公共卫生研究摘要 (2025-08-03)
共收录 52 篇研究文章
1. Podiatrists' Reflections on Content and Delivery of Their Pre-Registration Podiatry Programme at a Regional University in New South Wales, Australia: A Survey of Graduates.
期刊: Journal of foot and ankle research 发表日期: 2025-Sep 链接: PubMed
摘要
Understanding podiatrists’ perceptions of their undergraduate education is important to ensure that educational content and delivery meets the needs of the current workforce to inform future planning. This study aims to explore podiatrists’ perceptions of their undergraduate podiatry training at the University of Newcastle, Australia, and their preferences regarding educational content and delivery. We conducted an online survey of podiatry graduates from the University of Newcastle, Australia. Data were analysed using descriptive statistics and Fisher’s exact test to compare responses between groups. Qualitative responses were analysed using inductive content analysis. A total of 114 podiatrists responded. Nail avulsions, business management and modifying orthoses were perceived as being given insufficient time and focus in undergraduate training, with a higher proportion of private (71%) compared to public (33%) podiatrists reporting business management as lacking (p = 0.02). There was strong support for embedding endorsed scheduled medicines training within the programme (80%) and for delivering theoretical content face-to-face rather than online. Inductive content analysis revealed four areas to be emphasised in future curricula: modern technologies, biomechanics, wound care and routine podiatric care. Potential strategies to reduce examination stress included mock assessments, changed assessment weighting, reduced exam structure rigidity and reducing assessor bias. This study provides insights into Australian podiatrists’ preferences for pre-registration curricula. Topics to emphasise in future curricula at the University of Newcastle, Australia, include greater manual skills and business training, modern technologies, biomechanics and routine podiatric care. Our results suggest exercising caution when substituting face-to-face with online learning. These findings provide valuable guidance for future curricula in a context of declining student numbers and increasing healthcare demands.
2. Assessment of Hemophagocytic Lympho-Histiocytosis (HLH) in the Setting of Adult Acute Liver Failure.
期刊: Journal of viral hepatitis 发表日期: 2025-Sep 链接: PubMed
摘要
Hemophagocytic lympho-histiocytosis (HLH) is a life-threatening disease, only occasionally presenting as acute liver failure (ALF) in adults. HLH is challenging to diagnose. We reviewed the ALF Study Group (ALFSG) registry for suspected HLH subjects, as well as 184 with other ALF etiologies for cases that might have been missed, assessing standard laboratory tests, as well as interleukin-18 (IL-18) and soluble interleukin-2 receptor (sIL-2r), to determine the diagnostic utility of these biomarkers. We also calculated standard diagnostic algorithms (H score, HLH-2004 diagnostic criteria) to assess their value. Within 3364 ALF subjects, only 14 were initially cited as HLH. Upon thorough review by an adjudication committee, 5/14 (35.7%) were considered definite, five probable, two possible, and two unlikely. Definite HLH patients had significantly higher ferritin (p = 0.047), IL-18 (p = 0.003) and s-IL2r (p = 0.005) levels, H scores (p < 0.001) and HLH scores (p < 0.001). Other etiologies (APAP, DILI and viral) showed lower IL-18 and sIL2r levels and scores, but overlapping ferritins. Several probable/possible HLH cases lacked complete data for scoring. No additional (missed) HLH cases were identified. HLH remains a rare cause of ALF. Biomarkers, particularly IL-18 and sIL-2r, appear of value. HLH and H scores were also helpful but limited when data was missing.
3. A Novel Score for Predicting Long-Term Outcomes in Recanalisation-Treated Patients With Budd-Chiari Syndrome: A Multicentre Study.
期刊: Liver international : official journal of the International Association for the Study of the Liver 发表日期: 2025-Sep 链接: PubMed
摘要
A recanalisation-specific model for Budd-Chiari syndrome (BCS) is lacking. We aimed to develop a novel score for individual long-term outcome prediction and risk stratification. Overall, 834 BCS patients undergoing recanalisation (566 received percutaneous transluminal angioplasty alone, and 268 with routine stenting) from January 2010 to May 2019 were included from six Chinese centres. The model was developed using Cox multivariable regression, internally validated through a 1000-times bootstrapped method, and compared its performance with existing BCS prognostic models, like the Clichy score. During the median follow-up period of 58.0 months, 44 patients were converted to transjugular intrahepatic portosystemic shunt (TIPS), none underwent orthotopic liver transplantation (OLT) and 75 died. The final BCS-Recanalisation score incorporated: variceal bleeding history, degree of ascites, albumin, creatinine, urea, white blood cell count and Ln (alkaline phosphatase). The score outperformed other available models with good discrimination (C-index: 0.74) and calibration in predicting TIPS-free survival in the whole cohort, internal validation and most subgroups. Moreover, patients were categorised as low-risk (BCS-Recanalisation score ≤ 2.0), intermediate-risk (2.0-2.6) and high-risk (> 2.6) groups using X-tile software, with a 5-year TIPS-free survival rate of 92.2% (95% CI: 89.5%-95.0%), 84.7% (95% CI: 80.0%-90.0%) and 67.8% (95% CI: 59.4%-77.5%), respectively (p < 0.001). Significant differences were observed in overall survival, stenting-TIPS-free survival and competing-risk adjusted outcomes (restenosis, symptom recurrence, TIPS conversion) across risk strata. The BCS-Recanalisation score enables individualised outcome prediction and risk stratification in recanalisation-treated patients with BCS, showing promise for clinical application. Future external validation is required.
4. Post-pandemic Inequalities: Evolutionary Anthropological Frameworks for Long-Term Impacts of the 1918 Influenza Pandemic.
期刊: Evolutionary anthropology 发表日期: 2025-Sep 链接: PubMed
摘要
The 1918 influenza pandemic was a major mortality event that is well understood in its proximate heterogeneous impacts, but its long-term impacts on inequality are less understood. Within anthropology, evolutionary frameworks such as the epidemiological transitions, biocultural anthropology, and evolutionary medicine can give meaning to ultimate explanations for pandemics’ long-term consequences. I seek to identify and shape the gap in the 1918 influenza pandemic literature around the analysis of post-pandemic inequalities compared with pre-pandemic and pandemic period inequalities. I discuss six papers that address consequences on the demography and epidemiology of surviving populations and 11 papers that engage with the fetal origins hypothesis to understand unequal long-term impacts on cohorts exposed to stressful intrauterine environments during the pandemic. I contextualize existing knowledge of unequal impacts within evolutionary anthropological theory and argue that evolutionary anthropology is well suited to lead holistic research on ultimate determinants of long-term pandemic consequences.
5. Prevalence of Depression in Elderly Patients With Osteoarthritis: A Cross-Sectional Study.
期刊: Musculoskeletal care 发表日期: 2025-Sep 链接: PubMed
摘要
This study aimed to investigate the prevalence of Major Depressive Disorder (MDD) among elderly patients with osteoarthritis (OA) and explore the association between MDD and OA severity. Additionally, the impact of depression on OA prognosis and treatment outcomes was examined. A cross-sectional study was conducted at a Rehabilitation Clinic from April 2022 to December 2023, including patients aged 50 years and older with OA. Written informed consent was obtained from all participants before enrolment. OA severity was classified using the Kellgren and Lawrence grading system as Grade 1 (n = 20,25.6%), Grade 2 (n = 42,53.8%), and Grade 3 (n = 16,20.5%). Depression prevalence and severity were assessed using the Hamilton Depression Rating Scale. 78 OA patients (mean age: 60.35 ± 7.28 years) participated. Depression was prevalent in 83.3%, with a mean depression score of 18.14 ± 8.69. The most frequently reported symptoms were somatic anxiety, psychiatric anxiety, and depressed mood. Depression was more common and severe in females, particularly housewives. Patients with concurrent knee and spine OA exhibited greater depression severity than those with a single affected site. Notably, depression scores significantly improved following the OA treatment (p-value: 0.045). The high prevalence of depression among elderly OA patients highlights the need for routine depression screening and management in OA care. Given the significant association between depression severity and OA type, addressing mental health concerns may enhance treatment outcomes and quality of life in this population. Future research should further investigate the long-term impact of depression on OA prognosis and treatment response.
6. The SLC58A Na+-Monocarboxylate Transporter-Can It Scavenge Lung Metabolites to Prevent Airway Infections?
期刊: Acta physiologica (Oxford, England) 发表日期: 2025-Sep 链接: PubMed
摘要
7. Penalties in 2024 in Medicare's Skilled Nursing Facility Value-Based Purchasing Program.
期刊: Journal of the American Geriatrics Society 发表日期: 2025-Aug-02 链接: PubMed
摘要
The Medicare Skilled Nursing Facility (SNF) Value-Based Purchasing Program (VBP) provides incentive or penalty payments to SNFs based on their 30-day readmission rates. Our objective was to identify facility-level characteristics associated with penalties in the 2024 program. This retrospective, cross-sectional analysis of 10,278 SNFs used publicly available CMS data for the 2024 SNF VBP program. Using logistic regression, we analyzed the relationship between patient makeup (proportion of Black or Hispanic patients), structural characteristics (facility size, profit status, Medicare or Medicaid certification, hospital affiliation, SNF operating margin, and total nursing staff hours per resident per day), and community characteristics (ZIP SDI, rural versus urban location, region, and state average home health quality rating) on receipt of maximum penalty. Most SNFs participating in the 2024 SNF VBP were penalized (71.7%), with 33.1% of facilities receiving the maximum penalty of -1.98%. In multivariate regression models, facilities with a high proportion of Black residents (adjusted odds ratio [aOR] 1.14, 95% confidence interval [CI] 1.02-1.28) or Hispanic residents (aOR 1.42, 95% CI 1.26-1.60) and for-profit SNFs (aOR 1.42, 95% CI 1.26-1.61; vs. non-profit) were more likely to receive maximum penalties than their counterparts, as were those located in socioeconomically deprived ZIP codes (aOR 1.20, 95% CI 1.04-1.39), urban location (aOR 1.56, CI 1.35-1.81) or the South (aOR 2.32, 95% CI 1.98-2.71). Other measured characteristics were not associated with increased likelihood of maximum penalty. Penalties under the Medicare Skilled Nursing Facility Value-Based Purchasing Program vary by key facility characteristics, including patient mix, ownership, and geography. This information may help inform policymakers on how to improve outcomes in new iterations of the SNF VBP program and identify areas where technical modifications or additional investments in facility support for quality improvement could be prioritized.
8. Alveolar bone configuration in mandibular first molars with disto-lingual roots: A cross-sectional radiographic study.
期刊: Journal of periodontology 发表日期: 2025-Aug-02 链接: PubMed
摘要
Precise assessment of anatomical variations and alveolar bone configurations (ABCs) in permanent mandibular first molars (PMFMs) is crucial for effective periodontal treatment. This cross-sectional study aimed to evaluate the prevalence of disto-lingual roots (DLRs) and ABCs in PMFMs and investigate the correlation between DLRs and clinical parameters related to ABCs at the distal aspect of PMFMs. A total of 572 patients (863 PMFMs) were included in the analysis. The prevalence of DLRs and ABCs (parallel [P], distal inclined [D], and mesial inclined [M] types) and their relationship with clinical parameters were investigated. Multivariable logistic regression analysis was used to identify subject-, tooth-, and site-specific factors influencing the frequency of ABCs at the distal site of PMFMs. The prevalence of DLRs was 28.32% of subjects and 24.22% of examined PMFMs. The presence of DLRs significantly altered the distribution of ABCs, with a notable increase in M type configurations at the distal sites of PMFMs (p < 0.05). Clinical attachment loss (CAL) was significantly greater at the distal sites of PMFMs with DLRs compared with those without (p < 0.05). Multivariable logistic regression revealed that DLRs, lingual furcation involvement, and severe CAL (≥5 mm) were significantly associated with a higher frequency of M type ABCs. Mesial inclined (M) type ABCs were significantly higher in PMFMs with DLRs, lingual furcation involvement, and severe CAL, suggesting a notable link between DLRs and specific ABCs at distal sites of PMFMs. This study focuses on the unique anatomical structure of disto-lingual roots (DLRs) in permanent mandibular first molars and their impact on periodontal health. The key finding(s) discovered that teeth with DLRs had a significantly higher prevalence of certain patterns of bone loss (mesial inclined configurations) at their distal sites compared with teeth without DLRs. This type of bone loss was associated with more severe clinical attachment loss and lingual furcation involvement. These findings underline the importance of recognizing DLRs as contributing factors in periodontal disease progression and highlight the need for careful diagnosis and tailored treatment strategies.
9. Multi-cohort evaluation of "Don't know" responders to self-report oral health questions: Implications for etiologic research.
期刊: Journal of periodontology 发表日期: 2025-Aug-02 链接: PubMed
摘要
Self-reported data can extend the reach of oral health research, but “Don’t know” responses may threaten validity. We explored characteristics of participants who responded “Don’t know” to a periodontal health question across three distinct cohorts. We used data from three questionnaire-based observational studies, namely, the Pregnancy Study Online (PRESTO) (N = 10,996), the Black Women’s Health Study (BWHS) (N = 479), and the National Health and Nutrition Examination Survey (NHANES) (N = 15,502), to evaluate responses to questionnaire items related to periodontal health (e.g., “Has a dentist or dental hygienist ever told you that you have periodontitis or gum disease?”). We compared sociodemographic and behavioral factors across each response category (“Yes,” “No,” “Don’t know”). We used Monte Carlo simulation to create multiple datasets of 100,000 participants under different scenarios to calculate the percent change in observed effect estimates in analyses using the full cohort compared to analytic cohorts excluding “Don’t know” respondents. “Don’t know” prevalences ranged from 1.6% to 4.1%. We observed differences between “Don’t know” responders and those who answered “Yes” or “No” across all three cohorts. “Don’t know” responders were more likely to have lower educational attainment, lower income, and reduced engagement with oral healthcare services. We observed substantial bias in complete-case effect estimates in some simulated scenarios. Bias was larger when the underlying population prevalence of “Don’t know” responses was higher. “Don’t know” responders had distinct patterns of sociodemographic characteristics and oral healthcare engagement. The degree of bias in complete-case analysis was dependent on simulated factors. Research about oral health often asks people to answer questions about their teeth and gums. Sometimes people respond that they “Don’t know” the answer to these questions, which can make data challenging for researchers to analyze. In this study, we used three different data sources to look at whether there were particular characteristics that were more common among people who said they “Don’t know” in response to a question about their gum health. “Don’t know” responses were not very common in any of the three groups, ranging from 1.6% in a representative survey of people in the United States to 4.1% in a group of women in the United States and Canada trying to become pregnant. In all three groups, people who said “Don’t know” had a lower household income, less education, and were less likely to have seen a dentist recently. We also used simulated datasets to evaluate when excluding people who responded “Don’t know” would be expected to cause the most bias in analyses. The expected bias increased with the number of “Don’t know” responses in the data.
10. Agreement Between Fingerstick Blood Glucose and Continuous Glucose Monitor Measures Among Long-Term Care Facility Residents.
期刊: Journal of the American Geriatrics Society 发表日期: 2025-Aug-02 链接: PubMed
摘要
Long-term care facility (LTCF) residents with diabetes are at high risk of hypoglycemia. Continuous glucose monitoring (CGM), which measures interstitial glucose at 5-min intervals over 10-14 days, and fingerstick blood glucose (FBG) which analyzes glucose from a drop of blood, are both used to monitor glucose levels. Observational studies using electronic health record (EHR) data containing FBG measures could help to identify ways to reduce hypoglycemia risk. We first need to understand the validity of such data. Our objective was to compare EHR-based FBG measures against reference-standard CGM measures of hypoglycemia. We studied two cohorts of residents with diabetes in parallel. In Cohort 1, we analyzed linked CGM and Long-Term Care Data Cooperative EHR-based FBG data collected in 2023. In Cohort 2, we analyzed linked CGM and EHR-based FBG data obtained directly from LTCFs between 2022 and 2023. We defined hypoglycemia as glucose < 70 mg/dL and assessed the sensitivity and specificity of FBG versus CGM measures to detect hypoglycemia. The unit of analysis was each pair of contemporaneous FBG-CGM measures. In Cohort 1, two White female residents with a mean (standard deviation [SD]) age of 81 [12.7] years generated 25 daily hypoglycemia measurements. The sensitivity and specificity were 14% and 100%, respectively, for FBG-measured hypoglycemia. Cohort 2 included 40 residents (mean [SD] age 68 [11] years, 45% females, 60% White race) who generated 425 daily measurements of hypoglycemia. The sensitivity and specificity were 13% and 99%, respectively. EHR FBG measures of hypoglycemia had high specificity but failed to identify four out of every five hypoglycemic events among LTCF residents. Researchers and healthcare providers should assume hypoglycemia is measured with substantial errors in EHRs and account for this in their research and clinical practice.
11. Forward Outlook on Oral Health: The American Association of Public Health Dentistry's 2025 Research Agenda for Dental Public Health.
期刊: Journal of public health dentistry 发表日期: 2025-Aug-02 链接: PubMed
摘要
Dental public health (DPH) research is crucial in improving and promoting community oral health by generating and translating new knowledge into practice. Since the last AAPHD research agenda in 1992, the DPH field has made significant advancements. This research agenda aims to outline key research areas in DPH, including priority topics and evidence gaps in our scientific understanding of factors influencing population oral health and oral health equity. A workgroup under the AAPHD Council on Scientific Information (CSI) surveyed 503 AAPHD members in September 2021 to gather feedback on seven draft research objectives. The survey used a Likert scale to assess agreement and included open-ended suggestions. A total of 115 AAPHD members responded to the survey, resulting in a response rate of about 23%. Six of the seven objectives were agreed or strongly agreed upon by respondents as important areas of focus for DPH research. The final research agenda includes six key areas: oral health policy and legislation, delivery system innovations and care models, oral health workforce, DPH education, social determinants of health, and epidemiology and surveillance systems. The research agenda describes advancements and gaps in these areas, existing evidence, example priority topics, and research questions. The AAPHD encourages DPH partners, including federal agencies, DPH organizations, foundations, and dental associations, to advocate for, support, use, and fund high-quality DPH research. This support is crucial for translating emerging evidence into oral health improvements and equity across the diverse US communities.
12. Development of the Japanese Version of the Modified Yale Preoperative Anxiety Scale (mYPAS) in Pediatric Anesthesia: A Pilot Study for Psychometric Evaluation.
期刊: Paediatric anaesthesia 发表日期: 2025-Aug-02 链接: PubMed
摘要
Preoperative anxiety in children can lead to enduring psychological effects, highlighting the need for validated assessment tools. Although the modified Yale Preoperative Anxiety Scale is internationally recognized for evaluating pediatric anxiety, no validated Japanese version is available. We aimed to develop a Japanese version of the modified Yale Preoperative Anxiety Scale per internationally recognized translation guidelines, and conduct a pilot study to assess its feasibility, psychometric properties, and sample size requirements for future formal psychometric evaluations. After obtaining approval from the original authors, a translation team followed the International Society for Pharmacoeconomics and Outcomes Research Task Force Guidelines, including forward and back translations, cultural adaptation, and cognitive debriefing. This pilot study involved 15 children (aged 5-12 years) undergoing elective surgery under general anesthesia. Reliability (internal consistency, inter-rater, and intra-rater) and validity (concurrent validity against the State-Trait Anxiety Inventory for Children) were assessed. The Walter’s formula was used to calculate the sample size needed for formal reliability studies. Following a successful translation and cultural adaptation process, the Japanese version of the scale demonstrated high internal consistency (Cronbach’s α = 0.954) and moderate-to-very-good inter-rater reliability (weighted Kappa = 0.42-0.92). Intra-rater reliability was excellent (intraclass correlation coefficient = 0.86-0.97). However, correlations with the STAIC-State were poor (rs = -0.20 to -0.01), likely reflecting cultural norms of emotional restraint and differences in assessment timings. Sample size calculations indicated that 99 patients would be required for future reliability studies. The Japanese version of the scale was successfully developed, and pilot findings indicated its feasibility in Japanese clinical settings; a large multicenter validation is now required to confirm its psychometric properties. Incorporating the developed version of the scale into clinical practice may facilitate earlier identification and management of pediatric preoperative anxiety in Japan. UMIN Clinical Trials Registry: UMIN000047537.
13. Plasmodium falciparum Parasitemia Does Not Diminish Neutralizing Antibody Responses After mRNA COVID-19 Booster Vaccination in HIV-infected Adults.
期刊: The Journal of infectious diseases 发表日期: 2025-Aug-02 链接: PubMed
摘要
mRNA vaccines have emerged as powerful tools for the prevention of infectious diseases, but subclinical malaria may reduce vaccine immunogenicity. We evaluated neutralizing antibody responses in asymptomatic HIV-infected adults with and without PCR-confirmed Plasmodium falciparum who received either monovalent mRNA-1273 or bivalent mRNA-1273.222 (WA-1 and BA.4/5) booster vaccines. In previous studies, a 50% pseudovirus inhibitory dose neutralizing antibody (ID50) titer of 1,000 correlated with 96% efficacy in preventing COVID-19. We observed ID50 geometric mean titers >22,000 in both parasitemic and non-parasitemic participants one month after boosting. We conclude that COVID-19 mRNA vaccine antibody responses are unimpaired by concurrent asymptomatic parasitemia.
14. Effectiveness of 13-Valent Pneumococcal Conjugate Vaccine Against Pneumonia Hospitalization Among Medicare Beneficiaries Aged ≥65 in Long-Term Care.
期刊: The Journal of infectious diseases 发表日期: 2025-Aug-02 链接: PubMed
摘要
Pneumonia causes high rates of hospitalization among adults living in long-term care (LTC) facilities and is a major cause of mortality in this population. Since 2014, pneumococcal conjugate vaccines (PCVs) have been recommended for U.S. adults aged ≥65 years; however, effectiveness of PCVs against all-cause pneumonia hospitalization among adults living in LTC remains unclear. We used Medicare Fee-for-Service claims data to construct an open cohort of beneficiaries aged ≥65 years between September 2014 and December 2019. We estimated 13-valent PCV (PCV13) vaccine effectiveness (VE) by comparing rates of pneumonia hospitalization among PCV13-exposed and PCV13-unexposed time during LTC stays. Discrete-time logistic regression models with generalized estimating equations were used to estimate VE, incorporating time-varying exposures and covariates. Among 3,485,071 beneficiaries meeting the eligibility criteria, the proportion vaccinated with PCV13 increased from 1.1% to 52.7% during the study period. The characteristics of beneficiaries with shorter LTC stays differed from those with longer LTC stays: a lower proportion of beneficiaries aged ≥85 years (LTC stay ≤100 days vs >100 days: 38.5% vs. 48.2%), but a higher proportion with chronic medical conditions (71.4% vs 66.4%), immunocompromising conditions (36.6% vs. 25.2%), and recent hospitalizations (84.1% vs. 74.7%). VE of PCV13-only against all-cause pneumonia hospitalization was 3.8% (95% confidence interval 2.4%-5.2%) overall; 5.6% (3.9%-7.2%) for LTC stays ≤100 days and 0.3% (-2.1%- 2.77%) for LTC stays >100 days. PCV13 reduced the risk of pneumonia hospitalization among this population. Differences in beneficiary characteristics could explain differences in VE by length of LTC stay.
15. Improving equity in cardiovascular disease prevention through microplanning in low- and middle-income countries.
期刊: European journal of preventive cardiology 发表日期: 2025-Aug-02 链接: PubMed
摘要
16. Managing Haemophilic Arthropathy in People With Haemophilia in Japan: An Informal Consensus.
期刊: Haemophilia : the official journal of the World Federation of Hemophilia 发表日期: 2025-Aug-02 链接: PubMed
摘要
People with haemophilia who develop haemophilic arthropathy experience disabling physical effects, limiting functionality and quality of life (QOL). Although Clinical Practice Guidelines are available for haemophilia management, consensus on haemophilic arthropathy management is needed. To develop recommendations for haemophilic arthropathy management in people with haemophilia adapted to the Japanese medical setting. Using an informal consensus method, a steering group of 14 clinical experts (orthopaedic, rehabilitation, paediatric, and haematology) in Japan developed 40 literature-based statements and 18 sub-statements related to haemophilic arthropathy management in people with haemophilia. A panel of 30 experts was surveyed by email about their level of agreement with each statement/sub-statement. Responses were tabulated to determine the level of agreement with each statement/sub-statement: strong consensus, consensus, non-consensus, and strong non-consensus. The survey was completed by 27/30 respondents. Strong consensus/consensus was reached for 39 statements/sub-statements, non-consensus/strong non-consensus was reached for four (all related to pain assessment and management), and consensus/non-consensus was not reached for 15. Based on insights from a wide range of clinical experts, recommendations for the management of haemophilic arthropathy in people with haemophilia in Japan were developed to aid in addressing the unique challenges faced by healthcare providers in the country. The survey findings indicate that diagnostic tools are needed to aid in haemophilic arthropathy diagnosis. Routine evaluations (physical function, joint ultrasound, QOL, and psychological), activities (physical therapy, rehabilitation, aerobic exercise, and sports), appropriate pain management, and proactive screening for osteoporosis are important when managing haemophilic arthropathy in people with haemophilia.
17. Attitudes, Perceptions and Workplace Factors Predict Well-Being in Forensic Healthcare Workers Caring for Sex Offenders.
期刊: Journal of psychiatric and mental health nursing 发表日期: 2025-Aug-02 链接: PubMed
摘要
Forensic healthcare workers in mental health settings face significant challenges when working with sex offenders. Balancing staff wellbeing with effective offender rehabilitation remains critical. This study examined how attitudes, perceptions and workplace factors influence the wellbeing of frontline forensic healthcare workers caring for sex offenders. A cross-sectional design, adhering to the STROBE checklist, was used. Ninety-one participants from UK privatised mental health settings completed an online survey. Wellbeing was assessed using measures of compassion satisfaction, burnout and secondary traumatic stress, with predictors including attitudes, perceptions and workplace factors. Positive attitudes, such as understanding offender intent, were associated with improved wellbeing, while excessive trust reduced compassion satisfaction. Perceptions like risk awareness acted as psychological buffers. Workplace factors, including environmental safety and quality supervision, enhanced wellbeing, whereas co-worker support unexpectedly reduced compassion satisfaction. The findings highlight the importance of rational attitudes in enhancing wellbeing. While punitive perceptions offered emotional buffering, fostering balanced approaches is essential for improving therapeutic environments. The study focused on privatised UK settings, limiting generalisability to NHS contexts. Future research should explore broader populations. Employers should enhance environmental safety, supervision and training to foster rational attitudes and address peer dynamics.
18. Efficacy, Quality of Life, and Cost-Effectiveness of Superselective Adrenal Arterial Embolization in Idiopathic Hyperaldosteronism: A Comparative Study.
期刊: Journal of clinical hypertension (Greenwich, Conn.) 发表日期: 2025-Aug 链接: PubMed
摘要
Idiopathic hyperaldosteronism (IHA) is the most common subtype of primary aldosteronism, typically managed with mineralocorticoid receptor antagonists (MRAs). However, long-term MRA therapy is associated with suboptimal cardiovascular outcomes and adverse effects. Superselective adrenal arterial embolization (SAAE) is a novel minimally invasive alternative, but its long-term efficacy, particularly regarding quality of life and cost-effectiveness, remains underexplored. In this study, 62 patients with bilateral IHA were prospectively enrolled and assigned to two groups: SAAE (n = 42) and MRA therapy (n = 20). Outcomes, including blood pressure, serum potassium, aldosterone-renin ratio normalization, and quality of life (measured by SF-36 and EQ-5D), were assessed at 12 months. A supervised Random Forest model was developed to predict treatment success. A 5-year cost-utility analysis compared SAAE and MRA therapy from a healthcare system perspective. Results showed that SAAE led to greater reductions in blood pressure (mean -27.4 ± 21.3 mmHg systolic, -23.1 ± 17.4 mmHg diastolic) compared to MRA therapy (-15.6 ± 11.4 mmHg systolic, -12.4 ± 10.1 mmHg diastolic, p < 0.001). Clinical success was achieved in 63.2% of the SAAE group, with biochemical remission in 39.6%. SAAE also led to greater improvements in quality of life and demonstrated lower costs and higher quality-adjusted life years (QALYs) compared to MRA therapy. SAAE is a safe, effective, and cost-effective treatment for IHA, offering superior blood pressure control, hormonal normalization, and improved quality of life compared to MRAs. Trial Registration: ClinicalTrials.gov identifier: ChiCTR2200062738.
19. Comparison of Globorisk, SCORE2, and PREVENT in the Stratification of Cardiovascular Risk and its Relationship with End-Organ Damage Among Adults With Arterial Hypertension.
期刊: Journal of clinical hypertension (Greenwich, Conn.) 发表日期: 2025-Aug 链接: PubMed
摘要
Arterial hypertension often coexists with comorbidities that increase vascular damage. Although the primary goal is to reduce cardiovascular risk, the available risk scores can produce varying estimates. Here, we aim to compare the prevalence of cardiovascular risk categories using three equations (Globorisk, SCORE2, and PREVENT) in adults living with arterial hypertension and to assess their association as stratification tools for end-organ damage (EOD). To achieve this, we performed a cross-sectional sub-analysis of the RIHTA study, an electronic health record-based registry of adults with arterial hypertension in Mexican primary care centers. EOD was defined as aortic stiffness, reduced eGFR, hypertensive retinopathy, peripheral artery disease, or left ventricular hypertrophy. Inverse probability weighting (IPW) was used to evaluate the association between cardiovascular risk and EOD, adjusting for relevant confounders, and areas under the receiver operator curve (AUROC) were calculated to assess detection capacity. Among 4512 participants (median age 64 years; 61% women), EOD was present in 33% (n = 1492). The PREVENT equation yielded the highest median 10-year risk (15%, IQR 8-24), followed by Globorisk laboratory-based (12%, 7-22), Globorisk office-based (11%, 7-19), and SCORE2 (5.06%, 3.86-7.18). In IPW models, each 1% increase in score was associated with higher odds of EOD (PREVENT OR 1.16, 95% CI 1.15-1.17; Globorisk-office 1.09, 1.08-1.10; Globorisk-lab 1.07, 1.06-1.08; SCORE2 1.04, 1.02-1.06). The PREVENT score demonstrated the strongest discrimination for detecting EOD (AUROC: 0.751, 0.735-0.750). These findings suggest that among adults with arterial hypertension, the PREVENT score identifies high-risk individuals and improves discrimination for EOD.
20. Forgetfulness to Take Antihypertensive Medications and Poor Blood Pressure Control in Older Adults With Type 2 Diabetes and Hypertension in Vietnam.
期刊: Journal of clinical hypertension (Greenwich, Conn.) 发表日期: 2025-Aug 链接: PubMed
摘要
One of the leading causes of poor adherence to antihypertensive medications is forgetfulness. A better understanding of the impact of forgetfulness can help in developing targeted interventions to improve blood pressure (BP) control. This study aimed to (1) examine the prevalence of forgetfulness to take antihypertensive medications and its associated factors in older adults with type 2 diabetes and hypertension, and (2) investigate the relationship between forgetfulness to take antihypertensive medications and poor BP control in this population. This observational study was conducted at the outpatient clinics of two hospitals in Vietnam from June 2023 to June 2024. Forgetfulness was assessed using the question: “Do you sometimes forget to take your prescribed antihypertensive medications?”. Poor BP control was defined as a mean systolic BP ≥140 mm Hg or a mean diastolic BP ≥90 mm Hg. There were 448 participants. They had a mean age of 73.5 years (SD 7.2), 32.1% were female. The prevalence of forgetfulness to take antihypertensives was 29.5%, highest among participants in the first 5 years of hypertension (43.8%), followed by those with >15 years (28.0%), 11-15 years (25.2%), and 6-10 years (23.9%) (p = 0.009). Logistic regression analysis revealed that hypertension duration and disability in activities of daily living were significantly associated with forgetfulness. Forgetfulness increased the odds of poor BP control, with an adjusted OR of 1.64 (95% CI 1.03-2.56). These findings suggest the need for future studies focusing on interventions on forgetfulness to improve medication adherence for this population.
21. Influenza Vaccination and Short-Term Risk of Stroke Among Elderly Patients With Chronic Comorbidities in a Population-Based Cohort Study.
期刊: Journal of clinical hypertension (Greenwich, Conn.) 发表日期: 2025-Aug 链接: PubMed
摘要
The protective effect of influenza vaccination on stroke risk has been inconclusive. In this study, we aimed to investigate the impact of influenza vaccination on the 1-year risk of stroke in individuals aged 60 years and older with COPD and hypertension or diabetes mellitus. We conducted a retrospective cohort study in four districts of Shanghai, China, from August 2017 to July 2019. Data were collected from various information systems related to chronic disease management, cardiovascular reporting, and immunizations. The incidence of stroke within 1 year was compared between vaccinated and unvaccinated chronic disease patients. Cox proportional hazards regression was used to calculate hazard ratios (HRs). Sensitivity analysis was performed using the Poisson regression model to examine the association between influenza vaccination and stroke incidence, and propensity score matching was employed to address confounding. We found that influenza vaccination was associated with a lower risk of stroke during the two influenza seasons, 2017-2018 (adjusted HR, 0.27; 95% CI, 0.10-0.73) and 2018-2019 (adjusted HR, 0.46; 95% CI, 0.21-1.02). The results from the Poisson regression model (RR, 0.26; 95% CI, 0.10-0.70) were consistent with those obtained from the Cox model analysis. The reduction in stroke risk associated with influenza vaccination ranged from 54% to 73%. Our findings suggest that influenza vaccination is associated with a lower 1-year risk of stroke in individuals with chronic illnesses, compared to those who are not vaccinated.
22. Association Between Estimated Pulse Wave Velocity and Carotid Plaques in Non-Dialysis CKD Stages 3-5: A Cross-Sectional Study.
期刊: Journal of clinical hypertension (Greenwich, Conn.) 发表日期: 2025-Aug 链接: PubMed
摘要
Carotid plaques are common in CKD patients and serve as a key marker of cardiovascular risk. Arterial stiffness, assessed by estimated pulse wave velocity (ePWV), is a valuable non-invasive indicator of vascular health. However, the association between ePWV and carotid plaques in CKD stages 3-5 remains unclear. Of the 296 participants, 199 were included in the cross-sectional study after applying exclusion criteria. Carotid plaques were assessed using ultrasound, and ePWV was calculated based on established equations. Logistic regression models examined the association between ePWV and carotid plaques, while subgroup and mediation analyses evaluated the robustness of the association and mediating effects, respectively. ePWV was significantly associated with carotid plaques (OR: 1.85; 95% CI: 1.47-2.32; p < 0.001) after adjusting for covariates. The highest ePWV tertile (ePWV ≥ 11.2 m/s) was associated with a markedly increased risk of carotid plaques compared to the lowest tertile (OR: 21.52; 95% CI: 7.09-65.36; p < 0.001), and trends between tertiles have been observed. Subgroup analysis showed that diabetes influenced the robustness of the association between ePWV and carotid plaque. Mediation analysis revealed that ePWV accounted for 32.9% of the effect of diabetes on carotid plaques, indicating its potential role as a partial mediator. This study identified a robust association between ePWV and carotid plaques in CKD stages 3-5, with diabetes significantly influencing this relationship. The findings highlighted the clinical relevance of ePWV in cardiovascular risk assessment and underscored the importance of managing arterial stiffness in advanced CKD populations.
23. Statewide Academic Performance of High School Students With Sickle Cell Disease.
期刊: Pediatric blood & cancer 发表日期: 2025-Aug-01 链接: PubMed
摘要
Among patients with sickle cell disease (SCD), poor academic attainment in adolescence is associated with a greater frequency of acute care visits and a poorer health-related quality of life in adulthood. We compared the academic performance of high school students with SCD to students without SCD after controlling for race and sex. This retrospective cohort study was constructed based on the Tennessee Medicaid program claims data and Tennessee Department of Education Race to the Top educational data from October 1, 2007 to September 30, 2019. For every ninth grade student with SCD identified, eight students without SCD were identified. Academic achievement was measured using rates of proficiency on end-of-course assessments. The number of days absent per school year, grade retention, and school withdrawal were used as measures of academic attainment. The analysis included 498 students with SCD and 3188 students without SCD. After race and sex were adjusted for, students with SCD had English proficiency odds of 0.8 times (95% confidence interval [CI]: 0.7-0.9; p < 0.001) those of students without SCD. Students with SCD were 1.2 times (95% CI: 1.0-1.5; p = 0.045) more likely to be retained in the ninth grade. The effect of SCD on grade retention was mediated by days absent from school (odds ratio for indirect effect, 1.18 (95% CI: 1.1-1.26; p < 0.0001). SCD negatively affects academic performance partly through frequent school absence.
24. When a Mental Health Policy Change Meets a Youth Early-Intervention Service: Reflections on the Role of Diagnosis.
期刊: Early intervention in psychiatry 发表日期: 2025-Aug 链接: PubMed
摘要
Psychiatric diagnosis often generates controversy regarding its necessity, validity and utility. While it can help determine service eligibility and guide clinical decision-making, a formal diagnosis can also reinforce negative stereotypes and self-stigma, particularly among adolescents and young adults in critical stages of identity formation. In this article, we argue that a policy shift from a national, free-to-all funding to HMO-based coverage-with mandatory diagnostic documentation-might contradict the principles of early-intervention services for youth. Between 2016 and 2018, we collected routine data for an evaluation study of youth early-intervention services in Israel. During this period, eligibility changed from open access to a requirement of receiving a formal DSM diagnosis. Our secondary analysis shows no significant differences in demographic characteristics, psychological distress or social and occupational functioning before and after the policy change. However, clinicians reported a significantly higher proportion of youth meeting full diagnostic criteria for DSM diagnosis and expressed greater certainty in their assessments. These findings underscore the potential influence of policy on clinical judgement-or at least its documentation-demonstrating a paradox: a system intended to broaden early intervention may inadvertently hinge on a stigmatising label, potentially deterring help-seeking among youth. Financial and policy structures can challenge the low-barrier, youth-friendly framework that characterises early intervention in psychiatry. Further investigation is needed to understand the fragile dynamics of mental health coverage policy and the principles youth-oriented early-intervention services.
25. Building capacity and equity in implementation science: evaluation of a national mentored training program.
期刊: Implementation science : IS 发表日期: 2025-Aug-01 链接: PubMed
摘要
As implementation science evolves, it is essential to expand training capacity to build intellectual capital continually. The demand for training in implementation science far outstrips the current supply. This paper presents the methods and findings from the Institute for Implementation Science Scholars (IS-2) national training program (2020-2024). The IS-2 was a US-based, two-year training program that provided mentored training for early- and mid-career researchers interested in applying implementation science principles to reduce the burden of chronic disease disparities. Scholars attended two annual, 2.5-day intensive training sessions, received ongoing remote and in-person mentoring, and were supported by other activities (e.g., pilot funding, networking events, mock grant reviews). A quasi-experimental (pre/post) design evaluated IS-2 on skill building, mentoring, and networking. We used descriptive and inferential statistics to characterize the sample and analyzed primary outcomes and networks. A majority of the 59 scholars were female (86%), white (61%), and assistant professors (61%). Forty-three implementation science competencies were assessed; all skill categories increased from baseline to 10 months and from 10 to 22 months post-enrollment. The relative change was largest for advanced competencies. Scholars rated their assigned mentors as highly competent across all mentoring competencies. A vibrant mentoring network was established, with the highest number of network ties in 2023, facilitating manuscript publication and joint research. Under-represented scholars (n = 21) had similar skill gains relative to scholars not-under represented, yet were less likely to hold network ties in 2024. After accounting for other predictors, sharing a mentoring relationship within the previous two years was a strong positive predictor of forming collaboration ties between network members in 2024 (odds ratio = 9.66; 95% confidence interval = 6.34-14.74). IS-2 showed multiple impacts of practice and societal relevance (e.g., improving intervention reach, building cost data in patient decision aids). The approaches used in IS-2 effectively helped mentees gain skills in implementation science, experience mentorship for career development, and establish collaborative networks. The results demonstrate how the field can develop and utilize a mentoring program to reach diverse scholars, incorporate equity into curricula, and conduct high-quality mentoring to address critical implementation science topics.
26. Exploration of dietary patterns in southern China: application-based comparison of factor analysis and latent class analysis.
期刊: Journal of health, population, and nutrition 发表日期: 2025-Aug-01 链接: PubMed
摘要
27. Investigating key factors influencing substance abuse among undergraduate medical students at Saint Paul's hospital millennium medical college, Addis Ababa, Ethiopia: a qualitative approach.
期刊: BMC psychiatry 发表日期: 2025-Aug-01 链接: PubMed
摘要
Substance abuse is prevalent among college students, especially in low- and middle-income countries like Ethiopia. Few studies have explored the factors influencing substance abuse among medical students, and it has been particularly neglected in the Ethiopian context. This study aims to fill this gap through a qualitative exploration, providing insights crucial for intervention and treatment strategies. This study aimed to understand the primary influencers contributing to substance abuse among undergraduate medical students at Saint Paul’s Hospital Millennium Medical College. An exploratory qualitative study design was employed from March 2023 to May 2023 at Saint Paul’s Hospital Millennium Medical College. In-depth interviews were conducted with seven substance-abusing students selected via snowball sampling. The interviews explored their experiences, challenges, and perceptions. Thematic analysis was utilized to identify and categorize emergent themes. The study found that khat, alcohol, and cigarettes were perceived as the most commonly abused substances among medical students. Psychosocial and economic factors, the medical school environment, and challenges in cessation were identified as significant influencers of substance abuse. These findings were organized into four main themes and six subthemes derived from the thematic analysis. Psychosocial, economic factors, and being medical students, contribute to substance abuse. The study recommends college interventions such as strengthening support groups and campus activities. Policy changes enforcing stricter substance control by the government are also suggested to mitigate substance abuse among medical students.
28. The influence of vaginal microbiota on ewe fertility: a metagenomic and functional genomic approach.
期刊: Microbiome 发表日期: 2025-Aug-01 链接: PubMed
摘要
Despite advancements in artificial insemination, sheep fertility rates remain suboptimal. Recent studies in other species highlight the critical role of reproductive microbiota in influencing fertility outcomes. This research explores the relationship between ovine vaginal microbiota, associated functional pathways, and fertility using advanced nanopore long-reading metagenomic sequencing on 297 ewes from three Spanish breeds across four herds. The study aimed to describe a core vaginal microbiota, analyse the complex interactions with herd, breed, age, and parity factors, and identify taxa and genes associated with reproductive success by artificial insemination. The study identified Staphylococcus, Escherichia, and Histophilus as the most abundant genera. Microbial communities varied considerably between breeds and herds, with high predictive accuracy (> 90%) in classification models. Differential abundance analysis revealed that the genera Histophilus, Fusobacterium, Bacteroides, Campylobacter, Streptobacillus, Gemella, Peptoniphilus, Helococcus, Treponema, Tissierella, and Phocaeicola were more abundant in non-pregnant ewes. Some of these taxa were also associated with four COG entries and one KEGG orthologue significantly linked to non-pregnancy, primarily involving carbohydrate metabolism, defence mechanisms, and structural resilience. Age and parity were also associated with microbiota composition, particularly in ewes older than five years or with more than three parturitions, suggesting that cumulative physiological changes may contribute to microbial shifts over time. The ewe’s vaginal microbiome appears to be mainly influenced by both herd and breed, though distinguishing genetic from environmental factors is challenging within our study design. While the overall microbiota showed a subtle effect on pregnancy, certain genera had a significant negative impact, likely due to pathogenic or inflammatory properties that disrupt reproductive health. The metagenomic approach used here enabled not only comprehensive taxonomic classification but also detailed functional analysis, providing deeper insights into the microbiome’s role in reproductive outcomes. Video Abstract.
29. Use and susceptibility of youth aged 13-15 years to cigarettes, e-cigarettes and heated tobacco products: results of the Global Youth Tobacco Survey 2022 in eight Italian regions.
期刊: European journal of public health 发表日期: 2025-Aug-01 链接: PubMed
摘要
Smoking is a leading risk factor for many preventable chronic diseases across the lifespan. Adolescence represents a critical period for the adoption of health-risk behaviours, including tobacco and nicotine products consumption. Evidence shows that adolescents who are susceptible to tobacco use are more likely to initiate and maintain smoking than their non-susceptible peers. This study examines factors associated with susceptibility to cigarettes, electronic cigarettes (e-cigs) and heated tobacco products (HTPs) in adolescents aged 13-15 years. Data were drawn from the 2022 Global Youth Tobacco Survey conducted in eight Italian regions. Susceptibility to tobacco products was measured through intentions to use tobacco and responses to hypothetical peer offers. Influencing factors (i.e. age, gender, having smoking friends or parents, exposure to tobacco advertising and to anti-smoking messages at school) were evaluated using a multivariable random intercept logistic regression to account for variability between macro-regions (North, Centre, South). The study included 17 713 participants from 738 schools and 1219 classes. Susceptibility to cigarettes was 27.8%, to e-cigs 36.6%, and to HTPs 29.5%. Regional differences emerged, with higher cigarette susceptibility in the South and higher e-cig susceptibility in the North. Having smoking friends was the strongest risk factor [cigarettes: odds ratio (OR) = 2.02, e-cigs: OR = 2.03, HTPs: OR = 2.22]. Anti-smoking messages at school were protective (cigarettes: OR = 0.92, e-cigarettes: OR = 0.91, HTPs: OR = 0.88). Individual factors had a stronger influence than geographical differences. The findings underscore the need for comprehensive tobacco control policies addressing the rising prevalence of poly-product use, stronger marketing regulations, and school-based and peer-led interventions.
30. Health-related quality-of-life evaluation in epidermolysis bullosa: a scoping review protocol.
期刊: Systematic reviews 发表日期: 2025-Aug-01 链接: PubMed
摘要
Epidermolysis bullosa (EB) is a group of rare congenital inherited skin diseases. Evaluation of health-related quality of life (HRQoL) is key to understanding the psychosocial and emotional impact on patients and their relatives or carers. The BUR-EB project aims at ascertaining the socio-economic burden of the disease, including its impact on costs and HRQoL. The aim of this scoping review is to identify which instruments or questionnaires are being used to evaluate the HRQoL of patients with EB and their relatives and carers. A scoping review will be conducted to ascertain the HRQoL of EB patients, their family circle and caregivers over the past 12 years. The wide-ranging review question is as follows: “Which measurement tools are available for evaluation of HRQoL in EB?” A search will be made in the MEDLINE, WOS and Scopus databases, and the Joanna Briggs Institute methodology will be applied. The data and findings will be shown in tables and in narrative form, in line with the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). This scoping review will provide an overview of evidence on the use of HRQoL instruments, both in patients with EB and in relatives and carers. The results of this scoping review will offer a guidance to the researchers to measure the health and well-being of EB patients.
31. Association between self-worth and health promotion behaviors among older adults living in the community: a cross-sectional study.
期刊: BMC public health 发表日期: 2025-Aug-01 链接: PubMed
摘要
Population aging is one of the most significant global social changes, making the improvement of the health and quality of life for the elderly a key health priority. The adoption of health promotion behaviors and having self-worth are effective approaches to maintain the health of older people. The current study aimed to investigate health promotion behaviors and their relationship with self-worth among the elderly in Tabriz, Iran. This cross-sectional study recruited 427 older people, who lived in Tabriz in 2022. The participants were selected using multistage random cluster sampling. The Health Promotion Activities of Older Adults Measure, and the Contingencies of Self-Worth Scale were used for collecting the data. Descriptive and inferential statistics methods were applied to the data. The results showed a moderate mean score of health promotion behaviors (93.25 ± 15.39) and a low mean score of self-worth (79.30 ± 10.29) for the participants. The multivariate linear regression analysis showed a significant relationship between health promotion behaviors and self-worth among the older adults (p < 0.01). Therefore, self-worth could predict about 3.7% of the variance of health promotion behaviors among this population (R2 = 0.037, t = 4.01). Although the association was statistically significant, the explained variance was low, indicating that self-worth had a limited predictive value for health promotion behaviors in this sample. While self-worth showed a modest correlation with health promotion behaviors, multivariable analysis revealed socioeconomic factors as stronger predictors. Interventions should address structural determinants alongside psychosocial factors to improve elderly health. Future studies are needed to explore causal pathways between self-worth and health behaviors in aging populations.
32. Mental wellbeing during pregnancy and the transition to motherhood: an explorative study through the lens of healthcare professionals.
期刊: BMC pregnancy and childbirth 发表日期: 2025-Aug-01 链接: PubMed
摘要
33. SMAD3 orchestrates RNF167 and STAMBPL1-mediated Sestrin2 ubiquitination to drive gastric cancer progression.
期刊: Cell division 发表日期: 2025-Aug-01 链接: PubMed
摘要
Gastric cancer (GC) continues to pose a significant global health burden, necessitating a thorough understanding of the molecular mechanisms driving its progression. This study aimed to investigate the regulatory role of SMAD3 in modulating Sestrin2 ubiquitination stability and its implications in GC cell behaviors. Leveraging GC-related single-cell transcriptomic data, we employed advanced analytical approaches to unveil the relationship between SMAD3 and Sestrin2. Experimental validations involving RT-qPCR, Western blotting, and immunofluorescence analyses elucidated the impact of SMAD3 on Sestrin2 expression and subcellular localization. In vitro models of SMAD3 overexpression and knockdown were utilized to assess the functional consequences on GC cell proliferation, migration, invasion, and apoptosis. The interaction between SMAD3 and ubiquitination-related enzymes RNF167 and STAMBPL1 was investigated through immunoprecipitation assays. Our findings revealed a positive correlation between SMAD3, Sestrin2, and STAMBPL1 expression, indicating a regulatory network within GC cells. SMAD3 was shown to stabilize Sestrin2 protein levels by influencing the ubiquitination processes of STAMBPL1 and RNF167. Functional assays demonstrated the promotion of GC cell proliferation, migration, and invasion, along with decreased apoptosis, by the SMAD3-Sestrin2 axis. Moreover, SMAD3-mediated regulation of Sestrin2 stability was found to enhance GC metastasis. The study underscores the critical role of SMAD3 in modulating Sestrin2 expression and stability, consequently impacting GC cell behaviors and metastatic potential. The SMAD3-Sestrin2 axis emerges as a promising therapeutic target for GC treatment.
34. Enhancing surgical care for torture survivors: healing trauma, promoting recovery, and advancing best practices.
期刊: BMC surgery 发表日期: 2025-Aug-01 链接: PubMed
摘要
35. Dokdo sea lion Zalophus japonicus genome reveals its evolutionary trajectory before extinction.
期刊: BMC biology 发表日期: 2025-Aug-01 链接: PubMed
摘要
The Dokdo sea lion (Zalophus japonicus), commonly referred to as Gangchi in Korea and the Japanese sea lion internationally, was endemic to the Northwest Pacific before its extinction in the 1950s. However, its origins, speciation, and genetic diversity remain poorly understood. To address this, we sequenced DNA from 16 Z. japonicus bone fragments, obtained from Dokdo and Ulleungdo islands in Korea. Our genome-wide SNP analyses reveal Z. japonicus as the earliest diverged species within its genus, redefining its evolutionary relationship with the California (Z. californianus) and Galapagos (Z. wollebaeki) sea lions. Our research further elucidates the phylogeny of Z. japonicus, shedding light on the complexity of the genetic isolation process within its genus that was prompted by the geographic isolation of the three populations of Zalophus ancestral stock. Conversely, the genetic signature of the Dokdo sea lion genome can be modeled as an evolutionary pathway involving gene flow from Otariidae species with shared range. In addition, we discovered that the population decline of Z. japonicus started already over 100,000 years ago; however, Z. japonicus genome maintained a relatively high heterozygosity despite nearing extinction. Our genome-scale analysis sheds light on the phylogeny of Z. japonicus, the evolutionary pathways underlying its speciation, and its genetic diversity before extinction. Broadly, we elucidate Zalophus gene flow complexity and genetic diversities among extant species. Furthermore, this study offers retrospective genomic insights into the extinction process of a carnivorous marine mammal, information that could aid conservation efforts for extant Otariidae species.
36. Nutritional interventions in muscle hypertrophy research: a scientometric analysis within the context of resistance training (1992-2025).
期刊: Journal of health, population, and nutrition 发表日期: 2025-Aug-01 链接: PubMed
摘要
Muscle hypertrophy, as a central goal in sports training, rehabilitation interventions, and health promotion, relies on scientifically designed resistance training and appropriate nutritional strategies. However, research on the synergistic effects of nutritional interventions and resistance training in promoting muscle hypertrophy is characterized by thematic fragmentation, insufficient integration between mechanistic and applied research, and imbalances across different regions and population groups. To systematically delineate the developmental trajectory and emerging trends in this field, a comprehensive search was conducted in the Web of Science Core Collection, initially retrieving 456 publications. After rigorous screening and data cleaning, 411 English-language articles published between 1992 and 2025 were retained for analysis. Scientometric techniques were applied to construct knowledge maps using three major tools: Bibliometrix (R 4.4.3), VOSviewer (1.6.20), and CiteSpace (6.2.6). Bibliometrix was used to analyze publication trends and thematic evolution; VOSviewer to map keyword co-occurrence and collaboration networks; and CiteSpace to detect citation bursts and visualize knowledge structures. Collectively, these methods facilitated the identification of high-frequency keywords, hotspot transitions, collaborative patterns, and underexplored thematic gaps. The results indicate that: (1) the combination of protein supplementation and resistance training represents the most prominent intervention strategy; (2) a stable tripartite research model has emerged, centering on the interaction among training, nutrition, and structural adaptation; (3) the thematic focus has gradually shifted from molecular mechanisms toward practical applications, emphasizing issues such as aging and functional improvement; and (4) notable research gaps remain, particularly the underrepresentation of women and Asian populations, insufficient attention to recovery, metabolism, and periodized nutrition, and the lack of a systematic framework for individualized interventions. This study delineates the developmental trajectory, structural characteristics, and future directions of research in this field over the past three decades, providing empirical evidence and a theoretical foundation for the scientific formulation of muscle health enhancement strategies.
37. The perspective of socially vulnerable youth on healthcare services: a Portuguese cross-sectional study.
期刊: Archives of public health = Archives belges de sante publique 发表日期: 2025-Aug-01 链接: PubMed
摘要
Socially vulnerable adolescents are often forgotten in the healthcare system, which is more prone to manage those who are assigned to the system, leaving others. We aimed to characterise the perception of these patients about preferences and priorities concerning healthcare services in their medical appointments, relevant healthcare topics, and value attributed to the contact with their physicians.This cross-sectional study surveyed a group of adolescents living in institutional settings to enhance a patient-centred approach and, therefore, higher health promotion and better health outcomes for adolescents and young adults.A total of 571 adolescents with a mean age of 17 (55.4% females) answered the survey. Primary healthcare centres were the main location for medical surveillance. The most wanted topics were diet (83%), diseases (82%), and exercise (75%), with less emphasis surrounding topics such as free time, tobacco, and drugs. A significant association was found between valuing physicians’ characteristics and perceived doctor skills.This research highlights the pertinence of understanding the priorities and preferences of institutionalised socially vulnerable adolescents to reinforce equity and create a cosy environment for everyone.
38. A Risk Stratification Model for Predicting Benefits of Intensive Blood Pressure Treatment: Analysis of the Systolic Blood Pressure Intervention Trial.
期刊: Journal of clinical hypertension (Greenwich, Conn.) 发表日期: 2025-Aug 链接: PubMed
摘要
Current hypertension guidelines lack personalized strategies for blood pressure control. While the Systolic Blood Pressure Intervention Trial (SPRINT) demonstrated benefits of intensive blood pressure lowering, identifying optimal candidates for such treatment remains challenging. We developed and validated a risk stratification model using data from 9139 SPRINT participants. The model incorporated 11 clinical variables through multivariable Cox regression analysis. Patients were stratified into low-, medium-, and high-risk groups. The study protocol was registered at ClinicalTrials.gov (NCT01206062). The model showed good discrimination with C-indices of 0.7354 (95% CI: 0.7065-0.7710) and 0.6894 (95% CI: 0.6545-0.7266) at 3 years for training and validation sets, respectively. Intensive treatment significantly reduced cardiovascular events in medium-risk (3.17% vs. 5.11%, p = 0.0376) and high-risk groups (9.34% vs. 11.86%, p = 0.0269), while showing a nonsignificant trend in the low-risk group (2.87% vs. 3.34%, p = 0.0870). The Rank-Weighted Average Treatment Effect analysis (16.06) supported potential benefits from individualized treatment allocation. No increased risk of severe adverse events was observed across risk groups. Our risk stratification model effectively identifies patients who derive significant cardiovascular benefits from intensive blood pressure lowering, particularly in medium- and high-risk groups. This approach could guide more personalized hypertension management strategies.
39. Drug management of TB in the intensive care setting: an international multicentre study.
期刊: The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease 发表日期: 2025-Aug-01 链接: PubMed
摘要
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40. Sociodemographic and occupational factors influencing pregnant workers' awareness and utilization of the New York City Pregnant Workers Fairness Act.
期刊: BMC public health 发表日期: 2025-Aug-01 链接: PubMed
摘要
The New York City (NYC) Pregnant Workers Fairness Act (PWFA) went into effect in January 2014 to provide greater flexibility for pregnant workers’ accommodations, yet no studies to date have evaluated its effectiveness and utilization. We examined factors associated with pregnant workers’ PWFA awareness, understanding of PWFA, and receipt of accommodations in a lower socioeconomic status population in NYC. Participants included 481 pregnant workers who attended prenatal visits at Mount Sinai Hospital Obstetrics and Gynecology Clinic in NYC in 2017. Detailed demographic and occupational data were collected via in-person interviews using a pregnancy and work survey. Information on participants’ PWFA awareness, knowledge of PWFA-eligible accommodations, and accommodations received was also obtained. Multivariable-adjusted logistic regressions were used to identify the factors influencing PWFA awareness, knowledge of PWFA-eligible accommodations, and accommodations received among six common examples. Only 14% of participants had ever heard of NYC PWFA legislation. Lower educational level (≤ 12th grade) (Adjusted Odds Ratio [aOR] = 0.54, 95% Confidence Interval [CI] = 0.30-0.98) and being unsure of workplace maternity leave policy (aOR=0.39, 95% CI=0.18-0.87) were associated with lack of PWFA awareness. Regardless of PWFA awareness, no maternity leave policy (aOR = 0.15, 95% CI = 0.04-0.48 vs. paid policy) and being unsure of maternity leave policy (aOR = 0.19, 95% CI = 0.06-0.59 vs. paid policy) were associated with no knowledge of any PWFA-eligible accommodations. Regardless of their PWFA awareness, women working for ≤ 5 years (aOR=0.42, 95% CI=0.22-0.83), non-U.S. born (aOR=0.57, 95% CI=0.36-0.90), and high-risk pregnancy clinic patients (aOR=0.59, 95% CI=0.38-0.93) all had lower odds of receiving PWFA-eligible accommodations, such as adjustment to lighter duty, compared to their counterparts. Lower educational level, lack of paid workplace maternity leave policy, shorter job tenure, and non-U.S. born were associated with decreased PWFA awareness and/or accommodations received. As more women continue to work during pregnancy, interventions promoting PWFA awareness and utilization are paramount for protecting the maternal and child health of these identified vulnerable groups, especially given that final regulations for a national PWFA recently went into effect across the United States in June 2024.
41. Exploring the Long-Term Human Exposure to Short-, Medium-, and Long-Chain Chlorinated Paraffins under Variant Environmental Release Trends and Patterns.
期刊: Environmental science & technology 发表日期: 2025-Aug-01 链接: PubMed
摘要
Releases of chlorinated paraffins (CPs) have led to long-term human exposure globally. Differences in CP use patterns (indoors vs outdoors) and temporal release trends in different regions may be reflected in differences in the extent and pathways of long-term exposure to CPs between human populations. We used the dynamic mechanistic model PROTEX to simulate releases and environmental fates of CPs in China, Canada, and Europe from 1930 to 2020 and contrast the resultant exposures for different birth cohorts. Predicted environmental and human body concentrations agree with measurements from the three regions. Far-field exposure pathways dominate for all cohorts even in China where CP indoor use is high. Longitudinal exposure trends differ between generations and regions due to the divergent release trends. Perinatal exposure causes high body concentrations in infants and children born in years with peak releases. Due to human elimination half-lives that are short relative to the period of release, cross-sectional concentration-age trends have similar shapes regardless of release trend and sampling time. These results imply that whereas use patterns and release trends add to the influence of physicochemical properties on relative exposure pathway importance and cross-sectional concentration-age trends, the release trends are the main factors shaping longitudinal exposure trends.
42. Supervised toothbrushing programs: evaluating impact, barriers, and facilitators - a mixed-method umbrella review.
期刊: Evidence-based dentistry 发表日期: 2025-Aug-01 链接: PubMed
摘要
To assess the effectiveness of supervised toothbrushing programs in improving oral health outcomes among children and adolescents aged 3 to 18 years and to explore stakeholders’ perceptions in implementing and sustaining tooth brushing programs. This mixed-method umbrella review followed JBI methodology and PRISMA guidelines. A systematic search was conducted across databases including MEDLINE, Cochrane, Scopus, Web of Science, CINAHL, Epistemonikos, ProQuest, and Google Scholar. A total of 159 articles were identified, and after screening, three systematic reviews met the inclusion criteria. The quantitative and qualitative findings were synthesized using a convergent segregated approach. The Theoretical Domains Framework (TDF) was applied to map barriers and facilitators influencing program adoption and sustainability. The quantitative synthesis included one systematic review with four included trials, two of which found statistically significant reductions in dental caries with supervised toothbrushing. The qualitative synthesis (two mixed-method systematic reviews) revealed key facilitators and barriers. The most prominent enablers and barriers identified across these reviews were knowledge about oral health/tooth brushing, social influences, and environmental context and resources. Specifically, the knowledge domain received 32 enabler responses and 25 barrier responses, underscoring the importance of understanding oral health practices to improve toothbrushing behavior. Social support garnered 35 enabler responses and 26 barrier responses, highlighting the role of a supportive environment in enhancing adherence to toothbrushing routines. This review highlights the effectiveness of supervised toothbrushing programs in reducing dental caries. The qualitative synthesis, guided by the Theoretical Domains Framework (TDF), identifies key barriers and facilitators, including knowledge gaps, environmental constraints, social influences, and behavioural regulation factors.
43. The mitigation effects of residential green space and low air pollution on socioeconomic inequalities in depression.
期刊: Npj mental health research 发表日期: 2025-Aug-01 链接: PubMed
摘要
Depression is highly clustered among people with low socioeconomic status (SES). Improved environments are known to be potentially beneficial, but the extent to which environments alleviate socioeconomic inequalities in depression remains unclear. Based on 334,536 UK Biobank participants, we quantified mediating roles of green space and air pollution in association between SES and depression, and examined interactive and joint relationships between SES and environments on depression. Co-improvements in green space and air quality significantly mediated 2.7% of this association. Interaction analysis indicated stronger environmental benefits for low-SES populations. Joint analysis revealed that low-SES adults in favorable environments had a 14.6% lower depression risk than medium-SES individuals in unfavorable conditions, with more pronounced effects among females (16.4%) and older adults (9.8%). Our findings emphasize mitigating role of upstream environmental factors involving green space and air quality in tackling socioeconomic inequalities in depression, particularly for vulnerable populations like the elderly and females.
44. Frequency of leisure travel and psychological well-being in pharmacists: the sequential mediating roles of perceived stress and social support.
期刊: BMC psychology 发表日期: 2025-Aug-01 链接: PubMed
摘要
Pharmacists are frequently exposed to high occupational stress, yet limited research has explored psychological recovery mechanisms in this group. Leisure travel may offer restorative benefits that enhance psychological well-being, but the underlying processes remain insufficiently understood. This study aims to examine the association between the frequency of leisure travel and psychological well-being among pharmacists in Henan, China, with particular attention to the mediating roles of perceived stress and social support. A cross-sectional design was employed, with data collected from 947 licensed pharmacists working in community, clinical, and hospital settings across Henan, China, between August and October 2024. A stratified random sampling strategy was used to ensure balanced representation across pharmacy practice types, geographic regions, and experience levels. Key study variables were assessed using validated psychometric instruments. Regression-based mediation analysis was performed to determine the direct and indirect associations among the study variables. The frequency of leisure travel was positively and significantly associated with psychological well-being (β = 0.36, p < 0.001). Perceived stress (β = 0.13, 95% CI: 0.09-0.25) and social support (β = 0.18, 95% CI: 0.10-0.31) independently mediated this relationship. A significant sequential mediation pathway was also observed (β = 0.06, 95% CI: 0.01-0.17), wherein leisure travel was linked to lower perceived stress, enhancing social support, and improving psychological well-being. These results underscore the potential psychological benefits of frequent travel, suggesting that emotional recovery and interpersonal support may be key mechanisms linking travel behaviors to improved well-being. The study offers meaningful implications for healthcare organizations aiming to support pharmacists’ mental health through evidence-based leisure and recovery strategies.
45. Living by the clock of the book: religious observance enhances circadian stability and reduces social jetlag in older adults, a cross-sectional study.
期刊: BMC public health 发表日期: 2025-Aug-01 链接: PubMed
摘要
Religious practices often structure daily behavior, yet their role in shaping sleep-wake patterns remains underexplored. While stable schedules and socially reinforced habits are known to support circadian alignment and sleep quality, few studies have examined religious observance as a behavioral framework that promotes sleep health in older adults. This study investigated whether Jewish religious lifestyle, particularly Sabbath observance, affects habitual sleep-wake patterns in late adulthood. A cross-sectional field study was conducted among 473 community-dwelling Israeli Jewish older adults (median age 69 [range 60-88]; 74.6% female; 41.9% engaged in regular work or study). Data were collected between May 2022 and February 2023 via an anonymous self-administered online survey (CLISEF), which included validated questionnaires assessing sleep behaviors, chronotype and daytime sleepiness (ultra-short Munich ChronoType Questionnaire, MCTQ; and Epworth Sleepiness Scale, ESS), and items to report subjective sleep quality, napping habits, and screen exposure at bedtime. Religious participants (n = 274) reported a unique pattern of sleep habits in comparison to their Secular peers (n = 199): they had on average an earlier chronotype (02:53 ± 01:02 vs. 03:13 ± 01:11, midsleep time on free days), longer sleep duration on free days (Sabbath) (442.7 ± 77.0 vs. 424.8 ± 76.6, min) and lower social jetlag (14.1 ± 39.6 vs. 25.7 ± 37.9, min). These differences stemmed from the group-specific patterns of sleep timing during free days (Sabbath) relative to workdays. While the Religious group slightly but significantly advanced sleep onset times on Sabbath (∆=-9 min), the Secular group significantly delayed their sleep onset times (∆=16 min). Both groups delayed sleep offset on Sabbath (∆=32 min and ∆=29 min). Additionally, the religious participants who practice day-time napping reported longer naps. No significant differences between Religious and Secular groups in subjective sleep quality, sleep latency, nighttime awakening patterns and habits of alarm clock use and screen exposure after bedtime were observed. These findings suggest that Jewish religious observance contributes to more consistent sleep-wake behaviors and earlier chronotype in older adults, emphasizing the broad relevance of sleep timing regularity for promoting daily habits that may be adopted beyond specific religious or spiritual contexts.
46. Serum Krebs von den Lungen-6 as a potential biomarker for early diagnosis of silicosis: a case-control study.
期刊: BMC pulmonary medicine 发表日期: 2025-Aug-01 链接: PubMed
摘要
Silicosis is an irreversible and progressive pulmonary fibrosis that results in prolonged inhalation of crystalline silica. Despite its significant impact, no specific blood biomarkers currently exist for the early diagnosis of this disease. This study aims to evaluate the levels of Krebs von den Lungen-6 (KL-6) in patients with early-stage silicosis and explore its potential as a diagnostic biomarker. Blood samples were collected from 40 stage I silicosis patients, 57 dust-exposed workers (DEWs), and 70 healthy controls (HCs). The concentrations of KL-6, C-reactive protein (CRP), and angiotensin-converting enzyme (ACE) were measured using the automatic biochemical analyzer. Receiver operating characteristic (ROC) curve analysis was utilized to evaluate the diagnostic efficacy of KL-6, in combination with other biomarkers for the early stage of silicosis. The association between lung function and KL-6 levels in silicosis patients was evaluated using partial correlation analysis. Serum levels of KL-6, CRP, and ACE were remarkably elevated in stage I silicosis patients compared to HCs and DEWs. KL-6 demonstrated an adjusted area under the curve (AUC) of 0.770 for distinguishing stage I silicosis patients from HCs, with a sensitivity of 80.0% and a specificity of 70.0%. When comparing silicosis patients to DEWs, KL-6 alone achieved an adjusted AUC of 0.735, with sensitivity and specificity of 45.0% and 89.5%, correspondingly. The integration of KL-6, CRP, and ACE demonstrated the highest diagnostic efficacy among all tested combinations. Furthermore, serum KL-6 levels were negatively correlated with vital capacity (VC) in silicosis patients. Serum KL-6 may serve as a potential biomarker for early silicosis diagnosis. Its diagnostic performance is significantly improved when combined with CRP ad ACE, offering a potential multi-biomarker approach for enhanced detection in the early stages of the disease. Further validation in larger and more diverse populations is needed to confirm its clinical utility.
47. Improving heat stress prevention through targeted education in hot and humid workplaces: a study in a foundry industry.
期刊: BMC public health 发表日期: 2025-Aug-01 链接: PubMed
摘要
Heat-related illnesses and deaths are predictable and preventable, while lack of education can increase the associated risks. The aim of this study was to improve heat stress prevention through targeted education in hot and humid workplaces. This intervention study with a pre-posttest design was conducted in 2023 on 50 workers in a foundry industry. Initially, by literature reviewing valid scientific databases, factors related to the perception and awareness, knowledge, and functionality (PAKF) of the workers were identified. Subsequently, the face validity of the questionnaire was determined based on the opinions of nine experts in the field of occupational heat stress. The content validity and reliability of the questionnaire were determined using the Content Validity Ratio (CVR), Content Validity Index (CVI), and Cronbach’s alpha coefficient. A two-session (180 min each) educational intervention related to preventing occupational heat stress was implemented, and the results were compared using covariance analysis. Gathered data were analyzed using Excel v.2019 and SPSS v.26 software. The study results indicated that out of 53 items designed, ultimately 27 items were confirmed, with CVI, CVR, and Cronbach’s alpha coefficient values of 0.94, 0.78, and 0.76, respectively. Conducting exploratory factor analysis led to the confirmation of 7 factors explaining 50% of the total variance, and all 27 questionnaire items showed acceptable intercorrelations. Furthermore, implementing a heat stress management program resulted in improvement in the PAKF of the intervention group compared to the control group (P < 0.001). The results of this study demonstrate that a comprehensive educational program related to the prevention of heat stress can lead to an improvement in the level of the PAKF of workers in hot working environments. Therefore, there is a need to enhance the PAKF of workers regarding heat-related hazards, strengthen training, and update current heat prevention policies to ensure compliance and implementation.
48. Moral injury is independently associated with suicidal ideation and suicide attempt in high-stress, service-oriented occupations.
期刊: Npj mental health research 发表日期: 2025-Aug-01 链接: PubMed
摘要
This study explores the link between moral injury and suicidal thoughts and behaviors among US military veterans, healthcare workers, and first responders (N = 1232). Specifically, it investigates the risk associated with moral injury that is not attributable to common mental health issues. Among the participants, 12.1% reported experiencing suicidal ideation in the past two weeks, and 7.4% had attempted suicide in their lifetime. Individuals who screened positive for probable moral injury (6.0% of the sample) had significantly higher odds of current suicidal ideation (AOR = 3.38, 95% CI = 1.65, 6.96) and lifetime attempt (AOR = 6.20, 95% CI = 2.87, 13.40), even after accounting for demographic, occupational, and mental health factors. The findings highlight the need to address moral injury alongside other mental health issues in comprehensive suicide prevention programs for high-stress, service-oriented professions.
49. Effects of postoperative complications in oesophageal cancer on survival, hospital outcomes, and long-term quality of life: retrospective cohort study.
期刊: BJS open 发表日期: 2025-Jul-01 链接: PubMed
摘要
Postoperative complications pose a major challenge in oesophageal surgery, affecting survival, recovery, and healthcare resource utilization. The aim of this study was to quantify the proportional contribution of specific complications to survival and adverse outcomes and to evaluate their effects on long-term quality of life (QoL) in patients with oesophageal and gastro-oesophageal junction cancer. This retrospective cohort study included patients with oesophageal or gastro-oesophageal junction cancer who underwent surgery with curative intent between January 2010 and July 2022. Postoperative complications were categorized following Esophageal Complications Consensus Group guidelines. Population-attributable fractions (PAFs) were calculated to estimate the proportion of adverse outcomes and survival effects theoretically preventable if specific complications were avoided. In 632 patients who underwent surgery, the most frequently observed complications were pulmonary (31%), infectious (29%), and gastrointestinal (24%). Pneumonia had the highest adjusted PAF for overall survival (8.3% after 2 years; 95% confidence interval (c.i.) 1.8 to 14.7), suggesting that preventing pneumonia could substantially reduce mortality. Anastomotic leak had the highest PAF for recurrence-free survival (6.6%; 95% c.i. 1.8 to 11.5) and was the complication most significantly contributing to reoperations (PAF 39.8%; 95% c.i. 22.2 to 52.1) and prolonged hospital stays (PAF 56.9%; 95% c.i. 46.8 to 66.2). Respiratory failure had the largest effect on 90-day mortality (PAF 53.5%; 95% c.i. 30.9 to 73.9). In contrast, no significant effect of complications on long-term QoL was observed. This study underscores the critical importance of targeted strategies to prevent postoperative complications, particularly pneumonia and anastomotic leakage, which contribute significantly to adverse outcomes such as reduced survival and prolonged hospital stays. Effective complication management may enhance oncological outcomes and optimize healthcare resource utilization.
50. Risk factors and mitigating measures associated with bile duct injury during cholecystectomy: meta-analysis.
期刊: BJS open 发表日期: 2025-Jul-01 链接: PubMed
摘要
Cholecystectomy is a common procedure with a notable risk of iatrogenic bile duct injury. Understanding the factors contributing to bile duct injury and the effectiveness of preventative measures is crucial for improving surgical outcomes. This meta-analysis aimed to identify and synthesize high-quality evidence on risk factors and mitigating measures associated with bile duct injury after cholecystectomy. Following the PRISMA guidelines, a comprehensive literature search was conducted across multiple databases. Included studies reported on adult patients undergoing cholecystectomy with relevant risk factors for bile duct injury. Meta-analyses of unadjusted and adjusted risk estimates were conducted with a random-effects model to account for heterogeneity. The study period across all included studies spanned from 1989 to 2016. The review included 31 studies comprising 6 513 599 cholecystectomies and 18 259 bile duct injuries. The primary risk factors identified were male sex (adjusted odds ratio 1.27, 95% confidence interval 1.13 to 1.39) and acute cholecystitis (adjusted odds ratio 1.74, 1.27 to 2.39). The critical view of safety was inconsistently documented and not statistically linked to reduced bile duct injury. Intraoperative cholangiogram’s routine use did not show a statistically significant association with reduced incidence of bile duct injury (adjusted odds ratio 0.92, 0.70 to 1.23). Male sex and acute cholecystitis significantly increase the risk of bile duct injury after cholecystectomy. Risk stratification for these patients before surgery would ultimately aid the shared decision-making consent process.
51. Impact of 18F-choline PET-CT or PET-MRI on surgical strategy in patients with primary hyperparathyroidism.
期刊: BJS open 发表日期: 2025-Jul-01 链接: PubMed
摘要
Accurate preoperative localization is essential for successful, focused, minimally invasive surgery in primary hyperparathyroidism (PHPT). New imaging techniques have recently been proposed. This study evaluated the impact of 18F-choline positron emission tomography (PET)-computed tomography or 18F-choline PET-magnetic resonance imaging (FCh) in patients with negative or inconclusive results on neck ultrasonography (US) and 99mTc-sestamibi (MIBI) scintigraphy. Baseline biochemical characteristics (preoperative calcemia and PTH), parathyroid gland features (size and weight), preoperative imaging localization techniques accuracy, and surgical results were compared in a series of patients operated for PHPT who underwent only preoperative US and MIBI scintigraphy with concordant results (MIBI Group) or also FCh as additional imaging following US and MIBI with negative or inconclusive results (FCh Group). The overall cure rate was 100% in 185 patients operated for PHPT. The overall sensitivity of imaging was 63.9% in the MIBI group (n = 116), compared with 94.4% (P < 0.001) in the FCh group (n = 69). FCh provided clear unilateral localization in 86.9% of patients, avoiding unnecessary bilateral neck exploration; in contrast, based on MIBI results, unilateral localization would have been theoretically possible in only 61.6% of patients. Compared with the MIBI group, patients in the FCh group had significantly lower preoperative calcium levels (2.71 versus 2.79 mmol/l; P = 0.012), lower preoperative parathyroid hormone levels (177 versus 250 pg/ml; P = 0.032), and smaller (17 versus 21 mm; P <0.001) and lighter (1.47 versus 2.58 g, P = 0.005) parathyroid glands removed. FCh enables successful focused parathyroidectomy in PHPT patients with negative or inconclusive MIBI results, reducing unnecessary bilateral neck exploration in 33% of patients; it may also allow for a successful focused approach in patients with milder PHPT, characterized by lower preoperative calcium and PTH levels and smaller pathological parathyroid glands.
52. Towards Coproduction in Mental Health Academia: A Cooperative Inquiry.
期刊: International journal of mental health nursing 发表日期: 2025-Jul 链接: PubMed
摘要
Coproduction has emerged as an important means of effective mental health service delivery. Unfortunately, this term is commonly misunderstood, with tokenistic participation too often presented as coproduction. Funding and resourcing have been identified as significant, and often insurmountable, barriers to achieving coproduction. This paper presents findings from a cooperative inquiry project, addressing ideas and strategies for working towards coproduction within an academic unit. Three consumer/lived Experience academics and three nonconsumer academics (from Nursing, Occupational Therapy and Social Work) participated in a series of in-depth conversations to consider and identify potential strategies to advance the faculty’s progress towards coproduction. Conversations were transcribed and analysed using a thematic approach. Five main themes were identified: importance of coproduction; preparing for coproduction; barriers to coproduction; the need for university transformation; and power. A belief in the inherent value of coproduction was shared among the group, and strategies were identified to clarify the level of participation. Radical transformation of universities, aligned with contemporary industry practice, is essential to achieving coproduction. Strategies such as allocating vacant academic positions for health professionals to consumer academics are indicative of measures required for genuine aspirations for coproduction to be realised and to address the seemingly insurmountable funding issues. Universities must recognise power differences and remain honest about their position according to participation ladders. These findings provide guidance for academics who acknowledge the value of coproduction to address the commonly identified barriers to its implementation.