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The Innovation

Elsevier BV

Preprints posted in the last 30 days, ranked by how well they match The Innovation's content profile, based on 13 papers previously published here. The average preprint has a 0.01% match score for this journal, so anything above that is already an above-average fit.

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Effect of airborne particulate matter on mtDNA copy number: A systematic review and meta-analysis

Pathak, A.; Tandekar, A.; Singh, A. K.; Gurjar, V.; Sarma, D. K.; Nema, R. K.; Tiwari, R.; Mishra, P. K.

2026-08-23 occupational and environmental health 10.64898/2026.08.20.26360559 medRxiv
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Ambient particulate matter (PM) is a well-established environmental risk factor for non-communicable diseases, yet its influence on mitochondrial function remains poorly defined. Mitochondrial DNA copy number (mtDNA-CN) serves as a biomarker of mitochondrial biogenesis, making it a candidate exposure biomarker. We conducted the study per PRISMA guidelines (PROSPERO-CRD420261320957) and examined the association between ambient PM exposure and mtDNA-CN. Risk of bias was assessed using Joanna Briggs Institute tools, and relative and absolute changes in mtDNA-CN were pooled using random-effects models, with subgroup analyses by pollutant type and descriptive synthesis of mechanistic evidence. Of 1,224 records identified, 24 studies met inclusion criteria for quantitative analysis, with 12 reporting percentage change and 12 reporting absolute values, covering 13,092 participants. PM exposure was significantly associated with decreased percentage mtDNA-CN (ES: -4.90; 95% CI: -7.97 to -1.82; p = 0.002), while absolute mtDNA-CN levels increased significantly (ES = 0.55; 95% CI: 0.05 to 1.04; p = 0.030). Mechanistic pathways contributing included mtDNA hypermethylation, impaired mitochondrial biogenesis and dynamics. Our findings show ambient PM exposure alters mtDNA-CN, though directionality differs by metric, pointing to the need for larger prospective studies to validate mtDNA-CN as a reliable biomarker of airborne PM and nanoparticulate exposure.

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Mortality risk and burden associated with hydroclimate whiplash in the United States

Wang, P.; Ma, Y.; Stowell, J. D.; Abadi, A. M.

2026-08-21 occupational and environmental health 10.64898/2026.08.18.26360736 medRxiv
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Hydroclimate whiplash, defined as the rapid transition between unusually wet and dry conditions, is expected to intensify under climate change, yet its population health impacts remain largely unknown. Here we quantified the association between hydroclimate whiplash and mortality across the contiguous United States from 2003 to 2023 using monthly county-level mortality records, standardized precipitation evapotranspiration index data, and two-stage time-series models. We identified overall and direction-specific dry-to-wet and wet-to-dry whiplash events at seasonal and sub-annual timescales and across 5-, 10-, and 20-year recurrence intervals. More severe whiplash events were associated with higher all-cause mortality risk; 5-, 10-, and 20-year sub-annual overall whiplash events increased mortality risk over five months by 3.4%, 4.5%, and 5.7%, respectively. Elevated risks were observed across cause-specific mortality outcomes, with the strongest association for infectious diseases. We estimated that 103,471 deaths were attributable to overall whiplash during the study period. These findings identify hydroclimate whiplash as an emerging climate-related public health threat and suggest that adaptation strategies focused on single hazards may underestimate the health burden of rapid, sequential hydroclimatic extremes.

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Socioeconomic disparities in perceived air quality and associated respiratory health outcomes among residents of Nairobi, Kenya

Otieno, E. A.; Mwitari, J. M.; Makalliwa, G. A.

2026-08-23 occupational and environmental health 10.64898/2026.08.19.26360866 medRxiv
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Socioeconomic inequality in exposure to air pollution possess a significant public health challenge, yet little is known about how the disparities vary across the various economic status areas in Nairobi. Globally, studies have shown that exposure to air pollution is unequal across communities hence disparities in harm to human health. This study examined the association between socioeconomic characteristics and perceived air quality among residents of low- and high-socioeconomic status areas in Nairobi, Kenya. Two regions within Nairobi County were selected for this study: Mukuru kwa Njenga (representing the Low Socioeconomic Status) and Langata (representing the High Socioeconomic Status) with a sample size of 384 in HSES areas and 368 in LSES areas. A cross-sectional study was conducted among 752 respondents residing in selected LSES and HSES areas of Nairobi. Data was collected using a structured questionnaire assessing sociodemographic characteristics, income, education, employment, perceived air quality, and self-reported health outcomes associated with air pollution exposure. Descriptive statistics were used to summarize participant characteristics and perceived air quality. Chi-square tests were used to examine associations between residential area and categorical health outcomes, while ordinal logistic regression was used to assess the association between socioeconomic characteristics and perceived air-quality ratings. Perceived air quality differed significantly between residential socioeconomic groups. Respondents in LSES areas were more likely to rate air quality as poor or very poor, with 45.4% rating it as very poor, compared with only 1.6% of respondents in HSES areas. In contrast, 12.2% of HSES respondents rated air quality as good compared with 0.3% in LSES areas. The association between area of residence and perceived air-quality rating was statistically significant, {chi}2(3) = 282.672, p < 0.001. In the ordinal logistic regression model, HSES residence was associated with significantly lower odds of reporting poorer perceived air quality compared with LSES residence (OR = 0.135, 95% CI: 0.095-0.190, p < 0.001). Income was also significantly associated with perceived air quality, while respondents with no formal education had higher odds of reporting poorer perceived air quality compared with those with secondary education (OR = 3.254, 95% CI: 1.388-7.638, p = 0.007). Significant differences were also observed for several self-reported health outcomes. Respiratory problems were more prevalent among respondents in LSES areas than HSES areas (72.7% versus 50.4%; {chi}2(1) = 29.081, p < 0.001; Cramer's V = 0.224). However, allergies, eye irritation, and headaches were reported more frequently in HSES areas than in LSES areas, with significant associations observed for allergies ({chi}2(1) = 106.479, p < 0.001; Cramer's V = 0.429), eye irritation ({chi}2(1) = 136.577, p < 0.001; Cramer's V = 0.486), and headaches ({chi}2(1) = 149.180, p < 0.001; Cramer's V = 0.508). No statistically significant association was observed for cardiovascular problems, likely reflecting the very low number of reported cases. Substantial socioeconomic disparities in perceived air quality and self-reported respiratory health outcomes were observed. Residents of low-socioeconomic status areas consistently perceived poorer air quality and reported a higher burden of respiratory problems, highlighting the need for targeted interventions to reduce environmental health inequalities.

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Divergent social patterning of directly measured environmental exposures across Rhode Island communities

Walker, E. D.; Mandalapu, S. V.; Lefebvre, S.

2026-08-23 occupational and environmental health 10.64898/2026.08.20.26360933 medRxiv
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Background: Environmental noise and air pollution are both shaped by road traffic and the built environment, and exposure assessment increasingly folds them into composite indices or proxies both by traffic exposure. Whether the two share a social distribution has rarely been tested against direct measurement of several exposures in the same communities, and community noise is almost always characterized by A-weighted levels alone, which discount low-frequency energy. Methods: At 176 sites across Rhode Island, spanning the contiguous urban area of Providence, Central Falls, and Pawtucket together with four rural municipalities, we measured the acoustic environment under A- and C-weighting (LAeq, LCeq), fine particulate matter (PM2.5), night-time illuminance, and relative humidity across four session types over roughly one year (704 site-sessions). Exposures were linked to census-tract composition (American Community Survey), and mixed-effects models were fitted for each of eight area-level markers of disadvantage, adjusting for campaign and session. Relative humidity was carried through the identical model as a negative control. Results: A-weighted noise was consistently higher in more disadvantaged tracts, rising with non-White, poverty, renter, and no-vehicle shares and falling with income and older-resident share (six of eight markers significant; 1.3 to 1.8 dBA per standard deviation; 6.6 dBA between the least and most racially diverse neighborhoods). C-weighted levels followed the same gradient on every marker and exceeded their A-weighted counterparts at block-group scale for renter occupancy and vehicle absence. Night-time illuminance was also socially patterned, whereas short-term PM2.5 was roughly an order of magnitude weaker and relative humidity showed no gradient. The acoustic gradient persisted within the urban core alone. Conclusions: Measured burden was carried by the acoustic environment, including its low-frequency component, and by night-time light, not by short-term particulates. The exposure metric and the averaging time determine which disparities are visible at all.

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Ambient PM2.5 Concentration and the Cardiovascular Response to Exercise Training: A Systematic Review and Meta-Analysis Across Global Pollution Gradients

Donaldson, J. A.; Cai, S.; Hansell, A. L.; Vande Hey, J. D.; Panchal, R.; Edwards, J.; Abdelrazik, A. M.; Yates, T. E.; Ng, A.; O'Driscoll, J.

2026-08-23 public and global health 10.64898/2026.08.20.26360886 medRxiv
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Background: Exercise training is a cornerstone intervention for cardiovascular disease, yet large cohort studies have reported attenuation of physical activity benefits at elevated air pollution concentrations, creating uncertainty around exercise prescription in polluted settings where cardiovascular disease burden is greatest. Objectives: To determine whether ambient PM2.5 concentration modifies the cardiovascular benefits of structured exercise training, using a global sample of trials spanning a >100-fold pollution gradient. Methods: We conducted a systematic review and multilevel meta-analysis of exercise training interventions reporting pre-post changes in systolic blood pressure (SBP), diastolic blood pressure (DBP), peak oxygen uptake (VO2Max), or resting heart rate (HR) in adults. Annual ambient PM2.5 concentrations (3.5-283 g/m3) were assigned to each study location from CAMS ERA5 reanalysis data. Three-level random-effects models with cluster-robust variance estimation accounted for arms nested within studies. PM2.5 meta-regression was conducted unadjusted and adjusted for world region, exercise mode, trial duration, and health condition, with subgroup analyses by exercise mode and hypertension status. Results: Across 465 studies (27,629 participants), exercise training produced clinically meaningful benefits for all outcomes (SBP - mmHg, DBP - mmHg, VO2Max +3.2 ml/kg/min, HR - bpm; all p < 0.001), with benefits consistently larger in higher-pollution settings. Hypertensive participants showed the greatest improvements, particularly from aerobic exercise (SBP standardised mean difference 0.396 in the Low vs 1.020 in the High PM2.5 stratum). Although aerobic and resistance training participants experience similar chronic ambient PM2.5 exposure, only aerobic exercise showed a stratum gradient (interaction p = 0.074). Discussion: Exercise training delivers clinically meaningful cardiovascular benefits at every pollution level tested. The larger benefits observed in higher-pollution settings reflect the greater cardiovascular risk burden of those populations, and hypertensive patients stand to gain the most, particularly from aerobic exercise.

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Projected burden of alcohol-associated liver disease in China, 2020-2050: A microsimulation modeling study

Niu, Q.; Su, M.; Liang, L.; Che, Z.; Zhu, Q.; Wang, F.; Xiao, J.

2026-08-22 public and global health 10.64898/2026.08.19.26360748 medRxiv
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Background Alcohol-associated liver disease (ALD) has emerged as a major cause of chronic liver disease and liver-related mortality in China. This study aimed to project the future burden of ALD in Chinese adults from 2020 to 2050, including prevalence of ALD, number of alcoholic steatohepatitis (ASH) cases, incident hepatocellular carcinoma (HCC) cases, liver transplantation (LT) demand, liver-related deaths, and disability-adjusted life years (DALYs). Methods We developed an agent-based state-transition microsimulation model with yearly cycles and a lifetime horizon. The model simulated 5,678,912 representative Chinese adults (mean age 36.2 years, 51.2% male). Health states included no steatosis, alcohol-associated steatotic liver, ASH, fibrosis stages F0-F4, decompensated cirrhosis, HCC, LT, and liver-related death. Model inputs were derived from the China Kadoorie Biobank, Global Burden of Disease Study 2021, China's national surveys, published meta-analyses, and transplant registry data. Projections incorporated demographic shifts, alcohol consumption trends, and calibrated transition probabilities. Uncertainty was assessed via 1,000 Monte Carlo simulations generating 95% uncertainty intervals. Results ALD prevalence was projected to increase from 4.8% (55 million individuals) in 2020 to 8.5% (94 million individuals) by 2050. ASH cases rose from approximately 18 million to 20 million. Annual incident HCC cases nearly doubled from 20,500 in 2020-2025 to 45,200 by 2046-2050. LT demand quadrupled from 2,300 to 9,800 cases. Liver-related deaths increased from 50,000 in 2020 to 85,000 in 2050, while DALYs rose from 1.5 million to 2.6 million. Conclusions In the absence of strengthened alcohol control policies, ALD will impose a substantial and growing burden on China's health system by 2050, with marked increases in HCC incidence, LT demand, and liver-related mortality.

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Characterizing Preschool Children's Multi-Matrix Air Pollutant Exposures Across Home and Early Childhood Education Settings: A Paired Silicone Wristband Study Protocol

Mutic, A. D.; McCauley, L.; Andrew, A.; Fitzpatrick, A.

2026-08-31 occupational and environmental health 10.64898/2026.08.27.26361470 medRxiv
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Background: Children spend more than 90% of their time indoors, and early childhood education settings (ECEs) are an understudied, high-occupant-density indoor microenvironment where exposure to volatile organic compounds, particulate matter, and other toxicants has been documented. Limited knowledge exists on ECE-specific exposures affecting young children and how they compare to exposures in the home. Methods: This prospective, repeated-measures pilot study targeted enrollment of 44 preschool-aged children and 8 ECE staff across two geographically and sociodemographically distinct ECEs in metropolitan Atlanta, Georgia. Paired silicone wristbands, one home-designated and one ECE-designated, were exchanged between settings across three consecutive days and nights beginning at enrollment to characterize microenvironment-specific exposure. A single spot urine sample was also collected from each child. Continuous indoor air quality monitoring was conducted in two classrooms per site. Caregivers and ECE staff completed structured questionnaires assessing home and ECE environmental characteristics, child respiratory risk, and protocol feasibility and acceptability. Feasibility was evaluated using eight pre-specified indicators spanning recruitment and enrollment, wristband wear duration and loss by microenvironment, urine sample collection completeness, and survey completion by instrument and respondent group. Conclusion: This pilot will establish feasibility and acceptability parameters for a paired, multi-matrix silicone wristband protocol across home and ECE microenvironments. Findings will inform the design, sample size, and power calculations for a subsequent study testing indoor air interventions and pediatric respiratory outcomes in ECEs. Feasibility outcomes are reported in a companion manuscript.

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Multimodal spatial-omics reveal the heterogeneity and intercellular network characteristics of papillary craniopharyngiomas.

Jiang, Y.; Luo, H.; Zheng, H.; Li, C.; Zan, X.; Xu, J.; Chen, Y.

2026-08-24 cancer biology 10.64898/2026.08.20.746031 medRxiv
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Despite significant advancements in microsurgical techniques in recent years, the treatment and prognosis of craniopharyngiomas remain unsatisfactory. As a central nervous system tumor located adjacent to important brain structures such as the hypothalamus-pituitary axis and accompanied by a highly inflammatory microenvironment, the tumor heterogeneity and tumor microenvironment characteristics of papillary craniopharyngiomas (PCPs) remain unclear. In this study, we integrated multimodal single-cell and spatial profiling from PCP tissue and peripheral blood mononuclear cells (PBMCs) to elucidate the tumor heterogeneity and microenvironment characteristics of PCP. Our single-cell and spatial analyses defined four specific tumor cell states in PCP, representing specific transcriptional regulatory programs and spatial heterogeneity characteristics during tumor progression. By constructing a spatial niche composed of tumor, immune, and stromal cells, we analyzed the cellular and spatial ecosystem of PCP at multiple levels to further assess the communication relationships between different tumor cell states and microenvironment cells. This study established a multidimensional molecular atlas of PCP from the perspectives of cell state, spatial structure, and microenvironment interactions, providing a foundation for understanding its biological behavior and exploring new intervention strategies.

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BRIX1 Promotes Hepatocellular Carcinoma Progression via the MAPK/ERK Pathway and Serves as a Prognostic Biomarker

Pan, X.; Wang, x.; Zhou, Y.

2026-08-31 cancer biology 10.64898/2026.08.26.747409 medRxiv
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Hepatocellular carcinoma (HCC) is particularly aggressive and difficult to treat. Due to the lack of early clinical diagnosis and the unsatisfactory clinical treatment effect, it is particularly important to identify novel markers that can predict tumor behavior in HCC. biogenesis of ribosomes BRX1 (BRIX1) is abundant in various tissues of the human body. However, the regulatory mechanisms and its role in various tissues are not fully understood. Here, we analyzed the expression pattern of BRIX1 in HCC from public gene expression databases and tissue samples from clinical HCC. We confirmed that BRIX1 was upregulated in both HCC cell lines and HCC paraffin section samples. BRIX1 depletion significantly dicreased the capacity of cells to grow and migrate in vitro, and knockdown BRIX1 suppressed tumor growth in xenograft tumor model. Mechanistically, BRIX1 depletion suppressed the MAPK/ERK pathway, as reflected by reduced phosphorylated ERK (p-ERK) levels. In summary, we provide a rational clue for the further investigation of BRIX1 as an invaluable biological marker for diagnosing and predicting prognosis of patients with HCC.

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Joint Heat and PM2.5 Exposure Across US Metropolitan Areas: Multi-Stressor Disparities, Historical Redlining, and a Multi-Metric Assessment Framework

Mandalapu, S. V.; Sharma, R.; Pillarisetti, A.

2026-08-23 epidemiology 10.64898/2026.08.20.26360970 medRxiv
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Many urban health outcomes are shaped by environmental stressors that occur together rather than in isolation, yet methods for measuring such co-occurrence at the neighbourhood scale remain underdeveloped. We developed a multi-metric framework for joint co-exposure assessment and applied it to characterise the joint spatial distribution of summer surface heat and fine particulate matter (PM2.5) across 42,304 census tracts in 48 large US metropolitan areas during summers 2015 to 2020, covering approximately 174.6 million residents. The framework combines a composite co-exposure index, a joint exceedance indicator, a conditional exceedance ratio that compares observed joint occurrence to within-group statistical independence, and an upper tail dependence parameter estimated using both the non-parametric Caperaa-Fougeres-Genest estimator and a Gumbel copula, with bias-corrected and accelerated (BCa) confidence intervals obtained from a 5,000-replicate metropolitan-area block bootstrap. Among residents of predominantly Black tracts, 13.21% lived in neighbourhoods that simultaneously exceeded the within-metropolitan-area 80th percentile for both heat and PM2.5, compared with 3.33% of residents of predominantly White tracts; the corresponding heat-only and PM2.5-only ratios were 2.88 and 2.48. Residents of Home Owners Loan Corporation grade D tracts had 3.97 times the odds (95% confidence interval 2.79 to 5.66) of joint hotspot residence compared with grade A residents after adjustment for contemporary tract racial composition, poverty, renter-occupancy, and pre-1960 housing. The within-group conditional exceedance ratio at the 80th percentile was 2.29 in predominantly White tracts (95% BCa CI 1.81 to 2.78), 1.27 in predominantly Black tracts (0.71 to 1.56), and 1.13 in predominantly Hispanic tracts (0.70 to 1.41); the White interval excluded one while the Black and Hispanic intervals included one, which we interpret as power-limited given fewer contributing CBSAs. Magnitudes attenuated under near-surface air temperature surfaces but the direction and statistical significance of the primary findings were preserved. The framework is portable to other compound-exposure questions and supports cumulative-impact assessment.

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Warming, thermal variability, and the 96% decline in childhood respiratory-infection mortality in China: a national time-series analysis of the Global Burden of Disease Study 2021 and the C-LSAT high-resolution climate dataset

Li, D.; Miao, Y.; Zhang, Y.; Chen, H.; Wang, X.; Shen, C.

2026-09-02 epidemiology 10.64898/2026.08.31.26361879 medRxiv
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Background Childhood respiratory mortality in China has fallen by over 90% in three decades alongside sustained national warming, yet national long-run evidence on temperature and child respiratory mortality is lacking. Methods We linked Global Burden of Disease (GBD) 2021 mortality estimates for China - lower respiratory infections (LRI), ages 0-19, and asthma, ages 0-24, 1990-2021 - with C-LSAT 0.5 deg gridded temperature data (1990-2019), aggregated nationally and to five climate zones. Four annual indicators (mean temperature, diurnal temperature range, seasonal amplitude, interannual variability) entered regressions of log mortality rates with Newey-West standard errors. A bootstrapped (500 resamples) quadratic model probed the minimum mortality temperature (MMT), with PM2.5-adjusted analyses and future-exposure, permutation, and detrended falsification tests. Results LRI deaths fell by 96.3% (330,194 in 1990 to 12,098 in 2021; 95% uncertainty interval 9,669-14,891) and asthma deaths by 94.9% (3,287 to 167), while mean temperature rose 0.364 deg C per decade and diurnal temperature range narrowed 0.092 deg C per decade. Baseline coefficients were large (mean temperature -1.696, SE 0.174; diurnal temperature range +2.408, SE 0.336; seasonal amplitude -0.162, SE 0.082; interannual variability +2.924, SE 1.514, per 1 deg C in log rate), but the future-exposure test failed and detrending nullified every coefficient: the associations are trend-level, and short-cycle causal effects are not identifiable. Nor was the national MMT identifiable - observed temperature support spans only 6.66-8.13 deg C, and the nominal turning point of 35.84 deg C is an extrapolation artifact (quadratic term p = 0.963). Within the observed range, warming and declining mortality moved in the same direction. Conclusions The 96% decline in childhood respiratory mortality cannot be attributed to warming. China sits on the low-temperature side of the optimum, and the marginal direction of future warming requires stronger designs to establish. The falsification framework offers a discipline for climate-health inference in China.

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The impact of London's Ultra Low Emission Zone on respiratory prescribing: a synthetic control study

Williams, G. H.; Allen, T.

2026-09-01 epidemiology 10.64898/2026.08.27.26361515 medRxiv
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Urban air pollution remains a significant public health concern, contributing to premature deaths and adverse health outcomes. However, there is little causal research evaluating the effectiveness of policies designed to improve air quality. This study assesses the impact of all three stages of London's Ultra Low Emission Zone (ULEZ) on air pollution, via PM2.5 levels, and respiratory health, via prescription records for bronchodilator and respiratory corticosteroid medications. Analyses are at general practice level, using a generalised synthetic control method to estimate causal impacts. Stage 1 was associated with a statistically significant but negligible 0.77% reduction in PM2.5 levels, with no corresponding change in prescribing. Stage 2 produced a paradoxical 2.69% increase in PM2.5, alongside a 4.44% decrease in inhaled corticosteroid quantity but a 12.51% increase in average daily quantity (ADQ) usage, suggesting a worsening of disease severity among existing patients. Stage 3 yielded a 2.69% PM2.5 reduction and a modest 2.18% decrease in bronchodilator ADQ usage. Spillover effects beyond the ULEZ boundary were statistically significant, but negligible. We find overall that the ULEZ had minimal effects on both air quality and respiratory prescribing across all three stages. These findings provide new insights into the effectiveness of ULEZ policies in reducing air pollution and its associated health impacts, suggesting the zone's effects are considerably smaller than previously reported, and that integration with broader policy measures may be necessary to achieve meaningful public health gains.

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Wildfire smoke delays breeding and alters reproductive outcomes in cavity-nesting songbirds

Spina, H. A.; Sanderfoot, O. V.; Ahmadov, R.; Bailey, R. L.; James, E.; Karambelas, A.; Raby, S.; Siegrist, J.; Stillman, A. N.; Tingley, M. W.

2026-08-19 ecology 10.64898/2026.08.18.745532 medRxiv
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Smoke from spring boreal wildfires increasingly impacts eastern North America, exposing breeding birds to hazardous air pollution that may impact reproductive outcomes. Using data collected in 2018-2025 from 70,979 monitored nests of four widespread cavity-nesting songbirds, we found strong evidence that smoke greatly delays egg laying and can extend incubation and nestling duration. We further found that while smoke is associated with increased clutch sizes, in some species smoke exposure strongly decreases hatching or fledging success. Our results demonstrate that extreme smoke can have wide-ranging impacts on breeding birds, from altering phenology to impacting fitness. While the exact mechanisms underlying these results remain elusive, the full suite of effects suggests that modifications to adult behavior under smoky conditions is the most likely cause. As fire regimes shift, birds and other wildlife are at greater risk of exposure to toxic smoke during the breeding season, which may further exacerbate the biodiversity crisis.

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Inhaled black carbon induces depressive-like behavior and enhances stress-related blood-brain molecular vulnerability in mice

Bae, J.; Lee, J.; Song, S.; Jeong, K.; Frankiv, N.; Park, C.; Hwang, C. Y.; Kim, Y. K.; Yu, B.-Y.; Im, H.-I.

2026-08-27 neuroscience 10.64898/2026.08.24.745657 medRxiv
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Black carbon (BC), a combustion-derived component of fine particulate matter, has been linked to depressive symptoms, but controlled experimental evidence remains limited. We established a controlled BC inhalation model combined with chronic restraint stress (CRS) to determine whether inhaled BC alone induces depressive-like behavior and whether concurrent stress enhances behavioral and molecular vulnerability. Male C57BL/6J mice were assigned to Control, CRS, BC, or BC+CRS groups and exposed for 21 consecutive days, followed by behavioral testing and molecular analyses of plasma-depleted whole blood and stress-related brain regions. BC exposure alone induced depressive-like behavior, and the combined BC+CRS condition showed the most pronounced phenotype. These findings indicate that inhaled BC is sufficient to influence stress-relevant behavior and may heighten vulnerability under chronic stress. At the molecular level, BC shifted peripheral responses toward a stress- and inflammation-associated state with reduced plasticity-related signaling, whereas CRS preferentially engaged glucocorticoid-responsive regulation. Combined BC+CRS exposure further altered plasticity- and transcription-related regulatory programs in blood and stress-related brain regions, with prominent changes in the nucleus accumbens. These condition-dependent molecular patterns suggest that BC engages blood-brain stress-related pathways in a context- and region-specific manner. Together, these findings identify inhaled BC as a neurobehaviorally relevant environmental hazard.

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Post-pandemic ecological reshaping of respiratory pathogen circulation: A six-year FilmArray(R)-based surveillance study in Tokyo, Japan (2020-2026)

Takeuchi, J. S.; Kurokawa, M.; Yamamoto, K.; Yamanaka, J.; Morino, E.; Takayanagi-Nishisako, S.; Ohmagari, N.; Sugiura, W.; Kimura, M.

2026-09-02 infectious diseases 10.64898/2026.08.28.26360747 medRxiv
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Background The COVID-19 pandemic substantially altered respiratory pathogen circulation worldwide. However, longitudinal analyses of changes in respiratory pathogen ecology across the pandemic and post-pandemic periods remain limited. Methods We analyzed 19,968 respiratory samples tested with the BioFire(R) FilmArray(R) Respiratory Panel at a hospital in Tokyo, Japan, between January 2020 and March 2026. We evaluated temporal changes in pathogen circulation, age-specific epidemiology, co-detection patterns, pairwise pathogen associations, and clinical parameters. Results At least one respiratory pathogen was detected in 27.8% of tests. Respiratory pathogens resurged asynchronously following the relaxation of COVID-19-related public health measures. Influenza virus circulation remained markedly suppressed until late 2022 before re-emerging in successive large seasonal epidemics, whereas other pathogens, including RSV, human metapneumovirus, and Mycoplasma pneumoniae, exhibited distinct resurgence patterns. Pathogen distributions also varied by age. Human rhinovirus/enterovirus remained predominant among young children, whereas SARS-CoV-2 predominated among older adults. Co-detection occurred in 14.0% of positive specimens and was significantly more frequent in younger patients. Pairwise analysis identified both positive and negative pathogen associations; however, the patterns varied across age groups and study periods. Conclusions Respiratory pathogen circulation changed substantially during the transition from the COVID-19 pandemic to the post-pandemic period, with pathogen-specific, age- and period-dependent patterns. Continued surveillance is warranted to determine how respiratory pathogen circulation will evolve and to inform infection control strategies in the post-pandemic era.

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Combined effect of baicalein and thermal-cycling stimulation on suppressing non-small cell lung cancer A549 cells under CoCl2-induced hypoxia

Wang, Y.-W.; Lin, G.-B.; Hsu, F.-T.; Kuo, Y.-Y.; Chen, Y.-H.; Chao, C.-Y.

2026-08-13 cancer biology 10.64898/2026.08.11.744169 medRxiv
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Lung cancer continues to be the leading cause of cancer-related mortality globally, with non-small cell lung cancer (NSCLC) representing the most prevalent subtype. Tumor hypoxia is a characteristic feature of the neoplastic microenvironment in NSCLC, facilitating tumor progression and conferring resistance to oxidative stress through the stabilization of hypoxia-inducible factor-1 alpha (HIF-1). In this study, we investigated the combined anticancer effects of baicalein (Bai), a natural flavonoid, and thermal-cycling stimulation (TCS), a physical treatment that minimizes damage to normal cells, under cobalt (II) chloride (CoCl2)-induced hypoxic conditions in NSCLC. In A549 NSCLC cells, the combination of Bai and TCS significantly decreased cell viability and induced apoptosis, while exhibiting minimal cytotoxicity on IMR-90 normal human lung fibroblast cells. On a mechanistic level, this combined treatment suppressed the expression of HIF-1 and superoxide dismutase 2 (SOD2) proteins, elevated intracellular reactive oxygen species (ROS) levels, and impaired DNA repair capability by downregulating MutT homolog 1 (MTH1) protein expression. Additionally, disruption of mitochondrial membrane potential and increased poly (ADP-ribose) polymerase (PARP) cleavage further confirmed the induction of apoptosis. These findings indicate that combining Bai with TCS offers a promising synergistic approach to treating NSCLC under hypoxic conditions.

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Interaction between the Chemical Exposome and Epigenome in Follicular Fluid from Patients Undergoing Assisted Reproduction

Young, A. S.; Campbell, K. A.; Everson, T. S.; Gennings, C.; Braselton, M. E.; Mullins, C. E.; Jariwala, P.; Smith, A. K.; Spencer, J. B.; Hipp, H.; Gaskins, A. J.; Walker, D. I.

2026-08-25 occupational and environmental health 10.64898/2026.08.21.26361034 medRxiv
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Endocrine-disrupting chemicals can target ovaries and interfere with key milestones of reproduction. Previously, we found that mixtures of the chemical exposome measured in follicular fluid (FF) were cumulatively associated with lower oocyte yield. Because ovaries age faster than many other organs, our current aim was to evaluate associations of FF chemical mixtures with epigenetic age acceleration and epigenetic pathways in FF cells. FF was collected during oocyte retrieval from 76 patients undergoing assisted reproduction in Atlanta. The exposome was measured using untargeted high-resolution mass spectrometry with gas (GC) and liquid (LC) chromatography. Weighted quantile sum (WQS-RS) indices were constructed for three mixtures of chemicals in association with oocyte yield, separated by instrument configuration (GC, LC-HILIC, LC-C18). DNA methylation was measured from the cellular component of FF using Illumina MethylationEPIC BeadChip, with age acceleration based on the GrimAge clock. Regression and pathway enrichment analyses elucidated relationships between chemical exposures or mixture indices and epigenetic markers, adjusted for age and technical covariates. All three chemical mixture indices were associated with epigenetic age acceleration in FF (p<0.05). For example, a standard-deviation increase in the GC-detected mixture was associated with 0.23 standard-deviations higher accelerated aging (95% CI: 0.0058-0.45; p=0.048). Twenty-seven frequently detected chemicals, including benzo[a]pyrene, plasticizers, flame retardants, forever chemicals, and pesticides, were associated with epigenetic pathways related to ovarian follicle growth and hormone signaling (p<0.05; six under false discovery rate<5%). In summary, environmental chemicals may accumulate in ovaries, contribute to accelerated epigenetic aging of ovarian somatic cells, and potentially affect follicle development.

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Lactiplantibacillus plantarum PD01 supplementation reduces microplastics and microplastic-associated chemicals in humans: A randomized, double-blind, placebo-controlled trial

Lu, R.; Zhao, L.; Huang, X.; Feng, Y.; Huang, S.; Dong, R.

2026-08-13 occupational and environmental health 10.64898/2026.08.12.26360001 medRxiv
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Plastic products have greatly improved convenience in daily life. However, diverse pollutants released from these materials pose substantial risks to human health. Lactiplantibacillus plantarum PD01 has previously been demonstrated to reduce microplastic (MP) bioaccumulation and toxicity in murine model. In this study, we conducted a randomized, double-blind, placebo-controlled trial to further evaluate the efficacy of L. plantarum PD01 in reducing MPs and MP-associated chemicals in humans. A total of 106 participants were recruited in November 2025. Eligible participants were randomly assigned to either the placebo or intervention group, and orally received placebo or 1.0x1010 colony-forming units (CFU) L. plantarum PD01 after meals three times a day, respectively. Fecal, urinary, and blood samples were collected to determine the MPs contents, plasticizer levels, gut microbiota composition, blood metabolic profiles and biochemical indicators. Among these measurements, the analysis of urinary phthalate metabolites was completed first and revealed a significant reduction after the probiotic intervention. Compared with the placebo group, 6-week L. plantarum PD01 supplementation resulted in significant relative reductions in urinary levels of MCMHP by 60.2% (P = 0.0343), MMP by 51.2% (P < 0.001), MEHP by 49.6% (P = 0.0058), MiBP by 45.7% (P = 0.0085), MnBP by 35.8% (P = 0.0478), and {Sigma}DEHP by 46.2% (P = 0.0461). The interim results presented here provide the first clinical evidence that the probiotic strain PD01 can significantly reduce residual MP-associated chemicals in human body. To the best of our knowledge, this is the first randomized controlled trial (RCT) to evaluate probiotic intervention targeting MPs and MP-associated chemicals in humans.

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Exploring vulnerable proteins in the progression of head and neck squamous cell carcinoma

Agrawal, A.; Kumar, S.; Vindal, V.

2026-08-13 bioinformatics 10.64898/2026.08.07.743269 medRxiv
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A protein whose removal or deletion causes significant disruption or collapse of a protein-protein interaction (PPI) network is referred to as a vulnerable protein. Such proteins may serve as valuable therapeutic or diagnostic targets in disease-associated networks. In this study, two PPI networks were constructed, one for HPV-positive and the other for HPV-negative head and neck squamous cell carcinoma (HNSCC), and the vulnerable proteins of these networks were identified by the node deletion approach. After analyzing the networks, 27 unique vulnerable proteins in HPV-positive and 72 unique vulnerable proteins in HPV-negative HNSCC were identified. Among them, one HPV-positive and seven HPV-negative HNSCC vulnerable proteins were further chosen by integrating multi-omics data. To exploit the vulnerabilities of these proteins, candidate synthetic lethal (SL) partners were predicted whose inhibition may selectively impair tumor survival. Subsequently, drug-gene interaction analysis was performed to identify inhibitors targeting the SL partners of these vulnerable proteins. Notably, in HPV-positive HNSCC, TOP2A, CHEK1, and CHEK2 genes were identified as SL partners of TTN, and their inhibitors were already clinically approved. While in HPV-negative HNSCC, ADA and MMP19 were identified as an SL partner of LMO7; TMEM45B, CDH3, and ELF3 genes were identified as an SL partner of CGN; and ZNF433 was identified as an SL partner of FLNC. However, MMP19, ZNF433, and TMEM45B inhibitors were not reported. Thus, these vulnerable proteins, including their SL partners, provide novel avenues to explore and develop more efficient and precise therapeutic and diagnostic strategies.

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Epigenetics for Public Consumption: Evaluating Science Communication Strategies and Practices on YouTube

Raisa, A.; Santaliz-Moreno, I.; Ayala, A.; Hamilton, J. G.; McQueen, A.; Souroullas, G. P.; Maki, J.; Waters, E. A.

2026-08-17 genetic and genomic medicine 10.64898/2026.08.14.26360379 medRxiv
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Background: Epigenetics, the study of reversible changes in gene expression without altering the underlying DNA sequence, is increasingly applied in medical, commercial, and policy contexts. Yet, little is known about how this emerging science is communicated to the public. The purpose of this study was to examine communication strategies, sources, and modalities in epigenetic-related videos on YouTube- the most accessed platform for informal science education. Methods: We conducted a mixed-methods content analysis of 294 YouTube videos on epigenetics by conducting a keyword-based search on October 17, 2023. Video transcripts and meta-data were coded using a codebook developed both deductively and inductively. Qualitative analysis examined how communication strategies were used within videos and identified emergent themes (RQ1). Quantitative analyses examined the frequency of video and channel characteristics (RQ2), and presentation modalities (RQ3). Results: Findings reveal poor alignment with science communication best practices (RQ1): over 92% of videos failed to acknowledge scientific uncertainty, the comprehensibility level exceeded the recommended 8th-grade level (e.g., average readability grade 10.7), and professional research organizations were notably absent. Narrators were mostly male (56.7%) and white-presenting (73.7%) (RQ2). The majority of the videos used multi-modal strategies (e.g., visual texts mixed with animation and voice-over narration) to communicate epigenetic information (RQ3). Conclusion: Findings highlight the need for professional research organizations to be more proactive in public epigenetic communication efforts. Increasing narrator demographic diversity could broaden audience reach. Evidence-based communication tools are needed for health or science communicators discussing epigenetics on social media.