公共卫生研究摘要 (2026-07-14)

共收录 58 篇研究文章

1. Dyslexia, School-Connectedness, Depression, and Anxiety During the Transition From Primary to Secondary School.

期刊: Dyslexia (Chichester, England) 发表日期: 2026-Aug 链接: PubMed

摘要

Children with dyslexia are at elevated risk of depression and anxiety. The transition from primary to secondary school may be particularly challenging given increased educational demands. Past research indicates school-connectedness may be a protective factor across this transition. We tested longitudinal relationships between dyslexia, school-connectedness, depression, and anxiety over the secondary school transition. Children (N = 208, Mage = 12.16, 58% girls, 61 with dyslexia) and their caregivers (95% mothers) completed standardised measures of school-connectedness, depression, and anxiety in Year 6, and again in Year 7 after the transition to secondary school. Mediation models tested direct and indirect effects of dyslexia on Year 7 depression and anxiety through domains of school-connectedness (whole school, peer, friend, and teacher). After adjusting for Year 6 depression, anxiety, and gender, there were no significant direct effects of dyslexia on depression or anxiety in Year 7. However, dyslexia was indirectly associated with both depression and anxiety via school- and peer-connectedness. These findings support the role of school-connectedness in supporting mental health, and suggest peer-connectedness might be an important protective factor post-transition to secondary school. Future studies should explore further change across adolescence and mental health promotion targeting school- and peer-connectedness among children with dyslexia.

2. Medicare Advantage and Cancer Care-Insights on Quality.

期刊: JAMA internal medicine 发表日期: 2026-Jul-13 链接: PubMed

摘要

3. Limitations in the Use of Plasma Biomarkers of Brain Injury-Reply.

期刊: JAMA pediatrics 发表日期: 2026-Jul-13 链接: PubMed

摘要

4. Physical activity for the management of obesity in children up to the age of 9 years.

期刊: The Cochrane database of systematic reviews 发表日期: 2026-Jul-13 链接: PubMed

摘要

Childhood obesity is a major global public health concern. Although physical activity is recognised as an effective non-pharmacological intervention, most existing evidence synthesis has primarily focused on the role of physical activity in preventing obesity, with limited attention given to its effects on managing children with obesity. To synthesise evidence on the benefits and harms of physical activity for the management of obesity in children up to 9 years of age. We searched CENTRAL, MEDLINE, Embase, and two trial registries from 2012 to 2 June 2023, with an update on 4 December 2025. We also used Google Scholar to identify additional studies. We did not impose language or publication status restrictions. We included randomised controlled trials (RCTs) that investigated the effects of physical activity interventions of any frequency, mode (e.g. aerobic, resistance), or intensity, with a minimum intervention duration of 12 weeks, in children up to 9 years of age with obesity (as defined by the trialists) at baseline. Eligible comparators were standard care, waiting-list, no physical activity, or any other active interventions, such as comparisons of different physical activity parameters (e.g. duration, frequency, intensity). Critical outcomes: body mass index (BMI), BMI z-score, body weight, health-related quality of life, adiposity and fat distribution, glycaemia, and adverse events (minor and serious). Important outcomes: physical well-being, mental well-being, physical activity levels, blood pressure, hyperinsulinemia, resistance to insulin, alterations in lipid metabolism, presence of obesity-related comorbidities or any non-communicable diseases, obesity-associated disability, lipid hormones, alterations in hunger or satiety, disability, mortality, prevalence of obesity in adulthood, and access to health services. Pairs of review authors independently assessed the risk of bias in included studies using the original version of the Cochrane tool (RoB 1). We synthesised results using meta-analysis when appropriate. Given the clinical and statistical heterogeneity, we predominantly used a random-effects model alongside sensitivity analyses. When meta-analysis was not feasible, we employed synthesis without meta-analysis (SWiM) methods. We assessed the certainty of the evidence using the GRADE approach. We included four studies (five references, 517 children; female 46%; mean age ranged from 8.9 to 9.9) conducted in three countries (the USA, Brazil, and Iran). Three studies (75%) delivered the physical activity interventions in school settings. Three studies (75%) compared physical activity interventions with non-exercise controls, while one compared physical activity with a behaviour-changing intervention. The duration of physical activity interventions ranged from 12 to 32 weeks. We assessed three studies as having an overall high risk of bias. Physical activity interventions compared to control The evidence is very uncertain about the effect of physical activity interventions on BMI (mean difference (MD) -1.52 kg/m², 95% confidence interval (CI) -2.74 to -0.29; I² = 0%; 2 studies, 118 children; very low-certainty evidence), BMI z-scores (MD -0.10 z-score units, 95% CI -0.22 to 0.02; I² = 29%; 1 study, 222 children; very low-certainty evidence), body weight (MD -0.86 kg, 95% CI -3.17 to 1.46; I² = 0%; 2 studies, 118 children; very low-certainty evidence), health-related quality of life (MD -0.60 points, 95% CI -4.22 to 3.02; 1 study, 175 children; very low-certainty evidence), adiposity and fat distribution, assessed as body fat percentage (MD -1.23%, 95% CI -2.50 to 0.03; I² = 0%; 3 studies, 456 children; very low-certainty evidence), minor adverse events (risk ratio (RR) 3.58, 95% CI 1.95 to 6.55; 1 study, 222 children; very low-certainty evidence), and serious adverse events (RR 1.08, 95% CI 0.10 to 11.76; 1 study, 222 children; very low-certainty evidence). No studies assessed glycaemia. Combined training (aquatic exercises) versus combined training (video game exercises) The evidence is very uncertain about the effect of combined training in an aquatic setting compared to video-game-based combined training on BMI (MD -0.90 kg/m², 95% CI -3.21 to 1.41; 1 study, 39 children; very low-certainty evidence), BMI at 4-week follow-up (MD 0.03 kg/m², 95% CI -2.54 to 2.60; 1 study, 39 children; very low-certainty evidence), body weight (MD -1.30 kg, 95% CI -5.66 to 3.06; 1 study, 39 children; very low-certainty evidence), and body weight at 4-week follow-up (MD -0.70 kg, 95% CI -5.70 to 4.30; 1 study, 39 children; very low-certainty evidence). This study did not assess the other critical outcomes. Low-dose versus high-dose combined training The evidence is very uncertain about the effect of low-dose versus high-dose combined training on BMI z-scores (MD 0.12 z-score units, 95% CI 0.10 to 0.14; 1 study, 144 children; very low-certainty evidence), adiposity and fat distribution, assessed as body fat percentage (MD 1.07%, 95% CI -0.74 to 2.88; 1 study, 144 children; very low-certainty evidence), glycaemia, assessed as fasting glucose level (MD -0.50 mg/dL, 95% CI -2.77 to 1.77; 1 study, 144 children; very low-certainty evidence), minor adverse events (RR 0.91, 95% CI 0.64 to 1.30; 1 study, 144 children; very low-certainty evidence), and serious adverse events (RR 3.08, 95% CI 0.13 to 74.45; 1 study, 144 children; very low-certainty evidence). This study did not assess the other critical outcomes. The evidence from four randomised studies on the effects of physical activity interventions in children aged 0 to 9 with obesity is of very low certainty. Serious methodological limitations, clinical heterogeneity, small-study effects, and imprecise results constrained this evidence base. Important knowledge gaps remain because none of the included RCTs enroled children with disabilities. The RCTs provided little information on contextual factors. Future high-quality and better-reported RCTs will likely change our findings. The Department of Nutrition and Food Safety at the World Health Organization (WHO) commissioned and provided financial support for this work. WHO acknowledges financial support from the Norwegian Agency for Development Cooperation, the Swedish International Development Cooperation Agency, the Government of the Grand Duchy of Luxembourg, and the Government of Germany to the Department of Nutrition and Food Safety. Protocol available via https://doi.org/10.17605/OSF.IO/DSHUP.

5. Quality, Cost, and Timeliness of Cancer Treatment in Medicare Advantage and Traditional Medicare.

期刊: JAMA internal medicine 发表日期: 2026-Jul-13 链接: PubMed

摘要

Use of Medicare Advantage (MA) insurance has been associated with lower cancer treatment costs than traditional Medicare (TM). Whether there are differences in guideline-concordant care or treatment costs for beneficiaries insured under MA vs TM is unknown. To assess whether Medicare insurance type is associated with receipt of optimal cancer treatment and costs. Retrospective cohort study of a population-based sample using Medicare claims and encounter data from 2015 through 2019. Participants were Medicare beneficiaries with continuous enrollment in either MA or TM and an incident cancer diagnosis from 2016 through 2019. Included patients were those with cancer treatment scenarios (eg, metastatic melanoma, adjuvant therapy for stage III colon cancer) that had substantial variation in the costs of recommended treatment options. Data were analyzed from April 2025 to March 2026. Medicare insurance type of MA or TM. The pharmacologic cancer treatment among the available options each patient initiated was analyzed using Medicare data. Each patient’s treatment was linked by diagnosis date to contemporary National Comprehensive Cancer Network Guidelines recommendations and Medicare reimbursement rates to ascertain the coprimary outcomes whether a patient received the optimal treatment for their cancer type and the anticipated cost of the initiated treatment. The association of outcomes with insurance type was accessed using generalized estimating equations to estimate risk ratios (RRs) after balancing patient characteristics through inverse probability-of-treatment weighting. Models were clustered at the physician level and adjusted for scenario, diagnosis year, scenario × diagnosis year interaction, and oncologist characteristics. Of 35 245 patients (median age, 74 [IQR 70-79] years; 63.2% male), 24 269 had TM and 10 976 had MA. The median time to treatment initiation was 36 (IQR, 20-60) days for MA vs 35 (IQR, 19-59) days for TM. The unadjusted mean (SD) treatment cost was $29 252 ($80 391) for MA vs $40 874 ($106 205) for TM. MA beneficiaries had a likelihood of optimal treatment similar to TM beneficiaries (adjusted RR, 0.99; 95% CI, 0.97-1.02), and MA was associated with lower treatment cost (adjusted cost ratio, 0.94; 95% CI, 0.91- 0.97). Mean savings within this patient cohort was -$931 (95% CI, -$1244 to -$615). In this cohort study of Medicare beneficiaries with cancer, MA beneficiaries had lower estimated treatment costs and similar likelihood of receiving optimal treatment compared with TM beneficiaries.

6. Vitamin K Prophylaxis in Newborns and Bleeding in Infancy.

期刊: JAMA pediatrics 发表日期: 2026-Jul-13 链接: PubMed

摘要

Vitamin K deficiency bleeding in infants is a rare but potentially life-threatening condition that is effectively prevented by newborn intramuscular vitamin K prophylaxis. Despite this, there are reports of increasing parental refusal of vitamin K prophylaxis globally. To evaluate temporal trends of prophylactic newborn vitamin K administration and its association with bleeding diagnoses during infancy. This was a nationwide cohort study of births between January 1, 2003, and December 31, 2021, followed up until 6 months of age. The study setting was in Sweden and included all live-born infants born at 35 or more weeks’ gestation during the study period. Data analysis was performed from June 1 to December 19, 2025. The exposure was nonreceipt of intramuscular vitamin K administration at birth. The primary outcome was a bleeding diagnosis within the first 6 months of life. Data from the Swedish Medical Birth Register was linked to multiple Swedish national registers. Logistic regression was used to estimate adjusted odds ratios (aORs) with 95% CIs. Among 2 020 302 live births, 24 089 infants (mean [SD] gestational age, 40.0 [1.6] weeks; 12 472 male [51.8%]) had no record of intramuscular vitamin K administration at birth. The rate of nonreceipt decreased during the first study years from 1.32% (1242 of 94 214 newborns) in 2003 to 0.66% (667 of 100 429 newborns) in 2006, and then gradually increased and more than doubled to 1.50% (1619 of 107 915 newborns) in 2021. Infants without intramuscular vitamin K administration had 1.54-fold higher odds (aOR, 1.52; 95% CI,1.27-1.81) of bleeding and 3.18-fold higher odds (aOR, 2.91; 95% CI, 2.13-3.96) of an intracranial bleeding episode during infancy, compared with infants with intramuscular vitamin K. This cohort study shows that the number of infants in Sweden who do not receive intramuscular vitamin K administration at birth to prevent bleeding episodes continues to be low but is increasing, and these infants have a significantly higher associated risk of bleeding episodes, including intracranial hemorrhages. These findings suggest the importance of intramuscular vitamin K administration in the newborn period to prevent bleeding episodes and the need for continued education of parents and caregivers on its significance.

7. Perioperative immune checkpoint inhibitors with or without chemotherapy versus placebo with or without chemotherapy in elderly people with localised non-small cell lung cancer.

期刊: The Cochrane database of systematic reviews 发表日期: 2026-Jul-13 链接: PubMed

摘要

Lung cancer is typically a cancer of the elderly, with a median age at diagnosis of 71, and more than one third of the people diagnosed with lung cancer are over 75 years old. Immune checkpoint inhibitors (ICIs) have revolutionised the treatment of cancers, including lung cancer. ICIs targeting the programmed death-1/programmed death-ligand 1 (PD-1/PD-L1) axis, administered in the neoadjuvant setting, the adjuvant setting, or both, are currently the standard of care for resectable non-small-cell lung cancer (NSCLC) worldwide. These ICIs are commonly used in combination with platinum-based chemotherapy and have shown superior efficacy in patients eligible for curative surgery. The concept of immunosenescence, which refers to age-related changes in the immune system - particularly a decline in the efficiency of T-cell mediated responses - raises concerns about the benefits of ICIs in the elderly population. To assess the benefits and harms of ICI with or without chemotherapy compared to no treatment or placebo with or without chemotherapy given before surgery, after, or both in older adults diagnosed with NSCLC at the early resectable stage. We searched for all eligible randomised controlled trials (RCTs) in electronic databases (CENTRAL, MEDLINE, and Embase), trial registries (clinicaltrials.gov and the World Health Organization ICTRP), references of eligible studies, meeting abstracts of the main world conferences, and the Food and Drug Administration (FDA) and European Medicines Agency (EMA) websites. The search was up to 3 July 2025. We included parallel designed RCTs comparing ICI with or without chemotherapy versus no treatment or placebo with or without chemotherapy administered before surgery, after, or both for early-stage resectable NSCLC. We excluded studies comparing differential sequencing of ICIs or combinations of ICIs with alternate interventions (e.g. radiotherapy). Our critical outcomes were overall survival and grade ≥ 3 treatment-related adverse events. Our important outcomes were disease-free survival, event-free survival, pathological complete response rate, major pathological response rate, and health-related quality of life. Two review authors independently used version 2 of the Cochrane risk of bias tool for randomised trials (RoB 2) to assess bias in the included studies. We synthesised results for each outcome and pooled data where possible (using a random-effects model with DerSimonian and Laird methods for all outcomes; and the Mantel-Haenszel method for dichotomous outcomes). Where this was not possible due to the nature or the amount of data, we narratively summarised the results. Three authors independently assessed the certainty of the evidence, using the five GRADE considerations for each outcome. We included a total of 11 studies with 6788 participants, of whom 3152 were ≥ 65 years old (46.4% of all participants). We were also interested in those aged ≥ 75 years old but could not obtain the exact number of such participants in nine studies. The inclusion criteria were similar across studies: adults presenting with a resectable NSCLC (stages II to IIIB according to the eighth edition of the Tumor, Node, Metastasis (TNM) classification), with an Eastern Cooperative Oncology Group performance status score of 0 or 1. One study excluded people ≥ 70 years old. Six studies excluded NSCLC with known alterations in epidermal growth factor receptor and anaplastic lymphoma kinase genes. The following results relate to people ≥ 65 years old only. The term perioperative is used to label studies evaluating the administration of treatment before (neoadjuvant) and after (adjuvant) surgery. Overall survival at any time point (in all studies) Aggregated data from three studies (590 participants) showed that perioperative ICI probably results in little to no difference in overall survival compared to placebo or no treatment, with a hazard ratio (HR) of 0.88 (95% confidence interval (CI) 0.61 to 1.26) and moderate-certainty evidence (downgraded for risk of bias). Treatment-related adverse events ≥ grade 3 at any time point One study (39 participants) provided data indicating that perioperative ICI combined with neoadjuvant chemotherapy may result in little to no difference in treatment-related adverse events ≥ grade 3 compared to neoadjuvant chemotherapy alone, with a risk ratio (RR) of 2.75 (95% CI 0.38 to 19.83) and low-certainty evidence (downgraded for indirectness and imprecision). Disease-free survival at any time point Aggregated data from three studies (1403 participants) showed that adjuvant ICI probably slightly increases disease-free survival compared to placebo or no treatment (HR 0.85, 95% CI 0.73 to 0.99) with moderate-certainty evidence (downgraded for risk of bias). Event-free survival at any time point Aggregated data from seven studies (1531 participants) showed that neoadjuvant or perioperative ICI likely increases event-free survival compared to placebo or no treatment (HR 0.61, 95% CI 0.52 to 0.71) with moderate-certainty evidence (downgraded for risk of bias). Pathological complete response Aggregated data from six studies (1068 participants) showed that neoadjuvant or perioperative ICI may result in a large increase in pathological complete response rates compared to placebo or no treatment (RR 5.07, 95% CI 3.40 to 7.54) with low-certainty evidence (downgraded for risk of bias and imprecision). Major pathological response Aggregated data from six studies (1068 participants) showed that neoadjuvant or perioperative ICI probably results in a large increase in major pathological response rates compared to placebo or no treatment (RR 2.94, 95% CI 2.32 to 3.72) with moderate-certainty evidence (downgraded for risk of bias). In people aged ≥ 65 years old, the addition of ICIs probably results in little to no improvement in overall survival. Based on one study, treatment-related adverse events showed a similar profile, with low-certainty evidence. However, ICIs probably increase disease-free survival, event-free survival, and major pathological response rates by a clinically meaningful margin. ICI may also increase complete pathological response rates. No study reported health-related quality of life assessments in older adults. Data were also insufficient to evaluate outcomes precisely in participants aged 65 to 75 years, those ≥ 75 years, or in PD-L1 stratified subgroups. We classified 12 studies as ongoing, as no results are yet available for elderly participants. This Cochrane review had no dedicated funding. Protocol available via DOI: 10.1002/14651858.CD014907.

8. Low-Value Services and Longitudinal Knowledge Assessment Performance.

期刊: JAMA internal medicine 发表日期: 2026-Jul-13 链接: PubMed

摘要

Low-value services (LVSs) remain common and account for a substantial amount of wasteful US health care spending. To assess whether LVS use is associated with physicians’ general clinical knowledge as measured by performance on the American Board of Internal Medicine’s Longitudinal Knowledge Assessment (LKA). This cross-sectional study included general internists enrolled in the LKA in 2022 or 2023 caring for Medicare fee-for-service beneficiaries aged 67 years or older in an outpatient setting during their first year of participation. Physician first-year LKA scores. Receiving any of 25 LVSs designed to measure low-value primary care. Patient level regressions were adjusted for patient demographics, comorbidities, physician practice characteristics, and patient location. Of 898 365 included patients, 59% were female with a mean (SE) age of 76.8 (0.02) years, and 30% received at least 1 LVS. Of 7089 physicians, 3568 (50%) were male with a mean (SE) age of 52.5 (0.1) years. Having a physician with a top vs bottom quartile LKA score was associated with a logistic-regression adjusted 7.9% lower (95% CI, -10.5% to -5.3%, P < .001) chance of receiving any LVS during the year (bottom: 31.0% [95% CI, 30.4% to 31.7%]; top: 28.6% [95% CI, 28.1% to 29.1%]); absolute difference: -2.5 percentage points (95% CI, -3.3 to -1.6, P < .001). Significant differences were observed by LVS subtype including diagnostic or preventive testing (bottom: 10.4% [95% CI, 9.8% to 11.0%], top: 8.7% [95% CI, 8.3% to 9.1%]; absolute difference: -1.7 percentage points [95% CI, -2.5 to -0.9]; P < .001), cancer screening (bottom: 13.8% [95% CI, 13.4% to 14.3%], top: 12.3% [95% CI, 11.9% to 12.7%]; absolute difference: -1.5 [-2.1 to -0.9], P < .001), and imaging (bottom: 13.8% [95% CI, 13.4% to 14.2%]; top: 13.2% [95% CI, 12.9% to 13.5%]; absolute difference: -0.6 [95% CI, -1.1 to -0.1]; P = .02). LKA score quartile differences for individual LVSs were most prominent for total and free triiodothyronine testing in patients with hypothyroidism and prostate-specific antigen testing in males 75 aged years and older. The findings of this cross-sectional study suggest patients cared for by physicians with higher first-year LKA scores were less likely to receive LVSs.

9. Recommendations for Reporting on Potential Harms in Randomized Clinical Trials in JAMA Internal Medicine.

期刊: JAMA internal medicine 发表日期: 2026-Jul-13 链接: PubMed

摘要

10. PDA (Privacy-Preserving Distributed Algorithms) in action: ten principles for high-quality multi-site clinical evidence generation.

期刊: Journal of the American Medical Informatics Association : JAMIA 发表日期: 2026-Jul-13 链接: PubMed

摘要

Distributed Research Networks (DRNs) offer significant opportunities for collaborative multi-site research and have significantly advanced healthcare research based on clinical observational data. However, generating high-quality real-world evidence using fit-for-use data from multi-site studies faces important challenges, including biases associated with various types of heterogeneity within and across sites and data sharing difficulties. Over the last 10 years, Privacy-Preserving Distributed Algorithms (PDA) have been developed and utilized in numerous national and international real-world studies spanning diverse domains, from comparative effectiveness research, target trial emulation, to healthcare delivery, policy evaluation, and system performance assessment. Despite these advances, there remains a lack of comprehensive and clear guiding principles for generating high-quality real-world evidence through collaborative studies leveraging the methods under PDA. The paper aims to establish 10 principles of best practice for conducting high-quality multi-site studies using PDA. These principles cover all phases of research, including study preparation, protocol development, analysis, and final reporting. The 10 principles for conducting a PDA study outline a principled, efficient, and transparent framework for employing distributed learning algorithms within DRNs to generate reliable and reproducible real-world evidence.

11. A Socioeconomic Vulnerability Index for Persons with Disabilities via Machine Learning Approach.

期刊: Journal of occupational rehabilitation 发表日期: 2026-Jul-13 链接: PubMed

摘要

Employment is a key social determinant of health, yet people with disabilities (PWDs) face persistent disparities in vocational rehabilitation (VR) services and outcomes. Federally funded Vocational Rehabilitation (VR) programs serve individuals whose disabilities create barriers to competitive integrated employment, yet service allocation and outcomes vary widely across socioeconomic contexts. Understanding how cumulative socioeconomic disadvantage shapes VR service delivery and employment outcomes is essential for advancing equity. Using Rehabilitation Service Administration (RSA-9/11) data (n = 182,266), machine learning methods, including principal component analysis (PCA), were applied to develop a Socioeconomic Vulnerability Index, which was then used to examine associations with VR service delivery and employment outcomes. Results revealed that higher vulnerability was linked to increased likelihood of receiving basic support services but lower odds of career-oriented services. Higher vulnerability index scores correlated with higher expenditures (+ $246) yet substantially lower wages (- $3.13/hour). Findings suggest that an intake‑level vulnerability screening tool could support risk stratification and more targeted, equity‑focused VR service planning.

12. The role of economic evaluation in public health emergency management of disease outbreaks in Africa: a qualitative research.

期刊: Health economics review 发表日期: 2026-Jul-13 链接: PubMed

摘要

Recurrent disease outbreaks impose severe health and economic burdens on Africa, exposing critical gaps in public health emergency management (PHEM). Despite growing recognition of its value, economic evaluation (EE) remains largely absent from PHEM practice on the continent. This study aims to explore the role of EE in public health emergency management and assess its potential to strengthen health security in Africa, with a focus on the Africa Centres for Disease Control and Prevention (Africa CDC). A qualitative research design was employed, using in-person Key Informant Interviews (KIIs) with 12 purposively selected Africa CDC division heads and senior technical advisors between 15 March and 15 April 2023. Thematic analysis was conducted following the framework of Braun and Clarke (2006), with themes derived inductively from the interview data. A logic modelling framework was applied as a complementary tool to visualise EE’s causal chain across the four PHEM phases. Supplementary review of Africa CDC strategic documents, policy frameworks, and programme guidelines was undertaken to contextualise and triangulate the findings. Four themes emerged inductively from the analysis. First, key informants unanimously recognised EE as a critical but underutilised tool across the full PHEM cycle. Second, participants identified a concrete EE research agenda including return-on-investment analyses for preparedness, cost-effectiveness of diagnostic infrastructure, and health budget compliance monitoring. Third, significant barriers to EE integration were identified - principally a shortage of trained health economists, limited financial resources, and inadequate familiarity with health economics among decision-makers - alongside strategic opportunities presented by Africa CDC’s institutional positioning. Fourth, key informants framed EE as both a technical decision-support tool and a political communication instrument for influencing high-level policymakers. Mainstreaming EE into PHEM - through investment in health economics capacity, standardised methodologies, and institutionalised evidence use - can optimise the allocation of limited resources across preparedness, response, and recovery. Africa CDC is strategically positioned to lead this agenda continentally.

13. [Data on disability, health and participation in Germany-an update].

期刊: Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz 发表日期: 2026-Jul-13 链接: PubMed

摘要

Reliable population-based data are needed to identify policy needs regarding the health and participation of people with disabilities that are also in line with the UN Convention on the Rights of Persons with Disabilities. This article contains an update of an overview of relevant data sources in Germany published in 2016.Population-based studies/surveys, official statistics and process data from 2015 onwards were researched. The data sources had to be suitable for health reporting (Gesundheitsberichterstattung, GBE)-in particular, they had to be population-based, be collected regularly, be readily available and comply with the recommendations of the preliminary study for the participation survey. The tiered concept described there was used for categorisation.Twelve studies/surveys, five official statistical data sources and two process data sources were identified that contain data on the health and participation of people with disabilities with different focuses and varying breadth and depth. Compared to the previous overview, the participation survey has been added as a central data source. There are gaps, particularly in data sources on children and young people.In Germany, there is quite a large number of regularly collected data sources on disability, health and participation, the potential of which has not yet been fully exploited for analyses and reporting. Participation in studies should be barrier-free, and the use of standard instruments or the integration of a short instrument on participation into the surveys would be useful. A set of core indicators for GBE could support the evidence-based identification of areas where action is needed. Um politische Handlungsbedarfe zur Gesundheit und Teilhabe von Menschen mit Behinderungen ableiten zu können, werden belastbare, bevölkerungsbezogene Daten benötigt – auch im Sinne der UN-Behindertenrechtskonvention. Der Artikel enthält die Aktualisierung einer 2016 publizierten Übersicht zu entsprechenden Datenquellen in Deutschland.Recherchiert wurden bevölkerungsbezogene Studien und Surveys, Daten der amtlichen Statistik und Prozessdaten ab 2015. Die Datenquellen sollten für die Gesundheitsberichterstattung (GBE) geeignet sein – insbesondere mit Blick auf Bevölkerungsbezug, Regelmäßigkeit der Erhebung und Verfügbarkeit – und den Empfehlungen der Vorstudie für den Teilhabesurvey entsprechen. Zur Kategorisierung wurde das dort beschriebene Stufenkonzept genutzt.Identifiziert wurden 12 Studien und Surveys, 5 Datenquellen der amtlichen Statistik und 2 Prozessdatenquellen, die Daten zu Gesundheit und Teilhabe von Menschen mit Behinderungen mit unterschiedlichen Schwerpunkten und in unterschiedlicher Breite bzw. Tiefe enthalten. Im Vergleich zur vorherigen Übersicht ist mit dem Teilhabesurvey eine zentrale Datenquelle hinzugekommen. Lücken bestehen insbesondere bei Datenquellen zu Kindern und Jugendlichen.In Deutschland existiert eine Vielzahl regelmäßig erhobener Datenquellen zu Behinderung, Gesundheit und Teilhabe, deren Potenzial für Auswertungen und Berichterstattung noch nicht ausgeschöpft ist. Weiterhin ist es notwendig, die Teilnahme an Studien barrierearm zu gestalten. Sinnvoll wäre die Nutzung von Standardinstrumenten bzw. die Integration eines kurzen Instruments zur Teilhabe in die Surveys. Ein Kernindikatorenset für die GBE könnte dazu beitragen, die evidenzbasierte Identifikation von Handlungsbedarfen zu unterstützen.

14. From Knowledge to Action: Community-Based Strategies that Transform Diabetes Self-Management Among Black Adults with Type 2 Diabetes.

期刊: Journal of racial and ethnic health disparities 发表日期: 2026-Jul-13 链接: PubMed

摘要

Black adults with type 2 diabetes (T2D) experience disproportionately higher complications and poorer outcomes compared with other racial/ethnic groups. Community-based, culturally tailored diabetes self-management education and support (DSMES) interventions aim to improve glycemic levels, adherence, and self-care behaviors, yet strategies influencing success and sustainability remain underexplored among Blacks with T2D. This scoping review examined implementation strategies in community-based educational interventions for Black adults with T2D, identified effective practices, highlighted challenges, and offered recommendations for program design and policy. PubMed, CINAHL, Scopus, and EMBASE were searched through November 2025 for peer-reviewed quantitative or qualitative studies in English focused on Black adults and culturally grounded DSMES. Two reviewers independently screened studies, extracted data, and assessed quality using the Mixed Methods Appraisal Tool (MMAT). The Arksey and O’Malley framework guided the review. Thirteen studies met inclusion criteria. Most quantitative studies were of fair quality (40-60% MMAT criteria met), and the single qualitative study met 100% of the MMAT criteria for qualitative research. Interventions consistently improved diabetes knowledge, self-care behaviors, and psychosocial outcomes. Peer-supported and community health worker-led programs showed modest glycemic improvements. Faith- and church-based programs enhanced engagement, and structured lifestyle interventions integrating education, coping skills, and monitoring yielded clinically meaningful outcomes. Retention and long-term engagement were challenges, especially in extended or high-intensity programs. Community-based, culturally tailored DSMES interventions are feasible and effective in improving self-care, knowledge, and engagement among Black adults with T2D. Future programs should emphasize cultural relevance, address adherence barriers, and report outcomes to support sustainable practice and policy.

15. Newer and novel antidiabetic drug classes across the cardiovascular-kidney-metabolic continuum.

期刊: Endocrine reviews 发表日期: 2026-Jul-13 链接: PubMed

摘要

Cardiovascular-kidney-metabolic (CKM) syndrome represents an intricate and interdependent nexus among metabolic risk factors, such as diabetes and obesity, chronic kidney disease (CKD), and cardiovascular disease (CVD), collectively exerting a profound impact on global morbidity and mortality. The rising prevalence of type 2 diabetes (T2D) underscores the urgent need for therapeutic strategies that transcend glycemic control to target the intricate pathophysiology underlying these conditions. This review examines the expanding role of novel antidiabetic drug classes, including sodium-glucose cotransporter-2 (SGLT2) inhibitors, glucagon-like peptide-1 receptor agonists (GLP-1RAs), and dual or triple-incretin agonists, across the CKM continuum. These agents have demonstrated significant benefits in reducing major adverse cardiovascular events (MACEs), attenuating CKD progression, and enhancing metabolic health, independent of their glucose-lowering properties. Across the CKM continuum, we prioritize weight-centric incretin therapy (GLP-1RAs or dual incretins) in stage 0-1 (obesity/prediabetes), SGLT2 inhibitors first for albuminuric CKD and/or heart failure risk in stage 2 (with early addition of GLP-1RAs when CVD/obesity predominates), and layered combination therapy in stage 3, typically SGLT2 inhibitor + GLP-1RA/dual incretin (± finerenone for persistent albuminuria), to maximize cardiovascular and kidney protection. By synthesizing evidence from pivotal clinical trials, evaluating emerging combination therapies, and delineating the evolving treatment paradigm, this review aims to provide a comprehensive perspective on how these antidiabetic therapies influence CKM syndrome management. As research advances, an integrated, multifaceted approach to diabetes care leveraging these agents may lead to substantial improvements in cardiovascular, kidney, and metabolic outcomes.

16. The end of the primary-secondary prevention dichotomy in high-risk diabetes? Lessons from VESALIUS-CV.

期刊: Acta diabetologica 发表日期: 2026-Jul-13 链接: PubMed

摘要

The VESALIUS-CV trial was the first dedicated cardiovascular-outcomes study to demonstrate that adding the PCSK9 inhibitor evolocumab to statin therapy prevents a first major cardiovascular event in patients without a previous myocardial infarction or stroke. A prespecified analysis extended this benefit to patients with diabetes and no known significant atherosclerosis, in whom intensive low-density lipoprotein cholesterol (LDL-C) lowering reduced major adverse cardiovascular events by approximately one third. These findings challenge the long-standing reliance on the primary-secondary prevention distinction to determine the intensity of lipid-lowering therapy. We argue that in high-risk diabetes-a systemic immunometabolic syndrome characterised by adiposopathy, insulin resistance, chronic inflammation and atherogenic dyslipidaemia-the arterial wall is biologically diseased long before a first clinical event. Cardiovascular prevention in this population should therefore move from an event-based to a biology-based paradigm, governed by biological risk rather than by event history.

17. Heart Failure and Cognitive Impairment: A Narrative Review.

期刊: ESC heart failure 发表日期: 2026-Jul-13 链接: PubMed

摘要

Heart failure (HF) is a major global health burden affecting more than 64 million individuals worldwide, and is associated with substantial morbidity, mortality, and healthcare expenditure. Cognitive impairment (CI) is a prevalent and clinically consequential comorbidity, affecting approximately 40-50% of patients with HF across both reduced and preserved ejection fraction phenotypes. Despite its high prevalence and adverse prognostic implications, CI remains systematically underdiagnosed and insufficiently addressed in routine clinical practice. The pathophysiological mechanisms linking HF and CI are multifactorial and incompletely understood, encompassing cerebral hypoperfusion secondary to reduced cardiac output, systemic neuroinflammation driven by pro-inflammatory cytokines, oxidative stress, neurohumoral dysregulation, and cerebrovascular injury. Shared cardiovascular risk factors, including atrial fibrillation, hypertension, diabetes mellitus, and obesity, further compound the risk of cognitive decline. CI exerts a profound impact on clinical outcomes in HF, independently predicting increased all-cause mortality, higher rates of hospitalisation and 30-day readmission, impaired self-care capacity, and reduced medication adherence. Early and systematic identification is a reasonable clinical priority that may support optimised clinical management and informed shared decision-making. This review synthesises current evidence on the epidemiology, pathophysiology, clinical assessment, prognostic significance, and therapeutic implications of CI in HF, and highlights key controversies and priorities for future research.

18. A metabolic model of the leaf-associated bacterium Paraburkholderia dioscoreae links the ethylene precursor ACC to core carbon pathways.

期刊: mSystems 发表日期: 2026-Jul-13 链接: PubMed

摘要

Paraburkholderia dioscoreae MSB3T is a novel species with potential agricultural impact, isolated from leaf acumens of the “air potato yam” Dioscorea bulbifera. P. dioscoreae’s genome encodes a relevant combination of features mediating a beneficial plant-associated lifestyle, and it exhibits significant growth promotion when applied to agriculturally important plants such as tomato. Here, we constructed iPR1691, the first genome-scale metabolic model for P. dioscoreae MSB3, which includes 1,687 reactions, 1,487 metabolites, and 1,691 genes. From an available annotation of P. dioscoreae’s genome, a draft model was constructed using an automated approach followed by automatic gap-filling on Kbase and was manually curated using constraint-based modeling. The plant growth-promoting effect is related to 1-aminocyclopropane-1-carboxylic acid (ACC), an ethylene precursor in plants, which P. dioscoreae can use as a carbon and nitrogen source. Based on the reactions and genes present in the model, and on various pathways available in the MetaCyc database, a pathway for ACC usage was reconstructed. A sequence comparison against a library of phyllosphere bacterial genomes showed a broad occurrence of the pathway genes in phyllosphere strains. Flux balance analysis was used to validate growth of P. dioscoreae on different substrates, corresponding to diverse conditions of carbon and nitrogen availability. The model provides a representation of bacterial growth on ACC, thus elucidating the biochemical and genetic mechanisms of this plant-bacterial interaction.IMPORTANCEMetabolization of the plant ethylene precursor 1-aminocyclopropane-1-carboxylic acid (ACC) is an important mechanism for plant-associated bacteria to regulate their host’s ethylene status. While previous studies have typically focused on the first step (ACC deaminase) as a metabolic sink, we further investigated the metabolic role of ACC for the bacterium. Our model system is the species Paraburkholderia dioscoreae, isolated from leaf acumens of the “air potato yam” Dioscorea bulbifera and shown to mediate a beneficial plant-associated lifestyle, including significant growth promotion when applied to agriculturally important plants such as tomato. Here, we constructed the first genome-scale metabolic network reconstruction for P. dioscoreae, validated against in vitro growth data. The model incorporates a novel pathway that links ACC to succinate and thus explains the utilization of ACC as a carbon source. Moreover, a sequence similarity search of the pathway genes in a library of phyllosphere bacteria indicates that the pathway is present in several other leaf-associated species.

19. GC content mismatch of transgene destabilizes RNA virus genomes.

期刊: Journal of virology 发表日期: 2026-Jul-13 链接: PubMed

摘要

GC content-the proportion of guanine and cytosine nucleotides-varies widely among organisms and viruses. Although GC content is recognized to have biological significance, its functional role in viruses remains poorly understood. Here, we examined the impact of GC-content bias using three positive-sense single-stranded RNA viruses with distinct GC profiles: severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), Japanese encephalitis virus (JEV), and hepatitis C virus (HCV). Variants of the NanoLuc (Nluc) reporter gene, engineered with synonymous mutations to alter GC content, were inserted into each viral genome. Serial passaging experiments revealed strong effects on genome stability and viral fitness. In SARS-CoV-2, which has low GC content, the introduction of a GC-rich Nluc gene disrupted genome stability, leading to frequent deletions of Nluc. In both SARS-CoV-2 and HCV, Nluc with mismatched GC levels accumulated substitutions that optimized GC content toward that of the viral genome, predominantly at the third codon position. tRNA-seq analysis revealed a shift in the host tRNA pool toward a more GC-rich composition during HCV infection, consistent with this substitution bias. In contrast, JEV (intermediate GC content) maintained the Nluc variants across serial passages, suggesting reduced selective pressure. Taken together, these findings demonstrate that mismatches between viral genome GC content and inserted sequences profoundly affect genetic stability, suggesting evolutionary constraints that may shape RNA virus composition more broadly. This study provides mechanistic insight into how GC content influences viral genome maintenance and offers a framework for designing genetically stable recombinant reporter viruses.IMPORTANCEGC content is a fundamental genomic feature that influences gene expression, genome architecture, and adaptation. Although its role in cellular genomes has been extensively studied, the functional significance of GC content in viral genomes remains poorly understood. In this study, we show that incompatibility in GC content between a viral genome and an inserted transgene destabilizes RNA secondary structures, compromising viral genome integrity, and is accompanied by changes in the host tRNA pool consistent with this compositional bias. These findings identify GC content as a previously underappreciated determinant of virus-host compatibility and viral fitness. Importantly, our results provide mechanistic insight into how the GC content of a viral genome can be matched to its host cellular environment. By demonstrating that GC content matching is critical for the stability of recombinant viruses, this study provides a basis for the rational design of reporter viruses, vaccine platforms, and antiviral screening tools.

20. Eating behaviours, prevalence of obesity & health policies.

期刊: International journal of food sciences and nutrition 发表日期: 2026-Jul-13 链接: PubMed

摘要

Obesity prevalence is increasing, particularly in developing nations. To contain these trends, several countries implemented preventive measures such as taxation of food items and/or front-of-pack labels. An ecological cross-country observational study was conducted, using publicly available data (GBD, WHO-GHO) on 20 European and Latin American countries, to explore changes around the year of policy in the consumption of foods/nutrients considered “healthy” or “unhealthy” and in the obesity prevalence across age groups. Food/nutrient consumption trends did not show a consistent pattern according to policy adoption. In several countries, “healthy” food consumptions decreased over time, while “unhealthy” food/nutrient consumptions increased, regardless of the adoption of policies. Trend analyses around policy adoption suggested changes in obesity trajectories, particularly among children and adolescents, but these findings were inconsistent across settings. The multifactorial nature of obesity may explain the contrasting results evidenced by this study, indicating a more complex approach beyond focusing on single foods/nutrients.

21. Fermented spent coffee grounds affect cadmium toxicity and accumulation in Lolium perenne: implications for phytoremediation.

期刊: International journal of phytoremediation 发表日期: 2026-Jul-13 链接: PubMed

摘要

Cadmium (Cd) pollution poses severe threats to ecosystems and human health. Phytoremediation using fast‑growing plants offers a promising solution, but Cd toxicity restricts plant performance. This study investigated whether fermented spent coffee grounds (FSCG) can alleviate Cd stress in Lolium perenne and enhance Cd accumulation. In a greenhouse experiment, L. perenne was subject to four Cd levels (0, 0.5, 5, and 50 mg kg-1) fully crossed with two FSCG treatments (with or without FSCG). Cd significantly inhibited seed germination and biomass. The addition of FSCG increased the germination rate, root mass, root-shoot ratio, and root tolerance. However, the shoot mass was lower, except at the Cd level of 5 mg kg-1, where FSCG increased the shoot mass. Moreover, the chlorophyll and MDA content were reduced. Notably, FSCG reduced shoot Cd concentration across all Cd levels. The interactive effects between Cd and FSCG were significant for growth, with the greatest promotion occurring at the Cd level of 5 mg kg-1. This study reveals a dual role of FSCG in waste valorization and phytoremediation enhancement, demonstrating that FSCG protects L. perenne from Cd toxicity by improving root development, mitigating oxidative stress, and concurrently limiting Cd translocation to shoots. Although FSCG reduced shoot Cd concentration per unit biomass, its promotion of root development and plant health may favor sustained biomass production over repeated harvests, thereby enhancing long‑term phytoextraction efficiency. These findings provide new insights into the physiological mechanisms by which FSCG protects plants under Cd stress and offer a synergistic strategy for organic waste reuse coupled with soil remediation. This study is the first to investigate the effects of fermented spent coffee grounds (FSCG) on the growth and cadmium (Cd) uptake of plants used for the remediation of Cd polluted soil. Our experiments demonstrate that FSCG alleviates Cd toxicity in Lolium perenne. Although FSCG does not increase Cd uptake by L. perenne in the short term, it may benefit long‑term phytoextraction through sustained biomass production. These findings not only enable the reutilization of spent coffee grounds but also provide a novel reinforcement strategy for phytoremediation.

22. Community pharmacists' experiences and perspectives on GLP-1 receptor agonists for obesity management: a cross-sectional study in Ireland.

期刊: The International journal of pharmacy practice 发表日期: 2026-Jul-13 链接: PubMed

摘要

To assess the experiences and perspectives of community pharmacists in Ireland on Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) for obesity management. An online questionnaire of closed- and open-ended questions was distributed to community pharmacists in the Republic of Ireland in July 2025. Closed-ended questions were analyzed quantitatively using descriptive statistics, and conventional content analysis was utilized for open-ended responses. Two hundred questionnaires were available for analysis. Respondents dispensed GLP-1 RAs for obesity (n = 31, 16.1%), and for both obesity and diabetes management (n = 160, 82.9%). Respondents frequently provided counselling on the practical aspects of GLP-1 RA use including storage (n = 162, 83.94%), administration (n = 143, 74.09%), side effects (n = 128, 66.32%), and sharps disposal (n = 99, 51.3%). However, topics such as nutrition and contraception were discussed less frequently, with 45.6% (n = 88) never providing contraception advice to female patients. Time constraints were the main barriers reported to counselling. Several challenges and concerns were highlighted by pharmacists including the impact of medication shortages on practice, increased pressure on pharmacy workflows, safety and prescribing oversight, particularly for online prescribing, alongside a need for additional education and training. Community pharmacists in Ireland play a key role in dispensing GLP-1 RAs and providing patient support. They report gaps in counselling, training, professional guidance, and structural support, alongside safety concerns of online prescribing. Updated professional guidance, pharmacy-based practice models, and national policies will allow community pharmacists to better support the delivery of obesity care.

23. Interleukin 6 Receptor Blockade for Relapse Prevention in Myelin Oligodendrocyte Glycoprotein Antibody-Associated Disease.

期刊: JAMA neurology 发表日期: 2026-Jul-13 链接: PubMed

摘要

Myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) lacks proven relapse-preventive therapies. While clinical trials are ongoing, safety data may be limited and approved drugs are costly. Studies of interleukin 6 receptor blocker (IL-6RB) in MOGAD are limited by small numbers and no comparative studies, contributing to low use. To evaluate the impact of IL-6RB therapy on relapse rates in MOGAD and compare relapse frequency with intravenous immunoglobulin (IVIG). This international, multicenter, retrospective cohort study (January 1, 2015, through December 31, 2025) included a historical IVIG-treated cohort of varying doses. The study took place across sites in North and South America (US, Canada, Mexico, Argentina, Brazil, Chile, Colombia, and Peru). Patients with MOGAD (n = 116, no excluded patients) who received at least 1 dose of an IL-6RB were included. These data were analyzed in January 2026. Tocilizumab or satralizumab. Annualized relapse rate (ARR) during IL-6RB therapy, time to next relapse after treatment initiation, and adverse events. Outcomes were compared with the IVIG cohort using inverse probability of treatment weighting (IPTW) adjusted for age, sex, prior ARR, and concomitant therapies. A total of 116 patients with MOGAD (89% relapsing) receiving IL-6RB (tocilizumab, 104 [90%] and satralizumab, 12 [10%]) were included; overall, 60.3% were female, 39.7% were male, and 18% were younger than 18 years. The median (IQR) IL-6RB treatment follow-up was 1.4 (0.7-2.5) years and 23 relapses occurred during 241.8 person-years of IL-6RB therapy. The ARR decreased from 0.64 (95% CI, 0.58-0.70) for relapsing MOGAD before IL-6RB to 0.09 (95% CI, 0.06-0.14) during IL-6RB treatment (incidence rate ratio, 0.08; 95% CI, 0.04-0.16). Adverse events occurred in 58 patients (50%), most commonly mild infections, although 10 (9%) had severe infections. In the IVIG cohort (n = 59), 30 relapses occurred over 133.8 person-years (ARR, 0.22; 95% CI, 0.15-0.32). After IPTW, IL-6RB was associated with a lower hazard ratio (HR) than the group who underwent IVIG therapy less than 1 g/kg every 4 weeks (HR, 4.5; 95% CI, 2.0-9.8), with no significant difference vs the group who underwent IVIG 1 g/kg or more every 4 weeks (HR, 2.0; 95% CI, 0.8-4.5). In this multicenter observational cohort, IL-6RB use in MOGAD was associated with low relapse rates and a favorable safety profile, though severe infections occurred occasionally. Relapse rates were lower than the group who underwent IVIG less than 1 g/kg every 4 weeks but not significantly different from the group who underwent IVIG 1 g/kg or more every 4 weeks. This supports IL-6RB as a potential relapse-prevention therapy in MOGAD; the wide availability and relative affordability of tocilizumab may enable broad global use.

24. Disease-modifying antirheumatic drugs (DMARDs) for rheumatoid arthritis after failure of biologic or targeted synthetic therapy: a systematic review and network meta-analysis.

期刊: The Cochrane database of systematic reviews 发表日期: 2026-Jul-13 链接: PubMed

摘要

After inadequate response to first-line biologic or targeted synthetic (b/ts) disease-modifying antirheumatic drug (DMARD) therapy in adults with rheumatoid arthritis, there are numerous alternative DMARD options, and current understanding of their comparative benefits and harms is limited. The aim of this living systematic review and network meta-analysis was to compare the benefits and harms of DMARDs after failure of biologic or targeted synthetic DMARDs in adults with rheumatoid arthritis. We searched CENTRAL, MEDLINE, Embase, and two trial registries (ClinicalTrials.gov and the WHO ICTRP) from inception until 28 November 2025, with no restrictions on language or date of publication. We included randomised controlled trials (RCTs) of adults aged 18 years or older diagnosed with rheumatoid arthritis according to 1958, 1987, or 2010 classification criteria who previously demonstrated inadequate response to a b/ts DMARD. Eligible interventions included conventional synthetic DMARDs (methotrexate, antimalarials, sulfasalazine, leflunomide, ciclosporin, and azathioprine), biologic DMARDs (adalimumab, certolizumab, etanercept, golimumab, infliximab, abatacept, rituximab, tocilizumab, sarilumab, and anakinra), and targeted synthetic DMARDs (tofacitinib, baricitinib, and upadacitinib). Our critical outcomes were American College of Rheumatology 50% (ACR50) response, withdrawals due to adverse events, radiographic progression, Disease Activity Score 28 (DAS28) remission, pain as measured by visual analogue scale, function as measured by the Health Assessment Questionnaire (HAQ), and serious adverse events. Important outcomes included ACR20, ACR70, serious infections, fatigue, and quality of life. We used Cochrane’s RoB 1 tool to assess risk of bias in the included studies. We first screened the records using an approach that combined machine learning and crowdsourcing to identify probable RCTs. We then reviewed the records identified as RCTs for eligibility and simultaneously classified them to the appropriate Population, Intervention, Comparator, and Outcome (PICO) question(s). Two review authors then extracted relevant data from the included studies in duplicate and independently, with any disagreements resolved by a third review author. A Bayesian random-effects network meta-analysis was conducted using a semi-informative prior probability distribution. We assessed the certainty of evidence for each outcome using the GRADE approach. We included 19 unique studies (4779 participants) in the review, all of which were parallel-design RCTs. Eleven trials were placebo controlled; two trials had an inactive comparator arm; and six trials had an active comparator arm. The trials were performed in a well-established rheumatoid arthritis population, with the median baseline disease duration ranging from 6.4 to 14 years, median age of participants ranging from 49 to 58 years, and median baseline disease activity (DAS28) ranging from 4.87 to 6.79. ACR50 response We found moderate-/high-certainty evidence that using a tumour necrosis factor (TNF) inhibitor not previously tried, interleukin-6 (IL-6) inhibitors, abatacept, rituximab, and Janus kinase (JAK) inhibitors was more effective than placebo: TNF inhibitor not previously tried (odds ratio (OR) 6.04, 95% credible interval (CrI) 2.49 to 16.3; high-certainty evidence), sarilumab (OR 3.11, 95% CrI 1.25 to 7.76; high-certainty evidence), tocilizumab 4 mg/kg intravenous (OR 5.31, 95% CrI 2.09 to 12.09; high-certainty evidence), tocilizumab 8 mg/kg intravenous (OR 10.03, 95% CrI 3.65 to 31.27; high-certainty evidence), subcutaneous abatacept (OR 4.31, 95% CrI 0.97 to 18.28; moderate-certainty evidence), intravenous abatacept (OR 4.57, 95% CrI 2.21 to 10.18; high-certainty evidence), rituximab (OR 5.50, 95% CrI 2.31 to 13.12; high-certainty evidence), upadacitinib (OR 3.93, 95% CrI 1.53 to 10.32; high-certainty evidence), tofacitinib (OR 3.93, 95% CrI 1.53 to 10.32; high-certainty evidence), baricitinib 2 mg (OR 2.00, 95% CrI 0.77 to 5.23; moderate-certainty evidence), baricitinib 4 mg (OR 2.79, 95% CrI 1.10 to 7.22; high-certainty evidence). With an assumed risk for placebo of 78 out of 1000 patients, the expected effects for the active drugs ranged from 143 (baricitinib 2 mg) to 455 (tocilizumab 8 mg/kg). Withdrawals due to adverse events For most interventions, there were sparse data with low-certainty evidence, except for TNF inhibitor not previously tried (risk ratio (RR) 0.32, 95% CrI 0.07 to 1.1; moderate-certainty evidence), which is probably less harmful than placebo, and sarilumab (RR 1.98, 95% CrI 0.57 to 7.19; moderate-certainty evidence), which is probably more harmful than placebo. Low-certainty evidence suggests that intravenous abatacept (RR 0.92, 95% CrI 0.34 to 2.79), upadacitinib (RR 0.41, 95% CrI 0.08 to 1.83), and baricitinib 2 mg (RR 0.93, 95% CrI 0.22 to 4.01) may be less harmful than placebo. Low-certainty evidence suggests that tocilizumab 4 mg/kg (RR 1.39, 95% CrI 0.39 to 5.28), tocilizumab 8 mg/kg (RR 1.49, 95% CrI 0.51 to 4.81), subcutaneous abatacept (RR 3.11, 95% CrI 0.05 to 249.6), rituximab (RR 2.38, 95% CrI 0.44 to 23.31), tofacitinib (RR 1.37, 95% CrI 0.35 to 5.58), and baricitinib 4 mg (RR 1.43, 95% CrI 0.38 to 5.81) may be more harmful than placebo. Data were insufficient to perform a network meta-analysis for radiographic progression. For DAS28 and the HAQ, there was mostly moderate-/high-certainty evidence of a benefit, with some exceptions for comparisons with indirect evidence only that was of low or very low certainty. For the other efficacy outcomes, data were sparse with wide credible intervals, and the certainty of evidence was typically low. We found high-certainty evidence that nine therapies and moderate-certainty evidence that two therapies provide a clinically important benefit in improving disease activity compared to placebo for people with rheumatoid arthritis after failure of b/ts DMARD therapy. There was significant uncertainty surrounding treatment-related harms, with the evidence having been downgraded for serious or extremely serious imprecision. Pair-wise comparisons showed no significant differences among therapies, although the certainty of evidence was low. The lack of clarity regarding safety and comparative efficacy suggests that treatment decisions should be guided by individual patient characteristics and preferences. This work was supported by grants from the Canadian Institutes for Health Research (CIHR) [Funding Reference Numbers (FRN) 178375 and 180324] and the National Health and Medical Research Council (NHMRC) Cochrane Collaboration. This research was supported by Arthritis Society Canada (Doctoral Studentship TGP-23-0211). This study was outlined in a Cochrane protocol (CD013562; DOI 10.1002/14651858.CD013562).

25. Optimizing vaccine site locations while considering travel inconvenience and public health outcomes.

期刊: Health care management science 发表日期: 2026-Jul-13 链接: PubMed

摘要

During the COVID-19 pandemic, selecting vaccination sites and allocating limited doses required balancing accessibility, disease control, and fairness. We formulate a multi-objective mixed-integer linear programming model that jointly determines the locations of mega-sites and allocates vaccine doses while explicitly incorporating travel inconvenience, disease dynamics, and equitable distribution. The model incorporates commuting patterns from both residential and workplace origins to more accurately capture population mobility, and employs a tractable objective formulation that proxies key public health goals, enabling efficient and equitable mass vaccination planning. Compared with the solution empirically used in Los Angeles County in 2020, we recommend more dispersed mega-site locations that result in a 26% reduction in travel inconvenience and avert an additional 200 infections.

26. Unraveling Luteolin's Modulatory Effects on α-Synuclein Aggregation: A Combined Biophysical, Computational, and C. elegans Approach.

期刊: Cell biochemistry and biophysics 发表日期: 2026-Jul-13 链接: PubMed

摘要

Parkinson’s disease is associated with amyloid fibrillation of alpha-synuclein (α-syn) that involves the aggregation of protein into insoluble fibrils. In this study, we investigate the effect of luteolin (LUT) on α-syn aggregation in vitro, in silico, and in Caenorhabditis elegans. The decrements in light scattering and ThT fluorescence reveal that there is less formation of α-syn aggregates with an increase in the concentration of LUT. Also, a decrease in the ANS fluorescence depicts less exposure of hydrophobic patches in α-syn in the presence of LUT. Far UV CD data shows that LUT resists conversion structure into beta sheets. Dynamic light scattering and transmission electron microscopy revealed that LUT decreases the size and number of fibrils formed. Additionally, LUT reduced RBC hemolysis, indicating its potential therapeutic value in preventing the formation of toxic aggregates. In vivo studies in C. elegans also show that LUT improves the mitochondrial health, reduces reactive oxygen species (ROS), and enhances worm motility. Computational studies provide probable mechanistic insight that LUT interacted with α-syn via hydrophobic and hydrogen interactions, thus limiting the formation of fibrils by masking the sites that might be involved in aggregation. Consequently, LUT is an inhibitor of α-syn aggregation and may be a potential therapeutic agent against Parkinson’s disease.

27. Sex Differences in the Association Between Dietary Pattern and Type 2 Diabetes Mellitus: Protocol for a Systematic Review.

期刊: JMIR research protocols 发表日期: 2026-Jul-13 链接: PubMed

摘要

Diabetes mellitus encompasses disorders characterized by hyperglycemia due to pancreatic β-cell dysfunction. Type 2 diabetes (T2D) constitutes over 90% of cases, with a background of genetic, metabolic, and environmental risk factors. Knowing that sex differences impact insulin resistance and glycemic control, this review aims to identify differences in adherence to dietary patterns between women and men with T2D. This systematic review aims to evaluate sex differences in dietary pattern adherence among individuals with T2D and the implications of these differences for glycemic control. The protocol was developed using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Studies published until July 2026 will be identified by searching the following electronic databases: MEDLINE, Scopus, Cochrane Library, and Web of Science. Three investigators will independently screen articles based on titles and abstracts followed by a thorough analysis of selected full-text articles of interest. Articles on T2D and dietary pattern scores that include biological sex data will be included. The estimation of risk of bias will be performed using the Standard Quality Assessment Criteria for Evaluating Primary Research Papers From a Variety of Fields. To synthesize the results, a narrative analysis will be performed based on the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) framework. The search strategy was developed and refined between July 2025 and July 2026 through scoping and pilot searches. The comprehensive database search will be conducted in August 2026, covering records from database inception to July 2026. Study selection and data extraction are expected to be completed by December 2026, with publication anticipated in late 2027. This systematic review will provide a comprehensive overview of the role of sex in dietary adherence among individuals with T2D. Identifying sex-specific and gender differences may inform the development of tailored nutritional strategies and interventions aimed at improving glycemic outcomes. Ultimately, this work highlights the importance of incorporating sex-based approaches in the management of T2D to optimize long-term health outcomes. PROSPERO CRD42024340213; https://www.crd.york.ac.uk/PROSPERO/view/CRD42024340213. DERR1-10.2196/98958.

28. Cytoplasmic circular dsDNA is a key constituent of stress granules.

期刊: eLife 发表日期: 2026-Jul-13 链接: PubMed

摘要

Stress granules are large cytoplasmic bodies formed in response to environmental insults by eukaryotic cells. Stress granule formation is key for post-stress recovery, and many diseases and infections are characterized by dysregulation of these membraneless organelles. How specific and non-specific macromolecular interactions drive the formation of stress granules and other large assemblies is an area of active research. Stress granules are comprised of dense, ~200 nm cores, and these are known to contain numerous RNAs and proteins. Now, we have discovered that more than half of the nucleic acid content of stress granule cores is circular, double-stranded DNA. We demonstrate cytologically that these extrachromosomal circular DNAs (eccDNAs) colocalize cytoplasmically with canonical stress granule marker proteins in HEK293T cells, and through CRISPR targeting in budding yeast, that they are required for stress granule formation upon stress. This discovery thus reveals a key function for eccDNA in the eukaryotic stress response.

29. Effects of a low-lipid diet on the gut microbiome and head kidney transcriptome of juvenile Chinook Salmon.

期刊: Journal of aquatic animal health 发表日期: 2026-Jul-13 链接: PubMed

摘要

Pacific salmon Oncorhynchus spp. reared in production hatcheries are typically fed high-lipid, energy-dense diets to achieve large size and high body condition prior to release. In contrast, juveniles in natural environments tend to consume low-lipid, high-protein diets, and fish reared for research or conservation purposes are sometimes fed diets that are formulated to mimic natural diets and promote wild-like phenotypes. Understanding how these alternative diets affect fish health beyond growth and body condition could ultimately contribute to improving hatchery fish fitness. In this work, we evaluated changes in the fecal microbiome and gene expression of juvenile Chinook Salmon O. tshawytscha on a standard high-lipid hatchery diet versus a low-lipid diet formulated to mimic the nutrition profile of natural-origin fish. To evaluate the time scale at which diet alters the fecal microbiome, we collected longitudinal samples over a 12-week period and switched the diets of a subset of fish twice during the experiment. We used 16S ribosomal RNA gene amplicon sequencing to characterize fecal microbiome differences between fish on the two diets as well as hatchery-reared fish at a production hatchery, hatchery fish that had been captured after release into a stream, and natural-origin, stream-reared fish of similar ages. Additionally, we conducted RNA sequencing on head kidney samples from laboratory-reared fish to evaluate changes in gene expression in this important immune organ. We found that the low-lipid diet and the hatchery diet resulted in microbiomes that differed from the microbiome of natural-origin fish and from each other and that diet-driven changes to the microbiome could occur in under 14 d. The low-lipid diet did not result in a microbiome that resembled the microbiome of naturally produced fish. Instead, the low-lipid diet resulted in a microbiome community that was distinct from those of fish reared on the hatchery diet and fish sampled from the wild. The RNA sequencing results indicated differential enrichment of pathways related to immunity, metabolism, and hormone synthesis between fish that were fed the two experimental diets. The results suggest that additional environmental factors influence the microbiome more strongly than diet formulation or that the low-lipid diet has a smaller effect on the microbiome than a natural, -invertebrate-based diet. Given that the gut microbiome and systemic immune function contribute significantly to disease resistance, our findings highlight the importance of understanding how diets fed to fish in captivity may affect fish health beyond growth and body condition metrics. Juvenile salmon reared in hatcheries are often fed diets with a much higher fat content than their wild counterparts. This article describes how different diets and rearing environments (e.g. laboratory, hatchery, river) can influence the gut microbiome and the expression of certain genes that may be related to fish health.

30. Association between long-term exposure to environmental coarse particulate matter and the prevalence of thyroid disorders: a cross-sectional study in China.

期刊: Journal of endocrinological investigation 发表日期: 2026-Jul-13 链接: PubMed

摘要

Evidence linking long-term exposure to particulate matter with thyroid dysfunction is increasing, but data on particulate matter 10 micrometers or less (PM10) exposure and thyroid disorders remain limited. 73,900 subjects aged ≥ 18 years from a nationwide population-based study were included. Thyroid disorders were determined using standardized biochemical testing and thyroid ultrasound examination. Individual long-term PM10 exposure was estimated at a 1 × 1 km spatial resolution using a Space-Time Extra Trees model, and the five-year average concentration preceding enrollment was assigned to each participant’s residential address. Weighted estimates were calculated to account for the complex sampling design. The average long-term exposure to PM10 at residential addresses was 111.74 µg/m3, ranging from 35.08 µg/m³ to 374.8 µg/m³. Compared with those in the first quartile (35.08 to 75.50 µg/m³), participants in the highest PM10 quartile (130.80 to 374.80 µg/m³) had higher odds of overt hypothyroidism (OR 1.36 [CI 1.03-1.79]), subclinical hypothyroidism (1.14 [1.04-1.25]), autoimmune thyroiditis (1.10 [1.01-1.20]) and thyroglobulin antibody positivity (1.24 [1.12-1.37]). Each 10 µg/m³ increase in the PM10 concentration was associated with higher odds of overt hypothyroidism (OR 1.16 [1.07-1.25]) and subclinical hypothyroidism (1.07 [1.04-1.10]). TgAb positivity showed an increasing exposure-response pattern across PM10 concentrations. No consistent significant associations were observed for overt hyperthyroidism, subclinical hyperthyroidism, Graves’ disease, or thyroid peroxidase antibody positivity. Long-term PM10 exposure was associated with higher odds of overt hypothyroidism, subclinical hypothyroidism, autoimmune thyroiditis, and TgAb positivity among Chinese adults. These findings suggest that coarse particulate pollution may be a modifiable environmental factor related to hypothyroidism and thyroid autoimmunity.

31. Seasonal distribution of radionuclides and metal(loid)s in mining-contaminated soils: an integrated multivariate and risk assessment approach.

期刊: Environmental monitoring and assessment 发表日期: 2026-Jul-13 链接: PubMed

摘要

Unregulated artisanal mining increases soil contamination, while seasonal changes further worsen the distribution of potentially toxic elements (PTEs), including radionuclides and toxic metals. This study examined the seasonal variation of Zn, Ba, Bi, La, Sc, Sb, Sr, Pb, Th, U, and K in soils from a lead/zinc mining district in southeastern Nigeria. PTEs were measured using ICP-MS, and activity concentrations of 238U, 232Th, and 40 K were calculated from mass concentrations and natural specific activities. Results were compared to regulatory standards, and ecological, radiological, carcinogenic, and non-carcinogenic health risks were evaluated with multiple models. Source apportionment was conducted using multivariate analyses, while spatial variability was evaluated using the coefficient of variance (CV%). The average soil PTE concentrations were Pb > K > Zn > Ba > La > Th > Sr > Sc > U > Sb > Bi (dry), and K > Pb > Zn > Ba > La > Sr > Th > Sc > Sb > U > Bi (wet), while the mean activity concentrations followed ATh-232 > AK-40 > AU-238. Regulatory benchmarks for Zn and Pb were consistently exceeded, and ATh-232 surpassed the world average (45 Bq/kg) in 50% of dry season locations and 56.25% of wet season locations. Health risks were higher for children during the dry season, with non-carcinogenic and carcinogenic risks from cumulative exposure observed in all groups and seasons. Multivariate analysis linked Ba/La/Sc/Sr/U to natural sources and Pb/Zn/Th/Sb to mixed anthropogenic/geogenic sources. Locations L9 (dry) and L5 (wet) were the most ecologically degraded, with Pb posing the greatest ecological hazard. Urgent remediation and sustainable mining practices are recommended to protect the environment and public health.

32. Soil to host environmental determinants fueling horizontal gene transfer and global AMR dissemination.

期刊: Folia microbiologica 发表日期: 2026-Jul-13 链接: PubMed

摘要

Antimicrobial resistance poses a critical and escalating threat to global health, with horizontal gene transfer serving as a primary driver of resistance dissemination among microbial communities across diverse ecological niches. The three classical horizontal gene transfer mechanisms, including transformation, transduction, and conjugation, are complemented by supplementary routes involving outer membrane vesicles, gene transfer agents, and nanotubes. Both internal and external drivers synergistically influence horizontal gene transfer. Factors influencing the within-host microbiome include gut metabolites, antibiotic exposure, temperature fluctuations, and microplastic ingestion, while external environmental drivers such as antibiotic residues, heavy metals, agrochemicals, and micro/nano-plastics similarly enhance the mobility of antimicrobial resistance genes. The main mechanisms contributing to increased antimicrobial resistance gene transfer include elevated oxidative stress markers, altered membrane permeability, and stimulation of conjugation-related gene expression. The synergistic effects of these biotic and abiotic pressures have accelerated the co-selection of antimicrobial resistance genes and mobile genetic elements, intensifying the proliferation of antimicrobial resistance in both clinical and environmental reservoirs. Novel mitigation strategies such as conjugation inhibitors, bacteriophage-based interventions, and biochar amendments show promise in curbing horizontal gene transfer-mediated antimicrobial resistance; however, these approaches still lack insight into the intricate molecular mechanisms underlying horizontal gene transfer and often act non-specifically against different pathogens. Moreover, strategies utilizing biochar remain time-consuming and require further optimization. Overall, understanding the mechanistic interplay between environmental stressors and genetic exchange pathways is essential for developing sustainable interventions to counteract antimicrobial resistance. This review highlights the pressing need for integrated surveillance and ecological risk assessment to effectively manage the environmental aspects of antimicrobial resistance.

33. Lead (Pb) and the NMDA Receptor Hypofunction Hypothesis: A Comparative Review of Non-Essential Metal Exposures in Schizophrenia.

期刊: Current environmental health reports 发表日期: 2026-Jul-13 链接: PubMed

摘要

Schizophrenia (SCZ) is a debilitating neuropsychiatric disorder characterized by hallucinations, delusions, paranoia, and anhedonia [1, 2]. Strong biological plausibility supports a disease-specific relationship between metal and metalloid exposures and SCZ, particularly through disruption of metal ion coordination within with the N-methyl-D-aspartate receptor (NMDAr), a key regulator of neurodevelopment and synaptic plasticity [3-5]. This review synthesizes existing epidemiological evidence linking metal exposure to SCZ and integrates these findings with longstanding hypotheses implicating NMDAr hypofunction as a core neurobiological mechanism underlying the disorder. Fifteen studies met inclusion criteria, including thirteen identified through systematic database searches and two identified through external sources. Overall, findings demonstrated positive associations between metal exposures and schizophrenia-related outcomes. Lead (Pb) emerged as the most consistently associated metal across studies (associated with SCZ in 8 of 10 studies evaluating Pb). Additional metals and metalloids associated with SCZ included Cd (associated with SCZ in 4 of 9 studies evaluating Cd), Cr (associated with SCZ in 3 out of 5 studies evaluating Cr), U (associated with SCZ in 2 of 2 studies evaluating U), and As (associated with SCZ in 2 of 6 studies evaluating As). The following metals were each also associated with SCZ in 1 of 1 study evaluating them: W, Sb, Ba, and Cs. Dysregulation of essential metals including Se, Fe, Cu, Ca, Mn, and Zn were also associated with SCZ, suggesting that both toxic metal burden and disruption of essential metal homeostasis may contribute to disease risk. Current epidemiological evidence supports an association between metal biomarker levels and SCZ, with Pb most consistently implicated. These findings may be consistent with the NMDAr hypofunction hypothesis. However, inconsistent exposure assessment, variable diagnostic criteria, and limited consideration of developmental timing constrain causal inference. Future research incorporating standardized exposure metrics, improved temporal resolution, and gene-environment frameworks is needed to clarify causal relationships and identify vulnerable populations.

34. Genetic determinants of obesity: mechanisms, clinical implications, and targeted therapies.

期刊: Endocrine 发表日期: 2026-Jul-13 链接: PubMed

摘要

Obesity is a major global health crisis with rising prevalence in both pediatric and adult populations, leading to an increased risk of cardiovascular, metabolic, and other chronic complications affecting all organ systems. A clear understanding of the genetic contributors to polygenic, syndromic, and monogenic obesity is essential for early diagnosis and targeted management. Advances in genome-wide association studies (GWAS) and sequencing technologies have greatly expanded our understanding of the genetic alterations underlying this multifaceted disease and have helped in delivering personalized treatment. The pathogenesis of common, polygenic obesity is related to a complex interplay between genetic susceptibility and environmental factors. Syndromic obesity, a less common form, is characterized by early-onset accompanied by additional features such as developmental delay, dysmorphic traits, and various organ system involvement. The rarest form, monogenic obesity, is characterized by severe early-onset non-syndromic obesity caused by mutations in single genes regulating appetite within the hypothalamus. These monogenic obesity cases, though infrequent, have been instrumental in elucidating key pathways involved in hunger and satiety. This review provides a comprehensive summary of the most recent findings on the genetic basis of obesity across all age groups, highlighting clinical implications and emerging therapeutic opportunities.

35. Cadmium - and zinc-resistant Bacillus tropicus, Pseudomonas laurentiana, and Exiguobacterium indicum from the Mula-Mutha River, Pune, India.

期刊: Environmental monitoring and assessment 发表日期: 2026-Jul-13 链接: PubMed

摘要

Pune’s urban rivers face growing threats from untreated sewage and industrial waste, leading to toxic heavy metal buildup in sediments and posing ecological and health risks through bioaccumulation and trophic transfer. While contamination by cadmium (Cd) and zinc (Zn) has been documented, the presence of native metal-tolerant bacteria and their resistance genes in the Mula-Mutha River remains largely unstudied. This research measured Cd and Zn levels in sediments from five polluted stretches of the river and tested the heavy metal tolerance of local bacterial isolates. Metal content was determined via atomic absorption spectroscopy (AAS), and bacteria were enriched under increasing Cd and Zn concentrations (300-1000 ppm). Selected isolates underwent microbiological and molecular characterisation. Biosorption efficiency was assessed over 72 h, and Fourier-transform infrared spectroscopy (FTIR) identified functional groups involved in metal binding. The presence of the czc A resistance gene was confirmed using PCR. Results revealed significant contamination, with Cd (4.2-72.8 mg/kg) and Zn (145-428 mg/kg) levels exceeding safety limits, especially at Mundhwa. Out of 16 initial Cd-tolerant isolates, three highly resistant strains were identified as Bacillus tropicus, Pseudomonas laurentiana, and Exiguobacterium indicum. Pseudomonas laurentiana showed the highest biosorption capacity, absorbing 78.5 mg/g of Zn and 62.3 mg/g of Cd. FTIR analysis showed shifts in hydroxyl/amino (3400 cm⁻1), carboxyl (1650 cm⁻1), and phosphate (1080 cm⁻1) groups, indicating their involvement in metal sequestration. PCR confirmed the presence of the czc A gene in all three isolates. These findings underscore the heavy metal pollution in Mula-Mutha river sediments and discover indigenous bacteria carrying the czc A gene, providing essential data for environmental risk assessments and microbial remediation approaches.

36. Zoonotic Exposure to Kudoa Parasites (Myxosporea: Multivalvulida) in the Canary Islands (Macaronesia, Spain): Implications for Human Health and Immune Sensitization Associated with Seafood Consumption.

期刊: Acta parasitologica 发表日期: 2026-Jul-13 链接: PubMed

摘要

This study presents the first seroepidemiological investigation of anti-Kudoa spp. (Myxosporea: Multivalvulida) antibodies in the general population of the Canary Islands (Macaronesia, Spain), a region with high seafood consumption and pronounced geographic and climatic variability. A total of 1,096 serum samples from all seven islands were randomly selected and analyzed by ELISA for IgG and IgE antibodies against Kudoa spp. pseudocyst antigens extracted from locally consumed fish. The overall seroprevalence for both IgG and IgE was 16.4%, indicating widespread exposure to Kudoa parasites. Marked geographic variation was observed: IgG seroprevalence was highest in Lanzarote (47%), Fuerteventura, and Gran Canaria (29.4%), while IgE prevalence peaked in La Gomera (63.3%), El Hierro (30.9%), and La Palma (27.4%). Sex-related differences were also detected, with higher IgE levels in males (p < 0.001). In addition, seropositivity varied by climate zone, with the dry desert zone showing the highest IgG prevalence (35.7%) and mild temperate zones the highest IgE prevalence (16.5%). These findings suggest that environmental, dietary, and behavioral factors strongly modulate host immune responses to fish-borne parasites. The results underscore the clinical and public health relevance of Kudoa spp., highlighting the need for ongoing surveillance and targeted preventive measures in populations with elevated seafood consumption. Overall, this research provides novel insights into the epidemiology, immune sensitization, and risk determinants of Kudoa exposure, contributing to improved management of seafood-borne zoonoses and evidence-based risk assessment for public health authorities.

37. Needed and Received Work Accommodations During Return to Work Among Employees with Common Mental Disorders and Relationships with Depressive Symptoms and Work Ability.

期刊: Journal of occupational rehabilitation 发表日期: 2026-Jul-13 链接: PubMed

摘要

Work accommodations can facilitate return to work (RTW), but little is known about work accommodation needs and practices among employees with common mental disorders (CMDs). This study examines (1) needed work accommodations for RTW, (2) received work accommodations during RTW, and (3) the longitudinal relationships between received work accommodations and both depressive symptoms and work ability after RTW. Data were collected in two German longitudinal studies among employees with CMDs on long-term sickness absence: (I) an observational cohort study (F2385; N = 286; 30-month follow-up); and (II) a randomized controlled trial (RTW-PIA; N = 424; 24-month follow-up). Needed and received work accommodations were described and compared. Multiple regression analyses were conducted to examine the longitudinal relationships between received work accommodations and both depressive symptoms and work ability after RTW. Before RTW, 91-99% of the employees reported work accommodation needs, most frequently a gradual RTW (54-78%), workload reduction (35-45%), improvement of work organisation (31-55%), and regular feedback talks with supervisors (29-42%). During RTW, 64% of participants in both datasets received at least one work accommodation, most often a gradual RTW (48-49%), job change (28-29%), or workload reduction (11-19%). Only 13-16% had all work accommodation needs met. Receiving ≥ 1 work accommodation was related to reduced depressive symptoms and increased work ability after RTW. More frequent and systematic provision of work accommodations, particularly regarding the improvement of working conditions, is essential to support recovery and RTW for employees with CMDs.

38. Eating disorders and associated mental symptoms in Swedish elite athletes and a comparison group.

期刊: Discover mental health 发表日期: 2026-Jul-13 链接: PubMed

摘要

This cross-sectional two-step study aimed to investigate the prevalence of eating disorder (ED) symptoms and associated mental health difficulties among elite athletes and an age-and sex matched comparison group. National team athletes were recruited through national sport federations, while participants in the comparison group were recruited via social media. A total of 408 participants (athletes n = 256; comparison group n = 152) (72.1% female), completed an anonymous online survey comprising validated psychometric measures of ED symptoms, exercise addiction, depression and psychological flexibility. Participants who screened positive for ED symptoms and providing contact details were invited to undergo a clinical assessment using the ED Examination Interview (EDE 17.0D). Overall, 25.0% (n = 102) reported ED symptoms, with a higher prevalence in the comparison group than among athletes (37.5% vs. 17.6%, p < 0.001). Interviews were completed by 78.0% (n = 18) of athletes and 47.0% (n = 16) of comparison group participants who screened positive for ED symptoms, confirming an ED diagnosis in all but one athlete. Furthermore, 18.6% (n = 76) reported clinically relevant symptoms of depression, and 22.8% (n = 93) of exercise addiction. Associations were observed between ED symptoms and symptoms of exercise addiction, depression, and psychological inflexibility in the total sample, among athletes and in the comparison group. ED symptoms were common among athletes and the comparison group and were associated with depressive symptoms, problematic exercise behaviour, and psychological inflexibility. To safeguard athlete health and optimise performance, national sports organisations should implement systematic preventive strategies, promote early identification, establish clear referral pathways, and ensure access to coordinated multidisciplinary care.

39. Direct Associations Between Demographic and Socioeconomic Indicators and Positive Airway Pressure Therapy in Adults with Obstructive Sleep Apnoea- A Scoping Review.

期刊: Behavioral sleep medicine 发表日期: 2026-Jul-13 链接: PubMed

摘要

Obstructive sleep apnea (OSA) is a prevalent sleep disorder with multi-level adverse impacts. Although positive airway pressure (PAP) therapy is the gold standard treatment, sustained patient use remains a challenge. The aim of this study was to synthesize evidence on direct associations between demographic and socioeconomic indicators with PAP therapy in adults with OSA. A scoping review following PRISMA-ScR protocol was conducted. PubMed, PsycINFO, CINAHL, and Cochrane databases were searched for publications between 1990 and February 2026 with key words associated with OSA, PAP use, and demographic (age, gender), and socioeconomic (education, employment status, occupational prestige, income and neighborhood advantage) indicators. Data were extracted on study design, follow-up, sample characteristics, PAP use definitions and measurement, and direct association results. Findings were summarized graphically and synthesized narratively. The majority of evidence suggested no direct association of PAP therapy use with age, gender, or education. There was limited evidence available for other SES indicators. Findings suggest that demographic characteristics alone may not be key determinants of PAP use. Future studies could further explore SES associations with PAP therapy use or move beyond examining direct associations to consider other types of associations e.g. moderating or interactive effects. Open Science Framework (DOI 10.17605/OSF.IO/B9RT5).

40. Integrative analysis prioritizes proteins associated with renal cell carcinoma and its risk factors.

期刊: JNCI cancer spectrum 发表日期: 2026-Jul-13 链接: PubMed

摘要

Renal cell carcinoma (RCC), the predominant form of kidney cancer, is influenced by several risk factors (RFs) including obesity, hypertension, and smoking. However, the molecular mechanisms linking these RFs to RCC remain unclear. We investigated plasma proteins (PP) as potential intermediates of the effects of RFs on RCC using two-step Mendelian randomization (TSMR). In step 1, we identified PPs influenced by each RF, leveraging GWAS summary-statistics from the UK Biobank Proteomics (N = 34,557) for PPs and 19 RFs encompassing anthropometric traits, blood pressure, smoking behavior, blood cell, and kidney function. In step 2, we evaluated the effects of these RF-associated PPs on RCC, using the largest-to-date RCC GWAS (cases=29,020). Proteins significantly associated with both RFs and RCC were further prioritized through convergent evidence from multiple downstream analyses. Among 2,940 PPs, 2,339 were significantly associated (P < 1.7E-05) with at least one of the 19 RFs. Of these, 33 showed a significant effect on RCC (FDR<5%) with 28 mapping outside RCC GWAS loci. Using multivariable MR, we estimated mediation effects of associated PPs, finding that proteins such as APOL1 mediated 2.76% of white blood cell’s effect. Convergent evidence from multiple downstream analyses prioritized TYMP, UMOD, and USP28 as key protein intermediaries of the RF effects on RCC. TYMP and USP28, both inversely associated with RCC risk, showed immune-related and tumor-suppressive effects, while UMOD was positively associated, potentially linking renal dysfunction to carcinogenesis. Our analysis highlights PPs as intermediates of the effect of distinct RFs on RCC, thereby nominating molecular targets for further investigation.

41. The right to function at end of life: aligning advance care planning with palliative rehabilitation.

期刊: Annals of palliative medicine 发表日期: 2026-Jul-08 链接: PubMed

摘要

Movement and bodily autonomy are integral to life and participation in meaningful activities. Current advance care planning (ACP) and advance directive processes do not consistently elicit discussions or documentation about these topics. The problem is especially serious when continued movement increases the risk of falling or other negative health events. This review article integrates available evidence and the authors’ clinical experience to argue that ACP should include functional goals and that rehabilitation professionals should be regular members of end-of-life care teams. We address clinical, ethical, and system-level barriers to change and we present a composite case vignette to illustrate the implications and complexities that can occur when function and bodily autonomy are not considered during ACP activities. Rehabilitation providers such as physical therapists, occupational therapists, and speech-language pathologists provide support and interventions to help mitigate risk while facilitating functional independence. However, because discussions around mobility goals at the end of life do not consistently occur, rehabilitation professionals are inconsistently involved as care team members for people who are dying. Without access to rehabilitation, patients may face well-intentioned but overly restrictive care decisions that limit their participation in meaningful life activities. Including functional priorities in ACP, and rehabilitation professionals on care teams, will better align end-of-life care with what dying patients value.

42. Feasibility of upright carbon ion radiotherapy for prostate cancer: Dosimetric comparison between supine and upright postures.

期刊: Medical physics 发表日期: 2026-Jul 链接: PubMed

摘要

Carbon ion radiotherapy (CIRT) in the upright posture is a treatment technique which delivers carbon ion beams from a fixed direction to patients who sit or stand on a rotating chair. Although various potential advantages of the upright positioning have been discussed, feasibility of upright CIRT for prostate cancer has not been quantitatively evaluated. This study demonstrated prostate cancer CIRT in the upright posture and evaluated its feasibility by comparing anatomy and dosimetric metrics between the supine and upright postures. A total of 12 pairs of computed tomography (CT) images of asymptomatic volunteers in the supine and upright postures were retrospectively analyzed. Based on a clinical treatment protocol, clinical target volume (CTV) was defined as being a prostate gland and proximal seminal vesicle. Other target and organ-at-risk (OAR) contours within a planning volume were also delineated. A CIRT plan was calculated for each CT volume with the same dose prescription and evaluation criteria. The delineated contour volumes, 16 dosimetric metrics, dose-volume histograms (DVHs) of CTV and OARs, and robustness against setup and range uncertainties were compared between the supine and upright postures. No significant differences in the contour volumes were found between the two postures (p > 0.05). The CTV and rectum contour volumes were 34.30 ± 7.76 and 36.35 ± 13.53 cm3 for the supine posture and 35.89 ± 7.37 and 32.96 ± 8.08 cm3 for the upright posture, respectively. Moreover, mean absolute differences of five CTV dosimetric metrics (D2%, D5%, D50%, D95%, and D98%) were all less than 0.15 Gy (0.29% of the prescription dose of 51.6 Gy). Nine other dosimetric metrics in the upright posture were also equivalent to those in the supine posture. The DVHs and robustness in the upright posture were in agreement with those in the supine posture. The upright CIRT provided dose distributions with target dose coverage and OAR dose sparing equivalent to those of the conventional supine CIRT. Upright CIRT for prostate cancer is expected to have equivalent treatment effectiveness while offering reduced installation costs and simple system management of platforms.

43. Geographic and Social Equity in Population-Wide Genomic Screening.

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

摘要

Genomic screening for Centers for Disease Control and Prevention Tier 1 conditions, ie, hereditary breast and ovarian cancer syndrome (HBOC), Lynch syndrome, and familial hypercholesterolemia, enables early detection of these rare, but highly penetrant disorders and supports timely, evidence-based interventions. However, states with large rural and socially disadvantaged populations, such as South Carolina, face substantial structural and access-related barriers that limit the reach of population-wide genomic screening (PWGS). To examine whether combining implementation science and informatics infrastructure supports PWGS and to assess screening coverage and positivity by rurality and social disadvantage. This cross-sectional study used data from In Our DNA SC, a statewide PWGS program launched on November 8, 2021, in South Carolina. Recruitment and sample collection occurred via the health system, community-based collection events, and at-home kits. Analyses included adults aged 18 or older who completed screening as of July 23, 2025. Genomic screening for Centers for Disease Control and Prevention Tier 1 conditions. County-level screening coverage rates (per 100 000 population) and positivity prevalence (per 100 000 valid results) were stratified using rural-urban continuum (RUC) codes (1 = most urban to 9 = most rural) and Social Vulnerability Index (SVI) quartiles (from 1 = least disadvantaged to 4 = most disadvantaged). Of a total of 82 420 adults enrolled in the PWGS program, 50 897 completed screening (71.6% aged <65 years and 28.4% aged ≥65 years, 72.6% female). The program enrolled and screened participants from all 46 South Carolina counties. Screening coverage rates varied by RUC code and SVI. Screening rates per 100 000 population exceeded 1000 in RUC codes 1 through 3 and were significantly higher than RUC code 6 (791.4; 95% CI, 757.1-827.2), RUC code 8 (861.4; 95% CI, 801.1-926.2), and RUC code 9 (839.6; 95% CI, 683.6-1030.8). Screening coverage by overall SVI score was significantly higher in quartile 1 (1422.1; 95% CI, 1406.3-1438.1) and quartile 2 (1188.4; 95% CI, 1167.3-1209.9) compared with quartile 3 (888.4; 95% CI, 866.5-910.9) and quartile 4 (839.6; 95% CI, 952.3-1025.4). Positivity prevalence was generally similar across RUC codes, except for HBOC, which was significantly higher per 100 000 in RUC code 2 (801.3; 95% CI, 715.3-897.4) compared with RUC code 1 (268.5; 95% CI, 123.1-584.5). When examined by overall SVI quartiles, positivity prevalence for HBOC, Lynch syndrome, and familial hypercholesterolemia remained consistent, with no statistically significant differences across levels of disadvantage. This cross-sectional study of a statewide PWGS program supported by an implementation framework and informatics platform suggests broad geographic and social reach. Evaluation of clinical and behavioral outcomes is the critical next step for determining program effectiveness and performance in community and clinical settings. Taken together, these findings suggest that pairing implementation science with robust informatics infrastructure may support PWGS delivery in diverse communities.

44. Coping Strategies and Social Support for Transition Readiness Among Youth With Sickle Cell Disease.

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

摘要

Suboptimal transitions from pediatric to adult health care can negatively impact disease outcomes, medication regimen adherence, and disease self-management in adulthood. Little is known about whether the presence of coping strategies in young adults (YAs) with sickle cell disease (SCD) is associated with higher transition readiness scores. To evaluate whether coping strategies and social support are associated with higher transition readiness scores in YAs with SCD. This cross-sectional study was a subanalysis of baseline data from a prospective randomized clinical trial of YAs aged 17 to 25 years with SCD planning to transition to an adult sickle cell clinic within the next 12 months at 5 institutions across Connecticut, New York, Ohio, and Pennsylvania. The recruitment period was from January 15, 2019, to December 31, 2022. Analysis used data from this time period and was conducted from September 30, 2024, to June 30, 2025. Measures included the Transition Readiness Assessment Questionnaire (TRAQ) to assess transition readiness, the Medical Outcomes Study-Social Support Survey (MOS-SSS) emotional/informational subscale to assess social support, and the Brief-COPE (problem-focused, emotion-focused, and avoidant subscales) to assess coping strategies. Bivariate and multivariable linear regression analyses were used to assess differences of transition readiness. Covariates included worry (PedsQL Sickle Cell Disease Module worry I), age, gender, SCD disease severity, and social support. The final cohort included 373 YAs (mean [SD] age, 18.9 [1.9] years; 190 female [51.5%]), with 335 of 367 reporting race as Black (91.3%) and 335 of 365 reporting ethnicity as non-Hispanic/Latino (91.8%). Unadjusted analysis found that overall coping (mean difference, 0.14; 95% CI, 0.01-0.27; P = .03), problem-focused coping (mean difference, 0.18; 95% CI, 0.09-0.27; P < .001), and the emotional/informational subscale of the MOS-SSS (mean difference, 0.13; 95% CI, 0.07-0.19; P < .001) were associated with higher transition readiness scores. Adjusted linear regression analysis showed that problem-focused coping (mean difference, 0.10; 95% CI, 0.003-0.19; P = .04) was associated with transition readiness even after adjusting for age, gender, disease severity, worry, recruitment site, and social support. In this cross-sectional study in a national cohort of adolescents and YAs with SCD, problem-focused coping strategies were associated with higher levels of transition readiness. These findings suggest important intervention targets for supporting transitioning adolescents with SCD.

45. Neonatal Outcomes Following Selective Serotonin Reuptake Inhibitor Use During Pregnancy.

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

摘要

Evaluating the safety of selective serotonin reuptake inhibitors (SSRIs) during pregnancy is challenging due to ethical barriers to randomized trials and potential confounding in observational studies. To compare neonatal outcomes for pregnancies with SSRI continuation vs those with SSRI discontinuation using a target trial framework. This cohort study comprised target trials using electronic health records of linked mothers and neonates from a single academic center. The periconception trial examined congenital anomalies with first-trimester exposure, and the early-pregnancy trial evaluated nonanomaly outcomes with first- or second-trimester exposure. Participants were women with singleton pregnancies (2006 to 2022) with SSRI use within the 2 years before conception and at least 1 prenatal visit during the first trimester (periconception trial) or during the first or second trimester (early-pregnancy trial). Data were analyzed from May 2022 to December 2023. SSRI continuation vs discontinuation during pregnancy. Apgar scores, meconium in amniotic fluid, neonatal intensive care unit (NICU) admission, preterm birth, birth weight, respiratory distress, feeding problems, hypoglycemia, hypothermia, pulmonary hypertension, cesarean delivery, and congenital anomalies. The early-pregnancy trial included 1014 pregnancies (mean [SD] maternal age, 30.3 [5.4] years). The periconception trial included 807 pregnancies (mean [SD] maternal age, 30.4 [5.5] years). SSRI continuation was associated with lower Apgar scores at 1 minute (mean difference [MD], -0.39; 95% CI, -0.60 to -0.18) and 5 minutes (MD, -0.28; 95% CI, -0.42 to -0.13), and increased risk of meconium in amniotic fluid (odds ratio [OR], 1.73; 95% CI, 1.22 to 2.45). No significant associations were found for congenital anomalies (OR, 1.09; 95% CI, 0.63 to 1.90), though this result should be interpreted with caution given limited sample size. No differences were found for neonatal intensive care unit admission (OR, 1.23; 95% CI, 0.82 to 1.83) or other outcomes. In this cohort study, SSRI continuation during pregnancy was associated with impaired neonatal adaptation but not with severe complications or NICU admission. These findings highlight the importance of appropriate comparator selection to minimize confounding and illustrate how target trial emulation can improve causal inference in studies of medication safety during pregnancy.

46. Medically Assisted Reproduction and Hormone-Related Cancers.

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

摘要

It is critical that women undertaking medically assisted reproductive (MAR) treatment and their clinicians know whether the treatments are associated with an increased risk of hormone-related cancers. To determine the risk of hormone-related cancers following MAR treatment. This cohort study used an emulated target trial design including Australian health registries and administrative datasets. Participants included women enrolled in Medicare, Australia’s universal health insurance scheme, aged 18 to 55 years between January 1, 1991, and December 31, 2018. Data were analyzed from April 2024 to July 2025. Exposures were defined from Medicare records: assisted reproduction therapy, intrauterine insemination or ovarian stimulation, and ovulation induction with clomiphene citrate. Hormone-related invasive cancers (identified in the Australian Cancer Database) included breast, ovarian, uterine, thyroid, colorectal cancers and melanoma; in situ cancers included breast cancer and melanoma. Three cancers with no hormonal links-pancreatic, lung, and hematological-were included as negative controls. Flexible parametric survival models ascertained hazard ratios (HRs) and cumulative marginal survival differences in incident cancers per 100 000 population. E-values assessed the risk of bias due to unmeasured confounding. A total of 1 748 927 women were identified, including 396 661 with history of MAR exposure. Although elevated risk of most hormone-related cancers was observed after MAR treatment (HRs, 1.09-1.64), E-value analysis suggested confounding due to underlying infertility conditions (ie, endometriosis, polycystic ovarian syndrome) could account for this observed elevation for uterine, ovarian, and thyroid cancers. For any specific invasive cancer, fewer than 20 extra cancers per 100 000 women each year were estimated for treated vs comparator groups. Emulated trials on the 6 hormone-related cancers and pancreatic and hematological cancers showed increased cancer risk in the first years after treatment, suggesting detection bias. Increased risk of hematological cancers was observed after MAR treatment (HRs, 1.18-1.27), indicating uncontrolled confounding by race and ethnicity may account for observed excess risk seen for several cancers. Some treatments were associated with decreased lung cancer risk (HRs, 0.72-0.82). In this cohort study of MAR and cancer using a target trial emulation design, although associations between MAR and some hormone-related cancers were observed, the estimated difference in the number of expected cancers was small and may be explained by unmeasured confounding and detection bias.

47. Plasma Phosphorylated Tau 217 in Participants at Risk for Chronic Traumatic Encephalopathy.

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

摘要

In vivo biomarkers for detecting neuropathologies from repetitive head impacts (RHI), including chronic traumatic encephalopathy (CTE), are needed. To evaluate the utility of plasma phosphorylated tau 217 (p-tau217), assess its performance as a beta-amyloid (Aβ) biomarker in participants with RHI exposure at risk for CTE, and explore concordance with CTE neuropathology in a postmortem subsample. This longitudinal, multicenter, case-control study used data from the Diagnostics, Imaging, and Genetics Network for the Objective Study and Evaluation of CTE (DIAGNOSE CTE) Research Project, collected from September 2016 to October 2023. Participants were former American football players (case participants) and asymptomatic men unexposed to RHI (control participants). A subsample had available neuropathologic data. RHI, traumatic encephalopathy syndrome (TES) diagnoses, and levels of CTE certainty. Plasma p-tau217 (classified as positive [≥0.63 pg/mL], intermediate [0.40-0.62 pg/mL], and negative [<0.40 pg/mL]), Aβ-positron emission tomography (PET; 18F-florbetapir; with Aβ-positive defined as a standardized uptake value ratio [SUVR] ≥1.10), and tau-PET (18F-flortaucipir). TES diagnoses were assigned by multidisciplinary consensus conference. Analyses of postmortem brains controlled for age, race, and APOE ε4 status. Among 231 participants (mean [SD] age, 57.75 [8.25] years), 177 were former football players (117 professional and 60 college) and 54 were unexposed participants. Former football players had higher baseline mean (SD) p-tau217 concentrations than unexposed participants (0.35 [0.26] pg/mL vs 0.27 [0.14] pg/mL; P = .008), although this was driven by a higher proportion of Aβ-PET-positive participants among former players. Plasma p-tau217 increased over time across the sample (B = 0.207 [95% CI, 0.117-0.298]; P < .001), with no significant time × exposure group interactions. Among football players, p-tau217 showed no time × group interactions with TES diagnosis, TES-CTE certainty, or RHI metrics. Higher p-tau217 concentration correlated with higher global Aβ-PET SUVR (B = 0.058 [95% CI, 0.053-3.501; P = .01), with a few discordant cases (5 participants were p-tau217-negative and Aβ-PET-positive; 7 participants were p-tau217-positive and Aβ-PET-negative). P-tau217 had similar areas under the curve for projecting Aβ-PET positivity as cerebrospinal fluid (CSF) p-tau181/Aβ42 and CSF Aβ40/42 measures (p-tau217: AUC, 0.88 [95% CI, 0.80-0.96]; CSF p-tau181/Aβ42: AUC, 0.89 [95% CI, 0.79-1.00]; CSF Aβ40/42: AUC, 0.85 [95% CI, 0.72-0.98]). Among 9 brain donors, 6 had CTE (stages II-IV; none with Alzheimer disease). Seven had negative or intermediate p-tau217, concordant with Aβ-PET. Two p-tau217 outliers with stage III CTE had normal concentrations upon additional testing. The findings of this study suggest that plasma p-tau217 concentration is unlikely to be useful for the detection of CTE, but it does show utility for ruling out Aβ pathology in participants at risk for CTE.

48. Vision Screening and Vision Loss-Related Conditions Among American Indian or Alaska Native Children.

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

摘要

Early vision screening plays a critical role in detecting and treating vision loss-related conditions in children. Despite this, few studies have examined pediatric vision screening rates alongside vision health outcomes using large primary care electronic health record (EHR) datasets. To measure annual rates of vision screening at well-child care (WCC) visits and the prevalence of vision loss-related conditions among children aged 3 to 17 years, focusing on American Indian or Alaska Native children. This cross-sectional study used patient-level EHR data from a large Minnesota-based health system and included children aged 3 to 17 years with at least 1 WCC visit between January 1, 2018, and December 31, 2023. Analyses were conducted between January 2024 and April 2025. Patient age, self-identified race and ethnicity, and insurance type. Race and ethnicity categories included American Indian or Alaska Native, Asian, Black or African American, Hispanic or Latino, Native Hawaiian or Pacific Islander, White, and other (those who selected “some other race” as an option). Primary outcomes were (1) annual vision screening rates during WCC visits and (2) the prevalence of 9 vision loss-related conditions identified using diagnostic codes in the EHR. Two-proportion Z tests were used to test for statistical significance between children who identified as American Indian or Alaska Native and those who did not (ie, those who identified as any other race or ethnicity category). Overall, 209 775 children (mean [SD] age, 10.8 [4.6] years; 103 605 [49.4%] female) were evaluated, with 1358 children self-identifying as American Indian or Alaska Native (0.6%) and 203 197 (96.9%) identifying as any other race or ethnicity category. The annual vision screening rate at WCC visits was 88.7% (95% CI, 88.6%-88.8%), with small differences by race and ethnicity and insurance type and larger differences by age. Rates were lowest among those aged 3 to 5 years. Screening rates did not differ significantly between children who identified as American Indian or Alaska Native compared with those who did not; however, American Indian or Alaska Native children had a higher prevalence of amblyopia (5.2% [95% CI, 3.8%-6.5%] vs 3.7% [95% CI, 3.6%-3.8%]) and several refractive error conditions, including astigmatism (17.4% [95% CI, 15.3%-19.7%] vs 12.5% [95% CI, 12.3%-12.6%]), hyperopia (13.3% [95% CI, 11.2%-15.3%] vs 10.7% [95% CI, 10.6%-10.9%]), and myopia (11.1% [95% CI, 9.3%-12.9%] vs 8.3% [95% CI, 8.1%-8.4%]). In this cross-sectional study of children aged 3 to 17 years, American Indian or Alaska Native children experienced a higher burden of vision loss-related conditions despite comparable screening rates; across all race and ethnicity groups, screening rates were lowest among young children. These findings highlight opportunities to strengthen early vision screening and to better understand factors associated with observed inequities in pediatric vision health.

49. Children's Birthday Gatherings and SARS-CoV-2 Infection in Grandparents.

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

摘要

During the COVID-19 pandemic, the major burden of morbidity and mortality was in older age groups. While within-household transmission is well documented, the wider role of social networks for transmission to the older population is less well understood. To estimate whether children’s birthdays were associated with grandparents’ SARS-CoV-2 infection risk. This nationwide, register-based cohort study included grandparents residing in Denmark with 1 to 5 grandchildren aged 0 to 15 years during the period between February 19, 2020, and February 28, 2022. The timing of birthdays of grandchildren was used as a natural experiment to examine whether birthday-related opportunity for family gatherings was associated with the risk of SARS-CoV-2 infection in grandparents. Family structures were mapped at the individual level. Data were analyzed from June 2024 to December 2026. Birthdays of grandchildren turning 1 to 16 years. A birthday risk window, the period when positive test results could be ascribed to a celebration, was defined as the 7-day time window from 2 to 8 days after the grandchild’s birthday. The primary outcome was a positive result on a SARS-CoV-2 test (by polymerase chain reaction or antigen testing) recorded in the national surveillance system. Hazard ratios comparing the hazard of having positive test result for SARS-CoV-2 (outcome) in grandparents in birthday-windows vs grandparents who at the same moment were in nonbirthday periods, were estimated using Cox proportional hazards regression with birthdays as time-varying covariates. Among 1 106 493 grandparents (median [IQR] age, 67 [60-73] years; 54% female), grandparents had 9.9% (95% CI, 7.9%-12.0%) higher hazard of SARS-CoV-2 infection during birthday risk windows. The hazard varied over time and by variant and was not seen during the period when Alpha dominated. The risk was greater for birthdays of preschool-aged grandchildren (adjusted hazard ratio, 1.15; 95% CI, 1.12-1.18) than during birthdays of school-aged grandchildren (adjusted hazard ratio, 1.07; 95% CI, 1.04-1.09). This cohort study of grandparents found that grandchild birthdays, despite official advice not to gather during part of the pandemic, were associated with increased SARS-CoV-2 infection risk among grandparents during much of the pandemic, with magnitude of risk varying over time and by viral variant. These results emphasize the role of culturally important events in intergenerational transmission dynamics, supporting future targeted risk mitigation around small family events.

50. Allicin Attenuates Silica-Induced Pulmonary Fibrosis by Targeting the Serpinb2/NF-κB Pathway.

期刊: Journal of biochemical and molecular toxicology 发表日期: 2026-Jul 链接: PubMed

摘要

Silica-induced pulmonary fibrosis is a debilitating condition with limited therapeutic options. Allicin, a bioactive compound derived from garlic, has shown potential anti-inflammatory and antifibrotic properties. However, its role in silica-induced pulmonary fibrosis remains unexplored. Human lung epithelial cells (BEAS-2B) and alveolar epithelial cells (A549) were exposed to silica particles, followed by allicin treatment. In vivo experiments, a murine model of silica-induced pulmonary fibrosis was established, and lentiviral tracheal instillation was employed to validate the impact of Serpinb2 knockdown on fibrotic progression. Fibrosis and ferroptosis markers, including GSH/GSSG, MDA and hydroxyproline content, were assessed. Molecular mechanisms were evaluated using Western blot, RT-PCR, and Immunofluorescence to analyze Serpinb2 expression and NF-κB pathway activation. Allicin can alleviate ferroptosis and pulmonary fibrosis induced by silica. In addition, Serpinb2 is upregulated under the induction of silicon dioxide. Inhibiting Serpinb2 can alleviate ferroptosis and pulmonary fibrosis induced by silicon dioxide. Meanwhile, the addition of allicin can inhibit Serpinb2 and thereby exert the same effect. NF-κB functions as a downstream pathway of Serpinb2. The addition of allicin can inhibit Serpinb2 and thereby suppress the NF-κB pathway, thereby exerting its inhibitory effect on ferroptosis and pulmonary fibrosis. This study demonstrates that allicin attenuates silica-induced pulmonary fibrosis by modulating Serpinb2/NF-κB pathway via inhibiting ferroptosis. These results highlight the therapeutic potential of allicin in treating pulmonary fibrosis and provide a novel mechanistic insight into its antifibrotic effects.

51. Reduced Membrane CD163 Expression in 7-Oxysterol-Induced Apoptosis Accompanied by Elevated Oxidative Stress.

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

摘要

CD163 is a transmembrane scavenger receptor predominantly expressed by activated M2-like macrophages and is involved in inflammatory processes. Oxysterols, which accumulate in atherosclerotic lesions, are known to induce oxidative stress and apoptosis in macrophages. However, the relationship between CD163 expression and apoptosis induced by oxysterols remains poorly understood. Our brief report presents an examination of the effects of an atheroma-relevant mixture of 7β-hydroxycholesterol and 7-ketocholesterol (2mix) on cell surface CD163. THP-1 monocytes/macrophages were exposed to 2mix, and the surface expressions of CD163, apoptosis, and reactive oxygen species (ROS) production were assessed using flow cytometry and fluorescence microscopy. Exposure to 7-oxysterols induced a dose-dependent reduction in cell surface CD163 expression, with significant decreases observed in R1 and R2 cell populations but not in R3. This decrease was accompanied by a significant increase in apoptosis and ROS production. Notably, CD163 expression was inversely correlated with both apoptotic cell death and oxidative stress levels. Our findings suggest that macrophage surface CD163 may exert a protective role against 7-oxysterol-induced apoptosis and oxidative stress. This indicates a potential function of CD163 in macrophage survival and highlights its possible importance for plaque stability in atherosclerotic lesions.

52. Occupational Risk of Low-Level Blast Exposure and Health Outcomes: A Longitudinal Study of Postdeployment Army Enlisted Active Duty Soldiers.

期刊: The Journal of head trauma rehabilitation 发表日期: 2026-Jun-26 链接: PubMed

摘要

Evaluate the relationship between risk of occupational low-level blast (LLB) exposure and health outcomes (ie, substance use disorder, long-term opioid receipt, headaches, and back pain). We integrated 2 established military occupation-based LLB exposure risk classification strategies (Belding and colleagues and Carr and colleagues) to use military service occupation as a proxy for LLB exposure risk. Records were drawn from the Substance Use and Psychological Injury Combat Study and included Military Health System inpatient and outpatient care data, pharmacy fill records, and military history characteristics. Enlisted Army soldiers returning from an Afghanistan/Iraq deployment during fiscal years 2008-2014 (n = 477 746). Longitudinal and observational with exposure and outcome periods before and after the date of return from the first deployment ending in the study period, respectively. Belding and Carr classification strategies were integrated to create a 5-level LLB exposure risk framework (ie, High-Belding & Carr, High-Belding Only, Medium-Belding Only, Mixed, Low-Belding Only). Outcomes were long-term opioid receipt and diagnoses of substance use disorder, headache (including migraine), and back pain; covariates included demographic and military history characteristics, exposure-period traumatic brain injury diagnosis, exposure-period mental health and self-harm/suicidal behavior, and exposure-period observation of outcomes measures. Approximately 6.0% were classified as high exposure by the High-Belding & Carr classification, and 27.2% were classified as High-Belding Only. Comparing the High-Belding Only and High-Belding & Carr groups, respectively, with the Low-Belding Only group, survival models revealed elevated hazard ratios for long-term opioid receipt (1.29, P < .001; 1.33, P < .001) and substance use diagnoses (1.19, P < .001; 1.27, P < .001), somewhat elevated hazard ratios for headache (1.12, P < .001; 1.08, P < .001), and slightly lowered hazard ratios (0.98, P < .001; 0.98, P < .01) for back pain. Study results add to the existing research underscoring the urgency for advancing knowledge about LLB exposure and potential military health impacts and provide direction for future research.

53. Necrotic Hepatitis Associated with Phasianus Chaphamaparvovirus 1 and Coccidiosis Coinfection in Pheasant Chicks (Phasianus colchicus) in Bosnia and Herzegovina.

期刊: Avian diseases 发表日期: 2026-Jun 链接: PubMed

摘要

Phasianus chaphamaparvovirus 1 is a newly recognized pathogen associated with high mortality in young pheasant chicks with significant losses for pheasant breeders. Here we present an outbreak of necrotizing hepatitis with high mortality in a flock of young pheasant chicks in Bosnia and Herzegovina associated with Phasianus chaphamaparvovirus 1 and coccidiosis coinfection. Severe necrotizing hepatitis with characteristic intranuclear inclusion bodies in affected hepatocytes was observed on microscopic examination. In addition, multifocal areas of intestinal mucosal necrosis with numerous developing stages (meronts) of coccidia were present. Phasianus chaphamaparvovirus 1 was detected with qPCR from the livers of diseased birds. Our report represents the first data on the presence of this new virus in pheasant flocks in the Balkan region and suggests that the virus is widespread across Europe. It further supports the inclusion of Chaphamaparvovirus as a differential diagnosis of pheasant mortality outbreaks both in breeding facilities and in the wild. Reporte de caso- Hepatitis necrótica asociada a la coinfección por Phasianus chaphamaparvovirus 1 y coccidiosis en faisanes jóvenes (Phasianus colchicus) en Bosnia y Herzegovina. Phasianus chaphamaparvovirus 1 es un patógeno de reciente reconocimiento asociado a una elevada mortalidad en faisanes jóvenes, lo que conlleva pérdidas significativas para los criadores de esta especie. En el presente trabajo, se describe un brote de hepatitis necrotizante con alta mortalidad en una parvada de faisanes jóvenes en Bosnia y Herzegovina, asociado a una coinfección por Phasianus chaphamaparvovirus 1 y coccidiosis. El examen microscópico reveló una hepatitis necrotizante grave, caracterizada por la presencia de cuerpos de inclusión intranucleares en los hepatocitos afectados. Asimismo, se observaron áreas multifocales de necrosis en la mucosa intestinal, con presencia de numerosos estadios de desarrollo (merontes) de coccidios. La detección de Phasianus chaphamaparvovirus 1 se realizó mediante qPCR a partir de muestras hepáticas de las aves enfermas. Este informe constituye el primer reporte sobre la presencia de este nuevo virus en parvadas de faisanes en la región de los Balcanes, sugiriendo que dicho virus se encuentra ampliamente distribuido por toda Europa. Además, respalda la inclusión de Chaphamaparvovirus como diagnóstico diferencial ante brotes de mortalidad en faisanes, tanto en instalaciones de cría como en poblaciones silvestres.

54. High Mortality in Commercial Chukar Partridges (Alectoris chukar) Infected with Salmonella arizonae.

期刊: Avian diseases 发表日期: 2026-Jun 链接: PubMed

摘要

Arizonosis is a bacterial septicemic disease caused by Salmonella enterica subspecies arizonae. This case report describes S. arizonae septicemia in commercial chukar partridge (Alectoris chukar) chicks that resulted in a 7-day flock mortality of 30% (2100/7000), with mortality rapidly progressing to 99.3% (6950/7000) by 3 wk of age. To our knowledge, this is the first documented case of S. arizonae acute septicemia in chukars. Gross and histopathologic findings in the chukars included hepatosplenomegaly, omphalitis, and multiorgan inflammation. Salmonella arizonae was isolated from the liver, spleen, and yolk sac cultures, and the isolate was serotyped as Salmonella arizonae serovar 18:z4,z23. Minimum inhibitory concentration antimicrobial susceptibility testing performed on S. arizonae classified the isolate as resistant to erythromycin, gentamicin, neomycin, and sulfadimethoxine and not susceptible to amoxicillin and penicillin; the isolate was classified as susceptible to oxytetracycline, tetracycline, ceftiofur, and spectinomycin. In addition to the arizonosis case report, a retrospective analysis of poultry arizonosis cases diagnosed at the California Animal Health and Food Safety laboratories from January 2005 to December 2024 identified 79 poultry cases of S. arizonae, predominantly in turkeys (69/79). A sharp decline in annual S. arizonae poultry cases was noted after 2009. The most common site of isolation was the yolk sac (45/79 cases), suggesting that vertical transmission plays a significant role in the dissemination of the disease. This case report highlights the susceptibility of chukar partridges to S. arizonae infection and disease and underscores the importance of early diagnosis, antimicrobial susceptibility testing, and stringent biosecurity practices to mitigate transmission and economic loss in commercial game bird operations. Reporte de caso - Alta mortalidad en perdices chukar comerciales (Alectoris chukar) infectadas con Salmonella arizonae. La arizonosis es una enfermedad bacteriana septicémica causada por la subespecie Salmonella enterica subespecie arizonae. Este informe de caso describe una septicemia por S. arizonae en polluelos de perdiz chukar (Alectoris chukar) comerciales, la cual resultó en una mortalidad del 30% (2100/7000) en la parvada en un periodo de 7 días, progresando rápidamente la mortalidad hasta alcanzar el 99.3% (6950/7000) a las 3 semanas de edad. Hasta donde se sabe, este es el primer caso documentado de septicemia aguda por S. arizonae en perdices chukar. Los hallazgos macroscópicos e histopatológicos en las perdices incluyeron hepatoesplenomegalia, onfalitis e inflamación multiorgánica. Se aisló Salmonella arizonae a partir de cultivos de hígado, bazo y saco vitelino; el aislado fue serotipificado como Salmonella arizonae serovar 18:z4,z23. Las pruebas de susceptibilidad antimicrobiana, realizadas mediante la determinación de la concentración mínima inhibitoria (MIC) sobre S. arizonae, clasificaron al aislado como resistente a la eritromicina, gentamicina, neomicina y sulfadimetoxina, y como no susceptible a la amoxicilina y penicilina; el aislado fue clasificado como susceptible a la oxitetraciclina, tetraciclina, ceftiofur y espectinomicina. Además de este informe de caso de arizonosis, un análisis retrospectivo de los casos de arizonosis aviar diagnosticados en los laboratorios del Sistema de Salud Animal y Seguridad Alimentaria de California (California Animal Health and Food Safety) entre enero de 2005 y diciembre de 2024 identificó 79 casos aviares de S. arizonae, predominantemente en pavos (69/79). Se observó una marcada disminución en el número anual de casos aviares de S. arizonae a partir del año 2009. El sitio de aislamiento más frecuente fue el saco vitelino (45/79 casos), lo que sugiere que la transmisión vertical desempeña un papel significativo en la diseminación de la enfermedad. Este informe de caso destaca la susceptibilidad de las perdices chukar a la infección y enfermedad por S. arizonae, y subraya la importancia del diagnóstico temprano, las pruebas de susceptibilidad antimicrobiana y la implementación de prácticas estrictas de bioseguridad para mitigar la transmisión y las pérdidas económicas en las explotaciones comerciales de aves cinegéticas.

55. Facilitated Molting as a Management Strategy During a Low-Pathogenic H1N2 Avian Influenza Outbreak in a Breeder Turkey Flock.

期刊: Avian diseases 发表日期: 2026-Jun 链接: PubMed

摘要

Low-pathogenic avian influenza (LPAI) outbreaks in turkey breeder flocks can significantly impair egg production and impact economic viability, particularly in regions densely populated with swine production. In December 2024, after an egg production drop in one barn of an otherwise normal four-barn, 54 wk-of-age turkey breeder flock in southwestern Ontario, Canada, an H1N2 LPAI strain was detected. Following PCR confirmation, a controlled nonfasted molt was initiated across the four barns to mitigate production losses and facilitate a relatively uniform viral clearance. Diagnostic monitoring included serial PCR and ELISA testing during and after molt. Results indicated rapid horizontal transmission during the molt, with all barns seroconverted by 56 wk of age. The flock achieved negative PCR status by week 60, and subsequent testing confirmed clearance of the pathogen. Postmolt production resumed at acceptable levels, suggesting that facilitated molting may serve as a viable management strategy for LPAI outbreaks in high-value breeder operations. This case highlights the potential role of molting as an adjunct to biosecurity and regulatory measures, though controlled studies are needed to further validate efficacy and further consider welfare implications. Reporte de caso- Muda inducida como estrategia de manejo durante un brote de influenza aviar H1N2 de baja patogenicidad en una parvada de pavos reproductores. Los brotes de influenza aviar de baja patogenicidad (LPAI) en parvadas de pavos reproductores pueden comprometer significativamente la producción de huevo y afectar la viabilidad económica, particularmente en regiones con una alta densidad de producción porcina. En diciembre de 2024, tras una caída en la producción de huevo en una de las casetas de una parvada de pavos reproductores de 54 semanas de edad que, por lo demás, se mantenía en condiciones normales y constaba de cuatro naves, se detectó una cepa de influenza aviar de baja patogenicidad H1N2 en el suroeste de Ontario, Canadá. Tras la confirmación mediante PCR, se inició un proceso de muda controlada sin ayuno en las cuatro casetas con el fin de mitigar las pérdidas de producción y facilitar una eliminación viral relativamente uniforme. El monitoreo diagnóstico incluyó pruebas seriadas de PCR y ELISA tanto durante como después del proceso de muda. Los resultados indicaron una rápida transmisión horizontal durante la muda, observándose seroconversión en todas las casetas para la semana 56 de edad. La parvada alcanzó un estado negativo en las pruebas de PCR para la semana 60, y los análisis posteriores confirmaron la eliminación del patógeno. La producción posterior a la muda se reanudó a niveles aceptables, lo que sugiere que la muda inducida podría constituir una estrategia de manejo viable para los brotes de LPAI en explotaciones de reproductores de alto valor. Este caso pone de relieve el papel potencial de la muda como medida complementaria a las prácticas de bioseguridad y a las normativas sanitarias, si bien se requieren estudios controlados para validar con mayor rigor su eficacia y evaluar más a fondo sus implicaciones en el bienestar animal.

56. A novel IBV Lineage within Genotype GVII (GVII-2) Representing a Unique Serotype Circulating in Chicken Flocks in China.

期刊: Avian diseases 发表日期: 2026-Jun 链接: PubMed

摘要

In the present study, we report the detection of a novel infectious bronchitis virus lineage within genotypes GVII (GVII-2) in commercial flocks in China since 2008. Virus strains within this lineage have been isolated from different geographic regions in China. S1 genes of these viruses have an intralineage divergence of 0.2%-4.4% nucleotides and 0.1%-7.5% amino acids. The pairwise distances of nucleotide and amino acid sequences based on the S1 subunit between GVII-2 and the closest GVII-1 were 28.3% -28.8% and 28.1%-28.9%, respectively. Complete genomic sequence analysis of the first detected strain, ck/CH/LAH/08I (LAH/08I), suggested that it is derived from recombination events with a genomic backbone of the GI-19 ck/CH/LGS/08I-like strain and distinct S, 3a, and 5a genes. The GVII-2 strain represents a unique serotype that differs from the GVII-1 I0636/16 strain in the same genotype and its deduced parental virus GI-19 I0305/19. Strain LAH/08I not only showed strong tissue tropism in the kidneys of SPF chickens but also exhibited high replication capacities in the trachea, kidney, digestive tract, and immune system of infected chickens, attributed to its pathogenicity in SPF chickens. Strain LAH/08I also showed tropism in the oviducts and the ability to induce cystic oviduct formation in adult chickens after infection in baby chicks. Un nuevo linaje del virus de la bronquitis infecciosa dentro del genotipo GVII (GVII-2) representa un serotipo único que circula en parvadas avícolas de China. En el presente estudio, informamos de la detección de un nuevo linaje del virus de la bronquitis infecciosa dentro de los genotipos GVII (GVII-2) en parvadas comerciales en China desde 2008. Se han aislado cepas virales de este linaje en diferentes regiones geográficas de China. Los genes S1 de estos virus presentan una divergencia dentro del linaje de entre el 0.2 % y el 4.4 % de nucleótidos y el 0.1 % y el 7.5 % de aminoácidos. Las distancias pareadas de las secuencias de nucleótidos y aminoácidos, basadas en la subunidad S1, entre GVII-2 y el genotipo GVII-1 más cercano fueron del 28.3 % al 28.8 % y del 28.1 % al 28.9 %, respectivamente. El análisis completo de la secuencia genómica de la primera cepa detectada, ck/CH/LAH/08I (LAH/08I), sugirió que se deriva de eventos de recombinación con una estructura genómica de la cepa GI-19 similar al virus ck/CH/LGS/08I y genes S, 3a y 5a distintivos. La cepa GVII-2 representa un serotipo único que difiere de la cepa GVII-1 I0636/16 en el mismo genotipo y del virus parental deducido, cepa GI-19 I0305/19. La cepa LAH/08I no solo mostró un fuerte tropismo tisular en los riñones de pollos libres de patógenos específicos, sino que también exhibió una alta capacidad de replicación en la tráquea, el riñón, el tracto digestivo y el sistema inmune de los pollos infectados, lo que se atribuye a su patogenicidad en pollos libres de patógenos específicos. La cepa LAH/08I también mostró tropismo en los oviductos y la capacidad de inducir la formación de oviductos quísticos en pollos adultos después de la infección en pollitos.

57. Skill acquisition in Dentistry degree during the COVID-19 pandemic in Spain.

期刊: Dental and medical problems 发表日期: 2026 链接: PubMed

摘要

The acquisition of dental skills during the final year of the Dentistry degree is primarily based on clinical training, which was severely disrupted during the coronavirus disease 2019 (COVID-19) pandemic. The aim of the study was to determine the degree of acquisition of specific skills in the Integrated Dental Clinic course based on students’ perceptions. A total of 84 dental students were included in the study. Online forms were administered to evaluate students’ perception of competency acquisition in professionalism, communication, basic knowledge, information management, critical thinking, collection of clinical information, diagnosis, treatment, health establishment, health maintenance, and health promotion. The questionnaires were sent before and after the declaration of the COVID-19 state of alarm in Spain. Statistical analysis was performed using R statistical software, v. 4.1.1. The highest percentage of students reporting high levels of perceived competency acquisition corresponded to health promotion (72.37%), professionalism (52.86%) and ability to collect clinical information (52.34%). Statistically significant improvements in perceived skill acquisition between the beginning and the end of the course were observed for professionalism, collection of clinical information, diagnosis, treatment, health establishment, health maintenance, and health promotion. Despite the disruptions caused by the pandemic, fifth-year dental students perceived that they had successfully acquired specific skills by the end of the academic course, particularly professional skills, ability to collect clinical information, ability to diagnose and treat, ability to establish and maintain health, as well as health promotion skills.

58. SRM Represents a Novel Prognosis Biomarker and Correlates With Inflammation and Immune Infiltration in Hepatocellular Carcinoma.

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

摘要

Hepatocellular carcinoma (HCC) is widely recognized as one of the leading causes of cancer-related deaths worldwide. Although advances in screening, diagnosis, and treatment have been made, reliable biomarkers are urgently needed to monitor the disease. This study aims to investigate the association between spermidine synthase (SRM) and clinicopathological characteristics, inflammatory responses, and immune infiltration in HCC. RNA-seq data and clinical information for liver HCC (LIHC) were obtained from the Gene Expression Omnibus (GEO) and The Cancer Genome Atlas (TCGA) databases to assess SRM expression. The correlation between SRM expression and immune infiltration was analyzed using the TIMER algorithm. Comprehensive analyses of immune checkpoints (ICPs), microsatellite instability (MSI), and tumor mutational burden (TMB) were performed using R-based packages. KEGG analysis indicated SRM is involved in the IL-17 signaling pathway. This association was further supported by experimental validation of key markers via qPCR and western blot. Functional studies, including in vivo experiments, are needed to establish a causal relationship. Our results show that SRM expression is significantly elevated in HCC tissues compared to adjacent nontumor tissues and associated with adverse clinicopathological features and poor prognosis. SRM expression was significantly correlated with immune infiltration levels in LIHC, involving 22 immune cell subtypes, particularly tumor-associated macrophages (TAMs; CD86 and IL10). Moreover, SRM expression was closely associated with ICPs, TMB, and MSI. Based on transcriptomic data, KEGG pathway analysis of SRM-associated differentially expressed genes revealed significant enrichment in the IL-17 signaling pathway. These in vitro findings suggest a potential association among SRM, IL-8 expression, and pathways related to tumor progression and immune modulation, although further in vivo studies are required to confirm these observations. However, in vivo studies using animal models are required to evaluate whether targeting SRM has therapeutic effects on HCC and to further validate these mechanistic findings.