公共卫生文献雷达（2026-08-18）
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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. Diagnostic value of serum miR-4677-3p combined with ultrasound in endometriosis.
主题：流行病学
期刊：Gynecological endocrinology : the official journal of the International Society of Gynecological Endocrinology
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: Endometriosis faces diagnostic delays due to the lack of tools for diagnostic evaluation. The value of miR-4677-3p combined with ultrasound in the diagnosis of endometriosis.
METHODS: 110 healthy subjects and 110 endometriosis patients were recruited. miR-4677-3p level was detected by qRT-PCR. Color Doppler ultrasound was used to measure uterine artery blood flow parameters. Pearson analysis was applied to explore the correlation between miR-4677-3p and blood flow parameters. ROC curve was used to evaluate the diagnostic value. Logistic regression analysis was performed to identify risk factors.
RESULTS: miR-4677-3p serum expression in endometriosis patients was upregulated, EDV and PSV were decreased, while PI and RI were increased. miR-4677-3p level was negatively correlated with RI and PI, and positively correlated with EDV and PSV. miR-4677-3p has diagnostic value for endometriosis, with an AUC of 0.863. After combination with ultrasound parameters, the AUC increased to 0.925, indicating a superior diagnostic value for endometriosis. Aberrantly expressed miR-4677-3p, dysmenorrhea, and CA125 as risk factors.
CONCLUSION: The combined application of serum miR-4677-3p and ultrasound parameters can improve the diagnostic efficiency of endometriosis, providing a clinical tool for the accurate identification of the disease.
3. MIR210HG promotes preeclampsia progression through CDHR5.
主题：流行病学
期刊：Hypertension in pregnancy
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: Early diagnosis of preeclampsia (PE) remains challenging. We previously linked the long non-coding (lnc) RNA MIR210HG to pathological placental development. Here, we investigated its differential expression, pathophysiological phenotypic specificity, and non-invasive diagnostic potential for PE in the peripheral blood and placental tissue.
METHODS: We enrolled 88 PE patients (case group) and 81 normal pregnant women (control group) from the Affiliated Hospital of Qingdao University during January 2020-December 2021. MIR210HG expression was detected via RT-PCR and western blotting, and was modulated using siRNA/overexpression plasmid transfection in human trophoblasts and vascular endothelial cells.
RESULTS: MIR210HG expression was specifically upregulated in the peripheral blood of patients with early-onset PE, with superior diagnostic efficacy for the PE-fetal growth restriction subtype. Additionally, CDHR5 was upregulated in PE-associated placental tissues (P = 0.004). Cellular assays confirmed that MIR210HG knockdown reduced CDHR5 expression in trophoblasts and endothelial cells (Bewo: P = 0.019; JEG3: P = 0.006), and CDHR5 knockdown also downregulated MIR210HG expression (Bewo: P = 0.023).
CONCLUSION: Therefore, MIR210HG may contribute to placental pathological injury by regulating CDHR5, though the pathogenic mechanism remains unclear. In contrast to the invasive and lagging placental-derived lncRNA biomarkers reported in previous studies, peripheral blood MIR210HG allows for non-invasive monitoring during pregnancy, making it more clinically applicable for early screening and phenotypic stratification of PE.
4. The association between pubertal timing and diurnal cortisol activity in middle adolescence.
主题：流行病学
期刊：Stress (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。
The pubertal development stage is associated with mental health. One explanation is that the pubertal stage is linked to changes in hypothalamic‒pituitary‒adrenal (HPA) axis activity. However, no study has investigated the prospective association between pubertal timing and HPA axis activity, measured by cortisol, in middle adolescence. Using data from 914 individuals (54.70% female) from the Avon Longitudinal Study of Parents and Children (ALSPAC), the current study sought to determine whether pubertal timing across the ages of 8-15.5 years (measured by menarche for girls and voice breaking for boys) was associated with diurnal cortisol slope, the cortisol awakening response, total morning cortisol, and total daily cortisol output at the age of 15.5 years. In girls, earlier menarche was associated with higher (logged) cortisol awakening response (b = -.003; 95% CI = -.007, -.0004), but the association was significant only after adjustment for confounders, especially ethnicity. No associations were observed in boys.
Puberty is a time of very significant biological and social changes. This study looked at whether the timing of puberty affects cortisol activity – a hormone involved in the body’s stress response – in middle adolescence. Data from 914 participants were used to investigate whether the timing of puberty affects cortisol activity later, in middle adolescence. Pubertal timing was measured between ages 8 and 15.5 years, using the age of first period in girls and the age of voice breaking in boys. At the age of 15.5, participants provided saliva samples to measure four cortisol outcomes: daily slope (change throughout the day), awakening response (a morning peak), total morning output, and total daily output. The findings showed that girls who started their periods earlier had a higher cortisol awakening response, meaning a sharper rise in cortisol shortly after waking, in middle adolescence. No associations were observed in boys. These results suggest that early-maturing girls exhibit an increased cortisol awakening response in middle adolescence.
5. Walking together: exploring australian parent experiences of walking in nature with their preschool children with autism using a bioecological lens.
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: Walking regularly in natural settings is a common healthy activity for Australian parents and their preschool children. Extant research conveys that walking in nature provides cognitive, emotional and physical benefits for both parents and children. Children with autism are less likely to participate in physical activity or access nature regularly, and autistic adults are less likely to hold pro-environmental views. While research exploring the experiences of typical parents and preschoolers exists, the perceptions of parents of preschool children with autism on walking is yet to be studied.
METHODS: This paper examines the experiences of parents of children with autism using Bronfenbrenner’s bioecological model as a theoretical framework. We recruited 20 parents of preschoolers with autism and a comparison group of 12 parents of preschoolers without autism and invited them to complete an online qualitative survey about walking together in nature.
RESULTS: Five themes were generated from their responses, including calm, connection, coordination and communication, with an additional theme of priority. Parents identified that walking in nature provided opportunities for developmental growth for their children such as increased communication, connection and calm, but also highlighted challenges such as differences in moving together in coordination.
CONCLUSION: We advocate that supporting family priorities includes supporting their ability to access everyday activities such as walking in nature, a common activity that provides rich opportunities for parents and their preschoolers with autism.
6. Prevalence and associated factors with presumptive tuberculosis in the war-torn Tigray, Ethiopia: a community-based comparative study.
主题：生物统计与研究设计
期刊：Journal of clinical tuberculosis and other mycobacterial diseases
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。
PURPOSE: Presumptive tuberculosis refers to individuals who presents with symptoms or signs of suggestive active TB having at least one of these clinical manifestations (more than two weeks of, cough, fever, appetite loss, night sweating, chest pain, or weight loss). Although tuberculosis is both preventable and curable, it continues to cause millions of new infections and fatalities globally. With a national burden that ranks third in Africa and eighth globally, Ethiopia remains a high-burden country for tuberculosis. Tigray had 6700 confirmed tuberculosis cases in 2020, immediately before the war had started. War is an ideal condition for the spread of TB. This has happened in Tigray following the war. Therefore, this study aimed to assess a community-based presumptive tuberculosis among rural and urban residents after the conflict in Tigray region of Ethiopia.
METHODS: A community-based comparative cross-sectional study design was conducted from January to February 2024 for a total of 2340 participants selected using the multistage cluster sample technique. The data was collected using an open data kit and then exported to SPSS version 23 for analysis. Logistic regression, both bivariate and multivariable analysis, was used to see the association between independent and dependent variables.
FINDINGS: The overall prevalence of presumptive tuberculosis was found 10.6% (95% CI: 8.4%,13%), with a slight difference burden between the rural and urban, 12.3% (95% CI, 10.8%, 14%) and 11.8% (10.6%, 13.1%), respectively. Different factors, like inadequate ventilation, sleeping with hunger, close contact with known TB patients, and households unvisited by health extension workers were significantly associated with presumptive tuberculosis.
CONCLUSION: Given the conflict and the region’s destroyed medical infrastructure, this finding might help in identifying those who likely have active tuberculosis. Therefore, improving access to TB screening and diagnostic services closer to the communities throughout the region is critically important during post-war to address the burden of tuberculosis.
7. The global health workforce crisis toward 2030: A scoping review and systems-based policy framework.
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 integrate global workforce indicators and narrative evidence in order to develop a systems-based policy framework informing coordinated workforce sustainability strategies toward 2030.
STUDY DESIGN: Scoping review with mixed-methods synthesis.
METHODS: A structured scoping review was conducted of peer-reviewed literature, global datasets, and institutional policy documents published between 2014 and 2024. A mixed-methods synthesis combined quantitative analysis of workforce indicators with qualitative thematic analysis of structural drivers, governance gaps, and health system impacts.
RESULTS: Global projections indicate a shortfall of approximately 11.1 million health workers by 2030. The global nursing shortage was estimated at 5.9 million in 2018, while up to 13 million additional nurses may be required over the following decade when existing shortages, projected retirements, and future demand are considered together. An aging workforce, intensified migration flows, insufficient domestic training capacity, and deteriorating working conditions contribute to persistent shortages. Five systemic drivers were identified: deteriorating working conditions, weak retention mechanisms, demographic pressures, governance failures, and unmanaged migration flows. Impacts include increased mortality, reduced continuity of chronic care, weakened emergency response capacity, and widening geographic inequalities in workforce distribution between high-income and low- and middle-income countries. The Systems-Based Workforce Sustainability Framework integrates macro-, meso-, and micro-level determinants and identifies reinforcing feedback loops sustaining workforce instability.
CONCLUSIONS: The global workforce crisis is structural and self-reinforcing. Sustainable solutions require coordinated long-term planning, strengthened retention and wellbeing strategies, ethical migration governance, and expansion of domestic training capacity. The proposed framework supports multi-level policy coordination toward workforce sustainability by 2030.
8. Evaluation of a universal 3-4 month Healthy Child Programme visit in a local area of England: a mixed methods study.
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 interval between the 6-8 week and 9-12 month mandated reviews in the Healthy Child Programme is lengthy and may lead to delayed intervention. In Rotherham, northern England, an additional universal 3-4 month review was introduced to support child development and earlier identification of parent and child needs. We aimed to evaluate its reach, acceptability, and association with developmental outcomes.
STUDY DESIGN: Mixed methods study using administrative records, qualitative interviews and focus groups with parents (n = 31), nursery nurses (n = 7), and commissioners (n = 4).
METHODS: The association between uptake and recording of maternal mood by deprivation, ethnicity, maternal age, and parity for babies aged 3-4 months between January 2024 andFebruary 2025 was analysed using mixed-effects logistic regression. Developmental outcomes were compared (Ages and Stages Questionnaire (ASQ-3) scores at 9-12 months) for children eligible for the universal review versus pre-intervention cohort. Qualitative data were analysed using the Consolidated Framework for Implementation Research.
RESULTS: Uptake was approximately 80%, around 15% points lower than mandated reviews. Uptake was equitable across deprivation and ethnicity but lower among multiparous mothers (adjusted odds ratio (AOR) 0.29, 95% CI 0.22-0.37). Maternal mood recording was lower for mothers <20 years and for multiparous mothers (AOR 0.78, 95% CI 0.64-0.94). At 9-12 months, eligible children had higher odds of scoring above the close monitoring cut-off for problem solving (AOR 1.41, 95% CI 1.03-1.93), with no significant differences in other ASQ-3 domains. Parents valued reassurance, tailored developmental advice, and local signposting, though some noted inconsistent advice, maternal mood assessment and unclear visit purpose. Staff endorsed the visit’s developmental focus but reported capacity pressures.
CONCLUSIONS: The universal 3-4 month review was broadly acceptable, and associated with higher ASQ-3 problem-solving scores. Communicating visit purpose and consistent mood assessment is required.
9. Dose-response association between perinatal 25(OH)D status and postpartum depression.
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: Postpartum depression (PPD) is a common perinatal disorder that affects maternal and child health. Although vitamin D deficiency has been linked to depressive symptoms, the dose‑response relationship between perinatal serum 25(OH)D and PPD and predictive value remains unclear.
OBJECTIVE: To investigate the dose‑response relationship between perinatal 25(OH)D and PPD and evaluate its predictive value.
METHODS: A total of 326 perinatal women were enrolled, PPD was assessed within 6 weeks postpartum, and serum 25(OH)D was measured at 24-48 hours after delivery. Analyses included baseline characteristics, EPDS scores, risk factors, dose‑response, predictive performance, and interactions with supplementation.
RESULTS: PPD incidence was 23.31%. The PPD group had lower 25(OH)D, negatively correlated with EPDS scores. Each 1 ng/mL increase in 25(OH)D reduced PPD risk by 25% (OR = 0.75, 95% CI: 0.68-0.82, P < 0.001). Primiparity and fair spousal relationship were risk factors; planned pregnancy, sunlight, and oral supplementation were protective. Positive interactions with sunlight and supplementation were observed, with linear dose‑response. The AUC was 0.822, with an optimal cutoff of 24.26 ng/mL (sensitivity 67.11%, specificity 85.20%).
CONCLUSION: Perinatal 25(OH)D levels are linearly and negatively correlated with PPD risk and show good screening utility; exogenous supplementation appears to modify this protective effect.
10. Clinical value of hsa_circ_0003254 in postmenopausal osteoporosis and its role in the progression of osteoporosis.
主题：流行病学
期刊：Gynecological endocrinology : the official journal of the International Society of Gynecological Endocrinology
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: Circular RNAs (circRNAs) are important regulators of human disease, yet their specific mechanistic role in postmenopausal osteoporosis (PMOP) remains unclear. This study aimed to investigate the expression pattern, diagnostic value, and biological function of hsa_circ_0003254.
METHODS: This study enrolled 207 postmenopausal females grouped into osteopenia (OPn, n = 72), osteoporosis (OP, n = 85), and healthy controls (Health, n = 50). RT-qPCR was employed to detect expression differences of hsa_circ_0003254, receiver operating characteristic (ROC) analysis, and logistic regression were utilized to assess its diagnostic value. The functional role of hsa_circ_0003254 in osteogenesis was assessed by transfecting hBMSCs with pcDNA-circ or si-circ. Western blot analysis was performed to determine the protein levels of RUNX2, ALP, and OCN.
RESULTS: Analysis of the clinical cohort revealed that the expression of hsa_circ_0003254 was significantly elevated in patients with OPn and OP compared to healthy controls. Its expression level showed a significant positive correlation with both the PINP and the CTX-1. ROC analysis confirmed the diagnostic efficacy of hsa_circ_0003254 for PMOP, distinguishing healthy controls from OP patients (AUC = 0.876) and differentiating OPn from OP patients (AUC = 0.934). Multivariate logistic regression analysis confirmed hsa_circ_0003254 as a risk factor for PMOP (OR = 18.507, p < 0.001). Functionally, Osteogenic induction downregulated hsa_circ_0003254. Overexpression suppressed ALP activity, cell viability, and osteogenic gene expression (ALP, RUNX2, OCN), while knockdown enhanced all these parameters.
CONCLUSIONS: Hsa_circ_0003254 may serve as a potential circulating biomarker for PMOP. Its elevated expression might participate in osteoporosis progression by regulating osteogenic differentiation.
11. ‘COVID kills, and it’s not joking around’: Perceptions and experiences of COVID-19 in Soweto, South Africa.
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。
The COVID-19 pandemic intensified existing social and gender inequalities, disproportionately affecting Black women living in communities like Soweto, South Africa. This paper primarily draws on qualitative data from 25 in-depth interviews conducted in 2021, complemented by descriptive survey data from 204 women collected between 2020 and 2021. We employed inductive thematic analysis guided by the socio-ecological model to examine how intersecting individual, interpersonal, community and societal factors shaped women’s experiences during the pandemic. Women played vital caregiving roles, supporting families and communities despite considerable personal stress linked to fears of infection, violence, isolation and economic hardship. On an interpersonal level, stigma related to COVID-19 severely disrupted social bonds, causing mistrust and exclusion within communities. At the societal level, pre-existing distrust in government institutions worsened, contributing to vaccine hesitancy. The widespread looting and unrest observed in Soweto during lockdowns are interpreted as collective resistance reflecting the community’s perceived right to survival and fair treatment amid structural neglect. We argue that public health responses must adopt multi-level strategies that recognise women’s crucial caregiving roles, address stigma through community engagement, rebuild institutional trust and promote economic justice.
12. Cross-cultural validation of the social empathy index: a psychometric study among Japanese medical students.
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: Assessing and fostering social empathy among medical students is crucial for advancing health equity. While education on the social determinants of health (SDH) has become increasingly important in medical curricula, its impact has been evaluated mostly through qualitative approaches. Quantitative assessment tools that assess social empathy remain limited in medical education. The Social Empathy Index (SEI) is a self-report instrument designed to assess interpersonal and social empathy and may have relevance for medical education.
OBJECTIVES: This study aimed to examine the psychometric properties of the Japanese version of the SEI (SEI-J) among medical students and explore its potential application in medical education in Japan.
METHODS: A total of 414 medical students from three academic years at a private medical school in Tokyo completed the SEI-J and a self-developed sociodemographic questionnaire. Confirmatory factor analysis was conducted to examine structural validity based on the original SEI framework. Internal consistency was assessed using McDonald’s omega coefficients. Known-groups validity was examined using one-way analysis of variance.
RESULTS: Of the participants, 279 completed the survey (response rate 67.4%); 230 responses were included in the final analysis. Confirmatory factor analysis provided partial support for the original multidimensional structure of the SEI-J, and McDonald’s omega coefficients indicated acceptable to high internal consistency across subscales. Higher SEI-J scores were associated with female gender, volunteering or study-abroad experience, interest in the arts or literature, people-oriented specialty preference, and greater self-rated understanding of SDH, consistent with prior research.
CONCLUSIONS: The findings demonstrate that the SEI-J is a psychometrically valid and reliable tool for measuring social empathy. This study provides preliminary evidence supporting the applicability of the SEI in a Japanese medical education context, identifies factors associated with the development of social empathy, and offers an outcome measure that supports the evaluation and iterative improvement of SDH- and equity-oriented curricula.
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.