公共卫生研究摘要 (2025-08-05)
共收录 57 篇研究文章
1. Methylation profile of individuals with sickle cell trait.
期刊: Epigenetics 发表日期: 2025-Dec 链接: PubMed
摘要
Sickle cell trait (SCT) is due to heterozygosity for the β-globin sickle cell mutation. SCT recently has been associated with increased risk of various adverse health outcomes. DNA methylation (DNAm) is one potential mechanism by which SCT may impact disease risk. To identify DNAm sites associated with SCT, we conducted an epigenome-wide association (EWAS) meta-analysis using whole blood Illumina EPIC array data available in a total of 3,677 African American participants (including 1,071 with SCT) from the Women’s Health Initiative and Jackson Heart Study. We identified 103 differentially methylated CpGs and 119 differentially methylated regions associated with SCT. The strongest signals were hypermethylated cis loci within predicted regulatory elements within or near the β-globin gene cluster on chromosome 11. Beyond the globin locus, SCT-associated DMPs were enriched in genes involved in redox regulation and oxidative stress. We also demonstrate an association of SCT with differences in biological age and epigenetic age acceleration, though the pattern and strength of association differ according to the epigenetic clock used. Specifically, more recent epigenetic clocks that incorporate clinical phenotypes or laboratory biomarkers related to adverse health outcomes are associated with accelerated aging among individuals with SCT compared to African American controls. Our results lay the groundwork for future study of the role of DNAm in biologic aging and related health outcomes among individuals with SCT.
2. Anticoagulation Strategies Following Breakthrough Ischemic Stroke While on Direct Anticoagulants: A Meta-Analysis.
期刊: Neurology 发表日期: 2025-Aug-26 链接: PubMed
摘要
The management of anticoagulation after ischemic stroke while on direct oral anticoagulants (DOACs) is controversial. We performed an aggregate-data meta-analysis to compare anticoagulation strategies against each other to define the effect of switch to warfarin, switch to another DOAC, change in dosage, and add-on antiplatelet for the prevention of recurrent stroke, intracranial hemorrhage (ICH), any stroke, and mortality. The study protocol was deposited with PROSPERO (CRD42025639057). We systematically searched MEDLINE, Scopus, and the Cochrane Library-all studies reporting on anticoagulation strategies after a stroke while on DOAC up to January 31, 2025. We included randomized controlled clinical studies and cohort studies with sample size ≥50 that (1) enrolled adult patients who experienced ischemic stroke while on DOACs, (2) assessed modifications to anticoagulation therapy, and (3) reported on at least one of the outcomes. Main outcome was recurrent ischemic stroke; secondary outcomes were ICH, all-cause mortality, and any stroke. We pooled estimates by random-effects modelling, reporting risk ratio (RR) with 95% CIs comparing anticoagulation strategies against each other. We retrieved 2,171 results, with 8 observational studies reaching quantitative synthesis (n = 14,307 patients, mean age = 75 years, 48% female). Switching to warfarin was associated with a higher risk of ischemic stroke compared with keeping the same DOAC (RR 1.80, 95% CI 1.42-2.29, I2 = 0%, nstudies = 5) or changing DOAC dosage (RR 1.72, 95% CI 1.20-2.45, I2 = 0%, nstudies = 4). Switching to warfarin was also associated with higher ICH rates compared with keeping the same DOAC (RR 2.90, 95% CI 2.01-4.18, I2 = 0%, nstudies = 5) and DOAC-to-DOAC switch (RR 3.25, 95% CI 2.13-4.96, I2 = 0%; nstudies = 5). Keeping the same DOAC and switching to another DOAC, independently from mechanism, had similar rates of primary and secondary outcomes. Our meta-analysis indicates that switching to warfarin after a stroke while on DOAC seems less effective and safe in stroke recurrence prevention, ICH, and mortality compared with DOAC-based strategies.
3. Pelota-mediated ribosome-associated quality control counteracts aging and age-associated pathologies across species.
期刊: Proceedings of the National Academy of Sciences of the United States of America 发表日期: 2025-Aug-12 链接: PubMed
摘要
Ribosome-associated quality control (RQC) is a pivotal biological process that governs the fidelity of messenger RNA (mRNA) homeostasis and protein synthesis. Defects in RQC are implicated in cellular dysfunction and proteotoxicity, but their impact on aging remains elusive. Here, we show that Pelota, the ribosome rescue factor, promotes longevity and protects against age-related pathological phenotypes in multiple metazoan species. By performing a targeted genetic screen, we find that Pelota is indispensable for longevity in the nematode Caenorhabditis elegans. We show that Pelota mitigates premature senescence in cultured human cells, muscle aging in mice, and neuropathology in cellular and organoid models of Alzheimer’s disease. Mechanistically, we demonstrate that Pelota maintains autophagy-mediated proteostasis, by preventing the hyperactivation of mechanistic target of rapamycin signaling. Overall, our work highlights the conserved functional significance of RQC, regulated by Pelota, in extending lifespan and protecting diverse species against age-associated disease phenotypes.
4. Influenza A virus NS1 protein mimics oncogenic PI3K resulting in isoform specific cellular redistribution and activation.
期刊: Proceedings of the National Academy of Sciences of the United States of America 发表日期: 2025-Aug-12 链接: PubMed
摘要
The nonstructural protein 1 (NS1) of influenza A virus performs a broad variety of proviral activities in the infected cell, primarily mediating evasion from the host innate immune response by being the main viral interferon antagonist. However, there are several interactions whose biological relevance remains obscure, such as the ability of NS1 to bind and activate class IA phosphoinositide 3-kinases (PI3Ks). PI3Ks are highly regulated lipid kinases that act as critical nodes in multiple cell signaling networks and are also important proto-oncogenes. This activation is mediated by NS1 binding specifically to the p85β subunit. To better understand the consequences of this interaction, we developed a bimolecular fluorescence complementation (BiFC) assay to selectively track the different PI3K heterodimers and, using this system, we found that NS1 induces an isoform-specific relocation and activation of the different PI3K heterodimers. We found that clinically relevant oncogenic mutations in both catalytic and regulatory subunits of PI3K could mimic the effect caused by NS1, and partially rescue the loss of viral fitness in a recombinant virus encoding a p85β-binding deficient NS1.
5. Structural basis for anaerobic alkane activation by a multisubunit glycyl radical enzyme.
期刊: Proceedings of the National Academy of Sciences of the United States of America 发表日期: 2025-Aug-12 链接: PubMed
摘要
X-succinate synthases (XSSs) are glycyl radical enzymes (GREs) that catalyze the addition of hydrocarbons to fumarate via radical chemistry, thereby activating them for microbial metabolism. To date, the only structurally characterized XSS is benzylsuccinate synthase (BSS), which functionalizes toluene. A distinct subclass of XSSs acts on saturated hydrocarbons, which possess much stronger C(sp3)-H bonds than toluene, suggesting mechanistic and structural differences from BSS. Here, we use cryogenic electron microscopy to determine the structure of one such enzyme, (1-methylalkyl)succinate synthase (MASS) from Azoarcus strain HxN1, which functionalizes n-alkanes (C6-C8). The structure reveals an asymmetric dimer in which both sides contain a catalytic α-subunit and accessory γ-subunit. One α-subunit also binds two additional subunits, β and δ. The β-subunit binds a [4Fe-4S] cluster and adopts a fold similar to BSSβ. The β-subunit appears to regulate the flexibility of the α-subunit to enable opening of the active site, affording the binding of n-alkane substrates. The δ-subunit, which lacks homology to known GRE subunits, adopts a rubredoxin-like fold that binds a single Fe ion, an architecture not previously reported for GREs. MASSδ occupies the same region of the α-subunit as the activating enzyme (AE) and may regulate the conformational changes required for glycyl radical installation. Structural comparisons between MASS and BSS reveal differences in how fumarate is bound and show amino acid substitutions that could account for the binding of alkanes versus toluene. Together, this structure offers insight into anaerobic alkane activation via fumarate addition.
6. Nutritional status of adolescents undergoing tuberculosis treatment in urban Bangladesh: prevalence and determinants of malnutrition.
期刊: International journal of adolescent medicine and health 发表日期: 2025-Aug-06 链接: PubMed
摘要
Tuberculosis is a global public health challenge, disproportionately affecting adolescents in low-and middle-income countries. Malnutrition worsens immune function, delays recovery and increases the risk of treatment failure in Tuberculosis patients. The objectives of this study was to assess the nutritional status of adolescents undergoing TB treatment in urban Bangladesh and identify the determinants of malnutrition. A cross-sectional study was conducted from November 1, 2023, to May 31, 2024, among 339 adolescents receiving Tuberculosis treatment in five hospitals in Dhaka, Bangladesh. Nutritional status was primarily assessed by Patient-Generated Subjective Global Assessment (PG-SGA). Anthropometric data were collected to calculate BMI-for-age and height-for-age z-scores to verify nutritional status. The prevalence of severe malnutrition was 14.2 % and another 41.6 % were found moderately malnourished in PG-SGA. The z-scores also showed 14.2 % had severe malnutrition and 21.2 % had moderate malnutrition. The mean BMI was 17.89, with 59.3 % of participants underweight and 63.7 % experiencing some degree of stunting. Eating difficulties, particularly appetite loss, were reported by 45.4 % of adolescents. While 52.8 % received some nutrition-related information, only 1.8 % received comprehensive nutritional care. Logistic regression identified significant predictors of malnutrition, including female gender (AOR=0.51, p=0.01), presence of major comorbidities (AOR=3.67, p=0.01), eating difficulties (AOR=3.41, p<0.01), Type I Tuberculosis (AOR=2.57, p<0.01), and less than four meals (AOR=2.69, p=0.01). Both PG-SGA and anthropometric indicators revealed significant nutritional deficits. Integrated nutritional support and management of comorbidities should be prioritized alongside Tuberculosis care to improve treatment outcomes.
7. Efficacy of a Very-Low-Calorie Weight Loss Diet Plus Exercise Compared With Exercise Alone on Hip Osteoarthritis Pain : A Randomized Controlled Trial.
期刊: Annals of internal medicine 发表日期: 2025-Aug-05 链接: PubMed
摘要
Exercise is recommended to manage hip osteoarthritis, but weight loss recommendations are conflicting. To evaluate the efficacy of a weight loss diet added to exercise on change in hip pain. 2-group superiority randomized trial. (ClinicalTrials.gov: NCT04825483). Community. 101 adults with hip osteoarthritis and overweight or obesity. Both the exercise only group and very-low-calorie diet (VLCD) plus exercise group were provided with a 6-month home exercise program via 5 telehealth consultations. The VLCD plus exercise group also received a VLCD via 6 telehealth consultations. The primary outcome was 6-month change in hip pain severity (11-point scale; range 0 to 10, with higher scores indicating worse pain; minimum clinically important difference of 1.8). Secondary end points included other measures of hip pain, physical function, quality of life, body weight, body composition, and adverse events. 99 (98%) and 95 (94%) participants provided 6- and 12-month primary outcomes, respectively. Although VLCD plus exercise lost 8.5% more weight than exercise only, VLCD plus exercise was not more effective for change in hip pain severity (mean difference, -0.6 units [95% CI, -1.5 to 0.3]) at 6 months. Between-group differences for other secondary outcomes at 6 months favored VLCD plus exercise except Hip Disability and Osteoarthritis Outcome Score (HOOS) pain and function. At 12 months, weight, body mass index, HOOS pain and function, and overall hip improvement, but not quality of life and physical activity, favored VLCD plus exercise. There were no serious related adverse events. Participants were unblinded. Adding a weight loss diet to exercise did not change hip pain but improved most secondary outcomes. National Health and Medical Research Council.
8. Disproportionate Loneliness Burden Demonstrated in Two National Samples of Working-Age Adults With Varied Disability Types.
期刊: Annals of internal medicine 发表日期: 2025-Aug-05 链接: PubMed
摘要
9. Engineering Infection Controls to Reduce Indoor Transmission of Respiratory Infections : A Scoping Review.
期刊: Annals of internal medicine 发表日期: 2025-Aug-05 链接: PubMed
摘要
Engineering infection controls include a wide range of interventions used indoors to reduce occupants’ exposure to respiratory pathogens. To identify and describe primary studies evaluating the effects of engineering infection control interventions designed to reduce the spread of respiratory infections transmitted through indoor air. MEDLINE, Embase, Global Health, Cochrane Central Register of Controlled Trials, CINAHL, Scopus, and Environmental Science Collection from database inception to 12 December 2023. English-language primary research articles evaluating engineering infection control interventions. Publication information, population characteristics, intervention details, and all relevant outcomes were abstracted by a reviewer and verified by a second, senior reviewer. A total of 672 studies published between 1929 and 2024 were identified. Most (n = 606) evaluated environmental samples only, 57 included human participants, and 9 included sentinel animal subjects. About half of the studies included at least 1 intervention classified as pathogen inactivation (n = 405), with fewer involving pathogen removal (n = 200) or air exchange or dilution (n = 143). Across all studies, about half (n = 332) measured the quantity of viable nonpathogenic organisms from air samples, followed by the quantity of nonbiological particulates (n = 197) or viable pathogenic organisms (n = 149). Harms, such as toxic byproducts, were rarely measured. Exclusion of non-English-language publications and gray literature. There is substantial heterogeneity in the available evidence. Gaps in evidence include studies measuring efficacy outcomes that are highly relevant for human infection transmission or harms. Refinements in classification of interventions and outcomes could strengthen reporting of these evaluations. National Institute for Occupational Safety and Health at the Centers for Disease Control and Prevention. (Registered on Open Science Framework [https://osf.io/5zmhd]).
10. Prevalence of mental health symptoms in Singapore elite athletes.
期刊: Singapore medical journal 发表日期: 2025-Aug-05 链接: PubMed
摘要
Mental health research on elite athletes in Asian populations trails behind that of the West, especially in multiethnic societies such as Singapore. This study explored the prevalence and risk factors associated with mental health symptoms among national athletes in Singapore across various sports. Singapore national athletes answered an internet-based questionnaire comprising validated screening tools for symptoms of four mental health conditions - athlete-specific psychological strain, depression, anxiety and disordered eating. A total of 356 athletes participated in the study. Of these, 70% of respondents reported ‘high’ to ‘very high’ levels of athlete-specific psychological strain, 41% reported clinically significant (‘mild’ to ‘severe’) depressive symptoms, 18% reported ‘moderate’ to ‘severe’ anxiety symptoms, and 16% were suspected for disordered eating. Females were more likely to have clinically significant depressive (adjusted odds ratio [aOR] 3.44, P < 0.001) and anxiety (aOR 2.59, P = 0.006) symptoms compared to males. Athletes of Indian ethnicity were more likely to have depressive (aOR 4.18, P = 0.018), anxiety (aOR 4.24, P = 0.032) and psychological strain (aOR 11.83, P = 0.021) symptoms than their Chinese counterparts. Athletes who recently underwent a change in school (aOR 8.89, P = 0.002) or major examinations (aOR 3.23, P = 0.014) were more likely to have depressive symptoms than those who did not. Respondents with a current injury were more likely to experience greater athlete-specific psychological strain (odds ratio 1.79, P = 0.031) compared to those who were not injured. High-performance athletes from various sports in multiethnic Singapore carried a significant burden of poor mental health, comparable to both the local general population and Western sporting populations. Prioritisation of resources to target high-risk groups may serve to bridge the sizeable treatment gap.
11. Innovative approaches to collecting, aggregating, and analyzing adverse drug events in smart hospitals.
期刊: The International journal of risk & safety in medicine 发表日期: 2025-Aug-04 链接: PubMed
摘要
BackgroundThe increasing integration of electronic health records (EHRs) and their secondary use provide new pathways to advance drug safety. Smart hospitals use advanced data collection to enhance pharmacovigilance and better detect adverse drug events (ADEs). Finland’s secondary-use legislation embodies this data-sharing shift.ObjectiveThis work synthesizes current evidence and proposes strategies to strengthen ADE detection and analysis in smart hospitals by integrating multimodal data sources, including EHRs, sensor data, and the Internet of Medical Things (IoMT), to raise overall drug safety standards.MethodsWe review the Global Trigger Tool (GTT), sensor technologies, and IoMT for ADE detection and outline how these techniques can be combined, offering a more comprehensive approach to monitoring.ResultsIntegrating GTT, sensors, and IoMT into a unified system could improve ADE detection and prevention. Combining pharmacovigilance tools with advanced technology can increase the volume and quality of ADE data and supports a preventive focus on patient safety.ConclusionsThe study underscores the importance of the smart-hospital concept and emerging data-collection methods in pharmacovigilance. By adopting a holistic approach to ADE detection and integrating diverse data sources, more robust drug-safety surveillance and patient care can be achieved when coupled with human oversight and regulatory compliance.
12. Framework to Select Multi-Cancer Detection Assays in the National Cancer Institute's Vanguard Study.
期刊: Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology 发表日期: 2025-Aug-04 链接: PubMed
摘要
The Cancer Screening Research Network (CSRN) is a new clinical trials network funded by the National Cancer Institute. The first CSRN study, the Vanguard Study, will assess the feasibility of using multi-cancer detection (MCD) tests in future randomized controlled trials. This paper describes the framework NCI developed to engage MCD assay developers, evaluate emerging technologies using biobank reference sets, and select fit-for-purpose MCD assays for inclusion in the Vanguard Study. NCI evaluated twenty-three technologically diverse MCD assays, all utilizing machine learning and artificial intelligence components. Nine assays underwent blinded performance evaluations, using specimens from three biobanks. Assay developers were provided with independent assessments of their assays, which enabled them to make further assay refinements to enhance performance. The assay selection process resulted in participation by two assay companies in the Vanguard Study. NCI created a fair and transparent process to streamline the evaluation of assay performance and to select promising assays for clinical research and public health initiatives. Significant resources are required for large scale cancer screening trials, therefore promising technologies must be prioritized for inclusion in a definitive trial. NCI’s assay selection framework can be used and repurposed by other networks and institutions.
13. Deciphering neutrophil dynamics in the focal lesion tumor microenvironment to overcome immunosuppression in multiple myeloma.
期刊: Blood 发表日期: 2025-Aug-04 链接: PubMed
摘要
Understanding the roles of myeloid cells in the tumor microenvironment (TME) has emerged as a promising strategy to identify novel targets to counteract the immunosuppressive barriers protecting multiple myeloma (MM). Neutrophils are a new cancer research focus due to their potential to reduce the efficacy of immune-based therapies. This study aimed to deepen understanding of neutrophil function in MM by analyzing freshly isolated myeloid cells from paired focal lesions (FL) and bone marrow (BM) using single-cell RNA sequencing (scRNA-seq), immunofluorescence imaging, and functional assays. We describe three distinct CXCR2+ mature neutrophil subsets: TREM1+CD10+, RETN+LCN2+, and TNFAIP3+CXCL8+, each exhibiting unique phenotypes within the TME. Notably, the TREM1+CD10+ subset was highly prevalent, particularly in FL, demonstrating potent immunosuppressive effects on T cells. This subset’s gene signature was correlated with shorter overall survival (OS) in a large MM patient dataset, underscoring its clinical significance. Targeted inhibition of neutrophil activity through CXCR2 blockade, alone or combined with standard anti-MM therapies, significantly reduced tumor burden, improving OS in preclinical MM models. These insights into neutrophil-mediated immunosuppression in MM provide valuable knowledge regarding mechanisms driving immune evasion and reveal new therapeutic approaches to enhance the efficacy of MM treatment.
14. Quantifying the Predictability of Lesion Growth and Its Contribution to Quantitative Resistance Using Field Phenomics.
期刊: Phytopathology 发表日期: 2025-Aug-04 链接: PubMed
摘要
Measuring individual components of pathogen reproduction is key to understanding mechanisms underlying rate-reducing quantitative resistance (QR). Simulation models predict that lesion expansion plays a key role in seasonal epidemics of foliar diseases, but measuring lesion growth with sufficient precision and scale to test these predictions under field conditions has remained impractical. We used deep learning-based image analysis to track 6889 individual lesions caused by Zymoseptoria tritici on 14 wheat cultivars across two field seasons, enabling 27,218 precise and objective measurements of lesion growth in the field. Lesion appearance traits reflecting specific interactions between particular host and pathogen genotypes were consistently associated with lesion growth, whereas overall effects of host genotype and environment were modest. Both host cultivar and cultivar-by-environment interaction effects on lesion growth were highly significant and moderately heritable (h2 ≥ 0.40). After excluding a single outlier cultivar, a strong and statistically significant association between lesion growth and overall QR was found. Lesion expansion appears to be an important component of QR to STB in most-but not all-wheat cultivars, underscoring its potential as a selection target. By facilitating the dissection of individual resistance components, our approach can support more targeted, knowledge-based breeding for durable QR.
15. Drivers of Delayed Time to Surgery for Hip Fracture Patients: A Multi-Center Qualitative Study.
期刊: The Journal of the American Academy of Orthopaedic Surgeons 发表日期: 2025-Aug-04 链接: PubMed
摘要
Delays in time to surgery (TTS) for patients with a hip fracture negatively affect patient outcomes, including mortality. Surgery within 24 to 48 hours of admission for a hip fracture markedly reduces these risks; however, attempts at improving TTS after hip fracture have had mixed results. Drivers of delays in TTS across different settings in the United States are not well described. Therefore, the aim of this study was to identify drivers of delays in TTS for patients with a hip fracture from different settings to inform where patient- and context-specific improvements in TTS may be implemented. Semistructured interviews were completed using the Consolidated Framework for Implementation Research and Theoretical Domains Framework. Interviews were completed with stakeholders involved in hip fracture care between June 2023 and October 2023. Transcripts were analyzed iteratively through a combined inductive and deductive approach. The data were analyzed to synthesize overarching themes related to drivers of delays of TTS. A total of 25 stakeholders, 24 orthopaedic surgeons, and 1 nurse practitioner, from 22 different hospital systems across the United States participated in semistructured interviews. Eight themes of drivers of delayed TTS emerged: (1) patient health; (2) structural drivers of health; (3) care coordination; (4) prioritization; (5) improvement climate; (6) availability; (7) incentive structure; and (8) empowerment. Eight major themes related to drivers in TTS for patients with a hip fracture were identified across hospital systems. These findings inform the process of identifying site-specific drivers of delayed TTS at individual health systems and implementing targeted improvement programs for TTS for patients with a hip fracture.
16. Immediate Procedure Reimbursement, 30-Day and 90-Day Episode Payments are Lower in Ambulatory Surgery Centers Versus Hospital Outpatient Departments for Lumbar Laminectomy.
期刊: Clinical spine surgery 发表日期: 2025-Aug-04 链接: PubMed
摘要
Retrospective cohort study. The primary objective was to compare the immediate procedure reimbursement between ambulatory surgery centers (ASCs) and hospital outpatient departments (HOPDs) for single-level and multilevel lumbar laminectomies in commercially insured patients. The secondary objectives were to compare (1) patient out-of-pocket expenditures and surgeon-specific reimbursement and (2) 30-day and 90-day episode payments between the surgery settings. Lumbar laminectomy is a common treatment for lumbar spine pathology, with cases increasing annually in outpatient settings. However, there is no clear consensus on financial savings related to ASCs versus HOPDs for these procedures. The Merative MarketScan Commercial Claims and Encounters Database identified lumbar laminectomies performed at an ASC or HOPD in patients aged 18-64. Immediate procedure reimbursement, surgeon reimbursement, and 30-day and 90-day payments were constructed from gross payments; corresponding patient out-of-pocket expenditures were extracted. Multivariable regression models estimated adjusted between-setting mean differences and 95% confidence intervals. After matching, the single-level cohort included 699 patients (36.9% ASCs), and the multilevel cohort included 694 patients (36.0% ASCs). In multivariable models, the adjusted mean of immediate procedure reimbursement was lower for ASCs (single-level: -$2492, P=0.001; multilevel: -$5629, P<0.001). Surgeon reimbursement was higher for single-level procedures in ASCs ($911, P<0.001). Payments were lower for ASCs in the 30-day period (single-level: -$4354, P<0.001; multilevel: -$7781, P<0.001) and 90-day period (single-level: -$3757, P<0.001; multilevel: -$8465, P<0.001). Immediate procedure reimbursement, 30-day and 90-day payments were lower for ASCs versus HOPDs. Surgeon reimbursement was higher in ASCs for single-level while no difference was observed for multilevel procedures. These findings highlight the potential for savings from performing lumbar laminectomies in ASCs versus HOPDs for commercially insured patients. Level III.
17. Commentary: Sex Differences in the COVID-19 Vaccine Uptake in the United States.
期刊: American journal of health promotion : AJHP 发表日期: 2025-Aug-04 链接: PubMed
摘要
Objective: This commentary critically evaluates a recent scoping review on differences in COVID-19 vaccine intentions and uptake in the United States (U.S.) by gender or sex.Data Source: The reference articles in the scoping review titled “A Scoping Review on Gender/Sex Differences in COVID-19 Vaccine Intentions and Uptake in the United States” and other published articles on the subject.Study inclusion and exclusion criteria: Peer-reviewed articles in the English language that studied COVID-19 vaccine uptake in the U.S. population and evaluated sex/gender differences in vaccination were included. Studies that only assessed COVID-19 vaccine intentions in the U.S. population were excluded.Data extraction: Not applicable to this study.Data synthesis: Not applicable to this study.Results: The commentary findings on gender/sex differences are drawn from limited evidence, many with particular subpopulations (e.g., healthcare workers and military personnel) and an unbalanced gender/sex mix. Additionally, several studies use data from small surveys. By contrast, analyses using immunization registry data and large nationally representative surveys consistently find a higher COVID-19 vaccine uptake among women than men overall and in most age groups.Conclusion: This commentary argues for the inclusion of higher-quality, population-representative data sources within reviews to illustrate gender/sex differences in vaccine coverage more accurately.
18. Short-latency afferent inhibition on cortical motor representation in healthy humans.
期刊: Journal of neurophysiology 发表日期: 2025-Aug-04 链接: PubMed
摘要
The motor system continuously receives sensory inputs and uses this information to perform purposeful movements in a process known as sensorimotor integration. As a biomarker of sensorimotor integration efficacy, short-term afferent inhibition (SAI), the phenomenon whereby afferent sensory inputs inhibit cortical motor outputs in a given muscle, has been widely studied in humans. However, it remains unclear how the (sensory) nerve-muscle relationship, that is, anatomical proximity and homotopy (nerve-supply to muscles), affects SAI magnitude. To address this question, we assessed SAI magnitudes in cortical motor excitability by examining the size of the motor representations of two intrinsic hand muscles when afferent inputs were provided to the nerves either innervating or non-innervating to the muscles. In sixteen healthy adults, we measured the effect of conditioning electrical stimuli to the median nerve (MN) or ulnar nerve (UN) at the wrist on motor evoked potentials induced by transcranial magnetic stimulation in the first dorsal interosseous (FDI, innervated by UN) and abductor pollicis brevis (APB, innervated by MN) muscles, both of which are anatomically located closer to MN than to UN. Conditioning MN stimulation resulted in a significant SAI in both muscles, with no significant difference in SAI between the muscles. No clear SAI was found in either muscle with the UN stimulation. These results suggest that SAI magnitude may depend on anatomical proximity rather than on homotopy. Given the inhibition of motor representation size of both muscles, the specific nature of such SAI may contribute to the synergistic coordination between muscles.
19. The contralateral repeated bout effect is not caused by adaptations in skeletal muscle.
期刊: Journal of applied physiology (Bethesda, Md. : 1985) 发表日期: 2025-Aug-04 链接: PubMed
摘要
The repeated bout effect (RBE) refers to the phenomenon whereby the recovery of maximal voluntary contraction, a parameter considered to reflect muscle damage, is enhanced in a subsequent bout of exercise following an initial damaging bout. To investigate whether the ipsilateral RBE (IL-RBE) and contralateral RBE (CL-RBE) involve peripheral skeletal muscle adaptations, we assessed strength recovery following damaging eccentric contractions (ECCs) using supramaximal electrical stimulation to recruit all muscle fibers. Male Wistar rats were randomly assigned to one of four groups: non-damaging control (CNT), damage (DMG), IL-RBE, and CL-RBE. The plantar flexors were exposed to 100 repeated ECCs with supramaximal electrical stimulation: once in the DMG group, and twice at 2-week intervals in the IL-RBE and CL-RBE groups. In the DMG group, the maximum isometric torque (MIT) at a stimulation frequency of 100 Hz remained 30% lower than the initial value even 4 days after ECCs. This was accompanied by an increased number of Evans Blue Dye-positive fibers, activation of calpain 1, and decreased expression of excitation-contraction coupling proteins. In the IL-RBE group, membrane damage and protein degradation were almost completely prevented, and MIT returned to baseline by one day after ECCs. Conversely, the CL-RBE group did not show these beneficial effects observed in the IL-RBE group. These findings suggest that protective peripheral muscle adaptations contribute to the IL-RBE, but similar adaptations are unlikely to play a role in the CL-RBE.
20. Targeting axial and peripheral psoriatic arthritis: a retrospective observational study on the clinical relevance of upadacitinib.
期刊: Rheumatology (Oxford, England) 发表日期: 2025-Aug-04 链接: PubMed
摘要
To evaluate upadacitinib (UPA) effectiveness on axial and peripheral manifestations of psoriatic arthritis (PsA) by assessing the proportion of patients achieving low disease activity (LDA) and inactive disease (ID) status for axial involvement, and MDA and DAPSA-defined remission/LDA for peripheral domain. This retrospective study included PsA patients from 27 Italian rheumatology centers. Demographic, clinical, and outcome data were collected at baseline, 6, and 12 months. Kaplan-Meier curves assessed treatment persistence. Multivariate models identified predictors of discontinuation and outcomes. Among 425 patients, 282 (66.4%) had peripheral PsA and 143 (33.6%) mixed (peripheral and axial) PsA. The 12-month UPA survival rate was 75.1%, higher in peripheral than mixed PsA (p= 0.039). Fibromyalgia was the strongest predictor of discontinuation (aHR 1.72; 95% CI: 1.08-2.75; p= 0.022). At 12 months, 38.2% of patients achieved ASDAS-LDA and 20.6% reached ASDAS-ID (LUNDEX-adjusted rates were 29.4% and 15.8%, respectively). The crude 12-month MDA rate was 59.9% (47.4% after LUNDEX adjustment). Enthesitis resolved in 80.2% of patients (p< 0.001), and non-steroidal anti-inflammatory drugs use decreased to 32.9% (p< 0.001). Overall, VAS pain decreased significantly from 71.4-40 (mean change -31.4; 95% CI: - 42.5 to-33.6; p< 0.0001), with a 44% reduction, well above the minimal clinically important improvement. No major cardiovascular events were reported; most adverse events were mild, including gastrointestinal intolerance (19%), infections (9.5%), and elevated liver enzymes (14.2%). Our study confirms UPA effectiveness across PsA domains, with clinically meaningful improvements in axial involvement and pain.
21. Younger Adults, Earlier Screening-What We Are Learning About Colorectal Cancer and What Comes Next.
期刊: JAMA 发表日期: 2025-Aug-04 链接: PubMed
摘要
22. Veterans crisis line use among Asian American, Native Hawaiian, and Pacific Islander veterans: Contact reasons and risk assessment, by gender.
期刊: Psychological services 发表日期: 2025-Aug-04 链接: PubMed
摘要
Suicide rates have increased substantially among Asian American, Native Hawaiian, and Pacific Islander (AANHPI) veterans, as well as among women veterans. The Veterans Crisis Line (VCL) is a resource available to all veterans as part of the Department of Veterans Affairs’ multifaceted suicide prevention strategy. Despite well-documented gender differences in suicide risk and reasons for contacting the VCL, little is known about AANHPI veterans’ use of the VCL and whether their reasons for contacting the VCL differ by gender. This descriptive analysis examined the demographics, reasons for contacting the VCL, and suicide risk assessment ratings for AANHPI veterans who contacted the VCL, by gender, as a first step to better understand VCL use in this heterogenous population. Using VCL and Veterans Affairs administrative data, we examined demographics, reasons for contacting the VCL, and suicide risk assessment ratings for 1,645 AANHPI veterans who contacted the VCL in Calendar Year 2020, stratified by gender and disaggregated between Asian American (AA) and Native Hawaiian and Pacific Islander (NHPI) veterans. Mental health was indicated as the most frequent reason for VCL contact for AANHPI women (84.8% of contacts) and men (66.1% of contacts). Suicidal thoughts or crises (34.5% of women, 27.5% of men) were noted as the second most frequent reason for contact across groups, followed by relationship problems (23.7% of women, 21.4% of men). We observed some similar patterns across race/ethnicity and gender subgroups, with some variation between groups. Nearly three quarters (74.6%) of NHPI women endorsed suicide risk screen indicator(s), with lower proportions among AA women (69.1%), AA men (57.8%), and NHPI men (57.3%). Additionally, 12.7% of NHPI women, 9.8% of NHPI men, 8.1% of AA men, and 5.6% of AA women were rated by VCL responders as being at elevated suicide risk. These initial descriptive findings highlight the importance of disaggregating data both by gender and race/ethnicity among AANHPI veterans. Further study of suicide risk and protective factors salient to each subgroup of AANHPI veterans is a critical next step to suicide prevention among these veterans. (PsycInfo Database Record (c) 2025 APA, all rights reserved).
23. Quantifying Rurality: County-level case rates of Chlamydia trachomatis and Neisseria gonorrhoeae in the United States by Rurality, 2016-2022.
期刊: Sexually transmitted diseases 发表日期: 2025-Aug-04 链接: PubMed
摘要
Persons in rural communities experience barriers to preventative STI services, including screening. We calculated aggregated annual national rural and urban chlamydia and gonorrhea case rates for 2016-2022 and found rates were consistently higher among urban counties. Trends in both urban and rural case rates followed a similar trajectory over time.
24. Focal Boost to the Intraprostatic Tumor in External Beam Radiotherapy for Patients With Localized Prostate Cancer: 10-Year Outcomes of the FLAME Trial.
期刊: Journal of clinical oncology : official journal of the American Society of Clinical Oncology 发表日期: 2025-Aug-04 链接: PubMed
摘要
The FLAME trial hypothesized that focal boosting of intraprostatic tumor lesion(s) in addition to standard external beam radiotherapy (EBRT) improves biochemical disease-free survival (bDFS). In this multicenter randomized phase III trial, patients with intermediate- and high-risk prostate cancer (PCa) were assigned to the standard (EBRT of 77 Gy in 35 fractions to the whole prostate gland) or focal boost arm (standard EBRT with a focal boost of up to 95 Gy to magnetic resonance imaging-visible lesion(s)). Initial 5-year results showed a significant improvement in the focal boost arm for bDFS without additional toxicity. Here, we report bDFS, disease-free survival (DFS), local DFS, regional lymph node DFS, distant metastasis-free survival (DMFS), and overall survival (OS) after a 10-year follow-up. Dose-response curves were created using the dose heterogeneity in the study arm. Between 2009 and 2015, 571 patients were randomly assigned. The 10-year bDFS was 71% in the standard arm versus 86% in the focal boost arm. A significant improvement was also observed for other end points, except DMFS and OS. However, the dose-response curve suggests an association between dose and distant metastatic failure. The 10-year results demonstrated the sustained benefit of focal boosting on bDFS. By preventing biochemical failure, men are spared the potential burden of PCa recurrence.
25. Identification of and Response to Influenza A(H5) in Off-the-Shelf Raw Milk-Santa Clara County, California, November-December 2024.
期刊: Clinical infectious diseases : an official publication of the Infectious Diseases Society of America 发表日期: 2025-Aug-04 链接: PubMed
摘要
In November-December 2024, the County of Santa Clara Public Health Department detected influenza A and A(H5) virus in unpasteurized milk sold in the county. A(H5N1) virus surveillance of off-the-shelf unpasteurized milk led to early detection and recall of potentially infectious products that prompted state agencies’ verification and subsequent regulatory action.
26. The Invisible Extinction.
期刊: Annual review of microbiology 发表日期: 2025-Aug-04 链接: PubMed
摘要
The characterization of the human microbiome has opened a new chapter in understanding human biology and its relationship to health and disease. Yet we also have learned that our ancient coevolved microbiome has been changing across recent human generations; we have been losing a substantial amount of its diversity. This is especially concerning because the microbiota that we acquire early in life has important bearing on our developmental trajectory, especially with regard to metabolism, immunity, and cognition. Collectively, the early-life microbiota is a partner in our human developmental biology. We detail the medical, public health, and dietary phenomena bearing on the acquisition, maintenance, and loss of members of the microbiota and then consider the linkages between the altered microbiome and the diseases that have been emerging in recent years. Finally, we highlight ways to address and solve these problems associated with modernization.
27. Exposure assessment of ochratoxin a using paired serum and 24-hour pooled urine samples from Japanese adults.
期刊: Food additives & contaminants. Part A, Chemistry, analysis, control, exposure & risk assessment 发表日期: 2025-Aug-04 链接: PubMed
摘要
Ochratoxin A (OTA) is a mycotoxin produced by Aspergillus and Penicillium species, contaminating various food products. This study aimed to characterise OTA exposure in Japanese adults by analysing serum and urinary concentrations, evaluating demographic differences, and comparing these findings with international biomonitoring data. Serum and 24-h pooled urine samples were collected from 69 individuals, including 34 males and 35 females. OTA concentration in serum and urine were measured using a validated liquid chromatography-tandem mass spectrometry method. Detection frequencies for OTA above the limit of detection (10.0 ng/L for serum and 7.0 ng/L for urine) were 100% in serum and 55% in urine. The median concentrations (95th percentile) of OTA in serum and urine were 81.5 ng/L (177.4 ng/L) and 7.3 ng/L (15.5 ng/L), respectively. These concentrations were comparable to or lower than those reported in other countries. Additionally, the estimated probable daily intake values calculated using OTA concentrations in serum and urine were one to two orders of magnitude lower than the tolerable daily intake levels for OTA. This study represents the first comprehensive assessment for serum and urinary OTA level in Japanese adults. The findings provide valuable insights into dietary OTA exposure in Japan and contribute to a better understanding of OTA contamination in the context of food safety.
28. A novel mutant allele of Mta3 in the mouse: genetic analysis of roles in immunity and androgen biology.
期刊: G3 (Bethesda, Md.) 发表日期: 2025-Aug-04 链接: PubMed
摘要
The metastasis associated (MTA) proteins, encoded in mammals by three highly similar gene paralogs, Mta1, Mta2, and Mta3, are integral components of the nucleosome remodeling deacetylase (NuRD) complex. While biochemical and molecular studies have probed the functions of the Mta gene family, genetic data in animals is less complete. Here we report the creation of a novel allele of Mta3 in which the first two coding exons, which encode the bromo-adjacent homology (BAH) domain of Mta3, are deleted. Animals homozygous for this Mta3ΔBAH allele are viable, fertile, and have no obvious deleterious phenotype. Exploration of the Mta3ΔBAH allele revealed that the Mta3 locus has an unannotated promoter located between Mta3 exons 3 and 4, which is unperturbed in the Mta3ΔBAHallele, which appears to drive expression of an MTA3 protein variant lacking the BAH domain. To explore the genetic relationship of this allele to the paralog Mta1, the Mta3ΔBAH animals were crossed to animals bearing the Mta1tm1a(EUCOMM)Wtsi allele, no double homozygous mutant animals were recovered, indicating synthetic lethality between these two Mta alleles. To understand the impact of the Mta3ΔBAH allele on functions previously described ex vivo, studies were performed to examine roles of Mta3 in the immune response and in androgen biology. Mta3ΔBAH homozygous animals have modest defects in B lymphocyte activation and antibody production, which could result in a selective disadvantage in a natural environment. Conditional mutation in B lymphocytes revealed selection for cells escaping deletion in post germinal center stages of antigen-dependent activation. Although adult Mta3ΔBAHanimals did not exhibit androgen dysregulation, Mta3ΔBAHmales displayed sex-dependent behaviors suggesting dysregulation during critical windows of behavioral development. These studies clarify the genetic requirements for MTA proteins in mammalian development and identify specific functions for MTA3.
29. Autonomic modulation of pain perception in autism spectrum disorder: unraveling the role of parasympathetic activity among autistic adults.
期刊: Pain 发表日期: 2025-Aug-04 链接: PubMed
摘要
Autonomic dysfunction in autism spectrum disorder (ASD) is well-documented, yet its role in pain processing remains unclear. Given the established link between vagal tone and pain inhibition in neurotypical individuals, we hypothesized that autistic individuals would show reduced vagal tone associated with diminished pain inhibition capacities. This was measured via heart rate variability (HRV) and experimental pain intensity ratings. Forty-nine autistic adults diagnosed with level 1 severity of ASD and 39 typically developing controls (TDC), all with IQ above 80, underwent pain quantitative sensory testing and HRV assessments. Vagal tone indices, root mean square of successive differences (RMSSD), and the percentage of successive RR intervals that differ by more than 50 milliseconds (pNN50) were measured during resting-state, pain exposure to the individually tailored pain stimuli, and recovery. The ASD group demonstrated lower resting vagal tone (RMSSD: P = 0.019; pNN50: P = 0.017) but, similar to the TDC, responded with increased vagal tone both during pain exposure (RMSSD: P = 0.003; pNN50: P = 0.008) and recovery (RMSSD: P = 0.003; pNN50: P = 0.033). No significant main effects of RMSSD or pNN50 on psychophysical parameters were observed. However, only within the ASD group, higher resting vagal tone correlated with lower pain ratings to individually tailored stimuli (RMSSD: r = -0.389, P = 0.012; pNN50: r = -0.383, P = 0.013). Our findings suggest a potential protective role of parasympathetic activity in pain processing of autistic adults, although the complex nature of pain perception and study limitations warrant further investigation.
30. Many paths to one goal for occupational risk assessment: Insights from a practitioner dialogue.
期刊: Journal of occupational and environmental hygiene 发表日期: 2025-Aug-04 链接: PubMed
摘要
Assessing and minimizing potential health risks from chemical exposure in the workplace is a crucial role for an industrial hygiene professional. It is also a core objective for government agencies conducting research, developing guidance, and enforcing laws to protect occupational populations. The specific methods for occupational risk assessment-and in some cases, the sophistication of these methods-are evolving in the face of emerging technologies and changing regulations. Occupational health risks identified in recent agency assessments have led to increased dialogue among stakeholders and agencies regarding foundational practices and opportunities for standardizing a baseline methodology that can be made fit-for-purpose for specific programs. In response, the Foundation for Chemistry Research and Initiatives (FCRI) and the American Industrial Hygiene Association (AIHA)® jointly initiated a workshop series with an overall objective to facilitate conversations and knowledge-sharing regarding best practices for occupational risk assessment. This review summarizes the major topics discussed at the workshops and presents key guidance documents and other resources identified during and following the series. Specific topics discussed included: (1) foundational practices for collecting empirical industrial hygiene data, (2) optimizing use of near-field exposure models, (3) improving dermal exposure assessment, and (4) developing and applying occupational exposure limits for risk management. An overarching theme across the series was that while there often is no single best method, the goals of the assessment must be considered when selecting the methods and tools for each assessment. In other words, the nature of the question or issue that the risk assessor is addressing in the assessment must be defined and considered before starting the assessment and throughout its entirety, including when interpreting the results.
31. Association between exposure to air pollution and kidney function decline.
期刊: Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association 发表日期: 2025-Aug-04 链接: PubMed
摘要
Chronic kidney disease is a major global health concern, with air pollution increasingly recognized as a key contributor to kidney function decline. This study hypothesizes that exposure to air pollution accelerates kidney function decline, measured by ≥ 30% or ≥ 40% reductions in estimated glomerular filtration rate (eGFR). A nested case-control design was employed using data from the Adult Preventive Healthcare Services database and National Health Insurance claims (2016-2021). The study cohort comprised 871 295 health checkup participants. Cases were defined as participants with an eGFR decline of ≥ 30% or ≥ 40% from baseline, matched 1:1 with controls by time density sampling on sex, age, baseline eGFR, and follow-up duration. Air pollution exposure to six pollutants (PM2.5, PM10, NO2, SO2, CO, and O3) was assessed for the 1-year, 2-year, 3-year, and 5-year period prior to the outcome occurrence using land-use regression combined with machine learning algorithms. Multivariate conditional logistic regression models were used to estimate odds ratios (ORs) for eGFR decline per interquartile range (IQR) increase in pollutant concentrations. The study included 61 239 cases with eGFR declines ≥ 30% and 23 330 cases with declines ≥ 40%. Higher concentrations of all pollutants were associated with significant increases in odds for kidney function decline. CO and PM2.5 exhibited the strongest associations with eGFR decline. For eGFR decline of ≥ 30%, an IQR increase in CO was associated with an aOR of 2.78 (95% CI: 2.69-2.88), while PM2.5 showed an aOR of 2.60 (95% CI: 2.51-2.69). Similarly, for eGFR decline of ≥ 40%, CO had an aOR of 2.46 (95% CI: 2.33-2.60) and PM2.5 an aOR of 2.36 (95% CI: 2.23-2.48). Compared to 3- and 5-year exposure periods, the associations were strongest in the 1- and 2-year periods. Air pollution exposure accelerates kidney function decline, necessitating public health action.
32. Provider's attitudes towards telehealth and parenting interventions during COVID-19 pandemic: an exploratory cross-sectional study from Brazil and Mexico.
期刊: Psicologia, reflexao e critica : revista semestral do Departamento de Psicologia da UFRGS 发表日期: 2025-Aug-04 链接: PubMed
摘要
The COVID-19 pandemic presented challenges for mental health providers all over the world, since they had to abruptly change from in person assistance to remote meetings. The adverse effects from social isolation were critical in Latinx populations such as Brazil and Mexico, since these countries faced a great amount of social, health, and economic burden during the pandemic, which affected families’ access to care and increased inappropriate parenting practices. This study aimed to understand the impacts of adapting parenting interventions to online sessions for Brazilian and Mexican providers, due to the COVID-19 pandemic. Sixty-two Brazilian and 49 Mexican mental health care providers that worked with parenting interventions (including psychologists, social workers, occupational therapists, counselors, and others) took part in this study. The measures included two standardized questionnaires (the Questionnaire about Acceptability, Feasibility and Appropriateness of Telehealth, and the Epidemic-Pandemic Impact Inventory), demographic data, and complementary items developed specially for this study. All measures were translated from English to Brazilian Portuguese and Spanish, resulting in five sets of themes related to (a) service delivery, (b) barriers to mental health assistance, (c) acceptability, feasibility and appropriateness of telehealth, and (d) impacts of pandemic on providers´ professional and personal lives. For all participants, adapting to online sessions presented challenges related to technology issues, time management, less healthy habits, and overload of chores between work and home tasks, besides concerns related to confidentiality and privacy. Kruskal-Wallis Rank Sum Tests revealed that Mexican providers reported less barriers regarding technology, while Brazilian providers mentioned less economic impact. This study describes a comparison between providers of two Latinx countries facing demands from COVID19 pandemic, showing common challenges and specific barriers. Suggestions are presented in order to improve the experience of telehealth (i.e., tailored sessions, guidelines for families that ensure privacy, and policies that can increase telehealth access for vulnerable populations).
33. Health, Safety, and Aging in Elderly Farmers in the United States and Beyond: A Systematic Scoping Review.
期刊: Journal of agromedicine 发表日期: 2025-Aug-04 链接: PubMed
摘要
Understanding elderly farmers’ health and risk factors is fundamental to preventing agricultural injuries and illnesses as the farming population ages. Few reviews have focused on how aging impacts farmers’ health and safety. This study reviews scientific literature that characterizes aging farmers’ physical and mental health, work-related risk factors, and potential interventions to support healthy work and aging. In accordance with the framework established by Arksey and O’Malley (2003), we performed a scoping review by systematically searching the following databases: MEDLINE (via PubMed), CINAHL (via EBSCOhost), Web of Science (via Clarivate), AGRIS, PsycINFO (via APA PsycNet) and Embase (via Elsevier). Studies that examined elderly farmers’ health and related risk factors as the primary outcome were included. Eligibility was limited to studies published in English between 1980 and 2024, conducted in the United States or globally. Included publications were organized, thematically coded, and their key findings were synthesized (without meta-analysis). Ninety-six publications were included in the final review. Our review indicates that injuries, chronic and occupational diseases, mental health, health risk factors, aging, and retirement considerations have been reported among aging farmers. Significant gaps were identified in the study of healthy aging farmers, particularly in longitudinal studies assessing the relationship between long-term occupational hazard exposure and adverse health outcomes over time. A deeper understanding of aging and farmers’ health, particularly through longitudinal panel studies, is needed to develop targeted prevention strategies that sustain productivity until a reasonable retirement age. Additionally, research informs societal and policy interventions that support farmers in transitioning to retirement when appropriate.
34. Complication Risks Following Open Reduction Internal Fixation Versus Nonsurgical Treatment of Scapular Fractures.
期刊: Journal of the American Academy of Orthopaedic Surgeons. Global research & reviews 发表日期: 2025-Aug-01 链接: PubMed
摘要
Scapula fractures vary considerably in type, location, and management. Surgical management is commonly through open reduction internal fixation (ORIF), but the existing literature on its clinical outcomes is inconsistent compared with conservative management. This descriptive study reports the risk of short- and long-term complications from ORIF and nonsurgical treatment of various scapula fracture subtypes. Retrospective analysis of the TriNetX database was performed. Twelve cohorts were created, with two for each treatment modality for every fracture location investigated, including glenoid cavity, scapula body, neck, coracoid, acromion, and all fractures combined. Patients treated with surgery other than ORIF were excluded. Demographics and comorbidity prevalence were identified. Orthopaedic and medical complications were measured at 90 days, 1 year, and 5 years. Glenoid and scapular body fracture patients were the most and least treated with ORIF, respectively. In the ORIF cohorts, coracoid fracture patients saw risk for shoulder dislocation (3.6%) and brachial plexus injuries (3.0%) at 3 months, whereas acromion fracture patients had risk of malunion/nonunion (4.6%), ORIF revision (6.2%), and shoulder osteoarthritis (10.3%) 5 years after surgery. In the nonsurgical cohorts, glenoid fracture patients were at risk for shoulder stiffness, osteoarthritis, and arthroplasty at all time intervals. Coracoid and acromion fracture patients following ORIF, and glenoid fracture patients following nonsurgical treatment, were at risk for several mechanical complications. Such patients should be thoroughly counseled by their surgeons on these risks, and closely monitored following injury to ensure that adverse outcomes may be caught early and addressed to preserve their shoulder function.
35. Outcomes of THA versus ORIF for Acetabular Fractures in Older Adults.
期刊: Journal of orthopaedic trauma 发表日期: 2025-Aug-01 链接: PubMed
摘要
To compare outcomes of total hip arthroplasty (THA) versus open reduction internal fixation (ORIF) for acetabular fractures in older adults using a large national database. Design: Retrospective cohort study using the Medicare Limited Data set. 798 acute short-stay hospitals. Fee-for-service Medicare beneficiaries aged 65+ who underwent inpatient ORIF or THA for acetabular fractures (OTA/AO 62) (without associated femoral fractures) from January 2013 to December 2020 were included. To minimize confounding, 1 THA patient was matched with up to 2 ORIF patients based on sociodemographic factors, comorbidities, and surgery year using a propensity score approach. Multivariable generalized linear models identified adjusted associations between surgery type and outcomes; adjusted odds ratios (ORs) or mean differences with 95% confidence intervals (CI) were reported. Among 5,656 eligible procedures, the matched cohort included 2,879 patients (1,027 THA, mean age 78.6, 42.3% male; 1,852 ORIF, mean age 78.6, 42.4% male). THA (versus ORIF) patients had an increased odds of 30-day and 90-day hospital returns (30-day: OR=1.54, P<0.001; 90-day: OR=1.25, P=0.01) as well as 90-day and 1-year infection (90-day: OR=1.92, P<0.001; 1-year: OR=1.74, P<0.001). THA was also associated with higher odds of 90-day reoperation (OR=2.47, P<0.001) but not 1-year reoperation (OR=0.84, P=0.16). No significant associations were observed for hospital length of stay (P=0.42), discharge disposition (P=0.93), use of 90-day home health services (P=0.13), 90-day venous thromboembolism (P=0.75), or 1-year mortality (P=0.65). Patients who underwent THA for acetabular fractures were more likely to return to the hospital within 30 and 90 days post-surgery, have an infection in the year after surgery, and undergo a reoperation in the 90-day postoperative period compared to those who underwent ORIF. Further investigation of the mechanisms of the observed associations is necessary to understand which surgical approach provides optimal outcomes. Level III.
36. Staying On Peritoneal Dialysis: A Qualitative Study On The Experiences Of Black And Latino Patients.
期刊: Health affairs (Project Hope) 发表日期: 2025-Aug 链接: PubMed
摘要
Black and Latino patients are disproportionately affected by end-stage renal disease and face significant disparities in treatment, with underuse of peritoneal dialysis and higher conversion rates from home peritoneal dialysis to in-center hemodialysis. With concerted efforts from policy makers to increase the uptake of home dialysis modalities such as peritoneal dialysis, policies to better support Black and Latino patients who receive peritoneal dialysis are greatly needed. Through in-depth, semistructured interviews conducted during the period July 2022-June 2023 in Seattle, Washington, this qualitative study explored the experiences of twelve Black and eight Latino/a participants from a local community-based dialysis organization who were either receiving home peritoneal dialysis or had transferred from home peritoneal dialysis to in-center hemodialysis. Factors that influenced participants’ experiences with peritoneal dialysis included poor mental health, the medicalization of the home, and language and cultural barriers. Our findings suggest that policies to improve access to mental health services, promote the use of community spaces for storage of dialysis supplies, and address language and cultural barriers in health care could improve the experiences of Black and Latino patients receiving peritoneal dialysis.
37. Pay Gap Between Nonprofit Hospital CEOs And Employees Grew, 2009-23.
期刊: Health affairs (Project Hope) 发表日期: 2025-Aug 链接: PubMed
摘要
Nonprofit hospital workers represent a significant portion of the US health care workforce. Previous research indicates that wage inequalities exist within nonprofit hospitals, varying by hospital characteristics. To explore whether these inequalities have grown over time, particularly during the COVID-19 pandemic, we used Internal Revenue Service Form 990 and Medicare cost reports from the period 2009-23 to examine trends in wages and wage inequalities within nonprofit hospitals and assess differences by hospital characteristics. Persistent and widening wage inequalities in most years were observed, except during some years of the pandemic. Because hospitals are often large employers, wage inequality within them may reflect and reinforce broader patterns of local economic inequality, making this a relevant metric for evaluating the social benefit of nonprofit hospitals.
38. The Youth Mental Health Crisis In The US: Lack Of Political Will Poses The Greatest Barrier To Meaningful Action.
期刊: Health affairs (Project Hope) 发表日期: 2025-Aug 链接: PubMed
摘要
The mental health of US children and adolescents has reached a crisis point. As of 2023, 18 percent of adolescents had experienced a major depressive episode in the past year-more than double the percentage in 2010-and one-fifth of teens had seriously considered suicide. This article describes the alarming growth in the teen prevalence of mood disorders, suicidal ideation and death, and fatal drug overdoses and in the volume of pediatric patients visiting emergency departments and hospitals for mental health diagnoses. The crisis varies by sex and disproportionately affects LGBTQ+, rural, and racially and economically marginalized youth. For example, among LGBTQ+ high school students, nearly two in three report persistent sadness or hopelessness, and one-fifth have attempted suicide. Increased access to social media and lethal agents (for example, firearms and fentanyl) and deficiencies in behavioral health care are likely contributors. Although further research is needed to fully understand the etiologies of the youth mental health crisis and the effectiveness of individual interventions, the lack of political will-not evidence-poses the greatest barrier to meaningful action.
39. Trends In Telehealth Initiation Of Prescription Stimulants For Child And Adult Enrollees In Medicaid And CHIP During COVID-19.
期刊: Health affairs (Project Hope) 发表日期: 2025-Aug 链接: PubMed
摘要
The COVID-19 public health emergency disrupted access to in-person behavioral health treatment beginning in the spring of 2020. This prompted federal telehealth flexibilities that have permitted the initiation of controlled medications, including prescription stimulants for attention-deficit/hyperactivity disorder, via telehealth and without an in-person medical evaluation. In a national sample of child and adult Medicaid and Children’s Health Insurance Program (CHIP) enrollees, we found that the start of the public health emergency was associated with an immediate level increase of 24.7 telehealth-only stimulant initiations per 100,000 enrollees per month and an immediate level reduction of 53.5 in-person initiations per 100,000 enrollees per month. Key subgroups, including young adult and female enrollees, used telehealth for stimulant initiations at least as much as the overall Medicaid/CHIP sample. Still, total initiation rates during the public health emergency remained below pre-public health emergency levels through December 2022. These findings may inform considerations about extending telehealth flexibilities, showing that among Medicaid/CHIP enrollees, telehealth compensated for much of the pre-public health emergency levels of in-person stimulant initiations, but it did not appear to contribute to stimulant overprescribing that could elevate risks for misuse and diversion.
40. Foreign-Born Workers Made Up Half The Increase In The Direct Care Workforce In Home And Community Settings, 2012-22.
期刊: Health affairs (Project Hope) 发表日期: 2025-Aug 链接: PubMed
摘要
Persistent shortages of workers providing long-term services and supports (LTSS) for more than a dozen years have led to increased reliance on foreign-born workers to meet the growing demand. However, there is a dearth of empirical data on long-term changes in the composition of the direct care workforce by nativity status and care setting. Using data from the American Community Survey (2012-22), we examined the extent to which foreign-born workers contributed to LTSS workforce growth and how their participation was distributed across care settings. We found that foreign-born direct care workers have increasingly filled workforce gaps, particularly in the home and community-based services (HCBS) sector. The HCBS workforce grew by more than 24 percent during the period 2012-22, while the institutional workforce declined by 23 percent; this decline was primarily due to the exodus of native-born workers. Foreign-born workers accounted for approximately half of the increase in the direct care workforce in HCBS settings during this period. To address continued workforce shortages in LTSS and meet the demand for HCBS, policy makers should consider immigration reforms to support a sustainable supply of foreign-born workers, investments in training and career pathways, and improvements in job quality through higher wages and opportunities for career advancement.
41. Targeted Regulations Of Abortion Providers Associated With Significant Decreases In OB-GYN Density, 1993-2021.
期刊: Health affairs (Project Hope) 发表日期: 2025-Aug 链接: PubMed
摘要
Obstetricians and gynecologists (OB-GYNs) provide essential health care to women across their lifespan. Yet nearly half of US counties have no OB-GYNs, with nonmetropolitan communities disproportionately affected. Targeted Regulation of Abortion Providers (TRAP) laws, spurred by the 1992 US Supreme Court decision in Planned Parenthood v. Casey, impose regulatory burdens on abortion providers and may have influenced whether and where OB-GYNs choose to practice, which has not yet been comprehensively studied. Using a staggered difference-in-differences design and county-level data, we found that TRAP laws were associated with an average reduction of 4.67 percent in the density of OB-GYNs per 100,000 women ages 15-44 during the period 1993-2021, between Casey and the Dobbs v. Jackson Women’s Health Organization decision in 2022. TRAP laws affected both general and fellowship-trained OB-GYNs, as well as counties without abortion facilities. Concerningly, TRAP laws led to lower physician density in nonmetropolitan counties-a difference that persisted for a decade. As OB-GYN shortages are projected to worsen and TRAP laws are still in effect in twenty-four states, policy makers should consider the long-run effects of TRAP laws on women’s access to health care and their potential to exacerbate geographic disparities in access to care.
42. Insurance Denials And Cost Sharing For PrEP Among Sexual And Gender Minority People.
期刊: Health affairs (Project Hope) 发表日期: 2025-Aug 链接: PubMed
摘要
Despite coverage regulations requiring most insurers to cover pre-exposure prophylaxis (PrEP) without cost sharing, insurance coverage issues and cost-sharing practices persist. In this study, we assessed the prevalence of denials and cost sharing associated with PrEP among sexual and gender minority people in the US. Between August 2022 and July 2023, we recruited, via geosocial networking applications, sexual and gender minority people, who completed a screening survey for an HIV prevention study. Of 11,410 participants reporting current or former PrEP use, 23.7 percent had ever experienced a denial for their PrEP, ranging from 8.5 percent for generic tenofovir disoproxil fumarate and emtricitabine to 48.2 percent for Descovy. In addition, 34.6 percent reported cost sharing within the prior two years. The majority (58.3 percent) of cost-sharing instances were for laboratory bloodwork, and most (61.5 percent) were among privately insured people. Continued insurance denials and cost sharing associated with PrEP necessitate further policy intervention to address gaps in coverage, billing errors, and challenges resulting from formulary tiering.
43. Preclinical evaluation of the neutralising efficacy of three antivenoms against the venoms of the recently taxonomically partitioned E. ocellatus and E. romani.
期刊: PLoS neglected tropical diseases 发表日期: 2025-Aug 链接: PubMed
摘要
Snakebite is a significant public health concern in Africa, with the viperid species Echis ocellatus being responsible for the majority of snakebite deaths in West Africa. Recently E. ocellatus underwent taxonomic revision and was split into two species, E. ocellatus sensu stricto and E. romani, leading to questions regarding differences in venom bioactivities and the efficacy of antivenoms indicated for treatment of ‘E. ocellatus’ envenoming against the two redefined species. Using a range of in vitro assays we compared the toxin activities of the two species and the venom-neutralising efficacy of three antivenoms (EchiTAbG, SAIMR Echis and Echiven) raised against ‘E. ocellatus’. We then used murine preclinical assays to compare the in vivo efficacy of these antivenoms against E. romani and E. ocellatus s. str venoms. Mitochondrial barcoding of snake skins and venom revealed that E. romani, and not E. ocellatus, is used in the manufacture of several antivenoms raised against ‘E. ocellatus’. There were also a number of differences in specific toxin activity between the venoms of the two species in the three in vitro assays utilised in this study.; E. ocellatus (Ghana) had the strongest phospholipase A2 (PLA2) activity, followed by weak PLA2 activity for E. romani (Cameroon) and insignificant activity by E. romani (Nigeria). E. ocellatus (Ghana) and E. romani (Nigeria) demonstrated comparable snake venom metalloproteinase activity, whilst E. romani (Cameroon) had reduced, albeit still significant, activity in comparison. However no differences were observed in a plasma clotting assay measuring coagulopathy between the venoms and localities. Venoms from E. ocellatus (Ghana) and E. romani (Cameroon and Nigeria) were all recognised comparably by the three antivenoms, and there were only modest differences between antivenoms in neutralising the various in vitro toxin effects. In murine preclinical assays, each antivenom could neutralise the lethal effects of E. romani (Nigeria), but differences were seen in their comparative potency when the same antivenom doses were tested against E. romani (Cameroon) and E. ocellatus (Ghana). In these comparative potency assays, all three antivenoms were unable to confer 100% survival when tested against E. romani (Cameroon), but SAIMR Echis provided the best protection with 80% survival. When tested against E. ocellatus (Ghana), the comparative doses of SAIMR Echis and Echiven provided 100% protection whereas EchiTAbG failed to prevent lethality beyond three hours. This represents the first detailed analysis of differences between E. ocellatus and E. romani venom bioactivities and the efficacy of existing antivenoms against these two species. Our findings demonstrate that EchiTAbG, SAIMR Echis and Echiven antivenoms are preclinically efficacious against the lethal effects of E. ocellatus and E. romani venom across a number of localities.
44. SlHDZIV8-SlnsLTP33 module controls trichome density and lipid metabolism in tomato.
期刊: The Plant journal : for cell and molecular biology 发表日期: 2025-Aug 链接: PubMed
摘要
Trichomes are basic and important barriers necessary for plants to resist environmental stress. Although several regulatory transcription factors have been found to play an important role in tomato (Solanum lycopersicum) multicellular trichome development, the regulatory network underlying trichome density in tomato is still limited. Our results demonstrated that a non-specific lipid transfer protein gene, SlnsLTP33, was identified as a downstream target gene of the trichome regulator SlHDZIV8 (an HD-Zip IV transcription factor). By knocking out or co-suppressing the SlnsLTP33 gene, tomato plants exhibit fewer trichomes, while overexpressing plants exhibit more trichomes. We found that SlnsLTP33 directly interacts with SlHDZIV8 or CUTIN DEFICIENT2 (CD2) and synergistically activates the transcriptional activity of SlCycB2 by binding to the promoter of SlCycB2. Collectively, our data uncover the essential role of the SlHDZIV8/CD2-SlnsLTP33 regulatory module in regulating multicellular trichome density in tomato. Further research has shown that SlnsLTP33 plays a crucial role in the accumulation of glycerophospholipids, glycerides, and fatty acyl, which may be closely related to trichome development. Our findings provide a novel gene and new insights into the regulatory network controlling trichome formation in tomato.
45. Plasma hepcidin level is elevated by water immersion-induced central fatigue via hepatic inflammatory response in male and female rats.
期刊: Physiological reports 发表日期: 2025-Aug 链接: PubMed
摘要
Fatigue is a subjective phenomenon caused by physical or mental overexertion; however, its objective biomarkers specific to the types of fatigue remain unclear. Here, we examined whether plasma hepcidin levels, which are regulated by inflammation or iron metabolism, are elevated by peripheral and central fatigue in male and female rats. Eight-week-old Wistar rats were divided into three groups: peripheral fatigue, central fatigue, and sedentary control groups. Peripheral fatigue was induced by moderate-intensity aerobic treadmill running, and central fatigue was induced by keeping rats in a cage flooded with water to a 2.5 cm depth for 5 days. Although both male and female rats showed similar behavioral phenotypes in peripheral and central fatigue groups, plasma hepcidin levels after fatigue induction were significantly elevated only in the central fatigue group. While neither iron panels nor tissue non-heme iron levels corresponded to changes in plasma hepcidin, levels of phospho-STAT3 at Tyr(705) in the liver were significantly elevated in both sexes in the central fatigue group, suggesting the presence of hepatic inflammation that can lead to hepcidin upregulation. The collective findings indicate that elevation of plasma hepcidin level may be a promising biomarker for central fatigue, but not for peripheral fatigue, regardless of iron metabolism alteration.
46. Oligomeric SWEET1g of Solanum tuberosum confers resistance to potato virus Y and Potato virus X.
期刊: The Plant journal : for cell and molecular biology 发表日期: 2025-Aug 链接: PubMed
摘要
How the protein sugars will eventually be exported transporter (SWEET) affects plant virus infection remains largely unknown. Here, our findings showed that potato virus Y (PVY) coat protein (CP) directly interacted with SWEET1g of Solanum tuberosum (StSWEET1g). Silencing of StSWEET1g promoted PVY infection while overexpressing StSWEET1g in Nicotiana benthamiana inhibited PVY replication. Mutation of glycine (G) at position 80 to aspartic acid (D) impaired the self-interaction and attenuated the antiviral activity of StSWEET1g, indicating that oligomerization of StSWEET1g is indispensable for restricting PVY replication. The mutation of G80 to D also abolished the interaction between StSWEET1g and PVY CP. Moreover, StSWEET1g interacted with the CPs of tobacco vein banding mosaic virus (TVBMV; genus Potyvirus) and potato virus X (PVX; genus Potexvirus) similarly. We further demonstrated that the heat shock protein 70 of potato (StHSP70), a pro-viral factor of PVY, interacted with both StSWEET1g and CP. Our findings further provided evidence that StSWEET1g exerted its antiviral function via interfering with CP-StHSP70 interaction and initiating jasmonic acid (JA) defense pathway. To sum up, our results indicate that oligomeric StSWEET1g jointly manipulates StHSP70 and JA signaling pathway to regulate plant immunity and confer broad-spectrum resistance to plant RNA viruses of different genera.
47. Comparison of Available Tools to Screen for Autism at 12 and 15 Months.
期刊: Journal of developmental and behavioral pediatrics : JDBP 发表日期: 2025-Aug-01 链接: PubMed
摘要
To determine the performance of autism screeners at 12 and 15 months of age. Children were screened either at 12- (n = 1473) or 15-month (n = 1227) primary care visits. Children were screened with both the Infant/Toddler Checklist (ITC) and the First Year Inventory-Lite (FYI-L) at 12 months and FYI-L and the Modified Checklist for Autism in Toddlers, Revised with Follow-Up (M-CHAT-R/F) at 15 months. After a positive screen and/or clinical concern, families were offered a no-cost diagnostic evaluation. Of the 1473 toddlers screened at 12 months, 223 screened positive and 107 attended a diagnostic evaluation. Of the 1227 children screened at 15 months, 252 screened positive and 94 attended the evaluation. Overall, specificity for autism was high (>0.94) for all screeners at 12 and 15 months. At 12-month screening, sensitivity for autism was low on the ITC (0.26) and moderate on the FYI-L (0.67). Positive predictive value (PPV) was low for both screeners (0.24 for ITC and FYI-L). At 15 months, both the FYI-L and the M-CHAT-R/F demonstrated moderate sensitivity (0.61 for FYI-L and 0.60 for the M-CHAT-R/F) and low PPV (0.16 for FYI-L and 0.31 for M-CHAT-R/F). Although data do not support universal screening at younger ages, the study identifies tools that can be used at 12 and 15 months. Importantly, screening at these ages does not identify all cases of autism, and repeat screening at 18 months and beyond is essential to support autism detection as early as possible.
48. Preconception Care: A Comparative Review of Major Guidelines.
期刊: Obstetrical & gynecological survey 发表日期: 2025-Aug 链接: PubMed
摘要
Preconception care represents a crucial aspect of healthy pregnancy as it aims to optimize the health status of women and men before conception by mitigating the modifiable individual and environmental risk factors and providing education, counseling, and timely interventions. The aim of this study was to review and compare the most recently published influential guidelines on prepregnancy counseling and management of chronic medical conditions. A descriptive review of guidelines from the American College of Obstetricians and Gynecologists (ACOG), the Royal Australian and New Zealand College of Obstetricians and Gynecologists (RANZCOG), and the Public Health Agency of Canada (PHAC) on preconception care was carried out. There is a consensus among the reviewed guidelines that a detailed personal and family history and risk factor assessment and counseling against smoking, alcohol, and substance abuse are the main areas to focus when providing preconception care. In addition, assessment of immunization status and screening for intimate partner violence and sexual coercion, as well as screening for human papillomavirus and cervical cancer, are unanimously recommended. All medical societies also agree that counseling on diet, body mass index, and physical activity should be routinely offered along with a review of supplements and advice on folic acid supplementation. Furthermore, the need of medication review for potential teratogenic effects and the importance of assessing for environmental and occupational exposure to teratogens are underlined by all guidelines. Moreover, ACOG and PHAC recommend a discussion regarding contraception, support an optimal interpregnancy interval of at least 18 months, and underline that screening for sexually transmitted infections should be offered only in cases with existing risk factors. ACOG and RANZCOG also suggest that patients should be offered guidance on proper food handling and traveling restrictions to prevent certain infectious diseases. Finally, ACOG and PHAC provide guidance on the preconception management of chronic medical conditions, whereas RANZCOG, although mentioning that all preexisting medical conditions should be optimized before achieving pregnancy, provides no further guidance. Preparing for a healthy pregnancy not only drives favorable perinatal outcomes, but is also associated with long-lasting benefits for the offspring. Health care professionals are ideally positioned to offer clear, accurate, and timely counseling to the parents-to-be, screen for and act upon any potential impediments to a successful outcome, support the decision-making process, and offer referral to relevant services when required. Therefore, the development of consistent international guidelines on preconception care to guide clinical practice seems of insurmountable importance.
49. Impact of Extending Beta-Lactam Infusions on IV Access Requirements.
期刊: Critical care explorations 发表日期: 2025-Aug-01 链接: PubMed
摘要
This study aimed to determine if extended infusion (EI; over > 3 hr) beta-lactam therapy increased IV access requirements compared with traditional dosing (TD; over 30 min). Eighty-six adult ICU patients treated with TD anti-pseudomonal beta-lactams who underwent therapeutic drug monitoring (TDM) were included. Patients who transitioned from TD to EI after TDM (EI group) were matched 1:1 to patients who remained on TD. In the primary analysis, the median (interquartile range) total number of lumens in the 24 hours before TDM compared with the 48 hours after TDM were similar between groups (pre: TD 3 [2-5] vs. EI 4 [3-5]; p = 0.22 and post: TD 3 [2-4] vs. EI 4 [3-5]; p = 0.05). Delivery of beta-lactams via EI was not associated with a need for more IV access. Practical challenges such as access should not limit use of EI beta-lactams when indicated.
50. Photodegradation mechanisms of pyrrolizidine alkaloids and risk prediction of their degradation products based on high resolution mass spectrometry and theoretical calculations.
期刊: Journal of hazardous materials 发表日期: 2025-Jul-27 链接: PubMed
摘要
Pyrrolizidine alkaloids (PAs) and their N-oxides (PANOs) are emerging environmental pollutants, and they inevitably undergo degradation, particularly photodegradation. However, the photodegradation products of PAs/PANOs and their formation mechanisms remain poorly understood. Herein, a high-resolution mass spectrometry fragmented ions database of 34 PAs/PANOs was established, and several characteristic fragment ions, such as m/z 138.0913, 120.0808, and 94.0651, were used to screen photodegradation products retaining the necine base structure. A total of 60 photodegradation products of 11 PAs/PANOs were identified, and their fragmentation pathways under electrospray ionization were profiled in detail. The photolysis mechanism of PAs/PANOs was analyzed by using quantum chemistry methods and radical quenching experiments. The C7 ester bond region contained multiple reactive sites that underwent oxidation reactions mediated jointly by singlet oxygen (1O2) and superoxide anion (O2•-). Initial reaction pathways of PAs/PANOs were speculated in the process, including hydroxylation, ester bond cleavage, oxidation, and CC isomerization reactions, ultimately generating various transformation products (TPs). In silico assessments demonstrated that 13 %-33 % of TPs exhibited higher toxicity than their parent compounds, underscoring environmental and health risks. This study emphasizes the need for comprehensive risk assessments of PAs/PANOs and their photodegradation products.
51. Fisetin alleviates Aβ-induced neuronal cell ferroptosis by regulating Sirt6-mediated deacetylation modification.
期刊: Journal of neuroimmunology 发表日期: 2025-Jul-22 链接: PubMed
摘要
Ferroptosis contributes to Alzheimer’s disease (AD) pathology. Fisetin, a flavonoid with neuroprotective properties, has shown potential in reducing oxidative stress and inflammation. This study investigates the protective effects and underlying molecular pathways of fisetin against amyloid-β (Aβ)-induced ferroptosis in neuronal cells. HT22 mouse hippocampal neuronal cells were pre-incubated with fisetin before exposure to amyloid-β (Aβ). Cell viability was evaluated by Cell Counting Kit-8 (CCK-8) assay, and lipid peroxidation was measured with the C11-BODIPY probe. Protein expression patterns were determined via Western blot analysis. Co-immunoprecipitation (CoIP) and ubiquitination assays were used to explore the interactions between Sirtuin 6 (Sirt6), nuclear factor erythroid 2-related factor 2 (Nrf2), and kelch-like ECH-associated protein 1 (Keap1). Fisetin pre-treatment significantly alleviated Aβ-induced ferroptosis in HT22 cells. Sirt6 upregulation was observed following fisetin treatment, and silencing Sirt6 reversed its protective effects on Aβ-induced neuronal cell ferroptosis. Mechanistically, Sirt6 deacetylated Nrf2 and enhanced its stability by preventing its degradation through Keap1-mediated ubiquitination. As expected, fisetin alleviated Aβ-induced ferroptosis in neuronal cells through activation of the Sirt6/Nrf2 axis. Fisetin alleviated Aβ-induced neuronal cell ferroptosis by activating the Sirt6/Nrf2 axis. These results underscore fisetin’s therapeutic potential for AD by targeting ferroptosis, providing a new strategy for disease intervention.
52. Restricting outdoor advertising of unhealthy food: can Australia's food category-based classification system be applied consistently?
期刊: Health promotion international 发表日期: 2025-Jul-01 链接: PubMed
摘要
Most outdoor food advertising (e.g. billboards and bus stops) features foods that are considered unhealthy. The most important technical challenge when designing policies to restrict unhealthy outdoor food advertising is defining ‘unhealthy food’. To date, most restriction policies have used nutrient profiling models (i.e. foods are classified according to their nutritional composition) to determine which foods and beverages may be advertised. In Australia, state governments have endorsed a food category-based classification system, with no prescribed nutrient limits, which may create ambiguity when multiple users are identifying food advertisements to be restricted. This study aimed to assess the consistency of decisions (inter-rater reliability) using a food category-based system to assess outdoor advertisements. Three coders independently assessed outdoor food advertisements (n 550) around 64 schools in metropolitan Perth, Western Australia, using the Council of Australian Governments ‘National interim guide to reduce children’s exposure to unhealthy food and drink promotion’. Overall, 78.7% of outdoor advertisements were restricted by at least one of three coders and 25.5% by all three; inter-rater reliability was fair [0.29; 95% confidence interval (CI) 0.24, 0.34]. The strongest agreement was for confectionery (κ = 0.94; 95% CI 0.89, 0.99) and desserts, ice cream, and ice confections (κ = 0.99; 95% CI 0.94, 1.04) while the poorest agreement was for brand advertising (κ = 0.04; 95% CI -0.01, 0.09). This study found that the Australian-government-endorsed model could not be consistently applied to assess outdoor food advertising, apart from the narrowly defined categories of confectionery and desserts. Recommendations to reduce ambiguity and policy implications are discussed.
53. Implementation of link workers in primary care: Synopsis of findings from a realist evaluation.
期刊: Health and social care delivery research 发表日期: 2025-Jul 链接: PubMed
摘要
Social prescribing link workers formed part of the Additional Roles Reimbursement Scheme introduced into primary care in England from 2019. Link workers assist patients experiencing issues affecting their health and well-being that are ‘non-medical’ (e.g. lack of social connections, financial difficulties and housing problems). They give patients space to consider these non-medical issues and, when relevant, connect them to support, often within the voluntary-community-social-enterprise sector. We conducted an earlier realist review on the link worker role in primary care. We then carried out a realist evaluation, described in this report, to address the question: When implementing link workers in primary care to sustain outcomes - what works, for whom, why and in what circumstances? To develop evidence-based recommendations to optimise the implementation of link workers in primary care and to enable patients to receive the best support possible. A realist evaluation, involving two work packages. Data were collected around seven link workers in different parts of England. For work package 1, researchers spent 3 weeks with each link worker - going to meetings with them, watching them interact with patients, with healthcare professionals and with voluntary-community-social-enterprise staff. During this time, researchers had a daily debrief with the link worker, inviting them to reflect on their working day, and they collected relevant documents (e.g. job descriptions and information on social prescribing given to patients). They also conducted interviews with 93 primary care/voluntary-community-social-enterprise staff and 61 patients. As part of this work package, data on patient contact with a general practitioner before and after being referred to a link worker were collected. Work package 2 consisted of follow-up interviews (9-12 months later) with patients; 41 were reinterviewed. In addition, link workers were reinterviewed. A realist logic of analysis was used to test (confirm, refute or refine) the programme theory we developed from our realist review. Analysis explored connections between contexts, mechanisms and outcomes to explain how, why and in what circumstances the implementation of link workers might be beneficial (or not) to patients and/or healthcare delivery. We produced three papers from the research - one on link workers ‘holding’ patients, one on the role of discretion in their job, and another exploring patient-focused data and readiness to engage in social prescribing. Data from these papers were considered in relation to Normalisation Process Theory - a framework for conceptualising the implementation of new interventions into practice (e.g. link workers into primary care). By doing so, we identified infrastructural factors required to help link workers to: (1) offer person-centred care; (2) develop patients’ self-confidence, sense of hope and social capital; (3) facilitate appropriate general practitioner use; (4) foster job satisfaction among those delivering social prescribing. Our research highlighted the importance of a supportive infrastructure (including supervision, training, leadership/management, clarity about the role, link workers’ ability to use existing skills and knowledge and having capacity to connect with providers in the voluntary-community-social-enterprise sector) in order to produce person-centred care, to nurture hope, self-confidence and social capital among patients, to ensure they receive the right support (medical or non-medical), and to promote link workers’ job satisfaction. Data showed how link workers can contribute to the offer of holistic care beyond a purely medical lens of health and illness. This synopsis presents independent research funded by the National Institute for Health and Care Research (NIHR) Health and Social Care Delivery Research programme as award number NIHR130247. Approximately, one in five people see their general practitioner with problems that are social (e.g. loneliness), environmental (e.g. housing) or economic (e.g. debt). These ‘non-medical’ issues can affect how someone feels (physically or mental health wise). Social prescribing is one way to help. It involves connecting people to ‘community assets’ (e.g. a local group to meet others and an organisation that provides advice on housing/finances). Link workers are employed to deliver social prescribing in primary care. They meet with a patient (usually more than once) to find out what is happening in this person’s life and what they want to change/address. Link workers can connect patients to relevant community support or services. Our research focused on how link workers are being used in primary care. We collected data around seven link workers based in different parts of England. We spent 3 weeks with each link worker. We watched these link workers meeting with patients, healthcare staff and voluntary–community sector representatives. We also conducted interviews with 93 professionals (working in primary care or the voluntary–community sector) and 61 patients. We reinterviewed 41 patients, 9–12 months later, along with 7 link workers and a link worker manager. Key ideas from our data included: (1) link workers are an ongoing source of support for patients, who are relied on to listen to their difficulties; (2) link workers need flexibility in how they work to best assist patients and to develop a good working relationship with healthcare colleagues and (3) patients trust link workers to support them. Our study shows important changes needed to support link workers. These include: (1) establishing a clear definition of the job; (2) providing adequate supervision and training and (3) ensuring link workers have time to focus on non-medical issues and to develop relationships with community providers. The study is registered as research registry in 2021 (www.researchregistry.com/browse-the-registry#home/registrationdetails/5fff2bec0e3589001b829a6b/).
54. The effects of pregnancy on the progression of maternal glomerular disease.
期刊: Jornal brasileiro de nefrologia 发表日期: 2025 链接: PubMed
摘要
Although most women with underlying glomerular diseases (GD) are of childbearing age, there is limited information on how pregnancy affects these conditions and maternal outcomes. We carried out a single-center retrospective cohort study involving 44 planned pregnancies in 38 patients with biopsy-proven GD. Patients were divided into three groups based on their pre-conception CKD-KDIGO classification: I) Stage 1-2: 27 pregnancies, II) Stage 3a-3b: 11 pregnancies, and III) Stage 4-5: 6 pregnancies. Clinical data included age, chronic hypertension (CH), serum creatinine, preeclampsia (PE), and proteinuria. We considered CH, CKD stage before pregnancy, and PE and nephrotic proteinuria (NPu) during pregnancy as risk factors for maternal GD progression. We found that 8 women progressed to ESRD and began hemodialysis during pregnancy: 2 (7.8%) in Group I, 1 (9.0%) in Group II, and 5 (83.3%) in Group III. In the remaining 36 pregnancies, we observed a significant GFR loss (p < 0.0001) one year after pregnancy, and GFR loss was greater in group II than in I (p < 0.013). Low GFR rates before pregnancy and PE during pregnancy (p = 0.001) directly impacted GFR loss. We also observed a high incidence (63.6%) of adverse fetal outcomes. Although pregnancy is possible for women with GD, the impact of pregnancy in maternal GD continues after delivery. Having GD increases the risks of adverse pregnancy outcomes. The progression of GD is directly linked to the CKD stage before pregnancy and PE during pregnancy, and women in CKD stages 4-5 have a high risk of progressing to ESRD during gestation.
55. Injury reporting in elite ladies Gaelic football and camogie: Perspectives of athlete support personnel.
期刊: PloS one 发表日期: 2025 链接: PubMed
摘要
This study investigates athlete support personnel’s (ASP) perspectives on injury reporting among elite ladies’ Gaelic football and camogie players. ASP refers to individuals in coaching, management, and allied health and performance related practice. A mixed-methods design was employed, comprising an online survey and follow-up interviews. Forty-two ASP, currently or recently (within two years) involved in elite ladies’ Gaelic games, completed the survey. Eighteen ASP subsequently participated in semi-structured interviews. Quantitative survey data were analysed using frequency analysis, while interview transcripts were subjected to framework analysis. A significant proportion of ASP (43%, n = 18) believe that players do not report all injuries. Most respondents (95%, n = 40) agreed that players often avoid reporting injuries to prevent losing playing time, while 95% (n = 40) cited player fear of being side-lined as a key factor. Furthermore, 93% (n = 39) agreed that players are more likely to report injuries when immediate access to medical personnel, such as team doctors or physiotherapists, is available. Notably, 66% (n = 28) disagreed with the perception that managers view players as weak for reporting injuries, while 19% (n = 8) agreed with this notion. Qualitative findings corroborated these results and identified three overarching themes influencing injury reporting: player factors, system-driven influences, and environmental conditions. Individual factors included a competitive environment that prioritised maintaining team position over health, with experienced players exhibiting greater confidence in reporting injuries compared to younger players, who often perceived management as hierarchical and less approachable. Immediate, consistent access to physiotherapists and other medical professionals was highlighted as a critical enabler of injury reporting. Trust in ASP, built through visible involvement and positive relationships, emerged as a key determinant. Additionally, a supportive team culture that prioritises player well-being alongside performance outcomes was identified as essential for encouraging open injury reporting. Injury underreporting is a significant issue among elite ladies’ Gaelic games players, driven by personal, system-level, and environmental factors. Of critical importance for teams and organisations is to provide education for players and ASP on the importance and value of injury reporting to support early and appropriate intervention. Concurrently providing improved medical access will help to foster stronger, trust-based relationships between players and ASP, considered crucial for improving injury reporting practices.
56. Average acceleration and intensity gradient of 9-11-year-old rural and urban Kenyan school-going children and associations with cardiorespiratory fitness and BMI: The Kenya-LINX project.
期刊: PloS one 发表日期: 2025 链接: PubMed
摘要
Physical activity (PA) is crucial for children’s health, cardiorespiratory fitness (CRF) and weight status. However, research on the PA profiles of Kenyan children, especially between rural and urban areas, is limited. This study examined the PA profiles of 537 school-aged children (51.6% girls, 9-11-year-olds) from Nairobi City County, Kenya (urban setting), and Kitui County, Kenya (rural setting), using stratified multistage random cluster sampling. Participants wore an accelerometer (Axivity AX3) on their non-dominant wrist for 24 hours a day over seven days. Raw accelerations were extracted and averaged over a 5-s epoch (AvgAcc) to estimate PA volume. Intensity gradient (IG) was calculated as a standardised metric of PA intensity. Participants’ CRF was assessed by the 20-metre multistage fitness test. Anthropometric measurements (mass and stature) were taken to compute BMI z-scores. PA metrics varied by sex, weight, and CRF. Boys had higher AvgAcc (p < .001) and IG (p < .001) than girls. Healthy weight participants differed significantly in AvgAcc from overweight (p = .001) and obese (p = .001) groups and in IG from overweight (p = .039) and obese (p = .003). Participants with sufficient CRF and insufficient CRF differed significantly in AvgAcc (p < .001) and IG (p < .001). AvgAcc was negatively associated with BMI z-scores (β = -0.02, p < .001) and positively associated with CRF (β = 0.21, p < .001), independent of IG and other covariates. IG showed a significant negative association with BMI z-scores (β = -1.27, p = 0.003) and a significant positive association with CRF (β = 18.93, p < .001), dependent on AvgAcc. This study introduces AvgAcc and IG metrics among Kenyan children. Urban children accumulate less PA volume and exhibit an inferior intensity profile, which is reflected in important health indicators (BMI and CRF). These findings will inform policy as well as targeted interventions to enhance children’s health in diverse contexts.
57. Features of drug addiction treatment programs in Atlantic Canada that help (or not) with access and retention: A qualitative study.
期刊: PloS one 发表日期: 2025 链接: PubMed
摘要
Access to government-funded addiction treatment programs can reduce harms experienced by people who use substances (PWUS). There is some research on what features (e.g., policies and practices) of treatment programs help or do not help with access; however, not much is known about program directors’ and physicians’ perspectives of these features in Atlantic Canada. One-on-one semi-structured qualitative interviews were conducted with program directors and physicians working in government-funded addiction treatment programs in Atlantic Canada in 2021. Interview questions focused on perspectives of program features that helped or not with access and retention, including perspectives on changes due to COVID-19. Data were coded and analyzed using grounded theory techniques to develop themes and subthemes. Fourteen individuals were interviewed. They identified several features that helped (e.g., quick access) or did not help (e.g., wait times) with access and retention. Participants shared some features that changed due to COVID-19, including some that helped (e.g., virtual services) and did not (e.g., limited program spaces). Participants suggested changes that could support access and retention, including better linkages to mental health supports. This paper highlights program directors’ and physicians’ perspectives on how program features inform access and retention in Atlantic Canada. Findings on changes made during COVID-19 point to the need to maintain the changes that were helpful and implement additional changes to better support access for more PWUS. To support the implementation and sustainability of these changes, more resources must be invested.