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Influenza virus cross-subtype antibodies targeting epitopes in the hemagglutinin (HA) head are rare because these epitopes are variable between influenza virus subtypes. We found that a large proportion of monoclonal antibodies (mAbs) isolated from individuals immunized with the 2021-22 seasonal influenza vaccine bound to an epitope on the HA head of both the H1N1 vaccine strain and H3N2 strains from the mid-1990s. The unmutated common ancestors of many of these mAbs reacted to both the 1990s H3s and the 2021-22 H1 vaccine strain. These cross-subtype antibodies were also found in polyclonal sera, but only among individuals born in the 1990s. Ferrets sequentially exposed to a 1990s H3N2 virus and contemporary influenza vaccine also produced H1/H3 cross-reactive antibodies. Recently, H1N1 viruses have acquired a substitution that abrogates the binding of these antibodies. Together, our study demonstrates how prior influenza virus exposures can influence the specificity of antibodies elicited by entirely different influenza virus subtypes.
Considerable advances in the prevention and treatment of traumatic spinal cord injury (SCI) have been made in the last 3 decades; hence, it can be assumed that the groups at risk, etiology, and characteristics of SCI have evolved in tandem. The objective of this study was to analyze SCI data to discern changes in patient demographics, etiology, and characteristics of injury over the last 3 decades. Data from 5 multicenter, prospective sources were combined to create a dataset representing the period from 1991 to 2020. The data were divided into 3 decades; 1991-1999, 2000-2009, and 2010-2020. The analyzed variables included patient age, sex, etiology, baseline injury severity based on the American Spinal Injury Association Impairment Scale (AIS), surgery, and timing of surgery. One-way ANOVA was performed to examine the association between patient age and decade, whereas chi-square tests were used to assess the association of sex, etiology, surgery, timing of surgery, and baseline severity with decade. Further analyses were done using univariate and multivariate regression to evaluate the relationship between age and sex, etiology, and decade. The overall dataset included 2642 patients. From the 1990s to the 2010s, the mean age increased independent of changes in etiology (p < 0.001), the frequency of injuries related to falls increased from 20.6% to 42.1% (p < 0.0001), and the frequency of SCIs related to motor vehicle collision decreased from 50.4% to 39.1% (p < 0.0001). Significant changes were observed when examining injury severity between the 1990s and 2010s: the percentage of complete SCI (AIS grade A) decreased from 58.3% to 49.8%, the percentage of incomplete SCI (AIS grades B, C, and D) increased from 41.7% to 50.2%, and the percentage of central cord syndrome increased from 33.7% to 54.7%. The percentage of patients undergoing surgical treatment increased from 73.8% to 96.8% (p < 0.0001), and the proportion that underwent early surgery increased from 20.6% to 43.9% (p < 0.0001). The changes in the demographics, etiology, and characteristics of SCI reflect a combination of an aging population, an increased public awareness of neurotrauma, and enhanced clinical management of older patients. These findings have implications for further research and the optimization of primary and secondary injury prevention strategies.
The North American Pediatric Renal Trials and Collaborative Studies (NAPRTCS) registry has tracked outcomes of children receiving maintenance dialysis since 1992. We analyzed 8923 incident pediatric dialysis patients enrolled from 1992 to 2020, grouped into three eras (1992-2000, 2001-2010, 2011-2020). Demographics, primary diagnoses, dialysis modality, survival, causes of death, and time to kidney transplant were assessed. The cohort was 56% male and 49% White. The most common causes of kidney failure were hypoplasia/dysplasia (15%), focal segmental glomerulosclerosis (14%), and obstructive uropathy (12%). Dialysis practices changed over time, with peritoneal dialysis (PD) declining as the initial modality from 66% in the 1990s to 40% in 2011-2020, while hemodialysis (HD) increased correspondingly. Infants represented an increasing proportion of patients initiating dialysis, rising from 15% in the 1990s to 25% in the most recent era. Three-year survival improved between the first and second eras to 90% but has remained stable in the past decade (91%). Infants had the lowest survival (77%). Among 734 deaths, cardiopulmonary causes remained stable across eras (22%), whereas infection-related mortality declined from 22 to 15% and occurred more frequently in PD than HD (23% vs. 12%, p < 0.05). 90% of children listed received a kidney transplant, and this was the most common cause of dialysis discontinuation. Over time survival on dialysis has improved, though survival rates have recently been relatively static. Cardiopulmonary causes of death have not shown a decrease in prevalence across dialysis eras.
The first protein kinases and their role in cell regulation were identified in the mid-1950s, but it was not until the 1980s that the first inhibitors of these enzymes were developed. More specific inhibitors that suppressed kinase activity at low nanomolar concentrations were described in the mid-1990s and their potential to treat cancers caused by kinase mutation became clear during the late 1990s. Over 100 protein and lipid kinase inhibitors have now been approved for clinical use during the 21st century with combined annual sales of over US$ 65 billion in 2024. They have not only transformed the clinical care of multiple malignancies but have also been exploited widely to identify physiological substrates and cellular functions of these enzymes. Here, I present some personal reflections on the early days of kinases and their inhibitors, give a few examples of how they were first exploited to dissect signal transduction pathways and explain how the first panels of protein kinases came to be established to facilitate the development of more specific kinase inhibitors.
Prostate cancer (PCa) incidence and prognosis have changed substantially worldwide in recent decades, driven in part by early detection recommendations. Some countries such as the US have shown a rise in metastatic PCa incidence following recommendations against routine PCa screening around 2012. To evaluate trends in PCa incidence, mortality, and relative survival across age and prognostic groups and guide policy and practice in Switzerland. This cohort study included all registered cases of primary PCa based on data from the Swiss National Agency for Cancer Registration and the Swiss Federal Statistical Office from January 1, 1980, to December 31, 2021. Data were analyzed from January 8, 2024, until February 20, 2026. Diagnosis of PCa. Age-standardized incidence and mortality rates and relative survival to 10 years after diagnosis were estimated. Subgroup analyses were conducted by age, Surveillance, Epidemiology, and End Results stage, Union for International Cancer Control stage, and Gleason score. The study included 142 665 cases of primary PCa registered in Switzerland between 1980 and 2021, 100 102 (70.2%) of which were men aged 60 to 79 years. From 1980 to 2004, PCa incidence increased to 226.6 (95% CI, 218.8-234.7) per 100 000 men; it decreased markedly to 173.5 (95% CI, 168.9-178.2) per 100 000 men between 2011 and 2014, then increased again to 220.6 (95% CI, 216.0-225.3) per 100 000 men in 2021. These trends were primarily observed for localized, stage I to II PCa and PCa with a Gleason score of 7 or less in men aged 50 to 79 years. Incidence of distant and stage IV PCa increased after 2011, while incidence of PCa with a Gleason score of 8 to 10 remained relatively stable. PCa mortality declined continuously from the early 1990s to 34.8 (95% CI, 32.9-36.8) per 100 000 men in 2021, while 10-year relative survival increased from 46.2% (95% CI, 43.7%-48.8%) in 1982 to 1991 to 88.5% (95% CI, 86.6%-90.5%) in 2012 to 2021. The 10-year relative survival among men with localized PCa (99.2%; 95% CI, 96.0%-102.4%) was similar compared with men from the general population. In this population-based cohort study, trends in PCa incidence in Switzerland suggest that overdiagnosis of lower-risk PCa increased and that there was a concurrent rise in cancers diagnosed in advanced stages alongside improvements in overall prognosis. These findings further suggest substantial potential for optimizing early detection of PCa.
Community violence is a significant public health and safety problem in the United States that disproportionately affects Black and Brown communities. Community violence intervention (CVI)-a healing-centered approach implemented by and for those most affected by community and structural violence-received historic federal investment beginning in 2021. These investments are now under threat from the Trump administration, which canceled hundreds of millions of dollars supporting CVI. In this analytic essay, we (1) critically examine how racialized ideological frames underlying CVI differ from more traditional tough-on-crime approaches, using federal policy responses during the 1980s to 1990s and early 2020s as points of comparison; and (2) describe the efforts, events, and movements that contributed to unprecedented federal investment in CVI in 2021 to 2022. At a time of intensified governmental efforts to roll back antiracist policies and programs, we offer a timely, historically contextualized, and theoretically grounded analysis of how ideology, collective action, and research shape policy decisions of critical importance to population health and safety. (Am J Public Health. Published online ahead of print May 8, 2026:e1-e10. https://doi.org/10.2105/AJPH.2026.308458).
We consider the Kelvin-Helmholtz system describing the evolution of a vortex-sheet near the circular stationary solution. Answering previous numerical conjectures in the 1990s physics literature, we prove an almost global existence result for small-amplitude solutions. We first establish the existence of a linear stability threshold for the Weber number, which represents the ratio between the square of the background velocity jump and the surface tension. Then, we prove that, for almost all values of the Weber number below this threshold, any small solution lives for almost all times, remaining close to the equilibrium. Our analysis reveals a remarkable stabilization phenomenon: the presence of both non-zero background velocity jump and capillarity effects enables us to prevent nonlinear instability phenomena, despite the inherently unstable nature of the classical Kelvin-Helmholtz problem. This long-time existence would not be achievable in a setting where capillarity alone provides linear stabilization, without the richer modulation induced by the velocity jump. Our proof exploits the Hamiltonian nature of the equations. More specifically, we employ Hamiltonian Birkhoff normal form techniques for quasi-linear systems together with a general approach for paralinearization of non-linear singular integral operators. This approach allows us to control resonances and quasi-resonances at arbitrary order, ensuring the desired long-time stability result.
Since the first edition in November 2011 initiated by ICRP, 25 Fukushima dialogue meetings have been held in 12 different municipalities of the Fukushima Prefecture. Based on the Belarus experience in the 1990s and 2000s as part of the rehabilitation of living conditions in the territories contaminated by the Chernobyl accident, the dialogue meetings are offering a fair and transparent forum to share concerns, values and opinions in mutual respect and equal opportunity not only between local residents, but also with experts, government officials, and people from various groups and organisations from Japan and abroad. The Fukushima Dialogue clearly underlined that beyond the fear of radiation, the challenge after a nuclear accident is to empower the affected people to allow them to gradually acquire a practical culture of radiation protection helping them to regain their dignity and project themselves again into the future. The dialogue meetings emphasised that technical risk communication, however precise and substantiated it may be, is not sufficient to address the questions and concerns of those affected by the accident in a context of distrust.
In the decades of the 1980s and 1990s, before the onset of biologic therapies for rheumatoid arthritis (RA) management, there was a significant number of patients who did not achieve remission or low disease activity (LDA), due to limited therapeutic choices. At that time, only some conventional synthetic disease modifying anti-rheumatic drugs (csDMARDs), along with steroids, were used. Nowadays, despite the progress of RA management with the introduction of biologic (b) and targeted synthetic (ts) DMARDs, which showed significant clinical improvement and retardation of radiological damage, unmet needs of RA treatment still exist. On the other hand, the concept of treat-to-target (T2T) approach and tight control monitoring of disease activity, are considered now the cornerstone for achieving remission or LDA in RA patients. Several clinical trials confirmed the efficacy and safety of csDMARDs using the tight control and T2T strategies. Methotrexate is the fundamental drug for RA management and in combination with other csDMARDs, with or without steroids, it has proven to be efficacious and safe and less expensive in comparison to newer biologic therapies. Furthermore, MTX demonstrated cardioprotective effects and reduced the risk of cardiovascular events in RA patients Therefore, there is a potential for improving treatment strategies with conventional therapies in the management of early RA. Optimal and early use of csDMARDs controls disease activity similarly to biologic therapies and is less expensive.
Aquaculture is the fastest-growing animal food-producing sector for human consumption globally. Increasing population size, density, and interconnectivity among farms are expected to markedly increase disease outbreak risks, threatening sector sustainability. Infectious diseases cause around a third of observed mortality in farmed salmon in Norway. Cardiomyopathy syndrome (CMS), caused by piscine myocarditis virus (PMCV), is one of the most frequently detected diseases and often causes high mortality in the late phase of salmon production, compromising fish welfare and causing significant economic losses. Despite its impact, the limited understanding of PMCV dispersal and its drivers hampers effective risk mitigation interventions. To address this, we generated one of the largest genomic datasets for any aquatic viral pathogen, focusing on PMCV collected from Scotland (United Kingdom) and Norway. Combined with detailed metadata, this enabled one of the most comprehensive phylodynamic analyses of a fish virus. Phylodynamic analyses reveal that PMCV likely emerged in farmed salmon concurrent with the global expansion of aquaculture, with a most recent common ancestor around the 1970s-1990s. We identify a distinctive national clustering of virus genomes, reflecting intranational spread interspersed with multiple introductions of distinct PMCV lineages into Scotland. We assess factors influencing virus spread, highlighting the importance of geographic proximity and at-sea farm density, and the possible role of boat connectivity in facilitating long-distance dispersal events. Overall, our study emphasizes the importance of viral genomics in understanding the evolutionary and dispersal dynamics of aquatic pathogens and informs targeted biosecurity strategies to mitigate the growing risk of viral disease in expanding aquaculture systems.
The endangered Austrian Turopolje (AT) pig population, which originated from six Croatian Turopolje founders imported during the early 1990s, is nowadays preserved through a national conservation project. This study aims to identify genetic relations, genetic distances and migration events between the AT population, four Austrian commercial breeds, and seven local Balkan breeds, as well as their inbreeding levels by using medium-density single nucleotide polymorphism (SNP) arrays. The AT population was well separated from the other breeds (multi-dimensional scaling and Admixture analyses), although displaying a relative genetic proximity to Croatian Turopolje, Hungarian Mangalitsa, and Swallow bellied Mangalitsa. AT did not show any sign of possible gene flow deriving from the other breeds, except for the Banija Spotted (Treemix analysis). The AT genetic variability did not appear negatively influenced by its recent demographic history (inbreeding based on runs of homozygosity, FROHav = 0.17 ± 0.05). Its inbreeding trend, although increasing, does not appear to be alarming compared to Croatian Turopolje. In conclusion, the results of this study possibly highlight how an efficient management of an originally very narrow genetic stock may have contributed to shape the current genetic make-up of this recently established population. The observed differentiation between AT and its ancestral counterpart (Croatian Turopolje) may not only reflect the consequence of the initial founder effect but also derive from different management practices over the last three decades. This study represents a first step towards awareness raising about the originality of a local pig population traditionally characterised by the intimate connection with its rural breeding area.
Pronounced variations in suicide mortality persist across Europe. Understanding long-term temporal patterns through age, period and cohort (APC) effects, alongside suicide means, is essential for tailored prevention. This study aims to determine how suicide mortality rates in Europe have changed across APC dimensions at national and subregional levels. Our analysis was restricted to European countries with complete age- and sex-specific suicide mortality data from 1990 to 2019 within the World Health Organization mortality database. The analysis comprised two components. The first component disentangled long-term suicide mortality trends (1990-2019) into APC dimensions using an age-period-cohort model via the National Cancer Institute's APC Web Tool. The second component involved an assessment of suicide means, restricted to 2010-2019 and to countries with detailed International Classification of Diseases, 10th Revision (ICD-10) cause-of-death data. In 2019, Europe recorded 47,793 male and 13,111 female suicide deaths. Overall suicide mortality rates declined in most subregions from 1990 to 2019, with the largest reductions among Eastern European men, from 77.81 (95% CI: 77.17-78.45) per 100,000 in the mid-1990s to 22.93 (95% CI: 22.58-23.28) per 100,000 by 2019, although this region retained the highest male suicide burden. Age-specific risk patterns differed markedly: among men, risk peaked in early adulthood and then declined in Eastern Europe, while in Western and Southern Europe, it was lower and more stable but rose after age 60; for women, risk was generally lower, with peaks in early adulthood in Eastern Europe and in midlife elsewhere. Period reflected continued improvement, especially in Eastern Europe where the period risk in 2015-2019 was approximately 60% lower than 2000-2004. Cohort effects similarly showed progressive declines. However, upward trends emerged among younger generations. In Northern Europe, the cohort relative risk for females increased from 0.73 (95% CI: 0.68-0.78) in the 1980 cohort to 0.90 (95% CI: 0.70-1.04) in the 2000 cohort. While the completeness of suicide means analysis varied by subregion, the primary data indicated that hanging was the predominant means for both sexes during 2010-2019. Despite an overall decline, suicide mortality in Europe exhibits persistent regional and demographic differences. This study reveals emerging risks among younger cohorts, specifically Northern European women and Southern European men, signalling shifting patterns that are not apparent from overall temporal trends alone. This evolving risk profile calls for sustained surveillance and research to investigate the drivers of these population-specific vulnerabilities.
Maternal mortality continues to be a major global health concern that disproportionately affects low- and middle-income countries (LMICs), with the World Health Organisation (WHO) estimating a maternal death occurring every two minutes. The data-sparse LMICs employ a multitude of estimation approaches to gauge maternal mortality ratios (MMR); however, their classification of deaths and reproducibility of estimates remain open to discussion. Despite a considerable reduction of MMR levels since 2000, more recently, the MMR levels in countries including the US have resurged due to the sociomedical crises brought about by the COVID-19 pandemic. The United Nations' Sustainable Development Goal (SDG) 3.1 aims to achieve global maternal mortality ratios of less than 70 per 100,000 live births and below 140 per 100,000 live births at the national level by 2030. However, recent projections indicate it will remain unmet by a margin of a million maternal deaths. Many LMICs apply the three-delays framework of maternal deaths that requires verbal autopsy to be used in tandem with the identification of maternal deaths. The three-delays model devised in the mid-1990s allows LMICs to gear their resources towards specific intervention points. A significant portion of the existing literature has focused on the description of the magnitude of the issue and the factors precipitating maternal deaths. Innovative solutions have recently been implemented, such as repurposing military helicopters to reduce the delays in managing obstetric complications. Similarly, prospective studies are required to devise ways to address the sociomedical mechanisms underlying maternal deaths.
Peer review is central to how nursing defines, validates, and circulates knowledge, yet its historical role in shaping the discipline's intellectual boundaries has received limited critical examination. This conceptual-historical paper traces the evolution of peer review in nursing across three eras: early professionalization and nursing journal formation (1880s-1950s), the pursuit of scientific legitimacy and evidence hierarchies (1960s-1990s), and the contemporary metric-driven, impact-factor environment (2000s-present). Drawing on frameworks of epistemic injustice, coloniality of knowledge, patterns of knowing, and audit culture, we argue that peer review has functioned as a mechanism of epistemic gatekeeping that has progressively aligned nursing scholarship with ongoing colonization through dominant biomedical and positivist standards in pursuit of professional legitimacy. This alignment has marginalized qualitative, community-based, decolonial, and practice-rooted inquiry while reproducing racialized, classed, and gendered hierarchies across editorial authority, methods, and citation practices. Yet threads of resistance reveal possibilities for change. We propose strategies to expand paradigm-appropriate definitions of rigor, diversify epistemic leadership, resist metric dominance, and embed structural competence and accountability in review practices. Transforming peer review is essential if nursing is to produce knowledge that is equitable, accountable, and responsive to structural conditions shaping health and care.
The additional singleton paradigm, introduced in the early 1990s, has become a cornerstone in attention research and the study of attentional capture. In this task, observers search for a unique target singleton while an irrelevant, but salient distractor singleton is also present. Decades of research have demonstrated that such distractors reliably slow responses, supporting a stimulus-driven account of attentional selection. This paper reviews the origins of the paradigm, key findings, and ongoing debates, with particular focus on design features that shape results. Critical factors include the consistency of target-distractor assignments, distractor prevalence, display size, target-distractor similarity, and the use of compound versus simple search tasks. Guidelines are presented to maximize the paradigm's utility and to avoid misinterpretation of attentional capture effects. The review concludes that the additional singleton task continues to provide unique leverage in distinguishing stimulus-driven selection from top-down control.
This study explores how a sample of Generation Z women (Mage = 22 years) in the Republic of Ireland negotiate empowerment and disempowerment in their experiences of sexual and reproductive health. Five semi-structured focus groups (N = 30) were conducted with undergraduate women at an Irish university between December 2024 and January 2025. Using reflexive thematic analysis, three themes were developed: (1) Stigma surrounding sexual and reproductive health in families and medical spaces, (2) Empowerment through peers and social media, and (3) Navigating stigma and empowerment simultaneously. Family and clinical encounters often reproduced silence, dismissal, and discomfort, while peer and digital platforms fostered collective knowledge-sharing and resistance. Anticipated judgement from healthcare providers contributed to hesitancy and withdrawal from care. Notably, stigma and empowerment were not experienced as opposites but as coexisting and relational, shaping how participants made sense of their bodies and health needs. These findings highlight the need for health and medical practitioners to move beyond procedural care, fostering relational, sensitive, and culturally responsive dialogue. By centring the voices of Generation Z women (typically defined as those born between the late 1990s and early 2010s), this study offers insights into avenues for empowerment, informed decision-making, and equitable access to sexual and reproductive health services.
This article offers a Bourdieusian analysis of the demobilization of Brazil's AIDS movement, once a globally celebrated force in shaping innovative, rights-based public health responses. Drawing on extensive qualitative data, I argue that the movement's decline cannot be explained solely by institutional co-optation, biomedicalisation, or defunding, as suggested in previous scholarship. Instead, I conceptualise demobilisation as a deeper process of depoliticisation that emerges from transformations in the distribution of capital, shifts in habitus, and structural changes in the field of power under neoliberalism. I trace how the pauperisation of the epidemic brought into the field new agents with different dispositions, challenging the movement's politicised doxa forged in the 1980s and 1990s and fragmenting the field. The analysis emphasises the role of symbolic struggles over legitimacy and the effects of changing political-economic logics on activist practices. By combining field theory with a grounded empirical study of Brazil's AIDS movement, the article contributes to broader debates on the sociology of social movements, the neoliberal restructuring of civil society and the conditions of possibility for re-politicisation.
Miniprobe endoscopic ultrasonography (mEUS) combines high-resolution imaging of the gastrointestinal (GI) wall and bile ducts with ease of applicability during routine endoscopy. This narrative review aims to provide an overview of known and emerging fields of application for mEUS in gastrointestinal endoscopy. After its initial development in pancreatobiliary scenarios in the early 1990s, mEUS has been recently reconsidered a third-space endoscopic technique that is progressively developing and spreading for the treatment of early gastrointestinal neoplastic lesions. The high spatial resolution of mEUS provides an accurate assessment of the degree of submucosal invasion in early esophageal, gastric, and colorectal neoplasia, while the small caliber of catheters allows for mEUS employment in settings where standard echoendoscopes are impractical (e.g., severe stenoses or proximal colonic lesions). Beyond cancer staging, mEUS offers point-of-care characterization of subepithelial lesions by defining the layer of origin and echo-pattern, eventually defining endoscopic resectability, but definitive diagnosis remains histological. In pancreatobiliary diseases, miniprobe intraductal ultrasonography (IDUS) shows its strongest application for indeterminate biliary strictures when endoscopic retrograde cholangiopancreatography (ERCP)-based sampling strategies and brushing cytology show inconclusive diagnoses, and in choledocholithiasis, particularly for the detection of small stones/sludge and confirmation of duct clearance. IDUS is also valuable for the staging of ampullary tumors, for longitudinal extension mapping in hilar cholangiocarcinoma and for selected portal biliopathy scenarios. Overall, mEUS and IDUS are high-resolution adjuncts that can meaningfully refine local decision-making in the treatment of superficial epithelial/subepithelial tumors or lesions involving the bile ducts. Limitations include shallow penetration, lack of tissue acquisition capability, a relative increase in post-ERCP pancreatitis risk for intraductal use, and substantial cost with limited availability in lower-volume centers.
Adolescence is a vital time in human development, marked by fast physiological and mental changes that render teenagers more vulnerable to psychological suffering. With the growing frequency of mental health concerns among adolescents, the question of how to effectively intervene and help them in dealing with these challenges has emerged as a critical topic in the field of psychotherapy. Schema therapy, originally proposed by Young in the 1990s as an integrative psychotherapy approach, was initially developed for the treatment of chronic psychological disorders, particularly personality disorders. However, as schema therapy has evolved, its scope of application has gradually expanded, and numerous studies and clinical practices have begun to explore its use in adolescent populations. This paper focuses on schema therapy for adolescents, evaluating and summarizing important literature from 2000 to 2025 to inform future research and clinical practice.