公共卫生研究摘要 (2025-08-12)
共收录 56 篇研究文章
1. A Multivariable Model to Predict Risk of Dementia or Death in Older Veterans With Traumatic Brain Injury.
期刊: Neurology 发表日期: 2025-Sep-09 链接: PubMed
摘要
Traumatic brain injury (TBI) is associated with increased risk of both death and dementia in older adults, but no prognostic models currently exist to help identify which individuals are at greatest risk of long-term adverse outcomes. Our primary objective was to develop a single prognostic model that uses electronic health record (EHR) data to predict 5-year risk of dementia or death in older veterans who have experienced TBI. We performed a retrospective cohort study using EHR data from the US Department of Veterans Affairs Health Care System. Participants were US veterans aged 55 years or older without dementia who had a TBI diagnosis and received care between 2002 and 2019. Potential predictor variables included demographics, medical comorbidities, mental health conditions, and health care utilization factors. We used multinomial logistic regression with least absolute shrinkage and selection operator to develop a prognostic model for 5-year risk of dementia or death. Cohort members (N = 113,779) had a mean ± SD age of 68 ± 10 years; 6% were female, and 20% were non-White or Hispanic. The key predictors of dementia or death included older age; male sex; number of inpatient visits; and comorbidities such as Parkinson disease, diabetes, weight loss, epilepsy, substance use disorder, and psychosis. The c-statistics were 0.756 (95% CI 0.751-0.761) for dementia and 0.783 (0.779-0.786) for death. Among those in the lowest predicted decile of dementia risk, 3% developed dementia within 5 years, compared with 43% of those in the highest predicted decile of risk. Similarly, the proportion of participants who died without dementia was 4% among those in the lowest predicted decile of risk compared with 64% in the highest predicted decile of risk. A single prognostic model that includes demographics, comorbidities, and utilization variables can predict risk of dementia or death in older veterans who have experienced TBI with good accuracy. Additional studies are needed to determine how this information might be best used to support better care.
2. Association Between Food Desert Residence and Ischemic Stroke Risk: A Population-Based Study.
期刊: Neurology 发表日期: 2025-Sep-09 链接: PubMed
摘要
Food deserts (FDs) are low-income areas with poor access to healthy foods. FD residents have higher rates of several cardiovascular risk factors, but the link between FDs and stroke has not been well studied. We evaluated whether FD residence was associated with incident ischemic stroke within the Greater Cincinnati/Northern Kentucky Stroke Study (GCNKSS) and whether this association was due to low income, poor food access, or both. All hospitalized stroke cases in the GCNK region were ascertained during calendar year 2015 using ICD-9 and ICD-10 codes for screening and confirmed by physician review. Patient home addresses were geocoded using Decentralized Geomarker Assessment for Multi-Site Studies. FD locations were obtained from the US Department of Agriculture Food Access Research Atlas, defined as census tracts with both poor food access and low income according to established definitions based on proximity to healthy food sources as well as area poverty rates and median household income. Population estimates were obtained from the 2015 5-year American Community Survey. Poisson regression models were used to calculate census tract-level incidence rates by FD status, as well as by food access and income categories, adjusting for age, sex, race, and income-by-access interaction. A total of 1,802 first-ever ischemic stroke incidents occurred in the region during the study period. Stroke patients had a mean age of 69.7 years, and 53% were female. In unadjusted models, FD residence (vs non-FD) was associated with higher stroke incidence (incidence rate ratio [IRR] 1.23; 95% CI 1.06-1.42; p < 0.01). After adjustment for age, sex, and race, this relationship was attenuated and no longer statistically significant (IRR 1.11; 95% CI 0.96-1.30; p = 0.17). In a model where FD status was replaced by area income and food access (i.e., the 2 components of the FD definition), low income was associated with greater stroke incidence after full adjustment (IRR 1.21; 95% CI 1.05-1.39; p = 0.01) while poor food access was not (IRR 0.91; 95% CI 0.81-1.01; p = 0.08). FD residents are at increased stroke risk, and this is primarily due to low area income rather than poor food access. Alternative measures of the food environment may help elucidate the links between income, dietary patterns, and stroke risk.
3. Climate change and Vibrio: Environmental determinants for predictive risk assessment.
期刊: Proceedings of the National Academy of Sciences of the United States of America 发表日期: 2025-Aug-19 链接: PubMed
摘要
Climate change significantly impacts the incidence and abundance of microorganisms, including those essential for environmental cycles and those pathogenic to humans and animals. Shifts in conditions favorable for microbial growth have expanded the geographic range of many pathogens, contributing to the emergence and reemergence of infectious diseases. Waterborne diseases pose severe risks in regions where adverse climate conditions intersect with population vulnerabilities, especially inadequate water, sanitation, and hygiene infrastructure. Since many waterborne pathogens play crucial roles in the environment, such as in carbon and nitrogen cycling, their eradication is not possible. However, predictive intelligence models that identify environmental heuristics conducive to the growth of pathogenic strains, integrating microbiological, sociological, and weather data, can offer anticipatory decision-making capabilities, reducing infection risks. Here, the objective was to analyze data from studies since the 1960s to identify environmental determinants driving the occurrence and distribution of pathogenic Vibrio spp., enabling predictive modeling of the effects of climate change on cholera and noncholera vibriosis. The proliferation of Vibrio spp. in aquatic ecosystems has been linked to climate change and, concomitantly, with increased environmental disease transmission, notably cholera in Southeast Asia and parts of Africa and noncholera vibriosis in Northern Europe and along the Eastern seaboard of North America. Global predictive risk models for Vibrio cholerae have contributed to reduction in case fatality rates when coupled with individual and large-scale intervention early in outbreaks. These models, when appropriately modified, hold the potential to predict disease caused by all clinically relevant Vibrio spp. and other waterborne pathogens.
4. Bolstering the Medication Supply Chain and Ameliorating Medication Shortages: A Position Paper From the American College of Physicians.
期刊: Annals of internal medicine 发表日期: 2025-Aug-12 链接: PubMed
摘要
The U.S. health care system is experiencing numerous supply chain disruptions, including for important medications. Prescription drug shortages have been at record levels and have affected more drugs in recent years, especially generic sterile injectables and other low-margin medications. These shortages arise from a confluence of factors, including the complexity of the entire production and delivery supply chain, quality issues, outdated manufacturing facilities and practices, drug purchasing policies that prioritize lowest price over reliable production, changes in prescribing and usage patterns, geopolitical constraints, and market concentration, among other factors. When prescription drugs are in shortage, patients face negative health outcomes due to being unable to obtain necessary treatments, the stress associated with securing medications, and adverse effects from alternative treatments. Physicians also face substantial burden in navigating drug shortages because they must expend time and resources in identifying alternative treatment options and obtaining prior authorization for the coverage of alternative drugs, negatively affecting the patient-physician relationship. Policymakers, regulators, manufacturers, health systems, health professionals, and other relevant entities must collaborate to further efforts to ameliorate drug shortages and promote equitable access to treatments. In addition to short-term measures to address the immediate effect of drug shortages, policymakers, manufacturers, and drug purchasers should also undertake efforts to prevent future drug shortages by investing in, strengthening, and diversifying prescription drug supply chains and incentivizing procurement practices that emphasize reliable and sustainable production practices. Such efforts must be undergirded by policies to improve monitoring of and transparency into the prescription drug supply chain.
5. Geographic Variation in the Utilization of Cancer Care From Subspecialized Medical Oncologists in the United States, 2008 to 2020.
期刊: Annals of internal medicine 发表日期: 2025-Aug-12 链接: PubMed
摘要
The growing complexity of cancer care may be driving an increase in subspecialized medical oncologists who focus on treating specific cancer types. However, little is known about trends in subspecialization among oncologists and differences in utilization of subspecialists. To quantify trends in oncologist subspecialization and assess differences in utilization of subspecialized cancer care in the United States. Retrospective cohort study using Medicare claims data from 2007 to 2021. National, fee-for-service Medicare. Medicare beneficiaries initiating chemotherapy between 2008 and 2020. Chemotherapy episodes were defined using methods from the Oncology Care Model. Subspecialization was identified based on whether oncologists managed more than 80% of chemotherapy episodes within a single cancer category. Outcomes included the annual share of oncologists classified as subspecialists, and the share of chemotherapy episodes managed by these oncologists, stratified by cancer type, geography, and socioeconomic characteristics. Among 18 633 oncologists and 9.25 million chemotherapy episodes, the proportion of episodes managed by subspecialists increased from 9% in 2008 to 18% in 2020. Utilization varied widely across cancer types and regions, with the highest levels observed in large metropolitan areas. Differences by income widened over time: in 2020, 27.6% of episodes in the highest-income counties were managed by subspecialists, compared with only 8.8% in the lowest-income counties, despite higher cancer mortality in the latter. Analyses were limited to fee-for-service Medicare beneficiaries and excluded patients treated with surgery or radiation alone. Subspecialization was defined using practice patterns rather than formal training, and the study does not assess patient outcomes or causal effects. Subspecialization in oncology is increasing but is unevenly distributed, with growing differences in utilization across income groups and regions. National Institute on Aging.
6. Effectiveness of a multicomponent physical exercise program in synchronous telerehabilitation mode: A systematic review with meta-analysis protocol.
期刊: Medwave 发表日期: 2025-Aug-11 链接: PubMed
摘要
Telerehabilitation has been proposed as an innovative, safe, and effective method of intervention to prevent or improve frailty. This rehabilitation modality facilitates access to opportunities and reduces gaps in healthcare. The advantages and challenges of implementing synchronous telerehabilitation programs in older people should be explored. This protocol describes the methodology to analyze the effects of a multicomponent physical exercise program in synchronous telerehabilitation modality compared to a multicomponent physical exercise program in face-to-face modality in terms of quality of life of frail older people. A systematic review will be performed in the following databases: Medline/PubMed, Scopus, Web of Science, CINAHL, Central, PeDRO, Lilacs, and Epistemonikos. To identify randomized clinical trials that meet the proposed eligibility criteria. The primary outcomes are quality of life and functionality, and the secondary outcomes are strength, balance, and cardiorespiratory capacity. In addition, the risk of bias will be assessed using the ROB-2 tool, and the certainty of the evidence will be assessed using the GRADE system. A meta-analysis will be performed if the procedures used to determine the results of the study are homogeneous; mean differences with a 95% confidence interval will be calculated. Otherwise, standardized mean differences will be used to determine the effect sizes. results The main findings of this review and meta-analysis will contribute to clarifying the effectiveness of physical therapy applied in a synchronous remote modality. It will also identify the variables on which it has a positive effect. CRD42024605527. La telerrehabilitación se ha propuesto como un método innovador, seguro y efectivo de intervención para prevenir o mejorar la fragilidad. Esta modalidad de rehabilitación facilita el acceso a oportunidades y reduce las brechas en la atención médica. Las ventajas y desafíos de la implementación de programas de telerrehabilitación sincrónica en personas mayores deben ser explorados. Este protocolo describe la metodología para analizar los efectos de un programa de ejercicio físico multicomponente en modalidad telerrehabilitación sincrónica, en comparación con un programa de ejercicio físico multicomponente en modalidad presencial. Esto, en términos de calidad de vida de personas mayores frágiles. Se realizará una revisión sistemática en las siguientes bases de datos: MEDLINE/PubMed, Scopus, Web of Sciences, CINAHL, CENTRAL, PEDro, LILACS y Epistemonikos. Para identificar ensayos clínicos aleatorizados que cumplan los criterios de elegibilidad propuestos. Los desenlaces primarios son calidad de vida y funcionalidad. Los secundarios son fuerza, equilibrio y capacidad cardiorrespiratoria. Además, se evaluará el riesgo de sesgo con la herramienta ROB-2 y la certeza de la evidencia con el sistema GRADE. Se realizará un metaanálisis si los procedimientos utilizados para evaluar los resultados del estudio son homogéneos, para ello se calcularán diferencias de medias con un intervalo de confianza del 95%. En caso contrario, se utilizarán diferencias de medias estandarizadas para determinar los tamaños del efecto. esperados Los principales hallazgos de esta revisión y metaanálisis contribuirán a tener más claridad sobre la efectividad de la terapia física aplicada en modalidad remota sincrónica. También identificará las variables en las cuales propicia efectos positivos. CRD42024605527.
7. Correction: Effect of Live Environmental Music Therapy and Prerecorded Music on State Anxiety, Stress, Pain, and Well-Being Levels of Patients and Caregivers in the Emergency Department Waiting Room: Protocol for a Multicenter Randomized Clinical Trial.
期刊: JMIR research protocols 发表日期: 2025-Aug-11 链接: PubMed
摘要
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8. Human-Centered Design and Digital Transformation of Mental Health Services.
期刊: JMIR human factors 发表日期: 2025-Aug-11 链接: PubMed
摘要
Mental health services face a multitude of challenges, such as increasing demand, underfunding, and limited workforce capacity. The accelerated digital transformation of public services is positioned by government, the private sector, and some academic researchers as the solution. Alongside this, human-centered design has emerged as a guiding paradigm for this transformation to ensure user needs are met. We define what digital transformation and human-centered design are, how they are implemented in the UK policy context, and their role within the evolving delivery of mental health services. The involvement of one of our coauthors (DP) in the design and delivery of these policies over the past 5 years provides unique insights into the decision-making process and policy story. We review the promises, pitfalls, and ongoing challenges identified across a multidisciplinary literature. Finally, we propose future research questions and policy options to ensure that services are designed and delivered to meet the mental health needs of the population.
9. Use of Digital Technology Among Older Adults in Poland With and Those Without Near Visual Impairment: Cross-Sectional Study.
期刊: Journal of medical Internet research 发表日期: 2025-Aug-11 链接: PubMed
摘要
The rapid evolution of digital technologies has transformed many aspects of daily life, offering substantial benefits for health and well-being through telemedicine and telehealth services. However, disparities in access to these technologies, particularly among older adults with visual impairments, remain a significant concern. This study aimed to examine the differences in access to and use of digital technologies between older adults in Poland with near visual impairment and those without. In addition, it explored how sociodemographic factors, such as education level and place of residence, interact with near visual impairment to influence digital technology access and usage. This cross-sectional analysis used data from the PolSenior2 project, a nationwide, multicenter survey conducted between 2018 and 2019. The sample included 5872 community-dwelling Polish adults aged 60 years and older, selected using a random, 3-stage, proportional sampling method, stratified by age and gender. Self-reported data on access to and usage of digital technologies, including smartphones, computers, and internet access, were collected. Near visual acuity was assessed using the Snellen chart for near vision. Older adults with near visual impairment had significantly lower adjusted odds of owning and using digital devices compared to those without visual impairment. Specifically, the adjusted odds ratio of having and knowing how to use a smartphone was 0.62 (95% CI 0.46-0.84), a computer 0.65 (95% CI 0.50-0.86), and having internet access 0.64 (95% CI 0.48-0.83), all indicating lower access among individuals with visual impairment. Furthermore, these individuals were less likely to use the internet for tasks such as searching for information about goods and services (adjusted odds ratio 0.65, 95% CI 0.49-0.86). Older adults with near visual impairment in Poland face significant barriers in accessing and using digital technologies. These disparities highlight the need for targeted interventions to bridge the digital divide and improve digital inclusion for visually impaired seniors, ensuring they can benefit from the advantages of digital health solutions. Further research is required to develop and evaluate strategies to promote digital equity in this vulnerable population.
10. Open Source Web Application (HealthTest) for Emotional Health and Wellness Management in University Students: Development and Usability Study.
期刊: Online journal of public health informatics 发表日期: 2025-Aug-11 链接: PubMed
摘要
Emotional health plays a fundamental role in quality of life, particularly after the COVID-19 pandemic, which has increased stress and anxiety, especially among children and young people. This study aimed to focus on the early identification of emotional processes that affect individuals’ well-being and their effective management. The open-source web app HealthTest was developed to help users understand and manage their emotions through tests focused on aspects such as stress, anxiety, and depression. The Open Source Scrum (OSCRUM) framework was used to optimize collaboration and effectively achieve objectives. HealthTest has established itself as a valuable tool for mental health professionals by gathering data from seventh-semester software engineering students and external users. It identifies trends in stress, anxiety, and depression through user self-assessments. In addition, it provides meditation and relaxation resources designed to support users in managing their emotional well-being. This study promotes accessibility to self-care and health care tools. HealthTest reaffirms its commitment to benefiting both mental health professionals and patients, providing an effective avenue for controlling and improving emotional well-being.
11. Personality Genomics.
期刊: Annual review of psychology 发表日期: 2025-Aug-11 链接: PubMed
摘要
Recent research advances have precipitated the era of personality genomics: the study of how variation in human DNA sequence predicts individual differences in characteristic patterns of thinking, feeling, and behaving. Here, we introduce personality and genomics, and we review key findings from recent genome-wide association studies of personality traits. These findings support five key observations: (a) sizable genetic effects on personality arise from a vast number of genetic variants with individually miniscule effects; (b) genetic variants associated with personality have widespread associations with other attributes, including social, economic, and medical outcomes; (c) genetic effects on personality generalize across groupings of people; (d) genetic effects on personality are minimally confounded by familial environmental effects; and (e) many recent genomic findings were anticipated by classic twin genetic research. For personality psychologists, embracing genomics provides unique and powerful inferential tools. For genomics researchers, incorporating unifying personality frameworks enables an integrative understanding of core behavioral dimensions.
12. A Deep Learning Framework for Using Search Engine Data to Predict Influenza-Like Illness and Distinguish Epidemic and Nonepidemic Seasons: Multifeature Time Series Analysis.
期刊: Journal of medical Internet research 发表日期: 2025-Aug-11 链接: PubMed
摘要
The seasonal influenza epidemic poses a persistent and severe threat to global public health. Web-based search data are recognized as a valuable source for forecasting influenza or other respiratory tract infection epidemics. Current influenza prediction studies typically focus on seasonal trends in traditional monitoring data, neglecting the sensitivity of different web-based search terms to seasonal changes, thereby increasing prediction challenges. The aim of this study was to propose a deep learning framework for different influenza epidemic states based on Baidu index and percentage of influenza-like illness (ILI%). Official weekly ILI% data from 2013 to 2024 were extracted from the Chinese National Notifiable Infectious Disease Reporting System (NIDRIS). Based on the Baidu index, influenza-related search indexes were acquired for the corresponding time periods. To explore the association between influenza-related search queries and ILI%, the study conducted a cross-correlation analysis. The study period was divided into influenza epidemic and nonepidemic period. The study finally used the convolutional long short-term memory (CLSTM) network framework to predict influenza epidemics with 1-3 weeks ahead for the all-time period and epidemic + nonepidemic period. The evaluation metrics included model stability metric, accuracy metrics, and explanatory power metric. The ILI% presented a regular seasonal high incidence in China. Meanwhile, the prediction of ILI% after dividing the epidemic and nonepidemic seasons (mean absolute percentage error [MAPE]=10.730%, mean square error [MSE]=0.884, mean absolute error [MAE]=0.649, root-mean-square error [RMSE]=0.940, and R2=0.877) was better than that of the all-time period (MAPE=12.784%, MSE=1.513, MAE=0.744, RMSE=1.230, and R2=0.786). In addition, we found that the ILI% + Baidu search index predicts better than only the ILI% regardless of the time period and lag time of the study. Comparative analysis with long short-term memory (LSTM) and transformer models demonstrated that CLSTM achieved superior performance in 1 week-ahead ILI% predictions using ILI% + Baidu index data in epidemic + nonepidemic period (MAPE=11.824%, MSE=1.243, MAE=0.723, RMSE=1.115, and R2=0.827). Furthermore, CLSTM comprehensively surpasses LSTM in computational efficiency, complexity, extrapolation capability, and stability while partially outperforming transformer models. This study shows strong potential for influenza prediction by combining Baidu index data with traditional surveillance and specific keywords for epidemic and nonepidemic seasons. It provides a new perspective for public health preparedness. This research is expected to support early warning systems for influenza and other diseases. Future work will further optimize these models for more timely and accurate predictions, enhancing public health responses.
13. Health Outcomes Beyond Age 50 Years in Survivors of Childhood Cancer: A Report From the Childhood Cancer Survivor Study.
期刊: Journal of clinical oncology : official journal of the American Society of Clinical Oncology 发表日期: 2025-Aug-11 链接: PubMed
摘要
There are limited data on the risk for mortality and health outcomes among the increasing population of older (age >50 years) survivors of childhood cancer during this later stage in life when there is an expected increase in aging-related morbidities. We assessed cause-specific mortality, incident new cancers, chronic health conditions (CHCs), frailty, and health status among survivors from the Childhood Cancer Survivor Study, conditional on surviving to 50 years. We calculated conditional survival rates, standardized mortality ratios (SMRs), and, for incident new cancers, cumulative burden, standardized incidence ratios (SIRs), and relative rates (RRs), compared with the general US population. RRs for CHCs and prevalence ratios for frailty and health status outcomes were calculated for survivors compared with siblings. Piecewise exponential regression identified risk factors. Among 7,490 childhood cancer survivors alive at age 50 years, subsequent 5-, 10-, and 15-year mortality risks were 8%, 18%, and 32%, respectively; overall SMR was 3.2 (95% CI, 3.0 to 3.4). SMRs were highest for death due to new cancer (SMR = 4.7; 95% CI, 4.2 to 5.2). In subset analysis, survivors without radiation therapy (RT) exposure had similar new cancer rates as the general population. The population attributable fraction of new cancers to RT was 40%. Survivors had >2-fold risk of severe, life-threatening, or fatal CHCs (any: RR, 2.6 [95% CI, 2.2 to 3.1]; multiple: RR, 3.3 [95% CI, 2.5 to 4.4]), specifically among survivors with history of RT exposure, compared with siblings. We identified no associations between chemotherapy and late health outcomes. Older survivors of childhood cancer continue to have an elevated burden of premature mortality, new cancers, and adverse health outcomes as they age. The increased risk for cancer and CHCs among these older survivors is associated with RT, but not chemotherapy, exposure.
14. Peer review: The good, the bad and the ugly.
期刊: Archives of environmental & occupational health 发表日期: 2025-Aug-11 链接: PubMed
摘要
15. Chilling Controversy: Cold-Stored Platelets for Prophylactic Transfusions.
期刊: Blood 发表日期: 2025-Aug-11 链接: PubMed
摘要
The FDA recently licensed 14-day cold-stored platelets for bleeding patients. This policy change represents a reversal from the 1970s when cold-stored platelets were discontinued because of their short circulation time in healthy humans. This change will increase their availability in US hospitals with large trauma populations and in remote and rural settings in the U.S. In some of these hospitals, cold-stored platelets will be the only platelets available. It is currently unclear whether patients with hypoproliferative thrombocytopenia who need platelet transfusion for prophylaxis benefit from cold-stored platelets. However, it is noteworthy that in recent clinical trials using room temperature-stored platelets, the transfusion interval in hematology-oncology patients can be as short as one transfusion per day, very similar to what one would expect to achieve with cold-stored platelets. Furthermore, the emphasis on the post-transfusion count increment and the platelet count as transfusion trigger per se is questionable. In the PLADO trial, there was only a poor correlation between the morning platelet count and bleeding events, implicating other factors, such as red blood cells, coagulation factors, and vascular health, as possible culprits. In this perspective article, we review the history of cold platelets and the reason for their discontinuation, focus on recent clinical trial data using room temperature-stored platelets, and review the platelet count as a transfusion trigger. Overall, using cold platelets for prophylaxis may seem counterintuitive, but a closer look at the available data suggests that the indication expansion may hold more promise.
16. Development of an affordable multiplex quantitative RT-PCR assay for early detection and surveillance of Dengue, Chikungunya, and co-infections from clinical samples in resource-limited settings.
期刊: PLoS neglected tropical diseases 发表日期: 2025-Aug-11 链接: PubMed
摘要
Dengue and Chikungunya are Aedes-borne diseases that are predominantly prevalent in tropical and subtropical regions, affecting public health globally. Dengue is caused by multiple antigenically different Dengue virus (DENV) serotypes (DENV-1 to DENV 4) in the Flaviviridae family and Chikungunya (CHIKV) in the Togaviridae family. The overlapping clinical presentation of both diseases, particularly in early infection, complicates timely and differential diagnosis. In India, diagnosis primarily relies on rapid antigen-based or ELISA-based tests, which are prone to false negatives, leading to underreported disease burden. In resource-limited settings, the absence of confirmatory diagnostics often leads to reliance on clinical symptoms and epidemiological data, increasing the risk of misdiagnosis and undetected co-infections. To address these diagnostic limitations, we developed DENCHIK, a multiplex, quantitative real-time PCR (qRT-PCR) assay for the simultaneous detection of DENV serotypes and CHIKV. Between July and December 2022, a total of 903 serum samples from febrile patients across 161 public health centers in Bengaluru were analyzed. The performance of the DENCHIK assay was compared with ELISA-based tests (NS1 antigen and IgM antibody detection) and two commercially available qRT-PCR assays for DENV and CHIKV. Using the DENCHIK assay, 36% of samples were tested positive for DENV, 17% for CHIKV and 8% were tested positive for co-infections. In contrast, ELISA detected 29.90% of DENV and 22.92% of CHIKV infections. We observed a 9% DENV infection using NS1 ELISA and 24% by IgM ELISA, highlighting discrepancies between antigen-and antibody-based tests. Among DENV serotypes, DENV-1 was the most prevalent serotype followed by DENV-2, DENV-3, and DENV-4. A seasonal increase in cases was observed from June to September 2022, coinciding with the monsoon season. No significant difference in prevalence was noted across gender and age groups. DENCHIK demonstrated a sensitivity of 62.82% and specificity of 66.45% for DENV detection compared to NS1 ELISA. When evaluated against commercial qRT-PCR assays, DENCHIK exhibited superior performance with 99% sensitivity and 98% specificity for DENV detection. For CHIKV, DENCHIK showed 26% sensitivity, and 86% specificity compared to IgM ELISA, while achieving 98% sensitivity and specificity relative to commercial qRT-PCR assays. DENCHIK assay successfully enabled simultaneous amplification of all four DENV serotypes and Chikungunya, from clinical samples. DENCHIK assay detected 7.6% additional Dengue infections and 6.65% fewer Chikungunya infections in clinical samples, demonstrating enhanced diagnostic accuracy. With higher sensitivity and specificity, DENCHIK allows for early detection from day one of symptom onset, improving the estimation of true disease prevalence and mitigating misdiagnosis associated with ELISA-based methods. The integration and surveillance of molecular assays, such as DENCHIK, will enhance epidemiological monitoring of circulating DENV serotypes, CHIKV, and co-infections. These advancements will provide critical insights for public health authorities, enabling them to prioritize treatment, implement effective control measures, and mitigate the transmission of arboviral infections.
17. New insights into lactate in exercise adaptations: does protein lactylation play a role?
期刊: American journal of physiology. Endocrinology and metabolism 发表日期: 2025-Aug-11 链接: PubMed
摘要
Physical activity and exercise are widely recognized as effective ways to promote physical fitness and prevent disease; however, their underlying molecular mechanisms remain to be fully elucidated. Within the last few years, the discovery of lactylation has propelled the well-known exercise metabolite lactate into the scientific spotlight. As the end product of glycolysis, lactate was initially considered to be a “metabolic waste” leading to muscle fatigue; however, subsequent studies have demonstrated the importance of lactate as an energy substrate and a signal transduction molecule to coordinate various physiological processes. Importantly, the novel posttranslational modification, lactylation, establishes a bridge between lactate and epigenetics, and provides new perspectives for understanding the role of the lactate in exercise-mediated health promotion. Although some recent evidence in rodents suggests that exercise increases protein lactylation, there are mixed findings in this area with limited human studies showing no effects. This review summarizes current knowledge of exercise mediated lactylation, why mixed findings in the literature may exist, and suggests future research that can add further clarity to this area of molecular biology.
18. Idiopathic Mixed Neutrophilic Panniculitis of the Eyelid: An Unusual Finding.
期刊: Ophthalmic plastic and reconstructive surgery 发表日期: 2025-Aug-11 链接: PubMed
摘要
Panniculitis is an inflammatory condition typically presenting with painful, erythematous subcutaneous nodules on the extremities, often linked to systemic diseases such as lupus or erythema nodosum. Eyelid involvement is rare and has not been previously reported as an isolated finding. We report the case of a 74-year-old woman referred with presumed preseptal cellulitis secondary to a stye. Clinical signs included conjunctival chemosis, malar edema, and a firm, deep-seated mass in the inferolateral right lower eyelid. Orbital MRI revealed a well-defined lesion with homogeneous enhancement and surrounding inflammation. An excisional biopsy showed mature adipose tissue infiltrated by a polymorphous inflammatory cell population, predominantly neutrophils and eosinophils. Immunohistochemistry revealed a CD4>CD8 T-cell predominance. The lesion was diagnosed as idiopathic mixed neutrophilic panniculitis with no evidence of vasculitis or malignancy. This case represents the first report of isolated eyelid panniculitis, expanding the differential diagnosis of periocular inflammatory lesions.
19. Management of patients with heart failure at high risk of hyperkalaemia: The CARE-HK in HF registry.
期刊: European journal of heart failure 发表日期: 2025-Aug-11 链接: PubMed
摘要
Patients with heart failure (HF) at high risk for hyperkalaemia are underrepresented in prospective HF registries. The CARE-HK in HF registry sought to characterize prospectively the clinical profile, management, and outcomes for patients with HF at high risk of hyperkalaemia. CARE-HK in HF was a multinational prospective registry of outpatients with HF (regardless of left ventricular ejection fraction [LVEF]) treated with an angiotensin-converting enzyme inhibitor/angiotensin II receptor blocker/angiotensin receptor-neprilysin inhibitor (ACEI/ARB/ARNI) and either receiving or potential candidate for a mineralocorticoid receptor antagonist (MRA). All patients were at increased risk of hyperkalaemia, defined as hyperkalaemia at baseline, prior hyperkalaemia, or estimated glomerular filtration rate (eGFR) <45 ml/min/1.73 m2. Outcomes included frequency of hyperkalaemic events (defined by clinician report with associated potassium value), achievement of renin-angiotensin system inhibitor (RASi) optimization (defined as ≥50% target doses for ACEI/ARB/ARNI and MRA), medication changes following hyperkalaemic episodes, and clinical events. Overall, 2558 patients from 111 sites across nine countries were included. Median (25th-75th) age was 73 (65-80) years, 32% were women, 61% had LVEF ≤40%, and 40% had prior laboratory evidence of hyperkalaemia. Median baseline eGFR and serum potassium were 44 (33-60) ml/min/1.73 m2 and 5.0 (4.4-5.3) mEq/L, respectively. Over a median follow-up of 12.3 (9.4-18.1) months, 29% of patients had a hyperkalaemic event, and 7% had multiple events. In characterizing treatment prescribed for most of follow-up, 29% of patients received optimal RASi/MRA therapy, 69% received suboptimal RASi/MRA therapy, and 3% received no RASi/MRA. In the 30 days following the first hyperkalaemic event, RASi/MRA was down-titrated or discontinued in 3.6% of cases. Potassium binder use was low (patiromer 9.1%, sodium zirconium cyclosilicate 5.9%). Compared with patients without a hyperkalaemic event, patients experiencing a hyperkalaemic event had similar risk of all-cause mortality (hazard ratio [HR] 1.22, 95% confidence interval [CI] 0.92-1.62, p = 0.16) and a higher risk of subsequent hospitalization (HR 1.59, 95% CI 1.35-1.86, p < 0.001). In this contemporary multinational prospective registry of patients with HF at high risk for hyperkalaemia, hyperkalaemic events were common but infrequently associated with RASi/MRA modification or potassium binder use. Fewer than one in three patients received optimal RASi/MRA therapy for the majority of follow-up, and hyperkalaemic events were associated with higher risk of adverse clinical outcomes. ClinicalTrials.gov NCT04864795.
20. Intravenous Methamphetamine Use, HIV Status and PrEP Uptake Among a U.S. Sample of 29,880 Gender and Sexual Minorities, 2022-2023.
期刊: AIDS and behavior 发表日期: 2025-Aug-11 链接: PubMed
摘要
Methamphetamine use is prevalent among sexual and gender minority (SGM) populations and is associated with increased risk for HIV acquisition. Studies are needed to examine the prevalence of intravenous methamphetamine use and explore its association with HIV status and PrEP uptake. Between August 2022-July 2023, 29,880 SGM people who have sex with men in the U.S. aged 16 and over completed a screening survey for a cohort study on methamphetamine use and HIV prevention. The survey captured socio-demographic characteristics, methamphetamine use (any and injection) and other substance use, and HIV-related measures (including current and previous PrEP use). The median age was 34 years and 49.7% were persons of color. Overall, 35.0% reported methamphetamine use; of whom 45.1% had injected it in the prior 12 months. Compared to people with non-injection methamphetamine use, respondents who injected methamphetamine were more likely to be older, white (vs. non-Hispanic Black or Hispanic), living with HIV or not know their status (vs. HIV-negative), to have injected cocaine, and to have had a sexual encounter without consent under the influence of alcohol/drugs. Among those who were HIV-negative, people who injected methamphetamine were less likely to currently take PrEP and more likely to have discontinued PrEP compared to those who reported non-injection methamphetamine use. Expanded efforts are needed to develop and implement targeted interventions, including PrEP and harm reduction approaches for SGM people who inject methamphetamine, to reduce risk of HIV and other infectious diseases, as well as other injection-related harms.
21. Redistribution of fragmented mitochondria ensures symmetric organelle partitioning and faithful chromosome segregation in mitotic mouse zygotes.
期刊: eLife 发表日期: 2025-Aug-11 链接: PubMed
摘要
In cleavage-stage embryos, preexisting organelles partition evenly into daughter blastomeres without significant cell growth after symmetric cell division. The presence of mitochondrial DNA within mitochondria and its restricted replication during preimplantation development makes their inheritance particularly important. While chromosomes are precisely segregated by the mitotic spindle, the mechanisms controlling mitochondrial partitioning remain poorly understood. In this study, we investigate the mechanism by which Dynamin-related protein 1 (Drp1) controls the mitochondrial redistribution and partitioning during embryonic cleavage. Depletion of Drp1 in mouse zygotes causes marked mitochondrial aggregation, and the majority of embryos arrest at the 2 cell stage. Clumped mitochondria are located in the center of mitotic Drp1-depleted zygotes with less uniform distribution, thereby preventing their symmetric partitioning. Asymmetric mitochondrial inheritance is accompanied by functionally inequivalent blastomeres with biased ATP and endoplasmic reticulum Ca2+ levels. We also find that marked mitochondrial centration in Drp1-depleted zygotes prevents the assembly of parental chromosomes, resulting in chromosome segregation defects and binucleation. Thus, mitochondrial fragmentation mediated by Drp1 ensures proper organelle positioning and partitioning into functional daughters during the first embryonic cleavage.
22. Investigation and laboratory characterization of the fifteenth U.S. case of vancomycin-resistant Staphylococcus aureus - Michigan, 2021.
期刊: Infection control and hospital epidemiology 发表日期: 2025-Aug-11 链接: PubMed
摘要
23. Hand-Held Nanoelectrospray Ionization with Frequency and Amplitude Tunability for Metabolomics of Saline Biosamples.
期刊: Analytical chemistry 发表日期: 2025-Aug-11 链接: PubMed
摘要
Pulsed nanoelectrospray ionization (nanoESI) mass spectrometry has been proven to have several merits compared to its direct current (DC) counterparts, such as high sensitivity, high matrix tolerance, and low electrochemical interference. However, the reliance on external devices like signal generators and power amplifiers limits the technology’s suitability for on-site use. Here, we developed a frequency-amplitude tunable hand-held pulsed high-voltage supply specifically designed for nanoESI. This portable detection system eliminates reliance on bulky ancillary equipment of conventional approaches, with a total mass of 185 g and an ergonomic hand-held configuration. Through systematic modulation of frequency (10-50 kHz) and voltage (1.5-6 kV), the device achieves optimal detection performance across diverse analytical standards and complex matrixes, including serum and cellular samples. The pulse-induced self-cleaning effect prevented nozzle clogging while maintaining functionality under high-salt conditions (855 mM NaCl). To demonstrate clinical applicability, we analyzed 198 serum specimens (100 from atherosclerotic cardiovascular disease patients (ASCVD) and 98 age-matched controls), identifying statistically significant dysregulation of multiple metabolites in the ASCVD cohort and achieving a diagnostic accuracy of 85%. Field deployment trials using portable mass spectrometers further validated the system’s potential for rapid on-site diagnostics, establishing a new paradigm for point-of-care analytical technology.
24. A guide to diagnosing and managing dental pain and infections.
期刊: JAAPA : official journal of the American Academy of Physician Assistants 发表日期: 2025-Aug-11 链接: PubMed
摘要
Dental pain, infections, and abscesses are common concerns in primary care settings. Prompt diagnosis and targeted management are essential to prevent severe complications such as sepsis, bone or soft tissue loss, and airway compromise. This article provides physician associates and other clinicians with practical, evidence-based strategies to identify and manage odontogenic infections, distinguish between infectious and noninfectious dental pain, and select appropriate antibiotic regimens, with special attention to antibiotic resistance trends. It also highlights circumstances under which collaboration with dental specialists becomes necessary and emphasizes patient education to prevent recurrence. By bridging knowledge gaps in dental health management, this article empowers clinicians to address these conditions confidently in outpatient settings, improving patient outcomes, reducing unnecessary ED visits, and lowering healthcare costs.
25. Population genomics of Aedes albopictus across remote Pacific islands for genetic biocontrol considerations.
期刊: PLoS neglected tropical diseases 发表日期: 2025-Aug-11 链接: PubMed
摘要
Remote Pacific islands (RPI) are characterized by ecological isolation, diverse endemic species, and vulnerability to invasive organisms due to globalization-driven connectivity. Among these species, Aedes albopictus, a highly invasive vector of flaviviruses, has spread extensively across the RPI via human-mediated dispersal, posing significant health and economic burdens. While the population structure and the degree of gene flow between mosquito populations can inform the dispersal pathways critical for disease vector management, the population genetics of Ae. albopictus in Northern RPI remains understudied. The present work investigated the population structure and connectivity of Ae. albopictus populations from Guam, Hawaiian Islands, and the Republic of the Marshall Islands (RMI) to inform disease and vector-based biosecurity risks and develop targeted management strategies. This is the first assessment to develop and analyze whole genome sequences of Ae. albopictus for RPI, enabling more accurate estimates of differentiation, admixture, and ancestry. We found distinct genetic clustering between regions, distinct ancestry of populations across RPI, and potential invasions that originated from Hawaii and spread into the RMI, and invasions from North America that spread to Guam. These findings can inform biosecurity protocols to limit the invasion of Ae. albopictus and their associated diseases within Hawaii and around the Pacific. Given the significant degree of genetic differentiation, we found between islets, islands, and regions, the genome data from this study can be used to enable the development of locally confined geographically isolated gene drives. These drives may be used to prevent and control outbreaks of dengue, chikungunya, and Zika, diseases that have had devastating consequences in these remote island communities.
26. Immune Cell Membrane Protrusions: A Sensory Organelle.
期刊: Annual review of cell and developmental biology 发表日期: 2025-Aug-11 链接: PubMed
摘要
Immune cells possess a remarkable set of complementary surface protrusions, such as microvilli, podosomes, filopodia, and lamellipodia, which play pivotal roles in the sensing of and responding to varied environmental cues. These dynamic structures maximize the surface area-to-volume ratio of immune cells, which in turn enhances cell-cell and cell-matrix interactions, while generating pulling and pushing forces, allowing immune cells to integrate biochemical and physical cues from their surroundings. This review discusses recent insights into the structures and dynamics of different protrusions, the molecular machinery behind mechanosensing, the differential role of protrusions for different subsets of immune cells, and the cutting-edge technology that has advanced our understanding of those protrusions.
27. Enhanced Macrophage Internalization of Photoaged Nanoplastics Mediated by Altered Serum Albumin Secondary Structure.
期刊: Environmental science & technology 发表日期: 2025-Aug-11 链接: PubMed
摘要
After nanoplastics (NPs) experience photoaging in an aquatic environment, they may enter blood circulation of organisms and interact with proteins, which significantly affect their cellular uptake and biological effects. In this study, polystyrene nanoplastics (PSNPs) and human serum albumin (HSA) were chosen as representative models of NPs and proteins, respectively. The photoaged PSNPs exhibited decreased particle size and increased surface oxidation, which not only promoted their binding with HSA but also led to preferential binding with the α-helix regions of HSA. Consequently, the α-helical content of the adsorbed HSA molecules on photoaged PSNPs decreased significantly, leading to a denaturation effect comparable to thermal treatment. Dissolved substances released from PSNPs had a negligible impact on HSA’s conformation. The denatured HSA activated additional endocytic pathways, notably enhancing SR-A1-mediated endocytosis of mouse monocyte macrophages (RAW 264.7), which thus promoted the cellular uptake of the photoaged PSNPs compared with pristine ones. This study suggests that photoaging may greatly alter the interactions of NPs with proteins, thereby influencing cellular uptake mechanisms, and then alter their potential biodistribution and biological effects in vivo.
28. Radiometric study and associated radiological hazards in soil near the Bheramara 410 MW Combined Cycle Power Plant, Kushtia, Bangladesh.
期刊: Isotopes in environmental and health studies 发表日期: 2025-Aug-11 链接: PubMed
摘要
This pioneering study assesses the radiological risk of naturally occurring radionuclides in soil around the Bheramara 410 MW Combined Cycle Power Plant (natural gas and high-speed diesel) in Kushtia, Bangladesh. Thirty soil samples were collected at radial distances of 50 m, 500 m, 1000 m, and 3000 m from the plant, these distances were strategically selected to represent immediate proximity (50 m), near-field (500 m), mid-range (1000 m), and far-field (3000 m) zones, enabling a gradient analysis of potential radiological impact. Using high-purity germanium (HPGe) gamma-ray spectrometry, the activity concentrations of 226Ra, 232Th, and 40K were found to range from 20 ± 2 to 28 ± 3 Bq/kg, 25 ± 2 to 41 ± 4 Bq/kg, and 310 ± 21 to 440 ± 34 Bq/kg, respectively. While 226Ra concentrations were below the global average (30 Bq/kg), some measured values of 232Th exceeded the global average of 35 Bq/kg, and 40K concentrations in certain samples were higher than the global average of 400 Bq/kg. No detectable 137Cs was observed, confirming no artificial contamination. Radiological hazard indices such as radium equivalent activity (mean: 100.60 Bq/kg), outdoor absorbed dose rate (mean: 48.56 nGy/h), outdoor annual effective dose (mean: 0.06 mSv/year), external hazard index (mean: 0.27), gamma representative level index (mean: 0.74), and excess lifetime cancer risk (mean: 0.22 × 10-3) were all within recommended safety limits. Various statistical analyses, including descriptive statistics, Pearson correlation, principal component analysis (PCA), and hierarchical cluster analysis (HCA), were performed and these revealed that 226Ra and 232Th were the main contributors to radiological risk, while 40K showed weaker associations. The findings suggest that the soil is safe for agricultural and construction use, but routine monitoring is recommended to ensure environmental protection. This study provides essential baseline data and analytical insight into radiological risk management in power generation industrial regions of Bangladesh.
29. Quantitative Structure-Retention Relationship Approach in Assessing the Chloroacetamides' Biological Profile.
期刊: Chemistry & biodiversity 发表日期: 2025-Aug-11 链接: PubMed
摘要
Chloroacetamides (CAAs) are an important class of synthetic herbicides long utilized in agriculture for their strong weed-control efficacy. However, their environmental and health impacts have raised significant concerns. Therefore, both the structural modification of known active compounds and the identification and design of new compounds with desirable properties and biological activity represent a significant challenge in pesticide chemistry. The bioactivity parameters of 18 new chloroacetamide derivatives were evaluated by using both in silico and chromatographic approaches. Correlation of chromatographic parameters with software-derived log P and EC50 values by linear regression analysis identified key structural factors affecting their lipophilicity and potential toxicity to non-target organisms. Multivariate analysis revealed and quantified that the total number of carbon atoms in the molecule (determines lipophilicity), along with the chemical nature of the hydrocarbon substituent (affects water solubility), plays a major role in shaping the biological profile of the tested derivatives. Moreover, it was found that the number of rotatable bonds significantly influences their toxicity. Furthermore, the results show that chromatographic parameter RM 0 can serve as an alternative measure of lipophilicity, while the parameter m can indicate toxicity of the analyzed CCAs’.
30. ACOEM Guidance Statement: Harnessing Occupational and Environmental Medicine Expertise to Transform Medical Care: A Catalyst for Mitigating the Human Health Impacts of Climate Change.
期刊: Journal of occupational and environmental medicine 发表日期: 2025-Aug-11 链接: PubMed
摘要
31. The impact of age stigma on recommendations of technology for older adults in rehabilitation settings: a secondary analysis of qualitative data.
期刊: Disability and rehabilitation. Assistive technology 发表日期: 2025-Aug-11 链接: PubMed
摘要
This exploratory study provides preliminary insights into how age-related stigma impacts the adoption of technology-based interventions in rehabilitation practices. Our goal is to raise awareness about how our assumptions regarding aging can influence the quality of care provided to older adults. A better understanding of how stigmatizing beliefs by rehabilitation health care professionals might be a barrier to the recommendation of technology for older adults.To promote discussion about age-related stigma in geriatric education, research and clinical practices related to the adoption of technology.
32. Sex Differences in Mortality and Health Care Utilization After Dementia Diagnosis.
期刊: JAMA neurology 发表日期: 2025-Aug-11 链接: PubMed
摘要
Sex differences may contribute to disparities in dementia outcomes. To understand the association between sex and mortality and health care services use after dementia diagnosis. This nationwide cohort study used Medicare enrollment data and took place from 2014 to 2021 with up to 8 years of follow-up. Analysis was performed from April 2024 to April 2025. This study included 5 721 711 patients 65 years or older with International Statistical Classification of Diseases and Related Health Problems, Tenth Revision diagnosis codes for dementia with at least 1 year of prior fee-for-service Medicare enrollment. Sex, determined from Medicare enrollment data, derived from Social Security Administration records. The primary outcome was hazard of all-cause mortality, estimated with Cox proportional hazard regression. Secondary outcomes included hazards of use of common health care services, such as all-cause hospitalizations, skilled nursing facility stays, receipt of neuroimaging services, and physical/occupational therapy. A total of 5 721 711 patients (3 302 579 female and 2 419 132 male) with incident dementia between 2014 and 2021 were included in the study. Female patients had lower crude 1-year mortality rates (21.8% vs 27.2% for male patients; P < .001) and lower rates of all-cause hospitalizations (46.9% vs 50.5%; P < .001). The unadjusted hazard of death associated with male sex was 1.30 (95% CI, 1.29-1.31; P < .001). After adjustment for age, race and ethnicity, Medicaid dual eligibility, medical comorbidity burden, and access to health care resources, the association was modestly attenuated (adjusted hazard ratio, 1.24; 95% CI, 1.23-1.26; P < .001). Similarly, the unadjusted hazard ratio of all-cause hospitalization associated with male sex was 1.13 (95% CI, 1.12-1.14; P < .001); the adjusted hazard ratio was 1.08 (95% CI, 1.08-1.09; P < .001). Male patients also had increased hazards of hospice stay, neuroimaging services, and hospitalization for neurodegenerative disease diagnosis or behavioral disturbance. In this study, male patients with dementia had higher mortality rates and higher use of many health care services, especially hospital stays, than comparable female patients. Strategies to slow mortality and decrease health care use among male patients with dementia may be particularly impactful in limiting the burden of dementia. Given higher incidence of dementia among women, a focus on efforts to prevent dementia is necessary to achieve population-level health equity in dementia-attributable mortality by sex.
33. Return to Work or Not: The Paths to Psychiatric Disability and Back.
期刊: Journal of occupational rehabilitation 发表日期: 2025-Aug-11 链接: PubMed
摘要
Mental health-related work disability has increased in Europe, despite efforts to promote individuals´ work ability. We examined individuals´ occupational status before and after a psychiatric disability pension (DP). The study comprises individuals granted a DP for the first time between 2010 and 2012 in Finland (N = 18,373). We used modern methods to cluster the sequences of individuals´ occupational status before and after temporary (n = 8615) or permanent (n = 9758) psychiatric DP. We compared socioeconomic, illness and health care system-related factors between nine groups, formed by sequence analysis utilizing multinominal regression analysis. The analysis identified typical groups of temporary pensioners: after steady working careers, periods of unemployment and from mixed states. Severity of health and mental health problems, socioeconomic and occupational status, pension system-related factors as well as treatment or rehabilitation varied between the groups. Individuals with temporary DPs (tDP) appeared mainly to either remain disabled (74% of the study tDP) or return to the same status they had before disability: to work (17%) or unemployment (8%). A steady working career, high education and received psychotherapy and rehabilitation all promoted returning to work. Among young adults, severity of the illness and lack of occupational education were risk factors for long-term disability. Among those with tDP, circles of disadvantage may exist. They relate to unemployment, poor mental and somatic heath, low education, poverty, and failure of rehabilitative efforts. Especially young adults with severe mental disorders require not only rehabilitation but also educational support.
34. A Prospective Study to Determine Trimester-Specific Thyroid Function Reference Intervals.
期刊: Journal of endocrinological investigation 发表日期: 2025-Aug-11 链接: PubMed
摘要
Precise thyroid function assessment during pregnancy prevents inaccurate diagnosis of thyroid disease. This study aimed to establish trimester-specific reference intervals for thyroid function tests (TFTs) in Taiwanese pregnant women and analyze thyroid hormone and anti-thyroid antibody changes through gestation. This prospective study at Taipei Veterans General Hospital (2019-2022) included 209 pregnant women. After excluding those with positive anti-thyroid antibodies, use of thyroid-related medications, or plans for abortion, 123 participants were eligible for thyroid function reference interval analysis. TFTs including thyroid-stimulating hormone (TSH), free T4, total T4, free T3, and total T3 along with antibodies were measured once per trimester using a Roche electrochemiluminescence immunoassay. One spot urine sample from each woman was collected at baseline to ensure iodine adequacy and urinary iodine concentration was measured by inductively coupled mass spectrometry. The median urinary iodine concentration was 162.5 µg/L, indicating that the analyzed population had sufficient iodine status. TSH levels were significantly lower in the first trimester (0.007-3.08 µIU/mL) compared to the second (0.33-4.55 µIU/mL) and third trimesters (0.29-4.64 µIU/mL) (p < 0.001). Levels of free T4 and free T3 decreased consistently throughout pregnancy (p < 0.001), while total T3 levels remained stable. In contrast, total T4 levels, anti-thyroid peroxidase antibody titers, and the proportion of women with positive anti-thyrotropin receptor antibodies were higher in the first trimester compared to the second and third trimesters. This study underscores the importance of trimester-specific, population-based reference intervals for TFTs using the Roche assay and represents the first investigation in Taiwanese populations.
35. Exploring the feasibility, acceptability and preliminary efficacy of a Home-Based stretching program for adults with fibromyalgia: a prospective Pre-Post feasibility study.
期刊: Rheumatology international 发表日期: 2025-Aug-11 链接: PubMed
摘要
People with fibromyalgia face physical and cognitive impairments and are often intolerant to physical activity, making adherence to physical therapy a significant challenge. This prospective pre-post feasibility study aimed to explore the feasibility and acceptability of a six-week home-based stretching intervention for people with fibromyalgia. People aged 18-55 years diagnosed with fibromyalgia were eligible for participation. Participants were offered a home-based stretching intervention with weekly follow-up via a mHealth app. Semi-structured online focus group interviews were conducted to gain insight into the participants’ experience and acceptance of the intervention. Quantitative assessments included the Revised Fibromyalgia Impact Questionnaire, the SF-36, pressure pain thresholds, range of motion, and self-reported adherence. 12 females were recruited over 43 days. One participant withdrew from the study due to illness. The adherence rate was high. Four major themes emerged from the interviews: (1) Factors motivating participation, (2) The advantages of exercising at home, (3) Influence of weekly communication and (4) Potential areas for improvement. Qualitative findings suggest that the intervention was well tolerated and easily implemented in daily life. There were clinically relevant improvements in health-related quality of life, physical health, and mental health scores. A six-week home-based stretching program, supervised via an mHealth application, proved feasible and acceptable for individuals with FM and showed promising clinical outcomes. Based on insights from this feasibility study, an RCT is planned to evaluate whether the program of home-based stretching exercises provides greater benefits than usual care alone in enhancing quality of life and functional outcomes in patients with FM. Trial registration number: NCT06176053. Date of registration: 12/08/2023.
36. An approach to capturing the cultural contexts of health behaviours.
期刊: Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz 发表日期: 2025-Aug-11 链接: PubMed
摘要
This paper explores the relationship between cultural contexts and health behaviours, emphasising the need for a comprehensive understanding of cultural influences and acknowledging the limitations of current approaches to health behaviours in unpacking cultural dimensions of health behaviours. We argue that health behaviours, which are integral to achieving good health and health equity, are deeply intertwined with the cultural frameworks within which they occur. In response to an increasing recognition among health authorities of the importance of health behaviours and their cultural dimensions, the paper discusses (1) the role of culture in shaping health behaviours, (2) the intersectionality of cultural identities, and (3) the systemic factors that contribute to health inequities. Using the World Health Organization Tailoring Health Programmes approach as a framework, we propose an approach to health programmes and policies that is behaviourally informed and culturally grounded. By advocating for a participatory, community-engaged approach and emphasising the importance of disaggregated data, the paper aims to inform future public health strategies that are more equitable, responsive, and effective in promoting health behaviours across diverse populations. In diesem Beitrag wird die Beziehung zwischen kulturellen Kontexten und Gesundheitsverhalten untersucht, wobei die Notwendigkeit eines umfassenden Verständnisses kultureller Einflüsse hervorgehoben wird. Zudem werden die Grenzen aufgezeigt, die derzeitige Ansätze zur Erforschung des Gesundheitsverhaltens haben, wenn es darum geht, dessen kulturelle Dimensionen zu entschlüsseln. Gesundheitsverhalten ist für gute, chancengleiche Gesundheit unerlässlich, und wir argumentieren, dass es eng mit den kulturellen Rahmenbedingungen verwoben ist, in denen Gesundheit auftritt. Als Reaktion auf die zunehmende Anerkennung der Bedeutung von Gesundheitsverhalten erörtert der Artikel: (1) die Rolle der Kultur bei der Beeinflussung des Gesundheitsverhaltens, (2) die Überschneidung kultureller Identitäten und (3) die systemischen Faktoren, die zu gesundheitlichen Ungleichheiten beitragen. Auf der Grundlage des WHO-Konzepts für maßgeschneiderte Gesundheitsprogramme (Tailoring Health Programmes, THP) schlagen wir einen Ansatz für gesundheitsbezogene Programme und politische Maßnahmen vor, die sowohl verhaltensorientiert als auch kulturell verankert sind. Wir plädieren für einen partizipativen, gemeinschaftsorientierten Ansatz und betonen die Bedeutung von nach Subgruppen aufgeschlüsselten Daten. Dadurch soll der Artikel Informationen für künftige Public-Health-Strategien liefern, die gerechter, reaktionsfähiger und effektiver bei der Förderung des Gesundheitsverhaltens in unterschiedlichen Bevölkerungsgruppen sind.
37. Prenatal pyrethroid exposure, placental gene network modules, and neonatal neurobehavior.
期刊: International journal of hygiene and environmental health 发表日期: 2025-Aug-10 链接: PubMed
摘要
Prenatal pesticide exposure may adversely affect child neurodevelopment which may partly arise from impairing the placenta’s vital role in fetal development. In a cohort of pregnant farmworkers from Thailand (N = 248), we examined the links between urinary metabolites of pyrethroid pesticides during pregnancy, placental gene expression networks derived from transcriptome sequencing, and newborn neurobehavior assessed using the NICU Network Neurobehavioral Scales (NNNS) at 5 weeks of age. Focusing on the 21 gene network modules in the placenta identified by Weighted Gene Co-expression Network Analysis, our analysis revealed significant associations between metabolites and nine distinct modules, and between thirteen modules and NNNS, with eight modules showing overlap. Notably, stress was negatively associated with the interferon alpha response and Myc target modules, and the interferon alpha response module was correlated positively with attention, and negatively with arousal, and quality of movement. The analysis also highlighted the early and late trimesters as critical periods for the exposures influence on placental function, with pyrethroid metabolites measured early in pregnancy significantly negatively associated with the protein secretion module, and those measured later in pregnancy negatively associated with modules related to oxidative phosphorylation (OXPHOS) and DNA repair. Additionally, the cumulative sum of 3-phenoxybenzoic acid across pregnancy was significantly negatively associated with the OXPHOS module. These findings suggest that prenatal exposure to pyrethroids may influence neonatal neurobehavior through specific placental mechanisms that impact gene expression of metabolic pathways, and these effects may be pregnancy period specific. These results offer valuable insights for future risk assessment and intervention strategies.
38. Evaluation of Surgical Costs Associated With Total Ankle Arthroplasty.
期刊: The Journal of the American Academy of Orthopaedic Surgeons 发表日期: 2025-Aug-08 链接: PubMed
摘要
Growing attention is being paid to the costs associated with various orthopaedic surgeries, but limited data exist on the costs associated with total ankle arthroplasty (TAA). This study compared surgical costs between two established TAA systems (Zimmer Trabecular Metal and Salto Talaris). Patients who underwent primary TAA were retrospectively identified at one academic institution from 2012 to 2024. Total direct costs, facility costs, and implant costs were assessed using an institutional Value Driven Outcome tool which includes an item-level database capturing detailed cost data. Costs were converted to equivalent 2022 US dollars and analyzed using gamma regression adjusting for age, body mass index (BMI), surgery location, and year of surgery to report cost ratios with 95% confidence intervals (CIs). TAA costs over time were also studied. In total, 208 patients who underwent primary TAA were analyzed. Total direct costs and facility costs increased over time for both Zimmer Trabecular Metal (N = 177) and the Salto Talaris (N = 31) implants. The rate of the cost increase was faster for Salto Talaris at 6% per year (ratio 1.06, 95% CI, 1.04 to 1.07) compared with Zimmer Trabecular Metal at 1.4% per year (ratio 1.014, CI, 1.008 to 1.02; P < 0.001). Total surgical time was longer for the Zimmer Trabecular Metal group (median 3.3 hours, interquartile range, 3.0 to 3.7) compared with the Salto Talaris group (median 3.1 hours, interquartile range, 2.8 to 3.3; P = 0.034). Implant costs constituted the bulk of total direct costs for the Salto Talaris (70%) and Zimmer Trabecular Metal (67%) groups. Comparing TAA surgeries with either the Zimmer Trabecular Metal or Salto Talaris implants, total direct costs for each arthroplasty type rose at different rates over time. As increasing numbers of total ankle systems enter the marketplace, it will be important to better understand surgical costs given the expanding utilization of TAA. Level III, retrospective comparative study.
39. Postoperative Opioid Prescribing Among Adults with Disabilities After a Medicare Opioid Limit Policy.
期刊: Annals of surgery 发表日期: 2025-Aug-08 链接: PubMed
摘要
Determine whether a Medicare 7-day limit on initial opioid prescriptions (effective January 1, 2019) was associated with reductions in duration, dosage, and subsequent opioid fills among post-operative adults with disabilities. Post-operative adults with disabilities are at increased risk for uncontrolled pain and extended opioid use. We identified adults with disability entitlement aged 18-64 from national Medicare Advantage health plan claims data who underwent common surgeries between July 2016-June 2021. We used a repeated cross-sectional interrupted time series design to examine changes in opioid prescribing associated with the 2019 7-day limit. Sample included 24,910 member-index months (mean age [SD] 55.5 [8.0] years; 14,413 [57.9%] female) representing 24,283 members. The 7-day limit was associated with an 11.8 percentage point (pp) reduction (95% CI -13.3, -10.2) in the likelihood of an initial fill >7-day supply that remained lower than predicted (-5.7 pp, 95% CI -7.6, -3.7) by June 2021. Cumulative 30-day MME was lower than predicted (-35.9 MME, 95% CI -53.7, -18.1) in January 2019 but higher than predicted by June 2021 (95.2 MME, 95% CI 56.9, 133.6). The likelihood of ≥1 fills within 30-days of the initial fill was not significantly different in January 2019 but was 6.9 pp higher (95% CI 3.1, 10.7) than predicted by June 2021. The 2019 Medicare 7-day limit was associated with immediate large reductions in initial opioid duration and dosage. Increased dosage observed in June 2021 may have been mediated by an increase in subsequent opioid prescriptions after the initial fill.
40. Trophic transfer of per- and polyfluoroalkyl acids in a periphyton-mayfly-zebrafish food chain.
期刊: Aquatic toxicology (Amsterdam, Netherlands) 发表日期: 2025-Aug-07 链接: PubMed
摘要
Per-and polyfluoroalkyl substances (PFAS) are ubiquitous contaminants in freshwater ecosystems. Many PFAS are incorporated into food webs, with potential effects on ecological and human health. However, PFAS incorporation into the base of aquatic food webs remains poorly understood. The goal of this study was to quantify the uptake and trophic transfer of both legacy PFAS and the perfluoroether acid Nafion byproduct 2 (NBP2) using a simulated freshwater food chain in a lab setting. Natural periphytic biofilms were placed into trays containing equimolar binary aqueous PFAS mixtures at environmentally relevant concentrations for five days. Following the initial exposure period, newly hatched mayfly larvae were introduced into each tray to feed on periphyton for most of their larval development. The mature larvae were then fed to zebrafish. All water and biota samples contained detectable levels of the tested PFAS. All PFAS were more concentrated in periphyton than in water, and four of six PFAS were further concentrated in mayfly larvae relative to periphyton. PFDA was the most accumulative in all biota. PFAS concentrations in zebrafish were significantly correlated with those in larval mayflies. Assimilation efficiencies in zebrafish were high (>70 %) for all compounds. Bioaccumulation of PFAS in periphyton and mayflies was positively correlated with log KOW and number of carbons. Our findings demonstrate the functionality of the periphyton-mayfly-zebrafish food chain for studying the trophic transfer of PFAS, and provide novel data showing that the bioaccumulation of NBP2 is comparable to legacy PFAS.
41. Maslinic acid alleviates ulcerative colitis by inhibiting the colitis-aggravating pathogen Clostridium perfringens and modulating gut microbiota.
期刊: Phytomedicine : international journal of phytotherapy and phytopharmacology 发表日期: 2025-Aug-06 链接: PubMed
摘要
Ulcerative colitis (UC), a prevalent form of inflammatory bowel disease, continues to pose therapeutic challenges due to the limitations of conventional drugs and their inability to prevent relapse. Emerging evidence highlights the crucial role of gut microbiota dysbiosis in UC pathogenesis, yet our understanding of specific harmful microbes and their contributions to disease development remains limited. This study aims to (1) investigate the therapeutic potential of maslinic acid (MA), a food-derived natural compound, in colitis mice models; (2) elucidate the previously underestimated pathogenic role of Clostridium perfringens in UC development; and (3) reveal the molecular mechanisms underlying both C. perfringens pathogenesis and MA-mediated protection. We examined the therapeutic effect of MA using DSS-induced colitis model and performing metagenomic sequencing; elucidated the pathogenic role of C. perfringens using GMrepo database, clinical stool samples, and in vivo infection models. Additionally, we revealed its mechanism using inhibitors and markers of various cell death and inflammation pathways. The bactericidal effect of MA on C. perfringens was studied through in vitro experiments and two in vivo colitis models. MA alleviates DSS-induced colitis and restores gut microbiota. C. perfringens is enriched following DSS administration while significantly decreased after treatment with MA. C. perfringens contributes to the development of colitis and induces ZBP1-mediated PANoptosis in intestinal epithelial cells, while stimulates inflammation through NOD2 activation. MA has direct bactericidal activity against C. perfringens through ROS induction. It can almost completely rescue the exacerbation of colitis-related pathological and physiological phenotypes caused by C. perfringens in two mice colitis models. Our study reveals that MA effectively mitigates DSS-induced colitis by inhibiting the colitis-aggravating pathogen C. perfringens and modulating gut microbiota. Furthermore, it elucidates the previously underestimated role and mechanism of C. perfringens in the development of UC. It also highlights the therapeutic potential of MA in preventing and treating UC, particularly in patients who are C. perfringens positive.
42. Palliative care for solid organ transplant candidates and recipients: A scoping review.
期刊: Transplantation reviews (Orlando, Fla.) 发表日期: 2025-Aug-05 链接: PubMed
摘要
Solid organ transplant patients experience high morbidity and mortality before and after transplantation. International guidelines recommend integrating palliative care into the management of patients with advanced organ failure, including transplant candidates and recipients, as it supports advance care planning, enhances communication and improves symptom management. However, it remains unknown how and to what extent palliative care is actually provided to these patients. The present scoping review aimed to systematically summarize and compare existing evidence regarding the integration of palliative care for solid organ transplant patients. We searched PubMed, Web of Science, Embase, Cochrane and ClinicalTrials.gov for original articles published regarding the provision of palliative care to adult candidates or recipients of heart, lung, kidney, or liver transplant and/or their caregivers. This scoping review is reported in accordance with the PRISMA-ScR guidance. Thirty-two articles were included. Most studies were conducted in the United States, included lung or liver patients, and relied on small samples. Overall, between 2 % and 53 % of patients had at least one palliative care consultation, and between 0 % and 35 % had end-of-life care conversations. Symptom management, especially pain and dyspnea, was the most important reason for referral. Some studies demonstrated that early palliative care interventions improved symptom management and care planning. This scoping review shows that palliative care for organ transplant has received little attention heretofore. Further research is essential, especially for kidney and heart transplant patients, to determine optimal timing throughout the transplant journal, referral indications, and the effectiveness of palliative care interventions.
43. Assessment of psychosocial well-being, psychological distress, and financial burden in patients with chronic and recurrent dermatophytosis.
期刊: Psychiatrike = Psychiatriki 发表日期: 2025-Aug-05 链接: PubMed
摘要
Chronic dermatophytosis, a persistent fungal infection lasting over six months, is a significant public health concern. The study examines the psychosocial well-being, psychological distress, and financial burden experienced by patients with chronic and recurrent dermatophytosis. A hospital-based cross-sectional design was employed, enrolling 316 patients from a tertiary care dermatology outpatient department in South India over six months. Participants completed questionnaires of quality of life (Dermatology Life Quality Index, DLQI), financial burden (Financial Burden and Worry questionnaire, FBW), and psychological distress (Hospital Anxiety and Depression Scale, HADS). Findings revealed a substantial impact on the quality of life, with 71.6% of participants reporting a very large effect as per DLQI scores. Factors such as itching, embarrassment, and daily routine disturbances were significantly associated with higher DLQI scores. Financial challenges were prominent, with 56.6% of participants delaying treatment due to financial constraints and 30.7% reducing overall expenses. The economic burden was further evident as 26.2% used savings, 12.9% borrowed money, and 16.1% reduced essential healthcare spending for other family members. Psychological distress was significant, with 31.6% and 29.7% of participants showing abnormal anxiety and depression scores, respectively, on HADS. A strong positive correlation was observed between DLQI scores, anxiety, and depression, highlighting the interdependence between disease severity and mental health. This study underscores the need for a holistic approach to managing chronic dermatophytosis, addressing not only medical but also psychosocial and financial aspects. Integrating affordable treatment options, public health awareness campaigns, and psychological counselling can significantly alleviate the burden on affected individuals. These findings provide critical insights for clinicians and policymakers to design comprehensive care strategies aimed at improving patient outcomes and quality of life.
44. Similar cost-better results: the case of the hybrid Assertive Community Treatment model of care for severely mentally ill patients in rural Greece.
期刊: Psychiatrike = Psychiatriki 发表日期: 2025-Aug-05 链接: PubMed
摘要
The present study evaluated the impact of a hybrid Assertive Community Treatment (ACT) model of care on the direct medical costs of treating severe mental illness (SMI) patients in rural Greece. The study aimed to determine whether this model resulted in significant cost differences compared to usual treatment while also assessing its cost-effectiveness based on clinical improvements. A total of 23 patients with SMI and multiple hospitalizations were followed up for 16 months under the hybrid ACT model. Direct medical costs were estimated using previously published Greek data on schizophrenia treatment costs. Cost differences before and after the implementation of the hybrid ACT model were calculated, and cost-effectiveness was assessed using the Incremental Cost-Effectiveness Ratio (ICER), which reflects the cost per unit increase in Global Assessment of Functioning (GAF) scores. There was no statistically significant difference in direct medical costs between usual care (310,029€) and hybrid ACT care (313,896€), with a small cost increase of 3,867€ (p = 0.077). However, hybrid ACT care significantly reduced hospitalizations and length of inpatient stay, leading to an 86.9% reduction in total inpatient days. Clinical improvements were also observed, with GAF scores increasing from 40.43 to 47.26. Cost-effectiveness analysis demonstrated a particularly low ICER of 25.9€ per GAF point gained, suggesting a cost-efficient intervention. In an alternative scenario, the 2024 pricing was estimated with the use of the Consumer Price Index. In this case, the hybrid ACT care appeared to be significantly cost-saving by 25.5%. A rough estimation of indirect costs revealed further cost savings in favor of the hybrid ACT. The hybrid ACT model proved to be cost-effective due to its strong impact on reducing inpatient care and improving patient functioning. These findings align with international studies demonstrating the economic and clinical benefits of community-based mental health care. Future research should focus on larger, multicenter studies to confirm cost-effectiveness and explore the impact on indirect costs, such as caregiver burden and law enforcement involvement. The results support further investment in hybrid ACT services in rural Greece to enhance mental health care delivery in low-resourced settings.
45. Identification of Novel Wraparound Transcripts in JC Polyomavirus.
期刊: Journal of medical virology 发表日期: 2025-Aug 链接: PubMed
摘要
JC polyomavirus (JCPyV) is a ubiquitous pathogen that causes progressive multifocal leukoencephalopathy (PML). Although a recent study using next-generation sequencing (NGS) provided detailed transcriptome atlases for polyomaviruses (PyVs) such as BK polyomavirus and simian virus 40, the transcriptome of JCPyV remains poorly characterized. Here, we conducted a comprehensive analysis using both short-read and long-read NGS technologies to construct a transcriptome atlas of JCPyV. RNA extracted from IMR-32 and HEK293 cells transfected with the circular JCPyV genome was analyzed, leading to the identification of 39 previously uncharacterized viral transcripts in addition to 12 known ones. Among the novel transcripts, we identified wraparound transcripts, conserved across PyVs, which are generated through continuous, multicyclic transcription of the circular viral genome. These included both late transcripts containing leader-to-leader repeated sequences and SuperT transcripts with multiple LxCxE motifs. Notably, wraparound transcripts, including SuperT transcripts, were also detected in brain tissues from PML patients. Collectively, this study significantly expands our understanding of the JCPyV transcriptome, revealing the expression of wraparound transcripts in PML lesions. These findings provide valuable insights into the molecular basis of JCPyV gene expression and PML pathogenesis, potentially facilitating the development of effective countermeasures against PML.
46. Artificial Intelligence in Health Promotion and Disease Reduction: Rapid Review.
期刊: Journal of medical Internet research 发表日期: 2025-Aug-01 链接: PubMed
摘要
Chronic diseases represent a significant global burden of mortality, exacerbated by behavioral risk factors. Artificial intelligence (AI) has transformed health promotion and disease reduction through improved early detection, encouraging healthy lifestyle modifications, and mitigating the economic strain on health systems. The aim of this study is to investigate how AI contributes to health promotion and disease reduction among Organization for Economic Co-operation and Development countries. We conducted a rapid review of the literature to identify the latest evidence on how AI is used in health promotion and disease reduction. We applied comprehensive search strategies formulated for MEDLINE (OVID) and CINAHL to locate studies published between 2019 and 2024. A pair of reviewers independently applied the inclusion and exclusion criteria to screen the titles and abstracts, assess the full texts, and extract the data. We synthesized extracted data from the study characteristics, intervention characteristics, and intervention purpose using structured narrative summaries of main themes, giving a portrait of the current scope of available AI initiatives used in promoting healthy activities and preventing disease. We included 22 studies in this review (out of 3442 publications screened), most of which were conducted in the United States (10/22, 45%) and focused on health promotion by targeting lifestyle dimensions, such as dietary behavior (10/22, 45%), smoking cessation (6/22, 27%), physical activity (4/22, 18%), and mental health (3/22, 14%). Three studies targeted disease reduction related to metabolic health (eg, obesity, diabetes, hypertension). Most AI initiatives were AI-powered mobile apps. Overall, positive results were reported for process outcomes (eg, acceptability, engagement), cognitive and behavioral outcomes (eg, confidence, step count), and health outcomes (eg, glycemia, blood pressure). We categorized the challenges, benefits, and suggestions identified in the studies using a Strengths, Weaknesses, Opportunities, and Threats analysis to inform future developments. Key recommendations include conducting further investigations, taking into account the needs of end users, improving the technical aspect of the technology, and allocating resources. These findings offer critical insights into the effective implementation of AI for health promotion and disease prevention, potentially guiding policymakers and health care practitioners in optimizing the use of AI technologies in supporting health promotion and disease reduction.
47. Comparing the effectiveness of ring and block-vaccination strategies on networks.
期刊: PLoS computational biology 发表日期: 2025-Aug 链接: PubMed
摘要
Vaccination is vital for preventing disease spread, as demonstrated by its role played in recent outbreaks such as measles, COVID-19, and the 2014 West Africa Ebola crisis. Classical ring vaccination-targeting individuals near infected cases to form protective clusters-has become of interest due to its effectiveness, yet it is strongly influenced by the quality of contact tracing and availability of medical resources. Here, we model the efficiency of a family of ring vaccination-inspired strategies that address these limiting factors and disentangle them from the structure of the contact patterns. In particular, we evaluate scenarios that consider a vaccination radius r, used to vaccinate nodes in the network up to r contacts away (block vaccination) or exactly r contacts away (ring vaccination) from nodes of interest. Each one of these is tested under two further scenarios: the preventive one, where individuals are vaccinated before the epidemic takes place, and the containment one, where vaccination occurs during an outbreak to limit disease spread. They are tested in synthetic networks, where we find that in the preventive scenario, ring outperforms block vaccination, reducing the size of the epidemic and, in some cases, even preventing it from happening. On the other hand, in the containment scenario, we find that both strategies perform slightly similarly in reducing the impact of the diseases but block vaccination using fewer resources. As a case study, the proposed strategies are used to create epidemiological risk maps by employing the spatial position of olive trees in the Salento region in Italy, which recently suffered the impact of the bacterium Xylella fastidiosa.
48. Advancing Mycobacterium leprae transmission research: Insights from the R2STOP fund.
期刊: PLoS neglected tropical diseases 发表日期: 2025-Aug 链接: PubMed
摘要
Leprosy remains a significant public health burden in many low- and middle-income countries, with the transmission pathways of Mycobacterium leprae remaining incompletely understood. The Research to Stop Transmission of Neglected Tropical Diseases (R2STOP) fund was established by two NGOs to address this gap by supporting research projects focused on M. leprae transmission. This article outlines R2STOP’s selection process for funding projects and summarizes the impact and findings of the resulting research, illustrating the collective progress in understanding M. leprae transmission. The funding priorities established by R2STOP in the call were: (i) human-to-human transmission, (ii) non-human reservoirs, (iii) host-pathogen interactions and (iv) transmission networks. R2STOP allocated a total budget of CAD one million to support research projects focused on M. leprae transmission. The selection process involved remote reviews of letters of intent and full proposals, followed by an in-person proposal review meeting where projects were evaluated based on criteria such as significance, innovation, approach, and environmental impact. Final selections were made by a Scientific Review Committee, resulting in the funding of six projects. The funded projects all yielded significant findings from exploring a variety of topics such as persistent transmission in the Comoros islands; the potential role of patients and soil in transmission; ticks’ role in transmission to hosts; biomarkers for leprosy progression; ofloxacin resistance in India; and methods to grow M. leprae on axenic media. Twenty-four MSc and PhD students were involved in the six funded research projects, and 29 scientific articles were published. The R2STOP funding scheme played an important role in advancing our understanding of M. leprae transmission pathways and showcased the relevance of having funds allocated to this neglected aspect of leprosy control. Relevant research continues to be supported through the Leprosy Research Initiative.
49. In Memoriam: Adam William Darkins, MD.
期刊: Telemedicine journal and e-health : the official journal of the American Telemedicine Association 发表日期: 2025-Aug 链接: PubMed
摘要
50. Staffing levels and expenses in Canadian long-term care facilities by ownership status before and during the COVID-19 pandemic.
期刊: Health reports 发表日期: 2025-Jul-16 链接: PubMed
摘要
Low staffing levels and high turnover rates are longstanding issues in long-term care (LTC) facilities that were further exacerbated by the COVID-19 pandemic. Consequently, residents and staff were disproportionately affected, with high morbidity and mortality rates. This study examines changes in staffing levels, overall and by direct care worker category, across the LTC facilities sector by ownership status in Canada before and during the pandemic. It also explores differences in facility expenditures allocated towards employee wages, benefits, and subcontracts across homes by ownership status. Data were from the 2020 and 2021 Nursing and Residential Care Facility Survey, which collected information on facility characteristics, including expenses, revenue, ownership status, and staffing levels. Summary statistics and multivariate linear regression models were used to examine the association between staffing levels and ownership status, with analyses stratified by direct care worker category. On average, public LTC facilities had higher staffing levels and spent a greater proportion of their total costs on employee wages and benefits before and during the pandemic, compared with for-profit and non-profit private facilities. While the total hours of care per resident day (HPRD) increased during the pandemic, there were notable variations by region, ownership status, and direct care worker category. For example, Ontario public nursing homes provided 10% more HPRD from registered nurses during the pandemic, compared with the period before. Staffing levels of direct care workers in LTC facilities, overall and separately, are associated with ownership status. Allocation of employee-related expenses also differed by ownership. Further research is needed to explore interactions between ownership status, staffing levels, and quality of care for residents.
51. Dietary Inflammatory Potential and the Risk of Incident Kidney Failure in the Women's Health Initiative.
期刊: Kidney360 发表日期: 2025-Apr-04 链接: PubMed
摘要
Diet affects inflammation and kidney health, but few studies have investigated dietary inflammatory potential in CKD progression, particularly in women. We aim to examine this association in the Women’s Health Initiative (WHI). We conducted a non-concurrent prospective cohort study among WHI participants enrolled in the clinical trials and observational study (1993-1998) without baseline CKD and with available dietary intake assessments, Medicare data, and creatinine measurements at enrollment. The inflammatory potential of diets was assessed using the dietary inflammatory index (DII®), an acultural tool that quantifies diets from anti-inflammatory to pro-inflammatory. Scores were categorized into quartiles, with Q1 (reference group) and Q4 indicating the least and most inflammatory diets, respectively. Incident kidney failure (CKD stage G5, ESKD, or transplantation) was identified using diagnosis codes in Medicare claims from enrollment through 12/31/2019. We performed multivariable Cox proportional hazards regression and modeled death as a competing risk to determine the risk of incident kidney failure. Among the 17,334 women included in our study, the baseline mean age was 64.9 years (standard deviation 7.1); 33.5% self-identified as Black, 8.8% as Hispanic, 38% had hypertension, and 6.8% had diabetes mellitus. Baseline mean estimated glomerular filtration rate (eGFR) was 87.2 ml/min/1.73m2. Over a mean follow-up of 11.2 years, 1852 women (10.7%) developed kidney failure. Compared to Q1, women with dietary patterns in Q4 had a 18% higher risk (95% confidence interval 1.03-1.37; p-trend=0.01) of developing kidney failure after adjusting for age, race/ethnicity, education, region, comorbidities, medications, smoking, energy intake, physical activity, eGFR, and body mass index. Competing risk models yielded similar results. A pro-inflammatory diet (e.g., enriched in processed foods, refined sugars, and red meat) was associated with incident kidney failure in postmenopausal women without baseline CKD. Clinical trials are needed to assess the impact of an anti-inflammatory dietary pattern on CKD risk and progression.
52. The outcome of out-of-hospital cardiac arrest based on the etiology of cardiac arrest; A scoping review.
期刊: PloS one 发表日期: 2025 链接: PubMed
摘要
Disparity is believed to exist between generic Utstein etiological classifications of 2004 and 2015 when compared with confirmed etiologies, but the impact of this disparity on reported survival outcomes is unknown. This scoping review was proposed with two objectives: 1-to report outcomes based on confirmed etiology of OHCA in comparison with Utstein classified etiologies and 2- to identify outcomes of OHCA by etiology following cause-targeted interventions. Medline, Embase, and EBM- Cochrane databases were searched from inception to 2024. Studies were selected if included population was adults with OHCA for whom survival outcomes of OHCA were reported based on the confirmed etiology compared to Utstein etiological classification (2004 or 2015) or reported based on the etiology following cause-targeted interventions. A descriptive review of included studies was conducted. The search yielded 24,833 citations. Thirty-nine studies met inclusion criteria. These articles were predominantly published in Europe and North America between 2010-2024. The Utstein etiological classification was used in all studies (Utstein 2004; n = 31, Utstein 2015; n = 8). Survival to discharge was higher for drug overdose induced OHCA than presumed cardiac etiologies (9-83% vs 8.3-63%). For confirmed etiology of drowning, 30-day survival was higher than the rate reported by presumed cardiac etiologies (Utstein 2004) (11.5% vs 8.8%) while survival to discharge was lower following confirmed etiologies of trauma (1.7-5.1% vs 8-12%), hanging (3.3-43% vs 12-61%), respiratory disease (5% vs 9%), and intracranial hemorrhage (ICH) (11% vs 40%) compared with Utestin etiological classifications (2004 or 2015). Thrombolysis therapy resulted in better 30-day survival compared to placebo for OHCA due to presumed pulmonary embolism (16% vs 6%; p = 0.05), and conventional resuscitation resulted in higher survival for OHCA due to drowning (10.5% vs 8.6%) or respiratory disease (6.8% vs 4.54%) versus chest compression only. The reported survival outcomes for confirmed non-cardiac etiologies is inconsistent across studies compared with Utstein etiological classifications of 2004 or 2015. Better survival outcomes following few cause-targeted interventions may be attributed to etiologically well-defined patient cohorts. More vigorous case selection based on etiology may refine the reported outcomes and comparisons with interventions across published studies.
53. Unchanged but undecided: Reproductive intentions among Ghanaian women following COVID-19 lockdowns in two large metropolises in Ghana.
期刊: PloS one 发表日期: 2025 链接: PubMed
摘要
Evidence suggests that disaster situations such as the COVID-19 pandemic may affect reproductive intentions. These effects interact with an individual’s social context, including socioeconomic status, cultural norms, family size and structure, to shape reproductive intentions. In this paper, we review the COVID-19 lockdowns’ effects on reproductive intentions among Ghanaian women living in Accra and Kumasi. A correlational quantitative research design was adopted for the study while data was obtained through a survey of 532 women of reproductive age. Descriptive statistics, bivariate modeling using Chi-square and Fisher’s exact tests and multivariate modeling using Firth’s logistic regression model were conducted to understand determinants of changing intentions following the COVID-19 lockdowns. In all, 25 women (4.7%) reported changing their intentions. Those who come from Kumasi were more likely to change their intentions (p < 0.001) as were those who reside within their respective metropolis (p < 0.05). Those who had ever been married or cohabitated with a partner (p < 0.01), who have their childrearing decisions made with input from their partner or other family members (p < 0.05), and who were pregnant or expecting to become pregnant before the lockdowns were enforced (p < 0.001) were also more likely to change their minds. Residence in Kumasi (AOR = 4.21, 95%CI 1.41-12.62) and being pregnant or expecting to become pregnant just before lockdown (AOR = 4.29, 95%CI 1.28-14.32) were the strongest predictors for changing of intentions. Overall, reproductive intentions among those surveyed were largely characterized by ambivalence and inconsistency, with the largest groups of people labeling their state prior to COVID-19 lockdowns as “undecided” and their change in state after lockdown also as “undecided.” Future work should include more room for ambiguity when characterizing reproductive intentions among Ghanaian women. Incorporating room for ambiguity in characterizing reproductive intentions may improve accuracy in data collection in demographic health research and shift how success is measured in family planning policy. We hope that this shift will promote individualized and person-centered care in the realm of family planning.
54. Pandemic preparedness in shaping psychosocial working conditions - insights for occupational safety and health from a longitudinal mixed-methods study during the COVID-19 pandemic at six company sites of one organization in Germany.
期刊: PloS one 发表日期: 2025 链接: PubMed
摘要
This longitudinal mixed-methods study explores how one company group dealt with COVID-19 pandemic-related challenges and how employees and managers perceived work-related psychosocial demands in Germany. We analyzed panel survey data from 322 employees and managers across diverse working fields, e.g., assembly line/production, office, company medical service, and factory security service. Employees and managers were recruited from six German company sites in the federal states of Bavaria, Baden-Wurttemberg, and Lower Saxony of one large company group. The survey was conducted in August-October 2020, January 2021, and October-November 2021. Participants self-reported their perceived psychosocial demands from aspects of work organization, work environment, work content, and social relations at work during and retrospectively before the COVID-19 pandemic on a 5-point Likert scale. Additionally, nine managers were interviewed in September-October 2020 and April-May 2021 about pandemic-related changes in working conditions, organizational processes to adapt working conditions, and a culture of trust. For contextualization, we performed a comprehensive document analysis of prevailing national and federal laws and OSH-regulations for infection control in Germany. Quantitative results revealed that participants perceived stable psychosocial demands during the pandemic. Psychosocial demands relating to work organization were perceived as stressful, especially for managers and company’s medical service personnel. No statistically significant changes were identified with respect to psychosocial demand ratings during compared to before the pandemic. Qualitative results highlighted that a crisis management team, a culture of trust, extensive and transparent communication, and participatory approaches in change processes were key to managing pandemic-related challenges. Our findings contribute to a contextualized understanding of how the design of good and sustainable working conditions ensuredwork ability during the COVID-19 pandemic in Germany. They highlight the importance of pandemic preparedness in an organization’s psychosocial work design to successfully manage challenging times. The derived learnings for organizational pandemic preparedness on a meso-, macro-, and micro-level are of lasting significance with a view to future global challenges in terms of the design of good psychosocial working conditions.
55. Pneumococcal vaccination at 65 years and vaccination coverage in at-risk adults: A retrospective population-based study in France.
期刊: PloS one 发表日期: 2025 链接: PubMed
摘要
Age (> 50 years) is a risk factor for pneumococcal disease, but is not an indication for vaccination in France, by contrast to influenza. In 2018, the pneumococcal vaccine coverage rate (VCR) was 4.5% in adults at-risk, in contrast to the influenza VCR, which was 43.6%. We aimed to assess pneumococcal and influenza VCR in 2020 in the entire French population and factors associated with a higher VCR (including the age of 65 years). We retrospectively included all adults covered by the National Health Service in 2020 and identified patients at-risk using validated algorithms. We assessed VCRs by analysing pneumococcal vaccines reimbursed between 2009 and 2020 (13-valent pneumococcal conjugate vaccine [PCV13] and 23-valent polysaccharide vaccine [PPSV23]), and influenza vaccines reimbursed between September 2020 and March 2021. In 2020, we identified 7,336,769 adults at risk (median age: 67.0 years): 84.2% had comorbidities and 24.5% were immunocompromised. The overall pneumococcal VCR (PCV13 + PPSV23) was 9.9% and the seasonal influenza VCR was 51.1%. The variable associated with the highest odds of VCR was an “age ≥65 years” for influenza (odds ratio [OR] 4.14), but not for pneumococcal vaccination (OR 1.02). In patients with comorbidities, pneumococcal VCR did not significantly increase between those aged 18-65 years and those aged > 65 years (7.2% to 9.4%), and even decreased from 20% to 17.9% in patients with immunodeficiencies. In contrast, influenza VCR increased significantly from 35.5% to 67.9% (OR 3.55) in patients with comorbidities, and from 27.3% to 71.2% (OR 5.57) in those with immunodeficiencies. In France, pneumococcal VCR did not increase above 65 years of age (OR 1.02), by contrast to influenza VCR (OR 4.14) that increased significantly, suggesting that an age-based recommendation for pneumococcal vaccination will probably benefit to VCR in at-risk, elderly population.
56. Prevalence and factors associated with laboratory-confirmed cases of select enteric infections in three Ethiopian communities, 2018-2022.
期刊: PLOS global public health 发表日期: 2025 链接: PubMed
摘要
Enteric diseases are major contributors to morbidity and mortality worldwide; however, in Ethiopia, information on the prevalence of enteric infections and associated trends is limited. Understanding the epidemiology of enteric infections is necessary for determining disease burden and allocating resources. The objective of this study was to estimate the prevalence of laboratory-confirmed infections associated with select parasitic and bacterial pathogens in three Ethiopian hospitals, assess trends, and identify associated factors. Laboratory and patient metadata for stool samples tested at clinical laboratories in Addis Ababa, Gondar, and Harar in Ethiopia from 2018 through 2022 were collected and digitized. Descriptive statistics were used to summarize laboratory results and assess trends in sample submission and infection. Prevalence of laboratory-confirmed infection and 95% confidence intervals were estimated by pathogen using binomial proportion testing and logistic regression. Univariate and multivariable logistic regression were used to identify associated factors. A total of 48,643 samples were included in the analysis. Prevalence estimates for parasitic infection were 5.23% [95%CI:4.87%,5.62%], 17.48% [95%CI:17.04%,17.93%], and 15.69% [95%CI:14.57%,16.85%] in Addis Ababa, Gondar, and Harar, respectively. Prevalence estimates for bacterial infection were 0.25% [95%CI:0.07%,0.65%] and 7.59% [95%CI:5.97%,9.50%] in Addis Ababa and Gondar, respectively; stool samples were not tested for bacterial pathogens in Harar. Stool sample submission and enteric infection detection varied by year at each site. Age, season, and year of submission were identified as factors associated with the detection of enteric pathogens in stool samples. Prevalence estimates differed across study sites and testing was not conducted for many enteric pathogens associated with diarrhea. Additional research to understand the scope of enteric infection is necessary for resource allocation toward robust diagnostic procedures and increased laboratory capacity for stool testing. Efforts to mitigate enteric infection should utilize seasonal and geographic infection trends to anticipate areas in need of additional resources.