公共卫生研究摘要 (2025-07-03)
共收录 54 篇研究文章
1. In harm's way: moral injury and the erosion of trust for emergency responders in the United Kingdom.
期刊: European journal of psychotraumatology 发表日期: 2025-Dec 链接: PubMed
摘要
Background: Moral injury describes the impact of witnessing or being part of events that violate one’s values. Initially described in relation to conflict and war, recent work shows that moral injury is a relevant concept for professionals working in emergency situations. Emergency responders work in contexts of human suffering and make complex decisions in time-pressured, high-stakes situations, but emergency responders’ viewpoints regarding moral injury and how strongly they align with different viewpoints is currently not well understood.Objective: We sought to investigate how moral injury is conceptualised and how emergency responders in the United Kingdom (UK) relate to experiences of moral injury.Method: In this Q-methodology (mixed-methods) study, seven experts co-created a set of 45 opinion statements (Q-set) capturing different facets of moral injury in the context of emergency responding. Subsequently, N = 21 emergency responders (police, fire service, emergency medicine, ambulance, and community first-response staff) completed an online Q-sort task, sorting statements according to how much they identified with them.Results: A by-person factor analysis yielded a three-factor solution mapping onto theoretical positions of moral injury, including loss of trust in others (Factor 1), loss of trust in oneself (Factor 2), and loss of trust in authority (Factor 3).Conclusions: Our findings support the assumption that moral injury is not a unitary concept but instead comprises different facets that people may identify with to a greater or lesser extent, depending on their role. Our results suggest differences between police vs. hospital ward workers and length of time in the profession. Future research into tailored relational and systemic interventions may be required to address the variety of experiences of moral injury in emergency responders. Using Q methodology, we investigated how moral injury is conceptualised by emergency responders in the United Kingdom (UK).Emergency responders (police, fire service, emergency medicine, ambulance, and community first-response staff) completed an online Q-sort task, sorting statements according to how much they identified with them.We found three distinct viewpoints mapping onto theoretical positions of moral injury, including loss of trust in others (Factor 1), loss of trust in oneself (Factor 2), and loss of trust in authority (Factor 3).
2. Environmental and Work Environment Justice with Diversity, Inclusion, and Equity.
期刊: New solutions : a journal of environmental and occupational health policy : NS 发表日期: 2025-Aug 链接: PubMed
摘要
Editor’s Note: In light of the current attack on DEI, NEW SOLUTIONS reproduces here its DEI statement first published online April 15, 2022, It appeared in Volume 32, Issue 1.
3. We'll Keep the DEI Flag Flying Here.
期刊: New solutions : a journal of environmental and occupational health policy : NS 发表日期: 2025-Aug 链接: PubMed
摘要
4. Evaluating the Impact of the COVID-19 Pandemic on Telepharmaceutical Service Effectiveness: Systematic Review and Meta-Analysis.
期刊: Journal of medical Internet research 发表日期: 2025-Jul-02 链接: PubMed
摘要
Telepharmaceutical services (TPS) led by pharmacists, an emerging telehealth service, improve access to medical services and enable patients to receive specialized services in areas with limited resources. With a lower risk of infection and no restriction of isolation measures, TPS showed great potential during the COVID-19 pandemic. However, whether the effectiveness of TPS changed before and after the outbreak of the COVID-19 pandemic remained unclear. This study aimed to evaluate the effectiveness of TPS, compare the effectiveness before and after the outbreak of the COVID-19 pandemic, and explore whether the effectiveness changed over time. We searched PubMed, Embase (Ovid), SinoMed, China National Knowledge Infrastructure, Wanfang, and VIP databases for randomized controlled trials that evaluated the effectiveness of TPS. The search covered studies published from inception to October 24, 2023. Eligible studies were conducted before May 5, 2023, when the World Health Organization (WHO) declared the end of the COVID-19 pandemic as a Public Health Emergency of International Concern. We used the random-effect model to pool the results and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system to assess the certainty of evidence. To explore whether the effectiveness of TPS changed over time, we applied subgroup analyses (studies conducted before December 31, 2019, and studies conducted after January 1, 2020). Using the independent-sample z test, we compared the effectiveness of TPS between the 2 subgroups. When a significant difference arose between them, we conducted a meta-regression analysis to further evaluate the trend of effectiveness over time. In addition, 40 studies were finally included. Compared with no TPS or usual care (ie, face-to-face pharmaceutical services), TPS probably increased patient medication adherence (risk difference [RD] 0.15, 95% CI 0.09-0.20, moderate certainty), and may reduce the occurrence of adverse events (RD -0.10, 95% CI -0.18 to -0.02, low certainty) and improve the proportion of patients who were satisfied with medication (RD 0.16, 95% CI 0.05-0.26, low certainty). Moderate to high evidence indicated that patients accepting TPS probably achieved superior management of diabetes and hypertension. The effectiveness of TPS was not significantly different before and after the outbreak of the COVID-19 pandemic except for medication adherence (RD 0.12, 95% CI 0.03-0.21, P=.007), which also increased over time (coefficient=0.01, 95% CI 0.01-0.02, P<.001). TPS probably improved patient medication adherence and may lead to better satisfaction and the incidence of adverse events. The effectiveness of TPS in general did not change after the outbreak of the COVID-19 pandemic. PROSPERO CRD42023487476; https://tinyurl.com/3s47enj6.
5. A summary of the national cancer institute think tank on advancing gastric cancer prevention.
期刊: Journal of the National Cancer Institute 发表日期: 2025-Jul-02 链接: PubMed
摘要
Gastric cancer remains a major health challenge globally. In the U.S., gastric cancer outcomes remain poor with well-documented disparities in incidence and mortality. In 2024, the U.S. National Cancer Institute convened a Think Tank on Advancing Gastric Cancer Prevention with participation of over 200 global leaders from academia, clinical practice, and industry as well as patient advocates to exchange knowledge, lived experiences, and discuss future research opportunities. This commentary summarizes the Think Tank presentations and discussions of key existing evidence as well as challenges and opportunities on the prevention and control of this preventable disease. Primary prevention discussions focused on the use of the screen-and-treat strategy for Helicobacter pylori eradication. Secondary prevention discussions included endoscopic screening and surveillance of advanced gastric precancerous lesions. Primary conclusions for gastric cancer prevention and control included the need for: 1) developing large-scale study resources that optimize the ability to conduct research with potential clinical translation applications; 2) strengthening and building community-public health-academic partnerships to enhance research; and 3) leveraging evidence-based strategies developed in high-risk East Asian countries to high-risk subgroups in low- and moderate-risk countries including the U.S. There was overwhelming agreement that given the current state of gastric cancer incidence and survival in the U.S., novel strategies to control the carcinogenic effects of H. pylori and to improve detection of precursors are the key to substantially reducing the burden of this disease.
6. Evidence mapping and scoping review of pathways for potential dietary exposure to per- and poly-fluoroalkyl substances (PFAS).
期刊: Environmental science. Processes & impacts 发表日期: 2025-Jul-02 链接: PubMed
摘要
Concern for exposure to per- and poly-fluoroalkyl substances (PFAS) has been growing over the past couple of decades as more information is obtained and understood. PFAS are environmentally persistent and have found their way into the food chain. A better understanding of the impact to humans through the dietary route is imperative to address growing concerns and to mitigate these influences on the food supply. The goal of this study is to identify and map evidence in the peer reviewed literature of important pathways for dietary exposure to PFAS. A conceptual model of potential exposure pathways is described, evidence for these pathways from two previous systematic literature reviews is collated, and additional information on potential for PFAS transfer to food from targeted reviews is distilled. Evidence mapping confirms significant evidence for occurrence of legacy PFAS in foods and for association of dietary intake of certain foods with measured body burden for these chemicals. More limited information on sources of PFAS in agricultural inputs and food processing suggest important exposure pathways for consumers. There is also limited research reporting chemical transfers during food storage and preparation. Direct measurements for most PFAS in foods and for transfers from contaminated environmental media to foods remain limited. Addressing the most important gaps in the evidence for PFAS exposure through the dietary pathway will support actions to mitigate and prevent health impacts.
7. Mental Health Antecedents and Correlates of 2 Distinct Developmental Pathways to Suicidal Ideation.
期刊: JAMA psychiatry 发表日期: 2025-Jul-02 链接: PubMed
摘要
Suicidal ideation is increasingly common in youth. Trajectories and associated mental health symptoms across development remain poorly understood. To describe trajectories of suicidal ideation from early adolescence to young adulthood and identify preceding and co-occurring mental health symptoms to inform optimal prevention. This cohort study used data from a contemporary, longitudinal cohort study, the Québec Longitudinal Study of Child Development (QLSCD), including reports from participants, parents, and teachers. The QLSCD is a population-based birth cohort study of 2120 singletons born between 1997 and 1998 in Québec, Canada, and followed up to age 25 years (2023). Data were analyzed from September 2024 to February 2025. Serious suicidal ideation in the past 12 months was assessed by a question to participants at ages 13, 15, 17, 20, 23, and 25 years. Mental health symptoms (eg, internalizing, externalizing) as reported by parents, teachers, and self-reports on validated questionnaires and standardized across 5 developmental periods: preschool (3-5 years), childhood (6-12 years), early adolescence (13 years), mid-late adolescence (15-17 years), and young adulthood (20-25 years). A total of 1635 participants (845 female [51.7%]; participant number is weighted to account for selective attrition) provided answers on suicidal ideation, with survey weights applied. A total of 3 trajectories were identified: minimal/no ideation (1433 [87.6%]), onset in early adolescence (117 [7.1%]), and onset in young adulthood (86 [5.2%]). Relative to minimal/no ideation, onset in early adolescence was associated with elevated symptoms across nearly all mental health indicators from childhood through adulthood. This included both internalizing (eg, childhood depressive symptoms: risk ratio [RR], 1.75; 95% CI, 1.45-2.05) and externalizing (eg, childhood disruptive symptoms: RR, 1.60; 95% CI, 1.29-1.91) symptoms and maternal antisocial symptoms (RR, 1.39; 95% CI, 1.11-1.66). In contrast, onset of suicidal ideation in young adulthood was associated with internalizing symptoms (eg, mid-late adolescence depressive symptoms: RR, 1.84; 95% CI, 1.28-2.39) emerging in adolescence and worsening mental distress in young adulthood. Results of this cohort study revealed 2 pathways to suicidal ideation: onset in early adolescence, with persistent childhood internalizing/externalizing symptoms, and onset in young adulthood linked to internalizing symptoms emerging in adolescence without prior distress. Findings suggest timely addressing of mental health symptoms and developmental stage-specific prevention.
8. Autoimmune Skin Diseases and Survival Outcomes After Antineoplastic Treatment in Patients With Cancer.
期刊: JAMA dermatology 发表日期: 2025-Jul-02 链接: PubMed
摘要
Autoimmune skin diseases (ASDs) and cancer both involve immune system dysregulation, with ASDs characterized by heightened immune activity, and cancer associated with immune evasion; however, their impact on cancer prognosis remains unclear. To investigate the association of ASDs with cancer prognosis and survival outcomes after antineoplastic treatment in patients with cancer. This population-based cohort study used data from Taiwan’s Nationwide Cancer Registry and National Health Insurance Database to evaluate survival outcomes in patients with cancer who received antineoplastic treatment (ie, chemotherapy, targeted therapy, or immunotherapy) between January 1, 2019, and June 30, 2021. Data were analyzed from July 2023 to April 2025. ASDs, including alopecia areata, Sjögren syndrome, vitiligo, cutaneous lupus erythematosus, psoriasis, lichen planus, autoimmune bullous diseases, systemic sclerosis, morphea, hidradenitis, and dermatomyositis. All-cause mortality and cancer-specific mortality were assessed during the follow-up period. To account for potential confounding, both inverse probability of treatment weighting (IPTW) and propensity score matching strategies were applied. Cox proportional hazards regression models were applied to estimate hazard ratios (HRs) for all-cause mortality, while the Fine-Gray hazard model was used to estimate subdistribution HRs (SHRs) for cancer-specific mortality, with noncancer-related deaths considered as competing events. Of 197 895 patients included in the analysis, 26 008 were in the ASD group (mean [SD] age, 64.0 [13.3] years; 14 969 female [57.6%]) and 171 887 were in the non-ASD group (mean [SD] age, 62.8 [13.0] years; 80 525 female [46.9%]). Patients with ASDs had significantly better survival outcomes than those without ASDs, with an IPTW-adjusted HR of 0.94 (95% CI, 0.92-0.96) for all-cause mortality and an SHR of 0.94 (95% CI, 0.92-0.96) for cancer-specific mortality. These associations remained consistent in propensity score-matched analyses. Among ASD subtypes, alopecia areata and Sjögren syndrome were consistently associated with lower mortality risk. This population-based cohort study found that patients with ASDs had significantly better cancer survival outcomes than those without ASDs. This finding suggests that there is a potential immunological association between ASDs and cancer prognoses, highlighting the need for further investigation into the underlying mechanisms and the implications for oncologic management.
9. Penicillin-susceptible ST398 with strong biofilm-forming ability poses a significant threat to osteoarticular infections.
期刊: The Journal of antimicrobial chemotherapy 发表日期: 2025-Jul-02 链接: PubMed
摘要
Osteoarticular infections (OAIs), primarily caused by Staphylococcus aureus (both MSSA and MRSA), pose significant clinical challenges due to their heterogeneity and complexity. To investigate the epidemiology, clinical characteristics and bacterial features of S. aureus strains isolated from OAI patients treated at a major tertiary hospital in China over a 9-year period, with a focus on biofilm formation and colonization potential. A total of 178 S. aureus isolates (56.8% MSSA and 43.2% MRSA) were analyzed using whole-genome sequencing, antibiotic susceptibility testing, biofilm formation assays and phylogenetic analysis. A murine nasal colonization model and in vitro adhesion assays using A549 human epithelial cells were employed to evaluate colonization and adherence capabilities. Penicillin-susceptible Staphylococcus aureus (PSSA) showed a significant rise during the study period, particularly within clonal complex ST398, which exhibited enhanced biofilm-forming capabilities. Phylogenetic analysis revealed minimal transmission events, suggesting independent cases. Comparative genetic analysis demonstrated distinct human-adaptive features in MRSA and MSSA-ST398 strains. PSSA-ST398 strains exhibited superior biofilm formation and increased adherence to human epithelial cells and murine nasal cavities compared with penicillin-resistant counterparts, indicating a potential advantage in colonization and persistence. Penicillin-susceptible ST398 strains, particularly those with strong biofilm-forming capabilities, which increase their persistence in clinical settings, complicating treatment and eradication efforts, represent a significant threat to OAIs. Despite being penicillin-susceptible, these strains may still pose challenges due to their biofilm-mediated resistance and potential for chronic infection.
10. Rizedisben in Minimally Invasive Surgery: A Nonrandomized Clinical Trial.
期刊: JAMA surgery 发表日期: 2025-Jul-02 链接: PubMed
摘要
Fluorescence-guided surgery aims to improve intraoperative identification of vital structures. Rizedisben is a myelin-binding fluorophore that fluoresces in the blue light (370-425 nm) spectrum to improve intraoperative nerve identification. To determine the optimal safe and clinically effective dose of rizedisben for sustained intraoperative fluorescence of nerve structures. A single-arm, open-label, phase 1 study was conducted in patients undergoing robot-assisted laparoscopic radical prostatectomy (RALP) at an urban academic cancer center in New York City between January 2023 and October 2024. Using a dose escalation design, increasing doses of rizedisben were administered after safety was assessed at each level until a clinically effective dose was determined. The obturator nerve served as the reference nerve for measuring fluorescence intensity. Eligible patients were 18 years old and older, diagnosed with prostate cancer, and scheduled for RALP. Patients were recruited in preoperative clinic visits once deemed eligible for the study. Those with prior pelvic surgery or radiation, known central or peripheral nervous system disease, current use of neurotoxic medications, recent exposure to phototoxic drugs, or serious kidney or liver dysfunction were excluded. Rizedisben was intravenously administered intraoperatively 30 minutes prior to visualization of the obturator nerve. Safety was assessed through 45 postoperative days. Fluorescence was measured via subjective intraoperative scoring and by post hoc objective image analysis. Clinically effective dose was defined as achieving sustained fluorescence of the obturator nerve in 3 or more of 5 patients in 2 consecutive cohorts, provided fewer than 20% of patients experienced grade 2 or greater toxicity. Sustained fluorescence was defined as moderate or better fluorescence for 90 minutes or longer. At the clinically effective dose, fluorescence assessments of the neurovascular bundles were included. Thirty-eight patients (median [IQR] age, 61.5 [57.8-66.3] years) enrolled in and completed the trial. Dosing was escalated from 0.25 to 3.0 mg/kg. There was 1 grade 2 adverse event (rash) possibly attributable to rizedisben. Sustained fluorescence of the obturator nerve was achieved in all patients at 3.0 mg/kg. Prostate neurovascular bundles demonstrated evidence of fluorescence in 8 of 9 (89%) patients at 3.0 mg/kg. In this phase 1 trial of rizedisben, the 3.0-mg/kg dose was shown to be generally well tolerated and clinically effective. At this dose, there was excellent sustained fluorescence of the obturator nerves, and the neurovascular bundles were visualized in 8 of 9 patients. Based on these data, we are designing phase 2 studies with rizedisben for additional indications. ClinicalTrials.gov Identifier: NCT04983862.
11. Data-Driven Contingency Management Incentive Magnitudes: A Review.
期刊: JAMA psychiatry 发表日期: 2025-Jul-02 链接: PubMed
摘要
Interest in contingency management (CM) as a treatment for opioid and stimulant use disorders has increased because of the ongoing dual opioid/stimulant crisis, rising stimulant drug deaths, and demand for effective treatments for stimulant use disorder. The success of the US Department of Veterans Affairs nationwide rollout and the launch of California’s Recovery Incentives Program provide evidence that this treatment can be translated into effective clinical practice. To provide data-driven inflation-adjusted incentive estimates for modern CM protocols that can be customized for intervention duration. It is essential for CM protocols implemented in clinical care to use efficacious, research-supported parameters, including incentive magnitude. This review included 112 published CM protocols that involved reinforcement of stimulant- and/or opioid-negative urine drug tests, categorized each protocol in terms of impact (small/medium/large effect size) relative to a non-CM comparator condition, and computed weekly inflation-adjusted incentive magnitudes for voucher- and prize-based CM protocols. Drawn from protocols with medium to large impacts on patient outcomes, weekly median magnitude estimates are $128/week for voucher protocols and $55/week for prize protocols. For the most common duration of 12 weeks, these estimates translate to $1536 for voucher and $660 for prize protocols. These incentive magnitude estimates can be used to inform clinical, policy, and advocacy related to CM implementation. Practical suggestions (eg, starting values, escalation) for building protocols that meet these incentive magnitudes are provided and implications are discussed.
12. Use of systemic hormonal contraception and risk of depression: a registry-based study from Finland.
期刊: European journal of epidemiology 发表日期: 2025-Jul-02 链接: PubMed
摘要
Earlier findings on the relationship between use of hormonal contraception (HC) and depressive symptoms and disorders are contradictory. Thus, we assessed the associations of use of different types of systemic hormonal contraceptives in the six preceding months with the risk of depression in women aged 15-49 years. Data were obtained from national registers in Finland. All cases of depression in the years 2018-2019 were identified in a population-based cohort of women. We used a nested case-control design with 1:4 ratio (n = 117,360 cases) and applied multivariable conditional logistic regression models. During the follow-up a total of 23,480 new cases with the diagnosis of depression were observed (incidence rate: 21.7, 95% confidence interval = 21.5-22.0 per 1000 person-years). Use of HC in the six preceding months, specifically that of combined hormonal contraceptives (containing gestodene and ethinylestradiol, drospirenone and ethinylestradiol, and nomegestrol and estradiol), was significantly associated with a lower risk of depression compared to non-use when controlling for marital status, socioeconomic status, education, recent delivery, recent psychiatric hospitalization, chronic diseases, use of psychiatric medications (excluding antidepressants) and former use of HC (odds ratio: 0.90, 95% confidence interval = 0.85-0.95; 0.86, 95% confidence interval = 0.81-0.91, respectively). Current use of progestogen-only preparations (norethisterone, levonorgestrel, desogestrel) was not associated with depression. This pattern was evident in all age groups, including adolescent girls. HC use appeared not associated with an increased risk of depression in fertile-aged women and across all age groups, including adolescent girls.
13. Ingestion of titanium dioxide as an excipient in medicines and the risk of cancer: a nationwide study within the French National health data system.
期刊: European journal of epidemiology 发表日期: 2025-Jul-02 链接: PubMed
摘要
Concerns about the safety of titanium dioxide (TiO2), including potential carcinogenicity, have prompted its ban in foods in the European Union, while remaining allowed as pharmaceutical excipient. We aimed to evaluate whether ingesting increasing quantities of TiO2 through medicines is associated with higher cancer risk. Data were derived from the French National Health Data System, a nationwide medico-administrative database. A case-control study was nested within two cohorts: users of metformin (all doses) and users of 200 mg acebutolol, both available in TiO2-containing and TiO2-free formulations. During 2013-2021, 293,101 cancer cases were identified and matched to 2,930,633 controls. TiO2 exposure through metformin and acebutolol consumption was calculated based on drug claims from 2006 up to five years before the index date. Conditional logistic regression models estimated linear associations between TiO2 exposure and cancer risk. RRs of overall cancer per 1000 TiO2-containing tablets and per 10,000 mg of TiO2 increments were both 1.00 (95% CI: 0.99-1.01). Analyses by cancer site also yielded RRs very close to 1.00 or slightly different but not statistically significant, except for breast (RR per 10,000 mg: 1.03, 95% CI:1.00-1.07) and lymphoid/hematopoietic (RR per 1000 tablets: 0.97, 95% CI: 0.95-1.00) cancers, which however lost significance after Bonferroni correction. There was a suggestion of non-linear positive association for central nervous system cancers. This first epidemiological study on TiO2 ingestion and cancer found no meaningful linear association between increasing TiO2 exposure through medicines and overall or site-specific cancer risk. Non-linear associations cannot be excluded.
14. Incident Atherosclerotic Cardiovascular Disease Among Veterans by Gender Identity: A Cohort Study.
期刊: Journal of general internal medicine 发表日期: 2025-Jul-02 链接: PubMed
摘要
Transgender and gender diverse (trans) populations are at elevated risk for atherosclerotic cardiovascular disease (ASCVD). Measure the association of gender identity and gender-affirming hormone therapy (GAHT) with ASCVD outcomes. Cohort study. Over 1 million veterans receiving care in the Veterans Health Administration. Gender identity was identified via a validated natural language processing (NLP) algorithm. Incident ASCVD (acute myocardial infarction, ischemic stroke, or revascularization after the baseline date) was identified via International Classification of Diseases diagnosis codes among veterans without prevalent ASCVD. We calculated sample statistics stratified by gender identity and used Cox proportional hazard regression to assess associations of gender identity and GAHT with incident ASCVD. Among 1,105,082 veterans, 42,149 were classified as trans (8013 transfeminine, 7127 transmasculine, and 27,009 uncategorized trans) while 918,843 were cisgender men and 144,090 were cisgender women. During a median follow-up of 9.39 years, 92,910 veterans had incident ASCVD (2806 among trans veterans). Adjusting for age, race, Hispanic ethnicity, and sexual orientation, trans veterans had 1.52 [1.45, 1.59] and 0.92 [0.89, 0.96] times the hazard of ASCVD compared to cisgender women and cisgender men, respectively. Compared to trans veterans not receiving GAHT, GAHT among trans veterans assigned female at birth was significantly associated a reduced hazard of ASCVD (0.89 [0.80, 0.98]); GAHT was not associated with ASCVD among trans veterans assigned male at birth (0.99 [0.89, 1.09]). With NLP, there is potential for selection bias as clinicians may preferentially document the gender identity for trans more than cisgender veterans. This is one of the first studies to examine the association of both gender identity and GAHT with incident ASCVD in veterans. Future research must comprehensively evaluate ASCVD outcomes and the effects of gender-affirming care (including hormone therapy) in trans populations.
15. Social and Structural Determinants of Lower Extremity Amputations in Diabetes.
期刊: Current diabetes reports 发表日期: 2025-Jul-02 链接: PubMed
摘要
Lower extremity amputations (LEAs) are among the most severe complications of diabetes, with approximately 1.5 million procedures performed globally each year. This review explores the impact of social and structural determinants of health on amputation rates in diabetic patients, highlighting disparities driven by systemic factors. Structural determinants such as healthcare policies and economic systems intersect with social factors, including access to care, racial disparities, and socioeconomic status, influencing amputation risk. Black patients with diabetes face up to a fourfold increased risk of major amputation compared to non-Hispanic white patients. Lower socioeconomic status is also strongly linked to higher amputation rates. Geographic and environmental factors, like food deserts and limited access to specialized care, further exacerbate these disparities. Emerging prevention strategies, such as telemedicine and mobile health units, demonstrate promise in improving access to care. Addressing disparities in LEAs requires comprehensive policy changes and targeted interventions. Future directions include leveraging artificial intelligence and precision medicine alongside community-based programs to reduce amputation rates in high-risk diabetic populations.
16. The hidden crisis: classifying unmet healthcare needs in European older adults during COVID-19.
期刊: European journal of ageing 发表日期: 2025-Jul-02 链接: PubMed
摘要
This study investigates the unmet healthcare needs of older adults during the COVID-19 pandemic, leveraging data from the Survey of Health, Ageing and Retirement in Europe (SHARE) and the two waves of the SHARE Corona Survey (SCS) conducted in 2020 and 2021. Using latent class analysis (LCA) with covariates, we identified distinct groups based on experiences of forgoing medical treatments due to fear of infection, postponed medical appointments, and denied care, while examining socio-demographic, economic, and health-related differences in class membership. The two-wave data provide insights into patterns of unmet healthcare needs across time, highlighting groups whose situations appeared to either improve or deteriorate. Our findings reveal six distinct classes of healthcare needs: no unmet needs, high early postponement with rapid improvement, rising barriers, high early fear-based barriers, high denial with persistent postponement, and persistently high fear-based barriers. We observe significant disparities in class membership based on age, gender, living arrangements, rural/urban residence, education, employment status, financial hardship, self-rated health, changes in health, and the number of chronic conditions. High-risk groups, particularly women, those with lower education, those experiencing financial hardship, and individuals with multiple chronic conditions, were identified as especially vulnerable to unmet healthcare needs during the pandemic. Our findings offer targeted insights for intervention and policy, aiming to address healthcare access disparities among older adults during such crises.
17. Community engagement in the context of cancer: scoping review of definitions and measures to inform program-level analysis.
期刊: Cancer causes & control : CCC 发表日期: 2025-Jul-02 链接: PubMed
摘要
The objective of this research is to determine how community-engaged activities, and their resulting impact, are currently being measured by cancer centers. To accomplish this, the various definitions of community engagement as used by cancer center community outreach and engagement programs are identified and analyzed, and the frameworks and metrics employed in assessing community outreach and engagement programming are explored. This work can help to inform how to better determine community engagement impact and its overall return on investment, as well as compare impact across cancer centers. Between August 29 and September 1, 2022, MEDLINE, CINAHL, PsycINFO, EMBASE, and Google Scholar were searched for articles including the “community engagement” and “cancer” search concepts. After removal of duplicate records, a title abstract screen was conducted to identify those articles that (1) were conducted within the USA, (2) focused on cancer, (3) undertaken by a cancer center, (4) pertained to community engagement, and (5) published in the English language. The review excluded conference abstracts, editorials, and book chapters. Analysis of definitions identified within the included literature revealed the following four overarching core components of community engagement specific to cancer centers: defined stakeholders, resource exchange, collaborative relationships, and mutually beneficial outcomes. The most common frameworks/models were community-based research models, followed by social and behavioral focused. Measures to assess all essential aspects of community engagement were infrequently included in community projects. The results of this scoping review and analysis propose a common definition and model of community engagement for cancer-related activities conducted by cancer centers. These are important as common measures can be incorporated into all aspects of community engagement work. This can assist cancer centers in determining collective impact using both project and process outcomes. Common measures can help cancer centers include time and resources needed for community engagement within budgets and impact reporting.
18. Sitting time and risk of cancer incidence and cancer mortality in postmenopausal women: the Women's Health Accelerometry Collaboration.
期刊: Cancer causes & control : CCC 发表日期: 2025-Jul-02 链接: PubMed
摘要
Few studies have explored whether accelerometer-measured sedentary behavior increases cancer risk. We examined the associations of accelerometer-measured daily sitting time and mean sitting bout duration classified by the Convolutional Neural Network Hip Accelerometer Posture (CHAP) machine-learned algorithm with incidence of any cancer, incidence of 13 physical activity-related cancers, and cancer mortality among postmenopausal women. We used data from 22,097 women (mean age = 73.3 years, standard deviation [SD] = 6.7) in the Women’s Health Accelerometry Collaboration, a consortium of two US-based cohort studies of postmenopausal women: the Women’s Health Study and the Women’s Health Initiative Objective Physical Activity and Cardiovascular Health Study. Women who completed hip-worn triaxial accelerometry for ≥ 4 of 7 consecutive days were included. Associations between sedentary behaviors and physician-adjudicated invasive cancer incidence and mortality were tested using Cox regression. Women were followed on average 8.0 years to identify cancer cases (n = 1,861) and deaths (n = 601). Overall, mean sitting time was 567 (SD = 113) min/day and mean sitting bout duration was 12.8 (SD = 4) min/bout. In covariate-adjusted models, one-SD increment higher in sitting time was associated with a 6% increased risk of incident cancer (hazard ratio [HR] = 1.06, 95% CI: 1.01-1.11); associations were similar for bout duration (HR = 1.05, 95% CI: 1.00-1.10). Estimates were similar for the 13 physical activity-related cancers (sitting time: HR = 1.10, 95% CI: 1.04-1.17; bout duration: HR = 1.08, 95% CI: 1.02-1.14) and for cancer mortality (sitting time: 1.06, 95% CI: 0.98-1.16; bout duration: HR = 1.05, 95% CI: 0.97-1.13). Among postmenopausal women, sedentary behavior was associated with increased cancer risk, particularly for physical activity-related cancers and cancer mortality.
19. SHift-working Investigation of Fasting and Timing (SHIFT) of diet: A cross-sectional assessment of nurses' dietary quality, fasting duration, and feasibility of completing a 7-day diet log.
期刊: Chronobiology international 发表日期: 2025-Jul-02 链接: PubMed
摘要
Nurses experience some barriers to healthy eating and weight loss that are different than the general population. This study examined diet timing and quality, and interest in time-restricted feeding (TRF), and compared diet quality between day and shift-working nurses. The cross-sectional SHift-working Investigation of Fasting Time and Diet Study was conducted among nurses (n = 123) in the United States. Diet was tracked for up to 7 days using the ASA24 to determine Energy-density Dietary Inflammatory Index (E-DIITM) scores, Heathy Eating Index (HEI), and fasting duration. Self-reported demographics, psychosocial measures (e.g. stress and depression), and TRF anticipated barriers and facilitators were obtained. Multiple linear regression analyses were conducted to compare night/rotating and dayshift. The primarily white (86%) and female (95%) participants had a mean age and body mass index (BMI) of 34.1 ± 10.0 years and 27.3 ± 5.6 kg/m2, respectively. Most participants (75%) expressed interest in TRF. Fasting duration was short (mean hours = 11.9), and diet quality poor (mean: E-DII score = -0.05; HEI score = 54.0). Night/rotating shift had more anti-inflammatory diets compared to dayshift (mean E-DII: night/rotating = 0.19 vs dayshift = 1.21; p = 0.04). Nurses have challenging barriers to improving weight. Since most nurses indicated interest in a TRF intervention, TRF may hold potential as a key dietary approach for nurses.
20. Health policy challenges in Lebanon's healthcare system: on sexual and reproductive health and rights.
期刊: Sexual and reproductive health matters 发表日期: 2025-Jul-02 链接: PubMed
摘要
Lebanon’s healthcare system has demonstrated remarkable resilience amidst ongoing political and economic turbulence. Yet, the critical domain of Sexual and Reproductive Health and Rights (SRHR) remains underserved. This commentary analyses the systemic barriers, policy deficiencies, and urgent needs that shape SRHR within Lebanon’s healthcare landscape. Despite the country’s commitments to international frameworks like the ICPD and CEDAW, SRHR policies are hindered by political fragmentation, societal conservatism, and insufficient prioritisation. These challenges translate into inadequate and inconsistent family planning services, a lack of comprehensive sexuality education, inadequate maternal healthcare, and significant obstacles in accessing essential services, especially for marginalised communities such as refugees, women, and youth. Lebanon’s “Vision 2030” health strategy, while ambitious in scope, offers only limited engagement with SRHR, which leaves systemic inequities unaddressed. Renewed episodes of violence and displacement further strain the healthcare system and deepen the disparities faced by vulnerable groups. The reliance on temporary, NGO-led initiatives to fill gaps in service provision underscores a broader policy paralysis and inconsistent resource allocation, which together prevent the sustainable integration of SRHR into national health frameworks. This commentary calls for a gender-sensitive, inclusive healthcare policy that positions SRHR as a foundational pillar of public health, gender justice, and social equity. Achieving this requires concerted efforts among government agencies, NGOs, and international partners to overhaul existing frameworks and address structural barriers.
21. Association Between Initial Left Ventricular Systolic Dysfunction and Clinical Outcome in Sepsis: A Multicenter Cohort Study.
期刊: Critical care medicine 发表日期: 2025-Jul-02 链接: PubMed
摘要
To investigate the association between the severities of left ventricular (LV) systolic dysfunction and clinical outcomes in patients with sepsis, with a particular focus on in-hospital mortality. Multicenter cohort study. Nineteen tertiary or university-affiliated hospitals in South Korea. A total of 2274 adult patients with sepsis or septic shock underwent echocardiographic examination within 24 hours of sepsis recognition. None. Patients were stratified by left ventricular ejection fraction (LVEF) into three groups: normal (> 50%, n = 1803), mild-to-moderate dysfunction (30-50%, n = 356), and severe dysfunction (< 30%, n = 115). In-hospital mortality is significantly associated with LV dysfunction severity (normal: 25.73%, mild-to-moderate: 29.49%, severe: 40.00%; p = 0.023). After propensity score matching using three different methodologies, severe LV dysfunction remained independently associated with increased in-hospital mortality (adjusted odds ratio [OR] 1.81; 95% CI, 1.09-3.03). This effect was more pronounced in patients without preexisting cardiovascular disease (CVD) (OR 1.84; 95% CI, 1.08-3.13) and those with bacteremia (OR 2.20; 95% CI, 1.5-3.22). Cardiopulmonary arrest rates increased significantly with dysfunction severity (normal: 2.11%, mild-to-moderate: 3.93%, severe: 10.43%; p < 0.001), while other ICU complications showed no significant differences. Severe LV systolic dysfunction (LVEF < 30%) is associated with significantly increased in-hospital mortality in sepsis patients, particularly in those with bacteremia and without preexisting CVD. These findings highlight the importance of early cardiac function assessment in sepsis and suggest that infection status and underlying cardiovascular health modify the relationship between LV dysfunction and clinical outcome.
22. Assessing the Fit of a Digitally Delivered National Diabetes Prevention Program Among Rural Living Adults: Qualitative Study.
期刊: JMIR formative research 发表日期: 2025-Jul-02 链接: PubMed
摘要
Rural living adults are disproportionately affected by type 2 diabetes compared to their urban counterparts. The Centers for Disease Control and Prevention’s National Diabetes Prevention Program (National DPP) is an evidence-based intervention that reduces the risk of type 2 diabetes through increased physical activity and modest weight loss, but overall reach remains limited, specifically in rural communities. This qualitative study aimed to examine the fit of the National DPP delivered digitally using Zoom or Facebook to rural living adults at risk for type 2 diabetes. Focus group scripts assessed the characteristics and perceptions of rural adults at risk for type 2 diabetes, infrastructure supports for implementation and sustainability, and external factors that could influence program fit. A reflexive thematic analysis was conducted separately on coded transcripts for each focus group. Themes were then deductively linked to the Practical, Robust Implementation and Sustainability Model domains. Two focus groups were conducted with 14 participants after participating in the National DPP for 6 months, delivered through Zoom (n=9) or Facebook (n=5). Participants highlighted positive relationships between Practical, Robust Implementation and Sustainability Model constructs related to participant characteristics (ie, value of health improvements, weight loss, and reduced medication dependence as primary motivators) and perceptions of compatibility (ie, content alignment with participant needs) as well as infrastructure (ie, digital platforms provided better access) with program success in reach and engagement. Conversely, both formats were negatively impacted by interruptions in internet connectivity. External factors, such as referral pathways from local health care providers, could improve program reach. When considering differences between implementation infrastructure, Zoom facilitated greater social engagement and accountability compared to Facebook. This study identified contextual factors influencing the fit of digitally delivering the National DPP to rural living adults, including opportunities for using existing connections and health motivations to help improve acceptability, while tailoring curriculum, modality, and technology may improve appropriateness for rural populations. ClinicalTrials.gov NCT05387434; https://clinicaltrials.gov/study/NCT05387434.
23. First Report of Downy Mildew Caused by Hyaloperonospora parasitica on Cardamine violifolia in China.
期刊: Plant disease 发表日期: 2025-Jul-02 链接: PubMed
摘要
Cardamine violifolia is a selenium-enriched plant native to the Wuling Mountain region spanning western Hubei and Hunan provinces. In Enshi City, Hubei Province, it is cultivated on ~2,000 hectares as a critical economic plant for selenium protein extraction. In January 2025, downy mildew-like symptoms were observed on C. violifolia leaves at a cultivation base in Enshi (30°19’20.15’‘N; 109°28’20.25’‘E), Hubei Province, China, affecting an area of 1,800 hectares. The symptoms included light green to yellow spots on the adaxial leaf surface, accompanied by sparse white to grayish-white mycelial growth on the abaxial surface under humid conditions. The pathogen was characterized morphologically using a light microscope. Sporangiophores emerged from stomata, either singly or in bundles of 2-4, were colorless, aseptate, slightly swollen at the base, and exhibited dichotomous branching 2-5 times, and a total length of 154.5-415.5 μm. The central axis and branches formed an acute angle. Apical branches were sharp, inwardly curved slightly like forceps, bearing one sporangium at each tip. Sporangia were colorless, unicellular, oblong to ovoid, measuring 19.8-30.9 μm × 18.4-28.3 μm, and germinated via lateral germ tubes without forming zoospores. Oospores were yellowish-brown, unicellular, spherical, with diameters ranging from 27.9-45.3 μm and sleek surfaces. The oosphere diameter was 12.4-27.5 μm, and the cell wall was thick, exhibiting either wrinkled or smooth textures. Oospores demonstrated strong resistance to adverse conditions and could directly produce germ tubes for infection under favorable environments as described previously (Saharan et al., 2017). For pathogen identification, DNA was extracted from sporulating lesions using the CTAB method. Fragments of the ribosomal internal transcribed spacer (ITS) region (White et al., 1990) and the mitochondrial cytochrome B oxidase subunit 2 (cox2) gene (Hudspeth et al., 2000) were amplified by PCR and sequenced bidirectionally. The sequences were deposited in GenBank under accession numbers PV395549 (ITS) and PV573477 (cox2). BLAST analysis revealed 99.88% and 99.51% sequence identity to Hyaloperonospora parasitica (EU049244 and DQ365708, respectively). Pathogenicity tests were conducted by rinsing sporangia from infected leaves and spray-inoculating ten 4-week-old C. violifolia plants with a suspension of 1 × 105 sporangia/ml until runoff. Five control plants were sprayed with distilled water. All plants were maintained in a growth chamber at 22°C/18°C (day/night) with 80% relative humidity for 24 hours. Seven days post-inoculation, characteristic symptoms, including chlorotic spots and sporulation, were observed on inoculated plants, while control plants remained asymptomatic. The pathogen was successfully reisolated from inoculated leaves onto detached C. violifolia leaves, and its identity was confirmed morphologically and molecularly through PCR amplification and sequencing of the ITS and cox2 genes. To our knowledge, this is the first report of downy mildew caused by H. parasitica on C. violifolia in China. Given the broad host range of H. parasitica and the economic importance of C. violifolia, this disease poses a significant threat to the cultivation of this valuable crop. Therefore, it is imperative to develop effective management strategies to prevent further spread and mitigate potential economic losses.
24. First Report of Powdery Mildew Caused by Erysiphe pisi on Medicago ruthenica in Inner Mongolia, China.
期刊: Plant disease 发表日期: 2025-Jul-02 链接: PubMed
摘要
Medicago ruthenica, a perennial forage species in the Leguminosae, is widely distributed in Northern China, Siberia and Mongolia. It is considered a high-quality protein source for livestock, and a valuable gene resource for alfalfa genetic improvement (Yin et al., 2021). However, M. ruthenica is susceptible to powdery mildew. In September 2021, an investigation of 500 m2 plant nursery at Inner Mongolia Agriculture University (111.73°E, 40.83°N), Hohhot, China, found that 90% leaves of M. ruthenica cv. Zhilixing were infected. Initially, small, white, and diffuse spots appeared on the adaxial leaf surface, then expanded to white mildew layer. Severely, orange or brown spots formed on the top of the layer, and abaxial leaf surface, stems and pods were also affected. The pathogen structures are as follows: conidia (n = 50) were produced singly, smooth, and elliptical or cylindrical, 19 to 38 × 10 to 18 µm, with a length/width ratio of 1.6 to 2.6; chasmothecia (n = 50) were black-brown, spherical, or subspherical, with a diameter of 75 to 130 μm. Approximately 17 colorless appendages may be contained in chasmothecia, whose average length was 50 μm. Chasmothecia contains 4 to 8 asci with 58 to 75 × 30 to 44 µm. The ascus contains 3 to 4 monospora and oval ascospores, 18 to 28 × 10 to 15 µm. Based on these morphological characteristics, the fungus was tentatively identified as an Erysiphe pisi (Ainsworth and Bisby, 1995; Hawksworth et al., 1995). For further confirmation, the internal transcribed spacer (ITS) and 28S large subunit (LSU) regions of one isolate (MNPM-MruZB1) were amplified using ITS4/ITS5 and NL1/TW14 primers (Innis et al., 1990; Takamatsu and Kano, 2001; Mori et al., 2000). Sequences of about 750 bp size were obtained and submitted to GenBank (accession number: PQ299565 and PV017896). They showed 99.70% (664/666) identity for ITS (KY661137.1) and 99.01% (808/816) for LSU (ON314806.1) with the previously reported sequences of E. pisi, respectively. Furthermore, the amplified sequences were used to construct a phylogenetic tree in MEGA7.0, which revealed the MNPM-MruZB1 isolate to be closely related to E. pisi. Pathogenicity tests were repeated three times on two-months old seedlings of three M. ruthenica varieties (Zhiling, Mengnong No.1 and Mengnong No.2). Three pots of healthy seedlings, from each variety, were inoculated by gently pressing diseased leaves, and the other three pots served as control inoculated with sterile distilled water. The seedlings were incubated at 21℃ and 70% relative humidity with a 16 h/8 h light/dark photoperiod. Seven days after inoculation, the three M. ruthenica varieties showed powdery mildew symptoms, while the control plants remained asymptomatic. Likewise, the results of morphology and sequence characteristics were also consistent with those of previous studies. E. pisi was identified as the causal species of powdery mildew of M. sativa and M. truncatula previously, whereas the pathogen of M. ruthenica powdery mildew is still unknown globally (Edmunds et al., 1998; Gupta et al., 2020). To the best of our knowledge, this is the first report of powdery mildew caused by E. pisi on M. ruthenica. It could serve as a basis for the identification, diagnosis, and prevention of M. ruthenica powdery mildew.
25. An Outbreak of Sporotrichosis Associated With Tying Crabs.
期刊: JAMA dermatology 发表日期: 2025-Jul-02 链接: PubMed
摘要
This case series reports the incidence of sporotrichosis among 6 restaurant workers in Shandong, China.
26. Pathway Analysis and Genetic Markers in Parkinson's Disease: Insights into Subtype-Specific Mechanisms.
期刊: Molecular neurobiology 发表日期: 2025-Jul-02 链接: PubMed
摘要
Parkinson’s disease (PD) is a complex disease influenced by both genetic and environmental factors. Despite advances in understanding PD genetics, subtype-specific mechanisms remain poorly characterized. This study aims to identify distinct genetic markers and pathways across PD subtypes, addressing this gap to enable targeted diagnostics and therapies. Genes associated with PD were collected from various databases and categorized into groups based on the PD type to assess the PD risk. Protein interaction analysis was conducted to identify functional clusters and key genes within each group. KEGG enrichment analysis revealed common genes and pathways among the different PD groups. This study conformed to the PRISMA 2020 guidelines for systematic data collection and analysis. Hub genes such as PRKN, SNCA, and LRRK2 have demonstrated considerable potential as biomarkers for genetic predisposition in PD, alongside the identification of additional complementary genes. Analysis of hub node variants highlighted specific genetic variations in these genes. We identified several microRNAs, including hsa-miR-335-5p, hsa-miR-19a-3p, and hsa-miR-106a-5p, as well as transcription factors that interact with crucial hub genes. This study refines subtype-specific mechanisms for established PD genes and identifies novel genetic markers and pathways associated with juvenile, young-onset, late-onset, familial, and sporadic Parkinson’s disease, enhancing our understanding of their molecular mechanisms and potential for targeted diagnostics and therapies. Specifically, we highlight the roles of hub genes, such as PRKN, SNCA, and LRRK2, alongside significant microRNA interactions, which may serve as biomarkers for early detection and personalized treatment approaches.
27. Growth differentiation factor 15 predicts physical function impairment in Spanish older adults: a real-world prospective study.
期刊: GeroScience 发表日期: 2025-Jul-02 链接: PubMed
摘要
Growth differentiation factor 15 (GDF15) is an emerging biomarker of disease burden, but few studies explore its association with physical function impairment using validated objective measures. We evaluated the cross-sectional and longitudinal association between GDF15 and impaired physical function in older adults, assessed with five validated tools. Data were collected from 2481 individuals ≥ 65 years-old in the Seniors-ENRICA-2 cohort. Serum GDF15 was measured once, at baseline, and physical function was assessed at baseline and after 2.2 years using the following measures: lower-extremity performance (Short Physical Performance Battery), agility (Nagi scale), mobility (Nagi and Rosow & Breslau questionnaires), weakness (measured grip strength) and frailty (Deficit Accumulation Index). Analyses were performed with logistic regression and adjusted for relevant potential confounders.The odds ratios (95% confidence interval) per 25% increment in GDF15 in cross-sectional and prospective analyses were: 1.06 (1.01-1.12) and 1.18 (1.08-1.30) for reduced lower-extremity performance; 1.18 (1.12-1.26) and 1.21 (1.08-1.35) for impaired agility; 1.19 (1.11-1.27) and 1.21 (1.08-1.35) for impaired mobility; 1.15 (1.09-1.22) and 1.13 (1.02-1.25) for weakness; and 1.24 (1.16-1.33) and 1.18 (1.06-1.31) for frailty. Results were similar among participants without cardiovascular disease or diabetes. Higher levels of serum GDF15 are associated with prevalent and incident impaired physical function in older adults. GDF15 could serve as a convenient biomarker to identify older adults at risk of functional decline. Further studies should elucidate the underlying mechanisms, explore its potential to improve risk prediction, and assess the therapeutic value of modifying GDF15.
28. Climate Change and the Impact on Ocular Infectious Diseases: A Narrative Review.
期刊: Ophthalmology and therapy 发表日期: 2025-Jul-02 链接: PubMed
摘要
Climate change and global warming significantly affect the incidence and distribution of infectious ocular diseases. This narrative review explores how climate-related factors-including extreme weather events, precipitation, temperature fluctuations, humidity, wind patterns, ultraviolet radiation, and air pollution-can directly and indirectly influence the burden of ocular infections. By synthesizing evidence from the published literature, we examine how these environmental variables impact disease mechanisms such as pathogen survival, transmission dynamics, and host susceptibility. Increased precipitation has been associated with a higher incidence and recurrence of ocular toxoplasmosis (OT), likely due to the enhanced spread of Toxoplasma gondii oocysts through contaminated water and soil. Rainfall also creates breeding habitats for mosquitoes, facilitating the transmission of vector-borne diseases such as dengue fever and Rift Valley fever. Rising temperatures and humidity have been linked to increased rates of fungal infections, particularly fungal keratitis in tropical regions. Wind has been implicated in the airborne dispersal of pathogens, including fungal spores, T. gondii oocysts, and insect-derived particles such as moth setae, potentially contributing to OT and seasonal hyperacute panuveitis. Air pollution further exacerbates dry eye disease, which influences the vulnerability to microbial keratitis. These climate-related shifts disproportionately affect vulnerable populations-particularly those living in rural, low-income, and tropical areas. This review highlights the urgent need for further research into climate-sensitive mechanisms of ocular infections and the development of targeted adaptation strategies to mitigate their impact on global eye health. Climate change is increasingly influencing the global spread of infectious eye diseases. This review examines how extreme weather events, air pollution, and rising temperatures contribute to the changing epidemiology and distribution of these conditions. For instance, increased precipitation linked to climate change in South American countries has been associated with a higher incidence and recurrence of ocular toxoplasmosis. Similarly, warm and humid climates create favorable conditions for fungal eye infections. Air pollution has been shown to increase the risk of viral keratitis in animal models, with a corresponding rise in human keratitis cases already reported in India. By exploring these environmental influences on eye health, this study underscores the urgent need for further research and coordinated public health efforts to mitigate the growing threat of climate change on ocular infections.
29. Distinct β-diversity components, ecological specialization, and assembly processes shape abundant and rare bacteria in tropical seagrass meadow sediments.
期刊: Environmental science and pollution research international 发表日期: 2025-Jul-02 链接: PubMed
摘要
Benthic bacteria, in particular those existing in seagrass rhizosphere, play pivotal roles in supporting the growth and health of their hosts and also in nutrient cycling. Abundant (AT, relative abundance ≥ 0.05%) and rare (RT, relative abundance ≤ 0.001%) taxa reflect two distinct species pools in bacterial communities that differ in their structure and function and are assembled by different ecological processes. However, the mechanisms and factors controlling their spatial β-diversity patterns and ecological assembly are least understood in tropical seagrasses compared to their temperate counterparts. As rhizospheric effect vary between single and mixed plant communities, we examined AT and RT in both mono- and mixed species seagrass meadows and compared them with bulk (un-vegetated) sediments in a tropical coastal lagoon, Chilika (India). Results showed that the β-diversity (Bray-Curtis dissimilarity) of the AT and RT differed across seagrass meadows. RT exhibited a much stronger decay in community similarity with increasing spatial distance between samples than the AT. Spatial variation in RT was driven almost entirely by species turnover, whereas in AT both nestedness and turnover components played an important role. All AT were habitat generalists with broader niche breadth and environmental tolerances, while the majority of RT (66%) were specialists possessing narrower niche breadth and lower environmental tolerances. Stochastic processes (mostly dispersal limitation, 70.65-89.71%) contributed to the assembly of AT in both seagrass and bulk sediments, while deterministic factors (primarily variable selection, 45.78-60.78%) controlled the assembly of RT. Overall, this study highlighted the importance of examining AT and RT in bacterial communities for a broader understanding of the spatial patterns and underlying assembly mechanisms in tropical seagrass meadows.
30. Gender Differences in the Association Between Workplace Sexual Harassment and Psychological Well-Being: a Nationwide Study of Korean Workers.
期刊: Journal of general internal medicine 发表日期: 2025-Jul-02 链接: PubMed
摘要
31. The relationship between emotion regulation and activity performance and quality of life in adolescents with cerebral palsy.
期刊: Developmental neurorehabilitation 发表日期: 2025-Jul-02 链接: PubMed
摘要
Emotional and activity difficulties may affect adolescents’ daily lives with cerebral palsy (CP). Therefore, it is important to evaluate factors associated with emotion regulation in adolescents with CP. This study aims to determine how adolescents with CP use emotion regulation strategies during their interactions and to examine the relationship between emotion regulation, activity performance, and quality of life. The data was obtained using the Regulation of Emotions Questionnaire (REQ), The Pediatric Quality of Life Inventory (PedsQL), and the Canadian Occupational Performance Measure (COPM). The relationship between the scale scores was tested using the Spearman correlation coefficient. A significant relationship was found between internal functional emotion regulation and activity performance (p < .05), as well as between emotion regulation and quality of life (p < .05). These results indicated that adolescents’ activity performance and quality of life with CP were associated with emotion regulation skills. It is very beneficial for occupational therapists to consider emotion regulation skills to improve activity performance and adolescents’ quality of life with CP.
32. Motivation, psychological needs and physical activity in older adults: a qualitative review.
期刊: Age and ageing 发表日期: 2025-Jul-01 链接: PubMed
摘要
Despite the well-documented health benefits of Physical Activity (PA), older adults often struggle to engage in PA. The present review examines the relationship between PA, motivation and basic psychological needs among older adults aged 65 and over, through the lens of Self-Determination Theory (SDT). Relevant studies that used qualitative methodologies and applied SDT framework were systematically searched in five electronic databases (i.e. Scopus, Web of Science, PubMed, PsycINFO and CINAHL). Methodological rigour was assessed using the GRADE-CERQual (Confidence in the Evidence from Reviews of Qualitative Research). 21 studies met inclusion criteria (N = 412; ages 65-97). Four themes and nine subthemes were identified. Peer relationships emerged as a pivotal element in supporting most autonomous forms of motivation and satisfying psychological needs (i.e. autonomy, competence and relatedness). A peer coach was preferred during several health programs, enhancing competence and relatedness. Outdoor activities in natural settings promoted intrinsic motivation, while indoor activities were driven more by extrinsic motivation. Barriers included ageist stereotypes and perceptions of inevitable physical decline, which negatively impacted competence and autonomy, ultimately reducing motivation for PA. This qualitative synthesis highlights a complex interplay of SDT components and social factors in influencing PA behaviours among older adults. Tailored interventions that integrate social interaction, provide feedback from coaches and offer choices among several exercises with graduate intensity levels are likely to enhance adherence in PA. Future interventions should address both psychological and social barriers to create inclusive PA strategies that meet older adults’ needs and motivation.
33. Examining the association between toilet access and major depression among older adults in India: a cross-sectional analysis of the Longitudinal Aging Study in India from 2017 to 2018.
期刊: Age and ageing 发表日期: 2025-Jul-01 链接: PubMed
摘要
Inadequate access to toilets, which often results in open defecation, could be a risk factor for depression among India’s older and ageing population. Using cross-sectional data from the Longitudinal Aging Study in India from 2017 to 2018, we assessed associations between the lack of a toilet and major depression among 64 082 women and men above the age of 45. In our adjusted multilevel model, we found no association between the lack of a household toilet and the risk of major depression (OR = 0.94, 95% CI: 0.79 to 1.11). We also found no association when we stratified by respondent’s sex or age. Finally, we did not find any consistent association between toilet access and major depression across India’s states and Union Territories. Despite our results, it is possible that inadequate access to sanitation is associated with acute feelings of anxiety, stress and shame-as has been shown in previous studies-but that this is not associated with major depression. Therefore, more research is required to examine associations between toilet access and other more proximal mental health outcomes.
34. Targeting oral frailty indicators of late-life cognitive disorders and depression: a systematic review.
期刊: Age and ageing 发表日期: 2025-Jul-01 链接: PubMed
摘要
Oral frailty is an age-related gradual loss of oral function together with a cognitive and physical function decline. Previous systematic reviews and meta-analyses examined the association of some oral frailty indicators with late-life cognitive and late-life depression (LLD). However, none of these studies investigated a large series of possible indicators and outcomes. To clarify the impact of oral frailty indicators on late-life cognitive disorders and LLD. Systematic review. Sixty-three studies (56,520,662 subjects) with 11 oral frailty indicators in four categories: (i) oral health status deterioration, (ii) decline in oral motor skills, (iii) chewing, swallowing, and saliva disorders, and (iv) oral pain. From database inception to April 24, 2024, six different electronic databases were consulted by two independent researchers assessing the eligibility of 24,045 records against the inclusion criteria and found 63 studies fitting the eligibility requirements. The protocol was registered a priori with PROSPERO (CRD42021249428). Four oral frailty indicators (number of remaining teeth, periodontal disease, difficulties in chewing, and difficulties in swallowing) were associated with late-life cognitive impairment/decline, mild cognitive impairment (MCI), dementia, and LLD. Among categories, oral health status deterioration and chewing, swallowing, and saliva disorders were associated with late-life cognitive impairment/decline, MCI, dementia, and LLD. Decline in oral motor skills was associated with late-life cognitive impairment/decline, while oral pain was related only to LLD. Certain oral frailty indicators may contribute to the development of late-life cognitive disorders and LLD.
35. Influenza vaccination and risk of dementia: a systematic review and meta-analysis.
期刊: Age and ageing 发表日期: 2025-Jul-01 链接: PubMed
摘要
The association between influenza vaccination and a reduction in dementia was unclear with inconsistent evidence. We aimed to evaluate the association between influenza vaccination and dementia risk in the overall population and the high-risk populations for dementia, such as patients with chronic kidney syndrome (CKD), chronic obstruction pulmonary disease (COPD) and vascular disease. We performed a systematic review and searched PubMed, Embase and CENTRAL from inception to 6 April 2025. The risk of bias was assessed using the Newcastle-Ottawa Scale. A random-effects model meta-analysis was executed. We included eight cohort studies with 9,938,696 subjects. Except for one study, the risk of bias of all other included studies was low. Influenza vaccination was associated with a reduced risk of incident dementia in high-risk populations for dementia, but not in the overall population (HR 0.93; 95% CI: 0.86-1.01). For high-risk populations, more than one dose of influenza vaccination showed an association with a lower risk of incident dementia (2-3 doses: HR 0.84; 95% CI: 0.76-0.92; ≥ 4 doses: HR 0.43; 95% CI: 0.38-0.48). Influenza vaccination was associated with a decreasing risk of incident dementia in a dose-response manner.
36. Improving Kidney Health Through Environmental Epidemiology-California Teachers Earn an A.
期刊: JAMA network open 发表日期: 2025-Jul-01 链接: PubMed
摘要
37. Oral Vancomycin for Prevention of Recurrent Clostridioides difficile Infection: A Randomized Clinical Trial.
期刊: JAMA network open 发表日期: 2025-Jul-01 链接: PubMed
摘要
Systemic antibiotic use for patients with a non-Clostridioides difficile infection (CDI) is a major risk factor for recurrent CDI. Increasing use of oral vancomycin for secondary prophylaxis against recurrent CDI in this context has uncertain efficacy. To evaluate whether oral vancomycin prophylaxis compared with placebo is effective against recurrent CDI during and 8 weeks after the end of study treatment. This phase 2, placebo-controlled, double-blind randomized clinical trial was conducted in 4 large health systems across the upper Midwest US. Adults who had completed treatment for CDI within the past 180 days and were taking a systemic antibiotic for a non-CDI indication were enrolled between May 21, 2018, and March 30, 2023, and followed up for 8 weeks after the end of study treatment. Participants were randomized 1:1 to 125 mg of oral vancomycin or placebo once daily during antibiotic use for a non-CDI plus 5 days following cessation of those antibiotics. The primary outcome was recurrent CDI incidence during treatment and the 8-week follow-up period. The secondary outcome was vancomycin-resistant Enterococcus carriage in stool. Among 81 randomized participants (median age, 59 years [IQR, 50-67 years]), all were included in the primary as-randomized analysis (39 in the vancomycin group; 42 in the placebo group). Sixty patients (74.1%) completed 8-week follow-up and were included in the secondary as-completed treatment analysis (31 in the vancomycin group; 29 in the placebo group). Recurrent CDI occurred in 17 of 39 participants in the oral vancomycin group (43.6%) and 24 of 42 in the placebo group (57.1%; absolute difference in percentage, -13.5% [95% CI, -35.1% to 8.0%]). Adverse events occurred in 27 of 39 participants in the oral vancomycin group (69.2%) and 27 of 42 in the placebo group (64.3%). Vancomycin-resistant Enterococcus carriage was found in 15 of 30 patients in the oral vancomycin group (50.0%) and 6 of 25 in the placebo group (24.0%) (P = .048) 8 weeks after treatment. In this randomized clinical trial, the incidence of recurrent CDI was lower (though did not reach significance) in participants taking oral vancomycin compared with those taking placebo. Because the study was underpowered, it was unable to reveal firm conclusions about the efficacy (or lack thereof) of vancomycin prophylaxis with respect to recurrent CDI. ClinicalTrials.gov Identifier: NCT03462459.
38. Hurdles for the Delivery of Multinational Randomized Clinical Trials.
期刊: JAMA network open 发表日期: 2025-Jul-01 链接: PubMed
摘要
Ethical, administrative, regulatory, and logistical (EARL) procedures can hamper clinical trial delivery. Quantification of these hurdles is rare, prohibiting identification of areas for improvement. To identify and quantify EARL hurdles in trial delivery before and during the COVID-19 pandemic. This cohort study used data from the ongoing Randomized Embedded Multifactorial Adaptive Platform Trial for Community-Acquired Pneumonia to enable comparison of EARL procedures for multiple protocols across 19 European countries in the pre-COVID-19 pandemic (February 19, 2016 to March 10, 2020) and COVID-19 pandemic (March 11, 2020, to May 4, 2023) periods. Data were analyzed from November 2024 to March 2025 with contracts and protocol submissions as the units of analysis. Time to (1) site contract completion, (2) regulatory and ethical approval (TTA), and (3) first patient in (FPI). The UK was compared with non-UK countries because of its distinct research infrastructure. There were 257 fully signed first contracts with study sites for analysis. In the UK, contract completion times decreased by 97% (95% CI, 95% to 98%), from a median (IQR) of 196 (154 to 250) days in the pre-COVID-19 pandemic period to 5 (1 to 11) days during the COVID-19 pandemic. In non-UK countries, median (IQR) contract completion times were 224 (119 to 412) days and 183 (62 to 291) days before and during the COVID-19 pandemic, respectively (relative difference, -18%; 95% CI, -43% to 52%). In total, 44 interventions in 16 domains were submitted, yielding 232 protocol approvals for analysis. During the COVID-19 pandemic, median (IQR) TTA was 8 (5 to 31) days in the UK and 115 (47 to 103) days in non-UK countries (median difference, 107 days; 95% CI, 76 to 123 days), with large variation across non-UK countries. Time between approval and FPI during the COVID-19 pandemic was, on average, 3 months faster in the UK compared with non-UK countries (median difference, 90 days; 95% CI, 42 to 141 days). This study found that EARL procedures were lengthy and variable between countries, reflecting different interpretations of trial regulations, with faster processes in the UK. These findings underscore the need to streamline processes across European countries to improve trial efficiency, in particular during future public health emergencies such as pandemics.
39. Marginalized Neighborhoods and Health Outcomes in Younger Myocardial Infarction Survivors.
期刊: JAMA network open 发表日期: 2025-Jul-01 链接: PubMed
摘要
Neighborhood characteristics may be independently associated with survival after acute myocardial infarction (AMI). To examine the association of living in a marginalized neighborhood with mortality and care for younger AMI survivors (aged <65 years) in a universal health care system. Population-based retrospective cohort using clinical and administrative databases in Ontario, Canada. Participants were younger patients hospitalized for their first AMI who received invasive evaluation and survived to 7 days after discharge between April 1, 2010, and March 1, 2019. Statistical analysis was performed between May 27, 2022, and March 31, 2025. Neighborhood marginalization, a metric comprising material deprivation, residential instability, and dependency. All-cause death, all-cause hospitalizations, and subsequent AMIs. Proportional hazards regression models were used to quantify the association of marginalization with outcomes over 3 years. Among 65 464 AMI patients (median age, 56 [IQR, 50-61] years; 22.9% female), increasing neighborhood marginalization was associated with higher rates of mortality beginning 30 days after discharge and persisting over time. At 3 years, mortality rates ranged from 2.2% in the least marginalized neighborhood quintile (Q1) to 5.2% in the most marginalized (Q5). Adjusted hazard ratios for mortality over 3 years of follow-up were significantly higher in patients from marginalized neighborhoods and ranged from 1.13 (95% CI, 0.95-1.35) in Q2 to 1.52 (95% CI, 1.29-1.80) in Q5. Over 1 year, differences were observed between Q1 and Q5 in visits to primary care physicians (Q1, 96.1%; Q5, 91.6%) and cardiologists (Q1, 88.0%; Q5, 75.7%), as well as diagnostic testing. In this cohort study of younger AMI survivors with universal health care, living in marginalized neighborhoods was associated with adverse outcomes. The observed differences in health service utilization among marginalized patients warrant further investigation to better understand the underlying structural and systemic factors.
40. Impact of changing pre-exposure prophylaxis regimens on retention among men who have sex with men in Hanoi, Vietnam (2020-2023): a cohort study.
期刊: Journal of the International AIDS Society 发表日期: 2025-Jul 链接: PubMed
摘要
We examined the association of pre-exposure prophylaxis (PrEP) programme retention with the use of daily, event-driven (ED) or regimen switching reported during follow-up at any point prior to discontinuation among men who have sex with men (MSM) in Hanoi, Vietnam. Between April 2020 and February 2023, we collected data from PrEP clients at Hanoi Medical University Sexual Health Promotion clinic who were prescribed either ED or daily PrEP at the initial visit; at subsequent visits, clients reported the regimen used since the prior visit. We defined three categories of PrEP use: ED-PrEP exclusively, daily PrEP exclusively and switching regimens. The primary outcome was time to discontinuation in the PrEP programme during the study period, defined as missing a scheduled visit by > 30 days. We performed survival analysis using Kaplan-Meier curves. In total, 2107 people were included: 61.1% (n = 1288) reported exclusive use of daily PrEP, 10.4% (n = 220) reported exclusive use of ED-PrEP and 28.4% (n = 599) reported switching PrEP regimens. Among switchers, 29.40% (n = 176) switched more than once. Furthermore, 82.5% switched from daily to ED-PrEP and 17.5% switched from ED to daily PrEP. The median time to discontinuation in the PrEP programme was 105 days (IQR: 52-182) among those reporting exclusive use of ED-PrEP, 104 days (IQR: 56-274) among those reporting exclusive use of daily PrEP and 163 days (IQR: 101-308) among those who switched. Among switchers, those who switched more than once had a median time to discontinuation in the PrEP programme of 231 days (IQR: 137-380) in comparison to 133 days (IQR: 90-274) for those who switched once. We provide real-world data from MSM in an HIV PrEP programme in Vietnam that those who switched had longer periods of retention during the study period. Our findings suggest that offering flexible PrEP regimen options may improve engagement and long-term adherence among this population.
41. How Tay adolescent girls and their female carers navigate sexual and reproductive health information.
期刊: Health promotion international 发表日期: 2025-Jul-01 链接: PubMed
摘要
Achieving equity in sexual and reproductive health (SRH) outcomes for adolescents across geography, ethnicity, and gender remains a global public health challenge. Access to accurate information is a basic and important determinant of SRH, but for many young people, social norms and expectations limit what they can access. We know little about how SRH knowledge is accessed in the Asia Pacific, a region diversely rich in culture and related norms, and with persistently wide inequities in SRH outcomes. This study conducted face-to-face interviews with 20 adolescent girls (16-18 years) and their female carers (n = 20) from the Tay community-the largest ethnic minority group in Vietnam. Reflexive thematic analysis was used to construct three themes from the data. First, SRH issues relating to pre-marital sex, unwanted pregnancy, and the repercussions were the most important topics for adolescent girls and their female carers. Second, SRH topics were considered sensitive and personal, inhibiting interpersonal communication about SRH between women, their families, and across generations. Third, adolescent girls were accessing conflicting SRH information from a diverse range of sources, and both adolescent girls and female carers were reliant on SRH sources online. There is an opportunity to ensure reliable SRH information is available through a variety of sources: by focussing content and delivery of comprehensive sexuality education on pregnancy prevention at the high school level, contextualizing community-based health promotion to address sensitivities around SRH, and expanding national-level programmes to provide online safety skills and digital literacy for adolescents and parents.
42. Uncertain Benefits of Oral Vancomycin for Prevention of Recurrent Clostridioides difficile Infection.
期刊: JAMA network open 发表日期: 2025-Jul-01 链接: PubMed
摘要
43. Integrating Nonindividual Patient Features in Machine Learning Models of Hospital-Onset Bacteremia.
期刊: JAMA network open 发表日期: 2025-Jul-01 链接: PubMed
摘要
Hospital-onset bacteremia and fungemia (HOB) are common and potentially preventable complications of hospital care. To assess whether nonindividual patient features, which summarize interactions with other patients and health care workers (HCWs), can contribute to predictive and causal machine learning models for HOB. This prognostic study included adult patients admitted to Barnes-Jewish Hospital, an academic hospital in St Louis, Missouri, in 2021. Analyses were developed between October 2023 and August 2024 and in April 2025. Individual patient features were extracted from electronic health records and used to engineer nonpatient features, including interactions with HCWs and direct or indirect (consecutive room occupancy) patient contact. HOB was defined as a positive blood culture after the third day of hospitalization. Patients who were hospitalized for more than 3 days were considered at risk for the outcome. We developed 3 gradient boosting models: 2 predictive (with patient features only and with both patient and nonpatient features to predict the occurrence of HOB) and 1 causal to test the association of nonpatient features and HOB. Predictive performance is reported using area under the receiver operating characteristic curve (AUROC) and area under the precision-recall curve (AUPRC), and the results of the causal model are reported as difference in average effects. Sensitivity analyses separated intensive care unit-onset and ward-onset HOB and included a methicillin-resistant Staphylococcus aureus-specific model to adjust for colonization pressure. Among the 52 442 patients, 34 855 (66.5%) had admissions longer than 72 hours and were included for analysis; of these, 556 (1.6%) developed HOB. The median age for the included patients was 60 (IQR, 44-70) years, 50.5% were female, and obesity was the most frequent comorbidity (25.0%). Nonpatient features, such as a prior occupant of the same room receiving antipseudomonal beta-lactams and the mean number of HCWs per day for the 7 days preceding HOB, improved the model’s performance (AUROC, 0.88 [95% CI, 0.88-0.89]; AUPRC, 0.20 [95% CI, 0.20-0.22]) compared with the patient-only model (AUROC, 0.85 [95% CI, 0.85-0.86]; AUPRC, 0.13 [95% CI, 0.12-0.14]) (P < .001). These 2 features were also associated with a higher likelihood of HOB in the causal gradient boosting model. These findings suggest that nonindividual patient features may contribute to a comprehensive analysis of HOB when integrated with individual patient features in a machine learning model.
44. Community Water Trihalomethanes and Chronic Kidney Disease.
期刊: JAMA network open 发表日期: 2025-Jul-01 链接: PubMed
摘要
Over 90% of the US population relies on community water supplies (CWS), which generally use chlorine for disinfection. Trihalomethanes are regulated disinfection byproducts associated with bladder cancer and adverse birth outcomes. Animal studies report trihalomethanes, especially brominated compounds, may damage kidney function, but epidemiologic research is limited. To evaluate long-term exposure to trihalomethanes in residential CWS and its association with chronic kidney disease (CKD) risk. The California Teachers Study (CTS) is an ongoing prospective cohort of female teachers and administrators enrolled between 1995 and 1996 with data linked to mortality and health care records. This cohort study analyzed CTS data from January 1, 2005, once CKD diagnostic coding was adopted, through December 31, 2018. Statistical analysis was conducted from July 2023 to December 2024. Residence time-weighted mean concentrations of 4 trihalomethanes, including 3 brominated trihalomethanes and chloroform, were calculated using annual measurements from CWS serving participants’ homes from 1995 to 2005. Uranium and arsenic (potentially nephrotoxic metals, previously evaluated in the cohort) from CWS were included as part of a g-computation mixture analysis. Cases of moderate (stage 3) to end-stage CKD were identified with diagnostic codes or dialysis-related procedures. Mixed-effects multivariable-adjusted Cox proportional hazards regression models were used to estimate hazard ratios (HRs) and 95% CIs for CKD by exposure to trihalomethane levels (US maximum contaminant level of 80 μg/L). The study sample included 89 320 female participants (median age, 50 years [IQR, 43-61 years]) with 6242 CKD cases. Median concentrations were 5.5 μg/L (IQR, 0.5-24.1 μg/L; 95th percentile, 57.8 μg/L) for total trihalomethanes and 2.7 μg/L (IQR, 0.7-11.3 μg/L; 95th percentile, 30.0 μg/L) for brominated trihalomethanes. In flexible spline-based models, a clear exposure-response association was observed between trihalomethanes and CKD risk, with the highest risk for brominated trihalomethanes. The HRs for CKD risk associated with brominated trihalomethanes at the highest 2 exposure categories (75th percentile and at or above the 95th percentile) were 1.23 (95% CI, 1.13-1.33) and 1.43 (95% CI, 1.23-1.66), respectively (P < .001 for trend). Brominated trihalomethanes were the largest contributor (52.9%) to the association of the overall mixture with CKD risk, followed by uranium (35.4%), arsenic (6.2%), and chloroform (5.5%). In this prospective cohort study of California female teachers, exposure to trihalomethane concentrations less than 80 μg/L (US current standard) increased CKD risk, particularly brominated trihalomethanes, which are not separately regulated in community water. The findings may have public health implications given the widespread use of water chlorination and growing burden of CKD.
45. Enhancing Randomized Clinical Trial Readiness for Public Health Emergencies.
期刊: JAMA network open 发表日期: 2025-Jul-01 链接: PubMed
摘要
46. Early remote rehabilitation to improve health of the elderly after cardiac surgery - study protocol for a randomised trial.
期刊: Danish medical journal 发表日期: 2025-Jun-21 链接: PubMed
摘要
Early rehabilitation is recommended after cardiac surgery to enhance recovery. However, due to precautions of sternum healing, the initiation of cardiac rehabilitation is often postponed for 6-8 weeks after surgery, leaving patients to face physical and emotional barriers on their own. This study aims to investigate whether early remote cardiac rehabilitation can enhance physical function and reduce the emotional challenges that older patients face after discharge. In this bi-entre, randomised controlled trial, 120 patients older than 65 years of age undergoing open heart surgery are assigned to individualised exercise training and step counting supported by a mobile health app and weekly calls with a physiotherapist as an adjunct to standard care (intervention group), or standard care alone (control group) for six weeks after discharge. Outcomes are assessed at baseline, a six-week follow-up and a six-month follow-up. The primary outcome is change in the 30-second Chair Stand Test. Secondary outcomes include health-related quality of life, cost-effectiveness and prevalence of sarcopenia. This trial will determine if early remote rehabilitation after cardiac surgery can accelerate recovery and alleviate emotional distress, advocating for early post-discharge interventions through digitally delivered care. This trial is supported by external funds: the Novo Nordisk Foundation, the Health Foundation and the Eva and Henry Frænkels Memorial Fund. gov NCT06370611.
47. Quantitation of Catechin, Epicatechin, Quercetin and Kaempferol by Liquid Chromatography with Diode Array Detection and Friedelin by Gas Chromatography Coupled to Mass Spectrometry in Maytenus ilicifolia Mart. ex Reiss Extracts.
期刊: Journal of chromatographic science 发表日期: 2025-Jun-10 链接: PubMed
摘要
Maytenus ilicifolia Mart. ex Reiss (espinheira-santa) is a plant native to South America, popularly used in the treatment of gastric disorders. A liquid chromatographic (LC) method was developed using a C18 column and mobile phase composed of acetonitrile and 0.02% (v/v) trifluoracetic acid using gradient elution. Ultraviolet detection was performed at 270 and 369 nm. Gas chromatography coupled to mass spectrometry (GC-MS) analysis was performed using a DB-5MS column and helium as mobile phase. Five samples of M. ilicifolia extracts were assayed by both methods, which were fully validated. Using the LC method, the quantified levels varied from 0.06 to 0.49% (w/w) for catechin and from 0.10 to 0.79% (w/w) for epicatechin. The maximum content of quercetin and kaempferol were 0.01 and 0.004% (w/w), respectively. Friedelin was quantified only in the hydroacetonic extract (0.98% w/w), by GC-MS. Both chromatographic methods showed to be reliable tools for the screening and quantitation of the main vegetal markers in M. ilicifolia herbal products.
48. Empirical Research of Health Inequalities Between Male and Female Employees of the Hellenic National Organization for Healthcare Services Provision: A Cross-Sectional Study.
期刊: Cureus 发表日期: 2025-Jun 链接: PubMed
摘要
Aim The study attempts to delineate a framework of investigation regarding health inequalities and health-related behaviors among male and female employees of the Hellenic National Organization for Healthcare Services Provision (EOPYY). The pillars of the presented framework are self-perceived health, the presence of chronic diseases, health behaviors, mental well-being, and healthcare utilization. Subject and methods A cross-sectional study was conducted on 209 employees using a self-administered online questionnaire. Data were analyzed using descriptive and inferential statistics (Mann-Whitney U, Kruskal-Wallis, as well as Chi-squared Χ²) and multiple linear regression analysis. Results Men reported better overall health, lower stress levels, and higher quality of life, particularly in dimensions such as physical pain (p=0.001) and mental health (p=0.002), whereas women reported a higher prevalence of chronic diseases and more frequent doctor visits. Women adopted healthier dietary habits and exercised more frequently, while men exhibited higher rates of overweight and obesity (p<0.001). Gender emerged as a significant predictor of both physical and mental health, with men demonstrating more favorable health indicators. Conclusions While health inequalities are gaining global attention, their impact on employees in large public Organizations in Greece remains underexplored. This study generates novel insights to shape strategies such as flexible work policies, improved workplace health programs, and gender equality education, driving a more inclusive and supportive work culture. Practical implications include workplace mental health support, targeted health promotion initiatives, and policies enhancing work-life balance. These measures can reduce gender-related health disparities and improve overall employee well-being and productivity. The findings may inform workplace health policies and promote gender-sensitive interventions in the public sector. The findings may inform workplace health policies and promote gender-sensitive interventions in the public sector.
49. Network pharmacology and experimental verification: Rosmarinic acid alleviates doxorubicin-induced cardiomyocyte apoptosis by regulating BCL2L1.
期刊: Human & experimental toxicology 发表日期: 2025 链接: PubMed
摘要
PurposeThis study investigated the mechanism by which Rosmarinic acid (RA) may alleviate doxorubicin (DOX)- induced cardiomyocyte apoptosis.MethodsThe target genes of RA, DOX-related differentially expressed genes, and GEO database related genes were retrieved by bioinformatics analyses. The results of these analyses were further intersected to identify candidate genes. The protein-protein interaction network was constructed to develop the pharmacophore model. The molecular docking was simulated to determine the core target B-cell lymphoma 2-like 1 (BCL2L1) for subsequent molecular mechanism investigation in vitro. The effects of DOX and RA on the apoptosis of H9c2 cells were assessed using the CCK8 assay. The present study investigated the effect of RA on DOX-induced oxidative stress in cardiomyocytes. This investigation was conducted using an ELISA test and a DCFH-DA probe. The JC-1 probe was utilized to assess the effect of RA on DOX-induced cardiomyocyte mitochondrial membrane permeability. A Western blot assay was conducted to ascertain the activation of multiple signaling molecules, including those belonging to the BCL-2 and caspase-3 families, within the apoptosis pathway.ResultsA total of 17 differentially expressed genes (DEGs) were screened, and five genes were selected as hub DEGs. A subsequent KEGG enrichment analysis revealed that these DEGs were significantly enriched in various biological processes and pathways, including the MAPK signaling pathway, autophagy, apoptosis, and the TNF signaling pathway. The pharmacophore model and molecular docking of five candidate targets with RA were successfully established. It is noteworthy that DOX treatment led to a suppression of SOD and GSH levels, an exacerbation of oxidative stress, and a promotion of cardiomyocyte apoptosis. Furthermore, it has been demonstrated to suppress mitochondrial membrane permeability. Subsequent RT-qPCR analysis of the hub genes revealed that only BCL2L1 exhibited significant alterations. Treatment with DOX altered the expression levels of apoptosis-associated proteins, BCL-2 family members, and caspase-3 family members. However, the administration of RA mitigated the deleterious effects of DOX on cardiomyocytes.ConclusionsThe protective effects of RA may against myocardial cell apoptosis are likely mediated through its activation of BCL2L1 and inhibition of caspase cascade protein expression in myocardial cells.
50. Advancing sustainable practices with Paenibacillus polymyxa: From soil health to medical applications and molecular engineering.
期刊: AIMS microbiology 发表日期: 2025 链接: PubMed
摘要
Paenibacillus polymyxa is a multifaceted bacterium with widespread applications in agriculture, environmental management, medicine, and industry. In agricultural settings, it plays a crucial role in soil enhancement, plant growth promotion, and natural pathogen control, reducing the need for chemical interventions. Additionally, P. polymyxa exhibits promising potential in medical applications by aiding in infection prevention and supporting gastrointestinal health. In the realm of environmental management, this bacterium contributes to pollution remediation through biodegradation processes. Industrially, P. polymyxa is involved in producing enzymes, biofertilizers, bioplastics, and platform chemicals, offering sustainable alternatives that underscore its importance in driving sustainability initiatives. Despite these valuable attributes, widespread utilization of bioresources derived from naturally occurring P. polymyxa has been hampered by limited genetic manipulation capabilities and tools. In this comprehensive analysis, we aimed to provide a thorough understanding of P. polymyxa’s characteristics, genetic resources, and metabolic capabilities, while highlighting its potential as a versatile platform for protein expression, metabolic engineering, and synthetic biology. We delved into the diverse sustainable applications of P. polymyxa in these domains, emphasizing its benefits, challenges, and future outlook in advancing sustainable practices. Furthermore, we underscore the critical need for continued research and development of advanced engineering techniques and genetic editing technologies tailored specifically for this bacterium.
51. Patterns of lifestyle risk behaviors for cardiovascular disease in family caregivers: a latent class analysis.
期刊: Frontiers in public health 发表日期: 2025 链接: PubMed
摘要
Lifestyle risk behaviors for cardiovascular disease (CVD) often co-occur. However, little is known about their co-occurrence patterns among family caregivers, a high-risk population for CVD. This study aimed to identify distinct latent classes of lifestyle risk behaviors for CVD among caregivers and to examine socio-demographic, health-related, and caregiving characteristics associated with membership in the latent classes. We conducted a cross-sectional secondary data analysis of the 2019 Health Information National Trends Survey 5 Cycle 3, involving 643 unpaid family caregivers in the United States. The lifestyle risk behaviors for CVD included current cigarette use, current alcohol consumption, low physical activity, prolonged sedentary time, low fruit intake, and low vegetable intake, as defined by established guidelines. We performed latent class analysis to identify unobserved subgroups based on these multiple lifestyle risk behaviors. Subsequently, we conducted multinomial logistic regression to investigate socio-demographic, health-related, and caregiving characteristics associated with latent class membership. The majority of participants were females (55.3%) and non-Hispanic white (57.1%), with a mean age of 55 ± 16 years. Three distinct classes were identified: Class 1 (Physically active caregivers, 17.1%), Class 2 (Physically inactive, healthy eaters, 18.8%), and Class 3 (Physically inactive, unhealthy eaters, 64.1%). In unadjusted models, older caregivers (≥65 years) were more likely to belong to Class 2, relative to Class 1, compared to those aged 18-49 years. Caregivers with perceived financial difficulties, psychological distress, low self-efficacy in health management, and poor sleep quality were more likely to belong to Class 3, rather than Class 1, compared to their counterparts. Additionally, dementia care and caregiving ≥ 20 h/week were significantly associated with Class 3 membership. In the adjusted model, psychological distress remained significant. Caregivers reporting psychological distress were more likely to belong to Class 3 rather than Class 1, compared to those without psychological distress. Our findings reveal the presence of subgroups of caregivers with unique patterns of lifestyle risk behaviors, with most not meeting the recommended levels of health behaviors. Future studies should consider these co-occurring patterns along with the key factors associated with higher-risk lifestyle behavior patterns when developing interventions to promote caregivers’ cardiovascular health.
52. Methods to Evaluate DNA Damage in Spermatozoa.
期刊: Methods in molecular biology (Clifton, N.J.) 发表日期: 2025 链接: PubMed
摘要
Studying DNA damage in spermatozoa allows researchers fundamental insight into the molecular mechanisms underlying the cellular response of sperm to stressors and provides an opportunity for understanding novel mechanisms for mitigating this type of damage. Furthermore, since compromised genetic integrity is recognized as a leading contributor to infertility phenotypes, reliable methods for assessing DNA damage in populations of spermatozoa are essential in research and clinical laboratories alike. Here, we describe two methods, the sperm chromatin structure assay (SCSA) and alkaline comet assay, designed to assess both single- and double-stranded DNA damage within the spermatozoon.
53. Methods to Determine Oxidative Stress in Spermatozoa.
期刊: Methods in molecular biology (Clifton, N.J.) 发表日期: 2025 链接: PubMed
摘要
Assessing oxidative stress levels in spermatozoa provides crucial information on the health of the cell, while also potentially providing insight into the systemic health of the individual. Indeed, elevated oxidative stress in spermatozoa has been implicated in compromising sperm function and, consequently, is now considered one of the leading mediators of numerous male reproductive pathologies. Here we describe two flow cytometric assays: Dihydroethidium and Mitosox Red, which can be used to detect reactive oxygen species originating from the cytosol and mitochondria, respectively, in both mouse and human spermatozoa. Such tools have utility in studies investigating the impact of reproductive aging, toxicants, and environmental exposures on the male germline. These assays are also beneficial in the context of testing novel pharmaceutical interventions or antioxidant defence therapies aimed at preserving fertility or for use in assisted reproduction technologies.
54. Test-retest reliability and construct validity of a Japanese version of the Satisfaction with Daily Occupations and Occupational Balance for people with mental illness.
期刊: Scandinavian journal of occupational therapy 发表日期: 2025-Jan 链接: PubMed
摘要
Japan lacks efficient assessment tools for occupational balance (OB) in people with mental illness (MI). We investigated the test-retest reliability and construct validity of a Japanese version of the Satisfaction with Daily Occupations and Occupational Balance (SDO-OB-J) for people with MI. SDO-OB-J interviews were conducted twice at a 2-week interval. Fifty-three participants joined. Regarding test-retest reliability, the weighted kappa coefficients were 0.75 for total activity level, 0.85 for total activity satisfaction, and 0.54 for general OB. Concerning construct validity, activity level and activity satisfaction had no significant correlation with global functioning, neurocognition, or mental-related quality of life (QOL). Physical-related QOL had a significant correlation only with activity satisfaction. General OB responses showed no neurocognitive differences, and the in-balance group had higher mental-related QOL than the under-occupied group. Weighted kappa coefficients were classified as substantial for activity level, almost perfect for activity satisfaction, and moderate for general OB. Activity level demonstrated discriminant validity with global functioning, neurocognition, and QOL. Activity satisfaction displayed discriminant validity with global functioning and neurocognition and convergent validity with physical-related QOL. General OB showed construct validity. The SDO-OB-J showed good test-retest reliability and construct validity in people with MI. UMIN000050730.