公共卫生研究摘要 (2025-07-08)
共收录 56 篇研究文章
1. The Epidemiology of Snakebite in Bhutan: A Retrospective Study.
期刊: Public health challenges.. 发表日期: 2025-Sep 链接: PubMed
摘要
Bhutan is a tropical country where snakebite is supposedly common, but official data are scanty and unmethodical. Deaths from snakebites were reported from areas where snakebites are common. Four-year (2018-2021) data of snakebite from 45 Bhutanese hospitals were collected and analysed to describe the burden and map by districts. A total of 371 snakebites were recorded from 45 hospitals during the 4 years. Most cases were seen in the southern and central parts of the country. There was a definite rise in the number of cases in the warmer months, starting from March and peaking between June and August. About 240 (65%) of the bites occurred in males, and the highest number of snakebites occurred during farming (n = 100, 27%), bush walking (n = 42, 11.3%), herding (n = 15, 4%) and trekking (n = 1, 0.2%). The most common anatomical bite site was the leg (n = 167, 45.01%), followed by the hand (n = 81, 21.8%), finger (n = 56, 15.09%), toes (n = 11, 2.96%), thigh region (n = 6, 1.6%), head and face (n = 3, 0.8%), chest and shoulder (n = 3, 0.8%) and abdomen (n = 1, 0.3%). Most snakes were unidentified (n = 266, 71.7%). Those identified were vipers (n = 74, 19.9%), rat snakes (n = 12, 3.2%), kraits (n = 7, 1.88%), cobras (n = 6, 1.61%), river snakes (n = 5, 1.34%) and wolf snakes (n = 1, 0.26%). Forty-three (11.6%) of the bite victims had resorted to non-medical home treatment. Even with an obvious underreporting, snakebite is a significant public health problem, and Bhutan should embrace more public health and clinical activities to prevent morbidities and mortalities from snakebite.
2. Integrating a risk prediction score in a clinical decision support to identify patients with health-related social needs in the emergency department.
期刊: JAMIA open 发表日期: 2025-Aug 链接: PubMed
摘要
To improve the identification of patients with health-related social needs (HRSNs) in the emergency department (ED), we developed and integrated a risk prediction score into an existing Fast Healthcare Interoperability Resources (FHIR)-based clinical decision support (CDS). We conducted 2 phases of individual semi-structured qualitative interviews with ED clinicians to identify HRSN risk score design preferences for CDS integration. Following this, we used patient HRSN screening survey, health information exchange (HIE), and clinical data to run logistic regressions, developing an HRSN risk score aligned with ED clinician preferences. Emergency department clinicians preferred HRSN risk scores displayed via visual cues like color-coding with different ranges (low, medium, and high) with higher model sensitivity to avoid missing patients with HRSNs. The overall performance of the risk prediction model was modest. Risk scores for food insecurity, transportation barriers, and financial strain were more sensitive, aligning with users’ preference for inclusivity and accurately identifying patients likely to screen positive for these HRSNs. The design and risk score model choices, such as visual displays with additional data, higher sensitivity thresholds, and use of different thresholds for fairness, may support effective CDS use by ED clinicians. Using HIE data and an external CDS is a feasible route for including patient HRSNs information in the ED. We relied on clinician preferences for incorporation into the existing CDS and were attentive to performance fairness. While the predictive performance of our risk score is modest, providing risk scores in this manner may potentially improve the identification of patients’ HRSNs in the ED.
3. Impact of multidrug resistance in cancer patients with bloodstream infections caused by Gram-negative bacilli: results from a multicentre study.
期刊: JAC-antimicrobial resistance 发表日期: 2025-Aug 链接: PubMed
摘要
To evaluate the impact of multidrug resistance (MDR) on the mortality of cancer patients with bloodstream infection (BSI) by Gram-negative bacilli (GNB). This was a prospective observational multicentre study including cancer patients with BSI caused by GNB (June 2018-January 2020). The primary outcome was 30-day mortality. The secondary outcome was mortality attributable to MDR organisms, including extended-spectrum beta-lactamase (ESBL)-producing Enterobacterales, carbapenem-resistant (CR) Enterobacterales and CR non-fermenting GNB (CR-NFGNB). A multivariable regression analysis identified factors associated with 30-day mortality. Adjusted odds ratio (aOR) with 95% confidence intervals (95% CI) were calculated. Attributable mortality was estimated according to DRIVE-AB Consortium’s formula. Of 347 cancer patients, 232 (66.9%) had BSI caused by MDR-GNB. Thirty-day mortality was 27.2% in patients with BSI caused by MDR organisms compared to 7% in those with BSI by susceptible GNB (P < 0.001). In the multivariable analysis, MDR-GNB including ESBL-producing Enterobacterales (aOR 8.734, 95% CI 1.411-54.077, P = 0.02), KPC-producing Enterobacterales (aOR 8.548, 95% CI 1.296-56.411, P = 0.026), metallo-β-lactamases (MBL)-producing Enterobacterales (aOR 15.802, 95% CI 1.408-68.667, P = 0.022) and CR-NFGNB (aOR 53.373, 95% CI 5.104-89.146, P < 0.001) as compared to susceptible GNB were independently associated with 30-day mortality. Mortality attributable to MDR-GNB was 43%. According to causative pathogens, attributable mortality was 33% in ESBL, 32% in KPC, 47% in MBL and 73% in CR-NFGNB. In cancer patients, BSIs due to MDR-GNB are associated with excess mortality compared to BSI by susceptible GNB. Strategies to reduce the spread of MDR-GNB and to promote optimal management of affected patients are urgently needed.
4. The Community Vulnerability Compass: a novel, scalable approach for measuring and visualizing social determinants of health insights.
期刊: JAMIA open 发表日期: 2025-Aug 链接: PubMed
摘要
To determine whether a novel digital tool, the Community Vulnerability Compass (CVC), built using large datasets, can accurately measure neighborhood- and individual-level social determinants of health (SDOH) at scale. Existing SDOH indexes fall short of this dual requirement. Setting: A cross-sectional study by Parkland Health (Parkland) and Parkland Center for Clinical Innovation (PCCI) to design, build, deploy, and validate CVC in Dallas County/across Texas (2018-2024). Data Sources: Parkland Electronic Health Records; population-level data from diverse national datasets. Statistical Analysis: CVC’s Community Vulnerability Index (CVI), and 4 subindexes were used to classify all 18 638 Texas census-block groups as Very-High, High, Moderate, Low, and Very-Low social vulnerability. Individuals were assigned the vulnerability of their home address census-block group. CVC’s classifications were compared against 3 existing SDOH neighborhood tools (Area Deprivation Index [ADI], Social Vulnerability Index [SVI], or Environmental Justice Index [EJI]) and validated against individual-level SDOH screening tools or Z-code documentation. Spearman rank correlation was used for neighborhood-level comparisons and precision/recall, for individual-level comparisons. Neighborhood-level CVI measurement of social vulnerability strongly correlated with EJI (r = 0.83), SVI (r = 0.82), and ADI (r = 0.79). Individual-level CVI measurement had higher recall than ADI (68% vs 39%, respectively; P < .001) and high recall across self-reported SDOH (77%-79.6%). Precision was highest for food needs (75.1%); lowest for safety needs (1.2%). CVC measured a cross-cutting range of neighborhood social vulnerabilities and accurately approximated individual-level SDOH, outperforming existing indexes. CVC can be leveraged as an accurate and scalable SDOH digital measurement tool.
5. Considering Environmental Discrimination to Achieve Optimal Pregnancy Health for All.
期刊: BJOG : an international journal of obstetrics and gynaecology 发表日期: 2025-Jul-08 链接: PubMed
摘要
6. Normative study of the Taiwanese version of the Montreal Cognitive Assessment (MoCA) in community-dwelling individuals in Taiwan.
期刊: Journal of the Chinese Medical Association : JCMA 发表日期: 2025-Jul-08 链接: PubMed
摘要
The Montreal Cognitive Assessment (MoCA) may not be appropriately interpreted in Taiwan because of the lack of large-scale normative data. Moreover, examinees’ demographic characteristics may influence their MoCA scores. However, previous studies have not adequately adjusted for these effects. This study aimed to use regression-based methods to establish demographically adjusted MoCA norms. Participants were recruited from six hospitals and neighboring communities from all geographic areas of Taiwan. Multiple regression analyses were conducted to quantify the effects of age, education, and sex on MoCA total and domain scores, resulting in correction equations and adjusted cutoff scores. A total of 2,310 cognitively healthy participants were included in the analysis. Age and education significantly affected the total and all domain scores. Sex affected naming, language, and abstract thinking domain scores. Correction equations and corresponding cutoffs were proposed for MoCA total and domain scores to support more precise clinical interpretations. This study provides regression-adjusted norms for the MoCA, improving its accuracy and clinical utility in Taiwan. An adjusted total MoCA score of 23 points is recommended as the cutoff for identifying potential cognitive impairment, with domain-specific cutoffs further supporting individualized interpretation.
7. No country for old men - Finding homes for older people who have committed crimes.
期刊: Australasian psychiatry : bulletin of Royal Australian and New Zealand College of Psychiatrists 发表日期: 2025-Jul-08 链接: PubMed
摘要
8. Characteristics of Low-Speed Vehicular Rollover Trauma in Dogs Presenting to an Emergency Service at a Veterinary Teaching Hospital.
期刊: Journal of veterinary emergency and critical care (San Antonio, Tex. : 2001) 发表日期: 2025-Jul-08 链接: PubMed
摘要
To describe the epidemiology of, and injuries associated with, low- versus higher-speed vehicular trauma and to identify risk factors associated with mortality. Retrospective study from January 2015 to November 2020. University teaching hospital. A total of 150 dogs with low-speed (<20 mph) vehicular rollover (LSVRO) trauma and 272 dogs with other vehicular trauma (hit by car [HBC]). None. Eighty-five percent of vehicles causing LSVRO trauma were driven by owners or family members of the dogs. Dogs in the LSVRO group were older (median: 4 vs. 2 years, P = 0.001), smaller (median weight: 11 vs. 21.5 kg, P = 0.001), and more often female (53.3% vs. 40.1%, P = 0.005) than the HBC group. Pelvic fractures, sacroiliac luxation, prepubic tendon rupture, and vertebral fractures were more common in the LSVRO group, and more soft tissue surgical procedures were required than in the HBC group (18.0% vs. 8.85%, P = 0.02). Within the LSVRO group, abdominal injuries (e.g., abdominal hernia, prepubic tendon rupture), pelvic fractures, and traumatic brain injury were all associated with increased mortality. Surviving dogs had higher ionized calcium concentration (1.26 ± 0.1 mmol/L) than those that died (1.18 ± 0.1 mmol/L, P = 0.003). There was a 40% reduction in survival odds for every 1-point increase in animal trauma triage score (P < 0.001). Blood product requirement and each soft tissue surgery increased mortality by 98% (P < 0.001) and 74% (P = 0.001), respectively, while orthopedic surgery conferred a 25-fold increase in odds of survival (P < 0.001). LSVRO trauma is characterized by a specific constellation of injuries compared with HBC trauma. Veterinary practitioners should be aware of the differences between the two trauma types and focus triage, resuscitation, and diagnostic tests in dogs with LSVRO trauma accordingly.
9. Continuity of care in the context of a primary health care reform: a follow-up after the Swedish Patient Choice Reform.
期刊: Scandinavian journal of primary health care 发表日期: 2025-Jul-08 链接: PubMed
摘要
Continuity of care (CoC) is essential for effective primary health care (PHC), yet Swedish PHC has historically exhibited low levels of continuity. The Swedish Patient Choice Reform introduced privatization and market-oriented principles into PHC, leading to increased utilization and growing inequities in service use driven by socioeconomic disparities and misalignment with health care needs. However, little is known about its impact on continuity. The aim of this study is to explore long-term effects of longitudinal CoC in PHC within the context of the Patient Choice Reform. Using register data from Region Skåne (2007-2017), we created three closed cohorts, each capturing three years of PHC utilization. Continuity with GPs was measured using the Continuity of Care Index (CoCI). Quantile regression assessed associations between continuity and individual characteristics, including age, sex, income, education and residence. Among 322,641 individuals with 7,878,642 general practitioner (GP) visits, median CoCI declined from 0.17 (2007 cohort) to 0.13 (2015 cohort). Higher age, male sex and increased PHC utilization were linked to greater continuity in 2007, but these associations weakened by 2015. Continuity of care in Swedish PHC declined over time, particularly among older individuals and frequent PHC users. These findings highlight the need to address continuity deterioration in the context of the Patient Choice Reform.
10. Test-retest reliability and concurrent validity of three different handgrip dynamometers (Jamar, Jamar Plus+ and Biodex) in healthy young adults.
期刊: Hand therapy 发表日期: 2025-Jul-05 链接: PubMed
摘要
Handgrip strength (HGS) is a key indicator of upper limb function and overall health. While the Jamar dynamometer is considered the gold standard for HGS assessment, alternatives like the Jamar Plus+ and Biodex have emerged, though their reliability and agreement remain underexplored. To evaluate the test-retest reliability and agreement of the Jamar, Jamar Plus+, and Biodex dynamometers in healthy young adults. This exploratory cross-sectional study included 35 participants (22 females, 13 males; mean age 23.4 years). HGS was assessed using the three devices, following standardised protocols, with retest after 7 days. Reliability was analysed using the Intraclass Correlation Coefficient (ICC), Standard Error of Measurement (SEM), and Minimal Detectable Change (MDC). Agreement was examined through Bland-Altman plots and Limits of Agreement (LoA %). Jamar and Jamar Plus+ showed excellent reliability (ICC = 0.96-0.98) and strong agreement, with narrow LoA percentages and low measurement error, especially on the non-dominant hand. In contrast, comparisons involving the Biodex revealed wider LoA (up to ±73%) and higher SEM and MDC values, indicating lower agreement with handheld devices. These discrepancies are likely due to differences in measurement principles, hand positioning, and unit conversion. Male participants showed significantly higher grip strength across all instruments. The Jamar and Jamar Plus+ can be used interchangeably. The Biodex may be considered when appropriate adjustments are made, though its agreement with handheld dynamometers is limited. These findings highlight the need for standardised protocols and further research to ensure consistent and reliable HGS assessment across devices.
11. Dithioerythritol-capped silver/gold nanoclusters for determination of ciprofloxacin, norfloxacin, and enrofloxacin in food and urine samples.
期刊: RSC advances 发表日期: 2025-Jul-04 链接: PubMed
摘要
Fluoroquinolones (FQs) are widely used in the poultry and livestock industries due to their effectiveness in preventing and treating bacterial infections. However, improper use and poor biodegradability lead to their accumulation in the food chain, posing risks to human health. To address this, a novel ratiometric fluorescence probe was developed for sensitive FQ detection. The probe consists of dithioerythritol-protected silver-gold nanoclusters (DIT@AgAuNCs) with weak red fluorescence at 615 nm. Addition of Al3+ induces nanocluster aggregation, enhancing fluorescence emission. Upon adding FQs to the DIT@AgAuNCs/Al3+ system, fluorescence at 615 nm decreases due to the removal of Al3+ from the ligand (DIT) surface via coordination interactions. Simultaneously, a new blue fluorescence peak emerges at 465 nm, attributed to the formation of an Al3+-FQs coordination complex. Under optimal conditions, the fluorescence ratio (F465/F615) increased proportionally with FQ concentration. In this study, F465/F615 represents the ratio of fluorescence intensity at 465 nm (blue emission from the Al3+-FQ complex) to that at 615 nm (red emission from aggregated DIT@AgAuNCs). This ratiometric approach compensates for environmental and instrumental fluctuations, enhancing analytical reliability. The probe exhibited good linearity for ciprofloxacin (CIP), norfloxacin (NOR), and enrofloxacin (ENR) within the ranges of 0.01-60 μM, 0.018-60 μM, and 0.021-60 μM, respectively, with detection limits 0° 31 nM, 38 nM, and 44 nM. The probe was successfully applied to detect FQs (using CIP as an example) in egg, milk, and urine samples, demonstrating high accuracy with recoveries of 94.0-106.0% and excellent reliability, with an RSD below 4.09%.
12. Mechanistic insights and therapeutic innovations in engineered nanomaterial-driven disruption of biofilm dynamics.
期刊: RSC advances 发表日期: 2025-Jul-04 链接: PubMed
摘要
Bacteria employ biofilm formation as a survival strategy, characterized by the self-assembly of cells into 3D architectures encapsulated in an extracellular polymeric substance (EPS) that results in reduced antibiotic efficacy, increased tolerance, and emergence of multidrug resistance phenotypes. To overcome this challenge, persistent efforts are directed toward developing cutting-edge approaches and agents that rejuvenate antibiotic efficacy, mitigate biofilm formation, and eradicate biofilm-associated bacterial infections. Within this framework, nanotechnology has emerged as a pivotal tool for developing innovative functional materials with tailored attributes, exhibiting substantial potential in addressing the global health challenge of antibiotic resistance and biofilm-associated infections. This updated review article provides a comprehensive overview, commencing with a thorough analysis of biofilm formation and its implications, followed by a critical evaluation of cutting-edge strategies derived from recent research advancements. Our discussion encompasses novel strategies, including traditional nanomaterials, micro-nanobubbles, multifunctional nanozyme-mimetic platforms, artificial phage-like structures, and sophisticated nano-microrobotic systems. Each strategy is assessed for its potential to effectively target biofilms, enhance antimicrobial penetration, and restore antibiotic susceptibility. We anticipate that this timely review will inform and inspire innovative research directions, focusing on the rational design and application of advanced nanomaterials for targeted biofilm modulation and efficacious treatment, thereby advancing healthcare solutions.
13. The Relationship Between Prediabetes and Peripheral Neuropathy-A Systematic Review and Meta-Analysis.
期刊: European journal of neurology 发表日期: 2025-Jul 链接: PubMed
摘要
The present systematic review and meta-analysis study aimed to investigate the putative relationship between pre-diabetes and neuropathy. Original studies that assessed the association of pre-diabetes patients with neuropathy disorders in humans without setting and country were selected. The methodological quality of the included articles was evaluated using NHLBI quality assessment tools for observational studies. The meta-analysis was conducted using the relevant effect sizes to compare outcomes and the random-effects restricted model. An I2 value > 50% and a p < 0.05 indicated substantial heterogeneity. Galbraith plot is demonstrated for heterogeneity. Egger’s and Begg’s test was used to evaluate publication bias. A non-parametric trim-and-fill analysis of publication bias was used to assess the number of missing studies. According to the standardized mean difference (SMD) of included articles, there was a statistically significant association between pre-diabetes and the occurrence of peripheral neuropathy in the increasing neuropathy assessment metrics (e.g., Impaired unilateral vibration perception, Neuropathic pain, Sensory nerve dysfunction) 0.23[0.14; 0.33] and in decreasing neuropathy assessment metrics (e.g., corneal nerve fiber density, corneal nerve fiber length, warm threshold, cold threshold) -1.04[-1.05; -0.57]. Policymakers should give special attention to preventive strategies and effective lifestyle interventions for these patients to reduce the risk of neuropathy and its consequences.
14. Geographic variation in Medicare Advantage nonemergency medical transportation benefits 2020-2024.
期刊: Health affairs scholar 发表日期: 2025-Jul 链接: PubMed
摘要
Nonemergency medical transportation (NEMT) is a supplemental benefit in Medicare Advantage (MA) plans that helps individuals overcome transportation barriers to healthcare services. It remains unclear whether these benefits are targeted to communities with greater needs. We analyzed MA plan benefit data from 2020 to 2024 across 2764 US counties. Transportation barriers were assessed using 5 indicators: vehicle ownership, income levels, self-reported health status, avoidable hospital visits, and access to primary care. We examined trends in NEMT availability and its alignment with county-level transportation need, considering MA plan penetration as a modifying factor. Nonemergency medical transportation benefit prevalence in MA plans increased by 13.88% points from 2020 to 2024. In 2024, counties with the greatest transportation barriers had a 19.4% point higher prevalence of NEMT offerings compared to counties with the fewest barriers. Alignment was stronger in counties with higher MA plan penetration. Medicare Advantage plans increasingly offer NEMT benefits in areas with greater transportation challenges, especially where MA plan penetration is higher. These findings suggest responsiveness to social needs and the potential role of market dynamics. Policymakers can support equitable access by incorporating transportation needs into MA plan evaluations.
15. Factors Affecting the Decision to Become a Parent: A Content Analysis.
期刊: Health science reports 发表日期: 2025-Jul 链接: PubMed
摘要
The persistent issue of low fertility rates in many countries, including Iran, has raised concerns regarding population decline, aging demographics, and increasing dependency ratios. This situation underscores the necessity of investigating the factors that contribute to these trends and the implementation of policies to encourage childbearing. This study aims to explore the underlying factors related to childbearing intentions among young Iranian men and women who are about to be married. This study analyzed responses from participants in premarital courses to the survey question, “What circumstances may affect your decision to become a mother or father?” The main survey was conducted between June 22, 2021 and March 16, 2022, involving 1533 women and 1405 men who were about to marry and attended premarital courses at public health clinics across 5 cities in Iran. Data were collected through web-based questionnaires. The responses to this open question were text-based and sufficiently detailed for content analysis. A total of 334 text-based responses were analyzed using MAXQDA version 11, resulting in 270 open codes that were categorized based on thematic concepts. The main categories that emerged from the analysis were “Obscure Prospects” and “Individual Life Goals, Preferences, and Concerns.” The “Obscure Prospects” category included 181 codes, highlighting concerns related to economic hardship and sociopolitical conditions. In contrast, the “Individual Life Goals, Preferences, and Concerns” category comprised 89 open codes, focusing on disinterest in having children and the intention to postpone childbearing for various personal reasons. The results indicate that factors such as the role of an uncertain future arising from economic, social, and cultural challenges on fertility decisions, along with delays in childbearing due to prioritizing personal development goals, are critical considerations that must be addressed to ensure the success of new pronatalist policies in Iran.
16. Prevalence and Correlates of Behavioural Risk Factors for Non-Communicable Diseases Among Allied Health Undergraduate Students in Ghana: A Cross-Sectional Study.
期刊: Health science reports 发表日期: 2025-Jul 链接: PubMed
摘要
Non-communicable diseases (NCDs) are noninfectious diseases mostly marked by complex aetiology with different risk factors. They develop from an interplay between modifiable and non-modifiable risk factors, which are of great concern to the public as they mostly lead to varied metabolic changes. This study assessed the prevalence and correlates of behavioural risk factors of non-communicable diseases among undergraduate allied health students in Ghana. This was a cross-sectional study that used a pretested and structured questionnaire to collect data from 228 participants. The data was analysed using SPSS. Logistic regressions and Chi-squared tests were employed to assess the associations between sociodemographic factors and each NCD risk factor. Statistical significance was set at p ≤ 0.05. About 87.3% of undergraduate allied health students practised unhealthy dietary patterns. Only 45.2% were physically active. Being a Nonresident student was associated with drinking alcohol (OR = 2.5; 95%CI = 1.1-5.9). Male undergraduate students were less likely to be physically inactive (OR = 0.4; 95%CI = 0-0.9) while community nutrition students were less likely to engage in unhealthy diet practices (OR = 0.7; 95%CI = 0.2-1.3). Female proportions among those with one (60.7%, p = 0.02) and two (61.9%, p = 0.01) risk factors were high. A greater portion of the students with unhealthy dietary (81.4%, p = 0.032) and physical inactivity (69.5%, p = 0.010) patterns were 18-24 years old. Most participants with one (61.8%, p = 0.04) and two (69.5%, p < 0.001) behavioural risk factors were all 18-24 years old. The findings of this study highlight a concerning trend of poor dietary habits and physical activity patterns among undergraduate allied health students. Despite being future healthcare professionals, these students exhibited suboptimal behaviours that can negatively impact their own health and well-being, as well as their ability to provide effective health promotion and education to their future patients. Healthcare educators and administrators should recognize the importance of promoting a healthy campus environment that supports students’ physical and mental well-being.
17. Assessment of genetically modified soybean DBN9004 (application EFSA-GMO-BE-2019-165).
期刊: EFSA journal. European Food Safety Authority 发表日期: 2025-Jul 链接: PubMed
摘要
Genetically modified soybean DBN9004 was developed to confer tolerance to glufosinate-ammonium- and glyphosate-containing herbicides. These properties were achieved by introducing the cp4 epsps and pat expression cassettes. The molecular characterisation data and bioinformatic analyses do not identify issues requiring food/feed safety assessment. None of the identified differences in the agronomic/phenotypic and compositional characteristics tested between soybean DBN9004 and its conventional counterpart needs further assessment. The GMO Panel does not identify safety concerns regarding the toxicity and allergenicity of the CP4 EPSPS and PAT proteins as expressed in soybean DBN9004 and finds no evidence that the genetic modification would change the overall safety of soybean DBN9004, as food and feed. In the context of this application, the consumption of food and feed from soybean DBN9004 does not represent a nutritional concern in humans and animals. The GMO Panel concludes that soybean DBN9004 is as safe as the conventional counterpart and non-GM soybean varieties tested, and no post-market monitoring of food/feed is considered necessary. In the case of release of soybean DBN9004 material, including viable grains, into the environment, this would not raise environmental safety concerns. The post-market environmental monitoring plan and reporting intervals are in line with the intended uses of soybean DBN9004. The GMO Panel concludes that soybean DBN9004 is as safe as its conventional counterpart and the tested non-GM soybean varieties with respect to potential effects on human and animal health, and the environment.
18. Rare Case of Tongue Metastasis From Lung Adenocarcinoma, With White Coating Appearance.
期刊: Respirology case reports 发表日期: 2025-Jul 链接: PubMed
摘要
Tongue metastasis from other organs is rare, especially from lung cancer. However, in lung cancer cases, the tongue should be considered as a potential site for distant spread.
19. A Comparative Analysis of Departments of Medical Education at Four LCME Accredited Schools.
期刊: Medical science educator 发表日期: 2025-Jun 链接: PubMed
摘要
The authors sought to determine common features, challenges, and benefits of departments of medical education (DMEs) at LCME accredited medical schools. The authors utilized a multi-case case study approach to examine each department. Data were compiled in a constant comparative methodology, which included an iterative peer reviewing process by the researchers. Financial resources were similar at the DMEs, relying on allocations from varied sources, including tuition. Two departments were the home for faculty teaching in the MD program-particularly the basic/foundational sciences. Two provided some teaching for MD students but had other primary roles. One included teaching in graduate programs and another being a home for MD degree faculty administrators in the undergraduate, graduate, and continuing medical education programs. The results inform plans to develop a DME, which should be distinguished to align with an institution’s mission and needs. DMEs serve as a home for faculty contributing to the educational mission and provide a route for medical educators to seek promotion/tenure outside of traditional departments. DMEs provide synergies to innovate, produce educational scholarship, and access resources for medical educator faculty development. Challenges include finding a physical home and fitting into traditional department frameworks. DMEs are often subjected to administrative resource allocation. Leaders may need to seek alternative funding. Future studies should consider a comprehensive analysis that would significantly provide greater details and a clearer picture into DMEs.
20. Long-Term Impact of an Interprofessional Health Promotion Curriculum in Healthcare Students.
期刊: Medical science educator 发表日期: 2025-Jun 链接: PubMed
摘要
Health promotion (HP) curricula are essential for health professions education but currently lack strong long-term evidence for effectiveness. This project aimed to evaluate the multilevel long-term impact of an HP curriculum on healthcare students. An HP curriculum incorporating ten evidence-based interventions was implemented for healthcare students. Participants’ reactions and impact on learning, HP behaviors, and well-being change were collected through electronic surveys administered pre-, post-, and 6 months post-curriculum. Data analysis was conducted using STATA, Mplus, and ATLAS.ti. A total of 552 students (medical, nursing, counseling, physical therapy, and social work) completed the HP curriculum. Participants demonstrated improved awareness of distress factors (p < 0.01) and perceived value of (p < 0.01) and willingness to engage in HP behaviors (p < 0.01). Willingness to try HP interventions correlated significantly with perceived value (r = 0.73, p < 0.05). Most students (92%, n = 505) adopted HP interventions, with the highest rates for healthy sleep (23%, n = 146) and exercise (18%, n = 117). Six months post-curriculum, 92% of 153 respondents confirmed improved health and well-being, particularly in mood (33%, n = 51) and reduced stress (19%, n = 29). Overall, 47% (n = 258) valued the HP curriculum. Interestingly, medical students reported the lowest perceived value among professions (p < 0.01). This study demonstrates the long-term effectiveness of an interprofessional HP curriculum, addressing all levels of the Kirkpatrick pyramid (reaction, knowledge, behavior, and results). This HP curriculum offers a scalable solution for academic institutions aiming to enhance and sustain the health and well-being of healthcare students.
21. Work Smarter Not Harder: Mapping Interprofessional Education Collaboration Core Competencies Across Curricula.
期刊: Medical science educator 发表日期: 2025-Jun 链接: PubMed
摘要
Integrating Interprofessional Education and Collaborative Practice (IPECP) into health professions curricula is recognized as a challenging task due to factors such as timing, curriculum overload, and resource availability. This study aimed to identify opportunities within courses across all health professions that would help students achieve the Interprofessional Education Collaborative (IPEC) Core Competencies. These competencies include (1) Values and Ethics, (2) Roles and Responsibilities, (3) Interprofessional Communication, and (4) Teams and Teamwork. A quantitative, cross-sectional document review was conducted, analyzing curriculum maps and documents from 11 healthcare professions at a South African university. This process involved 22 participants, comprising two representatives from each profession who possessed expertise in the content and teaching methods relevant to their field. They completed a structured survey using the REDCap platform, with guidance from the first author, who was knowledgeable about the IPEC competencies. The results indicated that the curricula of all professions incorporated the IPEC Core Competencies. Notably, the Values and Ethics competencies had the highest representation (mean = 101.2), while Teams and Teamwork were the least represented (mean = 64.6). Thus, the analysis of the curriculum maps provided valuable insights for curriculum planners, allowing them to identify gaps and overlaps. This information serves as a foundation for developing an integrated, longitudinal, evidence-based IPECP curriculum.
22. The impact of the PEPFAR funding freeze on HIV deaths and infections: a mathematical modelling study of seven countries in sub-Saharan Africa.
期刊: EClinicalMedicine 发表日期: 2025-May 链接: PubMed
摘要
On January 24, 2025, the United States government issued an executive order to freeze all foreign aid programs, including The President’s Emergency Plan for AIDS Relief (PEPFAR), for 90 days. A limited waiver option became available, but its implementation remains incomplete. We estimated the impact of these policy changes on HIV deaths and new infections in seven sub-Saharan African (SSA) countries-Ethiopia, Kenya, Malawi, South Africa, Tanzania, Zambia, and Zimbabwe -, which together account for about half of all people living with HIV in SSA. We used STDSIM, an established individual-based simulation model, and previously published quantifications for the seven countries. We predicted changes in HIV deaths and new infections over the period 2025-2030 for four scenarios: (1) Executive order-proportional, where treatment disruption was proportional to the country-specific PEPFAR’s share of total HIV funding; (2) Executive order-realistic, assuming near-total system collapse due to program dependencies; and (3-4) Waiver scenarios where treatment was resumed after 4 or after 8 weeks. Resumptions of programs accounted for delays due to organizational and logistical challenges. A 90-day funding freeze would result in 60 thousand [95% UI: 49-71 thousand] excess HIV deaths for the Executive order-proportional scenario. This number would increase to 74 thousand excess HIV deaths [95% UI: 63-89 thousand] for the Executive order-realistic scenario. Under a 4-week and 8-week waiver scenario, projected excess HIV deaths ranged between 21 thousand [95% UI: 15-28 thousand] and 28 thousand [95% UI: 22-36 thousand] respectively. Excess new infections ranged between 35 and 103 thousand for the different scenarios. The sudden cessation of PEPFAR funding likely results in tens of thousands of HIV deaths and new infections. These losses of life and health should compel the United States government to rapidly and fully re-instate one of the most successful health programs in history. None.
23. An Analysis of Child Abuse Detected by Skeletal Surveys Before and During the COVID-19 Pandemic.
期刊: Pediatric discovery.. 发表日期: 2025-Mar 链接: PubMed
摘要
The COVID-19 pandemic and the stay-at-home order may have impacted the risk of child physical abuse (CPA). Analyzing injury types in suspected CPA cases before and during the pandemic can provide valuable insights. The objective of this study is to compare the incidences and types of injuries detected by skeletal surveys in suspected CPA cases at a large academic children’s hospital before and during the COVID-19 pandemic. The study compared the incidences and proportion of specific injury sites, types of traumas, and demographic characteristics before and during the pandemic using Pearson’s chi-squared and Fisher’s exact tests. A total of 479 patients who underwent skeletal surveys were included, with 306 patients sampled before the pandemic (63.8%) and 173 patients sampled during the pandemic (36.1%). There were no significant differences in age, gender, or ethnicity between the two groups. Highly suspicious CPA incidences were similar before (0.87/month) and during (0.81/month) the pandemic, reflecting 10.5% and 11.6% of all patients who underwent skeletal surveys, respectively. There were no significant demographic differences between the groups. However, the proportion of patients with intracranial or retinal hemorrhage significantly decreased (p < 0.05) during the pandemic, with no significant differences in types of skeletal fractures. In conclusion, the overall incidence of CPA remained similar before and during the pandemic. The significant decrease in intracranial and retinal hemorrhages suggests a potential change in injury patterns or reporting. Further research is needed to understand the factors contributing to these findings. This study is a retrospective clinical trial and therefore not subject to clinical trial registration requirements.
24. Growth parameters and food frequently consumed by Basotho children aged 6-24 months old at Maseru and Leribe districts of Lesotho: A cross-sectional study.
期刊: Pediatric discovery.. 发表日期: 2025-Mar 链接: PubMed
摘要
Undernutrition in children remains a public health concern. Despite the global efforts to address undernutrition, Lesotho continues to bear the highest burden of childhood undernutrition. The study assessed the anthropometric measurements and dietary intake of children aged 6-24 months. A descriptive cross-sectional study was conducted among 113 mother-child dyads attending clinic visits at Makoanyane Military Hospital (Maseru district); n = 50 and Motebang Hospital (Leribe district); n = 63. A structured sociodemographic and feeding practices questionnaires based on adapted World Health Organization (WHO) questionnaires were used. The usual food consumption was collected using an unquantified food frequency questionnaire. Anthropometric measurements and z scores computation were done as per WHO standard guidelines. Statistics included percentages for categorical variables and means for continuous variables. The percentage of continued breastfeeding was 54.0% in Maseru and 28.6% in Leribe districts. Complementary feeds were introduced at the mean age of 5.3 ± 1.0 (Maseru) and 5.2 ± 1.3 months (Leribe). In Leribe, 84.1% of children were consuming maize porridge every day while in Maseru, 68.0% of children were consuming commercial baby cereal every day. The prevalence of wasting was 10.0% (Maseru) and 20.6% with 14.3% of severe wasting (Leribe). A higher percentage of stunting was observed in Leribe (36.5%) than in Maseru (20.0%) (p < 0.001). The prevalence of moderate and severe stunting was 8.0% and 12.0% in Maseru and 20.6% and 15.9% in Leribe, respectively. The prevalence of stunting is alarmingly high in Leribe. The findings suggest an urgent need to strengthen maternal and child health and nutrition programs to ameliorate feeding practices and nutritional status.
25. Mortality trends in suicide among pediatric and adolescent patients aged 15-24 years in Mississippi, 2012-2022.
期刊: Pediatric discovery.. 发表日期: 2025-Mar 链接: PubMed
摘要
Due to the lack of studies examining suicide trends and its implications on pediatric populations, this study aimed to address the gap in research and to identify the magnitude and the impact of suicide by exploring trends in suicide among Mississippians from 2012 to 2022. The study uses data from the Mississippi Statistically Automated Health Resource System, which is an online database with data collected from vital statistics. Joinpoint regression models were used to calculate annual percentage change (APC) and average annual percentage change (AAPC) as an indicator of trends. The overall age-adjusted suicide rate increased from 9.4 deaths per 100,000 in 2012 to 10.8 deaths per 100,000 in 2022 for pediatric and adolescent patients aged 15-24 years (14.9% increase). There are upward trends for females (AAPC, 6.33%, 95% CI, -0.82%-16.82%), Blacks (AAPC, 7.72%, 95% CI, 2.19%-16.47%), and other races (AAPC, 7.59%, 95% CI, -0.83%-21.47%). Males had a downward trend from 2015 to 2022 (APC, -1.46%, 95 CI, -14.05%-1.35%). Whites also had a downward trend from 2017 to 2022 (APC, 4.74%, 95% CI, -15.42% to -0.96%). This study identified an overall increase in suicide. However, trends varied by gender, race, and age. Based on the findings, Mississippi needs more initiatives aimed toward equitable prevention of suicide among youth and the implementation of gun control policies. By implementing these measures, Mississippi could tremendously benefit and improve mental health outcomes and reduce suicide within the state.
26. Adverse drug reaction signal detection via the long short-term memory model.
期刊: Frontiers in pharmacology 发表日期: 2025 链接: PubMed
摘要
Drug safety has increasingly become a serious public health problem that threatens health and damages social economy. The common detection methods have the problem of high false positive rate. This study aims to introduce deep learning models into the adverse drug reaction (ADR) signal detection and compare different methods. The data are based on adverse events collected by Center for ADR Monitoring of Guangdong. Traditional statistical methods were used for data preliminary screening. We transformed data into free text, extracted text information and made classification prediction by using the Long Short-Term Memory (LSTM) model. We compared it with the existing signal detection methods, including Logistic Regression, Random Forest, K-NearestNeighbor, and Multilayer Perceptron. The feature importance of the included variables was analyzed. A total of 2,376 ADR signals were identified between January 2018 and December 2019, comprising 448 positive signals and 1,928 negative signals. The sensitivity of the LSTM model based on free text reached 95.16%, and the F1-score was 0.9706. The sensitivity of Logistic Regression model based on feature variables was 86.83%, and the F1-score was 0.9063. The classification results of our model demonstrate superior sensitivity and F1-score compared to traditional methods. Several important variables “Reasons for taking medication”, “Serious ADR scenario 4”, “Adverse reaction analysis 5”, and “Dosage” had an important influence on the result. The application of deep learning models shows potential to improve the detection performance in ADR monitoring.
27. The association between obesity-related indicators and female infertility: the United States National Health and Nutrition Examination Survey, 2013-2018.
期刊: Frontiers in endocrinology 发表日期: 2025 链接: PubMed
摘要
Infertility is a public health issue closely related to obesity. However, the relationship between obesity-related indicators and infertility is currently uncertain. The present study aimed to explore the association between obesity-related indicators and female infertility. This cross-sectional study included data for 2,875 adult females aged 20-45 years from the National Health and Nutrition Examination Survey conducted between 2013 and 2018. Logistic regression models, restricted cubic spline (RCS), and receiver operating characteristic (ROC) analyses were used to evaluate the relationship between obesity-related indicators [body shape index (ABSI), weight-adjusted waist index (WWI), body roundness index (BRI), waist-to-height ratio (WHtR), non-HDL cholesterol to HDL cholesterol ratio (NHHR), relative fat mass (RFM), body mass index (BMI), and waist circumference (WC)] and female infertility. Adult females were divided into five groups based on their ABSI, WWI, BRI, WHtR, NHHR, RFM, BMI, and WC. Individuals in the highest quintile for ABSI, WWI, BRI, WHtR, NHHR, RFM, BMI, and WC had a higher risk of infertility compared to those in the lowest quintile. The respective adjusted odds ratio values were 1.65 (95% confidence interval (CI), 1.14 to 2.42), 1.71 (95% CI, 1.15 to 2.57), 2.09 (95% CI, 1.39 to 3.19), 2.09 ( 95% CI, 1.39 to 3.19), 1.71 (95% CI, 1.14 to 2.59), 2.09 (95% CI, 1.39 to 3.19), 2.10 (95% CI, 1.40 to 3.18), and 2.28 (95% CI, 1.52 to 3.47). The p for trend values were 0.027, <0.001, <0.001, <0.001, 0.002, <0.001, <0.001, and <0.001after controlling for a series of confounding factors. RCS analyses showed a linear correlation between ABSI, WWI, BRI, WHtR, RFM, BMI, and WC and infertility (P nonlinear > 0.05). A nonlinear association was observed between NHHR and infertility (P nonlinear = 0.006). The ROC curve demonstrated that BRI, WHtR, RFM, and WC exhibited relatively high diagnostic efficiency for infertility, particularly among women aged 20-35 years. The WHtR, RFM, WC, and BRI are superior to BMI in predicting and diagnosing infertility, particularly among individuals aged 20-35 years. Consequently, these indices show promise as more effective tools for identifying populations at an early risk of infertility. To confirm these findings, future studies, such as Mendelian randomization or cohort studies, are warranted.
28. Impact of Symptoms of Late-Onset Hypogonadism as a Potential Driver of Presenteeism.
期刊: American journal of men’s health 发表日期: 2025 链接: PubMed
摘要
Presenteeism, defined as attending work despite physical or mental health issues that impair full productivity, is a prevalent concern with significant implications for workplace efficiency and employee well-being. Testosterone, the primary male sex hormone, plays a vital role in sustaining physical energy, cognitive function, and emotional stability-key factors for optimal work performance. This study explores the association between late-onset hypogonadism (LOH) and presenteeism, emphasizing how LOH-related symptoms such as fatigue, reduced libido, erectile dysfunction, and mood disturbances may contribute to reduced workplace productivity. Data from 96 male patients aged 27 to 76 years, who sought treatment at a university hospital for LOH-related symptoms, were analyzed using blood tests and validated questionnaires, including the Aging Males’ Symptoms (AMS) scale, Work Functioning Impairment Scale (WFun), and Sexual Health Inventory for Men. Significant correlations were observed between AMS scores and both work functioning impairment and erectile dysfunction, indicating a strong link between LOH symptoms and presenteeism. In addition, symptoms such as fatigue, diminished motivation, and poor sleep quality were identified as exacerbating factors for work-related impairments. The greatest strength of this study lies in its focus on clinically diagnosed LOH patients, a factor that significantly distinguishes it from prior research on presenteeism in general working populations. This study underscores the potential benefits of testosterone replacement therapy, lifestyle modifications, and workplace wellness programs in addressing presenteeism among employees with LOH. Further research is necessary to assess the efficacy of these interventions in mitigating presenteeism and improving employee well-being.
29. Consumption patterns and key motivational drivers: an analysis of food behavior in Spanish households.
期刊: Frontiers in nutrition 发表日期: 2025 链接: PubMed
摘要
Based on data collected in a market study, this analysis examines the food consumption patterns of Spanish households and the main individual motivations behind the use of these foods in each consumption occasion. A descriptive cross-sectional observational study was conducted using the “Household Usage Panel” (2023). Individual food consumption at home was recorded through an online survey over the course of a full week, twice a year, throughout the year. For each consumption occasion, the primary reason for the food choice was also recorded, selected from predefined options: “product was available,” “for health,” “by habit,” “taste,” “for pleasure/I felt like it,” and “quick/easy to prepare.” The sample included 5,207 individuals (4,000 households), representative of the Spanish population, excluding the Canary Islands, Ceuta, and Melilla. The food groups used by more than 80% of the panelists include cereals and cereal products, vegetables, meat, fish, milk and dairy products, and fruit. For all products combined, 80.2% of consumers reported that, on at least one consumption occasion, the primary reason for use was “for taste,” 77.1% “for pleasure/I felt like it” followed by “health” (68.4%), “product was available” (59.2%), “habit” (55.3%), and “quick/easy to prepare” (47.6%). For each food group, the primary reason for use varied by occasion, with “for taste” and “for pleasure/I felt like it” chosen by a higher percentage of consumers. An exception was found with the fruit and olive oil groups, where the main reason for consumption chosen by a larger percentage of consumers on some occasions was health (57.4 and 30.8%, respectively). Understanding the motives behind food consumption in Spanish households helps us better grasp specific dietary behaviors. Taste and pleasure have been identified in this study as key factors in food choices at home. These insights suggest the need for a renewed approach to food policies and interventions that promote healthy eating, with the potential for lasting improvements in dietary quality over the medium to long term.
30. A Statistical Framework to Detect and Quantify Operator-Learning Curves in Medical Device Safety Evaluation.
期刊: Medical devices (Auckland, N.Z.) 发表日期: 2025 链接: PubMed
摘要
Safety issues leading to patient harm and significant costs have been identified in several post-market medical devices. Recently, powerful learning effects (LE) have been documented in numerous medical devices. Correctly attributing safety signals to learning or device effects allows for appropriate corrective actions and recommendations to improve patient safety. To develop and assess the statistical performance of an analytic framework to detect the presence of LE and quantify the learning curve (LC). We generated synthetic datasets based on observed clinical distributions and complex feature correlations among patients hospitalized at US Department of Veterans Affairs facilities. Each dataset represents a hypothetical early experience in the use of high-risk medical devices, with a device of interest and a reference device. The study blinded the analysis team to the data-generation process. We developed predictive models using generalized additive models and estimated LC parameters using the Levenberg-Marqualdt algorithm. We evaluated the performance using sensitivity, specificity, and likelihood ratio (LR) in detecting the presence of LE and, if present, the goodness-of-fit of the estimated LC based on the root-mean squared error. Among the 2483 simulated datasets, the median (IQR) number of cases was 218,000 (116,000-353,000). LE were detected in 2065 of the 2291 datasets for which learning was specified (sensitivity: 90%; specificity: 88%; LR: 7). We adequately estimated the LC in 1632 (81%) of the 2013 datasets in which LE was detected and estimated LC. This study demonstrated the framework to be robust in disentangling LE from device safety signals and in estimating LC. In medical device safety evaluation, the operator-learning effects associated with the safety of medical devices can be effectively modeled and characterized. This study warrants subsequent framework validation by using real-world clinical datasets.
31. COVID-19 testing experiences and attitudes among young adults and socially isolated older adults living in public housing, New York City (2022).
期刊: Frontiers in public health 发表日期: 2025 链接: PubMed
摘要
As part of an initiative to increase COVID-19 testing uptake among underserved populations, we conducted focus groups to explore experiences and attitudes related to testing in two understudied groups-young adults and socially-isolated older adults-recruited from residents living in New York City Housing Authority (NYCHA) public housing developments. In June through November 2022, we conducted eight virtual focus groups with 21 young adults and 11 older adults living in NYCHA (n = 32 total). To identify themes, we conducted a rapid qualitative analysis approach. Residents discussed four overarching themes: (1) trusted COVID-19 information sources; (2) reasons for testing; (3) barriers to testing, and (4) strategies to increase testing uptake. Findings were similar across the two age groups; both cited multiple sources of information, including major media outlets, government or public health officials, and doctors. Young adults were more likely to access information from social media despite concerns about misinformation. Participants identified several barriers to testing, such as long lines, insurance coverage, and cost. Young adults reported that at-home COVID testing was more convenient, while older adults expressed concern about accuracy and administering the tests themselves. Recommendations for improving testing emphasized easier access via a central well-known location, in-home visits, free or low-cost tests, and increased outreach. Mainstream media, doctors and public agencies remain the most trusted sources of information among younger and older residents alike. Many resident recommendations involved leveraging NYCHA infrastructure, highlighting the continuing role public housing authorities can play in COVID-19 and other health initiatives.
32. Investigation and analysis of the radiation protection status of radiation workers during the peri-pregnancy period.
期刊: Frontiers in public health 发表日期: 2025 链接: PubMed
摘要
Radiation exposure during pregnancy poses serious risks to fetal health, including increased likelihood of miscarriage, preterm birth, congenital anomalies and developmental disorders, while also impacting maternal occupational safety. This study aimed to assess the concerns and needs of radiation practitioners regarding radiation exposure during the perinatal period, with a focus on radiation protection. A questionnaire survey of 147 radiation practitioners from public and private hospitals was conducted to assess their knowledge, concerns and needs regarding radiation protection during the peri-pregnancy period. Statistical analysis was used to compare the importance and implementation of radiation protection in different groups, and chi-squared tests were used to compare differences in policy implementation (public vs. private hospitals), attitudes toward radiation avoidance (male vs. female practitioners) and concerns about fetal exposure across age groups. Public hospitals demonstrated higher rates of radiation protection policies (39.37%) than private hospitals (21.43%). Among female respondents, 95.12% advocated for temporary removal from radiation-related positions when preparing for pregnancy. Of those who gave birth while working in radiation fields, 26.53% ceased radiation work pre-pregnancy, 30.61% avoided it post-pregnancy and 42.85% did not avoid it. Additionally, 86.58% of female respondents emphasized the need to avoid radiation work during breastfeeding. Among the male participants, 47.83% expressed concern about radiation effects on their fetuses compared with 90% of the female participants. Radiation protection measures were more effectively implemented in public hospitals than in other institutions, underscoring the need for standardized policies across all institutions. Female practitioners exhibited heightened concerns about radiation exposure of the fetus and infant, particularly during pregnancy and lactation. Strengthening policies and workplace adjustments are critical to mitigating occupational risks and safeguarding maternal and child health.
33. In-hospital cardiac arrest (IHCA): survival status and its determinants in Malaysian public healthcare.
期刊: PeerJ 发表日期: 2025 链接: PubMed
摘要
In-hospital cardiac arrest (IHCA) remains a significant clinical challenge despite advances in resuscitation and critical care. Enhanced inpatient monitoring and post-IHCA management have improved survival rates and better neurological outcomes at discharge. This study aims to evaluate the IHCA survival rate and analyse key determinants influencing survival status. A cross-sectional study was conducted using retrospective secondary data from a northern referral tertiary public hospital’s cardiac arrest registry, encompassing IHCA cases in patients aged 18 and above between February 1, 2018, and January 31, 2019. The data included patient demographics, clinical characteristics, IHCA event timing, return of spontaneous circulation (ROSC), survival status, and post-arrest neurological outcomes. Patient survival was measured from the initiation of resuscitation to discharge or death, with survival analysis performed. Factors associated with IHCA survival were explored using logistic regression. A total of 934 IHCA cases were analyzed. The mean patient age was 60.8 years, with most being male (63.9%) and of Chinese ethnicity (45.5%). IHCA commonly occurred in non-critical care areas (61.0%), with 79.6% admitted for medical conditions. Successful ROSC was achieved in 43.5% of cases, and 8.2% had a shockable first rhythm. Only 6.4% survived to discharge or 30-day, with 45% having good neurological outcomes. The IHCA survival rate remains low despite advances in resuscitation. Key survival factors include arrest location, shockable rhythms, and CPR-adrenaline dosage ratio. Strengthening early recognition, prompt intervention, and optimized post-arrest care may enhance IHCA outcomes, particularly in non-critical care areas.
34. Healthcare providers' experiences of community-based collaborative care for serious mental illness: a qualitative study in two integrated clinics in South Africa.
期刊: Global mental health (Cambridge, England) 发表日期: 2025 链接: PubMed
摘要
Community-based collaborative care (CBCC) is an internationally recognised model of integrated care that emphasises multidisciplinary teamwork and care coordination. In South Africa, community psychiatry has been integrated into some primary healthcare (PHC) facilities. This study examines healthcare providers’ perceptions of collaboration and its challenges in various integrated care settings. Three main components of CBCC (multidisciplinary teams, communication and case management) were explored through qualitative interviews with 29 staff members in 2 clinics. In Clinic-1, community psychiatry services operate independently in an outbuilding behind the main PHC clinic (“co-located”). In Clinic-2, these services are fully integrated within the PHC clinic (“physically integrated”). Both clinics had multidisciplinary teams, with various staff members conducting case management functions on an ad hoc basis. The physically integrated clinic (due to shared files, physical proximity and a facility manager with mental health experience) had greater levels of communication between the multidisciplinary team. In contrast, the co-located clinic struggled with poor management, unclear reporting structures and reinforced traditional hierarchies, limiting collaboration between the staff members. Integration does not guarantee collaboration. Improving collaboration between mental health and PHC staff requires clear roles, competent managers, CBCC endorsement from PHC clinicians, sufficient human resources and systematic communication channels, such as case review meetings.
35. Constructing and evaluating the physical literacy index for college students in China: a new insight and perspective.
期刊: Frontiers in public health 发表日期: 2025 链接: PubMed
摘要
College students today face significant challenges related to physical literacy, including declining fitness levels and low health awareness. Constructing a scientifically robust index to assess physical literacy in this demographic is essential. We distributed 800 questionnaires via simple random sampling across eight universities, ultimately obtaining 706 valid responses from first- and second-year undergraduate students in Shanghai. Various components of physical literacy-including exercise motivation, attitude, commitment, confidence, body appreciation, willpower, physical activity, and fitness-were measured using established tools. Data analysis was conducted using SPSS 26.0, covering descriptive statistics, reliability and validity assessments, correlation analysis, and difference analysis. The Physical Literacy Index (PLI) for Chinese college students was developed through principal component analysis. The weights for the components were as follows: motivation for sports (0.171), attitude toward sports (0.147), physical fitness (0.163), commitment to sports (0.130), physical activity level (0.105), appreciation of the body (0.122), confidence in sports (0.091), and willpower in sports (0.070). The PLI showed a significant negative correlation with screen time (correlation coefficient of -0.257) and strong positive correlations with other variables, with the lowest correlation coefficient at 0.594, indicating effective calibration. The overall physical literacy level among Chinese college students is concerningly low, with no significant differences found across genders, ages, or regions of origin (p < 0.05). Despite a relatively high pass rate for physical fitness tests (64.16%), only 1.42% achieved excellent grades, and just 21.67% scored good. The physical literacy index of Chinese college students constructed in this study is scientific and valid, but the current situation regarding college students’ physical literacy is worrying. In the future, physical education and health promotion should be emphasized and targeted measures should be taken to improve the physical literacy of college students.
36. Feasibility and preliminary efficacy of an online home-based functional exercise program for Parkinson's disease: a pilot study.
期刊: Frontiers in neurology 发表日期: 2025 链接: PubMed
摘要
Parkinson’s disease (PD) leads to motor and non-motor impairments, contributing to sarcopenia and reduced functional independence. While functional strength exercises can help manage these symptoms, adherence remains challenging, particularly in home-based setting. This pilot exercise intervention study aimed to evaluate the feasibility and efficacy of an 8-week Online Home-Based Exercise Program (OHEP), which provides easy-to-follow functional strength exercises for PD patients, enabling them perform these exercises safely and effectively at home. Fifteen patients with early-stage PD (Hoehn and Yahr Stage 1-2) participated in an 8-week exercise intervention, consisting of a 2-week in-person training followed by a 6-week online home-based exercise session using Zoom. The exercise regimen included softball, bodyweight, elastic band, and step box exercises targeting muscle strength, balance, and mobility. Feasibility was assessed through attrition rate, adherence rate, compliance rate, and safety. Efficacy was evaluated by examining changes in motor and non-motor symptoms, body composition, and physical performance. Three participants withdrew from the study, resulting in an attrition rate of 20%. Feasibility was supported by a high adherence rate (median: 91%) and exercise compliance rates exceeding 93% across all exercise types. No adverse events reported. Among clinical outcomes, depressive symptoms significantly improved (Beck Depression Inventory, p = 0.011). Additionally, lower limb muscle function significantly improved, as reflected by a reduced time in the Five Times Sit-to-Stand test (p = 0.002). However, no significant changes were observed in other clinical or physical performance measures. These findings suggest that a short-term OHEP is feasible and safe intervention for PD patients, with potential benefits in improving depressive symptoms and physical function. However, further randomized controlled long-term studies are needed to better delineate the effects of this intervention in the management of PD. https://cris.nih.go.kr, Identifier: KCT0008302.
37. Association between neighborhood environment and self-reported and objectively measured physical activity in Hispanic families.
期刊: Frontiers in sports and active living 发表日期: 2025 链接: PubMed
摘要
Given the limited information about how neighborhood environment relates to physical activity (PA) in Hispanic families, this work examined cross-sectional associations between perceived neighborhood environment and PA of Hispanic parents and children. Participants were 137 Hispanic parent-child dyads (children aged 6-11 years) in South Phoenix, AZ, USA. Parents completed a survey about their own and their child’s PA, and perceptions of neighborhood environment (i.e., scores of walking/cycling, neighborhood aesthetics, traffic safety, and crime rate) using NEWS survey. Participants also wore an accelerometer for 7 days. Children engaged in 60 min of moderate-to-vigorous PA (MVPA) on 2.3, and parents in 30 min of MVPA on 2.1 days per weeks. Additionally, children engaged in 104.4 min, and parents in 65.3 min of accelerometer-assessed MVPA per day. Participants rated their neighborhood (range 0-4) as favorable regarding walking/cycling (mean score 3.1), aesthetics (2.4), traffic safety (2.5), and crime rate (3.1). In Spearman correlation analyses, better neighborhood aesthetics was associated with higher accelerometer-assessed MVPA in children (r = 0.25, p = 0.04). Multiple linear regression analyses revealed an association between traffic safety and parent-reported MVPA in children (standardized beta coefficient 0.19, p = 0.03). No further associations between scores of neighborhood environment and physical activity in either children or parents were observed. Our findings may underscore the importance of neighborhood aesthetics and traffic safety for PA engagement in children. Longitudinal studies are needed to confirm our observations, and to untangle potential mechanisms linking neighborhood environment and PA in understudied populations such as Hispanics.
38. Knowledge, attitudes, and practices regarding malaria in rural Uganda: a cross-sectional study.
期刊: MalariaWorld journal 发表日期: 2025 链接: PubMed
摘要
Malaria is endemic in 96% of Uganda, making targeted malaria prevention programming critical to malaria elimination. In areas with low transmission rates prevention resources are limited to mass distribution of bednets every three years. Mosquito nets remain one of the most efficient and affordable malaria prevention strategies. While net distributions have increased net ownership, that has not translated to a comparable increase in net use. The Luwero District is one of two areas with increased rates of severe malaria between 2017-2021. Findings from previous studies indicate that there are a variety of factors associated with individuals choosing not to use a net even when available. This study examined community members’ knowledge about malaria, their prevention methods, net ownership, net characteristics, and net use. Using a convenience sample of 106 adults, quantitative data were collected using a structured, in-person survey in four villages in central rural Uganda. Questions and response categories were read aloud; the researcher documented each response electronically. Descriptive statistics were used to characterise the sample populations. Theoretical constructs were compared between those with and without a recent diagnosis of malaria with the household. Logistic regression was used to determine the association between the theoretical constructs and recent malaria diagnosis after controlling for demographic characteristics. Findings from this study indicate high rates of net ownership and self-reported use within the rural areas. Perceived susceptibility and barriers were greater among those with a recent diagnosis of malaria within the household. The positive association remained significant after controlling for household size. Understanding the specific factors related to individuals’ knowledge and use of bednets is key to reducing rates of severe malaria.
39. Equipping community health workers in Rwanda to deliver a gender transformative parenting program to prevent violence against women and children at scale.
期刊: Frontiers in reproductive health 发表日期: 2025 链接: PubMed
摘要
In Rwanda, the Bandebereho program has demonstrated long-term reductions in intimate partner violence (IPV) and violence against children. Since 2019, the program has partnered with government to train community health workers (CHWs) to deliver at scale. Evidence on how to equip CHWs to deliver Bandebereho, or similar programs, with quality and fidelity is needed to support scaling. This study sought to assess the impact of training on CHWs and their capacity to deliver Bandebereho during scale up. A pre/post, follow-up study was conducted with 573 CHWs in Burera district. Data were collected at three time points over 20 months using self-administered questionnaires (pre/post) and a follow-up phone survey. Questionnaires gathered data on CHW attitudes about gender roles and violence, self-reported skills, knowledge and confidence to implement Bandebereho, and training impacts on partner relations and community work. Informed consent was obtained from all study participants. The pre-survey was completed by 562 CHWs and 564 CHWs completed the post-survey after six to nine months. The phone survey was administered to 506 CHWs at follow-up (at 17-19 months). Analysis of changes between pre- and post-surveys found CHWs had more equitable gender attitudes after the training. Linear regression analysis found that CHWs with some secondary education (coefficient: -2.15, p < 0.01) and more than three years’ experience (coefficient: -2.27, p < 0.001) were less likely to hold inequitable attitudes. At post-survey, CHWs reported a high level of preparedness to implement, regardless of gender. A majority reported improved partner relations, including greater partner support for their community work. At follow-up, a majority of CHWs reported a high degree of comfort and confidence implementing Bandebereho, and benefits to their work and personal relationships. The findings highlight the importance of investing in high-quality facilitator training, which allows sufficient time for facilitators’ own transformation, to maintain quality and fidelity at scale. The findings underscore the importance of a slow and steady approach, with sufficient time to adapt, test, and refine IPV programs for scale, which can also support a progressive handover to government. The findings may support program originators who seek to scale proven IPV prevention programs with government in other settings.
40. Understanding the treatment of acute pancreatitis and its complications -a database for assessing traditional Chinese medicine use.
期刊: Frontiers in pharmacology 发表日期: 2025 链接: PubMed
摘要
Integrative medicine combining traditional Chinese medicine (TCM) with biomedicine has become a notable approach for treating acute pancreatitis (AP). However, the absence of a comprehensive and reliable database to store and organize TCM-related data for the prevention and treatment of AP presents a significant challenge for the development of herbal medicines. To develop a comprehensive, user-friendly platform for browsing, querying, and analyzing TCM-related data for treating AP. TCM-related data for treating AP were systematically extracted from the literature and established databases. The front-end interface was developed using HyperText Markup Language, Cascading Style Sheets, and JavaScript to enhance user experience. The back-end employed Hypertext Preprocessor and My Structured Query Language for improved performance and security. The Smarty template engine was utilized to separate the front-end and back-end, facilitating efficient updates to the TCMAP platform. The current version of the TCMAP includes: (i) documentation of 200 evidence-based TCM formulations, with comprehensive details on clinical applications, targets related to AP, and target pathway enrichment analysis, including 449 herbs; (ii) records of 58 natural metabolites, involving extensive information on their potential targets and pharmacological properties; and (iii) integration with a web server enables users to conduct similarity and enrichment analyses of input prescriptions based on herbs, metabolites, and genes. Furthermore, TCMAP also supports discovering anti-AP herb pairs with similar metabolites and targets. Network analysis further provides users with the intrinsic properties of anti-AP formulations. The TCMAP provides a robust data platform for predicting new metabolites and exploring the potential mechanisms of TCM in treating AP. The TCMAP is accessible at https://cellknowledge.com.cn/tcmap.
41. Unveiling therapeutic targets and preventive components for kidney insufficiency and blood stasis-type BPH: bridging metabolomics, network pharmacology and reverse screening.
期刊: Frontiers in pharmacology 发表日期: 2025 链接: PubMed
摘要
Benign prostatic hyperplasia (BPH) is a common disease affecting male urinary system function and quality of life, with its incidence increasing due to population ageing and unhealthy lifestyles. Modern medicine mainly adopts symptomatic treatments such as 5-alpha reductase inhibitors and alpha1 adrenergic receptor blockers. However, due to the complex pathogenesis of BPH, these drugs can only partially alleviate symptoms and have shortcomings such as high treatment costs and significant side effects. BPH is similar to the descriptions of “Jīng Lóng” and “Lóng Bì” in traditional Chinese medicine (TCM), and its onset is closely related to liver and kidney dysfunction. Kidney insufficiency and blood stasis are common clinical syndromes of BPH. Compared with modern medicine, treatment based on syndrome differentiation of TCM can achieve good results in treating this subtype of BPH. Therefore, guided by the holistic view of TCM, adopting a holistic and systematic research approach to explore therapeutic targets and potential therapeutic components for BPH with a specific syndrome can provide new ideas for the clinical treatment of BPH. This study integrated clinical metabolomics and network pharmacology to identify therapeutic targets for kidney insufficiency and blood stasis-type BPH. Serum analysis of BPH patients and healthy controls for testosterone, estradiol, SRD5α2, NF-κB p65, and TGF-β levels, alongside metabolomics and network pharmacology, revealed hormonal imbalance, increased inflammatory/fibrotic markers, and 58 differential metabolites in BPH. Pathway enrichment analysis identified 6 key metabolic pathways, while network pharmacology constructed four compound-reaction-enzyme-gene networks and pinpointed 178 potential targets, including 23 core targets. Reverse screening against the Yaozh Database-Natural Product AI Engine Platform matched 11 druggable targets with 49 interacting components, and target-component fitting analysis confirmed the reliability of 8 core targets. This combined approach validated the findings of hormonal imbalance and significant metabolic pathway changes and provided valuable insights for BPH treatment and drug development.
42. Cross-sectional study on the association between 24-hour urinary potassium excretion and the risk of H-type hypertension and non-H-type hypertension in Chinese adults.
期刊: Frontiers in endocrinology 发表日期: 2025 链接: PubMed
摘要
Reports on urinary potassium excretion and H-type hypertension remains rare. We aimed to describe the relationship between 24-hour (h) urinary potassium excretion and the risk of H-type hypertension and non-H-type hypertension, thus to guide personal and public health campaigns including dietary recommendations to lower H-type hypertension and non-H-type hypertension in China. In 2020 in Zhejiang, China, a cross-sectional survey on Salt Reduction and Prevention of Hypertension was conducted by using a stratified multistage random sampling strategy, with participants aged 21 to 72 years. Standardized questionnaires, physical examinations and laboratory measurements were carried out among them, as well as survey on knowledge, attitudes, and behavior (KAB) correlated with salt and hypertension. 24-h urine specimens were collected for sodium and potassium excretion measurement. Subjects were divided into three groups, normal blood pressure, non-H-type hypertension and H-type hypertension, according to their blood pressure, self-reported history of hypertension and blood homocysteine (Hcy) levels. 1141 participants with complete information were obtained with the median age of 53 years, 46.0% were males, 41.7% were hypertension, among which 80.5% were H-type hypertension. The median Hcy and 24-h urinary potassium were 11.7μmol/L and 40.83 mmol/24h, respectively. After controlling for confounding factors, logistic regression analysis displayed that for every 1 mmol/L increase in 24-h urinary potassium excretion, the risk of H-type hypertension and non-H-type hypertension decreased by 1.4% (OR=0.986, 95% CI: 0.978-0.995, P=0.002) and 1.7% (OR=0.983, 95% CI: 0.968-0.998, P=0.025), respectively. Restricted cubic spline (RCS) curves showed that with the increase of 24-h urinary potassium excretion, the risk of both H-type hypertension (P= 0.008) and non-H-type hypertension (P=0.027) decreased, while there were no nonlinear dose-response relationships between 24-h urinary potassium excretion with both H-type hypertension (P for non-linearity = 0.881) and non-H-type hypertension (P for non-linearity = 0.101). Participants’ level of KAB in H-type hypertension group presented a lower percentage (86.2%) knowledge of the risk factors of hypertension, a highest percentage (12.5%) of self-assessment of excessive salt intake, but a lowest percentage (23.0%) of taking initiative to reduce salt intake. 24-h urinary potassium excretion was negatively associated with the risk of both H-type hypertension and non-H-type hypertension, with a more stable negative response observed in H-type hypertension across logistic models and RCS curves. It is recommended that hypertension particularly H-type hypertension patients strengthen their KAB regarding salt reduction and hypertension, adopt reasonable dietary patterns, to improve potassium intake, and ultimately aid in better Hcy and blood pressure management.
43. The association between the dietary index for gut microbiota and its components with cardiovascular disease risk: a cross-sectional study based on NHANES.
期刊: Frontiers in nutrition 发表日期: 2025 链接: PubMed
摘要
Cardiovascular disease (CVD) is a leading cause of mortality worldwide, and its development and progression are closely associated with diet-induced changes in gut microbiota. This study aims to investigate the relationship between the dietary index for gut microbiota (DI-GM) and its components, including the beneficial gut microbiota score (BGMS) and the unfavorable gut microbiota score (UGMS), in relation to cardiovascular disease. We conducted a cross-sectional study using National Health and Nutrition Examination Survey (NHANES) data (1999-2020), collecting baseline sociodemographic and health-related data from 41,193 adults aged ≥20 years. We constructed multivariable weighted logistic regression models to evaluate associations between DI-GM, BGMS, UGMS, and CVD risk, generating weighted restricted cubic spline (RCS) plots to visualize dose-response relationships. Subgroup analyses assessed outcome robustness across sex, age, hypertension, and diabetes subgroups. After adjusting for confounders (age, sex, race, poverty-to-income ratio [PIR index], marital status, and education level, smoking status, alcohol consumption, body mass index [BMI], and comorbidities), significant associations emerged between DI-GM, BGMS, and CVD risk. Increasing DI-GM and BGMS levels showed gradually decreasing CVD risk trends (DI-GM: OR = 0.97, 95% CI: 0.94-1.00, p < 0.05; BGMS: OR = 0.92, 95% CI: 0.88-0.96, p < 0.05). No significant association was found between UGMS and CVD risk (OR = 1.04, 95% CI: 0.99-1.08, p > 0.05). Subgroup analyses revealed more significant DI-GM and BGMS associations with CVD risk in female versus male participants (p for interaction < 0.05). Among adults aged ≥20 years, DI-GM and BGMS showed significant inverse association with CVD risk. Compared to DI-GM, BGMS demonstrates a stronger inverse association with cardiovascular disease risk. These findings underscore the potential crucial role of favorable dietary patterns in cardiovascular disease prevention.
44. The relationship between vitamin D levels and Alzheimer's disease risk: insights from a centenarian study of Chinese women.
期刊: Frontiers in nutrition 发表日期: 2025 链接: PubMed
摘要
While vitamin D₃ (VD₃) has been implicated in Alzheimer’s disease (AD) prevention, limited evidence exists among centenarians-particularly women-who exhibit unique cognitive aging trajectories. This study aimed to examine the association between serum 25-hydroxyvitamin D [25(OH)D] levels and AD risk in Chinese female centenarians. We included 514 female participants aged ≥100 years from the China Healthy Longevity Multicenter Study (CHLMS). AD was diagnosed using education-adjusted MMSE thresholds and clinical exclusion of non-AD dementias. Serum 25(OH)D and biochemical markers were measured using standardized laboratory protocols. Logistic regression models (unadjusted and progressively adjusted) assessed associations between 25(OH)D and AD. Restricted cubic spline (RCS) and piecewise regressions evaluated non-linear and threshold effects, while subgroup analyses explored effect modification. Higher serum 25(OH)D levels were independently associated with lower odds of AD (adjusted OR per 1 ng/mL: 0.95; 95% CI: 0.90-1.00; p = 0.037). Compared to the lowest quartile, participants in the highest quartile had an 87% reduced risk (OR = 0.13; 95% CI: 0.03-0.50; p = 0.007). RCS analysis revealed a significant inverse dose-response relationship, with a potential threshold effect observed at 29.3 ng/mL. Piecewise regression confirmed that the protective association was strongest below this threshold. Subgroup analyses across smoking, hypertension, and early-life indicators showed consistent effects with no significant interactions. Among Chinese female centenarians, serum vitamin D₃ levels are inversely associated with AD risk in a dose-dependent manner, particularly below 29.3 ng/mL. These findings highlight the relevance of vitamin D₃ as a potentially modifiable factor in cognitive aging and support further interventional studies in the oldest-old population.
45. Health benefits of anthocyanins against age-related diseases.
期刊: Frontiers in nutrition 发表日期: 2025 链接: PubMed
摘要
Anthocyanins, a class of polyphenol flavonoids widely present in various fruits and vegetables, have attracted significant attention due to their potent anti-inflammatory, antioxidant, and anti-aging properties. Recent studies indicate that anthocyanins may play important roles in extending life and preventing or treating age-related diseases. This review systematically summarizes the chemical characteristics of anthocyanins and their potential roles in age-related diseases, including lifespan extension, neurodegenerative diseases, skeletal diseases, cardiovascular diseases, cancer, and metabolic syndrome. Furthermore, we explore the effects of anthocyanins on age-related diseases and their potential mechanisms of action to establish a theoretical foundation for future clinical applications.
46. Relationship between uric acid to high-density lipoprotein cholesterol ratio and sarcopenia in NHANES: exploring the mediating role of bilirubin and association with all-cause mortality.
期刊: Frontiers in nutrition 发表日期: 2025 链接: PubMed
摘要
Sarcopenia is a systemic disease characterized by a decline in muscle mass and function. It is associated with adverse health outcomes, and younger patients are at higher risk. Thus, early identification and prevention of high-risk factors are crucial. The uric acid to high-density lipoprotein ratio (UHR) is a novel marker of inflammation and metabolism, but studies on its association with sarcopenia are currently lacking. Data from the National Health and Nutrition Examination Survey (NHANES) 2011-2018 were utilized. Weighted multivariate logistic regression analysis was performed to explore the association between UHR and sarcopenia. Causal mediation analysis was conducted to investigate the mediating role of oxidative stress factors and systemic inflammatory markers in the UHR-sarcopenia relationship. Subgroup analysis and interaction tests were performed to identify high-risk populations for the positive association between UHR and sarcopenia. Restricted cubic spline (RCS) explored potential non-linear relationships between UHR and sarcopenia. Weighted multivariate Cox proportional hazards regression analysis assessed the relationship between UHR and all-cause mortality in sarcopenia patients. A total of 10,308 adult participants aged ≥ 20 years were included in the study, with 901 diagnosed with sarcopenia. The weighted multivariate logistic regression analysis showed a significant positive association between UHR and sarcopenia after adjusting for all confounding factors (OR = 1.057; 95% CI: 1.037-1.077; P < 0.001). Total bilirubin mediated -8.53% of the association between UHR and sarcopenia (95% CI: -13.42% to -5.91%; P < 0.001). The subgroup analysis and interaction test results indicate that the positive association between the two variables is relatively stable across different populations. RCS analysis revealed no significant non-linear relationship between UHR and sarcopenia (P = 0.167). Weighted multivariate Cox proportional hazards regression analysis showed a significant positive association between UHR and all-cause mortality in sarcopenia patients (HR = 1.053; 95% CI: 1.024-1.083; P < 0.001) in the unadjusted model. However, after adjusting for all covariates, UHR maintained a positive association with all-cause mortality in sarcopenia patients (HR = 1.023; 95% CI: 0.990-1.056), though this association did not reach statistical significance (P = 0.173). Elevated UHR shows a significant association with sarcopenia prevalence and exhibits a positive association trend with all-cause mortality among affected individuals. These findings suggest that UHR may serve as a potential indicator for sarcopenia risk assessment. Further prospective studies are warranted to validate its clinical utility for early screening and intervention strategies.
47. The interplay between nutrigenomics and low-carbohydrate ketogenic diets in personalized healthcare.
期刊: Frontiers in nutrition 发表日期: 2025 链接: PubMed
摘要
The field of nutrigenomics explores the interaction between diet and gene expression, examining how nutrients function as signaling molecules that influence cellular processes, protein synthesis, and metabolite production. This discipline aims to design diets that promote genomic stability through various genetic mechanisms, including minimizing DNA damage and epigenetic modifications, among others. Nutrigenomic profiling helps identify individual dietary needs and responses to food interventions. Nutrigenetics, a subfield of nutritional genomics, investigates how genetic variations affect nutrient metabolism and health outcomes. It operates on the principle that genetic differences influence nutrient absorption and metabolism, shaping disease susceptibility and treatment responses. Therefore, integrating nutrigenetics into dietary planning enables the development of personalized nutrition strategies to improve health and prevent disease. One key application of nutrigenomics is its impact on various diets, including the Low-Carbohydrate ketogenic diet (LCKD), a high-fat, low-carbohydrate regimen that induces ketosis. In this metabolic state, ketone bodies serve as energy sources and signaling molecules. Research suggests that LCKD may influence gene expression and epigenetic mechanisms, modulating inflammation-related pathways, oxidative stress, and metabolic regulation. Additionally, KD has been associated with improved insulin sensitivity, glucose control, lipid profiles, and weight loss. However, genetic factors affecting LCKD response require further investigation to refine personalized dietary recommendations. This review highlights the significance of nutrigenomics, focusing on the interplay between the LCKD and genetic factors. A comprehensive understanding of these interactions is essential for developing personalized dietary strategies that optimize LCKD benefits while mitigating potential risks, ultimately contributing to individualized nutritional guidance within a precision health framework.
48. Dietary inflammatory index and non-alcoholic fatty liver disease risk: a systematic review and meta-analysis of observational studies.
期刊: Frontiers in nutrition 发表日期: 2025 链接: PubMed
摘要
Chronic inflammation plays a significant role in the progression of non-alcoholic fatty liver disease (NAFLD). Adopting an anti-inflammatory diet can help prevent or mitigate NAFLD and its associated complications. This meta-analysis builds on previous research by examining the association between the Dietary Inflammatory Index (DII) and NAFLD risk, incorporating additional studies and employing rigorous evidence assessment. We systematically searched major databases (Cochrane Library, PubMed, Web of Science, and Scopus) from inception to June 2024 for English-language observational studies examining the association between DII and NAFLD prevalence. Pooled odds ratios (ORs) or hazard ratios (HRs) with 95% confidence intervals (CIs) were calculated using random-effects models for studies with significant heterogeneity; otherwise, fixed-effects models were applied. Subgroup analyses were conducted to explore heterogeneity based on body mass index (BMI), DII definition, sample size, geographical region, age, and NAFLD diagnostic criteria. Evidence certainty was assessed using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) framework. The study was registered in PROSPERO (CRD42023430798). Eleven studies (9 cross-sectional with 14 effect sizes and 2 cohort with 2 effect sizes) were analyzed. Higher DII scores were significantly associated with increased NAFLD risk, with a pooled OR of 1.56 (95% CI: 1.24-1.95; p < 0.001) in cross-sectional studies and an HR of 0.21 (95% CI: 0.12-0.30; p < 0.0001) in cohort studies. Subgroup analyses confirmed consistency across BMI ≥ 25, energy-adjusted DII or DII, studies in Asia and Europe, and participants <46 years, with reduced heterogeneity (I2 < 50%) in these categories. GRADE rated the certainty of evidence as “very low.” Anti-inflammatory diets can reduce NAFLD risk. However, high-quality studies are needed to confirm this association.
49. Sustainability aspects of food and drinks offered in vending machines at Slovenian universities.
期刊: Frontiers in nutrition 发表日期: 2025 链接: PubMed
摘要
Vending machines offer a convenient way for food distribution, particularly favored by employees, students, and individuals seeking a quick snack. Food vending machines typically offer unhealthy, calorie-dense, and nutrient-poor options, which contribute to the rise of non-communicable diseases. Creating a healthier food environment is crucial, particularly in universities where students are developing their eating habits and becoming more independent. Key considerations for vending machines include the quality, nutritional value, and price of the products with a recent and growing attention toward sustainability. The present study thoroughly examined 30 vending machines across 30 faculties in Slovenia. The analysis focused on assessing the variety and sustainability of the available products. The following was evaluated through three primary criteria, based on the information available on the product label: nutritional quality, environmental impact (palm oil content, packaging materials, and sustainability certificates), and socioeconomic indicators (suitability for people with special dietary needs). The results revealed a low proportion of products met the proposed sustainability criteria, highlighting the need to promote sustainability in the vending machine industry. Although food categories like dairy products, fruits, and nuts have better nutritional profiles, they are underrepresented. In contrast, items like biscuits, crisps, snacks, and pre-prepared sandwiches often exceed recommended fat, salt, and sugar levels. More than one-quarter of products contained palm oil, only two were labeled as palm oil-free, and a limited proportion of products were suitable for individuals with special dietary requirements such as gluten sensitivity and lactose intolerance. Improving the food selection in vending machines, guided by suggested sustainability criteria, presents a promising strategy for reshaping the food environment and promoting sustainable healthy diets, taking into account nutritional, environmental, and socioeconomic indicators.
50. Analysis of the dynamic correlation between chronic comorbidities and health shocks among middle-aged and older adults people in rural mountainous areas of southern Ningxia-from 14 years of follow-up panel data.
期刊: Frontiers in public health 发表日期: 2025 链接: PubMed
摘要
With the acceleration of the aging process, the health shock on the middle-aged and older adults people has become a key issue that urgently needs to be solved. Health shock refers to the long-term fluctuating effect on the future level of family health welfare due to the uncertainty of the health status of family members in the short term. The occurrence of health shocks is related to many factors, among which chronic comorbidity is an important factor affecting the occurrence of health shocks in the middle-aged and older adults people. The purpose of this study was to explore the developmental trajectories and interactions of chronic comorbidities and health shocks in rural residents in the southern mountainous areas of Ningxia. On the basis of health follow-up data from rural middle-aged and older adults people in Ningxia in 2009, 2015, 2019 and 2022, the dynamic associations between chronic comorbidities and health shocks in rural residents in mountainous areas of southern Ningxia were analyzed via the latent growth model (LGM) and cross-lagged model (CLM). The unconditional latent growth model (ULGM) revealed that chronic comorbidities (χ 2 = 26.807, p < 0.001) and health shocks (χ 2 = 64.296, p < 0.001) are increasing in the 14-year period from 2009 to 2022. The parallel latent growth model (PLGM) revealed that the initial level of health shock had a significant positive predictive effect on both the initial level and the rate of change of chronic comorbidities. The change rate of health shocks had a significant positive predictive effect on the initial level of chronic comorbidities and a relatively significant negative predictive effect on the rate of change of chronic comorbidities. The initial level of chronic comorbidities had a significant positive predictive effect on the initial level of health shock and a significant negative predictive effect on the change rate of health shock. The change rate of chronic comorbidity has no significant predictive effect on the initial level and change rate of health shock. The results of the cross-lagged model (CLM) indicate a bidirectional causal association between chronic comorbidities and health shocks. Based on a 14-year tracking data study, this research found that both chronic comorbidities and health shocks were on the rise, and there was a dynamic interaction and bidirectional causal relationship between the two, which could predict each other’s development trends. Based on the empirical results, it is recommended to strengthen the monitoring and management chronic comorbidities to reduce the risk of health shocks. Meanwhile, it is also necessary to closely monitor health shock events, and accordingly optimize the management strategies for chronic comorbidities, thereby reducing the incidence of health shocks among the middle-aged and older adults population, improving the quality of life and health, and promoting the realization of the goal of healthy aging.
51. Research on the association between community environmental perception and residents' intention to relocation-a case study of Guangzhou.
期刊: Frontiers in public health 发表日期: 2025 链接: PubMed
摘要
The community environment is an important factor affecting people’s residential relocation; however, existing literature has primarily focused on the objective aspects of the community environment, with less emphasis on residents’ perception of it. To address this research gap, we selected 74 typical communities and collected 1,568 questionnaires across Guangzhou. We employed factor analysis to capture participants’ community environmental perception and used binary logistic regression to analyze the association between independent and dependent variables. The results show that: (1) There is a significant association between age, household registration, and participants’ residential relocation intention; (2) Community environmental perception can be summarized into three aspects: environmental disorder perception, community attachment, and satisfaction, all of which are significantly associated with participants’ residential relocation intention; and (3) There is a positive association between perception of a disorderly environment and residents’ intention to relocation, and a negative association between community attachment and satisfaction and residents’ intention to relocation. This research is highly significant for enhancing our understanding of factors influencing people’s residential relocation intention and for guiding community construction.
52. Transdiagnostic remission of psychiatric comorbidity in post-traumatic stress disorder, ADHD, and binge-eating disorder using ketogenic metabolic therapy: a retrospective case report.
期刊: Frontiers in nutrition 发表日期: 2025 链接: PubMed
摘要
Psychiatric comorbidities, including post-traumatic stress disorder (PTSD), ADHD, and binge-eating disorder (BED), frequently share overlapping symptoms and metabolic dysfunctions. Disorder-specific treatments may not adequately address these shared biological mechanisms, resulting in suboptimal outcomes. This case report evaluates ketogenic metabolic therapy (KMT) as an intervention specifically targeting these transdiagnostic features. A 38 years-old female with PTSD, ADHD, BED, bipolar II disorder, depression, anxiety, and premenstrual dysphoric disorder diagnoses participated in a structured 8 weeks KMT psychoeducation program, with ongoing weekly professional and peer support up to 24 weeks. Standardized assessments, including the PHQ-9, GAD-7, DASS-21, PCL-5, BES, and CRAVED scales, measured symptom severity at baseline and 4 and 12 weeks. Daily biometric data including blood glucose and ketone levels were collected. Baseline measures indicated severe psychiatric symptoms, notably maximal scores for PTSD and severe binge-eating behavior. By week 12, all psychiatric symptoms resolved evidenced by quantitative reductions to 0 across all validated instruments. The patient consistently reported optimal symptom control when blood ketone levels were maintained between 3 and 5 mmol/L. Qualitative reports substantiated marked functional gains, including improved occupational engagement and social functioning. This report demonstrates the potential of KMT to achieve comprehensive remission in severe, treatment-resistant psychiatric comorbidities. The findings emphasize the necessity for controlled clinical trials to verify optimal therapeutic ketone ranges and establish generalizability across clinical populations experiencing complex psychiatric comorbidities.
53. miRNAs involved in the regulation of exercise fatigue.
期刊: Frontiers in physiology 发表日期: 2025 链接: PubMed
摘要
Exercise-induced fatigue refers to a temporary decline in physiological function resulting from prolonged or high-intensity exercise, which is characterized by decreased muscle strength, diminished exercise performance, and heightened subjective feelings of fatigue. The study of exercise fatigue holds significant importance not only in competitive sports and public health, but also extends to medicine, military applications, and occupational safety. MicroRNA (miRNA) represents a class of non-coding RNA that plays a pivotal role in the regulation of gene expression. The involvement of miRNAs in exercise-induced fatigue has garnered increasing attention within the scientific community. This article provides an overview of fundamental concepts and biological functions associated with miRNAs, defines and classifies exercise fatigue while outlining its physiological changes, emphasizes alterations in miRNA expression during episodes of exercise-induced fatigue, and conducts an in-depth analysis regarding the mechanisms through which miRNAs influence this phenomenon via modulation of energy metabolism, inflammatory responses, and oxidative stress. Furthermore, this article anticipates future research directions as well as potential clinical applications for miRNAs concerning exercise-induced fatigue. This review holds significant importance for elucidating the molecular mechanisms underlying exercise-related fatigue while fostering advancements within sports medicine and rehabilitation science.
54. Barriers and facilitators to implementation of interventions to mitigate moral injury among nurses.
期刊: Frontiers in health services 发表日期: 2025 链接: PubMed
摘要
In the post-pandemic recovery era, addressing moral injury is critical due to high prevalence and impact on mental and occupational health. Interventions that address moral injury in hospital settings are limited. Further, engaging HCWs in any mental health interventions has proven challenging for a variety of reasons and exacerbated by factors such as a rural setting. Implementation science aimed at understanding barriers and facilitators to interventions is needed in order to build and offer interventions that are usable, feasible, acceptable, and effective. The current study aimed to understand such barriers and facilitators to building moral injury interventions for nurses on the medical intensive care unit (MICU). We conducted semi-structured qualitative interviews using the Consolidated Framework for Implementation Science Research (CFIR) and Peer and Academic Model of Community Engagement with 25 participants in a rural hospital system, 19 nurses currently working in the MICU and six nurses who left their MICU employment. Interviews were transcribed and analyzed using a thematic analysis approach. There were five CFIR domains and 14 associated CFIR constructs that impacted intervention implementation in this population. Barriers included resource costs, skepticism regarding the effectiveness of new resources, lack of support from leaders, concerns that emotions affect professional image, inability to take breaks, and a disconnect between nurses’ lived experiences and community perceptions. Facilitators included interventions specifically tailored for the MICU, strengths in teaming and social support among fellow nurses, and a desire for change because of factors such as a high turnover rate. Participants also highlighted a strong motivation to provide the best care possible and a desire to build resilience by supporting each other. Analysis of barriers and facilitators suggests value in improving the opportunities for HCWs to process morally injurious experiences with interventions specific to a particular unit and resources such as peer support and chaplains. There is a demonstrated need for high-level organizational change to address the dynamic needs of our nurses.
55. Correction: Social, lifestyle, and health status characteristics as a proxy for occupational burnout identification: a network approach analysis.
期刊: Frontiers in psychiatry 发表日期: 2025 链接: PubMed
摘要
[This corrects the article DOI: 10.3389/fpsyt.2023.1119421.].
56. Advancements in cobalt-based oxide catalysts for soot oxidation: Enhancing catalytic performance through modification and morphology control.
期刊: Smart molecules : open access 发表日期: 2024-Dec 链接: PubMed
摘要
The widespread use of diesel engines results in significant environmental contamination due to emitted pollutants, particularly soot particles. These pollutants are detrimental to public health. At present, one of the most effective ways to remove soot particles is the catalytic diesel particulate filter after-treatment technology, which requires the catalyst to have superior low temperature activity. Compared with cerium oxide which is widely used, cobalt oxide in transition metal oxides has been widely studied in recent years because of its high redox ability and easy to control morphology. This paper elaborates on the influence of modification techniques such as doping, loading, and solid solution on the catalytic performance of cobalt-based catalysts in soot oxidation. Along the same lines, it further reviews the research progress on cobalt-based oxide catalysts with specific dimensional structures and morphologies in soot oxidation. Finally, it provides an outlook on the challenges faced by the theoretical basis and applied research of cobalt-based catalysts in soot oxidation.