公共卫生研究摘要 (2026-07-11)

共收录 58 篇研究文章

1. Intraosseous 'Synthetic Teretization' in the absence of ligamentum teres: surgical technique and early results.

期刊: Journal of pediatric orthopedics. Part B 发表日期: 2026-Jul-13 链接: PubMed

摘要

Achieving stable, concentric reduction in high-grade developmental dysplasia of the hip (DDH) remains challenging, particularly in older children or when the ligamentum teres is absent. Our previously described teretization technique enhances stability through intraosseous ligamentum teres ligamentodesis, but cannot be applied directly in such cases. We describe a synthetic variation using a button-suture-button construct to replicate ligamentum teres function and report early outcomes. We conducted a prospective case series of pediatric patients with International Hip Dysplasia Institute classification (IHDI) grade III-IV DDH and intraoperatively confirmed absence of the ligamentum teres. Open reduction with intraosseous femoral tunneling and synthetic teretization was performed, combined with femoral and pelvic osteotomies. The construct was tensioned to maintain concentric reduction without overconstraint. Clinical outcomes included hip stability, range of motion, McKay score, pain, and complications. Radiographic assessment included IHDI and Severin classification, acetabular index, and avascular necrosis. Nine hips in eight female patients, with a median age of 24 months, underwent synthetic teretization. At a median 23-month follow-up, all hips remained stable, painless, and without functional limitation. Eight hips achieved postoperative IHDI type I and one type II. Among patients aged 4 years or older at final follow-up, all hips were Severin grade I. No redislocation, infection, growth arrest, avascular necrosis, or hardware-related complications occurred. McKay scores were excellent in seven hips and good in two. Two hips in one patient developed acetabular graft resorption after Dega osteotomy and were successfully revised. Synthetic teretization is a feasible stabilizing option for DDH when the native ligamentum teres is absent. Level IV - Therapeutic case series. This study evaluates a novel surgical technique in a series of patients with congenital hip dislocation without a control group.

2. Prevalence of cancer-related fatigue after treatment in patients with non-metastatic gastrointestinal cancers.

期刊: Cancer treatment and research communications 发表日期: 2026-Jul-10 链接: PubMed

摘要

Cancer-related fatigue (CRF) is a prevalent and distressing symptom that persist long after treatment, significantly diminishing the quality of life in cancer survivors-particularly those with gastrointestinal (GI) malignancies. This study aimed to evaluate the prevalence and severity of CRF one year after treatment and to examine its associations with demographic and clinical characteristics in patients with non-metastatic GI cancers. In this observational cross-sectional study, 103 patients with non-metastatic GI cancers who had completed treatment at least 12 months prior were recruited from Besat Hospital and Mahdieh Radiotherapy Center in Hamadan between 2020 and 2021 using a census sampling method. Fatigue was assessed with the Brief Fatigue Inventory (BFI-10), and associations with demographic variables, cancer stage, tumor site, and treatment type were analyzed using SPSS version 26. The mean age of participants was 60.43 ± 10.52 years, and the average disease duration was 3.28 ± 0.45 years. The mean fatigue score was 5.63 ± 2.61 on a 0-10 scale. Most participants were male (51.5%), married (85.4%), had less than a high school education (49.5%), and were self-employed (57.5%). Rectal cancer was the most common diagnosis (53.4%), with the majority of patients diagnosed at stage III (68%). Fatigue severity was classified as mild in 26.2%, moderate in 34.0%, and severe in 39.8% of patients. Higher fatigue severity was significantly associated with female gender, advanced disease stage (stage III), and lower educational level (P < 0.05). No significant associations were found with age, disease duration, marital status, occupation, tumor location, or treatment type. A considerable proportion of patients with non-metastatic GI cancers continue to experience moderate to severe CRF one year post-treatment. The greater fatigue burden among women and those with advanced-stage disease underscores the importance of routine fatigue assessment and targeted supportive care interventions for these at-risk populations.

3. Comparative immunogenicity of three meningococcal vaccines as the first booster dose in children primed with MPCV-AC in China.

期刊: Vaccine 发表日期: 2026-Jul-10 链接: PubMed

摘要

This study aimed to compare the immunogenicity of three meningococcal vaccines used as booster doses in children primed with MPCV-AC in China. A total of 250 eligible children were enrolled to receive MPSV-AC, MPCV-ACYW135, or MPCV-AC as a booster dose. Participants were subdivided into day 7 and day 28 subgroups based on the timing of sample collection. Blood samples were collected at baseline, day 7, and day 28 to measure IgG antibodies against serogroups A and C by ELISA. Baseline GMCs of IgG were 4.34 μg/mL (seropositivity: 79.2%) for serogroup A and 4.36 μg/mL (seropositivity: 82.0%) for serogroup C, both negatively correlated with age and time interval (p < 0.05). All vaccines significantly increased IgG levels at days 7 and 28 post-booster compared with baseline (p < 0.01). In the day 7 group, MPSV-AC yielded a lower GMC (19.14 μg/mL) and seroconversion rate (43.8%) for serogroup A compared with MPCV-ACYW135 (44.69 μg/mL, 78.9%) and MPCV-AC (43.06 μg/mL, 78.1%). In the day 28 group, MPSV-AC showed a comparable GMC for serogroup A (44.42 μg/mL vs. 60.39 μg/mL and 44.66 μg/mL) and a higher GMC for serogroup C (113.40 μg/mL) than MPCV-ACYW135 (59.62 μg/mL) and MPCV-AC (72.75 μg/mL). Only two mild adverse events were reported during the study period. These findings suggest that boosting with MPSV-AC, MPCV-ACYW135, or MPCV-AC is safe and immunogenic; however, further studies are warranted to assess the long-term persistence of immunity conferred by these booster vaccines.

4. Protective titre of the WHO international standard for anti-chikungunya virus antibodies in a mouse model.

期刊: Vaccine 发表日期: 2026-Jul-10 链接: PubMed

摘要

Chikungunya virus (CHIKV) is an arthritogenic mosquito-borne virus of public health concern, causing incapacitating febrile illness and, in some cases, chronic long-lasting recurring arthritis. The epidemic potential and unpredictable nature of CHIKV outbreaks provided a stimulus for establishing the WHO International Standard (1502/19) for anti-CHIKV antibodies in 2022. To enhance the value of this serological material, the in vivo immune protection of 1502/19 was assessed to determine the protective titre. Dilutions of 1502/19 were administered to naïve mice and circulating antibody levels measured prior to challenge 24 h later with CHIKV isolate LR2006-OPY1. Mice administered with undiluted 1502/19 survived an otherwise lethal infection to the end of the study (14 days post-challenge), indicating protection was afforded by 1502/19 and establishing a protective titre can be attained. Our results confirm that standalone humoral immunity can provide protection and aid in future vaccine evaluation by elucidating a standardised protective threshold.

5. COVID-19 vaccination among people with HIV in Uganda: lessons from a high-risk group with high vaccine uptake for the next pandemic.

期刊: Vaccine 发表日期: 2026-Jul-10 链接: PubMed

摘要

Despite the effectiveness of the COVID-19 vaccine, vaccination rates vary across settings and populations, especially among people living with HIV (PLHIV). We assessed factors associated with COVID-19 vaccination among PLHIV in Mbarara, Uganda. We conducted a cross-sectional, secondary analysis of a prospective cohort study consisting of PLHIV ≥18 years old on antiretroviral therapy (ART). We collected data on COVID-19 vaccine uptake and associated factors beginning in December 2021, 9 months after the vaccine became available in Uganda. Reasons for vaccine acceptance and hesitancy were analyzed descriptively, while factors associated with vaccine uptake were assessed using Poisson models with robust standard errors. We analyzed data from 449 participants with a mean age of 46 years (SD 9) and ART duration of 10 years (SD 4). 42% were female, 96% were virally suppressed (<50 copies/mL), and 83% (95% CI = 75%-92%) reported vaccination for COVID-19. In unadjusted analyses, greater concern about COVID-19, obtaining COVID-19 information from health resources, longer ART duration in years, and continuous access to soap and water were positively and significantly correlated with vaccine uptake (p < 0.05). Among those unvaccinated (n = 77/449, 17%), fear of side effects (n = 32/77, 42%) and beliefs that vaccination increased infection risk (n = 12/77, 16%) were predominant reasons for vaccine hesitancy. We found high rates of COVID-19 vaccination among PLHIV on ART in Uganda. Among those unvaccinated, lack of confidence in the safety of the vaccine was the primary barrier to uptake. Future vaccine campaigns should emphasize vaccine safety and efficacy and actively combat misinformation to promote uptake. Clinical Trials Registration. NCT04066036.

6. Characteristics of successful and unsuccessful strategies to increase vaccine intention and improve vaccine uptake for U.S. adult populations in the Affordable Care Act era (2010-2025): a systematic review and meta-regression.

期刊: Vaccine 发表日期: 2026-Jul-10 链接: PubMed

摘要

Vaccine-preventable diseases continue to burden U.S. population health. Despite the Affordable Care Act (ACA) eliminating cost-sharing for recommended vaccines in 2010, adult vaccination rates persistently fall below Healthy People 2030 targets, signaling that access alone is insufficient. To synthesize peer-reviewed literature (2010-2025) on interventions designed to increase vaccine intention or uptake among U.S. adults; characterize strategies, populations, settings, and study quality; and identify predictors of vaccine uptake rate. Following PRISMA 2020 guidelines, a multi-database search was conducted across PubMed, Web of Science, Ovid/MEDLINE, and EBSCOhost, with a final updated search in December 2025. Dual independent reviewers screened studies in two stages. Quality was assessed using the EPHPP tool and certainty evaluated using GRADE. Strategies were categorized per the WHO Behavioral and Social Drivers of Vaccination (BeSD) Model. A meta-regression was conducted on 79 studies, with narrative synthesis across all 92 included studies. Of 11,219 records, 92 studies were included. Study designs were predominantly RCTs; Influenza and COVID-19 vaccines were most commonly studied. In the meta-regression (adjusted R2 = 0.229), prioritizing a specific population (b=0.121, p=.027), using service quality improvement strategies (b=0.226, p=.040), and recruiting through community-based partner organizations (b=0.585, p=.005) or healthcare organizations (b=0.230, p=.040) were associated with significantly higher vaccine uptake rates. Onsite vaccination was associated with lower uptake rates (b=-0.185, p=.033), an effect confirmed as specific to the COVID-19 pandemic emergency-response context rather than a generalizable effect of the strategy in sensitivity analysis. Narrative synthesis identified message framing and educational campaigns as the most frequently deployed strategies, with multi-component designs and community partnerships showing the most favorable outcomes. Effective adult vaccination strategies were multifactorial. Service quality improvement, priority population focus, and community-based recruitment were the strongest predictors of higher uptake. Findings support the WHO BeSD model’s Practical Issues domain: reducing friction outperformed persuasion alone. GRADE certainty remained LOW to MODERATE, emphasizing the need for higher-quality, equity-focused research. This systematic review was registered at Open Science Framework: 10.17605/OSF.IO/SM7YD.

7. DDAH1 and DDAH2 drive vasculogenic mimicry and more aggressive phenotypes in triple negative breast cancer cells.

期刊: Biomedicine & pharmacotherapy = Biomedecine & pharmacotherapie 发表日期: 2026-Jul-10 链接: PubMed

摘要

The overexpression of dimethylarginine dimethylaminohydrolase 1 (DDAH1) and 2 (DDAH2) has been associated with several types of cancer. Specifically, DDAH1 has been shown to play a critical role in the establishment of a vascular network by tumour cells, vasculogenic mimicry (VM), in triple negative breast cancer (TNBC). In turn, VM favours TNBC progression and is associated with poor patient prognosis. DDAH1 is well characterised in its capacity to metabolise asymmetric dimethylarginine (ADMA), an endogenous nitric oxide synthase inhibitor. By contrast, DDAH2 is incapable of metabolising ADMA, and its ADMA-independent functions and role in TNBC are unknown. In an in vitro MDA-MB-231 TNBC cell model, CRISPR-Cas9 knockout and siRNA knockdown of either DDAH1 or DDAH2 significantly reduced VM. This effect was accompanied by a significant reduction in proliferation, migration, invasion, and Vascular endothelial growth factor A (VEGF-A) secretion. These results suggest ADMA-independent mechanisms for DDAH2 in the occurrence of VM and identify DDAH2 as a novel therapeutic target in TNBC.

8. The associations of code reform zoning and activity-oriented zoning with neighborhood social connectedness in the U.S., including mediation by walkability and park coverage.

期刊: Health & place 发表日期: 2026-Jul-10 链接: PubMed

摘要

Zoning codes influence the built environments of communities in the United States (U.S.), which in turn have potential to promote social connections. This study assessed associations between code reform zoning (CRZ) and activity-oriented zoning (AOZ) exposure and perceived neighborhood social connectedness and whether these associations were mediated by walkability and park coverage. Data from the Current Population Survey September 2019 Volunteering and Civic Life Supplement were linked to U.S. county-level data on (1) population-level exposure to CRZ and an index of 10 AOZ measures as of 2010, (2) EPA’s 2021 National Walkability Index, and (3) proportion of area devoted to parks from the 2018 National Neighborhood Data Archive (n = 21,616). Multivariable logistic regression models with robust standard errors examined associations between CRZ and AOZ exposure and three perceived neighborhood social connectedness measures and mediation analyses examined mediation by walkability and park coverage. CRZ (OR: 1.22, 95% CI: 1.08-1.36) and each additional AOZ measure (OR: 1.03, 95% CI: 1.01-1.05) were associated with having conversations or spending time with neighbors. CRZ (OR: 1.22, 95% CI: 1.10-1.35) was also associated with neighbors doing favors for each other, as was AOZ (OR: 1.03, 95% CI: 1.01-1.04). None of these associations were mediated by walkability or park coverage. CRZ (OR: 1.29, 95% CI: 1.14-1.46) and AOZ (OR: 1.04, 95% CI: 1.02-1.06) were associated with neighbors getting together to do something positive; both associations were mediated by walkability but not park coverage. Zoning is a policy lever that can promote neighborhood social connectedness.

9. Agreement and reliability analysis of sarcopenia measures based on muscle function, body composition, and imaging in spinal deformity patients.

期刊: Journal of neurosurgery. Spine 发表日期: 2026-Jul-10 链接: PubMed

摘要

There is no gold standard for assessing sarcopenia. The authors aimed to quantify agreement and reliability among common sarcopenia measures based on muscle function, body composition, and imaging characteristics in a cohort of adult spinal deformity (ASD) patients. This was a cross-sectional study. Preoperative ASD patients at a single tertiary-care center underwent the following sarcopenia assessments: 2 functional muscle assessments (grip strength and gait speed), 3 bioelectrical impedance (BIA) measures (skeletal muscle index [SMI], phase angle, and extracellular water [ECW]/total body water [TBW] ratio), and 2 imaging-based assessments (psoas muscle index [PMI] and total psoas area [TPA]/vertebral body area [VBA] ratio). Spearman’s correlation analysis was used to test for associations. Measurements were standardized into sex-specific z-scores. Bland-Altman analysis was used to quantify agreement and Cronbach’s alpha analysis was used to quantify reliability between sarcopenia measures. Between 2017 and 2025, 272 ASD patients were enrolled in the study. Of these, 88 ASD patients (59.1% female, median age 67.7 years) completed all sarcopenia assessments and thus were included in the analysis. Most sarcopenia measures were weakly correlated, except for PMI and TPA/VBA, which were moderately correlated (ρ = 0.84, p < 0.001), and phase angle and ECW/TBW (ρ = -0.82, p < 0.001). Bland-Altman analysis demonstrated poor agreement between all pairs of sarcopenia measures. Cronbach’s alpha analysis showed poor reliability (α < 0.7) between all pairs of sarcopenia measures except for PMI and TPA/VBA (α = 0.89). These results did not significantly change when all 272 patients with imputed missing data were included. The authors found low agreement and reliability between 7 commonly used sarcopenia measures, except for good reliability between PMI and TPA/VBA. These sarcopenia measures are not interchangeable and may not be measuring the same underlying clinical entity. This is the first study to quantify agreement and reliability between sarcopenia measures. Future studies are needed to determine which sarcopenia measures best predict clinical outcomes in ASD patients.

10. Diagnostic approaches and clinical challenges of imaging in peripheral nerve tumors: data from the multicenter Peripheral Nerve Tumor Registry.

期刊: Journal of neurosurgery 发表日期: 2026-Jul-10 链接: PubMed

摘要

Peripheral nerve tumors (PNTs) are diagnostically challenging due to their heterogeneous histology, variable size, diverse anatomical locations, and imprecise signs of malignancy. Imaging is crucial for detection, characterization, and surgical planning. This study systematically assessed imaging data to identify diagnostic patterns and their limitations across different techniques, as well as to generate a focused, standardized imaging recommendation. A retrospective analysis was conducted on 396 patients with histopathologically confirmed tumors associated with peripheral nerves from five centers participating in the prospective Peripheral Nerve Tumor Registry in Germany and Austria. Preoperative imaging data including MRI, high-resolution ultrasound (HRU), CT, and PET-CT were evaluated with a focus on tumor size, contrast enhancement (CE), T2 signal characteristics, cystic components, and patterns of tissue infiltration and correlated with clinical and histopathologic data. MRI protocols were assessed for consistency. MRI was the primary modality in 94.7% of patients (n = 375), although protocols varied: 7% lacked contrast-enhanced sequences, 22% lacked T2-weighted sequences, and 95% lacked apparent diffusion coefficient maps. Tumors were classified as benign (group 1, n = 321 [81.1%]), malignant (group 2, n = 24 [6.1%]), or rare (group 3, n = 51 [12.9%]). Median tumor sizes were 28.0 (IQR 22.0, range 4-130) mm, 59.5 (IQR 53.0, range 22-96) mm, and 52.0 (IQR 64.0, range 7-190) mm for groups 1-3, respectively. Benign tumors were significantly smaller than malignant and rare tumors (each p < 0.001). CE was present in 97.5%, mainly showing an inhomogeneous pattern in malignant and rare tumors. An inhomogeneous T2 signal (n = 214) and cystic components (n = 99) were more frequent in malignant (79%) and rare (43%) tumors. Perilesional edema (n = 13) and tissue infiltration (n = 26) were found in 84.6% of malignant and rare tumors. Receiver operating characteristic (ROC) analysis identified a tumor size cutoff of 44.5 mm, indicating malignancy (area under the ROC curve = 0.83, sensitivity 78.8%, specificity 75.0%). FDG (18-fluorodeoxyglucose)-PET revealed overlapping maximum standardized uptake values (6.1-33.7) across all groups. MRI offers critical morphological detail, supports differentiation between tumor subtypes, and guides surgical planning. Therefore, it is the imaging of choice in PNTs, whereas PET-CT and HRU may help to close diagnostic gaps left by MRI. Establishing standardized imaging protocols is essential to improve diagnostic accuracy and support consistent, high-quality patient care.

11. Real-World Long-term Comparisons of Rituximab versus Calcineurin Inhibitors for Membranous Nephropathy in the Cure Glomerulonephropathy Study.

期刊: Kidney360 发表日期: 2026-Jul-10 链接: PubMed

摘要

Clinical trials in rare glomerular disease may establish short-term treatment efficacy but are limited by small sample sizes and short study duration. Observational data are needed to assess longer-term outcomes and can provide insights into real-world prescribing practices. This study applied modern statistical methods to real-world data from the Cure Glomerulonephropathy (CureGN) network to compare the effectiveness of rituximab and calcineurin inhibitors on long-term primary membranous nephropathy outcomes. CureGN participants with biopsy-confirmed primary membranous nephropathy who initiated either of the two treatments at least 6 months after any previous immunosuppressant exposure were eligible. Inverse-probability-of-treatment weighting balanced covariates at treatment initiation. Inverse-probability-of-censoring weights accounted for censoring individuals if another immunosuppressant was started during follow-up. Outcomes included time from treatment initiation to composite kidney disease progression (40% decline in eGFR, kidney replacement therapy, or eGFR <15), proteinuria remission, and relapse following remission. Hazard ratios and differences in restricted mean survival times were estimated. 325 treatment initiations across 250 unique participants were eligible, with median follow-up 53 months (25th-75th percentile: 24-79). Participants on calcineurin inhibitors had significantly higher risks of disease progression (HR=2.81; 95% CI: 1.16, 6.80). Hazard ratios for proteinuria remission (HR=0.77; 95% CI: 0.50, 1.17) and relapse (HR=1.42, 95% CI: 0.69, 2.92) had wide confidence intervals. Rituximab was associated with better kidney function preservation than calcineurin inhibitors over long follow-up. Proteinuria remission and relapse results favored rituximab but did not reach statistical significance. Long-term treatment comparative effectiveness in rare diseases can be evaluated with real-world data.

12. Disparities in Telemedicine Utilization Among Kidney Transplant Candidates and Recipients.

期刊: Kidney360 发表日期: 2026-Jul-10 链接: PubMed

摘要

13. Family Size and Longitudinal Outcomes of a Digital-Human Parenting Intervention in Chinese Preschool Families: Secondary Analysis.

期刊: Journal of medical Internet research 发表日期: 2026-Jul-10 链接: PubMed

摘要

Parenting interventions can improve parental and child outcomes across diverse settings. However, less is known about how family size, including the number of children, shapes baseline conditions, and how intervention effects unfold over time. Most studies also focus on average treatment effects, with limited attention to heterogeneity across family contexts and trajectories of change. This study examined whether the number of children was associated with baseline differences in parental and child outcomes, moderated immediate postintervention effects, and shaped postintervention trajectories over 6- and 12-month follow-up periods. We conducted secondary analysis of a pragmatic cluster randomized controlled trial evaluating a universal digital-human parenting intervention delivered through the preschool system in China (N=541). Families were categorized by the number of children (1, 2, 3, or more). We examined (1) baseline differences in parental and child outcomes, (2) moderation of intervention effectiveness at immediate postintervention, and (3) trajectories of change over 6- and 12-month follow-up periods using mixed-effects models. Of the 541 enrolled families, 494 were included in the complete-case baseline analysis. Compared with 1-child families, 2-child families, and families with 3 or more children, reported lower levels of baseline early learning and stimulation and proactive parenting, as well as greater endorsement of corporal punishment and higher parenting stress. We found no statistically significant evidence that the number of children moderated immediate postintervention effects. In intervention-group trajectory analyses, 2-child families showed greater improvement in early learning and stimulation at the 6-month follow-up (b=3.966, 95% CI 1.468-6.463). Families with 3 or more children showed a similar pattern (b=5.749, 95% CI 0.536-10.962), although estimates for this subgroup were less precise because of the small sample size. This subgroup also showed larger but more variable reductions in selected child behavioral outcomes over follow-up. Family size might not always be associated with short-term intervention effectiveness but was associated with divergence in longer-term trajectories. These findings suggest that caregiving demands are relevant for the sustainability of intervention effects. By integrating baseline differences, short-term effects, and longitudinal trajectories within a single framework, this study highlights the importance of moving beyond average treatment effects to more dynamic, context-sensitive evaluations. Designing parenting interventions, particularly scalable digital-human programs, that incorporate sustained and context-responsive support may be critical for addressing variation in family structure and enhancing long-term effectiveness.

14. Community Health and Demographic Surveillance System for Noncommunicable Disease Epidemiology Among Adults in Rural and Urban Zimbabwe, 2024-2029: Protocol for a Longitudinal Surveillance Study.

期刊: JMIR research protocols 发表日期: 2026-Jul-10 链接: PubMed

摘要

Zimbabwe currently faces a rapidly escalating burden of noncommunicable diseases (NCDs) concurrently with persistent communicable disease challenges, resulting in profound epidemiological differences between rural and urban populations. To effectively address this evolving epidemiological landscape and guide evidence-based public health interventions, reliable and high-quality longitudinal data are essential for capturing temporal shifts and contextual determinants often overlooked by conventional health information systems. This protocol details the methodology for establishing a health and demographic surveillance system (HDSS), a longitudinal, population-based cohort designed to continuously monitor the prevalence, incidence, and key determinants of NCDs, specifically cardiovascular diseases and diabetes, and their associated risk factors in selected rural (Mt Darwin) and urban (Bindura) sites in Mashonaland Central Province over a 5-year period (2024-2029). The HDSS uses a stratified multistage sampling design to recruit adults (aged ≥18 y) residing across 2 rural and 2 urban wards. Initial activities include comprehensive community profiling and household mapping, followed by a rigorous baseline survey, with systematic follow-ups scheduled every year. Data encompass essential domains such as vital events, migration patterns, detailed social determinants of health, health behaviors, self-reported and clinically assessed NCDs, physical examinations (including height, weight, blood pressure, and waist/hip circumference), biochemical markers (fasting glucose, lipid profiles, and urine sodium/creatinine), and standardized verbal autopsies. Data capture will make use of REDCap (Research Electronic Data Capture) to facilitate real-time data entry and validation. The protocol is underpinned by rigorous quality assurance procedures, continuous community engagement, and comprehensive ethical oversight. The Zimbabwe HDSS received ethical approval on July 30, 2024 (MRCZ/A/3191). Baseline data collection was completed in Mt Darwin (rural site) in December 2024 and in Bindura (urban site) in March 2025. Statistical analysis of baseline NCD prevalence, risk factor distributions, and rural-urban comparisons is underway, with findings expected to be submitted for publication by the end of 2026. The first annual longitudinal follow-up round is planned for the second quarter of 2027, subject to funding availability, with subsequent rounds scheduled annually through 2029. Longitudinal incidence estimates and NCD trend analyses are expected to be published progressively from 2026 to 2029. This community HDSS addresses a critical evidence deficit within Zimbabwe’s national health information infrastructure. By implementing an ethical, sustainable, and community-engaged research methodology, the HDSS serves as a potent regional model. It is designed to generate actionable, policy-relevant data for national health authorities and stakeholders, thereby accelerating the country’s NCD prevention and control agenda while simultaneously acting as an enduring platform for academic innovation, capacity building, and policy translation efforts targeting both rural and urban health disparities.

15. Using Ecological Momentary Assessment, Geolocation Tracking, and Neuroimaging to Assess Effects of Tobacco Retail Exposure on Smoking Behavior: Protocol for the GeoSmoking Study.

期刊: JMIR research protocols 发表日期: 2026-Jul-10 链接: PubMed

摘要

Cigarettes are a global public health concern, as cigarette smoking is the leading cause of death in the United States and throughout most high-income countries. Exposure to tobacco retail has been linked to adverse smoking outcomes, but research using naturalistic and causal approaches to quantify these effects in the real world remains relatively sparse. To address these gaps, this study used geolocation tracking, ecological momentary assessment, and neuroimaging to assess smoking outcomes in daily life and conducted a randomized controlled trial focused on the effects of exposure to tobacco retail. The GeoSmoking study aimed to evaluate (1) within-person associations between real-world tobacco retail exposure and cigarette craving and smoking, (2) causal effects of real-world tobacco retail exposure, and (3) neural cue reactivity as a mechanism for real-world tobacco retail effects. This paper describes the implemented protocol, including study status and flow reporting. In a 2-week baseline period, the study collected reports of craving and smoking multiple times per day using ecological momentary assessment, in addition to other measures. Simultaneously, geolocation tracking was used to quantify tobacco retail exposure through the creation of a tobacco retail database across 3 US states (Pennsylvania, New Jersey, and Delaware). A 4-week intervention period followed, in which participants were randomly assigned to make a purchase at either a nontobacco retail store 5 days per week (nontobacco retail condition) or a tobacco retail store 5 days per week (tobacco retail condition), or follow their normal routines (control condition). An optional functional magnetic resonance imaging (fMRI) session concluded the study. Individuals participated remotely, unless they opted into the fMRI session, which was completed at the University of Pennsylvania. The GeoSmoking study was approved by the Institutional Review Board at the University of Pennsylvania. Data collection started on May 25, 2022, and ended on June 10, 2024. In total, 310 participants were enrolled, 282 participants completed the baseline phase, 244 participants completed the intervention phase, and 24 participants completed the optional fMRI scan. This study protocol was implemented successfully. Findings from planned analyses will quantify the strength of relationships between naturalistic exposure to tobacco retail, craving, smoking, and a range of other outcomes. These findings have significant implications for our understanding of health behaviors and outcomes, as well as policy.

16. Have we forgotten our obligation to train health workers on disability? A policy analysis in sub-Saharan Africa.

期刊: Journal of health services research & policy 发表日期: 2026-Jul-10 链接: PubMed

摘要

ObjectivesPeople with disabilities have worse health outcomes than people without disabilities, leading to a 10-20-year life expectancy gap. Health workers’ attitudes and lack of training are barriers to health care for people with disabilities, yet current training initiatives are unsystematic and limited to specific cadres or institutions. Countries that have adopted the UN Convention on the Rights of Persons with Disabilities likely have legal obligations to train health workers on disability. We sought to explore how this obligation is included in disability laws and policies in sub-Saharan Africa, as this is an important indication of activities to close the health gap for people with disabilities.MethodsWe searched the two available databases on disability laws: WHO MiNDBANK and UN websites for disability laws and policies for each country to systemically extract information across 11 domains.Results57 documents in English, French, and Portuguese from 31 countries were included. No relevant documents were found for 18 countries. Of the most recent document for each country, nearly half (n = 16, 52%) had no mention of disability training, while the remaining countries required or mandated it (n = 15; 49%, respectively). Most laws and policies had limited details, though more robust ones had information on budget allocation, competencies, and cadres included.ConclusionsTherefore, several countries in sub-Saharan Africa include health worker training in disability laws, but more detailed policies could improve disability training initiatives.

17. The convergence of health system, climate, and social pathways in Malawi's 2022-2024 cholera outbreak - A qualitative assessment.

期刊: PLoS neglected tropical diseases 发表日期: 2026-Jul-10 链接: PubMed

摘要

Climate-related disasters increase cholera risks, yet their contribution to outbreaks is often explained through microbiological, epidemiological or ecological lenses, limiting our understanding of system convergence. Examining the 2022-2024 cholera outbreak in Malawi, we explore how healthcare providers in two rural districts perceived the interconnected pathways that transformed a seasonal cholera outbreak into a two-year epidemic. Drawing from field visits in Neno and Chikwawa Districts of Malawi, we conducted 24 in-depth semi-structured interviews with first responders. We identified three converging pathways: tropical cyclones that disrupted traditional disease patterns and recovery capacity; health system vulnerabilities characterized by growing unpredictability and infrastructure destruction; and social and economic determinants of health including mass displacement, inadequate water, sanitation, and hygiene infrastructure, and cross-border transmission. The convergence of these pathways amplified acute climate impacts and chronic structural vulnerabilities. These findings highlight the need for integrated system approaches that address pathway interconnections rather than isolated interventions in cholera containment, essential for meeting 2030 elimination goals.

18. Sport-discipline and age-related differences in knee extensor musculotendinous morphology and function.

期刊: The Knee 发表日期: 2026-Jul-10 链接: PubMed

摘要

Sport-specific mechanical demands and progression from youth to elite competition may influence musculotendinous morphology and function, that potentially contribute to knee pain and injury in athletes. The objective of this study was to assess sport- and age-related differences in the knee extensor musculotendinous morphology and function, and self-reported knee pain and injury incidence in competitive athletes. A total of ninety male athletes volunteered for the present study: cyclists (CY), basketball players (BP), and ice hockey-players (IH), with 15 youth (U19 teams - 17.3 ± 1.1  years) and 15 elite men (27.2 ± 3.8  years) per discipline. Muscle thickness (vastus lateralis, rectus femoris, vastus medialis) and patellar tendon cross-sectional area (CSA) were assessed with ultrasonography. Maximal isometric and isokinetic torque, and countermovement jump (CMJ) height were measured. Anterior knee pain (AKP) and knee injury history (KIJ) were collected via structured interviews. Data were analyzed using a two‑way ANOVA with discipline and age category as between‑subject factors. A discipline × age interaction was observed for quadriceps muscle size (QMS) (p = 0.01). Elite athletes showed larger muscles than youth and CY had smaller absolute QMS but higher body-mass-normalized values than BP and IH (p < 0.05). Muscle and tendon size and maximal torque were greater in elite athletes (p < 0.03), but differences disappeared when normalized for body mass. CY displayed lower patellar tendon stress and CMJ height than BP and IH (p < 0.05). Elite athletes reported higher AKP and KIJ than youth (p ≤ 0.05). Cycling was associated with a greater muscle size-to-body mass ratio, yet lower tendon stress, whereas basketball and ice hockey were associated with superior explosive performance. Despite proportional scaling from youth to elite suggesting a coordinated muscle-tendon development, elite athletes suffer more from knee pain and injury rates.

19. Association for Academic Surgery Presidential Address - Hidden Figures: They Are all Around Us.

期刊: The Journal of surgical research 发表日期: 2026-Jul-10 链接: PubMed

摘要

The United States surgical workforce faces an impending crisis, with projections of a shortage of 10,000-19,900 surgeons by 2036 and no meaningful expansion of general surgery residency positions. In this fixed-capacity system, retention is synonymous with workforce production. Yet, attrition disproportionately affects trainees from underrepresented backgrounds, resulting in preventable losses of talent and leadership potential. This manuscript expands upon the 2025 Academic Surgical Congress Presidential Address, using the framework of “Hidden Figures” to explore how systemic invisibility, lack of sponsorship, and absence of allyship undermine resident persistence and career advancement. Through personal narrative and professional reflection, Dr Callisia Clarke illustrates how microinvestments, intentional leadership development, and caritas-driven allyship can reverse attrition trends and strengthen the academic surgical pipeline. Throughout this commentary, brief italicized passages reflect personal narrative from her Presidential Address, followed by analytic reflections that situate these experiences within broader structural and workforce challenges in academic surgery. True workforce sustainability calls for a change from symbolic diversity to measurable retention, promotion, and belonging.

20. Training Programs for Dementia Care Staff and Aggression in Nursing Homes: Secondary Analysis of a Cross-Sectional Online Survey.

期刊: JMIR nursing 发表日期: 2026-Jul-10 链接: PubMed

摘要

Training programs help dementia care staff handle residents’ behavioral symptoms in nursing homes and assisted living facilities. However, it is unclear how feeling well-prepared from such training relates to experiences of physical and verbal aggression from residents. This study aimed to determine whether perceived training preparedness was related to experiences of physical and verbal aggression from residents in nursing homes and assisted living facilities using data from a large, nationally representative dementia care workforce sample. This study was an analysis of the 2024 National Dementia Workforce Study, a cross-sectional online survey of the national dementia care workforce. Weighted regression modeling was used to identify associations between feeling well-prepared by training programs and experiencing physical or verbal aggression. Dementia care staff in nursing homes (weighted n=896,320) commonly reported experiencing physical (365,452/896,320, 40.8%) and verbal (470,536/896,320, 52.5%) aggression from residents with dementia, whereas more than two-thirds (614,561/896,320, 68.6%) reported feeling that their training prepared them well to manage resident behaviors. Staff in assisted living facilities (n=738,856) less commonly reported experiencing physical (198,964/738,856, 26.9%) and verbal (223,343/738,856, 30.2%) aggression, whereas almost three-quarters (527,621/738,856, 71.4%) reported feeling that their training prepared them well to manage resident behaviors. In regression modeling in nursing homes, feeling well-prepared by training for managing resident behaviors was associated with a lower likelihood of experiencing physical aggression (odds ratio [OR] 0.4, 95% CI 0.223-0.711; P=.01) and verbal aggression (OR 0.5, 95% CI 0.299-0.844; P=.02). In assisted living facilities, feeling well-prepared by training for managing resident behaviors was associated with a lower likelihood of experiencing physical (OR 0.14, 95% CI 0.04-0.55; P=.01) and verbal (OR 0.07, 95% CI 0.0134-0.354; P=.001) aggression. While physical and verbal aggression from residents with dementia is common in nursing homes and assisted living facilities, nationally representative weighted regression modeling highlights an association between feeling well-prepared to handle resident behaviors and a lower likelihood of experiencing aggression. As the data used were derived from a cross-sectional survey, the causal link between these 2 factors should be explored in interventional studies. Our results indicate that effective training programs are associated with worker-reported reduced experiences of physical and verbal aggression in both nursing homes and assisted living facilities. The specific components of training programs that may support effectiveness remain unknown.

21. Seeing is Believing? Credibility and Behavioral Intentions Toward Evidence-Based and Misleading Health Information.

期刊: American journal of health promotion : AJHP 发表日期: 2026-Jul-10 链接: PubMed

摘要

PurposeTo examine how adults respond to real-world health videos that vary in credibility.DesignRandomized, within-subjects online experiment.SettingOnline U.S. survey.Sample179 adults recruited from an online panel.InterventionParticipants viewed one misleading and one evidence-based health video, in randomized order.MeasuresBefore viewing, participants reported trust in traditional and social media. After each video, they rated perceived information credibility (PIC) and perceived source credibility (PSC), relevance, and behavioral intention to adopt the recommended behavior. Demographic data were also collected.AnalysisPaired-samples t-tests and hierarchical linear regressions examined responses to evidence-based vs misleading videos and associations among the variables.ResultsThe evidence-based video was rated higher for relevance (t (178) = -4.93, P < .001), PSC (t (178) = -11.36, P < .001), PIC (t (178) = -10.61, P < .001), and intention (t (178) = 5.73, P < .001). For both videos, PSC and relevance were positively associated with intention. Trust in traditional media was related to higher PSC (b = .43, P < .001) and PIC (b = .35, P < .001) of the evidence-based content, whereas trust in social media was related to higher PSC (b = .46, P < .001) and PIC (b = .33, P = .022) of the misleading content. Higher education was associated with a better ability to distinguish between the PSC and PIC of the two videos (ps < .01).ConclusionsFindings highlight psychological and contextual factors shaping engagement with online health information and the importance of speaker credibility and platform trust in promoting informed health decision-making.

22. European Society of Cardiology updated curriculum for heart failure nurses: developed by the Heart Failure Association, in collaboration with the Association of Cardiovascular Nurses and Allied Professions of the European Society of Cardiology.

期刊: European journal of heart failure 发表日期: 2026-Jul-10 链接: PubMed

摘要

The role of the nurse in the heart failure (HF) multi-disciplinary team (MDT) has become well-established, with clear evidence of improved patient outcomes and recommended by professional guidelines. Recognizing the change in the HF landscape since the publication of the first Heart Failure Association (HFA) of the European Society of Cardiology (ESC) HF nurse curriculum in 2016, and the expanding role of HF nurses of in the HF MDT, the HFA in collaboration with the Association of Cardiovascular Nursing and Allied Professions (ACNAP) of the ESC prioritized this update to the curriculum. Standardized training programmes for HF nurses improve the quality of care provided to patients with HF and their caregivers. Recognizing the variability of education background and clinical autonomy across Europe and beyond, this curriculum is designed in a flexible way to be able to be adapted and adjusted based on individual country regulations and forms. Endorsement of this curriculum from national professional bodies or Nursing Councils would ensure uniformity and enhance the profession’s contribution to HF care. The updated specialist HF nurse curriculum provides the basis for the advanced level of knowledge, skills and attitudes required for the appropriate expansion of the role of the HF nurse that can be adapted across Europe and beyond, while complying with professional legislation of different healthcare systems and supporting nurses who move between countries.

23. Influence without medical expertise: a social network analysis of Mounjaro discussions on twitter (X).

期刊: Saudi pharmaceutical journal : SPJ : the official publication of the Saudi Pharmaceutical Society 发表日期: 2026-Jul-10 链接: PubMed

摘要

Mounjaro (tirzepatide) is a recently approved medication for type 2 diabetes that is increasingly used off-label for weight loss, in part due to extensive promotion on social media. X has emerged as a major venue for discussions about weight-loss medications, yet limited research has examined public discourse surrounding Mounjaro. Identifying key influencers and mapping conversation dynamics are critical for understanding how social media may shape public awareness and adoption of emerging pharmacotherapies. This study examined Mounjaro-related discourse on X to identify influential information sources, dominant discussion topics, and public sentiment. A quantitative, exploratory observational design was employed using social network analysis and automated sentiment analysis of publicly available tweets. The dataset included 5,566 tweets generated by 5,641 unique users collected between January 9 and February 24, 2025. Using NodeXL, betweenness and in-degree centrality measures were used to identify influential users and content sources, and cluster analysis identified dominant discussion topics within the network. Sentiment analysis assessed the overall tone of Mounjaro-related tweets. Results indicated that the most influential users were predominantly non-medical individuals, including public figures and patients sharing personal experiences. Overall sentiment toward Mounjaro was largely positive, with 62.6% of tweets expressing favorable attitudes. Network clusters centered on weight loss, comparisons with Ozempic and Wegovy, pharmaceutical branding, and diabetes treatment. These findings highlight the prominent role of non-expert voices in shaping online discourse and underscore the need for evidence-based health communication strategies on social media.

24. Current Contraceptive Practices and Pre-exposure Prophylaxis Modality Preferences among Black and Non-Black Women in the United States: Implications for Bundled Messaging.

期刊: Archives of sexual behavior 发表日期: 2026-Jul-10 链接: PubMed

摘要

This study examined women’s PrEP awareness, knowledge, and preferences for PrEP modality (daily oral pill or two-month injectable) based on their current contraceptive method and race. Data were from an online survey of 779 women (ages 18-64, 64% Black) in four US counties and were analyzed using descriptive statistics, chi-square tests, and regression models. More Black women reported PrEP awareness than non-Black women (55% vs. 41%). Though most women reported PCPs or OB-GYNs could prescribe PrEP, overall PrEP knowledge was low, with minimal differences by race. Women taking a birth control pill, other birth control, or no birth control preferred PrEP as a pill. Women who reported currently using an injectable form of birth control did not demonstrate a clear preference for injectable PrEP versus PrEP as a pill. There were no significant differences by race. Knowledge about PrEP was limited, indicating a need for awareness campaigns designed to reach all women. Clinicians have the potential to play a pivotal role in promoting PrEP awareness and options to women, emphasizing the importance of health promotion messages that incorporate PrEP-modality preferences and contraceptive use.

25. Efficacy and safety of dual antiplatelet treatment up to 72 hours after mild ischemic stroke or transient ischemic attack in patients with established cardiovascular disease.

期刊: Neurotherapeutics : the journal of the American Society for Experimental NeuroTherapeutics 发表日期: 2026-Jul-10 链接: PubMed

摘要

Patients with established cardiovascular disease (CVD) may have a higher risk of recurrent stroke and a higher prevalence of antiplatelet resistance than those without CVD. This study investigated the efficacy and safety of dual antiplatelet therapy (DAPT) with clopidogrel plus aspirin in patients with established CVD. This is a secondary post hoc analysis of the Intensive Statin and Antiplatelet Therapy for Acute High-risk Intracranial or Extracranial Atherosclerosis (INSPIRES) trial. Patients with mild ischemic stroke (IS) or high-risk transient ischemic attack (TIA) of presumed atherosclerotic cause were randomized to receive either DAPT or aspirin alone within 72 h after symptom onset. Established CVD was defined as a prior diagnosis of IS, coronary artery disease, TIA, or peripheral arterial disease. The primary efficacy and safety outcomes were the occurrence of new stroke and moderate-to-severe bleeding within 90 days. This study included 6100 patients, with a mean age of 63.7 ± 9.6 years and 35.8% of female. DAPT was associated with a reduced risk of new stroke (hazard ratio [HR] = 0.67, 95%CI: 0.54-0.85, P < 0.001) in non-CVD patients but not in those with established CVD (HR = 0.97, 95%CI: 0.73-1.28, P = 0.82), compared with aspirin (P for interaction = 0.04). Moderate-to-severe bleeding did not differ by antiplatelet treatments across CVD subgroups (P for interaction = 0.32). In the INSPIRES trial, patients with established CVD may benefit less from clopidogrel-aspirin in reducing the risk of recurrent stroke within 90 days than those without CVD after mild IS or high-risk TIA. TRIAL REGISTRATION: URL: https://www.clinicaltrials.gov; Unique identifier: NCT03635749.

26. Targeted Inhibition of Gut-Microbial Trimethylamine N-Oxide Production Fosters Regression of CKD Phenotypes.

期刊: Journal of the American Society of Nephrology : JASN 发表日期: 2026-Jul-10 链接: PubMed

摘要

Recent studies demonstrate gut-microbial trimethylamine N-oxide (TMAO) is clinically and mechanistically linked to chronic kidney disease (CKD) development. Prior studies showed selective targeting of gut-microbial TMAO production can prevent CKD initiation. A highly relevant clinical question is whether inhibiting TMAO generation can reverse established kidney dysfunction and fibrosis. CD1 mice were first randomized (Phase 1) to unilateral nephrectomy or sham surgery and fed a high-fat diet ± 1% choline supplementation to document CKD through measures of multiple indices of kidney function, tissue remodeling/fibrosis, and uremic toxins. Mice were then randomized (Phase 2) to continue the same diet ± fluoromethylcholine (FMC), a mechanism-based gut-microbial TMAO inhibitor, for 8 additional weeks, and the impact on CKD related phenotypes assessed. After 12-weeks, choline-supplemented unilateral nephrectomized mice exhibited 15-fold higher circulating TMAO levels. In parallel, multiple kidney dysfunction indices progressed, including 48% reduction in measured glomerular filtration rate (mGFR), elevated Cystatin C and creatinine, 3.5-fold greater tubulointerstitial fibrosis, and upregulated profibrotic gene expression. Following Phase 2 (8 weeks ± FMC), choline-supplemented (high-TMAO) unilateral nephrectomized mice without FMC showed further elevation of circulating TMAO and multiple indices of progressive kidney function decline and fibrosis. Conversely, FMC-treated animals showed virtual elimination in circulating TMAO and significant improvements in all monitored CKD phenotypes including >50% higher mGFR, and improved (decreased) creatinine, Cystatin C, pseudouridine, urinary albumin/creatinine ratio, kidney fibrosis measures, and many uremic toxin levels (e.g. indoxyl sulfate and phenylacetylglycine). Beyond halting progression of kidney functional decline and fibrosis, there was frank regression in tubulointerstitial fibrosis (41% reduction) and significant improvement in mGFR (39% increase). Pharmacological targeting of gut-microbial TMAO production after CKD establishment halted disease progression and promoted regression of key CKD pathophysiological features.

27. Protective effects of influenza B neuraminidase antibodies against symptomatic influenza virus infection.

期刊: The Journal of infectious diseases 发表日期: 2026-Jul-10 链接: PubMed

摘要

Influenza vaccines are designed to induce hemagglutinin-inhibiting (HAI) antibodies rather than neuraminidase-inhibiting (NAI) antibodies; therefore, NAI antibodies’ protective effects need further investigation. NAI antibodies’ protective effects, independent of HAI antibodies, have been demonstrated for influenza A viruses, but not influenza B viruses (IBV). Employing H6NB reassortant virus targets, we evaluated NAI antibodies’ protective effects against IBV in sera from a prospective influenza vaccine effectiveness study among healthcare personnel (HCP) in Israel. Antibody titers against B/Brisbane/60/2008 and B/Phuket/3073/2013 were quantified by HAI and NAI assays. Matched NAI and HAI antibody titers from baseline and post-vaccination sera were analyzed for the 2017-2018 influenza season. Laboratory-confirmed IBV infection was recorded in 64/262 HCP, and influenza vaccination in 187/262 HCP. Vaccination did not consistently elicit rising NAI titers against vaccine strain B/Brisbane, with a geometric mean fold rise of 1.1 (95% CI: 0.9, 1.3). However, comparing baseline NAI titers, geometric mean titer ratios were 1.50 (95% CI: 1.0, 2.1) times higher against B/Brisbane and 2.5 (95% CI: 1.7, 3.6) times higher against circulating B/Phuket in vaccinated versus unvaccinated HCP. Each two-fold rise in NAI antibody titers reduced the hazard of symptomatic infection by 42% (95% CI: 36%-48%) against B/Phuket and 23% (95% CI: 13%-33%) against B/Brisbane, adjusting for HAI titers. NAI antibodies were a strong correlate of protection against symptomatic IBV infection, with protective effects independent of those from HAI antibodies. These findings suggest the use and standardization of neuraminidase content in influenza vaccines could provide broader protection against influenza.

28. Waveguide-based in-process ultrasound inspection and imaging in harsh environments: advances and challenges.

期刊: Ultrasonics 发表日期: 2026-Jul-10 链接: PubMed

摘要

Process engineering often requires continuous monitoring of structural health in components exposed to chemically aggressive environments or high temperatures. Examples include thermal solar power plants, where liquid-metal heat-transfer fluids must be monitored to ensure safe and efficient operation, and lithium or next-generation batteries, where liquid-metal electrodes or electrolytes may develop uneven flow, instabilities, or hotspots detectable in real time using ultrasound. Conventional contact ultrasound imaging, however, is limited in these applications because transducers are highly sensitive to harsh conditions, since harsh environment already include elevated temperatures, often resulting in device failure. Waveguides provide a promising alternative by shielding transducers from aggressive environments. Single-mode waveguides (SMWGs) have been widely studied for ultrasound testing, offering protection from thermal damage but requiring slow point-by-point scanning for imaging. Multimode waveguides (MMWGs) have therefore been proposed for ultrasound imaging at high temperatures, though challenges remain regarding wettability, geometry, boundary conditions and the development of aberration correction algorithms to address wavefront distortion. This paper presents a systematic review of ultrasound waveguide transducers for structural health monitoring under high-temperature conditions. It evaluates key designs, highlighting their benefits, drawbacks and contributions to knowledge and surveys aberration correction methods and modelling approaches applicable in harsh environments. The review also traces the evolution from SMWGs to advanced MMWGs that exploit multiple wave modes, discusses opportunities in computational ultrasound imaging, and outlines future research directions. These findings support the optimization of waveguide-based ultrasound imaging for high-temperature liquids in solar power and battery applications, with potential transferability to improve medical ultrasound imaging through aberrative medium (e.g skull).

29. Beyond Statistical Significance: Methodological Fragility and Censoring Bias in the 5-Year Update of CheckMate 743.

期刊: Journal of clinical oncology : official journal of the American Society of Clinical Oncology 发表日期: 2026-Jul-10 链接: PubMed

摘要

30. Watching the Ship, Missing the Forest: Why Ecological Spillover, Reservoir Ecology, and Environmental Change Remain the True Hantavirus Threats in North America.

期刊: The Journal of infectious diseases 发表日期: 2026-Jul-10 链接: PubMed

摘要

31. Nanoplastics Pollution Threatens Sustainable Nitrogen Fixation in Agroecosystems by Disrupting Legume-Rhizobium Symbiosis.

期刊: ACS nano 发表日期: 2026-Jul-10 链接: PubMed

摘要

The rhizobium-legume symbiosis plays a vital role in the global nitrogen cycle. Although microplastics have been shown to affect this symbiotic system, the accumulation and impacts of nanoplastics (NPs) in rhizobia and their root nodules remain poorly understood, particularly regarding the interactive effects of NPs of different sizes on symbiotic nitrogen fixation. This study demonstrated that polystyrene (PS) NPs exhibited a significant size difference effect on rhizobia and their symbiotic nitrogen-fixing association with soybean (Glycine max). We found that both rhizobia and soybean nodules efficiently internalized PS NPs, with differently sized NPs showing mutual enhancement during the cellular uptake of rhizobia. 100 mg/kg of 20 nm PS NPs severely disrupted the symbiotic nitrogen fixation, reducing nitrogenase activity by 51.3% in single exposures and 28.6% in combined exposure to 200 nm PS NPs. This observed disruption caused by 20 nm PS NPs was associated with suppressed nodule formation (26.0% reduction in number, 50.4% decrease in fresh biomass), diminished leghemoglobin content (64.9% reduction), impaired nutrient acquisition (26.5% decrease in nodule Mo content), reduced rhizobia infection efficiency, impaired plant growth, and modified expression of nodulation- and nitrogen-fixation-related genes. These findings revealed that small-sized PS NPs posed a substantial threat to the rhizobium-legume symbiosis, underscoring the ecological risks of NP pollution in agricultural systems.

32. β-caryophyllene gradients act as ecological filters shaping microbial life-history strategies via iron competition.

期刊: The ISME journal 发表日期: 2026-Jul-10 链接: PubMed

摘要

Plant-emitted volatile organic compounds (VOCs) are increasingly recognized as key mediators of plant-microbe interactions, yet how they shape microbial community assembly and adaptive strategies remains unclear. Here, using the widespread plant sesquiterpene β-caryophyllene as a model VOC, we demonstrate that plant volatiles drive dose-dependent ecological filtering and microbial adaptation, governed by life-history trade-offs and resource availability. Soil microcosm experiments revealed that low concentrations of β-caryophyllene selectively enrich competitive bacterial taxa, whereas high concentrations favor ruderal, fast-growing opportunists, restructuring communities along a competitor-stress tolerator-ruderal (CSR) axis. Focusing on representative taxa, Bacillus subtilis and Pseudomonas aeruginosa, we show that these contrasting ecological outcomes are underpinned by divergent physiological, metabolic, and transcriptional reprogramming. Across both taxa, low-dose β-caryophyllene consistently induces siderophore biosynthesis, identifying iron availability as a central integrator of volatile perception and response. Experimental manipulation of iron reprogrammed growth, carbon utilization, and antibiotic resistance, gating whether β-caryophyllene functions as a signal that primes competition or as a stressor that selects for ruderal traits. Together, our work offers critical insights into the VOC-mediated microbiome management for ecological restoration and sustainable agriculture.

33. Interventions to Enhance COVID-19 Pandemic Health Literacy in Health Professionals: Systematic Review.

期刊: JMIR medical education 发表日期: 2026-Jul-10 链接: PubMed

摘要

The COVID-19 pandemic has placed a significant burden on health professionals (HPs). They face higher infection risks due to the nature of their work environment and patient care responsibilities. Their ability to access and apply reliable COVID-19 information affects their own preventive behavior and that of those around them. In this context, health literacy (HL) has become increasingly important. Despite extensive research, information to foster COVID-19-related HL in HPs remains limited. This systematic review aimed to identify, appraise, and synthesize intervention studies on the effectiveness of COVID-19-related HL interventions in HPs. Five electronic databases (eg, PubMed (MEDLINE), Embase), six clinical trials registries (eg, ISRCTN registry), one preprint server (MEDRXIV), published conference proceedings, and five gray literature databases (eg, opengrey.eu, ProQuest) were searched in May 2022 and updated in August 2025. Reference lists of included studies were screened manually. Two reviewers independently screened titles, abstracts, and full-texts according to eligibility criteria and extracted data; disagreements were resolved by discussion or consultation with a third reviewer. We included randomized controlled trials (RCTs), nonrandomized studies of interventions, and uncontrolled before-and-after studies evaluating the effectiveness of any COVID-19-related HL intervention. Primary outcomes include COVID-19-related HL, its four facets (access, understand, appraise, and apply COVID-19 information), and indicators (eg, COVID-19-related knowledge), assessed at postintervention and follow-up. When studies were sufficiently similar, random-effects meta-analyses were performed; otherwise, a narrative synthesis was provided. Risk of bias was assessed using validated tools based on study design, and the overall certainty of the evidence was evaluated by the GRADE (Grading of Recommendations, Assessment, Development, and Evaluation) approach. We included 15 RCTs (2034 participants), 4 nonrandomized studies of interventions (291 participants), 74 uncontrolled before-and-after studies (327,298 participants), 5 ongoing studies, and 1 study with awaiting classification. Interventions targeted a broad range of health occupational groups. Intervention type, delivery mode, methods, settings, and comparator varied widely. No outcome measure explicitly referred to an HL model. Most studies aimed to enhance COVID-19-related knowledge and skills, and had a high risk of bias. COVID-19-related interventions may increase knowledge of vaccines (standardized mean difference 1.00; 95% CI 0.33 to 1.67, I2=24%), and the infection prevention control skills, such as donning and doffing of personal protective equipment (standardized mean difference 1.95; 95% CI 1.82 to 3.09, I2=46%), but the evidence remains very uncertain. COVID-19-related HL interventions may promote HP’s short-term competencies in infection control. However, the evidence remains uncertain, primarily due to the low quality of studies, characterized by a high risk of bias. Interventions specifically designed to enhance the full COVID-19 HL operationalized by its four facets are lacking. High-quality RCTs with sufficient statistical power, grounded in HL theoretical principles, are needed to achieve precise understanding.

34. Polyarteritis Nodosa and Sarcoidosis Presenting with Myalgia and Myositis-Mimicking MRI Findings: A Report of Two Cases.

期刊: Modern rheumatology case reports 发表日期: 2026-Jul-10 链接: PubMed

摘要

Diseases presenting with muscle symptoms are diverse. We report two cases initially suspected of idiopathic inflammatory myopathies (IIMs) that were ultimately diagnosed as polyarteritis nodosa and sarcoidosis, respectively. Case 1 was a 30-year-old man with fever, limb muscle pain, and elevated inflammatory markers. Muscle MRI showed high signal intensity on fat-suppressed T2-weighted images, and biopsy revealed vasculitis with fibrinoid necrosis, leading to a diagnosis of polyarteritis nodosa. Case 2 was a 70-year-old man with proximal muscle pain and weakness and elevated muscle enzymes. MRI showed high signal intensity in the thigh muscles, and biopsy revealed noncaseating granulomas consistent with sarcoidosis. These cases highlight the diagnostic pitfalls of interpreting MRI findings and serum creatine kinase levels in isolation when evaluating suspected IIMs and underscore the critical role of histopathological evaluation, including muscle biopsy, in establishing an accurate diagnosis.

35. "My patience has limits": A qualitative study on how supervisors manage their conflicts of interest with employees who returned to work after mental health leave.

期刊: Work (Reading, Mass.) 发表日期: 2026-Jul-10 链接: PubMed

摘要

BackgroundEmployees who return to work (RTW) after mental health leave are a vulnerable, yet understudied population. While work adjustments are often implemented to facilitate their return, these changes may conflict with the operational interests of supervisors.ObjectiveThe present study aims to understand the perspectives of supervisors on (1) work adjustments that conflict with their interests post-RTW, (2) the strategies they used to navigate these conflicts, and (3) reflections on their strategies. The Dual Concern Model was used as a framework for this study.MethodsA qualitative design was employed, involving semi-structured interviews with 15 supervisors. Data were analyzed using reflexive thematic analysis.Results(1) Supervisors identified task adjustments and job changes as primary areas of conflict. (2) To manage their conflicts of interests with employees, supervisors primarily aimed for win-win solutions and compromises. Secondarily, other strategies were used, such a as dominating approach to prioritize organizational interests. (3) The majority of supervisors held a nuanced perspective on their management of perceived conflicts.ConclusionsThe study results cautiously suggest that supervisors play an important role in the sustainability of work changes after mental health leave.

36. Co-Designing Person- and Family-Centered Care for Older Adults Living With HIV: Protocol for a Community-Based Participatory Study.

期刊: JMIR research protocols 发表日期: 2026-Jul-10 链接: PubMed

摘要

Advances in antiretroviral therapy have transformed HIV into a chronic condition, leading to a growing population of adults aged 50 years and older living with HIV in Canada and globally. These individuals experience higher rates of multimorbidity, frailty, cognitive changes, and polypharmacy than their HIV-negative peers, and many rely on caregivers for emotional and practical support. Caregiving often occurs within chosen families of partners, friends, and community members, yet these caregivers remain largely unrecognized in policies that prioritize bio-legal family structures. Existing person- and family-centered care (PFCC) models in HIV focus mainly on pediatric and adolescent populations, leaving a critical gap in guidance for older adults and their diverse caregivers. This study aims to co-design Canada’s first equity-informed person- and family-centered care model tailored to older adults living with HIV and their biological, bio-legal, and chosen family caregivers. The objectives are to (1) examine experiences of accessing and providing caregiving support, including gendered and intersectional differences; (2) identify key components of a PFCC model to improve access and care experiences; and (3) develop a context-sensitive implementation strategy to support uptake across care settings. This multiphase study uses an equity-informed Experience-Based Co-Design methodology guided by the UK Design Council’s Double Diamond framework. An advisory committee of knowledge users, clinicians, and older adults living with HIV will provide ongoing input. Phase 1 involves approximately 45 semistructured interviews with older adults living with HIV, caregivers, and health care professionals, analyzed using reflexive thematic analysis. Phase 2 includes 2 co-design workshops with about 45 participants to collaboratively develop model components. Phase 3 includes 3 to 4 focus groups (approximately 30 participants) guided by the Consolidated Framework for Implementation Research to refine an implementation strategy. Equity will be operationalized using the Culturally-Competent Research Criteria for Methodological Areas and monitored using PROGRESS-Plus (place of residence, race/ethnicity, occupation, gender, religion, education, socioeconomic status, social capital, plus additional factors) indicators to support intersectional analysis. The study was funded on July 17, 2025. Data collection for phase 1 is scheduled to begin in January 2027, with subsequent co-design workshops (phase 2) planned for fall 2027 and evaluation activities (phase 3) anticipated in winter-spring 2028. Completion of data analysis is expected by mid-2028, with dissemination of findings anticipated later in 2028. This study will generate a rigorously developed, equity-informed PFCC model grounded in lived experience. Findings will inform policy, program planning, and service delivery to better support older adults living with HIV and their diverse caregivers while offering a replicable framework for co-designing inclusive care models in other chronic or stigmatized conditions.

37. Influence of fatigue on risk-taking behavior in Chinese construction workers: Moderation by multilevel factors.

期刊: Work (Reading, Mass.) 发表日期: 2026-Jul-10 链接: PubMed

摘要

BackgroundFatigue significantly contributes to construction accidents, exacerbated by intense work and complex environments.ObjectiveThis study explores how physical and psychological fatigue influence risk-taking among Chinese construction workers, examining moderating effects of work environment, management commitment, and individual resilience.MethodsA cross-sectional study was conducted with 1026 frontline construction workers from 53 sites. Validated self-report scales assessed fatigue, risk-taking behavior, and multilevel moderators during rest periods. Hierarchical regression and moderation analyses, controlling for gender, age, working hours, and experience, were performed using SPSS 27 and the PROCESS v4.2 macro to examine the direct effects of fatigue on risk-taking behavior, as well as the moderating effects of physical work environment perception, management safety commitment, and individual resilience on the relationship between fatigue and risk-taking behavior.ResultsBoth physical and psychological fatigue were significantly associated with increased risk-taking behavior, with adverse physical work environment perceptions amplifying these relationships. Management safety commitment mitigated the association between physical fatigue and risk-taking but showed no significant moderating effect on psychological fatigue. Unexpectedly, higher individual resilience intensified the association between physical fatigue and risk-taking, revealing a “resilience paradox,” while its moderation of psychological fatigue was non-significant. These findings highlight the complex interplay of environmental, organizational, and individual factors with fatigue in driving risk-taking behavior, challenging the notion of resilience as universally protective.ConclusionsThe study offers a robust theoretical framework for understanding fatigue-related safety risks and provides practical guidance for implementing fatigue management programs and tailored resilience training to enhance safety in high-risk construction environments.

38. Association between occupational working time and cardiovascular morbidity: a cross-sectional study of NHANES database.

期刊: Occupational medicine (Oxford, England) 发表日期: 2026-Jul-10 链接: PubMed

摘要

Long working hours are recognized as an occupational hazard that may increase the risk of cardiovascular diseases. However, limited contemporary evidence exists from nationally representative US populations. This study aimed to examine the association between occupational working time and cardiovascular morbidity using the recent National Health and Nutrition Examination Survey (NHANES) data. A cross-sectional analysis including 4502 adults from the 2021-23 NHANES dataset was conducted. Working hours were categorized into 1-34, 35-40, 41-54, and ≥55 h per week. Cardiovascular outcomes included self-reported heart failure, coronary heart disease, angina, myocardial infarction, stroke and hypertension. Participants working 35-40 h last week had significantly lower odds of having coronary heart disease (odds ratio [OR] = 0.524; 95% confidence interval [CI] 0.275-0.998), and angina (OR = 0.411; 95% CI 0.191-0.887) compared to those working 1-34 h. Those working 41-54 h also had reduced odds of angina (OR = 0.125; 95% CI 0.029-0.550). Conversely, working ≥55 h last week was significantly associated with increased odds of hypertension (OR = 1.496; 95% CI 1.135-1.971). No significant association was found between working days per week and CV morbidity. Standard full-time work (35-40 h/week) may be protective against certain cardiovascular conditions, while long working hours (≥55 h/week) may elevate hypertension risk. These findings support international calls to regulate excessive work hours and highlight the importance of balanced employment for better cardiovascular health.

39. Musculoskeletal Anatomy Education-A Survey of Nationally Accredited Allied Health Profession Training Programs.

期刊: Clinical anatomy (New York, N.Y.) 发表日期: 2026-Jul-10 链接: PubMed

摘要

A clear understanding and ability to apply musculoskeletal (MSK) anatomy knowledge in a clinically relevant manner is an essential element of clinician training. Unfortunately, a critical review of the literature illustrates the lack of information available about the MSK anatomy learning environment that exists within allied health profession training programs around the world. The purpose of this investigation was to document the current state of MSK anatomy education within nationally accredited allied health profession training programs. A survey was sent to all Canadian accredited allied health profession programs in the fields of physical therapy, occupational therapy, athletic therapy, and physician assistant. Responses were received from 87% of programs. MSK curricular hours were highly variable both within and between professions: physical therapy ( x ¯ \(\overline{x}\)  = 56.4 ± 31.2; 37.2, 75.6), occupational therapy ( x ¯ \(\overline{x}\)  = 44.4 ± 26.2; 26.2, 62.5), athletic therapy ( x ¯ \(\overline{x}\)  = 124.0 ± 88.4; 58.5, 189.5), and physician assistant ( x ¯ \(\overline{x}\)  = 16.5 ± 12.0; 0.1, 33.1), with curricula being delivered in the 1st year of professional training for all but one program. Thirteen of the twenty-five programs integrated MSK anatomy instruction into the clinical learning environment. Content related to muscle, bone & joint, anatomical terminology and clinical correlates was consistently covered by all programs (regardless of profession). This study is the first-of-its-kind to document the current state of MSK anatomy education across nationally accredited allied health programs. Data provide important insight about the MSK anatomy learning environment within allied health profession training programs and serve as a reference point against which other medical and healthcare programming can be compared. Results are expected to assist in the refinement of MSK anatomy educational standards that can be used to guide curricular renewal and reform within nationally accredited allied health profession training programs.

40. Association of Intrapancreatic Fat Deposition with Mortality: A Prospective Cohort Study with Genetic Risk Profiling.

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

摘要

Pancreatitis and pancreatic cancer lead to excess mortality in the general population. Excessive intrapancreatic fat deposition (IPFD) is a common driver of diseases of the exocrine pancreas according to the PANDORA hypothesis. However, the relationship of IPFD with mortality has never been investigated. We aimed to explore the association of IPFD with mortality. Participants from the UK Biobank were divided into two cohorts based on the availability of IPFD quantified using MRI. The Kaplan-Meier survival analysis and multivariable Cox-proportional hazard model were used. Genome-wide association study (GWAS) on IPFD and Mendelian randomization analysis were performed. An IPFD-linked polygenic risk score (PRS) was applied in the MRI-naïve cohort. A total of 55,058 participants were analyzed, 695(1.26%) of whom died during a median follow-up of 4.9 years. Excessive baseline IPFD was significantly associated with an increased risk of all-cause mortality (HR=1.081, p<0.05) and mortality from vascular diseases (HR=1.247, p<0.001). GWAS identified 38 significant IPFD-associated SNPs. The PRS derived from these SNPs showed significant associations with all-cause mortality and mortality from vascular diseases. In the MRI-naïve cohort of 354,761 participants, consistent results were obtained using the PRS as a genetic proxy for IPFD. Excessive IPFD is associated with elevated risk of future mortality especially from vascular diseases in the general population.

41. Whose stress counts? Wearable biosensing in urban spaces through a feminist lens.

期刊: Health & place 发表日期: 2026-Jul-09 链接: PubMed

摘要

The experience of urban stress can profoundly influences health and well-being of city residents. Importantly, stress is experienced differently depending on social and individual factors, making certain groups more vulnerable than others. This paper presents a literature review of wearable biosensing research on stress in urban settings. It analyzes how physiological measures, including heart-rate metrics (HRV/ECG), electrodermal activity (EDA) and electroencephalography (EEG), have been used to link built environments to individual stress experiences. Drawing on feminist theory, the review asks whether biosensing research acknowledges that stress is not experienced uniformly but reflects social inequalities. The findings show limited attention of published studies to different perceptions of stress. Most studies analyze urban stress in an aggregated form with only about one-third of the identified publications focusing on subgroup differences related to age, mental health, or gender. The paper argues that future research should use biosensing not only to map stress but to create insights into how underrepresented groups physiologically respond to urban space by systematically focusing on social and cultural contexts and embodied differences next to environmental aspects.

42. Behavioural phenotyping with small aquatic model organisms: why digital video resolution and bitrate matter.

期刊: Behavioural pharmacology 发表日期: 2026-Jul-09 链接: PubMed

摘要

Behavioural analysis with small aquatic model organisms is increasingly applied across diverse areas of biosciences and biomedicine, including ecology, pharmacology, and experimental neurobiology. High-throughput behavioural phenotyping workflows frequently employ organisms such as larval zebrafish (Danio rerio) in multiwell laboratory plates, yet the considerable cost of commercial imaging platforms often limits access for smaller laboratories, early career investigators and researchers in low- and middle-income countries. Here, we describe a rapid and practical approach for constructing an inexpensive, flexible and fully customisable behavioural data acquisition system suitable for use with a broad range of aquatic model species. We also examine an important but frequently overlooked methodological issue in quantitative behavioural research: how video acquisition parameters, particularly resolution and bitrate, influence the reliability of automated animal tracking. Using Artemia franciscana nauplii, adult Daphnia carinata, and 7 days postfertilisation larval Danio rerio, we show that video resolution is a major determinant of detection reliability, particularly for very small test organisms. Artemia franciscana could not be reliably tracked in multiarena configurations at resolutions below full high definition, whereas ultra high definition (3840 × 2160 pixels) provided robust detection across all tested species. We also show that concerns regarding ultra high definition file size can be mitigated by optimising bitrate settings. Moderate compression produced major reductions in file size while preserving detection reliability at practical compression levels. Together, these findings provide a practical framework for designing affordable and custom animal tracking systems and selecting video acquisition settings that support reliable high-throughput behavioural phenotyping across diverse aquatic species.

43. What can we learn from 30 years development of clinical decision support system?

期刊: International journal of medical informatics 发表日期: 2026-Jul-07 链接: PubMed

摘要

Clinical decision support systems (CDSS) have emerged as a vital means to boost decision-making capabilities of clinicians, but still exhibit low clinical adoption rates. Systematically exploring the evolution, status, topic trends and variations of CDSS is expected to guide the development of next-generation CDSS. This study investigated scientific publications pertaining to CDSS over a 30-year period. Publications about primary topic (clinical decision support system) and 24 sub-topics grouped into application purposes, technical features and medical resources in PubMed and IEEE from 1 January 1995 to 31 December 2024 were collected. A total of 34,100 publications across 4315 journals were identified, where the number of publications belonged to Q1, Q2, Q3, and Q4 journals was 9721, 5074, 2667 and 1328 respectively, and 15,310 publications were not indexed by Journal Citation Reports in the publication year. This study found that data processing techniques from 2007 to 2024 profoundly steered CDSS toward data centric paradigms, whereas its clinical applications were significantly neglected from thereon. Uncannily, with the rising attention to “knowledge graph”, its two important knowledge resources, “medical knowledge” and “clinical guidelines”, have simultaneously declined in attention. Similarly, although interpretability has gradually gained visibility, focus on clinical reasoning/thinking/decision (RTD) theory has paradoxically declined. Concerning data processing techniques has significantly upwardly diverged with declined focus on medical related concerning. Such a focus shift has reduced contemporary CDSS to a technical showcase of data manipulation, a trend that should be reversed to enhance subsequent clinical utility.

44. The impact of sleep and physical activity on the quality of life of community-dwelling Schizophrenia patients: a cross-sectional study.

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

摘要

Schizophrenia is a disabling mental disorder. Quality of life (QoL) reflects patients’ social-psychological prognosis in mental health services. Sleep and physical activity relate to symptoms and prognosis closely, but their interplay and link to QoL are unclear. This study aimed to explore their impact on schizophrenia patients’ QoL. The samples for this study were derived from Shanghai Community-based Severe Mental Disorders cohort. QoL was assessed using the World Health Organization Quality of Life Assessment Scale Short Form (WHOQOL-BREF); sleep quality was evaluated using the Pittsburgh Sleep Quality Index (PSQI); physical activity was assessed using the International Physical Activity Questionnaire Short Form. The statistical analysis was conducted using SPSS 24 and R 4.4.1. We used linear regressions to assess the impact of sleep quality, analysis of variance for PA, and analysis of variance and post-hoc tests for the interaction effect. The final sample consisted of 5210 cases, with an average age of 59.0 years. Among them, 2,778 were female (53.3%). The patient scored the lowest on the dimension of social relationships (M = 12.864, SD = 2.254) regarding their QoL. Improvement in sleep and an increase in physical activity (all p < 0.001) both contribute to QoL of patients. For the environmental health (F = 5.013, p = 0.007, ηp2 = 0.002) dimension, the two have a mutual compensatory effect. This study emphasizes the significance of sleep and physical activity for the recovery of patients with schizophrenia, particularly highlighting the crucial role of improving sleep.

45. Protecting At-Risk Families From Secondhand Smoke at Home-Forward-Looking Measures of the WHO Framework Convention on Tobacco Control.

期刊: JAMA health forum 发表日期: 2026-Jul-02 链接: PubMed

摘要

This Viewpoint describes how the World Health Organization (WHO) Framework Convention on Tobacco Control recommendations create an opportunity to extend protection from secondhand smoke to private and semiprivate residential spaces and, thus, improve health and housing equity.

46. Individualized Physiotherapy Improves Quality of Life and Symptom Burden in Advanced Cancer: A Quasi-Experimental Study.

期刊: Physiotherapy research international : the journal for researchers and clinicians in physical therapy 发表日期: 2026-Jul 链接: PubMed

摘要

Patients with advanced cancer frequently experience high symptom burden and reduced quality of life. Physiotherapy may represent an important nonpharmacological component of palliative care; however, evidence regarding its effectiveness in hospitalized patients remains limited. This study evaluated the effects of individualized physiotherapy on quality of life and symptom burden in hospitalized patients with advanced cancer receiving palliative care. A quasi-experimental study with pre-post evaluation and nonrandomized allocation was conducted. Participants were hospitalized adults with stage IV cancer and a Palliative Performance Scale score of 40%-50%. Participants were allocated to an experimental group receiving physiotherapy or to a control group receiving usual care. The intervention consisted of 12 physiotherapy sessions delivered over approximately 2 weeks. Quality of life and symptom burden were assessed at the baseline and post-intervention using the EORTC QLQ-C30, Version 3. Mixed analysis of variance was used to evaluate changes over time between groups. Ethical approval was obtained, and all participants provided written informed consent. Sixty patients were included (30 per group). Global health status and quality of life improved significantly in the experimental group, whereas the control group showed no meaningful change. Significant improvements were observed in physical, emotional, and occupational functioning. Reductions were noted in fatigue, pain, dyspnea, insomnia, nausea and vomiting, and appetite loss. Social functioning did not change significantly in either group. Most participants reported favorable perceptions of physiotherapy, with 96.7% indicating perceived benefit. Individualized physiotherapy was associated with clinically meaningful improvements in quality of life, functional outcomes, and symptom burden in hospitalized patients with advanced cancer. These findings support the integration of physiotherapy within interdisciplinary palliative care teams. However, interpretation should consider the nonrandomized design and the short follow-up period, which may limit causal inference and long-term generalizability.

47. Rethinking perioperative chemotherapy in older adults with gastric cancer: a retrospective cohort 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-Jun-30 链接: PubMed

摘要

Older adults bear a disproportionate burden of gastric cancer yet remain markedly underrepresented in perioperative chemotherapy trials, leading many to undergo upfront surgery without systemic therapy. This study evaluated postoperative outcomes and long-term survival in adults aged ≥75 years undergoing curative gastrectomy, comparing neoadjuvant chemotherapy with upfront surgery alone. This retrospective cohort study included consecutive patients aged ≥75 years who underwent elective curative-intent gastrectomy for gastric adenocarcinoma at a tertiary academic center between 2011 and 2019. Patients were stratified into upfront surgery (UFS) and neoadjuvant chemotherapy (NEO) groups. Postoperative complications were graded using the Clavien-Dindo classification. Overall survival was analyzed using the Kaplan-Meier method and Cox proportional hazards regression. Seventy-seven patients were included (43 UFS, 34 NEO). NEO patients were younger (median 78.3 vs. 82.6 years, p = 0.006) and all had stage III disease versus 54.2% in UFS (p < 0.001). Among NEO patients, 23.5% did not complete chemotherapy and grade ≥3 adverse events occurred in 14.7%. Complication rates (29.4% vs. 30.2%, p = 1.0), 90-day mortality (11.8% vs. 9.3%, p = 0.726), and 5-year survival (47.1% vs. 46.5%, p = 1.0) were comparable. Advanced tumor stage (HR 2.47, p = 0.025) and postoperative complications - minor (HR 3.12, p = 0.020) and major (HR 3.33, p = 0.002) - were independent predictors of worse survival. A trend toward improved survival favored the NEO group (adjusted HR 0.49, p = 0.078). Neoadjuvant chemotherapy was feasible and safe in selected older adults undergoing gastrectomy, without increasing postoperative morbidity or mortality. Postoperative complications were the strongest survival predictors, underscoring the importance of perioperative optimization and individualized, geriatric-informed treatment strategies.

48. Age and Gender-Based Clinical and Laboratory Features in Dengue Infection: A Comparative Study.

期刊: Journal of infection in developing countries 发表日期: 2026-Jun-30 链接: PubMed

摘要

Dengue infection remains prevalent globally, with a shift toward adult cases. WHO diagnosis relies on clinical and laboratory criteria to identify and manage the disease effectively. This study aims to investigate the differences in clinical and laboratory findings of dengue infection based on age and gender. This analytical cross-sectional study utilized medical record data from 162 pediatric and adult dengue patients diagnosed with dengue fever (DF) or dengue hemorrhagic fever (DHF) in Surabaya hospital in 2022. The study assessed hemoglobin, hematocrit, leukocyte, and platelet levels across six age groups: toddlers (0-5 years), children (6-10 years), adolescents (11-18 years), young adults (19-29 years), and adults (30-59 years). The variables observed in this study include age, gender, classification, and type of dengue infection among hospitalized patients diagnosed with dengue. The findings of this study indicate no statistically significant difference between pediatric and adult patients regarding the classification of DF and DHF (p = 0.085). However, laboratory results revealed a significant difference in the incidence of thrombocytopenia between children and adults (p = 0.019). Furthermore, a significant association was found between platelet count and dengue classification, with lower platelet levels observed in DHF cases compared to DF (p = 0.001). This study shows significant clinical and laboratory differences between children and adults with dengue, highlighting the necessity of age-specific diagnostics to enhance early detection and appropriate treatment.

49. A six-year experience of catheter-related bloodstream infections in hemodialysis patients.

期刊: Journal of infection in developing countries 发表日期: 2026-Jun-30 链接: PubMed

摘要

This study investigated the clinical characteristics, causative microorganisms, and antibiotic resistance patterns of catheter-related bloodstream infections (CRBSIs) in hemodialysis patients at a tertiary healthcare institution. A retrospective analysis of 300 patients treated for CRBSIs between January 2018 and December 2023 was conducted. Patients were divided into two groups: those with less than 1 year of hemodialysis (Group 1) and those with more than 1 year of hemodialysis (Group 2). Risk factors for intensive care unit (ICU) transfer and 28-day mortality were analyzed. The median age was 68 years. Gram-positive bacteria were the predominant pathogens (69%), with Staphylococcus aureus being the most frequent. Group 1 had significantly higher rates of recent hospitalization (p = 0.014) and a history of previous ICU admission (p = 0.001). However, no significant differences were found in causative microorganisms or antimicrobial resistance between the two groups. Risk factors for ICU transfer included carbapenem resistance (OR: 7.657, p = 0.013), history of catheter revision (OR: 4.632, p = 0.022), and leukocytosis (OR: 1.150, p = 0.004). The 28-day mortality rate was 8%. Significant risk factors for mortality were ICU transfer (OR: 17.29; p = 0.001) and Vancomycin-Resistant Enterococcus (VRE) infection (OR: 14.10; p = 0.002). Despite shorter-term dialysis patients having more frequent hospitalizations, the distribution and resistance of pathogens remain similar regardless of hemodialysis duration. Empirical therapy should prioritize broad anti-staphylococcal coverage and be tailored to specific risk factors such as VRE or carbapenem resistance rather than hemodialysis duration.

50. Burden of infectious diseases in a West African tertiary hospital: a two-year retrospective study at CHNU de Fann, Senegal.

期刊: Journal of infection in developing countries 发表日期: 2026-Jun-30 链接: PubMed

摘要

Despite progress in prevention and treatment, infectious diseases remain a major cause of morbidity and mortality in West Africa. Hospital-level data are limited. This study aimed to assess the burden, clinical spectrum, and outcomes of infectious diseases at a referral hospital in Senegal. A retrospective study of all non-coronavirus disease 2019 (COVID-19) infectious disease admissions at the Centre Hospitalier National Universitaire (CHNU) de Fann from January 2021 to December 2022 was conducted. Sociodemographic, clinical, diagnostic, and outcome variables were recorded. Logistic regression identified factors independently associated with in-hospital mortality. A total of 1,098 patients (median age 42, 57.2% male) were included. Tuberculosis (TB; 21.8%), malaria (13%), and community-acquired pneumonia (9.2%) were the leading diagnoses. Human immunodeficiency virus (HIV) infection was present in 28.1% of patients, with 58.4% having opportunistic infections. Overall mortality was 25.0%. Independent predictors of death included HIV-positive status (OR: 2.1; 95% CI: 1.4-3.2), neurological involvement (OR: 1.7; 95% CI: 1.2-2.5), age > 60 years (OR: 1.9; 95% CI: 1.1-3.1), and sepsis (OR: 2.3; 95% CI: 1.5-3.6). Infectious diseases remain a leading cause of hospitalization and death in Senegal. Improving early diagnostics, integrating TB/HIV services, and expanding access to fungal testing are crucial to improve outcomes in resource-limited hospital settings.

51. Molecular detection by PCR of Rickettsia rickettsii in canines in Ciudad Obregón, Sonora, México.

期刊: Journal of infection in developing countries 发表日期: 2026-Jun-30 链接: PubMed

摘要

Rickettsia is an intracellular, Gram-negative, zoonotic bacterium that is transmitted by arthropods, such as ticks, fleas and lice. Rickettsioses have been reported in Mexico since the 1930s, with a higher prevalence in the northern states. Infections affect both dogs and humans in marginalized areas, with Rickettsia rickettsii being the most pathogenic species and associated with high mortality rates. This study aimed to detect R. rickettsii in dogs from Ciudad Obregón, Sonora, using the ompA gene PCR. Between July and August 2024, 110 EDTA whole blood samples were collected: 95 from dogs with a presumptive clinical diagnosis of rickettsiosis, and 15 from stray dogs with active tick infestations. DNA extraction, PCR amplification and product purification were performed at the Veterinary Molecular Biology Laboratory of the Instituto Tecnológico de Sonora. Sanger sequencing, Snap Gene Viewer, and BLASTn against GenBank were used to confirm the identity of the sequences. Sequencing of the ompA fragment confirmed 99-100% homology with R. rickettsii. One positive case (6.7%) was detected, corresponding to a stray dog from a disadvantaged area of the municipality of Cajeme, indicating the presence of the pathogen in a localized area. The detection of R. rickettsii in a stray dog in Ciudad Obregón confirms the presence of the pathogen in the area, highlighting the importance of free-roaming canines and environmental conditions in sustaining vectors. Early diagnosis and control of ectoparasites are critical to reducing zoonotic transmission, underlining the importance of continuous molecular surveillance in public health.

52. Gender and regional equity in the European Society of Gynaecological Oncology: a longitudinal analysis of a professional medical society.

期刊: International journal of gynecological cancer : official journal of the International Gynecological Cancer Society 发表日期: 2026-Jun-13 链接: PubMed

摘要

To evaluate longitudinal trends in gender and regional equity in membership and governance representation within the European Society of Gynaecological Oncology and the European Network of Young Gynaecological Oncologists. We analyzed European Society of Gynaecological Oncology and European Network of Young Gynaecological Oncologists membership and governance data from 2013 to 2024. Descriptive analyses were supplemented with multi-variable logistic regression models to identify predictors of female membership and European Society of Gynaecological Oncology Council representation, including European Network of Young Gynaecological Oncologists status, calendar year or Council term, and United Nations geographic region. European Society of Gynaecological Oncology and European Network of Young Gynaecological Oncologists membership increased from 1588 members in 2013 to 3385 in 2024, and female members reached parity by 2024. Female membership was associated with European Network of Young Gynaecological Oncologists participation (odds ratio 1.82, 95% confidence interval 1.73 to 1.91, p <.001) and calendar year (odds ratio 1.04 per year, 95% confidence interval 1.03 to 1.05, p <.001). Compared with Western Europe, female membership was higher in Northern Europe (odds ratio 1.69, 95% confidence interval 1.55 to 1.84, p <.001) and lower in Eastern Europe (odds ratio 0.78, 95% confidence interval 0.71 to 0.85, p <.001) and non-European regions (odds ratio 0.80, 95% confidence interval 0.74 to 0.86, p <.001). Gender was not associated with Council membership (odds ratio 0.95, 95% confidence interval 0.63 to 1.42, p =.79), and no independent temporal trend was observed (odds ratio 0.91 per term, 95% confidence interval 0.81 to 1.03, p =.13). Geographic variation was evident, with lower odds of Council representation in Eastern Europe (odds ratio 0.54, 95% confidence interval 0.28 to 0.98, p =.05), while estimates for non-European regions were unstable because of sparse representation. European Society of Gynaecological Oncology and European Network of Young Gynaecological Oncologists have made substantial progress toward gender equity at the membership level, largely through early-career engagement. Governance representation appears to be influenced more by geographic and structural factors than by gender, highlighting the need for equity-focused strategies that sustain gender-balanced leadership development while addressing regional disparities.

53. Workflow-dependent noise peaks and exposure assessment in operating rooms: implications for occupational risk.

期刊: Annals of work exposures and health 发表日期: 2026-Jun-03 链接: PubMed

摘要

Operating room noise is a recognized occupational exposure with potential implications for worker health and performance. Most workplace noise risk assessments rely on time-averaged levels, which may obscure short-duration, high-intensity exposure peaks occurring during specific workflow phases. Task-aligned exposure characterization may therefore provide additional value for occupational risk assessment. A field measurement study was conducted in 26 operating rooms under routine clinical conditions. A total of 611 real-time sound level measurements were obtained across 13 predefined surgical workflow stages using a calibrated sound level meter. Stage-specific noise levels were recorded to characterize exposure variability and peak events. Surgical nurses completed the Perceived Stress Scale and the Attention Control Scale immediately before and after procedures. Descriptive statistics, paired comparisons, and correlation analyses were performed. The mean noise level across workflow stages was 66.57 dB, while short-term peak levels reached up to 87 dB. Peak exposures clustered in workflow stages involving equipment movement and patient transfer. Noise variability differed substantially between workflow stages. No statistically significant pre- to post-procedure differences were observed in perceived stress or attention control scores. Associations between stage-averaged noise levels and psychological measures were weak and not statistically significant. Reliance on average noise levels alone may underestimate task-dependent peak exposures in operating rooms. Workflow-aligned measurement approaches improve exposure characterization and may strengthen occupational noise risk assessment. Integrating stage-specific monitoring into routine workplace exposure evaluation may support more precise hazard identification and targeted risk control strategies for operating room personnel.

54. Real-world evidence of physical activity practices and policies in Greater London primary schools: A cross-sectional survey.

期刊: PloS one 发表日期: 2026 链接: PubMed

摘要

The World Health Organization (WHO) recommends six domains for a whole-school approach to promote physical activity (PA) levels. This approach aims to help children achieve 30 of the recommended 60 minutes of daily moderate-to-vigorous physical activity (MVPA). Evidence on PA practice and policy in school settings is limited, particularly in urban areas with high deprivation, where children’s PA levels are lowest. We developed a 20-item survey based on the WHO domains and distributed it to 1826 state-funded primary schools in all 32 Greater London boroughs between 6 November 2023 and 31 December 2024. We extracted survey items relating to each domain and calculated the percentage of schools reporting each practice. Our sample of 185 schools (10.1%) included at least one school from each borough and was broadly representative of school populations in Greater London, except that responding schools were more likely to have fewer pupils eligible for free school meals. Most schools (68.5%) reported implementing at least one practice aligned with each of the six WHO domains. Specifically, 98.4% reported providing curricular physical education (Domain 1), 78.9% had an active travel plan (Domain 2), 98.4% offered PA opportunities before/after school (Domain 3), 92.4% provided opportunities for PA during breaks (Domain 4), 81.7% incorporated PA into lessons (Domain 5), and 81.5% reported supporting the inclusion of pupils with additional needs in PA opportunities (Domain 6). However, implementation within domains varied; for example, only 53.5% met the nationally recommended two hours of physical education per week, with similarly low levels for before‑school PA provision and active travel initiatives. Most primary schools in this large, multi-ethnic urban sample reported school policies and practices aligned with WHO domains, suggesting that a whole-school approach to creating an active school environment is feasible to implement. However, we identified areas for improvement within domains, and alignment alone may be insufficient to meaningfully increase children’s PA levels. This study provides a foundation for future research linking active school environments with children’s PA and mental health, thereby informing efforts to increase MVPA and promote equitable outcomes.

55. Prevalence and risk factors of hypertension in rural Bangladesh: A population-based cross-sectional study.

期刊: PloS one 发表日期: 2026 链接: PubMed

摘要

Non-communicable diseases (NCDs), such as hypertension, are amongst the most fatal conditions afflicting people living in low- and middle-income countries (LMIC), including Bangladesh. This study addresses the lack of population-based studies in rural Bangladesh by examining the prevalence and distribution of hypertension and its associated risk factors. To this end, we surveyed adults aged ≥18 years (i.e., household heads and their spouses) from 7384 households across 149 villages in rural Bangladesh in 2017 using a semi-structured questionnaire to collect data on blood pressure, anthropometric, socioeconomic, lifestyle, and behavioral risk factors. Multivariate logistic regression analyses identified age, gender, and socioeconomic status as potential predictors of hypertension. The findings also showed that men and women from higher socioeconomic status (SES) groups had higher rates of overweight and obesity, risk factors for the development of hypertension (4.29% and 1.4% in adult men; 5.8% and 2.29% in adult women), as well as higher rates of fruit and vegetable consumption (10.29% and 7.25% in adult men; 9.95% and 6.84% in adult women). A significant association between tobacco consumption and age was observed for women (p=<0.0001), while higher levels of physical activity were found among men aged 45-54 years [OR:1.9, CI 95% (1.1-3.1)]. Furthermore, women in the highest SES brackets were 1.3 times as likely to engage in “moderate” physical activity as those in the lowest brackets. Age and overweight/obesity were found to be the strongest risk factors for hypertension in both genders, while education was not found to be significantly associated with hypertension in women. Notably, the findings revealed that 33.7% of men and 28.6% of women had elevated blood pressure, qualifying them as either prehypertensive or hypertensive. As such, we recommend that policy interventions aimed at stemming the growth of hypertension among Bangladesh’s rural populations should take gender-specific risk factors, rural-urban disparities, and socioeconomic context into serious policy consideration.

56. Impact of socioeconomic, demographic, maternal, infant and healthcare factors on early initiation of breastfeeding in Bangladesh: Evidence from Bangladesh demographic health survey (BDHS) 2022 data.

期刊: PloS one 发表日期: 2026 链接: PubMed

摘要

Introducing an infant to the breast within an hour of birth is known as early initiation of breastfeeding (EIBF). Early initiation of breastfeeding (EIBF) was measured using BDHS 2022 data and defined as initiation of breastfeeding within one hour of birth, based on maternal self-report of the time elapsed between delivery and first breastfeeding. Using maternal self-reported timing of first breastfeeding from the Bangladesh Demographic and Health Survey (BDHS) 2022, this study examined factors associated with EIBF among mothers in Bangladesh. Data from 4,758 women who were fertile and had given birth were included in the study. To investigate the prevalence of EIBF and its association with different factors (socioeconomic, demographic, maternal, infant, and healthcare-related), descriptive analysis, and bivariate analysis using Pearson chi-square tests were carried out. Significant EIBF factors were found using binary logistic regression analysis. Skin-to-skin contact within one hour of birth was significantly associated with higher odds of EIBF (OR = 1.62; 95% CI: 1.39-1.89). Cesarean delivery was associated with substantially lower odds of EIBF (OR = 0.40; 95% CI: 0.33-0.49). Compared with home deliveries, births in government facilities (OR = 0.58; 95% CI: 0.47-0.71) and private/NGO facilities (OR = 0.53; 95% CI: 0.42-0.66) were associated with reduced likelihood of EIBF. Significant regional variation in EIBF was observed across administrative divisions. Maternal age, education, and household wealth index were not consistently associated with EIBF after adjustment. Based on the univariate analysis, the prevalence of EIBF among mothers in Bangladesh is 63.3%. The 95% Confidence Interval for this prevalence is (61.9% - 64.7%). The significance of skin-to-skin contact for EIBF in Bangladesh is demonstrated in this study. The results indicate the necessity of focused initiatives to support EIBF, especially in medical settings and after cesarean deliveries. To understand the geographical differences in EIBF rates and create strategies to deal with them, more investigation is required. These discoveries can influence practice and policy to raise EIBF rates among Bangladesh’s varied demographics, improving the health of mothers and their offspring in the process.

57. Psychological distress in hypertension: Prevalence and links to self-care in Gonabad, Iran.

期刊: PloS one 发表日期: 2026 链接: PubMed

摘要

A critical component in the hypertension management and the prevention of its life-threatening complications, is self-care. Psychological factors such as stress, anxiety and depression may significantly influence self-care behaviors in people with hypertension. Therefore, this study aimed to investigate the prevalence of anxiety, depression and stress and their association with self-care levels among hypertensive patients. This analytical cross-sectional study was conducted in 2024-2025 in Gonabad, Iran, among a population of 509 hypertensive patients. Participants were selected through cluster random sampling, with inclusion criteria consisting of: A confirmed diagnosis of hypertension by a physician, Willingness to provide informed consent, Absence of cognitive impairment, and At least one year of residency in Gonabad. Data were gathered by three self-administered questionnaires: a demographic questionnaire, the DASS-21 (Depression, Anxiety, and Stress Scale), and the Self-Care of Hypertension Inventory (SC-HI V3). The collected data were analyzed using SPSS v25, with statistical tests including independent t-tests, ANOVA, Multiple Linear Regression and Pearson’s correlation. The majority of participants in this study were female and older persons (age > 60 years). Marital status showed a significant association with levels of depression, anxiety, and stress. Additionally, variables such as age group, marital status, education level, and occupation were significantly correlated with hypertension self-care levels and all three of its subscales. Furthermore, 62.5%, 75.2%, and 59.3% of hypertensive patients exhibited depression, anxiety, and stress, respectively. Pearson’s correlation analysis revealed a significant negative association between: Depression and self-care (r = -0.314, p < 0.001), Anxiety and self-care (r = -0.330, p < 0.001). A significant negative correlation was also observed between depression/anxiety and the age at hypertension onset. Variables of Depression, Anxiety, Stress, Age, Education and Income could predict 15% of self-care of hypertension variance. The prevalence of psychological disorders-particularly stress, depression, and anxiety-among hypertensive patients is alarmingly high. Moreover, significant negative correlations exist between these mental health conditions and hypertension self-care levels. These findings underscore the critical need for: Preventive interventions and Mental health promotion programs tailored to this population. Policymakers, healthcare providers, and researchers must prioritize integrating psychological support into hypertension management strategies to mitigate these adverse effects and improve patient outcomes.

58. Examining relationship between unhealthy lifestyle and life satisfaction among new students at Tehran University of Medical Sciences.

期刊: PloS one 发表日期: 2026 链接: PubMed

摘要

Transitioning to university is a critical period marked by lifestyle changes, academic pressures, and increasing autonomy, which can influence students’ overall well-being. Previous research suggests that unhealthy lifestyle behaviors-including poor diet, insufficient physical activity, inadequate sleep, and ineffective stress management-may negatively impact life satisfaction among young adults. This cross-sectional study examined the relationship between lifestyle and life satisfaction among newly enrolled undergraduate students at Tehran University of Medical Sciences in 2024. Participants completed structured questionnaires assessing multiple lifestyle domains (diet, physical activity, sleep, smoking, alcohol use) and life satisfaction using validated Iranian questionnaires. Lifestyle scores were categorized as “healthy” or “unhealthy,” and life satisfaction as “good” or “poor.” Associations were analyzed using Pearson’s chi-square test and multivariable logistic regression, adjusting for age, sex, socioeconomic status, and anxiety. Overall, of the 419 students, 294 (70.2%) reported good life satisfaction. Socioeconomic status and anxiety levels differed significantly across life satisfaction groups (p < 0.001). Students with healthier dietary patterns reported higher life satisfaction (76.6% vs. 60.4%, p = 0.02). Multivariable analysis indicated that students with healthy lifestyles had significantly higher odds of good life satisfaction compared to those with unhealthy lifestyles (adjusted odds ratio [aOR = 1.91; 95% confidence interval [CI]: 1.10,3.35; p = 0.02). Each one-unit increase in lifestyle score was associated with a 28% increase in the odds of good life satisfaction (aOR = 1.28; 95% CI: 1.05,1.57; p = 0.02). Unhealthy lifestyle behaviors are negatively associated with life satisfaction among new university students. Interventions promoting balanced nutrition, regular physical activity, adequate sleep, and overall health-conscious behaviors may enhance students’ life satisfaction and well-being.