公共卫生研究摘要 (2026-07-15)

共收录 57 篇研究文章

1. A Five-Step Faculty Development Checklist for Artificial Intelligence in Nursing Education.

期刊: The Journal of nursing education 发表日期: 2026-Jul-16 链接: PubMed

摘要

Artificial intelligence (AI) is increasingly available to faculty and students, yet adoption remains uneven. Faculty report uncertainty about capabilities, limitations, and ethical boundaries, and lack time for integration, while institutions grapple with policy, privacy, and equity concerns. The purpose of this article is to provide a concise, nursing faculty-centered AI development checklist for responsible AI integration in teaching and assessment. AI implementation guidance was synthesized into a five-step checklist for faculty AI competency development. The checklist converts exploratory evidence into a logical faculty development plan, emphasizing practical steps that reduce cognitive load, standardize expectations, and support equitable access to enable rapid adoption and consistent implementation for individuals, programs, and institutions. With a concise evidence-based checklist, nurses can achieve the benefits of AI while advancing equity and preserving the human-centered core of the nursing profession. This checklist simplifies steps for understanding new technologies, adds to research on competencies, and improves instructional efficiency.

2. An integrative review of adolescent voice on vaccination.

期刊: Journal of pediatric nursing 发表日期: 2026-Jul-14 链接: PubMed

摘要

Adolescents are a critical population for immunization efforts, yet their voice in vaccination decisions remains underrepresented. Vaccine decision-making during adolescence is frequently parent-driven, limiting adolescent engagement and agency. Studies were included if they examined adolescent perspectives on vaccination, involved participants aged 10-19 years, and addressed vaccines on the WHO-recommended immunization schedule. Quantitative, qualitative, and mixed-methods peer-reviewed studies were eligible. Studies without direct adolescent voice were excluded. This integrative review was conducted using PRISMA methodology. A comprehensive search of global databases identified studies including adolescent vaccination attitudes and decision-making. After screening, 93 studies met inclusion criteria. Data were extracted and synthesized using thematic analysis. Five themes emerged: concepts of Health Belief Model, knowledge deficits, influence of parents, peers, and healthcare providers, vaccine-related concerns, and limited adolescent autonomy in vaccine decisions. The human papillomavirus (HPV) vaccine was frequently examined, with adolescents associating it with sexuality, stigma, and misinformation. Adolescents identified healthcare providers as trusted sources; however, parents continued to control vaccination decisions. Barriers such as fear of needles, concerns about side effects, and access challenges were reported. Adolescent voice remains insufficiently represented in vaccination research. This highlights knowledge gaps, barriers, and constrained autonomy influencing vaccination attitudes and behaviors. The study emphasizes the need for adolescent-centered education, improved access, and inclusive decision-making practices. By spotlighting adolescent voices, this review contributes to strategies for increasing vaccine uptake and addressing vaccine hesitancy in a population crucial to public health.

3. Corrigendum to "Mathematical frameworks for left ventricular assist device therapy: Ventricular mechanics, blood rheology, haemodynamics, control, and nonlinear dynamics" [Progr. Biophys. Molec. Biol. 201 (2026) 152-174].

期刊: Progress in biophysics and molecular biology 发表日期: 2026-Jul-14 链接: PubMed

摘要

4. Prevalence of Social Frailty Status and its Educational Gradients Among Middle-Aged and Older Adults Across 6 Longitudinal Aging Cohorts.

期刊: Journal of the American Medical Directors Association 发表日期: 2026-Jul-14 链接: PubMed

摘要

Social frailty is common among older adults and is associated with adverse health outcomes, yet cross-national evidence on its prevalence and relationship with education remains limited. This study examined the prevalence of social frailty across countries and its association with educational attainment. Cross-sectional study. A total of 83,869 adults aged ≥50 years from 6 longitudinal aging studies in the United States, England, European countries, South Korea, Mexico, and China. We estimated the age- and gender-standardized prevalence and examined associations between education and social frailty status within each country and in a pooled meta-analysis. Social prefrailty ranged from 54.0% in the United States to 74.1% in South Korea; social frailty ranged from 5.9% in Mexico to 14.4% in European countries. A clear educational gradient was observed across most countries, with lower educational attainment associated with higher odds of both social prefrailty and frailty, except in South Korea. Despite substantial between-country heterogeneity, the pooled meta-analysis revealed that, compared with the lowest education group, the middle-education group had reduced odds of prefrailty (odds ratio [OR], 0.72; 95% CI, 0.60, 0.86) and frailty (OR, 0.54; 95% CI, 0.44, 0.67). The high-education group exhibited stronger reductions (prefrailty OR, 0.53; 95% CI, 0.36, 0.78; frailty OR, 0.29; 95% CI, 0.17, 0.51). Social prefrailty and frailty are prevalent and follow a clear educational gradient. Integrating social frailty assessments into routine clinical screenings and directing targeted policy interventions toward less-educated older adults are urgently needed to promote healthy aging.

5. Prognostic Disparities in Multiple versus Single Primary OSCC: A Large-Cohort Analysis and Predictive Modelling.

期刊: International dental journal 发表日期: 2026-Jul-14 链接: PubMed

摘要

The rising incidence of multiple primary cancers among patients with oral squamous cell carcinoma (OSCC-MPCs) presents a profound clinical challenge. This study aimed to characterize the clinicopathological phenotypes and survival outcomes of OSCC-MPCs compared with those of single primary OSCC (SPOSCC), and to develop robust prognostic nomograms for the OSCC-MPCs population. In this single-centre retrospective cohort study (2015-2025), clinicopathological and systemic inflammatory indices were extracted. Survival outcomes were compared using Kaplan-Meier analysis. Least Absolute Shrinkage and Selection Operator (LASSO) coupled with multivariable Cox regression were employed to identify independent predictors and construct nomograms for overall survival (OS) and progression-free survival (PFS). Among the 1,909 patients (OSCC-MPCs: n = 249; SPOSCC: n = 1,660), the OSCC-MPCs cohort exhibited an older age at diagnosis, lower rates of smoking and alcohol consumption, higher T but lower N categories, and significantly elevated preoperative neutrophil-to-lymphocyte ratios (NLR). Survival analysis based on complete survival data (OSCC-MPCs: n = 249; SPOSCC: n = 1,546) revealed significantly inferior outcomes in the OSCC-MPCs group compared with the SPOSCC group, demonstrating markedly reduced 5-year OS (51.28% vs. 79.85%, P < .001) and PFS (37.97% vs. 63.05%, P < .001) rates. LASSO-Cox regression identified age > 60 gt; 60 years, advanced T/N categories, NLR > 2.5, and specific treatment modalities as independent prognostic factors. The resulting dual-endpoint nomograms demonstrated reliable discrimination, optimal calibration, and substantial clinical net benefit. OSCC-MPCs exhibit highly distinct clinical phenotypes and are associated with significantly poorer survival compared with SPOSCC. Our nomograms, integrating clinicopathological features with NLR, provide robust, non-invasive quantitative tools to tailor individualized therapeutic interventions and optimize long-term surveillance strategies.

6. From Barriers to Solutions: A Community Network Approach to Equitable Oral Healthcare Access.

期刊: International dental journal 发表日期: 2026-Jul-14 链接: PubMed

摘要

Across Europe, oral health is increasingly recognized as a public health priority. Still, structural, financial, and social barriers disproportionately affect people in vulnerable circumstances. Within the EU-funded DELIVER project, this study aimed to (1) identify which barriers to oral healthcare manifest across urban contexts, and (2) explore how community networks including citizens, healthcare professionals, social workers, policy makers, and other local stakeholders can contribute to developing local solutions related to improving quality of oral healthcare for citizens in vulnerable circumstances. A participatory action research design, guided by the Community Health Improvement Process, was used. Participants included citizens with lived experience of poverty or social exclusion, oral healthcare professionals, social workers, and policymakers. Data collection methods included semi-structured interviews, focus groups, co-creation meetings, and creative workshops. Data were analyzed using inductive thematic analysis. A total of 64 participants contributed to 21 interviews, 7 focus groups, and 4 co-creation meetings. Seven key barriers were identified: high treatment costs, limited insurance coverage, low oral health literacy, emotional and psychological factors (e.g., shame and fear), competing life priorities, limited support from professional organizations, and poor communication between social and oral healthcare services. Proposed solutions included walk-in consultations in community settings, buddy systems, improved support for navigating insurance, stronger integration of dental and social care, and oral health promotion through trusted local networks. Community-network approaches can substantially reduce inequalities in access to oral healthcare. Engaging citizens as co-creators enables inclusive and needs-based solutions and improvements. This study offers a promising model for improving oral healthcare accessibility by systematically identifying barriers and addressing them through community-based collaboration.

7. Temporal 2G-5G RF-EMF exposure assessment in ten European countries during one year.

期刊: The Science of the total environment 发表日期: 2026-Jul-14 链接: PubMed

摘要

Due to the rapid evolution and densification of mobile communication networks, there is an increased interest in the long-term assessment of environmental exposure to radiofrequency electromagnetic fields (RF-EMF). While numerous studies have investigated RF-EMF exposure using short-term or spatial measurement campaigns, the number of comprehensive analyses capturing temporal variability across multiple frequency bands and countries remain limited. This pilot study aims to establish a multi-country sensor network to collect data on long-term RF-EMF exposure, including 5G, and to investigate whether temporal trends occur. Twenty frequency-selective sensors were deployed at fixed indoor and outdoor locations in ten European countries, continuously measuring E-field (electric field) strengths in four mobile communication frequency bands (806 MHz, 942 MHz, 1842 MHz, and 3625 MHz) over a period of 17 months with a temporal resolution of 1 s. The raw measurement data were calibrated and analyzed to describe RF-EMF exposure levels, temporal patterns, and variability across environments and spatial characteristics. A strong and recurring diurnal pattern was observed across the four frequency bands. The highest day-night contrasts occurred in the 806 MHz and 1842 MHz bands, where nighttime values decreased by 35.1% and 48.4%, respectively compared to daytime values. Milder contrasts were observed between weekdays and weekends with the most pronounced decrease of 16.6% for the 1842 MHz band. Temporal variability, quantified using the R-factor (i.e. the ratio of the median field strength to the maximum field strength measured during the period of interest), varied substantially across frequency bands and locations, with lower R-factors observed for higher-frequency bands (with a median R-factor of 0.45 for 3625 GHz), indicating a greater variability. Given the scope and duration of this study, it aims to serve as a pilot study for long-term exposure monitoring at fixed sites in multiple countries.

8. Breast cancer treatment delays in the Brazilian public health system: Evaluation using international and national quality metrics.

期刊: Cancer epidemiology 发表日期: 2026-Jul-14 链接: PubMed

摘要

Despite advances in breast cancer treatment, delays in care delivery remain a major challenge in many health systems, particularly in low- and middle-income countries. Evidence evaluating adherence to oncology quality metrics within public health systems remains limited. This study evaluated adherence to breast cancer treatment timeliness quality metrics in a Brazilian public referral hospital using established benchmarks (ASCO and ESMO) alongside Brazil’s national 60-day treatment law and identified factors associated with delayed treatment initiation. This retrospective cohort study included women with stage I-III breast cancer treated at the Brazilian National Cancer Institute between 2016 and 2018. Adherence to six treatment timing quality metrics was evaluated, and multivariable logistic regression models were used to identify factors associated with delayed treatment initiation. A total of 966 patients were included. Only 35% of patients with hormone receptor-positive tumors initiated endocrine therapy within the recommended timeframe, and 23.6% of those undergoing breast-conserving surgery received radiotherapy within 365 days. In the ESMO-Q cohort, only 0.2% initiated chemotherapy within 120 days of diagnosis. Patients with Luminal A-like tumors were more likely to initiate treatment within recommended timeframes, whereas younger age and locally advanced disease were independently associated with treatment delays. Substantial delays in breast cancer treatment initiation were observed across all evaluated quality metrics within the Brazilian public health system, revealing a marked gap between recommended treatment timelines and real-world care delivery. Improving adherence to national and international quality benchmarks will require a better understanding of the patient- and system-level factors associated with treatment delays and the implementation of targeted interventions across the cancer care continuum. This retrospective cohort study evaluated adherence to international (ASCO, ESMO) and national quality metrics for breast cancer care in Brazil’s public health system. Marked delays in treatment initiation were observed across endocrine therapy, radiotherapy, chemotherapy, and surgery, highlighting important gaps in timely cancer care delivery.

9. Identifying carcinogenic hazards among pharmaceutical agents: An update from the IARC Monographs programme.

期刊: Cancer epidemiology 发表日期: 2026-Jul-14 链接: PubMed

摘要

We aim to review the evaluation of pharmaceuticals classified as human carcinogens by the International Agency for Research on Cancer (IARC) Monographs programme (1971-2024) and the recommended evaluation priorities (2024-2029) for pharmaceuticals. This work aims to stimulate epidemiological research that can contribute to human cancer and mechanistic evidence for cancer hazard identification. Data on cancer in humans or experimental animals, and mechanistic evidence, for pharmaceuticals evaluated as IARC Group 1, 2 A, and 2B (carcinogenic, probably carcinogenic, and possibly carcinogenic to humans, respectively) between 1971 and 2026 were extracted from published IARC monographs. Pharmaceuticals given high priority for evaluation by the IARC Monographs Advisory Group for the period 2025-2029 were summarised, highlighting available data in human cancer or mechanistic studies. 77 pharmaceuticals have been evaluated as Group 1 (n = 24), 2 A (n = 13), or 2B (n = 40). 22 pharmaceuticals were recommended with high priority for evaluation, including 8 antineoplastic, 4 hormonal, and 2 immunosuppressant agents. The IARC Advisory Group gave high priority for evaluation to several commonly used pharmaceuticals, including several treatments in cancer patients (anthracyclines, cisplatin, textured implants), highlighting evidence of increased haematological and solid malignancies; GLP-1 agonists; paracetamol; progestogen-only contraceptives; and clomiphene citrate. Evidence from studies conducted in humans with cancer or mechanistic endpoints largely contributed to this prioritisation. Pharmacoepidemiology data with cancer or mechanistic endpoints can largely contribute to cancer hazard identification of pharmaceuticals within the IARC Monographs programme. These data can inform policy decision-making for patients and workers protection.

10. Relationship Between Generative AI Use and Life Satisfaction and the Mediating Role of AI Literacy Among Hong Kong Adults: Cross-Sectional Study.

期刊: Journal of medical Internet research 发表日期: 2026-Jul-14 链接: PubMed

摘要

Rapid technological advances have led to the development of generative artificial intelligence (GenAI). GenAI tools such as ChatGPT (OpenAI) and DALL-E (OpenAI) can generate text and images in response to prompts and have permeated various life domains. Existing literature has reported mixed relationships between GenAI use and life satisfaction. By synthesizing the Technology Acceptance Model and self-determination theory, this study aimed to examine the associations between GenAI use, perceived artificial intelligence (AI) usefulness, behavioral intention to use AI, AI literacy, and life satisfaction in general adults. A population-based survey recruited 1800 community-dwelling adults (mean age 49.3, SD 14.9 years, 995/1800, 55.3% women) via a 2-stage random sampling design in Hong Kong in spring 2024. Participants completed self-report measures on GenAI use and validated measures on perceived AI usefulness, behavioral intention to use AI, AI literacy, and life satisfaction. Multivariate analysis of covariance examined the gender and age differences in the study variables. Structural equation modeling was used to examine the associations between AI-related constructs, GenAI use, and life satisfaction in the whole sample and across gender and age subgroups. Two-fifths (693/1800, 38.5%) of the sample reported GenAI use in the past year. There were significant age differences with declining trends in perceived AI usefulness, behavioral intention to use AI, GenAI use, and AI literacy from young adults to older adults. GenAI users with daily use of more than 2 hours reported significantly higher perceived AI usefulness, behavioral intention to use AI, AI literacy, and life satisfaction than nonusers. In the structural equation modeling, the direct effect of GenAI use on life satisfaction was not significant. There were significant positive indirect effects (αβ=0.186, 95% CI 0.134-0.242) from perceived AI usefulness to life satisfaction via behavioral intention to use AI, GenAI use, and AI literacy. Subgroup analyses found stronger total indirect effects in men (αβ=0.260, 95% CI 0.177-0.348) than in women (αβ=0.112, 95% CI 0.055-0.180) and in older adults (αβ=0.227, 95% CI 0.113-0.367) than in young adults (αβ=0.124, 95% CI 0.038-0.214). These findings synthesized the Technology Acceptance Model and self-determination theory and found a positive modest relationship between GenAI use and life satisfaction in Hong Kong adults. AI literacy showed a potential bridging role in the relationship between GenAI use and life satisfaction. Further longitudinal studies are needed to elucidate the causal direction and determinants of GenAI use and AI literacy.

11. Modeling Short-Term Symptom Changes and Behavioral Subtypes of Depression and Anxiety in the General Population: Observational Study Using Smartphone Data.

期刊: JMIR formative research 发表日期: 2026-Jul-14 链接: PubMed

摘要

Smartphone-based digital phenotyping has emerged as a promising approach for monitoring mental health using passive behavioral data. Prior studies have linked smartphone-derived features to depression and anxiety severity; however, knowledge regarding whether short-term changes in symptoms can be captured using passive smartphone data in general population samples remains limited, as does the understanding of how such findings should be interpreted vis-à-vis behavioral patterns and demographic variability. This study aimed to model short-term changes in depression and anxiety severity using passive smartphone data, examine model performance across demographic subgroups, and identify behavioral patterns associated with symptom changes. We collected 2 weeks of smartphone usage data from 95 adults in the general population and assessed depressive and anxiety symptoms using the clinician-rated Hamilton Depression Rating Scale and Hamilton Anxiety Rating Scale, respectively. Behavioral features-including physical activity, app use, and screen usage metrics-were extracted and compressed using an autoencoder and principal component analysis. The resulting features-along with age, sex, and baseline Hamilton scores-were used to train random forest classifiers predicting symptom score changes (increase, decrease, or unchanged). Additionally, we examined whether model performance differed across demographic subgroups and whether models excluding baseline scores retained predictive performance, as baseline severity was expected to be a strong predictor. To add explanatory value beyond prediction, behavioral subtypes associated with symptom changes were identified by applying unsupervised clustering. The model exhibited moderate performance in predicting changes in the Hamilton Depression Rating Scale (mean accuracy=0.70, mean area under the receiver operating characteristic curve=0.74) and Hamilton Anxiety Rating Scale (mean accuracy=0.65, mean area under the receiver operating characteristic curve=0.69) scores. Performance varied according to demographics, with reduced accuracy among younger adults and females, although these differences were not significant in permutation tests. Excluding baseline Hamilton scores diminished performance substantially, suggesting that baseline symptom severity accounted for a substantial proportion of the predictive performance. Clustering revealed 4 distinct behavioral subtypes according to smartphone usage patterns. A cluster characterized by structured, daytime-focused smartphone use and lower temporal entropy demonstrated greater improvement in depressive symptoms, whereas clusters with lower and irregular usage patterns exhibited minimal improvement or worsening. Passive smartphone-derived behavioral data demonstrated moderate ability to model short-term symptom changes in this predominantly nonclinical sample. However, a substantial proportion of the predictive performance was attributable to baseline symptom severity, underscoring that passive smartphone data may provide modest supplementary information rather than robust stand-alone predictive value. Nevertheless, clustering analyses indicated that passive data may still assist in identifying behaviorally distinct subtypes associated with different depressive symptom trajectories. These findings reflect a practical contribution to digital phenotyping research by elucidating both the potential and constraints of passive smartphone data for short-term symptom monitoring in small general population samples.

12. Preferences for mHealth Features to Support Engagement in the HIV Preexposure Prophylaxis Cascade Among Men Who Have Sex With Men in Peru: Cross-Sectional Online Survey.

期刊: JMIR public health and surveillance 发表日期: 2026-Jul-14 链接: PubMed

摘要

Despite policy-level progress, implementation of oral HIV preexposure prophylaxis (PrEP) remains limited in Latin America. In Peru, men who have sex with men (MSM) account for most new HIV diagnoses, yet uptake remains low. Widespread smartphone ownership and the use of digital platforms present an opportunity to expand access through mobile health (mHealth) interventions. However, limited data exist on user preferences to guide the design of mHealth tools in Spanish-speaking Latin American settings. This study aimed to assess preferences for mHealth features to support PrEP engagement among Peruvian MSM and their association with PrEP cascade stages. We conducted a cross-sectional online survey (June-August 2023) among 600 HIV-negative MSM residing in Peru (median age 29, IQR 24-35 years), recruited via Facebook, Instagram, WhatsApp (Meta Platforms, Inc), and Grindr (Grindr LLC). The survey assessed communication platform use, interest in mHealth features measured on a 4-point Likert scale, and PrEP cascade stages. Exploratory factor analysis (principal axis factoring with Promax rotation) identified domains of mHealth preferences, from which median domain scores were calculated. Bivariate analyses used chi-square tests and Wilcoxon rank sum tests. Multivariable logistic regression models (α=.05), with covariates selected using stepwise procedures from candidate sociodemographic and behavioral variables, estimated associations between each domain score and PrEP cascade stages, each modeled as a separate binary outcome. Nearly all participants (589/600, 98.2%) reported owning a smartphone. WhatsApp was the most frequently used and preferred platform for PrEP support, with 547 (91.2%) reporting frequent use and 302 (50.3%) ranking it first. Exploratory factor analysis identified three mHealth preference domains: informational support (Cronbach α=0.94), self-management tools (Cronbach α=0.94), and interactive communication (Cronbach α=0.91). Among participants, 483 (80.5%) had decided to use PrEP, 190 (31.7%) had sought PrEP, and 109 (18.2%) had initiated PrEP. Higher informational support was associated with the decision to use PrEP (adjusted odds ratio [aOR] 4.54, 95% CI 3.36-6.28; P<.001), seeking PrEP (aOR 1.43, 95% CI 1.10-1.89; P=.001), and PrEP initiation (aOR 1.64, 95% CI 1.16-2.44; P=.009). Self-management tools showed similar associations with the decision to use PrEP (aOR 3.23, 95% CI 2.51-4.22; P<.001), seeking PrEP (aOR 1.34, 95% CI 1.06-1.70; P=.02), and PrEP initiation (aOR 1.49, 95% CI 1.11-2.05; P=.01). Interactive communication was associated with the decision to use PrEP (aOR 2.74, 95% CI 2.15-3.53; P<.001) but not with initiation. Preferences for mHealth features were associated with engagement at multiple stages of the PrEP cascade among MSM in Peru. Informational support features demonstrated the most consistent associations with cascade engagement. These findings provide empirical evidence on user-prioritized digital functions that could support early engagement in HIV prevention services in a Latin American implementation context. Integrating culturally tailored mHealth tools within widely used platforms such as WhatsApp may strengthen early PrEP cascade engagement and support scalable digital strategies for HIV prevention in Peru and similar settings.

13. Trust Barriers and Vulnerabilities in Older Adults' Telemedicine Adoption: Scoping Review.

期刊: Interactive journal of medical research 发表日期: 2026-Jul-14 链接: PubMed

摘要

Aging populations worldwide face increasing health care demands, particularly for chronic disease management. While telemedicine offers a viable solution to enhance health care access, significant trust-related barriers hinder its adoption among older adults, warranting a scoping synthesis of available evidence. This scoping review aims to map the available evidence on trust barriers experienced by older adults in telemedicine, identify underlying vulnerability domains, and chart the evidence base for design and policy recommendations. We conducted a scoping review in accordance with PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) guidelines, analyzing literature from PubMed, Web of Science, and Scopus. Thematic analysis was applied to synthesize findings from 30 included studies. Four primary trust barriers were identified: technophobia and technical difficulties, privacy and data security concerns, negative emotional and social impacts, and a strong preference for in-person care. These barriers mapped onto 4 vulnerability domains: limited telemedicine literacy (particularly low eHealth self-efficacy), declining health status (including sensory and cognitive impairments), psychological and cognitive factors (such as anxiety about losing autonomy), and inadequate social support systems. The review also underscored how rapid technological change amplifies these challenges for older adults. Effective telemedicine implementation for older adults requires multipronged interventions, including age-appropriate interface design, targeted digital literacy training, robust privacy protections, and personalized support systems. These approaches address both technological and psychosocial barriers, potentially increasing engagement while mitigating vulnerabilities. Future research should assess the effectiveness of these interventions across diverse older populations.

14. Development of a Blended Physical Activity Intervention for Office Employees Using Intervention Mapping: Intervention Development Study.

期刊: JMIR human factors 发表日期: 2026-Jul-14 链接: PubMed

摘要

Insufficient engagement in moderate to vigorous physical activity (MVPA) is a significant risk factor for major noncommunicable diseases, including cardiovascular diseases (eg, coronary heart disease and stroke), type 2 diabetes, and several cancers. Physical inactivity accounts for an estimated 3.2 million deaths annually. Office employees, due to their sedentary and desk-based work patterns, are particularly vulnerable to low MVPA levels, which negatively affect health and work productivity. The COVID-19 pandemic exacerbated these issues, further reducing MVPA levels due to lockdowns and work-from-home policies. Although numerous interventions have aimed to promote MVPA, many lack theoretical grounding, stakeholder involvement, or systematic development frameworks. A theory- and evidence-informed approach is warranted to target modifiable determinants and mechanisms, improve coherence and replicability, and enhance effectiveness and scalability. This study aimed to design an evidence-based blended intervention to improve MVPA, health, and productivity among office employees, guided by the intervention mapping (IM) framework. Following the first 4 steps of the IM framework, we developed a 12-week blended intervention and created a website named “Smartly Active for Health and Life.” Step 1 involved a needs assessment through a literature review and focus group discussions (n=12 office employees) to identify barriers, facilitators, and determinants of MVPA. Step 2 defined intervention outcomes, performance objectives, and change objectives based on the social ecological model. Step 3 integrated theory- and evidence-based behavior change techniques with delivery methods, resulting in a 3-group randomized controlled trial design: (1) a blended intervention group (web-based sessions and e-workshops), (2) a web-only intervention group, and (3) an active control group. Step 4 developed and refined intervention materials and protocols through a pilot study (n=18). Key behavior change techniques included problem-solving, goal setting, self-monitoring, and habit formation. The pilot study demonstrated the intervention’s acceptability, feasibility, and adaptability. Participants reported increased motivation, improved knowledge of MVPA benefits, and greater confidence in goal setting and self-regulation. Feedback led to refinements such as improved website navigation and interactive content. The intervention is expected to enhance MVPA levels, health, and work productivity by addressing both motivational and volitional phases of behavior change while supporting habitual behaviors. The IM framework offered a systematic and iterative approach for developing a blended MVPA intervention tailored to the needs of office employees. This study highlights the importance of theory-driven and stakeholder-informed approaches in designing scalable and sustainable health promotion programs. The intervention has the potential to address the critical public health challenge of physical inactivity in office settings and serves as a model for future behavior change interventions. RR2-10.1186/s12889-020-09128-z.

15. The Case for Building Physician Engagement and Competencies in Quality & Safety… and How to Do It.

期刊: Quality management in health care 发表日期: 2026-Jul-14 链接: PubMed

摘要

Despite widespread benefits of physicians engaging in organizational quality & safety (Q&S) activities, such engagement often remains infrequent, informal, and inconsistent. This work aimed to design and implement uniquely-tailored and concurrent interventions to increase the size and Q&S competency levels of UHN’s Physician Council on Q&S over a 2-year period. Ten Q&S competency dimensions were tracked as outcome measures: Q&S science & methods, engaging stakeholders for success, aligning local projects with organizational priorities, building local Q&S infrastructure, navigating organizational Q&S processes, obtaining funding for Q&S, scholarly approach to Q&S, academic promotion through Q&S, career development through Q&S, and teaching Q&S. Competency levels were reported on a 4-point scale (ie, novice, competent, proficient, and expert). Process measures centered around change concepts and included the number of attendees at Q&S events, the number of mentorship pairings, the number of QI projects awarded grant funding, and the number of visits to our Q&S intranet site. Baseline results (n = 32) revealed participants were predominantly in the novice/competent categories for all dimensions. Competency levels were retested in 2023 (n = 41) and chi-square analyses revealed improvements in the expected direction on all dimensions. Statistically significant increases were observed for navigating UHN processes (P < .01) and building organizational Q&S infrastructure (P < .05). The Council grew over 5-fold in size from its 13 original members to 75 members with representation from all of our organization’s programs, departments, and divisions. Results indicate that this approach to Educate and Connect (eg, rounds and summit), Promote and Support (eg, grants and awards), and provide Customized Resources (eg, playbook and intranet) was effective in growing a robust and competent physician Q&S community of practice.

16. Scientific Smuggling: The Dark Side of Instagram's Evidence-Free 'Expert' Health Science Courses.

期刊: European journal of dental education : official journal of the Association for Dental Education in Europe 发表日期: 2026-Jul-14 链接: PubMed

摘要

This study aimed to investigate the prevalence and characteristics of health-related courses promoted on Instagram that advertise unvalidated or scientifically unsupported clinical and surgical techniques, specifically targeting courses taught by self-identified healthcare professionals on the Instagram platform. Metadata regarding user credentials, engagement metrics, course format, claimed outcomes, and references to scientific evidence were extracted. An unvalidated technique was defined as any procedural claim made in a course promotion lacking citation to peer-reviewed literature, documented pre-clinical or clinical trials, or formal recognition by a relevant professional regulatory body. Scientific validity was assessed based on the presence or absence of these predefined criteria: (1) citation of peer-reviewed studies, (2) evidence of prior regulatory approval (e.g., from a professional council), and (3) documentation of clinical trial data. Statistical analyses were performed in RStudio using Pearson’s correlation and Kruskal-Wallis tests (p < 0.05). A total of 612 accounts promoting 1120 courses were screened, with 77 eligible accounts included in the final analysis. The instructors had an average of 11.6 years since graduation, though some had only months of professional experience. Only 17 specialists were trained in the relevant field, and advanced degrees were rare. Seventy-six distinct unvalidated techniques were identified, 17 of which were surgical, and 11 explicitly prohibited by professional councils. Most instructors lacked formal academic affiliation, and 35 falsely self-identified as specialists. Notably, only 14.5% of unvalidated techniques faced regulatory prohibition, leaving the majority unmonitored. The findings reveal alarming trends in the commercialisation of unvalidated aesthetic practices through Instagram-based courses, often taught by underqualified professionals. Urgent regulatory reforms are needed to address the role of social media in promoting harmful health practices.

17. Effect of Intergenerational Support on Successful Aging Among Older Adults: A Cross-Sectional Study.

期刊: Research in gerontological nursing 发表日期: 2026-Jul-14 链接: PubMed

摘要

To examine the association between intergenerational support from children and successful aging among older adults. Using data from 6,573 adults (aged ≥60 years) in the 2020 China Health and Retirement Longitudinal Study, intergenerational support was measured across three dimensions, and successful aging was defined according to Rowe and Kahn. Multivariate logistic regression analyzed their association, and a classification and regression tree (CART) model explored multi-factor interactions. Caregiving, higher financial support, and moderate monthly emotional contact were each significantly associated with greater odds of successful aging. CART analysis further revealed that although health and education served as foundational factors, their associations with successful aging were synergistically moderated by intergenerational support. Successful aging is closely linked to the interplay of individual characteristics and intergenerational support. Policies should therefore prioritize health promotion and educational investment while facilitating differentiated intergenerational support strategies.

18. Role of vaccine age restrictions on rotavirus vaccine coverage, Vaccine Safety Datalink 2018-2024.

期刊: Journal of the Pediatric Infectious Diseases Society 发表日期: 2026-Jul-14 链接: PubMed

摘要

Rotavirus vaccines (RVs) are coadministered in the United States with diphtheria-tetanus-acellular pertussis (DTaP) vaccines but have age restrictions for the first and last doses. We examined how delays in preventive care visits for vaccination affected RV initiation and series completion. We compared the timeliness of DTaP vaccination relative to RV in children born January 1, 2018 to June 30, 2023 across eight U.S. health systems. Adjusted risk ratios (aRR) were estimated using modified Poisson regression to identify risk factors for delayed DTaP vaccination and no RV vaccination. Among 391,892 children who initiated DTaP, 12,546 (3.2%) did not initiate RV. Of these, 7,721 (61.5%) children had delayed DTaP initiation and were age-ineligible for RV at the time of DTaP initiation. Children who became eligible for RV during the early stage of the COVID-19 pandemic (March-May 2020) had a higher risk of delayed DTaP and no RV initiation (aRR = 2.20; 95% CI 1.98-2.45), as did children with fewer than five primary care visits within the first year of life (aRR = 4.03; 95% CI 3.81-4.26), and Medicaid recipients (aRR = 2.34; 95% CI 2.23-2.45). Similar factors were associated with failure to complete the RV series due to age restrictions. Age restrictions may have contributed to lack of RV initiation and series completion in this cohort. Public health strategies tailored to populations at risk for delayed vaccination may be needed to promote timely administration of RV.

19. Trajectories of fear of movement in heart failure: implications for clinical practice.

期刊: European journal of cardiovascular nursing 发表日期: 2026-Jul-14 链接: PubMed

摘要

20. Toward a 'Holistic' Approach to Promoting Physical and Mental Health in Children and Adolescents Through Physical Activity.

期刊: Acta paediatrica (Oslo, Norway : 1992) 发表日期: 2026-Jul-14 链接: PubMed

摘要

Physical activity in childhood and adolescence is a cornerstone of holistic health, supporting physical growth, cognitive development, emotional wellbeing and social connectedness. We aimed to explore how lifestyle-based physical activity interventions in enriched school and community settings can support development and address health inequities. This paper is a narrative mini-review that discusses the promotion of physical activity for holistic development in the light of a selection of representative and scalable whole-school programs that incorporate transdisciplinary initiatives. In the framework of such scalable programs, we highlight the role of collaborative governance and public-private partnerships, including corporate social responsibility commitments. Comprehensive School Physical Activity Programs and Whole School, Whole Community, Whole Child frameworks illustrate the potential of physical activity as an affordable, equitable strategy for promoting children’s and adolescents’ healthy development. Globally, despite growing evidence of effectiveness, systemic barriers continue to impede the timely translation of scientific evidence into practice and the potential of policy and practice to orient scientific research. To address this gap, new implementation approaches such as the dual-logic framework that integrates scientific rigour with policy-driven pragmatism can play a crucial role in creating sustainable pathways to implement lifestyle-based interventions at scale.

21. Global Trends and Insights in Cervical Cancer Research: A Bibliometric Analysis from 2000 to 2024.

期刊: Reproduction & fertility 发表日期: 2026-Jul-14 链接: PubMed

摘要

Cervical cancer is the fourth most common malignant disease in women worldwide. Although the promotion and use of human papillomavirus (HPV) vaccinations have to some extent reduced the incidence of cervical cancer, problems persist, particularly in low- and middle-income nations. This bibliometric study, which shows the worldwide landscape of cervical cancer research from 2000 to 2024 through scientometric analysis of Web of Science Core Collection publications, provides significant insights into key research topics, new trends, and the networks of collaboration within this field. Early study concentrated on HPV’s role in cervical cancer, whereas more recent studies highlight advances in HPV vaccinations, molecular biology, targeted therapies, and artificial intelligence applications in cervical cancer screening. However, global health disparities, vaccine accessibility, and regional disease burden remain significant challenges. This study provides a comprehensive summary for academics, clinicians, and policymakers to inform future research efforts to reduce the global incidence of cervical cancer.

22. Prevalence and functional impact of respiratory sarcopenia in a COPD-enriched smoking cohort.

期刊: Respiratory investigation 发表日期: 2026-Jul-14 链接: PubMed

摘要

Respiratory sarcopenia, defined as a combination of respiratory muscle weakness and decreased respiratory muscle mass, is a novel concept with unclear prevalence and clinical relevance in the chronic obstructive pulmonary disease (COPD) population. This study aimed to evaluate the prevalence of respiratory sarcopenia in a COPD-enriched smoking cohort and its association with clinical features. This prospective observational study included smokers who were categorised into four groups based on respiratory muscle weakness (% maximal inspiratory pressure and/or % maximal expiratory pressure <80%) and low skeletal muscle index (<7.0 kg/m2 for men and <5.7 kg/m2 for women). Pulmonary function, physical function, and the 6-min walking distance (6MWD) were compared between the groups. A total of 184 smokers (79% with COPD) were classified into the following groups: normal (n = 77, 42%), muscle mass loss only (n = 32, 17%), respiratory muscle weakness only (n = 53, 29%), and probable respiratory sarcopenia (n = 22, 12%). The probable respiratory sarcopenia group demonstrated a significantly lower %FEV1 and elevated RV/TLC. Compared with the other groups, the probable respiratory sarcopenia group exhibited markedly impaired physical performance, with reduced gait speed, 6MWD, and knee extension strength. Multivariable regression analysis revealed that probable respiratory sarcopenia (β = -0.24; p = 0.02) was independently associated with a lower 6MWD after adjusting for age, sex, height, body mass index, smoking pack-year, and FEV1 (adjusted R2 = 0.48). Probable respiratory sarcopenia, which was identified in 12% of elderly smokers, was independently associated with exercise capacity and may be a clinical phenotype requiring early detection and intervention to prevent functional decline. Registered at UMIN (UMIN000049755).

23. Frontline Health Workers' Perspectives of the World Health Organization Skin Neglected Tropical Diseases App in Kenya: Qualitative Study on AI-Embedded mHealth Implementation.

期刊: JMIR mHealth and uHealth 发表日期: 2026-Jul-14 链接: PubMed

摘要

Skin neglected tropical diseases (NTDs) pose significant diagnostic and management challenges in resource-limited settings due to constrained dermatological expertise, frontline health worker (FHW) training, and limited access to diagnostic resources. Mobile health apps with artificial intelligence (AI)-enabled diagnostic imaging capabilities have the potential to enhance clinical decision-making and professional development at the primary care level. The World Health Organization (WHO) skin NTD mobile app uses convolutional neural networks to analyze images of skin lesions and generate differential diagnoses, intended to be used alongside clinical history and examination, to support FHWs in identifying 12 skin NTDs and 24 common skin conditions. Beyond clinical decision support, the app also aims to upskill FHWs in the recognition and management of these diseases. However, the success of such tools depends on understanding users’ needs and the realities of implementation in diverse clinical contexts. This study aimed to explore FHWs’ perspectives on the real-world use and impact of the AI-embedded WHO Skin NTDs app on diagnostic workflows, dermatological understanding, clinical decision-making, and FHW-patient interactions across diverse health care delivery settings in Kenya. This qualitative study involved 36 FHWs from 5 skin NTD-endemic counties in Kenya. Following a training workshop, FHWs integrated the app into routine clinical workflows from June to October 2024. Data were collected through 15 semistructured interviews (each 30-45 minutes) and 4 focus group discussions (1-1.5 hours) exploring FHW experiences across diverse health care delivery contexts. All sessions were audio-recorded, transcribed verbatim, and thematically analyzed using NVivo (QSR International), using a bottom-up inductive coding approach. FHWs reported that the app facilitated a shift from habitual referral to more proactive case management at the local-level facility, reinforcing clinical ownership and positioning them as local dermatology reference points. It was perceived to enhance diagnostic confidence, strengthen patient trust, and encourage community engagement. Some FHWs described how the app helped mitigate situations for patient stigma due to decreased reliance on public colleague consultations. However, technical limitations (eg, internet dependency and algorithmic errors) constrained consistent use. While most FHWs used the app in line with its intended role as an assistive tool, a minority reported situations of diagnostic deferral to the AI output, highlighting potential considerations of clinical autonomy. The WHO Skin NTDs app shows strong potential to strengthen frontline dermatological capacity that aligns with WHO strategies to decentralize NTD care and promote “skin health for all.” Our findings underscore the importance of embedding such tools within ethical and pedagogical frameworks that protect clinical autonomy and foster sustainable capacity building. Further research will examine real-world use in situ to guide context-specific governance, ensuring that this AI-embedded tool enhances-rather than displaces-clinical reasoning and epistemic authority.

24. Lost in Scheduling? A Reliable Tool for Detecting Subtle Cognitive Decline in Mild Cognitive Impairment and Mild Alzheimer's Disease.

期刊: American journal of speech-language pathology 发表日期: 2026-Jul-14 链接: PubMed

摘要

Neurodegenerative diseases, notably Alzheimer’s disease (AD), present a significant public health challenge. This study aims to evaluate the effectiveness of the Ecological Assessment Battery for Numbers (EABN) in detecting subtle cognitive decline in mild cognitive impairment (MCI) and mild AD, focusing on everyday life mathematical situations. This cross-sectional study involved 66 participants (21 mild AD, 23 MCI, and 22 controls). Clinical assessments included the Mini-Mental State Examination (MMSE), the EABN, and the Numerical Activities of Daily Living questionnaire. Statistical analyses utilized nonparametric tests, Spearman rank correlation, and receiver operating characteristic curve analyses. The EABN demonstrated an area under the curve (AUC) of 0.83 (95% confidence interval [0.73, 0.92]) in distinguishing patients and controls. Patients with pathologically high EABN scores were significantly older, and a positive correlation was observed between EABN and MMSE scores (r = .30; p = .04). The Appointment subtest within EABN emerged as the most discriminative (AUC = 0.86). Among MCI patients with pathological EABN scores, 70% progressed to AD or amyloid angiopathy. This study reveals early manifestation of mathematical cognition impairments in cognitive decline, even before patient-reported complaints. The EABN, a practical tool for ecological assessment, could aid in early diagnosis and guide interventions. Integrating mathematical cognition assessment into routine care aligns with recommendations for cognitive rehabilitation in MCI patients, potentially preventing autonomy loss. These findings underscore the significance of a comprehensive approach to patient management, incorporating ecological assessments for nuanced diagnostics and early intervention in neurodegenerative diseases.

25. Bidirectional Automated Texting for Cardiovascular Health Among People Living With HIV: Observational Cohort Analysis of a Stepped-Wedge Cluster Randomized Controlled Trial.

期刊: JMIR cardio 发表日期: 2026-Jul-14 链接: PubMed

摘要

Feasible and potentially scalable strategies are needed to address the growing cardiovascular disease (CVD) risk among people living with HIV. Bidirectional automated texting (BAT) programs that remind and encourage adherence to evidence-based CVD-reducing interventions represent a potentially scalable strategy, but data on their feasibility are lacking. The goal of the study was to determine whether participant sociodemographic factors and technological constraints influenced engagement with a BAT CVD prevention program by people living with HIV. We conducted an observational cohort analysis embedded within a stepped-wedge cluster randomized trial. The BAT program was designed to address the “Million Hearts” ABCS (aspirin therapy, blood pressure control, cholesterol management, and smoking cessation) of cardiovascular health. The parent study was a stepped-wedge randomized trial that rolled out in 3 wedges across 8 practice sites that provided care to people living with HIV. Participants received and could engage with the text messages weekly using their own phones during the study period. We used a zero-inflated negative binomial model to identify factors associated with participants sending text messages during the study. Of the 471 participants, 94% owned a smartphone capable of text messaging, and 70% reported monthly incomes less than US $1500. Overall, 60.3% (n=284) engaged with the BAT program at least once. Regarding texting behavior, participants aged ≥65 years were more likely to send a text than those aged <50 years (P=.047), although age did not influence the number of texts sent. White participants showed lower texting intensity than Black participants (incidence rate ratio 0.69; P=.04). Overall, 60.3% (n=284) of the participants in the study engaged with BAT at least once. The BAT intervention for ABCS appears to be a feasible intervention for people living with HIV. Only a few factors were associated with sending a text or with the number of text messages sent.

26. Discovery and Mechanism of Action of a Novel Desloratadine Derivative Inhibiting Mycobacterium tuberculosis 3-Dehydroquinate Synthase.

期刊: Journal of chemical information and modeling 发表日期: 2026-Jul-14 链接: PubMed

摘要

Mycobacterium tuberculosis, the etiological agent of tuberculosis (TB), remains a leading cause of mortality from infectious disease worldwide. The continued emergence of multidrug-resistant strains highlights the urgent need for new therapeutic agents with novel mechanisms of action. Here, we report the discovery and comprehensive characterization of DL25, a synthetic desloratadine-derived small molecule exhibiting potent antimycobacterial activity (minimum inhibitory concentration (MIC) 2-4 μg/mL against multiple mycobacterial species). Using a supra-inhibitory DL25 selection strategy, we isolated and characterized spontaneous resistant mutants. Whole-genome sequencing identified recurrent mutations in aroB, which encodes 3-dehydroquinate synthase (DHQS), an essential enzyme of the shikimate pathway. Consistent with target involvement, aroB overexpression reduced susceptibility to DL25, while DL25 decreased DHQS-associated biochemical activity in vitro with an apparent IC50 of approximately 5.0 μg/mL. In addition, DL25 exhibited concentration- and time-dependent bactericidal activity and showed partial synergy with several established antitubercular agents. Structural modeling, molecular docking, and 100 ns molecular dynamics simulations supported stable binding of DL25 within the DHQS active site and identified interactions with residues implicated in substrate recognition and catalysis. Collectively, the genetic, biochemical, and computational findings support DHQS as a biologically relevant target associated with DL25 activity and establish DL25 as a promising lead-like scaffold for the development of future shikimate pathway-directed antimycobacterial agents. More broadly, this study demonstrates the value of integrating genetic, biochemical, and computational approaches for mechanism-guided antituberculosis drug discovery.

27. The Impact of Hospitals on Language Learning: A Case Study of a 3-Year-Old Boy With Developmental Delay Who Needed Augmentative and Alternative Communication.

期刊: American journal of speech-language pathology 发表日期: 2026-Jul-14 链接: PubMed

摘要

The purpose of this pilot study was to describe the language learning contexts experienced by a young child with global developmental delays and limited speech during an inpatient stay. An observational case study was completed to describe the language learning contexts during the inpatient stay of a 3-year-old child with global developmental delay. Six health care providers participated and interacted with him during the 16-hr observational period over two consecutive days. Interactions were video-recorded and coded, and researcher memos were used to describe environmental variables. During the observation period, the child interacted with at least one adult partner for a total of 6 hr. During the remaining 10 hr, he did not have human contact. His stay was characterized by extended periods without adult interaction interspersed with concentrated periods of linguistic input by providers during activities related to medical procedures, mealtimes, daily care, and therapy sessions. Providers were generally unfamiliar with his signals, preferences, and routine. They demonstrated general responsiveness during caregiving activities and positive affect during most interactions but responded inconsistently to his unique presymbolic communication signals. Findings suggest that characteristics associated with the hospital experience-extended periods without adult interaction, limited access to familiar communication partners, and inconsistent responses to nonsymbolic communication-may constrain language learning opportunities for children with limited speech. These results underscore the need for developmentally appropriate strategies (e.g., adult interaction, consistent routines, augmentative and alternative communication access) to support communication access and optimize language outcomes in hospitals. https://doi.org/10.23641/asha.32942690.

28. Metagenomics for antimicrobial resistance: from resistome surveillance to mechanistic inference.

期刊: Journal of bacteriology 发表日期: 2026-Jul-14 链接: PubMed

摘要

Antimicrobial resistance (AMR) is a global health crisis shaped by complex ecological and evolutionary processes that often occur in polymicrobial communities. Metagenomics enables culture-independent profiling of microbial DNA directly from clinical or environmental samples, providing an unparalleled view of community composition, resistome content, and the mobile genetic elements that drive horizontal gene transfer (HGT). Yet, a recurring challenge is that metagenomic detection of antibiotic-resistance genes does not automatically translate into a mechanistic understanding of resistance phenotypes, nor does it replace culture-based functional validation. Here, we synthesize how modern metagenomics supports AMR research across three linked questions: (i) what resistance determinants are present and how do they change across time and space, (ii) which hosts and mobile genetic elements carry these determinants, and how gene flow can be inferred, and (iii) what evidence is required to move from “resistance potential” to robust mechanistic claims. We emphasize practical design principles (sampling, controls, and contamination management), analytical choices (database and parameter effects), and recent advances, including long-read sequencing for resolving antibiotic-resistance genes context, and rapid clinical metagenomic sequencing for time-sensitive decision support. We propose an evidence ladder for mechanistic inference that integrates metagenomics with targeted assays and culture-dependent experiments. Beyond synthesizing recent advances, this review provides operational tools for critical appraisal and study design: an evidence ladder for mechanistic inference, a decision-gated workflow that ties metagenomic outputs to allowable claim language, a minimum reporting checklist aligned to evidence strength, and a “pitfall → consequence → fix” guide to reduce over-interpretation. To support a more comprehensive, forward-looking view, we also summarize emerging directions that are rapidly reshaping AMR metagenomics-multi-omics integration, single-cell, and epigenetic linkage strategies, CRISPR-enabled enrichment/depletion, and AI-assisted discovery/mining-and clarify where these advances strengthen (or do not strengthen) mechanistic claims within the same evidence ladder.

29. Tailoring the unified protocol for the treatment of burnout: A co-design approach.

期刊: Acta psychologica 发表日期: 2026-Jul-14 链接: PubMed

摘要

Burnout persists as an unresolved issue, as the effectiveness of interventions remains a subject of ongoing debate. To address the need for more suitable intervention approaches, this study describes a methodology for adapting the Unified Protocol (UP), an evidence-based cognitive-behavioral intervention, for group-based use to treat burnout. To ensure that the intervention reflected lived experiences, we employed a co-design methodology based on the Experience-Based Co-Design Framework. The sample comprised participants currently experiencing burnout or who had experienced it within the past year (n = 4) and a panel of experts (n = 4) actively working with individuals experiencing burnout. The co-design process included interviews, four feedback sessions, seven iterative co-design sessions, and an expert evaluation. Insights from interviews and feedback sessions informed the adaptation of the intervention. Key modifications included introducing a values-based module, merging two modules into a single session, and adding a new component on cognitive functioning, along with content and technique adjustments tailored to the realities of burnout. The resulting protocol is referred to as the Unified Protocol for Burnout (UP-B), a group-based adaptation of the UP designed for therapeutic use. Future research should examine the feasibility, efficacy, and underlying mechanisms of the intervention.

30. Guidance for Building Hospital at Home: Qualitative Descriptive Thematic Analysis of a Pan-Canadian Community Participatory Workshop Series.

期刊: Journal of medical Internet research 发表日期: 2026-Jul-14 链接: PubMed

摘要

Virtual health care models, such as Hospital at Home (HaH), are an alternative to in-person care and allow hospitals to expand care capacity and delivery without the need for additional brick-and-mortar structures. While generally well received, there is an overall lack of awareness among those receiving and giving care about what HaH is and what it does, and uncertainty about the conditions needed to implement HaH in a safe, sustainable, and equitable way. In this descriptive qualitative study, we aimed to synthesize key interest holder-generated perspectives about the implementation, sustainability, and equity of HaH models in Canada using data generated through a national participatory workshop series. Health care providers, patients, caregivers, and hospital administrators were recruited to participate in the workshop series through social media, professional, and community networks. Five 60-minute virtual workshops were held from January to June 2025 using a “Lunch and Learn” format and Liberating Structures techniques. The workshops each comprised 2 parts: speaker presentations followed by participant group discussions. Workshop presentations, along with 3 written observer reports (from a patient partner, an academic, and a clinician), and workshop attendee polling responses, were collected and analyzed. Descriptive thematic analysis was used to construct key themes salient to the data. Three themes were constructed from the data: (1) making HaH work for health care systems, (2) making HaH work for its people, and (3) making HaH better now and in the future. Participants reported generally positive outcomes and high satisfaction with HaH programs in Canada. Participants highlighted the need for clear communication and collaboration across care teams, technology support for staff, managing health care provider and caregiver workloads, and ensuring access for rural and remote communities. There is a need to better understand the economic sustainability of the HaH program and to study and share outcomes from HaH models to help others and refine the model. This study provides insights into how the HaH virtual care model is perceived by health care providers, patients, caregivers, and hospital administrators in Canada. Our findings highlight the importance of equity, communication, care workloads, and fiscal sustainability in supporting HaH models.

31. Visualization of time-resolved scattered radiation distribution in a computed tomography room utilizing a semiconductor survey meter.

期刊: Radiation protection dosimetry 发表日期: 2026-Jul-14 链接: PubMed

摘要

In diagnostic computed tomography (CT), radiological technologists and assisting staff may need to remain inside the CT room during patient assistance. Understanding temporal changes in scattered radiation distribution is therefore important for reducing occupational exposure. Conventional measurements mainly provide instantaneous dose rates or accumulated doses and are less suited to intuitively capturing temporal changes during CT scanning. This study conducted a fundamental investigation of a visualization approach, defined as dynamic dose distribution (DDD), based on time-resolved air kerma measurements obtained with a semiconductor survey meter. Scattered radiation was measured during chest-to-pelvis helical CT scanning of an anthropomorphic phantom under fixed tube current and automatic exposure control conditions. DDD allowed temporal changes in scattered radiation distribution to be visually identified in relation to tube current modulation, patient table position, and measurement height. DDD may provide useful temporal information for considering staff positioning and reducing occupational exposure.

32. Peripubertal Changes in Asthma.

期刊: American journal of respiratory and critical care medicine 发表日期: 2026-Jul-14 链接: PubMed

摘要

Asthma is a heterogeneous disease affecting nearly 300 million people around the world. It is the most common chronic respiratory disease of childhood. There are significant sex differences in asthma incidence, severity, and morbidity around the time of puberty. The reasons for these peri-pubertal changes around the time of puberty are still not fully understood but they are likely multifactorial. In this review, we will discuss several proposed contributing mechanisms, including sex differences in anatomy and development, the effects of sex hormones on airway inflammation and reactivity, the immunomodulatory effects of sex hormones, differences in mucociliary function, and sex differences in genetic and epigenetic factors.

33. Correction: Fatigue, physical and daily activity, and self-perceived work ability in cancer survivors: a long-term follow-up study with a matched non-cancer reference group.

期刊: Journal of cancer survivorship : research and practice 发表日期: 2026-Jul-14 链接: PubMed

摘要

34. Age-related differences in the intake of heart failure therapy among participants from the MyoVasc study.

期刊: European geriatric medicine 发表日期: 2026-Jul-14 链接: PubMed

摘要

To investigate whether older individuals (≥70 years) with heart failure receive guideline-recommended heartfailure medications less frequently than younger individuals. Older individuals had a higher prevalence of heart failure and greater polypharmacy but were treated lessoften with guideline-based therapies, including aldosterone antagonists and beta-blockers, even after adjustment forrenal function and comorbidities. In contrast, calcium channel blockers were prescribed more frequently in geriatricpatients. Older individuals with heart failure appear to be undertreated with evidence-based therapies, highlightingage-related gaps in guideline-concordant care. In Germany, heart failure (HF) is the most common diagnosis in hospitalized patients. Its prevalence rises significantly with age. In addition, age-related conditions, such as hypertension, coronary artery disease, obesity, and diabetes mellitus, contribute to an elevated risk of heart failure. It is assumed that older patients are more likely to receive treatment that does not conform to the guidelines because of frequent comorbidities, such as chronic renal disease and pre-existing polypharmacy. Data from a prospective cohort study on chronic HF (MyoVasc study, N = 3289; NCT04064450), were analyzed. Participants underwent a 5-h highly standardized examination, including assessment of medication with subsequent categorization according to the anatomical therapeutic chemical (ATC) coding system. Study participants were categorized as older adults aged ≥ 70 years and subsequently compared to younger adults regarding frequency of medication intake. Poisson regression with robust standard errors with adjustment for age, sex, cardiovascular risk factors, comorbidities, and kidney function was used to analyze medication intake by age status in subjects with chronic HF stages C/D. The analyzed sample comprised 1281 older adults (mean age: 75.4 ± 3.6 years, 33.1% women, 66.9% men) and 2,008 younger adults (mean age: 57.7 ± 8.5 years, 35,2% women, 64.8% men). A total of 68.5% (n = 878) of the older individuals presented with HF stage C/D, compared to 43% (n = 863) in younger adults. On average, older individuals took 6.53 (standard deviation (SD) ± 3.14) drugs as compared to younger participants taking 4.65 (SD ± 3.45) drugs regardless of the severity of HF. Poisson regression analysis demonstrated that older individuals received aldosterone antagonists less frequently (Prevalence Ratio (PR): 0.64, 95%CI 0.54; 0.77, p < 0.0001). This effect persisted after additional adjustment for kidney function (PR: 0.53, 95%CI 0.44; 0.63, p < 0.0001). Beta-blockers were used significantly less frequently in older adults compared to younger adults (PR: 0.93, 95%CI 0.88; 0.99, p = 0.016). In contrast, calcium channel blockers were prescribed significantly more often in the older group (PR: 1.22, 95%CI 1.01; 1.48, p = 0.035). Additionally, older adults with impaired renal function received loop diuretics less frequently (PR: 0.88, 95%CI 0.78; 0.99, p = 0.033). The present study identified age-related disparities in the use of guideline-based therapy for heart failure. These differences persisted even after adjusting for renal dysfunction, a common and relevant comorbidity in the aged population. These findings suggest a potential underutilization of evidence-based heart failure therapies in older individuals with heart failure. NCT04064450.

35. 'Fathers' world in words': First-time fathers' expressions of their paternal role to preterm infants - A critical discourse analysis.

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

摘要

To explore how first-time fathers articulated their caregiving roles for preterm infants following admission to neonatal intensive care units (NICUs) and to identify the dominant discourses shaping their caregiving identities. A qualitative study informed by Fairclough’s three-dimensional framework for critical discourse analysis, grounded in social constructivist and poststructuralist perspectives. Four focus group interviews were conducted with 17 Danish first-time fathers of preterm infants between October 2022 and January 2023. Transcripts were coded and thematized using an emic, data-driven approach. Fairclough’s framework guided analysis at the textual, discursive, and social levels. Butler’s theory of performativity informed interpretation of how fathers reproduced, reinforced, and challenged gender norms through caregiving practices and language use. Three themes were identified in the textual analysis: (1) first-time fathers’ practical and emotional involvement in caregiving; (2) first-time fathers’ expressions of protection and responsibility; and (3) shared parenting practices and negotiations of caregiving roles. These themes intersected with broader discourses: paternity leave, caregiving, the father’s role, and gender roles. Fathers expressed strong emotional and practical engagement but were sometimes positioned as secondary caregivers by organizational routines. First-time fathers actively constructed identities as competent and involved caregivers while negotiating institutional and societal expectations. Findings highlight opportunities for neonatal nurses to foster father-inclusive, family-centered care by actively involving fathers in caregiving tasks and addressing implicit gender assumptions. Promoting inclusive caregiving cultures that recognize both parents as competent caregivers may advance gender equity and improve outcomes for preterm infants.

36. [Transformation of Epidemiology in the Age of Artificial Intelligence].

期刊: Revista medica del Instituto Mexicano del Seguro Social 发表日期: 2026-Jul-13 链接: PubMed

摘要

Epidemiology has been fundamental for analyzing health problems and supporting decision-making in healthcare systems and public health. However, traditional epidemiological methods, designed fundamentally to identify causal associations at the population level through aggregate data measures, present inherent limitations in capturing individual heterogeneity in response to specific exposures. This population-based approach hinders personalized prediction of outcomes in a particular individual whose risk factors may manifest differently from the group average, particularly when multiple contextual variables and unique biological profiles are involved. Advances in artificial intelligence have generated tools capable of integrating large volumes of information, identifying complex patterns in specific subgroups, and producing more personalized estimates, transitioning from a reactive approach based on population averages toward predictive models centered on individual trajectories. However, these developments do not replace the methodological foundations of epidemiology, as the identification of exposures, outcomes, and causal relationships continues to depend on the epidemiological conceptual framework. From this perspective, current tensions do not represent a disciplinary crisis, but rather a transition toward broader approaches that combine population-based analyses with advanced predictive tools. This integration is particularly relevant for large-scale healthcare institutions and national health systems, which require models capable of leveraging diverse data to improve understanding of health processes and support clinical and operational decisions. La epidemiología ha sido fundamental para el análisis de los problemas de salud y para la toma de decisiones en los sistemas sanitarios y la salud pública. No obstante, los métodos tradicionales de la epidemiología, diseñados fundamentalmente para identificar asociaciones causales a nivel poblacional mediante medidas de datos agrupados, presentan limitaciones inherentes para capturar la heterogeneidad individual en la respuesta ante exposiciones específicas. Esta aproximación poblacional dificulta la predicción personalizada del desenlace en un individuo particular, cuyos factores de riesgo pueden manifestarse de forma distinta al promedio grupal, particularmente cuando intervienen múltiples variables contextuales y perfiles biológicos únicos. Los avances en inteligencia artificial han generado herramientas capaces de integrar grandes volúmenes de información, identificar patrones complejos en subgrupos específicos y elaborar estimaciones más personalizadas, transicionando desde un enfoque reactivo basado en promedios poblacionales hacia modelos predictivos centrados en trayectorias individuales. Sin embargo, estos desarrollos no sustituyen los fundamentos metodológicos de la epidemiología, ya que la identificación de exposiciones, desenlaces y relaciones causales continúa dependiendo del marco conceptual epidemiológico. Bajo esta perspectiva, las tensiones actuales no representan una crisis disciplinaria, sino una transición hacia enfoques más amplios que combinan análisis poblacionales con herramientas predictivas avanzadas. Esta integración resulta especialmente relevante para instituciones de gran escala, como las de seguridad social, que requieren modelos capaces de aprovechar datos diversos para mejorar la comprensión de los procesos de salud y apoyar decisiones clínicas y operativas.

37. Expert consensus validation of an instrument to improve the timely detection of developmental dysplasia of the hip in children.

期刊: Revista medica del Instituto Mexicano del Seguro Social 发表日期: 2026-Jul-13 链接: PubMed

摘要

Developmental Dysplasia of the Hip (DDH) is the most common human congenital malformation. When diagnosed and treated before five months of age, it has a high cure rate. If not, surgical management is required with high economic costs, a great impact on morbidity and sequelae that can generate permanent disability. To design and validate an instrument to timely detect DDH. A systematic review of the current literature on the timely diagnosis of DDH was carried out using PRISMA methodology. An expert panel, with eight specialists from different public and private health institutions was formed to validate it. All participants in the expert panel agreed that DDH is a public health problem. They consider that there are many patients with late diagnosis and sequelae due to a lack of timely treatment. There was consensus on the feasibility of implementing the proposal. The expressed need to update the current regulations regarding diagnostic means was identified. It is necessary to promote epidemiology, risk factors, correct physical examination, ideal imaging methods according to the patient’s age, and timely referral pathways for patients. Add our DDH instrument to the section to the healthy child card. This should include risk factors: pelvic presentation, female sex, and family history of DDH. As well as the marking of a normal vs abnormal physical examination. la displasia del desarrollo de la cadera (DDC) es la malformación congénita más común en humanos. Si se diagnostica y trata antes de los cinco meses de edad presenta una alta tasa de curación; si no, requiere tratamiento quirúrgico con altos costos económicos, gran impacto en la morbilidad y secuelas que pueden generar discapacidad permanente. diseñar y validar un instrumento para detectar tempranamente la DDC. instrumento elaborado a partir de una revisión de la literatura sobre el diagnóstico oportuno de DDC, utilizando la metodología PRISMA. Para validarlo se conformó un panel de expertos con especialistas de diferentes instituciones de salud. todos los participantes del panel de expertos coincidieron en que la DDC es un problema de salud pública. Consideran que existen muchos pacientes con diagnóstico tardío y secuelas debido a la falta de tratamiento oportuno. Hubo consenso sobre la viabilidad de implementar la propuesta. Se identificó la necesidad de actualizar la normativa vigente en materia de medios de diagnóstico. es necesario promover la exploración física correcta, los métodos de imagen ideales según la edad del paciente y las vías de derivación oportunas. Incluir nuestro instrumento de DDC en la sección de la tarjeta del niño sano. Se deben incluir factores de riesgo: presentación pélvica, sexo femenino y antecedentes familiares de DDC. Además, se debe marcar una exploración física normal frente a anormal.

38. [Elephantine Psoriasis. A case report].

期刊: Revista medica del Instituto Mexicano del Seguro Social 发表日期: 2026-Jul-13 链接: PubMed

摘要

Hyperkeratotic psoriasis is a rare variant that includes forms such as elephantiasis, considered the rarest. It is characterized by thick, persistent plaques, resembling elephant skin, located mainly on the extremities and buttocks. Early detection and appropriate treatment, including systemic therapies, are essential for its management. A 58-year-old male patient presented in 2018 with dermatosis on his forehead, right elbow, and the backs of both hands. He was initially diagnosed with seborrheic dermatitis and chronic lichen simplex and received multiple topical therapies without improvement. In 2024, he developed new, disseminated lesions on his elbows, hands, and both legs, characterized by hyperkeratotic plaques and excoriations. A biopsy confirmed the diagnosis of elephantiasis variant hyperkeratotic psoriasis. Treatment with ustekinumab was initiated, resulting in significant improvement of the lesions. Elephantine psoriasis is a rare and difficult-to-treat variant, with few reported cases, which hinders the standardization of its management. Biologic therapies represent an effective alternative for improving prognosis, reducing complications, and preventing progression to other associated pathologies. Disseminating these cases is essential to expanding knowledge of this variant and optimizing available therapeutic options, for the benefit of patients. la psoriasis hiperqueratósica es una variante poco frecuente que incluye formas como la elefantina, considerada la más rara. Se caracteriza por placas gruesas y persistentes, con aspecto similar a la piel de un elefante, localizadas principalmente en extremidades y glúteos. La detección temprana y el tratamiento adecuado, incluyendo terapias sistémicas, son fundamentales para su manejo. paciente hombre de 58 años que inició en 2018 con dermatosis en frente, codo derecho y dorso de ambas manos, con diagnóstico inicial de dermatitis seborreica y liquen simple crónico, recibiendo múltiples terapias tópicas sin mejoría. En 2024 presentó nuevas lesiones diseminadas en codos, manos y ambas piernas, caracterizadas por placas hiperqueratósicas y excoriaciones. La biopsia confirmó el diagnóstico de psoriasis hiperqueratósica variante elefantina. Se inició tratamiento con ustekinumab, observándose mejoría significativa de las lesiones. la psoriasis elefantina es una variante rara y de difícil tratamiento, con escasos casos reportados, lo que dificulta la estandarización de su manejo. Las terapias biológicas representan una alternativa efectiva para mejorar el pronóstico, disminuir complicaciones y prevenir la progresión hacia otras patologías asociadas. La difusión de estos casos es fundamental para ampliar el conocimiento de esta variante y optimizar las opciones terapéuticas disponibles, en beneficio de los pacientes.

39. [Twelve-month clinical follow-up of patients diagnosed with bronchopulmonary dysplasia].

期刊: Revista medica del Instituto Mexicano del Seguro Social 发表日期: 2026-Jul-13 链接: PubMed

摘要

Bronchopulmonary dysplasia (BPD) is a chronic disease with a high prevalence in premature infants. Its development is related to multiple risk factors, including prolonged oxygen use, mechanical ventilation, and the presence of infections. To analyze the clinical characteristics and factors associated with readmission in patients with bronchopulmonary dysplasia after 12 months of follow-up. This was an observational, analytical, and longitudinal study. Patients born before 36 weeks of gestation with BPD, seen in the Pediatric Pulmonology outpatient clinic between September 2023 and August 2024, were included. Eighty-one patients were analyzed. The median gestational age was 30 weeks (IQR 5; 25th percentile: 28 weeks; 75th percentile: 33 weeks); 53% were female, and 64.2% presented with moderate BPD. All patients had at least one hospital readmission. 61.7% presented with retinopathy of prematurity. 30% required oxygen for more than one year. A significant association was found between low birth weight at one year and a higher number of readmissions (OR: 9.08; 95% CI: 2.10-39.2; p = 0.002). The clinical course of patients with bronchopulmonary dysplasia (BPD) remains unfavorable. Low birth weight at one year was the main factor associated with readmissions. Nutritional monitoring and infection prevention strategies are needed to improve long-term prognosis. la displasia broncopulmonar (DBP) es una enfermedad crónica de alta prevalencia en neonatos prematuros. Su desarrollo se relaciona con múltiples factores de riesgo, entre ellos el uso prolongado de oxígeno, la ventilación mecánica y la presencia de infecciones. analizar las características clínicas y los factores asociados al reingreso en pacientes con displasia broncopulmonar a 12 meses de seguimiento. estudio observacional, analítico y longitudinal. Se incluyeron pacientes menores de 36 semanas de gestación con DBP, atendidos en consulta externa de Neumología Pediátrica entre septiembre de 2023 y agosto de 2024. se analizaron 81 pacientes. La mediana de edad gestacional fue de 30 semanas (RI 5; percentil 25: 28 semanas; percentil 75: 33 semanas); el 53% eran mujeres y el 64.2% presentó DBP moderada. Todos los pacientes presentaron al menos un reingreso hospitalario. El 61.7% presentó retinopatía del prematuro. El 30% utilizó oxígeno durante más de un año. Se encontró una asociación significativa entre bajo peso al año y mayor número de reingresos (OR: 9.08; IC95 %: 2.10–39.2; p = 0.002). la evolución clínica de los pacientes con DBP continúa siendo desfavorable. El bajo peso al año fue el principal factor asociado a los reingresos. Se requieren estrategias de seguimiento nutricional y prevención de infecciones para mejorar el pronóstico a largo plazo.

40. [Comment on the article: "Changes in the triglyceride-glucose index after one year of antiretroviral therapy"].

期刊: Revista medica del Instituto Mexicano del Seguro Social 发表日期: 2026-Jul-13 链接: PubMed

摘要

Both HIV diagnosis and antiretroviral therapy (55.1%) increase the risk of developing lipid profile abnormalities. This has led the European Society of Cardiology, in its 2025 update on the management of dyslipidemias, to incorporate statin therapy in patients older than 40 years with an HIV diagnosis as primary prevention for atherosclerotic cardiovascular disease. These updates not only recommend strict control of the lipid profile in this population group, but also pharmacological therapy for the prevention of future cardiovascular events. Tanto el diagnóstico de VIH como la terapia antirretroviral (55.1%) aumentan el riesgo de presentar alteraciones en el perfil lipídico. Esto ha llevado a la Sociedad Europea de Cardiología, en su actualización de 2025 sobre el manejo de las dislipidemias, a incorporar la terapia con estatinas en pacientes mayores de 40 años con diagnóstico de VIH como estrategia de prevención primaria de la enfermedad cardiovascular ateroesclerótica. Estas actualizaciones no solo recomiendan un control estricto del perfil lipídico en este grupo poblacional, sino también el uso de terapia farmacológica para la prevención de eventos cardiovasculares a futuro.

41. [Epidemiological surveillance and mass events: lessons learned ahead of the 2026 FIFATM World Cup].

期刊: Revista medica del Instituto Mexicano del Seguro Social 发表日期: 2026-Jul-13 链接: PubMed

摘要

The FIFA World Cup™ 2026 in Mexico will be a major public health challenge worldwide. Large gatherings can facilitate the spread of diseases, raise the number of cardiovascular emergencies caused by stress, and require careful monitoring of vaccine-preventable illnesses, particularly given ongoing concerns about measles and pertussis. This editorial article reviews lessons learned from past events and highlights the need to improve food safety, mental health support, and active disease surveillance. The healthcare system’s success will depend on how well it can respond and plan to manage the risks that come with people traveling from around the world. La Copa Mundial FIFA™ 2026 en México será un reto importante para la salud pública a nivel mundial. Los eventos masivos pueden ser favorecedores de la propagación de enfermedades, aumentar las emergencias cardiovasculares por el estrés, así como las enfermedades prevenibles por vacunación, principalmente sarampión y tos ferina, por el contexto epidemiológico actual. En este manuscrito se revisan las lecciones aprendidas en eventos previos y se destaca la importancia de reforzar la seguridad alimentaria, la atención a la salud mental y la vigilancia epidemiológica activa. El éxito del sistema de salud dependerá de su capacidad de respuesta y de una buena planeación para controlar los riesgos asociados con la llegada de personas de todo el mundo.

42. [Interaction between oxidative stress and inflammatory processes in fetal membranes: One Health].

期刊: Revista medica del Instituto Mexicano del Seguro Social 发表日期: 2026-Jul-13 链接: PubMed

摘要

The balance between oxidative mechanisms and inflammatory responses is essential for the proper progression of pregnancy, as it preserves the functionality and integrity of the fetal membranes. Among them, the amnion plays a key protective role by regulating maternal-fetal exchange and interpreting chemical and mechanical signals from the uterine microenvironment. However, various adverse stimuli, particularly bacterial infections mediated by lipopolysaccharide (LPS), environmental contaminants, sustained physiological stress, or metabolic disturbances, can disrupt this homeostasis, increasing the generation of reactive oxygen species (ROS) and promoting the release of proinflammatory cytokines that compromise cellular and tissue stability. When these pathways remain imbalanced over time, a dysfunction known as the redox-inflammatory axis emerges, which is associated with structural damage, extracellular matrix degradation, premature aging of amniotic cells, and a considerable increase in the risk of preterm birth. Examining these interactions through a One Health perspective enables integration of biological, environmental, and social factors, providing a more comprehensive understanding of the determinants of maternal-fetal health and guiding the development of more effective preventive strategies, such as zoonotic surveillance and food safety, to mitigate risks during pregnancy. El equilibrio entre los mecanismos oxidativos y las respuestas inflamatorias es fundamental para el desarrollo adecuado del embarazo, ya que permite mantener la funcionalidad y la integridad de las membranas fetales. Entre ellas, el amnios destaca por su papel protector al participar en la regulación del intercambio materno-fetal y en la interpretación de señales químicas y mecánicas del microambiente uterino. No obstante, diversos estímulos adversos, especialmente las infecciones bacterianas mediadas por lipopolisacárido (LPS), contaminantes ambientales, estrés fisiológico sostenido o alteraciones metabólicas, pueden perturbar esta homeostasis, incrementando la generación de especies reactivas de oxígeno (ERO) y favoreciendo la liberación de citocinas proinflamatorias que comprometen la estabilidad celular y tisular. Cuando estas rutas se desequilibran de forma prolongada, surge una disfunción conocida como eje redox–inflamatorio, vinculada con daño estructural, degradación de la matriz extracelular, envejecimiento prematuro de las células del amnios y un aumento considerable del riesgo de parto pretérmino. Analizar estas interacciones desde el enfoque de Una Sola Salud permite integrar factores biológicos, ambientales y sociales, proporcionando una visión más completa de los determinantes que influyen en la salud materno-fetal y orientando la formulación de estrategias preventivas más eficaces —como la vigilancia de zoonosis y la seguridad alimentaria— que mitiguen los riesgos durante la gestación.

43. [When the one who heals dies. The physician at the end of life].

期刊: Revista medica del Instituto Mexicano del Seguro Social 发表日期: 2026-Jul-13 链接: PubMed

摘要

A physician’s death represents a critical point of tension between the values of modern medicine and the ethical limits of care. This review article analyzes how physicians face their own end of life and the type of care they receive compared with the general population. A narrative review of literature published between 2014 and 2025 was conducted using PubMed, Scopus, and SciELO databases with the MeSH and DeCS descriptors: “Terminal care”, “Palliative care”, “Attitude to death”, “Health personnel”, “Right to die”. Findings show that although physicians express a preference for a dignified death with therapeutic proportionality and symptom control, many still die under highly technological and interventionist schemes. Mexico lacks systematic data documenting how its physicians die, revealing a gap between ethical intention and institutional practice. This analysis proposes developing a observational study to characterize therapeutic intensity, respect for autonomy, and the moral distress experienced by healthcare teams as bioethical and occupational issues within the health system. La muerte del médico representa un punto de máxima tensión entre los valores de la medicina moderna y los límites éticos del cuidado. Este artículo de revisión analiza cómo los médicos enfrentan el final de su propia vida y qué cuidados reciben en comparación con la población general. Se realizó una revisión narrativa de la literatura publicada entre 2014 y 2025 en las bases de datos PubMed, Scopus y SciELO, utilizando los descriptores MeSH y DeCS: “Cuidados al final de la vida”, “Cuidados paliativos”, “Actitud ante la muerte”, “Personal de salud” y “Derecho a morir”. Los hallazgos muestran que, aunque los médicos expresan preferencia por una muerte digna, con proporcionalidad terapéutica y control sintomático, muchos continúan falleciendo bajo esquemas de alta intervención tecnológica. México carece de registros clínicos que documenten cómo mueren sus médicos, lo que revela una brecha entre la intención ética y la práctica institucional. Este análisis propone desarrollar un estudio observacional que caracterice la intensidad terapéutica, el respeto a la autonomía y el sufrimiento moral del equipo tratante como problemas bioéticos y ocupacionales dentro del sistema de salud.

44. Vitiligo and skin cancer risk across racial/ethnic groups: A retrospective propensity score-matched study on 123,179 patients.

期刊: European journal of cancer (Oxford, England : 1990) 发表日期: 2026-Jul-10 链接: PubMed

摘要

The association between vitiligo and skin cancer has been previously studied, with most studies reporting either a reduced or no increased risk. However, findings remain inconsistent, and data on potential variation across ethnic groups remain limited. The aim of this study was to investigate the association between vitiligo and the risk of skin cancer, and to explore whether this association varies by race/ethnicity. A large-scale retrospective propensity score-matched study was conducted using real-world data from the TriNetX US Collaborative Network. A total of 123,179 patients with vitiligo were matched to an equal number of comparators. Outcomes were any skin cancer, including malignant melanoma, squamous cell carcinoma, and basal cell carcinoma. Several sensitivity analyses were performed to assess robustness in addition to subgroup analyses. The risk of any skin cancer was significantly lower in the vitiligo cohort compared with comparators (HR 0.83, 0.78-0.88, p = 0.002). The risk reduction was most pronounced for any malignant melanoma (HR 0.69, 0.58-0.81, p = 0.003). Exploratory subgroup analyses indicated a possible increased risk of squamous cell carcinoma in Black/African American individuals with vitiligo (HR 2.16, 1.09-4.28, p = 0.024). Sensitivity and control analyses were consistent. Vitiligo was associated with a reduced overall risk of skin cancer. However, the association varied by race/ethnicity, with a potentially increased risk observed among Black/African American patients. Further studies in diverse populations are warranted to confirm these findings.

45. Assessing the magnitude of surveillance bias in prostate cancer, melanoma and lung cancer.

期刊: European journal of cancer (Oxford, England : 1990) 发表日期: 2026-Jul-09 链接: PubMed

摘要

Changes in cancer incidence can result from changes in screening and diagnostic practices rather than changes in the true occurrence of cancer, leading to surveillance bias. Quantitative approaches to estimate this bias are lacking. To develop an approach to estimate surveillance bias in prostate cancer, melanoma, and lung cancer. We used population-based data from Swiss cancer registries on incidence and mortality from 1989 to 2021. Age-standardized incidence was analyzed using Joinpoint regression to identify periods with distinct trends. The same periods were used to segment mortality trends. The magnitude of surveillance bias was assessed for each period by computing the absolute normalized difference between the mean annual changes in age-standardized incidence and mortality rates, since mortality is less affected by screening and diagnostic practices than incidence. Larger differences indicated greater bias. We defined three cut-offs to categorize the bias into low, moderate and high. Analyses were also conducted by cancer stage. Our estimator of surveillance bias for prostate cancer points to a high bias in 1989-2004 (absolute normalized difference= 5%), low in 2004-2011 (absolute normalized difference = 0.3%), and high in 2011-2014 and 2014-2021 (absolute normalized difference = 6% and 5%). For melanoma, the bias was high from 1989 and 2003 and moderate between 2003 and 2021 (absolute normalized difference = 5.5% and 1.6%). For lung cancer, it was low over the entire study period (absolute normalized difference = 0.5%). In stage-specific analyses, surveillance bias was greater for early-stage than advanced-stage cancers. We estimated surveillance bias using a simple approach that can be used in daily monitoring activities. Further studies are needed to refine these estimates.

46. Cannabis use and testicular germ cell tumour subtypes in the french nationwide TESTIS case-control study.

期刊: European journal of cancer (Oxford, England : 1990) 发表日期: 2026-Jul-09 链接: PubMed

摘要

Testicular germ cell tumours (TGCTs) are the most common malignancy among young men, and their rapidly increasing incidence suggests a role for modifiable risk factors. The role of increasingly prevalent cannabis use, particularly during developmental periods before biological maturation, in TGCT etiology remains unclear. The association between cannabis use in adolescence and early adulthood and TGCT was assessed in a nationwide hospital-based case-control study in France (454 cases, 670 controls). Exposure was characterized by timing and frequency, including persistent use. Weekly-equivalent exposure scores were used to approximate exposure-response. Conditional logistic regression estimated odds ratios (ORs) and 95% confidence intervals (CIs), overall and by histological subtype. Cannabis use was not consistently associated with TGCT risk overall. Associations varied by timing and histological subtype. Early adulthood daily use was associated with increased TGCT risk overall (OR baseline=1.50, CI 1.02-2.19) and with seminoma (OR baseline=2.02, CI 1.22, 3.33; OR adjusted=1.93, CI 1.13-3.31), adjusted for tobacco, alcohol, and education. Exposure-response was observed in early adulthood (p-trend = 0.046), particularly for seminoma (p-trend = 0.016). Weekly use across 12-25 years was associated with increased TGCT risk (OR adjusted=1.85, CI 1.11-3.07), with similar patterns for seminoma (OR adjusted=2.29, CI 1.09-4.79). No associations were observed in adolescence or for non-seminoma. Findings support an effect of cannabis use during early adulthood on TGCT risk with significant dose-response relationships and stronger associations for daily use, particularly for seminoma; however, subtype results require cautious interpretation and independent confirmation.

47. Prognostic host phenotypes based on body composition and systemic inflammation predict survival in patients with resected pancreatic and periampullary cancer.

期刊: European journal of cancer (Oxford, England : 1990) 发表日期: 2026-Jul-09 链接: PubMed

摘要

Most present-day survival-models of patients with cancer do not account for tumor-host interactions. We hypothesized that host phenotypes based on systemic inflammation and body composition are prognostic of overall survival (OS) in patients with pancreatic ductal adenocarcinoma (PDAC). We performed a post-hoc analysis of the nationwide PORSCH-trial, including all patients undergoing pancreatoduodenectomy for PDAC. Primary outcome was OS. Body composition analysis was performed using automatic segmentation (Mosamatic™) of preoperative abdominal computed tomography scans. Low muscle mass and myosteatosis were defined using log-rank stratification of sex-standardized Z-values of skeletal muscle index and radiation attenuation, respectively. Patients were clustered in eight host phenotypes based on combinations of adverse host factors: [1] low muscle mass, [2] myosteatosis, [3] systemic inflammation (C-reactive protein >6mg/L). Their association with OS was tested using multivariable-adjusted Cox-proportional hazard-analysis. Distinct combinations of adverse host factors were stratified into low-, intermediate-, and high-risk phenotypes according to k-means clustering based on log hazard-ratio’s. 549 patients were included. The high-risk phenotype, characterized by the presence of all adverse host factors, showed lower median OS than intermediate ([1], [2], [1 +2], [1 +3], [2 +3]) and low-risk ([3]; none) phenotypes (13.0 months [95%CI 11.4-19.3] vs. 21.9 months [95%CI 19.3-24.7] vs. 35.2 months [95%CI 29.2-45.3], respectively; p < 0.001). In multivariable analysis, host phenotypes were associated with OS (adjusted [a]HR 1.39 [95%CI 1.08-1.80, p = 0.01; aHR 2.10 [95%CI 1.53-2.88], p < 0.01, for intermediate- and high-risk respectively), independent of tumor stage. Host phenotypes based on body composition and systemic inflammation predict OS independent of tumor stage in patients with resected PDAC, underscoring the importance of tumor-host interactions for clinical survival prediction.

48. Comparative analysis of in vitro diagnostic medical devices and laboratory-developed tests: Insights from global regulation.

期刊: Health policy (Amsterdam, Netherlands) 发表日期: 2026-Jul-09 链接: PubMed

摘要

Oversight of in vitro diagnostic medical devices (IVD-MDs; synonymous with IVDs) and laboratory-developed tests (LDTs) remains fragmented across jurisdictions, posing challenges for global market access and patient safety. This study compares LDT regulatory frameworks in major regions to identify gaps and opportunities for international convergence. A comparative review was conducted across five jurisdictions-the IMDRF, United States (US), European Union (EU), Japan, and Korea-using official regulatory documents, guidelines, and recent updates. The EU’s transition from the In Vitro Diagnostic Directive (IVDD) to the In Vitro Diagnostic Regulation (IVDR) established a risk-based classification and stricter requirements for LDTs. Conversely, the US Food and Drug Administration (FDA) rescinded its 2024 Final Rule on LDTs in 2025 following a federal court ruling, thereby restoring primary authority to CLIA. Japan and Korea regulate LDTs under broader laboratory accreditation systems without dedicated legislation. The IMDRF has not yet issued binding guidance on LDT oversight. LDT regulation worldwide remains non-harmonized. The newly issued ISO 5649:2024 provides internationally recognized specifications for LDT design, validation, and quality management, supporting future efforts toward global regulatory convergence and patient safety assurance.

49. Trends in the rates of mortality from chronic obstructive pulmonary disease mortality among older adults in the United States, 1999-2020, and near-term projections.

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

摘要

To evaluate trends and disparities in the rates of mortality from chronic obstructive pulmonary disease (COPD) among adults aged 65 years or more in the United States from 1999 to 2020, and to make near-term projections. Population-based ecological time-trend analysis using mortality data from the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research database. Age-adjusted mortality rates (AAMR) per 105 adults, stratified by sex, age, race and ethnicity, census region, urbanization, and state. Joinpoint regression estimated annual percent changes, autoregressive integrated moving average (ARIMA) models projected rates to 2030, and Socio-Demographic Index (SDI) correlations and stochastic frontier analysis assessed state-level disparities and performance gaps. Among 2,564,672 COPD deaths, overall AAMR declined from 303.5 to 238.6 per 105 over the period 1999-2017 (APC -0.45%), with a further decline observed over 2017-2020 (APC -4.40%). Male AAMR declined significantly in both periods (APC -1.36% and - 3.97%), whereas female AAMR remained relatively stable during 1999-2017 (APC 0.18%) before declining significantly during 2017-2020 (APC -4.90%), suggesting an acceleration in mortality reduction in recent years. Despite the overall decline, mortality remained unevenly distributed, with the highest AAMRs observed in the Midwest (301.1) and South (297.3), nonmetro areas (339.4), and low-SDI states, particularly West Virginia (401.3). ARIMA projections suggested that the overall AAMR would continue to fall to 223.3 by 2030, mainly because of an 18.6% projected decline among males; in contrast, female rates were projected to plateau at approximately 246.4. Frontier analysis further indicated that several high-burden states had excess mortality relative to benchmark states with comparable SDI levels, highlighting opportunities for targeted improvement. Mortality risk declined, but the burden remained concentrated among the oldest adults (≥85 years), women, rural residents, and socially disadvantaged states. Sex-, geriatric-, and place-based strategies are needed to reduce persistent inequities.

50. Mapping of microplastic toxicity: Uptake, trophic transfer, and ecotoxicological risks in marine ecosystems.

期刊: Aquatic toxicology (Amsterdam, Netherlands) 发表日期: 2026-Jul-03 链接: PubMed

摘要

Microplastics (MPs) have emerged as pervasive contaminants in marine ecosystems, posing escalating ecotoxicological risks across trophic levels. This review highlights the current knowledge on the sources, types, and mechanistic pathways of MPs toxicity by assessing their environmental uptake, trophic transfer, and associated impacts on aquatic organisms and human health. Previous studies collectively demonstrate that integrated field assessments, chemical characterization, and advanced multi-omics methodologies provide a holistic understanding of polymeric particle bioavailability, transport pathways, and cellular interactions across diverse marine species, ranging from primary producers to higher trophic level apex consumers. In this review, modeling and spatial analyses further elucidate the transport processes and distribution patterns of MPs within marine ecosystems. Prior studies have shown that MPs ingestion alters nutrient absorption, enzymatic efficiency, and redox homeostasis in marine organisms, triggering oxidative stress, metabolic disruption, and sub-lethal physiological impairments across multiple trophic levels. Recent evidence reveals that MPs can be translocated through pelagic and benthic food webs and may facilitate the transfer of sorbed contaminants and additives across trophic levels. Reviews of molecular or histopathological data show MPs trigger inflammatory responses, oxidative damage, apoptosis, genotoxicity, and immunity alterations in marine species. Review studies evaluate nanoremediation, biochar amendment, and engineered carbonaceous sorbents as key mitigation strategies against MPs risks. Probabilistic risk assessments underscore substantial human dietary exposure through seafood, policy integration, urging integration of MPs monitoring into global marine health frameworks for proactive intervention. These reviewed insights enhance mechanistic MPs ecotoxicology knowledge, underpinning sustainable strategies and policies for marine biodiversity protection and human well-being security.

51. Chandipura Virus: An Emerging Neurological Threat Transmitted by Sandflies in India.

期刊: Immunity, inflammation and disease 发表日期: 2026-Jul 链接: PubMed

摘要

Chandipura virus (CHPV), a neurotropic, negative-sense RNA virus belonging to the genus Vesiculovirus (family Rhabdoviridae), has emerged as a significant cause of acute encephalitis syndrome (AES) in India, predominantly affecting children. Since the major outbreaks in 2003-2004 and the recent resurgence in 2024, CHPV has re-emerged as a high-fatality, climate-sensitive arboviral threat transmitted primarily by phlebotomine sandflies. The absence of specific antivirals or licensed vaccines underscores the need for comprehensive understanding and preparedness. This narrative review synthesizes available literature on CHPV epidemiology, outbreak history, molecular virology, transmission ecology, neuropathogenesis, host immune responses, diagnostic modalities, therapeutic candidates, and preventive strategies. Data from published outbreak reports, genomic analyses, experimental studies, and public health updates were critically examined to provide an integrated One Health perspective. CHPV outbreaks have been characterized by rapid disease progression, high case-fatality rates (often 30%-70%), and marked pediatric predominance. Molecular studies reveal a conserved vesiculovirus genomic organization (3’-N-P-M-G-L-5’), with emerging phylogenomic evidence indicating geographic clustering but limited global genomic representation. Neurotropism is mediated by rapid viral replication in the central nervous system, triggering microglial activation, oxidative stress, cytokine dysregulation, complement interactions, and Fas-mediated neuronal apoptosis. Diagnosis relies primarily on RT-PCR during the early viremic phase and IgM ELISA in later stages, though rapid field-deployable diagnostics remain unavailable. Experimental antiviral strategies, including ribavirin, favipiravir, lycorine, RNA interference, and immunomodulatory approaches, demonstrate preclinical promise but lack human clinical validation. Vector control and environmental management remain the cornerstone of prevention. Chandipura virus represents a re-emerging neuroinvasive arbovirus with significant public health implications in India. Strengthening AES surveillance, integrating genomic monitoring, developing rapid diagnostics, advancing antiviral and vaccine research, and implementing climate-informed vector control strategies are critical priorities. A coordinated One Health framework is essential to mitigate future outbreaks and reduce pediatric mortality.

52. Effect of Hormonal Contraceptives on Circulating Biomarkers of Inflammation, Chemotaxis, Angiogenesis, and Vascular Stress.

期刊: APMIS : acta pathologica, microbiologica, et immunologica Scandinavica 发表日期: 2026-Jul 链接: PubMed

摘要

Hormonal contraceptive (HC) use is known to be associated with elevated CRP levels. However, evidence on the effect of HC on several circulating inflammatory biomarkers in healthy humans is limited. The aim of this study was to examine the association between hormonal contraceptives and circulating biomarker levels and differential cell counts. A cross-sectional observational study design with biomarker measurements from 4,160 healthy females was used, coupled with registered HC prescriptions. We compared 752 high and low dose combined oral contraceptive (COC) users, 77 progestin-only pill users, 417 levonorgestrel intrauterine device users, 65 hormonal therapy users, and 1,523 post-menopausal women with a control group of 1,326 women below 50 years. Repeated differential cell counts from a different dataset of 16,231 females were analyzed for the effects of HC. Data were analyzed using various regression models. COC use was associated with higher vascular marker levels but lower chemokine levels. We found no association with progestin-only use. The association with differential cell counts was limited for most HC types. This study emphasizes the widespread impact of HC on the immune and vascular systems and how the impact may differ between HC types. The biomarker associations found could be targets for elucidation in functional studies.

53. Knowledge, Attitudes and Practices on the Use of Antidiabetic Medications for Weight Loss: A Cross-Sectional Study in the Lebanese Population.

期刊: Endocrinology, diabetes & metabolism 发表日期: 2026-Jul 链接: PubMed

摘要

The growing use of antidiabetic medications for weight loss has raised concerns about public awareness, safety and appropriate use. This study assessed knowledge, attitudes and practices (KAP) regarding antidiabetic medications use for weight loss among Lebanese adults and identified associated factors. A cross-sectional online survey was conducted among Lebanese adults between June and July 2025 using convenience sampling through social media. The questionnaire was adapted from published instruments, expert-reviewed and pilot-tested. Data on sociodemographic characteristics, KAP and medication use were collected. Knowledge and attitude scores were calculated, and factors associated with medication use were evaluated by multivariable regression. A total of 405 participants were included. Mean knowledge and attitude scores were 69.39 ± 8.71 and 69.11 ± 5.54 (out of 100), indicating moderate knowledge and cautious attitudes. Higher education and healthcare-related employment were independently associated with higher knowledge and more appropriate attitudes toward safe use of antidiabetic medications, whereas previous weight-control complications were associated only with more appropriate attitudes. Overall, 12.3% reported using antidiabetic medications for weight loss, primarily semaglutide. Among users, 62.0% experienced side effects, 46.0% reported weight regain after discontinuation, and 32.0% used these medications without medical consultation. Medication use was associated with smoking (aOR 3.13, 95% CI 1.53-6.38), prior weight-control complications (aOR 8.50, 95% CI 3.27-22.12), higher knowledge scores (aOR 1.05, 95% CI 1.00-1.09), and adherence to a weight-loss diet (aOR 2.21, 95% CI 1.35-3.60), while higher occupational physical activity was inversely associated (aOR 0.58, 95% CI 0.41-0.84). Lebanese adults demonstrated moderate knowledge and generally appropriate attitudes toward the safe use of antidiabetic medications for weight loss. Reported side effects, weight regain and unsupervised use underscore the need for public education, physician-guided counselling and stronger oversight. Findings should be interpreted considering the cross-sectional design and convenience sampling, limiting causal inference and generalizability.

54. Multigene identification of new subtypes in the Acanthamoeba T4 genotype and description of Acanthamoeba pussardi sp. nov.

期刊: European journal of protistology 发表日期: 2026-Jun-28 链接: PubMed

摘要

Acanthamoeba is a widespread free-living amoeba that can cause rare but serious opportunistic infections in humans and animals. Various species have been described based on morphological criteria that have proven unreliable, and strain identification is currently based on genotype assignment using nuclear 18S rDNA sequences. Most Acanthamoeba strains belong to genotype T4, which is the most abundant in the environment as well as the most frequently reported in clinical samples. Due to its richness, the T4 genotype has been further subdivided into subtypes, which correspond almost perfectly to the subtypes of the mitochondrial small subunit (mtSSU) rDNA. The 18S/mtSSU subtype clusters provide a clearer picture of species groups, and other subtypes remain to be identified. In this study, we provide evidence, through 18S/mtSSU co-clustering, for the existence of additional subtypes of the Acanthamoeba T4 genotype, two nuclear and four mitochondrial, and describe a new species, Acanthamoeba pussardi sp. nov. The data are supported by the analysis of two mitochondrial protein-coding genes, cytochrome c oxidase subunit 1 (cox1) and nicotinamide adenine dinucleotide (NADH) dehydrogenase subunit 5 (nad5), as well as the mitochondrial rDNA spacer.

55. The antibiotic resistome in oysters across the Chinese coastline: Enrichment, microbial drivers, and implications for health risk.

期刊: Journal of hazardous materials 发表日期: 2026-Jun-25 链接: PubMed

摘要

Oysters extensively farmed in China represent a critical but under-investigated pathway for human exposure to antibiotic resistance genes (ARGs). This study employed metagenomic analysis of 75 samples from representative Chinese oyster farms to explore ARGs distribution in oysters and their surrounding environments, alongside assessing their health risk. Results exhibited significant spatial heterogeneity and marked ARG enrichment in oyster compared to surrounding seawater along the Chinese coastline, with an enrichment factor 2.60 ± 2.43 folds higher. This enrichment is primarily driven by selective retention of specific microbes, particularly the opportunistic pathogen Vibrio, which emerged as a dominant ARG host. Furthermore, the co-occurrence of mobile genetic elements and diverse ARGs, particularly IS91 and tnpA, suggests a high potential for horizontal gene transfer within oyster bacteriome, potentially exacerbating the dissemination of antibiotic resistance. From a public health perspective, the mean estimated daily intake (EDI) of ARGs via oyster consumption was calculated at 1.7E-1 ± 1.7E-1 copies/16S/g/individual. Given that oyster can be consumed raw and harbor pathogenic Vibrio, this ARG exposure may underscores potential health risk for consumers. Integrating the EDI with a resistome scoring system, the Risk Index (RI) demonstrated site-specific health threats that necessitate differentiated management priorities. Collectively, these results provide critical evidence of how marine aquaculture serves as a reservoir for ARGs and highlight the urgent need for integrated surveillance under the One Health approach to mitigate the transmission of antibiotic resistance from marine environments to the human food chain.

56. Ocular injury awareness, knowledge, and safety practices among dental professionals, students, and supporting staff: A cross-sectional analysis.

期刊: PloS one 发表日期: 2026 链接: PubMed

摘要

Ocular health is important in dentistry because the profession relies on visual acuity and has a high risk of splatter, aerosols, and projectiles. There is a great deal of promotion with respect to personal protective equipment (PPE), but little is known about how the awareness is turned into protective behaviour in dental practice in Indian contexts. To assess the extent of knowledge, awareness, and clinical practices related to ocular safety among dental professionals, students, and auxiliary staff in India, and to identify significant discrepancies between their theoretical knowledge and practical implementation. An online cross-sectional survey was conducted among 512 dental professionals across various institutions in India by using a 27-item questionnaire that was diligently piloted and validated. The questionnaire serves to assess self-reported awareness, the incidence of ocular injuries, and patterns of eye protection for both clinicians and their patients. Although 86.1% of respondents reported being familiar with eye safety regulations, 62.5% reported eye injuries during clinical procedures, mainly as a result of spatter, aerosol, and removing restorations, which doesn’t suggest lack of protection but lack of protective eyewear. Responsive to the conditions mentioned, only 42.6% were compliant overall and consistent in wearing protective eyewear, while 93.6% report acknowledging the need for protective eyewear. Additionally, 13.3% had observed ocular injuries in patients, and 38.35% admitted to not providing eye protection during procedures. There is a significant differential between the high awareness and poor uptake of ocular safety practices in Indian dentistry. This requires enhancing policy in institutions, introducing ocular protection in dental education and establishing standard procedures. Reducing preventable injuries and ensuring the safety of patients and practitioners is justified.

57. Associations of demographic, socioeconomic, lifestyle factors and comorbidity with accelerometer-measured physical activity in adults with cardiovascular diseases.

期刊: PloS one 发表日期: 2026 链接: PubMed

摘要

Cardiovascular diseases (CVDs) are a leading cause of morbidity and mortality, and physical activity (PA) is central to secondary prevention. However, factors associated with PA among individuals with CVDs remain poorly understood, with few studies using accelerometer-based methods. This cross-sectional study examined the associations between accelerometer-measured PA and demographic, socioeconomic, lifestyle factors, and comorbidity in a large Swedish cohort of individuals with CVDs. Participants aged between 50 and 64 years with a confirmed diagnosis of angina pectoris, myocardial infarction, atrial fibrillation and flutter, heart failure, or stroke were included. Moderate-to-vigorous physical activity was measured using hip-worn triaxial accelerometers over seven consecutive days and categorized into tertiles of low, medium and high PA level. Demographic, socioeconomic, lifestyle factors, and comorbidities were assessed through questionnaires and registry data. Associations with PA levels were analyzed using multiple ordinal logistic regression. A total of 1,484 participants (32% women; median age 60.2 years) were included. Being in the oldest age group was significantly associated with lower odds of having a higher PA level (OR = 0.59; 95% CI [0.44, 0.77]), as well as female sex (OR = 0.73; 95% CI [0.59, 0.91]), regular/occasional smoking (OR = 0.37; 95% CI [0.26, 0.52]), and having one (OR = 0.61; 95% CI [0.48, 0.77]) or more comorbidities (OR = 0.45; 95% CI [0.30, 0.68]). A healthy diet was significantly associated with higher PA levels (OR = 1.84; 95% CI [1.46, 2.31]). Financial strain, level of education and alcohol consumption had no association with PA. Using data from a representative sample of middle-aged adults, the findings indicate that engagement in PA is primarily associated with lifestyle factors, demographic characteristics, and comorbidity. These identified characteristics may inform future research aimed at CVD populations with low PA. Further research should investigate mediating and moderating pathways to clarify how these factors influence PA.