J Glob Infect Dis. 2026 Mar 27;18(1):35-40. doi: 10.4103/jgid.jgid_99_25. eCollection 2026 Jan-Mar.

ABSTRACT

INTRODUCTION: Pneumocystis jirovecii pneumonia (PJP) is a severe opportunistic infection in patients with weakened immune function, especially those infected with human immunodeficiency virus (HIV) and various non-HIV immunocompromised patients. Here, we retrospectively compared the clinical, laboratory, and imaging features of PJP between HIV-infected and non-HIV-immunodepressed patients in Jiangxi Province to improve diagnostic accuracy and guide clinical treatment. Statistical analysis using normality tests (Shapiro-Wilk), t-tests, and nonparametric tests highlighted major differences between the two groups.

METHODS: The study included patients diagnosed with PJP from January 2020 to December 2024 in a tertiary A hospital in Jiangxi Province. The patients were divided into two groups: HIV infection (n = 30) and non-HIV immunosuppression (n = 60). Clinical data, laboratory results, and imaging findings of the two groups were analyzed. Statistical tests including Shapiro-Wilk normality test, t-test for normally distributed variables, and nonparametric test were performed using SPSS version 26.0 to determine significant differences between groups.

RESULTS: Compared with the HIV group, non-HIV immunocompromised patients had a higher mechanical ventilation rate and a higher likelihood of intensive care unit admission (P < 0.05). HIV-infected patients are younger and exhibit more severe systemic and respiratory symptoms (fever, dyspnea, cough, and asthma). Blood analysis showed white blood cell (WBC), Neutrophilicgranulocyte (NE), blood urea nitrogen (blood urea nitrogen) in non-HIV group. BUN) and Creatine Kinase MB Isoenzyme (CK-MB) levels were significantly increased (p<0.05), suggesting that most of these patients were complicated with immune function disorders such as heart, lung and kidney. The level of albumin-globulin (GLB) in HIV was significantly reduced, suggesting that the disease involved the liver or kidney and may be advanced. Imaging studies showed mediastinal lymph nodes, pleural effusion, bilateral infiltration, and ground-glass shadow in both groups. However, bilateral small pulmonary nodules, ground-glass shadows, and mediastinal lymph nodes were predominant in HIV patients, suggesting that various opportunistic infections may have occurred. In non-HIV immunocompromised patients, bilateral small lung nodules, mixed low-density shadows, and pleural effusion were predominant, suggesting a variety of potential diseases. A state of immunosuppression can lead to increased susceptibility to infection, tumorigenesis, and an increase in autoimmune diseases.

CONCLUSION: The majority of HIV-infected PJP patients in Jiangxi Province are young men, showing systemic symptoms and abnormal early lung imaging features. Non-HIV immunocompromised PJP patients showed nonsystemic symptoms and advanced lung imaging abnormalities. Basophils, total protein (TP), and GLB can reflect some states of the immune system. It can be used to preliminarily distinguish PJP patients with HIV infection from non-HIV immunocompromised patients. PJP co-infection with HIV usually involves complex immune responses and clinical manifestations, and relying on these indicators alone is not ideal for identification. A more accurate identification method should be combined with clinical symptoms, medical history, immune function tests (such as CD4+ T-cell count), viral load, and other indicators for comprehensive evaluation. Therefore, although the above indicators can provide a certain reference value for identification, they cannot be used as the only basis.

PMID:41958494 | PMC:PMC13061152 | DOI:10.4103/jgid.jgid_99_25

Front Sports Act Living. 2026 Mar 25;8:1768915. doi: 10.3389/fspor.2026.1768915. eCollection 2026.

ABSTRACT

INTRODUCTION: The objective of this study is to evaluate whether intermittent hypoxia can enhance physical recovery following the induction of delayed onset muscle soreness (DOMS).

METHODS AND ANALYSIS: A randomized controlled trial will be conducted with male participants aged 18-35 years who engage in at least two organized training sessions per week. After a DOMS induction protocol targeting the hamstrings, participants will be randomized to receive either intermittent hypoxia, hypoxia-hyperoxia, or placebo for five consecutive days. During this period, several outcome variables will be assessed, including: cognitive function-attention and executive functions (D2 Test and Trail Making Test A and B); stress (DASS-21 questionnaire); physical performance-VO₂max, countermovement jump (CMJ, My Jump App), 30-m sprint speed (MySprint App), one-repetition maximum in half-squat (Vitruve linear encoder), isometric hamstring strength (ActivForce2 dynamometer), muscle soreness (VAS scale), heart rate variability, muscle oxygen saturation, hip flexion range of motion with extended knee (Goniometer Pro App); and blood inflammatory markers: HIF-1α, PGC-1α, Klotho protein and lactate. To analyze the effects of the intervention, a repeated-measures ANOVA will be performed to assess Group × Time interactions.

ETHICS AND DISSEMINATIONS: The study was reviewed and approved by the Medical Ethics Committee of Hospital Clínico San Carlos, Madrid, Spain (internal code 25/446-E) prior to data collection. If effective, intermittent hypoxia and hypoxia-hyperoxia could be implemented as non-pharmacological recovery strategies for athletes and physically active populations, offering a novel alternative to current methods with inconsistent results. The findings may guide future research on hypoxic conditioning, inform clinical practices for rehabilitation and performance recovery, and potentially shape policy regarding safe, evidence-based applications of hypoxia in sports medicine.

CLINICAL TRIAL REGISTRATION: https://www.anzctr.org.au/, registration code ACTRN12625001404415.

PMID:41958823 | PMC:PMC13057297 | DOI:10.3389/fspor.2026.1768915

Eur J Popul. 2026 Apr 10. doi: 10.1007/s10680-025-09762-6. Online ahead of print.

ABSTRACT

Lifespan inequality is a fundamental indicator of population health, reflecting inequalities in the timing of death. Life expectancy-based indicators have been widely used to monitor changes in lifespan variation across populations. This study proposes using indicators relative to the modal age at death (M): the standard deviation below the mode, [Formula: see text], which captures variation in premature mortality, and the standard deviation above the mode, [Formula: see text], which reflects variation in senescent mortality. Although trends in [Formula: see text] are relatively well documented, less is known about how [Formula: see text] has changed over time and what drives these changes. This study aims to (1) document and compare trends in [Formula: see text] and [Formula: see text] across high-income countries since 1960, and (2) examine the contribution of cause-specific mortality to changes in [Formula: see text] in selected countries. To achieve this, we propose a novel two-step decomposition method. In the first step, changes in [Formula: see text] are decomposed into two components: one attributable to shifts in the modal age itself (“mode” component) and another to changes in the shape of the age-at-death distribution (“distribution” component). In the second step, the “distribution” component is further decomposed by cause of death. Applying this framework to data from Japan and the U.S., results revealed that the decline in [Formula: see text] in the U.S. was primarily driven by reductions in heart disease and neoplasm mortality. However, these gains were partially offset by increased variation linked to infectious diseases and external causes. In Japan, declines in [Formula: see text] were primarily driven by reductions in cerebrovascular diseases, heart disease (women), and neoplasms (men), while increases in variation since the mid-1990s were largely attributable to external causes and neoplasms (women). This decomposition is a useful tool for identifying the factors that drive or hinder the compression of premature mortality.

PMID:41961155 | DOI:10.1007/s10680-025-09762-6

J Urol. 2026 Apr 10:101097JU0000000000005061. doi: 10.1097/JU.0000000000005061. Online ahead of print.

ABSTRACT

OBJECTIVES: To examine generalized sensory sensitivity (GSS) in patients with urinary urgency.

METHODS: Adult men and women who presented with urinary urgency, with or without urgency incontinence, and seeking treatment for their overactive bladder (OAB) were enrolled in the Symptoms of Lower Urinary Tract Dysfunction Research Network (LURN) II Study. Controls without urgency or incontinence was enrolled. The GSS-Short Form (GSS-SF) questionnaire was used to assess self-reported sensitivity to external environmental stimuli (chemicals, bright lights, sounds), sensitivity to internal bodily sensations (dry mouth, rapid heart rate, balance), and the anatomical extent of body pain.

RESULTS: 617 cases with urinary urgency and 125 controls were included. Cases had higher total GSS-SF scores (median 2 vs. 0, p<0.001) compared to controls. For each of the three external stimuli and three internal sensations, cases were more likely than controls to report heightened sensitivity to environment stimuli and internal bodily sensations. There were significant positive correlations between GSS-SF total scores and OAB-q symptom severity (ρ=0.23, p<0.001), LURN SI-29 urgency subscales (ρ=0.19, p<0.001), and LURN SI-29 incontinence subscales (ρ=0.21, p<0.001). GSS-SF was negative correlated to OAB-q Health-Related Quality of Life (ρ=-0.24, p<0.001).

CONCLUSIONS: Patients with urinary urgency had higher GSS compared to controls without urgency. Cases with higher GSS scores had more severe OAB symptoms and worse HRQL. These findings suggest a subset of urinary urgency patients may exhibit global, multisystem hypersensitivity to sensory input. In these individuals, bladder symptoms may represent a manifestation of broader sensory dysregulation rather than an isolated organ-specific pathology.

PMID:41962022 | DOI:10.1097/JU.0000000000005061

JMIR Public Health Surveill. 2026 Apr 10;12:e88806. doi: 10.2196/88806.

ABSTRACT

BACKGROUND: While prior studies have examined structural and individual-level barriers to pre-exposure prophylaxis (PrEP) uptake, little is known about the psychological mechanisms underlying resistance to PrEP, particularly among high-risk groups. The status quo bias (SQB) theory provides a theoretical framework for understanding why individuals may resist beneficial health innovations.

OBJECTIVE: The aim of this study was to examine the associations between SQB and PrEP resistance intention among Chinese men who have sex with men (MSM) and to test whether condom-use inertia moderated these relationships.

METHODS: We conducted a cross-sectional online survey among 1022 MSM in China from November 2024 to February 2025. Theory-guided multi-item measures were constructed to capture key dimensions of SQB. Their internal consistency and construct validity were examined using confirmatory factor analysis prior to regression modeling. Multiple linear regression models assessed main effects and moderation effects, adjusting for sociodemographic and behavioral covariates.

RESULTS: A total of 1022 MSM were included in the final analysis (mean age 29.6 y); the majority identified as homosexual (767/1022, 75.1%) and were unmarried (896/1022, 87.7%). Regression analyses revealed that transition costs were positively associated with PrEP resistance intention (β=0.26, 95% CI 0.17-0.35; P<.001), while social norms were negatively associated (β=-0.19, 95% CI -0.27 to -0.12; P<.001). Condom-use inertia significantly moderated both associations, amplifying the positive relationship between transition costs and resistance (β=0.04, 95% CI 0.01-0.09; P=.03) and enhancing the negative association of social norms (β=-0.05, 95% CI -0.09 to 0.00; P=.04). Subgroup analyses showed that the amplifying effect of condom-use inertia on transition costs was particularly evident among participants with postgraduate education (β=0.13, 95% CI 0.01-0.26; P=.04). Conversely, its strengthening effect on social norms was more pronounced among MSM 30 years or younger (β=-0.11, 95% CI -0.17 to -0.04; P=.001) and those identifying as homosexual (β=-0.07, 95% CI -0.12 to -0.02; P=.01).

CONCLUSIONS: This study suggests that SQB is an important psychological barrier to PrEP adoption among Chinese MSM. The moderating role of condom-use inertia highlights the relevance of habitual condom-use routines in shaping PrEP resistance. Behaviorally informed strategies that reduce transition costs and leverage social norms may help mitigate resistance and improve PrEP uptake.

PMID:41962129 | DOI:10.2196/88806