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{"title":"Sustaining progress in HIV care in Africa with a transition to enabled self-care: a modelling study.","authors":"Andrew N Phillips,Kenly Sikwese,Valentina Cambiano,Loveleen Bansi-Matharu,Jennifer Smith,Euphemia Sibanda,Cheryl Johnson,Brooke E Nichols,Edinah Mudimu,Frances M Cowan,Paul Revill","doi":"10.1016/s2214-109x(26)00088-4","DOIUrl":"https://doi.org/10.1016/s2214-109x(26)00088-4","url":null,"abstract":"BACKGROUNDThe funding crisis for HIV services in east, central, southern, and west Africa means that innovative strategies for continuing prevention and care for HIV are needed. One such strategy is enabled self-care: the provision of free HIV self-tests, pre-exposure prophylaxis (PrEP), tenofovir-lamivudine-dolutegravir for post-exposure prophylaxis (PEP), and antiretroviral therapy (ART) provided in local pharmacies and by community-based health workers. We modelled the introduction of a policy of transition to enabled self-care compared with continuation of current service provision.METHODSWe used an established individual-based model (HIV Synthesis) to simulate HIV epidemics in 1000 setting scenarios representing diversity in setting characteristics across east, central, southern, and west Africa, and uncertainty in parameter values. For each setting scenario, we simulated 100 000 people aged ≥15 years between 1989 and 2076. The model incorporates ART access informed by studies of barriers to accessing clinics. Our main outcomes included the number of adults testing for HIV in a 3-month period, PrEP and PEP use, coverage of people on ART, HIV-related deaths, HIV incidence, perinatal transmission, disability-adjusted life-years (DALYs), and costs. We chose a 50-year time horizon to capture the full effects of the policies. For each setting scenario, we performed three replicate runs for each of the two policies and for each policy took the mean across the three runs.FINDINGSOur model estimated that transitioning to enabled self-care would lead to increases in testing from a median of 5·0% (90% range 2·3-11·5) of adults testing per 3 months to 12·7% (6·6-21·1), an increase in PrEP and PEP use (+0·5% of adults [0·0-2·2]), and an increase in ART coverage for people with diagnosed HIV (+1% [0-3]) with enhanced benefits in those previously without access to PrEP and testing services. Enabled self-care was predicted to result in a median 18% (90% range 4-33) fewer HIV deaths, and a relative rate of 0·73 (0·52-0·94) in terms of HIV incidence per 100 person-years over 10 years. Overall, over a 50-year time horizon, enabled self-care was predicted to cut discounted programme costs by US$6·0 million (5·6-6·5; a 7% decrease), avert 34 000 (32 200 to 36 000) DALYS, and be cost-effective (at a cost-effectiveness threshold of $300 per DALY averted) in 95% of setting scenarios. The mean undiscounted annual cost per adult in the population per year across setting scenarios was $12 (median $11 [90% range 6-22]). The higher the HIV prevalence was in a setting scenario, the more cost-effective the policy was found to be (odds ratio 1·41 [95% CI 1·25-1·60] per 1% higher HIV prevalence).INTERPRETATIONIntroduction of community access to self-tests and antiretroviral drugs through a transition to enabled self-care is very likely to be cost-effective in most settings in east, central, southern, and west Africa; enable incidence declines to be sustained at reduced cos","PeriodicalId":48783,"journal":{"name":"Lancet Global Health","volume":"40 1","pages":"103943"},"PeriodicalIF":34.3,"publicationDate":"2027-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148349219","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enabled self-care for HIV infection: an inflection point for sustainable epidemic control.","authors":"Dvora Joseph Davey","doi":"10.1016/j.langlo.2026.103970","DOIUrl":"https://doi.org/10.1016/j.langlo.2026.103970","url":null,"abstract":"","PeriodicalId":48783,"journal":{"name":"Lancet Global Health","volume":"1 1","pages":"103970"},"PeriodicalIF":34.3,"publicationDate":"2027-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148349222","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A qualitative study on fertility preferences and barriers to fertility autonomy in rural Uganda among women with an unmet need for family planning.","authors":"Rebecca L Luttinen, Christine Muhumuza, Susan M Kiene, Rhoda K Wanyenze, Trace S Kershaw, Haruna Lule, Samuel Sekamette, Katelyn M Sileo","doi":"10.1080/17441692.2026.2635898","DOIUrl":"https://doi.org/10.1080/17441692.2026.2635898","url":null,"abstract":"<p><p>Women's autonomy in fertility decision-making is essential for improved health and social outcomes. Guided by the social-ecological model, this investigation explores multilevel influences on the fertility autonomy of women with an unmet need for family planning in rural Uganda. We conducted four focus groups with men and women (<i>n</i> = 26), and 15 key informant interviews with community leaders and individuals involved in the provision of family planning. The data were analyzed thematically. The results highlight how community-level norms reinforce gender inequalities in decision-making and underpin beliefs to not limit men's number of children. Religious norms and polygamy practices were shown to influence attitudes towards family size and family planning, as well as shape relationship dynamics related to fertility. Concerns about poverty were identified as a driver of shifting preferences and increasing acceptance of family planning. Results showcase how health system weaknesses limit women's access to family planning services, contribute to mistrust of health systems and drive misinformation about contraceptives, especially among men. This study underscores the need for multifaceted gender transformative interventions to increase women's fertility autonomy. This study also highlights health system strengthening, religious leader endorsement and male engagement as approaches to increase women's autonomous use of family planning.</p>","PeriodicalId":12735,"journal":{"name":"Global Public Health","volume":"21 1","pages":"2635898"},"PeriodicalIF":2.1,"publicationDate":"2026-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147304604","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adipose-derived mesenchymal stem cells-derived exosomes containing nano-pearl powder water-soluble matrix promote osteogenic differentiation of MC3T3-E1 cells.","authors":"Ling Chen, QiuHua Mao, WenBai Zhang, YaNan Cheng","doi":"10.1080/15476278.2026.2630547","DOIUrl":"10.1080/15476278.2026.2630547","url":null,"abstract":"<p><strong>Objective: </strong>To explore the synergistic effect of nano-pearl powder (NPP) and adipose-derived stem cell exosomes (ADSC-Exos) on the osteogenic potential of MC3T3-E1 cells.</p><p><strong>Methods: </strong>The water-soluble matrix of NPP (NPP-WSM) was extracted via freeze-drying, and ADSC-Exos were isolated by ultracentrifugation. NPP-WSM was incorporated into ADSC-Exos through co-incubation to generate NPP-WSM-Exos. MC3T3-E1 cells were treated with NPP-WSM or NPP-WSM-Exos. Cell proliferation and migration were evaluated using CCK-8 and wound-healing assays, respectively. Osteogenic differentiation was assessed by Alizarin Red S staining and alkaline phosphatase (ALP) activity. The expression of osteogenesis-related genes (COL1A1, RUNX2, OCN, and OPN) was measured by qPCR and Western blotting. Transcriptome sequencing (RNA-seq) was conducted to identify signaling pathways activated by NPP-WSM-Exos.</p><p><strong>Results: </strong>NPP-WSM-Exos displayed distinct exosome morphology and biomarkers, confirming their successful preparation. Significantly, NPP-WSM-Exos enhanced the viability of MC3T3-E1 cells compared to NPP-WSM alone and upregulated the expression of osteogenic genes, including COL1A1, RUNX2, OCN, and OPN, at both the transcriptional and translational levels. Additionally, NPP-WSM-Exos strongly promoted mineralization, as evidenced by the increased calcification observed through Alizarin Red S staining, and elevated alkaline phosphatase (ALP) activity, indicating excellent potential for osteogenic differentiation. Transcriptome sequencing showed that NPP-WSM-Exos significantly enhanced the PI3K/AKT pathway in MC3T3-E1 cells, while protein level detection indicated that NPP-WSM-Exos could increase AKT phosphorylation levels and inhibit GSK3β activity to improve osteogenic efficiency.</p><p><strong>Conclusion: </strong>The use of adipose-derived stem cell exosomes to encapsulate NPP-WSM can increase the utilization of WSM, promote the proliferation of MC3T3-E1, and enhance the osteogenic differentiation ability.</p>","PeriodicalId":19596,"journal":{"name":"Organogenesis","volume":"22 1","pages":"2630547"},"PeriodicalIF":2.8,"publicationDate":"2026-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12947552/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147308609","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"生物学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gut microbiota and hypertension: role of exercise training.","authors":"Meng Zhao, Qi Liu, Na-Jie Shi, Ying Li, Hong-Bao Li","doi":"10.1080/10641963.2025.2608905","DOIUrl":"https://doi.org/10.1080/10641963.2025.2608905","url":null,"abstract":"<p><p>Regular exercise training can significantly improve the gut environment and influence the metabolic activity of the gut microbiota. These changes promote the production of beneficial metabolites, which may modulate blood pressure regulation through multiple mechanisms. The beneficial microbial species including <i>Faecalibacterium prausnitzii</i>, <i>Bifidobacterium</i> spp., <i>Lactobacillus</i> spp., <i>Roseburia</i> spp.,and <i>Bacteroides</i> spp. These beneficial microbes produce various metabolites during metabolism, including short-chain fatty acids, vitamins, lactic acid, bileacids, and gamma-aminobutyric acid. These metabolites are not only essential for maintaining gut health but also positively influence hypertension by modulating the nervous system, immune system, and improving metabolic function. This review aims to elucidate the complex interactions among exercise training, gut microbiota, and hypertension.</p>","PeriodicalId":10333,"journal":{"name":"Clinical and Experimental Hypertension","volume":"48 1","pages":"2608905"},"PeriodicalIF":3.5,"publicationDate":"2026-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145846328","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acute phenylcapsaicin supplementation improves CrossFit® performance: a randomized, triple-blind, placebo-controlled crossover trial.","authors":"Alejandro R Triviño, Carlos Díaz-Romero, Juan J Martin-Olmedo, Pablo Jimenez-Martinez, Carlos Alix-Fages, Magdalena Cwiklinska, Daniela Pérez, David Funes Pol, Lucas Jurado-Fasoli","doi":"10.1080/15502783.2026.2615274","DOIUrl":"10.1080/15502783.2026.2615274","url":null,"abstract":"<p><strong>Background: </strong>Phenylcapsaicin (PC) may enhance high-intensity exercise performance by reducing perceived exertion, increasing mechanical output, and limiting muscle damage, making it potentially beneficial for CrossFit^® (CF) athletes.</p><p><strong>Objective: </strong>To examine the acute effects of PC supplementation on performance, recovery, and metabolic responses during a CF session.</p><p><strong>Methods: </strong>This study had a randomized, triple-blind, placebo-controlled crossover design. Fifty CF-trained athletes (50% women) ingested either 2.5 mg of PC or a placebo (PLA) 45 minutes before a standardized CF session, including a warm-up, weightlifting block, and WOD. Delayed-onset muscle soreness (DOMS) was assessed 24- and 48-hours post-session. Countermovement jump (CMJ) was evaluated pre- and post-session, while a deep squat at 70% 1RM was performed post-session. Throughout the session, heart rate, capillary lactate, rating of perceived exertion (RPE), and perceived recovery status (PRS) were monitored.</p><p><strong>Results: </strong>Compared to PLA, PC improved squat performance at 70% 1RM in both load and repetitions (<i>P</i> ≤ 0.035), attenuated the decline in CMJ (<i>P</i> < 0.001), and maintained weightlifting performance over time (<i>P</i> interaction = 0.011), with significantly higher load in round 9 (<i>P</i> = 0.030). No differences were observed during the WOD (<i>P</i> interaction ≥ 0.826). DOMS was significantly lower in the PC group at both 24 h and 48 h (<i>P</i> = 0.030), while no group differences were found for lactate, RPE, PRS, or heart rate (<i>P</i> interaction ≥ 0.340). Analysis stratified by sex showed that PC reduced CMJ loss in men (<i>P</i> = 0.043) and increased squat load in women (<i>P</i> = 0.021).</p><p><strong>Conclusion: </strong>In conclusion, acute PC supplementation enhances performance and recovery in CF athletes.</p>","PeriodicalId":17400,"journal":{"name":"Journal of the International Society of Sports Nutrition","volume":"23 1","pages":"2615274"},"PeriodicalIF":3.9,"publicationDate":"2026-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12810409/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145971150","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dengue modelling and policy integration: A necessary step toward sustainable epidemic control.","authors":"Mukhamad Zulianto","doi":"10.1080/17441692.2026.2631237","DOIUrl":"https://doi.org/10.1080/17441692.2026.2631237","url":null,"abstract":"","PeriodicalId":12735,"journal":{"name":"Global Public Health","volume":"21 1","pages":"2631237"},"PeriodicalIF":2.1,"publicationDate":"2026-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146179120","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bilateral hypertensive retinopathy (grade 4): Case report and review of the literature on intravitreal injection anti-VEGF therapy.","authors":"Yang Jianjun","doi":"10.1080/10641963.2025.2604831","DOIUrl":"10.1080/10641963.2025.2604831","url":null,"abstract":"<p><strong>Objective: </strong>To introduce bilateral hypertensive retinopathy (HR) (grade 4) complicated with macular edema (ME) patients with binocular intravitreal injection of anti-vascular endothelial growth factor (anti-VEGF) treatment.</p><p><strong>Methods: </strong>Three cases of hypertensive retinopathy were observed. The fundus examination was consistent with HR (grade 4). The patients received anti-VEGF intraocular injection.</p><p><strong>Results: </strong>The patient's ME and optic nerve edema were significantly reduced, visual acuity was significantly improved, and a case of secondary choroidal neovascularization (CNV) in the fundus of HR (grade 4) was also noted.</p><p><strong>Conclusions: </strong>The use of intravitreal anti-VEGF agents in stage IV hypertensive retinopathy appears satisfactory but not perfect. In severe cases with vitreous hemorrhage, early injection avoids vitrectomy.</p>","PeriodicalId":10333,"journal":{"name":"Clinical and Experimental Hypertension","volume":"48 1","pages":"2604831"},"PeriodicalIF":3.5,"publicationDate":"2026-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145818438","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comments on \"efficacy of mindfulness-based interventions on perinatal mood disorders and neonatal outcomes: a systematic review and meta-analysis\".","authors":"Archana Mehta, Sushma Narsing Katkuri, Varshini Vadhithala, Arun Kumar, Sushma Verma, Dhanya Dedeepya","doi":"10.1080/0167482X.2025.2611110","DOIUrl":"https://doi.org/10.1080/0167482X.2025.2611110","url":null,"abstract":"","PeriodicalId":50072,"journal":{"name":"Journal of Psychosomatic Obstetrics & Gynecology","volume":"47 1","pages":"2611110"},"PeriodicalIF":2.0,"publicationDate":"2026-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145858930","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A dual diacylglycerol kinase (DGK) alpha/zeta inhibitor augments the activity of human tumor infiltrating lymphocytes in <i>in vivo</i> and <i>ex vivo</i> models.","authors":"Phurin Areesawangkit, Karen Pei-Yi Fong, Emma Niemeyer, Yan Li, Kelly Markowitz, Devora Delman, Ryan Krause, Justine Carl, Pat Feldman, Lisa Troung, Rodrigo Hess, Xiaodi Ren, Cynthia Timmers, Sunkyu Kim, Robert Brody, Sunil Singhal, Jarrod Predina, Evgeniy Eruslanov, Gregory Beatty, Bihui Melidosian, Steven M Albelda","doi":"10.1080/2162402X.2025.2608439","DOIUrl":"10.1080/2162402X.2025.2608439","url":null,"abstract":"<p><p>Endogenous or adoptively transferred tumor-infiltrating lymphocytes (TILs) often lose their functional capacity due to the activation of intrinsic inhibitory pathways, which then limits their ability to control tumor growth. In this study, we examined the effects of blocking a key intracellular inhibitory enzyme, diacylglycerol kinase (DGK) in human T cells, using a novel inhibitor (DGKi) called INCB165451 that blocks both DGKα and DGKζ, the two primary DGK isoenzymes that negatively regulate T cells through the diacylglycerol (DAG) signaling pathway. We first evaluated the effects of the DGKi in enhancing the efficacy of adoptive human T cell transfer in a non-small cell lung cancer (NSCLC) mouse model and found that the DGKi significantly potentiated anti-tumor efficacy through multiple mechanisms, including increased intratumoral T cell infiltration, upregulation of genes associated with inflammatory responses, and reduction of TIL hypofunction, as evidenced by enhanced cytokine production following ex vivo anti-CD3 antibody stimulation. We next studied the effects of the DGKi on human TILs derived from tumor digests or studied <i>in situ</i> in precision-cut tumor slices of both head and neck cancer and NSCLC patient samples. After stimulation of the TILs with anti-CD3 antibodies, we found that the DGKi enhanced gene and protein expression of proinflammatory cytokines and chemokines. Finally, we demonstrated that the DGKi could augment T cell activation in human tumor slices that were stimulated by an anti-EGFR/anti-CD3 bispecific T cell engager (BiTE). These data demonstrate strong activity of the DGKi in human TILs and highlight promising potential avenues for clinical translation.</p>","PeriodicalId":48714,"journal":{"name":"Oncoimmunology","volume":"15 1","pages":"2608439"},"PeriodicalIF":6.5,"publicationDate":"2026-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12758329/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145851153","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}