公共卫生文献雷达（2026-08-08）
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1. Retention of fellows to the faculty at a research-intensive academic medical center: a mixed-methods study.
主题：流行病学
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: As clinical practice provides >50% of medical schools’ revenue, research-intensive medical schools often seek to retain fellows with clinical-care interests. Fellows’ considerations when deciding whether to stay at research-intensive institutions where they trained remain understudied. We sought to identify experiential factors associated with faculty-position offers and decisions of fellows in training.
METHODS: We conducted a mixed-methods study using a survey and semi-structured interview. We invited 471 fellows training in all clinical departments at our institution to complete an anonymous survey between April and June 2021 to examine their level of agreement (strongly disagree [1] to strongly agree [7]) with positive training and mentoring experiences and their academic-medicine career goals in association with being offered a position and, if offered, accepting or declining. After survey completion, we invited fellows for interviews about their decision-making to seek, accept, or decline post-fellowship faculty-positions as well as what our institution could do to encourage fellows to accept offered positions.
RESULTS: We analyzed survey data from 168 (35.7%) fellows. Of 48 fellows who were offered faculty positions, 21 accepted and 27 declined; 56 fellows were not offered a position and 64 were too early in training to have received an offer. Fellows who were offered/accepted positions reported higher mean (SD) agreement with positive training (5.9 [1.2]; p < 0.02) and mentoring (6.1 [1.0]; p < 0.001) experiences and having academic-medicine career goals (5.8 [0.8]; p < 0.001) than fellows in other faculty-offer groups. In interviews, 24 fellows reported career goals and institutional resources as influencing decisions. Fellows described institutional opportunities for intervention, especially enhanced communication about institutional priorities and potential positions.
CONCLUSIONS: Clear communication with clinical fellows about their academic-medicine career goals and fellowship-training and mentoring experiences can inform decision-making about faculty offers and better equip institutional leaders to retain fellows who align with institutional needs.
2. Large language model use in dental education: a cross-sectional multi-country study.
主题：流行病学
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: Large language models (LLMs) are increasingly used in higher education, but multi-country evidence on dental students’ use, verification, and integrity practices is limited.
OBJECTIVE: To compare senior dental students’ LLM use, perceived time and academic impact, reliability judgements, verification practices, and integrity safeguards across five countries.
METHODS: An anonymous cross-sectional online survey was administered to final-year dental students in the United Arab Emirates (UAE), Jordan, Malaysia, Oman, and Brazil. Measures included tools used, frequency and motivations, learning activities, perceived time and academic impact, verification frequency and strategies, guideline awareness, and integrity safeguards. Analyses used Kruskal-Wallis and chi-square tests with Benjamini-Hochberg adjustment, effect sizes, Spearman correlations, and ordinal logistic models.
RESULTS: In total, 454 students participated (UAE 160, Jordan 101, Malaysia 75, Oman 62, Brazil 56; mean age 22.9; 74.9% female). ChatGPT predominated (95.9%), followed by Gemini, formerly Bard (18.0%), DeepSeek (16.4%), and Claude (7.4%). Tool diversity varied across country-based cohorts, with Oman showing greater multi-tool uptake. Use was frequent (several times/week 39.2%, daily 28.6%). Key motivations were saving time (73.0%), clarifying concepts (56.9%), and summarising (54.1%). Common activities included understanding complex concepts (75.3%), summarising lecture notes (70.0%), exam preparation (61.5%), and assignment research (53.2%); exam-time assistance was reported by 25.6%. Verification was ‘always’ 20.0% and ‘often’ 34.1%, varying across country-based cohorts, with Oman verifying less frequently than other cohorts. Guideline awareness was 40.3% overall (UAE 61.3% vs Brazil 8.3%). Integrity safeguards commonly involved paraphrasing (69.6%), citations (39.2%), and plagiarism checks (38.0%); disclaimers were uncommon (9.2%). LLM-use frequency correlated with broader academic use (ρ = 0.289) but not with integrity concern (OR = 0.963).
CONCLUSIONS: LLM use is widespread and heterogeneous across settings, including non-trivial higher-stakes use. Dental programmes should implement explicit training in verification, evidence traceability, and disclosure, supported by clear, enforceable guidance and assessment designs aligned with real-world LLM practices.
3. Comparative safety profiles of antibody-drug conjugates: a real-world analysis of monotherapy and combination regimens in solid tumors.
主题：流行病学
期刊：Drug delivery
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 expanding clinical use of Antibody-Drug Conjugates (ADCs) necessitates a clearer understanding of their real-world toxicity profiles across diverse clinical settings. This retrospective pharmacovigilance study analyzed 19,697 adverse event (AE) reports for seven approved ADCs from the FDA Adverse Event Reporting System (FAERS) database (Q1 2004 to Q1 2025). Using disproportionality analysis validated by multivariable logistic regression, we identified safety signals for both monotherapy and combination regimens. The analysis revealed that toxicity profiles are strongly driven by an ADC’s molecular structure and treatment setting. Target-specific ‘on-target, off-tumor’ effects were prominent, linking Nectin cell adhesion molecule 4 (NECTIN-4) targeting to skin reactions, Trophoblast cell-surface antigen 2 (TROP2) to gastrointestinal toxicities, and both folate receptor α (FRα) and tissue factor (TF) to ocular disorders. Furthermore, payload and linker types drove distinct toxicities; topoisomerase I inhibitors were associated with increased respiratory toxicity and mortality, while non-cleavable linkers conferred a significantly stronger risk of hepatobiliary toxicity. Combination regimens not only amplified specific risks, such as endocrine disorders with immune checkpoint inhibitors (ICIs), but also fundamentally reshaped toxicity kinetics, accelerating AE onset with ICIs while significantly delaying it with other combinations. This real-world analysis confirms that ADC toxicities are highly specific to their molecular design and clinical context, highlighting that understanding these complex structural and kinetic interplays is essential for optimizing safety management in clinical practice.
4. Experiences of a postpartum depression prevention programme in a circumpolar setting: insights from pregnant women and healthcare providers.
主题：流行病学
期刊：International journal of circumpolar 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。
Supporting maternal mental health is a priority in circumpolar settings, where seasonality and constrained service availability can limit psychosocial support. This qualitative study explored pregnant women’s and healthcare providers’ experiences of a postpartum depression prevention programme and perspectives on integrating it into routine antenatal care in Arkhangelsk, Northwest Russia. Four focus group discussions with pregnant women (n = 17) and individual interviews with four healthcare providers were analysed using reflexive thematic analysis. Participants described the programme as providing trusting spaces for sharing, expert-led preparation for childbirth and the postpartum period, and brief individual follow-up after birth. Women reported greater confidence in identifying signs of vulnerability, articulating needs, and accessing support. Providers highlighted that these benefits depended on feasible scheduling, group formats, reusable materials, and coordinated delivery across professionals to avoid fragmentation. System-level factors (reach, retention, and cross-provider coordination) were seen as central for sustained uptake and routine integration. The findings suggest that the programme’s contribution lies in the interaction between participant experiences of support and the organisational conditions needeed to sustain them in routine antenatal care. Preventive perinatal mental health programmes in circumpolar contexts can strengthen preparedness and help-seeking when designed for relational participation and supported by coordinated service structures.
5. Early-life microbiota in the LIMIT cohort: unveiling meconium microbiota types beyond maternal lifestyle.
主题：流行病学
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。
INTRODUCTION: Early gut microbiota development plays an important role in lifelong human health, and meconium offers a unique matrix to understand prenatal microbial exposures. This study from the LIMIT cohort aimed at investigating associations between maternal pre-pregnancy body mass index (pre-BMI) and gestational weight gain (GWG), as well as other maternal lifestyle and environmental factors, with the structure of meconium microbiota at delivery.
METHODS: Two hundred pregnant women were enrolled during the pre-hospital care before birth at Fondazione IRCCS Policlinico San Matteo (Pavia), according to the inclusion/exclusion criteria. Mothers were grouped based on their GWG gain category according to the IOM guidelines. 168 meconium samples were analyzed using a targeted long-reads sequence approach. Bacterial 16S rRNA (V1-V8) amplicons were sequenced using the Oxford Nanopore PromethION platform. Supervised analyses assessed associations between maternal variables and bacterial diversity, while an unsupervised learning approach based on the Partitioning Around Medoids (PAM) clustering algorithm was applied to identify specific microbial clusters unrelated to the cohort’s metadata.
RESULTS: No significant associations were observed between GWG, pre-BMI or other lifestyle factors and overall microbial diversity. Unsupervised learning revealed five distinct meconium microbial clusters, i.e. “microbiota-types”, related to different taxonomic profiles, determined by the variations in specific bacterial species.
CONCLUSION: No significant influence of the studied variables was observed on meconium microbiota. However, the meconium microbial communities appear to organize into enterotype-like structures, highlighting the need for longitudinal studies to identify key determinants of early colonization.
6. The hidden patterns of alignment: exploring variability between generative AI and human.
主题：流行病学
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: Aligning medical education curricula with standardized competency-based assessments is a multifaceted task that requires accuracy and consistency. While generative artificial intelligence (GenAI) models offer potential assistance, their performance compared to that of human subject matter experts remains unclear. This study investigates the consistency, accuracy, and strategies of human- and AI-generated alignments of pharmacological topics with the United States Medical Licensing Examination (USMLE) Step 1 content.
METHODS: A comparative case study examined curricular alignment results produced by GenAI models and human experts. Agreement percentages and pairwise correlation coefficients were calculated to assess consistency and consensus within and between the two groups, highlighting similarities and differences in alignments. We also examined challenges, strategies, and the impact of time constraints on the alignment task.
RESULTS: GenAIs exhibited higher inter-rater reliability in within-group comparisons, with exact agreement percentages ranging from 60% to 79% and stronger correlations. In contrast, human raters demonstrated greater variability, with exact agreement percentages between 14% and 66% and weaker correlations. While partial agreement improved alignment for both groups, GenAIs maintained higher overall consistency and consensus. On the other hand, only two human raters and all GenAI models exhibited high inter-rater reliability in between-group comparisons. GenAIs generated alignments based on contextual analysis and hierarchical mapping, while humans engaged in iterative refinement using their expertise and reflection. Time constraints had a minimal impact on GenAIs, whereas it was acknowledged as a limiting factor for human performance.
CONCLUSION: GenAIs can efficiently provide accurate and consistent alignments of pharmacological content in medical curricula but lack the sophisticated decision-making capabilities of human experts. While human alignments show variability due to human experts’ diverse perspectives and backgrounds, trained experts make more contextually informed decisions. A conceptual model of Curricular Human-AI Teaming (Curricular HAT) could combine these complementary strengths to enhance the workflow and outcomes of curricular alignment. The model supports the transparency and scalability of human-AI collaboration while maintaining the responsibility of human judgment and ethical use of GenAI.
7. No difference in anxiety symptoms between women with unilateral and bilateral ovarian endometriosis: a prospective cross-sectional study.
主题：生物统计与研究设计
期刊：Annals of medicine
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。
OBJECTIVE: This study aimed to investigate whether women with unilateral and bilateral OMA differ in anxiety symptoms, and secondarily in depressive symptoms and sexual dysfunction symptoms, and to evaluate the independent contribution of chronic pelvic pain to psychological outcomes.
STUDY DESIGN: This study, a prospective, cross-sectional study, included 149 women aged 20-35 who had OMA but were not pregnant and had a desire to become pregnant. There were 79 women with unilateral OMA and 70 women with bilateral. The Zung Self-Rating Anxiety Scale, Self-Rating Depression Scale, and Female Sexual Function Index were administered at enrolment. Multivariable linear regression models were adjusted for age, BMI, chronic pelvic pain, dysmenorrhoea, primary infertility, and medication use. Post-hoc power analysis was performed.
RESULT: The average age of the patients was 27.45 ± 3.44, with an average BMI of 19.46 ± 2.28. 29.53%(44/149) of the patients had mild or moderate anxiety, while 38.92%(57/149) had mild or moderate depression. Among the 103 patients with a history of sexual activity, 67.96%(70/103) had sexual dysfunction. In multivariable analyses, cyst laterality was not significantly associated with anxiety symptoms (adjusted B = -2.58[-5.19, 0.03], p = 0.052), depressive symptoms (adjusted B = -1.86[-5.25, 1.53], p = 0.279), or sexual dysfunction symptoms (adjusted B = -0.91[-2.01, 0.19], p = 0.072). Chronic pelvic pain independently predicted anxiety symptoms (p = 0.01) and depressive symptoms (p = 0.025). Post-hoc power analysis indicated an achieved power of 50% for the primary SAS comparison.
CONCLUSION: In this study, the prevalence of anxiety, depression and sexual dysfunction was high in OMA, but there was no significant difference between unilateral and bilateral OMA. Chronic pelvic pain, rather than cyst laterality, independently predicted psychological distress. These findings underscore the importance of comprehensive pain assessment and routine psychological screening for all women with OMA.
8. Probable sarcopenia and bone health in transfusion-dependent beta thalassemia patients.
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: Low bone mass is common in adults with transfusion-dependent thalassemia (TDT). While sarcopenia contributes to frailty, studies examining its association with falls and fractures in TDT remain limited. This study aimed to determine the prevalence of probable sarcopenia in adults with transfusion-dependent thalassemia and to identify related risk factors.
METHODS: This cross-sectional study included 45 adult TDT patients followed at Bursa City Hospital Hematology Clinic between September 2023 and September 2024, and 40 age- and sex-matched healthy controls. Bone mineral density (BMD) was assessed per Turkish Endocrinology Osteoporosis Guidelines and classified as normal, osteopenia, or osteoporosis. Probable sarcopenia was evaluated according to EWGSOP2 criteria based on handgrip strength measurements[14]. Anthropometric data and biochemical parameters were recorded.
RESULTS: Eighty-five participants (52.9% TDT, 47.1% controls) were evaluated. The mean BMI was 21.6 ± 1.99 kg/m2. No significant differences were observed in calcium, vitamin D levels (p = 0.492, p = 0.068, p = 0.911, respectively). Handgrip strength was significantly lower in TDT patients (24.96 ± 12.75 kg) than in controls (33.9 ± 15.39kg; p = 0.004). Probable sarcopenia was identified in 13.3% of patients and in none of the controls (p = 0.027).
DISCUSSION: Routine screening for probable sarcopenia should be incorporated into fracture prevention strategies for TDT, particularly among osteoporotic individuals. Therefore, the findings of this study should be interpreted as exploratory observations rather than confirmatory evidence.
CONCLUSION: Probable sarcopenia was identified in a subset of adult patients with TDT based on reduced handgrip strength according to EWGSOP2 criteria. Future longitudinal and multicenter studies incorporating muscle mass and functional performance measurements are required to confirm these findings.
9. Strengthening maternal: preparedness of maternity nurses for clinical emergencies and deterioration.
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。
Maternal deterioration during pregnancy, childbirth, or the postpartum period can rapidly progress to severe maternal morbidity if early warning signs are not recognized and managed promptly. This study aimed to assess maternity nurses’ knowledge and attitudes regarding maternal deterioration and to examine their association with nurses’ preparedness to recognize and manage maternal deterioration in maternity units. A cross-sectional study was conducted among 360 nurses working in maternity units of tertiary hospitals. Data were collected using a structured questionnaire assessing demographic characteristics, knowledge related to maternal deterioration, professional attitudes toward obstetric emergency care, and preparedness for managing maternal deterioration. Descriptive statistics, correlation analysis, and multiple regression analysis were used to examine relationships between study variables. Data were collected over a six-month period from January to June 2026. The mean knowledge score was 3.45 ± 0.71, indicating a high level of knowledge among participants. The mean attitude score was 3.68 ± 0.64, reflecting generally positive attitudes toward managing maternal emergencies. Preparedness for managing maternal deterioration showed a mean score of 3.41 ± 0.59, indicating a moderate-to-high level of preparedness. Knowledge and attitudes were significantly correlated with preparedness (p < 0.05). Multiple linear regression analysis demonstrated that nurses’ knowledge and attitudes were significant independent factor associated with preparedness for managing maternal deterioration. Higher knowledge and more positive attitudes were associated with greater preparedness after controlling for the other variables included in the regression model. Nurses’ knowledge and professional attitudes significantly influence preparedness to manage maternal deterioration in maternity units. Strengthening competency-based education, simulation-based obstetric emergency training, and implementation of maternal early warning systems may enhance maternity nurses’ preparedness and contribute to improved maternal safety outcomes.
10. Parental preferences for immunization advisory clinic settings for children with special health care needs and associated factors in Shanghai: A cross-sectional study.
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。
Children with special health care needs (CSHCN) face persistent immunization inequity despite high overall childhood vaccination coverage. Immunization advisory clinics (IACs) have expanded in China, yet parental preferences for different IAC settings remain poorly understood. This cross-sectional survey was conducted at the IAC of Children’s Hospital of Fudan University, Shanghai, between October and December 2023. Parents of CSHCN younger than 14 y with incomplete National Immunization Program schedules were invited. The primary outcome was parental preference for IAC setting (community clinic, general hospital, or children’s hospital); the secondary outcome was preferred vaccination-assessment provider under discordant recommendations. Multinomial and binary logistic regression models identified associated factors, adjusted for child, parent, and vaccine-attitude covariates. Sensitivity analyses were stratified by medication status. Reporting followed the STROBE statement. Of 102 questionnaires, 101 were valid (99.0% response rate). 51.0% of parents preferred community clinics, 25.7% preferred children’s hospitals, and 23.3% preferred general hospitals. Parent Attitudes about Childhood Vaccines (PACV) score was not independently associated with setting preference. Parents of girls were more likely to prefer general hospitals (adjusted RRR, 7.02; 95% CI, 1.50-32.77), whereas lower household income was associated with reduced preference for general hospitals (adjusted RRR, 0.14; 95% CI, 0.03-0.75). Sensitivity analyses yielded consistent findings. Parental preferences for IAC settings among CSHCN families are shaped by child and socioeconomic characteristics rather than by vaccine hesitancy alone. Hybrid hospital-community delivery models and standardized referral pathways may improve vaccination equity for medically complex children.
11. 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.
12. 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.
13. 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.
14. 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.
15. 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.
16. 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.
17. 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.
18. 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.
19. 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.
20. 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.
21. 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.
22. 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.
23. 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.
24. 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.
25. 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.
26. 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.
27. 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.
28. 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.
29. 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.
30. 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.