公共卫生文献雷达（2026-08-13）
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1. Impact of lamiaceae plants on anthropometric indices in patients with metabolic syndrome: A systematic review and meta-analysis of randomized clinical trials.
主题：临床研究与数据方法 / 流行病学
期刊：Journal of ethnopharmacology
发表日期：2027-Jan-10
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。
ETHNOPHARMACOLOGICAL RELEVANCE: The Lamiaceae family, commonly known as the mint or sage family, comprises a vast group of aromatic medicinal plants with a global distribution and a deeply entrenched history in traditional medicine systems worldwide. This systematic review and meta-analysis investigated the effects of Lamiaceae plants on anthropometric indices in metabolic syndrome patients.
MATERIALS AND METHODS: We searched PubMed, Scopus, ISI Web of Science, ProQuest, SID, and MagIran from inception to July 15, 2025, for RCTs evaluating Lamiaceae plants versus placebo in adults (≥18 years) with metabolic syndrome or related conditions (obesity, type 2 diabetes, dyslipidemia, nonalcoholic fatty liver disease). Two reviewers independently screened records, extracted data, and assessed risk of bias using the Cochrane RoB 2.0 tool. Random-effects meta-analyses were performed, with subgroup analyses by intervention duration (≤8 vs. >8 weeks), metabolic status, and Lamiaceae genus. Certainty of evidence was evaluated using NutriGrade. This review followed PRISMA 2020 guidelines and was pre-registered (PROSPERO: CRD420251051273).
RESULTS: Twenty eligible RCTs (n = 2445 participants) met inclusion criteria. Using the Cochrane RoB 2.0 tool, 50% of studies had unclear allocation concealment, and 10% had high performance bias risk. Random-effects meta-analysis demonstrated statistically significant reductions in size-based indices (BMI, weight) and proxies of central adiposity (WC, WHR), while changes in direct body composition (BFM) were not significant. Both short-term (≤8 weeks) and long-term (>8 weeks) consumption of Lamiaceae reduced BMI, with effects on WC and weight primarily in overweight/obese individuals. Subgroup analyses revealed that specific genera within the Lamiaceae family, particularly Salvia and Zataria, were effective in reducing BMI and WC (only Salvia). Meta-regression analysis revealed no significant linear associations between intervention duration, metabolic status, or Lamiaceae genus and the anthropometric changes. The NutriGrade assessment rated the overall confidence in the meta-evidence as high for the pooled estimates of BMI and weight and moderate for WHR.
CONCLUSION: Lamiaceae supplementation is associated with modest reductions in size-based and central adiposity indices (BMI, WC, WHR) in adults with metabolic syndrome; exploratory subgroup analyses suggested potential signals for Salvia and Zataria, though based on limited trials. However, current evidence is insufficient to demonstrate significant changes in BFM or benefits in patients with diabetes, likely due to limited trial numbers, short durations, and indirect measurement methods. Therefore, Lamiaceae may be considered a supportive adjunct within multicomponent lifestyle interventions.
2. Navigating a fragile capability: meanings of encountering patients in a suicidal process from the perspective of ambulance clinicians.
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。
PURPOSE: To illuminate the meanings of encountering patients in a suicidal process from the perspective of ambulance clinicians.
METHODS: Narrative interviews were conducted with eighteen ambulance clinicians in Sweden. Data were analyzed using a phenomenological hermeneutical approach inspired by the philosophy of Ricœur.
RESULTS: The main theme, “Navigating a fragile capability,” reveals a profound tension within professional identity. Traditionally anchored in technical agency, this identity is challenged by a movement toward vulnerability and shared humanity. Capability in these encounters is defined not only by medical problem-solving but by the courage to remain present during existential crises. Entering the patient’s narrative imposes an extensive responsibility, where experiences of indecisiveness and powerlessness emerge as expressions of moral sensitivity rather than professional inadequacy.
CONCLUSIONS: Encountering suicidal patients reveals professional capability as a fragile construct dependent on reciprocity, requiring a shift from technical agency toward an ethical presence when medical protocols reach their limit. By validating being with as a clinically meaningful component of care, the encounter moves beyond procedural care toward a meaningful ethical aim. Practically, professional standards must expand beyond technical management to integrate relational competence and existential care as core elements of prehospital practice.
3. The case for near-term artificial intelligence risks to be considered a public health problem.
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。
AI is being rapidly integrated across nearly all sectors, including within healthcare and health systems. The prevailing dominant narrative frames AI’s impact on health as overwhelmingly positive and destined to improve further. However, this benefit-focused discourse overlooks a growing set of serious risks to human health arising from AI systems already in use or clearly on a path to deployment-termed as near-term AI risks to health. The most prominent near-term AI risks to health are outlined, including algorithmic bias, erroneous clinical diagnoses and recommendations, AI-enabled health disinformation, harms to mental health, AI-driven mass unemployment, lethal autonomous weapons systems, AI-enabled chemical and biological weapons and AI as both a vulnerability and an enabler of cyberattacks on health systems. Each risk is already causing harm, or could plausibly do so soon, to the health of substantial proportions of populations, thereby collectively satisfying the criteria for a public health problem. Recognising near-term AI risks to health as a public health problem rebalances the benefit-centric narrative. The article addresses counterarguments and briefly outlines potential risk management responses: mandatory AI health impact assessments for high-risk systems, public health-oriented surveillance of AI-related harms and systematic embedding of public health expertise within AI governance structures.
4. Investigating the association between climate change anxiety and premenstrual syndrome severity among young women: a cross-sectional study.
主题：流行病学
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。
BACKGROUND: Climate change is a significant threat to global health. While its psychological impacts are documented, research exploring the link between climate change anxiety and premenstrual disorders is scarce.
OBJECTIVE: This study investigated the relationship between climate change anxiety and premenstrual syndrome (PMS) severity among young women.
METHODS: A cross-sectional study was conducted with 1035 young women (mean age: 20.83 ± 1.76) in Türkiye. Data were collected using the Climate Change Anxiety Scale (CCAS) and the Premenstrual Syndrome Scale (PMSS). Data were analyzed using Pearson’s correlation and linear regression.
RESULTS: PMS prevalence was 60.8%. A significant positive correlation was found between total CCAS and PMSS scores (r = 0.188, p < 0.001). Higher levels of overall climate change anxiety were significantly correlated with increased PMS severity (r = 0.188, p < 0.001). Regression analysis revealed that climate change anxiety is significantly associated with PMS symptoms, explaining 3.5% of the variance (R2 = 0.035, p < 0.001). Age and menstruation-related daily life interference were also associated with higher climate anxiety.
CONCLUSION: Climate change anxiety acts as a modern psychosomatic stressor contributing to premenstrual symptoms. Healthcare professionals should adopt holistic approaches, considering environmental distress a potential factor in menstrual health management for young populations.
5. An individualized nomogram for predicting progression-free survival in systemic anaplastic large cell lymphoma: a multicenter, retrospective, and internally validated study.
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 develop an individualized nomogram for predicting disease progression risk in systemic anaplastic large cell lymphoma (sALCL).
METHODS: Independent predictors of progression-free survival (PFS) were identified using Cox regression in a multicenter retrospective cohort of 109 sALCL patients (2010-2022). These were incorporated into a three-factor nomogram, evaluated via bootstrapped internal validation (1000 resamples), ROC analysis, C-index, decision curve analysis (DCA), and clinical impact curve (CIC).
RESULTS: A total of 29 PFS events occurred during a median follow-up of 31 months. Multivariable modelling selected serum β2-microglobulin elevation, extranodal disease, and front-line chemotherapy choice (CHOP versus CHOPE or BV+CHP) as autonomous progression drivers. Upon internal bootstrap validation, the nomogram yielded strong prognostic accuracy, achieving AUCs of 0.81, 0.85 and 0.87 for 1-, 3- and 5-year progression-free survival, alongside a corrected C-index of 0.779 (95% CI: 0.699 - 0.861). Calibration plots showed close agreement between predicted and observed outcomes, while DCA confirmed superior net clinical benefit versus conventional IPI or Ann Arbor stratification across multiple decision thresholds.
CONCLUSION: This first sALCL-specific nomogram integrates clinical and treatment variables to provide personalized PFS risk estimation. While internally validated, this exploratory, observation-based tool requires external validation and recalibration in prospective cohorts before clinical implementation.
6. Next of kin’s experiences of healthcare encounters in the context of severe self-harm: “We know them best”.
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。
PURPOSE: Policies in Norway and similar countries emphasize the inclusion of next of kin in healthcare. However, research shows that many experience limited involvement and recognition. This study explores how next of kin to individuals with severe self-harm experience and make sense of healthcare encounters in a Norwegian context.
METHODS: The study draws on in-depth interviews with 15 parents, partners, and siblings of individuals engaging in severe self-harm. Reflexive thematic analysis was employed, guided by a phenomenological sensibility.
RESULTS: Three interconnected themes illuminated different aspects of participants’ encounters with healthcare services. “In the hands of the system” captures experiences of navigating the healthcare system while concerned for a loved one’s wellbeing. “Who do I become when excluded” highlights participants’ experiences of their experiential knowledge being marginalized and how emotional involvement appeared to undermine their credibility. “The ones who stand by” reflects concerns about their own wellbeing and that of the wider family, alongside a desire for greater recognition and support.
CONCLUSIONS: The results suggest that healthcare encounters involve not only support and participation but also recognition of next of kin’s experiential knowledge and needs, which appears to shape their sense of legitimacy and ability to remain involved in care.
7. Exploring early career pharmacists’ sources of stress and their coping strategies: a qualitative interview 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。
BACKGROUND: Workplace stress is inversely correlated with job satisfaction and, when left unmanaged, can manifest as burnout. Prior research shows pharmacists under the age of thirty years and Early Career Pharmacists (ECPs) are at an especially high risk of burnout. This study aimed to: (i) explore the experiences of ECPs dealing with stress, (ii) determine the sources of stress and joy experienced by ECPs, and (iii) to explore strategies used by ECPs to reduce stress.
METHODS: ECPs were recruited through social media. Following informed consent, semi-structured interviews based on Critical Incident Technique (CIT) were conducted in January-February 2025. Data were analysed using CIT and reflexive thematic analysis.
RESULTS: Twenty-four ECPs (mean age 29 years; mean experience 4 years; 75% female) described 80 critical incidents. Key stressors included: 1) lack of support by management, 2) self-imposed unrealistic expectations among ECPs and 3) feeling disrespected as healthcare professionals. Participants described a need for belonging and peer connection as a coping strategy.
CONCLUSION: The wellbeing and retention of pharmacists is paramount to an effective healthcare workforce and optimal patient care. These results have highlighted the areas requiring attention for pharmacist wellbeing, career retention and workforce sustainability.
8. What works to address inequalities in primary care: Development of Living Evidence Maps using machine learning.
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: Health inequalities in primary care persist across many high-income countries, with populations experiencing disadvantage often receiving less care despite greater need. Traditional evidence synthesis methods struggle to keep pace with the growing volume of research to help policy makers and practitioners to take timely, evidence-informed action. Our aim was to develop a Living Evidence Map of interventions that address inequalities in primary care, using machine learning (ML) to enhance the efficiency of evidence identification, screening, and mapping.
STUDY DESIGN: Evidence synthesis.
METHODS: We used EPPI-Reviewer software to train a machine learning classifier to identify relevant studies. This was complemented by citation searching, and records were manually screened in order of predicted relevance (priority screening). Included studies were coded by intervention type, disadvantaged group, and health or care outcome, which was then visualised using EPPI-Visualiser.
RESULTS: A total of 31,871 articles were screened, resulting in 577 primary studies, 481 systematic reviews, and 6 umbrella reviews being included in the Living Evidence Map. Most studies focused on ethnic minority groups, with common interventions including education, advice and counselling, and culturally tailored care. There was a paucity of studies targeting gender and sexual minorities, and structural interventions (e.g. funding, workforce).
CONCLUSIONS: The Living Evidence Map offers a dynamic, policy-relevant tool for navigating the evidence base on health inequalities in primary care. It serves both researchers and decision-makers by making it easier to see what evidence exists, where it’s concentrated, and where there are gaps. However, further work is needed to improve inclusion of grey literature evidence and interventions addressing intersectional disadvantage to support decision-making for end users.
9. Peer-led mentoring to support racially minoritised applicants to UK public health specialty training: A regional pilot.
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: Differential attainment (DA) describes persistent differences in academic and professional outcomes between demographic groups that cannot be explained by differences in ability or effort. In UK public health specialty training, racially minoritised applicants experience lower success rates during recruitment. Peer-led mentoring interventions have shown potential in helping to address inequities by providing access to informal knowledge and support. This study aimed to evaluate the feasibility and early outcomes of a regional peer-led mentoring scheme designed to support racially minoritised applicants applying to UK public health specialty training.
STUDY DESIGN: Pilot intervention and mixed-methods evaluation.
METHODS: This peer-led pilot intervention was delivered over two public health specialty recruitment cycles in the South-East of England. Applicants from Black and South Asian backgrounds were matched with current public health trainees (“buddies”) for informal mentoring. Participation outcomes were tracked, and feedback was collected throughout the scheme alongside anonymous post-scheme surveys of applicants and buddies.
RESULTS: In 2023-24, 13% of participants in the buddy scheme were invited to interview, with 4.3% subsequently receiving offers, compared with a national offer rate of approximately 9.8%. In 2024-25, 17.2% of participants were invited to interview and 10.3% received offers, compared with national offer rates of approximately 5.7%. Applicants reported increased confidence and a clearer understanding of the recruitment process. Buddies described mentoring as rewarding but highlighted challenges balancing the role alongside existing workload.
CONCLUSION: This peer-led buddy scheme appears feasible and valued by participants and may help support racially minoritised applicants navigating public health specialty recruitment. However, the small sample size and comparison with overall national offer rates, rather than ethnicity-specific comparator data, limit interpretation of recruitment outcomes. Addressing differential attainment is likely to require interventions beyond peer support alone and should be embedded within broader structural equity initiatives.
10. Student perceptions of a three-minute thesis presentation activity in undergraduate pharmacology education: a post-intervention evaluation.
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。
Communication skills are a core competency in pharmacy education; however, traditional presentation approaches often place limited emphasis on clarity, engagement, and meaningful integration of knowledge. This study evaluated student perceptions and immediate post-activity knowledge following implementation of a Three-Minute Thesis (3MT) group presentation task among third-year Doctor of Pharmacy (Pharm.D) undergraduate students in a pharmacology course at Umm Al-Qura University, Makkah, Saudi Arabia. A single-group, post-intervention, cross-sectional evaluation design was used. Learning outcomes were assessed using a structured 20-item evaluation questionnaire measuring five domains (engagement, perceived learning, communication confidence, satisfaction, and peer perception) and a five-item knowledge quiz administered immediately after the activity. A total of 59 students participated (79.7% response rate). Perceptions were highly positive across all domains, with the highest mean scores observed for satisfaction ($M = 4.37$, $SD = 0.80$) and peer perception ($M = 4.32$, $SD = 0.79$), followed by engagement ($M = 4.21$, $SD = 0.74$), perceived learning ($M = 4.16$, $SD = 0.81$), and communication confidence ($M = 4.11$, $SD = 0.77$). Subscale reliability was strong (Cronbach’s $\alpha = 0.79-0.92$). Quiz performance reflected high immediate post-activity knowledge, with a mean score of 3.86 out of 5 ($SD = 1.18$), and 72.9% of participants achieving scores of 4 or 5. The 3MT-style format is a feasible and highly engaging active-learning strategy in undergraduate pharmacology. While the descriptive single-group design limits direct causal inferences, the strong student reception and solid immediate knowledge profiles demonstrate its pedagogical viability and educational value. Future controlled, multi-institutional studies are warranted to evaluate long-term impacts.
11. The global scientific consensus on genetically modified crop risk assessments.
主题：流行病学
期刊：GM crops & food
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。
Initial risk assessments of genetically modified (GM) crops began in the early 1990 s, focusing on herbicide tolerance and insect resistance, with approvals by the mid-1990s. These assessments compare GM crops to non-GM equivalents, a framework unchanged for over 30 years. Since the first assessment in 1994, over 4,400 evaluations have been conducted across more than 70 countries for both cultivation and food/feed use. To date, none have identified increased risk relative to conventional varieties. This article analyzes three decades of GM crop approvals, highlighting the consistency of scientific assessment processes. Fourteen crops underwent 692 cultivation and 1,891 food-release assessments for herbicide tolerance, while insect resistance accounted for 523 cultivation and 1,396 food-release assessments, largely involving Bacillus thuringiensis (Bt). The findings underscore that GM crops are equivalent in risk to conventional varieties, supporting reliance on established international scientific expertise, particularly in resource-constrained regions.
12. Pregnant women’s experiences during a public health emergency: A cross-sectional analysis of the COVID-19 Pregnancy Risk Assessment Monitoring System COVID-19 supplement.
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: The COVID-19 pandemic was associated with increased maternal morbidity and mortality, with racially minoritized women having worse outcomes than other women in the United States. However, there is little understanding of pandemic-specific stressors that may contribute to disparate outcomes. Thus, this analysis provides descriptive statistics of COVID-19 pandemic related factors among a sample of women who recently gave birth in the United States that can inform future public health disaster preparedness.
STUDY DESIGN: Cross-sectional analysis of secondary data.
METHODS: Analysis of 2020-2021 Pregnancy Risk Assessment Monitoring System COVID-19 supplement data (weighted n = 453,231) identified five pandemic experience factors through factor analysis: family household stressors, housing instability, COVID prevention measures, COVID household exposure, and external exposure. Prevalence of each factor was estimated overall and by demographic factors.
RESULTS: Family household stressors affected 42.1% of women, including increased anxiety (48.5%) and job loss (29.9%). Housing instability impacted 11.3%, while 35.2% struggled accessing prevention supplies. Significant disparities emerged: Black and Hispanic women experienced highest family stress rates (48.5%, 48.0%); American Indian/Alaska Native women faced greatest housing instability (21.6%). Younger, unmarried women and those with lower education, Medicaid enrollment, or pre-existing vulnerabilities experienced disproportionate burdens.
CONCLUSIONS: Findings necessitate targeted emergency preparedness protocols prioritizing pregnant women’s social support infrastructure, including housing assistance programs, expanded childcare services, and guaranteed access to prevention resources. The pandemic exacerbated maternal health disparities, with marginalized communities bearing the greatest burden. Medicaid expansion and culturally-responsive interventions should be implemented to support vulnerable populations during public health crises.
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. 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. Post-marketing safety profile and potential aspirin interaction of Serenoa repens extract: A real-world study using FAERS and network toxicology.
主题：卫生政策与真实世界证据
期刊：Journal of ethnopharmacology
发表日期：2027-Jan-10
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。
ETHNOPHARMACOLOGICAL RELEVANCE: Saw palmetto (Serenoa repens) extract (SPE) originated from Native American traditional medicine and is now globally consumed for benign prostatic hyperplasia. Despite its popularity, its real-world safety profile regarding rare events and potential interactions remains incompletely characterized.
AIM OF THE STUDY: To evaluate post-marketing safety signals of SPE using the FDA Adverse Event Reporting System (FAERS) database and preliminarily explore molecular targets related to SPE-aspirin interactions.
MATERIALS AND METHODS: FAERS reports (2004-2025) listing SPE as a suspect drug were analyzed. Disproportionality analyses (reporting odds ratio (ROR), proportional reporting ratio (PRR), empirical Bayes geometric mean (EBGM), and Bayesian Confidence Propagation Neural Network (BCPNN)) were performed to identify safety signals. Logistic regression assessed factors associated with the reporting of haemorrhage and mortality. Network toxicology investigated molecular targets linking SPE, aspirin, and haemorrhage.
RESULTS: Among 634 reports, hepatobiliary and blood/lymphatic disorders emerged as significant signals. Frequent adverse events included pruritus, cholestasis, confusion, and eosinophilia. Multivariate analysis indicated that age ≥75 and concomitant aspirin were associated with significantly elevated reporting odds for haemorrhage (OR 3.89; 2.28) and fatal outcomes (OR 2.87; 7.26). Network analysis revealed 46 shared targets enriched in clinically relevant pathways, particularly arachidonic acid metabolism and platelet activation, suggesting a potential pharmacological overlap affecting haemostasis.
CONCLUSIONS: Real-world data demonstrate significant disproportionate reporting of hepatobiliary and hematological events with SPE. The increased reporting frequency of haemorrhage and fatal outcomes in elderly aspirin users warrants clinical vigilance. These findings, alongside the potential targets identified in silico, suggest that concurrent use in high-risk populations requires careful monitoring.
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. Optimal dose window, formulation efficacy, and molecular mechanisms of curcumin in MASLD animal models: A systematic review and three-level meta-analysis.
主题：临床研究与数据方法
期刊：Journal of ethnopharmacology
发表日期：2027-Jan-10
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。
ETHNOPHARMACOLOGICAL RELEVANCE: Approximately 25% of the global adult population is affected by metabolic dysfunction-associated steatotic liver disease (MASLD), yet no universally approved first-line pharmacotherapy exists. Curcumin is the major bioactive constituent of turmeric (Curcuma longa L.), a plant with a long history of use in traditional medicine systems for treating digestive, inflammatory, and liver disorders. Despite promising multi-targeted activity, the clinical application of curcumin is hindered by poor bioavailability and inconsistent efficacy due to variable dosing and formulations.
AIM OF THE STUDY: This systematic review and meta-analysis aimed to: (1) identify the optimal dose range of curcumin for MASLD intervention in preclinical models; (2) quantitatively compare the efficacy of different curcumin-based formulations; and (3) validate its modulation of key mechanistic targets including SREBP-1c, PPARα, TNF-α, and Nrf2.
MATERIALS AND METHODS: PubMed, Embase, and Web of Science were searched from inception to December 2025 for in vivo studies evaluating curcumin interventions in mouse or rat models of MASLD. A three-level meta-analysis with robust variance estimation (RVE) was used to handle data dependencies from multi-dose studies. The study protocol was preregistered with PROSPERO (CRD420261276896). Non-linear dose-response relationships were modeled using restricted cubic splines (RCS). Efficacy differences across formulation types were quantitatively compared, and effect sizes for key mechanistic targets were calculated.
RESULTS: Seventy-two studies were included. Dose-response analysis revealed a non-linear effect on serum ALT reduction, with an optimal window of 50-150 mg/kg; efficacy declined notably at doses >400 mg/kg. Subgroup analyses showed that curcumin derivatives and novel delivery systems were significantly more effective than native curcumin (P < 0.05). Mechanistically, curcumin significantly downregulated SREBP-1c (g = -8.00) and TNF-α (g = -4.36), and upregulated Nrf2 (g = 8.95). Following the FDA body surface area conversion, the 50-150 mg/kg animal dose corresponds to 486-1458 mg/day in humans, which is consistent with dosages used in current clinical trials. This alignment supports the biological plausibility of the animal-derived dose window, though direct translation to human dosing requires clinical validation.
CONCLUSIONS: This is the first meta-analysis to quantitatively define an optimal dose window for curcumin in MASLD animal models and to demonstrate non-linear dose-response characteristics across different formulations. Our findings provide a pharmacological rationale for dose selection in future preclinical standardization and hypothesis-driven clinical trial design for curcumin-based interventions in MASLD.
27. 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.
28. 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.
29. 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.
30. 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.