公共卫生研究摘要 (2025-08-06)
共收录 56 篇研究文章
1. RSV vaccination uptake among adults aged 60 years and older in the United States during the 2023-2025 vaccination seasons.
期刊: Human vaccines & immunotherapeutics 发表日期: 2025-Dec 链接: PubMed
摘要
Older adults and adults with certain chronic conditions are at increased risk for severe respiratory syncytial virus (RSV) disease. In 2023, RSV vaccines first became available in the United States (US) for adults aged ≥60 years. This retrospective database analysis evaluated RSV vaccination uptake from August 2023-February 2025 using IQVIA’s open-source pharmacy (LRx) and medical (Dx) claims data. The study included US adults aged ≥60 years with ≥1 claim in 2023. For those without RSV vaccination in 2023, ≥1 claim was also required between January 2024-February 2025. Uptake was assessed as the number and percentage of eligible adults who received an RSV vaccine during the study period. Multivariable logistic regression modeling explored factors associated with RSV vaccination. Nearly 12.8 million adults aged ≥60 years (16.4%) received RSV vaccination between August 2023-February 2025. Uptake generally increased with age and was higher among those with ≥1 potential risk factor for severe RSV disease. Disparities in uptake were observed by race, ethnicity, and other social determinants of health. In multivariable analyses, odds of RSV vaccination were nearly 24 times higher for those who received ≥1 non-RSV vaccine from August 2023-February 2025 versus those who had not. Despite the increased risk of severe RSV disease among older adults and those with certain risk factors, relatively limited RSV vaccination uptake was observed during the 2023-2025 seasons, with disparities observed. Additional efforts are needed to support RSV prevention among those at highest risk and to ensure equitable access to vaccination. What is the context?Respiratory syncytial virus (RSV) can result in severe illness in adults aged 60 years and older, as well as adults with certain health conditions.RSV vaccines for use in adults aged 60 years and older became available in the United States (US) in 2023.What is new?During the first two seasons of vaccine availability, only 16.4% of US adults aged 60 years and older received an RSV vaccination (August 2023–February 2025).The percentage of older adults receiving RSV vaccination was relatively low, even among adults with health conditions that place them at increased risk of severe RSV illness.Differences in uptake were found by race, ethnicity, and other patient characteristics.What is the impact?Additional efforts are needed to ensure that adults aged 60 years and older are able to receive RSV vaccination.
2. Serum Levels of Aryl Hydrocarbon Receptor Plasma Agonist Activity Are Reduced in Patients With NMOSD and Correlate With Disease Activity.
期刊: Neurology(R) neuroimmunology & neuroinflammation 发表日期: 2025-Sep 链接: PubMed
摘要
Neuromyelitis optica spectrum disorders (NMOSDs) are severe autoimmune diseases characterized by recurrent CNS inflammation and high risk of persistent disability. Effective disease monitoring is essential for timely intervention and relapse prevention. While biomarkers such as soluble glial fibrillary acidic protein and neurofilament light chain indicate astrocytic and neuronal damage, additional markers are needed to improve disease monitoring and treatment strategies. The ligand-activated transcription factor aryl hydrocarbon receptor (AHR) is a key immune regulator in autoimmune diseases such as multiple sclerosis, where its ligands correlate with disease activity. Given overlapping immunologic pathways, AHR signaling may also influence NMOSD pathophysiology. In this context, this study examines serum levels of AHR ligand in NMOSD, assessing their regulation and association with disease activity. Elucidating the role of AHR signaling may pave the way to explore novel markers of disease activity and therapeutic intervention in NMOSD. AHR agonistic activity was assessed in the serum of 102 patients with aquaporin-4 antibody-positive NMOSD across various stages of the disease. As control, serum samples from 36 patients with noninflammatory diseases were evaluated for AHR agonistic activity. In addition, we measured AHR activity longitudinally in 10 individuals at 3 distinct time points-during a quiescent phase preceding relapse, at relapse, and during a postrelapse quiescent phase-to evaluate the dynamic changes in AHR activity over time. Serum AHR agonistic activity was globally decreased in the NMOSD cohort compared with the control group. AHR agonistic activity was further reduced during or near relapses. Finally, we conducted longitudinal analyses on individual serum samples obtained from patients with NMOSD. Our findings reveal that AHR activity significantly decreases during the relapse phase compared with the quiescent phase, with a subsequent recovery after relapse. Serum AHR agonistic activity is reduced in patients with NMOSD compared with controls and further modulated in temporal vicinity to a relapse. Furthermore, our longitudinal analysis confirmed that AHR activity is markedly reduced during relapse, underscoring its dynamic modulation in relation to disease activity. AHR agonist activity might represent a potential tool to monitor disease activity and develop novel therapeutic strategies. This study provides Class III evidence that serum levels of AHR agonistic activity are reduced in patients with NMOSD compared with noninflammatory controls, and that these levels are further modulated across different stages of the disease.
3. Clinical and Safety Outcomes of Edaravone Dexborneol in Acute Ischemic Stroke: A Multicenter, Prospective, Cohort Study.
期刊: Neurology 发表日期: 2025-Aug-26 链接: PubMed
摘要
Although edaravone dexborneol, a multitarget cytoprotective drug, has demonstrated benefits in previous clinical trials, its actual clinical efficacy and safety in patients with acute ischemic stroke (AIS) remain unclear. This study aimed to test the hypothesis that edaravone dexborneol is associated with better outcomes in patients with AIS in real-world clinical practice. We conducted a prospective, multicenter, real-world cohort study at 72 centers in China from January 14 to July 4, 2023. We included patients age 18 years or older, with AIS within 14 days of onset, and a prestroke modified Rankin Scale (mRS) of 0 or 1. Patients were divided into those receiving edaravone dexborneol (the exposed group) or not (the unexposed group). Clinical outcomes included favorable functional outcome (mRS score 0-1) at 90 days, symptomatic intracerebral hemorrhage (sICH) during the hospital, and all-cause mortality within 90 days. Multivariable logistic regression, propensity score matching (PSM), and inverse probability of treatment weighting (IPTW) analyses were conducted. Of 4,401 participants (2,904 men [66.8%]; median [interquartile range] age, 65 [57-72] years), 3,017 (68.6%) were treated with edaravone dexborneol. The exposed group was younger (65 [56-72] years vs 66 [58-74] years), had higher NIH Stroke Scale (3 [2-7] vs 3 [1-5]), and had shorter time from onset to admission (7.0 [2.5-24.0] hours vs 10.4 [2.8-48.0] hours). The exposed group had a higher proportion of patients with favorable functional outcome at 90 days compared with the unexposed group (68.6% [2,071/3,017] vs 66.0% [914/1,384], adjusted odds ratio [aOR] 1.23 [95% CI 1.06-1.43]). Moreover, sICH rates (0.4% vs 0.6%, aOR 0.44 [95% CI 0.14-1.44]) and mortality within 90 days (2.1% vs 3.3%, adjusted hazard ratio 0.89 [95% CI 0.58-1.37]) were similar in both groups. PSM and IPTW analyses yielded results consistent with the multivariate adjustment model. In this observational cohort study involving Chinese patients with AIS, edaravone dexborneol was associated with significantly better functional outcome at 90 days. Verification of our findings is warranted in other populations. This trial is registered with Effectiveness and Safety of Edaravone Dexborneol in Acute Ischemic Stroke, number NCT05644223; submitted for registration on November 30, 2022; first patient enrollment was on January 14, 2023. This study provides Class III evidence that treatment of patients with AIS with edaravone dexborneol is associated with significantly better functional outcome at 90 days measured using the mRS.
4. Risk Factors for First-Year Recurrence in Patients with Synchronous Metastatic Renal Cell Carcinoma Undergoing Cytoreductive Nephrectomy and Complete Metastasectomy.
期刊: The Journal of urology 发表日期: 2025-Aug-05 链接: PubMed
摘要
Patients with metastatic renal cell carcinoma (mRCC) with oligometastatic disease can achieve radiographic disease-free (M1 NED) status following cytoreductive nephrectomy and concurrent complete metastasectomy (CNCM). This study aimed to evaluate outcomes and identify risk factors associated with metastatic recurrence and overall survival in mRCC M1 NED patients. Patients with synchronous mRCC who were M1 NED following CNCM from four institutions (2010-2020) were identified. Survival outcomes were analyzed by Kaplan Meier method. Patients were grouped by early (first year following surgery) recurrence or delayed/no known metastatic recurrence. Logistic regression modeling identified risk factors for first-year recurrence and decision curve analysis evaluated the utility of a model incorporating identified risk factors. 109 M1 NED patients were identified including 36 patients who had recurrence in the first year following surgery and 73 patients with delayed or no recurrence. First-year recurrence resulted in significantly shorter overall survival (OS) compared to those with delayed/no recurrence after 1 year (median 15 vs. 97 months respectively, P<0.0001). First-year recurrence predictors included liver metastases, increasing primary tumor size, and elevated preoperative C-reactive protein (CRP). A prognostic model incorporating these factors demonstrated discriminatory capacity and improved clinical decision-making compared to a universal immediate post-operative systemic therapy or active surveillance strategy. Liver metastasis, increasing primary tumor size, and elevated preoperative CRP are associated with increased risk for first-year progression following cytoreductive nephrectomy and complete metastasectomy. Despite radiographic NED status, high risk patients should be considered for immediate systemic therapy following surgery given poor outcomes.
5. Digitally Enabled AI-Interpreted Salivary Ferning-Based Ovulation Prediction: Feasibility Study.
期刊: Journal of medical Internet research 发表日期: 2025-Aug-05 链接: PubMed
摘要
Females with irregular or unpredictable cycles, including those with polycystic ovary syndrome (PCOS), have limited options for validated at-home ovulation prediction. The majority of over-the-counter ovulation prediction kits use urinary luteinizing hormone (LH) indicators that were optimized for those with regular menstrual cycles exhibiting a predictable mid-cycle LH surge. Artificial intelligence (AI) holds potential to address this health deficit via a smartphone-based salivary ferning ovulation test. Research on populations with irregular menstruation and PCOS can be challenging due to the duration and frequency of menstrual cycles. The objective of this study was to evaluate the feasibility for participants with diverse menstrual cycle lengths to complete study tasks designed to train and develop a potential future AI model for salivary ferning-based ovulation prediction. Participants were recruited for 2 menstrual cycles where retention, engagement, and adherence were evaluated. Participation entailed remotely collecting and uploading daily data (saliva, LH values), attending lab visits, and returning biological saliva samples. Of the 133 females recruited from February to October 2023 via targeted patient messages and a public research website, 69 (51.9%) were eligible (age 19-35 years at enrollment, currently menstruating, able to read and comprehend English, weigh more than 110 lb, have an active primary care or gynecological provider, and able to commute to the Massachusetts General Hospital (MGH) main campus within 10 days of their ovulatory event). Of the 43 (62.3%) eligible participants who consented and completed the baseline survey, the majority were White (n=24, 55.8%), employed (n=33, 76.7%), and highly educated (college or more; n=32, 74.4%) and had a mean BMI of 28.9 (SD 7.8) kg/m2. Of those who received a study kit (n=29, 42%), 17 (58.6%) participants began data collection, 9 (31%) provided data for completed study tasks for 1 menstrual cycle, and 7 (24.1%) completed the study. Furthermore, 19 (44.2%) eligible participants who completed the baseline survey withdrew from the study, citing menstrual cycles being too irregular for the study timeline (n=5, 26.3%), becoming pregnant (n=4, 21.1%), moving outside the study area (n=4, 21.1%), no time to dedicate to the study (n=2, 10.5%), ineligibility (n=2, 10.5%), and stress related to observing anovulation (n=2, 10.5%). To optimize future scaled participant completion, the study design would include a more targeted recruitment message to address the high ineligibility status, streamline study procedures to ease the participant burden, and incorporate health education to equip participants with ovulatory health information to ameliorate the potential stress impacts of observing anovulation. After optimization, when scaled, this study design could provide an AI model with sufficient data to develop a smartphone-based ovulation predictor specifically tested on females with irregular or unpredictable cycles, including those with PCOS. A well-informed study design is the foundation to AI advancement and femtech (the technology sector focused on enhancing female health) growth, particularity for ovulatory and fertility digital health.
6. Evaluating the Acute Effects of Energy Drink Consumption on Arterial Stiffness in Healthy Young Adults.
期刊: Anatolian journal of cardiology 发表日期: 2025-Aug-05 链接: PubMed
摘要
Energy drinks are popular among adolescents and young adults for their perceived benefits in enhancing energy, alertness, and performance. These beverages often contain high levels of caffeine, sugar, and various stimulants, which may have acute effects on cardiovascular health. Arterial stiffness, assessed by augmentation index (AIx), is a key indicator of cardiovascular health and can be influenced by these beverages. This study aimed to evaluate the acute effects of energy drink consumption on arterial stiffness in healthy young adults. In this cross-sectional study, 64 healthy subjects with normal blood pressure (BP) and no cardiovascular or metabolic disorders participated. After a baseline measurement of vascular and hemodynamic parameters, participants consumed a can of energy drink. Measurements of arterial stiffness, including AIx, pulse wave velocity (PWV), and central BP, were taken at baseline and then 30 minutes and 2 hours post consumption using a validated non-invasive system. Significant decreases in diastolic BP at both peripheral and central were observed at 2 hours compared to baseline (P = .011 and P = .020, respectively). Total vascular resistance decreased notably over time (P = .044). While stroke volume, cardiac out-put, cardiac index, heart rate, PWV, augmentation pressure, and coefficient of reflection remained stable, significant transient increases in AIx and AIx@75 were recorded at 30 minutes after energy drink consumption (P = .016 and P = .005, respectively), returning to baseline values by 2 hours, indicating a transient but notable effect on arterial stiffness. This study underscores the need for caution regarding energy drink consumption, particularly among young people, due to its acute effects on arterial stiffness. Further research is warranted to explore the long-term effects and underlying mechanisms of energy drinks on cardiovascular health.
7. Cryptosporidium infection and associated factors among diarrheic children under five years of age in Eastern Ethiopia.
期刊: PLoS neglected tropical diseases 发表日期: 2025-Aug-05 链接: PubMed
摘要
Cryptosporidium infection causes diarrhea that may lead to malnutrition, growth faltering, cognitive impairment, and mortality if left untreated. Cryptosporidiosis continues to be a significant public health issue in low-income countries, including Ethiopia. However, its epidemiology among children under five years of age remains understudied. Therefore, this study aimed to determine the prevalence and factors associated with Cryptosporidium infection among diarrheic children under five in Eastern Ethiopia. A cross-sectional study was conducted among children under five years of age attending health centers with diarrhea in Eastern Ethiopia between November 2022 and October 2023. Fecal specimens were analyzed by auramine-phenol staining using light-emitting diode fluorescence microscopy. A structured questionnaire was used to obtain information on sociodemographic and other variables potentially associated with Cryptosporidium infection. Poisson regression with a robust variance model was employed to assess factors associated with Cryptosporidium infection using the prevalence ratio with 95% confidence intervals (CI). This study included 756 diarrheic children under five years of age (mean = 20.8 months with a standard deviation of 13.4 and median of 16 months). The prevalence of Cryptosporidium infection was 15.2% (95% CI: 12.7-17.9). Wet season (adjusted prevalence ratio (APR) = 1.7, 95% CI: 1.2-2.4), having caregivers with no formal education (APR = 2.6, 95% CI: 1.1-6.3), presence of a diarrheic member in the household (APR = 1.9, 95% CI: 1.2-3.2), not being exclusively breastfed (APR = 1.6, 95% CI: 1.1-2.3), lack of handwashing practice after toileting (APR = 2.8, 95% CI: 1.7-4.5), and the use of toilet paper after defecation (APR = 1.6, 95% CI: 1.6-3.3) were factors significantly associated with increased risk of Cryptosporidium infection. Cryptosporidiosis was highly prevalent in diarrheic children under five years of age in Eastern Ethiopia. Exclusive breastfeeding, improving sanitation, and ensuring proper hygiene practices are essential steps in reducing the risk of Cryptosporidium infection.
8. Pathway polygenic risk scores (pPRS) for the analysis of gene-environment interaction.
期刊: PLoS genetics 发表日期: 2025-Aug-05 链接: PubMed
摘要
A polygenic risk score (PRS) is used to quantify the combined disease risk of many genetic variants. For complex human traits there is interest in determining whether the PRS modifies, i.e. interacts with, important environmental (E) risk factors. Detection of a PRS by environment (PRS x E) interaction may provide clues to underlying biology and can be useful in developing targeted prevention strategies for modifiable risk factors. The standard PRS may include a subset of variants that interact with E but a much larger subset of variants that affect disease without regard to E. This latter subset will dilute the underlying signal in former subset, leading to reduced power to detect PRS x E interaction. We explore the use of pathway-defined PRS (pPRS) scores, using state of the art tools to annotate subsets of variants to genomic pathways. We demonstrate via simulation that testing targeted pPRS x E interaction can yield substantially greater power than testing overall PRS x E interaction. We also analyze a large study (N = 78,253) of colorectal cancer (CRC) where E = non-steroidal anti-inflammatory drugs (NSAIDs), a well-established protective exposure. While no evidence of overall PRS x NSAIDs interaction (p = 0.41) is observed, a significant pPRS x NSAIDs interaction (p = 0.0003) is identified based on SNPs within the TGF-β/ gonadotropin releasing hormone receptor (GRHR) pathway. NSAIDS is protective (OR=0.84) for those at the 5th percentile of the TGF-β/GRHR pPRS (low genetic risk, OR), but significantly more protective (OR=0.70) for those at the 95th percentile (high genetic risk). From a biological perspective, this suggests that NSAIDs may act to reduce CRC risk specifically through genes in these pathways. From a population health perspective, our result suggests that focusing on genes within these pathways may be effective at identifying those for whom NSAIDs-based CRC-prevention efforts may be most effective.
9. Association of hormone therapy and outcomes in COVID-19.
期刊: Menopause (New York, N.Y.) 发表日期: 2025-Aug-05 链接: PubMed
摘要
To investigate the association between hormone therapy use and severe outcomes due to COVID-19 in perimenopausal and postmenopausal women. Using the Rochester Epidemiology Project, we retrospectively searched for the records of women aged 40-65 years who had a documented case of COVID-19 between March 12 and September 29, 2020. We further identified those who were perimenopausal or postmenopausal. The rates of emergency department visits, hospitalizations, and deaths were compared by hormone therapy use. Logistic regression models were used to assess the odds of the combined outcome based on hormone therapy use. Among the 689 patients included in this study, the median age was 56 years, and 77.5% were White. Compared with patients currently using hormone therapy, those with past/never use of hormone therapy were significantly older, had more risk factors for severe COVID-19, and had a higher incidence of diabetes. A total of 102 emergency department visits/hospitalizations/deaths occurred among both groups. Participants with current hormone therapy use had similar rates and risk of emergency department/hospitalization/death outcomes as those without hormone therapy, even after adjusting for age and severe COVID-19 risk factors. Severe COVID-19 outcomes were not significantly different between women with current versus past/never use of hormone therapy. Our study adds to the data suggesting no harm with hormone therapy use in women with severe symptoms of COVID-19.
10. Epidemiology of Chikungunya Hospitalizations, Brazil, 2014-2024.
期刊: Emerging infectious diseases 发表日期: 2025-Aug-05 链接: PubMed
摘要
We describe 7,421 chikungunya hospitalizations in Brazil covered by the country’s unified health system during 2014-2024. Most (43.2%) hospitalizations occurred in 2016 and 2017, reaching 0.72 (95% CI 0.69-0.76) hospitalizations/100,000 population in 2016. Hospitalizations were more frequent among persons who were female (55.8%), identifying as brown or black (63.5%), and 1-19 years of age (31.4%). Intensive care unit admissions occurred in 1.4% of cases, predominantly among children <5 and adults >85 years of age. The overall in-hospital case-fatality rate was 1.1%, which increased substantially with age, reaching 11.5% among patients >90 years of age and 14.1% among men 85-89 years of age. Patients admitted to the intensive care unit had a case-fatality rate of 21.1%. The total cost of chikungunya hospitalizations was US $560,746 (US $76.26 per patient). Our findings provide insights for surveillance of the most severe chikungunya cases.
11. Modelling the potential use of pre-exposure prophylaxis to reduce nosocomial SARS-CoV-2 transmission.
期刊: PLoS computational biology 发表日期: 2025-Aug-05 链接: PubMed
摘要
The nosocomial transmission of respiratory pathogens is an ongoing healthcare challenge, with consequences for the health of vulnerable individuals. Outbreaks in hospitals can require the closure of bays or entire wards, reducing hospital capacity and having a financial impact upon healthcare providers. Here we evaluate a novel strategy of pre-exposure prophylaxis as a means to reduce the nosocomial transmission of SARS-CoV-2. We model the effect of ursodeoxycholic acid (UDCA) upon levels of angiotensin-converting enzyme 2 (ACE2) expression, SARS-CoV-2 viral entry, and ultimately the probability of an infection. We then implement this model within simulations describing the spread of SARS-CoV-2 infections within a hospital context, simulating an intervention in which UDCA is given to patients on a ward for 10 days following the detection of a case of SARS-CoV-2 on that ward. Under default model parameters we infer a potential 17% reduction in the nosocomial transmission of SARS-CoV-2 to patients, with increased importation of cases into the hospital increasing the effectiveness of the intervention, and of the order 1000-2000 patient treatment days per nosocomial patient infection prevented. Our study provides preliminary evidence of the value of pre-exposure prophylaxis with UDCA as a strategy to reduce nosocomial SARS-CoV-2 transmission.
12. COEXIST: Coordinated single-cell integration of serial multiplexed tissue images.
期刊: PLoS computational biology 发表日期: 2025-Aug-05 链接: PubMed
摘要
Multiplexed tissue imaging (MTI) and other spatial profiling technologies commonly utilize serial tissue sectioning to comprehensively profile samples by imaging each section with unique biomarker panels or assays. The dependence on serial sections is attributed to technological limitations of MTI panel size or incompatible multi-assay protocols. Although image registration can align serially sectioned MTIs, integration at the single-cell level poses a challenge due to inherent biological heterogeneity. Existing computational methods overlook both cell population heterogeneity across modalities and spatial information, which are critical for effectively completing this task. To address this problem, we first use Monte-Carlo simulations to estimate the overlap between serial 5μm-thick sections. We then introduce COEXIST, a novel algorithm that synergistically combines shared molecular profiles with spatial information to seamlessly integrate serial sections at the single-cell level. We demonstrate COEXIST necessity and performance across several applications. These include combining MTI panels for improved spatial single-cell profiling, rectification of miscalled cell phenotypes using a single MTI panel, and the comparison of MTI platforms at single-cell resolution. COEXIST not only elevates MTI platform validation but also overcomes the constraints of MTI’s panel size and the limitation of full nuclei on a single slide, capturing more intact nuclei in consecutive sections and thus enabling deeper profiling of cell lineages and functional states.
13. Long-Range Air Transportation for High-Consequence Infectious Diseases: Findings from a Global Tabletop Exercise on Patients with Viral Hemorrhagic Fever.
期刊: Prehospital emergency care 发表日期: 2025-Aug-05 链接: PubMed
摘要
Air medical services evacuation of patients with viral hemorrhagic fevers (VHFs) is a complex process. The United States National Emerging Special Pathogens Training and Education Center held an in-person tabletop exercise (TTX) in June 2023 to review and evaluate global processes and plans for long-range VHF air transportation capabilities. The TTX sought to test the coordination, prioritization, capacities, and plans for using VHF transportation capabilities when multiple countries simultaneously request support in air medical services evacuation of their sick or exposed citizens to a high-level isolation unit in their country for care. Organizations invited to participate in the exercise (N = 16) were identified based on the TTX planning team’s knowledge of their VHF transport capabilities. The TTX included a scenario involving a significant Sudan ebolavirus exposure event of an index case to 18 close contacts of diverse nationalities. Following the exercise, scribes’ notes, evaluators’ observations, and participant feedback forms were thematically analyzed to develop key findings and opportunities. The After Action Report was reviewed by all participants and finalized with their written approval. Representatives from 15 organizations in six countries participated in the TTX; the only organization unable to attend was the World Health Organization. Findings indicated many countries rely on the same organization for VHF air transportation resources that would be quickly exceeded in this scenario. There is a need to further define processes for determining global prioritization of transportation assets when requests exceed capacity. Reliance on the same limited global transportation assets has implications for health security and limits the global response to multiple patients or individuals needing repatriation simultaneously. This indicates the importance of prioritizing resources, enhancing multinational coordination, and highlights the need to elevate these findings and discussions to national and international policy levels to increase air transportation resources and expand global capacity for managing patients with VHFs.
14. The Psychology of Crowd Behavior.
期刊: Annual review of psychology 发表日期: 2025-Aug-05 链接: PubMed
摘要
This review describes the social identity approach to crowd behavior. Research based on the social identity approach to crowds has grown significantly in the last 20 years, both quantitatively and qualitatively. I organize the new research into three sections. First, I consider the recent findings on crowd density behaviors, heightened emotion in crowds, mass gatherings health, and crowd events that function to strengthen group identity. Second, I cover research on behavior in emergencies and discuss how models of crowd behavior have shaped policy and practice in emergency response. Third, I describe the recent research on psychological change in collective action, public order policing, and social influence. The increased number of practical applications demonstrates that the social identity research on the psychology of crowd behavior has value beyond the advances it has made in terms of theory.
15. Atrial cardiomyopathy: From healthy atria to atrial failure. A clinical consensus statement of the Heart Failure Association of the ESC.
期刊: European journal of heart failure 发表日期: 2025-Aug-05 链接: PubMed
摘要
The importance of atrial cardiomyopathy (AtCM) as a specific clinical entity is increasingly recognized. Past definitions have varied, and the lack of consistent cut-offs for imaging parameters and biomarkers have limited clinical utility to diagnose and track AtCM progression. While research has mainly focused on AtCM in the context of atrial fibrillation, emerging evidence underscores its relevance in remodelling and development of heart failure. The aim of this consensus document was to provide a contemporary framework for AtCM, evolve the definitions of AtCM and atrial failure for more widespread clinical use, and help to direct emerging research and future clinical trials. Supporting the work of early career researchers, this consensus document evaluates diagnostic markers and summarizes the underpinning mechanisms, clinical characteristics and prognostic impact of AtCM. Our objective was to bring together new translational scientific progress, catalyse future research and enable clinical application to facilitate better management, for example in patient groups where aggressive control of risk factors or comorbidities could prevent AtCM progression. We redefined AtCM as a graded disorder that includes electrical dysfunction of the atria along with evidence of either mechanical atrial dysfunction, atrial enlargement and/or atrial fibrosis. Atrial failure is the end-stage manifestation of AtCM, characterized by progressive structural, electrophysiological and functional changes. Earlier identification, risk stratification and ongoing research into therapeutic options have the potential to prevent the clinical consequences of AtCM and atrial failure, including adverse patient outcomes and poor quality of life associated with atrial fibrillation and heart failure.
16. Evaluation of Net Withdrawal Time and Colonoscopy Video Summarization Using Deep Learning Based Automated Temporal Video Segmentation.
期刊: Journal of imaging informatics in medicine 发表日期: 2025-Aug-05 链接: PubMed
摘要
Adequate withdrawal time is crucial in colonoscopy, as it is directly associated with polyp detection rates. However, traditional withdrawal time measurements can be biased by non-observation activities, leading to inaccurate assessments of procedural quality. This study aimed to develop a deep learning (DL) model that accurately measures net withdrawal time by excluding non-observation phases and generates quantitative visual summaries of key procedural events. We developed a DL-based automated temporal video segmentation model trained on 40 full-length colonoscopy videos and 825 cecum clips extracted from 221 colonoscopy procedures. The model classifies four key events: cecum, intervention, outside, and narrow-band imaging (NBI) mode. Using the temporal video segmentation results, we calculated the net withdrawal time and extracted representative images from each segment for video summarization. Model performance was evaluated using four standard temporal video segmentation metrics, and its correlation with endoscopist-recorded times on both internal and external test datasets. In both internal and external tests, the DL model achieved a total F1 score exceeding 93% for temporal video segmentation performance. The net withdrawal time showed a strong correlation with endoscopist-recorded times (internal dataset, r = 0.984, p < 0.000; external dataset, r = 0.971, p < 0.000). Additionally, the model successfully generated representative images, and the endoscopists’ visual assessment confirmed that these images provided accurate summaries of key events. Compared to manual review, the proposed model offers a more efficient, standardized and objective approach to assessing procedural quality. This model has the potential to enhance clinical practice and improve quality assurance in colonoscopy.
17. Geriatricians and occupational therapists' perspectives on the role of occupational therapy in delirium care in long-term care settings: a multi-site study.
期刊: European geriatric medicine 发表日期: 2025-Aug-05 链接: PubMed
摘要
Delirium is a frequent and serious condition in older adults in long-term care (LTC), often underdiagnosed and insufficiently addressed despite its significant impact on morbidity and mortality. Occupational therapists (OTs) may play a key role in non-pharmacological prevention and treatment approaches, yet their specific contribution may remain unclear and undervalued in clinical practice. This study explored the perceptions of geriatricians and OTs regarding the role of OT in delirium care in LTC settings across three European countries. A qualitative, multi-site study was conducted through semi-structured interviews with six geriatrician-occupational therapist dyads working in LTC settings in Italy, Spain, and Switzerland. Transcripts were analyzed thematically through inductive coding. Three main conceptual categories emerged: (1) the perceptions of the OT’s role by geriatricians, (2) the goals and interventions of OTs in delirium care, and (3) barriers and facilitators to OT involvement. Geriatricians with greater familiarity with OTs recognized their role in prevention through environmental modifications and meaningful activity promotion, whereas others saw OTs’ contributions as overlapping with physiotherapy. OTs often lacked standardized tools and specific training for delirium care, and caregiver involvement was minimal. Barriers included time constraints, unclear interprofessional roles, and limited geriatric training; facilitators included strong interdisciplinary collaboration and supportive teams. Enhancing the role of occupational therapy in delirium care requires clearer interprofessional definitions, dedicated training, and structural support in LTC. Structured collaboration between geriatricians and OTs may improve prevention and management outcomes for delirium in older adults.
18. [Utilising behavioural data to promote climate-healthy behaviour: methods, potential and future directions].
期刊: Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz 发表日期: 2025-Aug-05 链接: PubMed
摘要
Climate-healthy behaviour plays a key role in designing sustainable strategies for health promotion. This article demonstrates how behavioural data can be leveraged to gain a clearer understanding of individual routines and structural conditions, and how evidence-based measures can be developed on that basis. Based on the interdisciplinary approach of behavioural and cultural insights (BCIs) and the COM‑B theoretical framework (Capability, Opportunity, Motivation-Behaviour), it explains how psychological, social and cultural factors influence human behaviour and the role of systematic behavioural data collection in promoting climate-healthy routines.On one hand, quantitative approaches such as online surveys, experience sampling (a real-time survey of experience and behaviour in everyday life) and (online) experiments allow for large-scale analysis and the identification of behavioural patterns. On the other hand, qualitative methods (e.g. interviews, focus groups, diary studies) provide in-depth insights into decision-making processes and social norms. Combined into so-called mixed-methods approaches, these procedures can uncover barriers-such as limited knowledge or insufficient infrastructure-and target them.Using the HEATCOM and PACE projects as examples, the article illustrates how heat protection and climate-healthy behaviour are examined within this integrative concept. Ethical considerations and data protection issues are also discussed, demonstrating how transparency and scientific evidence can dispel concerns of manipulation. Finally, the challenges of political implementation are explored, and recommendations for decision-makers are outlined on how to successfully integrate behavioural data into climate adaptation and health promotion measures. Klimagesundes Verhalten nimmt eine Schlüsselposition in der Gestaltung nachhaltiger Strategien zur Gesundheitsförderung ein. Dieser Beitrag zeigt, wie Verhaltensdaten genutzt werden können, um individuelle Routinen und strukturelle Rahmenbedingungen besser zu verstehen und wirksame Maßnahmen evidenzbasiert zu konzipieren. Auf Basis des interdisziplinären Ansatzes Behavioural and Cultural Insights (BCI) sowie des theoretischen COM-B-Frameworks (Capability, Opportunity, Motivation – Behaviour) wird erläutert, wie psychologische, soziale und kulturelle Faktoren das menschliche Verhalten beeinflussen und welche Rolle die systematische Verhaltensdatenerhebung für die Förderung klimagesunder Routinen spielt.Einerseits erlauben quantitative Ansätze wie Online-Umfragen, Experience Sampling (Echtzeiterhebung von Erleben und Verhalten im Alltag) und (Online‑)Experimente die Analyse großer Stichproben und das Aufdecken von Verhaltensmustern. Andererseits liefern qualitative Methoden (z. B. Interviews, Tagebuchstudien) vertiefte Einblicke in Entscheidungsprozesse und soziale Normen. Zu sogenannten Mixed-Methods-Ansätzen zusammengeführt können diese Verfahren Barrieren identifizieren – etwa mangelndes Wissen oder unzureichende Infrastruktur – und gezielt adressieren.Anhand der Projekte HEATCOM und PACE wird exemplarisch illustriert, wie Hitzeschutz- und klimagesundes Verhalten diesem integrativen Konzept folgend untersucht wird. Zugleich werden ethische Fragen sowie Aspekte des Datenschutzes diskutiert und aufgezeigt, wie Manipulationsvorwürfen durch Transparenz und wissenschaftliche Evidenz begegnet werden kann. Abschließend werden Herausforderungen in der politischen Umsetzung erörtert und Handlungsempfehlungen für Entscheidungsträger*innen formuliert, um Verhaltensdaten erfolgreich in Maßnahmen zur Klimaanpassung und Gesundheitsförderung zu integrieren.
19. Determining the best predictive function to mathematically describe the lactation curve of primiparous Murcia does in Iran.
期刊: Tropical animal health and production 发表日期: 2025-Aug-05 链接: PubMed
摘要
20. β-Sitosterol improves murine ulcerative colitis by inhibiting the expression of ribosomal proteins and the attempted polarization of type 1 macrophages.
期刊: International journal of colorectal disease 发表日期: 2025-Aug-05 链接: PubMed
摘要
As the inflammatory bowel disease subtype, ulcerative colitis (UC) is the idiopathic chronic inflammatory condition affecting colonic mucosa. Characterized by high incidence and therapeutic challenges, UC imposes significant burdens on global health. β-Sitosterol, a phytosterol abundant in fruit and medicinal plants, has demonstrated potential anti-inflammatory properties. Herein, the UC mouse model was created by administering dextran sulfate sodium, followed by β-sitosterol treatment. Histopathology, single-cell RNA-sequencing (scRNA-seq), Kyoto Encyclopedia of Genes and Genomes (KEGG), flow cytometry (FCM), enzyme-linked immunosorbent assays (ELISAs), Western blotting, and quantitative real-time reverse transcription PCR (qRT-PCR) were implemented. Oral administration of β-sitosterol markedly alleviated intestinal damage and inflammation in UC mice. The scRNA-seq assay revealed that the immune cell subpopulations in the colorectal tissues of mice treated by β-sitosterol gavage apparently decreased compared with them in UC mice, with the most significant difference in the number of macrophages. KEGG analysis predicted significant downregulation of ribosome pathway activity in CD68 + MΦ1 macrophages following β-sitosterol treatment. Both FCM and ELISA analyses showed that β-sitosterol significantly downregulated inflammatory factor generation like interleukin-1β (IL-1β) and inducible nitrous oxide synthase (iNOS) by RAW264.7-derived MΦ1 macrophages. In vitro, as confirmed by qRT-PCR and Western blotting analyses, β-sitosterol dramatically inhibited MΦ1 macrophage expression of ribosome pathway core factors. The present study confirmed that β-sitosterol inhibits MΦ1 macrophage polarization and inflammatory activity by downregulating the key gene transcriptional activity and expression in ribosome signaling pathway in MΦ1 macrophages, thereby ameliorating UC symptoms in mice.
21. Health risk assessment of dermal exposure and urinary biomarker related to arsenic-contaminated tap water in abandoned tin mine communities, Thailand.
期刊: Environmental geochemistry and health 发表日期: 2025-Aug-05 链接: PubMed
摘要
Arsenic is a strongly toxic element with widespread environmental presence, posing significant health risks especially from water contamination. This study aimed to investigate the As concentrations in tap water, assess the cancer and non-cancer risks related to bathing dermal exposure, and examine the As-urine including the associated factors. This study found tap water samples from abandoned tin mine residences exceeded Thailand’s Department of Health standard (10 µg/L), with levels up to 12 times higher in the dry season and 53 times higher in the wet season. The average of As in tap water from abandoned tin mine residences was 119.30 ± 3.71 µg/L (range: 113.98-127.72 µg/L). In contrast, all samples from non-mining areas showed undetectable levels (< 0.60 µg/L). For As-urine, the abandoned tin mine residents found 127.86 ± 46.51 µg/L in dry season, and 103.88 ± 82.78 µg/L during wet season. The Mann-Whitney U-test found As-urine of abandoned tin mine area residents were significantly higher than non-mining area residents in both seasons. Over 70% of abandoned tin mine area participants found As-urine exceeded the normal level. Cancer risk assessments showed 13.29 × 10-6 and 56.18 × 10-6 in dry and wet seasons respectively. Furthermore, the binary logistic regression found using tap water in abandoned tin mine residences for brushing teeth, for rice cooking, and for bathing were associated factors with As-urine. Public health measures, such as community education also health promotion on the health impact of As-contaminated water, are crucial for mitigating exposure and associated health risks.
22. Sexual Health Education for Behavior Change: Revisiting How Much is Enough.
期刊: The Journal of adolescent health : official publication of the Society for Adolescent Medicine 发表日期: 2025-Aug-05 链接: PubMed
摘要
Successful implementation of school sexual health curricula relies on students receiving sufficient exposure to lesson content. This large replication study assesses the longitudinal association between exposure to sexual health lesson frequency and content domains and delayed sexual initiation of middle school students. Post hoc data analysis was conducted using a large harmonized dataset from 3 randomized controlled trials evaluating It’s Your Game curricula in the South Central United States. The sample comprised 1,022 sexually inexperienced middle school students (grades 7 and 8) who completed grade 9 follow-up after using either a 24-lesson hybrid (classroom and computer-based) (It’s Your Game…Keep It Real!) or a 13-lesson computer-based (It’s Your Game-Tech) curriculum. Multilevel logistic regression was used to assess the association of lesson exposure variables on initiation of any sex by grade 9 while adjusting for covariates of age, gender, and race/ethnicity. Delayed initiation was directly associated with lesson exposure (odds ratio = 1.06; p < .001). The greatest association of exposure on delayed sexual initiation was a duration of 13 or more lessons (odds ratio = 2.09; p = .01). Significant univariate associations of delayed sexual initiation (refusal skills, pregnancy consequences) were not significant in the multivariate model. No single topic was predictive of delayed initiation of sex in the multivariate model. Results support previous exposure studies indicating the need for adequate lesson exposure and the importance of broad-based content. Findings contribute to guidance on how effective sexual health curricula can meet the delivery challenges in a reduced and “crowded” academic schedule.
23. Confirmation of a hyperendemic focus of porcine cysticercosis in Northern Uganda: Prevalence and risk factor analysis.
期刊: PLoS neglected tropical diseases 发表日期: 2025-Aug-05 链接: PubMed
摘要
Taenia solium (T. solium), a neglected zoonotic tapeworm transmitted between humans and pigs, is a leading cause of acquired epilepsy in endemic areas where it is propagated by poor sanitation and pig husbandry practices. The World Health Organisation (WHO) NTD roadmap 2021-2030, recommended that targeted control interventions need to be initiated, and intensified in T. solium hyperendemic areas. Geospatial risk maps have identified Northern Uganda as a potential hyperendemic area. This study aimed to validate these findings and provide contextual evidence to support design and implementation of targeted interventions to control the parasite. A cross-sectional study was conducted in 2023 in four districts of northern Uganda. Blood samples were collected for serological analysis from 1049 pigs drawn from 714 households. Self-reported and observational data, and environmental variables from secondary sources were also collected. A subset of the seropositive pigs was dissected to confirm the presence of the parasite. The crude prevalence was adjusted for the test’s sensitivity (Se = 0.867) and specificity (Sp = 0.947). Risk factors for seropositivity were evaluated using generalized mixed-effects models run in both R and Stata statistical software. The prevalence of porcine cysticercosis in this area was 17.4% (15.1- 19.7; 95% CI). Pig level predictors of infection were pigs that were eight months or older (odds ratio (OR)=1.88; p = 0.001), and non-local breeds of the pig (OR=1.7; p = 0.01). Household-level risk factors included the use of borehole water, (OR=6.39; P = 0.001), free-roaming pigs (OR=1.92; p = 0.023), whilst the presence of a toilet in the compound was protective (OR=0.64, p = 0.05). Our findings confirm that the study area is hyperendemic for T. solium infections, as the geospatial risk maps predicted. To achieve the targets laid out in the 2021-2030 WHO roadmap for control of NTDs, this region requires intensified targeted control interventions, preferably targeting both human and porcine hosts using the One Health approach.
24. The Chemical Toxicology of Ambient Air Pollutants.
期刊: Annual review of pharmacology and toxicology 发表日期: 2025-Aug-05 链接: PubMed
摘要
Many of the adverse effects of ambient air pollution have been attributed to reactions of chemical species generated from fossil or biogenic fuel combustion. This review focuses on two reactions: (a) a prooxidant reaction, in which oxygen is reduced to hydrogen peroxide, and (b) covalent bond formation between electron-rich centers on biological targets with reactive compounds called electrophiles. Prooxidants were found to be concentrated in the particulate matter (PM) fraction of ambient air in the Los Angeles Basin with electrophiles concentrated in the volatile organic compound (VOC) fractions. Actions on mouse macrophages indicated the adverse effects to be mostly attributed to the PM, with anti-inflammatory actions to the VOC fraction. The latter observation does not include, however, the adverse effects of VOCs associated with the transient receptor potential (TRP) calcium channels on epithelial cells, a perspective that needs further investigation.
25. End-user reported outcomes of a customizable manual wheelchair.
期刊: Assistive technology : the official journal of RESNA 发表日期: 2025-Aug-05 链接: PubMed
摘要
NeoFly™ is a customizable, compact, ergonomic manual wheelchair. This indigenously designed, personalized wheelchair was devised to enhance the user’s health and lifestyle. This study aimed to evaluate the long-term impact of NeoFly™ on users’ daily routines. All participants (N = 43, 20-males, 23-females), selected through convenience sampling, had spinal cord injuries and were remotely screened for inclusion-exclusion criteria by an occupational therapist. Eighteen customizations ensured an appropriate fit for users. During the 6-month study period, the participants used NeoFly™ in their daily routines. To assess the impact of NeoFly™ on users’ health and lifestyle, participants’ feedback was captured using a questionnaire related to productivity, community participation, leisure, accessibility, mobility, functionality, body functions, self-care, portability, and device feedback. Around 88% of users were satisfied with their sitting posture and could easily perform pressure relief maneuvers. Nearly 91% of users felt that maintaining a good sitting balance and bladder voiding were easy tasks and found environmental controls and doorways accessible. Around 86% of users felt ease in overhead reach. About 77% and 88% of users felt independent in performing ADLs and in terms of educational/vocational mobility, respectively. Overall, user responses indicate a positive impact of NeoFly™ on the users’ health and lifestyle.
26. Teams, tools, and time: a mixed methods study of workforce practices to identify mental health concerns in young people with complex communication needs.
期刊: Disability and rehabilitation 发表日期: 2025-Aug-05 链接: PubMed
摘要
To understand the current practices and future needs of practitioners involved in identifying low wellbeing and/or mental health problems in 10-24-year-olds with complex communication needs. This mixed methods study (cross-sectional survey and follow-up focus groups) included participants who may be involved in identifying mental health concerns in young people with complex communication needs. Analyses included descriptive statistics (quantitative data) and interpretive description methods (qualitative data). These data were then synthesised before interpretation. Survey participants (n = 112 from 17 occupational backgrounds) mostly used “interaction with the person” to identify both low wellbeing and mental health problems. The least used method was “formal tool”. An interpreted description of focus group data (n = 19 participants) produced a six-part Practitioners’ Story. The Story described practitioners’ current practice (facilitating and inhibiting), feelings towards the present situation, and ideas for improving identification of mental health concerns in this population. There was little consistency in how mental health concerns were evaluated in young people with complex communication needs, but informal methods were most common. Workforce education, access to relevant resources, and service settings which promote a collaborative approach to assessment should be prioritised to better address the mental health needs of this currently underserved population. Practitioners from a range of occupational backgrounds are involved in identifying mental health concerns in young people with complex communication needs.Practitioners need to understand wellbeing and mental health problems as separate but related constructs, and that one or both may need addressing.Practitioners should not avoid, and be willing to, ask augmentative and alternative communication (AAC)-users about their mental health, even if it is out of their comfort zone.Identification of mental health concerns in this cohort requires collaborative practice, access to and skills in using relevant tools, and sufficient time.
27. Associations of neutrophil-based inflammatory markers with all-cause and cardiovascular mortality in individuals with osteoarthritis.
期刊: Maturitas 发表日期: 2025-Aug-04 链接: PubMed
摘要
Osteoarthritis is increasingly understood as a heterogeneous disease, with certain phenotypes involving low-grade inflammation. Novel neutrophil-based inflammatory markers, including the neutrophil-to-lymphocyte ratio (NLR) and neutrophil-to-platelet ratio (NPR), have shown prognostic value in many disorders, but evidence for their relevance in osteoarthritis is limited. This study examined the associations between the NLR and NPR and all-cause and cardiovascular mortality in this population. Utilizing data from the National Health and Nutrition Examination Survey (1999-2020), we used logistic regression and multivariate Cox proportional hazards models and Fine-Gray models to assess the relationships of the NLR and NPR with the prevalence of self-reported osteoarthritis and all-cause and cardiovascular mortality. We further used restricted cubic spline (RCS) and performed a time-dependent receiver operating characteristic (ROC) curve analysis to assess the prognostic significance of these markers for all-cause and cardiovascular mortality. A total of 3545 osteoarthritis patients were included in the analysis. After adjusting for potential confounders, a high NLR and a high NPR were significantly associated with increased risks of all-cause mortality (NLR: hazard ratio [HR] = 2.42, 95 % CI 1.84-3.18; NPR: HR = 1.57, 95 % CI 1.31-1.90) and cardiovascular mortality (NLR: HR = 1.92, 95 % CI 1.22-3.03; NPR: HR = 2.07, 95 % CI 1.42-3.01). The RCS revealed a nonlinear (J-shaped) relationship between the NLR and mortality. The ROC curve analysis indicated that the NLR and NPR had modest predictive accuracy for mortality outcomes, with area under the curve values ranging from 0.616 to 0.690 across different time points. An elevated NLR or NPR is associated with increased all-cause and cardiovascular mortality in osteoarthritis patients. These results suggest that the NLR and NPR should be considered for risk stratification and personalized management strategies.
28. Appraisal of the composition, structure, diversity, and functioning of bacterial and fungal communities in drinking water systems: A case study in the developing world.
期刊: International journal of hygiene and environmental health 发表日期: 2025-Aug-04 链接: PubMed
摘要
Bacterial and fungal communities’ successions were examined in a typical drinking water system in South Africa (Global South) using metagenomic sequencing. Bacterial taxa abundance was similar in water matrices but not in biofilm samples with Bacteroidota being higher in tap water and Actinobacteriota, Firmicutes, and Chloroflexi in biofilms. Fungal taxa abundance varied less, with Rozellomycota and Basidiomycota being interchangeably abundant. Both bacterial and fungal taxa and richness decreased during chlorination, but bacterial increased and fungal decreased in the distribution system. Fungal and particularly bacterial communities’ diversity in raw water was closely clustered together with biofilm samples, which could suggest that biofilms act as a sink and reservoir for microbes found in raw water, however microbes’ resuspension or dispersion from biofilms was less likely. Functional profile prediction revealed the presence of mainly common metabolic pathways for pathogenesis, antibiotic or chlorine resistance, with the denitrification pathway being significantly enriched within the distribution network. Finally, changes in residual chlorine had a larger influence on the composition and structure of bacterial fractions than the fungal communities. Given that drinking water systems in the developing world are ridden with many challenges, assessing both planktonic and biofilm communities is much-needed, particularly at their distal ends where chlorine decay is more pronounced and microbial regrowth can be an issue of prime concern. Finally, metagenomics analyses can shed light on bacterial and fungal succession and dynamics across the water supply chain and identify microbial risks. This can inform evidence-based interventions to underpin improved water quality and protect public health in South Africa and further afield.
29. Nasal high flow therapy in the emergency department - A prospective study.
期刊: International emergency nursing 发表日期: 2025-Aug-04 链接: PubMed
摘要
Globally, emergency department (ED) nurses routinely care for patients requiring respiratory support; this support may include nasal high flow (NHF) therapy. The study objective was to profile and evaluate the outcomes of ED patients receiving NHF respiratory support compared to those receiving all other forms of respiratory support. A prospective, observational, multicenter method was used to capture real-time, real-world epidemiological data at four New Zealand EDs for two 12-hour periods in April and May 2023. N = 898 patients presented to the participating EDs; the minority, n = 76 (8.46 %), received respiratory support, with a subset of these (n = 12, 15.7 %) receiving NHF. Most of those receiving NHF were male (n = 8, 66 %), of New Zealand European ethnicity (n = 4, 33 %), with a mean age of 69.91 years (SD 18.93). These participants had a mean triage score of 2.66 (SD 0.65) and a mean modified early warning score of 7.58 (SD 3.32). ‘Respiratory’ was the most common participant diagnostic category (n = 5, 41.5 %). The most common reason for NHF delivery was ‘oxygenation improvement’ (n = 4, 33.3 %). Those receiving NHF appeared to require less escalation of respiratory support versus those receiving other forms of respiratory support (n = 1, 8.3 %, versus n = 21, 32.8 %). No significant difference in treatment effect was seen for escalation to NHF versus other forms of respiratory support (RR 0.31, 95 % CI 0.04 to 2.12, P = 0.23, NNT (benefit) 5.87, 95 % CI 2.43 to 14.07). The median overall length of stay for those admitted to the hospital was eight days (4-15). This was seen to be significantly higher for those receiving NHF in the ED (Mann-Whitney U, 183, P = 0.004). Given the methods used, all findings must be viewed with caution. The study reports that a minority of ED patients requiring respiratory support receive NHF. However, these patients appear to have high acuities, a high need for hospitalization, and an increased length of stay (LOS). Collectively, these data suggest that these patients are high consumers of healthcare resources. These New Zealand study findings may have implications for research and care planning across health sectors, including the ED. What is already known about this topic? Nasal high-flow therapy, which provides respiratory support, is provided in the emergency department to patients with many conditions. What does this paper add to the currently published literature? This description of the epidemiology of emergency department patients provided nasal high flow here may inform benchmarking for future ED clinical practice and research. What is the most important implication for clinical emergency nursing practice? The patients profiled in this study are vulnerable, have high acuity, and require targeted respiratory support to improve their outcomes.
30. Evaluating the Distribution of Otological and Neurotological Surgeons in the United States With the Social Vulnerability Index.
期刊: Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology 发表日期: 2025-Aug-04 链接: PubMed
摘要
Assess the relationship between neighborhood-level social determinants of health (SDoH) and the distribution of otology and neurotology surgeons (ONSs) with the Social Vulnerability Index (SVI). Cross-sectional study. United States. A dataset of US-based ONS and their practice addresses were obtained from the American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS) and American Neurotology Society (ANS) directories. The overall SVI and its four subthemes, socioeconomic status (SES), household composition and disability status (HH), racial-ethnic minority status (RE), and housing and transportation status (HT), were used to quantify neighborhood-level disadvantage at the census-tract level. The distance from each census-tract to the nearest ONS was calculated. Subsequently, multivariable and univariable linear regression analyses were performed to assess associations between SVI quartiles and distance to the closest ONS. This study included 415 otology and neurotology surgeons. The most vulnerable quartile of overall SVI, SES, and HH was associated with greater distances to the nearest otologist (p < 0.001). Conversely, the most vulnerable quartile of RE and HT were associated with decreased distance to the nearest ONS (p < 0.001). Regions experiencing greater social vulnerability across specific SDoH are further from ONS. SVI may be useful in identifying regions deficient in ONSs while characterizing the factors that contribute to this disparity. The projected workforce deficit highlights the need for proactive measures to ensure equitable access to ONS care, guiding future research and policy efforts aimed to improve healthcare equity and access.
31. Association Between Acute Plasma Glial Fibrillary Acidic Protein Levels and White Matter Integrity in Recent Trauma Survivors.
期刊: Journal of neurotrauma 发表日期: 2025-Aug-04 链接: PubMed
摘要
Traumatic brain injuries (TBIs) account for over 2.5 million emergency department (ED) visits each year in the United States. The bulk of TBI research in acute care settings has focused exclusively on individuals who receive computed tomography (CT) scanning. Recently, more sensitive TBI assessment tools have been identified, including blood biomarkers such as glial fibrillary acidic protein (GFAP) and magnetic resonance imaging (MRI) of white matter microstructural integrity. These methods can evaluate for evidence of TBI in CT-negative patients. However, limited prior work has investigated the relationship between blood GFAP levels and white matter microstructural integrity. The present study examined the association between acute (≤72 h) GFAP levels and white matter microstructural integrity at 2 weeks post-trauma among ED patients (n = 328) recruited after a qualifying traumatic experience. We hypothesized that acute GFAP concentrations would be associated with disrupted microstructural integrity, quantified with Tract-Based Spatial Statistics-derived diffusion tensor imaging (DTI) metrics (reduced fractional anisotropy and increased axial diffusivity [AD], radial diffusivity, and mean diffusivity), in tracts previously shown to be vulnerable to TBI. Our secondary hypothesis was that there would be a stronger association between GFAP levels and white matter integrity among female relative to male trauma survivors, in line with previous literature suggesting that females’ axons are less resilient to stretch injury. To test the primary hypothesis, we fit four sets of linear regression models to assess the association between natural log-transformed acute GFAP concentration and DTI metrics for 15 white matter regions of interest (ROIs). The false discovery rate (FDR) was controlled at 0.05 for each set of models. Models were adjusted for age, sex, neuroimaging site, and a composite lifetime traumatic stress variable. To test the secondary hypotheses, we fit identical sets of linear regression models, with an additional interaction term between sex and ln(GFAP). We followed up all significant results surviving FDR correction with correlational tractography to examine the location and direction of tracts associated with the DTI metric passing through those ROIs. We observed significant and positive associations between acute GFAP and AD in the parahippocampal cingulum (B = 1.416 × 10-5, standard error [SE] = 4.806 × 10-6, p = 0.003, FDR-corrected p = 0.026), and the sagittal stratum (B = 1.012 × 10-5, SE = 3.438 × 10-6, p = 0.003, FDR-corrected p = 0.026), including fibers of the inferior longitudinal fasciculus and the inferior fronto-occipital fasciculus. Furthermore, the association between GFAP and AD of the parahippocampal cingulum was stronger in female trauma survivors compared with male trauma survivors (B = 2.898 × 10-5, SE = 9.352 × 10-6, p = 0.002, FDR-corrected p = 0.032). Our results suggest that among ED patients with low rates of intracranial injuries observed on CT and MRI scans, acute peripheral levels of GFAP may be able to predict later disruption in structural connectivity.
32. "From birth to puberty: the main physio-pathological changes of the mammary gland during childhood and adolescence, described and illustrated".
期刊: Early human development 发表日期: 2025-Aug-04 链接: PubMed
摘要
Under hormonal stimulation, from birth to puberty, various normal and abnormal changes in the mammary gland occur, and pediatric patients may sometimes present with significant breast changes. Many conditions are physiological and transient; however, they can cause anxiety and concern. Some of them, although less common, may involve a non-physiological process or a latent disease, therefore, timely diagnosis is essential to prevent complications that can lead to permanent consequences. The objective of this review is to provide a systematic description of the clinical and radiological characteristics of the most common breast disorders during childhood and puberty, in order to help formulate a correct differential diagnosis and promptly intervene if necessary. A set of illustrations relating to the conditions described is supplied to complete the document, mainly ultrasound images but not only, which can support the professional in clinical practice. The main literature on pediatric breast (reviews and case reports) published over the past twenty-five years was examined, using as keywords “breast development,” “pediatric breast,” “breast enlargement”; “neonatal mastitis”; “infantile breast/mammary ductal ectasia”; “gynecomastia”; “isolated premature thelarche”; “central precocious puberty”; “breast asymmetry”; “breast ductal ectasia”; “juvenile breast hypertrophy”; “fibrocystic changes”; “fibroadenoma”. A careful physical examination, combined with a targeted ultrasound evaluation, in most cases allows for a correct diagnosis of the breast pathology in childhood and adolescence; appropriate laboratory tests may be necessary. Furthermore, ultrasound examination may help avoid unnecessary worry, and set aside unnecessary invasive diagnostic and therapeutic strategies.
33. Factors influencing caregiver burden among those caring for older people over 65 years in long-term care: insights from Taiwan's long-term care services system.
期刊: Geriatric nursing (New York, N.Y.) 发表日期: 2025-Aug-04 链接: PubMed
摘要
Home care, which supports the concept of aging in place, has been shown to negatively impact caregivers’ health and quality of life. This study examined how care recipients’ self-care abilities and caregivers’ support environment affect caregiver burden, using data from the Multi-Aspects Assessment Instrument of Taiwan’s long-term care system. A total of 653 records met the study’s inclusion criteria. The caregivers’ had a mean age of 59.17 years, 73.15 % lived with the care recipient, and the average caregiver burden score was 7.16. After controlling the care recipients’ gender, age, education level, and marital status, the results revealed that better IADL abilities in care recipients were associated with less burden on the caregiver (unstandardized coefficient b=-0.04, p<.01). Additionally, caregivers were less burdened when care recipients could remain at home alone for one to three hours (unstandardized coefficient b=-0.32, p<.01). However, caregiver burden increased if they had more than one person to take care of (unstandardized coefficient b = 0.78, p<.001), and their health status deteriorated (unstandardized coefficient b=-0.37, p<.001). Targeted interventions to improve recipients’ independence could alleviate caregiver stress.
34. Emerging Roles of Ferroptosis in Skin Pathophysiology.
期刊: The Journal of investigative dermatology 发表日期: 2025-Aug-04 链接: PubMed
摘要
Programmed cell death (PCD) is a hallmark of tissue homeostasis and numerous human diseases. Ferroptosis, a more recently discovered type of PCD, is uniquely dependent on enzymatically driven accumulation of specific hydroperoxy-phospholipid species and iron-dependent reduction-oxidation (redox) dysregulation. Emerging evidence suggests that ferroptosis plays a critical role in the pathogeneses of several dermatologic disorders, including infections, malignancies, and chronic inflammatory and autoimmune diseases. In this study, we review relevant regulatory mechanisms of ferroptosis, illustrate the challenges faced by the studies of ferroptosis, and highlight ferroptosis vulnerabilities in the redox balance of the skin. Furthermore, we review the link between ferroptosis and skin immunosurveillance and discuss ferroptosis functions in select skin diseases. Additional mechanistic studies that link ferroptosis to dysregulated cellular metabolism and proliferation, inflammation, and carcinogenesis will accelerate the emergence of new preventative and therapeutic strategies across a variety of dermatologic conditions.
35. Subjective and Objective Evaluation Of Physical Activity Level And Its Relationship With Work Ability Of Nurses In Different Hospital Departments.
期刊: La Medicina del lavoro 发表日期: 2025-Aug-04 链接: PubMed
摘要
Due to the nature of shift work, nurses experience very high mental and physical pressure, which can ultimately affect their work ability (WA). One factor that affects work ability is the level of physical activity (PAL). Since nurses are responsible for providing healthcare for the public, it is necessary to evaluate their WA and PAL. Therefore, the present study used subjective and objective evaluation to test the relationship between PAL and WA among nurses in different hospital departments affiliated with Isfahan University of Medical Sciences. A descriptive-analytical study was conducted over 6 months. A questionnaire was used to measure the work ability index (WAI). The International Physical Activity Questionnaire (IPAQ) was used for subjective evaluation, and the Xiaomi smart wristband Mi Band Five was used for objective assessment. These tools extracted the components of behaviors related to physical activity for 7 days. One hundred nurses were selected for subjective evaluation, and then 40 of them were randomly selected for objective assessment. The SPSS software version 23 was used for data analysis. Multiple regression analysis was used to test the effect of physical activity on the work ability index by controlling other demographic variables. 7% of participants had poor WAI, and 45% had moderate work ability. Also, the ability to do good and excellent work was 32% and 16%, respectively. In this study, 31% of participants had low PAL, 42% moderate PAL, and 27% high PAL. In the objective evaluation, 12.5% of participants had a PAL of 100, 35% less than 100(poor), and 52.5% had a PAL above 100(High). In the subjective evaluation, the highest PAL belonged to the emergency department. The results of the subjective and objective methods to check the correlation between WAI and PAL showed a positive and significant correlation. In the present study, subjective and objective evaluations showed a significant relationship between work ability and PAL. The present findings can be used to develop future interventions to improve nurses’ health and work performance.
36. The Effectiveness of Ergonomic Intervention in Work-related Postures and Upper Crossed Syndrome of Metal Industry Workers.
期刊: La Medicina del lavoro 发表日期: 2025-Aug-04 链接: PubMed
摘要
Upper Crossed Syndrome (UCS) is a musculoskeletal disorder that mainly occurs due to awkwardposture in a static position. Considering the impact of musculoskeletal disorders on individual and social life, and the limited studies carried out in metal industries, this study evaluated the effect of ergonomic interventions using engineering controls on work-related postures and skeletal abnormalities caused by UCS in one of the metal industries. In this interventional study, 132 welders, press, and warehouse workers who had symptoms related to UCS were included. There were 78 participants in the experimental group (43 welders and 35 press operators) and 54 warehouse workers in the control group. Sitting and standing workstations were evaluated using the RULA and REBA methods, respectively. Then, with the technical committee’s decision, the necessary ergonomics interventions were carried out. After three months of applying the interventions, the postures were re-evaluated. The paired t-test method was used for intra-group evaluation, and the independent t-test was used to compare the experimental and control groups using SPSS. This study showed that ergonomic interventions can significantly reduce the risk score of musculoskeletal disorders in different body segments in sitting and standing workstations. Examining the UCS of the experimental group with sitting activities after the intervention, the average angle of the forward head, round shoulder, and kyphosis was reduced by 3.89, 4.05, and 3.73 degrees, and with standing activities by 3.27, 2.70, and 3.10 degrees, respectively. The results of the study revealed that modifying the workstation has a significant role in reducing the UCS.
37. Gender Disparities in Workplace Violence Among Italian Healthcare Workers: A Cross-Sectional Study.
期刊: La Medicina del lavoro 发表日期: 2025-Aug-04 链接: PubMed
摘要
Workplace violence (WPV) is a prevalent issue globally among Healthcare Workers (HCWs). Moreover, WPV may disproportionately impact marginalized groups within the healthcare workforce, such as women and gender minorities. This study aims to examine the prevalence of WPV experienced by HCWs through a gender-focused lens and to investigate factors influencing the risk of WPV. A cross-sectional observational study was conducted over a month in Apulia, Italy, involving employees from major healthcare institutions, including hospitals, Local Health Authorities, selected correctional facilities, and Residences for Execution of Security Measures. The study used the Italian-validated WHO Workplace Violence in the Health Sector questionnaire, modified to include ‘Other’ in the gender definition. 3,259 HCWs participated, representing 88.8% of the 3,670 invited participants. The prevalence of violence incidents within the last 12 months was 29.6% in the HAW group and 57.1% in the CRW group. Within the HAW group, transgender and gender expansive (TGE) workers exhibited a higher prevalence of verbal, physical, and sexual harassment. Logistic regression analysis identified gender, job type, night shifts, interactions with specific patients, and the type of medical settings as significant predictors of experiencing various kinds of violence. The study underscores the vulnerability of TGE and female HCWs to workplace violence. These findings underscore the imperative for comprehensive yet gender-sensitive interventions promoting safety, equity, and inclusion in the healthcare workplace.
38. Longitudinal Changes in Work Ability, Well-Being, and Psychosocial Risk Factors Among Older Workers: The ProAgeing Study.
期刊: La Medicina del lavoro 发表日期: 2025-Aug-04 链接: PubMed
摘要
As the workforce ages, older employees face increasing challenges in adapting to changing job demands, including technological advances and ongoing occupational risks such as shift work and physically demanding tasks. Work ability is a reliable indicator of older workers’ capacity to meet both physical and mental requirements of their jobs. The ProAgeing study, a multicenter investigation specifically focused on workers over 50 years old, examined long-term patterns in work ability, perceived health, and psychosocial risk factors, along with their interactions across this demographic. Participants completed self-reported questionnaires at baseline and after one year, including the Work Ability Index (WAI), technostress, sleep quality, perceived stress, health, and psychosocial risk factors. A first-difference linear regression model was used to assess predictors of changes in WAI. Subgroup analyses examined differences across occupational roles (bank employees, administrative employees, and manual workers). Of the 470 workers enrolled, 356 (76%) completed the follow-up. A significant decline in average WAI score was observed over 12 months (-1.2 points, p<0.001), mainly in subscales related to work demands and physical illness. Technostress levels slightly decreased, suggesting adaptation over time. Bank employees showed less favorable trends than manual workers, indicating that digitalization and higher job demands significantly affected employees’ well-being, especially older workers. Improvements in perceived health and reduced stress mostly contributed to enhanced work ability. These findings highlight the importance of targeted interventions to enhance health and lower stress among aging workers, supporting their well-being and subsequently their work ability.
39. A 21-Year Perspective on Occupational Skin and Respiratory Diseases Among Food Handlers.
期刊: La Medicina del lavoro 发表日期: 2025-Aug-04 链接: PubMed
摘要
Food handlers may have an increased risk of developing occupational skin and respiratory diseases. This retrospective study was based on examinations, skin prick testing, and patch testing performed at the Unit of Occupational Medicine at the University of Trieste (N-E Italy) between 2002 and 2022 in food-handler workers referred to the unit for suspected occupational allergic diseases. More than half of the population (58.1%) experienced occupational skin diseases, with a higher prevalence among women (OR 3.3, 95% CI 1.5-7.6). Irritant contact dermatitis was the most prevalent skin condition (22.9%), followed by allergic contact dermatitis (20%) and protein contact dermatitis (15.1%). Pastry makers and bakers exhibited a high rate of protein contact dermatitis (20.6 and 17.7%, respectively), which was primarily attributed to wheat flour. Of the participants, 47.8% reported having rhinitis, and 17.6% reported having asthma. Positive SPT results were observed in 34.4% of workers with rhinitis and 58.3% of those with asthma, with bakers and pastry makers being more frequently sensitized to wheat flour (22.8% and 20.6%, respectively). Cooks reported rhinitis (43.2%) and asthma (12.3%) with sensitization to soy, scampi, peanuts, and other foods. Atopy determined by prick test was significantly linked to respiratory symptoms. Bakers and pastry makers showed significantly higher sensitivity to wheat flour (OR 3.3, 95% CI 1.3-7.8). Food handlers can experience occupational skin and respiratory diseases, and more efforts are needed to prevent such diseases by improving preventive habits and avoiding exposure to allergens.
40. Breast, Cervical, and Colorectal Cancer Screening Among New Jersey Medicaid Enrollees: 2017-2022.
期刊: JCO clinical cancer informatics 发表日期: 2025-Aug 链接: PubMed
摘要
The COVID-19 pandemic disrupted cancer screenings in the United States, with disproportionate impact on health disparity populations. The objective of this study was to examine the impact of the pandemic on routine screening for breast, cervical, and colorectal cancer among Medicaid enrollees. This study is a retrospective, descriptive analysis to estimate the rate of breast, colorectal, and cervical cancer screenings among Medicaid enrollees age 50-75 years in New Jersey. Secondary enrollment and claims from the 2017-2022 Medicaid Management Information System were used. The results were stratified by screening type and socioeconomic factors. Bivariate analysis assessed between-group differences. Although April 2020 had the lowest screening rates in the 6-year period, rates for all three cancer types rebounded to prepandemic levels by late summer 2020. In 2022, breast cancer screening rates exceeded previous peaks. However, cervical and colorectal screening rates did not resume their prepandemic trajectories. Key findings comparing 2022 with 2019 were (1) across all three cancer screening groups, the younger group (50-64 years) had a higher screening rate than the older group (65-75 years); (2) Hispanic enrollees consistently had the highest screening rates; (3) the screening rate among dually eligible enrollees increased throughout the pandemic; and (4) there was wide screening variation by geographic region. Multilevel, multisectoral approaches, including policy and health system strategies, are critical to addressing gaps in care for Medicaid enrollees. Future efforts should focus on bolstering cervical and colorectal cancer screening rates and ensuring equitable access to cancer screening and treatment.
41. Relationship Between Personality Traits and Psychological Well-Being in Childhood Obesity: A Cross-Sectional Study Following the Five-Factor Model.
期刊: Early intervention in psychiatry 发表日期: 2025-Aug 链接: PubMed
摘要
Childhood obesity, a global public health issue, is associated with numerous psychological comorbidities. Identifying risk factors that could impact the psychological well-being of this population is essential. Personality traits have been linked to obesity and mental health; however, research in children remains limited. Personality traits may predict differences in mental health in children with obesity by influencing emotional, cognitive and behavioural patterns, which could affect how they cope with lifestyle habits, weight-related stigma and other psychosocial stressors associated with obesity. This study aimed to evaluate the relationship between personality traits and psychological well-being variables in children with excess weight. A cross-sectional study was conducted with a sample of 145 children with overweight or obesity (mean age = 10.34, SD = 1.42; 43.40% female). Personality traits were assessed using the Big Five Personality Questionnaire, depressive symptomatology with the Children’s Depression Inventory, anxiety with the Spence Children’s Anxiety Scale and self-esteem with the Lawrence Self-Esteem Questionnaire. Principal statistical analyses included multiple hierarchical regression analyses, with personality traits as predictor variables. After controlling for sociodemographic variables and z-BMI, personality traits-particularly Neuroticism and Conscientiousness-significantly predicted depressive (β Neuroticism = 0.44), anxious symptoms (β Conscientiousness = 0.69) and self-esteem (β Neuroticism = -0.39), explaining an additional 30%, 19%, and 20% of the variance, respectively. The findings suggest that certain personality traits may increase the vulnerability of children with obesity to mental health issues. Considering a child’s personality profile could enhance both the prevention and treatment of obesity by developing interventions tailored to each child’s behavioural patterns.
42. Quantifying the effects of antibiotic resistance and within-host competition on strain fitness in Streptococcus pneumoniae.
期刊: PLoS biology 发表日期: 2025-Aug 链接: PubMed
摘要
Competition plays a key role in shaping the structure and diversity of bacterial populations. In many clinically important bacterial species, strains compete at multiple scales: at the between-host scale for new hosts to colonise, and at the within-host scale during co-colonisation. Characterising these multiple facets of competition plays an important role in understanding bacterial ecology. This is particularly relevant for antibiotic resistance, where competition between antibiotic-susceptible and resistant strains determines resistance dynamics. In this work, we perform survival analyses on a large longitudinal dataset of Streptococcus pneumoniae carriage to quantify how within-host competition affects the rates of clearance and establishment of pneumococcal strains. We find that the presence of a within-host competitor is associated with a 33% increase in clearance and a 54% reduction in establishment. Priority effects and serotype differences partially predict the outcomes of this within-host competition. Further, we quantify the effects of antibiotic resistance on between- and within-host components of fitness. Antibiotic consumption is associated with increased clearance rate for both susceptible and resistant strains, albeit to a higher extent in susceptible strains. In the absence of antibiotics, we find some evidence that resistance is associated with increased susceptibility to within-host competition, suggesting a fitness cost of resistance. Overall, our work provides quantitative insights into pneumococcal competition across scales and the role of this competition in shaping pneumococcal epidemiology.
43. The Use of Radiotherapy in the Cure of Different Cancers - Further Results From the FORTY (Favourable Outcomes From RadioTherapY) Project.
期刊: Clinical oncology (Royal College of Radiologists (Great Britain)) 发表日期: 2025-Jul-05 链接: PubMed
摘要
Overall, almost 40% of patients surviving 5 years are estimated to have received radiotherapy (RT). The utilisation of RT for individual tumour types in 5-year survivors was examined. Patient-level data on RT utilisation in cancer patients in England were analysed. Patient, tumour, and treatment event data were obtained for the 5-year period 2009-2013, together with 5-year individual patient survival (to 2018 ie pre Covid-19 pandemic). All tumour sites (excluding C44) and ages were included. 5-year survivors (n = 537,970) were divided into 22 tumour sites, plus a category of ‘Other’ (5% of patients) where tumour site was unknown, leaving 508,753 with known tumour site diagnosis. Overall cancer-specific 5-year survival was 52%. Of the 5-year survivors with definite tumour site diagnosis, 200,269 (39%) received RT. Breast cancer accounted for 50% of RT patients, prostate 24%. 75% of breast cancer 5-year survivors received RT, 65% of head and neck patients, 49% of rectum, 49% of central nervous system (CNS), and 43% of prostate patients. 25% of lymphoma 5-year survivors received RT. Only 29% of lung cancer 5-year survivors received RT. In 6 tumour sites (pancreas, leukaemia, kidney, colon, ovary, and melanoma), <5% of patients (n = 3981, 2%) received RT. Excluding these, 50% of 5-year survivors received RT. RT contributes significantly to 5-year survival. RT was delivered to 50% of 5-year survivors in tumour sites where RT is utilised for ≥5% of patients. Including the additional tumour sites where RT is used rarely, RT was delivered to almost 40% of patients. We recommend that this exercise is repeated regularly. This 50% figure emphasises the importance of RT. It is critical for service planning and public health messaging. It should be noted for the development of the new cancer plan.
44. Severe Mycoplasma Pneumoniae Infections During the 2023-2024 Outbreak: A Single-Center Descriptive Study in a Pediatric Intensive Care.
期刊: The Pediatric infectious disease journal 发表日期: 2025-Jun-01 链接: PubMed
摘要
In this brief report, we describe Mycoplasma pneumoniae infections admitted to our pediatric intensive care unit during 2023-2024. We compare with the previous 6 years and analyze their treatments and outcomes. We observe an increase of cases, half of them with underlying conditions. Hypoxemia was their main severity sign. Viral coinfections were common. Bacterial coinfections appeared to worsen outcomes.
45. Physical activity, sedentary time and sperm DNA fragmentation index in healthy Japanese men.
期刊: Reproductive biomedicine online 发表日期: 2025-Apr-17 链接: PubMed
摘要
Are physical activity and sedentary time associated with the DNA fragmentation index (DFI) score and conventional semen parameters in healthy Japanese men? Baseline data from the Preconception Research and Education Study for Men, an ongoing randomized controlled trial, were used to assess the long-term effects of preconception health education on male fertility. This cross-sectional analysis included 323 men, aged 20-39 years, recruited from September 2021 to December 2022 at workplace health check-up sites in Japan. Demographic, lifestyle and health check-up data were collected, and physical activity and sedentary time were measured using the International Physical Activity Questionnaire-Short Form. Semen quality was assessed using the DFI score and conventional semen analyses. Generalized linear models were used to evaluate the associations between physical activity, sedentary time and semen parameters, adjusting for confounders. Higher total physical activity was associated with a lower DFI score (P-value for trend = 0.002), with the third and fourth total physical activity quartiles showing a 21% (95% CI 5-34%, P = 0.013) and a 29% (95% CI 12-43%, P = 0.002) reduction in DFI score compared with the first quartile reference, respectively. There was a trend for a shorter sedentary time to be associated with a lower DFI score, but this failed to reach significance (P-value for trend = 0.057). The first sedentary time quartile showed a 22% reduction in DFI score compared with the fourth quartile reference (95% CI 3-37%, P = 0.024). There were no significant associations between total physical activity, sedentary time and conventional semen parameters. Higher physical activity and shorter sedentary time are associated with a lower DFI score in Japanese men. However, these associations were not observed with conventional semen parameters.
46. Nutritional deficiencies and abortions in sheep and goats: An in-depth study from East Azerbaijan Province, Northwest Iran.
期刊: PloS one 发表日期: 2025 链接: PubMed
摘要
Vitamin and mineral levels in sheep and goat herds experiencing abortions in East Azerbaijan, northwest Iran, were studied. Between November 2023 and February 2024, 373 blood samples and 62 samples from aborted fetuses in various cities were collected. To find out whether a lack of selenium and copper in mothers led to heart and brain problems in their fetuses. Sheep and goats were mainly raised in a semi-intensive system, grazing from spring to mid-autumn and keeping indoors during winter. Sheep and goat flocks were categorized by size: small (1-100 sheep), medium (101-300 sheep), and large (over 300 sheep). The data show significant deficiencies in essential vitamins and minerals, affecting animal health and reproduction. A notable lack of vitamin A was observed in Bostan Abad. Widespread vitamin D deficiency was noted, especially severe in Jolfa, suggesting diet inadequacies despite enough sunlight. A slight deficiency of vitamin E was found, alleviated through farmers’ supplements helped some. Calcium and phosphorus deficiencies, particularly calcium, were also major concerns. Copper and zinc shortages were common across different cities. Aborted fetuses from copper-deficient mothers showed brain tissue damage, like Wallerian degeneration and neuronal necrosis. Severe iodine deficiency was observed in Marand and Khoda Afarin, risking thyroid and reproductive health and function. More than 87% of samples revealed significant selenium deficiency, indicating a need for supplementation. Pathological studies showed heart tissue damage in aborted fetuses from selenium-deficient mothers, including fragmentation, calcification, and necrosis. These results highlight the need for proper nutritional interventions and regular monitoring of vitamin and mineral levels to fix deficiencies. Proper nutrition in mothers is crucial for lowering abortion risks and fetal developmental issues. Our data highly recommend dietary changes and balanced vitamin and mineral supplements in the studied province, considering local factors such as soil quality, pasture, and crop residues.
47. Prevalence, morphological and molecular characterization of Leucocytozoon macleani (Apicomplexa: Haemosporida) from chickens in Thailand.
期刊: Parasite (Paris, France) 发表日期: 2025 链接: PubMed
摘要
Leucocytozoon species are common in countries with warm climates but are an often neglected blood parasite in poultry. Although Leucocytozoon macleani is less virulent than Leucocytozoon caulleryi, it can still negatively impact production performance. In Thailand, the available reports indicate a high prevalence of Leucocytozoon spp., but detailed morphological characteristics of the parasites remain insufficiently known. In this study, Giemsa-stained blood smears and extracted genomic (g) DNA were obtained from 60 domestic chickens (Gallus gallus domesticus). Blood smears were examined for the presence of Leucocytozoon species and their morphological characteristics were examined. A total of 60 gDNA samples were used for nested-PCR amplification of the cytochrome b gene of Leucocytozoon species, followed by sequencing and phylogenetic analysis. The microscopic and molecular examinations revealed prevalence of leucocytozoonosis in chickens of 85% and 90%, respectively. Sequence analysis indicated that several infected chickens harboured multiple Leucocytozoon lineages. Leucocytozoon macleani was morphologically identified in nine samples and could be linked to the lineages GALLUS17, GALLUS34, and the new lineages GALLUS63. The found gametocytes of L. macleani morphologically resembled those reported previously, but exhibited some distinct characteristics. Phylogenetically, the lineages of L. macleani isolated in this study grouped separately from some other L. macleani lineages deposited in GenBank. In conclusion, the prevalence of Leucocytozoon infection in chickens from Northeastern Thailand was high, with frequent co-infections by multiple lineages. Leucocytozoon macleani may exhibit cryptic specification. This study is the first report of L. macleani lineages described using MalAvi database nomenclature, alongside their morphological characteristics. Prévalence, caractérisation morphologique et moléculaire de Leucocytozoon macleani (Apicomplexa : Haemosporida) chez les poulets en Thaïlande. Les espèces de Leucocytozoon sont courantes dans les pays à climat chaud, mais sont souvent négligées comme parasites sanguins chez les volailles. Bien que Leucocytozoon macleani soit moins virulent que Leucocytozoon caulleryi, il peut néanmoins avoir un impact négatif sur les performances de production. En Thaïlande, les rapports disponibles indiquent une prévalence élevée de Leucocytozoon spp., mais les caractéristiques morphologiques détaillées des parasites restent insuffisamment connues. Dans cette étude, des frottis sanguins colorés au Giemsa et de l’ADN génomique (g) extrait ont été obtenus chez 60 poulets domestiques (Gallus gallus domesticus). Les frottis sanguins ont été examinés pour détecter la présence d’espèces de Leucocytozoon et leurs caractéristiques morphologiques ont été étudiées. Soixante échantillons d’ADNg ont été utilisés pour l’amplification par PCR nichée du gène du cytochrome b des espèces de Leucocytozoon, suivie d’un séquençage et d’une analyse phylogénétique. Les examens microscopiques et moléculaires ont révélé respectivement une prévalence de leucocytozoonose chez les poulets de 85% et 90%. L’analyse des séquences a indiqué que plusieurs poulets infectés hébergeaient plusieurs lignées de Leucocytozoon. Leucocytozoon macleani a été identifié morphologiquement dans neuf échantillons et pourrait être lié aux lignées GALLUS17, GALLUS34 et aux nouvelles lignées GALLUS63. Les gamétocytes de L. macleani trouvés ressemblaient morphologiquement à ceux rapportés précédemment, mais présentaient certaines caractéristiques distinctes. Phylogénétiquement, les lignées de L. macleani isolées dans cette étude se sont regroupées séparément de certaines autres lignées de L. macleani déposées dans GenBank. En conclusion, la prévalence de l’infection à Leucocytozoon chez les poulets du nord-est de la Thaïlande était élevée, avec de fréquentes co-infections par plusieurs lignées. Leucocytozoon macleani pourrait présenter une spécification cryptique. Cette étude est le premier rapport sur les lignées de L. macleani décrites à l’aide de la nomenclature de la base de données MalAvi, ainsi que sur leurs caractéristiques morphologiques.
48. Establishing a learning agenda for learning health system implementation and research in Canada.
期刊: PloS one 发表日期: 2025 链接: PubMed
摘要
Health systems in Canada struggle to generate and use knowledge to improve equity-centred quadruple aim measures, resulting in care that is misaligned with local contexts. Learning Health Systems (LHS) offer a solution by aligning real-time evidence, informatics, patient-provider partnerships, and institutional strategies to support continuous improvements in care. Despite their potential, LHS initiatives in Canada remain siloed and lack harmonized leadership, knowledge exchange, and capacity building. To address these gaps, the Learning Health Hub was established to foster collaboration, disseminate best practices, and enhance collective capacity for LHS in Canada. In June 2024, the Learning Health Hub hosted its inaugural virtual symposium. This event brought together partners, researchers, health professionals, system operators, and policymakers from across Canada interested in LHS work. The symposium aimed to map assets and build momentum for larger-scale impact in LHS. Participants engaged in generative activities to define challenges and co-create solutions, resulting in the identification of key learning priorities. Three learning themes were identified: Patient, Caregiver, and Community Partnership; Enabling Environments; and Benchmarking and Evaluation. By advancing these themes, the Learning Health Hub aims to drive meaningful, sustainable change and improve healthcare quality and outcomes.
49. Tracking the financial flows of Indonesia's COVID-19 vaccination program.
期刊: PLOS global public health 发表日期: 2025 链接: PubMed
摘要
Despite available funding mechanisms for COVID-19 vaccination programs, disparities persisted in certain areas. This study aimed to track the sources, allocation, and utilization of provincial and district-level government expenditures on the COVID-19 vaccination program in Indonesia to identify financial gaps affecting vaccination coverage. This study used a mixed-method approach to track the expenditure of Indonesia’s COVID-19 vaccination program in 2021 and 2022 using the System of Health Accounts (SHA) framework. We collected expenditure data and conducted focus group discussions and in-depth interviews with government representatives from targeted provinces and districts. Case studies were conducted in four Provincial Health Offices (PHOs) and four District Health Offices (DHOs) in Indonesia. The results of expenditure tracking show significant variation in the expenditure for the COVID-19 vaccination program across subnational levels, based on factors such as fiscal capacity, political commitment, national and regional priorities, access challenges, geography, existing immunization infrastructure, and private sector engagement. Despite these variations, most of the programs were primarily funded by the National or Regional Budget, with subnational governments highly dependent on central government budget transfers. The largest expenditures generally included funding for the cold chain, distribution, vaccinator incentives, and per diem.This study found that Indonesia’s complex health financing mechanism, coupled with limited fiscal capacity, struggles to ensure equitable vaccination delivery, especially in underserved areas. The budget transfer process from central to subnational levels is inadequate to account for vulnerabilities like geographical challenges. These disparities underscore the need for more coordinated and flexible health financing mechanisms during pandemics. Developing resource allocation guidelines and improving national-to-local resource distribution during health crises are essential for better outcomes.
50. Acceptability and implementation potential of a health literacy intervention to increase colorectal cancer screening in deprived areas: A qualitative study of patients and general practitioners participating in a cluster randomized controlled trial.
期刊: PloS one 发表日期: 2025 链接: PubMed
摘要
Colorectal cancer (CCR) is one of the leading causes of death worldwide. Early detection remains a highly effective strategy for curing this disease. In France, despite a free organised screening programme for people aged between 50 and 74, participation rates remain suboptimal. Socioeconomic position and health literacy levels exacerbate the situation, with the lowest screening rates observed in the most socially disadvantaged areas. This study assessed patients’ and General Practitioners’ (GP) views on the acceptability of an intervention to increase screening uptake using a simple brochure and video on the importance and process of CCR screening. We conducted a cross-sectional qualitative study using semi-structured interviews with patients (n = 24) and GPs (n = 22) who used or participated in the DECODE project intervention. The interviews were conducted by telephone or videoconference and analysed thematically using Nvivo software and dual independent coding. 95% of GPs expressed a clear preference for the video over the brochure. Patients had varied results with 50% preferring the video, as it demonstrated how to do the test, versus the brochure. The humorous and de-dramatising aspects of the video were the two key factors highlighted by interviewees. However, support from healthcare staff (GPs, nurses, etc.) is still essential, in supporting patients in prevention. This presents a challenge for GPs, who are frequently constrained by time limitations during consultations. Our findings emphasize the need to tailor promotional materials for both patients and healthcare professionals to improve CCR screening uptake, balancing digital efficiency with maintaining core human relationships in healthcare. Such intervention can be integrated into different workflows. The addition of video into national CRC screening programs might also help. Targeting CRC screening interventions at provider-patient interactions, ensuring they are tailored, accessible, and engaging, is key to reducing disparities.
51. Prevalence and risk factors for Chlamydia trachomatis seropositivity and seropersistence among women: A prospective cohort study.
期刊: PloS one 发表日期: 2025 链接: PubMed
摘要
Population-based Chlamydia trachomatis (CT) serology studies help evaluate the effectiveness of CT-control strategies. Determinants of CT seropersistence over time are largely unknown, but may include host genetic factors. This study aims to assess seropositivity, map antibody trajectories, and identify determinants of seropositivity and seropersistence. We analyzed anti-chlamydial immunoglobulin G levels in serum of women of reproductive age who participated in a prospective cohort and CT screening study. CT history was determined using screening results and self-reported diagnoses from sexual debut onward. We assessed seropersistence for n = 1,405 participants with samples at baseline and after six years, and seropositivity for n = 2,997 participants with baseline samples. Multivariable logistic regression identified demographic, behavioral, and host single nucleotide polymorphism (SNP) factors associated with seropersistence and seropositivity. Among seropositive women at baseline, 42.0% (n = 118/281) were seropositive at follow-up. Seropersistence was more often found in women who reported treated asymptomatic and symptomatic CT infections as compared to those who did not (aOR: 3.74, 95%CI: 1.75-8.15 and 4.79, 95%CI: 2.42-9.47, respectively). Other associated factors were higher baseline antibody titers, carrying SNPs in TLR2 (aOR: 3.06, 95%CI: 1.31-7.36) and TLR9 (2.09, 95%CI: 1.09-4.08) genes and practical education (aOR: 3.16, 95%CI: 1.56-6.64). Seropositivity (24.9%, n = 748/2,997) was associated with a CCR5 deletion (aOR: 0.65, 95%CI: 0.42-0.99). CT seropersistence was more often found in women who reported treated CT infections as compared to women who did not report having had a CT infection or receiving treatment for it. Genetic predisposition and behavioral factors are linked to diversity in seropersistence patterns.
52. Nationwide investigation of eukaryotic pathogens in ticks from cattle and sheep in Kyrgyzstan using metabarcoding.
期刊: PloS one 发表日期: 2025 链接: PubMed
摘要
Ticks are significant vectors of bacterial, viral, and protozoan pathogens, impacting both public health and agriculture. In Kyrgyzstan, tick-borne diseases are a growing concern for livestock and human health. While bacterial and viral pathogens are widely studied, and limited previous investigations have focused on specific Babesia and Theileria species in certain host animals, comprehensive data on tick eukaryotic microbiota and potential pathogens across diverse hosts nationwide is scarce. To address this gap, our study provides the comprehensive nationwide assessment of the potential protozoan pathogens in ticks from cattle and sheep, analyzing data of Babesia and Theileria at the genus level. We collected 472 tick samples from cattle and sheep across seven regions of Kyrgyzstan (March-July 2022). Tick species were identified via microscope and Sanger sequencing (mitochondrial COI gene). Eukaryotic microbiota was analyzed using 18S rRNA V9 NGS. Sanger sequencing identified five genera and 11 tick species. NGS analysis revealed Babesia (13.3%) and Theileria (12.7%) as among the most prevalent protozoa detected at the genus level. Babesia was significantly more prevalent in nymph-stage ticks and those collected from sheep, whereas Theileria was detected across a broader range of tick species and host animals, showing less variation across life stages. No significant differences in prevalence were observed based on tick sex or the number of hosts in the tick life cycle. Regionally, Babesia detection was highest in the Osh region, particularly in ticks collected from both cattle and sheep. This is the first comprehensive nationwide analysis of tick eukaryotic metabarcoding study in Kyrgyzstan focusing on pathogenic protozoa detected at the genus level. Findings provide crucial baseline data on Babesia and Theileria geographic and host-specific prevalence. Understanding these information is essential for advancing future research and supporting the development of effective surveillance and control strategies against babesiosis and theileriosis in regional livestock.
53. Trends in public perceptions of patient safety during the COVID-19 pandemic: Findings from a repeated cross-sectional survey in Germany, 2019-2023.
期刊: PloS one 发表日期: 2025 链接: PubMed
摘要
In recent years, public perceptions of patient safety have evolved significantly, driven by media coverage, healthcare reforms, and greater awareness during the coronavirus disease 2019 (COVID-19) pandemic. The present study aimed to examine trends in public perceptions of patient safety, knowledge and self-efficacy in Germany during this pandemic between 2019 and 2023. A repeated cross-sectional study was conducted, using data from TK Monitor of Patient Safety. TK Monitor of Patient Safety in a nationwide survey assessing public perceptions of safety in medical treatment and diagnosis. Self-reported data were collected annually from a randomly selected sample of 1,000 different adults aged 18 and older residing in Germany. Statistical analyses included descriptive statistics, chi-square tests, and linear regressions for trend analyses. Our results revealed high perceived patient safety risk during the years of the study. Up to one third of respondents considered it very likely or somewhat likely that patients would be harmed when receiving medical treatment in hospital or ambulatory care, with lower perceived levels of risk before the COVID-19 pandemic. Regarding perceived prevalence of preventable adverse events, over half of respondents considered it very likely or somewhat likely that an illness of theirs would be diagnosed incorrectly, or that they would contract a nosocomial infection, at some stage in their lives. The majority of respondents considered themselves overall well informed about patient safety and reported higher levels of self-efficacy with regard to error prevention before and after the pandemic than during it. Given the facts that patient safety remains an important issue and that the German public perceives the level of patient safety risk but also of patient safety knowledge, and self-efficacy as high, actively involving patients in safety initiatives is essential for shaping positive public perception.
54. Anatomical factors associated with the lingual fracture pattern in sagittal split ramus osteotomy: A case-control study.
期刊: PloS one 发表日期: 2025 链接: PubMed
摘要
Unfavorable fractures are among the most challenging complications in sagittal split ramus osteotomy (SSRO), potentially increasing surgical morbidity and compromising postoperative outcomes. The preoperative identification of anatomical risk factors through imaging can enhance surgical planning and prevent such events. This study aims to investigate the anatomical factors associated with lingual fracture patterns in SSRO using multislice computed tomography. This retrospective case-control study included 180 mandibular rami from patients who underwent SSRO at a Clinical Research Center for Oral and Maxillofacial Surgery. Fractures were classified according to Plooij (2009), with Types 3 and 4 grouped as cases and Types 1 and 2 as controls. Linear measurements of mandibular ramus thickness, the distance between the mandibular canal and the buccal cortical bone, as well as parameters related to the mandibular lingula were analyzed. The case group showed significantly thinner mandibular bone (p < 0.001) and a shorter canal-cortical distance (p = 0.013), suggesting a direct association between these anatomical variables and unfavorable fracture patterns. Bonferroni post hoc analysis revealed no significant difference between fracture patterns Type 3 and Type 4 (p = 1.000), supporting their grouping in a single analytical category. The presence of third molars was not significantly associated with fracture patterns (p > 0.05). These results underscore the importance of anatomical parameters in predicting the risk of unfavorable fractures. Specifically, reduced bone thickness and proximity of the mandibular canal play a crucial role in the occurrence of unfavorable SSRO fractures. Preoperative evaluation using computed tomography is essential to optimize surgical planning and minimize complications. However, given the limitations of retrospective designs potential biases are acknowledged, and further prospective studies are needed to confirm these findings and improve risk assessment in SSRO.
55. Global trends in smoking-attributable rheumatoid arthritis burden: Insights from GBD 2021.
期刊: PloS one 发表日期: 2025 链接: PubMed
摘要
Smoking is one of the most significant environmental risk factors for Rheumatoid Arthritis (RA). However, there is a lack of research examining the impact of smoking trends on the RA disease burden globally. This study utilized the Global Burden of Disease (GBD) 2021 database to analyze the burden of RA attributable to smoking. Five key indicators were examined: Deaths, Disability-Adjusted Life Years (DALYs), Years Lived with Disability (YLDs), Years of Life Lost (YLLs), and the Socio-Demographic Index (SDI). The analysis was stratified by age, sex, year, and region. Additionally, smoking prevalence and tobacco use data from 2000 to 2021 were extracted from the World Health Organization (WHO) to evaluate trends in smoking and RA burden. From 1990 to 2021, while the age-standardized Smoking Attributable Fraction for RA burden metrics generally declined globally, alongside decreasing age-standardized rates (ASR) of smoking-attributable burden in many regions, the absolute global number of both deaths and DALYs due to smoking-attributable RA paradoxically increased (deaths: from 1,792-2,264; DALYs: from 145,727-215,780; all 95% Uncertainty Intervals provided in text). Significant disparities were observed: high-income regions demonstrated greater reductions in smoking-attributable burden than low- and middle-income regions. Males and older populations experienced higher burdens across all metrics. Moderate SDI countries had the highest smoking-attributable age-standardized Deaths and YLLs rate (e.g., Deaths 0.04 per 100,000 population), whereas high SDI countries showed higher YLDs rate (e.g., 3.5 per 100,000 population). This study highlights the persistent impact of smoking on the global RA burden and underscores the critical role of tobacco control policies in alleviating this burden. Tailored interventions for high-burden regions (e.g., Eastern Europe and East Asia) and high-risk populations (e.g., middle-aged and older males) are essential. Strengthening early interventions and resource allocation in low- and middle-income regions and enhancing long-term RA management in high-income regions are crucial steps to further reduce the global RA burden.
56. Sociodemographic and behavioral characteristics of older people with HIV in Almaty City, Kazakhstan: A cross-sectional study.
期刊: PloS one 发表日期: 2025 链接: PubMed
摘要
Globally, there are increasing numbers of people with HIV (PWH) age ≥ 40 years (y). Despite this, there are few studies of older PWH in low- and middle-income countries, and no studies in Kazakhstan. Aging with HIV influences HIV treatment response and is associated with the occurrence of non-communicable diseases. A cross-sectional study of PWH ≥ 40y was conducted at the Almaty City AIDS Center in Kazakhstan. Biological, sociodemographic, health behavior, medical history, mental and cognitive health, quality of life, and HIV factors were measured and characterized. The study enrolled and interviewed a clinical sample of 150 PWH ≥ 40y. Males (sex at birth) comprised 54.7% (N = 82); average age 51.6y, + /-10.4y; 54.7% aged 40-49y; maximum age 75y. Females (sex at birth) were younger (47.5y) than males (56.8y) (p = 0.020). Level of education differed by sex (p = 0.001). Females with HIV were more likely than males to be unemployed (33.8% versus 24.5%, respectively, p < 0.001). Among all PWH, 4% were disabled, 8.7% retired, 37.3% were in an official or civil marriage and 60.7% lived in their own home. More males consumed alcohol than females (32.9% versus 1.3%, respectively) (p = 0.001). Drug use was higher among males (25.6%) compared to females (8.8%) (p = 0.050); 91.4% of males versus 64.7% of females smoked ≥100 cigarettes in their lifetime, and 76.8% of males versus 48.5% of females smoked cigarettes currently (p = 0.001). HIV viral load among males was higher (p = 0.050) and CD4 + count, lower among males (p = 0.004) compared to females. Physical and physiological health, environmental and social relationships among males and females were similar. The majority of PWH were of working age, employed, and reported good quality of life, however, sex differences were observed. Future prospective studies are recommended.