公共卫生文献雷达（2026-08-04）
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1. Association between mid-to-late pregnancy gestational weight gain and adverse birth outcomes among women with gestational diabetes mellitus.
主题：生物统计与研究设计 / 流行病学
期刊：Asia Pacific journal of clinical nutrition
发表日期：2028-Aug
内容状态：待评估
为什么值得看：同时命中多个关注主题；包含可供初筛的摘要；仅作为选题线索，不代表证据质量结论。
BACKGROUND AND OBJECTIVES: The gestational weight gain (GWG) range during mid-to-late pregnancy associated with the lowest combined risk of adverse birth outcomes in women with gestational diabetes mellitus (GDM) remains unclear. This study aims to examine the associations between GWG and adverse birth out-comes among women with GDM.
METHODS AND STUDY DESIGN: This study included a cohort of 1,673 pregnant women with GDM. GWG was defined as weight gain from pre-pregnancy to a measurement between 24 and 32 gestational weeks, residualized for gestational age and standardized as z-scores. Multivariable logistic regression models were used to assess associations between GWG z-scores (per 1-SD increase and categories: <-1, -1 to 1 [reference], and ≥1) and small for gestational age (SGA), large for gestational age (LGA), and preterm birth. Restricted cubic splines were fitted to explore nonlinear associations.
RESULTS: Each 1-SD higher in GWG z-score was associated with lower odds of SGA (odds ratio [OR], 0.55; 95% confidence interval [CI], 0.43-0.71) and higher odds of LGA (1.48; 1.29-1.70). Compared with the reference group, women with GWG z-scores <-1 had higher odds of SGA and lower odds of LGA, whereas those with z-scores ≥1 showed the opposite pattern. No significant association was observed with preterm birth. Spline analyses indicated that a GWG z-score of approximately -0.07 (equal to 8.2 kg at 28 weeks) was associated with the lowest combined odds of SGA and LGA.
CONCLUSIONS: Among women with GDM, both insufficient and excessive mid-to-late pregnancy GWG were associated with adverse size-for-gestational-age outcomes.
2. Inter-ankle systolic blood pressure difference is associated with microalbuminuria in non-diabetic hypertension patients: A cross-sectional study from two cohorts.
主题：流行病学
期刊：Clinical and experimental hypertension (New York, N.Y. : 1993)
发表日期：2026-Dec-31
内容状态：待评估
为什么值得看：包含可供初筛的摘要；仅作为选题线索，不代表证据质量结论。
This cross-sectional study aimed to analyze whether inter-ankle systolic blood pressure difference (sIAND) was associated with different stages of hypertensive renal damage. 1,658 and 831 nondiabetic hypertensive patients were included from two cohorts. The hypertensive renal damage was reflected by urinary albumin-to-creatinine ratio (UACR), Cystatin C, and estimated glomerular filtration rate. Logistic regression results showed that sIAND was only associated with subclinical hypertensive renal damage reflected by microalbuminuria (UACR > 30 mg/g) independently. Receiver operating characteristic curves indicated sIAND can identify microalbuminuria more effectively. sIAND can aid in identifying microalbuminuria to provide useful clues for risk stratification and clinical management.
3. Early prediction of preeclampsia among the advanced-age pregnant women: A retrospective multicenter study.
主题：流行病学
期刊：Clinical and experimental hypertension (New York, N.Y. : 1993)
发表日期：2026-Dec-31
内容状态：待评估
为什么值得看：包含可供初筛的摘要；仅作为选题线索，不代表证据质量结论。
BACKGROUND: Preeclampsia (PE) remains a leading cause of maternal and perinatal morbidity. Women of advanced maternal age (AMA, ≥ 35 years) constitute a rapidly expanding high-risk subpopulation in China. Existing first-trimester prediction models were derived in general obstetric populations and often rely on specialized biophysical or proprietary biomarker assays, with limited validation in AMA women.
METHODS: This multicenter retrospective study enrolled 2,582 AMA pregnant women from three tertiary centers in southern China, partitioned into a training cohort (n = 1,327), an internal validation cohort (n = 569), and two external validation cohorts (n = 399 and 287). Predictors were selected using LASSO and multivariable logistic regression and assembled into a nomogram. Performance was evaluated by area under the receiver operating characteristic curve (AUC), calibration, Brier scores, decision curve analysis, and clinical impact curves.
RESULTS: Seven independent predictors were retained: pre-pregnancy BMI, parity, mode of conception, uric acid, white blood cell count, red blood cell count, and hemoglobin. The nomogram achieved AUCs of 0.819, 0.795, 0.787, and 0.756 across the four cohorts, with close calibration and favorable net benefit. Performance was preserved when women with chronic hypertension were included and across early-onset and late-onset PE subgroups. Notably, maternal age itself was not discriminative within the AMA stratum (P = 0.626).
CONCLUSIONS: This nomogram relying exclusively on routine clinical and laboratory parameters provides an accessible tool for individualized early-pregnancy PE risk assessment and risk-stratified antenatal management in AMA women.
4. AI-assisted post-mortem classification of vehicle trauma in free-roaming cats using transformer-based large language models.
主题：流行病学
期刊：The veterinary quarterly
发表日期：2026-Dec-31
内容状态：待评估
为什么值得看：包含可供初筛的摘要；仅作为选题线索，不代表证据质量结论。
Veterinary forensic science is a specialized discipline that investigates non-natural animal deaths and injuries. Determining the cause of death in free-roaming cats often presents challenges due to underdeveloped pattern recognition methods and the intricate interplay of events and contributing factors. The integration of natural language processing into forensic investigations may offer potential for the computerized automation of document analysis, with the goal of supporting investigational decision-making. The objective of this study was to develop an AI framework leveraging a transformer-based large language model (LLM) to classify veterinary forensic autopsy reports derived from 271 feline autopsies and to identify the causes of death. We first identified discriminative lexical patterns between vehicular trauma (VT; n = 111) and non-VT cases (n = 160) using Term Frequency-Inverse Document Frequency analysis. The best-performing model, based on Clinical-Longformer, achieved an accuracy of 0.945, precision of 0.885, recall of 1.000, F1 score of 0.939, and AUC-ROC of 0.950. Model interpretability using Integrated Gradients revealed that VT cases were characterized by terms associated with traumatic physical injuries, whereas non-VT cases exhibited a broader range of diagnostic descriptions. These findings demonstrate the feasibility of applying LLMs to veterinary forensic pathological texts and underscore the importance of domain-specific token interpretation for model explainability.
5. Burden of Gastric Cancer in China from 1990 to 2023.
主题：生物统计与研究设计
期刊：Public health in practice (Oxford, England)
发表日期：2026-Dec
内容状态：待评估
为什么值得看：包含可供初筛的摘要；仅作为选题线索，不代表证据质量结论。
OBJECTIVES: To comprehensively assess the gastric cancer burden in China over the past three decades and analyze its epidemiological trends to inform control strategies.
STUDY DESIGN: This was a population-based observational study that systematically evaluated the burden of gastric cancer in China from 1990 to 2023, utilizing data from the Global Burden of Disease (GBD) 2023 study.
METHODS: We evaluated gastric cancer burden metrics from GBD 2023, including incidence, mortality, YLLs, YLDs, and DALYs. Joinpoint regression and age-period-cohort modeling were employed to analyze trends and epidemiological characteristics.
RESULTS: Between 1990 and 2023, the age-standardized incidence rate decreased from 54.23 to 25.04 per 100,000 , and mortality decreased from 50.93 to 16.62 per 100,000. Joinpoint analysis showed an average annual percentage change of -2.8% in incidence, with a significant trend reversal in females during 2020-2023. Age-period-cohort analysis revealed peak risk at 65-69 years and lower risk in recent birth cohorts.
CONCLUSIONS: While China has achieved substantial reductions in gastric cancer burden over 34 years, emerging challenges include trend reversals in females and persistent sex disparities, necessitating targeted prevention strategies.
6. Shelf help: what powers medical student subject exam performance in the United States.
主题：生物统计与研究设计
期刊：Medical education online
发表日期：2026-Dec-31
内容状态：待评估
为什么值得看：包含可供初筛的摘要；仅作为选题线索，不代表证据质量结论。
BACKGROUND: Following the change in 2022 of a scored United States Medical Licensing Examination (USMLE) Step 1 to a binary pass-fail grading system, greater emphasis has been placed on the Step 2 Clinical Knowledge (Step 2 CK) exam. Shelf or subject exams offered by the National Board of Medical Examiners (NBME) help prepare students for Step 2CK and therefore deserve the attention of clerkship directors. This paper reviews the literature pertaining to the factors that positively and negatively impact medical students’ performance on the shelf exams, including but not limited to performance in the pre-clinical years, clinical exposures, peer learning, active or team-based learning, length of clerkships, and order and number of previous shelf exams.
METHODS: The PubMed database was searched to identify studies describing factors influencing performance on shelf exam scores during medical school and strategies for improving shelf scores. Studies were identified through iterative searches using multiple keyword combinations related to NBME shelf examinations, NBME subject examinations, clerkship performance, academic achievement, and educational interventions. Inclusion criteria consisted of English-language studies published between 2005 and 2025 involving students at U.S. allopathic or osteopathic medical schools. The included studies were reviewed for relevance and methodological rigour, including consideration of study design, sample size, statistical analyses, and reported outcomes.
RESULTS: A robust pre-clinical education remains vital for success on NBME shelf examinations. Exam scores are also influenced by the number and order of previous exams. Increased clinical exposure, active learning, team-based approaches, and peer review sessions have not consistently shown improvements in performance.
CONCLUSIONS: This review underscores the importance of a foundational understanding of the basic sciences for student success on exams, while acknowledging that clerkship directors must balance their obligation to adequately prepare students for standardized testing with their mission to craft compassionate and competent future clinicians.
7. Diagnostic outcomes of the 2023 race-neutral and 2012 race-specific global lung function initiative spirometry equations in healthy Algerian adults: a cross-sectional comparative analysis.
主题：流行病学
期刊：The Libyan journal of medicine
发表日期：2026-Dec-31
内容状态：待评估
为什么值得看：包含可供初筛的摘要；仅作为选题线索，不代表证据质量结论。
In 2023, the Global Lung Function Initiative (GLI) introduced race-neutral spirometric reference equations (2023-GLI-RNEs) to address concerns of racial bias inherent in earlier 2012-GLI race-specific models. While the 2012-GLI Caucasian equations (2012-GLI-CEs) were previously identified to reflect contemporary adults’ Algerian spirometry, the 2023-GLI-RNEs applicability remains untested. This study aimed to compare the diagnostic outcomes of the 2023-GLI-RNEs and the 2012-GLI-CEs in a healthy adult Algerian population. A cross-sectional study was conducted on 488 Algerian healthy adults (49.6% female) aged 18-85 years. Participants underwent standardized plethysmography/spirometry in accordance with the most updated international guidelines. Z-scores and percent predicted values for FEV₁, FVC, and FEV₁/FVC ratio were computed using both 2012-GLI-CEs and 2023-GLI-RNEs. Diagnostic classifications (e.g. normal pattern, obstructive ventilatory impairment (OVI), non-specific ventilatory impairment (NSVI), or spirometric restrictive pattern (SRP), isolated low FEV1 (ILF)) were compared across the two equations. Classification changes between the two norms appeared to be relatively limited. Percent predicted FEV₁ and FVC values were significantly but slightly higher when interpreted using 2023-GLI-RNEs by 6% and 7% points, respectively, and the percent predicted FEV₁/FVC value was marginally lower by -0.9%. Compared to 2012-GLI-CEs, 2023-GLI-RNEs identified more cases of OVI (4.10% vs. 6.35%, respectively, p = 0.003), fewer cases of NSVI or SRP (2.05% vs. 0.20%, respectively, p = 0.008) or ILF (1.84 vs. 0.00%, respectively, p = 0.008), and comparable cases of normal spirometry (92.01% vs. 93.44%, respectively, p = 0.230). In a sample of healthy Algerian adults’ spirometric data, 2023-GLI-RNEs and 2012-GLI-CEs produced broadly comparable classifications of normal spirometry, although modest but statistically significant differences were observed in several abnormal spirometric categories.
8. Evaluation of the measles surveillance system in Chereponi District, Ghana, 2019-2024.
主题：生物统计与研究设计
期刊：Public health in practice (Oxford, England)
发表日期：2026-Dec
内容状态：待评估
为什么值得看：包含可供初筛的摘要；仅作为选题线索，不代表证据质量结论。
OBJECTIVES: To evaluate the design, implementation, and performance of the measles surveillance system in Chereponi District, Ghana, from 2019 to 2024 using the United States Centres for Disease Control and Prevention (CDC) Updated Guidelines for Evaluating Public Health Surveillance Systems.
STUDY DESIGN: Cross-sectional mixed-methods surveillance system evaluation.
METHODS: A mixed-methods evaluation was conducted across all 26 health facilities implementing measles surveillance and 13 purposively selected key informants. Quantitative data were collected through facility assessments and review of Surveillance Outbreak Response Management and Analysis System (SORMAS) records. Qualitative data were obtained through semi-structured interviews. Descriptive statistics, predictive value positive (PVP), Cochran-Armitage trend analysis, and thematic analysis were performed.
RESULTS: Timeliness was the strongest surveillance attribute (100%), followed by data quality (96.2%) and representativeness (88.5%). Acceptability (80.8%), simplicity (73.1%), and flexibility (61.5%) showed moderate performance, whereas usefulness (42.3%) and stability (38.5%) were weakest. During 2019-2024, 167 suspected measles cases were reported, of which 31 were laboratory confirmed (PVP = 18.6%; 95% CI: 13.4-25.3%). Laboratory confirmation rates increased significantly from 0% during 2019-2021 to 30.8% in 2024 (Cochran-Armitage χ2 = 14.57, P < 0.001). Qualitative findings attributed operational weaknesses to inadequate refresher training, staff attrition, transport constraints, delayed laboratory feedback, unreliable internet and electricity, and inconsistent community-based reporting.
CONCLUSIONS: The measles surveillance system was functional and supported timely case detection, laboratory confirmation, and outbreak response within Ghana’s IDSR framework. However, strengthening workforce capacity, logistics, laboratory feedback, digital infrastructure, and community-based surveillance is essential to improve system stability and advance measles elimination effort.
9. Correlation analysis of metabolically healthy obesity and erectile dysfunction: a cross-sectional study based on the NHANES database (2001-2004).
主题：流行病学
期刊：The aging male : the official journal of the International Society for the Study of the Aging Male
发表日期：2026-Dec-31
内容状态：待评估
为什么值得看：包含可供初筛的摘要；仅作为选题线索，不代表证据质量结论。
OBJECTIVE: To explore the relationship between metabolically healthy obesity (MHO) and erectile dysfunction (ED).
METHODS: Using National Health and Nutrition Examination Survey (NHANES) data from 2001 to 2004, 974 participants were classified into ED and non-ED groups. MHO diagnosis combined BMI-based obesity assessment with metabolic status evaluation per National Cholesterol Education Program-Adult Treatment Panel III (ATP III) criteria. Weighted univariate and multivariate logistic regression models assessed the association between obesity subtypes and ED. Subgroup analyzes examined association stability across populations. Two-sample Mendelian randomization (MR) evaluated causal relationships between individual metabolic syndrome criteria and ED occurrence.
RESULTS: In the optimized model, MHO was not associated with significantly increased ED risk compared to non-obese individuals. Metabolically abnormal obesity was associated with a 13% higher ED risk versus non-obese individuals (OR = 1.13, 95% CI: 1.02-1.25, p = 0.019). Subgroup analyzes showed no significant effect modification across subgroups (p > 0.05). Combined BMI and metabolic indicators demonstrated stronger predictive ability for ED than BMI alone, with waist circumference showing the strongest individual correlation (p = 0.001).
CONCLUSION: MHO does not confer elevated ED risk. Metabolically abnormal obesity is associated with a 14% increased ED risk compared to non-obese individuals.
10. Adaptation before and one year after liver transplantation: a longitudinal grounded theory study.
主题：流行病学
期刊：International journal of qualitative studies on health and well-being
发表日期：2026-Dec-31
内容状态：待评估
为什么值得看：包含可供初筛的摘要；仅作为选题线索，不代表证据质量结论。
INTRODUCTION: Liver transplant recipients undergo emotional, social and existential changes. Adaptation begins before surgery and continues long after discharge. However, no longitudinal grounded theory study has described this process across the transplantation trajectory. This study explored how individuals adapted by addressing their main concerns.
METHODS: Twelve adults (mean age 49.3 years, range 25-70) were interviewed pre- and post-transplantation. Data collection and analysis proceeded concurrently using Charmaz’s constructivist grounded theory and the constant comparative method.
RESULTS: The grounded theory conceptualised adaptation as striving for a life in social belonging. This process was explained through five interrelated categories: Comprehending, Accepting, Adapting, Coping and Balancing. Before transplantation, participants sought to maintain social belonging by preserving continuity in everyday life despite disruption, uncertainty and hope, reflecting existential concerns and conceptualised as optimising a disruptive situation. One year after transplantation, the process shifted from maintaining to reconstructing social belonging by rebuilding stability while managing vulnerability and ongoing uncertainty, reflecting existential concerns related to vulnerability and the future, conceptualised as managing an uncertain presence. Although the categories persisted across time, their meanings evolved throughout the transplantation trajectory.
CONCLUSION: Adaptation after liver transplantation involves creating a stable new normality, that accommodates uncertainty, gratitude, vulnerability and hope.
11. Global spatiotemporal analysis in hepatitis B third dose vaccine coverage from 1980-2023 across 204 countries and territories.
主题：流行病学
期刊：Human vaccines & immunotherapeutics
发表日期：2026-Dec-31
内容状态：待评估
为什么值得看：包含可供初筛的摘要；仅作为选题线索，不代表证据质量结论。
The Hepatitis B third dose (HepB3) vaccination is essential in preventing chronic infections, liver failure, and cancer. Despite progress, global coverage remains uneven, especially in low-income regions. This study analyzes the global and regional spatiotemporal trends in HepB3 vaccine coverage from 1980-2023 using the Global Burden of Disease (GBD) 2023 estimates. Data from GBD 2023, covering 204 countries and territories from 1980 to 2023, was analyzed to assess HepB3 vaccine coverage. Descriptive statistics summarized global and regional trends, and linear mixed-effects regression models evaluated the impact of time and region on coverage. The study also utilized choropleth maps to visualize global and regional coverage variations. Global coverage increased from near 0% in the 1980s to 81.82% in 2023. Regional disparities were evident, with Europe and Oceania showing higher coverage, while sub-Saharan Africa and South Asia lagged. Regression results indicated an annual increase in coverage of 2.50% (95% CI: 2.41%-2.59%, p < .0001). Albania had the highest global coverage at 98.2%, while Somalia had the lowest at 14%. Global HepB3 coverage has significantly improved, but geographic disparities persist. Targeted interventions in low-coverage areas and strengthened healthcare systems are needed to meet the 2030 universal coverage goal.
12. ‘When you hear such rumours, you get scared’: A comparison of vaccine-related concerns between the oral polio vaccine and Covid-19 vaccines among communities in Cameroon and Ethiopia.
主题：流行病学
期刊：Global public health
发表日期：2026-Dec-31
内容状态：待评估
为什么值得看：包含可供初筛的摘要；仅作为选题线索，不代表证据质量结论。
Despite widespread acceptance of the oral polio vaccine (OPV), vaccine hesitancy towards OPV in some countries presents a barrier to global eradication efforts. Between 2021 and 2022, the Global Polio Eradication Initiative implemented OPV campaigns concurrently with the roll-out of Covid-19 vaccines, for which vaccine hesitancy is well-documented. We sought to understand stakeholder perceptions of OPV and Covid-19 vaccines in Cameroon and Ethiopia. We implemented 32 focus group discussions (16 per country) with n = 216 caregivers of children under 5 and polio frontline workers to understand reasons for hesitancy, which included: fear of side effects, fear of vaccine overdosing, religious leaders being against vaccines and a lack of confidence in health workers, among others. These concerns were especially prominent toward the introduction of Covid-19 vaccines, less so toward OPV. Hesitancy reasons were more often reported as a concern held by community members, rather than participants themselves. Despite concerns, 69% of Ethiopian and 57% of Cameroonian respondents had received a Covid-19 vaccine. Our findings suggest a need for continued efforts to listen to caregiver and health worker concerns and co-create local solutions to enhance vaccine acceptability. Building trust amongst populations and addressing commonly held misconceptions is integral to vaccine introduction plans.
13. Immune reconstitution and viral reactivation after allogeneic hematopoietic stem cell transplantation in hematologic malignancies.
主题：流行病学
期刊：Hematology (Amsterdam, Netherlands)
发表日期：2026-Dec-31
内容状态：待评估
为什么值得看：包含可供初筛的摘要；仅作为选题线索，不代表证据质量结论。
OBJECTIVES: To evaluate associations between post-transplant immune reconstitution, Epstein-Barr virus (EBV) and cytomegalovirus (CMV) DNAemia/reactivation, and survival after allogeneic hematopoietic stem cell transplantation (HSCT).
METHODS: We conducted a retrospective observational cohort study of 312 patients with hematologic malignancies who underwent allogeneic HSCT between 2016 and 2024. Bone marrow B-cell proportion and peripheral blood lymphocyte subsets were assessed longitudinally by flow cytometry. EBV and CMV reactivation was monitored by quantitative PCR and analyzed as surveillance-defined reactivation status. Landmark-based logistic regression evaluated associations between immune-reconstitution parameters and viral reactivation; receiver operating characteristic analysis assessed model discrimination, and Cox regression evaluated overall survival determinants.
RESULTS: CMV and EBV DNAemia/reactivation occurred in 42.0% and 31.4% of patients, respectively, and were significantly correlated (ρ = 0.191, p = 0.028). Higher bone marrow B-cell proportion at sixmonths was associated with lower odds of CMV DNAemia/reactivation (OR = 0.947, 95% CI: 0.901-0.995, p = 0.034). For EBV, an exploratory interaction between 12-month CD8⁺ T-cell recovery and chronic GVHD was associated with EBV DNAemia/reactivation status (p = 0.039). Lower NK-cell levels were observed in patients with EBV and CMV coinfection (p = 0.021 and p = 0.036, respectively). Overall survival was mainly associated with relapse (HR = 5.5, p0.001) and conditioning regimen, whereas viral reactivation was not significantly associated with survival.
DISCUSSION: Intermediate immune-reconstitution landmarks showed distinct associations with surveillance-defined viral reactivation, particularly six-month B-cell proportion for CMV and CD8⁺ T-cell recovery in the context of chronic GVHD for EBV.
CONCLUSION: Longitudinal immune-reconstitution patterns may help characterize persistent post-HSCT immune vulnerability, although prospective studies incorporating viral timing and treatment-exposure data are needed for validation.
14. Metformin added to lifestyle intervention for physical function in older adults with obesity (DEMFOS trial): a randomised controlled trial.
主题：临床研究与数据方法
期刊：The lancet. Healthy longevity
发表日期：2027-Jul-01
内容状态：待评估
为什么值得看：包含可供初筛的摘要；仅作为选题线索，不代表证据质量结论。
BACKGROUND: Obesity in older adults is associated with functional decline and increased risk of disability. Lifestyle interventions improve physical function, but the role of metformin as an adjunct to lifestyle intervention in this population remains unclear. In this randomised clinical trial, we evaluated whether metformin enhances the effects of an intensive lifestyle intervention on physical function in older adults with obesity.
METHODS: The Diet and Exercise plus Metformin to Treat Frailty in Obese Seniors (DEMFOS) trial (ClinicalTrials.gov: NCT04221750 [completed]) was a randomised, placebo-controlled trial conducted at the Michael E DeBakey Veterans Affairs Medical Center and Baylor College of Medicine (Houston, TX, USA). Older adults (aged 65-85 years) with obesity (BMI ≥30 kg/m2) were randomly assigned to intensive lifestyle intervention (weight-management and exercise training) plus placebo, intensive lifestyle intervention plus metformin, or healthy lifestyle (diet education) plus metformin groups. The primary outcome was change in the modified physical performance test score at 6 months. The primary analysis was by intention-to-treat.
FINDINGS: Of 221 participants assessed for eligibility between March 30, 2021, and Dec 12, 2024, 114 were included in this study (mean age 72·8 years [SD 5·2]; 101 [89%] men and 13 [11%] women). 64 (56%) participants were White, 50 (44%) were Black, and 15 (13%) were Hispanic or Latino. Changes in physical performance test differed between groups (group-by-time interaction p<0·0001). At 6 months, physical performance test improvement was greater in the intensive lifestyle plus metformin group than in the healthy lifestyle plus metformin group (mean difference 2·5 points, 95% CI 1·2-3·8; p=0·0002), whereas there was no difference between the intensive lifestyle plus metformin and intensive lifestyle plus placebo groups (0·1 points, -1·2 to 1·4; p=0·92). Serious adverse events were infrequent and not attributed to the study interventions.
INTERPRETATION: Our findings suggest that in older adults with obesity undergoing intensive lifestyle intervention, metformin does not provide additional improvement in physical function. These results support prioritising lifestyle-based strategies to improve functional outcomes in this population.
FUNDING: US Department of Veterans Affairs.
15. State of the global tuberculosis epidemic: burden, progress towards WHO End TB Strategy targets and systemic challenges.
主题：流行病学
期刊：The Lancet. Microbe
发表日期：2027-Apr-26
内容状态：待评估
为什么值得看：包含可供初筛的摘要；仅作为选题线索，不代表证据质量结论。
Mycobacterium tuberculosis remains the leading cause of death from a single infectious pathogen globally despite decades of effective chemotherapy. In 2024, an estimated 10·7 million people developed tuberculosis, including approximately 620 000 people living with HIV (PLHIV), and tuberculosis caused an estimated 1·23 million deaths overall, including approximately 150 000 deaths among PLHIV. Men accounted for more than half of the cases, and children represented a substantial burden, reflecting ongoing transmission and diagnostic gaps. Approximately a quarter of the world’s population has been infected with M tuberculosis, with immunological evidence of previous or current infection. This population includes groups at increased risk of progression to tuberculosis disease, particularly those with recent infection, HIV, undernutrition, young age, or other clinical and social vulnerabilities. Following 3 years of COVID-19-related setbacks, global tuberculosis incidence declined modestly (1%) from 2023 to 2024 but remains higher than in 2020 and far off-track to meet the 2025 WHO End TB Strategy milestones. Case detection improved to 8·3 million notifications (78% of estimated incident cases), supported by expanded molecular diagnostics; however, prevalence surveys continue to reveal substantial proportions of bacteriologically confirmed but asymptomatic tuberculosis, highlighting persistent transmission and missed diagnoses. 30 high-burden countries accounted for 87% of cases, led by India, Indonesia, the Philippines, China, Pakistan, Nigeria, the Democratic Republic of the Congo, and Bangladesh. M tuberculosis-HIV co-infection remains a major driver of mortality in sub-Saharan Africa. Drug-resistant tuberculosis threatens progress: of 390 000 estimated multidrug-resistant or rifampicin-resistant tuberculosis cases in 2024, only 42% initiated treatment, although treatment success improved to 71%. Tuberculosis-preventive treatment reached 5·3 million people, including 58% of PLHIV and 25% of eligible household contacts, well below global targets. Persistent undernutrition, poverty, HIV, diabetes, smoking, alcohol use, air pollution, migration, and conflict continue to shape tuberculosis epidemiology. With financing at only 27% of global targets, accelerated prevention, proactive case finding, social protection, and sustained political commitment are essential to eliminate tuberculosis.
16. A qualitative exploration of pregnant women’s awareness and utilization of the Australian dietary guidelines for pregnancy.
主题：卫生政策与真实世界证据
期刊：International journal of qualitative studies on health and well-being
发表日期：2026-Dec-31
内容状态：待评估
为什么值得看：包含可供初筛的摘要；仅作为选题线索，不代表证据质量结论。
PURPOSE: The Australian dietary guidelines for pregnancy advise on optimal maternal intake. However, previous literature demonstrates suboptimal adherence to guidelines, with no evidence of the experience of sourcing nor uptake of the dietary guidelines among pregnant women. We aimed to explore pregnant women’s knowledge of nutrition information, including the current Australian dietary guidelines for pregnancy.
METHODS: Nineteen pergnant women were recruited using convenient sampling. Semi-structured interviews were analysed thematically, underpinned by the Capability, Opportunity, Motivation and Behaviour (COM-B) model and Theoretical Domains Framework.
RESULTS: Three themes were identified. Women showed limited awareness and/or utilization of the dietary guidelines for pregnancy, partially due to the inconsistent opportunity to receive guidelines from maternity healthcare providers. When seeking advice independently, women’s capability to acquire pregnancy-related food knowledge was primarily dedicated to food safety and to identifying reliable advice from other non-evidence-based information. Women’s motivation to utilize the dietary guidelines for pregnancy is low, with the perception that the broad recommendations may not meet their diverse, individual nutritional needs.
CONCLUSIONS: To optimize pregnancy nutritional intake, multi-disciplinary efforts should be made to increase the awareness of the dietary guidelines for pregnancy and to support the delivery and uptake of dietary advice among pregnant women.
17. TRANSformative perspectives on endometriosis research policy, and practice: Insights from multidisciplinary focus groups.
主题：卫生政策与真实世界证据
期刊：Global public health
发表日期：2026-Dec-31
内容状态：待评估
为什么值得看：包含可供初筛的摘要；仅作为选题线索，不代表证据质量结论。
Transgender and gender diverse (TGD) people with endometriosis have unique health needs. Current health research, policy, and clinical practice are developed within a biomedical and cisheteronormative paradigm that structurally excludes the TGD community, whose health needs remain largely unmet. This study aims to set an agenda for future research in the fields of endometriosis and gender diversity and to make recommendations for policy and practice through focus group methods. Twenty community members and professionals gathered for a two-day event at the Brocher Foundation in Switzerland. The group was heterogeneous in terms of gender, age, race, ability status, and professional background. On the first day, the participants gave twelve plenary presentations. On the second day, two plenary sessions and three parallel discussions in subgroups were facilitated. The data were analyzed through content analysis. Three main categories were identified: research, policy, and practice. Future studies should center the experiences of TGD people embodying different intersecting identities through transdisciplinary and community-based methods. The effects of gender-affirming care on endometriosis and the adequacy of endometriosis treatments for TGD people need to be further investigated. The education of healthcare providers is crucial to improve clinical practice, as well as a shift in health policy beyond cisheteronormativity.
18. The effects of sexual counseling based on the EX-PLISSIT and BETTER models on female sexual function after assisted reproductive treatment failure: a randomized clinical trial.
主题：临床研究与数据方法
期刊：Journal of psychosomatic obstetrics and gynaecology
发表日期：2026-Dec-31
内容状态：待评估
为什么值得看：包含可供初筛的摘要；仅作为选题线索，不代表证据质量结论。
BACKGROUN AND OBJECTIVE: Women who experience assisted reproductive treatment failure may be at risk of developing sexual dysfunction. This study compared the effects of two different sexual counselling models, EX-PLISSIT and BETTER, on the sexual function of women after an unsuccessful assisted reproductive treatment.
METHODS: This randomized clinical trial included 66 infertile women, out of the 72 initially recruited following assisted reproductive treatment failure, who referred to the Infertility Clinic, Mashhad, Iran. The EX-PLISSIT and BETTER groups received sexual counselling individually in two online and two in-person sessions. Data were collected using a Female Sexual Function Index (FSFI). Data analysis was performed using SPSS 25 with a significance level of P = 0.05.
RESULTS: There was no statistically significant difference in the total score of sexual function and the scores of subscales of desire, arousal, lubrication, orgasm, sexual satisfaction and pain between the two groups before the intervention (P > 0.05). Both groups showed significant improvement post-intervention. Their total mean scores for sexual function, desire, sexual satisfaction, arousal and lubrication were all higher than pre-intervention. Additionally, their scores for pain were significantly lower after the intervention (P < 0.001).
CONCLUSION: Sexual counseling, using either the EX-PLISSIT or BETTER model, improved the sexual function of women who experienced a failed assisted reproductive treatment.
19. Mental health first aid in the workplace: a reflexive thematic analysis of UK workers’ experiences.
主题：临床研究与数据方法
期刊：International journal of qualitative studies on health and well-being
发表日期：2026-Dec-31
内容状态：待评估
为什么值得看：包含可供初筛的摘要；仅作为选题线索，不代表证据质量结论。
BACKGROUND: Mental Health First Aid (MHFA) is used in workplaces to improve mental health literacy, reduce stigma, and promote help-seeking. This paper explores how employees perceive and engage with MHFA in work settings.
METHODS: This qualitative study was embedded within the EMPOWER cluster randomised controlled trial (Atanda et al., 2020). Twenty-four participants, including Mental Health First Aiders, recipients of MHFA support, employees, and senior managers, took part in semi-structured interviews. Guided by a relativist epistemological position, data were analysed using reflexive thematic analysis.(Atanda et al., 2020).
FINDINGS: Three themes were identified: (1) ambiguity surrounding the purpose of MHFA; (2) uncertainty and scepticism regarding the role and effectiveness of MHFA (subthemes: Anticipated Stigma, MHFA not addressing core concerns affecting staff well-being); and (3) risks to personal relationships following disclosure. Participants questioned the purpose, boundaries, and organisational value of MHFA, contributing to reluctance to engage. Disclosure decisions were shaped by concerns about stigma, confidentiality, and potential impacts on workplace relationships and career progression.
DISCUSSION: The findings suggest MHFA is most effective when part of a broader organisational commitment to employee wellbeing. Clarifying MHFA’s purpose, addressing workplace stigma, and tackling organisational sources of distress may improve engagement and strengthen mental health initiatives.
CLINICAL TRIAL REGISTRATION: Clinicaltrials.gov NCT04311203. Registered on 17 March 2020, protocol published in 2020.
20. Challenges to Achieving Universal Health Coverage Through Public Financial Management Reforms: Insights from the Implementation of Single Nodal Agency Reform in India.
主题：卫生政策与真实世界证据
期刊：Health systems and reform
发表日期：2026-Dec-31
内容状态：待评估
为什么值得看：包含可供初筛的摘要；仅作为选题线索，不代表证据质量结论。
Public Financial Management (PFM) reforms are being increasingly recognized for their potential to enhance health financing systems and advance progress toward Universal Health Coverage (UHC). Although theoretical frameworks have outlined the pathways through which PFM reforms operate, empirical evidence on their effectiveness in specific low- and middle-income country (LMIC) contexts remains limited. This paper examines the reform of the Single Nodal Agency (SNA) system in India, aimed at improving budget execution in centrally funded schemes, including the flagship health sector scheme, the National Health Mission (NHM). The study analyzes the gains and challenges associated with the reform and highlights the institutional features that are critical to its effectiveness. The study draws on an assessment of SNA implementation in two Indian states, Bihar and Odisha, using qualitative evidence from key informant interviews conducted across multiple administrative levels between February 2023 and February 2024. This was supplemented with data provided by state finance departments and NHM implementing agencies. Results indicate that the reform has achieved its intended gains in cash management, expenditure transparency, and improved alignment of central fund releases with scheme expenditures at the sub-national level. However, weak budget credibility, coupled with constraints in digital connectivity and limited personnel capacity to manage financial transactions, is likely to exacerbate inequities in access to scheme funds. The increased emphasis on spending has heightened compliance pressures on fund utilization, while attention to actual health system outcomes remains limited. In sum, a conducive institutional environment is essential for reaping benefits through PFM reforms in LMICs.
21. From giant components to communities: community-level insights for prioritizing interventions within large clusters of HIV-1 transmission networks.
主题：流行病学
期刊：Infectious Disease Modelling
发表日期：2027-Mar
内容状态：待评估
为什么值得看：包含可供初筛的摘要；仅作为选题线索，不代表证据质量结论。
Large clusters in HIV-1 molecular networks contain a substantial proportion of people living with HIV and dominate local epidemics; however, their large size and complex structure pose a challenge for effective public health interventions. We developed an analytical framework to partition the large cluster into small groups for precise intervention. In the HIV-1 CRF07_BC molecular transmission network in Guangzhou, China (2008-2020), a giant component (681 members) was partitioned into 34 communities with dense internal and sparse external links. All 378 inter-community links involved high-centrality members from Community 1 (P < 0.001) and phylogenetic analysis identified Community 1 as the most likely ancestral source of the giant component (marginal probability = 0.989). Exponential random graph models (ERGMs) revealed significant homophily effect among members with specific characteristics in the giant component and its large communities, highlighting potential outbreaks within specific subgroups. Partitioning giant components into communities may be a promising approach to help develop community-level interventions and could improve the effectiveness of interventions targeted at large clusters.
22. Local governance and health equity: Practical reflections from Chinese crisis governance.
主题：卫生政策与真实世界证据
期刊：Global public health
发表日期：2026-Dec-31
内容状态：待评估
为什么值得看：包含可供初筛的摘要；仅作为选题线索，不代表证据质量结论。
This study examines mass testing in three Chinese cities since 2020 as a ‘stress test’ for local governance. It analyses the governance performance of Shenzhen, Nanjing and Wuxi in terms of efficiency, equity and community resilience. Using Melbourne’s pandemic lockdown as a reference case, it discusses the underlying mechanisms linking different governance approaches to health equity outcomes. The study adopts a nested governance framework to examine how governance capacities and policy logics operate across different local contexts. The results indicate that Chinese cities can efficiently complete mass testing within a few days, but face pressures related to health equity and community resilience. Melbourne’s lockdown governance emphasised participation and institutional transparency, but advanced policies at a relatively slower pace. This study recommends building a dynamic governance mechanism that better balances efficiency and equity.
23. Ecological restructuring of the nonbacterial fecal microbiome in obesity across human cohorts.
主题：可复现研究与开放科学
期刊：Gut microbes
发表日期：2026-Dec-31
内容状态：待评估
为什么值得看：包含可供初筛的摘要；仅作为选题线索，不代表证据质量结论。
Obesity is a complex metabolic disorder increasingly linked to alterations in the gut microbiome. While most research has focused on bacterial communities, the contribution of nonbacterial components including viruses, archaea, and eukaryotic microorganisms remains insufficiently characterized. Here, we performed a multicohort analysis to investigate the role of the nonbacterial gut microbiome in obesity across three independent human cohorts. Using compositional analyses adjusted for key covariates and network based approaches, we identified consistent multikingdom alterations associated with obesity. Individuals without obesity showed a reproducible enrichment of methanogenic archaea, particularly Methanobrevibacter smithii and Methanobrevibacter millerae, whereas individuals with obesity were characterized by increased abundance of bacteriophages from the class Caudoviricetes. In an elderly cohort, eukaryotic taxa such as Blastocystis spp. were additionally associated with the without obesity group. These patterns were largely consistent across cohorts and robust to sex stratification. Beyond taxonomic differences, ecological network analyses revealed substantial reorganization of microbial interactions in obesity. The identity and composition of hub taxa differed significantly between obesity and without obesity networks across all cohorts, indicating a shift in the taxa occupying central ecological roles. Notably, these differences were observed even when similar microbial kingdoms were represented, underscoring the importance of species-level resolution. Collectively, our findings demonstrate that obesity is associated with coordinated compositional and ecological alterations across the nonbacterial gut microbiome. This multikingdom perspective expands current understanding of microbiome dysbiosis in metabolic disease and highlights the archaeome and virome as potential contributors to host metabolic health.
24. Longitudinal modelling of microbiome subcommunities reveals parity-dependent dynamics during pregnancy and postpartum.
主题：临床研究与数据方法
期刊：Gut microbes
发表日期：2026-Dec-31
内容状态：待评估
为什么值得看：包含可供初筛的摘要；仅作为选题线索，不代表证据质量结论。
BACKGROUND: Dysregulation of maternal adaptations to pregnancy due to high pre-pregnancy BMI (pBMI) is associated with worsened health outcomes for mothers and children. The role of the gut microbiome in these adaptations remains unclear.
METHODS: Stool samples were collected from pregnant participants (n = 52) enrolled in the Be Healthy in Pregnancy study (NCT01689961) during first, second, and third trimesters, and 6-months postpartum, along with samples from their infants at 6 months of age. Following 16S rRNA gene sequencing, we implemented time-aligned LDA (TALDA) using a time-weighted sampling strategy with exponentially decaying weights to construct time-proximal cohorts, applied LDA to each cohort independently, and aligned resulting topics using the alto R package. Infant samples were analyzed using standard LDA.
RESULTS: Seven distinct subcommunities were identified, one of which represented perineal contamination and was excluded from further analysis. Remaining subcommunities had distinct taxonomic definitions which remained stable throughout pregnancy (mean cross-cohort stability 0.899) while subcommunity proportions within individuals varied. Multiparous individuals showed greater shifts in subcommunity proportions during early pregnancy, while primiparous individuals displayed progressively increasing shifts with the largest changes during the transition from pregnancy to postpartum. High pBMI was associated with reduced microbiome remodelling, particularly among multiparous individuals. In exploratory analyses, maternal SCFA-producing subcommunity abundance at late pregnancy was positively associated with infant Bifidobacterium-dominated subcommunity proportions at 6 months, while pBMI > 25 was independently associated with lower infant Bifidobacterium.
CONCLUSION: TALDA effectively distinguished between stable subcommunity definitions and dynamic subcommunity proportions, revealing that the microbiome maintains functional organization while subcommunity proportional contributions shift over the course of pregnancy and postpartum. These maternal dynamics may have intergenerational consequences through their influence on infant gut colonization. This work demonstrates that maternal factors modify microbiome trajectories and supports the existence of an ecological memory of pregnancy history within the maternal gut microbiome.
25. Towards standardized gut microbiota diagnostics: normobiosis beyond geographical borders.
主题：可复现研究与开放科学
期刊：Gut microbes
发表日期：2026-Dec-31
内容状态：待评估
为什么值得看：包含可供初筛的摘要；仅作为选题线索，不代表证据质量结论。
Defining clinically meaningful reference states of the human gut microbiota remains a major barrier to the clinical translation of microbiome testing, largely due to variability across populations. We aimed at evaluating whether dysbiosis can be identified in a standardized, geography-independent manner, using a composite, system-level microbiome diagnostic framework. We performed a retrospective observational analysis of 831 adult stool samples collected from healthy individuals and patients with inflammatory bowel disease, irritable bowel syndrome, or other chronic inflammatory conditions across seven countries. In addition, U.S. National Institute of Standards Technology (NIST) human fecal reference materials were analyzed. Dysbiosis was assessed using a fixed microbial marker panel and composite distance metrics anchored to a clinically validated healthy Scandinavian reference population, using GA-map® Dysbiosis Test as an exemplar of this diagnostic framework. The diagnostic framework reproducibly identified normobiosis and dysbiosis across geographically distinct populations (USA, Canada, Germany, Italy, and the UK). Severe dysbiosis was detected with high specificity (93.6%) and positive predictive value (90.2%), independent of subjects’ country of origin. Healthy individuals showed highly comparable dysbiosis index distributions across regions. These findings demonstrate that clinically useful dysbiosis diagnostics do not require geographically tailored reference populations and support the feasibility of standardized, geography-independent microbiome diagnostics for clinical application.
26. Rethinking vaccine mandates through the lens of penalties and incentives: A 7S framework approach.
主题：卫生政策与真实世界证据
期刊：Global public health
发表日期：2026-Dec-31
内容状态：待评估
为什么值得看：包含可供初筛的摘要；仅作为选题线索，不代表证据质量结论。
Conceptually, current definitions of vaccine mandates involve two key elements: the requirement to be vaccinated and sanctions for non-compliance. However, during COVID-19, governments frequently introduced vaccine mandates in contexts where people were already denied access to work, travel, and social activities due to lockdowns and restrictions. This important context disrupts the standard operation of vaccine mandates. Accordingly, this paper explores COVID-19 vaccine mandates in New South Wales (Australia), France, Israel, Malaysia, Singapore, and Vietnam, where mandates primarily served as incentives to restore basic rights to travel, work, and access public spaces, that were restricted during the pandemic. Through document analysis and key informant interviews, the paper examines how governments employed this “removal and restoration” model and explores how mandate policy instruments create incentive structures. In discussing the implications of mandates in relation to lockdowns and restrictions, and the perception of mandates as “coercive offers”, the paper proposes a revised conception and a 7S vaccine mandate framework by adding synergy and sustainment to the existing 5S model. It concludes by outlining the significance of this revised conception and framework for vaccine mandate policy research, design, and communication.
27. Effects of serotonergic pharmacological manipulation on exercise performance and central fatigue: a systematic review and three-level meta-analysis.
主题：临床研究与数据方法
期刊：Journal of the International Society of Sports Nutrition
发表日期：2026-Dec-31
内容状态：待评估
为什么值得看：包含可供初筛的摘要；仅作为选题线索，不代表证据质量结论。
BACKGROUND: Exercise-induced fatigue is a complex, non-pathological state that acutely limits physical performance, and the serotonergic (5-HT) system has been proposed as an important modulator of its central components. This systematic review and meta-analysis aimed to clarify the effects of serotonergic pharmacological manipulation on exercise-related outcomes.
METHODS: Following PRISMA guidelines, we systematically searched PubMed, Scopus, Web of Science, Cochrane Central, and SportDiscus from inception to August 2025. Randomized controlled trials examining the effects of serotonergic pharmacological manipulation on exercise-related outcomes in healthy adults were included. Study selection, data extraction, and risk-of-bias assessment using RoB 2.0 were conducted independently. Pooled effects were synthesized using three-level random-effects models, and the certainty and robustness of the evidence were examined in additional analyses.
RESULTS: Twenty-one randomized controlled trials involving 248 healthy adults were included in the systematic review, of which 19 studies involving 229 participants were included in the meta-analysis. In the primary models, serotonergic pharmacological manipulation was associated with small reductions in evoked motor response (Hedges’ g = -0.24, 95% CI -0.46 to -0.02), time-domain EMG (Hedges’ g = -0.18, 95% CI -0.33 to -0.02), heart rate (Hedges’ g = -0.17, 95% CI -0.34 to -0.01), and blood glucose (Hedges’ g = -0.50, 95% CI -0.89 to -0.11). Voluntary activation showed a borderline negative pooled estimate (Hedges’ g = -0.20, 95% CI -0.40 to 0), whereas ratings of perceived exertion showed a positive but statistically uncertain pooled estimate (Hedges’ g = 0.63, 95% CI -0.01 to 1.28). Resting twitch torque showed a small positive pooled effect (Hedges’ g = 0.12, 95% CI 0.04 to 0.19), whereas superimposed twitch torque, maximal voluntary contraction, prolactin, lactic acid, and time to task failure did not show clear overall effects.
CONCLUSIONS: Overall, this meta-analysis indicates that serotonergic pharmacological manipulation has outcome-specific effects on exercise-related fatigue rather than a single uniform influence across domains. The most consistent primary-model signals were found for evoked motor response, time-domain EMG, heart rate, and blood glucose, whereas overt performance and perceptual outcomes remained more variable. By integrating evidence across different serotonergic interventions and exercise paradigms, these findings improve our understanding of how 5-HT-related mechanisms may contribute to central fatigue during exercise.
28. Efficacy and safety of doravirine/islatravir for HIV-1: a GRADE-assessed systematic review and meta-analysis of randomized controlled trials.
主题：临床研究与数据方法
期刊：HIV research & clinical practice
发表日期：2026-Dec-31
内容状态：待评估
为什么值得看：包含可供初筛的摘要；仅作为选题线索，不代表证据质量结论。
BACKGROUND: The combination of doravirine and islatravir (DOR/ISL) is a novel two-drug regimen for HIV-1. Early development faced challenges due to dose-dependent immunological signals. We aimed to synthesize the evidence on the efficacy and safety of DOR/ISL across all treatment-experience categories, specifically evaluating the impact of islatravir dosage (0.25 mg vs 0.75 mg) on clinical and immunological outcomes.
METHODS: We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) following PRISMA guidelines. We searched PubMed, Embase, Cochrane Library, and Google Scholar from inception through April 2026. Primary outcomes were virological suppression (<50 copies/mL) and mean change in CD4+ T-cell count at week 48. Data were pooled using random-effects models. Islatravir dose was evaluated as a pre-specified moderator. Quality was assessed using Cochrane RoB 2.0 and certainty of evidence was graded using the GRADE approach.
RESULTS: Seven RCTs (n = 3,600 participants) were included. At Week 48, DOR/ISL showed non-inferior suppression rates (RR 1.01 [95% CI 0.99-1.02]; p = 0.516; moderate-certainty evidence) and a statistically significant reduction in virological failure risk (RR 0.55 [0.33-0.92]; p = 0.022) compared to active control. Overall CD4+ gain was lower with DOR/ISL (MD -34.55 cells/μL; low-certainty evidence); however, a profound moderator effect of dose was observed (p < 0.0001). The 0.75 mg dose was associated with significant CD4+ and lymphocyte declines, whereas the approved 0.25 mg dose was immunologically neutral. DOR/ISL was weight-neutral compared to bictegravir/emtricitabine/tenofovir alafenamide (MD -0.25 kg [-0.66 to 0.16]; low-certainty evidence).
CONCLUSION: DOR/ISL 100/0.25 mg once daily achieved virological suppression comparable to standard-of-care ART regimens and was associated with lower rates of virological failure compared with active comparators. The immunological safety concerns observed in early trials were successfully resolved by dose optimization. These findings support the use of DOR/ISL (IDVYNSO) as a potential treatment option for both treatment-naïve and virologically suppressed adults while emphasizing long-term safety surveillance.
29. Professional identity formation among participants in a longitudinal pediatric program for final year medical students: a qualitative case study.
主题：生物统计与研究设计
期刊：Medical education online
发表日期：2026-Dec-31
内容状态：待评估
为什么值得看：包含可供初筛的摘要；仅作为选题线索，不代表证据质量结论。
OBJECTIVE: To explore aspects of professional identity formation in participants of a longitudinal pediatric program for final-year medical students in the US.
INTRODUCTION: Many institutions have specialty-specific courses focused on the transition to residency, typically at the end of medical school. This study examines professional identity formation among participants of a longitudinal fourth-year Pediatric Concentration.
METHODS: Authors used a case study design for this qualitative research study using semi-structured interview questions based on a conceptual model of professional identity formation. Authors used purposeful sampling to identify study participants who were randomly selected from former students who completed the program between 2019 and 2021. Three interviewers independently conducted interviews with individual program participants. Thematic analysis with coder reliability was utilized for data analysis; two investigators independently coded and performed inter-rater reliability (IRR) on three sets of questions from transcriptions. After ensuring acceptable IRR, investigators coded the remaining questions and subsequently identified themes and sub-themes.
FINDINGS: Eleven former students completed interviews. Following initial independent coding, IRR for three questions was 80%. After coding the 11 interviews, investigators determined that code saturation was achieved. They subsequently identified six main themes: career development, interpersonal connection, personal growth, positive role models, skill-building, and supportive learning environment. Two cross-cutting themes were recognized throughout the data: sense of belonging and gaining confidence toward starting residency.
CONCLUSIONS: Participants in a longitudinal specialty-specific program in the final year of medical school experienced professional identity formation through a supportive learning environment fostering connection and personal growth while building skills, surrounded by positive role models. This community of practice cultivated a sense of belonging and helped participants gain confidence toward their residency and career. This longitudinal, specialty-specific approach to the final year of medical school may enhance professional identity formation for students entering all specialties and could facilitate transition to internship.
30. Effects of combined versus single supplementation of creatine and beta-alanine on aerobic and anerobic performance: a systematic review and network meta-analysis.
主题：临床研究与数据方法
期刊：Journal of the International Society of Sports Nutrition
发表日期：2026-Dec-31
内容状态：待评估
为什么值得看：包含可供初筛的摘要；仅作为选题线索，不代表证据质量结论。
BACKGROUND: Creatine (Cr) and β-alanine (BA) are among the most studied ergogenic supplements, acting on distinct physiological pathways-Cr facilitates phosphocreatine resynthesis and rapid ATP turnover, while BA elevates intramuscular carnosine to enhance acid-base buffering. Although both compounds improve high-intensity performance independently, the ergogenic potential of their combined use remains uncertain.
OBJECTIVE: To systematically evaluate and compare the isolated and combined effects of Cr and BA supplementation on aerobic and anaerobic performance indices using a network meta-analytic approach.
METHODS: Following PRISMA guidelines, a comprehensive search of PubMed, Scopus, and Web of Science (to August 2025) identified randomized controlled trials (RCTs) examining Cr, BA, or Cr + BA supplementation (≥2 weeks) in healthy adult athletes. Fifty-two RCTs (PEDro ≥ 6) met the inclusion criteria. Standardized mean differences (SMD) and 95% confidence intervals (CI) were computed within random effects models. Performance outcomes included sprint, jump, agility, upper- and lower-body muscular endurance (UME, LME), and repeated-sprint ability (RSA).
RESULTS: Cr supplementation significantly improved sprint performance (SMD = -0.64; p = 0.04), jump performance (SMD = 0.33; p = 0.002), RSA (SMD = -0.78; p = 0.01), and UME (SMD = 0.43; p = 0.01) versus placebo, with P scores ≥ 0.90 across these domains. In contrast, BA supplementation produced non-significant or context-specific effects, and combined Cr + BA showed no synergistic benefits. Agility and LME outcomes remained unaffected (p > 0.05). Heterogeneity ranged from low to moderate (I2 = 0-73%), with no global inconsistency or substantive publication bias.
CONCLUSION: Evidence indicates Cr supplementation alone yields the most consistent improvements in high-intensity and anaerobic performance by enhancing phosphocreatine recovery and neuromuscular output. BA’s buffering advantage appears task-specific and insufficient to augment Cr’s ergogenic efficacy. Co-supplementation of Cr and BA offers no additional advantage beyond Cr monotherapy. Standardized, long-term, multi-arm RCTs are warranted to further clarify potential interactive mechanisms and sex or sport-specific responses.