期: 2026-Aug 链接: PubMed

摘要

Goals for comprehensive care are important in the management of individualized treatment for patients with myasthenia gravis (MG), a disease with variable presentation and degrees of severity. Yet there is limited guidance on how comprehensive care should be achieved and implemented. We present global consensus recommendations for comprehensive care of patients with MG. An international panel of experts was formed, and a targeted literature review was conducted to inform the recommendations. A steering committee selected relevant topics and draft recommendations were developed for each topic. Formal consensus was achieved using the RAND/UCLA appropriateness method. Seventeen panelists from North America, Europe, and Asia rated statements online from 1 (“extremely inappropriate”) to 9 (“extremely appropriate”) and provided comments and suggestions for modifications. The methodologist modified statements for further rating, based on panel scores and feedback. Statements achieving agreement as appropriate by 4 rounds of rating were accepted. Consensus was achieved for 21 statements. Statement 1 defined the ongoing treatment goal: “to work toward, achieve, and sustain minimal symptoms and treatment-related adverse events, with a patient-acceptable quality of life (using validated measures)”. Subsequent statements described implementation of this goal and covered: early control of symptoms; establishing and sustaining a treatment goal; vaccination and screening for infection; family planning/pregnancy; management of fatigue and comorbidities; and management of impending crisis and crisis. Expert consensus was achieved on a series of global recommendations for comprehensive care goals, which has implications for improved disease outcomes and health-related quality of life for patients with MG. These recommendations will require updating as treatment paradigms evolve.

2. Altered EEG in Creutzfeldt-Jakob Disease: Improving Diagnostic Accuracy Using American Clinical Neurophysiology Society 2021 Criteria.

期刊: Neurology. Clinical practice 发表日期: 2026-Aug 链接: PubMed

摘要

Creutzfeldt-Jakob disease (CJD) is a rapidly progressive neurodegenerative disease characterized by significant changes in EEG and structural alterations on MRI. Both are integrated in the current World Health Organization (WHO) surveillance criteria of CJD. We aimed to re-evaluate the EEG recordings, along with clinical and MRI data, in patients with different subtypes of definite CJD by applying the adapted American Clinical Neurophysiology Society (ACNS) criteria, 2021. Fifty-one routine EEG recordings in 16 patients with sporadic CJD were reanalyzed. Generalized slowing, according to standard terminology, was present in 94% of patients. Generalized periodic discharges (GPDs) and generalized rhythmic delta activity (GRDA), as defined by the 2021 ACNS criteria, occurred frequently (31% and 38%, respectively). The differentiation from ictal activity may be challenging because 25% (4/16) of the patients fulfilled the criteria of the recently proposed ictal-interictal continuum (IIC) in at least 1 EEG. By contrast, no status epilepticus (SE) was observed. The EEG alterations varied among the different CJD molecular subgroups: more cortical involvement in MM/MV1 and mixed MM/MV1 + 2C histotypes was associated with periodic discharges (PDs) (57% and 80%) and also IIC (43% and 20%). We could not detect any PD or IIC in patients with the VV1 or MV2K (predominant subcortical pathology) histotype. Assessing the EEGs according to the 2021 ACNS criteria may help prevent misdiagnosis of nonconvulsive status epilepticus, and repetitive recordings may help in earlier diagnosis of CJD.

3. Outcomes and Cost-Effectiveness of an Interdisciplinary Clinic for Functional Neurologic Disorders.

期刊: Neurology. Clinical practice 发表日期: 2026-Aug 链接: PubMed

摘要

Functional neurologic disorder (FND) is a common and disabling condition associated with diagnostic delays, poor outcomes, and fragmented care. Evidence for interdisciplinary models within public health systems is limited. We evaluated outcomes and cost-effectiveness of an interdisciplinary FND clinic in a public hospital. We conducted a prospective observational cohort study of 101 individuals referred to a public interdisciplinary FND clinic in Sydney, Australia. All patients received neuropsychiatric assessment and multidisciplinary team discussion involving psychology, physiotherapy, and occupational therapy to guide ongoing care. Forty-two patients in addition completed a 6-week structured psycho-behavioral group program. Outcomes were assessed at intake, 1-week, 3-month, and 6-month follow-up using measures of functioning (World Health Organization Disability Assessment Scale total score 2.0), quality of life (EQ-5D-5L, SF-36), psychological distress (K10), somatic symptom burden Patient Health Questionnaire-15 (PHQ-15), and clinical severity (CGI-S/I, HoNOS). Mixed-effects models were used to assess repeated longitudinal change. Cost-effectiveness was evaluated using EQ-5D utilities and incremental cost-effectiveness ratios (ICERs). Across the full cohort, CGI-S improved by -1.02 points at 6 months (95% CI -1.28 to -0.77; d = 0.95). In adjusted observational analyses, between-group differences were examined across clinical, functional, and economic outcomes. Compared with standard care, the intervention group showed greater CGI-S improvement at 3 months (B = -0.81, 95% CI -1.19 to -0.43; d = 0.92) and 6 months (B = -0.88, 95% CI -1.35 to -0.41; d = 0.99). SF-36 social functioning scores improved at 6 months (+17.1, 95% CI + 6.2 to +28.1; d = 0.68). PHQ-15 scores decreased (-2.1, 95% CI -4.1 to -0.1). The intervention generated an estimated +0.16 quality-adjusted life year (QALYs) over 12 months (95% CI 0.08 to 0.23), corresponding to an ICER of AU$9,093 per QALY (95% CI $6,077.88 to $18,332.89). Participation in an interdisciplinary FND clinic with an embedded brief psycho-behavioral program was associated with clinically meaningful improvements and favorable cost-effectiveness estimates. Findings support consideration of interdisciplinary, psychologically informed FND services within public health systems.

4. Addressing the Public Health Threat of Steatotic Liver Disease in Mexico.

期刊: Archives of medical research 发表日期: 2026-Jul-09 链接: PubMed

摘要

Liver diseases constitute the fifth leading cause of death in Mexico, and metabolic dysfunction-associated steatotic liver disease (MASLD) is one of the main causes. MASLD, formerly known as non-alcoholic fatty liver disease (NAFLD), is estimated to affect one in three adults worldwide, and limited evidence suggests that its prevalence in Mexico may approach 50%. Social and commercial determinants of health are key drivers of this situation, and genetic susceptibility also appears to play a notable role. MASLD is increasingly recognized as a condition requiring multidisciplinary collaboration across multiple disease specialties, since it shares risk factors, pathophysiological mechanisms, and clinical trajectories with obesity, type 2 diabetes, dyslipidemia, and cardiovascular disease. While some of the building blocks for an effective response to MASLD and other forms of steatotic liver disease (SLD) are already in place in Mexico, there is an unrealized opportunity for the national health system and medical community to define and implement a more cohesive and effective public health response. Recommendations include increasing the timely diagnosis of SLD and improving models of care. More broadly, MASLD and other forms of steatotic liver disease must be integrated into national noncommunicable disease strategies and clinical practice guidelines, especially those addressing diabetes, obesity, and unhealthy lifestyles. Mexico should also strengthen multisectoral policies regarding unhealthy foods and alcohol, improve healthcare coverage, and invest in research and innovation to contribute to equitable and comprehensive care for MASLD and other forms of SLD, such as alcohol-related liver disease.

5. Moderate-to-vigorous physical activity and cognition among older adults in China: Mediation by depressive symptoms and moderation by age.

期刊: Public health 发表日期: 2026-Jul-09 链接: PubMed

摘要

To examine the association between moderate-to-vigorous physical activity (MVPA) and global cognitive function among older Chinese adults, and to assess the mediating role of depressive symptoms and moderating role of age in this association. Cross-sectional, survey-weighted analysis of CHARLS 2020. We analysed data from 5318 community-dwelling adults aged ≥60 years participating in the 2020 wave of the China Health and Retirement Longitudinal Study (CHARLS). MVPA was derived from the International Physical Activity Questionnaire-Short Form, and global cognition was assessed using education-adjusted z-scores constructed from episodic memory, figure drawing, and mental status items. Depressive symptoms were measured with the 10-item Center for Epidemiologic Studies Depression Scale (CES-D-10). Survey-weighted linear regression models estimated associations between MVPA and cognition, progressively adjusting for sociodemographic, health, and behavioral covariates. Bias-corrected bootstrapped mediation analyses quantified the indirect association via depressive symptoms, and interaction terms with age tested moderation. All analyses incorporated survey weights, clustering, and stratification. Weighted mean age was 69.8 years, and 50.1% of participants were women; 32.6% met education-adjusted criteria for cognitive impairment. Higher MVPA was positively associated with better cognitive performance in models adjusting for sociodemographic, health, and behavioral factors (standardized β = 0.38, 95% CI 0.34-0.42), with the direct association attenuating but remaining significant after further adjustment for depressive symptoms (β = 0.30, 95% CI 0.26-0.34). Depressive symptoms partially mediated the MVPA-cognition association (indirect effect = 0.08, 95% CI 0.06-0.10), accounting for 21.1% of the total association. Age strengthened the positive MVPA-cognition association (interaction β = 0.025, 95% CI 0.015-0.035), with conditional slopes ranging from β = 0.25 at ∼63 years to β = 0.45 at ∼77 years. Among community-dwelling older Chinese adults, higher MVPA was associated with better global cognitive function, with a meaningful portion of this association statistically attributed to lower depressive symptom burden and stronger effects observed at older ages. Although the cross-sectional design precludes causal inference, these findings support age-attuned MVPA promotion combined with routine mood assessment and support as a pragmatic strategy to help preserve late-life cognitive health.

6. Applying the Brief Interview for Mental Status in a Diverse Home Health Patient Population.

期刊: Journal of the American Medical Directors Association 发表日期: 2026-Jul-09 链接: PubMed

摘要

In 2023, the Brief Interview for Mental Status (BIMS) was added to the Medicare-funded home health (HH) standard patient assessment (Outcomes and Assessment Information Set [OASIS]). This is the first validated cognitive screening tool in the OASIS, but no existing work reports on BIMS implementation in real-world HH clinical practice, overlap between BIMS and clinician-reported cognitive symptoms in the OASIS, or patient characteristics associated with lower BIMS scores. Cross-sectional study. We examined 2023 to 2024 OASIS clinical assessments for 42,745 older (65+) patients at a large, urban HH agency. BIMS scores range from 0 (severe impairment) to 15 (cognitively intact). We describe BIMS score distribution, report overlap between BIMS scores and other OASIS items describing patient cognition, and fit a multivariable model predicting a BIMS score indicating cognitive impairment (score <13). Based on the BIMS score, 78% of patients were cognitively intact, 15% moderately impaired, and 7% severely impaired. Over half (59%) received the maximum possible score of 15, indicating no impairment. Even among those with probable dementia, reported memory deficits, or reported impaired decision-making, one-quarter scored as cognitively intact (25%, 25%, and 22%, respectively). Patients were more likely to score as cognitively impaired if they primarily spoke Spanish (adjusted odds ratio [aOR], 1.58; 95% CI, 1.42-1.76) or another language (aOR, 1.54; 95% CI, 1.41-1.67) compared with English, were non-Hispanic Black (aOR, 1.44; 95% CI, 1.34-1.54), Hispanic (aOR, 1.38; 95% CI, 1.25-1.53), Asian (aOR, 1.34; 95% CI, 1.20-1.48), or other race/ethnicity (aOR, 1.51; 95% CI, 1.35-1.70) compared with non-Hispanic White, or paid for HH using Medicaid compared with traditional Medicare (aOR, 1.34; 1.24-1.44). Findings suggest value in combining BIMS scores with other data elements to inform care planning and indicate a need for additional resources and training to ensure BIMS is implemented as intended across subgroups.

7. Molecular surveillance of coronaviruses in livestock in northern Vietnam.

期刊: Infection, genetics and evolution : journal of molecular epidemiology and evolutionary genetics in infectious diseases 发表日期: 2026-Jul-09 链接: PubMed

摘要

Coronavirus (CoV) infections continue to pose a significant challenge to global public health and food security. The COVID-19 pandemic has underscored the importance of One Health approaches and improved surveillance systems. This is due to the considerable potential of CoVs to infect a broad spectrum of hosts and cause respiratory diseases. The present study investigated CoVs circulating in livestock in northern Vietnam using molecular detection and phylogenetic analysis. A total of 412 samples collected from livestock were analysed for the presence of CoVs, and we detected infectious bronchitis virus (IBV), porcine haemagglutinating encephalomyelitis virus (PHEV), and avian Gamma-CoV. Nearly full-length genomes of IBV and PHEV were obtained in this study. Phylogenetic analysis inferred that the IBV strains detected in this study were GI-13 vaccine-like strains. Furthermore, this study provides the first genome sequences of Vietnamese PHEV strains. The viruses were closely related to the respiratory-variant lineage detected in China, suggesting that the viruses may have entered Vietnam from China; however, further analysis of PHEVs would likely be necessary for a more detailed characterization. Moreover, avian Gamma-CoVs were inferred to be related to migratory birds, thereby suggesting the risk of transmission from migratory birds to livestock. In summary, this study provides insights into the diversity of CoVs in livestock in northern Vietnam. Therefore, continuous surveillance is necessary to prevent further spread of CoVs among livestock.

8. Psychedelics stores, their regulation and public health: knowledge, perceptions, attitudes and opinions of Canadians.

期刊: The International journal on drug policy 发表日期: 2026-Jul-09 链接: PubMed

摘要

Psychedelic retail stores illegally selling psilocybin, DMT and related substances have proliferated in Canada, with close to 60 brick-and-mortar shops documented in 2023. This echoes the pre-legalization and regulation cannabis landscape. Public responses have remained inconsistent, oscillating between de facto tolerance and enforcement of the law, raising concerns among public health authorities and other stakeholders. How to regulate these stores has become a pressing policy question, yet no research has examined what Canadians know, perceive, and think about the stores and their regulation. A web-based survey of 3,674 Canadian adults was conducted in March 2025 via the Léger Opinion online panel. Descriptive and bivariate analyses examine knowledge, perceptions, and attitudes toward regulatory options and their associations with substance use, proximity to stores, and sociodemographic characteristics. Most respondents were unfamiliar with psychedelic stores (79.1%) or the products sold (80.3%). Among those with some familiarity, risk and benefit perceptions coexisted, with ambivalence being the most common configuration. Respondents were equally divided on closing the stores or maintaining the current unregulated status quo. By contrast, 66.6% supported authorization of sales by stores under a regulatory framework, including among respondents with no direct exposure to psychedelics. Large majorities favored public health protection over fiscal considerations, product restrictions, promotion limits, and caps on store numbers. Despite widespread unfamiliarity with psychedelic retail stores and ambivalent perceptions of their potential risks and benefits, Canadians appear more receptive to their authorization under a legal framework than to the status quo. Attitudinal ambivalence suggests that public support is not fixed and may be shaped by the features of the regulatory framework proposed.

9. Testosterone abuse in Brazil: a growing public health challenge.

期刊: Clinics (Sao Paulo, Brazil) 发表日期: 2026-Jul-09 链接: PubMed

摘要

10. The association of dietary inflammatory index with auditory and vestibular disorders in Korean adults: Differential links to peripheral vertigo, hearing loss and tinnitus.

期刊: Clinics (Sao Paulo, Brazil) 发表日期: 2026-Jul-09 链接: PubMed

摘要

The auditory and vestibular systems are crucial for human perception, spatial orientation, and balance control. Dysfunction in these systems is a significant public health issue. This study explores the relationship between the Dietary Inflammatory Index (DII) and auditory-vestibular disorders such as hearing loss, tinnitus, and Peripheral Vertigo (PV). The authors used data from the 2020-2023 Korea National Health and Nutrition Examination Survey (KNHANES) to assess the associations between DII and hearing loss, tinnitus, and PV in Korean adults. A cross-sectional design was employed, with DII calculated based on dietary recall. The study found significant associations between DII and moderate-to-severe hearing loss and PV. Specifically, higher DII scores were associated with an increased odds of hearing loss and PV. Subgroup analyses showed that women and older adults exhibited a stronger association between DII and hearing loss. The present findings suggest an association between higher DII and both hearing loss and PV. However, the cross-sectional design limits causal inference. Future longitudinal studies are needed to confirm the role of dietary inflammation in auditory and vestibular dysfunction.

11. Off-label testosterone therapy is associated with higher long-term cardiovascular risk in men.

期刊: EBioMedicine 发表日期: 2026-Jul-09 链接: PubMed

摘要

Testosterone therapy (TT) is increasingly initiated outside classical hypogonadism, but long-term cardiovascular safety in this context remains uncertain. We assessed whether TT initiation without evidence of hypogonadism is associated with higher long-term cardiovascular risk than TT initiation with evidence of hypogonadism. In this global retrospective real-world cohort study, men aged 30-75 years initiating TT were identified from secondary, de-identified structured EHR data from 123 healthcare organisations. A prespecified 3-year pre-index washout excluded prior TT and major cardiovascular/thromboembolic events. Men initiating TT without evidence of hypogonadism were compared with those with evidence of hypogonadism using 1:1 propensity-score matching. The primary outcome was major adverse cardiovascular events (MACE); secondary outcomes included separately all-cause mortality, myocardial infarction, ischaemic stroke, cardiac arrest, and heart failure. Acute appendicitis served as a negative-control outcome. Among 358,957 TT initiators, 127,152 (35.4%) had no evidence of hypogonadism. After matching, 113,554 pairs were followed for up to 10 years. TT without evidence of hypogonadism was associated with higher risk of MACE (16.53% vs 11.83%; HR 1.51, 1.45-1.56) and all-cause mortality (HR 1.90, 1.79-2.00), with higher risks of ischaemic stroke (HR 1.23, 1.14-1.33), cardiac arrest (HR 1.41, 1.23-1.61), and heart failure (HR 1.32, 1.26-1.39). Race-stratified estimates were directionally consistent but varied in magnitude. The cardiovascular safety of TT appears context-dependent and less favourable when treatment is initiated without evidence of hypogonadism, with clinically relevant heterogeneity across race/ethnicity, supporting biologically informed prescribing and cardiovascular risk surveillance. Deutsche Forschungsgemeinschaft, Schleswig-Holstein Excellence-Chair Program, and Region Stockholm.

12. Dietary Guidelines 2025-2030 For Americans Are Concerning For Liver Health.

期刊: The American journal of gastroenterology 发表日期: 2026-Jul-09 链接: PubMed

摘要

The 2025-2030 Dietary Guidelines for Americans (DGA-2025) introduced substantial changes in nutrition recommendations, including greater emphasis on total protein intake and omission of prior alcohol guidance. We evaluated how individual dietary components-derived from both Healthy Eating Index-2020 (HEI-2020) and z-score models-relate to steatotic liver disease (SLD), fibrosis, and cirrhosis in U.S. adults. We analyzed data from 10,944 adults (NHANES 2017-2023) with 24-hour dietary recall and vibration-controlled transient elastography (VCTE). Dietary exposures included HEI-2020 component scores and energy-adjusted z-scores for DGA-2025-aligned food groups. An alcohol adherence score was derived based on prior DGA-2020 thresholds. Logistic regression and stepwise models were adjusted for sociodemographics, diabetes, obesity, caffeine, and survey design. Several HEI-2020 and z-score components were consistently associated with liver outcomes. High intake of total fruit, whole fruit, vegetables, greens and beans, whole grains, and seafood/plant protein was associated with lower odds of SLD and fibrosis. In contrast, higher intake of red/processed meats, sodium, total protein, saturated fat, and added sugars was associated with a greater prevalence. Alcohol adherence scores were strongly protective across all outcomes. In stepwise models, greens and beans, seafood and plant protein, saturated fat, and alcohol use were retained as independent predictors. Notably, components emphasized in DGA-2025-such as total protein and red meat-were associated with greater fibrosis risk, while several protective components (e.g., greens and beans, seafood/plant protein) were omitted from the updated guidelines. HEI-2020 and z-score models identify multiple protective and adverse dietary components associated with SLD and fibrosis. The findings underscore the importance of component-level nuance-particularly regarding protein sources and alcohol intake-when formulating dietary guidance for liver health.

13. Risk of Severe Coronavirus Disease 2019 (COVID-19) in Pregnant and Postpartum Individuals After the Pandemic Emergency.

期刊: Obstetrics and gynecology 发表日期: 2026-Jul-09 链接: PubMed

摘要

To evaluate the risks of severe coronavirus disease 2019 (COVID-19)-related outcomes among pregnant and postpartum individuals and nonpregnant women during the Delta variant period and after the pandemic emergency ended in the United States. We conducted a retrospective cohort study of 18- to 49-year-old women identified in a national U.S. commercial insurance claims database during the Delta variant (July 1-December 20, 2021) and postemergency periods (May 11, 2023-September 10, 2024). Pregnant and postpartum individuals unvaccinated for COVID-19 during the year before follow-up were propensity score-matched to four nonpregnant women. Primary outcomes were laboratory-confirmed or clinically diagnosed COVID-19 with subsequent COVID-19 hospitalization, pneumonia hospitalization, or a severe composite COVID-19 hospitalization such as acute respiratory failure, intensive care unit admission, acute respiratory distress syndrome, or respiratory support. Among the individuals followed during the Delta variant (1,109,384) and postemergency (878,003) periods, hospitalization rates with COVID-19 were substantially higher among pregnant individuals than among postpartum individuals or nonpregnant women. In propensity score-matched analyses, the risks of all primary outcomes were elevated for individuals who were pregnant during the Delta period, compared with matched nonpregnant women. Although absolute risks of severe COVID-19 outcomes were lower during the postemergency period, the relative risks (RRs) of COVID-19 hospitalization (RR 4.09; 95% CI, 3.65-4.59) and pneumonia hospitalization (RR 2.78; 95% CI, 1.38-4.81) during pregnancy remained elevated. The RR for severe composite COVID-19 hospitalization (RR 2.17; 95% CI, 0.35-6.67) was imprecise, reflecting substantial uncertainty. Risks for severe COVID-19-related outcomes were also elevated postpartum. Sensitivity analyses reinforced these findings. Higher risks of severe COVID-19-related outcomes among pregnant and postpartum individuals have persisted since the resolution of the pandemic emergency.

14. Conservatives Belong in Public Health.

期刊: American journal of public health 发表日期: 2026-Jul-09 链接: PubMed

摘要

Public health depends on trust with the communities it seeks to serve, and yet this trust has historically been difficult to establish within conservative-leaning communities and individuals. Much of the current mistrust of public health professionals is a partisan phenomenon, one that may reflect the progressive slant of programming and policy development within modern public health. In response, we discuss why it would be beneficial to include more conservatives within the profession of public health. We further discuss 6 conservative values-the importance of religious communities and moral narratives, the rich varieties of community expression, the role of the family and other social orders in promoting health, an emphasis on local decision-making, an appreciation for procedural justice, and a cautious approach to large-scale social change-that could help enrich public health theory, research, and practice. We propose several practical strategies for expanding the representation of conservatives within the profession, including surveys of political affiliation, institutions of civil discourse, and intentional recruitment. Public health’s mission of serving all people demands a pluralistic, trust-centered approach that explicitly welcomes conservative voices, communities, and ideas. (Am J Public Health. Published online ahead of print July 9, 2026:e1-e8. https://doi.org/10.2105/AJPH.2026.308532).

15. Matching Pedestrian‒Vehicle Crash Records and Clinical Follow-Up Data to Describe Demographic, Geographic, and Temporal Patterns in Pedestrian Injuries: Chicago, IL, 2018-2022.

期刊: American journal of public health 发表日期: 2026-Jul-09 链接: PubMed

摘要

Objectives. To gain a more comprehensive understanding of the morbidity associated with pedestrian risk in Chicago, Illinois, by probabilistically matching the data of injured pedestrians in standardized police traffic crash reports to their associated emergency department (ED) visit record. Methods. Between 2018 and 2022, we extracted information on pedestrians injured by vehicles as recorded by the Chicago Police Department pedestrians seen at a city ED for injuries sustained by a vehicle. Among matched records, we used descriptive statistics to describe temporal, geographic, and demographic patterns in ED-attended pedestrian injury. We used multivariable regression modeling to calculate incidence rates of ED-attended pedestrian injury across Chicago communities of varying economic hardship. Results. Among 2631 ED patients matched to a police department crash record, 73.9% were initially recorded by police with nonincapacitating injuries or less at the crash scene. Five of the 6 communities with the highest combination of crash frequency and injury severity were among the 40% most economically disadvantaged communities. Conclusions. Incorporation of ED data highlighted pedestrian injuries that would have been missed with police crash data alone, which disproportionately affects economically vulnerable neighborhoods. Public Health Implications. Regular incorporation of pedestrian-injury data from local EDs could help jurisdictions better understand broader public health implications and disparities in pedestrian risk and identify additional opportunities for intervention. (Am J Public Health. Published online ahead of print July 9, 2026:e1-e10. https://doi.org/10.2105/AJPH.2026.308516).

16. Serum aromatic l-amino acid decarboxylase activity as a biomarker for prodromal and manifest Parkinson's disease.

期刊: EBioMedicine 发表日期: 2026-Jul-09 链接: PubMed

摘要

Aromatic l-amino acid decarboxylase (AADC), or dopa decarboxylase (DDC), is a key enzyme in levodopa metabolism. Previous studies suggested that AADC protein levels may be increased in Parkinson’s disease (PD), particularly if treated with levodopa in conjunction with a peripheral decarboxylase inhibitor (PDI). Serum AADC enzyme activity was measured by quantifying ex vivo conversion of levodopa to dopamine, and correlated to diagnosis, disease stage and clinical parameters in (i) n = 43 people with probable prodromal PD; (ii) n = 592 people with early PD (≤5 years since diagnosis), of whom n = 116 unmedicated; (iii) n = 48 medicated people with PD with longer disease duration (>5 years); and (iv) n = 74 non-parkinsonian controls. AADC activity was higher (P < 0.001) in probable prodromal PD (median 44.20 mU/L, IQR 34.30-58.60) and in manifest but unmedicated early PD (median 45.76, IQR 35.50-53.37) than in controls (median 35.09, IQR 26.92-44.49). Although AADC activity increased with disease duration (P < 0.001), there was no difference in AADC activity between probable prodromal and unmedicated manifest PD (P = 0.65). Use of dopaminergic medication increased AADC activity dose-dependently (median AADC in medicated PD: 110.09, IQR 85.44-145.82, P < 0.001). People with PD have higher serum AADC activity than controls, even in prodromal and unmedicated stages, suggesting a process driven by dopaminergic neurodegeneration. In medicated people with PD, AADC activity is markedly and dose-dependently increased. Results suggest that increased AADC activity could serve as an early biomarker for disease in unmedicated patients and that use of dopaminergic medication paradoxically induces AADC. This study was funded by Stichting Alkemade-Keuls. Underlying cohorts were funded by Verily Life Sciences LLC, Radboud University Medical Center, Radboud University, the city of Nijmegen, the Province of Gelderland, ParkinsonNederland, the Dutch Digestive Foundation, Stichting Woelse Waard, Stichting Alkemade-Keuls, the Luxembourg National Research Fund (FNR), and the European Union’s Horizon 2020 research and innovation programme.

17. Reflections on "Conservatives Belong in Public Health".

期刊: American journal of public health 发表日期: 2026-Jul-09 链接: PubMed

摘要

18. Addressing the Key Challenges of Decentralized Clinical Trials in Europe: Multistakeholder Perspective Delphi Study.

期刊: Journal of medical Internet research 发表日期: 2026-Jul-09 链接: PubMed

摘要

Decentralized clinical trials (DCTs) represent an emerging model in clinical research, accelerated by the restrictions imposed during the COVID-19 pandemic. By leveraging digital technologies and local health care resources, DCTs aim to increase accessibility and reduce participant burden compared to traditional site-based models, which often face recruitment failures and high attrition rates. While various regulatory initiatives in Europe, such as the Accelerating Clinical Trials in the European Union program and the European Medicines Regulatory Network recommendation paper (updated in October 2025), have sought to facilitate their implementation, the widespread adoption of DCTs remains limited due to significant operational, regulatory, and technological challenges, including platform fragmentation and gaps in digital literacy. This study aimed to identify and prioritize actionable solutions to the main challenges of DCT implementation in Europe from a multistakeholder perspective, gathering insights to address specific ethical, legal, and operational barriers. Building on a preceding strengths, weaknesses, opportunities, and threats analysis, a 2-round Delphi study was conducted, involving 26 experts in clinical trials, ethics, law, regulation, and patient engagement between March and May 2023. In the first round, 309 open-ended responses were collected via REDCap (Research Electronic Data Capture; Vanderbilt University) surveys and underwent systematic inductive content analysis using ATLAS.ti (ATLAS.ti Scientific Software Development GmbH) with independent double coding. This process resulted in 244 unique proposals that were categorized according to 6 key challenges. In the second round, 39 synthesized proposals were evaluated using a 4-point Likert scale. Consensus was defined as ≥80% agreement on the appropriateness of each proposal. High levels of consensus were achieved, with 32 out of the 39 proposals reaching the threshold and 14 achieving 100% unanimity. Overall, 82% of the proposals were rated as “appropriate” or “very appropriate.” Key recommendations included providing support and training for health care professionals, enhancing investigational medicinal product and biological sample logistics through validated technologies, improving collaboration with local health care providers, fostering regulatory harmonization while respecting national specificities, strengthening capacity-building initiatives, and promoting accessible, user-friendly digital tools supported by hybrid trial models. Conversely, proposals such as peer-to-peer participant support and the centralization of ethics reviews at the European Union level failed to reach consensus. The study offers a prioritized compilation of expert-driven recommendations for overcoming current barriers to DCT implementation in Europe. The adoption of these recommendations could support the development of more inclusive, efficient, and sustainable decentralized research frameworks across diverse health care systems.

19. Adaptation across an extreme elevational gradient in Andean leaf-eared mice, the world's highest-dwelling mammal.

期刊: Science (New York, N.Y.) 发表日期: 2026-Jul-09 链接: PubMed

摘要

Andean leaf-eared mice (Phyllotis vaccarum) live at the highest elevations of any mammal, and they also have the broadest elevational range, from sea level to mountain summits of >6700 meters. Highland populations have evolved an enhanced thermogenic capacity in hypoxia relative to lowland conspecifics, and this improved physiological performance is associated with an increased mitochondrial respiratory capacity in skeletal muscle. Population genomic analyses identified mechanisms of hypoxia adaptation and revealed an unanticipated dimension of environmental adaptation in P. vaccarum because selection on biotransformation pathways suggests an evolved capacity to metabolize plant-derived dietary toxins. The world’s highest-dwelling mammal has adapted to habitats at both the low- and high-elevation limits of its range, and much of the elevation-related selection relates to previously unappreciated aspects of feeding ecology.

20. Landscape of training for non-commissioned officers in difficult conversations with soldiers in their commands.

期刊: Military psychology : the official journal of the Division of Military Psychology, American Psychological Association 发表日期: 2026-Jul-09 链接: PubMed

摘要

Faced with increasing suicide rates in the U.S. Army, efforts are underway to bolster noncommissioned officer (NCO) training as suicide prevention gatekeepers and also to support upstream prevention efforts more generally. This qualitative study examined the literature on best practices for non-clinical suicide prevention and training in the skills necessary to have difficult conversations to identify and address suicide risk factors (e.g. financial and relationship issues, mental health and substance use). We reviewed the empirical literature and conducted structured interviews with key Army leaders, trainers, and NCOs about the current Army training efforts. Interviews revealed multiple enhancements to training being made that are in line with best practices, but some gaps were noted as well. Based on our findings, we recommend that the Army increase the availability of training in how to have difficult conversations (especially “soft skills”), enhance support for skills-building after trainings occur through coaching, mentoring, and performance feedback, clarify that this type of soldier support is part of the NCO role, and more strongly promote the concept that soldier well-being is key to a ready and resilient force.

21. Cardiovascular Safety of Romosozumab Versus Other Anti-Osteoporosis Medications in Patients with Osteoporosis: A Nationwide Health Insurance Claims Database Study in Japan.

期刊: Calcified tissue international 发表日期: 2026-Jul-09 链接: PubMed

摘要

Romosozumab (Rmab) is a potent anti-osteoporosis agent with dual effects on bone resorption and formation. Although superior to alendronate in fracture reduction, cardiovascular safety concerns have been raised. This study compared cardiovascular disease (CVD) incidence between Rmab and other anti-osteoporosis medications (AOMs) using Japan’s National Database of Health Insurance Claims. Patients aged  ≥ 50 years initiating Rmab, parathyroid hormone analogues (PTH), denosumab (Dmab), or bisphosphonates (BP) between March 2019 and March 2023 were identified. Outcomes were acute myocardial infarction, ischemic heart disease, and cerebrovascular disease occurring within 570 days of initiation or within 180 days after discontinuation. Patients with prior myocardial infarction or cerebrovascular disease were excluded. Hazard ratios (HRs) were derived from Cox regression with inverse probability weighting using propensity scores. The study included 25,584 men and 236,467 women receiving Rmab; 50,688 and 289,132 on PTH; 50,319 and 460,182 on Dmab; and 232,484 and 1,144,757 on BP. Cumulative incidence of outcomes was highest with PTH, followed by Dmab, BP, and lowest with Rmab. Compared with PTH, adjusted HRs for Rmab in men were 0.49 for acute myocardial infarction, 0.59 for ischemic heart disease, and 0.70 for cerebrovascular disease. Compared with Dmab, HRs were 0.62, 0.62, and 0.59, respectively. Versus BP, HRs were 0.68, 0.74, and 0.72. All HRs were similarly below 1.0 in women. After adjustment for baseline characteristics, no excess incidence of cardiovascular events was observed among patients receiving Rmab compared with those receiving other AOMs.

22. Development of a prediction model for recurrence in patients with malignant ovarian germ cell tumors undergoing fertility-sparing surgery: A multicenter retrospective study.

期刊: European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology 发表日期: 2026-Jul-09 链接: PubMed

摘要

To investigate the clinical characteristics associated with recurrence in malignant ovarian germ cell tumors (MOGCT) patients who received fertility-sparing surgery (FSS) and to develop a machine learning-based risk prediction model to support treatment decision-making for these specific MOGCT patients. This study enrolled MOGCT patients who received FSS at four university-teaching hospitals in China between 2005 and 2020. The primary outcome was disease-free survival (DFS). Four machine learning algorithms-Cox Proportional Hazards Model (Cox), Random Survival Forest (RSF), Cox Proportional Hazards Model Boosting (CoxBoost), and eXtreme Gradient Boosting (XGBoost)-were used to develop the risk prediction models for DFS. The Cox Proportional Hazards Model was selected to construct the final risk prediction model, and visualized by a nomogram. The prediction model was internally validated with bootstrapping, and its performance was estimated by the receiver operating characteristic (ROC) curve, calibration curves, and decision curve analysis (DCA). A total of 264 MOGCT patients receiving FSS were enrolled in this study. Tumor size (hazard ratio [HR] ≥15 cm vs. <15 cm = 6.15, 95% confidence interval [CI]: 1.29-29.34; P = 0.023), tumor laterality (HR Right-sided vs. Left-sided = 0.13, 95% CI: 0.03-0.57; P = 0.007), and International Federation of Gynecology and Obstetrics (FIGO) stage (2014) (HR Stage II-III vs. Stage I = 7.57, 95% CI: 2.50-22.96; P < 0.001) were associated with DFS and subsequently selected for the establishment of prediction models. Among the four machine-learning models, the Cox algorithm-based model showed relatively high predictive accuracy and was thus chosen for the establishment of the final model. The areas under the ROC curves of the prediction model were 0.838 for 3-year DFS and 0.851 for 5-year DFS. Meanwhile, the model demonstrated excellent discriminative ability, calibration, and favorable clinical utility. This multicenter study developed a Cox algorithm-based prediction model that may help assess the individual recurrence risk in MOGCT patients who received FSS.

23. Pneumococcal Vaccination Uptake in People With Immunosuppressed Conditions Using Real-World Primary Care Data Across England: Protocol for a Retrospective Descriptive Study.

期刊: JMIR research protocols 发表日期: 2026-Jul-09 链接: PubMed

摘要

The introduction of pneumococcal vaccination programs in the United Kingdom has led to substantial reduction in the burden of pneumococcal disease in the general population, decreasing the incidence of invasive pneumococcal disease and preventing associated mortality. Current UK guidelines recommend pneumococcal vaccination for adults aged ≥65 years, as well as for individuals aged ≥2 years with underlying medical conditions that place them at increased risk of severe pneumococcal disease. This includes adults with immunosuppression. To date, there are few data in the United Kingdom of pneumococcal vaccine coverage in specific high-risk groups, such as those with immunocompromised conditions. We aim to evaluate the yearly uptake of pneumococcal vaccine in adults who are included in national recommendations as people with immunosuppressive conditions, stratified by etiology of immunosuppression. This will be a retrospective cohort study with data from the Oxford-Royal College of General Practitioners Research and Surveillance Centre network, which is nationally representative of the English population. The population under study includes adults registered in the Research and Surveillance Centre database with immunosuppression, including those with bone marrow compromise, with solid organ transplant, receiving oncological treatment, using immunosuppressive drugs, or with primary or acquired immunodeficiencies. The exposure is the underlying medical condition leading to an immunosuppression category. The primary outcome will be pneumococcal vaccination, defined as one dose of the 23-valent pneumococcal polysaccharide vaccine (PPV23). The study was funded in May 2025, and data extraction was performed from December 2025 to February 2026. Analysis was started in March 2026, with final results expected to be submited for publication in 2026. We will report pneumococcal vaccine uptake disaggregated for the high-risk group of people with immunosuppressive conditions, which has not been previously reported. We will also report on the socioeconomic gradient for vaccine uptake (through the use of the Index of Multiple Deprivation score and region) and report on the differences among ethnic groups. We will inform on the granularity of routine primary care data to include disaggregated reports of vaccine uptake in the immunosuppressed population in routine surveillance in the United Kingdom. This will aim to address the gap on pneumococcal vaccination coverage in people with immunosuppressive conditions, helping to identify potential unwarranted variations in vaccine adoption.

24. Socioeconomic and ecological drivers of contagious pig diseases in free-range systems: Evidence from Gwembe Valley, Zambia.

期刊: PLoS neglected tropical diseases 发表日期: 2026-Jul-09 链接: PubMed

摘要

Free-range pig systems support rural livelihoods in Zambia but increase exposure to contagious diseases through unrestricted movement, environmental contamination, and informal trade. We explored non-biological drivers of disease risk in Gwembe District to inform practical control strategies. We used Spatial Group Model Building (SGMB) with LayerStack mapping to engage 12 purposively selected value-chain actors (farmers, traders, transporters, and veterinary personnel). Participants co-produced spatial layers (settlements, production zones, markets, disease occurrence, service points), behavior-over-time graphs, and causal loop diagrams (CLD). Findings highlighted intersecting non-biological drivers: free-range husbandry, open defecation and shallow-well contamination, seasonal water scarcity, limited veterinary access, informal marketing, and economic pressures that shape herd management and pig movement. Discrepancies between transporters’ reported volumes and district records suggested unreported flows that could undermine surveillance. Participants recognized risks consistent with African swine fever (ASF) spread via pig movement and porcine cysticercosis (PCC) via sanitation failures, but awareness of PCC pathways was limited. Disease dynamics in free-range systems arise from feedback across human practices, animal behavior, environment conditions, within markets interactions acting as key transmission paths that shape both local persistence and wider disease spread. Low-cost housing, community sanitation, participatory surveillance, and tailored farmer education are feasible entry points for improving disease prevention and control in free-range pig production systems. In Gwembe valley, SGMB effectively elicited local knowledge and revealed leverage points for integrated One Health interventions that align with community realities and can strengthen rural livelihoods. Disease dynamics in free-range systems arise from feedback across human practices, animal behavior, and environmental conditions, with market interactions acting as key transmission nodes that shape both local persistence and wider disease spread.

25. Bridging the Gap between External and Internal Exposure: Challenges and a Machine Learning Approach Validated Using Benzene Ring-Containing Pollutants.

期刊: Environmental science & technology 发表日期: 2026-Jul-09 链接: PubMed

摘要

Establishing quantitative linkages between external and internal exposures is essential for accurate exposure and health risk assessment, yet this goal remains hindered by multiple challenges. This Perspective systematically reviews major challenges limiting the quantitative linkage across three dimensions: (i) External exposure: complex multimedia and multipathway exposure, environmental factor variability, and substantial data gaps; (ii) Internal exposure: difficulties in biological sample collection, large-scale biomonitoring, and appropriate biomarker selection; and (iii) External-internal exposure linkage: interindividual variability, scarce toxicokinetic parameters, and methodological limitations. In this context, the Perspective proposes ML-EIExpLink (machine learning-based external-internal exposure linkage), a framework integrating multisource, multidimensional variables, including pollutant physicochemical properties, ADME parameters, exposure factors, environmental conditions, and socioeconomic indicators, to model complex external-internal exposure relationships. An exploratory case study on benzene ring-containing pollutants demonstrates the framework’s feasibility and reliability. Using gradient boosting decision trees as the core predictive engine, the model achieved robust predictive performance, with an external validation Qext2 of 0.784. Most key variables, including external air concentration, molecular planarity, and temperature, exhibited nonlinear and threshold effects on predicted blood concentrations. This Perspective introduces a novel ML-based framework for establishing robust, interpretable external-internal exposure linkages, thereby providing a useful basis for improved exposure assessment and health risk evaluation.

26. Portraying Ethical Risks of Medical AI: Mixed Methods Study From Connotation Definition to a Survey on Physicians' Cognition.

期刊: Journal of medical Internet research 发表日期: 2026-Jul-09 链接: PubMed

摘要

Ethical risks of medical artificial intelligence (AI) are a global concern, but existing understanding remains fragmented without an integrated framework, and physicians’ awareness of these ethical risks is unclear. This study aimed to construct a multidimensional ethical risk framework for medical AI in the Chinese context, assess physicians’ perceptions of these risks, and provide theoretical support for AI risk governance. In the first phase, we conducted semistructured interviews with 36 experts (102,000-word transcript), analyzed via grounded theory (NVivo 11 [Lumivero]), yielding 5 main risk categories and 15 subcategories. In the second phase, a 21-item questionnaire based on this framework was administered to 600 physicians across 19 Chinese provinces. After the reliability and validity of the questionnaire, descriptive statistics, and multiple linear regression identified risk perceptions and influencing factors. The framework includes physiological risks (eg, diagnostic error and improper treatment), psychological risks (eg, physicians’ technical anxiety and patient’s psychological anxiety), data and privacy risks (eg, privacy leakage and data security), social risks (eg, trust crisis, occupational impact, unclear liability, and autonomy erosion), and economic and sustainability risks (eg, increased financial burden, resource waste, environmental pollution, and energy consumption). Physicians (n=600) showed the highest concern for data and privacy risks, ambiguous accountability, and a physician-patient trust crisis. Economic and sustainability risks received the lowest agreement. Multiple linear regression identified significant predictors for risk perception. Specialized AI training was positively associated with perceptions of misdiagnosis risks (β=0.230, 95% CI 0.031-0.429; P=.02), privacy leaks (β=0.220, 95% CI 0.041-0.399; P=.02), and unclear liability (β=0.285, 95% CI 0.110-0.460; P=.002). The establishment of medical institution AI ethics review procedures was positively associated with perceptions of diagnostic errors (β=0.355, 95% CI 0.141-0.569; P=.001) and unclear liability (β=0.390, 95% CI 0.200-0.580; P<.001), while AI unfamiliarity was negatively associated with trust crisis (β=-0.260, 95% CI -0.450 to -0.070, P=.006). This study proposes a contextualized ethical risk framework for medical AI in China to guide targeted governance. It is recommended that future efforts should focus on enhancing the ethical training of medical professionals, improving the ethical review mechanisms for AI in health care institutions, and clarifying the division of liabilities and accountability. These measures will promote the robust development of medical AI within an ethically compliant framework.

27. Biological reinvasion of Cochliomyia hominivorax (Diptera: Calliphoridae) in Mexico: impacts and risks under different climate change scenarios.

期刊: Journal of economic entomology 发表日期: 2026-Jul-09 链接: PubMed

摘要

The New World screwworm, Cochliomyia hominivorax (Diptera: Calliphoridae), is an obligate parasitic fly that causes severe myiasis in livestock, wildlife, and humans, generating substantial economic and public health impacts. Following its historical eradication from North and Central America through sterile insect technique (SIT) programs, recent outbreaks in Central America and southern Mexico indicate ongoing biological reinvasion. We evaluated current and future environmental suitability for C. hominivorax using ecological niche modeling (Maximum Entropy [MaxEnt]) calibrated with 1,972 occurrence records derived from 10,204 outbreak reports across Mexico and Central America. Models were developed using WorldClim bioclimatic variables under current climatic conditions (1970-2000) and future climate scenarios (Shared Socioeconomic Pathways [SSPs]: SSP1-2.6 and SSP5-8.5 for 2050). Suitable environments currently encompass most of Central America and 27 of 32 Mexican states, with highest suitability concentrated in southeastern Mexico. Future projections indicated expansion and intensification of highly suitable areas, particularly in the Yucatán Peninsula, Chiapas, and Tabasco. Spatial analysis of 238 human myiasis cases reported in Mexico during 2025-2026 revealed significant aggregation within highly suitable areas predicted by the models (χ2 = 179.3, P < 0.001). These findings suggest that environmental suitability is spatially associated with the current reemergence of C. hominivorax and may facilitate further expansion under climate change. Our results highlight the need for strengthened surveillance, regional biosecurity strategies, and coordinated One Health interventions to prevent large-scale reinfestation across Mesoamerica.

28. Experiences and Challenges of Patients With Chronic Respiratory Disease During a Virtual Research Study: Qualitative Study.

期刊: Journal of participatory medicine 发表日期: 2026-Jul-09 链接: PubMed

摘要

Virtual research has emerged as a promising and convenient approach. This study investigates the experiences and challenges faced by patients with chronic respiratory diseases who participated in a virtual research study. This study aimed to explore the experiences of adults with chronic respiratory diseases participating in a virtual research study and to identify challenges they encountered to inform future virtual research design and implementation. Adults with a diagnosis of asthma or chronic obstructive pulmonary disease taking medications for their condition were recruited from the Greater Vancouver Area. A total of 185 participants completed an asthma-specific or chronic obstructive pulmonary disease-specific health literacy measurement tool through telephone interviews and then completed a postinterview checklist (n=36) or survey (n=149) on their experience with virtual research. To test the health literacy tool’s reproducibility, 110 participants were retested and completed the same checklist (n=79) or survey (n=31). Interviews were transcribed and thematic analyses were conducted on interviews, surveys, and checklists. Six overarching themes were identified: overall experience with virtual research, clarity of instructions, technology, communication, condition and cognition, and logistics. While participants generally reported a positive experience, the study identified significant challenges, including technological barriers, the need for clear and concise instructions, mental fatigue, and communication difficulties. These findings highlight the importance of providing comprehensive technical support, ensuring clear communication, and addressing ethical considerations in virtual research. This study contributes valuable insights to the growing body of literature on the viability and challenges of virtual research in health care.

29. Preliminary Reliability and Validity of the Toileting Habit Profile Questionnaire-Second Revision.

期刊: Occupational therapy in health care 发表日期: 2026-Jul-09 链接: PubMed

摘要

Occupational therapists are skilled in facilitating participation in activities of daily living and in evaluating and treating sensory integration problems that interfere with engagement in everyday activities. The Toileting Habit Profile Questionnaire (THPQ) was developed to assess sensory issues impacting toileting participation in children. The aim of this study was to examine the preliminary reliability (internal consistency) and validity (known-groups discrimination) of the THPQ-R2, an expanded version of the THPQ. We adopted a descriptive survey methodology in which parents of three- to six-year-old children with and without functional defecation disorders (FDD) completed the THPQ-R2. The hyper-reactivity subscale demonstrated acceptable internal consistency, with a Cronbach’s alpha of .755. The internal consistency analysis of the hypo-reactivity/poor perception subscale yielded Cronbach’s alpha of 0.616. Children without FDD had significantly higher scores (less problems) on the hyper-reactivity subscale (M = 29.22, SD = 1.22) compared to children with FDD (M = 26.36, SD = 1.70). The scores on the hypo-reactivity/poor perception subscale of children without FDD (M = 19.08, SD = 1.30) were significantly higher (less problems) than those of children with FDD (M = 17.72, SD = 1.70). Our findings provide preliminary support for both the internal consistency and construct validity of the THPQ-R2.

30. Examination of psychometric properties of the Posttraumatic Stress Related Functioning Inventory, Revised (PRFI-5) in veterans.

期刊: Psychological trauma : theory, research, practice and policy 发表日期: 2026-Jul-09 链接: PubMed

摘要

The Posttraumatic Stress Related Functioning Inventory (PRFI) is a 33-item, self-report measure that assesses functioning associated with symptoms of posttraumatic stress disorder (PTSD) across occupational, social relationships, and lifestyle domains (McCaslin et al., 2016). The purpose of the current investigation was to examine the psychometric properties of the DSM-5 version of the PRFI (PRFI-5). The data were drawn from a completed randomized, controlled trial that compared Individual Placement and Support (IPS) supported employment with a stepwise vocational rehabilitation involving transitional work (TW) among veterans with PTSD. Veterans completed the PRFI-5 and related measures (e.g., quality of life, PTSD symptom severity, self-esteem, and suicidality; N = 450). Psychometric analyses included a review of item and scale descriptives, evaluation of the scale’s reliability and cohesiveness, assessment of the scale factor structure, and its convergent and discriminant validity. Broadly, results were similar to those of the previous version of the PRFI and support the PRFI-5 as a reliable (αs = .70-.97) and valid measure of posttraumatic stress-related functional impairment. The measure can provide a high-level summary of functioning (e.g., total scale score) yet also can be used to provide a detailed clinical analysis of psychosocial functioning across several domains (i.e., work/school, relationships, lifestyle). This study examines a pragmatic measure of PTSD-related psychosocial functioning and highlights the importance of incorporating a measure of psychosocial functioning routinely alongside symptom measures as a component of psychological assessment and practice. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

31. Parents' perspectives on equine-assisted occupational therapy intervention for their children with attention deficit hyperactivity disorder (ADHD).

期刊: Disability and rehabilitation 发表日期: 2026-Jul-09 链接: PubMed

摘要

This study examined how parents experienced the ASTride Equine-Assisted Occupational Therapy intervention for their children with ADHD, and the meanings they ascribed to changes observed in their children and themselves. Thirteen parents of children aged 7-12 who completed the ASTride intervention participated in in-depth, semi-structured interviews. A grounded theory approach guided the analysis, which included open coding, category mapping, and thematic modeling to identify central processes across narratives. (1) Parents’ perceived benefits for children including emotional growth, improved regulation, and the transfer of skills beyond the stable; (2) Benefits for parents such as active involvement, reflection, and enhanced parenting strategies; and (3) Environmental benefits highlighting the calming, sensory-rich nature of the stable and interaction with animals. Parents experienced ASTride as a transformative, family-centered intervention that supported children’s regulation and participation while fostering parental insight and engagement. Interviewing parents provided unique insight into how therapeutic changes were recognized, interpreted, and generalized across home, school, and family contexts. These findings demonstrate that parents’ perspectives can inform the refinement of Equine Assisted Occupational Therapy by highlighting the processes through which families perceive children’s participation, strategy transfer, and engagement in everyday life. Parent perceived the ASTride (Attention Skills Therapy), Equine-Assisted Occupational Therapy intervention as supporting their children’s emotional regulation, confidence and participation in daily activities.Parents described interaction with horses as facilitating engagement, motivation, and regulation processes relevant to rehabilitation goals.Parents perceived their involvement in the intervention as contributing to greater reflection and the use of supportive strategies that generalize to daily routines.Parents described the stable’s sensory-rich, natural environment may optimize participation and therapeutic responsiveness.

32. Self-Care Experiences and Influencing Factors Among Patients Undergoing Hemodialysis in Ghana: A Theory-Based Descriptive Qualitative Study.

期刊: ANS. Advances in nursing science 发表日期: 2026-Jul-09 链接: PubMed

摘要

This qualitative study examined self-care experiences and influencing factors among patients undergoing hemodialysis in Ghana using the Middle-Range Theory of Self-Care of Chronic Illness. Fourteen participants were interviewed on self-care practices. Thematic analysis revealed 12 themes reflecting the theory’s components. Patients were on hemodialysis for at least 3 months. Self-care maintenance included rest and recovery, fluid and dietary practices. Monitoring included self-monitoring and reporting, and monitoring at the hospital. Management included care evaluation and modification. Influencing factors were barriers to self-care, support systems, sociodemographics, and clinical/health-related. Findings suggest nurses and health care workers should address these factors through tailored interventions.

33. Lymph node-targeted mRNA delivery of fine-tuned peptide-nanocomplexes for SARS-CoV-2 Vaccination.

期刊: Biomaterials 发表日期: 2026-Jul-07 链接: PubMed

摘要

Messenger RNA (mRNA) vaccines require efficient delivery systems to reach antigen-presenting cells (APCs). Lipid nanoparticles (LNPs) are a standard delivery carrier. However, LNPs often accumulate in the liver and exhibit transient protein expression. These limitations can restrict their safety and immunogenic potential. Here, we developed a modular, peptide-based nanocomplex to overcome the current limitations. The system comprises three functional peptides: an RNA-binding peptide (RBP) for condensation, l-polyglutamic acid (PGA) for charge modulation, and an APC-targeting cell-penetrating peptide (A-CPP). This A-CPP features a newly discovered 7-mer immune cell-binding motif identified in this study. We optimized the physicochemical properties by systematically fine-tuning the ratios of these peptide modules. The optimized nanocomplex formed stable particles under 200 nm. Unlike LNPs, which showed significant liver accumulation, the peptide-nanocomplexes remained localized at the injection site and effectively drained to the lymph nodes. Furthermore, the peptide-nanocomplex retained mRNA expression for up to 7 days in vivo, whereas LNP-mediated expression diminished within 48 h. In mice immunized with SARS-CoV-2 spike mRNA, this prolonged antigen exposure elicited robust neutralizing antibody titers comparable to LNPs. Notably, the peptide-nanocomplex induced significantly higher CD8+ T cell responses than LNPs. Moreover, the peptide-nanocomplex demonstrated an excellent safety profile in vivo with no toxicity observed even after daily injections for two weeks at doses up to 200 times higher. This study establishes a data-driven fine-tuning strategy for peptide-based mRNA delivery. The resulting peptide-nanocomplex offers a safer, lymph node-targeted, and longer-lasting efficacy alternative to lipid-based carriers for next-generation vaccines.

34. Occupational Skin Cancer in Interventional Catheterization Staff: A Scoping Review.

期刊: Health physics 发表日期: 2026-Jul-07 链接: PubMed

摘要

Chronic and asymmetric exposure to ionizing radiation in interventional catheterization units represents a potential occupational risk for skin health among healthcare workers. Although case reports and small series have described cutaneous malignancies in radiation-exposed personnel, epidemiological characterization remains limited due to scarce population-based data and inconsistent dermatological surveillance. This scoping review synthesizes the available evidence on occupational skin lesions in interventional staff, focusing on anatomical distribution, tumor characteristics, and protection gaps. The purpose of this paper is to map and summarize the scientific evidence on malignant and non-malignant skin lesions reported among interventional catheterization personnel exposed to ionizing radiation. A scoping review was conducted following PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) guidelines across major scientific databases. Eligible studies reported occupational skin cancer, precancerous lesions, chronic dermatological changes, or asymmetric radiation exposure among interventional personnel. Two reviewers independently screened studies and extracted data using a standardized template. Six studies met the eligibility criteria, comprising five descriptive publications (case reports and a small case series) and one large prospective cohort of radiologic technologists involved in fluoroscopically guided procedures. The descriptive evidence reported 120 tumors with documented laterality, 79.2% of which occurred on the left side of the body, predominantly affecting the face, neck, and upper extremities, consistent with scatter-radiation geometry. Basal cell carcinoma was the most frequent tumor type (76.7%), followed by squamous cell carcinoma (23.3%). The cohort study reported elevated hazard ratios for melanoma, while estimates for basal and squamous cell carcinomas remained near unity. Overall, 96% of lesions occurred in anatomical regions not covered by conventional protective shielding. The evidence reveals a consistent pattern of asymmetric lesion distribution in unshielded anatomical regions and highlights critical gaps in dermatological surveillance, exposure assessment, and skin dosimetry among interventional personnel.

35. Bipolar disorder and borderline personality disorder comorbidity: an 8-year population-based retrospective study.

期刊: General hospital psychiatry 发表日期: 2026-Jul-06 链接: PubMed

摘要

Comorbidity between bipolar disorder (BD) and borderline personality disorder (BPD) is associated with greater clinical severity, yet its impact in inpatient settings remains insufficiently characterized. This study aimed to evaluate the association between comorbid BPD, clinical characteristics and inpatient outcomes among BD hospitalizations. A population-based retrospective study was conducted using a nationwide administrative database of public general and psychiatric hospital admissions in mainland Portugal over an 8-year period. Hospitalizations involving adults with a primary or secondary BD diagnosis were identified. Comorbid BPD was identified using ICD-9-CM code 301.83. Sociodemographic characteristics, psychiatric comorbidities, and hospitalization outcomes were compared between hospitalizations with and without BPD. Multivariable regression models adjusted for age, sex, and Charlson Comorbidity Index were applied. A total of 32,610 hospitalizations were identified, of which 342 had comorbid BPD. Compared with BD-only admissions, BD + BPD hospitalizations involved younger patients, a higher proportion of women, more frequent urgent admissions, depressive and mixed episodes, and greater psychiatric comorbidity. Comorbid BPD was associated with higher odds of discharge against medical advice (aOR = 1.59; 95%CI: 1.02 to 2.47), suicidal ideation or self-harm (aOR = 3.60; 95%CI: 2.79 to 4.65), alcohol-related disorders (aOR = 3.31; 95%CI: 2.44 to 4.47), illicit drug-related disorders (aOR = 3.84; 95%CI: 2.87 to 5.13), and 1-year readmission (aOR = 1.34; 95%CI: 1.07 to 1.69), but not with 30-day readmission. Among BD hospitalizations, those with comorbid BPD were characterized by greater psychiatric complexity, elevated suicide-related morbidity, and increased longer-term hospital utilization, highlighting the importance of improved recognition and targeted inpatient and post-discharge management.

36. Alleviating late-life depression with smart technology: Evidence from China.

期刊: Psychiatry research 发表日期: 2026-Jul-04 链接: PubMed

摘要

Digital public policies are increasingly promoted as tools for supporting healthy aging, yet causal evidence on their mental-health consequences remains limited. This study examines the effect of China’s Smart Health and Eldercare Pilot Policy on depressive symptoms among older adults. Using five waves of the China Health and Retirement Longitudinal Study from 2011 to 2020, comprising 18,570 person-wave observations, we exploit the phased rollout of the policy as a quasi-natural experiment and estimate difference-in-differences models. The results show that the pilot policy reduced depressive-symptom scores by 0.304 points, with supporting evidence from parallel-trend tests, placebo analyses and propensity-score-matched difference-in-differences estimates. Mechanism analyses suggest that smart health and eldercare policies improve mental well-being by lowering the transaction costs of service access and social interaction. Specifically, digital technologies appear to expand social participation by reducing participation barriers and to improve service accessibility by increasing the effective regional supply of eldercare services through data-driven platforms. The protective effect is stronger in areas with poorer air quality and among married and non-retired older adults. These findings suggest that digital public policy can function as a capability-enhancing instrument for mental health in aging societies, particularly where environmental and service-access constraints are more pronounced.

37. What can we learn from a simulation of older adults' movement through emergency care?

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

摘要

38. Artificial Intelligence-Powered Radiotherapy for Resource-Limited Settings: Advancing Cervical and Prostate Cancer Treatment Planning With the Radiation Planning Assistant.

期刊: JCO global oncology 发表日期: 2026-Jul 链接: PubMed

摘要

Radiotherapy treatment planning is a resource-intensive process characterized by multiple manual steps that can contribute to treatment delays and interobserver variability. The Radiation Planning Assistant (RPA) is a Web-based platform designed to deliver automated contouring and planning approaches tailored to low-resource settings. This work expands the RPA to develop and clinically validate end-to-end, artificial intelligence-driven workflows for prostate and cervical cancers, designed to improve efficiency, consistency, and accessibility in low- and middle-income countries. We developed deep learning-based auto-contouring models using nnU-Net and integrated them with knowledge-based planning models trained on curated data sets from over 1,000 prostate and 110 cervical cancer treatment plans. For prostate cancer, models were developed to accommodate prostate directed, prostate bed, and nodal treatment scenarios. Cervical cancer planning followed EMBRACE II guidelines and included pelvic and para-aortic nodal volumes. These tools were integrated into the RPA. Clinical acceptability of the auto-contours and plans was assessed retrospectively by radiation oncologists using a five-point Likert scale. In all, 50 test patients (40 prostate, 10 cervical) were evaluated end-to-end. For prostate cancer, 70% of target auto-contours and 73% of treatment plans were clinically acceptable without edits; for cervical cancer, these rates were 80% and 80%, respectively. For prostate cancer planning, 77% of target and 98% of organ-at-risk structures met all per-protocol compliance criteria. For cervical cancer planning, all EMBRACE II protocol hard constraint criteria were met. Bowel and vaginal contours demonstrated lower performance, but these did not compromise plan quality. We present validated, end-to-end radiotherapy planning workflows for prostate and cervical cancers that leverage the RPA’s infrastructure to streamline treatment planning in a globally accessible platform and demonstrate high clinical acceptability.

39. Erratum for "The Impact of Care Delivered Through the Self-Management Promotion Model on Health Literacy Levels in Patients with Chronic Obstructive Pulmonary Disease: Quasi-Experimental Research".

期刊: Health literacy research and practice 发表日期: 2026-Jul 链接: PubMed

摘要

40. The impact of school-based mitigation measures on the transmission of respiratory pathogens: the case of SARS-CoV-2.

期刊: International journal of epidemiology 发表日期: 2026-Jun-24 链接: PubMed

摘要

School-based mitigation measures can curb transmission of severe respiratory pathogens but may also impose high societal costs. Understanding their impact at the population level is key for pandemic preparedness evaluations. We developed an individual-based model of SARS-CoV-2 transmission in households, schools, and the general community, calibrated to epidemiological estimates from complete contact tracing data collected in the province of Reggio Emilia, Italy, during March-April 2021 (a period characterized by the dominance of the Alpha variant and strict community restrictions). We quantified the impact of school-based mitigation measures, including distance-learning mandates, reactive class quarantines, and periodic screening. Unmitigated transmission in schools would increase the population-level SARS-CoV-2 reproduction number from 0.94 (95% confidence interval [CI]: 0.84-1.03) to 1.38 (95% CI: 1.29-1.47), substantially amplifying COVID-19 morbidity and mortality. Intensive contact tracing with reactive class quarantines would reduce disease burden but would be insufficient to prevent widespread epidemic growth. Weekly universal screening of students and teachers with highly specific rapid tests, on top of contact tracing and reactive class quarantines, could effectively reduce the spread of infections and maintain a high level of in-person education. For highly transmissible severe respiratory infection with significant cryptic transmission, distance learning mandates may be necessary to protect vulnerable populations. However, weekly screening in schools may offer a viable strategy to preserve in-person education.

41. Global prevalence of elevated high-sensitivity C-reactive protein in patients with atherosclerotic cardiovascular disease, with and without chronic kidney disease: findings from the POSEIDON study.

期刊: Atherosclerosis 发表日期: 2026-Jun-18 链接: PubMed

摘要

Inflammation is a causal risk factor for atherosclerotic cardiovascular disease (ASCVD). Contemporary global data on the prevalence of high inflammatory risk (high-sensitivity C-reactive protein [hsCRP] ≥2 mg/L), remain limited. We evaluated the global prevalence and characteristics of patients with high inflammatory risk among ASCVD patients, with and without chronic kidney disease (CKD). POSEIDON (NCT06122961) measured clinical and laboratory characteristics in 13,475 patients with ASCVD across 317 sites in 18 countries (2023-2025). The primary outcome was prevalence of hsCRP ≥2 mg/L, stratified by CKD status (estimated glomerular filtration rate <60 or ≥60 mL/min/1.73 m2); also assessed were factors associated with hsCRP ≥2 mg/L and the correlation between hsCRP and interleukin (IL)-6. Among ASCVD patients with CKD (n = 5757; mean age 75 years, 25.9% women), 39.3% had elevated hsCRP; among those without CKD (n = 7718, mean age 67 years, 21.6% women), 28.3% had elevated hsCRP. Factors associated with hsCRP ≥2 mg/L were smoking, high body mass index, comorbid autoimmune disease, heart failure, polyvascular disease, and dyslipidaemia in both groups, and female sex and hypertension in those without CKD. IL-6 levels were significantly higher in patients with hsCRP ≥2 mg/L than without for both groups. Variability was observed in the prevalence of elevated hsCRP by country/region. High inflammatory risk is common, affecting ∼30% of patients with ASCVD globally and ∼40% of those with concomitant CKD, despite standard therapies. Routine hsCRP assessment may help characterize inflammatory risk, with implications for optimizing current preventive strategies, while awaiting potential benefits of future targeted therapies in these high-risk patients.

42. Obesity prevalence varies markedly by definition: multiple cross-sectional and prospective studies.

期刊: Nutrition research (New York, N.Y.) 发表日期: 2026-Jun-16 链接: PubMed

摘要

Multiple operational definitions of obesity have been proposed. We compared obesity prevalence and incidence according to World Health Organization (WHO), National Institute of Health (NIH), and European Association for the Study of Obesity (EASO) using the baseline survey and subsequent follow-ups of a population-based cohort (CoLaus|PsyCoLaus), in Lausanne, Switzerland. Sample included adults aged 35 to 75 years (n = 6733 at baseline). Obesity was defined by WHO (body mass index [BMI]), NIH (BMI and waist circumference), and EASO (BMI/waist-to-height ratio plus obesity-related complications such as hypertension, type 2 diabetes, cardiovascular disease, or chronic kidney disease). The joint prevalence of overweight and obesity did not change, but there was a twofold increase in obesity prevalence between WHO and NIH/EASO (average obesity prevalence combining all follow-ups: 17.4%, 33.9% and 37.5%, respectively), at the expense of the overweight category (average prevalence of 38.7%, 22.2% and 18.6%, respectively), with a particularly marked shift at older ages: obesity prevalence in age group +75 years old for follow-up 2 was 19.2%, 48.9% and 55.9% for WHO, NIH and EASO, respectively. Regarding the incidence analysis (n = 2334, 34.7% of the baseline cohort), after a median follow-up of 14.5 years, the incidence of obesity among participants without obesity at baseline was 5.8% (WHO), 16.8% (NIH), and 20.6% (EASO). For EASO definition, final prevalence of obesity (20.6%) exceeded overweight (18.3%). We conclude that broader definitions, notably EASO, identify more individuals at potential risk but substantially expand the obesity category, with implications for case classification, clinical management, and resource allocation.

43. Metabolic biomarkers and cardiometabolic risk among night shift workers: evidence from night shift workers in Europe.

期刊: European journal of public health 发表日期: 2026-Jun-10 链接: PubMed

摘要

Circadian disruption resulting from night shift work has been associated with cardiometabolic diseases, but the underlying biological pathways remain insufficiently understood. We analyzed data from the EPHOR-NIGHT cohort, including questionnaires, clinical assessments [body mass index (BMI), blood pressure (BP), waist/hip circumference], and plasma metabolites in blood samples (N = 860; day shift workers n = 362, night shift workers = 498) from Sweden, Spain, and Denmark. We applied multivariable linear regression to examine differences in cardiometabolic risk factors and metabolite levels between shift workers and examined associations between metabolites and cardiometabolic risk factors. Night shift work was associated with higher mean systolic BP (β = 1.89, 95%CI 0.00, 3.79 mmHg), higher mean BMI (β = 1.14, 95%CI 0.44, 1.84 kg/m2), and higher odds of hypertension (OR = 1.38, 95%CI 1.00, 1.89) and overweight/obesity (OR = 1.37, 95%CI 1.02, 1.82), compared to day shift work. Associations were stronger among women in sex-stratified analyses. Night shift workers had metabolic alterations, with lower fractions of polyunsaturated fatty acids, higher fractions of mono-unsaturated and saturated fatty acids, and higher levels of amino acids isoleucine, valine, and phenylalanine. These changes remained after multiple adjustments, including diet. Effects were more pronounced for those working more consecutive night shifts, more night shifts per week, and for permanent night schedules versus rotating shifts. The night shift-related metabolites were associated with higher BMI and higher blood pressure. Night shift work was associated with specific metabolic alterations linked to increased cardiometabolic risk. Our results suggest that reducing night shift intensity and consecutive nights may help mitigate these adverse effects.

44. Universal interventions to improve young children's mental well-being: A systematic review and meta-analysis.

期刊: Psychological bulletin 发表日期: 2026-Apr 链接: PubMed

摘要

This meta-analytic review quantified the effects of universal interventions, those implemented with all children, on improving mental well-being in young children aged 0-6 years old. Potential factors that moderated the effects of interventions were explored. A systematic search of PubMed, Cumulative Index to Nursing and Allied Health Literature (Elton B. Stephens Company), APA PsycInfo (ProQuest), and grey literature identified 21,942 records. After screening, 134 articles reporting 133 studies and 141 interventions among 32,512 participants met eligibility criteria. Meta-analyses were conducted, using random-effects models and cluster-robust variance estimation to account for within-study dependence and to compute pooled Hedges’ g. Mean effects at postintervention were small-to-medium on overall mental well-being (g = 0.35) across cognitive (g = 0.35), social (g = 0.36), emotional (g = 0.38), and behavioral (g = 0.31) domains. Sensitivity analyses (e.g., excluding high-risk and low-reliability studies) produced similar results. Follow-up effects adjusted for baseline were 0.22, and the maintenance of effects from postintervention to follow-up was only 0.04. Exploratory moderator analyses revealed three significant moderators, including study design, control group, and intervention target. Child-focused interventions yielded the largest effects, exceeding those targeting family and child, the occupational role (e.g., teachers), or family member only. Though these results support some promises of universal interventions for enhancing early mental well-being, interpretation warrants caution. Between-study heterogeneity was substantial, some studies exhibited a high risk of bias, and publication bias was present. Future research should prioritize rigorous designs with follow-up assessments and booster strategies to support maintenance and include implementation-relevant outcomes (e.g., fidelity), while adhering to transparent reporting. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

45. Nicotine e-cigarettes in Peru: analysis of law 32159 against international evidence and gaps for adolescent protection.

期刊: Revista peruana de medicina experimental y salud publica 发表日期: 2026-Mar-31 链接: PubMed

摘要

The article analyzes the regulation of nicotine electronic cigarettes (EC) in Peru, with an emphasis on Law 32159 and its capacity to protect the health of adolescents in light of international evidence. Although they are often perceived as less harmful than combustible cigarettes, studies link their use to cardiovascular and respiratory risks, as well as a higher probability of transitioning to combustible tobacco use in adolescents. The evolution of the Peruvian regulatory framework for tobacco control is reviewed, and it is recognized that Law 32159 constitutes an advance by explicitly incorporating electronic nicotine delivery systems within a comprehensive regulatory approach. In this sense, the law addresses 100% smoke- and vape-free environments, the prohibition of advertising, promotion, and sponsorship, health warnings, marketing restrictions, multisectoral oversight, and incorporates Art. 5.3 of the Framework Convention on Tobacco Control regarding industry interference in control policies for the consumption of tobacco products, nicotine, and substitutes for both. However, gaps persist between the law and its implementation: insufficient definitions of flavorings, lower requirements for health warnings, and limited capacity to control indirect and digital advertising in a context of informal markets and online trade. The absence of fiscal measures weakens public policy. In conclusion, the impact of the law will depend on precise regulations, effective oversight, and complementary instruments such as price and tax policies. El artículo analiza la regulación de los cigarrillos electrónicos (CE) con nicotina en el Perú, con énfasis en la Ley 32159 y su capacidad para proteger la salud de los adolescentes a la luz de la evidencia internacional. Aunque suelen percibirse como menos dañinos que los cigarrillos combustibles, estudios vinculan su uso con riesgos cardiovasculares, respiratorios, además de mayor probabilidad de transición hacia el consumo de tabaco combustible en adolescentes. Se revisa la evolución del marco normativo peruano de control del tabaco y se reconoce que la Ley 32159 constituye un avance al incorporar explícitamente los sistemas electrónicos de administración de nicotina dentro de un enfoque regulatorio integral. En ese sentido, la norma aborda ambientes 100% libres de humo y vapeo, prohibición de publicidad, promoción y patrocinio, advertencias sanitarias, restricciones de comercialización, fiscalización multisectorial e incorpora el Art. 5.3 del Convenio Marco para el Control del Tabaco referida a la interferencia de la industria en las políticas de control del consumo de productos de tabaco, nicotina y sucedáneos de ambos. No obstante, persisten brechas entre la norma y su implementación: definiciones insuficientes sobre saborizantes, exigencias menores de advertencias sanitarias y limitada capacidad para controlar publicidad indirecta y digital, en un contexto de mercado informal y comercio en línea. La ausencia de medidas fiscales debilita la política pública. En conclusión, el impacto de la ley dependerá de un reglamento preciso, fiscalización efectiva e instrumentos complementarios como políticas de precio e impuestos.

46. Development of a voltammetric analytical method for the quantification of mercury in urine.

期刊: Revista peruana de medicina experimental y salud publica 发表日期: 2026-Mar-30 链接: PubMed

摘要

Exposure to mercury represents a critical challenge for public health, necessitating precise and portable analytical methods for biomonitoring. This experimental analytical study develops an analytical method and evaluates the performance of square wave anodic stripping voltammetry (SWASV) for the quantification of mercury in urine. For this purpose, the operating conditions of the SWASV system were optimized through tests with standard mercury solutions. Commercial urine (BIO-RAD®) pretreated with nitric acid was used. Linearity, precision, trueness, limit of detection (LOD), and limit of quantification (LOQ) were evaluated. The results showed high precision, with a relative standard deviation (%RSD) of 6.21. Furthermore, the trueness analysis revealed no significant differences between SWASV and the cold vapor atomic absorption (CVAA) method, p = 0.2601. The LOD and LOQ were 0.68 and 2.2 μg L-1, respectively. These findings suggest that SWASV is a precise method comparable to CVAA for the detection of mercury in urine under controlled laboratory conditions. Additional studies are required to evaluate its applicability in real population biomonitoring scenarios. La exposición al mercurio representa un desafío crítico para la salud pública, por lo que es necesario contar con métodos analíticos precisos y portátiles para su biomonitoreo. Este estudio de tipo experimental analítico, desarrolla un método analítico y evalúa el desempeño de la voltamperometría de redisolución anódica de onda cuadrada (VRAO) para la cuantificación de mercurio en orina. Para ello se optimizaron las condiciones de funcionamiento del sistema VRAO mediante pruebas con soluciones estándar de mercurio. Se utilizó orina comercial (BIO-RAD®) pretratado con ácido nítrico. Se evaluó la linealidad, precisión, veracidad, el límite de detección (LDD) y de cuantificación (LDC). Los resultados mostraron una alta precisión, con una desviación estándar relativa (%DER) de 6,21. Además, el análisis de veracidad no reveló diferencias significativas entre VRAO y el método de absorción atómica de vapor frío (AAVF), p = 0,2601. El LDD y LDC resultaron 0,68 y 2,2 μg L-1, respectivamente. Estos hallazgos sugieren que VRAO es un método preciso y comparable con AAVF para la detección de mercurio en orina bajo condiciones controladas de laboratorio. Se requieren estudios adicionales para evaluar su aplicabilidad en escenarios reales de biomonitoreo poblacional.

47. The heat exposure, aging trajectories, and Alzheimer's disease (HEAT-AD) study protocol.

期刊: PloS one 发表日期: 2026 链接: PubMed

摘要

Urban heat islands (UHIs) are areas of elevated surface temperature caused by limited vegetation and dense development. Extreme heat disproportionately affects older adults and may increase risk for Alzheimer’s disease (AD) and related dementias (ADRD), but few studies have examined whether cumulative neighborhood-level heat exposure is associated with cognitive decline or ADRD biomarkers. This study will investigate whether recent UHI exposure is associated with cognitive function; determine whether cumulative UHI exposure is associated with cognitive decline, plasma ADRD biomarkers, and brain imaging biomarkers; and evaluate whether UHI exposure is associated with ADRD risk factors, including physical inactivity, social isolation, and inflammation, and whether tree canopy mitigates heat-ADRD associations. The study includes 500 adults aged ≥50 years from the Healthy Brain Initiative cohort in South Florida. Geocoded residential addresses will be linked to satellite-derived land surface temperature data to quantify recent exposure at the baseline cognitive visit and cumulative exposure during the month before, and 1 and 5 years before baseline. Participants complete annual clinical and neuropsychological assessments, brain MRI, and blood collection for ADRD biomarkers. A sub-sample of 200 participants will wear smartwatches during two 3-week periods to capture GPS-based heat exposure, physical activity, and daily cognitive testing. Analyses will be replicated using the nationally representative Health and Retirement Study. Primary outcomes include cognitive domain scores, brain imaging measures, and preclinical AD status determined from plasma biomarkers. This study will provide comprehensive data on cumulative UHI exposure and ADRD risk by integrating cognitive assessment, neuroimaging, and biomarkers. Findings will clarify whether neighborhood heat represents a modifiable ADRD risk factor and inform urban greening and brain health promotion strategies.

48. Perceptions of plastic pollution among inland fishery stakeholders in a subtropical reservoir.

期刊: PloS one 发表日期: 2026 链接: PubMed

摘要

Plastic pollution is becoming a serious problem in freshwater ecosystems, impacting the livelihoods of people who rely on inland fisheries. Although plastic waste is widely discussed around the world, limited research has explored how local fishery stakeholders perceive pollution, particularly in Southern Africa. As such, using semi-structured interviews, the current study assessed the awareness, concerns, and solution perspectives of three different stakeholder groups, i.e., commercial fishers (CF), recreational fishers (RF), and fishmongers (FM) around Nandoni Dam, a subtropical reservoir in Limpopo Province, South Africa. Thirty participants, i.e., 10 per stakeholder, were interviewed, and our results showed that 96.7% of all stakeholders were aware of plastic pollution, yet 86.7% had limited understanding of microplastics. Perceptions of the impacts of plastic pollution varied across groups, with visitors (CF = 60%; RF = 60%; FM = 66.7%) and local residents (CF = 20%; RF = 20%; FM = 11.1%) being linked as a source of plastic pollution around Nandoni Dam. Willingness to participate in reducing plastic pollution was high across stakeholders (CF = 90%; RF = 90%; FM = 70%), with the majority emphasising the need for local municipal involvement and community engagement during clean-up activities and awareness initiatives. These findings highlight the need for targeted environmental education, and enhanced community-municipal collaboration to improve awareness and support collective action against plastic pollution in inland fisheries. Strengthening these actions could promote sustainable fisheries management, protect inland waters, and improve the well-being of the people who rely on these waters for food, income, and daily activities.

49. Early life stress enhances the association between residential nature exposure and fasting blood glucose.

期刊: PloS one 发表日期: 2026 链接: PubMed

摘要

Emerging epidemiological evidence indicates that groups in low socioeconomic positions exhibit more pronounced health benefits from nature exposure compared to more privileged groups. We have previously posited one possible mechanism underlying this phenomenon through our framework: (susceptibility to stress) groups in low socioeconomic positions are often exposed to more early-life stressors, which can induce a lifelong susceptibility to stress through various neurobiological pathways; (environmental sensitivity) susceptibility to stress, traditionally understood as heightened reactivity to stressors, could also encompass enhanced responsivity to health-protective exposures, inducing greater risks in adverse environments, but also greater benefits in protective environments. Examine the moderation effect of early life stress on the association between residential nature exposure and fasting glucose. We assessed the impact of residential nature exposure (Normalized Difference Vegetation Index) on glucose dysregulation (elevated levels of fasting blood glucose) with a specific focus on the moderation effect of early life stress (Stress and Adversity Inventory for Adults) using baseline data from a cohort of 340 nursing students. An initial analysis did not support our linear dose-response hypothesis. However, a theory-guided exploration revealed a significant curvilinear trend wherein participants with higher but also lower exposure to early-life stressors both exhibited lower levels of fasting glucose when living in greener neighborhoods. By contrast, for participants with relatively moderate early-life stressor exposure, there was no association between neighborhood greenness and fasting glucose. Our findings contribute to growing evidence and further support the idea that increasing access to nature within disadvantaged neighborhoods could be an effective strategy to mitigate metabolic risks and attenuate health disparities among vulnerable populations. As the evidence for this framework expands, it could inform more targeted interventions that leverage individual differences in environmental sensitivity to promote health equity, ultimately providing more nuanced and socioeconomically attuned approaches to public health.

50. Anthropogenic landscapes and vector-borne disease dynamics: Unveiling the complex interplay between Human Footprint and disease transmission in Colombia.

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

摘要

Anthropogenic landscape transformations are fundamentally reshaping the epidemiology of vector-borne diseases (VBDs), yet their causal impacts remain poorly quantified across diverse ecological and socio-economic contexts. This study evaluates the causal effect of the Human Footprint (HFP) on the transmission dynamics of malaria, dengue, and visceral leishmaniasis in Colombia. We conducted an ecological analysis using municipal-level retrospective data from Colombia’s National Public Health Surveillance System (SIVIGILA, 2007-2019). Epidemiological records were integrated with environmental and socio-economic indicators, and a Double Machine Learning (DML) framework was applied to estimate the Average Treatment Effect (ATE) and Conditional Average Treatment Effect (CATE) of HFP on excess disease cases. Model robustness was assessed through refutation tests and non-parametric sensitivity analyses for unmeasured confounding. A one-standard-deviation increase in HFP significantly reduced the probability of excess malaria cases by 7.6 percentage points (ATE = -0.076, 95% CI: -0.094 - -0.058), an effect that was more pronounced in socio-economically deprived municipalities and modulated by temperature and precipitation gradients. Conversely, the ATE for dengue and visceral leishmaniasis was not different from zero. Robustness tests suggest the presence of residual bias, but the sensitivity test points to a low plausibility of an unobserved confounder. These findings underscore the necessity of integrating HFP monitoring into public health planning to design context-specific, multi-sectoral interventions that address the evolving landscape of VBD risk in rapidly transforming regions.