公共卫生研究摘要 (2025-06-23)

共收录 59 篇研究文章

1. Diving practices in technical divers’ community and behaviour towards self-reported unusual symptoms.

期刊: Diving and hyperbaric medicine 发表日期: 2025-Jun-30 链接: PubMed

摘要

The use of gas mixtures containing helium for deep recreational diving is increasingly common, involving complex logistics and decision-making compromises. The characteristics and inherent risks of this practice remain poorly documented. This study aims to provide an epidemiological inventory of practices and diving-related incidents within the technical diving community. An international online survey was disseminated on social networks targeting certified trimix divers. It collected demographic data, diving experience, and dive management practices, along with self-reported unusual symptoms, treatments, and outcomes following trimix dives. A total of 558 questionnaires were analysed, predominantly from males (92%), mostly over 46 years old (61%), with high certification levels and recreational diving purposes. Forty-two percent reported one or more medical risk factors related to diving. Rebreather use was prevalent (79% at least occasionally). Decompression was primarily managed using compartmental models (85%) with gradient-factors adjustment. Dive planning varied significantly among individuals. Gas density at depth frequently exceeded the current recommendations. Ten percent had experienced symptoms suggestive of gas toxicity, mainly related to nitrogen narcosis. Thirty-six percent (199/558) reported experiencing, at least once, symptoms of diving-related incidents, with 61% (n = 121/199) expressing certainty. In 48% (120/261) of incidents involving decompression sickness (DCS) or breathing symptoms, no treatment was initiated. Among episodes involving DCS symptoms (n = 254), 42% received normobaric oxygen, and 23% sought medical advice, while 16% were treated with hyperbaric oxygen. Only 2.5% reported probable long-lasting sequelae. The diversity of practices highlights the lack of robust scientific data supporting them. The accident rate in mixed-gas diving may be higher than in typical scuba air diving, though mostly of mild severity. Treatment appears to be neglected despite divers’ high knowledge levels. Continued research into decompression and the physiological effects of these dives is essential, along with ongoing awareness and education efforts in diving first aid within this exposed community.

2. Core outcome set for research in necrotising soft tissue infection patients: an international, multidisciplinary, modified Delphi consensus study.

期刊: Diving and hyperbaric medicine 发表日期: 2025-Jun-30 链接: PubMed

摘要

Necrotising soft tissue infections (NSTI) are serious infections associated with considerable morbidity and mortality. Heterogeneity of outcome reporting in the NSTI literature precludes the synthesis of high-quality evidence. There is substantial interest in studying the efficacy of hyperbaric oxygen treatment as an adjunctive treatment in NSTI. The aim of this study was to develop a set of core outcome measures for future trials evaluating interventions for NSTI. A modified Delphi consensus method was used to conduct a three-round survey of a diverse panel of clinicians and researchers with expertise in NSTI, and patients with lived experience of NSTI. Participants rated the preliminary list of outcomes using a 9-point scale from 1 (least important) to 9 (most critical). The a priori definition of consensus required outcomes to be rated critical (score ≥ 7) by ≥ 70% of participants, and not important (score ≤ 3) by ≤ 15% of participants. After meeting consensus, outcomes were removed from subsequent rounds. Outcomes that did not meet consensus were included in subsequent rounds. Ninety-eight participants from 14 countries registered and 86%, 69% and 57% responded for each round, respectively. Outcome measures quantifying five core areas achieved consensus: Death, surgical procedures of debridements and amputations, functional outcome among survivors, measures of sepsis, including septic shock and organ dysfunction and resource use measured through length of hospital and intensive care unit stay. This initial core set of outcome measures will be evaluated and optimised and can harmonise outcome measurements for investigations among patients with NSTI.

3. Psychosis and diving.

期刊: Diving and hyperbaric medicine 发表日期: 2025-Jun-30 链接: PubMed

摘要

Psychotic disorders, characterised by impaired reality testing and a spectrum of symptoms, present significant challenges in assessing fitness for diving. While diving can be a safe and rewarding activity, the unique physiological and environmental stresses of hyperbaric conditions can exacerbate psychotic vulnerability or mimic psychotic symptoms. This article reviews the literature on psychosis and diving, exploring the implications of psychotic disorders, psychotropic medications, and hyperbaric effects. It highlights the critical importance of illness insight, the absence of comorbid conditions, and complete remission in determining diving fitness. Key recommendations include avoiding deep dives, careful evaluation of medication use, and a nuanced differentiation between chronic and transient psychoses. By synthesizing existing evidence, this article aims to guide diving medicine professionals in making informed decisions about psychosis and diving suitability.

期刊: Diving and hyperbaric medicine 发表日期: 2025-Jun-30 链接: PubMed

摘要

Long COVID syndrome is a major health issue. Multiple treatments have been proposed but efficacy is inadequately investigated. Hyperbaric oxygen therapy (HBOT) has been promoted based on a small number of publications. As there is potential for a placebo effect and the financial cost of HBOT is high, we sought to investigate the effects of HBOT in Long COVID in a randomised trial. We randomised 101 patients into four treatment groups, receiving 10 sessions of oxygen ‘treatment’ inside a pressure chamber, according to one of four modalities: A - 100% oxygen at 253 kPa (2.5 atmospheres absolute); B - 40% oxygen at 253 kPa; C - 100% oxygen at 101.3 kPa (1 atmosphere absolute); D - 21% oxygen at 101.3 kPa. Groups B and C thus received a similar effective oxygen dose of 101.3 kPa. Quality of life symptom scores (Visual Analogue Scale; EQ-5D-5L, C19-YRSm), a 6-minute walking test and five neurocognitive tests were administered before and after the treatment series. At three months post-treatment, a telephone questionnaire probed for lasting effects. All groups were comparable with regards to demographics, Long COVID symptoms and severity. After treatment, there were no significant differences in subjective symptoms, functional scores, and cognitive performance between any groups. The response to treatment was highly variable, with some patients in even the ‘placebo’ group D reporting a significant improvement in their well-being. This was not reflected in any objective outcome scores. No subgroups of patients responded better to any of the treatments. There was no significant effect from different doses of oxygen in a hyperbaric chamber. It is possible that the very modest improvements reported in other studies were due to a placebo effect. Claims that HBOT has a significant effect on Long COVID need further investigation before indiscriminately prescribing or promoting HBOT.

5. Comparative efficacy of remifentanil and fentanyl in mechanically ventilated ICU patients: a systematic review and meta-analysis on ventilation duration and delirium incidence.

期刊: Journal of anesthesia, analgesia and critical care 发表日期: 2025-Jun-22 链接: PubMed

摘要

The ultrashort-acting properties and organ-independent metabolism of remifentanil may be advantageous in mechanical ventilation management. Unlike fentanyl, which accumulates over time and may prolong sedation, remifentanil enables more predictable titration and rapid weaning. This study aimed to determine the effect of remifentanil on shortening the duration of mechanical ventilation in comparison with fentanyl in adult intensive care unit (ICU) patients. A systematic review and meta-analysis was conducted, including randomised controlled trials (RCTs) and observational studies from MEDLINE, Cochrane, EMBASE, ICTRP, and ClinicalTrials.gov, from inception to July 2024. Studies comparing remifentanil with fentanyl in mechanically ventilated ICU patients were included, whereas those that used only remifentanil or fentanyl intraoperatively were excluded. The primary outcome was ventilation duration, with a minimal important difference (MID) of 90 min. A random-effects meta-analysis was performed and the certainty of evidence was assessed using the GRADE approach. The risk of bias was evaluated using RoB 2.0 and ROBINS-I tools. We included 18 studies (14 RCTs and 4 observational studies). Ten studies (8 RCTs and 2 observational studies; 901 patients) were analysed. Remifentanil may reduce ventilation duration compared to fentanyl (8 RCTs: MD -6.70 h, 95% CI -14.36 to 0.97; low certainty; 2 observational studies: MD -21.26 h, 95% CI -37.29 to -5.24; low certainty). Remifentanil may reduce the duration of mechanical ventilation, potentially improving patient outcomes. However, owing to the low certainty of the evidence and study heterogeneity, further high-quality RCTs are required to validate these findings. PROSPERO 2024 and CRD42024557414.

6. Vascular (dys)function in the failing heart.

期刊: Nature reviews. Cardiology 发表日期: 2025-Jun-22 链接: PubMed

摘要

Heart failure (HF) is not confined to contractile failure of cardiomyocytes or myocardial fibrosis. Coronary and systemic vascular dysfunction contributes to the initiation and progression of HF with or without reduced ejection fraction. Furthermore, HF compromises vascular function, creating and sustaining a vicious cycle with deranging effects on coronary blood flow, cardiac metabolism and cardiac function. In HF, systemic arterial dysfunction, characterized by increased arterial stiffness and resistance, raises cardiac afterload and impedes myocardial contractile function. Reduced coronary blood flow impairs myocardial oxygen delivery and consequently cardiomyocyte metabolism and function. Coronary microvascular dysfunction is heterogeneous in its pathogenesis and manifestations, complicating the diagnosis and management across different HF phenotypes. Understanding the alterations in function in different segments of the vasculature, from the aorta to the capillary level, offers mechanistic insights into disease drivers and therapeutic interventions. Interventional approaches can improve vascular haemodynamics, whereas established and emerging pharmacotherapies target the neurohumoral axis and reduce extravascular compression, inflammation, and oxidative stress, thereby improving vascular function and HF-related outcomes. In this Review, we provide a mechanistic framework of vascular dysfunction in the pathogenesis of HF with or without reduced ejection fraction, pointing towards integrated therapies that consider the vascular implications of contemporary HF management across HF phenotypes.

7. The learning curve for single-incision laparoscopic colectomy for colon cancer: succession of surgical techniques for novice surgeons.

期刊: Surgery today 发表日期: 2025-Jun-22 链接: PubMed

摘要

Single-incision laparoscopic surgery (SILS) for colon cancer is technically challenging for novice surgeons. Although it has been shown to be safe and feasible, the learning curve (LC) among novices has not been characterized. The present study investigated the LC for SILS based on data from several novice surgeons. We retrospectively reviewed consecutive cases of SILS-ileocecal resection (SILS-ICR) performed by two experienced and three novice surgeons from May 2009 to March 2020. A cumulative sum (CUSUM) analysis was used to analyze the learning curve and evaluate SILS completion. In addition, a statistical model was created to clarify the difference between the operation times of novices (Surgeons C, D, and E) and experienced surgeons (Surgeons A and B), estimating the operative time and risk estimation model. Two experienced surgeons and three novice surgeons performed 187 and 103 SILS-ICRs, respectively. A CUSUM analysis showed LCs of 20, 18, and 20 cases for Surgeons C, D, and E, respectively, suggesting that novice surgeons would achieve results comparable to those of experienced surgeons in 39, 47, and 36 cases, respectively. In SILS-ICR, novice surgeons reached the nadir in 18-20 cases and reached the level of experienced surgeons in 36-47 cases.

8. The role of intersectionality in shaping participant engagement with health research through digital methods: findings from a qualitative study.

期刊: Trials 发表日期: 2025-Jun-21 链接: PubMed

摘要

Digital research methods were rapidly adopted into clinical trials and health research during the COVID pandemic in 2020. Current UK policy aims to make digital research methods a norm, but their influence on recruitment, retention, and representation in health research remains largely unknown. Whilst efforts have been made to improve engagement with digital health interventions, less attention has been given to digital research methods-such as informed consent, data collection, and research communications-despite their potential to influence study participation and participant experience. This qualitative study aims to understand the factors influencing the initial uptake and ongoing engagement with digital research methods across diverse populations, capturing experiences and perspectives to inform diverse and efficient health research conduct. Semi-structured interviews were conducted with 50 people who had participated in health research in the past 12 months. Reflective thematic analysis was used to understand factors influencing study engagement from participant perspectives, acknowledging the role of the researcher in data interpretation. Three interconnected themes were identified: (1) Digital Positionality: The Interplay of Social Position, Personal Experience, and Identity; (2) Power Redistribution in Research Relationships: Navigating Vulnerability and Agency; (3) Trust Assemblages: How Intersecting Identities Shape Multi-modal Verification Practices in Research Engagement. These themes illustrate how intersecting identity factors and social contexts shape engagement with digital methods in health research. The first theme revealed how factors such as age, social role, migration, and socioeconomic status create pathways towards or away from engagement with digital methods. The second theme highlights how different digital methods can shift power dynamics in participant-research relationships or expose social vulnerabilities. The third theme uncovered the complex ways participants established trust in research, relying on multi-channel trust makers. The study reveals intersecting factors shaping participant engagement with digital methods, offering insights to enhance research conduct and increase diversity in health research participation. Future studies should integrate theoretical frameworks to examine these influencers and develop effective approaches for optimising diverse engagement with digital methods.

期刊: Systematic reviews 发表日期: 2025-Jun-21 链接: PubMed

摘要

Conflict-related sexual violence (CRSV) is a public health issue affecting thousands of survivors and with long-term consequences; however, it is underreported and difficult to investigate. This systematic review, covering 2015 to 2024, will explore sexual violence in conflict zones, extract and summarize the various reported health outcomes, and address knowledge gaps. Quantitative, qualitative, and mixed method studies will be included to explore the physical, mental, and social consequences of sexual violence. The WHO definition of sexual violence will guide the review to ensure consistency and alignment with global standards. Search terms will be selected with the assistance of a health information specialist and based on previous research. Only peer-reviewed articles will be included. Two reviewers will independently screen titles and abstracts.. Selected articles will be assessed for quality using the MMAT tool. Covidence will be used to assist in the study selection and data extraction. The objective of this study is to assess the reported health consequences of CRSV. Key research questions include the following: how sexual violence is defined in the literature; its physical, mental, and social health consequences; how perpetrators and the type of sexual violence are portrayed; and the contextual factors that facilitate or hinder such violence in conflict settings. In light of ongoing global conflicts, this review will address the urgent need to understand the health consequences of CRSV. Building on previous work, including Ba and Bhopal (Public Health 1(142):121-35, 2017) and to supplement Rubini et al. (Int J Equity Health 27(22):1-227, 2023), this study integrates quantitative, qualitative, and mixed-method research within a Biopsychosocial Model (Engel, Fam Syst Med 1977:317-31, 1992) framework to provide a holistic perspective on CRSV. Recognizing challenges such as underreporting by the survivors-shaped by stigma, safety concerns, and survivor agency (Mannergren-Selimovic, Peacebuilding 30:1-15, 2018)-this review also considers how perpetrators and experiences are portrayed. PROSPERO (CRD42024503037).

10. Who receives health advice? Prevalence and correlates of receiving health advice among adults in Cape Verde.

期刊: Journal of health, population, and nutrition 发表日期: 2025-Jun-21 链接: PubMed

摘要

Achieving the sustainable development goal target 3.4 requires an all-hand-on-deck approach. Healthcare professionals are expected to provide health advice on lifestyle changes that will reduce the risk of developing non-communicable diseases, or improve the quality of life of those who already have the condition. The study examined the prevalence and correlates of receiving health advice among adults in Cape Verde. We analyzed the data 1,098 adults aged 18-69 years who participated in the 2020 WHO STEPS survey. All estimates were weighted. Bivariable and multivariable logistic regression were performed to assess correlates of receiving at least one health advice. Statistical significance was set at p < 0.05, with 95% confidence intervals reported. Overall, 60.4% (95%CI: 55.3, 62.3) of adults in Cape Verde had received at least one health advice. Compared to younger adults (< 30 years), individuals aged 30-59 years having 1.55 times higher odds (AOR = 1.55, 95%CI: 1.11-2.15) and those aged 60 years and older having nearly three times the odds (AOR = 2.93, 95%CI: 1.71-5.02) of receiving advice. Previously married (AOR = 1.69, 95%CI: 1.09-2.61) and cohabiting individuals had higher odds (AOR = 1.56, 95%CI: 1.12-2.18) of receiving advice compared to those who were never married. Alcohol consumption was inversely associated with receiving advice, as drinkers had 40% lower odds of receiving advice compared to non-drinkers (AOR = 0.60, 95%CI: 0.45-0.81). Individuals consuming fewer than four servings of fruit per day had significantly lower odds of receiving advice (AOR = 0.58, 95%CI: 0.37-0.90), while those consuming fewer than four servings of vegetables per day had 1.41 times higher odds (AOR = 1.41, 95%CI: 1.06-1.88). The likelihood of receiving health advice was high among those living with hypertension (AOR = 1.94, 95%CI: 1.41-2.65). Evidence from this study suggests that there is a moderately high prevalence of receiving health advice in Cape Verde. The key correlates are hypertension status, increasing age, marital status, alcohol consumption and dietary habits. The findings underscore the need for targeted health education and counseling strategies that address the unique needs of different population subgroups, particularly younger adults, non-drinkers, and those with suboptimal dietary habits, to ensure equitable access to health advice.

11. Evaluation of vitamin A levels in patients hospitalized in the general pediatrics unit.

期刊: Journal of health, population, and nutrition 发表日期: 2025-Jun-21 链接: PubMed

摘要

Vitamin A deficiency is an important public health problem worldwide, especially in undeveloped and developing countries. Vitamin A deficiency; It can cause visual disorders, growth retardation, as well as cellular and humoral immunological disorders. We aimed to evaluate vitamin A levels in hospitalized patients and to determine the factors that may be related to vitamin A deficiency. Children between the ages of 2 months and 18 years admitted to Ege University Faculty of Medicine, General Pediatrics Unit in 2017-2020 were included. Three hundred sixty patients with vitamin A levels were evaluated retrospectively. The mean serum vitamin A level of the study group was 413.6 ±187.7. Serum vitamin A level was found to be below 316 µg/L (low) in 89 (24.7%), and within normal limits in 271 (75.3%) of the 360 patients. In 62 (69.6%) of the patients with low vitamin A levels, vitamin A was found to be in the marginal range, while in 27 (30.4%) patients, it was below 200 µg/L. Malnutrition was found in 98 (27.2%) of 360 patients included in the study. Vitamin A deficiency may be observed in hospitalized children. Detailed evaluation of each patient, especially in developing countries, will prevent vitamin A deficiencies and malnutrition.

12. Exclusive breastfeeding practices in Afghanistan: evidence from the 2022-2023 multiple indicator cluster survey.

期刊: Journal of health, population, and nutrition 发表日期: 2025-Jun-21 链接: PubMed

摘要

National prevalence estimates of exclusive breastfeeding practices could serve as the basis for future policy efforts and specific interventions. However, little is known about the prevalence and factors associated with exclusive breastfeeding practices in Afghanistan. This study aims to determine the prevalence and factors associated with exclusive breastfeeding practices among infants aged 0-5 months in Afghanistan. Multiple Indicator Cluster Survey (MICS) data collected between 2022 and 2023 were used for this analysis. Data from 3,141 mother-infant dyads were included in the study. The outcome variable was exclusive breastfeeding (EBF), defined as the proportion of infants 0-5 months of age who were fed only breast milk in the past 24 h. Binary logistic regression models were applied to examine the likelihood of EBF across the categories of independent variables. In the studied population, 67.0% (95%CI 65%-69%) of the infants were exclusively breastfed. The likelihood of EBF was higher in infants born to mothers with secondary or higher education [AOR = 1.35, 95%CI 1.04-1.76] and in infants with timely initiation of breastfeeding [AOR = 1.25, 95%CI 1.07-1.46]. However, the female sex of the infant was associated with lower odds of EBF practices [AOR = 0.83, 95%CI 0.72-0.97]. The practice of exclusive breastfeeding is at a good level (67%) in Afghanistan. Higher maternal education level, timely breastfeeding initiation, and being a male infant increased the likelihood of EBF practices. Policy efforts and interventions focused on these factors could enhance EBF practices in Afghanistan.

13. A novel approach to enhance glioblastoma multiforme treatment efficacy: non-coding RNA targeted therapy and adjuvant approaches.

期刊: Clinical epigenetics 发表日期: 2025-Jun-21 链接: PubMed

摘要

Glioblastoma multiforme (GBM) is a lethal brain tumor. With the current gold standard chemotherapy treatment, temozolomide (TMZ), many patients do not survive beyond one year. While the urgency of researching novel treatments is understandable, the prohibitively high costs and the prolonged duration of research and clinical trials significantly delay the availability of medical advancements to the general public. This highlights the urgent need for adjuvant therapies to enhance treatment effectiveness. Recent research has suggested the potential of repurposing FDA-approved drugs such as temozolomide (TMZ), disulfiram (DSF), and aspirin for the treatment of glioblastoma, with encouraging evidence particularly for DSF and aspirin. Additionally, compounds like histone deacetylase inhibitors (e.g., vorinostat) are being investigated for their impact on non-coding RNA (ncRNA) modulation, including microRNAs (miRNAs) and long non-coding RNAs (lncRNAs). Combining traditional therapies with ncRNA modulation has shown potential in enhancing therapeutic efficacy and targeting specificity. NcRNAs play a crucial role in regulating gene expression and have been implicated in tumor growth, invasion, and treatment resistance. Recent discoveries, such as cuproptosis, offer new insights into tumor cell death mechanisms. This review focuses on how these molecular insights can serve as novel therapeutic targets and how drug adjuvant therapy may improve GBM treatment strategies. It focuses on how the integration of ncRNA modulation with conventional therapies and the combination strategy of enhancing efficacy of drugs can enhance treatment efficacy and pave the way for innovative approaches in managing GBM. In short, we will explore how non-coding RNAs (ncRNAs) might serve as promising targets and how repurposing TMZ, DSF, and aspirin could help enhance the efficacy of GBM treatment.

期刊: Trials 发表日期: 2025-Jun-21 链接: PubMed

摘要

Sepsis is a life-threatening condition with high mortality rates of up to 40% due to multiple organ dysfunction. Systemic inflammatory response plays a key role in the pathophysiology and progression of this disease. Therefore, anti-inflammatory drugs can be considered as augmentation therapy for the management of the early phase of inflammation in septic patients, along with appropriate antimicrobial therapy and source control. Experimental studies suggest the beneficial effects of colchicine in animal septic models. However, the clinical effects of colchicine in the setting of sepsis have not been investigated yet. This prospective, double-blinded, placebo-controlled, randomized trial will be conducted at Imam Reza Hospital, the largest northwest referral hospital, in Tabriz, Iran. A total of 44 patients aged 18 to 80 years with sepsis diagnosis will be randomized 1:1 to receive colchicine 1 mg daily or placebo for 10 days. The primary outcome is interleukin-6 (IL-6) changes from the baseline through day 4. Sequential organ failure assessment (SOFA) and qSOFA scores will be evaluated at baseline, day 4, and day 10. Patients will be assessed regarding the need for supplemental oxygen, mechanical ventilation, and vasopressor from the randomization through day 4 and day 10. The Colchicine IN Sepsis (COLINS) trial will be the first to investigate colchicine’s efficacy versus placebo in sepsis patients. The results of this trial will be a step forward in treating patients with sepsis. Clinical trial ID: IRCTID: IRCT20231017059748N1. Registration date: 21 October 2023. https://irct.behdasht.gov.ir/trial/73232 .

15. Postoperative Initiation of Thromboprophylaxis in patients with Cushing’s Disease (PIT-CD): a randomized controlled trial.

期刊: Trials 发表日期: 2025-Jun-21 链接: PubMed

摘要

Pituitary surgical intervention remains the preferred treatment for Cushing’s disease (CD) while postoperative venous thromboembolism (VTE) is a significant risk. Whether to prescribe pharmacological thromboprophylaxis presents a clinical dilemma, balancing the benefit of reducing VTE risk with the potential for increasing hemorrhagic events in these patients. Currently, strong evidence and established protocols for routine pharmacological thromboprophylaxis in this population are lacking. Therefore, a randomized, controlled trial is warranted to determine the efficacy and safety of combined pharmacological and mechanical thromboprophylaxis in reducing postoperative VTE risk in patients with CD. This investigator-initiated, multi-center, prospective, randomized, open-label trial with blinded outcome assessment aims to evaluate the efficacy and safety of combined pharmacological and mechanical thromboprophylaxis compared to mechanical thromboprophylaxis alone in postoperative patients with CD. A total of 206 patients diagnosed with CD who will be undergoing transsphenoidal surgery will be randomized in a 1:1 ratio to receive either combined pharmacological and mechanical thromboprophylaxis (intervention) or mechanical thromboprophylaxis only (control). The primary outcome is the risk of VTE within 12 weeks following surgery. This trial represents a significant milestone in evaluating the efficacy of combined pharmacological and mechanical prophylaxis in reducing VTE events in postoperative CD patients. ClinicalTrials.gov Identifier: NCT04486859, first registered on 22 July 2020.

16. The nexus between healthcare provider distribution and neonatal mortality based on the context of maternal and child healthcare services in Pakistan.

期刊: Journal of health, population, and nutrition 发表日期: 2025-Jun-21 链接: PubMed

摘要

Healthcare provider dearth, particularly in Low and Middle-income countries (LMICs), reduces the development towards improved healthcare outcomes and accomplish the Sustainable Development Goals (SDGs-3). This study aims to investigate the association between Professional and Non-professional healthcare provider distribution and neonatal mortality through the mediating role of maternal and child healthcare (MCH) services in Pakistan. The present research used data from the 2018 Pakistan Demographic and Health Survey (PDHS) total sample that comprises (N = 8022). The dependent variable includes the risk of neonatal mortality 0-30 days. Bivariate and Multivariate analyses were conducted by utilizing the Cox proportional hazards and regression models. The estimation of mortality rates was achieved through generalized structural equation modelling (GSEM) and the 5000 bootstrap technique. All the investigations were carried out in STATA v. 16.1. Our results revealed that around 2.46% of neonatal deaths occur. The average healthcare provider distribution type was professional, 83.45%, non-professional, 1.45%, and no care, 15.11%. 0.88% of females are less likely to die within the first thirty days of their birth compared to males. The regression outcomes demonstrate that the healthcare providers were positive and significantly linked to neonatal mortality. Additionally, a unit increase in healthcare providers has a 1.20% Higher likelihood of increasing the MCH and overall reducing neonatal mortality (HR = 0.60). The outcomes illustrate that healthcare provider distribution and MCH play a vital role in minimizing neonatal mortality. To ensure well-distributed healthcare provider distribution, promoting maternal education, empowering women’s decision-making in acquiring MCH services utilization, and expanding access to free MCH services are the essentials for better maternal and healthcare outcomes.

17. Artifacts affecting dual-energy X-ray absorptiometry and bone mineral density measurements: a case report and review of the literature.

期刊: Journal of medical case reports 发表日期: 2025-Jun-21 链接: PubMed

摘要

It is important to recognize artifacts of dual-energy X-ray absorptiometry because they may alter bone mineral density measurements. To prevent erroneous decisions and misdiagnosis regarding treatment and follow-up, bone mineral density measurement adjustments are needed. We present three cases in which artifacts altered the measurements of bone mineral density in the lumbar field of a dual-energy X-ray absorptiometry scan. The first case was oral contrast in the transverse colon in a 55-year-old white Hispanic American woman; the second case was kyphoplasty in lumbar spine in a 73-year-old white Hispanic American woman; and the third case was spinal fusion with vertebroplasty in a 70-year-old white European American man. Clinicians who interpret dual-energy X-ray absorptiometry imaging should routinely reexamine the scans and be attentive toward potential artifact involvement and other alternative origins of unreliable data.

18. The aging immune system and all-cause mortality in older americans: differences across sex and race/ethnicity.

期刊: Immunity & ageing : I & A 发表日期: 2025-Jun-21 链接: PubMed

摘要

As individuals age, the immune system undergoes complex changes, including an increase in the number of CD8 T cells relative to CD4 T cells, a decline in naïve cell production (including T and B cells), and an accumulation of terminally differentiated cells with diminished functionality. These age-related immune alterations collectively contribute to immunosenescence, a phenotype associated with aging-related declines and diseases such as dementia, Alzheimer’s disease, osteoporosis, and diabetes. Premature mortality at older ages often results from cumulative health deterioration initiated by physiological dysregulation over the life course. Mortality risk, therefore, provides a meaningful measure of the long-term impact of physiological changes, including those related to the immune system. Examining the link between mortality risk and immune aging in older adults could illuminate the underlying pathology of aging-related health decline. This study uses data from the Health and Retirement Study (HRS), a national, population-based sample of middle-aged and older Americans, to explore the relationship between specific immune aging ratios and six-year mortality, stratified by race/ethnicity and sex. Using a sample of 8,259 individuals from the HRS, we found that overall, the presence, magnitude, and direction of the association differed by the specific immune ratio measure, sex, and race/ethnicity. We found particularly robust associations among Hispanic and non-Hispanic Black females. Among Hispanic females, for example, a one-unit increase in the log CD4 EMRA: Naïve ratio was associated with a nearly 50% increase in mortality for Hispanic females and a 25% increase in mortality for non-Hispanic Black females which was robust to adjustment for additional covariates. While we found little evidence of an association between immune function and mortality among non-Hispanic White and Hispanic males, we found associations in the opposite direction as what we would expect among non-Hispanic Black males. For example, a one-unit increase in the CD4, EMRA: Naïve ratio was associated with a 15% decrease in mortality among non-Hispanic Black males. Our findings demonstrate that associations between immune aging and mortality are not uniform but instead vary in magnitude and direction across sex and racial/ethnic subgroups. The strongest and most consistent associations were observed among Hispanic and non-Hispanic Black females-groups experiencing multiple forms of marginalization-suggesting that these populations may face heightened vulnerability to the downstream consequences of immune aging. However, the absence or reversal of expected associations in some subgroups-particularly non-Hispanic Black males-underscores the complexity of immune aging processes and their interaction with social and biological contexts. These results highlight the importance of disaggregated analyses and suggest that immune aging may manifest and impact mortality risk differently across populations.

期刊: BMC oral health 发表日期: 2025-Jun-21 链接: PubMed

摘要

Early childhood untreated caries (ECC) has numerous adverse effects on children and remains more prevalent in Asia than the global average. Despite recent improvements in ECC prediction and treatment, inequalities related to parental education and economic status may persist and have potentially worsened in the context of the COVID-19 pandemic. This study analyzed the trends and associated factors of education- and economy- related inequalities in ECC among 5-year-old children in Guangdong, China, from 2005 to 2021. Data from three cross-sectional surveys from Guangdong, China, were utilized, including dental examinations of 2,584 five-year-old children and parental questionnaires. Logistic regression models and education-economy-related interactions were used to identify factors associated with ECC. The Slope Index of Inequality (SII) and Relative Index of Inequality (RII), derived from linear regression models, were applied to access trends in inequalities over the survey years. Children living in rural areas (OR = 1.97, 95%CI = 1.47 to 2.64) and those who have dental visits because of treatment (OR = 5.73, 95%CI = 2.73 to 12.05) were associated with a higher chance of having ECC, compared to their urban and non-visiting counterparts. Children whose parents had high (OR = 0.53, 95%CI = 0.31 to 0.88) or medium (OR = 0.64, 95%CI = 0.41 to 0.99) educational levels and those had high (OR = 0.60, 95%CI = 0.43 to 0.85) and medium (OR = 0.59, 95%CI = 0.42 to 0.84) economic levels were associated with a lower chance of having ECC compared those with levels. The highest education- and economy- related SII were observed in 2005. These declined by 14.0 and 4.3% points, respectively, in 2015, but increased again by 9.8 and 0.4% points in 2021. Besides, inequality as measured by SII increased continuously in rural areas. The RII values reflected similar trends in inequality distribution. Children from rural areas, lower parental education and family economic level exhibited significantly higher ECC prevalence. The education- and economy- related inequalities persisted across different groups and demonstrated a downward trend overall, but inequalities have continued to rise in rural regions from 2005 to 2021.

期刊: Diabetology & metabolic syndrome 发表日期: 2025-Jun-21 链接: PubMed

摘要

Obesity indices that combine anthropometric and lipid measurements, such as the atherogenic index of plasma (AIP), cardiometabolic index (CMI), lipid accumulation product (LAP), metabolic score for insulin resistance (Mets-IR), triglyceride-glucose (TyG) index, and visceral adiposity index (VAI), have been recommended as surrogates for assessing cardiometabolic risk. This study aimed to examine the association between these indices and type 2 diabetes mellitus (T2DM) incidence risk using large routine health checkup data. This retrospective cohort study involved 195,989 participants aged 35-74 years who attended the Specific Health Checkups in 2015 and were observed until 2021 in Fukushima, Japan. We used multivariable Cox regression analysis to examine the associations between the indices and T2DM risk and evaluated the diagnostic utility of the indices. The accumulated T2DM incidence rate per 100,000 person-years over a mean follow-up of 4.61 years was 706.6 in males and 441.2 in females. Multiple adjusted hazard ratios were significantly higher in the highest quartile of indices (1.33-4.22 fold higher) compared to the lowest quartile. The increased risk in the higher quartiles was more pronounced in participants aged < 50 years than in those aged ≥ 50 years for both sexes. The areas under the receiver operating characteristic curves (AUC) of AIP, CMI, LAP, and VAI were between 0.821 and 0.844, whereas those of Mets-IR and TyG were between 0.756 and 0.780. For both sexes, AUCs for AIP, CMI, and LAP showed no significant differences (P values > 0.05), but other pairwise indices had significant differences (P values < 0.001). AUCs were higher in participants with a body mass index (BMI) of < 25 kg/m2 or aged < 50 years than in those with a BMI ≥ 25 kg/m2 or aged ≥ 50 years, respectively. Net reclassification improvements of models for CMI and LAP were similar to AIP, while those for Mets-IR, TyG, and VAI were significantly lower than AIP. Obesity indices are positively associated with and applicable for predicting new-onset T2DM in Japanese adults, particularly AIP, CMI, and LAP.

21. Weight loss with real-world doravirine use in the OPERA cohort: a US-based cohort study.

期刊: AIDS research and therapy 发表日期: 2025-Jun-21 链接: PubMed

摘要

Weight gain has been associated with the use of antiretrovirals in people with HIV, especially with integrase inhibitors or tenofovir alafenamide, and among women. In 2018, doravirine became the latest non-nucleoside reverse transcriptase inhibitor to be approved in the US. We assessed changes in weight over time among virologically suppressed individuals who switched to a regimen containing doravirine (DOR). From the US-based OPERA cohort, treatment-experienced adults with HIV who switched to a DOR-containing regimen between 30AUG2018-30NOV2022 with a viral load < 50 copies/mL were included (followed through 31MAY2023). The study population was characterized and a linear mixed model was used to estimate rates of weight change on DOR. Results were stratified by sex, by patterns of efavirenz (EFV) and/or tenofovir disoproxil fumarate (TDF) use before/after switch to DOR, and by integrase inhibitor (INSTI) & tenofovir alafenamide (TAF) use combination (restricted to individuals who maintained the same combination before/after switch). Of 388 included individuals, 21% were women, 33% were Black, and 78% were obese or overweight at DOR switch. Overall, people who switched to DOR lost an average of 0.80 kg/year (95% CI: -1.32, -0.28). Both women and men experienced statistically significant weight loss; women (70% Black, 70% aged ≥ 40 years) lost weight at a rate of -1.67 kg/year (95% CI: -3.32, -0.02) and men at a rate of -0.60 kg/year (95% CI: -1.12, -0.08). When EFV and TDF were absent before and after switch to DOR, statistically significant weight loss was observed. Among those who had the same INSTI and TAF combination throughout and had any INSTI or TAF use, a statistically non-significant trend toward weight loss was observed. In one of the first real-world analyses of weight changes among virologically suppressed individuals who switched to a DOR-containing regimen in the US, DOR was associated with statistically significant weight loss. Patterns of use of other antiretrovirals did not fully explain the observed weight loss. These findings are clinically meaningful given that most individuals included were overweight or obese at switch to DOR and that women were predominantly of perimenopausal or menopausal age.

22. A minimum data standard for wildlife disease research and surveillance.

期刊: Scientific data 发表日期: 2025-Jun-21 链接: PubMed

摘要

Rapid and comprehensive data sharing is vital to the transparency and actionability of wildlife infectious disease research and surveillance. Unfortunately, most best practices for publicly sharing these data are focused on pathogen determination and genetic sequence data. Other facets of wildlife disease data - particularly negative results - are often withheld or, at best, summarized in a descriptive table with limited metadata. Here, we propose a minimum data and metadata reporting standard for wildlife disease studies. Our data standard identifies a set of 40 data fields (9 required) and 24 metadata fields (7 required) sufficient to standardize and document a dataset consisting of records disaggregated to the finest possible spatial, temporal, and taxonomic scale. We illustrate how this standard is applied to an example study, which documented a novel alphacoronavirus found in bats in Belize. Finally, we outline best practices for how data should be formatted for optimal re-use, and how researchers can navigate potential safety concerns around data sharing.

23. Association of sleep problems with suicidal behaviors and healthcare utilization in adults with chronic diseases: the role of mental illness.

期刊: Annals of general psychiatry 发表日期: 2025-Jun-21 链接: PubMed

摘要

This study aimed to investigate the association between sleep problems and suicidal behaviors as well as healthcare utilization in Canadian adults with chronic diseases, while also examining the mediating role of mental illness. Data were drawn from the 2015-16 cycle of the Canadian Community Health Survey, specifically from Ontario, Manitoba, and Saskatchewan - the provinces that included the optional sleep module. A total of 22,700 participants aged ≥ 18 years and diagnosed with at least one chronic disease were included in the analysis. Sleep problems were defined as extreme sleep durations (either < 5 or ≥ 10 h) and insomnia. Mental illness was classified as a self-reported mood or anxiety disorder. Participants with extreme sleep durations (compared to 7 to < 8 h) and those with insomnia (compared to no insomnia) showed a higher prevalence of suicidal ideation, suicidal plans, and increased healthcare utilization. After adjusting for multiple covariates, both extreme sleep durations and insomnia remained significantly associated with increased odds of suicidal ideation, suicidal plans, and healthcare utilization. Mediation analyses indicated that mental illness partially mediated these associations. Both extreme sleep durations and insomnia were independently associated with higher odds of suicidal behaviors and increased healthcare utilization in adults with chronic diseases, with mental illness playing a partial mediating role in these relationships.

24. Surviving the first five years: the economic and healthcare determinants of child mortality in Sri Lanka.

期刊: Journal of health, population, and nutrition 发表日期: 2025-Jun-21 链接: PubMed

摘要

This study investigates the role of economic growth, healthcare investment, immunization coverage, and malnutrition in reducing under-five mortality rates (U5MR) in Sri Lanka. Understanding how these factors interact within socio-economic ecosystems is essential to formulating sustainable strategies to improve child survival outcomes. This study employs multiple linear regression to analyze the statistical associations between economic growth, healthcare investment, immunization, malnutrition, and under-five mortality in Sri Lanka. Using secondary data from the World Bank and UNICEF (2000-2021), U5MR was modeled against economic growth (per capita GDP), government healthcare expenditure (GHE), immunization coverage (DTP1), and malnutrition (MLN), with significance assessed through p-values and model fit via R². The multiple linear regression model demonstrated strong explanatory power, accounting for 85% of the variation in under-five mortality (R² = 0.85). Economic growth and immunization coverage were negatively associated with U5MR and found to be statistically significant (p < 0.05 and p < 0.10 respectively), indicating their potential role in reducing child mortality. Malnutrition showed a strong positive association (p < 0.01), emphasizing its continued threat to child health. Although government healthcare expenditure had a negative association, it was not statistically significant, suggesting possible inefficiencies in resource utilization. The study highlights the significant role of economic growth, healthcare expenditure, immunization coverage, and nutrition in shaping U5MR trends in Sri Lanka. The findings emphasize the need for targeted policy interventions to enhance child health outcomes and ensure sustainable progress in reducing child mortality.

25. Characterization and abundance of malaria vectors in Sakassou, Central Côte d’Ivoire.

期刊: Malaria journal 发表日期: 2025-Jun-21 链接: PubMed

摘要

Before implementing vector control interventions, it is important to assess the mosquito species composition and their biting and resting behaviour. In preparation for an indoor residual spraying campaign for malaria control in Sakassou, Central Côte d’Ivoire, baseline entomological data were collected to characterize the local vector species composition and their biting behaviour. A longitudinal entomological survey was carried out from November 2018 to July 2020 with monthly assessments, except in April and May 2020 due to lockdown restriction of the COVID-19 pandemic. Mosquitoes were collected with the human landing catch method outside and inside of four houses, with two houses located in an urban setting and two in a rural setting. Additionally, in each setting, 15 houses were sampled using the pyrethrum spray catch method and two houses with Centers for Disease Control and Prevention light traps. Mosquitoes were identified morphologically to the lowest possible taxonomic level, while a subset of Anopheles gambiae sensu lato (s.l.) specimens were further determined to species level by diagnostic polymerase chain reaction (PCR). Parity and Plasmodium sporozoite rates were estimated from a subsample of the caught specimens by dissecting the ovaries and screening heads and thoraces using enzyme-linked immunosorbent assays. Overall, 98,346 mosquitoes, including 91,799 anophelines and 6,547 culicines, were collected with counts following the rain pattern. Anopheles gambiae s.l. was the predominant taxon (90%). Out of 826 specimens successfully screened with a diagnostic PCR, all were identified as Anopheles coluzzii. The estimated biting rates of An. coluzzii were high, peaking shortly after midnight. The overall Plasmodium falciparum infection rate in An. coluzzii was 0.02 (95% confidence interval: 0.01-0.03). Anopheles coluzzii is the main malaria vector in Sakassou, exhibiting indoor resting and biting behaviours, with the peak biting rate after midnight when people are likely to be asleep. Given these characteristics, both insecticide-treated nets and indoor residual spraying hold promise for malaria vector control. As biting started early in the evening when people tend to be outside, outdoor interventions should also be considered.

26. Wild wisdom meets cultivation: comparative rhizomicrobiome analysis unveils the key role of Paraburkholderia in growth promotion and disease suppression in Coptis chinensis.

期刊: Microbiome 发表日期: 2025-Jun-21 链接: PubMed

摘要

The sustained monoculture and irregular planting practices rendered the cultivated Coptis chinensis more prone to various diseases compared to its wild counterparts. Rewilding the rhizomicrobiome of cultivated plants has emerged as a promising strategy to promote plant growth, but ancestral microbiota suitable for C. chinensis remain largely uncharted. The amplicon data analyses revealed that habitat transition strongly influenced the rhizosphere microbial communities. The rhizomicrobiomes of wild C. chinensis encompassed a more diverse array of ecological groups and exhibited a greater functional diversity compared to their cultivated counterparts. A higher proportion of beneficial fungi was observed in the rhizosphere of wild C. chinensis, while the cultivated plants had a higher population of pathogenic fungi. Furthermore, a well-documented plant-growth-promoting rhizobacterium genus, Paraburkholderia, was found to play an essential role in the resistance of the wild C. chinensis to potential disease caused by Ilyonectria. Two strains of Paraburkholderia (Paraburkholderia nemoris and Paraburkholderia phytofirmans) were isolated, and in vitro experiments confirmed that these isolates possess various growth-promoting properties and antagonistic activities against known pathogens for C. chinensis root rot. Both of the Paraburkholderia isolates could markedly promote the plant immune response and enhance the overall health of the cultivated C. chinensis. By a comprehensive comparison of the rhizosphere microbiome between wild and cultivated C. chinensis, the promising bacterial genus Paraburkholderia was identified as a beneficial microbe significantly promoting the growth of C. chinensis, providing pivotal insights for future endeavors aimed at engineering the rhizosphere microbiome of C. chinensis, as well as other medicinal herbs. Video Abstract.

27. Unraveling time-dependent genetic components underlying alcohol response.

期刊: Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology 发表日期: 2025-Jun-21 链接: PubMed

摘要

While numerous studies have examined the subjective response to alcohol as an intermediate phenotype to understand its variability, heritability, and predictive capacity for alcohol-related disorders, in-depth analyses linking alcohol reactivity indicators to genetic factors within a large cohort have been absent. Our study aimed to quantify the exact contribution of each genetic variant relevant to the alcohol metabolism to the variability in alcohol response. Specifically, we focused on two primary genes involved in alcohol metabolism (ALDH2 and ADH1B) and three additional loci (ALDH1B1, ALDH1A1, and GCKR) that have been shown to have significant associations with drinking behaviors in Japanese individuals. We conducted the first study to assess the relationship between subjective response to alcohol (SR), evaluated by various assessment subscales, and genetic factors using an intravenous clamp technique in 429 healthy Japanese young adults. By reducing the dimensionality of the data to assess similarity structures, we identified three distinct clusters of SRs and participants. Each participant cluster exhibited a distinct alcohol response profile shaped by specific genetic contributions. Participant cluster 1 demonstrated the strongest response, followed by participant cluster 2, and then participant cluster 3. Participant cluster 1 may also be the most strongly influenced by the allelic status of ALDH2 and ADH1B. SR patterns varied accordingly, and the enrichment of the ALDH22 and ADH1B2, differed across both participant and subscale clusters. Notably, the three participant clusters closely aligned with the three subscale clusters, highlighting a consistent genotype-phenotype relationship. Furthermore, the proportion of variance explained by these genes also varied across subscale clusters. Contrary to known functions, ADH1B showed associations at later timings when ALDH2 associations attenuate. Our three-cluster classification may improve prevention by enabling early identification of individuals at health risk.

28. Truncated LKB1 nonenzymatically enhances Fas-induced apoptosis by acting as a surrogate of Smac.

期刊: Cell death discovery 发表日期: 2025-Jun-21 链接: PubMed

摘要

Although liver kinase B1 (LKB1) has been established as a tumor suppressor kinase, its mechanism of action is incompletely understood. Here we describe a novel nonenzymatic function of LKB1 in cell death induced by Fas/CD95. In BID knockout HeLa cells, inactivation of mitochondrial outer membrane permeabilization (MOMP) prevents Smac-induced inhibition of X-linked inhibitor of apoptosis (XIAP), causing resistance to Fas-induced apoptosis. However, reexpression of LKB1 in those cells naturally deficient for endogenous LKB1 restored apoptosis. Mechanistically, caspase-8 activated by Fas processed LKB1 to a truncated form, tLKB1. Both WT and kinase-inactive LKB1 antagonized XIAP to restore apoptosis, but somatic mutants of LKB1 found in Peutz-Jeghers syndrome (PJS) failed to do so. Thus, in addition to the known caspase-8 / tBid / Smac / XIAP pro-apoptotic axis, our results unveil a novel one, caspase-8 / tLKB1 / XIAP that potentially contributes to the antitumor functions of LKB1.

29. Decoding the impact of exercise and αCGRP signaling on murine post-traumatic osteoarthritis progression.

期刊: Arthritis research & therapy 发表日期: 2025-Jun-21 链接: PubMed

摘要

Osteoarthritis (OA) is a chronic degenerative joint disease characterized by cartilage breakdown, subchondral bone remodeling, and inflammation. Mechanical stress, such as exercise, can influence OA progression, acting as either a therapeutic intervention or a risk factor depending on intensity. The sensory neuropeptide αCGRP plays a role in modulating cartilage, bone, and inflammatory responses, making it a potential mediator of exercise effects on OA. This study investigated the impact of αCGRP deficiency and exercise intensity on OA progression in a post-traumatic murine model. OA was induced in male αCGRP knockout (KO) and wild type (C57Bl/6J) mice via destabilization of the medial meniscus (DMM). Mice underwent moderate or intense treadmill exercise for up to 6 weeks (8 weeks post-surgery). Histological analyses were performed to assess cartilage degradation. Subchondral and metaphyseal bone morphology as well as cartilage stiffness were evaluated by nanoCT and atomic force microscopy (AFM), respectively. Serum inflammatory markers were analyzed using multiplex immunoassays. Serum levels of proinflammatory markers were elevated in αCGRP-deficient mice, particularly after intense exercise, independent of OA progression. DMM surgery induced significant cartilage degradation. Gross cartilage morphology was not influenced by exercise intensity or αCGRP deficiency, but αCGRP deficiency prevented articular cartilage extracellular matrix stiffening after DMM and intense exercise. Subchondral bone sclerosis was induced by αCGRP deficiency and DMM but mitigated by intense exercise. In metaphyseal bone, intense exercise induced trabecular loss in αCGRP-deficient mice. This study highlights αCGRP as an intrinsic regulator of joint and bone responses to mechanical loading during OA. While cartilage degradation after DMM and treadmill exercise was unaffected by lack of αCGRP, its deficiency altered ECM stiffness, bone remodeling, and inflammatory responses. These findings position αCGRP as a critical regulator of joint homeostasis, particularly for bone health during running exercise and OA progression.

30. Chronic cOronary Syndrome in Swedish PRImary care (COSPRI)-a study protocol for a 5-year cluster randomized controlled trial on a novel package versus standard investigation in patients with suspected chronic coronary syndrome referred from primary health care.

期刊: Trials 发表日期: 2025-Jun-21 链接: PubMed

摘要

This trial aims to assess the effectiveness of a novel diagnostic package in the investigation of symptomatic chronic coronary artery disease (CAD), with a focus on reducing the time to diagnosis and improving risk assessment, compared to the current standard investigation approach. The package investigation is comprised of combined single photon emission computed tomography (SPECT), echocardiography, coronary artery calcification (CAC) scoring, not previously evaluated in Sweden for individual cardiovascular prevention, and CadScore, an acoustic risk score. The standard investigation is comprised of exercise bicycle stress testing and echocardiography. The trial involves patients with a pre-test probability > 15% for significant CAD referred from primary healthcare centers (PHCs) in Region Östergötland (population 471,241 in March 2023) in south-east Sweden. All the 47 PHCs of the region will be invited to participate and will, after approval, be cluster randomized into two groups: package investigation versus standard investigation. The primary outcome is a composite measure comprised of waiting time to invasive coronary angiography or communication of non-invasive myocardial ischemia investigation results. Secondary outcomes include major adverse cardiovascular events (MACE), cost per patient, signs of reversible ischemia on any test, radiation exposure, and adherence to prescribed cardioprotective drugs. This trial addresses the urgent problem of chest pain and dyspnea assessment in primary care and aims to speed up diagnosis, reduce the need for specialist consultations, and potentially improve patient outcomes, with referral to SPECT directly from PHC in comparison with the widely used exercise test. The novel approach includes CAC scoring. Additionally, the utility of acoustic CadScore in reclassifying the risk of CAD is explored. The trial was registered on March 11, 2023, at ClinicalTrials.gov with the identifier: NCT05782582.

31. CD44 mediates the internalization of foot-and-mouth disease virus through macropinocytosis.

期刊: Veterinary research 发表日期: 2025-Jun-21 链接: PubMed

摘要

Foot-and-mouth disease virus (FMDV), a member of the Picornavirus family, poses a significant threat to global animal husbandry. While it is known that macropinocytosis plays a crucial role in the entry of FMDV into cells, the specific cellular proteins that regulate this process and the downstream signalling pathways associated with these proteins are not yet fully understood. In this study, we demonstrated that the membrane protein cluster of differentiation 44 (CD44) is essential for the internalization of FMDV in BHK-21 cells, while it is not involved in the attachment of the virus to the cell. In addition, we found that CD44 is internalized in response to FMDV entry. Interestingly, the use of a macropinocytosis inhibitor impaired both CD44 internalization and FMDV entry and infection, indicating a strong connection between these two processes. Further experiments revealed that CD44 facilitates FMDV internalization through macropinocytosis. Importantly, our study shows that CD44 interacts with FMDV capsid proteins VP2 and VP3 and becomes phosphorylated during the entry of the virus. The phosphorylation of CD44 subsequently promotes the phosphorylation of p21-activated kinase 1 (PAK1), which is a critical component in the macropinocytotic entry of FMDV. Overall, this study provides new insights into the role of CD44 in the invasion of pathogens into host cells and highlights potential strategies for improving FMDV vaccines.

32. DC-SIGN (CD209)-mediated interactions between bacteria, lung cancer tissues, and macrophages promote cancer metastasis.

期刊: Infectious agents and cancer 发表日期: 2025-Jun-21 链接: PubMed

摘要

One of the hallmarks of lung cancers is the earlier metastasis resulting from the dissemination of cancer cells. Although accumulating evidence suggests that bacterial infection may be involved in the development of the metastasis of lung cancer, few studies have explored the molecular mechanisms of bacterial infection in the dissemination of lung cancer cells. A series of studies have indicated that certain Gram-negative bacteria are able to hijack antigen-presenting cells (APCs) via interaction with DC-SIGN (CD209) receptors to facilitate the dissemination of pathogens, including viruses, bacteria, fungi, and parasites. Therefore, in the present work, it was hypothesized that bacterial infection may promote the dissemination of cancer cells via the utilization of a similar mechanism. It was first discovered that human lung cancer tissues contain a very high diversity of bacterial DNAs, indicating the co-existence of lung cancer tissues and microbial organisms. It was then found that lung cancer tissues express DC-SIGN, leading to binding with a Gram-negative bacterium, Shigella sonnei. Further, this bacterium was found to be able not only to induce the expression of DC-SIGN on macrophages but also to enhance the migration ability of lung cancer cells in vitro. The in vivo experiments supported these observations, showing that in wild-type (WT) mice, Shigella sonnei infection significantly increased tumor size, weight, and metastatic nodules compared to SIGNR1 knockout (KO) mice. These observations were associated with increasing DC-SIGN expression in WT mice. Finally, these results suggest that bacterial infections could play a significant role in promoting lung cancer progression and metastasis via DC-SIGN-mediated mechanisms.

33. The effect of promotional health message framing on the perceived benefit of mammography: evidence from estimation of willingness to pay.

期刊: Journal of health, population, and nutrition 发表日期: 2025-Jun-21 链接: PubMed

摘要

Evidence from behavioral economics has shown that framing health information can impact the demand for screening. We examined the effect of promotional message framing on mammography demand by estimating willingness to pay (WTP). This experimental study was conducted in 2024 over a period of 3 months. The interesting outcome was a WTP for mammography. 354 women were randomly selected and randomly assigned between the two study arms. The intervention involved the presentation of health information in two frames of gain and loss. The mammography demand has been estimated using robust standard error Logistic regression. Demand rate of mammography has been compared between two types of information framing using the chi-square test. Finally, the monetary value of willingness to pay (WTP) for mammography was estimated using the methodology developed by López-Feldman. All analyses were done using STATA 17. The price and income elasticity of mammography demand were estimated as - 0.19 and 0.24, respectively (P < 0.01). The higher demand rate in the loss frame compared to the gain frame (38.7% vs. 25.1%) was statistically significant, and its effect size was estimated to be 0.282 (p < 0.01). The value of WTP in the loss frame (10.68 US$) was estimated to be more significant than in the gain frame (4.74 US$) (p < 0.01). This study suggests that health educators consider the message’s persuasiveness with the type of health action before designing health messages. Moreover, health practitioners should use health messages with a loss frame to increase the demand for screening services such as mammography.

34. Targeting the RAGE-RIPK1 binding site attenuates diabetes-associated cognitive deficits.

期刊: Journal of neuroinflammation 发表日期: 2025-Jun-21 链接: PubMed

摘要

Microglial activation can cause neuroinflammation and the consequent neurological impairments play prominent roles in diabetes-associated cognitive deficits. Receptor-interacting protein kinase 1 (RIPK1) phosphorylation is involved in this deleterious microglial activation, but the exact molecular mechanisms are not clear. Here, RIPK1 expression was increased in diabetic patients with cognitive impairment. Furthermore, in diabetic mice, RIPK1 death domain directly binds to C-terminal of the receptor for advanced glycation end products (ctRAGE) could regulate RIPK1 phosphorylation in microglia. This RAGE-RIPK1 complex activates inflammatory signaling, resulting in cascades that ultimately promote cognitive impairment in diabetic mice. An engineered brain-targeting RIPK1 peptide blocked binding of RIPK1 to RAGE, which inhibited RIPK1 phosphorylation, decreased neuroinflammation, improved neuronal morphology and function, and prevented diabetes-associated cognitive deficits in mice. This study uncovers a previously unknown mechanism of neuroinflammation and suggests a novel therapeutic avenue for treating cognitive deficits induced by hyperglycemia.

35. Role of inflammasomes in diabetes mellitus: mechanisms, complications, and therapeutic potential.

期刊: Molecular biology reports 发表日期: 2025-Jun-21 链接: PubMed

摘要

Diabetes mellitus (DM) is a chronic metabolic disease characterized by insulin resistance and hyperglycemia. Emerging evidence suggests that chronic inflammation is central to the development of diabetes and associated complications. Inflammasomes, multi-protein complexes, are key regulators of the innate immune response. The pro-inflammatory cytokines such as interleukin-1β (IL-1β) and interleukin-18 (IL-18) are released upon activation. This causes inflammation in DM. This review aims to explain the mechanisms leading to the activation of inflammasomes and the regulation of different inflammasome isoforms concerning DM and related complications such as cardiovascular disease, neuropathy, nephropathy, and retinopathy. We will also explore the impact of metabolic factors like hyperglycemia and insulin resistance on activating inflammasomes. A better understanding of the interplay between different inflammasome isoforms and DM can help develop novel therapeutic strategies that target inflammasome pathways for preventing and treating complications associated with diabetes.

36. Improved gut microbiota by selenium-enriched Bifidobacterium longum DD98 alleviates chemotherapy-induced intestinal mucositis via inhibiting the STING pathway.

期刊: NPJ science of food 发表日期: 2025-Jun-21 链接: PubMed

摘要

Intestinal mucositis, a common chemotherapy side effect, lacks effective treatments. This study evaluated the protective effect of selenium-enriched Bifidobacterium longum DD98 (SeDD98) on irinotecan-induced intestinal mucositis. Irinotecan caused intestinal mucositis, characterized by weight loss, severe diarrhea, damaged intestinal structure, reduced tight junction proteins, and gut dysbiosis. These effects could be inhibited by SeDD98. Additionally, fecal microbiota from SeDD98-treated mice protected against intestinal mucositis. Mechanistically, irinotecan activated the stimulator of interferon genes (STING) / nuclear factor kappa-B (NF-κB) pathway, whereas SeDD98 and fecal microbiota from SeDD98-treated mice suppressed this activation. Furthermore, depletion of gut microbiota by a broad-spectrum antibiotic cocktail (ABX) blunted the protective effect of SeDD98 and its inhibition of the STING/NF-κB pathway. These findings suggest that SeDD98 could protect against intestinal mucositis via inhibiting the STING/NF-κB pathway, likely through improving gut microbiota. Overall, SeDD98 may be a potential therapeutic agent for preventing chemotherapy-induced intestinal mucositis via gut microbiome improvement.

37. Chromosome-level genome assembly of the Rhizoctonia solani.

期刊: Scientific data 发表日期: 2025-Jun-21 链接: PubMed

摘要

Rhizoctonia solani is a ubiquitously distributed soil-borne fungal pathogen that causes serious diseases in many plants worldwide. It attracts significant research attention due to its considerable economic importance in agricultural production. However, the limited availability of genome information has further impeded the development of new molecular-targeted control technologies. By utilizing Illumina short-read, PacBio HiFi long-read, and high-throughput chromosome conformation capture (Hi-C) sequencing technologies, we present a comprehensive and continuous chromosome-level assembly for R. solani. The final genome size is 40,801,261 bp, consisting of 23 contigs with a N50 of 2,529,230 bp. Hi-C data aids in anchoring the assembly onto 16 chromosomes. Additionally, the genome contains 16.17% (6,597,897 bp) repeat elements, including 10,698 protein-coding genes and 232 non-coding RNAs. The high-quality genome of R. solani not only provides valuable genomic information for further comprehending the fungal pathobiology and evolution, but also contributes to the development of scientific control strategies for disease prevention and control in agriculture.

38. Biomedical and environmental applications via nanobiocatalysts and enzyme immobilization.

期刊: European journal of medical research 发表日期: 2025-Jun-21 链接: PubMed

摘要

Nanobiocatalysts have emerged as transformative tools in biomedical science, enabling precise, efficient, and sustainable enzyme-based technologies. By immobilizing enzymes onto nanostructured materials, these systems overcome major limitations, such as poor enzyme stability, limited reusability, and high production costs. There are many immobilization techniques such as adsorption, covalent bonding, encapsulation, entrapment, and cross linking with a focus on their biomedical relevance. The incorporation of nanomaterials such as magnetic nanoparticles, porous silica, carbon nanostructures, and metal-organic frameworks has significantly enhanced enzyme performance under physiological conditions. A particular emphasis is placed on biomedical applications, including targeted drug delivery, high-sensitivity biosensing, thrombolytic therapy for clot dissolution, and management of oxidative stress and inflammation. The emerging role of nanozymes engineered nanomaterials with intrinsic enzyme-like activity is also discussed for their potential in diagnostics and disease modulation. Surface functionalization strategies are addressed to improve enzyme-carrier interactions and ensure biocompatibility in clinical environments. Despite promising outcomes, key challenges remain regarding large-scale production, potential nanotoxicity, and regulatory compliance. Addressing these limitations is essential for translating laboratory findings into practical biomedical solutions. This review provides a comprehensive perspective on how nanobiocatalyst-based platforms are reshaping therapeutic and diagnostic strategies in modern healthcare.

39. The Reliability of a Video Analysis Tool to Evaluate Outcomes for Animal Assisted Therapy Involving Dogs in Children and Young People with Autism.

期刊: Physical & occupational therapy in pediatrics 发表日期: 2025-Jun-21 链接: PubMed

摘要

To determine inter-rater and test-retest reliability of a video analysis tool (VAT-AAT) for evaluating changes in frequency and duration of verbal social behaviors, non-verbal social behaviors, play behaviors, and negative behaviors of children and young people aged 3-25 years with autism during animal-assisted therapy (AAT). Following recruitment and training, 23 occupational therapy students from an Australian metropolitan university rated a simple or complex video-recorded AAT session on two occasions. Expert raters determined acceptable score ranges which were compared with collected data from the raters to determine intraclass correlation coefficients (ICC). ICCs were 0.84 (simple session) and 0.89 (complex session) for inter-rater reliability and 0.84 (simple session) and 0.89 (complex session) for test-retest reliability. The percentage agreement was similar across level of session complexity and rater experience with children and autism but was lower for participants with less experience with animals (<10% difference in percentage agreement). The VAT-AAT has good inter-rater and test-retest reliability when used in AAT with children and young people with autism. Session complexity or rater experience with children or autism did not impact on the level of agreement with expert raters. Validity of the tool now needs to be established.

40. Corrigendum to “Is ‘minimally adequate treatment’ really adequate? investigating the effect of mental health treatment on quality of life for children with mental health problems” [J. Affect. Disord. 276 (2020) 327-334].

期刊: Journal of affective disorders 发表日期: 2025-Jun-20 链接: PubMed

摘要

41. The Cost-Effectiveness Analysis of Radiofrequency Ablation Compared to Hepatic Resection for Resectable Small Hepatocellular Carcinoma in Thailand.

期刊: Clinical therapeutics 发表日期: 2025-Jun-20 链接: PubMed

摘要

Hepatocellular carcinoma (HCC) is a leading cause of cancer death in Thailand. For early-stage HCC patients with preserved liver function, hepatic resection (HR) or radiofrequency ablation (RFA) are considered curative options. RFA is suitable for small tumors, ideally ≤3 cm and up to ≤5 cm. and can be performed in patients who are unfit for surgery. However, the cost of ablative devices like the RFA electrode is not covered by the National Health Security Office (NHSO), limiting access for many patients. Thus, this study evaluates the cost-effectiveness of RFA compared to HR for single resectable HCC in Thailand. A cost-utility analysis using a Markov model was conducted from a societal perspective, simulating a cohort of 40-year-old patients with compensated cirrhosis (Child-Pugh A or B) and resectable HCC. Two patient subgroups were compared: those with single HCC sized 3.1-5 cm and those with single HCC ≤3 cm. Costs and outcomes were assessed over a lifetime horizon and measured in quality-adjusted life years (QALYs), with a 3% annual discount rate applied. Data sources included systematic reviews, national databases, and local hospitals. For tumors ≤3 cm, RFA proved more cost-effective than HR, with an incremental cost-effectiveness ratio (ICER) of THB 11,015 (USD 350) per QALY gained, significantly below the Thai threshold of THB 160,000 (USD 5,079) per QALY gained. RFA provided 7.55 QALYs versus 5.92 QALYs for HR, with an additional lifetime cost of THB 24,922 (USD 791)per patient. The discount rate and cost of follow-up significantly impacted the ICER. For tumors 3.1-5 cm, HR was more effective (1.25 QALYs) and costly (THB 21,294 or USD 676) than RFA, making HR a favorable option. RFA should be considered a primary treatment for HCC ≤3 cm in Thailand, with policy changes to support device reimbursement. For HCCs sized 3.1-5 cm, HR remains the preferred treatment due to better survival outcomes and cost-effectiveness unless surgery is not feasible.

期刊: Sleep health 发表日期: 2025-Jun-20 链接: PubMed

摘要

Insomnia disproportionally affects women and is prevalent among rural Appalachian adults at higher rates than in the general US population. Given the strong, bi-directional relationship between sleep and health, a better understanding of insomnia in this health-disparate population is critical. The present study focused on the sex (females), gender (women), and age group (45+) at highest insomnia risk and explores the social determinants of sleep that contributed to insomnia. Semistructured telephone interviews were conducted to understand factors associated with insomnia among rural Appalachian women who self-reported insomnia symptoms ≥3 nights per week for ≥3months. Interviews were recorded with permission and transcribed. We used a multistage, inductive and deductive coding process aided by NVIVO 12.0 software. Participants were 46 cisgender women in rural Appalachia who met the criteria for insomnia. The social-ecological model was our interpretative framework. Findings illuminate individual (e.g., rumination, menopause, pain, depression), social (e.g., family roles, grief, caregiving, financial concerns), and societal (e.g., gender norms, technology use) factors that likely contribute to insomnia among middle-aged rural Appalachian women. Across levels of the social-ecological model, factors of female sex (e.g., menopause) and gendered behaviors, roles, and norms (e.g., caregiving close and extended kin) played a central role in the precipitation and perpetuation of insomnia in this population. Attending to the regional cultural norms of heightened self-sufficiency, domestic work, and inter-generational familial care may aid healthcare providers and policy makers aiming to address insomnia among rural Appalachian women as well as other rural populations.

43. Foreword: Disorders of the neuromuscular junction.

期刊: Disease-a-month : DM 发表日期: 2025-Jun-20 链接: PubMed

摘要

44. French protocol for the diagnosis and management of juvenile idiopathic arthritis including pediatric-onset Still’s disease.

期刊: La Revue de medecine interne 发表日期: 2025-Jun-20 链接: PubMed

摘要

Juvenile idiopathic arthritis (JIA) is characterised by arthritis onset before the age of 16, persisting for at least 6weeks without a known cause. Symptoms include joint swelling, inflammatory pain (worse at night and in the morning), or also back, heel, or buttock pain. Timely diagnosis and referral to a paediatric rheumatologist are crucial to reduce errors, invasive procedures, and long-term complications. Around 5000 children under 16 are affected by JIA in France. The current international classification recognises 7 subgroups: the systemic form, oligoarthritis, polyarthritis without rheumatoid factor, polyarthritis with rheumatoid factor (juvenile rheumatoid arthritis), enthesitis associated with JIA (juvenile spondyloarthropathy), JIA associated with psoriasis and undifferentiated JIA. A new classification divides JIA into 5 groups: the systemic form, early-onset oligo- and polyarthritis with anti-nuclear antibodies (associated with a risk of chronic anterior uveitis), polyarthritis with rheumatoid factor, juvenile spondyloarthropathy and non-groupable forms. JIA management involves a multidisciplinary team led by a paediatric rheumatologist, using targeted therapies (biologics, small molecules) and numerous health professionals (physiotherapist, occupational therapist, etc.), improving overall outcomes. Physicians (paediatricians or general practitioners) play a vital role in overall management, ensuring treatment compliance, monitoring effectiveness, and managing infection risks. This includes updating vaccination schedules and addressing febrile episodes. We present recent international recommendations including the “treat-to-target” approach, consisting in setting precise objectives at the beginning and during the evolution, which involves regularly assessing the patient’s situation to adapt treatments, control inflammation and disease complications, limit the toxicity of treatments. This strategy aims to achieve, ideally in a few months an inactive disease or complete remission. Regarding systemic JIA (or pediatric Still’s disease), we pay attention to particularly severe clinical forms in very young children, which may be life-threatening by major activation of the immune system (macrophage activation syndrome) or secondary pulmonary involvement. For non-systemic forms, i.e. oligoarthritis, polyarthritis, enthesitis related JIA (or juvenile spondylarthropathies) and JIA associated with psoriasis, we specify the state of current knowledge and uncertainties regarding prognosis and therapeutic choices.

45. Safety of cryobiopsy for peripheral pulmonary lesions in older people.

期刊: Respiratory investigation 发表日期: 2025-Jun-20 链接: PubMed

摘要

Cryobiopsy enables bronchoscopists to perform high-quality, large, and entirely circumferential sampling and has been reported to improve the diagnostic yield of peripheral pulmonary lesions (PPLs) when combined with conventional bronchoscopic procedures. However, little is known regarding the safety of cryobiopsy for PPLs in older patients. Thus, we aimed to evaluate whether cryobiopsy is safe when performed on elderly patients with PPLs. We reviewed consecutive patients who underwent cryobiopsy for PPLs using a 1.7-mm single-use cryoprobe at the National Cancer Center Hospital between June 2020 and December 2021. Patients’ characteristics, vital signs before and during the procedures, and complications were compared between the E (elderly patients, aged ≥75 years) and NE (non-elderly patients, aged <75 years) groups. A total of 165 patients were analyzed, with 45 in the E group and 120 in the NE group. No significant difference was observed in the Charlson Comorbidity Index between the two groups. The E group had higher rates of hypertension (55.6 % vs. 33.3 %, P = 0.012), eastern cooperative oncology group-performance status of 1 (31.1 % vs. 13.3 %, P = 0.012), and antiplatelet or anticoagulant use (22.2 % vs. 6.7 %, P < 0.01) than the NE group. There were no significant differences in the complication rates: bleeding, pneumothorax, pneumonia, and hypoxemia. Additionally, no significant difference was observed in vital sign changes during the procedures. There were no significant differences in complication rates or changes in vital signs between the two groups. Therefore, cryobiopsy may be safe even for patients over 75 years of age.

46. Integrated culture-based and metagenomic profiling of airborne and surface-deposited bacterial communities in residential environments.

期刊: Environmental pollution (Barking, Essex : 1987) 发表日期: 2025-Jun-20 链接: PubMed

摘要

Indoor environments host diverse microbial communities, where airborne and surface-deposited bacteria contribute to human exposure and potential health risks. This study applies metagenomic analysis to examine bacterial diversity in residential apartments, focusing on four key indoor spaces: kitchens, living rooms, toilets, and bedrooms. Airborne bacteria were collected using a culture-based air sampler and surface-deposited bacteria were collected via swabbing of high-contact areas; both were analyzed through 16S rRNA gene sequencing and bioinformatics processing. Airborne bacterial communities were primarily composed of Staphylococcus, Bacillus, and Enhydrobacter, whereas surface-deposited bacteria varied by location, with Streptococcus and Staphylococcus being most common on high-contact surfaces. Overall, surface-deposited bacterial diversity was greater than that of airborne communities, highlighting their distinct but interconnected roles in indoor microbial ecosystems. Functional pathway analysis suggested that indoor bacterial communities may harbor metabolic functions, as well as antibiotic resistance and virulence-related pathways, pointing to potential health concerns. Principal component analysis (PCA) showed clear distinctions between airborne and surface-deposited bacterial communities. These findings highlight the need for space-specific microbial management strategies, such as improved ventilation and surface hygiene, to reduce exposure risks and promote healthier indoor environments.

47. Residential Greenness and Adolescent Mental Health Trajectories: A Longitudinal Pre-registered Study.

期刊: Environmental research 发表日期: 2025-Jun-19 链接: PubMed

摘要

Exposure to natural environments, such as residential green spaces, have been proposed as a promising approach to health promotion and prevention of mental health issues among adolescents. This study investigated the association between residential greenness and trajectories of adolescent mental health. PARTICIPANTS: (n=245) were part of the Orygen Adolescent Development Study and reported on anxiety and depression symptoms, using the Beck Anxiety Inventory and Center for Epidemiologic Studies Depression scale, at ages 12, 15, 17, and 19. Parent-reports of externalizing behavior was assessed with the delinquent behavior and aggressive behavior scales from the Child Behavior Checklist were collected at the same time points. Residential greenness was measured using the Normalized Difference Vegetation Index (NDVI) at baseline within a 1600m road network radius. Robust linear mixed models were used to examine associations between NDVI and within-subject changes in mental well-being, allowing for the inclusion of participants with only one data point while accounting for missing data. An exploratory analysis examined the interaction with sex in the association between NDVI and mental health. None of the models investigating residential greenness and mental health trajectories indicated consistent associations. The application of alternative buffer zones or distance to nearest park did not alter the conclusion. Sensitivity analysis investigating the moderating effect of childhood maltreatment did not reveal notable effects. Exploratory analyses, however, found a link between higher levels of childhood residential greenness and decreases in externalizing symptoms over time in males (β: -0.31 [95% CI -0.56, -0.06]), though no such observation was observed in females. Our study adds to the existing literature by highlighting the complex relationship between nature exposure and adolescent mental health. It emphasizes a need for future investigations to adopt a life-course approach and further explore potential sex differences and intersections of adolescent social identities with the potential benefits of nature.

48. Predicting symptom worsening in remitted depression on maintenance pharmacotherapy using digital biomarkers: A prognostic modeling study using machine learning.

期刊: Journal of affective disorders 发表日期: 2025-Jun-19 链接: PubMed

摘要

Depression is highly recurrent, and predicting relapses in a timely manner is critical. We applied machine learning to predict the worsening of depressive symptoms. We conducted a 52-week cohort study of patients with recurrent depression on maintenance pharmacotherapy, using a smartphone app and a wearable device. Participants reported their depression level by filling in the Kessler Psychological Distress Scale (K6) every week on the app. We first classified participants based on their lifestyle characteristics. We then applied the leave-one-participant-out cross-validated (LOOCV) XGBoost to predict K6 scores. We also simulated how the model can perform, where the data of a new patient is collected for some time and then added to the existing dataset to predict the new patient’s symptom worsening in the future. We analyzed the data from 89 participants (49 males; median age, 44 years). We identified two distinct clusters of participants: participants in Cluster 1 had unstable sleep patterns and spent more time indoors, whereas those in Cluster 2 spent more time working/studying. The straightforward LOOCV performance showed good AUC but low kappa. When we added observations of a new patient for three months, the weighted kappa between the predicted and the observed K6 classes improved to 0.68 (95 % confidence interval: 0.55-0.81) for Cluster 1 and 0.59 (0.48-0.70) for Cluster 2. Subtyping patients by their behavioral patterns and applying machine learning allowed us to build prediction models for depression relapses among patients on maintenance pharmacotherapy. Shionogi & Co., Ltd.

49. Efficacy and safety of time-restricted eating in metabolic dysfunction-associated steatotic liver disease.

期刊: Journal of hepatology 发表日期: 2025-Jun-19 链接: PubMed

摘要

Time-restricted eating (TRE) may improve weight loss, insulin resistance, and body composition, key factors in the pathophysiology of metabolic dysfunction-associated steatotic liver disease (MASLD). However, evidence in patients with MASLD is limited. This study aimed to evaluate the potential benefits of TRE in patients with overweight or obese MASLD. This 16-week randomized controlled trial included patients who were overweight or obese and had MASLD randomized into three groups in a 1:1:1 ratio: standard of care (SOC), calorie restriction (CR), and TRE. The primary endpoint was an improvement in hepatic steatosis, measured using magnetic resonance imaging proton density fat fraction. Changes in liver fibrosis, body composition, lipid profiles, glucose homeostasis, and sleep quality were also analysed. This study is registered at ClinicalTrals.gov, NCT05579158. Among the 337 participants randomized, 333 were included in the full analysis set (113 in SOC, 110 in CR, and 110 in TRE). After the 16-week intervention, hepatic steatosis significantly decreased in the TRE group (- 25.8%) than in the SOC group (0.7%, p < 0.001), with no significant difference between TRE and CR (- 24.7%, p > 0.999). The TRE group also showed greater reductions in body weight, waist circumference, and body fat mass compared to those of SOC, while changes were comparable between TRE and CR. Liver stiffness, glucose homeostasis, or sleep quality were similar between the TRE and CR groups. No serious adverse events were reported. TRE effectively reduces hepatic steatosis in MASLD, with comparable benefits on weight loss, body composition, and metabolic parameters as CR. This approach may serve as a practical dietary strategy for MASLD management.

50. Lead Induced Intracellular Copper Redox Imbalance with Aggravated Cellular Dysfunction.

期刊: Environmental pollution (Barking, Essex : 1987) 发表日期: 2025-Jun-19 链接: PubMed

摘要

Lead (Pb) represents a critical environmental health concern due to its profound impact on neurodegenerative processes, yet its specific influences on copper (Cu) redox states and associated cellular dysfunction remain inadequately understood. Cu is an essential element required for numerous physiological processes, with its redox equilibrium being particularly critical for mitochondrial function. In this study, we used SH-SY5Y cells as normal human neuron cells and constructed Alzheimer Disease (AD) cell model to study the effects of Pb toxicity in AD-like pathogenesis in human neuron cells. To investigate the toxicity of Pb on Cu redox dynamics and cellular responses, the subcellular locations of Cu(II) and Cu(I) were imaged and combined with proteomic analysis in SH-SY5Y cells and AD cell model. Our findings revealed that Pb exposure promoted the oxidation of Cu(I) to Cu(II), resulting in aberrant Cu(II) accumulation in mitochondria and lysosomes, ultimately disrupting intracellular Cu homeostasis. This imbalance was associated with mitochondrial dysfunction, increased oxidative stress, and impaired cellular integrity. Proteomic analyses further demonstrated that Pb exposure dysregulated proteins involved in cellular metal ion homeostasis especially for Cu ion, up-regulated the AD pathologies proteins (e.g. APP), underscoring the central role of mitochondrial damage in Pb-induced cytotoxicity in AD. Collectively, these results revealed a plausible mechanism by which Pb induced intracellular Cu redox imbalance by reducing Cu(I) to Cu(II) and aggravated AD pathogenesis. Our study provides critical insights into the molecular basis of Pb cytotoxicity and aggravation of AD pathogenesis in normal neuron and AD cell model with environmental Pb exposure.

51. Environmental Factors Mediate Mercury Exposure in Fish with Diverse Feeding Habits in the Beibu Gulf.

期刊: Environmental research 发表日期: 2025-Jun-19 链接: PubMed

摘要

Tropical and subtropical oceans, including the Beibu Gulf, a key fishing area in China, receive a substantial share of global mercury (Hg) deposition, yet the exposure levels and influencing factors in marine organisms remain underexplored. This study analyzed total and methylated Hg (THg and MeHg) concentrations in 650 fish from 10 species across 24 sites in the eastern Beibu Gulf in April and August 2022, along with concurrent surface water parameter measurements. The significant variations in fish Hg content across species were primarily driven by feeding habits, with benthic feeders exhibiting notably higher Hg levels than nekton and zooplankton feeders. Among 13 seawater parameters, temperature and pH were found to significantly influence Hg concentrations across species, with these effects varying by feeding guild. As sea temperature rose, MeHg levels increased in nekton-feeding fish but decreased in zooplankton-feeding fish, whereas in benthos-feeding species, MeHg levels showed a significant negative correlation with pH rather than temperature. Hg levels in Upeneus sulphureus and Johnius belangerii pose moderate and low risks for human consumption, respectively, with long-term consumption potentially reducing neonatal IQ by 0.45 points and increasing the risk of fatal heart attacks by 2.68 cases per 100,000 person-years in adults.

52. Tracking Early-Life PFAS Exposure in Children at Ages 4, 8, and 14 years: A Longitudinal Study from the INMA Spanish Birth Cohort.

期刊: Environmental research 发表日期: 2025-Jun-19 链接: PubMed

摘要

In recent times, the widespread use of PFAS, combined with their persistence and mobility, has led to global environmental contamination and human bioaccumulation. Mapping PFAS exposure in children at critical developmental stages (4, 8, and 14 years) is essential to assess early exposure and its relationship with living place, biological sex and potential health outcomes. In this work, plasma samples from two regions of Gipuzkoa have been analyzed from 207 children at early childhood, 241 children, and 167 adolescents in the INMA Gipuzkoa Spanish birth cohort (2011-2022) for 42 targeted PFAS. The results confirmed 18 different PFAS, including long and short-chain congeners, precursors, and emerging PFAS. The most detected PFAS were PFOS, PFOA, PFNA, PFDA, and PFHxS, with detection frequencies of 70-97%. At 4 years, children showed the highest detection frequencies, while short-chain PFAS detection (PFBA, FPrPA, PFBS, PFPeA) increased when they reached puberty indicating a change on the environmental exposure patterns. The samples coming from the Urola region showed higher concentrations, exceeding the EFSA limit for chronic exposure to sum of 4 PFAS (PFNA, PFOA, PFOS, PFHxS) in 26-35% of 14-year-old males and females. PFOA concentrations, in particular, increased between the 8- and 14-year follow-up in this region indicating an exposure between follow-ups. No significant differences were found between sexes for the total PFAS burden but for individual PFAS with overall higher levels in males at 14 years. Hazard quotient assessments employing points of departure taken from literature indicated no risk or moderate risk for hepatic and developmental effects in the general studied population. Finally, multivariate linear regression models showed that maternal PFAS levels and breastfeeding duration were positively associated with children’s PFAS concentrations in early development, while environmental or regional factors became more influential with age. Parental socioeconomic status did not emerge as a significant predictor in the models.

53. Using the Pollution Load Index to Evaluate Rooftop Harvested Rainwater Metal(loid) Contamination in Environmental Justice Communities.

期刊: Environmental research 发表日期: 2025-Jun-19 链接: PubMed

摘要

Water scarcity poses a significant public health crisis exacerbated by climate change-induced disruptions to freshwater sources. Rainwater harvesting offers a sustainable solution by harnessing rooftop runoff for domestic use. This study analyzed 577 rooftop-harvested rainwater (RHRW) samples from four Arizona, USA environmental justice communities and 162 control samples from five National Atmospheric Deposition Program wet-only deposition collection sites across Arizona. The samples were tested for metal(loid)s, and the pollution load index (PLI) and Nemerow Integrated Pollution Index (NIPI) were used to assess contamination. The PLI was calculated for 11 known contaminants (As, Pb, Cd, Mn, Al, Cr, Cu, Zn, Ni, Ba, and Be), with the highest contamination factor observed for Ni (1340). PLI levels ranged from 0.118-65.8, with the active mining community Globe-Miami showing the highest range (0.244-65.8). The PLI was significantly greater during the monsoon season than during the winter season for all the communities (p < 0.05). Compared with urban communities (0.118-13.1), active mining communities (0.169-65.8) had higher PLI values. pH was positively correlated with PLI in Tucson (β = ln 0.27). In non-urban/rural mining communities, locations closer to potential contamination sources had higher PLI values (β = ln -0.33 to -0.38). However, in Tucson, the proximity relationship was less defined because of multiple potential contamination sources in urban areas. This study highlights the importance of using indices like PLI and NIPI to assess water quality; PLI reflects cumulative contamination burden, while NIPI contextualizes this burden within potential water uses. The strong positive correlation observed between PLI and NIPI across all use categories supports the validity of both indices and affirms utility. Together, they provide a nuanced understanding of pollution dynamics in RHRW and strengthen the case for public health interventions and ensuring the safety and sustainability of RHRW.

54. Effects of web-based behavioral intervention on fine particulate matter, pulmonary function, and airway inflammation in children: The COCOA randomized controlled trial.

期刊: Environmental research 发表日期: 2025-Jun-19 链接: PubMed

摘要

Although web-based intervention programs are effective in changing health behavior, evidence of their effectiveness in relation to air pollution and respiratory health in children is lacking. We assessed the effects of web-based behavioral intervention on exposure to fine particulate matter (PM ≤2.5μm in diameter [PM2.5]), lung function, and airway inflammation in children. We randomized 80 mother-child pairs into intervention or control groups (two arms, 1:1 allocation). Personal and indoor PM2.5 concentrations over a sampling period of 24 hour up to four occasions during the study period were measured in participants’ homes. We used linear mixed models to assess the intervention effects on PM2.5 concentration, lung function parameters including forced vital capacity (FVC), forced-expiratory volume in 1 second (FEV1), FEV1/FVC, and forced-expiratory flow at 25-75% (FEF25%-75%), and the airway inflammation marker, fractional exhaled nitric oxide (FeNO), as well as the association of PM2.5 with lung function and airway inflammation. Quantile regression was also used to examine the effects of PM2.5 exposure at different quantiles of the outcome distribution. In comparison with the control group, the intervention group showed reduction in indoor and personal PM2.5 concentrations by 20.5 % (95% confidence interval [CI]: -30.7, -8.7) and 12.9% (95% CI: -20.1, -5.1), respectively. Lung function parameters such as FVC, FEV1, and FEF25%-75% were higher in the intervention group, with greater benefits observed for children at the lower end of these parameters. Higher levels of outdoor and personal PM2.5 (≥90th percentile) were negatively associated with these lung function parameters at the lower quantiles, whereas the higher level of outdoor PM2.5 concentration was positively associated with FeNO at the lower quantile. The behavioral intervention reduced PM2.5 concentration in the homes, which was linked to markers of lung function and airway inflammation in children, particularly at the lower quantiles.

55. The trials of interpreting clinical trials - A Bayesian perspective on colchicine following an acute coronary syndrome.

期刊: The Canadian journal of cardiology 发表日期: 2025-Jun-19 链接: PubMed

摘要

A 2022 meta-analysis concluded colchicine reduced the cardiac risk in secondary prevention. Nevertheless, a large, randomized clinical trial (RCT) continued to randomize patients to colchicine or placebo and in 2025 published findings of no benefit. Bayesian sequential analyses and hierarchical meta-analysis can assist in understanding not only the interpretation of this latest trial but also the totality of the evidence. A systematic review and Bayesian meta-analysis including the recent CLEAR trial results was performed. The primary outcome was major adverse cardiovascular events (MACE), a composite of death from cardiovascular causes, recurrent myocardial infarction, stroke, or unplanned ischemia-driven coronary revascularization. Bayesian sequential analyses were performed with vague (result dominated by CLEAR), fully informative (based on all previous studies), and “focused” (considering only the largest and most similar previous trial) priors and results compared with a hierarchical meta-analysis. The probabilities of clinically meaningful results were based on > absolute 15% MACE reduction. While the 2022 meta-analysis suggested a statistically significant MACE decrease with colchicine, the Bayesian reanalysis showed a 95% credible interval (95% CrI 0.26, 1.70) for the next study, justifying CLEAR continuation. The Bayesian sequential analyses using vague, all-inclusive, and focused priors showed 58%, 100% and 92% probabilities respectively of MACE decrease with colchicine. Clinically meaningful probability decreases, based on > absolute 15% reduction, were smaller, ranging between 2% to 41%. Bayesian analyses offer advantages in trial design and interpretation, suggesting some benefit for colchicine in secondary cardiovascular prevention, but considerably less certainty of its clinical importance.

56. Cuproptosis-based nanoparticles for cascade reaction to boost radioimmunotherapy.

期刊: Colloids and surfaces. B, Biointerfaces 发表日期: 2025-Jun-17 链接: PubMed

摘要

Radiation resistance significantly limits the effectiveness of radiotherapy, presenting substantial challenges in breast cancer treatment. This work developed a novel cuproptosis-based nanoparticle system, ZnO2@Cu, composed of a ZnO2 core and a Cu-doped polydopamine shell. The nanoparticles were characterized using transmission electron microscopy (TEM) for morphology, X-ray photoelectron spectroscopy (XPS) for elemental analysis, and dynamic light scattering (DLS) for stability assessment. In the mild acidic tumor microenvironment, ZnO2@Cu decomposed, releasing copper ions and ZnO2, which generated significant amounts of H2O2. The released copper ions triggered cuproptosis and depleted glutathione (GSH), while also converting H2O2 into toxic reactive oxygen species (ROS) through Fenton-like activity. Upon X-ray irradiation, the radiotherapy-induced tumor cell death synergized with copper ion-induced cuproptosis and the Fenton-like activity promoted by ZnO2@Cu. In vivo experiments demonstrated that ZnO2@Cu mediated a cascade reaction that generated abundant ROS, induced cuproptosis by disrupting copper metabolism, and effectively killed tumor cells under X-ray irradiation. This process promoted immunogenic cell death (ICD), activated systemic immune responses, and alleviated radioresistance through ROS generation and cuproptosis, leading to enhanced tumor suppression.

57. Characterizing volatile organic compounds from personal protective equipment users: Implications to cleanroom air quality and occupational health.

期刊: Journal of hazardous materials 发表日期: 2025-Jun-14 链接: PubMed

摘要

Human-related contaminants are the primary pollution source in cleanrooms. This study employed time-of-flight mass spectrometry (PTR-ToF-MS) to characterize volatile organic compound (VOC) emissions from breath and skin under different activity levels and personal protective equipment (PPE) conditions in a climatic chamber. The results show that, without PPE, breath and skin emission rates were 968.2 ± 350.8 μg h-1p-1 and 2115.8 ± 1813.7 μg h-1p-1, respectively. With PPE, breath emissions slightly increased to 1068.6 ± 472.7 μg h-1p-1, while skin emissions stabilized at 2181.1 ± 1302.5 μg h-1p-1. Key VOCs included acetone, isoprene, and ethanol from breath, and propanamide, acetone, and isoprene from skin. Activity levels increased skin emissions, but prolonged PPE use reduced them. Females showed higher sensitivity to PPE in breath emissions, while males were more sensitive in skin emissions. PPE had minimal efficacy in mitigating the outward emission of skin VOCs into the ambient environment. The hydroxyl radical reactivity and secondary organic aerosol formation potential from human-related VOCs were 0.27 ± 0.08 s-1 and 2.13 ± 0.51 μg m-3, respectively. Breath VOCs, especially acrolein and acetaldehyde, pose significant health risks to users and may affect industrial processes. These findings highlight the importance of human activities in VOC emissions, crucial for contaminant control, health assessments, and industrial processes like semiconductor cleanrooms.

58. In adults living with type 1 diabetes, additional autoimmune diseases are associated with more chronic complications and depression. A BETTER registry analysis.

期刊: Diabetes & metabolism 发表日期: 2025-Jun-04 链接: PubMed

摘要

People living with type 1 diabetes (T1D) are at elevated risk of additional autoimmune diseases (ADs) than the general population. We aimed to describe the association between additional ADs and T1D-related physical and mental burden in adults. This was a cross-sectional analysis using data from the BEhaviors, Therapies, TEchnologies, and hypoglycemic Risk in T1D (BETTER) registry. Using patient reported-outcomes and validated questionnaires, we compared prevalence of vascular complications, hypoglycemia, and mental health issues between those with T1D alone (AD-) and T1D with additional AD (AD+). Among 3222 participants (66.2 % female, 42.7 ± 15.0 years), 36.3 % reported ≥ 1 AD+. The AD+ group was older (+4.4 years) and more female (+17.7 %) than the AD- group. The AD+ group had similar HbA1c (P = 0.20) but was more likely to report level 2 hypoglycemia in the past month (OR: 1.27 [95 %Cl 1.06-1.52]) and level 3 hypoglycemia since diagnosis (1.22 [1.05-1.42]). The AD+ group reported more cardiovascular disease (1.40 [1.03 to 1.90]), nephropathy (1.49 [1.19-1.86]), neuropathy (1.38 [1.13-1.69]), retinopathy (1.48 [1.22-1.78]), higher depression scores (p = 0.015), and anxiety/depression medication use (1.31 [1.10-1.56]). Number of AD+ was positively associated with depression scores (1 AD+ P = 0.055, 2+ AD+ p = 0.027), level 3 hypoglycemia since diagnosis (1 AD+ p = 0.037, 2+ AD+ P = 0.025), and number of chronic complications (1 AD+ P < 0.001, 2+ AD+ P < 0.001). For people with T1D, living with additional ADs is associated with higher levels of physical and mental diabetes complications, warranting regular screening in this population.

59. Development of Experimental Models of Antithrombin-independent Heparin Resistance Using Platelet Factor 4 and the Effect of Antithrombin in These Models.

期刊: Journal of cardiothoracic and vascular anesthesia 发表日期: 2025-May-27 链接: PubMed

摘要

Antithrombin (AT) deficiency is considered the primary cause of heparin resistance (HR); however, some patients with HR have normal AT activity (AT-independent HR). Supplementation with concentrated human AT is recommended for patients with AT-deficient HR, whereas treatment for AT-independent HR has not been established. Interestingly, the efficacy of concentrated human AT for AT-independent HR has recently been reported. Therefore, this study was designed to experimentally investigate the effects of AT on AT-independent HR using experimentally developed models with platelet factor 4 (PF4), a potent heparin inhibitor and a potential risk factor for AT-independent HR. In vitro and in vivo experimental studies. Experimental laboratory. Normal human plasma, whole blood, and 8- or 9-week-old male Institute of Cancer Research mice. Recombinant PF4 (rPF4), heparin, and AT were added or administered. Coagulation parameters, including activated partial thromboplastin time and clotting time using the INTEM assay of rotational thromboelastometry, were assessed. In addition, the AT activity of the rPF4-containing plasma was measured, and the interaction of rPF4 or AT with heparin was evaluated. Recombinant PF4 shortened activated partial thromboplastin time and clotting time prolonged by heparin, without affecting AT activity. AT ameliorated this shortening in a dose-dependent manner. The binding affinity of AT for heparin was weaker than that of rPF4. This work experimentally demonstrated that AT has the potential to ameliorate AT-independent HR. The potential mechanism was considered to involve an increased absolute number of AT-heparin complexes. This report provides insights into therapeutic strategies for AT-independent HR.

公共卫生研究摘要 (2025-06-23)

1. Diving practices in technical divers’ community and behaviour towards self-reported unusual symptoms.

摘要

2. Core outcome set for research in necrotising soft tissue infection patients: an international, multidisciplinary, modified Delphi consensus study.

摘要

3. Psychosis and diving.

摘要

4. Effect of normobaric and hyperbaric hyperoxia treatment on symptoms and cognitive capacities in Long COVID patients: a randomised placebo-controlled, prospective, double-blind trial.

摘要

5. Comparative efficacy of remifentanil and fentanyl in mechanically ventilated ICU patients: a systematic review and meta-analysis on ventilation duration and delirium incidence.

摘要

6. Vascular (dys)function in the failing heart.

摘要

7. The learning curve for single-incision laparoscopic colectomy for colon cancer: succession of surgical techniques for novice surgeons.

摘要

8. The role of intersectionality in shaping participant engagement with health research through digital methods: findings from a qualitative study.

摘要

9. A protocol for a systematic review of health consequences of conflict-related sexual violence (2015-2024).

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10. Who receives health advice? Prevalence and correlates of receiving health advice among adults in Cape Verde.

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11. Evaluation of vitamin A levels in patients hospitalized in the general pediatrics unit.

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12. Exclusive breastfeeding practices in Afghanistan: evidence from the 2022-2023 multiple indicator cluster survey.

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13. A novel approach to enhance glioblastoma multiforme treatment efficacy: non-coding RNA targeted therapy and adjuvant approaches.

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14. The effect of Colchicine IN Sepsis (COLINS): a study protocol for a randomized, double-blind, placebo-controlled trial.

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15. Postoperative Initiation of Thromboprophylaxis in patients with Cushing’s Disease (PIT-CD): a randomized controlled trial.

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16. The nexus between healthcare provider distribution and neonatal mortality based on the context of maternal and child healthcare services in Pakistan.

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17. Artifacts affecting dual-energy X-ray absorptiometry and bone mineral density measurements: a case report and review of the literature.

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18. The aging immune system and all-cause mortality in older americans: differences across sex and race/ethnicity.

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19. Trends in education-economy-related inequalities in the prevalence of early childhood untreated caries in Guangdong, China from 2005 to 2021.

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20. Predictive value of obesity-related indices for incident type 2 diabetes mellitus: a longitudinal study of the Fukushima Health Database 2015-2021.

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21. Weight loss with real-world doravirine use in the OPERA cohort: a US-based cohort study.

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22. A minimum data standard for wildlife disease research and surveillance.

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23. Association of sleep problems with suicidal behaviors and healthcare utilization in adults with chronic diseases: the role of mental illness.

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24. Surviving the first five years: the economic and healthcare determinants of child mortality in Sri Lanka.

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25. Characterization and abundance of malaria vectors in Sakassou, Central Côte d’Ivoire.

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26. Wild wisdom meets cultivation: comparative rhizomicrobiome analysis unveils the key role of Paraburkholderia in growth promotion and disease suppression in Coptis chinensis.

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27. Unraveling time-dependent genetic components underlying alcohol response.

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28. Truncated LKB1 nonenzymatically enhances Fas-induced apoptosis by acting as a surrogate of Smac.

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29. Decoding the impact of exercise and αCGRP signaling on murine post-traumatic osteoarthritis progression.

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30. Chronic cOronary Syndrome in Swedish PRImary care (COSPRI)-a study protocol for a 5-year cluster randomized controlled trial on a novel package versus standard investigation in patients with suspected chronic coronary syndrome referred from primary health care.

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31. CD44 mediates the internalization of foot-and-mouth disease virus through macropinocytosis.

摘要

32. DC-SIGN (CD209)-mediated interactions between bacteria, lung cancer tissues, and macrophages promote cancer metastasis.

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33. The effect of promotional health message framing on the perceived benefit of mammography: evidence from estimation of willingness to pay.

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34. Targeting the RAGE-RIPK1 binding site attenuates diabetes-associated cognitive deficits.

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35. Role of inflammasomes in diabetes mellitus: mechanisms, complications, and therapeutic potential.

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36. Improved gut microbiota by selenium-enriched Bifidobacterium longum DD98 alleviates chemotherapy-induced intestinal mucositis via inhibiting the STING pathway.

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37. Chromosome-level genome assembly of the Rhizoctonia solani.

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38. Biomedical and environmental applications via nanobiocatalysts and enzyme immobilization.

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39. The Reliability of a Video Analysis Tool to Evaluate Outcomes for Animal Assisted Therapy Involving Dogs in Children and Young People with Autism.

摘要

40. Corrigendum to “Is ‘minimally adequate treatment’ really adequate? investigating the effect of mental health treatment on quality of life for children with mental health problems” [J. Affect. Disord. 276 (2020) 327-334].