Nguyen HV. · Jul 1, 2026
Issue addressed Underage alcohol use has been linked to risks of physical, mental, and social harms to young people. Despite the known risks, research shows that parents may choose to supply alcohol to their children on occasions for various reasons. This has prompted several health promotional campaigns aimed at parents to discourage the practice of parental supply of alcohol, but there has been little evidence of how the messages are received by the target audiences, i.e., parents of adolescents. Methods Grounded in the existing literature on alcohol-related harms, social dimensions and communication of risks, the current paper conducted a qualitative analysis of interviews with parents of adolescents to understand their interpretation of risks in a series of Australian health promotion campaigns that addressed underage drinking. Result The study demonstrated how target audiences brought in their own lived experiences and social worldviews to interpret and internalise messaging about risks in ways that are nuanced and situational. Conclusions The findings demonstrated how parents' lived experiences and worldviews influenced their interpretation and alignment with the health promotion messages about parental supply of alcohol. While the ways the parents negotiated with the health promotion messages may not be scientifically-grounded, it was not always due to unawareness of risks but based upon strategies and assessment of risks in situational contexts. SO WHAT?: Understanding of how lived experiences inform interpretation of health promotion campaigns has implications for more effective alcohol-related risk communication aimed at behaviour change to reduce alcohol-related harms among young people.
Medicine
Dourado TMH et al. · Jul 1, 2026
The effects of obesity on the vasculature and perivascular adipose tissue (PVAT) function vary according to the vascular territory. Nebivolol is a third-generation β-blocker that exerts vasculoprotective effects in obesity. The thoracic and abdominal aorta show different responses under physiological conditions, and their PVATs have a distinctive composition and secretory profile. We hypothesized that obesity would affect thoracic and abdominal aortic responsiveness, as well as their PVAT function, differently and that nebivolol would restore obesity-induced vascular and PVAT changes. To test this hypothesis, male Wistar Hannover rats were fed a hypercaloric diet for 14 weeks. Nebivolol (10 mg/kg/day) was administered via gavage during the last 4 weeks. Obesity increased superoxide (O 2 • - ) generation within the thoracic PVAT, but this response did not result in a loss of its anticontractile effect. Vascular hypercontractility was detected in thoracic aortas, which was mediated by the overproduction of NADPH oxidase-derived O 2 • - and reduced nitric oxide (NO) bioavailability. Conversely, obesity induced a pro-contractile phenotype in the PVAT of the abdominal aorta. This response occurred in an endothelium-dependent manner, was ameliorated by tiron, and was accompanied by increased O 2 • - levels. In all cases, nebivolol reversed the effects of obesity. In summary, obesity differentially affects the thoracic and abdominal aorta and their respective PVATs. Nebivolol exerts vasculoprotective effects through antioxidant mechanisms, leading to a reversal of obesity-induced vascular hypercontractility in both aortic segments. The beneficial effects of nebivolol described here could help mitigate cardiovascular complications associated with obesity. Obesity induces PVAT dysfunction. Extending this knowledge, we demonstrated that obesity differentially affects the thoracic and abdominal aorta along with their associated PVATs. This widespread impairment of PVAT function can drive various adverse vascular consequences, including arterial hypertension and aneurysm formation. Critically, peri-aortic PVAT is of particular clinical relevance due to its association with metabolic risk factors and vascular calcification. Nebivolol exerts vasculoprotective effects via antioxidant mechanisms within PVAT, ultimately reversing obesity-induced vascular hypercontractility in both aortic segments. Thus, investigating pharmacological agents that restore PVAT function, as demonstrated here with nebivolol, represents a promising therapeutic strategy to mitigate obesity-related cardiovascular complications.
Medicine
Zhong D et al. · Jul 1, 2026
Renal aging shortens healthspan and propagates organ dysfunction beyond the kidney, yet its molecular drivers remain incompletely defined. Here we identify microsomal prostaglandin E synthase-2 (mPGES-2) as a critical regulator of renal aging and its skeletal consequence. Genetic ablation of Ptges2 improved health indices in aged mice, prolonged median survival, and markedly alleviated glomerulosclerosis, podocyte injury, and renal senescence. Single-cell transcriptomic analysis, together with podocyte- and tubule-specific knockout models, showed that podocyte mPGES-2, rather than tubular mPGES-2, is the dominant intrarenal driver of aging-related kidney injury. Mechanistically, mPGES-2 promoted podocyte senescence through a PGE 2 /EP1 signaling axis. Podocyte-specific Ptges2 deletion also mitigated age-related osteoporosis and restored renal calcitriol and α-klotho, supporting a kidney-bone mechanism secondary to impaired renal endocrine function. Consistent with the genetic models, pharmacological inhibition of mPGES-2 with SZ0232 attenuated renal aging and improved bone microarchitecture in aged mice. Both genetic deficiency and pharmacological inhibition of mPGES-2 were well tolerated, with no overt adverse effects on major organs. These findings identify podocyte mPGES-2 as a druggable determinant of renal aging and a potential therapeutic target for aging-associated osteoporosis.
Medicine
Gotine AREM et al. · Jul 1, 2026
To conduct a pragmatic clinical trial with multiple micronutrient powders (MNPs) for anaemia prevention during the first year of life in primary care in Nampula, Mozambique. A total of 275 infants, aged 6-8 months, were randomly assigned to intervention (IG, n = 145) and control (CG, n = 130) groups. The IG received 90 sachets of MNP for daily use up to 180 days; the CG received standard care. Haemoglobin (Hb) was measured at baseline and after 6 months. Analysis used linear regression adjusted for child and maternal variables (p < 0.05). At baseline, mean Hb (95% CI) was 102.2 g/L (100.4-104.0) in the IG and 103.8 g/L (102.0-105.7) in the CG, with corresponding anaemia rates (Hb < 105 g/L) of 55.2% (47.1; 63.0%) and 47.7% (39.3; 56.2%). After intervention, IG had 106.2 g/L (104.2-108.1) vs CG 99.5 g/L (97.3-101.8), with anaemia rates of 36% (27.8; 45.1) and 67.3% (57.9; 75.4), respectively. Adjusted mean intra-group difference of haemoglobin (g/L) from baseline to follow-up was +2.8 in IG and -4.3 in CG. MNPs improved haemoglobin levels, supporting their potential for anaemia control in vulnerable populations. TRIAL REGISTRATION: https://ensaiosclinicos.gov.br/rg/RBR-4r37q7z. Registered 11/11/2024.
Medicine
Poeta M et al. · Jul 1, 2026
Purpose Elevated transaminases have been associated with increased severity in adult influenza cases, but data in the pediatric population are limited. This study aims to evaluate the prevalence, clinical characteristics and prognostic value of elevated transaminases in children hospitalized for influenza. Methods A multicentre retrospective cohort study was conducted on 543 children hospitalized for acute viral respiratory infections. Demographic, clinical, biochemical, radiological features, and outcome were collected and analyzed, comparing children with influenza to those with other respiratory viruses. The association between elevated transaminases and clinical severity, complications, and intensive care unit (ICU) admission was assessed. Results Among 543 children, 127 (23.4%) had laboratory-confirmed influenza, with 24.4% showing elevated transaminases versus 7.2% in noninfluenza infections (p Conclusion Elevated transaminases occur in one fourth of children hospitalized for influenza and are associated with more severe disease, systemic complications, and worse outcomes. The findings suggest that transaminase elevation reflects systemic and muscular involvement rather than primary liver injury. Monitoring transaminases provides an early, easy marker to identify children at risk of severe influenza.
Medicine
Hyvärinen M et al. · Jul 1, 2026
Background Assessing functional capacity is a key aspect of exercise testing and offers important insights into health in adult populations. However, accurate assessment often requires laboratory-based maximal tests. This pilot study investigated whether a field-based self-paced submaximal stair ascent test could feasibly assess aerobic capacity and lower-limb strength in middle-aged and older adults. Methods Twenty-eight participants (20 women, 8 men) aged 40 to 70 years completed maximal treadmill and isometric leg press tests to assess maximal oxygen consumption (VO 2 max) and lower-limb strength, respectively. Participants also performed two separate self-paced stair ascents of four and six flights. Ascent time, mean vertical power, as well as rate of perceived exertion, absolute heart rate, and relative heart rate following the test were recorded. Results Ascent time and mean vertical power were associated with VO 2 max and lower-limb strength, with standardized regression coefficients ranging from -0.61 to -0.27 and from 0.41 to 0.73, respectively. However, these associations were attenuated and no longer statistically significant after controlling for age and sex. Predictive models based on the two best-performing stair ascent predictors selected by LASSO regression showed weak-to-moderate ability to predict VO 2 max (R 2 = 0.21-0.52) with cross-validated model performance significantly different from zero. In contrast, the models did not significantly predict lower-limb strength. Conclusions These preliminary findings suggest that a brief self-paced stair ascent test may offer a feasible field-based approach for estimating aerobic capacity in middle-aged and older adults. However, its predictive accuracy appears limited and should be further examined in larger samples.
Medicine
Chintolo E et al. · Jul 1, 2026
Background Little is known about myocardial perturbations in African children hospitalised with severe anaemia. Methods An observational study nested within a clinical trial of blood transfusion was conducted on the paediatric ward in Blantyre, Malawi. Children were ages 2 months-12 years hospitalized with uncomplicated severe anaemia (haemoglobin 4-6 g/dl). By randomisation, 13 children received 30 ml/kg whole blood, 13 received 20 ml/kg whole blood and 26 had no immediate transfusion (usual care). We measured standard parameters of cardiac function using ultrasonic cardiac output monitoring (USCOM) at enrolment, 8 and 24 hours and discharge. Results Fifty-two children, median age 39 months (interquartile range [IQR] 25-58) and median haemoglobin 5.1 g/dl (IQR 4.8-5.6) were studied. Severe tachycardia and tachypnoea over time corrected faster in the transfused arms than the controls. At enrolment, the stroke volume index was within the normal range and 26/52 (50%) had a cardiac output index (COI) >97.5% the standard centile. The COI decreased in all arms by discharge but was greatest in the transfusion arms (p=0.05 for 20 ml/kg and p=0.009 for 30 ml/kg). A higher volume or receipt of whole blood did not worsen cardiac function. No child required diuretics. Conclusions The data generated by this small but granular study of haemodynamic and cardiac function provide reassuring physiological evidence showing the safety of higher doses of blood transfusion than currently recommended. It also supports the findings of a secondary analysis of the Transfusion and Treatment of Severe Anaemia in African Children trial indicating that whole blood transfusions are safe. These data support the new evidence-based paediatric transfusion algorithm for anaemic African children and its recommendation for safe use.
Medicine
Renda M et al. · Jul 1, 2026
Introduction Return to studies or employment, a major element of recovery after a first episode of psychosis (FEP), is out of reach of a significant proportion of patients. Specific programs such as Individual Placement Support (IPS) have been proposed to overcome this hurdle. While some early intervention programs include IPS, others must rely on IPS programs that are open to a wider range of patients. The aim of this paper was to explore the accessibility of IPS for FEP patients treated in such a context. Methods One hundred and eighty nine patients of an ongoing FEP cohort study who were treated at our program in the period where the IPS program was available and for whom sufficient data was available were included in the study. We assessed reasons for non-referral to RESSORT and compared baseline and outcome characteristics of patients who did or did not enter the program. Results A small minority of patients had access to RESSORT. Patients who entered RESSORT had better premorbid functioning and a higher degree of insight at baseline than the ones who did not enter the program. Patients who entered RESSORT had a significantly higher rate of return to premorbid PAS score, without significant difference on other dimensions of functioning. Conclusions When IPS programs are not embedded in early intervention programs, FEP patients have limited chances to access them. Integrating supported employment skills within the role of case managers may be a solution in programs where resources are lacking to develop an IPS program specifically dedicated to FEP patients.
Medicine
Zhu C et al. · Jul 1, 2026
Background Very high energy electron (VHEE) radiotherapy has gained growing interest owing to its potential to reach deep-seated targets and induce FLASH effect. Dose calculations can be performed using analytical or Monte Carlo (MC) methods. Analytical approaches enable rapid dose computation but suffer from limited accuracy in heterogeneous media, whereas MC methods provide high accuracy at the expense of substantial computational cost. Macro Monte Carlo (MMC) is a local-to-global method designed to improve dose calculation efficiency compared to general-purpose MC methods. In MMC, particle transport is based on precalculated transport data generated with general-purpose MC simulations on specific geometries, which is subsequently used to model particle transport over macroscopic steps within the absorber, avoiding computationally expensive microscopic tracking. MMC made it to a standard electron dose calculation engine in a commercial treatment planning system. However, to date, MMC has not been investigated for electron energies above 25 MeV. Purpose To develop and validate an MMC framework for VHEE radiotherapy that improves dose calculation efficiency while preserving accuracy compared to general-purpose MC methods for electron energies up to 250 MeV. Methods Local simulations were performed using EGSnrc with monoenergetic electron pencil beams incident perpendicularly on spherical geometries (0.2-25 MeV) with radii of 0.5-3 mm, and slab geometries (25-250 MeV) of 2 mm thickness, composed of various materials. Physical quantities including energy loss, lateral displacement, and angular distributions of primary and secondary particles were scored and stored in a database. This database was subsequently used to transport electrons step-by-step in the global simulations, employing slab-based transport at energies ≥25 MeV and switching to spherical geometries for electron energies 2 . MMC and EGSnrc dose calculations were also performed for two patient CT datasets. Comparisons between MMC and EGSnrc were conducted using integrated depth dose curves, lateral dose profiles, and 3D gamma analysis with 2%/1 mm and 2%/2 mm (global) criteria and a 10% dose threshold. All simulations were performed with statistical uncertainties below 1%, and computation times were recorded. Results Integrated depth dose curves and lateral dose profiles agreed within 2% of the maximum dose for all cases considered. For homogeneous and heterogeneous phantoms, MMC dose distributions yielded gamma passing rates above 97% (2%/1 mm) and 99% (2%/2 mm), respectively, compared to EGSnrc. For patient CT datasets, gamma passing rates exceeded 94% (2%/1 mm) and 97% (2%/2 mm). Overall, MMC achieved up to a 27-fold improvement in dose calculation efficiency compared to EGSnrc. Conclusions An MMC framework for VHEE dose calculation was successfully developed and validated for electron energies up to 250 MeV. The method demonstrated good agreement with EGSnrc while providing up to an order-of-magnitude improvement in dose calculation efficiency for the studied cases.
Medicine
Jones RA et al. · Jul 1, 2026
Issue addressed Early childhood education and care (ECEC) centres are an ideal setting to promote key healthy eating and active living (HEAL) practices. Redesigning messages around such practices to be digital could help engage ECEC educators and assist with long-term implementation and reach. The aim of this study was to evaluate the potential impact of a HEAL-focused video initiative (Small Bites for Big Steps) on precursors to behaviour change including educators' self-efficacy, perceived behavioural control and behavioural intentions and the acceptability of the videos. Method A pilot randomised controlled trial was conducted with early childhood educators (56% aged 25-44 years, 98% female). Participants randomised to the intervention group received on average 3-4 weekly videos promoting HEAL practices, whilst participants in the control group maintained usual practice. Educators' self-efficacy, perceived behavioural control, and behavioural intention were assessed using questionnaires at baseline and post-intervention (9 weeks). Data were analysed using Mann Whitney U tests in SPSS and thematic analysis. Acceptability data were collected using questionnaires, focus groups, interviews, and Vimeo analytics. Results One hundred and six educators from 16 ECEC services were recruited. Exploratory efficacy analysis found significant improvements from baseline to post-intervention between groups for healthy eating/drinking perceived behavioural control. At post-intervention, there was a significant difference between intervention and control groups for healthy eating/drinking behavioural intention, physical activity behavioural intention, and overall behavioural intention. No significant between group differences were observed for changes in perceived behavioural control relating to physical activity or for any self-efficacy measures. Educators valued the content, length and approach of the videos. Limitations identified from the qualitative data included technical difficulties and cultural appropriateness. Conclusions This video-based intervention positively influenced educators' perceived behavioural control and behavioural intentions, key precursors to behaviour change. The video suite was acceptable to educators. SO WHAT?: Redesigning HEAL messages into video resources may support ECEC educators to promote and implement these practices to young children and their families/carers.
Medicine