公共卫生研究摘要 (2025-08-07)
共收录 59 篇研究文章
1. The effectiveness of etoposide-containing chemotherapy regimens in the initial treatment of Hemophagocytic Syndrome in pregnancy.
期刊: Hematology (Amsterdam, Netherlands) 发表日期: 2025-Dec 链接: PubMed
摘要
To summarize the clinical characteristics, treatment outcomes, and prognosis of pregnant patients with hemophagocytic lymphohistiocytosis (HLH), and to evaluate the efficacy of chemotherapy regimens containing etoposide (VP16) in these patients and their impact on survival outcomes. A retrospective analysis was performed on 41 pregnant HLH patients admitted to our hospital between April 2015 and March 2024, focusing on clinical features, treatment strategies, and prognostic factors. Among the 41 cases, 29 developed HLH during pregnancy and 12 postpartum. Etiologies included malignancy-related HLH (5 cases), Epstein-Barr virus (EBV)-related HLH (5 cases), rheumatologic disease-related HLH (2 cases), and pregnancy-related HLH (29 cases, defined as no comorbid HLH-related etiologies except pregnancy). In pregnancy-related HLH patients presenting during gestation, the 2-week overall response rate (ORR) was significantly higher in those receiving VP16-containing induction chemotherapy compared to glucocorticoids-only induction therapy (P = 0.011). Multivariate analysis identified the interval from symptom onset to VP16 initiation as an independent prognostic factor for pregnancy-related HLH (P = 0.025). Survival analysis revealed improved survival in patients who received VP16 within 7 weeks of onset versus those treated after 7 weeks (P = 0.044). HLH in pregnancy progresses rapidly. Early administration of VP16-containing chemotherapy significantly improves ORR and survival outcomes, particularly in pregnancy-related HLH.
2. Excess Mortality and Containment Performance During the COVID-19 Pandemic: Evidence From 34 Countries.
期刊: American journal of public health 发表日期: 2025-Sep 链接: PubMed
摘要
Objectives. To expand COVID-19 containment indicators to evaluate the relationship between excess mortality and government response. Methods. We developed a longitudinal study analyzing excess mortality, COVID-19 containment, and structural conditions in 34 countries between 2020 and 2022. Results. The average excess mortality ratios of the 34 countries were 1.09, 1.14, and 1.11 in 2020, 2021, and 2022, respectively. Thirteen countries experienced continuous annual rises, while only 2 had consistent annual declines. Top-performing countries significantly reduced excess deaths by 5.7% (b = -0.06; 95% CI [confidence interval] = -0.10, -0.01; P = .02) in 2020 and 12.9% (b = -0.13; 95% CI = -0.17, -0.08; P < .001) in 2021, compared to bottom performers. Middle-performing countries saw reductions of 6.7% (b = -0.07; 95% CI = -0.11, -0.02; P = .01) and 10.6% (b = -0.11; 95% CI = -0.15, -0.06; P < .001). These findings suggest that better containment is associated with fewer excess deaths, even after accounting for preexisting structural differences. Conclusions. The COVID-19 containment indicators’ precision emphasizes the association between better containment and lower excess mortality during early and postvaccine development periods. Public Health Implications. Our findings urge governments to utilize new metrics that balance flexibility and strictness for pandemic strategies, informing future policy interventions. (Am J Public Health. 2025;115(9):1518-1528. https://doi.org/10.2105/AJPH.2025.308136).
3. Adolescents' Mental Health: Disparities, Prevention Strategies, and Future Directions.
期刊: American journal of public health 发表日期: 2025-Sep 链接: PubMed
摘要
4. Promulgating Joy and Expiating Guilt: Camp and LGBTQ+ Health Education in the History of The Sisters of Perpetual Indulgence.
期刊: American journal of public health 发表日期: 2025-Sep 链接: PubMed
摘要
The Sisters of Perpetual Indulgence (The Sisters) have engaged in health education and promotion for more than 40 years, yet their contributions remain underexplored in public health literature. This article examines the role of camp, humor, and joy in their work by drawing on primary sources from the San Francisco, California, and Boston, Massachusetts, Sisters’ archives, as well as publicly available interviews. The Sisters published one of the first safer-sex pamphlets in the United States, written by and for gay men, using camp and setting a precedent for community-led health education. Since then, they have continued to leverage public health knowledge-sourced from health professionals within their order, local health organizations, and public agencies like the Centers for Disease Control and Prevention-while using camp to make it accessible, engaging, and quintessentially queer. The Sisters exemplify how serious public health initiatives can be conducted with queer pride, humor, and joy. (Am J Public Health. 2025;115(9):1536-1544. https://doi.org/10.2105/AJPH.2025.308112).
5. Is Your Home Making You Sick? Health Risks Associated With Black Mold in Air Vents.
期刊: American journal of public health 发表日期: 2025-Sep 链接: PubMed
摘要
6. Classical Syndromes in Occupational Medicine: Dimethylaminopropionitrile Excerpted from: James P. Keogh, "Classical Syndromes in Occupational Medicine: Dimethylaminopropionitrile," American Journal of Industrial Medicine 4, no. 3 (1983): 479-481, https://doi.org/10.1002/ajim.4700040309.
期刊: American journal of public health 发表日期: 2025-Sep 链接: PubMed
摘要
7. Occupational Therapy Practice Guidelines for Nonoperative Management of Osteoarthritis and Rheumatoid Arthritis.
期刊: The American journal of occupational therapy : official publication of the American Occupational Therapy Association 发表日期: 2025-Sep-01 链接: PubMed
摘要
Occupational therapy practitioners play an essential role in supporting the occupational performance needs of people with osteoarthritis (OA) and rheumatoid arthritis (RA). These Practice Guidelines aim to assist occupational therapy practitioners, educators, and researchers in applying evidence-based clinical recommendations within the scope of occupational therapy for people with OA and RA. These guidelines can also serve as a reference for people with arthritis as well as other health care professionals, health care managers, regulators, policymakers, third-party payers, and managed-care organizations. The ADAPTE methodology was the basis for the development of these Practice Guidelines. It supported efficiency by allowing us to systematically adapt existing clinical practice guidelines (CPGs) to occupational therapy practice. We selected existing CPGs for inclusion, extracted relevant evidence-based clinical recommendations, and developed associated action statements to align the recommendations with occupational therapy practice. We evaluated the quality of all the included CPGs using the Appraisal of Guidelines for Research and Evaluation (AGREE) II and AGREE-Recommendations Excellence instruments. Seven existing CPGs were included, from which 53 evidence-based clinical recommendations were extracted. Six action statements were developed related to (1) client education and self-management interventions, (2) psychosocial interventions, (3) lifestyle management interventions, (4) physical activity and exercise interventions, (5) interventions to support occupation, and (6) interventions for work participation. These statements can guide the application of the evidence-based clinical recommendations to develop personalized care solutions to support people with OA and RA so they can live well with these chronic conditions. Plain-Language Summary: These Practice Guidelines provide strategies for occupational therapy practitioners to help people with osteoarthritis and rheumatoid arthritis live well with their chronic condition. The guidelines include specific recommendations that have been published by other professional groups. The guidelines also provide examples of how to apply these recommendations in ways that are relevant for occupational therapy practitioners. The strategies focus on educating clients with arthritis and supporting them in managing pain, fatigue, well-being, health, and participation in daily activities.
8. Ciprofloxacin versus Aminoglycoside-Ciprofloxacin for Bubonic Plague.
期刊: The New England journal of medicine 发表日期: 2025-Aug-07 链接: PubMed
摘要
Plague is a high-consequence infectious disease with epidemic potential. Current treatment guidelines are based on weak evidence. We enrolled persons (excluding pregnant persons) in Madagascar who had clinically suspected bubonic plague during 2020-2024. Using an open-label noninferiority design, we compared two treatments included in the national plague guidelines: oral ciprofloxacin for 10 days (ciprofloxacin monotherapy) or injectable aminoglycoside for 3 days followed by oral ciprofloxacin for 7 days (aminoglycoside-ciprofloxacin). The primary end point was treatment failure on day 11, with treatment failure defined as death, fever, secondary pneumonic plague, or alternative or prolonged plague treatment. To show noninferiority of ciprofloxacin monotherapy among patients with laboratory-confirmed or probable infections, the upper boundary of the 95% confidence interval around the risk difference had to be less than 15 percentage points. A total of 933 patients underwent screening; 450 patients with suspected bubonic plague were enrolled and underwent randomization. A total of 220 patients (110 per group) had confirmed infection, and 2 (1 per group) had probable infection. Of the patients who underwent randomization, 53.2% were male, and the median age was 14 years (range, 2 to 72). Ciprofloxacin monotherapy was noninferior to aminoglycoside-ciprofloxacin therapy: among the patients with confirmed or probable infection, treatment failure occurred in 9.0% (10 of 111 patients) in the ciprofloxacin monotherapy group and 8.1% (9 of 111 patients) in the aminoglycoside-ciprofloxacin group (difference, 0.9 percentage points; 95% confidence interval, -6.0 to 7.8). Noninferiority was consistent in other prespecified analysis populations. A total of 5 patients in the ciprofloxacin monotherapy group and 4 patients in the aminoglycoside-ciprofloxacin group died, and secondary pneumonic plague developed in 3 patients in each group. The incidence of adverse events among patients with confirmed or probable infections was similar in the two groups - 18.0% in the ciprofloxacin monotherapy group and 18.9% in the aminoglycoside-ciprofloxacin group had adverse events, and 7.2% and 5.4%, respectively, had serious adverse events. Oral ciprofloxacin monotherapy for 10 days was noninferior to an aminoglycoside-ciprofloxacin sequential combination for the treatment of patients with bubonic plague. (Funded by the U.K. Foreign, Commonwealth, and Development Office and Wellcome; IMASOY ClinicalTrials.gov number, NCT04110340.).
9. Chipping Away at an Old Foe.
期刊: The New England journal of medicine 发表日期: 2025-Aug-07 链接: PubMed
摘要
10. Patients' Perception of a Brief Web- and Mindfulness-Based Intervention for Pain Following Discharge After Total Joint Arthroplasty: Qualitative Description.
期刊: JMIR nursing 发表日期: 2025-Aug-06 链接: PubMed
摘要
Important levels of pain are reported upon discharge from major surgery, with a risk of becoming chronic. Further, individuals express the need for support in managing pain after discharge. However, very few studies address pain management interventions in the postdischarge phase after surgery, including for individuals undergoing total joint arthroplasty (TJA). We have conducted a pilot randomized controlled trial testing a brief mindfulness intervention targeting people at risk for chronic postsurgical pain 2 weeks after surgery. Although the intervention we proposed was judged acceptable based on ratings obtained through a questionnaire, the nuanced perceptions of why and how it is considered acceptable are critical in refining the intervention. Moreover, the acceptability of mindfulness interventions in the perioperative context remains generally unknown and even more so in the postdischarge setting. The purpose of this study was to use qualitative data to explore the individual perception of acceptability of a brief 4-week, Web- and mindfulness-based intervention for pain following discharge after a TJA. A qualitative description was used to assess patients’ perception of the preliminary version of the intervention for pain management following discharge after surgery. The qualitative assessment was done at the end of the 4-week intervention (6 weeks after surgery). Semistructured interviews with open-ended questions were used to encourage free expression from participants (n=16) before proceeding to content analysis. When reflecting on the benefits of the intervention, the main themes that emerged were mindfulness, pain acceptance, and supplementary relief. Overall, the intervention was perceived as relevant and suitable during recovery, although participants experienced a few challenges related to the novelty of mindfulness practice. Engagement and readiness were discussed in relation to adherence to the intervention. Addressing expectations and personal beliefs before the intervention could improve participants’ adherence. Offering additional support when spikes of pain occur could help overcome some challenges related to mindfulness practice during postoperative recovery. Given the increasing number of TJA surgeries performed annually and the effectiveness of nonpharmacological interventions, such as mindfulness-based approaches, in supporting recovery and well-being, efforts should be made to increase patient access to these promising adjunctive treatments. Combining nonpharmacological interventions before and after surgery may be an interesting avenue to optimize pain relief and recovery, as well as prevent complications. Finally, the use of technology could improve the accessibility, scalability, and adoption of these promising approaches for individuals with limited resources and mobility.
11. Assessing the Ability to Use eHealth Resources Among Older Adults: Cross-Sectional Survey Study.
期刊: JMIR formative research 发表日期: 2025-Aug-06 链接: PubMed
摘要
Increasing reliance on digital health resources can create disparities among older patients. Understanding health-related, mobility, and socioeconomic factors associated with the use of eHealth technologies is important for addressing inequitable access to health care. We sought to assess digital health literacy among patients aged ≥65 years and identify factors associated with their ability to access, understand, and use digital health resources. We developed a survey instrument grounded in the Technology Acceptance Model and conducted a cross-sectional, mixed-mode survey of patients aged ≥65 years from an integrated, multispecialty medical center. Digital health literacy was measured using the eHeals health literacy scale, and responses were analyzed across self-rated health, self-reported mobility, and socioeconomic deprivation assessed with the Area Deprivation Index (ADI). Counts (n) and frequencies (%) are reported across response groups, and analyses for differences are performed using the χ2 test for independence or the Fisher exact test. Analyses included 878 responses (response rate=878/2847; 30.8%). There was a significant difference in the distribution of race between responders and nonresponders (P<.001) but no significant differences were observed by age (P=.053) or gender (P=.73). Respondents with lower self-rated health had lower levels of digital health literacy; only 54.2% (n=13/25) participants with poor self-rated health were able to send a message to their doctor compared to 89.5% (n=68/77) of patients with excellent self-rated health. All comparisons across the digital health literacy domains revealed significant differences across self-rated health groups (P<.05). Respondents with mobility restrictions had lower levels of digital health literacy, including lower frequencies of reporting knowledge of what health resources are available on the internet (mobility restricted, n=92/182; 52.0% vs no mobility restriction, n=433/688; 64.7%), knowledge of how to find health resources on the internet (mobility restricted, n=120/182; 67.4% vs no mobility restriction, n=513/688; 76.8%), and ability to use a camera or video with a doctor easily (mobility restricted, n=58/182; 32.6% vs no mobility restriction, n=321/688; 48.0%). Older adults experiencing increased socioeconomic deprivation, as measured by the ADI, reported lower rates of digital health literacy across most categories, including knowledge of how to find health resources on the internet (high ADI, n=28/49; 59.6% vs low ADI, n=551/751; 75.5%) and the ability to send an electronic message to their doctor easily (high ADI, n=27/49; 57.4% vs low ADI, n=584/751; 80.2%). Our findings highlight the need for targeted interventions to improve engagement with eHealth among patients aged ≥65 years, who are impacted by poor health, limited mobility, and socioeconomic deprivation. Enhancing digital health literacy can help bridge the gap in access to digital health resources and improve overall health outcomes for this population.
12. Prevalence of Chronic Back Pain and Associated Factors in Children and Adolescents: Secondary Analysis of the 2001-2019 Health Behavior in School-Aged Children Study.
期刊: JMIR public health and surveillance 发表日期: 2025-Aug-06 链接: PubMed
摘要
Backache, which is considered a leading cause of adult disability worldwide, is seldom studied in children and adolescents despite it being associated with multiple detrimental health outcomes in this age group. The aim of this study is to explore the prevalence, time trends, and correlates of chronic backache among children and adolescents. Data were extracted from the cross-sectional Health Behavior in School-Aged Children (HBSC) study, which collected data from 2001 to 2019. The final sample size for this study consisted of 1,011,368 children and adolescents (515,899/1,011,368 or 51.01% were girls). Prevalence estimates and time trends were calculated using weighted proportions. Generalized linear mixed models were conducted to determine whether certain correlates (ie, age group, sex, socioeconomic status, excess weight status, or year of data collection) were associated with higher odds of reporting chronic backache in the population of the HBSC. Additionally, we analyzed country-level changes in chronic backache trends over time. The weighted global prevalence of chronic backache among children and adolescents was 6.6% (n=12,641; wave 2017-2019). The time trend indicated a general increase in the prevalence of chronic backache in children and adolescents over time (from 2001 to 2019). Indeed, Northern and Eastern Europe, as well as parts of North America, presented relatively higher weighted prevalence rates of chronic backache, ranging from 7% to 9%. This corresponded to approximately 70,796 to 91,023 cases of 1,011,368 participants. Regarding correlates, older age (aged 12.5-14.5 y: odds ratio [OR] 1.10, 95% confidence interval [CI] 1.05-1.15; P<.001; aged 14.5-17 y: OR 1.27, 95% CI 1.22-1.32; P<.001), female sex (OR 1.22, 95% CI 1.17-1.28; P<.001), excess weight (OR 1.14, 95% CI 1.11-1.17; P<.001), and later years of data collection (OR 1.04, 95% CI 1.04-1.05; P<.001) were associated with higher odds of reporting chronic backache. In contrast, medium (OR 0.83, 95% CI 0.81-0.85; P<.001) and high (OR 0.90, 95% CI 0.86-0.93; P<.001) socioeconomic status showed lower odds of experiencing chronic backache than low socioeconomic status. This study revealed a sustained upward trend in the prevalence of backache in children and adolescents over the years (2001-2019), especially in North America and Northern and Eastern Europe. In addition, older age, female sex, excess weight, and later years of data collection were identified as correlates of experiencing chronic backache. Moreover, middle and high socioeconomic status were associated with lower odds of reporting chronic backache, potentially indicating differences in lifestyle, access to health care, or other protective factors.
13. Electronic Clinical Decision Support System for Stroke Risk Screening in Patients With Atrial Fibrillation in Mental Health Care: Mixed Methods Study.
期刊: JMIR cardio 发表日期: 2025-Aug-06 链接: PubMed
摘要
Electronic clinical decision support systems (eCDSSs) are key to the digital transformation of health care. Despite their growing adoption, little is known about the perspectives of mental health clinicians on the implementation of eCDSS to assist them in managing physical health conditions within mental health care settings. This study aimed to explore how clinicians in older adult mental health services manage stroke risk in patients with atrial fibrillation (AF) and comorbid serious mental illness who are admitted to the hospital under their care. It also sought to examine clinicians’ views on the potential role of an eCDSS in enhancing stroke risk assessment and management. A cross-sectional mixed methods study was conducted between March and May 2023 in 3 inpatient wards for mental health of older adults at South London and Maudsley NHS (National Health Service) Foundation Trust. Health care professionals, including psychiatrists and pharmacists, participated in a web-based survey and individual semistructured interviews. Ethical approval and informed consent were obtained. A descriptive analysis was conducted on the survey data, while interview data were analyzed thematically using an inductive approach. In total, 10 clinicians participated in the study. Thematic analysis revealed 2 primary themes. First, clinicians reported significant challenges in clinical practice, including difficulties accessing patient medical histories, limited expertise in managing physical health conditions, fragmented care pathways, and the impact of mental health symptoms such as psychotic beliefs on stroke prevention. Second, clinicians identified strategies to improve practice, such as embedding alerts in electronic records, establishing clear organizational policies, and providing tailored training on AF-related stroke management. Clinicians recognized the potential of an eCDSS to enhance clinical effectiveness, improve the identification of high-risk patients, ensure safer and more consistent care, and save time. However, they expressed concerns about potential risks, including rigidity in decision-making, overreliance on the tool, false positives, reduced critical thinking, annoyance, and increased workload. This study highlights the challenges and opportunities in managing AF-related stroke risk in mental health settings. While clinicians acknowledged the potential of an eCDSS to improve care quality and efficiency, addressing concerns about its design and implementation is essential. These insights can inform the development of eCDSS tools that effectively balance benefits with user needs, ultimately improving patient outcomes in mental health services.
14. A Machine Learning-Based Prognostication Model Enhances Prediction of Early Hepatic Encephalopathy in Patients With Noncancer-Related Cirrhosis: Multicenter Longitudinal Cohort Study in Taiwan.
期刊: JMIR medical informatics 发表日期: 2025-Aug-06 链接: PubMed
摘要
Hepatic encephalopathy (HE) contributes significantly to mortality among patients with liver cirrhosis. Early prediction of HE is essential for clinical decision-making, yet remains challenging-particularly in noncancer-related cirrhosis due to the unpredictable disease course. This study aimed to develop a novel machine learning (ML) model to improve early prediction of HE in patients with noncancer-related cirrhosis. A multicenter, retrospective cohort study was conducted from January 2010 to December 2017 across all Chang Gung Memorial Hospital branches in northern, middle, and southern Taiwan. We applied several ML models to evaluate HE predictability and compared their performance in the training dataset and testing dataset. Optimal sensitivity and specificity were determined using the Youden index. The best ML model was interpreted by the Shapley Additive Explanations plot. A total of 5878 patients with cirrhosis were included in the analysis, of whom 1187 (20.2%) subsequently developed HE. Compared to the non-HE group, patients with HE were older (median age 55, IQR 46-65 vs median age 54, IQR 44-66 years; P=.04) and had higher rates of hepatitis B virus infection (351/1187, 30% vs 961/4691, 20.5%; P<.001), alcohol use (540/1187, 45.5% vs 1512/4691, 32.2%; P<.001), sepsis (393/1187, 33.1% vs 792/4691, 16.9%; P<.001), and mortality (425/1187, 35.8% vs 502/4691, 10.7%; P<.001), along with distinct laboratory abnormalities reflecting liver dysfunction. Among the ML algorithms evaluated, the extreme gradient boosting algorithm demonstrated the highest predictive accuracy, achieving an area under the curve (AUC) of 0.86 (95% CI 0.83-0.88) in the testing dataset. This performance was significantly superior to that of the neural network (AUC 0.79, 95% CI 0.76-0.81; P<.001), support vector machine (AUC 0.77, 95% CI 0.73-0.80; P<.001), and the model for end-stage liver disease score (AUC 0.74, 95% CI 0.71-0.77; P<.001). Using a probability threshold of 0.25, the extreme gradient boosting model demonstrated a sensitivity of 72% (95% CI 0.67-0.77), specificity of 80% (95% CI 0.78-0.82), a positive predictive value of 48% (95% CI 43-53), and a negative predictive value of 92% (95% CI 90-94) in the testing set. Comparable performance was observed in the training dataset, with a sensitivity of 80% (95% CI 0.77-0.83), specificity of 81% (95% CI 0.80-0.82), and a negative predictive value of 94% at the same threshold. The most influential predictive variables identified by the model included serum ammonia, aspartate transaminase, alanine transaminase, prothrombin time, and serum potassium. We developed a novel ML model for predicting HE in patients with noncancer-related cirrhosis. This model provides a practical guide to help physicians and these patients in shared decision-making regarding treatment strategy, with the ultimate goal of improving clinical care and reducing the burden of HE-related morbid complications.
15. Time from arrival in Chile to tuberculosis diagnosis in migrants treated at primary care centers in two Metropolitan Region municipalities, Chile.
期刊: Medwave 发表日期: 2025-Aug-06 链接: PubMed
摘要
In Chile, the number of migrants affected by tuberculosis has experienced a significant increase from 7.1% in 2014 to 29.7% in 2023, ranking as the first group at risk. The objective was to estimate the time to diagnosis of tuberculosis from arrival in Chile in a series of migrants undergoing treatment between January 2021 and March 2022. We analyzed a cohort of migrants over 18 years of age with a diagnosis of tuberculosis treated in the communes of Recoleta and Independencia. Those who agreed to participate and signed the informed consent form were included. Cases with non-tuberculous mycobacteria and residents outside the Metropolitan Region were excluded. Sociodemographic, clinical, and arrival dates, as well as symptoms and diagnoses, were recorded. Proportional hazards models in STATA v.18 were used to analyze times according to independent variables. A p value < 0.05 was considered significant. The median time to diagnosis was 93.5 months, varying by subgroup. The recent migration subgroup without Chilean documentation had a hazard ratio of 13.1, which indicates that, at any time after arrival, these individuals have a 13-fold increased risk of tuberculosis diagnosis compared to the reference subgroup (traditional migration with Chilean identity documents). This hazard ratio is reduced by 2.4 times when these types of migrants have documentation from Chile (95% confidence interval: 1.2 to 4.5). There is a wide range of time from arrival in Chile to the diagnosis of tuberculosis. Factors such as the type of migration and the type of identity document have an impact on the development of this disease. It is necessary to expedite the legal administrative process for migrants and implement timely screening policies, along with follow-up and improved access to healthcare, to reduce exposure and risk of tuberculosis. En Chile, las cifras de migrantes afectados por tuberculosis, han experimentado un aumento significativo desde 7,1% en 2014 hasta 29,7% en 2023, calificando como el primer grupo de riesgo. El objetivo fue estimar el tiempo hasta diagnóstico de tuberculosis desde la llegada a Chile en una serie de migrantes en tratamiento entre enero de 2021 y marzo de 2022. Se analizó una cohorte de migrantes mayores de 18 años con diagnóstico de tuberculosis atendidos en las comunas de Recoleta e Independencia. Se incluyeron a los que aceptaron participar y firmaron el consentimiento informado. Se excluyeron casos con micobacterias no tuberculosas y residentes fuera de la Región Metropolitana. Se registraron datos sociodemográficos, clínicos y fechas de llegada, síntomas y diagnóstico. Se usaron modelos de riesgos proporcionales en STATA v.18 para analizar los tiempos según variables independientes. Se consideró significativo un valor de p < 0,05. La mediana de tiempo hasta el diagnóstico fue 93,5 meses y varía dependiendo del subgrupo. El subgrupo migración reciente y sin documentación de Chile tuvo h 13,1, lo que indica que, en cualquier momento posterior a su llegada, estas personas presentan un riesgo de diagnóstico de tuberculosis 13 veces mayor, comparado con el subgrupo de referencia (migración tradicional con documento de identidad de Chile). Este disminuye a 2,4 veces cuando este tipo de migración reciente tiene documentación de Chile (intervalo de confianza 95%: 1,2 a 4,5). Existe un amplio rango de tiempo desde la llegada a Chile hasta el diagnóstico de tuberculosis. Factores como el tipo de migración y el tipo de documento de identidad impactan en el desarrollo de la enfermedad. Es necesario favorecer un proceso administrativo legal expedito a las personas migrantes e implementar políticas de tamizaje oportuno, junto con un seguimiento y mejora del acceso a la atención para reducir la exposición y el riesgo de tuberculosis.
16. Analyzing Disparity in Geographical Accessibility to Home Medical Care Using a Claims Database and Geographical Information System: Simulation Study.
期刊: JMIR aging 发表日期: 2025-Aug-06 链接: PubMed
摘要
The demand for home medical care services has increased in aging societies. Therefore, allocating health care resources optimally to meet the needs of each community is essential. Geographical accessibility is an important factor affecting access to home medical care services; however, little research has been conducted on regional disparities in geographical accessibility. This study aims to analyze the regional disparities in geographical accessibility to home medical care services using the Kokuho database (KDB), a comprehensive medical claims database for a prefecture in Japan. This study included 39 municipalities in Nara Prefecture, Japan. Using a geographical information system, accessibility to home medical care services, that is, travel distance and time from hospitals and clinics to hypothetical patients, was analyzed in two scenarios: (1) an ideal scenario, where we assumed that all hospitals or clinics in Nara Prefecture provided those services and (2) an actual scenario, where hospitals or clinics in Nara Prefecture that actually provided home medical care services, identified from KDB data analysis, were used in the analysis. Hypothetical patients were randomly distributed on the geographical information system in accordance with the usage rates of home medical care services and with the distributions of the population aged ≥75 years. The usage rate by municipalities was aggregated from the analysis of KDB data of Nara Prefecture in FY2019. The median travel distance was longer than 16 km, the reference limit value specified in the Japanese fee table, and the median travel time exceeded 30 min in certain rural municipalities in the southern part of Nara Prefecture, in the actual scenario, whereas the travel distance and time were improved in the ideal scenario. The differences in travel time between the ideal and actual scenarios were the largest in the depopulated municipalities in the southern part, such as Totsukawa (32.6 vs 5.8 min), Kawakami (30.1 vs 11.8 min), Kurotaki (21.3 vs 5.2 min), and Kamikitayama (20.7 vs 3.5 min). The usage rates were also lower in rural municipalities in the southern part. The results revealed that geographical accessibility was lower in depopulated municipalities in the southern part, and the disparity could be partly solved in the ideal scenario, especially in that area, highlighting the necessity of increasing supply in the southern areas. KDB is a comprehensive database that includes medical claims information for home medical care patients and details of the provision of medical institutions, enabling geographical analysis that reflects actual health care usage.
17. Understanding gendered connections: investigating the relationship between body dissatisfaction and healthy eating in a sample of first-year college students.
期刊: Journal of American college health : J of ACH 发表日期: 2025-Aug-06 链接: PubMed
摘要
We investigated the path of body dissatisfaction to intentional healthy eating behaviors. We had 2038 participants from a predominantly first-year college student sample. Path models, including a multiple-group model, were used to test the hypotheses. Our conceptual model included the variables of recent eating behavior, body dissatisfaction, and healthy eating. We also hypothesized that weight status would moderate the association between body dissatisfaction and perceived self-control. Among women, there was a direct association between recent eating behavior and body dissatisfaction and between body dissatisfaction and healthy eating behaviors. Weight status was not a significant moderator, and perceived self-control was not a significant mediator. Among men, the one significant association was between body dissatisfaction and healthy eating intention. The findings highlighted gender differences. During this vulnerable developmental period, the path between body dissatisfaction and healthy eating is stronger for women than men.
18. Salicornia europaea L. Ethyl Acetate Fraction Induces Adipocyte Browning and Exhibits Anti-Obesity Effect in 3T3-L1 Preadipocytes.
期刊: Chemistry & biodiversity 发表日期: 2025-Aug-06 链接: PubMed
摘要
Obesity is a widespread health issue, closely associated with metabolic conditions like Type 2 diabetes and heart disease. Salicornia europaea L. (SE), a halophytic coastal herb, has gained attention for its potential as a natural therapeutic agent. The anti-obesity activity of SE-ETAC was examined in vitro in 3T3-L1 cells treated during adipocyte differentiation. Lipid accumulation, cholesterol, triglycerides, and glycerol release were measured, while protein markers for adipogenesis and browning were analyzed by Western blot. ROS and cytokine levels were assessed using fluorescence microscopy and ELISA. Mechanistic insights were further examined using zinc protoporphyrin (ZnPP), CoPP, and compound C, and GC-MS was conducted to identify active constituents. SE-ETAC significantly inhibited adipogenesis and promoted lipolysis, reducing lipid accumulation, cholesterol, and triglyceride levels while increasing free glycerol. It also lowered reactive oxygen species (ROS) and suppressed proinflammatory cytokines (IL-6, IL-1β, and TNF-α). Mechanistically, SE-ETAC exerted its effects primarily through upregulation of the heme oxygenase-1 (HO-1)/nuclear factor erythroid 2-related factor 2 (Nrf2) pathway, with ZnPP-mediated HO-1 inhibition nearly abolishing its efficacy. In contrast, AMP-activated protein kinase (AMPK) inhibition with compound C only partially reduced its effects. Furthermore, SE-ETAC induced adipose browning by upregulating AMPK, PRDM16, UCP1, and PGC-1α, facilitating the conversion of white adipocytes into metabolically active beige cells and enhancing energy expenditure. SE-ETAC demonstrates strong anti-obesity potential by targeting multiple mechanisms, including suppression of adipogenesis, enhancement of lipolysis, reduction of oxidative stress and inflammation, and promotion of adipose browning. These effects are mainly mediated by the HO-1/Nrf2 pathway, which showed a stronger influence on SE-ETAC’s anti-obesity actions than AMPK signaling. Overall, these findings support the development of S. europaea L. as a functional, plant-based intervention for obesity and metabolic health.
19. Pause & Refresh: formative evaluation of a virtual nature initiative to tackle stress among university students.
期刊: Journal of American college health : J of ACH 发表日期: 2025-Aug-06 链接: PubMed
摘要
Background: Immersive Virtual Nature (IVN) can provide psychological benefits such as stress relief and foster engagement with nature. Methods: Through a mixed methods approach with sequential explanatory design, we conducted a formative evaluation of an IVN initiative for university students, including a prototype testing trial (n = 54), focus groups with students and experts (n = 7), and a workshop with representatives of the Student Welfare Organization. Results: The integrated findings indicated that the IVN experience was associated with stress relief and increased nature connectedness, though its potential to encourage nature visits was limited. Some issues (e.g., a wish for more variation) and technical challenges (e.g., somewhat poor video and sound quality) were highlighted, alongside suggestions on how to best deliver the initiative on campus. Discussion: This study provides novel knowledge about IVN as a means of health promotion among university students, emphasizing the value of adopting participatory approaches when designing IVN-based initiatives.
20. Determinants of physical health, mental health, and academic success of international women of color in college.
期刊: Journal of American college health : J of ACH 发表日期: 2025-Aug-06 链接: PubMed
摘要
Objective: This study examined the factors contributing to the physical, and mental health of international women of color in college and how they relate to their academic success. Method: A qualitative research design, involving in-depth interviews with twenty international women of color from a large U.S. Midwestern college was used to explore factors affecting their health, and academic success. A hybrid deductive and inductive thematic analysis approach was employed to identify thematic patterns. Results: Most participants reported good physical health. However, their physical health may be impacted by unhealthy habits. Some participants would not seek mental health help due to cultural differences. Physical and mental health could influence their academic success and vice versa. Social connections and support groups may positively influence their well-being and academic success. Discussion: International college women of color need tailored interventions to address their concerns. Support groups, with peers facing similar stressors can enhance connections.
21. Research on health education and health promotion during the process of schistosomiasis elimination III new approaches for student health education.
期刊: PLoS neglected tropical diseases 发表日期: 2025-Aug-06 链接: PubMed
摘要
Schistosomiasis remains a critical public health challenge in endemic regions, particularly among school-aged children. Despite global efforts, conventional health education approaches show limited success in translating knowledge into sustained practices change. This study evaluates the efficacy of two innovative educational approaches-curriculum-integrated infiltration and stepwise progressive approaches-compared to traditional methods in enhancing schistosomiasis-related knowledge, attitudes, and practices (KAP) among students. A school-based intervention was conducted in Duchang County’s Zhouxi township, with is an area afferted by schistosomiasis in China. Sixth-grade students (n ≈ 300) were divided into three groups: a traditional intervention group receiving standard WHO-aligned lectures, an infiltration group with cross-disciplinary curriculum integration, and a stepwise group with modular, tiered content. KAP outcomes were assessed via validated questionnaires at baseline and post-intervention. Both intervention groups demonstrated significant knowledge gains compared to traditional intervention (post-intervention accuracy: infiltration 89.67%, stepwise 91.10%, traditional intervention 86.50%; P < 0.001). Practices knowledge showed the most significant improvement (41.47% increase in the infiltration group vs. 22.38% in traditional intervention). The stepwise approaches achieved the highest overall accuracy (91.10%) but showed no statistically significant advantage over the infiltration approach (P > 0.05). Attitudinal improvements were consistent across groups, with high baseline rates limiting further gains (post-intervention: 95.60-96.68%). Curriculum-integrated and stepwise approaches effectively address the knowledge-practices gap in schistosomiasis education. The infiltration strategy, requiring minimal resources, is ideal for practices reinforcement in low-resource settings, while the stepwise approach suits rapid knowledge dissemination in well-resourced areas. These findings advocate for context-adaptive, multisectoral frameworks to optimize school-based interventions, aligning with WHO goals for neglected tropical disease elimination.
22. Development of a Clinic-Based, Sociostructural Intervention to Improve the Provision of Pre-Exposure Prophylaxis for Cisgender Women: Formative Study Using the Assessment, Decision, Adaptation, Production, Topical Experts, Integration, Training, and Testing (ADAPT-ITT) Framework.
期刊: JMIR formative research 发表日期: 2025-Aug-06 链接: PubMed
摘要
Cisgender women (subsequently referred to as women) account for 23% of new HIV diagnoses in the United States. There are significant sociostructural barriers to engagement and retention in the pre-exposure prophylaxis (PrEP) cascade, particularly for Black women. In response to the lack of evidence-based interventions (EBIs) to improve PrEP initiation, adherence, and persistence among women in the United States, we developed a clinic-based, sociostructural intervention focused on engagement and retention in the PrEP cascade for women. We used the Assessment, Decision, Adaptation, Production, Topical experts, Integration, Training, and Testing (ADAPT-ITT) model to adapt two Centers for Disease Control and Prevention (CDC) best practices in HIV prevention: HIV PrEP Services for Urban Women and Project Shikamana to create a culturally appropriate EBI responsive to Black women’s HIV prevention needs. In this paper, we focus on the first 6 steps of iterative adaptation in preparation for pilot testing. We conducted semistructured interviews and focus group discussions with key populations to inform and guide intervention development and used theater testing to evaluate the mock-up of the prototype. We conducted rapid qualitative analysis to identify key themes related to delivering PrEP to the intended population and engaged subject matter experts to refine the prototype. For the Assessment phase, we conducted 10 in-depth interviews with key informants from community-based and HIV-prevention organizations and led 7 focus group discussions (n=4-8) to guide intervention development among health care providers (n=2 groups), PrEP navigators and educators (n=1 group), and female patients (n=4 groups). Key themes included population-specific barriers to PrEP use, namely accessibility and availability, perceived risk, and stigma. In addition, participants advised on model adaptation specific to PrEP navigation, clinic-level training, and social support. For the Decision phase, we selected 2 EBIs from the CDC HIV Compendium of Best Practices. For the Adaptation phase, we adapted and theater tested a preliminary intervention for feedback. For the Production phase, using feedback from theater testing, we created a prototype of the Women’s PrEP Project (W-PrEP) designed to address patient-, provider-, and clinic-level barriers to the provision of PrEP for women through a clinic-wide intervention delivering education, resources, and support (including PrEP navigation). For the Topical experts and Integration phases, we collected iterative feedback from our advisory board and subject matter experts and integrated feedback into the final prototype. The adaptation of the W-PrEP integrated key elements of the local context for women with potential exposure to HIV, as well as health care providers, clinic staff, and PrEP navigators. Next steps include training clinic staff in a real-world setting to pilot-test the acceptability, feasibility, and preliminary effectiveness of the intervention.
23. Experimental challenge of African green monkeys with contemporary Hendra virus isolates produces divergent clinical disease.
期刊: Emerging microbes & infections 发表日期: 2025-Aug-06 链接: PubMed
摘要
Hendra virus (HeV) is a medically important, zoonotic paramyxovirus that emerged over thirty years ago which causes severe, often fatal disease in humans and animals. There are presently no approved medical countermeasures to prevent or treat human HeV disease, although many are in various stages of development. Critical to the stringent evaluation of these experimental countermeasures are nonhuman primate models of HeV disease which accurately recapitulate the pathogenesis of human infection. The continued emergence of HeV since its initial discovery in 1994 has recently expanded to include a second genotype. Although this variant HeV produced fatal equine disease, its pathogenesis and lethality are unknown in humans. Here, we investigated the pathogenesis of clinically relevant and contemporary HeV isolates from genotype 1 (HeV/Australia/Horse/2008/Redlands) and genotype 2 (HeV-var/Australia/Horse/2015/Gympie) in the African green monkey (AGM) model of henipavirus disease. AGMs challenged with HeV genotype 1 (HeV-g1) or genotype 2 (HeV-g2) isolates via the combined intranasal/intratracheal route of exposure produced divergent survival outcomes, with four of five AGMs infected with the HeV-g2 isolate surviving. All five HeV-g1 infected subjects developed acute HeV disease which accurately recapitulated HeV pathogenesis reported in humans. Our findings revealed that HeV-g2 is less pathogenic than HeV-g1 in the AGM model and suggests that HeV-g2 may be less pathogenic in humans.
24. The long reach of Hermann J. Muller: How Muller influenced the development and content of secondary school biology curricula.
期刊: Journal of occupational and environmental hygiene 发表日期: 2025-Aug-06 链接: PubMed
摘要
The Cold War provided incentive for radiation geneticists from the United States (U.S.) to offer guidance on scientific/public health issues. A notable case involved the U.S. National Academy of Sciences (NAS) recommendations concerning radiation-related heredity/cancer risk assessment, which have guided regulatory agencies from the 1950s to the present. A neglected, generally unknown, yet important strategic direction, involves influence exerted over the development of secondary school biological education programs in the U.S. With U.S. federal government funding, the American Institute for Biological Sciences (AIBS) led the development of a major revision of secondary school biological sciences’ curricula, called the Biological Science Curriculum Study (BSCS), with the first education product widely adopted in 1963. The BSCS textbook content was directed by Arnold Grobman and Bentley Glass, leaders of the academic genetics community, especially those who participated in the Manhattan Project and the NAS Genetics Panel and how they engaged the involvement of the Nobel Laureate, Hermann Muller, to transform the actions of the BSCS committee to create an educational framework in which evolution was the overriding and integrative theme. Muller would ensure that the BSCS curriculum was based on the Dobzhansky rubric that “Nothing in biology makes sense except in light of evolution.” Muller also led these geneticists in a failed attempt to integrate “reform” eugenics principles and practices into the BSCS curriculum While Muller’s influence on hereditary/cancer risk assessment has been extraordinary, his role in framing what biology students were taught, and how it would influence their concept of life, beliefs about humanity’s place in the universe, and how humans could or should direct their evolution, has remained largely unknown.
25. Regulatory KIR+CD8+ T cells are elevated during human pregnancy.
期刊: Science translational medicine 发表日期: 2025-Aug-06 链接: PubMed
摘要
During pregnancy, immune responses must balance protection from infections with tolerance of the semiallogeneic fetus. However, the mechanisms regulating maternal-fetal tolerance remain poorly understood. Recently, we identified CD8+ T cells expressing inhibitory killer cell immunoglobulin-like receptors (KIRs) as a regulatory subset important for suppressing self-reactivity in human autoimmune and infectious diseases. To better understand what other roles these cells might play, we asked whether they are active during pregnancy. We first observed an increased frequency of KIR+CD8+ T cells in the peripheral blood of pregnant people in the second trimester, especially in those carrying a male fetus. In vitro, KIR+CD8+ T cells inhibited the alloreactive responses of maternal T cells against irradiated cord blood cells and selectively suppressed CD8+ T cells targeting male-specific proteins in mothers with male pregnancies. Therefore, the higher induction of KIR+CD8+ T cells in mothers carrying a male fetus may help suppress additional allogeneic responses triggered by male-specific alloantigens. Longitudinal analysis showed that KIR+CD8+ T cells undergo expansion and differentiate into functional cytotoxic cells during pregnancy. Single-cell RNA sequencing of decidual CD8+ T cells from early pregnancy revealed elevated numbers and increased expression of activation markers in KIR+CD8+ T cells at the maternal-fetal interface. In addition, a higher frequency of KIR+CD8+ T cells was associated with spontaneous abortion and preeclampsia. Together, our findings suggest that KIR+CD8+ T cells may contribute to maternal tolerance by modulating fetal-specific alloreactive T cell responses. They may also be useful as candidate biomarkers or therapeutic targets for human pregnancy disorders.
26. Community risk of environmental-borne cystic echinococcosis transmission in South America: Results from the multistep cross-sectional and case-control PERITAS study.
期刊: PLoS neglected tropical diseases 发表日期: 2025-Aug-06 链接: PubMed
摘要
Cystic echinococcosis (CE) is mainly described as a food/waterborne zoonosis. However, evidence about matrices contamination is scarce. Identifying main transmission routes could optimize health messages aiming to prevent ingestion of parasite eggs. We evaluated Echinococcus granulosus contamination of matrices in two areas of Chile and Peru. In stage 1, areas with high active CE prevalence were identified through cross-sectional ultrasound surveys. Stage 2 was a case-control study encompassing matrices sampling in public places and households with and without CE cases in these areas, followed by (stage 3), matrices processing by sequential sieving and E. granulosus detection by PCR. Bayesian multilevel mixed-effects logistic regression analysis was used to identify factors associated with risk of contamination. In households, soil (19%-42%); dogs’ fur (10%-30%); shoes’ soles (5%-33%); and dogs’ feces (0-50%) were highly contaminated. In public areas, ~ 30% of fecal and soil samples were contaminated. Overall, matrices from public areas were more contaminated than those from households. When examining households, there was no difference in risk of contamination according to presence of CE cases, while CE-free households had lower risk when considering households and public areas. There was no difference in risk of contamination according to matrix. Vegetables were PCR-negative. Results suggest the need for a paradigm-shift towards considering CE an environmental-borne infection with a “community risk” to which people are exposed.
27. The endogenous circadian system impairs nighttime blood pressure responses to active standing in older adults.
期刊: The Journal of physiology 发表日期: 2025-Aug-06 链接: PubMed
摘要
Falls affect approximately 30% of older adults and are a major cause of morbidity and mortality, especially when they occur at night. Impaired blood pressure (BP) recovery upon standing is a known predictor of falls and mortality. Whereas younger adults show circadian-system-driven reductions in BP response to passive postural tilt at night, circadian influences on BP responses to active standing in both young and older adults are unknown. Twenty-five healthy adults (19 midlife, 50 ± SD 5 years; 6 older, 64 ± 2 years) completed a 5-day laboratory protocol in dim light where all behaviours and all physiological measurements (e.g., cardiovascular response to active standing) were evenly distributed across the 24-h period. Participants underwent 10 recurring 5-h 20-min behavioural cycles of 2-h 40-min sleep opportunities and 2-h 40-min standardized waking episodes. Active standing challenges occurred during each wake period, and BP and heart rate were measured at rest and at 1 and 3 min of standing. Older adults had significantly impaired systolic BP responses at 1 min (P = 0.014) and 3 min (P = 0.03) into standing, particularly during the biological night (10:30 PM to 6:30 AM). Diastolic BP was also significantly reduced at 3 min (P = 0.013) in older adults. Heart rate responses were elevated on standing but did not differ significantly between groups or across circadian phases. Results were independent of body mass index, resting BP, and sex. The endogenous circadian system impairs BP response to standing in healthy older adults at night, potentially increasing fall risk. Chronotherapy strategies may include adjusted medication timing, compression garments, or safer nighttime mobility options. KEY POINTS: About 30% of older adults experience falls, which are a leading cause of injury and death. Blood pressure (BP) maintenance after standing is key to maintaining brain blood flow and is a predictive factor of future falls and death. We discovered that in older adults, the internal body clock-related mechanisms impair BP responses when they stand, particularly during the biological night. Compared to midlife adults, in older adults, BP decreased significantly during the night during standing, and did not recover for 3 min after active standing, without a compensatory increase in heart rate. These changes increase the risk of fainting and falls in older adults. Our data support the use of better-timed BP medications to maintain nighttime BP in older adults.
28. A novel approach - occupational therapy on campus: A systematic review.
期刊: Journal of American college health : J of ACH 发表日期: 2025-Aug-06 链接: PubMed
摘要
Objective: To demonstrate the potential value of occupational therapy (OT) services for students in higher education settings. Methods: Peer-reviewed articles published between 2010 and 2024 were searched across PsychInfo, CINAHL, Academic Search Complete, and PubMed databases. Results: Thirteen articles met the inclusion criteria. OT interventions included occupational performance coaching, group sessions, physical activity interventions, time management, occupation centered and other tailored support services. OT services showed positive impacts on occupational and academic performance, student well-being, reduced stress levels, and improved engagement. Conclusions: Consistent positive outcomes observed across OT interventions suggest that occupational therapy has value for addressing student challenges in higher education, particularly in academic performance, well-being, and engagement. Institutions would benefit from exploring how OT services could complement current support offerings. Future research should focus on conducting controlled studies to better understand service delivery models and sustainability.
29. Social Participation When Aging With an Early-Onset Neurological Disability: Protocol for Descriptive Qualitative Research.
期刊: JMIR research protocols 发表日期: 2025-Aug-06 链接: PubMed
摘要
Due to improvements in health care and rehabilitation, as well as better social conditions, individuals living with traumatic brain injury (TBI), multiple sclerosis (MS), or spinal cord injury (SCI) are living longer. It is therefore necessary to ensure the presence of social and health services adapted to the realities and specific needs of these populations aging with disabilities. Social participation is a key determinant of active aging and health. However, there is limited evidence regarding the social participation of these aging populations. To support the development of more inclusive approaches promoting the health of older adults, it is essential to better understand the diversity of social participation experiences among individuals aging with neurological disabilities. This study aims to explore how social participation is experienced by individuals aging with TBI, MS, or SCI; document the barriers and facilitators to their social participation; and explore avenues for interventions supporting their social participation. This descriptive qualitative research is part of a larger action research project conducted in partnership with individuals aging with disabilities, researchers, and community organizations providing services to these populations. Individuals 50 years or older living with TBI (n=8), MS (n=8), or SCI (n=8) will participate in a semistructured interview. The interviews will be transcribed verbatim, and the accuracy of the transcripts will be ensured through peer validation. Qualitative data will be analyzed using a mixed approach in alignment with the Framework methods. The use of the Human Development Model-Disability Creation Process (HDM-DCP) conceptual model will be used for deductive analysis. The coding tree will combine significant themes arising from the interviews’ inductive part and the themes from the HDM-DCP. Also, 12.5% of the analysis will be tested for stringency (ie, double-blind and interrater reliability exercise). This study will provide insights into the diversity of social participation experiences of these populations as well as the influence of individual characteristics and environmental resources on their social participation. This project will lay the groundwork for the codevelopment of health promotion programs aimed at supporting the social participation of individuals aging with neurological disabilities. This study will also help to identify the resources and strengths that support social participation for these populations, as well as the systemic barriers that need to be addressed. DERR1-10.2196/66963.
30. The Use of Perioperative Cephalexin in Penicillin Allergic Patients in Dermatologic Surgery: An Advisory Statement.
期刊: Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.] 发表日期: 2025-Aug-06 链接: PubMed
摘要
Approximately 10% of patients report penicillin allergy. Based on historical guidelines, patients with a penicillin allergy should receive an alternative to cephalexin for prophylaxis in dermatologic surgery. To determine, based on evidence, if cephalexin should be used as a first-line prophylactic antibiotic in dermatologic surgery for patients with penicillin allergy. Systematic review of the literature was performed with defined search terms. Less than 5% of those with penicillin allergy labels have a true penicillin allergy. For patients with true, persistent penicillin allergy, there is an overall low cross-reactivity with cephalosporins, especially with cephalosporins that do not share identical R1 side chain. The first-generation cephalosporins, including cephalexin, have a slightly higher risk of cross-reactivity in patients with reported allergy to amino-penicillins (amoxicillin, ampicillin) but not other penicillins. The risk of severe cross-reactivity of cephalosporins in patients with low-risk penicillin allergies is extremely low. Cephalexin has a superior side effect profile and efficacy compared to alternatives. Cephalexin should be used as the first-line prophylactic antibiotic in dermatologic surgery for patients with documented penicillin allergy, including anaphylaxis. There may be a higher risk of cross-reactivity with cephalexin in patients with a confirmed amino-penicillin allergy.
31. Evaluation of molecular and serological diagnostics for dengue during the 2023 outbreak in Jember, East Java, indonesia.
期刊: Diagnostic microbiology and infectious disease 发表日期: 2025-Aug-05 链接: PubMed
摘要
Dengue virus (DENV) is a major public health concern in Indonesia, with all four serotypes contributing to recurrent outbreaks. This study evaluated molecular diagnostic tests for DENV and identified circulating serotypes despite limited national surveillance. Clinically diagnosed dengue patients were recruited during the 2023 outbreak in Jember, Indonesia. Dengue was confirmed using Rapid Diagnostic Tests (RDTs) for NS1, IgM, IgG, and RT-PCR assays (Fast Track Diagnostics (FTD) and DENV in-house RT-qPCR), with diagnostic accuracy assessed using a composite reference standard. DENV serotypes were identified using Altona, CDC, and Serotype in-house RT-PCR. The FTD RT-PCR test showed higher sensitivity (100 %) than the DENV in-house test (78 %). All RDTs-positive cases were confirmed as DENV RNA-positive by RT-PCR. Serotyping detected all four DENV serotypes, with DENV-3/4 co-infections in seven patients. While the CDC and Serotype in-house tests effectively identified DENV-2, DENV-4, and DENV-3/4; DENV-1 was better detected by the Altona and Serotype in-house tests. The Altona test failed to detect DENV-4 in our study. All four DENV serotypes were detected during the 2023 outbreak, with possible re-emergence of DENV-4. The FTD dengue test proved effective for confirming infections, though rapid serological tests remain a practical but less precise alternative.
32. Lead-driven synergistic interactions in environmental metal (loid) mixtures: Systemic inflammation mediating autism spectrum disorder risk in Chinese children.
期刊: International journal of hygiene and environmental health 发表日期: 2025-Aug-05 链接: PubMed
摘要
Environmental metal (loid) exposure, particularly to lead (Pb), constitutes a growing concern for potential associations with autism spectrum disorder (ASD). Current risk assessments may underestimate neurodevelopmental impacts due to co-exposure interactions, while systemic inflammation’s mediating role in Pb-ASD relationships remains poorly characterized. This case-control study quantified serum concentrations of eight metal (loid)s via inductively coupled plasma mass spectrometry (ICP-MS) in 81 ASD cases and 402 typically developing (TD) Chinese children. Logistic regression demonstrated significantly elevated ASD risk with increasing Pb exposure quartiles (Q3 vs. Q1: OR = 2.64, 95 % CI 1.42-4.89; Q4 vs. Q1: OR = 6.85, 95 % CI 3.24-14.48; Ptrend < 0.001). Restricted cubic spline analysis confirmed a positive nonlinear dose-response relationship between log-transformed Pb levels and ASD risk (Pnon-linear = 0.004, Poverall < 0.001). Multi-pollutant mixture analyses identified Pb as the predominant contributor to ASD risk in both quantile g-computation (weight = 0.5099) and Bayesian kernel machine regression (PIP = 1.00) models, with evidence of significant cobalt (Co)-Pb interaction. Mediation analyses indicated systemic inflammation indices (SIRI, SII) partially mediated the Pb-ASD association (15.8 % and 8.6 %, respectively). These findings identify Pb as a principal determinant of metal (loid)-associated ASD risk, with inflammatory pathways contributing to its neurotoxicity. The observed Co-Pb interaction warrants investigation into co-exposure neurotoxicity mechanisms.
33. Air pollution exposures and adverse childhood experiences in relation to sleep health in middle childhood.
期刊: International journal of hygiene and environmental health 发表日期: 2025-Aug-05 链接: PubMed
摘要
Sleep health is an understudied but potentially important outcome of joint air pollution and psychosocial stress exposures in children. This study examined children’s sleep health outcomes in relation to air pollution (PM2.5, NO2, O3; aim 1), adverse childhood experiences (ACEs; aim 2), and air-pollution-by-ACEs interactions (aim 3). Participants were from ECHO-PATHWAYS, a three-cohort consortium. Aim 1 included 1166 participants across the three cohorts, and aims 2 and 3 included a subset of 719 participants from a single cohort. PM2.5 (μg/m3), NO2 (ppb), and O3 (ppb) were estimated during early infancy (0-6 months) and early childhood (6 months-6 years) using geocoded residential histories and spatiotemporal prediction models. Children’s lifetime exposures to 8 different types of ACEs were measured via parent report at child age 8-9 years. Sleep disturbance and sleep-related impairment outcomes were measured via children’s self-report at age 8-9 years. Analyses included linear regressions, adjusting for a priori-selected confounders. Aim 1 results showed that, for every 1 IQR increase in early infancy NO2, children scored 0.31 (95 % CI 0.01, 0.61) points lower on sleep-related impairment. Aim 3 results showed that, for every additional ACE, the difference in sleep-related impairment per IQR increase in early infancy and early childhood NO2 was 0.43 (95 % CI 0.08, 0.78) and 0.41 (95 % CI 0.08, 0.73), respectively (psinteractions = 0.02). No other associations were observed. We found little evidence of associations, with the exception of suggestive evidence for associations of NO2 and NO2-by-ACE interactions with sleep-related impairment.
34. Supervised Toothbrushing and Silver Diamine Fluoride Application of Rohingya Children in a Refugee Camp in Bangladesh.
期刊: International dental journal 发表日期: 2025-Aug-05 链接: PubMed
摘要
Previous studies have highlighted the high burden of oral diseases in refugee camps, but there are few robustly evaluated school-based oral health programmes in these settings. The objective of this study was to pilot a school-based toothbrushing, handwashing, and silver diamine fluoride (SDF) application in a refugee camp in Bangladesh. It hosts the world’s largest number of refugees with over 1 million Rohingya from Myanmar. A prospective cohort study that consisted of a multipronged oral health intervention: supervised daily toothbrushing, handwashing, and SDF application of active caries in the primary and permanent dentition. Clinical examination of the children and child and parental questionnaires were completed at baseline and the 6-month follow-up. A total of 176 children were assessed at baseline, with a follow-up rate of 87.5%. The number of children reporting regular toothbrushing and handwashing significantly increased between baseline and 6-month follow-up, with a corresponding fall in plaque and bleeding scores. There was a 54.3% caries arrest rate in teeth where SDF was applied. Supervised toothbrushing and SDF application in learning centres in refugee camps can improve the oral health of refugee children and instil healthy hygiene habits. Further research is warranted to robustly assess the long-term impact of this intervention and scalability across humanitarian settings. In the absence of accessible oral health care in refugee camps, low-resource oral health interventions can safeguard oral health and instil healthy hygiene habits from a young age.
35. Neferine inhibits Zika virus replication by targeting viral protease.
期刊: Phytomedicine : international journal of phytotherapy and phytopharmacology 发表日期: 2025-Aug-05 链接: PubMed
摘要
Zika virus (ZIKV) belonging to the Flaviviridae family causes critical neurological abnormalities, including congenital microcephaly and Guillain-Barré syndrome. Despite being a major public health concern, effective therapeutic interventions against ZIKV remain unavailable. NS2B-NS3 (ZIKVpro), the viral serine protease critical for polyprotein processing as well as viral replication, is a potential target for developing antiviral agents PURPOSE: This study aims to develop ZIKV inhibitors targeting the ZIKVpro from natural products. Surface plasmon resonance (SPR) based assay were used for drug screening from a natural product library. qRT-PCR, Western blot and plaque assay was used for the evaluation of their antiviral activity and studies of their mechanisms of action. Hydrogen-deuterium exchange mass spectrometry (HDXMS) analysis and Molecular dynamics (MD) simulation were used for confirmation of action site. We demonstrate that neferine, a bisbenzylisoquinoline alkaloid derived from the green embryo of the mature seeds of Nelumbo nucifera Gaertn (Plumula Nelumbinis), exhibits potent inhibitory effects against ZIKV replication in vitro and in vivo. Mechanistic analyses revealed that neferine directly binds to ZIKVpro, interacting with catalytic residues Tyr161 and Ser135, thereby suppressing protease activity in enzymatic assays and impairing polyprotein processing in infected cells. Notably, neferine also demonstrated broad-spectrum antiviral activity against Dengue virus, suggesting its potential as a pan-Flavivirus inhibitor. Our results highlight neferine’s therapeutic potential for combating ZIKV and related Flavivirus infections, providing a robust foundation for further drug development.
36. Co-design of school-based strategies and supports for Aboriginal and Torres Strait Islander youth living with type 2 diabetes: A qualitative study.
期刊: Australian and New Zealand journal of public health 发表日期: 2025-Aug-05 链接: PubMed
摘要
Youth-onset type 2 diabetes is an emerging condition impacting Indigenous populations worldwide. Schools have an important role in supporting students to manage their health. We undertook a qualitative study to (i) explore the lived experience of type 2 diabetes, diabetes management and support in school environments and (ii) co-design recommendations for age-appropriate, culturally safe school-based strategies and supports. Interviews and focus groups were undertaken with Aboriginal and Torres Strait Islander youth, caregivers, health professionals and school-based staff. Aboriginal and Torres Strait Islander youth were involved in determining the research topic. We found a need for school-based measures to address diabetes stigma, medication management, privacy and confidentiality, healthy eating and social and emotional wellbeing and identified further needs for staff training. In many cases, schools are providing extensive support to students, but without adequate resources, supportive systems and policies or staff training, current approaches are insufficient. Recommendations include whole-of-school responses to address diabetes stigma and to generate sensitive approaches to nutrition, school-based management plans for students with T2D and adoption of Aboriginal and Torres Strait Islander-driven approaches.
37. Immune checkpoint inhibitor-related pneumonitis: From guidelines to the front lines.
期刊: Respiratory investigation 发表日期: 2025-Aug-05 链接: PubMed
摘要
Immune checkpoint inhibitors (ICIs) have changed cancer treatment, evoking durable responses in various cancers. However, their immune-mediated mechanisms can lead to unique toxicities known as immune-related adverse events (irAEs), among which ICI-related pneumonitis (ICI-P) is a critical concern owing to its potential severity and impact on treatment continuity. This review provides a comprehensive overview of ICI-P, covering its epidemiology, pathophysiology, clinical features, diagnosis, risk factors, and treatments. ICI-P is more frequently observed in real-world settings than in clinical trials, especially in patients with risk factors such as pre-existing interstitial lung disease. The pathogenesis of ICI-P involves Th1/Th17 inflammation and autoantibody production, but the exact mechanisms remain unclear. An organizing pneumonia-like pattern is a characteristic radiological finding on chest computed tomography. Diagnosis can be supported by the evaluation of biomarkers like Krebs von den Lungen-6 and surfactant protein-D. High-dose corticosteroids are the standard treatment, although optimal regimens remain under investigation. Relapse is not uncommon, particularly in cases with an organizing pneumonia-like pattern or prolonged exposure to ICIs. Resuming ICIs after ICI-P is associated with a marked risk of relapse and must be carefully considered. Notably, immune modulation by ICIs may persist after discontinuation, potentially increasing susceptibility to drug-induced pneumonitis from subsequent therapies. As the use of ICIs expands, enhanced recognition, timely intervention, and individualized management of ICI-P are essential. Future strategies incorporating biomarkers, real-world data, and artificial intelligence may further improve outcomes for patients with ICI-P.
38. Wartime trauma surge volume and its impact on surgical care delivery and patient outcomes: A nationwide study.
期刊: Surgery 发表日期: 2025-Aug-05 链接: PubMed
摘要
An effective medical response to multiple-casualty incidents is critical for trauma systems worldwide. These events-which strain, but do not exceed, trauma center capacity-are increasingly common in civilian settings as a result of natural disasters, terrorism, and armed conflicts. This study evaluates the impact of combat casualty load on the time to urgent surgical intervention and on clinical outcomes during the Israel-Hamas war in southern Israel. This retrospective cohort study analyzed data from the Israel National Trauma Registry and included combatants who were hospitalized between October 27, 2023, and October 31, 2024, at 7 civilian Level I trauma center in Israel. Patients were stratified by arrival time and casualty volume per hour. The primary outcome was transfer to urgent surgery within 60 minutes of arrival. Secondary outcomes included in-hospital mortality and time to surgery. A total of 1,388 patients were included. The median age was 23 years (interquartile range, 21.0-28.0), and 99% were male. Most patients (93%) were evacuated by helicopter; 78% sustained penetrating injuries. Hemodynamic compromise was observed in 8% of cases. No significant differences were found in the proportion of urgent surgical interventions performed within 60 minutes or in in-hospital mortality across the different arrival clusters. Multivariable logistic regression revealed that only severe or critical injury (adjusted odds ratio, 4.62; 95% confidence interval, 1.56-17.17, P = .01, and adjusted odds ratio, 10.08; 95% confidence interval, 3.52-36.72, P < .001, respectively) and arrival during the morning shift (adjusted odds ratio, 2.83, 95% confidence interval, 1.27-6.71, P = .01) were independently associated with expedited surgical care. Clustered arrival of multiple combat casualties-ranging from 1 to 6 per hour-to civilian Level I trauma centers was not associated with delays in surgical care, increased mortality, or higher admission rates to the intensive care unit. However, night admissions were associated with longer times to operative care. These findings provide valuable insights for optimizing hospital and prehospital emergency response strategies during multiple casualty events.
39. Forecasting the adoption of digital health technologies: The intention-expectation gap.
期刊: Evaluation and program planning 发表日期: 2025-Aug-05 链接: PubMed
摘要
Healthcare funders and program planners are increasingly recognising that the value and impact of assistive digital health technologies (ADHT) on the traditional healthcare systems are not exclusively realised in their procurement or inhouse design and development phases. Instead, these benefits are more evident in their implementation, adoption, scaling and consistent use. However, predicting the potential for the adoption and use of future health technology such as ADHT remains a significantly challenging task. Invariably, there is limited information available for estimating their initial uptake and continued use before their procurement or design. This research relies on the results of a cross-sectional field survey of 679 participants to explore the intention-expectation gap in target adopters, as an early indicator of an ADHT’s potential for adoption and use. The results confirm that behavioural expectation is a better predictor of ADHT’s uptake and use than behavioural intention. Furthermore, the larger the intention-expectation gap, the less likely the initial ADHT’s uptake. Consequently, promotional and educational campaigns become more valuable and necessary to close the above gap and avoid the probable subsequent intention-behaviour gap and its resultant non-adoption and use.
40. Keratoconus in Sub-Saharan Africa: A Scoping Review.
期刊: Cornea 发表日期: 2025-Aug-05 链接: PubMed
摘要
To assess the prevalence, associated conditions, diagnostic and treatment modalities, and provider education regarding the diagnosis and management of keratoconus (KCN) in sub-Saharan Africa (SSA) based on the currently available body of literature. Peer-reviewed publications from any year and any language were included. The databases included Cochrane Database of Systematic Reviews, Embase, and Ovid. A separate search of African Journals Online was conducted using the same Medical Subject Heading (MeSH) terms as the database search. Additional publications were identified in the references during full-text extraction. The abstracts of all publications were evaluated by two reviewers. The full text was then examined by one reviewer for inclusion. A data extraction tool was used by a single reviewer to document the findings. Sixty-two publications were included in data extraction. Fourteen countries in SSA were represented. Prevalence was reported in eight SSA countries and ranged from 0% to 2.8%. The highest prevalence of 1.2% was found in a cross-sectional study in Banjul, Gambia. Diagnosis in urban areas is often made using slit lamps, although some sites had access to keratometry and/or topography, whereas rural areas use penlight exams alone. Penetrating keratoplasty was reported as an available treatment in 14 manuscripts, glasses and hard contact lenses in 10, and corneal cross-linking in two. Publications discussing provider education reported a knowledge gap. There is a need for increased data on KCN in SSA to better inform public health policy to improve KCN patients’ access to care and quality of life.
41. Transcription-coupled repair: protecting genome across generations.
期刊: Current opinion in genetics & development 发表日期: 2025-Aug-05 链接: PubMed
摘要
The primary objective of life is to ensure the faithful transmission of genetic material across generations, despite the constant threat posed by DNA-damaging factors. To counter these challenges, life has evolved intricate mechanisms to detect, signal, and repair DNA damage, thereby preventing mutations that can cause developmental abnormalities or diseases. DNA repair is especially vital during development - a period of rapid cell proliferation and differentiation. Failure to repair DNA damage in somatic cells can result in tissue dysfunction, while during embryonic development, it is often fatal. Transcription machinery plays a key role in the mechanisms of DNA repair. This review highlights current insights into DNA repair pathways that are driven or facilitated by transcription and their essential contribution to preserving genome stability.
42. Needlestick and Sharp Injury Among Dental Instrument Reprocessing Personnel: Incidence and Reporting Practices in China.
期刊: International dental journal 发表日期: 2025-Aug-05 链接: PubMed
摘要
This study aimed to determine needlestick and sharps injuries (NSIs) incidence, identify associated risk factors, and describe reporting practices among dental instrument reprocessing personnel (DIRP) in China. A nationwide cross-sectional study utilized stratified multistage random sampling across seven Chinese regions. Validated questionnaires were administered to 1942 DIRP from 130 dental facilities, collecting data on demographics, occupational conditions, NSI history, and reporting. Multivariate logistic regression identified independent NSI predictors. The one-year NSI period incidence was 21.7% (n = 421/1942), with 28.5% of these individuals experiencing multiple injuries. Daily instrument handling volume demonstrated a dose-response relationship with NSI risk (aOR = 5.73, 95% CI: 3.17-10.34, for >1000 vs. ≤100 instruments). The NSI reporting rate was 87.2%. Primary barriers included demanding work schedules (51.9%) and perceived low exposure risk (40.7%). Post-training assessment was significantly associated with a reduced NSI risk (aOR = 0.65, 95% CI: 0.51-0.83). Both receiving NSI prevention training (aOR = 3.11) and undergoing post-training assessment (aOR = 2.47) significantly increased NSI reporting. NSI prevalence among Chinese DIRP is substantial, strongly associated with instrument workload and work experience, and influenced by training assessment. Targeted interventions focusing on workload management, assessed training, and streamlined reporting are essential. These findings highlight critical areas for improving DIRP safety. Implementing evidence-based workload limits, ensuring training includes competency assessment, and simplifying NSI reporting can reduce preventable injuries and enhance occupational health in dental settings globally.
43. Mechanism of Eucalyptus oil in alleviating UUO-induced renal fibrosis revealed by transcriptomics and metabolomics.
期刊: Phytomedicine : international journal of phytotherapy and phytopharmacology 发表日期: 2025-Aug-05 链接: PubMed
摘要
Renal fibrosis (RF), a major contributor to the progression of chronic kidney disease (CKD), is an important therapeutic target. Eucalyptus oil (EO), a volatile extract derived from traditional Chinese herbal medicine with known anti-inflammatory and antioxidant properties, has shown potential in CKD treatment. However, its efficacy and mechanisms in preventing kidney injury induced by unilateral ureteral obstruction (UUO) remain unclear. This study aimed to evaluate the protective effects of EO against renal injury in UUO rats and to investigate its underlying mechanisms of action. A UUO-induced rat model of RF was established to assess the antifibrotic effects of EO. Integrated multi-omics approaches, including genomic and metabolomic analyses, along with molecular docking and experimental validation using Western blot and qPCR, were employed to systematically elucidate the molecular mechanisms and pharmacodynamic basis of EO in alleviating RF. EO significantly reduced RF in the UUO model by concurrently inhibiting the transforming growth factor-beta 1 (TGF-β1)/Smad3 signaling pathway and the tryptophan metabolism-aryl hydrocarbon receptor (AhR) axis. Specifically, EO suppressed Smad3 phosphorylation, fibroblast activation, and extracellular matrix (ECM) accumulation. It also inhibited AhR nuclear translocation and reduced the expression of cytochrome P450 1A1 (Cyp1A1), cytochrome P450 1B1 (Cyp1B1), and aryl hydrocarbon receptor nuclear translocator (ARNT). These molecular effects were associated with improvements in renal function indicators, including reductions in serum creatinine (SCR), blood urea nitrogen (BUN), and kidney injury molecule-1 (KIM-1). EO also mitigated histological damage and decreased oxidative stress markers-malondialdehyde (MDA), superoxide dismutase (SOD), and glutathione (GSH)-as well as inflammatory mediators-monocyte chemoattractant protein-1 (MCP-1), interleukin-1 beta (IL-1β), and tumor necrosis factor-alpha (TNF-α). These findings highlight the multitarget antifibrotic potential of EO. EO suppresses renal fibrosis by inhibiting both the TGF-β1/Smad3 signaling pathway and the tryptophan metabolism-AhR pathway, thereby reducing abnormal ECM accumulation.
44. Mechanisms of histopathologic vascular damage caused by pancreatic juice leakage: Implications for preventing hemorrhagic complications.
期刊: Surgery 发表日期: 2025-Aug-05 链接: PubMed
摘要
This study presents a prospective experimental analysis aimed to investigate the enzymatic interactions that cause histologic changes in the vascular wall to help prevent bleeding complications after pancreatic surgery. Severe hemorrhage can result from the accumulation of pancreatic juice and digestive fluids around vascular stumps. However, the specific digestive enzymes and their interactions that cause histologic damage to vascular walls remain unclear. Histopathologic changes in porcine arterial and venous walls were examined 48 hours after exposure to enzymatic solutions and human pancreatic juice, with or without a mixture of other digestive fluids obtained from 4 patients undergoing pancreatoduodenectomy. Moreover, the protective effect of a protease inhibitor added to active pancreatic juice against histopathologic damage was evaluated. Thinning of the arterial walls, with degeneration of smooth muscle nuclei and muscle/collagen fibers in the media, was significant after exposure to trypsin or chymotrypsin, and, among human digestive fluids, only after exposure to pancreatic juice mixed with intestinal fluid. Venous walls were more vulnerable to proteases and digestive fluids. Histopathological changes in the arterial wall were prevented when 10 units of nafamostat mesylate (protease inhibitor) were added to the pancreatic juice mixed with intestinal fluid. The activation of pancreatic proteases through mixing with intestinal fluids is a major factor causing histologic damage to the arterial media, leading to aneurysm formation and rupture of the vascular wall. Developing methods for the localized and continuous administration of protease inhibitors around vascular stumps could reduce life-threatening bleeding complications after pancreatic surgery.
45. Mercury methylation in methanogenic archaea: A protocol for stabilized cultivation and accurate assessment.
期刊: Journal of hazardous materials 发表日期: 2025-Aug-05 链接: PubMed
摘要
Although methanogenic archaea are among the oldest microorganisms capable of mercury methylation, their contribution to methylmercury (MeHg) production has only recently gained attention. Studies with laboratory-cultivated methanogens elucidate the transformation of inorganic mercury (Hg) into MeHg, thereby uncovering underlying microbial methylation mechanisms. However, this field faces challenges such as significant Hg loss and unstable culture systems, which impede accurate assessment of these processes. This study aims to develop a reliable low-Hg-loss cultivation protocol for Hg methylation by methanogens, enabling a more accurate evaluation of their contribution to MeHg production. Our findings demonstrate that redox potential is a critical factor for Hg methylation, affecting Hg speciation and microbial growth. Notably, titanium nitrilotriacetate (Ti(III)-NTA), a reducing agent used in prior studies, was identified as a primary cause of Hg loss, reducing 83.2 % of Hg(II) to elemental Hg(0) at 500 μM. Adding cysteine satisfied both the redox and sulfur requirements of methanogens. Under these optimized conditions, Methanospirillum hungatei JF-1 achieved the highest MeHg production of all methanogens, converting 75.7 % of Hg(II) to MeHg and 630.4 pmol MeHg/mg protein. Overall, this study establishes a stable culture system for investigating Hg methylation by methanogens and indicates that the role of methanogens in mercury methylation is more substantial than previously acknowledged.
46. Inhibition of Daphnia pulex swimming behavior by volatile petroleum products: Optical monitoring in a novel sealed chamber.
期刊: Chemosphere 发表日期: 2025-Aug-05 链接: PubMed
摘要
Since volatile organic chemicals (VOCs) evaporate at room temperatures, concentration-response studies are challenging in conventional assay systems, and new methods are needed to evaluate the effects of exposure that minimize VOC loss. In this study, the effects of three VOCs, benzene, toluene, and ethylbenzene on Daphnia pulex swimming behavior were evaluated. A novel bioassay system consisting of a sealed single-well cylindrical stainless-steel chamber with a glass bottom and top permit infrared light transmission and recording of movement with a digital camera. Exposure to increasing concentrations of toluene, benzene and ethylbenzene in water media significantly affected swimming behavior by decreasing swimming distance and increasing turning behavior. This novel assay system enables the study of VOCs at consistent exposure levels, and an upgraded multi-well version will increase throughput to test VOC mixtures for potential interactions among constituents that affect behavioral and transcriptomic responses.
47. Development of a digital, self-guided return-to-work toolkit for stroke survivors and employers using intervention mapping.
期刊: PLOS digital health 发表日期: 2025-Aug 链接: PubMed
摘要
Stroke incidence is rising among working-age adults in high-income countries. Employers often lack knowledge and skills to support return-to-work post-stroke. In the United Kingdom, nearly 40% of stroke survivors stop working. Vocational rehabilitation is rarely accessible, and self-guided resources often lack tools to support practical application. This study developed a self-guided return-to-work toolkit for stroke survivors and employers. Steps 1-4 of the six-step Intervention Mapping approach were followed. Intervention goal, content, and design were informed by three online workshops with employers (n = 12) and meetings with an advisory group (n = 20), including stroke charity and trade union representatives, stroke survivors, healthcare professionals, and experts in human resources and vocational rehabilitation. Theory-based pretesting (task-based usability review, advisory group discussions) was shaped by prototype review with advisory group members, including employers (n = 4), stroke survivors (n = 7), and healthcare professionals (n = 4). Framework analysis was used to structure feedback related to acceptability, ease of use/learnability, accessibility, inclusivity, perceived usefulness, and technical or environmental issues. No personal data were analysed. The toolkit aims to empower stroke survivors and employers to plan and manage a sustainable return-to-work post-stroke. It exists as two Xerte eLearning packages, with accessibility features such as screen reader compatibility and keyboard navigation. The toolkit contains theory- and evidence-based content for a) stroke survivors and b) employers, and includes downloadable PDF tools. Stroke survivor-focused content provides guidance on identifying and disclosing support needs to employers. Employer-focused content guides employers in increasing and maintaining understanding of stroke survivors’ work abilities, and implementing and monitoring tailored reasonable adjustments. Pretesting indicated the toolkit is comprehensive, empowering, and fosters open communication, offering key information and practical tools. Minor refinements and technical improvements were suggested. This toolkit addresses a gap in return-to-work guidance in the United Kingdom. Refinement, testing, and evaluation in real-world settings are needed.
48. Association between depressive symptoms and cognitive performance in middle-aged and older adults across digital divide.
期刊: Journal of psychiatric research 发表日期: 2025-Jul-31 链接: PubMed
摘要
Depression and cognitive problems are common in older adults and are often associated with social isolation. This study compared depression and cognitive function between older adults with digital inclusion and those with digital exclusion. Data were derived from the 2020 wave of the China Health and Retirement Longitudinal Study. Depression was evaluated using the Center for Epidemiologic Studies Depression Scale-10 items. Cognitive function was assessed with episodic memory and executive function tests. Propensity score matching was employed to match the digital inclusion and exclusion groups after controlling for covariates. Network analysis was used to examine the difference in the interaction of symptoms between both groups. In total, 9436 eligible participants were included in the analyses, with 4718 in the digital inclusion and 4718 in the digital exclusion groups. Participants in the digital inclusion group exhibited higher levels of global cognition, including executive function (z = -23.08; p < 0.001) and episodic memory (z = -26.34; p < 0.001), compared with those in the digital exclusion group. In contrast, participants in the digital exclusion group displayed more severe depression (z = 11.15; p < 0.001) compared with those in the digital inclusion group. Both groups had similar most central symptom of “Feeling blue” (EI: 1.16 in digital inclusion; 1.11 in digital exclusion) and bridge symptoms, including “Orientation” (bridge EI: 0.21 in digital inclusion; 0.17 in digital exclusion), “Delayed memory” (bridge EI: 0.18 in digital inclusion; 0.14 in digital exclusion) and “Hopelessness” (bridge EI: 0.16 in digital inclusion; 0.24 in digital exclusion). Digital exclusion is significantly associated with more severe depressive symptoms and cognitive impairment among older adults. The central and bridge symptoms should be prioritized in developing treatment strategies for older adults with depression and cognitive decline.
49. Genomic insights into esterase-mediated dibutyl phthalate biodegradation by Paenarthrobacter sp. PB10 and its role in phthalate abatement in rice seedlings.
期刊: Journal of hazardous materials 发表日期: 2025-Jul-31 链接: PubMed
摘要
Dibutyl phthalate (DBP), a persistent pollutant, poses serious ecological and health risks, demanding effective bioremediation strategies. This study explores DBP degradation by Paenarthrobacter ureafaciens PB10 using genomic, enzymatic, and in situ analyses. The ∼4 Mb genome encodes 3678 proteins, including two pht clusters, a pca cluster, and genes for gentisate, butanol, and fatty acid metabolism. Thirteen putative phthalate esterases (>30 % similarity, all with the conserved GXSXG motif) were identified; four were structurally validated and docked with DBP. One putative extracellular esterase exhibited serine esterase catalytic mechanisms by binding affinity of -4.7 kcal/mol toward DBP, with conserved serine residues. In vitro assays and GC-MS confirmed the hydrolysis of 300 mg/L DBP by extracellular extracts (134.67 nmol/mL/min), yielding hexadecanoic and octadecanoic acids, implying subsequent butanol metabolism via fatty acid pathways. In DBP-contaminated soils, PB10 removed over 94 % of the initial total DBP concentration (130 mg/kg) through a preincubation approach. Degradation followed first-order kinetics, with half-lives of 12.26 and 16.00 days in sterile and non-sterile soils, respectively. PB10 coexisted with indigenous microbes to further enhance DBP dissipation. Notably, PB10 fully inhibited DBP accumulation in rice seedlings (bioconcentration factor, BCF = 0) and alleviated phytotoxic effects, promoting seedling growth. Under controlled laboratory conditions, these results imply that PB10 has potential for DBP bioremediation and plant growth promotion; however, additional research is required to confirm its efficacy in complex agroecosystem settings.
50. Columbianadin targets TRIM7 to maintain P2X7 palmitoylation, inhibiting cuproptosis in synovial M2 macrophages.
期刊: Phytomedicine : international journal of phytotherapy and phytopharmacology 发表日期: 2025-Jul-30 链接: PubMed
摘要
Traumatic synovitis often arises from sports injuries, and early intervention is crucial for preserving joint health. Columbianadin (CBN), a natural phytochemical, has demonstrated efficacy in inhibiting inflammatory progression through Chinese herbal injection therapy; however, its underlying mechanism remains unclear. This study aims to investigate the molecular mechanism by which CBN maintains P2X7 palmitoylation, characterize TRIM7 as a novel cuproptosis-alert protein, and provide a theoretical foundation for the bench-to-bedside translation of CBN in treating traumatic synovitis. A non-destructive anterior cruciate ligament tear model was established to induce knee joint instability in mice. TRIM7 conditional knockout mice were generated via tissue-specific gene knockout. Single-cell sequencing and bioinformatics analysis were used to screen and validate CBN targets and downstream signaling pathways. Subcellular localization changes of P2X7 were detected via fluorescence co-localization. Copper concentrations in cells and tissues were measured using inductively coupled plasma-mass spectrometry. Palmitoylation levels of P2X7 were analyzed via acyl-biotin exchange assay. CBN effectively suppressed synovial inflammation in mice. Mechanistically, CBN directly bound to TRIM7 and downregulated its expression. TRIM7 knockout significantly attenuated CBN’s anti-inflammatory effects. TRIM7 competed with P2X7 for binding to ZDHHC5, leading to ubiquitination-mediated degradation of ZDHHC5. This disrupted ZDHHC5-dependent palmitoylation of P2X7, preventing its membrane localization and subsequent copper efflux. Accumulated intracellular copper induced cuproptosis. CBN directly targets TRIM7 to preserve ZDHHC5-mediated P2X7 palmitoylation, thereby inhibiting M2 macrophage cuproptosis in synovial tissues. These findings provide a theoretical basis for developing precision drug delivery systems targeting traumatic synovitis.
51. Strategies and responses to the effects of Climate Change on health systems in Sub-Saharan Africa: A scoping review protocol.
期刊: PloS one 发表日期: 2025 链接: PubMed
摘要
Climate change is recognized as the greatest global health threat of the 21st century. Projections suggest that the Sub-Saharan African region will face more consequences of climate change than any other region globally. The health systems within the region have been affected by the negative effects of climate change. Mapping strategies and responses used in the region to address the effects of climate change on health systems in Sub-Saharan Africa could be a starting point for understanding evidence-based decision-making to inform best practices. This scoping review will follow the methodological framework by Arksey & O’Malley. A wide range of databases will be searched to identify articles published on the strategies and responses to the effects of climate change on the health systems in Sub-Saharan Africa. Only peer-reviewed articles (original quantitative and qualitative studies, mixed methods, systematic reviews, editorials, and commentaries) published in English Language between 2010 and 2024 will be reviewed. All Book chapters and the grey literature (dissertations, conference proceedings, abstracts, reports) and publications primarily focusing on climate change strategies and responses without effects on health systems will be excluded. Covidence software will be used during study selection, data extraction, and summary. Deductive thematic analysis will be performed using predetermined themes from the objectives. The results of this scoping review will be disseminated at local and international research conferences. Furthermore, the findings will be published in open-access journals targeting different audiences. The findings will also be shared with the Ministry of Health in Malawi for possible policy considerations.
52. Reproductive health programs in women with physical disabilities: A scoping review protocol.
期刊: PloS one 发表日期: 2025 链接: PubMed
摘要
Approximately 15% of people with disabilities are women of reproductive age. Women with physical disabilities are neglected in reproductive and sexual health. Complex health conditions, mobility limitations, negative disability stereotypes, and misconceptions about their needs directly and indirectly affect their sexual and reproductive health. Access to appropriate reproductive health care is crucial for empowering these women to manage their reproductive and sexual health challenges effectively. This scoping review aims to identify, explore, and map the existing evidence on reproductive health programs and interventions in women with physical disabilities. This scoping review will be based on Arksey and O’Malley’s methodological framework and the subsequent recommendations of Levac et al. We will search for studies published from January 2006-2024 in English and Persian without restriction by study design in databases such as Web of Science, PubMed, ProQuest, Springer, Google Scholar, ScienceDirect, Cochrane Library, Agency for Healthcare Research and Quality, and websites like the World Health Organization, UNICEF and government sites for policies and reports about reproductive health programs for women with physical disabilities. Two or more reviewers will independently conduct all stages of the study. Data synthesis will utilize a qualitative analysis approach, and this review will be reported using the PRISMA-ScR checklist. This scoping review synthesizes evidence on reproductive health interventions for women with physical disabilities, including educational and awareness programs, healthcare access initiatives, support groups, and policy interventions. We will explore these interventions across various dimensions of reproductive health. The results of this review will offer a comprehensive overview of available resources and identify critical gaps in reproductive health for this population. To our understanding, this study may be the first scoping review in this field, which could provide valuable guidance to key stakeholders.
53. Using best-worst scaling experiment to understand factors influencing self-medication practices with antimicrobial drugs: A survey of students studying health programs at a tertiary institution in Ghana.
期刊: PLOS global public health 发表日期: 2025 链接: PubMed
摘要
Antimicrobial drugs have saved millions of lives, but their widespread use to treat infections has significantly contributed to healthcare challenges, particularly antimicrobial resistance (AMR), which poses a global threat. This study investigated the factors influencing self-medication practices with antimicrobial drugs among health science students at a tertiary institution. A cross-sectional survey was conducted from July to August 2024, using interviewer-administered questionnaires to collect data from 300 students. Participants were selected proportionally based on their disciplines through a random sampling technique. We employed the maximum difference model for data analysis. Our results indicated that 51.67% of participants were male, and 77.93% were between 18 and 25 years old. While 58% of respondents perceived themselves to be in good health, 44.67% reported using antimicrobial drugs without a prescription, with 51.33% having done so in the past year. Ampicillin was the most reported non-prescription antimicrobial; participants typically obtained it from pharmacies (52.33%). The key findings revealed that a good knowledge of antimicrobial drugs was the most significant factor influencing self-medication practices, indicated by a marginal utility estimate (MUE) of 0.6958 and a marginal probability (MP) of 0.1243, with a 95% confidence interval (CI) of 0.6203 to 0.7712. Other important influencing factors included previous knowledge of health conditions (MUE: 0.6205; MP: 0.1153; 95% CI: 0.5448 to 0.6959), previous experiences with the same illness (MUE: 0.4886; MP: 0.1011; 95% CI: 0.4122 to 0.5648), previous use of antimicrobial drugs (MUE: 0.2189; MP: 0.0772; 95% CI: 0.1416 to 0.2959), easy access to over-the-counter antimicrobial drugs (MUE: 0.1711; MP: 0.0736; 95% CI: 0.0938 to 0.2482), and the concept of self-care (MUE: 0.1075; MP: 0.0690; 95% CI: 0.0301 to 0.1848). Conversely, participants tended to trade off frustration with hospital protocols, like long waiting queues/times for medical care (MUE: -0.358; MP: 0.0433; 95% CI: -0.4349 to -0.2815), distance to health facilities (MUE: -0.362; MP: 0.0432; 95% CI: -0.4389 to -0.2855), poor quality of care provided (MUE: -0.374; MP: 0.0427; 95% CI: -0.4506 to -0.2971), and dissatisfaction with healthcare workers’ attitudes (MUE: -0.392; MP: 0.0419; 95% CI: -0.4688 to -0.3155). This study is the first to quantify the factors influencing self-medication practices with antimicrobial drugs among health science students using a best-worst scaling (BWS) statistical design methodology. The findings could inform policy discussions on effective health promotion strategies and regulations for prescribing and dispensing antimicrobials. Such efforts are essential for addressing the issue of AMR in Ghana and other developing countries.
54. Risk of dementia in Nepal: A cross-sectional survey in mountainous, hilly, and lowland regions.
期刊: PloS one 发表日期: 2025 链接: PubMed
摘要
Globally dementia is a growing public health problem, with over 135,000 people in Nepal living with dementia. Nepal lacks national and community-based data on dementia prevalence. This study aims to determine the dementia risk in Nepal and assess the effects of age, sex, and geographical location on disease prevalence. It also intends to inform policy makers about the burden of dementia, prompting them to plan and prepare appropriate health and social care services for individuals affected by dementia. A cross-sectional survey of 933 older people (aged 60 years and over) was conducted to determine the prevalence of suspected cognitive impairment or dementia risk in three geographical regions of Nepal. The Rowland Universal Dementia Assessment Scale (RUDAS) was used to measure cognitive impairment. The study evaluated the overall prevalence of suspected cognitive impairment or risk of dementia and subgroups by region, age group, and sex. Chi-squared tests and multiple logistic regression analyses were conducted to assess the effects. 53.7% (501) participants had cognitive impairment or risk of dementia, with slightly higher rates in women (56.5%) than men (51.7%). Cognitive impairment prevalence increases with age and region, with hilly and mountainous areas and low-lying regions having a greater geographic effect. There is high risk of dementia in Nepal. The risk is influenced by age and geographical regions, necessitating early diagnosis and tailored interventions for older people and who are residing in higher altitude areas. Policies implemented to address this issue should prioritise community awareness and early screening and diagnosis to reduce complications from dementia. National-level studies and exploration of factors affecting early dementia diagnosis are needed.
55. The influence of audience's regulatory focus on the persuasive effect of different pro-vaccine messages.
期刊: PloS one 发表日期: 2025 链接: PubMed
摘要
The aim of this study was to investigate the influence of an audience’s regulatory focus on the persuasive effect of different pro-vaccine messages. Study 1 (N = 169) examined attitude changes among audiences with different regulatory focus after reading pro-vaccine messages, and Study 2 (N = 201) added the exploration of message persuasiveness and vaccination intentions as well. The results of Study 1 and Study 2 showed that both high promotion fucus and high prevention focus could facilitate the attitude change elicited by messages emphasizing vaccine safety, official position and credibility. Meanwhile, high-promotion individuals were also more easily influenced by messages highlighting the benefits of vaccination, while high-prevention individuals were more receptive to messages focusing on the personal responsibility. Similar results also appeared when measuring perceived persuasiveness as dependent variable. However, these impacts of regulatory focus did not remain statistically significant on behavioral intention for most messages, except for the messages emphasizing vaccine effectiveness. The behavioral intention changes after reading these messages were significantly promoted by high promotion focus. Our findings could shed some light on the mechanism underlying personalized persuasion as well as more targeted vaccination promotion strategies.
56. Utilizing an explanatory case method approach to explore alternative recruitment strategies for a longitudinal randomized clinical trial of insomnia treatment in cancer survivors amid COVID-19.
期刊: PloS one 发表日期: 2025 链接: PubMed
摘要
COVID-19 was a barrier to meeting recruitment goals in clinical trials particularly for behavioral interventions requiring innovative and evolving strategies. This paper explores recruitment approaches prior to, during, and after the in-person recruitment pause in a longitudinal randomized controlled trial (RCT) in which cancer survivors received one of two interventions to self-manage insomnia. An explanatory case study method was used to investigate pre, during, and post COVID-19 recruitment during a longitudinal RCT. Data analysis included descriptive frequencies of enrollment approaches and outcomes obtained from the research team’s weekly documented recruitment activities, and qualitative analysis of post-recruitment focus group of clinical partner experiences within the environmental context of the clinic settings. Team analysis included data triangulation between research team’s recruitment data and clinical staff experiences, and times series analysis with explanation building with team consensus on the final product. A total of 136 heterogenous cancer survivor participants were recruited utilizing both in-person and virtual strategies with an 87.5% retention rate. Variability in success of recruitment approaches over time was demonstrated within the environmental contexts. Overall, in-person recruitment was the most effective strategy (55.1%) followed by passive strategies of print outreach and social media (36.8%). A creative and persistent research team was needed to achieve the recruitment target with a high retention rate. Recruiting in-person post COVID-19 was challenging due to clinical staff barriers. The explanatory case study method offers insight into the complex recruitment process and potential approaches that could be implemented for future public health insomnia treatment studies.
57. Factors impacting university students' quality of life.
期刊: PloS one 发表日期: 2025 链接: PubMed
摘要
Quality of life (QoL) is a broad multidimensional concept that incorporates a person’s physical health, psychological well-being, social relations, and environmental factors. Although previous studies have explored QoL among students in health-related disciplines, limited research has assessed QoL in students from diverse academic programs in Bangladesh. This study sought to assess the QoL of University students in Bangladesh and to identify the key factors that determine it. In this cross-sectional study, 417 students were recruited from Daffodil International University. Data were obtained using the WHOQoL-BREF, Pittsburgh Sleep Quality Index (PSQI), Rosenberg Self-Esteem Scale (RSES), and a structured questionnaire that included information pertaining to sociodemographic and lifestyle variables. The highest mean score was observed in the social relationships domain (62.93%), while the environmental health domain had the lowest (58.07%). Students who were physically active and had normal self-esteem reported significantly higher scores across physical and psychological health domains. Poor sleep quality, low self-esteem, and lack of exercise were consistently associated with lower QoL scores, particularly in the physical, psychological, and social domains. Female students also reported significantly lower scores than males in three of the four domains. The most consistent and strongest predictors of quality of life across domains were self-esteem and sleep quality, followed by gender, physical activity, and screen time. The findings highlight the significant impact of emotional, behavioral, and lifestyle factors on the quality of life of university students. These understandings reinforce the need for campus-based interventions that prioritize mental health support, encourage regular physical exercise, and promote sleep hygiene. Such efforts are essential to enhancing overall student well-being and fostering a healthier, more resilient academic community.
58. Unveiling health disparities: Diagnostic prevalences in a transgender cohort versus matched controls.
期刊: PloS one 发表日期: 2025 链接: PubMed
摘要
Transgender and gender-diverse (TGD) individuals are at risk for discrimination and inequities across legal, social, and medical contexts. Population-level resources have rarely been used for TGD health research and, therefore, data is lacking about prevalences of a wide range of clinical conditions among TGD populations. To leverage the Utah Population Database’s demographic, vital, and health records and examine population-level diagnostic prevalences in TGD individuals and an age-matched general cohort. 6,664 TGD individuals were identified using ICD codes for gender incongruence between 1995 and 2021; 64,124 age-matched individuals comprised the control cohort. Using Phecodes to collapse ICD codes, this study examined differences in the prevalence of medical, mental health, and neurodevelopmental clinical phenotypes in TGD and control cohorts using modified Poisson regression models. Affiliated healthcare systems within the state of Utah. We evaluated adjusted prevalence ratios of identified Phecodes. The TGD cohort showed broadly higher documented prevalences of medical, mental health, and neurodevelopmental conditions compared to controls. Medical diagnoses more common in the TGD cohort included sleep disorders and chronic pain. Disparities in diagnoses such as “other endocrine disorders” and “need for hormone replacement therapy” likely reflect gender-affirming treatments. Mental health conditions including mood, depression, anxiety, and personality disorders were significantly more prevalent in the TGD cohort. This study highlights diagnostic disparities for TGD individuals across multiple clinical categories. Our findings may be driven by: 1) discrimination and over-medicalization of TGD individuals, 2) differences in accessing and interacting with the healthcare system, and 3) variation in the true incidence of medical and mental health outcomes in the TGD vs control cohorts.
59. Personalized goal setting and predictors of functional gains following constraint-induced movement therapy in preschool-aged children with unilateral cerebral palsy.
期刊: PloS one 发表日期: 2025 链接: PubMed
摘要
This study aimed to identify caregiver-selected goal characteristics that predict functional improvements following constraint-induced movement therapy (CIMT), offering novel insights into personalized rehabilitation for younger children with unilateral cerebral palsy (UCP). This study included 19 children with UCP aged 4-6 years who participated in a three-week CIMT program comprising 15 sessions (30 hours total), during which the unaffected hand was constrained to encourage intensive use of the affected limb. Caregivers identified five meaningful rehabilitation goals per child using the Canadian Occupational Performance Measure, categorizing them into self-care, productivity, or leisure domains and ranking them by importance. Upper-limb function was objectively evaluated using the Assisting Hand Assessment before and immediately after CIMT. Linear regression analyses identified the factors influencing goal selection, and least absolute shrinkage and selection operator regression determined whether prioritized goal types predicted improvements in upper limb function. Self-care goals were most frequently selected (72.6%), followed by leisure (26.3%) and rarely productivity (1.1%). Leisure goal selection was significantly associated with greater baseline upper limb range of motion and lower baseline occupational performance scores. The higher prioritization of goals involving quiet leisure activities (e.g., arts, crafts, computer play) and dressing tasks (e.g., buttoning, zipping) significantly predicted greater functional improvements post-intervention. This study provides important new evidence indicating that caregiver-selected rehabilitation goals that are closely aligned with a child’s latent motor capacities positively affect functional outcomes. These findings underscore the clinical importance of individualized, family-driven goal setting for optimizing therapeutic effectiveness in preschool-aged children with UCP.